#2 – I crashed – part 2 – the hospital

If you would like to start my amputee journey from the beginning click here 

 

When I arrived at the hospital I was taken into Resus where the doctors and nurses needed to look at my injuries more closely. The paramedics gave a very detailed account of my injuries and the accident to the staff then wished me well and said goodbye. By this point, I was wired up to all sorts of machines and had cannulas in both arms, as you would expect I was very out of it.

I don’t really remember any of this part very well, I was very, drugged up. I vaguely remember being taken in and having CT scans done of my entire body, making sure I hadn’t had any damage to my brain etc. I was told, other than my leg, I had fractured my lower left rib and my left clavicle, in where it joins my shoulder joint. I don’t remember much after that until I was back in resus.

I had a doctor introduce himself to me, Mr Harwood, he explained that they needed to have “a poke around” and as it would be quite intrusive they were going to put me to sleep for a while. As they put me under I remember starting to drift off and close my eyes. I started feeling though I was moving fast as colours were emerging out of darkness, rushing past me. I understood I was under anaesthetic and I could still think. I remember thinking that it was almost like a cartoon acid trip as all these colours blurred past at speed while I felt as though I was almost driving incredibly fast. I was aware of what they were doing I just couldn’t see or feel it, but I could even hear the nurses talking as they inspected my leg. I then started to come around quickly as all the colours started to slow down and I gradually started to open my eyes. Two blurred people shapes started to appear, I said as I opened my eyes I mumbled: “wow I’m moving really fast.”

One of the blurry faces was my consultant, Mr Harwood, He introduced his boss to me, I didn’t get his name, as all I then remember was the repeated word amputation, amputation, it would be best, amputation. I obviously took those words as you would expect anyone to. I started to panic and cry, my heart rate monitor started to alarm, and the nurses came over to check I was ok. Mr Harwood said to them “It’s fine, we have just upset him a little.” That was quite an understatement, I didn’t really know what was going on as I was so out of it. All I could do was kind of cry to people in my drugged-up state “they want to take my leg.” From there I remember them saying they would keep my leg safe for me, so I could decide what I wanted to do. They reassured me they were not going to take my leg today. They cut me out of the remainder of my clothes and transferred me to a new bed ready to take me straight through for surgery.  

They woke me up after surgery and asked me if I knew where I was, as I was so out of it I couldn’t get any words out and just managed to force out “Leeds!” The nurses and anaesthetist just laughed. I then woke up on Ward 10, the major trauma unit. The pain was less, even though it was still bad. They had put scaffolding out of my foot and up my leg to keep it secure. I also had tubes coming out of the bandages I had on my heel and on the front of my ankle. The nurse came to see me and offered me a cup of tea and some toast which sounded amazing as I hadn’t eaten since the day before. They also gave me some medication and some oral morphine to take the edge off. That night was incredibly difficult with the pain from my leg, ribs and shoulder but also with the knowledge that I’m going to have to make an impossible decision to try and save or lose my leg.

At around 1 in the morning, I needed a wee, but it was not happening. After trying for around an hour I called the nurse and she said I would need a catheter and went to find someone that could fit one. Another hour went by and I was getting incredibly uncomfortable, I buzzed for the nurse again who came back and said there is only one person on able to do it and they would be here soon. When he arrived, he set up a little trolley and carefully unfolded paper containing a catheter kit, he got the long tube and tried pushing it in but couldn’t get it where it needed to be which was very painful. Can you tell I’m trying to write this without being too graphic! He asked the nurse to see if she could get a different size tube. So, she went off to have a look and he stood there holding my knob which was incredibly awkward. About five minutes went by of trying not to make eye contact with him in silence when he placed a cloth on my lap and said, “I’ll just put that there”, and placed it on the cloth. The nurse finally returned and told him that she couldn’t find any, so he went off to have a look. We then awkwardly waited in silence for him to return with my junk neatly presented on the cloth.  He then returned and proceeded to very painfully force a tube into my bladder. Little did I know I wouldn’t be manually weeing for the next two weeks.

The next morning; with not much sleep, I had my first introduction to the wards daily routine. The nurse comes around at 6 am to check everyone’s observations, blood pressure etc. Then at about 7 am they bring around the tea and breakfast trolley; tea and toast went down very well. That is closely followed by the medication trolley where I got given 2 paracetamols; gabapentin (a nerve painkiller); dihydrocodeine and some lactulose to counteract the meds effect on the bowels. We then get a bowl of hot water and a towel, so we can have some sort of a wash.

There were four beds in my room.  Mine, across from me was Malcolm, an older chap with a circulatory problem, he had been there for nearly 6 months. To my left was a young lad, Harry, who had been in a car crash. And across from him Graham who had broken his back in a fall. Living in such proximity to people you get to know them quite well and talking to each other to pass time becomes vital.

After the meds and the wash at around 11, you would usually have the doctors do their morning rounds. This was the first time after coming into the hospital I had seen my consultant Mr Harwood. He came and sat down with a team of people around him who were all taking notes. He introduced himself again and introduced the clinical phycologist that I would be dealing with while in hospital. We went over how I was feeling and what level of pain I was in; which was very worried and around a 7 or an 8. He then went on to explain what had happened to my leg and what they had done in the surgery. I had some metal plates and fixation from a previous injury in my ankle already which made things difficult. I had fractures above and below the fixations of my tibia and fibula. I had broken just about every bone in my foot which you might expect being crushed between two engine blocks. I had open wounds on the front of my ankle and my heel which had been cleaned and vacuum sealed with a pump sucking out any excess fluid etc. to prevent infection. I was told that when they went to clean the wound on my heel, that when they opened the flap of tissue to clean it my heel bone fell out in pieces. Mr Harwood described it as if you hit a crunchie bar with a hammer my bone was like the cinder toffee that was left. He had installed scaffolding to my foot and a few other places up my leg to keep it supported and in one place.

 

Mr Harwood went over with me the options that I had; firstly, we could try and reconstruct my leg. This would involve, due to the damage to my foot and ankle, fusing all the bones in my foot and bottom of my ankle together into basically one solid piece. This would mean I would have no movement in my foot at all, but I would have a feeling in it and more importantly, I would still have a leg. I would also need to have skin grafts off my right shoulder to fill in the flesh that was missing from my heel and ankle. Which would mean my good shoulder would be weaker as it was missing muscle. Basically, I would still have my leg and able to feel it, but it would be unusable in the sense of a normal leg. Also, I would be in the hospital for a very long time possibly months waiting for it to heal and prevent infection, which there is a very high risk of in this situation.

My other option was to have what Mr Harwood described as a reconstructive amputation, unlike military personnel, who usually have lots of trauma throughout the limb, or vascular patients that have blood flow issues and tissue damage throughout the limb. I didn’t have any damage to my leg where an amputation would be performed below the knee. Because of this, he said it would be reasonably straightforward and risk of infection was slim to none. They would cut the bone and leave some overlapping calf muscle which they would slim down and fold over the bottom of the amputation to seal it. After the amputation, he explained it may be possible to go home as quickly as a few days if it has healed well. Then I may be fitted with a prosthetic and starting to learn to walk within 3 months.

It doesn’t take a genius to see which of these two options is better considering the extent of my injuries, although I understand the need and the reasoning behind people’s choices to go down the reconstruction route and keep their legs. I didn’t have to make the choice right away, but a decision did have to be made within around four days as the chance of infection shoots right up.

So, I was left with this immense decision that even though was obvious, was still incredibly difficult. I knew that the only real option was an amputation, as I did not want to have a useless, rigid leg that I could feel and not move. Plenty of support was given from the hospital; as well as the occupational therapist, they were sending an amputee who was part of the Day 1 Charity which operated out of the ward to give advice and guidance to people faced with this decision. The staff would even sit and talk to me about the situation and offer support.

More to come…

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