Getting Put Back Together

The morning bustle of the hospital woke me from a strange dream where a helicopter circled over my head but never landed...

It all worked like a well-oiled machine. Various people came to see me to set up my operation. I was assured that my tendency to vomit after general anaesthetic could be dealt with and the doc who was going to do the operation promised me that he would put the bones back in exactly the right place, "Because if they are even a few mm out, you'll know".

A nurse helped me to wash and produced a toothbrush for me (bliss!), and suddenly it was time for my op. I was wheeled in to the anaesthetists who gently diss'ed their colleague's difficulties in getting my "baby" cannula in. "Don't worry, once you're asleep, we'll sort you out a good one."

The next thing I knew, I was in recovery, with a brand new cannula, and not even a hint of queasiness. I had 2 lots of metal work holding my tibia together, though the fibula would sort itself out, apparently. I also had that instrument of torture known as a backslab attached to my leg. It's very heavy, lies behind and at the sides of the leg. It's tightened with bandages and is designed to keep the leg supported whilst it's still swollen.

In almost no time at all, I'd been returned to the ward and the loving embrace of my family, who had come down from Crianlarich and were in to say hello before leaving to sort out a room in a nearby cheap hotel. They also needed to explore train ticket options as we needed the whole back seat of the car for me to go home with my leg up.

The afternoon rolled by in a haze of the fun painkillers you get in hospital, though the fix on the tibia didn't even twinge, which made me hope they were good at jigsaws and had put everything back in the right place. Though there was a somewhat unnerving clunking sensation in the area of the fibula when I moved my leg. The hospital still seemed to be an oasis of calm, as all kinds of weather hit the windows, but I was told that they'd got busy so they needed to move me to the Day Case ward to make room for someone needing more care.

I crossed my fingers that this wouldn't be a multi-bed crazy ward, and was rewarded with - a room of my own! As my bed had an amazingly comfy mattress, it was all quite deluxe. If the tv screen arm had reached far enough over my bed to see it, it would have been perfect! J turned up and we had a nice companionable evening - as much as you can when one of you hasn't slept for a few nights and the other is wrapped in a happy cocoon of pain killers.

Lessons learned today:

No1. It's great if the surgeon who puts your leg back together is a perfectionist - even a small difference can mean more pain and arthritis for you.

No2. A comfy mattress really helps when you can't move about much.

Taking A Break to Hospital

It seems as if one of the main qualifications to be a paramedic in the UK is to also do a great comedy routine. The two guys who picked me up, kept me laughing until the entonox kicked in. I'd had a bit of the gas from the Mountain Rescue but once we started moving along one of Scotland's more pothole-rich roads, I really started to appreciate the stuff. For me, the main benefit was that it acts as a muscle relaxant, and most of my broken leg muscles were set like stone, so it really helped.

My personal entertainer / paramedic riding in the back checked my vital signs. My heart rate was up a bit, but the blood pressure was quite excitingly high. It may have gone up further when he said,
"If you'd been on our side of the hills, with that rain coming in, they'd have taken you out in a chopper." (Damn!)

In between me getting as high as a kite on the entonox, we chatted about life, the universe and everything. My ride-along companion was of the opinion that walking, or doing anything else exciting in the hills, was a daft idea because of what he had to scrape up when folk fell off them.

Whilst I was getting my suspension-free ride, Jeremy and the boys were being given a lift back to our hotel by the police - a major help as we were on the wrong side of the Loch. It was over and hour away, but I couldn't get a good phone signal, so that was all I knew. There was a potential that if the leg had an uncomplicated break, I'd just be plastered and discharged, so the lack of communication was a worry.

The roads smoothed out as we neared the hospital, then got really bad again as the driver took a short cut to avoid the Friday traffic, and I got to enjoy a rutted country lane flanked by huge new posh houses (apparently the farmer made a mint). And then we were there.

Forth Valley Royal may be the newest hospital I've been in. It also seemed remarkably calm for a Friday evening - maybe we were too early for the drunks. The first bloke to assess me seemed to spend a long time prodding my foot before I realised that he'd mistaken the remains of my last-year's sandal-tan for areas of good and poor blood flow! Once he was reassured by seeing the other foot, he said the phrase I was dreading - "Ok, now I just need to get a cannula into you." My family all have veins that look like maps of the Mississippi, but mine are more like streams under a glacier. Let's just say he had a stab at it. After about 5 goes, he managed to put a mini cannula into my left arm, then I
was sorted out quickly and X-rayed.

The results were sobering. My tibia (big lower leg bone) was fractured in at least 2 places, and the fibula (thin lower leg bone) was broken into 3 bits. Just to add to the fun, my foot was now displaced sideways by about half an inch (12mm in new money), which explained why it looked wrong. This also got me a ticket to the fun activity of having my bone re-aligned by being hauled back into place.

They set me up in a room ready to plaster me, and then gave me some morphine. A young female doc had a bit of a pull on my foot, then called for support "It's not moving..."

A wonderfully calm older woman came in, "You're just used to doing this to old ladies, not someone who has the muscles to get them up a hill. It will work, but we'll need to pull a lot harder."

She took the lead - "More morphine I think - lots more."

"Should I use the entonox too?"

"If this was happening to me, I certainly would!"

So I started sucking on the gas and air and closed my eyes as calm female voices around me chatted as they were preparing for the "big pull". It felt as if everything was spiralling away from me as they encouraged me to keep taking the stuff in, and then someone said, "You can probably ease back on that now", and I opened my eyes to see I had a fully plastered leg. I hadn't felt a thing.

I laughed, "I see what you did there. Clever!"
So obvious really - don't let the patient have a reason to tense up, just get on with it.

"Well done. We've almost got it in the right place now, but you'll need an operation tomorrow to screw things together and they'll finish it off then."

I was wheeled off to a 4 bed ward, where fortunately I could get a mobile signal. I first called the hotel to explain I'd be in overnight, then managed to get a call through to Jeremy and the boys, who had actually started driving to the hospital in case they needed to pick me up. The entonox clears after a few breaths, but the morphine doesn't, so I ended up having the slowest conversation ever with him, as I had to form the words up in my head and force them out. Even then I was hard to understand (what I'd said to the hotel, I'm not sure!). So they turned round and drove back to the hotel, and I got settled down for the night. My ward had 3 quiet older women, but down the corridor, I could here a commotion every so often. A nurse came to give me a check up so I asked what was going on.
"It's old ladies who have broken their hips, but they have dementia, so they keep trying to get up and go home, and they don't like it when we stop them."

That put things in perspective. All I had to worry about was that whenever I began to drop off to sleep, I re-lived the foot slide that had started my problems.

Lessons I learned:

Entonox definitely works as a muscle relaxant, so it's worth taking in quite a bit.