A plan is just a list of things that don’t happen, 01/11/16

“[…] I am in blood
Stepped in so far that, should I wade no more,
Returning were as tedious as go o’er.”

Macbeth, Act III Scene 4

Well, my right leg is the correct length and I have the terrifying x-rays to prove it, but I’ve been able to feel the frame flexing and I’ve not been able to move without crutches for a few weeks. Anyhow, last Tuesday, I noticed I had sheared through one of the pins that run through my tibia. I had a consultant appointment by Thursday and was in surgery on Friday. The frame is much more stable and I was able to manage a few steps without crutches before the nerve block wore off. Thanks to RP for collecting me from hospital and for indulging my craving for fish and chips on the way home. I owe you one. Not enough to listen to Whitesnake, mind, but I am in your debt.

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There’s bone in that there gap.

It’s now just a matter of waiting for my tibia to fill in the gap with bone, so I thought I’d write about some of the things I’ve learned over the past couple of years. Some of this stuff is already in other posts and some of it isn’t. Don’t judge me – we’re all desperate for content. Except perhaps you, gentle reader. Don’t give me your troubles…

Long term use of non-steroidal anti inflammatory drugs may inhibit bone growth. I learned this not long after I’d seen the state of my leg for the first time post-accident. Good grief, it was swollen. I asked the nurse if I could have something like ibuprofen to bring the inflammation down. I couldn’t. The swelling only came down, in fact, when it encountered a combination of Iyengar yoga and hydrotherapy. And now it’s gone back up again.

Ribs are a really important part of breathing. Nearly as important as lungs. Yes. You (or anyway, I) don’t fully grasp this fact until you break a load of them. Then you grasp it really very firmly indeed. That’s why surgeons can’t do much with broken ribs. If you strap them up, they can’t expand and if they can’t expand, you can’t inhale and that really makes for issues much further up the triage ladder. I didn’t sneeze for about four months because I couldn’t get air into my lungs quickly enough to expel it reflexively. It was odd.

I was on the fell for somewhere between eight and nine hours. The selfie on the post about the accident was taken (when I look at the info on my iPhone) at 12:38, meaning I probably peeled at around 13:00. When I recorded for the Listening Project, MB told me that they got to me somewhere between 21:00 and 22:00. Gosh.

I wasn’t found by dogs. Again, when I recorded for the Listening Project, MB told me that there were dogs but they didn’t get there until 10 minutes after he did and he didn’t get there until 15 minutes after I’d been found. The mind, let me tell you, is an odd and powerful  beast.

The tibia is a difficult bone to regrow – apparently I’d have been better off breaking my thigh bone. The femur is surrounded by muscle and so has a good blood supply and therefore a good nutrient supply. The tibia is mostly surrounded by skin. The tissue graft that they took from my right calf and slapped over the break? I think the point of that was to increase blood flow around the wound and so speed healing. Only the bone was dead. Just my luck…

And here’s some stuff for those of you that have been injured (or may yet be injured – I hope you won’t be, but if you are, you may this useful).

img_0091Crutches: get yourself some fingerless gloves – they’ll save your palms. I have belay gloves because, you know, climbing, but weightlifting gloves would be good too. Also, some kind of shoulder bag for moving things around the house – books, flasks of coffee, guinea pigs – while your hands are full. Mine is from Maxpedition and sits on really comfortably on my hip, across my abdomen or lower back. When not in use, crutches are such a pain to balance. No, they really are – you can’t appreciate this until you have some. Balance them upside down. If you learn one thing from my blog, learn this. You’re welcome.

There shouldn’t be any flex in an Ilizarov frame. If you can feel it shifting about, that’s not right. Don’t panic, but do make an appointment with your consultant. Seriously, don’t freak out – you probably just need the clamps on the pins tightened. You’re going to be fine. I’ve had a pin replaced. I’ll be frank, it wasn’t fun. The surgeons pulled the broken pin out and then inserted a new one in a brand new hole. I’m told this is more hygienic. The nerve block has worn off and I’m in some considerable discomfort, but it’s going to be fine, and so will you.

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You should not be able to do this with any of the pins. No. Call the hospital now.

Everybody’s experience of injury and surgery is unique to them. Their physical and emotional response is theirs and theirs alone. If it’s the first time they’ve been through the mill, there’s nobody to teach them the ropes. Surgery is hard, gosh, but it is. The drugs and the anxiety and the sheer physical brutality of what happens while the lights are out  – it all comes at a price. Be patient with them. They’re doing their best in difficult circumstances. Questions that are basically “why aren’t you better yet?” are not helpful. Close the hole under your nose and think before you make any more noise come out of it.

Similarly, if you’re in the trauma club and your patience is being tried by well-meaning but unhelpful loved ones, try to cut them slack. They don’t know what it’s like to be trapped in your sack of scars. How could they? I certainly didn’t understand before I tipped off the world. When I first came round in hospital in November, 2014, I thought I’d be back at work by Christmas. I wasn’t back until May, 2015, and I’ve just spent my fifth day in surgery, earning two new scars.

Speaking of scars…
…deep scar tissue is a strange thing alright. There’s an oddness where the numbness between the surface and the tissue that can still feel is almost a physical presence itself. It will cling to your skeleton and slow you down. In addition to the scars, there’s the fascia tissue – this is wrapped around your muscles. It clamps down around your muscles when they’re subjected to trauma, limiting their movement. My word, does it clamp down – almost two years down and it’s still a problem for me. Once the wound is stable, think about seeing a sports physiotherapist. They can help break down the scar tissue and they’ll free up the fascia. It will be uncomfortable and expensive. In my first session, my left shoulder was given a Chinese burn that went on for 15 minutes. I thought I was going to cry, and believe me, I can soak it up by now. It will be worth it, though.

So, I think that’s all I’ve got right now. Or, at any rate, all I can get to the surface through the mound of codeine. Perhaps I’ll add to this in the future. If you know anyone who’s going through the wringer with physical injuries at the moment, and you think this will help, please share it with them. If you’re going through the wringer, remember what I said about unique personal experience. This is written solely from my point of view. Some of this will chime with you, some of it won’t. The bits where we part company don’t mean you’re getting it wrong. You’re just you. Stick with it; you’ve made it this far and you can see it through.

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One thought on “A plan is just a list of things that don’t happen, 01/11/16

  1. Pingback: An accretion of brutality, 12/05/17 | not really a llama

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