One year later

What a journey. It started with me forgetting my keys, and has a long way to go still.

Exactly one year afterwards, almost to the minute, I rode my ancient Lambretta past the site of the "accident". And amazingly, saw almost exactly the chain of events unfold once again. This time there were no cyclists and no motorbike, but I was only 30 yards further back than 1 year ago when a driver just drove across the flow of traffic. He didn't look, he didn't slow down, he didn't take care.


We have to change the way we penalise bad driving. When two vehicles bump together, scratch paint, dent the metal, it doesn't matter how bones were broken, lives, lost or molecules of paint transferred from one car to another. The driver's error was still of exactly the same magnitude. It was just bad driving. So lose your licence! Lose it every time.  Only when you lose your licence for a month for a minor scratch will you change the way you drive so that next time you don't crush a leg. The only reason the leg gets crushed is because it is in the wrong place at the wrong time.


So where is my leg now?

It's walking reasonably well. I still haven't run a single pace for a year, but I look fairly normal and the level of pain is low enough to ignore. Pain has become the normal state. It aches if I work at a desk, and hurts if I step down a little too heavily.

The good leg is approximately twice as strong as the bad one. In physio classes I can lift 12 weights with one and 6 with the other. I stand on one leg with a slightly bent knee on a trampette 10 times for 30 seconds, after which I have to take a quiet walk to ease the muscles. I can balance on the "easy" wobble board without problems, but that's because I surf. I can't do calf raises on one leg. The muscle and tendon pain is probably caused by the rough shape of the fibula and the massive callus. The flexibility still needs a lot of work. The ankle is still badly positioned. The foot is turned outward by a few degrees, and the lower leg is bent slightly so that the right foot is a couple of inches behind the left. That will never change now. It's for life. And boy, is it ugly!

The other driver is still driving around London. I sometimes wonder if he has had any more accidents or injured anybody else. Does he take more care these days? I'm told that one of the witnesses has other things to do and so can't turn up in court. My friends express amazement, but I think I can understand. If you don't have any idea of a persons life being wrecked, then why would you bother?

After all, the police have a written statement, so why do you need to turn up in court? If you have no concept of the thousands of pounds an accident victim can have to pay to move from A to B, to get shopping delivered, to buy painkillers and antibiotics, to get their bath cleaned and their bed made, then going to your daily work will always be more important. ...until your child goes under a car, or you find yourself picking up your foot and throwing it back to where it should be at the other end of your leg.

And then you will understand.

'tis the season for giving.

My trousers have reached Poland. I took them in to the hospital so that they could be given to any needy person. Apparently a Polish lorry driver broke his leg and was fitted with a frame, and now wears my trousers back home. I wish him the best of luck.

There are two more pairs of trousers to give away, and the original shorts given to me when I had no clothes on a very very cold and snowy Monday in December. They came from a soldier from Aghanistan.

I have still to give away my comfy crutches. But I don't want to lose them until I am fairly sure that I will not need them again. I find Ade's story horrifically frightening.

I also have the extended bicycle pedal to give away. I have asked Debbie (at the hospital) to let me know if anyone can use it.

This year I have to think about Christmas presents for the family. Last year I didn't bother.

Ade's story

About 5 years ago, a guy called Adrian broke his leg while riding his bike. I think it was a traffic accident.

Ade frequents one of the support groups on the Internet. They talk, tell each other their stories, and help each other with advice, consolation, and encouragement. I was there too a few times, both giving and receiving.

Ade's leg mended of course. He was treated at the same hospital as me. He worked to help the Limb Recontruction Foundation, a charity run by the hospital staff.

Then two years after the original accident he broke the leg again. I don't know the full history, but I think the bone was infected, became weak, and broke easily. I think he then had a total of 8 frames fitted to his leg over a period of 5 years. What a nightmare! He's a physically fit person, he swims long distance races, but obviously a marathon is out of the question. To go through the agonising levels of pain, the lack of sleep, the loss of lifestyle and ambition (your horizons become very foreshortened when you know that your capabilities have become limited) for FIVE YEARS...!

A few days ago I read some of he email on the support group. Ade was explaining how he had fully accepted his decision to have the leg amputated.

What more can I say?




Shit. That could be me in 5 years.

Things you end up doing when you get into hot yoga

1. Become a yoga bore. Tell everyone how good it is and how it really makes you feel better, calmer, more focussed... and how they should obviously take it up. And then tell them again. And again.

2. Get photographed in yoga poses in strange places. Obviously it is sensible to do "balancing stick" pose on an escalator on London Underground. Who wouldn't?

3. Realise that your poses are not as good as you thought they were. That photo of "balancing stick" on an escalator shows how low your leg is, and how bent your arms are.. Dear me, you look like a broken umbrella instead of T for Tomas. More effort needed!

4. Start drinking coconut water. Nearly flavourless, often tepid, and a little like drinking your own sweat. Yes, but in 2 minutes time your yoga brain disappears, breathing gets back to normal, and you start to feel human again.

5. Take out a mortgage for washing powder. Also expect the washing machine to wear out five times faster than the average.

6. Discover the idea that your body is "just working something out".  Most people call this pain, but you are now absolutely sure that if you just keep on working at it, the pain will go away and the problem part of your anatomy will then feel better and be far more flexible.

7. Drink lots. Urinate very little. Even consuming a litre of water (with or without electrolytes) just before bedtime will not result in needing a pee in the middle of the night. In fact, put a large bottle of water by the bed in case you feel thirsty in the night.

A really good pose. Just lower the heel by an inch, and move the weight forward a tad.

8. Whilst standing bent over with straight legs and with sweat running into your nose, ponder the true meaning of "The object of pulling is stretching". Who knows? Then wonder what a Japanese ham sandwich really looks like. Do the Japanese even have ham in their sandwiches? Perhaps their sandwiches are made from a single slice of bread folded over in the middle instead of the more traditional 2 slices...?

9. Stop using moisturiser.

10. Fail to see anything unusual in standing nearly naked, nearly shoulder to shoulder in a massively mirrored room with 71 other people, all of who are similarly semi naked and sweating profusely.

11. Smile wryly but inoffensively and sympathetically when a guy comes in wearing a T-shirt.

12. Wonder how it is possible to have "no knee", or an "exactly forehead".

Ongoing infection

Throughout the time when I have been wearing the frame I have had some form of infection in one of the pins or wires. Initially one if the pin sites refused to heal, and eventuallythe pin was removed and a new one added. The clear yellow liquid emitted at the infected site soon movedto another hole. As we closed each hole off it moved to another one. Finally it settled in the inner side of the site of the olive wire. For a few days it heals over, but then a blister appears, bursts, and a small amount of liquid oozes out. The sore stays open for a while until take antibiotics, and then the cycle repeats.

I've probably spent more time on antibiotics than not.

About three weeks ago I emailed the consultant -with photos- and asked if we should be doing something about the problem. No answer. So, 10 days ago I called the clinic to ask for advice, but only got an answering machine. I got on my bike and rode to the hospital.

We took two more Xray shots which seem to show no evidence of the bone being infected. The swabs we have taken always seem to be reported as "no growth".

So, a new batch of antibiotics... And boy is this concoction bad?! My gastric system has suffered a major attack of fluid flow, to put it politely. I started to take Imodium before the meal, to prime the system, then take the antibiotic after the meal to dilute it in the food. The effect was reduced, but nonetheless evident and uncomfortable.

So back to the clinic again today. The sore has healed over, but a blister is developing. The surrounding area is red and tender. The doctor prescribed the original AB, plus an additional one, for a one-month course.

If the AB don't work then I should expect to be called in for another op to clean out any infection. I guess they bore away the infected bone and then somehow fill the hole with a strong antibiotic.

Castaway

This whole year reminds me of the film where Tom Hanks survivrs an air crash and is washed up on a oceanic island many miles away from civilisation. He learns to survive on his own, to catch and find food, and to look after himself.
His companion is Wilson, a volleyball with a painted face. My Wilson is the internet. I talk to friends who may as well be painted faces on balls. They communicate but stay behind the screen hidden from reality. And no doubt I am also someone else's Wilson.

Castaway on my island, I go a little bit crazy just like Tom Hanks. There are good days and bad days, there are challenges and problems that need solving, and mostly there is no one to help or support. Just like Tom I found a discipline to carry me from day to day, and to keep me healthy whilst I await the end of the story, the return to normality.
The story doesn't end when Tom is rescued. His wife has remarried and raised a family, He has no home. But he has a package to deliver, so he does just that.
My story will end in a similar way. There's a new version of my life waiting for the credits to roll.

Back to work

In the early days, when I got my first and only exposure to daytime TV, and I thought that I would be running around by April or May, I tried to carry on working. I offered my services to my boss who just told me to spend some time getting better. I gave up daytime TV, and I gave up offering to work.

I had years and years of backlog to clear. And the company rewarded me for busting my guts and putting in months of overtime with... Nothing. So I decided to do some catch-up. By July I was still working on those things that had always been put off, put on the backburner, given low priority, because of work.

As life became easier I began the process of returning to the grindstone. I offered to work normally from home. The company decided to send me for an ndependant assessment, in case there was a risk of the company being sued for a cripple falling over in the lift.

The doctor faced me across a massive Harley Street desk. Fully 10 feet away, she eyed the frame and leg as I sat unmoving in the chair. She asked a few questions. Did it hurt? Did it bend? Can I walk? Would I fall over in a lift? "No, but I might slip on my crutches if the marble floor was wet, like I did in Sainsburys". She dictated a letter to a recording device as I sat watching the £ signs roll up. The company was paying, but she was going to make a point that I was a few minutes late... Some of which were spent in reception, and some on the doorstep waiting to be let in.

Luckliy she didn't really need to get close to the leg, or watch me walk, sit, stand, or bend over. Luckily I could tell her everything she needed for her letter.

She asked if I wanted to see a copy before it went to the company. Well, why not?

The company got the letter a few weeks later. By now it was about 6 weeks after I had suggested coming back to work. But then I learned that I also have to produce a doctor's note to explain why I have not been coming to the office for 7 months. It took about 4 days to get an appointment. The doctor then had to explain the concept of a sick note to me. I've never had one before, not in 35 years of working.

So it is that on 12 August 2011, I return to work.

Unfortunately, the infection was on the rise, and my leg bleeds pus and blood in the office.

I try to hide it, and blythly say "oh dear, yes, that does happen sometimes".

Directions...

It's now 12 July 2011.


............


This blog should be read in chronological order, earliest event first. 


Look at the right hand list at the top of the page. Start reading from the top of the list.


I wrote this as a result of seeing a web page created by a someone who had a similar experience. His record of events helped prepare me for some of the experiences I have had and am yet to have. 


I hope it will prove useful.


I also see it as a way of downloading some of the frustration.


It wasn't an easy trip, so be warned. There are dark moments.


............



The whole blog is also show below, but it appears in "most recent first" order, and that won't work.


...errrr, enjoy.


Chris

A new awakening

A few weeks before the accident, I had been planning to attend a yoga retreat in Portugal in late June 2011. It sounded perfect! I could take my kitesurfing gear and do yoga in the morning, kitesurfing in the afternoon, and yoga again before the evening meal. Fantastic.

I emailed Paul, the organiser, a few days after the accident, and let him know that my plans had to be put on hold. I also cancelled the planned Italy snowkiting holiday intended for Christmas, and the kiteboarding trip to Kenya in February. :-(

By late April I was convinced that I would be able to manage the yoga retreat, and given that I'd cancelled two holidays, and not taken a break since last August, I felt justified in going the whole hog and booking both weeks of the retreat. And what a good decision that was!

So on 25 June I found myself standing in a very long check-in queue at Gatwick. My leg hurt like hell. Someone kindly volunteered to move my bag each time the queue moved. The check-in guy arranged "assistance" which came in the form of a sort of golf buggy to drive me to the boarding gate.

The crutches were x-ray'd, the fixator frame was sniffed and swabbed, and I was searched more thoroughly than a wide-eyed fast-talking Columbian with diamonds on the soles of his shoes.

At Faro the chief trolly lady kindly arranged for a hydraulic lift to lower me out of the aircraft... There was a very surreal moment as a face appears at the aircraft window 10 meters up in the air and someone knocks to say "open the door". I was then treated to a fast track route through passports and customs, only to have to wait long-long-time for my bag. Notably, it was the first time in 6 months that I have been in a real wheelchair.
What fun!  Weeeeee....!  Hand-brake turns are wicked.


What can I say about the next two weeks? Excellent food, great company, hot dry weather, a selection of 3 swimming pools, and 2 sessions of yoga every day. The accommodation was nice and comfortable, and the orchards supplied fresh fruit daily. But look, a picture says more than words, so pause for a moment, sit back and watch my holiday pics slideshow:-

Slideshow... 

Amongst other events, two strange things happened. Well, strange for me anyway. I have arrived home with a bit of a flutter, and I miss the people very much.
Maybe I'll add some more details later. Suffice to say that prior to the holiday I'd pretty much given up on dating. Just wasn't interested. I don't know if it was the stress of The Leg, the side effects of the painkillers, previous girlfriend, or just that I'm not as young as I was. Whatever... By the time I got back home I found myself absolutely gagging to find a girlfriend again. It's deep down with a nearly painful aching need. I feel like a teenager again.

Measuring Progress

One of the problems with slow recuperation is that it is difficult to perceive progress. Every day seems the same as the last. You are actually getting a tiny bit better but you can't see it unless you make a mark somehow, and then check how far you have come a few weeks later.

I recently realised that yoga has provided a means of measuring progress The postures are the same day after day, but with each class I have been able to see some sort of change. Once the change was negative, but then a few days later I reached a new high point.

I'm writing this from Portugal on a two week yoga retreat. The weather is roastingly hot. The group has been superbly supportive, helping me in the airport, and fetching and carrying my food and drink at mealtimes. Some of them find the sight of the frame quite unpleasant.

Twice a day we gather on our mats and go through the same routine. Twice a day I try to push the depth a little further, and am rewarded by tiny achievements. On day one, Saturday, there was a massive change. I stood on the the broken leg, all of my weight! Since then I have been making significant improvements and the objectives have been tumbling one after the other. I can now walk without the crutches. Well, to be fair, the crutches are still in my hands, ready for instant use, and the steps are tiny and slow, but it is walking. Mentally I feel like I could just step off and stride away. The physical reality is a bit more limited.

Standing Tree, on the last day of the holiday

The White Rabbit

Alice drank a potion, and her world suddenly changed, she became small. The invalid has a similar change; their world shrinks.

One day you need a nice shiny TV, high quality sound from your Hifi, knife foek and spoon, the right glass, a nice car, a clean and tidy house, lots of clothes, a range of shoes that compliment your outfit, a broad and varied diet... What things look like is important.

The next day you need food, any food that is easy to buy, store, and prepare. You need a simple radio that will keep you in touch with the world and if you are lucky, play music that you like. You need plastic containers to carry your food, and you can eat with your fingers and drink from the bottle. You need a small stack of t-shirts, shorts, and underwear next to your bed so that you can dress with a minimum of problems. Your house becomes a corridor of stuff which has been left near to where it might be needed, or where it was last needed, and no longer put away in cupboards or on shelves. You need a urinal bottle by the bed. You have 1 pair of trainers that are easy to wear, and sandals for warm days. You need a bag to carry anything. And that's all.

Your world has shrunk.

Life without Gabapentin

...is so much happier. It seems that many painkillers have some sort of depressive effect, even if it is just to trash your libido, but Gabapentin brings you down. It makes you negative, slow, forgetful, and all those other things that are bad for recuperation. 

My advice is to get off it just as soon as you can stand the additional pain. The grass is greener on this side of the fence.

An Exogen Machine

This sounds like a serious device doesn't it?

The Exogen is simply an ultrasound generator with some fancy electronics to control its use. For example, it is set for a 20 minute period of use only. It can tell whether or not it is attached to a body, and if not, it switches off. It counts how many uses it has had, so that the transducer can be replaced when its life is ended.

There's a velcro band which is strapped around the broken limb, and the transducer fits into a pocket in the strap. The transducer face is lubricated with a coupling gel so that the ultrasound waves are carried into the body.

The theory is that the ultrasound encourages the growth of capillaries in the area of the fracture, and so results in a greater supply of blood to the site of healing.  Apparently it's possible to get a 20% improvement in healing time.  The device is very expensive, and is intended for one user only. The doctors will generally offer the device to people with fractures they fear may not join, or may join slowly.

Thinking

I think a lot these days. 

...What am I doing? 

...How can I make things count? 

The answer seems to be just out of reach, on the tip of my tongue, as if I just thought of it but have momentarily forgotten. 

Take this to A&E

These weird experiences get weirder by the day.

A week ago I started to get a pain in my chest. Not too bad, just a sort of stitch. By Thursday it was fairly severe and I decided to go to the doctor. Naturally, they can't fit me in until 5pm, so by 5:10 I am explaining the problem to the Doc'.

He checks the result of the cholesterol test I had earlier this week. I score 5.7, not bad but just a touch higher than good. So then I get a lecture about reducing cholesterol by good diet. Imagine this; a man so fat that he spills over the chair, so large that he never actually lifts or shifts in his seat (there's no space), with a belly that M.Creosote's younger brother would be proud of, explaining that I should eat white meat not red, skip the butter and cream... In fact, in a few short moments he recommended to me my current diet. I find myself checking to see if my belt has another hole in it in case I get any thinner. It doesn't.

He seems to keep his paper stock in a cupboard under his desk. He tries to find a blank sheet of paper. He could not reach down into the cupboard, could not tidy the jumbled mess of paper. He cannot bend his body over the mass of blubber that passes for a waistline. Eventually he extracted a slightly crumpled sheet and carefully writes a short letter.

"Take this to A&E."

So I get a cab and go to St George's. The driver took a very strange route. It made me wonder that if this was a real emergency, how would I handle a driver with no sense of direction and no knowledge of traffc levels at 6pm on a London Friday?

Eventually I was called in to a triage room. The nurse told me to take off my T-shirt, and I'm a little taken aback at the reaction to the sight of my chest. While the electrodes are being stuck to my body, I am treated to a few suggestions that the ladies might prefer it if I were "trimmed" a bit. I respond by saying that some girls seem to like running their fingers through the hair, and am then told that it is very long. Suddenly I realise that the nurse might be taking a bit of a fancy to me. Makes me chuckle. He's right out of luck!

The ECG shows that I am not having a heart attack, so the next stage is to get an X-ray. Luckily, there's nothing unexpected on the picture, but I am surprised at the quality and detail. I like the look of my ribs. 

Time to take blood. After several phials of the red stuff are extracted (I'm sure the needles don't hurt as much these days) I am consigned to a row of seats to wait for the test results. They are going to check for infections, clots, etc, etc.

And so I meet strange bloke.

We probably talked for an hour or more. He was a weird one, the sort of guy you hear talking for a moment, and then quickly avoid. He'd had cancer, a malignant melnoma. It just started with a mole on the sole, but by the time they had finished he had skin grafts and lymph nodes removed. Like me, he was amazed at how many different types of pain there are. But that night he was just accompanying his mother. She has serious dimentia.

As we talked I realised he was always focusing on the positive side. I was acutely conscious of my immediate but unspoken answer to everything he said; for every positive statement I seemed to have a negative response. I learned a lesson that night, but I didn't use the phone number he gave me.

And after about 3-4 hours they said "Go home. You're OK".

Yoga

So what does yoga do?

For me, it provides an objective to aim for. Every day, I have to follow a routine which gets me to the studio and then challenges me to do something physical and difficult. I also happen to get to meet people and to talk.

Without this discipline, I might go mad.

An Olive

The olive wire came out today. This is not a reference to the sexual preferences of Popeye's wife.

The loose segment of bone was tied into place by the olive wire during the second operation in early February. The blob of metal soldered onto the wire pressed up against the bone and preventing it moving any further out of alignment. It was extremely painful! The olive has to press against the sensitive sheath that surrounds the bone, and until that erodes it is like a nail in the leg.

So at this week's clinic, Debbie unbolted the complex structure that was holding the wire in place. It seems so odd getting the tool-kit out when you're doing something medical... After donning the rubber gloves she prepared a dish of iodine and wash, cotton pads etc. She soaked the wire cutters in the iodine and then prep'd the leg.

She carefully snipped off one end of the olive wire, then clamped the snips onto the other end and yanked it out! I really wasn't ready. I have got used to pain, but to have the olive pulled straight out and burst through the skin without warning was a fairly extreme experience. I was not very thankful.

On the good side, the x-ray shots show the callus forming. Last week Naveen had mentioned that I might need a bone graft. We'd been discussing the previous x-rays and the fact that Mr Lahoti wanted to get a clearer view of the gap between the bones. Naveen thought this might be to understand "the timing for the bone graft".  So by this week I had settled myself to the likelihood of another operation.

The size of the callus shows that it is extremely unlikely that a bone graft will be needed. So I am thankful, breathing a gasp of relief.

Soon

There will be a day soon, when I walk down the street and people do not look at me as if I have walked out of a B-movie. The look of horror and pain on people's faces is extraordinary.

Some of them ask what happened.

Only one person has ever asked if I needed a lift. That was today, over four months since I came out of hospital. It turns out that he had a similar problem some time ago, and as he put it, he "could feel it".

Confused and disorganised.

This has been a weird week.

I went to the clinic last Wednesday, and for the second week in succession the whole place was pandemonium. There were lots of people hopping around on frames, and so little being done. Mr Lahoti was away, and so was Debbie.

I was seen by Naveen who decided that an x-ray was not necessary. He looked at the x-ray taken 2 weeks ago and talked about the possibility of removing the middle wire next week. We talked about painkillers and suggested i reduce the Gabapentin to 2 x 300mg per day.

I got some more prescriptions for antibiotics and gababentin, but all in all, I felt like I'd just wasted half a day.

I skipped the afternoon dose of Gabapentin and went to yoga. By late evening I was in severe pain. I decided to go back to the usual dose.

I can't remember what happened on Thursday. there's nothing in my calendar except "yoga 6 pm". I must have been working on Mum's accounts. I think I noticed increased pain at yoga.

Friday: It's not everyday that there is a royal wedding. It was a purposeless day for me, with no one actually doing much. I woke up very early. I was definitely feeling more pain in the leg and took it easy at yoga. The leg felt strange, loose, and the fracture felt as if was moving. I felt odd, aimless. I'm having lots of short term memory lapses. At about this time I suspected that I had got confused about the drug regime. I couldn't remember what drugs I had taken or when.

Saturday: Disorganised? Again no memory of what I did. Still more pain though. I think it was Saturday when I thought that I should get more antibiotic; maybe the pain was an infection. The sensation of movement in the fracture was increasing. Again I was confused about the painkillers routine. I forgot to take my water bottle and codeine to yoga. More memory problems! I decided I was tired and took some melatonin at night to help me sleep.

Sunday. I asked Pete to come and help me move the VW. He said he would be there at 12:00 but urned up at 13:30. He said how tired I looked. I told him i'd been sleeping badly due to the pain. We used jump leads to start the van, and I drove it to the other side of the road. He drove me into Balham to get antibiotics but the chemist had run out and the other chemist was shut. I took more melatonin in the evening and went to bed early.

Monday. Woke up several times, and eventually got out of bed at about 10:30. I hate it when I do that. I felt disorganised and confused all day. Still in pain. Bin Laden has been killed. I watched too much news, put the battery charger on the VW, cleared piles of old receipts, then decided to walk into Balham. I wrote an email to guy at the office who has had a similar accident and has a TSF too. I read the email later and thought how disjointed and odd it seemed. It was as if I had not been the writer. I didn't check the yoga timetable and so discovered too late that the evening classes had been cancelled. Why didn't I see that coming? I should have known because it's a public holiday. Stupid. And why didn't I try to get the antibiotics?

Tuesday. Woke up at about 5 a.m. And couldn't sleep. my mind is rambling around the last week. I don't like the sense of disorganisation and confusion. I'm wondering if the Gabapentin is causing problems. The latest prescription was a different brand than the previous type. Or is it the codeine? I've taking more because of the pain. I've never noticed any effect of codeine before, except pain reduction. Should I be getting antibiotics? The pain as stabilised, and maybe even reduced except for brief moments.

Crutches

Several weeks ago I began suffering from severe pain in my right wrist. When I visited the KCH clinic I was given a "comfy crutch". The only problem was that the new crutch couldn't be extended as far as the old basic crutch. The physio shortened the old crutch to match the new crutch length and told me that it was now the correct length.

We then went through some walking exercises. The aim was to get me to walk with straight legs, left right left right, instead of buckling at the knee. It was very painful. One problem was that when I tried to flex the ankle, it became extremely painful. Another issue was that I would stoop and use my shoulder strength to try to lift myself over the unbending ankle. The third problem was that if I didn't lift myself through or buckle at the knee then my hips would bend to shorten my body.

I tried to put the walking exercise into practice for a few days but found it either impossible or too painful. Eventually I gave up.

I then attended a Physio appointment at St Georges. There was no actual treatment but instead some assessment of my abilities. I questioned the mismatched crutches. The physio said the handle should be next to my wrist bone. It wasn't. It was 1-2 inches lower.

A few days later I suddenly realised that I could probably buy my own crutches. A few minutes of browsing and I had ordered a new pair of crutches from Amazon.

As with everything related to health and care, the crutches took an age to be delivered. Debenams and Next both delivered other stuff far quicker despite the orders placed on the same day.

Eventually the two new comfy crutches arrived. I set them up using the old crutches as a guide, but was so disappointed tho discover they were no better.

For a week I soldiered on. Then, today, I happened to pick up the olde crutch and compare it with the new crutch, only to discover that they were set to the same height. I re-adjusted the new crutches and tested them. I found that I could swing my leg through properly without lifting up on the crutches, and could land on my heel, rolling forward onto the toe. Fantastic! I still found that I rotated around the right hip, but it was so much better.

A few hours later I decided to go for a walk. I needed to post a cheque, so why not? By the time I'd reached the post box I wanted to go further. About an hour later I had done a full half mile walk. Ok, so I was overtaken by a troop of marauding ants, two racing worms and a GTI snail, but it was a proper left right left right walk. I was so pleased I gave myself a beer.

Clinic

More X-Rays of course. But more important right now is the pain in my wrist. Helen the physio gave me a comfy crutch to spread the load.  It made me wonder why they don't issue these as standard for those people who will spend several months on them.

The next check-up should be in 4 weeks time. In that time I have somehow got to learn to walk again. The problem is that the ankle doesn't bend very well, and so it's almost impossible to put weight on the leg and move over it without putting huge bending pressure on the ankle, which causes pain up the front of the shin.

I've now been given an Exogen machine. I am to use it for 20 minutes every day. These things cost a heck of a lot of money, and for some reason have a very limited lifespan.

House Arrest

As I went to bed last night, I realised that I had not actually spoken to another human being all day. And then I realised that the only person I had seen was a neighbour working in her kitchen.

Lots of pain today. The biggest problem is my right wrist which seems to be suffering from too much weight bearing. I can't use the crutch properly anymore, just little hops of 6-12 inches. Codeine helps.

Morale

I now think I should have been keeping a tracker of morale.

I am really quite surprised at how low my (whatever) has dropped over the last few days.

Last Adjustments ... I hope

Today is the last day on which I should have to adjust the frame.  Hooray. 

The last few days have been more painful than usual. I assume that the bones are making contact and that pain is the result.

Once again I am a little concerned that I have been told to skip the weekly clinic. Surely, if something was wrong about the way it has been adjusted, then we should find out on the last day of adjustments and not in a week's time when the problem has had to time to settle in, like last time.

Strange

There are moments when I stop and can't move on.

I think they happen most when the pain has been minimal, I've been sitting comfortably, and distracted by normality. And then I have to get up and do something, i stumble or bang my frame, and suddenly the whole weight of the situation lands heavily. For a short while it is impossible to push things into th bacground.

the normal future seems a long way away, and I have to admit to what' real. I've got a le full of metal pins, I can't walk, I can't see what the builders are doing in the loft, I can't look for a girlfriend

The future seem a long time away.

A quiet week

Not too bad.

That sums it up.

I got some good sleep this week, only waking 2-3 times during the nights. I take 30mg of Codeine just before sleeping, then again if I wake up due to pain. One night I managed 5 hours of uninterrupted sleep. The strange thing is that I now have to sleep in a different position. I use a recovery position with the broken leg on top and the good leg straight. I've stopped raising the leg at night. It was more painful than lying flat.

Yoga has been good. I put far more weight onto the leg after every session. Today I also hobbled back home rather than taking a cab.

Maz gave me a lift to Beach's flat where we sat around discussing broken legs, autism, and buttering toast right to the edges.

Xray shots show the gap between the ends of the bones getting smaller.

Time

Time.

Time x pain = ?

After 11 weeks of pain I am becoming desperate.

Imagine if you will, someone stuck a needle in your leg and left it there. When you move, it hurts. Sometimes it hurts even if you don't move.

Now multiply that by 10. Imagine you have 10 needles in your leg, and four of them are 5mm thick. They all hurt like the first one.

Now imagine that the thinner of those pins all have inflamed boils or spots on them, and that they are incredibly sensitive. Any contact is very sore.

Now put a vice on your leg and clamp it so tight the you can feel the bone stress.

Finally add a pain that you will not know unless you've broken a bone. It's a sharp fiery sort of pain deep in your leg. You can't quite work out where it is located. It pulses with your heartbeat. It is strong enough to make you wince every now and again.

When the pain is at its worst you can't think. You just sit and stare, blankly unaware of things going on or what people are saying to you,

Now imagine that pain being present to varying degrees, 24 hours a day, every day for 11 weeks.

Week 11 - Leg Shortening

After a week of lengthening the leg, last week's X-rays showed that the upper part of the shin was well clear of the loose segment. The adjustments were all about moving the upper shin across the top of the segment.

Today the X-ray pics show that the ends are fairly well aligned. Week 11 will be all about shortening the leg to bring the ends together. 

Broken bones do not heal well if the gap is too big. Ideally the bones are in contact. We are now dropping the upper shin onto the top of loose segment to make contact and make the healing process quicker.

The lower part of the break is now showing signs of calcium deposits appearing in a mist around the break.  That's really good news. However, we can't see anything appearing around the upper break, though there is a mist in between the broken ends...

I'm worried about a strange thin line running down the shin bone. To me, it looks every bit like a hairline fracture! What is it?

There are also signs of calcium loss around one of the upper pins. "Nothing to worry about yet" was the verdict. Well that depends on whose leg it is I suppose.  If the loss becomes excessive, they take the pin out and move it to a new location. I could end up with a leg that looks like Swiss cheese. 

  

Drugs

Drugs...

I've been taking antibiotics for about 10 weeks now. (Flucloxacillin).  The leg is still weeping a clear yellow liquid which I assume to be lymph fluid. There is no opaque pus. The stabbing pain in the old empty pin site has stopped. I've stopped taking the Flucloxacillin.

They've given me a new pain killer; Gabapentin. This works on the nerve endings, not the neurons that carry the pain signal or the areas of the brain that interpret the pain signal. I wish I'd known that sooner! I was given a prescription for Gabapentin two weeks ago and avoided getting it because I am sick of taking painkillers.

Many painkillers slow the processes in the colon, will the result being a severe bunging effect. Luckily, most antibiotics have the reverse effect and so cancel the problem out. I suffered constipation very badly a little while ago; not a simple lack of movement, but instead an intense pressure as the upper part of the colon pushed, only to be met with an immovable lower colon. Imagine that you have desperate need for a bowel movement, so strong that you are running/waddling to the toilet, but you just can't go. It's painful.  However, one bag of prunes later, and the problem was sorted.  The effect took only 15 minutes to initiate, and lasted about 4 hours!  What a sense of relief!

So faced with a third painkiller, you can imagine my reluctance.

However, the leg pain became intolerable. Elevating the leg relieved the pain of swelling and strain around the pins and wires, but introduced a new sharp pain on the bone.  I couldn't sleep. I'd prop the leg up on a pillow as normal, and within 5 minutes I'd have to hang it over the side of the bed. Minutes later I'd put it back on the pillow.

I took the first Gabapentin on the Thursday evening, and suffered less pain. On Friday the dose increased to two capsules (the dose has to be increased slowly) with one taken at night. I was amazed and surprised to wake up at 6 a.m. and realise that I'd slept 7 hours with only one brief period awake in the middle of the night. I took the first Gabapentin of the day and drifted back to sleep. I was woken by Maz calling on the phone at 11 a.m. !!  I'd slept almost 12 hours.

Fantastic!

Week 10

Just back from the clinic...

The plan is to leave the tilted bone segment where it is and let the leg heal.  There will always be a large lump on my shin. But I'm sick of the pain and immobility. I am now prepared to put up with a degree of disfigurement.

We've been moving it for 10 weeks now. The fracture should be in the middle of the soft callus phase and it's probably becoming difficult to move the segment by hand. The leg will still be mechanically straight and strong which is what counts.

I have been given another week of adjustments to make, in which the two ends are to be realigned by about 5 degrees. 

But I don't really get it. The more I think about what they are doing with my leg, the more baffled I become. 


Two weeks ago I had an operation in which they intended to straighten the tilted segment of shin.  The fact that they used a beaded wire and the way the pin and wire sites were forcefully re-opened seems to confirm that. But that part of the op failed, and the consultant said something about the bone or leg being too strong.

A week after the op we took some more x-rays and the they gave me a new set of adjustments to stretch the leg by 8mm. My understanding last week was that they would then push the bone back into place and then we would shorten the leg.

However, this week the plan seems to have changed. There is now no intention of correcting the tilted bone. The senior consultant tells me that if we adjust it then we may cut off the blood supply and the separated chunk of bone could die.

But by separating the upper part of the shin from the loose segment we will extend the time it takes to heal. So why did we bother separating it? And why don’t we shorten it and put it back?

Each time these guys make a decision and set me on a particular course, it all sounds very logical, but in the end it seems to be a mistake. 


I’m very concerned.

Post Op, the results

Today's x-rays show that last weeks operation was not hugely successful.

On the good side, a new pin was fitted, and the old infected pin was removed. That hole now has a rather unpleasant mess at skin level, but the aim is to let the infection out as the soft tissue closes up.

The main aim of the operation was to move and stabilise the large chunk of shin bone that was forced out of alignment by the last set of adjustments.  A hole was drilled through the piece of loose tibia and a new wire was threaded through. There's a bead fixed to the wire, and when the wire is pulled through, the bead locks against the bone. The surgeon should then have been able to pull on the wire whilst an assistant stretched the leg and so manoeuvre the bone into position. It seems that the bone was stuck and the attempt failed.  Given the amount of metalwork already on the leg, it was not possible to get the wire to the ideal position.

We are now going to stretch the leg by 8mm by lengthening each of the struts by 1mm per day. The aim is to move the upper shin-bone out of the way so that the loose piece is then moved back into the correct position by the surrounding soft tissue.

I'm worried that the wire will hold the bone in the wrong position, even if it the upper shin-bone releases it. I think the wire will have to be released first, and that this will involve another visit to the theatre.

Two of the struts needed to be changed for longer versions in order to get the extra 8mm. This is done by inserting a temporary strut to hold the frame in position, then swapping the short struts with longer struts, and then removing the temporary one.

When the second strut went into place, for some reason the consultant could not get the new strut to the correct length, and it is 4mm short of where it should be. The next half hour was incredibly painful. I have to get that 4mm back as quickly as possible tonight. Maybe 1mm per hour?

Where does the pain come from? The bone itself does not have any nerves... Apparently there is a close fitting sheath attached to the outside of the bone, and this has a nerve supply. When the bone breaks, the sheath can pull away from the bone, and then obviously any contact with it will cause pain. Believe me. it ******* hurts!

Is Aviva the worst insurance company in the country?

The only reason I'm insured with Aviva is because there is almost no alternative in the world of motorbike insurance. Any other company asks for far more money. I know this fact, and yet I still insured myself with Aviva because I was prepared to take the risk that I would have to pay for repairs, and I have medical insurance.

Aviva are rubbish:-

• When my neighbour's car caught fire and burned mine, Aviva would not pay his claim because it was a "mechanical fault", so I had to claim against my insurance at a cost to my no-claims bonus.
• When an Audi TT pulled across in front of me and I claimed for damages to my bike, they lost the claim, then were unable to trace the other car owner, then eventually offered me £35 which was less than the cost of my no-claims bonus. I turned it down and paid for the repairs myself.
• Try phoning them. "Press 5 for 52 more options, and speak to someone in Little Bombay who can just about read a script but doesn't understand what you are telling them."
• ...I had several other unfortunate dealings with Aviva, and so it goes on.  Every time I come across Aviva they refuse to pay or else offer a ridiculous settlement.  Even their pension plan actually LOST money last year. (Yes, I'm moving my money out.) 

So now, it is over 7 weeks since the accident, and they have done nothing about my motorbike. First they tell me not to get the repairs done because they may want to inspect the damage. Then they demand estimates etc from me (which I sent), then they wrote to me to say they have closed the claim. The lawyer wrote to them telling them that the claim is still open. And at long last they have decided to inspect the bike to check the estimate.

Today they have asked me to send a sketch of the accident with names of people and registration numbers of vehicles. ... SEVEN weeks after the accident?

I tried to call them. A recorded message tells me that they seem to be having technical problems and cannot connect my call. I should "call back in an hour" by which time they will be closed for the day.

If you ever hope to be properly insured, do not use Aviva. They are only a useful service if all you want to do is tell the DVLC that you have insurance so that you can get a tax disc. But they will never be of any use to you as an insurer.

Operation 2

Thursday, very early... I set two alarms last night to make sure I get up and have a hearty breakfast. I'm supposed to finish eating by 07:00, and then it's "nil by mouth". I realise that the clothes I intended to wash the previous night have not been washed but I need them in hospital, so I put them on a speed-wash cycle and go back to bed.
I get up again at nine, hang the clothes over the radiator to dry, and absentmindedly have a cup of tea. Ooops.


I arrive at the hospital at lunch time and am shown straight to my room. The next 2 hours is spent answering questions about the drug regime, my health, my "current worries", next of kin, etc. The nurse measures my leg and gets a stocking that should prevent thrombosis. Sexy. Erm not.  The nurse covers me me in ECG patches (she shaves me to enable them to stick) and then prints off 3 or 4 sheets of ECG report. She seems happy, I still have only one heart. The sticky bits are removed. Ouch. Ouch. Ouch.


I do some work on a project plan whilst I wait. Then someone knocks and says they've come to take me to theatre. On with the gown and off with the undies. More sticky patches are attached for the monitors.
It feels strange to be carted around in a bed when I could easily get there faster on crutches. Still nervous, still frightened of a repeat of the last time.


The anaesthetist checks my tag and ask asks me my name and date of birth. A junior consultant marks an arrow on my leg, pointing at the frame. This time the canala goes in first time and something cold is pumped into my arm. He asks me about the drug regime and then injects some antibiotic.
"You should be feeling more relaxed now."  No chance. Nervous as hell.
A mask goes over my nose, I adjust it, he says "thanks" and suddenly the lights are brighter, I am in a different room and agony is coming from my leg.


I call for help, someone comes over and tells me it's ok. Huh? "Painkillers! Please!"
"Carlos" and I then go through a cycle of injecting morphine, waiting, then injecting more until I can tolerate the pain and tell him to stop.

Another bed is wheeled in beside me, containing a women who moves briefly, but then lies quietly. Somewhere behind me another bed is wheeled out with it's sleeping passenger.


We spend 15 minutes watching the monitors until Carlos is satisfied, and he leaves for the day. My trainee  nurse arrives and then it's my turn to be wheeled out.


Back at the ward the nurse sorts out the drip and monitor. I try to hold a conversation but my memory is shot. She keeps reminding me to breathe. "Don't forget to breathe." She stays for a long time and keeps me awake.
I ask for food, and someone has kept a sandwich for me. That's nice. Two bits of Mothers Paste white bread with a slice of ham which is oddly exactly the same outline as the bread. Not so nice. I eat a bit, and drink some water.

I worried about water retention again, I don't want another catheter, so I ask for urinal bottles. But I just can't pee lying down. I have to get up. The nurse helps me swing my legs over the side of the bed and I stand very gingerly, dizzy dizzy dizzy. After 5 minutes of standing holding a bottle I manage to dribble, and I get back into bed. Really dizzy.

Eventually I'm sick, vomiting harder than I can remember ever before. But it feels better.

And eventually the lid is cracked and the urine begins to flow. I heave a sigh of relief. This is a major target in getting home quickly, they won't let me out until I can pee properly. If you ever find yourself in bed after an operation, pee as much as you can at every opportunity!

Weirdly I don't need my glasses to see the TV. I've temporarily gone non-short sighted. I have no idea what time it is, so eventually I realise that the TV programmes have reached an intellectual level which will interest rodents an so it must be time to sleep.

Friday morning;  Full breakfast with tea. I'm starving and surprise myself by eating every crumb and morsel as if I had been starved for 24 hours.

A very pleasant Physio called Jo comes to inspect my leg. I'm sure I've seen her face before. She thinks maybe so too, but we can't place it. She puts rubber gloves on before touching my foot.   Is it that bad? She takes me for a crutch walk along the corridor and after a few tips on how to walk says "OK, I'm discharging you."
I'm somewhat taken aback. Already? I can go?  Yes. We just need the drugs, the paperwork etc.

The troop of doctors and consultants arrive immediately afterwards. There are lots of smiles and jokes. Yes, I can go home.  :-)

About 5 hours later we manage to get a supply of antibiotics, a letter saying that I'm free, and a cab booked to take me home. It's a really painful ride, but I'm happy to be out.

Going back in...

Going back in for another op. They're going to move one of the pins (the pin site refuses to heal) and manipulate the lump of bone that has become dislodged.

If all goes well this will be a quick turnaround but given my previous experience I'm still worried. At least this time I will have the opportunity to take essentials with me and will not have to put up with having nothing to wear except an arse revealing hospital gown.

Increasingly Worried

It's been a painful day.
If the team had arranged to have the leg checked every week, rather than sending me off for a full fortnight of adjustments, we would have spotted the current problem a week earlier and the solution would have been decided upon immediately.
If the consultant had been available at the clinic last week then the decision would have been made 5 days ago.
If we count from the first day of the adjustments which caused the problem (the painful day) it has now been 20 days since the pain started. It's been 13 days since we should have discovered the problem. It's been 6 days since we knew about it. It's 6 and a half weeks since the surgery, and one of the pin sites is still bleeding and seeping clear yellow liquid.
And yet nothing has been done.
I was expecting a call from the hospital today, but have heard nothing. I emailed them to ask if it had been discussed, or if there was a plan. There was no reply.
This is my leg. It's my future. I am worried.

Two weeks forward, 4 weeks back

Here's a little game for you. One of the two X-rays below was taken two weeks ago, and one was taken today.

Which is which?

You would be forgiven for thinking that the left hand picture was today and the right hand two weeks ago. Unfortunately you would be wrong.  The clue is in the head of the bone near the two bolts.  Today's picture shows that the vertical split has almost healed. The bad news is 2/3rds of the way down the bone.

The series of adjustments that were started two weeks ago were intended to align the bone as seen from the front. (The lateral alignment had already been done, and is still good.) However, it appears that moving the top half of the bone laterally across the bottom half, it has opened up the fracture which was an inch or so below the main area of breakage. You can just see the break above the bolt in this picture below.

That thin line is now a major gap.

So what do we do now? The options are probably;-

1. Reverse the adjustments and hope that the bone goes back to its previous position and leave it. Or maybe stretch the leg and adjust again, hoping that this time the bones won't touch until dropped back into place. The problem is that new bone is now growing, and it may be difficult to get a leg of the original length without operating.

2. Go for another operation, and manipulate the errant bit of bone back into place. They would loosen the struts, reposition, and then reassemble. They might fit another wire through the large loose section of tibia. Given my previous experiences, I'm really not keen on having another operation.

The consultants will discuss this over the weekend, and I am expecting a call to visit the hospital on Monday.