Two years later,10/11/16

“Yesterday, in my 4th operation, the surgeon put a chisel through my tibia. I can conclusively assert that the first cut is not the deepest.”

Me, affecting bravado on Twitter

Two years ago from more or less the time at which I post this, I was dangling by my left arm. Not nonchalantly, no, more in blind panic – very literally clinging on for dear life. My right hand, to be fair, was doing its best to get me latched back onto the rock, whilst my feet scrabbled for purchase on the overhang. Below, a good 5 metres of gravity beckoned me towards an uncomfortable reckoning.

My left arm did its best – for all that I’m right handed, it suspended me for a remarkable span. I vividly remember the enormous surge of adrenaline;  the baffling, committing, all-or-nothing power in my forearm; the tension in my left bicep; the calm voice in my head saying “get your game face on, this is going to hurt”. I hung on my left arm until I stretched the brachial plexus – that’s the nerve cluster that the works it – paralysing it.

Then I fell.

I often wonder how I must have looked, tumbling down the side of the crag. Was my face creased in pain? Terror? Was it blank with grim acceptance? Did I cry out? I remember the the sensation of my skeleton breaking far less clearly than the sound. At what point did unconsciousness drag me from my horror? Was it before or after my helmet was torn from my head? As friction overcame gravity did I gently slide to a halt in unlikely, cinematic grace?

I will never have the answers to much of this, and perhaps that’s for the best. I may never regain feeling in my left arm – now numb between elbow and shoulder – or across my left shoulder or down my spine. I am very happy to be here, though. Deeply so. And I am genuinely grateful to people and hounds of Keswick Mountain Rescue Team for scraping my bloody ruin off the mountain in such awful conditions. I genuinely owe them my life, just as I do, the staff of Royal Newcastle Victoria Infirmary. Thereafter, Leeds General Infirmary and St. Luke’s Hospital (Bradford) have expended considerable resource on my continuing recovery. Thanks to all of you.

img_0121

Cheers! Yes, it’s 58% ABV. Who needs codeine? (please drink responsibly)

I have much for which to be grateful. I have set aside today to ponder that, not with solemnity but with quiet and intense joy. And with a ridiculous navy strength gin. I don’t normally drink in the week or this early in the day, but I feel I’ve earned this. Cheers.

Advertisements

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.

img_0065

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.

img_0066

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.

On the bright side 27/09/16

“Yeah…well…you know what Napoleon said: Give me a man who is lucky.”

Spartan

So I’ve been cranking open my tibial break by 0.75mm a day since the 18th of August; by the end of this week my right leg should be the correct length. This is really quite a big deal. After that, it’s just a matter of how quickly I can fill a 30mm gap with bone tissue. I might be rid of this frame in January.  Anyway, I thought I’d try to write about the positive things that have emerged from all this horror.

Before I get to that, three caveats.

  • I haven’t coped with this all on my own – it’s been a team effort. Thank you so much to those who have helped me.
  • I have certainly wallowed in this, I’ve been selfish, used my injuries and medication as excuses, and I’ve let people down. I’m not trying to gloss over my multitude of flaws, but I do (for a change) want to focus on the good things about my flirtation with the infinite.
  • Everything is relative (except Newtonian physics – I ‘m pretty certain they’re absolute). There are people who have suffered much more than I have – I empathise with them, but I can only talk about my own experience.

Resilience
Um…it seems like I’m pretty tough. Not in a ridiculous, macho way; more in a I’ve survived a lot and kept going kind of way. Surviving the fall was absolutely a matter of luck rather than physical prowess. Keeping it together for eight hours or so, though, is absolutely the hardest thing I’ve ever done – I don’t really have the words to explain how grim that was. The genuine strangeness of the next week or so in intensive care is a close second. And then the tottering months following discharge, working my way back to some kind of fitness only to find that, no, there’s still more to come: more surgery, more pain, more dizzying medication, more struggling on crutches, more physiotherapy. And yet, here I am – head up, leg elevated (just now while I’m typing, not all the time; that would be impractical), looking at a point where I might be able to get back to doing the thing that nearly killed me. There’s no I in quit. No, wait, that’s gibberish – there is totally an I in quit. There’s no quit in me. Yes. I mean no. And first caveat notwithstanding, when I’ve been down at the bottom, when I’ve been riddled with doubt and, for that matter, physical pain, it’s really been me that’s soaked it up and got on. I did that.

Self discipline
I’ve absolutely stuck at it. I’ve seen a lot of people in physiotherapy who aren’t keeping up to their exercise regime between appointments. I’m not judging them because I don’t know their circumstances. I do know that the NHS, in as much as it has one, has waved its magic wand. The rest of this recovery is down to me. Only I can rebuild muscle, bone and the less concrete attributes like balance. I’m sticking to exercises I’ve been given and more generally doing what I can to regain strength. I’m getting to shops and back, on crutches, with shopping; to stop my toes curling under, I’m working on Adho Mukha Svanasana a little every day; to rebuild grip strength, I’m handing my bodyweight from my fingerboard every other day, gradually building to smaller and smaller holds.

Four of these nuts, 0.25mm a time, three times a day.

Four of these nuts, 0.25mm a time, three times a day.

Admin
No, you shut up. Seriously, managing medication on medication is quite a feat. Codeine really affects my grasp of how time is passing – when you’re on the limit of your daily paracetamol allowance for prolonged periods, you can’t afford any mistakes. In almost three months, I’ve only lost the thread twice; and I made the right choice – if you’re not sure whether you’ve taken them, assume that you have. Likewise, I’ve kept track of extending the frame: 0.25mm, three times a day, every day. The one time I got confused, I got myself back on track the following day. The admin is dull but by no means trivial.

Good people
More by luck than good judgement, I’ve surrounded myself with good people. My parents have helped me out hugely, caring for me for months after the accident and helping me out with shopping after my recent operations. Friends have visited me (with coffee) in hospital, raised money for Keswick MRT, put food in my freezer, changed my bedding, driven me around, helped me get to the shops and back, modified my clothing.  My employer has really looked after me – not just meeting its contractual obligations, but being really human about my rehabilitation. The members of my team have covered over the holes I’ve left in various rosters, picked up my slack, and sheltered me from cold, cold world outside.  So, caveating my caveat about my first caveat – thanks, everyone.

Look how majestic I am! disclaimer: actual majesty may vary.

Look how majestic I am! disclaimer: actual majesty may vary.

Death
None of my injuries were, in and of themselves, life threatening. In combination with one another and hypothermia, I have gazed in awe on my own death and been returned. It’s gradually given me a slightly different perspective on life. I’m not saying I’ve got that all the time, and silly things still get under my skin. But when I’m there, it’s odd and refreshing to be staring back into the world from death’s grey kingdom. Hello, you

 

An age of marvels, 07/08/16

“This shouldn’t hurt, but you might feel a slight discomfort.”

The Hold Steady, A Slight Discomfort

So, the district nurse bottles removing my stitches two weeks running – they’ve been in for four weeks now. I make an appointment with my GP practice nurses. They are hesitant when they see my frame but as soon as they hear the district nurse baulked at it, there’s no stopping them. It takes two nurses 45 minutes to get them out and they have to have a time-out in the middle. They are heroic, though, and I salute them. The following day, my leg aches just from tensing up for so long. And it is quite the picture.

31BF54E6-B415-4BA4-B135-2B1A55289298

Air-drying is not the only way in which my leg resembles a ham…

I’m physically competent enough to shower now, which is a relief. No more flannel baths for Marquis. I have to pull a bin liner up over my right leg and strap it in place above my knee (to prevent infection, not oxidation – titanium doesn’t rust). Once a week, when the pin site dressings are changed, I can shower fully. I strip out all the dressings and then let the pin sites air-dry until the dressings are replaced.

The appointment with my consultant arrives and I am x-rayed to see whether the tibia has sufficiently healed for it to be re-broken. Normally, they would crack the bone when they fit the cage. Because they also had to remove an intramedullary nail, my leg swelled up too much to take all that punishment at once. The surgeon is pleased with how I have healed, which means that he can now drill a series of holes across my tibia and then put a chisel through it. Then I use the frame to crank the gap open by 1mm a day – my bone will grow into the ever-widening crack until I’ve got back the missing 3cm. What, as they say, a time to be alive. For all the incoming brutality, it’s a massive relief. I’ve had 20 months of no-growth in my tibia and it’s a huge weight off my mind that my skeleton is back in the game. Crikey.

IMG_3391

Good news, Lyndon – we can now put a chisel through your tibia.

I return to physiotherapy at St. Luke’s. I’ve spent so much time here over the past year and half that it’s a sort of homecoming. Unexpectedly, they have me working on some quite heavy equipment on the first session. I keep going until my leg is shaking with the effort. Repeat on every session.

I meet a young woman at physiotherapy who had an Ilizarov frame fitted by my surgeon. She was told she’d need to wear the frame for a year, and yet had it removed after 3 months. She’s 20 years south of me, so I imagine she heals more quickly, but it’s good to hear some  positive affirmation of the process. She warned me that the first time I put my weight on the new break, it’s going to feel really alarming. It’s going to feel like something terrible has happened but that the medical staff aren’t going to alert me to that. I was grateful that she took the time to share her experience of the procedure with me. One of the positives out of all this is the camaraderie among the patients; those that have already trod the path coming back to show me the way. Thanks, HB, if you’re reading this.

It’s been an emotionally overwrought month. I’ve cried at two episodes of Castle now, and a Lie to Me. Good grief. They were all episodes where characters were being physically rescued. Feeling impaired has set me pondering what a profound experience it is to be rescued. I don’t think that, even after all this time, I’m quite over that huge crest of relief when the cavalry showed up for me. Gosh, it was a colossal moment, such a huge heart-shaking thing to experience that sudden reprieve from the infinite. Forgive my lack of clarity here – it is difficult to articulate because I’m not entirely sure what I’m feeling. To physically damage yourself to the extent that you will die unless somebody steps into save you; to absolutely understand that in that moment; to be saved amidst the certainty of your own death – it is a big thing to process, and I’m still in the middle of it. Which is fine. It is what it is, but I need to acknowledge what it is and that it is affecting me.

And while I’m on the subject of danger, it’s time for a sweeping generalisation. I know I shouldn’t speak for everyone who’s been to the brink, but I just need to get this off my chest. If you have a loved one who’s survived a life-threatening  ordeal, please think twice before you utter the words “it could have been worse”. It is a thing you say to comfort yourself* and not to comfort them. The notion that they might have suffered more than they did will in no way mitigate the suffering they have endured. And, believe me, they already have an iron grasp of the fragility of human life without your insight. If they’re like me, they’ve already devoted a lot of time to thinking about how much worse it could have been. My favourite scenario is where one of my seven broken ribs punctures my left lung and then I drown in my own blood; I’ve spent hours rolling that one back and forth behind my eyes. They get to say “it could have been worse” and you get to listen – that’s the deal for this. If something dreadful happens to you (and I genuinely hope that it does not) they will return the favour. And because they themselves have spent some time lost at the bottom of the world, they won’t try your patience with platitudes.

*this is a legitimate need – you’ve had a terrible fright – but it needs to be kept separate from their need

Learning to live with Ilizarov, 21/07/16

So, it’s now twenty three days since I woke up with my lower right leg in an Ilizarov frame, and I think it’s starting to settle. It’s genuinely the oddest thing, and I’ve no idea how to explain to you how it feels. There was a moment where I clattered my left leg with the frame that’s pretty vivid and easy to describe: it was like both legs had been simultaneously dipped in ice-cold water and set on fire. Behind the inner howl, I could hear a very clear voice saying “we are never doing that again.” It’s been right so far.

What else? Hmmmm, on the Sunday after I was discharged I had a bit of a meltdown. The frame felt cold and I started imagining I could feel that cold in my bones and then panicked that I might never be free of it. There may have been some tears. Possibly snot. I perked right up after I ate something so perhaps it was low blood-sugar.

And the sleeping, oh, mother of grief weeping on the shores of sorrow, the sleeping. I’m not sure how much the frame weighs but it’s really pretty big. I naturally prefer to sleep on my side, and I’ve had to find a way to support all this metal so that I can get off my back in comfort. In fits and starts, I’m getting around 6 hours a night. I realise that, to many, this is a lot of sleep. I normally do 9 hours at a stretch, and I really need my sleep at the moment. I’m up, out of bed and downstairs before 07:00 every day. It’s strange.

They did a pretty decent job of tidying the frame in theatre, but there are still twenty sharp titanium ends ever so slightly proud of the rings, and they catch on everything. I’ve got two old pillows, two bedspreads and a mattress-topper to protect my furniture from the scratches and gouges.

Toenails. Oh, toenails. They’re still covered in blood and a gosh-awful long way away. And

IMG_3297

Blood? Where was your right foot on the night of the murder?

long, so long. They’re talons. I wish I’d cut them before the operation. With some huffing and pain and quite a lot of profanity, I clip and clean them. Touching my swollen foot is still a very odd sensation, so the blood between my toes is staying there until I sweat it off. Oh, the glamour.

IMG_3335

Medication time! Medication time!

I’m summoned to see the consultant at a day’s notice. It’s taken me 6 months to get an appointment before, so this a novel and alarming development. Apparently my blood tests show that there may be an infection in the bone. I have to take a course of antibiotics. The prescription is faxed over to the hospital pharmacy and I’m left waiting around 40 minutes for it. When it arrives, I understand why – it’s actually a carrier bag full of antibiotics. If you need clindamycin for anything in the near future, I’m sorry – I have all of it. I’ve got 504 capsules to get through, on top of my pain control medication, calcium supplement and vitamin D. Gosh, I’ve got a lot of pills.

The first time the pin site dressings are changed, it takes two districts nurses over an hour (this isn’t a complaint – there are forty pads to replace). The second time, we’ve got a system going. I strip the old pads off while they cut up new ones and clean the pin sites, then they re-dress with new pads. We’re down to 45 minutes. They say they’ll take my four sets of stitches out on the next visit. It’s a completely different nurse on the third visit and she bottles it on the stitches. To be fair, if you’re not confident with it, I don’t want you down there with a stitch ripper and tweezers. If I get my dynamic duo back next visit, then they’ll take them out. Failing that, I’ve a clinic appointment with the surgeon the following day and they can go then.

IMG_3338

That’s where they took out the intramedullary nail.

My first visit to physiotherapy gets me prodded and poked a bit, and I get some exercises to build up mobility in my ankle. I’m not using crutches in the house any more, and then I’m getting up and down stairs without crutches and then I’m going up the stairs with a reciprocal gait (still leading with the bad leg on the way down). At my next visit, they have me working like a (lame) mule. Damn them, they can look right into me and see the bit that wants their approval, and they exploit it  It’s like I’m caught in some strange, therapeutic Stockholm syndrome. It works, mind you. The next day I walk into Bingley and back. It’s a 1km loop – it takes me 50 minutes. My ribs are aching from using crutches for so long. It’s a massive thing, though, a huge weight off my mind. If I can get to Bingley then I’m on my way back to independence. A small triumph but a triumph nonetheless.

Back down the rabbit hole, 07/07/16

“Here I lie in my hospital bed
Tell me, Sister Morphine
When are you coming round again?”

The Rolling Stones, Sister Morphine

 

Well, here I am on the far side of surgery, tender, tired and swollen. No, my leg. And when I say swollen, oh my word, but it’s swollen. And crusted with dried gore. But I am, nevertheless, still very much here, bloodied but unbowed (if a bit hunched when I’m stood up on crutches).

“What’s new, Llama?” I’m glad you asked. Even though they’ve removed the tibial nail, I’ve got some more titanium: five rings of it round my calf, all connected by nuts and bolts. Each ring supports two rigid wires. The wires – and this never gets any less strange to me – pass completely through my leg. As each wire makes an entry and an exit hole and there are ten of them, that’s twenty holes in my leg. Twenty little scars when the frame has gone. For the rest – removing the nail, cutting out the dead bone – the surgeon went in through old scars, which is a relief. Scar tissue clings to bone like tar, impeding movement, and I’m glad he’s made no more than he has to.

I was under the anaesthetic for about five hours, I think, and came to in the strangeness of the recovery room. It’s full of baffled people on hospital gurneys all blinking and looking confused. A bit like we’re all waking up in the Matrix, but none of us know kung fu.

After the consultant rounds the next day, I peel back the cotton wool curtain and take my first look at the frame. It’s huge, much bigger than I was expecting. And it’s here for a good long while. On the positive side, they had to take out only half as much bone as expected, so I shouldn’t have the frame on for as long as I first feared. They’ve shunted the two halves up together so my leg is one inch shorter than before. It looks more swollen than it is because the muscles are slack around my shortened skeleton. I have to come back when the break has set; they’ll re-break my leg and stretch the inch back in. I’ll have to crank the new break open with the frame 1mm a day and bone will grow into the gap as it heals. What a time to be alive!

IMG_3266

First view of my Ilizarov frame. They appear to have grafted the Chunnel to my leg.

The following night, the pads on my pin sites are changed. Twenty holes, remember, and two pads per hole so that’s forty pads. I’m not doing all this myself – not yet – and I’m glad of this. Under the pads, there is still a lot of gauze stuck in blood dried on to the hair on my very tender leg. As the nurses remove the dressings, I howl soundlessly (and sometimes soundfully) at the ceiling. Occasionally (alright, frequently) I swear and (in the most British way possible) I apologise (I’m so sorry, that’s not directed at you, please forgive me). When they are done, I think about how sore it was and how I’ll have to do it once a week, and how I don’t know if I’m up to it. I sit on my own in the dark, crusted in my own blood, and weep just a little. And, to be perfectly honest, the opiate constipation isn’t helping.

Because I hallucinate horribly on morphine, I’m on a synthetic opioid called oxycodone. Your body breaks it down differently to the way it metabolises morphine so you don’t get those side effects. On the other hand, it can provoke a side effect where it feels like your skin has been filled with ants. What’s got two thumbs and gets that that side effect? It’s calmed down with antihistamines but I am soon shifted to my old friend, dihydrocodeine, and exactly that much is right in the world.

A nurse arrives with my evening medication. “I’ve got to inject you with this to stop you getting DVT” – tinzaparin, another old friend – “do you want it in your arm or your abdomen?” “Just pass it here, I’ll do it myself” “Ooh, champion, you can come again.”

IMG_3295

It is a thing of strange beauty…

Let’s not get into detail, but let’s say the constipation has been dealt with. For this relief, much thanks (Hamlet, 1.1.10). I’m making my way hither and yon around the ward on a zimmer frame. I’m wearing my own clothes. My cleverly altered underpants have made such a difference to getting dressed – I cannot thank you enough, LB. Those of you who know me will understand what a huge part coffee plays in my life. Hospital coffee has no part in my life, and a succession of friends bring me good coffee from the outside world on a daily basis. Thanks, NT, LB, MR, JB, EM.

A young man is admitted to our ward on Saturday evening. He’s be in a motorbike accident on a motocross circuit somewhere to the east. He’s taken a jump too hard and he’s come off his ‘bike and then the ‘bike behind him has run over his back and he’s still broken less* bones than I did. Slacker. So there’s that – competing over who’s had the worst injuries. Gallows humour or not, here I am dragging around the least constructive traits of masculinity. I don’t know what to do about that right at the moment except acknowledge that it’s happening.

Soon I am up on crutches and then I’m going up and down stairs on crutches and then I’m being discharged and then I’m at home, going up and down stairs on crutches just to get better at it. It has its moments, this self-discipline, it has its place. It’s been holding me up and not blinking in the glare for about 20 months now, but there’s not much tenderness in it, not much comfort, not much room to soothe the wide-eyed, frightened child.

My GP practice arranges for a doctor to call me to discuss pain-control medication. The doctor asks how I am, and I start to explain a poor night’s sleep and how I’m feeling a bit sorry for myself. She stops me to tell me that I’m allowed to feel sorry for myself, that I’ve been out of hospital for less than a week and that the operation was pretty savage. And this is all true. The accident was brutal, the surgery that followed it was brutal and this surgery was brutal. There’s more to come – they still have to re-break my leg. But I don’t have to face this unflinching, all day and every day. So this week, I am going to feel a bit sorry for myself, and not feel bad about that. Next week, I’m going over the top but for now, I can crouch in the trench and stay out of harm’s way.

*Yes, it has been pointed out that this should be fewer. This is correct. I was on a lot of codeine when I wrote this.

 

 

Llama at bay, 20/06/16

“You must pay for everything in this world one way and another.”

Charles Portis, True Grit

What do you do with an outdoor blog when you can’t really do much in the outdoors for about 10 months? Well, let’s start typing and see what happens, eh? If you’ve been following me on Twitter or on this blog then you cannot have failed to notice that this happened. It was painful and frightening and humbling, but with enough sheer bloody-mindedness I would surely bounce back (although you’d think that after 130 feet of bouncing, I’d have earned some respite). Well, yes and no. I held up my head as high as I could and I did what the physiotherapists told me to do but it seems that was not and never could be enough. So here, by way of an introduction to the the medium term future of this blog, are some things I have found out through surgical consultations, physiotherapy and psychotherapy. Sitting comfortably? Then I shall begin. And I may ramble.

IMG_2458

Not an exit wound…

So, when I smashed my skeleton out through my musculature, the bone took the path of least resistance. I had thought the thing that looked like a small shark bite was the exit wound but it was not; that was the donor site for the tissue graft they took to pad over the repair job on my tibia. The almost-not-there scar that I had wondered about for ages was in fact where my hard infrastructure was exposed to the  atmosphere.

When you break a bone and then introduce it to the air, apparently it starts dying. My tibia was out meeting and greeting for 8 or 9 hours. The end of a bone cannot start regrowing from dead tissue. There’s still quite a lot of dead bone in there and so I’m going to have another operation. The surgeon is going to drill into the top of my tibia and remove the intramedullary nail. Then he is going to trim (I’ve no idea with what) 5cm of bone out of my tibia . Then he’s going to re-break it. Then he’s going to fit an Ilizarov frame to my leg – that’s an external cage that’s screwed into my skeleton. As the bone regrows from the new break, the frame will be used to winch it up the inside of my leg* until it meets the other side of the old break. The frame will take my weight so that I can remain mobile while I grow a new shin, and the muscle will not atrophy as it would in a cast. This will take around 10 months.

IMG_2832

That‘s going to leave a mark.

I’ve no idea how I’m going to react to this. Will I be self-conscious about it? Will I feel clumsy? How much will it hurt? I’m hoping that I will not react to morphine as I did before, given that the circumstances of our meeting will be less traumatic. I’ve bought a kilt so that I don’t have to try to wrestle trousers over the frame. A friend is putting velcro side seams into some underpants for the same reason (thanks, LB). I’ll be like half a male stripper. Tragic Mike, if you will.

And after the physiology, there’s the stuff that I’ve been ignoring for months – where, as Black Francis asked, is my mind? The bit where I was found by dogs? I wasn’t. When I was recording for the Listening Project, I discovered that I’d imagined that. Oh, there were dogs alright, but they showed up 25 minutes after I was found. Those slackers. My mind has just re-ordered things, presumably for a more satisfying narrative.

And you know what? It didn’t hurt as much as you might think. By the time I peeled, the panic already had me over the shock horizon and still accelerating. Don’t get me wrong, it hurt plenty, just not as much as the as the list of fractures would suggest. But the sheer intimacy of death’s presence – oh my word, the weight of that terror, pressing me into the Earth’s crust as firmly as gravity had pulled me there. And it just went on and on and on and on and on. I would not wish it on the worst of us.

But that, after all, is the bargain I made. My stubbornness and me against as much risk as I could handle. Or couldn’t handle, as it turns out, because I lost. And the loss isn’t just the injury, it’s everything that follows; the genuine strangeness of hospital; the slow return to work, struggling with tasks that would once have taken moments; the inability to enjoy the pursuits that got me here in the first place; and now the shuffle back, the regression – you thought you were here but really you’re back here. And that’s all there is for that. This was a leisure activity; I didn’t need to be doing it. So now I have to accept the consequences of my actions, soak up the surgery and try not to moan about it. Next stop – hand tools and my tibia.

Disclaimer: I might moan about it. A bit.

*this is an imperfect understanding of the process