On the Road to Recovery

Ahhh, recovery. What a simple concept. What a non-trivial analysis.

The first question you ask after you wake up in the ambulance is... well, actually, the first question is "what happened?" Or maybe "who am I?" But once that's sorted out, and you perhaps deal with the trauma of "wow that coulda been a lot worse", the question that takes up most of your energy in the ensuing weeks is: when will I be back to normal?

It turns out there are a lot of conflicting opinions on this. Some things I've picked up...

  • Conventional wisdom in the cycling community is that it takes 8-12 weeks to get back on the bike. Not back at 100%, but back out, riding on the bike.

  • Some of the pro riders just keep riding after breaking a collarbone. Tyler Hamilton is the legend in this space - winning a stage of the Tour de France on a solo breakaway with a broken clavicle. Lots of them seem to keep riding. But then again, lots of them also seem to be riding in a, shall we say, altered state... (sigh) but in any case, the pros seem to be back out on the road in 4-6 weeks.

  • My doctor says, unequivocally: 12 weeks from time of surgery. Nothing before that. Then he kinda makes that expression that tells me there's a lot of wiggle room in there, but he's not going to discuss that.

  • Many, many people offer the advice of "take the time, recover well, don't screw it up and cause worse harm for later". Sounds great, but I'm not sure what this actually means, because there's a point where it shifts from "I'm recovering" to "I'm just chillin'". I'd love a good excuse for "lazing around", but I can't tell which one I'm doing.

  • Several of my cyclist friends have broken their collarbones. (The fact that this is a "normal" break is alarming in and of itself.) None of them have great stats on recovery. Either they had a poorly healing bone and had to have surgery a month or two after the accident with recovery dragging on for six months, or else they had the accident at the end of the season, so they healed their way into the winter and aren't sure when they were back to "normal".

This situation - not really knowing how long it takes to recover - leads to a lot of secondary questions like: what does it mean to be recovered? Well enough to ride at all? Strong enough to ride with confidence? Completely back to the power levels I was at before the accident? Two inches taller than i was before?

So since these answers seem to be all over the map, I'm keeping a log of how things are going. Stupid things are noted with minus signs (-); the more signs, the more stupid (---). Here's the log so far:

Week 1:

  • Day 0: Wipe out, ER visit. Notable problems: broken clavicle, two broken ribs, slightly collapsed lung, major hip abrasion. (-----)

  • Day 1: Arm in sling, breathing exercises, on Percocet at night. Drove two hours with other arm. (-)

  • Day 2: Lay on a couch, not moving. Worked a little. (-)

  • Day 3: Lay on a couch, not moving. (+)

  • Day 4: Drove two hours back home (-), visited doctor (+). Lung is ok now. Hip has developed a large hematoma.

  • Day 5: Surgery on clavicle to put titanium plate in (+++).

  • Day 6: Lay on a couch, not moving. (+) Spending 2-3 hours a day napping. Some work. Pain meds at night.

Week 2:

  • Medical: Follow-up visit with doctor late in the week. So far so good.

  • Health: Clavicle needs coddling. Main pain is from ribs, but no special care. Hip is weird and hurts, but not needing treatment.

  • Exercise: Got on a bike trainer for 15 minutes one day, then 30 minutes another. Zone 2. (+)

  • Work: Spent the week at home, working some remotely, napping a lot. (+)

  • Mental: A bit slow, but lots of energy on pain management and sleeping.

Week 3:

  • Medical: No follow-up needed. Down to just ibuprofen at night.

  • Healthy:

    • Everything hurts, but only when I move wrong. Have quit using the sling at home. Night sleeping is still tough.

    • Discovered that I should be eating as if I'm in high-intensity training mode: significant protein and carbo. My body's burning more energy than it seems.

  • Exercise:

    • Worked out on trainer 3-4 times - keeping intensity low, but increasing duration.

    • Did not try to ride up Mt. Washington with my friends on Newton's Revenge despite thinking I might be able to. (++)

  • Work: Back to work. Mostly.

  • Mental: Normal - still lots of energy going into napping.

Week 4:

  • Medical: No changes.

  • Health:

    • Flew to California for family vacation. Flight was rough on the hip - numbness and pain.

    • Ribs continue to be the sorest spot, with some issues with hips.

    • Probably over-using my left arm and clavicle. (-)

  • Exercise:

    • Working out on indoor bike trainer at normal levels, still not pushing max

    • Got back on a bike! Rode it in a loop on the driveway. Unsteady. Climbing a 10% grade was VERY hard on ribs. (--)

    • Went on a 6 mile hike & overnight camping trip with my daughter.

    • Went on a 16 mile hike carrying 20lbs in a waist pack and one-shoulder pack (avoiding the left clavicle), climbing 4000 feet. Felt great, but the last two miles were tough. Recovery on next day was a bit hard.

  • Work: on vacation, but would otherwise have been a normal week.

  • Mental: Normal. Trying to figure out if I can ride the big rides and go backpacking later.

Week 5:

  • Medical: pretty much not using the sling. Noticing I still need to nap / sleep extra.

  • Health: Endurance is not where it was before the accident. Clavicle, ribs, and hip remain pain/movement problems. Hard to swim - no way to reach above my head. (Well - it's easy to swim in tight circles, turning left forever... :-)

  • Exercise:

    • Regular riding on trainer at standard off-season levels, pushing into zone 5.

    • Still recovering a bit from long hike on weekend. Need more sleep than normal.

    • Choosing not to go river exploring with my son because the stress of rapid riding and boulder-hopping would be too much. (+)

  • Mental: Normal. Tired of being injured. Tend to forget I am until I move in a way that hurts. Oops. (-)

So... here I am in week 5. I'm feeling pretty good, but clearly not "100%". I'm mentally completely ready to be out and about doing "normal" things, i.e. endurance athletic activities, extensive work, long drives, and so on. And I can definitely do some athletic stuff - workouts, hikes, and so on. But I don't trust my ability to respond quickly to complicated situations on the road, and I do wonder if I'm likely to re-injure myself.

I think if I keep going at this rate things will be fine - I haven't done anything that has caused major new pain. My mobility keeps increasing and the pain keeps decreasing. At this rate I'll probably be fully healthy at about 12 weeks, but also probably way below my previous endurance level.

But.

It's summer time. There's a lot going on. In particular, I'm signed up for the Pan Mass Challenge that takes place 3 weekends from now. (End of week 7.) And I've got my annual backpacking trip coming up in late August. (Week 9.) Am I going to be able to go on these? Should I?

Originally, after the accident, I had thought these were simply not options. But I'm feeling pretty good now.... I have questions - endurance, hills, recovery, how to carry 30-40 lbs without putting any weight on my left shoulder, ... but I also feel like I can do these if there are reasonable answers to the questions and if I take it easy.

I really want to do the PMC because .... people have committed money to it, because it's one of my major goals for the year, because it looks like fun. I want to go backpacking because I'd like to spend time with the gang and because, mentally, I really need that annual week out in the wilderness - the bio-reset button. I don't want to do either if they are going to be dangerous or impair my long-term recovery.

So, for both of these, I'm now cautiously planning to do them in careful ways - i.e. not pushing for speed, limiting my weight, moving carefully in the pack, not holding freeekin' cameras in one of my hands while riding at 30mph. I'm preparing for possible last-minute cancellations of both depending on how I feel before and on various smaller rides and hikes between now and then.

So am I being stupid? Should I wait the entire doctor-advised twelve weeks before doing anything at all so that I don't risk the long-term? Or am I being pragmatic and doing what feels reasonable, but continuing to be at the limit?

I don't know.

I guess I'll find out.

In the meantime, I'm going to keep being true to my nature rather than second-guessing myself. Go go go - but a bit carefully.