Surprise #2 – The Prognosis

I saw my surgeon, Dr. Dasilva, yesterday for a surgery follow-up, 19 days after the surgery and three weeks after the fall. He looked at new X-rays with me and noted “It’s all looking good!” A welcomed comment for sure.   The four plated ribs were perfectly aligned with the unplated ones tagging along. Exactly as it’s supposed to be! This was of course the news I wanted to hear. In spite of lingering low level pain, and sleeping difficulties, I was moving in the right direction. And my hopes rose that I would be able to start running in another two or three weeks. Right? Wrong!

Dr. Dasilva proceeded to explain how the healing process works: it takes six weeks for basic bonding of the bones and then another two months for things to solidify. I could then expect to gain full strength six months post surgery. His advice was to see him in three months and not run before that. This was not what I wanted to hear! I actually flashed back to the fall, remembering how clear it was in that excruciating moment that it would be a while before I would run again. And so it was coming to pass!

As this reality set in, and with obvious disappointment, I pulled out a list of questions I had prepared. We went through them in order.

  1. How long before I can start doing regular aerobic (70%+ of max heart rate) exercise without setting back the recovery? In particular, phasing in deep water running, which does put some pressure on the ribs from the flotation belt, and StairMaster? I was glad to learn these were OK now. Weight bearing exercise that moves the rib cage is the problem.
  1. How long before I can begin some flexibility and resistance training to regain strength in my core and range of motion and how should I stage these activities? Dasilva was cautious, saying to lift no more than 10 pounds per hand. Weighted squats and front-bending exercises were a no. Lower body weights are OK as long as I’m not lifting plates on to the machines. Progressive easy stretching is fine. Be incremental in everything I do.
  1. Once the pain has subsided, is it OK to sleep on my side, which places a different type of torque on the ribs? Yes, this is OK with pain as my guide.
  1. What is the process for clearance to begin running easily, and assuming that goes well how quickly might I expect to be able to pick up the pace and volume of running? We had already covered the when so I surmised it was not worth talking about the pick up now.
  1. What is the prognosis for a full recovery, meaning will I be able to extend myself fully in both aerobic workouts and resistance training? He said yes to both as long as I allowed for a full recovery first.
  1. How durable will my ribs be after my recovery? Are the plated ribs more or less susceptible to breaking again upon subsequent impacts? They should be as strong or even stronger than before.
  1. How susceptible are the healed ribs that were not plated to injury down the road? They too should be 100% and no more susceptible to fracture.
  1. Would it not be wise to test my bone mineral density? While the impact was hard, is it expected so many breaks would have happened if my BMD were normal? He explained that by hitting the corner of the suitcase it was like a hammer hitting a small area and this caused the extensive damage. He agreed nothing is lost by testing bone density but did not think that was the reason for the number of breaks.
  1. This is a relatively new procedure. How might my experience and training as a personal trainer help the medical community in promoting the benefits of rib plating and help other patients navigate their recovery? We agreed I would reach out to the Brigham & Women’s Communications Department to start a conversation, as it might appear self-serving if he made the contact.

So I’m on a path. A longer one than expected. But it’s good to be in the game with expectations for a full recovery. I will need to be creative about finding exercises that don’t compromise the healing while maintaining a good portion of my fitness. I look to enlist the help of a physical therapist with this.

My next post(s) will document this continuing journey. Hopefully my experience might help guide others in their journey.  For now, it’s off to bed in hopes of getting a good night’s rest!

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