Boston Update - Choices

Following a great trail ride in Chelsea last Saturday and my visit to the ER, I went to the see  orthopedic surgeon Dr. James Moravek today.  I explained my athletic goals for the year:  the Boston Marathon in April, Ironman Traverse City in August.  He listen and then here is what he showed me:

The doctor counted the pieces of bone that had once been my clavicle.  There are, he said, at least 4 pieces.  He went on to talk about the choices:

1. Let the break heal naturally.  The doctor said this was a choice because it would heal up. There would be a "bump" under the skin where the bones healed and fused together.  

2. Surgically repair the break.  In this surgery, the skin is cut and the collarbone is repositioned back to where it should be and then held in position with screws and a plate. The plate and screws do not typically get removed, but sometimes patients find the plate bothersome under the skin. If this is the case, the plate and screws can be removed after the fracture has healed, usually at least 6 months after the break. This operation is performed in the operating room under general anesthesia. The surgery will take about 60 minutes. Usually, this operation is outpatient surgery.

I listened, a little confused actually because the two avenues were being presented as choices.  I had assumed that treatment plan had already been determined while at the ER on Saturday:  the break was to heal naturally.

I listened some more as doc recited the research that had been done about natural healing of the clavicle versus the surgical option.  It was a mixed set of research.  In some collarbone breaks, it sounded like having the surgery made more sense while in other situations, natural healing made the most sense.

Finally, I found a moment of silence and said, "I hear you saying it is as choice to have this surgically repaired."  I listened to his clarifying response:  "We don't just treat the ailment seen on the x-ray; we treat the patient.  Every patient might have a different need. Some patients need surgery so they can get back to work in two weeks rather than three months."

Choices.  I like choices.

I thought for a second and said, "Let's do the surgery."  The doc responded that is exactly what I'd do if I were you.   Surgery is next Tuesday.  I'm hoping the surgical treatment plan will likely get me back to running about two weeks after surgery.  Fingers crossed.

As an aside, some of you know part of what I'm thinking about / remembering:

1. Tyler Hamilton winning a stage of the Tour de France in 2003 while riding with a broken collarbone taped into place.  

2. Lance Armstrong falling during the 2009 Vuelta a Castilla y Leon and fracturing his collarbone.  He went on to have the same surgery I'm having and then riding the Giro d'Italia and Tour de France.