Clavicle havoc...le...

[orlyysrly]

Hey there --

I'm a longtime occasional lurker...I always knew I'd eventually get desperate for advice on something or other and emerge from the shadows of the interwebbbzz, and, well, here I am.

I broke my clavicle in a crit over the weekend (long, bitter story withheld). Supposedly it doesn't need surgery, though I'm getting a second opinion next week. My melodramatic concern is that I may have a complete breakdown before then: I'm not sleeping much, since I can't lie down, and at the moment have to pick between holding down food and taking painkillers. Shower #1 yesterday was several times more traumatic than the ER. I know I'm being a baby, but the honest truth is I'm totally miserable and freaking out.

In short: I know this is a common injury among cyclists. I'm looking for any suggestions -- on pain management, drugs, recovery, life one-handed, anything -- for an apparently not-so-stoic first-time road-crash kid.

All thoughts appreciated. And here's my x-ray!

http://photos-f.ak.fbcdn.net/photos-ak-snc1/v2291/239/26/1217215/n1217215_43640989_9368.jpg

[ClockworkOrange]

Sorry to hear of your bad luck but always good to see lurkers de-lurk.

Hope you start to get some sleep, nothing worse than sleep deprivation.

I expect some of the more seasoned riders on here will be able to give you some advice.

Just one small question, are you sure you have been given the correct X-ray as that shows the date as 1987 Jan 20?

Take it easy.

Clock

[orlyysrly]

1/20/87 is my birthday. :) I *wish* that wasn't my x-ray!

Thanks for the good wishes.

[Irulan]

we just have gone through one almost like that - far end of the clavicle, with DH. Unfortunately for him the bone did not knit and he had to have it plated.
I know you don't want to hear that.

Just do what they say. Don't try and "man up" to stay off the pain killers. They give them to you for a reason. Let pain be your guide for activity, and FOLLOW INSTRUCTIONS from your doc and your PT. Try using extra pillows at night, that seemed to help DH a lot. Stay on top of your meds: getting behind and trying to play catch up is a real drag.

Ask for help. Let the little things slide. If you have someone that will take care of you LET THEM DO IT.

Painkillers are notorious for digestive track stoppage. Stock up on stool softeners, senekot, whatever it takes to keep things moving. Esp. if they gave you morphine in the ER, you could really get sluggish in a hurry.

[OakLeaf]

Can you ask for a different painkiller? Even though most of the stronger ones are related and have the same general side effect spectrum (opioids), different people can have very different side effects from different drugs.


And you ARE NOT being a baby. You're listening to your body. (Even when what it has to say isn't very pleasant.) That's a good thing and what an athlete should do.

Welcome, sorry you're de-lurking under yucky circumstances.

[wackyjacky1]

Eeeewww, that looks hideous! :eek: Right now I have inflamation in the joint where my clavicle meets my sternum, and that's been pretty uncomfortable...I can't even imagine how painful your break is.

I hope you feel better soon.

eta: Don't take those pain meds on an empty stomach. When I've done that it's a sure thing I'll be nauseated.

[jaydee]

Been there just before Christmas!

Lots of pillows for sleeping - upright will be best for quite a while. I am only just back to 2 pillows now.

Painkillers - try to get ones that don't have codeine in them if painkillers are making you ill. Codeine is instant throw-up for me, but once doctor gave me some without, I was able to medicate and eat.

Shower / dressing - buy some loose neck / wide neck t-shirts or button shirts and it will be a while before you can manoevre into 'normal' clothing.

shower - take a chair into the bathroom so that when you come out of the shower and feel completely exhausted, sit down, regroup and then dry yourself and get dressed.

Being a baby - part of this is because you are in shock - and will be for a while. Accept as much help as you can - start to potter around when you are ready. And keep on popping in here for lots of support and suggestions. :D

[tulip]

Take your painkillers if you need them. When I had my head injury, I was so glad to go back to the ER for some intravenous morphine, but they wouldn't send me home with a bag! But I took my percocet without regret. No sense in being more uncomfortable than you have to be.

Chocolate helps, too. :)

[Possegal]

I second the idea that you should try a different pain killer - dr of pharmacology here, I've advised many a friend and family member of the same thing and they were forever grateful. You would be amazed at how differently people can react to drugs that are very similar. You shouldn't have to choose between eating or no pain. Call your dr and tell them you are not reacting well to the pain meds and ask them to call a different one into the pharmacy.

Good luck and feel better soon!

[lunacycles]

That XRay looks miserable! How do those bones find each other again to heal up?

Looks like you are getting great advice from the much wiser members of this here forum.

Hearing your story makes me all the more stupefied and amazed that Tyler Hamilton (yes, swoon now, smurfalicious:D) about 5 years back somehow rode all but one stage of the Tour de France with a broken collarbone:eek::eek::eek:....and...finished in the top 5:eek::eek:

Best wishes for rapid healing and even more rapid alleviation of your pain.

[DebW]

I fractured mine about 5 years ago, broke it into 4 pieces (2 very small pieces, 2 long pieces), and didn't have surgery. See if you can find one of the large wedge-shaped foam boosters to sleep on for a week or two. Mine was about 18" high and held up my whole back and head. I didn't have huge pain issues if I didn't more, but the slightest movement was bad for the first two week. The pain gradually lessens after two weeks as things begin to knit. Trying to get a shirt on or off was very painful, but then I had the idea of cutting shirts and sewing in separating zippers. With those shirts, I could change clothes with my arm still immobile in the sling. If you broke your right clavicle and can wear a women's medium, I could send you a couple of these shirts. Otherwise, just find some short-sleeved button-front shirts, cut across the front of the chest and down the arm, and get someone to sew in a zipper. Same principal as hospital gowns with snap sleeves.

The other problem I had was needing PT after the bones knit because my shoulder was then frozen. That was painful, and one PT session had me very close to passing out. So I'd say that when you can begin to move your shoulder without pain, then give it some limited motion to try and avoid lots of scar tissue in the joint. I was told that the only motion to really avoid was lifting the arm more than 90 degrees.

Good luck. Know that this level of pain should diminish in a couple weeks.

[Lucky, Fabulous]

I broke mine in 3 spots this summer. I also felt like I was being a big baby, but it was extremely painful. Did they give you a figure 8 brace? They gave me one, but I could not use it for a couple of weeks, because it hurt to pull the shoulders back. I used a sling for quite awhile, and eventually did the brace/sling combo. Fortunately, sleeping on my back was possible. It was slightly painful, but if you can learn to relax in that position, you might be able to do it. Showering was horrible, however. And I did get some button down shirts.

What did they give you for pain pills? They first gave me oxycodone, but that was too harsh on my stomach, so I switched to vicadin. Make sure you eat something or drink milk when you take your pills. The occassional cocktail helps as well ;)

[Lucky, Fabulous]

Oh, and as far as healing goes, the ends of the bones don't really find each other. They do sort of move back in line, but basically your body fills in the spaces with scar tissue, which eventually turns into bone. Then, after awhile (probably years) your body will dissolve the bone that is in areas where it should not be. Or something like that. :p

[Eden]

Painkillers - try to get ones that don't have codeine in them if painkillers are making you ill. Codeine is instant throw-up for me, but once doctor gave me some without, I was able to medicate and eat.


I heard recently (at a hospital inservice about pain management, so I trust it) that many people are not able to metabolize codine..... so all it does is make them throw up, without even giving them any pain relief. If your pain killer is making you puke definitely see if you can get it changed.

[smurfalicious]

Hearing your story makes me all the more stupefied and amazed that Tyler Hamilton (yes, swoon now, smurfalicious:D) about 5 years back somehow rode all but one stage of the Tour de France with a broken collarbone:eek::eek::eek:....and...finished in the top 5:eek::eek:

That's why he's my lust object. He could come ride bulls with me any day! I remind myself of that when I hit the 13% percent hill to work, and the 10% long beasty on the way home.

That aside, my brother raced moto-cross for a long time and broke his 3 times. It's a bone that is meant to break. Otherwise lots of babies wouldn't make it out. Especially now that we idealize skinny, slight framed women. That aside I think everyone has good advice. You're not being a baby, but this is not the end of the line.

Travis, my brother, was back out there pretty quick and I think that had a lot to do with brake numbers two and three. Take care of yourself, get a Netflix account, eat ice cream. Just chillax a bit. What we do on our bikes is more than most of the couch potatoes in the world do.

[maillotpois]

Nice looking x-ray!!!

I also have a hard time with a lot of the standard pain killers (like vicodin - can't hold that stuff down). Try darvocet if you have not yet. It is a LOT easier to take. Really helped out with my broken scapula last year from my crash.

Good luck - heal well. and go easy on yourself like the others said. Give yourself a break.

[lph]

Oh man, that looks painful! :eek: I've never broken mine, but remember vividly my mother breaking hers falling off a horse when I was a teenager, and she was in a LOT of pain afterwards. It's maybe not a major bone but I know it can give you major pain.
In general I second everybody's thoughts on finding pills that work, painkillers are a true miracle when they work and will help you heal so much better.

Good healing to you and lots of strength!

[AnnieBikes]

OH OH OH!!! I sympathize so very much. I broke my collar bone a few years ago (are you sure it wasn't my xray up there!!). It was awful sleeping, dressing, showering, and anything else for about 2 weeks, as someone else mentioned. Then the bones begin to lay down callus and get "sticky". That is when the pain decreases, albeit very slowly.

I second everyone who says you should get different pain meds!! They will not all make you sick (and shouldn't) so get a change! I took Lortab and only a half at that, as it made me so spacey. The button down the front shirts were all I could wear and I bought a few at Walmart and wore a few of my son's shirts.

As far as surgery, I would avoid it like the plague. You will heal without it. You go to Midas, you get a muffler, you go to the orthopod, you get surgery!! The ends hook up, make a bumpy heal and then remold them selves. I am a little shorter on that side but the bump is gone...it took about a year. Do work your shoulder in a few weeks to avoid the frozen shoulder that Deb talked about.

You are not a baby. This is one of the most painful fractures you can have because there is no way to totally immobilize it like for a wrist or ankle and so much of what you do with your arms is dependent on your shoulders (collarbone) stabilizing for you to move. Good luck and take care of yourself. This too shall pass!!! I am thinking of you!!!!

[Irulan]

As far as surgery, I would avoid it like the plague. You will heal without it. You go to Midas, you get a muffler, you go to the orthopod, you get surgery!!




That is a pretty broad, stereotypical (and incorrect) statement. It depends on the surgeon and the situation. DH and I BOTH have shoulder injuries. He broke his clavicle, and I tore the labrum. We see the most respected shoulder guy in the community, who is not "knife happy" as you imply. Some may be, ours is not.

You are not a doc, you don't know that she will heal without it.

The game plan on DH's clavicle was to let it knit naturally as is most common with collarbones. However, after 12 weeks there was no bone growth. This is a legitimate reason for plan B which involved 7 screws, a plate and yes, surgery.

My torn shoulder could have gone either way. He recommended a "wait and see" approach, to be re assessed after six months. Then at six months, I was re diagnosed with a frozen shoulder. While this can be corrected with surgery, the surgeon suggested aggressive PT instead. Now, I am doing just great and have not had surgery in either situation.

Do you homework, ask around for who is the respected medical professional, and get a second opinion.

I.

[singletrackmind]

Welcome to the Collarbone Club!! It's supposed to hurt, that's what's (supposed to) keep you from letting it heal.


Mine didn't fix the second time around.....
I don't recommend racing on it is all I can say about that!

[roadie gal]

Broken clavicles are very painful, but it's better than breaking something in the shoulder joint itself. I tell my patients that the clavicle is the "giveaway bone". It absorbs the impact and breaks (like a bike helmet) and protects the shoulder joint. A humeral head fracture is a LOT more disabling than a clavicle fracture.

We used to tell everyone that if the pieces of the bone were in the same county they would heal. The thinking on that has changed somewhat. Now some of the orthopods are fixing clavicles if there are a lot of pieces or a lot of overlap. The idea is if it heals shortened it can limit range of motion for very active people or those whose jobs require a full range of motion. Yours would probably be a toss up as it looks (from the one film) like a clean break, but there is a lot of overlap.

I would speak to a sports medicine doc if you can find one in your area.

Also, definitely keep up with the pain meds. Being miserable helps nothing and sleep is essential for healing. There are a number of meds to chose from. Don't settle for something that makes you sick.

Good luck.

[orlyysrly]

I really appreciate all your good wishes and suggestions -- I swear I'd be issuing individual thank-you's if I could type a little faster one-handed!

I'm doing a little better with the drugs -- I'm now taking pretty much just extra-strength Tylenol and getting by with that; walking and showering are getting easier as the road rash heals.

I saw a second orthopod today who recommended surgery to prevent shortening of the shoulder. I was initially kind of gung ho but now find myself leaning against it: three other doctors (ER, orthopod #1, and a family friend) have said based on X-rays it's not necessary. I'm torn between thinking it's generally good to avoid the additional trauma of surgery if you can and thinking I should do everything possible to be solid in the long-term. Conflicting opinions suck! I'm in no position to weigh one MD against another...

Next up this evening is a CT to check out my bonus fractured scapula, which (not at all reassuringly) nobody but the family friend looking at the X-ray long-distance even noticed. Most of all I'm just trying to figure out how the hell I'll lie down in the machine...pffft.

Many, many thanks again; you are wonderful.

[smilingcat]

Hi,

I've shattered both clavicle. Right side was in three big pieces and smaller ones. Left was shattered in separate crash and that one snapped into only two pieces.

In both cases, the doctors advised against it saying that the surgery will risk further nerve damage and it was best to leave it alone and let it heal on its own.

I had a sharp point on the bone. The doctor did say that over time the sharp point will disappear and will be just a bump. Apparently, the bone can re-sculpt on its own. Add extra bone here and removing excess from there. The sharp point was really bother some for about a year as it happened to be right under the bra strap.

Both times I was fitted with a figure 8 brace of sort. It was uncomfortable. Still it was lot better than not having it on.

Be patient, take one day at a time.

Sending you healing thoughts,
Smilingcat