Towards the end of July 2026, on a weekday afternoon, I was riding my Brompton bike to West Oakland BART so I could go pick up my bib for the San Francisco Marathon. I was making a right turn at Horton and Mandela at speed, my back wheel slipped out in some debris and I overcorrected. I went down on my left shoulder and hip. I missed some seconds from shock, and recovered standing on the sidewalk with a couple of very nice guys who had called 911 for me. The paramedics pointed out to me that my left collarbone was tented up and that I really needed to go to the ER, so I got a ride to the emergency room at Kaiser Oakland. They took my bike as well, which I was very happy about, there’s nowhere safe to leave a pricey folding bike. The whole point of it is to bring it with you where you go, so like many owners I don’t carry a lock. I tried to show the paramedics how to fold it up but that didn’t work for either of us; luckily it’s a small bike. As you might pick up from the wikipedia article, the clavicle is an important structural component, and my left hand is my dominant side, so I couldn’t do very much at all in the departments of lifting, pushing, pulling, or even pointing. I stuck my left hand in my pocket until it was time to lay down on the gurney in the ambulance.
My wife met me at the ER, where I got a minimalist sling, X-rays, a shot of narcotic painkiller, and two painkiller prescriptions. The reviewing doctor decided not to do immediate surgery because of capacity. The prescriptions were for Naproxen and Hydrocodone+Acetaminophen, with instruction to top off with Tylenol during the day. Diagnosis was acute fracture of the left mid clavicle associated with inferior displacement of the distal clavicle and mild overlap. There was a small separated displaced fragment lying inferiorly. Normal alignment of the left acromioclavicular joint. No visible additional fracture. No shoulder dislocation.
Late on the following Saturday night I got a voicemail asking me to fast for potential surgery Sunday. I was in hospital prep from 10am to 2pm, but they couldn’t fit me into schedule. Fun fact about July in the US, there’s lots of firework related injuries and apparently reconstructing someone’s hand correctly took priority. On Monday I was able to schedule a surgeon consult for Thursday afternoon, and the ER visit notes were updated with surgeon notes agreeing that surgery was called for but not urgent. “I was not present for this exam; I reviewed the patient’s history and agree with the findings, orders and plan as developed. Skin clinically appropriate on uploaded photograph. Given fracture pattern I would recommend fixation of this. Had initially planned to do over the weekend though unfortunately unable to get to owing to other more urgent patients. Patient likely to be scheduled with another trauma surgeon in the next week or two.”
On Wednesday morning I got access to the schedule surgery phone number, which is an unattended voicemail box. No message I left there was ever returned. Questions I wanted to ask and ended up going to the internet for: What is recovery timing, how can I maintain cardio fitness, when can I fly, is there anything special about guitar, running, or cycling. Those last few were pretty obvious because by this point it was agonizing to sit up or lie down and I needed to wear the sling most of the time. Even with pain pills, swelling had declined and I could feel the bone parts moving against each other. Unpleasant. The internet’s answers were, of course, all over the place.
Thursday afternoon I was able to talk with a doctor, who told me to expect surgery Friday morning. They also gave me instructions: for six weeks from surgery, don’t take any load through the shoulder. No running, cycling, guitar might be okay. Normal activity should be okay after 3 months. Stationary cycle and flying are okay after surgery (no pulling luggage or carrying bags on that side though).
Surgery was delayed until the afternoon but did happen on the planned day. The surgeon said three months to total heal, and eight weeks before any activity that might involve falling. After surgery the sling is just for comfort, start working on range of motion immediately. Post surgery guitar and maybe treadmill are okay. Stationary bike is great. They put in a plate and screws, plus another screw across the fracture. I was warned of some risk of chest numbness, which I definitely felt and am still feeling a reduced bit of now. Thankfully I did not experience infection. They mentioned that about 20% of patients later want the plate removed (another surgery) because of irritation, which I am fervently hoping will not be my story because surgery sucks.
For post-op care they suggested Tylenol and ibuprofen (with food), continued oxycodone, and stopping naproxen. I was eager to get off the oxycodone though, so I only took tylenol and ibuprofen. The surgery site was cauterized and covered with steri-strip dressings, which you leave in place and don’t get wet until it falls off. That was under a gauze dressing which came off after five days. I gradually trimmed the edges of the steri-strips with scissors as they loosened up. I generally stopped wearing the sling, except for when doing tasks where I might be tempted to carry things like groceries. I was able to move my arm more, stretch my hand and straighten my elbow, and reach out to walk my hand along a table or wall. I was able to start reducing my Tylenol and ibuprofen dosages after three weeks, and was no longer taking pain pills every day by five weeks after surgery. I started light running 7 weeks after surgery, 8 weeks after injury. I started light commute and errand cycling 8 weeks after surgery, 9 weeks after injury.
My medical care experience was frustrating. Nothing like what some people have gone through but needlessly dumb. The doctors and nurses were all outstandingly excellent when I could talk with them. The ER was fine, the surgery went well, insurance has paid out (even covered the ambulance!), but the administrative aspects are Kafkaesque. I could never get a straight answer for when the surgery would be, it took a week of phone tag and false starts. I suspect I was misfiled somewhere since both times I went through pre-op they were surprised that I hadn’t been given preparatory materials (disinfectants and hydration). I emailed my primary care physician on a Tuesday about physical therapy, which prompted the surgeon who’d fixed my shoulder to email me back and suggest a post-op visit the next week… fine! Phone tag starts, I finally get through to scheduling and they give me a time six weeks out. I ping the surgeon, he responds Thursday through my PCP’s account to say come in next Tuesday, and try to get an X-ray first. There’s no appointment for Tuesday. There’s no way in the app to book an X-ray without a doctor’s recommendation. On Friday, the app started showing an X-Ray recommended message from February, for my knee, which got an MRI in March… and the recommendation is actually for both knees. I guess I’ll just go hang around radiology and orthopedics, see what happens, maybe I’ll get care? Several phone calls later I found someone who said I could drop in for an X-ray, which showed everything is nominal. The surgeon visit is still in the future. However, I have been able to see a physical therapist twice, who has given me useful exercises and guidance. Last week I was able to plank and even hang a little bit, I’m starting to think of rock climbing again. I can’t sleep on my left side yet, though.
- Medical provider communication when I need medical care: very hit or miss, try leaving a few voicemails, did you check the app, it doesn’t let you make this appointment, but it’s a very nice app in many other ways, let’s try some more voicemails?
- Medical provider communication when I haven’t filled out an NPS survey: Johnny on the spot! I can count on at least three emails reminding me that I could still fill out that survey for each interaction I’ve had.
All of this has coincided with high stress at work and work-related travel, fine. I was able to walk and use stationary bikes at the gym. I discovered the point at which I was overdoing it on that stationary and had to take a few days of rest. I caught some travel crud in Denver, then got my flu and Covid double-tap as I was starting to recover. By the time I was able to really exercise properly, my Garmin watch’s training status had gone from Productive to Recovery to Detraining, ok, screw you too. When I finally got a nice run in, the watch came up with a new insulting status: Unproductive? I’m not demotivated, just amused — I have tried and hated Apple Watch, it’s definitely not for me. It took a couple of weeks of slightly lower than normal exercise for training status to settle back down through Overreaching to Productive. I have my goals set to Finish for my upcoming races instead of setting a time, and it’s aiming me towards a 2:10 half marathon which is fine.
