I got hit by a taxi part three: the long hobble to freedom

vlog: marking my first day weight bearing

I started physio yesterday. I’m having it twice a week; one session for the ankle and one for the knee. We started with ankle yesterday and I can’t really walk today. The physio got me to lie face down on the bed massage table thing and he grabbed my foot and tried to twist it off the bottom of my leg. Now that it’s all titanium, you can’t break anything it’s just the pain thing so I told him to go hard out because I could handle the pain and I just want to get going again. He warned me that the ‘safe word’ is STOP and not ARGgGGGHHWDHHHHHhhhhhhhhhhhhhhhh because it was going to be a bit of a hard restart so I got through it with lot of ARGgGGGHHWDHHHHHhhhhhhhhhhhhhhhh. Needless to say, my pain threshold has gone up considerably over the last few months. 

this is pretty much how I walk

Your body adjusts really fast and you end up with your ‘good leg’ really strong from hopping around and the damaged leg all floppy and without muscle tone.

    
first steps weight bearing- feels like walking on marbles- kermit the frog styles

I was surprised how much of the physio is on your quads and your gluts and hips but I guess it’s getting all the scaffolding and balance back to normal. Without the crutch, or one crutch which I use to take the weight off the damaged leg, it feels like you are going to flip backwards like being on a snowboard. 

6-week x ray of my leg. knee to ankle tibial nail that will stay there forever
It takes about six months for the bone to grow back and 18 months for all the tissue and muscles and stuff to get back to normal. The tibial nail will stay in forever so it’s a life-long injury. Insurance companies love it when you tell them that and you can hear the team of ‘Rehab Services’ people, which is insurance company code for ‘lawyers’, go really quiet when you say ‘life-long injury’.  Keeping it simple works really well with them too. I’ve found that by ending every sentence with ‘…because your client drove a car into my leg’ makes them super happy and they just want to rush off the phone and go outside to celebrate or something- they just can’t contain their joy. 

surgeons ooo and aaahh and take photos and say this is a really good graft
We still have to watch the skin grafts on the front of the leg and make sure that the open wound from the reconstruction is healed up properly. A community nurse from St Vincent’s hospital comes and visits me and changes the wound dressing which is pretty ace. Wound care technology is pretty sensational. 

wound care technology is awesome
I have a hydrogel called Flaminal Forte that goes on the wound out of a big toothpaste tube and that gets covered with this cool silicon gauze stuff called Adaptic (some surgeons like Adaptic, some like JeloNet or this other dressing called Mepitel but Adaptic has smaller holes so less bacteria gets in and the silicon stops it sticking to the wound) and then a big nappy thing called Zetuvit that protects everything and then a compression stocking to hold it all together. The swelling stays around for a really long time so I have to try and elevate it but the reconstruction is happy and the circulation seems to be working and it’s not all purple like it was a few weeks ago. 

So tomorrow, it's the knee's turn at the physio- ARGgGGGHHWDHHHHHhhhhhhhhhhhhhhhh

Isaiah 35:3-6
3 Strengthen the feeble hands,
    steady the knees that give way;
4 say to those with fearful hearts,
    “Be strong, do not fear;
your God will come,
    he will come with vengeance;
with divine retribution
    he will come to save you.”
5 Then will the eyes of the blind be opened
    and the ears of the deaf unstopped.
6 Then will the lame leap like a deer,
    and the mute tongue shout for joy.
Water will gush forth in the wilderness
    and streams in the desert.

Related: Part I: How the accident happened
               Part II: Hospital things and what they did to me

I got hit by a taxi - let's see what they did to me

I’ve got a plastic surgery clinic on Thursday and I’m going to pack a few things because the last time I went in for a clinic I got readmitted to hospital for two weeks.

When they took the plaster off from the first surgery, there was a big hematoma which is a big swollen blood clot that was from the impact of the taxi bonnet, or the brick wall maybe but that was where it took the biggest bash anyway. 

The first four days after the accident were a lifetimes worth of hospital for me so being told I had to go back in for two weeks felt like I was being sucked out to sea.  Then I decided to be like the chill-ass orangutan and surrender to the whole process so Christmas and New Year's in hospital for me it was. There are starving children in Africa and people in the ward with lifetime, genetic muscle-wasting illness and stuff like that who needed four people to move them in bed. My leg seemed very minor and temporary in comparison. I've been pretty healthy for the last three years or so. I stopped drinking booze altogether and got a lot more active and tuned into managing stress and just generally realising that I wasn't bulletproof and had to listen to my body more. It made a big difference to my physical healing and just being able to push your body to relearn things. It also meant that I was thumped by all the medicines being pumped into me so I was pretty quick to start refusing pain meds and wanting all the chemicals to stop. I took my last antibiotic tablet yesterday and I'm not on any medication now- fingers crossed that's the end of it. 

Of course, you can't just sprinkle some Chia seeds over your leg and have some fish oil tablets when you're having open surgery on your leg. They have to knock you out which involves wheeling you into a cupboard and putting a rubber mask on your face and shoving a pipe down your throat which triggered a reptilian 'do not want' response from me apparently- I don't remember any of that but a traumatic frightened cat hit by a car response seemed pretty understandable. Well done me. 

I've finally read the discharge letter and can see what they did now: 

Surgery one

Tibial nail insertion and open reduction internal fixation of left medial malleolus 11/12/2014

Titanium rod thing from knee to ankle, inner ankle screws and something to my knee that isn’t a knee replacement but when people say they are having their knees done that’s what I had. Washout is cleaning up all the mess. 

Surgery two
Washout left leg wound 23/12/14
Then I had to go in for a second surgery which is a Washout to clean up all the hematoma blood clot stuff and get it back to a point where it could be stitched up. 

Surgery three
Washout and application of vac dressing to left leg wound 25/12/14 <<< Christmas Day

plastic surgeon checking the donor muscle -hole left from the hematoma- yes the white part is bone
Turns out the skin had all died above the hematoma so I had to go for surgery number three to have all the skin cut off. Then you get a left with a big hole in the front of your leg. Having a huge hole is a totally bad idea at the best of times but when you’ve just had a metal rod put in your munted leg it’s an even worse idea because you can get a bone infection and if that gets into the metal work then you can’t get it out so you have to amputate the leg.  Yes amputate. So as much as everyone reassured me that wasn’t going to happen my brief stint in public health was enough to make me know that there are all sort sorts of ebola-cousins lurking in hospitals and the only places more germy than hospitals are those floating petri dishes called Cruise Ships (seriously: Google cruise ships + norovirus, it’s not just an evening show you’re catching on the Emerald Princess). 

vac dressing sucking out all the bad stuff and circulating air and moisture to fast track healing
Then I had a vac dressing put on to prepare for the fourth surgery which means you have a plastic pipe stuck in your leg-hole to suck all the bad stuff out and speed up healing. It also means that you are plumbed to the bed and if you want to go to the toilet, you have to take a big tube and wrap gauze around it with medical tape so you get to do some craft. Then you go to the toilet and hold the pipe that is attached to your leg and are quite convinced that salmonella is setting up shop in your leg and pouring down the pipe like a bacteria hydroslide at Wet n Wild. 

Surgery four
Local flap reconstruction of left lower leg wound + skin graft repair

Covering up the hole required plastic surgery and some skin grafts. It’s called Local Flap so they cut a piece of good skin off the side of your leg where it’s just muscle and tissue, and move it around the front to cover the exposed bone. I also had some skin taken from my upper thigh and used to patch up the parts that weren’t covered by the Local Flap. Skin is the most amazing thing in the universe I think (name a man-made thing that can self-heal? exactly…) so the side of my leg skin has covered up the bone and no more Oscar Pistorious for me. OK, technically there is still a risk because when you get a crushing injury, stuff can get left behind and it could go feral but I got doused with IV antibiotics for a week or so to blast all the Cruise Ship germs. 

Skin grafts have to be untouched for about five days so you have to lie in the bed and do the worst thing in the world —nothing. You would think that lying in bed watching TV all day and being brought food would be like an awesome long-haul flight but it’s actually terrible because you have to pee in a bed pan which is the most revolting thing I have ever experienced because you are horizontal and you marinade your butt in your pee and have to balance until the nurse comes to take it out or it spills everywhere. After two goes I refused any further bedpan action and opted for the high-tech toilet seat chair option although the nurses would get a bit angry with me because it’s more work for them getting you up and down but the bedpan decision was final.

mobile sanitation device connect to your regular toilet and minimises ebola in your leg

One especially tricky nurse tried to convince me that she had to ‘measure my urine volume’ but I was on to her and her tricky schemes and I had to get my terse voice out, and then she threatened to put a catheter into me, nurses really do have a strong escalation game. So I got the doctors to put on my notes that it was infection control issue and i had to be taken to the toilet, i.e. no bedpans. Touche. 

During this time, a lot of attention is paid to your plumbing actually and you soon surrender to the morning ‘have you opened your bowels today’ questioning and it’s all recorded and charted and they give you potions to ensure the question is answered in the affirmative. I was provided with ‘treats for my bowels’ aka Coloxyl and sometimes they just wheel you to the bathroom and leave you there for a while to see if anything happens so you feel like a puppy being left on the lawn to go number twos. When you do go, you get a big pat on the head and tick in your chart so it’s a great shared achievement. The old guy in the room next to me was on Day 15 and refusing treats for his bowels which you’d have to think was a seriously bad life decision. Protip: take the treats. 

Local flap 'dusky' due to blood vessels venous congestion -wiring not all connected up yet
The skin is your skin so that part is happy but all the blood vessels have to reconnect. Blood goes in but doesn't come back out so that's when the leeches were brought in to try and save the bottom part of the Local Flap that was looking a bit -according to the discharge letter- Dusky. 

Harvard Medical School highly trained specialist surgical leech- likes blood and warm places

The leeches are proper medical ones and you prick the skin like a diabetes person does and get it to attach. The leech has natural anti-coagulant in its saliva so a good one can sit there for a couple of hours and hoover away at the wound. The leech created much excitement- it feels like a normal garden worm on your leg and doesn't hurt. 

Leech doing his/her thing on the Local Flap

The only thing is when they bloat up and are full, they wander off really quickly and head for the warm parts of your body so I had one full bloated one travelling at speed up toward my warm parts which was suboptimal so I decided to stop the overnight treatment because nightmares. 

The good news is the fracture is all zipped up now. There is a big wound on the side of my leg where the surgeon took the Local Flap from and it looks bad but people in the know assure me that it's all muscle and tissue so meh.

   


I couldn't care less about scars and how it looks as long as my leg works I'll be beyond happy. A quick journey through disability has been a huge eye-opener for me and I'm beyond blessed that my journey has been relatively short and successful -some people have to live everyday with chronic pain, unhappy outcomes and far worse limitations. 

The wound specialist came and visited me yesterday and we put this cool hydrogel stuff on the wound and it soaked up all the bacteria and it's all looking nice and pink and healthy now. 

So yes, Plastics clinic on Thursday so I can remove the big dressing on my upper thigh from the skin graft donor site hopefully, and then the big date is Monday 19 January with an orthopaedic clinic and x-ray to see if my leg can bear weight so I don't have to ski around on crutches. Then I can test-drive my new titanium leg- good times :)


7-10 How beautiful on the mountains
    are the feet of the messenger bringing good news,
Breaking the news that all’s well,
    proclaiming good times, announcing salvation

Related: See how the accident happened - I got in the paper and everything