When I got hit by a van my collar bone was broken and due to other more urgent injuries it wasn't treated. As a result the fracture healed with a large part of the bone in the wrong position, causing  my overall shoulder girth to shorten and droop forward.

Over the following months, my body adapted to its new shape and I worked out in the gym to try to overcome what deficiencies I could. At first I couldn't even raise my arm out of the water to swim front crawl. I eventually reached the stage where I could manage crawl but with hardly any power in the stroke. Although my cycling has been largely restricted to the turbo, when I did venture out on a road bike, my right knee would hit my shoulder when on the drop handlebars. I could run, but was always in discomfort. So, although all three sports were possible, I haven't been able to perform any of them very well. Even running, my strongest event, has been a long way short of my previous standard.

I'm not sure how much the imbalance has contributed to my sub-standard performances but it certainly hasn't helped. With initial concerns that I had possible nerve damage I wasn't offered any prospect of surgery. Eventually, after many unsatisfactory NHS appointments, a route I was channelled into by my previous case manager, never seeing the consultant named on the letter, I took the private medicine route and saw an experienced surgeon who I was supposed to see at the RNOH. Simon Lambert, examined me and his opinion was that surgery was possible. After learning that news I must have stopped sub-consciously blocking out the symptoms of the injury and I began to suffer a lot more discomfort.

I was actually looking forward to surgery, hopeful that I'd be able to start doing the every day things I could no longer do. Then again post brain-injury I don't actually find anything “bothers” me that much! On a Saturday morning my dad drove me to the Spire Hospital Bushey where Mr Lambert performs surgery on private patients.

After checking in I was visited by Mr Chandra, the anaesthetist, and then Mr Lambert. [Mr Lambert drew an arrow on my right arm to make sure he performed surgery on the correct arm!] I was eventually taken down to the operating theatre where a cannula was inserted in to my left wrist. Mr Chandra started injecting the anaesthetic, I remember a theatre nurse asking me why I was having surgery and telling him that my family wouldn't like me to ride a bike anymore.....the next thing I knew I was staring at a hospital ceiling and asking “where am I?” For a while it was eerily reminiscent of when I “awoke” after being in a coma. Thankfully it didn't take long for a nurse to say “Bushey” and me to realise where I was and what must have happened. I was taken back to my room and gradually became more lucid. With my iPhone at the ready it didn't take me long to call my wife, send some text messages and get my dad to take a photo or two.

Surgery actually involved making an incision, breaking the clavicle with a drill, chiselling off some  of the damaged growth to use as bone graft, rotating the bone and using a stainless steel plate and screws to join together the two halves. It was all closed up and a water-proof dressing used.

When I saw Mr Lambert the next day he was with happy with the success of the procedure. He said there was good blood flow in the bone and that he had managed to protect the nerve, all key to a good prognosis. His guidance included telling me to make sure that I don't move my arm too far in any direction, especially overhead or behind my back. I've been given a set of very simple exercises to do by the hospital physio; probably too easy for me not to start over-doing it and compromising the repair! I had an x-ray taken which showed the plate and screws as well as the gap between the two halves of the clavicle. Hopefully the two halves will have started to join by the next x-ray, six weeks after surgery, when I go back for consultant follow-up.

So now its six weeks in a sling but no exercise that puts any impact stress on the body. As well as a standard poly-sling I also have a Cryo/Cuff. This is a cold-compression sling, these have been shown to lessen swelling and pain after surgery, thus improving the recovery time. Both the poly-sling and the Cryo/Cuff use Velcro to enable the sling to be used for different sized people. However Velcro seems to want to attach itself the wrong way around or to anything that comes close when you're attempting to put the sling on!

I'm taking the prescribed painkillers, as I'm told its better to keep (orthopaedic) pain away rather than try to get rid of it afterwards. I don't feel any pain where the incision is and rather like the accident itself I think, did it really happen? Do I really have to wear a sling? Why can't I pick heavy things up? But, if I do move in a certain direction, or breath deeply, there is a definite surge.

I had my first physiotherapy session with the physio who has been keeping my back spasms at bay. It was evident that I had real difficulty trying to move my arm in certain directions where the muscles hadn't been used properly for the last couple of years or so.

I have to be realistic. Don't let physical pain be a guide, follow medical advice, even if you don't think you believe in it.

Being one-handed is a source of frustration in that I'm not able to drive or do a lot of day-to-day tasks. Its somewhat like the early days after my initial discharge from hospital, following the collision, but this time I have more vitality and am not content just to lay around watching TV.

I'm typing this account one handed. Usually, as a proficient IT geek, I type with both hands. Its a bit tricky not being able to use the normal, to me, combinations of keyboard shortcuts that rely on using both hands. If I'm not shackled to the Cryo/Cuff, then balancing my laptop on my lap, rather than on a desk [must be why its called a laptop!], I can manage some two-handed typing.

Sleep, or the lack of, is the biggest obstacle following the op. At the moment I'm using loads of pillows to try and sleep propped up, with another under my right arm. I'll try another configuration this evening in the hope that I can get a good night's sleep. It can be hard enough trying to cope with the tiredness of mental fatigue without starting the day tired before I've done a thing.

A comment I've had via the wonderfully supportive, on-line TriTalk forum is; “It astounds me you're still having to go through procedures to correct your injuries. Get well soon.“

Welcome to the world of insurance companies and the so-called independent case management companies that rely on their patronage to remain in business. I'd sum it up as “here's a chair and desk, get back to work”; without any real regard for the quality of life issues which rehabilitation should be all about. Thankfully my new case manager is more sympathetic, then again he doesn't get his business from insurance companies. I'd be satisfied if nobody else has to put up with the poor service I've had to endure, although I have my doubts. Surviving the trauma of a catastrophic accident is enough to contend with without people unnecessarily putting extra barriers in the way.

“Still amazes me how determined you are and how far you've come.“ No thanks to companies more interested in their bottom line. I'm not sure where I'd be now without all the support I continue to get.

Friendship, love, empathy, call it what you will, something that you can't put a price on, gives me additional drive to keep going. Thanks, again, to everyone who has supported me.

Train safe.