In an Instant, Part 2

It took some doing to get here, but today turned out to be a pretty special day.

October 22 – Little did I know, standing at the intersection of Academy Boulevard North and Jannie Drive in Colorado Springs as I gingerly explored the edges of a broken collarbone under my skin, what an ordeal recovery would become. The nice off-duty EMT who stopped at the accident site assured me that it was a common motor vehicle accident injury. As did the ER doc and the radiologist who made me raise my arm over my head for one of the views. (First major ouch.) I was released with an arm sling, a couple of prescriptions and a recommendation to see my own doctor for follow-up once I returned home.

Sitting through the soccer game and the hour or so van ride back to Denver wasn’t too bad, thanks to some heavy duty meds. Fortunately I was TSA Pre-Checked and sailed through security, although the sling probably helped. I converted my camera backpack to a right shoulder sling and draped my coat over my left shoulder and was good to go on the long walk to our gate. The agent who helped me switch out my exit row seat to one next to Laura also allowed both of us to pre-board. Unfortunately we had quite a bit of turbulence. It helped to put my right hand directly over my injury to keep it still, a little. (Second major ouch.)

October 24 – I see my regular physician. He says he thought the break would heal normally over the next six weeks, and prescribes a shoulder extender that he thought would be more comfortable. I visit two orthopedic shops and call several pharmacies only to find that it is a specialty item that will take several days to arrive. Frustrated, I text an orthopedic physician that attends my church, who makes room in his schedule the next day.

October 25 – I visit the orthopedic physician. X-rays show a 2cm displacement, on the cusp of needing surgical repair. He outfits me with a figure-8 brace (much better than the sling) and puts me on a two-week watch and wait with instructions to come back in if one of the bone ends starts protruding.

October 28 – I sneeze, violently. I feel it coming but am powerless to do anything other than throw my hand over my collarbone. I feel the ends of the bones rolling under the skin. (Third major ouch.) And just like that, one of the broken ends is much more prominent. Unfortunately it is Saturday morning, so nothing can be done but to get through the weekend.

October 31 – Another visit to the orthopedic physician. The followup X-rays show that the ends of the collarbone, previously overlapping, have moved apart and are no longer likely to heal properly on their own. He and his partner recommend that I see a trauma surgeon in Columbia.

November 2 – The first available consult with the trauma surgeon is November 28. Surgery will be scheduled shortly after. I am not at all happy about the delay. They later call back with a November 14 appointment. My orthopedic physician calls to see about a different surgeon, but they are both booked solid.

November 3 – A highly recommended local orthopedic surgeon is able to see me the following Thursday. The appointment is later moved up to Tuesday.

November 7 – The local surgeon tells me that he likes to do clavicle repairs within two weeks of the initial injury. I am just beyond that, so surgery is scheduled for the next day.

November 8 – The anesthesiologist recommends a brachial plexus nerve block for better pain control after the surgery. It is standard procedure, but one of the risks is a droopy face. This being my left side, I decline the block. The anesthesiologist, surgeon, and Phil all think I should reconsider, so I do. The surgeon tells us that he plated the broken ends, also having to screw together two additional bone fragments. I am sent home back in the sling. The nerve block should wear off over three days.

November 11 – My hand is still completely numb. Unfortunately it is once again a weekend.

November 13 – The orthopedic surgeon’s nurse tells me that I must have gotten a really good nerve block. I insist that something is wrong and get an appointment for the next day.

November 14 – The surgeon is pleased with my incision healing. He removes 15 surgical staples, replacing them with steri-strips. He examines my arm and what movement has returned. He thinks that I will eventually regain use of my wrist and hand, but it may take a while. Meanwhile he puts me in a wrist brace so that my hand is not flopping around, gives me some stretching exercises for my fingers and prescribes neurontin for the pins and needles. Then he sends me upstairs for an EMG. After that most enjoyable series of shocks and pricks, that doc says I have every reason to hope for the best, but again, when is anyone’s guess. He does say weeks rather than months. He does not think it was due to the block entering the nerve because there are so many non-responsive nerves, and instead calls it a “conduction event.” I discuss with both doctors the side effect of my pudendal block years ago as well as my neurosurgeon’s comments about my facial nerve during my microvascular decompression surgery. They both agree that I am not a good candidate for future nerve blocks.

November 16 – The orthopedic surgeon calls to discuss my nerve scan (EMG). The nerves are intact, but not conducting. Basically I wait and watch and stretch my fingers (which really hurts btw) and hopefully heal. On the plus side, I have some movement in my shoulder and elbow, and can curl my fingers slightly (although I can’t straighten them). I feel pressure, temperature, itching, texture and TONS of pins and needles. Today I noticed that the bruises on my breastbone and shoulder are really tender. That has to be a good sign.

On the other hand, loss of the use of my hand is really hard. Obviously, typing takes a lot more effort, and my job requires a lot of computer work. But there are so many other things that I took for granted. Phil has to help me put my contacts in. I can’t tie my shoes or floss my teeth. I am limited in my wardrobe choices. A colleague helped me put my earrings in; necklaces and bracelets are out of the question. So far I have not attempted to drive, though now that I am in the wrist brace I am thinking about trying to again. Everything is just harder and more tiring and takes longer and I am extremely frustrated and sad. Everyone has been incredibly kind and helpful, and while I appreciate it immensely, I still wish that I did not need the help. I am also angry with myself for not following my gut instinct to forego the nerve block.

I also nearly mistake a Smirnoff Ice for Gatorade. That could make things interesting.

November 17 – Gabapentin is an evil drug. I don’t even want to talk about its nasty side effects. We are going to try Lyrica, but insurance doesn’t cover much, so switching to Topamax. I seem to remember getting along all right with it back in my hemifacial spasm days.

November 20 – A friend who is a physical therapist gives me some exercises for my hand and says my scar looks good and I can peel off the steri-strips. I have a lot of brain fog and opening an envelope one-handed takes about 10 minutes. Frustrating.

November 21 – I am driving again. I hit the garage door with the breakaway mirror backing out, and it, well, breaks. I thought that wasn’t supposed to happen.

December 3 – I can uncurl my hand, but just once per day. Phil is camping and I have to call my brother over to open a paint can so I can do some touchup painting in our family room. It’s tricky but doable with one hand.

December 4 – I attempt some housework, but the feeling of wet laundry literally makes my nerves crawl. I spend fifteen minutes shuddering as the skin on my left fingertips executes a counterrevolt.

December 6 – My mother-in-law falls. At the emergency room I see a boy with a matching wrist brace and invite him to arm wrestle. He declines. I’m not sure why because he almost certainly would have beat me.

December 9 – My fingers have really opened up over the past week and the wrist drop has improved as well. I can pick things up and manage slightly heavier objects. Weakness is an issue though, for instance I can hold a toothpaste tube but can’t squeeze it. I can touch my thumb and each fingertip together but am neither strong enough nor coordinated enough to type. One new accomplishment for the week was tying the drawstring in my sweatpants. The first time took nearly 10 minutes but just like folding socks I have improved upon my technique so it is faster and the outcome is better. Shoelaces are still too fine to manage, but soon. I see the surgeon for a follow up Thursday so I hope to find out about physical therapy.

December 14 – My collarbone is 85% healed. The surgeon orders 6 weeks of hand PT/OT, but there are no openings until after Christmas. Still, there is progress! The surgeon warned me that my collarbone would ache in the cold. He is right.

December 28 – At my PT/OT evaluation I measure fourteen pounds of grip in my left hand, around 70 with my right. Our plan is twice-weekly visits to work on strength and dexterity.

December 29 – I see my optometrist to utilize my vision insurance benefits before they run out. He is very impressed with my LaserFit scleral lenses and thinks it would be great to bring them to mid-Missouri. I offer to put him in touch with Dr. Gemoules. I remove the lenses to be measured for a pair of eyeglasses, and have a routine numbing drop put in my left eye. Everything goes according to schedule with my right eye, but when it’s time to read the lines with my left, I can’t see anything. Literally nothing, and I panic. The good optometrist remains calm, assuring me that it is a reaction to the numbing drop. This is hard for me to believe since we have been doing the same thing for five years, but I agree to rest in the waiting room for half an hour. I think I actually waited longer than that, but by the time I returned to the exam room the corneal swelling has abated and we proceed with the exam. The optometrist asks me if I have been experiencing double vision lately, which I have. I believe it is due to the Topamax, along with some “jumpiness” in my vision. The doctor would like to add a slight prism to my lenses, and I agree. An appointment that I thought would take an hour actually takes four.

January 13 – In two weeks I have increased grip strength to 21! My therapist thinks I will have 35 in two more weeks. BTW therapy hurts. A lot. But it’s the good kind of pain, where you know it means you are getting better. We mainly work on strength, dexterity and desensitization in my fingers. My range of motion is really good now, and dexterity is way ahead of strength. The nerve sensitivity is now limited to my fingertips, with my thumb and forefinger ahead of the other three. I asked how long it typically takes to go away altogether. Of course, the answer is that it varies; could be a few more weeks, could be a few more months.

January 25 – My clavicle is completely healed! My surgeon is pleased with the progress of my hand and prescribed four additional weeks of PT/OT for my shoulder. As I’ve resumed typing, my left hand has started to exhibit symptoms of carpal tunnel syndrome, so we are addressing that in therapy as well. Saturday is my final day weaning off Topamax and while the weight loss side effect has been great, I won’t miss the brain fog or jumpy vision. I am also very happy that the Tylenol-only OTC pain relief restriction is lifted – my right knee has missed its naproxen. It may be months yet before the ultra-sensitivity in my fingertips and the tenderness in my breastbone resolve completely, but there is light at the end of the tunnel.

Which brings us to today, March 1 – I have been released from occupational therapy! Grip strength and pinch are back to normal in my left hand, and have even increased in the right. I have less sensitivity in my fingertips so I can type with both hands. I have much less numbness in my left hand and have every reason to hope that it was due to residual nerve irritation rather than carpal tunnel. I only had to utilize 17 of 41 prescribed visits.

There was that instant on October 22 when we were in the wrong place at the wrong time and my collarbone was broken in an auto accident. There was a second instant November 9 when I wish I had followed my gut instinct to forego a nerve block, but caved to the recommendation of others. In both instances things could have turned out worse, and I feel blessed to be where I am now. Thanks to everyone who has offered prayers and good thoughts, kind deeds and support. It’s meant the world to me.

Note: I have chosen not to identify health care practitioners publicly, other than Dr. Gemoules, whom I previously discussed in relation to my LaserFit lenses. Anyone desiring a recommendation is welcome to ask for a private recommendation.


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