Tuesday, 25 January 2011

Rehab week 2

It's nearly a week after visiting Joe my physiotherapist and there is nothing much to report because I've done virtually nothing. I have a bed set up in the middle of my living room with everything I need to hand and with the help of my wife, daughter and son I can stay comfortable but more importantly I have control of the remote of my Sky+, a real bonus. I have a ton of Star Trek episodes amongst over things as well as the Tour Down Under to watch so for most of the time I'm not bored.

I did actually manage to go out last Saturday for the North Cheshire Clarions first annual awards dinner and that was only achievable because I've mastered the art of swivelling on my good leg to get from the wheelchair into the car seat and out again. I'm glad I made the effort as it was a great evening with great company. We had a 'Sportsmans' meal which I think means a menu with only 2 or 3 choices for each course and that worked out just right, next we had a very interesting speech from Denise Hampson who is a recent past member of the team GB track team, next the club awards one of which I received, then a raffle, then another speech from Ian Clark who talked mostly about the history of the Clarion and then a disco which of course was not for me. What got to me about the whole evening was the clapping and cheering I received when I was wheeled in from the 70+ people there, highly unexpected but very moving I can tell you. After an hour though the pain started to get to me, sat in the wheelchair I was sitting on all the bruising and no matter how much I shifted around the pain wouldn't go away but I managed 3 hours or until 11:30 pm before we set off for home.

This week I'm having a lot of pain mostly in my elbow, every night I'm woken up by this pain, I think the reason is that if my arm is static for an extended period of time it gets very stiff and starts to throb, I've been given strong co-codamols for the pain but I'm reluctant to take them as they give me bad nightmares which result in me jerking awake with my arms and legs flying everywhere and believe me that hurts, really hurts.

Another problem I'm having occurs during one of the exercises I've been given for my elbow in where I have to bend my elbow to 90' and rotate my wrist is that at midpoint rotation there is an audible click accompanied by a sharp stab of pain in my elbow. I don't know what it is, I can only guess, could it be the excess of bone protruding from my broken Radius catching on my Ulna or possibly even that the break is not healed and I'm just making it worse. A question to ask Joe next time I see her.

My leg is doing OK, virtually no pain except at night, I have a lot more strength and am able to move it around with the exception of moving my leg inwards towards the other - it's still weak. When I was getting ready to go out for last Saturdays dinner I momentarily forgot and stood on my bad leg resulting in an immediate jolt of pain, I'm 3 weeks post break and in another 3 weeks I'm expected to walk, I'm worried, I really am, I would have thought that by now I would have at least managed to put some weight on it without loads of pain.

So that's it for now, this is where I'm up to...

Thursday, 20 January 2011


I'm back at home now and have set out on a journey along a road called rehab. It's a long road that will take me many weeks if not years to traverse. When I was in hospital I had been given a few exercise to do within the confines of my bed which I have described in a previous blog entry and mostly for my leg, the result being that my leg has near full range of motion but virtually no strength. The strength exercises will come once I've been given the go-ahead to do them but first my body will need to learn to walk properly again. 6 weeks is a long time to be bed-bound resulting in a lot of muscle wastage so I will have a lot of work to do once the 6 weeks are up.

Last week when I first saw my x-rays I also had the half cast on my arm removed. As she was cutting the cast off I was a little nervous thinking that I will have a noodle for an arm and it's going to hurt whenever my arm is moved but I was pleasantly surprised that my arm was quite normal. Yes it was/is very weak and hurt with any quick sudden movements, it was also very stiff with only a few inches of movement but over the next few days it did loosen up a little to allow me to pat myself on the head and stretching it out the other way nearly open it out fully but not quite.

A few days ago on Tuesday 18th January I had another follow up hospital appointment with more x-rays where it was spotted that along with the now fixed multiple breaks along my Ulna bone there was a hairline crack at the very end of my Radius bone and that answers the question as to why it is so painful to rotate my arm. It is decided to let it heal naturally, no more surgery.

The next day Wednesday 19th, I have my first rehab clinic at Halton hospital where I'm assessed for my arm. Joe who is dealing with my case is happy with the range of motion I have already but there is scope for more just as long as I get started right now on the prescribed exercises she gives me. She explains that my limited rotation is due to this hairline crack at the very end of my radius. The end of the radius rotates in a channel in the ulna and she explained that in the healing process the body over calcifies and produces more new bone than needed in other words the new bone overflows the break and gets in the way of rotation - it's catching on my ulna as it rotates. The only way to limit this is to keep rotating my lower arm and this should wear the soft new bone away so that rotation is possible but I need to do it now or else i will lose some rotation. Joe gives me a few exercises to do and sends me on my way so it's all up to me now to keep up with the exercises.

So that's where I'm up to right now.

What amazes me about this broken bone business is just how quickly I was out of plaster. I had envisioned my leg and arm being held prisoner by a ton of the stuff for months to come however the only evidence of a broken bone on my leg is a 7 inch zipper like scar and a lot of swelling and bruising that is diminishing day by day, no plaster and no immobilisation of any sort and I was out of plaster in under 2 weeks with my arm and only a 5 inch scar and bruising as evidence of trauma. Amazing stuff...

Sunday, 16 January 2011

Oh dear, what I have I done now - part 2

It's the morning after now, Monday morning, bank holiday Monday the day before I'm due back in work and I'm on my back with my left arm in a half cast and my left leg immobile and unmovable with lightning bolts of pain shooting up at the slightest of movements. I have had 2 more cannula's inserted into my right arm, it's a good job I'm a skinny git with veins like railway tracks, it makes the whole job of taking blood and inserting cannula's so much easier and less painful.

A physio pays me a visit with a little plastic disc and shows me a few exercises she wants me to do. Stick it under my heel and move my leg around on the bed, draw my knees up as far as I can towards my stomach, extend it back so it's flat again, push my leg out to the edge of the bed, bring it back to the other leg, all easier demonstrated than done as the pain only allows me to move it a couple of inches either way and not at all back towards my other leg, I could move my leg out towards the edge of the bed very slowly for a couple of inches but no way could I move it back in again...

The pain is continuous, I'm off the vein fed morphine and on the oral morphine which IMO is no-where near as good, I'm lying on my back for hours at a time in-between visitors giving me plenty of thinking time, negative thoughts such as will I walk again, will I regain the use of my left arm and will I ever get back on a bike again? walk and use my arm, yes I'm sure I will but it will take time, but will I ever get back on a bike? That's not so clear cut, everyone is so positive about getting me back on the bike, my wife brings me cycling mags, she dismisses my thoughts of ditching the bike, shes already washed all my cycling gear I was wearing on the day of the fall but I'm not so positive, what if I fall again, I'm not wanting to go through all this again it's just not worth it. My back is glued to the bed and I can't move, I'm itchy and uncomfortable, all I want to do is get some fresh air on my back and I can't even sit up, I'm getting a little panicky letting it all get to me but thank goodness for for my wife my mother and son Adam who visit me twice a day taking my mind of my predicament for hours at a time and guys from the club who visited over the week, Giles, John, Geoff, Ste, Phil, Martin and Jim with his big bottle of Malt and of course theres Racheal my daughter who helped with the wee bottles once I was home.

I'm still unsure as to what's been done to me but then my consultant who is also my surgeon visits me and informs me that my elbow was shattered, that he's put lots of metal work in to hold it all together and that he did a good job, some bone is missing but it will regrow; my hip also has a lot of metal work in it but he's sure the blood supply to the ball of the femur was uninterrupted so less likely of the need for a hip replacement. I will not be able to put any weight onto my left leg for 6 weeks and it's going to be difficult for me getting around as normally the use of crutches is employed but you need two good arms to do that...

As the week progresses I'm getting more movement out of my leg, I can draw it up and out further but sliding it back in towards my other leg is still really difficult, it's getting there but it's slow and painful. My elbow is locked in the cast so no movement there, all I can do is lift the whole lot over my shoulder and move my fingers. Friday comes along and I've manged during the week with the help of the physios to get into my chair a couple of times but I can only manage 10 minutes or so as the pain gets too much. They tell me I can go home the next day and I'm elated, I can go home just as long as I've got constant help, that I've got a bed that's 19 inches from floor to the top of the mattress and that I've got a chair I can slide into that is also approx 19 inches high and that both are on the ground floor oh and a commode which is delivered on Friday. Saturday comes along and I'm ready for 11am the earliest time for shipping me out and I'm fuming by the time they do eventually come for me at near 7 pm. Just my luck I'm on the last Ambulance of the day in fact I'm the very last patient of the day...

Over the next weekend I'm enjoying being at home with my family around me but of course I can't do a tap so Mel my wife does everything for me. I'm totally reliant upon someone else for the first time in my life since childhood, even when I had surgery for my peritoneal dialyses and later kidney transplant I still two legs and two arms that worked so all of this is unique and a real eye opener as to what it's like for those that rely on carers, it's scary.

The week progresses and I'm moving better, I have an appointment to see my consultant on Friday the 14th. It's here for the first time that I get to see my x-rays 12 days after the event. My smashed elbow was in lots of pieces and the after OP x-ray shows the plate and screws that's been put in to bring all those bits of bone back into the correct place

Next was the hip x-rays, the crash x-ray showed a clean break across the broadest part of the bone (Intertrochanteric) and you can just see it here as a darker shadow of a line running through the two bolts. I've been fitted with a 'dynamic hip screw' which is made up of the plate that's screwed onto the side of the bone with 3 screws and two big bolts.

You can see from the x-ray that alongside the big bolt that actually pulls the bones together is another bolt - a 'torque' bolt iirc. My surgeon said that he had much more than the usual problems when it came to operating on me, firstly he said my leg is built like an ox, lots of muscle to cut through then when it came to drilling and tapping he said that there was lots of white strong ivory in there and that when tapping the broken loose part, the 'ball', it was far too tough and was just turning so he had to put the other rod in first so the 'ball' wouldn't just spin when it was being tapped. So glad I well out of it when he was doing all this...

Normally I was told, a person with this operation is encouraged to put weight on the leg within a few days but ironically because I have big strong bones and needed that extra rod, I have to wait the full 6 weeks because apparently if I put too much weight on my leg before it's sufficiently healed there is a risk of a crack developing in the bone running between the two rods because they are so closely drilled...

PS Yes the pelvis x-ray has been edited to hide my modesty just in case you are wondering ;-)

Wednesday, 12 January 2011

Sunday 2nd January 2011 - Oh dear, what I have I done now - part 1

The new years here at last, the mince pies, xmas cake and booze are all done with and it's Sunday which can only mean one thing, yup it's the club run. A 40 odd mile flat route was decided upon bearing in mind the extra calories (fat) some of us may be carrying around the midriff and the blunted fitness of the overindulgers. I was looking forward to this ride as I had been doing mostly turbo seated base miles and now is the time to take it up to the next level. My fitness was spot on and I was ready willing and eager for real rides on real roads over varied terrain.

Meeting at Stretton as normal for 9 am the weather was cool, just around freezing and enough of us to warrant splitting into two groups. I somehow was nominated to lead the first (I think it was because I had a Garmin) and off we set riding down familiar roads and lanes of our beloved Cheshire countryside. Caution was called for in places because of small patches of ice that hadn't cleared from the sub-zero temperatures of the previous night and regular calls of 'ICE' sounded from the front. For the first few miles of the ride I was on the front with Graeme as we trundled along Summer lane, Newton Lane, Morphony Lane and then crossing the A49 at the bottom of Marsh Lane. Graeme was at the back now gassing with Anthony and I had Ade for company at the front so once over the main road we travelled Heath Lane turning right onto Ashhouse Lane then once again crossing over a busy A road, the A533 onto Smithy Lane.

Its over the previous few miles I had noticed the icy patches seem to be intensifying and here we had to do a left onto Willow Green Lane. I had been talking to Ade about the ice and our recent falls and how we will have to careful because we are about to ride down a hill. Here's the left turn, I'm to the right of Ade on the front and ahead on the apex of the bend there is a pothole full of ice and as I loudly shout "ICE" my front wheel disappears under me and I land heavily on my left side.

Nothing hurts at first, just dull aches and numbness, my bike has slid over there somewhere and somehow I manage to get into a sitting position awaiting something to happen with my elbow which starts to hurt ever so slightly and my left leg which is just numb, I move my arm slightly and it now it starts to hurt quite a bit, not screamingly but enough for me to not want to move again. I'm sat in middle of the road and some of the guys are around me saying that it would be safer for me to be at the side of the road whilst I'm waiting for my left leg to come alive. Someone offers me a hand up but just an inch of upwards motion has my leg in agony so it's back on the cold ground with my left arm supported by the other and my left foot hooked over my right foot. I'm sat there not knowing what to do, am I a hospital case or am I just badly banged up. My cars only a few miles away so I'm thinking that everyone should carry on and I will head back, I move my left arm to feel bone rubbing bone, now I think a visit to the hospital is on the cards, someone drapes a rain jacket over me, don't know who, don't recognise the jacket.

The other group arrive and quickly Phil Jones calls for an ambulance and within a few minutes there she is coming to my rescue and I feel slightly cheerier knowing I will be soon taken care of. Somebody mentions my bike but I don't particularly care about it, I'm in a world of my own. As the ambulance men deal with me I ask Ade to take some shots for this blog just to make light of my situation and perhaps have a few shots to go with this post and then I'm whisked off on gas & oxygen.

A fairly quick trip to the hospital with the ambulance men making an initial assessment of a broken and dislocated left elbow and probably a badly bruised left leg but my leg looks wrong as my foot is pointing sideways, the gas & air is taking the edge of the pain, then it's into A&E where I'm assessed yet again and now it's not a bruised leg but a broken leg to go with the elbow injuries. There's blood on my elbow, apparently one of the broken bones popped out through my skin so that's cleaned and dressed. Next comes the palaver of my shoes and 3 nurses trying to get them off, they are Specialized BG's (the shoes not the nurses!) but they can't work out how to press the red tab and pull out the strap at the same time, eventually they manage it and then everything comes off fairly easily bar one underlayer of the three that had to be cut off. A cannula is stuck into my good arm and then it's the bliss of morphine where I am tossed and turned being checked by three different doctors for additional injuries - there are none.

A nurse comes in and starts drawing arrows on my arm and thigh just so the surgeon gets it right, another doctor talks to me about the ball of my femur and that the break is high up on a neck of some sort, he makes mention about a possible death of the head and how we won't know for a year or so if death of this head thingy does occur and if so then it's a hip replacement, too many words are being thrown at me with lots of it just going over my head. My elbow is broken and dislocated, the bone has broken through the skin so extra care is needed in cleaning up the wound so infection won't become a problem.

Then it's consent forms and at approx midday I'm sort of whisked to surgery with the next available slot at 2pm. At 6pm I'm finally on my way as two other more severe cases push my surgery back. At midnight I come to in the recovery room with a cast on my arm and a 7 inch dressing on my leg, I'm taken up to my room.

Ades writeup
Phil Jones writeup

To be continued...

ps if you're wondering what took so long with this update, well the enthusiasm had to come back first and then it's one fingered typing, a long drawn out affair..