clavicular fragments revisited

It’s been a month since I was in Almaty for my mid-service physical where I was inspected head to toe by our PCMO (Peace Corps Medical Officer), and it’s about time I share the results. After a winter of gaining weight (I was at 193 in March), I’m back to my PC entry weight, 185. I guess 8lbs is a noticeable loss, due to the “you’ve lost weight” comments I’ve had from a few people. I think it’s actually the sandals and lack of winter attire that people notice first. My teeth are clean and cavity-free. I don’t have any hernias or clogged sinuses. Hooray!

Now about this collar bone: I went for a 2 month follow-up x-ray, which the DC doctor had said we should begin to see a calcium deposit forming to fuse the “clavicular fragments” back together. I went with the assistant PCMO to the clinic (a different one than the first time, and incidentally much nicer, not being a converted apartment block) where I was directed to the big white bone-seeing machine in the corner. Once the print was developed and delivered to the x-ray doctor I was summoned in to take a look. The doctor, whom I had never met and who didn’t know about the initial injury, motioned me closer with a stern look and pointed urgently to the backlit black and white reproduction of my left shoulder. “You’re going to have to see a traumatologist at once!” I saw my humerus, attached to my scapula and distal end of my clavicle, and then… two jagged ends of my clavicle pointing in different directions, separated by about a centimeter of milky tissue. “Another day like this and you could do some serious damage!” It was exactly the same as two months earlier. Now, I can reassure you, that by the time I had the x-ray I was feeling better than I had since June 1st, and had been out of my brace for a relatively pain-free week. My shoulder no longer hurt on a regular basis and I had been thinking surely it had been healing. Obviously the picture disagreed.

Seeing as how I wasn’t in pain, we decided to not see the traumatologist until sending the x-rays to the DC doctor for analysis, who a day later reported that: (1) no, the bone didn’t heal, but the surrounding muscles and tissues had, explaining the lack of pain; (2) surgery to reattach the fragments would probably be a good idea, but; (3) one could live their whole life with a broken collar bone provided that it wasn’t grinding or jabbing nerves, etc. The muscles would rebuild and re-strengthen, maybe not to peak level, but enough to live comfortably.

So, my choices are to (1) have surgery now, miss a couple months of work and get a trip home, (2) wait until the end of service and have surgery when I get home, or (3) just leave it and creep people out at parties, “Hey, wanna feel something weird?” The first runs the risk of not making the 45 day limit for PCVs home for medical leave before being administratively separated, so it looks like right now we’ll plan on the second. It means that I have to be somewhat careful for the rest of my service, only to go home and have a second surgery on my left shoulder, but I think it’ll work out alright. I have, fortunately, been able to play soccer again, having told the guys I play with to take it easy on me, and Mike and I have been a couple times to the gym to lift weights. It’s frustrating like no other to be there bench pressing an empty bar, but you know what Aesop’s tortoise taught us…