It happened

That lovely afternoon in May, returning from a brief bike ride with my daughter on the W&OD bike trail, I was hit by a car at a 4-way stop intersection ending up with four broken ribs and a distal fracture of the right clavicle (collar bone).  The entire ordeal that lasted barely a second, set me for a surgery of my collar bone and set me for some time off the bike (3 months, my Dr. says).  This is a brief account of what happened.

The sound of something dark approaching me from my right side, hitting me at my lower right back, sharp pain, me hitting the ground, inability to inhale the air, moaning painfully, me moving the feet and arms, neck and head, (concluding that, thankfully, they are OK); followed by my laborious and painful attempt to stand up, move from the middle of the intersection, getting the bike, moving everything off the road, and finally, regaining the ability to breath, are all the images that were happening to me as if I were watching a movie rather than living it.  Once off the road, I tried to elevate my arms, but with mixed results: the right one would go up, but only with lots of pain.  Palpated the right collar bone and found nothing really bad there (the rapid swelling started shortly thereafter while in the emergency vehicle).  The stress, better say – shock, of the experience made me shiver wildly.  It did not stop until some time later in the emergency room.  They gave me one oxycodone and sent me for x-rays.  The verdict: four ribs on the right back side and the right clavicle fractured – you may go home now.

Prior to this experience, I thought that fractured collar bones, often cited as the most common bone fracture in bicyclists, heals on its own, i.e., no surgery needed.   This understanding was furthered with the discharge letter that emphasized fractured ribs and collar bones heal on their own, i.e., no surgery needed except in a very small number of cases.   With expectations of the orthopedic surgeon telling me the same thing at our first meeting three days following the accident, I departed for that appointment thinking of it as of a formality.  Not so fast.  The guy pulled up the x-ray and told me: you need a surgery! Shock.  Your bone fractured very near the acromio-clavicular joint, which created a substantial discrepancy between the two fragments making for those two dislocated fragments find each other and heal, extremely unlikely.  Therefore, to avoid the prospect for having a painful dis-union between the two pieces of bone, and in order to have your torn ligament reconstructed, your only option is a surgery, he stated.  The x-ray image was very convincing in supporting his statements.  The larger piece of my broken clavicle dislocated substantially upward, while the remaining piece moved downward: at least 2-3 cm below with no contact with the other piece.

Surgery or not? It is relatively easy to give an advice to somebody else, but very hard to give one to yourself.  Husband of a friend of mine, another orthopedic surgeon, offered me an informal second opinion.  That gesture meant a lot to me at the time.  Unfortunately, we could not act on that due to the conflict in timing of my already scheduled surgery.  To make it short: I had the surgery on the 10-th day after the accident.  It went well, which in part is due to the fact that the surgeon was very experienced in this type of surgeries, that he was not surprised with anything when he opened me up, and in part this was due to some help from pain-killer drugs that I "enjoyed" for a few days afterwards. 

Now I am on the path of recovery.  The predicament is rather clear: 4-6 weeks of no weight bearing on that arm and passive physical therapy.  (At the time of this writing, I am exactly four weeks after the surgery.) After that some stationary bicycle pedaling would probably be fine, but excluding any substantial pressure on the shoulders.  Gradual weight bearing will start after about 6 weeks, with the earliest expectation coming back gradually to bicycling after about 3 months after the surgery.

Now, if you go on the internet and search for collar bone and bicycling, you are going to find lots of information that needs to be taken with some salt.  Anecdotal situations were a professional bicyclist will be back on a stationary bike two weeks after surgery, to compete after four, may be correct, but…  It is worthy to keep in mind that those professionals are typically in their 20’ or 30’s, meaning their wounds will heal faster than in guys in their, say 50s.  Also, their fractures may be simple – the bone fractures somewhere in the middle and for the sake of saving the season, they may just opt for a quick surgery that will shorten their recovery.  In my case, however, a ligament was involved, which substantially adds to the length of my anticipated recovery time.

A few other observations:  the guys from one of Vienna firefighter organizations responding to the call, not only responded quickly to the call – within minutes, but also took care of my bicycle by delivering it later that evening to my home.  Thank you guys!

All those discussions whether we should be wearing a helmet or not, never really made me think that we should not.  My helmet cracked all the way!  While I have no recollection of even hitting anything with my head, I suppose I hit the pavement. In short, my head and neck were totally preserved and completely unaffected in the ordeal.  For me this means: always wear a helmet and hope you will never need it.

My daughter passed this unfortunate stress test with flying colors: she did not scream, get scared, or anything of that nature.  She tried to help me get up and provided me verbal comfort all the time.  If there is anything positive with this experience then it is that my daughter reacts very maturely to the stress. I am proud of her.

Credit also goes to my physician wife for her communication with the fellow physicians treating me and for being supportive during this time of recovery.