#Pain – Baffled Ape

Once there was Social Security, now there’s the Tories and their DWP (Pt.1)

From the archive: Reposted due to the crippling impact now of mortgage interest rate payments, energy costs, inflation etc. I realised there must be many disabled people like myself with a similar, depressing and scary predicament. We ‘were’ just about managing … but not now

I thought I’d write about my experiences with the DWP since turning to them for some help in 2012. I will start with a letter I wrote to my GP and others some 13 or so months later in 2013 …

A letter to; My Doctor. My MP. The DWP. The Courts Tribunal Service.

Over a year ago, mid August 2012 after several months of ever increasing pain & reduced ability to work I eventually booked an appointment with my GP. This was the first time I had seen my GP since 2004. Being self-employed, I had soldiered on with my aches & pains for 13 years since spinal surgery in 2000. In fact 33 years since 1979 when I had a rather nasty Road Traffic Accident that started all my long term skeletal problems.

My GP was great and agreed to get me to specialists for advice on any possible treatment for my long term ankle and more urgently, back pain.

Meanwhile being self-employed with no sick pay and a young family, mortgage & all the associated bills thereof, I contacted the DWP. It seemed there was something called ESA. An advisor at the JobCentre told me via telephone that this would be an entitlement given my contributions to National Insurance, income tax etc since starting work at 16 in 1976.

Despite the GP prescribed pain killers, my back pain worsened, my income trickled down to zero during the next couple of months & inevitably, my customers looked elsewhere. I was awarded ESA, contributions based at £42 per week. Not very much but every little helped. I had by now contacted my bank, credit card issuers, loan companies, mortgage company etc to inform/warn of my financial predicament as one is advised to do in such circumstances.

In November I was seen by a specialist regarding my long term ankle pain as a result of my 1979 accident. Luckily I have an orthopaedic splint made for me in 2003 by the Conquest Hospital via the then orthopaedic specialist, which along with the painkillers helps alleviate the pain. This made the updated diagnosis of traumatic arthritis of the damaged ankle a lower priority than my agonising & incapacitating back pain. I was placed on a list for some targeted pain killing injections in my ankle. Not a long term solution I felt but I went along with the consent.

In December I wrote to my GP asking for progress on the referral for my back problem. At the same time I was asked to attend an ATOS Work Capability Assessment (WCA) in Hastings. This I painfully attended under threat of losing my £40 odd pounds per week award. I was puzzled at not being asked to remove my surgical splint for the medical exam but then they are the experts, aren’t they? In January 2013 a letter arrived from the DWP, as a result of the WCA exam I had been placed in the Work Related Activity Group (WRAG) and would need to attend a meeting with a ‘disability adviser’ at my local Job Centre. This I duly attended (again under threat of loss of payment) and struggled up to the first floor (no lift) in much pain & discomfort only to be told that I was obviously unfit for any work. As this all seemed very illogical and with no sign of any appointment with a back specialist I asked that the DWP decision be looked at again and subsequently appealed against the decision.

February 2013 I receive a letter from ‘VirginCare‘.(Note: NHS Logo) With an appointment date to see an ‘Extended Practitioner’.

This centre in Hastings I attend and am advised to have an MRI scan. This took place in Eastbourne later that same month. At the follow up feedback appointment back in the Hastings Virgin Care centre I was told that I need to be referred back to the NHS to see a surgeon for severe damage to discs & nerve damage.

By this time my business is now gone. My financial problems are much worse with CAB advising Bankruptcy as my only option. I have constant pain & discomfort. On a visit to my GP (to request the DWP demanding ‘sick note’) I discuss further pain relief & Neuropathic tablets to help with the constant sciatica & feet pain. My blood pressure is very high. I very reluctantly ask for help with moods having recognised a return of depression which I had been treated for in the late 1990’s. My GP is again very helpful and supportive in prescribing antidepressants & drugs for the blood pressure.

July 2013. An appointment with a spinal surgeon at the Conquest Hospital. X-rays & exam. I consent to a spinal probe to establish disc damage. Further fixation surgery is mentioned. I expressed to the surgeon my fear of more spinal surgery as the surgery I had in 2000 seemed to have caused the permanent sciatica (in my ‘good’ leg). We agree to discuss this again after the probe.

As I write it is September 2013. No sign of an appointment for the probe. My mental health is deteriorating. I fear any surgery, even the probe. The pain is manageable with the assortment of pain killers I now have providing I do not do very much. And I do not do very much these days. I have watched, read & listened to the media destroying the reputation & integrity of the NHS. And I wonder if I will ever volunteer for any kind of surgical procedure.

My business has collapsed. I am not fit for work according to the Job Centre. And despite the DWP saying I should be in the Work Related Activity Group, I have not had one invite for a consultation to discuss possible work options.

I conclude now that my stoic attitude to my pain is perhaps my undoing. In 1979 at age 18 I suffered major multiple open fractures to my right leg. Breaks to the knee, severed artery & muscle & badly dislocated ankle. This is like major surgery on the roadside without anaesthetic, fully conscious throughout. There followed months on traction, bone grafting surgery etc, etc. Only someone like myself who has experienced this could understand any of the above.

I say this because my attitude in life since has been to soldier on. There are folk much worse off. Keep working & because of that experience of pain, my 1 – 10 pain scale sees ’10’ as that on the road, bones, flesh, protruding. That level of pain.

But in August 2012 I tried to stop grinning and bearing it and ask for help. Both of the medical profession & the DWP.

My GP has been fantastic & possibly saved my life.

The DWP have been an incompetent nightmare and sole cause of my anxiety, stress and inevitable depression. The NHS specialists have been very good but I suspect they are frustrated by politics. And Virgin Care who have I bet presented their invoice!

I have tried to keep this brief. I cannot articulate face-to-face or via telephone my thoughts above unfortunately. I needed to get this off of my chest and out of my mind which is increasingly fragile.

Thank you for reading.

Mr Baffled Ape

The text in italics above is a copy of a letter i wrote to my GP, MP, DWP, Tribunal Service

So, my lovely GP called me on the telephone to see if I was OK and promised to chase up my Spinal Probe surgery. My GP also explained the directive doctors have now to refer people via Virgin Care who then when they see a difficult (non profit I suspect) case refer you back to the NHS. Before Virgin Care the GP would refer you directly to the specialist. Great work Cameron & Hunt!

I received a reply from my MP the Conservative Greg Barker, who said he’d passed it onto his colleague Mr Iain Duncan Smith. I was almost overjoyed with excitement at the prospect of such a letter ¡¡ (inverted exclamation = universal sign for sarcasm)

Meanwhile a 2nd ATOS Work Capability Assessment appointment arrived, despite many phone calls to the Newcastle DWP office explaining & reminding them of the pending appeal, I was told that I must attend or, you guessed, get sanctioned and lose my ESA award.

So, at this stage I was now 15 months on from asking the DWP for help. Despite paying income tax and having paid in the maximum contributions to National Insurance since starting work in 1976, I am having to fight every step to receive the ‘Social Security’ I am, according to the system entitled to!

End of Part 1

Part 2 coming soon. The Tribunal, more surgeons etc.

Published on

9/22/14 10:45 AM

Expecting The Unexpected – Musings on ‘Everyday’ PTSD …

What I wanted to talk about here is the stuff that’s present every single day of your life. It’s just there, lurking and then jabbing at your subconscious then invading your thoughts and sending that unexpected and most unwanted adrenaline rush. It’s just momentary, the thought itself lasting no more than a second, the raised heart rate and associated adrenaline buzz however lasting longer. There are days when this is simply exhausting, debilitating and I guess you’d say depressing. Some days overwhelming to a point where retreat to a safe dark room, and the perceived security of a duvet calls out.

I very rarely succumb to that literal security blanket, instead the mask goes up, the appearance of normality, though no doubt those nearest and dearest detect the ‘absence’ and strange distraction, vagueness or (to them) just plain strangeness I seem to be displaying. What should one do? Should one just announce boldly ” Look folks, I have this problem, stuff from the past hides around every corner, behind every door, at every road junction, as a possible consequence of every driving decision”, and it extends to loved ones, those I care about most, nightmare scenarios chattering in my head, ‘what if?’

PTSD is debilitating, exhausting, relentless, ever present, relationship harming, marriage destroying, barrier creating, socially isolating and just makes you ‘Appear Weird, Aloof’

Over 40 years of “Expecting The Unexpected”, ‘dreading’ the unexpected, ‘fearing’ the unexpected, always there, always present, like the chronic pain, the legacy of that ‘unexpected’ moment all those years ago.

Recently, my old friend or (enemy?!) diagnosed by various professionals as PTSD or Post Traumatic Stress Disorder, has been niggling away at me. It happens, it has been happening for a very long time in my case, since 1979 in fact, but has only had an official ‘name’ (diagnosis) in the last few years.

A few years ago I put up my hand and admitted that I needed some kind of therapy, counselling, psychotherapy, talking therapy or whatever. I didn’t know what I needed but I acknowledged I needed something. I’d hit a low point, something was wrong, something I thought might be connected to grief, to losing my Father a couple of years before in 2016.

So, my GP referred me to therapy, I went through what seemed like a selection or filtering process of speaking to therapist after therapist asking different questions until I was placed with a psychotherapist, let’s call her ( ‘A’ ) and after a while, a whole can of worms was opened and each wriggling worm of dark and troubling thoughts from a lifetime led to an exploration of deep stuff that needed dealing with! After several weeks of therapy with (A), she said to me “I think you are suffering with PTSD”, she went on to say “PTSD is outside my field of expertise, but I’m sure you are showing symptoms, here at these sessions of PTSD”. She advised me to go back to my GP and ask for a PTSD assessment via a specialist in that field …

My initial response was “No Way!” You see, I’d heard of PTSD, who hasn’t? And there was no way I deserved that particular badge.

… My initial response was “No Way!” You see, I’d heard of PTSD, who hasn’t? And there was no way I deserved that particular badge. That’s how I saw it, to truly truly hold your hand up and declare “I have PTSD”, you must have earned it, gone through the ‘rite of passage” those veterans, firefighters, emergency service and rescue workers I’d heard about had. They deserved the PTSD Badge … I simply did not! But I learned it is not as clear cut and simple as that.

I wanted to talk about the relentless, ever present daily reminders, not so much the vivid ‘in detail’ nightmare flashbacks (though more later) but the constant, dripping tap like intrusions into every day, every hour sometimes, life. My own PTSD is all related to sudden surprise and shock. In my case it was a sudden, surprise extreme and catastrophically violent impact. And now, to this day, 40+ years later, daily, sometimes hourly, I experience the adrenalin rush associated with the imminent blow I am suddenly, without any warning expecting! This is normal to me. It is distracting, ever present, distressing, incredibly upsetting and absolutely exhausting. But here’s the catch, and I wonder how many readers here can relate, this constant fear, high alert state is endured in silence, in secret, in shame even, without saying a word, without telling a sole, a loved one, anyone … until those therapy sessions that is a few years back. And then it was (and remains) only discussed with a professional, a stranger and one-to-one during various sessions and treatments.

I’ve not had any therapy for a couple of years. To be honest I think I suffered from ‘Therapy Fatigue’ after what seemed like years of weekly sessions. I ended up seeing an EMDR (Eye movement desensitisation and reprocessing) Therapist. I was very sceptical, it seemed like Voodoo to me when first described, but I stuck with it and it seemed to do some good, it did help me to see and consider other perspectives. It was a strange but very revealing process and it helped me understand how I process other thoughts and experiences.

PTSD is not something you casually mention daily, like maybe some other niggling ailment. I experienced trauma at a relatively young age. Such an experience can ‘rewire’ the brain, and I believe it did for me.

In conclusion I’m now in my 60’s, I’ve always felt different, I really wish I didn’t for most of my life, but I am what I am, I am who I am. I’ve tried, I’ve researched, explored, reached out for professional help, and I’ve learned from that exploration. What seems insurmountable, and saddest to me, is my inability to maintain friendships and connections with individuals or groups of other people.

I don’t know if anyone will read this, or if anyone will relate? My hope is that it might help someone feel less alone.

Thank you for reading.

Tibia Nonunion – Closure (or not) of sorts …

Have you ever doubted a memory? Have you, many years later come to the conclusion that you must have been mistaken, surely that didn’t happen. But then you stumble upon something, (and I’ll tell you at the end of this post) that confirms that old memory – and in this case it has made it even more shocking for me!

Back in August 1979, I made a real mess of my right leg. 3 months later, after 6 weeks or so in hospital, bed ridden on ‘bone traction‘ and the dreaded ‘Braun Frame‘ … then home with a full plaster ‘big toe to bollocks‘ as it was known and weighing in at 14lbs! I couldn’t walk without crutches as the plaster (and my shattered leg) was deemed ‘non load bearing’, indeed the occasional experiment (or slip of a crutch) resulting in ‘load bearing’ was a very unpleasant and painful experience!

So, here I was in late November that same year, at the orthopaedic out patients department, dropped off by a good samaritan, long time friend of the family called Alf Challis. I limped my way on those two old style full length wooden ‘armpit’ crutches to the plaster room where that evil one stone dead weight, hard as your house walls, heavy cocoon was split by an electric reciprocating saw blade that was not at all pleasant as it buzzed its way passed the many scars underneath. Into a wheelchair with injured leg resting on outstretched supporting board and onto the x-ray department, then back to the waiting room to await the call from Mr Ahmed, the orthopaedic surgeon into who’s care I had been placed some 3 months earlier.

Now, here I was, just 19 years old, 3 months of hospitalisation and unable to walk, work, do anything much fun. Eager to move on, put this thing behind me etc, etc. I’d watched the progress of many others like me who I’d met on the ward while I was there. I’d seen how these things progress – Full length non load bearing plaster to ‘below the knee’ and load bearing, get that knee joint moving again, actually start to walk again, albeit with a plaster cast but hey, actually walking again. I’d dreamt of not having that solid mass constricting my leg at nighttime when simply rolling over in your sleep resulted in a harsh and painful awakening as the plaster crushed my good leg or worse – my balls!

So, I was expecting good positive news, then in I went to Mr Ahmed’s consulting room. Mr Ahmed was not known for his pleasant bedside manner. He hardly spoke, and when he did it was in a thick accent. He in no way invited questions. As I was wheeled in there he was standing, facing away from me, staring at the x-rays clipped onto one of those old school ‘light box’ units fixed to the wall. He turned to look at my outstretched leg, looked back at the x-rays then walked over to me. He placed his left hand just under my knee and gripped the top of my shin bone (Tibia) above where the fractures were, he looked at the x-rays, shook his head, looked at my leg, placed his right hand below the fracture sites, looked again at the x-ray as if to get co-ordinates and locate what he was looking for. He then tightened his grip with both hands and proceeded to twist in opposite directions and my leg snapped! I nearly went through the ceiling!

“It is no good … It is not healing” he said, “you will have bone grafting … I will take bone from your hip and if in 3 months time it’s the same I will take bone from the other hip, then if no healing after 3 months, a rib”. He was talking about a timeline consisting of 3 month increments, no end point just a 3 monthly cycle punctuated by surgery.

So, there I was alone in that room with Mr Ahmed, in shock from the pain, but more so from the devastating news that I was back at square one! Back in the day we didn’t question or challenge these people, they were ‘surgeons’, pretty much god like, the attending staff nurses on the ward rounds would look at you sternly with a ‘speak when you are spoken to’, silent, compliant respect had to be shown. I said nothing. But I was devastated, and I felt sick at the prospect of Bone Grafting because I had witnessed the post operative and 2 week hospital stay recovery during my first spell in hospital.

A guy arrived called Keith, he was on crutches, non load bearing, he was put in the bed next to me and explained how he’d broken his leg some time before and it wasn’t healing. He was to have surgery, a bone graft the following day. Keith was a Fireman, early 20’s. A really nice bloke, down to earth and obviously tough as nails, no wimp, no soft touch, not afraid of pain (and believe me we met some men that were total babies in that ward) … Part of my shock and fear in that consulting room with Mr Ahmed, was the flashback playing in my head of Keith a couple of months earlier, Keith was also under the care of Mr Ahmed, and Keith really suffered post operatively, and I remember the nursing staff comforting him and explaining just how painful bone grafting was. Keith took it like a man, he was indeed tough, but we could all see how he was suffering … Would I be able to take it?

… I started this post asking if memories can be wrong, imagined? The account above is from way back at the end of 1979! To be honest, I have doubted myself so much over the whole “He broke my leg again” account I’ve told (some) not many people over the years, but then;

Just a week or so ago at the time of writing (August 2021) some 42 years later, I was watching a YouTube video posted by ‘Talking With Docs‘ … they were talking about Tiger Woods injuries and I was interested to hear that his fractured Tibia was not unlike my own injury back in 1979. Then they used the term ‘Nonunion’ to describe the ‘not healing’ comment Mr Ahmed had used as a laymen’s term for me back then. I’d never heard that term and went ‘Googling’ … There’s an image below illustrating a ‘Test’ for ‘Tibia Nonunion’ … low an behold, there in that illustration is precisely what old Mr Ahmed did to my leg that day, without warning, no numbing, no pain relief, no apology!

… Why did I find it so shocking? Because it confirmed my recollection was correct. I’d rather hoped and decided internally long ago that I was mistaken.

But no!

This ‘Bone / Skeletal’ traction confines you to your hospital bed – in my case for 6 weeks!

The Braun Frame for 6 weeks bed bound, and with Bone/Skeletal traction pin through the ankle in my case.

And here in the image below, top left is the illustration Google presented me when searching ‘Tibia Nonunion’ … and what prompted me to compose this post as some form of ‘closure’ on my own experience of ‘Nonunion’ which is ironically failure of bones to ‘close’ !

Top left the ‘Shocking Twist’ in my own story!

I may talk more of my experience of ‘Bone Grafting’, I may not. I’d like to talk more about how the 19 year old me was affected psychologically at that time, I think in many ways that is more important. For instance – I was given no explanation as to why my bones had failed to heal, and I felt like a failure myself. I had taken the calcium pills, the iron pills (as i’d been diagnosed as ‘anaemic’ due to the massive blood loss) and I’d stuck to the ‘no load bearing’ so as not to disturb those re-knitting bone pieces. So here was another revelation and explanation after 42 years, in the YouTube video, the doctors spoke about soft tissue damage and compromised blood supply hindering the bone healing process, and I had suffered both, including a severed artery. At 19, I had chastised myself for not healing faster, I’d seen others back walking 6 months before me. I was very hard on myself and have been ever since, but thanks to the Talking With Docs video I’ve finally learned that something else wasn’t really my fault, and that is ‘closure’ of sorts.

Thank you for reading 🙂

Bone Graft Harvesting – For the non squeamish;

Physical Recovery – The First Three Days …

I write this stuff as therapy. And it works for me. Somehow getting the thoughts out of my head and into written words reduces the frequency of unwanted flashbacks. I like to think, and from feedback I know that to some extent these accounts help people who have experienced similar. And for those who have not, I hope you never do, but encourage empathy maybe for many who suffer in silence. However, these experiences are what have made me the person I now am, for that I am strangely fond, even grateful for having been selected by fate to join this exclusive club.

… My first memory of consciousness after the surgery was of a physical tugging at the foot of the hospital bed. My foot and leg were being ‘pulled at’ by someone or something. Forcing my incredibly heavy eyelids open, I saw a dimly lit and out of focus scene with people standing at the foot of the bed. I recognised only one of the faces, that of my father, the others were nurses and/or doctors, and the tugging I had felt was the attaching of weights via wires and pulleys to a steel pin that had been driven through my ankle and was protruding perhaps a couple of inches each side. This I later discovered is called ‘bone traction‘, …

Thankfully asleep for the drilling/insertion – “a steel pin that had been driven through my ankle and was protruding perhaps a couple of inches each side”

Bed bound for Months like this necessitates ingenuity

… the weights, some 9 pounds on one side and 5 pounds on the other were intended to keep the broken ends of the bones apart so as to encourage repair across the gap and hopefully, healing. That first conscious memory was just that, I suspect less than a minute and at approximately six pm. I had been out cold for the surgery since 12:45pm.

‘a kind and caring nurse would appear, only to give me the bad news that the last morphine shot was perhaps only 2 hours ago!’

The following three or four days are just random flashes of semi conscious memories. I was positioned very close to the nurses station or desk. A busy and noisy place to be on the ward but necessary I later learnt for close observation. The next few days of consciousness / unconsciousness, were punctuated by a cycle of morphine injections to the bum cheek or thigh, changing of blood transfusion bags and changing of blood soaked bed sheets.

Everything revolved around excruciating pain! Pain would wake me from my blissful sleep, pain that would get stronger as the last shot of morphine wore off. Having been awakened by the pain some assessment of my situation was possible. The bed was at a very steep incline, head low, feet high. There was a ‘cage’ over my legs, a metal frame which thankfully kept the sheets & blankets away from the wounds. A triangle shaped ‘handle’ hung from another attachment above my head. This was to be grabbed by hand(s) in order to pull myself up from lying flat. From another frame hung 2 bags of blood, one dripping constantly into the pipe plumbed into my left arm, the other on standby for when the first was empty to ensure a swift changeover. The nurses would fuss around this often and around other bottles suspended under the bed on the right which were draining blood and fluids from the wounds in my leg.

Another ritual I remember because of its pain inflicting consequences was the changing of the sheet upon which I was lying. That severed artery despite being expertly stitched back together in the operating theatre was somewhat stubborn in its willingness to heal, consequently it leaked copious amounts of blood through the sixty stitches keeping the flesh together covering the broken bones, onto the bed sheets.

The nurses would visit every half hour or so and draw with a Biro pen around the blood stain, comparing it with the previous half hours pen mark. They’d then remove the sheet, painfully manoeuvring me and my shattered leg in the process and replace with a clean sheet. I believe they even weighed the blood soaked sheet in order to work out the blood loss! Whatever, it was not my favourite procedure.

So, awake with the morphine wearing off and the pain ramping up, any thoughts of sleep were just fantasy! I would try to be tough and put off the pressing of the buzzer to summon a nurse as long as possible, but inevitably I would give in and buzz. Not being aware of the time (or being in a state to even understand a clock) a kind and caring nurse would appear, only to give me the bad news that the last morphine shot was perhaps only 2 hours ago! They were permitted only every 4 hours! Gulp! Another 2 hours of steadily increasing pain and discomfort until any chance of temporary relief! And that was the 4 hourly cycle, 24 hours, night and day for the next few days. Awakened by pain, increasing in severity for another 2 hours, the morphine shot (painful in itself), 1/2 hour to take effect, blissful feeling of the pain receding then wonderful sleep, for perhaps 1-1/2 hours, then awakened by the pain again. On and on it went!

Once again this is one of those situations that only someone who’s experienced similar could relate to or understand. When in severe pain, five minutes feels like an hour. It was worse at night, less going on in the ward for distraction, all in all, a very lonely negative experience that you have to find a coping strategy for.

I was 18 years old and all previous routine normality in my life had gone, changed, in a split second.

‘make sure your underpants are clean in case you have an accident‘

Thinking now about those first 3 or 4 days, I have no recollection of visitors, although I know I did have visitors, family, my girlfriend, not sure anybody else would have been allowed at that stage. I guess it was the morphine that has rendered those first days just a dim memory of the 4 hour pain-relief-sleep-pain cycle.

I do however quite clearly remember a delicate operation to remove the only item of clothing not cut off in the A&E department. There is a great Billy Connolly sketch (Link tba) in his stand up routine where he berates his mother for that old saying ‘make sure your underpants are clean in case you have an accident*’ he rants in his inimitable way how insignificant a pair of dirty pants might be when your body is smashed by some accident.

It’s a great sketch and reminds me of my own under pants and their eventual removal sometime in those first few days. I’d worn a pair of horrendous bright yellow Y-fronts with white piping. Because of the (a) the camber of the road and (b) the steep incline of my hospital bed, these had become saturated with blood, and they had to come off!

Now the Brook hospital was a teaching hospital with many student nurses, I was 18 going on 19 and many of those nurses were not a lot older than myself and two young nurses whom I got to know quite well and became friends with in the following months, were sent (possibly as a test for them, which happened a lot I learnt) to remove the offending pants in a as dignified way as possible, given that I could hardly move and in order to navigate the traction wires, pulleys and paraphernalia, the pants needed to be cut off. Now, in the state I was I couldn’t care less about my dignity and remember telling them politely so through gritted teeth and to get on with it whichever way was easiest for them, so out came the scissors and the jokey comments from me to ‘be careful with those’ and in a very slick and discrete manoeuvre off they came and on went what can only be described as a cross between a large cotton handkerchief and and those sexy bikini bottoms that tie up at the sides! The nurses had passed their test with flying colours and ticked another process off of their ‘skills sheet’ something I understood fully due to my own apprenticeship of which I was in the fourth of five years. The nurses had knowingly informed and advised me to get someone to modify a few pairs of my old pants, cutting through the seem of the right leg and stitching Velcro for easy removal / refitting. This was duly done by either my mother or girlfriend, I can’t remember which but they served me well in the months to come lying stuck in that bed, leg permanently attached by wires and via pulleys to those wretched traction weights, and the dreaded ‘Braun Frame’ (more of which later).

Thank you for reading

Previous: Conscious throughout

Next: Physical Recovery – The move to the Long Stay Bay

*I will post a link to that Billy Connolly sketch when I find it.

Skeletal Traction

Originally Published on

12/19/14 12:04 PM

Conscious Throughout …

From the archives [ Originally published October 16th 2014 ] Please bear with me as I migrate these old posts from the now defunct Google Blogger

I’ve carried this around since 1979, never written it down, it often flashes back to me in the middle of the night, I don’t know why I’m writing it down now, but I am. Perhaps my recent acceptance of the resulting Chronic Pain condition has fed my compulsion to share or just exorcise old demons

… It was 10:30am, Monday 20th August 1979. A bright, warm sunny summer’s morning. The the first day of my two week holiday away from work and I had set out on my pride and joy, my Honda CX500 motorbike. I stopped to pick up my girlfriend, we were childhood sweethearts, having lived opposite sides of the road. We’d known each other for many years. At age 14 she started a saturday job at the grocery shop where my mother worked, I was 16 and we became boyfriend & girlfriend. At the time of this account, we had been together for over two years, she had just turned 16 we planned to tour and camp for the next few days as the weather forecast was good. So we set off from Erith in Kent where we both lived a short distance apart en route to Lewisham where we planned to do some shopping for our trip to Hampshire the following day. At the junction of Wickham Street and Bellegrove Road, I turned right, and straight into the path of a white Renault 16! The driver didn’t have a chance to brake. Bang! The most horrendously loud, sudden and incredible violence. The only way I can describe that moment. My right leg taking the full impact, the bike’s petrol tank, foot peg frame and the cylinder castings forming a strange shaped anvil into which my leg was hammered by the bonnet of the car. I can conjure up that instant any time since, and it has an annoying habit of flashing back to me daily, every time I make any similar right turn manoeuvre when driving on the roads even now.

“watching my right leg fold and bend in places it shouldn’t”

Disorientated, confused and totally stunned, I dragged myself from under the bike now lying on the tarmac, i remember the image of my right leg inside my jeans and my white training shoe tracing the shape of the bike as if the foot was not connected but just hanging and the jeans leg still covering my leg bending and flowing as if there were nothing inside the jeans. My instinct was to find my girlfriend and see if she was ok. Desperately I clambered to stand, and I did, for a moment, before collapsing to the ground, watching my right leg fold and bend in places it shouldn’t, seeing this and feeling nothing, then crumpling to the ground, seeing the red stain seeping through my jeans and the pulsating squirt of blood hitting my white trainer that was facing the wrong way, the toe end now tucked under my knee. I struggle to get my helmet off and I fell back, lying my head on the tarmac, dazed, shocked and seeing only the sky above. It is at this point, 30, 40, 50 seconds after the impact that the pain hits, and hits it does! I will not attempt to describe the pain. It is pointless. Many times in the years since people have asked about the pain. My answer depends upon what I know of that person and their own history and experience of pain. I have concluded that if I am talking to someone who has not experienced that level of fully conscious destruction & mutilation to a major limb or limbs, then only a smile and change of subject will do. On the other hand, when speaking to someone who has experienced the same or similar mutilation to their body, there is never conversation relating to pain, just an unsaid and understanding empathy. The whole pain issue has haunted me ever since, especially when trying to relate to someone who simply does not and cannot understand. It is a very isolating condition and probably what is now considered PTSD.

“I was in a very bad way in terms of shock, and THAT PAIN!”

So, back to that time 50 or so seconds after the collision, lying absolutely still in the middle of a (usually) very busy road, traffic beginning to back up, looking up and then one, two three then more people begin to stand around me looking down. This ever increasing forrest of people surround me. Fate had dealt me a fortunate coincidence in the form of an off duty nurse who lived adjacent to the junction(1). This very kind and professional lady took charge and was the only member of the ‘human forrest’ not standing, she knelt beside me and. I do not recall any conversation with her or anyone else for that matter, I was in a very bad way in terms of shock, and THAT PAIN! My only question to the forrest of people was asking after my girlfriend. The nurse lady knelt at my side somewhere down near my lower legs. Another ‘kneeling’ person joined her, a man in shirt & tie. At some point here I attempted to lift my head in order to see my leg, the kneeling man and others encouraged me to lie back, to look away, the phrase …

“Nothing to See” – A similar injury to my own

“there’s nothing to see, lie back, you’ve broken your leg, don’t look, there’s nothing to see”.

The forrest of people was joined by my girlfriend, who was pillion on the bike & fortunately unhurt having been thrown clear. The girlfriend I mention in this piece later becomes my wife & mother of my eldest three children. There will be more about our life together in another post sometime.

The “there’s nothing to see” chorus I seem to remember coincided with her coming into view, the look on her face as she burst into tears having looked directly at my mangled leg told me all I needed to know. At some point here, due to the camber of the road I became aware of the wet road on this sunny dry day, the wet was of course my own blood running down the camber of the road and past my head. I noticed the kneeling shirt & tie man helping the nurse, his hands, forearms and shirt covered in blood. The nurse aided by this man and possibly some others carried out the necessary but absolutely agonising procedure of straightening the leg, again, unless you have experienced similar there is no point me trying to explain.

“Remember this is 1979, ambulances are fairly basic, no paramedics or doctors on board, just a driver & assistant, first aiders basically”

I have absolutely no idea as I write this of how much time has elapsed since the collision and subsequent blocking of a busy road by my mangled and bleeding body. The collision was approximately 10:30am, it may now be 10:45, I’m aware of some activity behind my head. A large truck was being guided past, inching slowly, its huge wheels seemed way too close to my head as I recall, much shouting and delicate guiding of said huge truck past the accident scene. I guess I will never find out what important journey justified such a delicate & risky manoeuvre. I am now aware that some of the human forrest are wearing police uniforms, notepads in hands, asking questions. I remember thinking to myself ‘why am I conscious? This is unbearable, they pass out in the films’. Other uniforms appear, the ambulance people. Remember this is 1979, ambulances are fairly basic, no paramedics or doctors on board, just a driver & assistant, first aiders basically. They proceed to take over from the lovely nurse(1), I think I thanked her profusely and the shirt & tie man also who was consoling my still sobbing girlfriend, apologising for his ruined shirt etc. The ambulance driver and mate start messing about with my leg, more agonising movements as they lift the leg and place it in an inflatable splint, again any attempts by me to see what is going on we’re met with “no, don’t look there’s nothing to see”! But there was plenty to feel. I asked if I could have anything for the pain, no sorry was the reply, you are going to need to go to the operating theatre when we get you to the hospital, we can’t give you any drugs because of the anaesthetic they will be giving you. You can have some gas and air in the ambulance they added. So at this point, not only quite devastating denial of pain relief but also the first mention of surgery. The realisation that this is genuinely serious hitting me now, not just me perhaps not coping too well, operating theatre and soon. The ambulance men had now very unpleasantly inflated the ‘splint’ and were now assembling a contraption around me, it was a kind of split stretcher, with tapered wedge like halves that were slid under me from each side, again very uncomfortable as any movement at all was. The stretcher was locked together with various clicks and clunks, and then I was lifted onto an adjacent wheeled stretcher and painfully manoeuvred to the open ambulance doors. The forest of people had now either disappeared or my full attention had been drawn to the approaching insides of the ambulance. A frightening sight (Years later the sight of an ambulance, lights flashing and especially the back doors open, brought me out in a cold sweat), all those bits and pieces of medical equipment, pipes gauges etc, etc. The trolley thing raised with an agonising jolt, then slid me and the split stretcher into the ambulance. My girlfriend climbed in still crying & in shock herself, I do not recall any conversation with her. She was too young to put on a brave face and attempt to comfort me, she was horrified at what she’d seen and absolutely petrified at the thought of what was going to happen to me. The ambulance began its short but bumpy thus incredibly painful journey to the Brook General Hospital.

“it did nothing for me in terms of pain relief, it just added another negative feeling”

I was 18, I was frightened, I’d been in intolerable pain for more than half an hour, and I’m not ashamed to say that I was pleading for pain relief. The ambulance man handed me the mouthpiece of the gas & air, this I grasped and sucked on manically, too manically apparently, it did nothing for the pain but it made my head spin and buzz in a way I’ve thankfully never experienced since. It was not a pleasant experience as many say it is, it did nothing for me in terms of pain relief, it just added another negative feeling I could well do without! During my maniacal session with the gas and air, the ambulance man with us in the back proceeded to mess about with my leg again! This time to position a contraption that I got a better look at later in the A & E department. It looked like a long metallic box and it’s positioning was agony.

“it was a contraption for collecting blood. My blood, lots of it”

None too soon the agonisingly bumpy ride came to a halt, doors opened, bumpy trolley, open air, those old swing doors bumped painfully open by the feet end of my trolley (none of those automatic doors back then), the still sobbing girlfriend taken aside by a nurse and the nightmarish scenario of the fluorescent ceiling strip lights sliding past above. I say nightmarish because I was totally overcome by fear at this point, no control over my body, my destination, my fate. I was really scared at what lie ahead. I believe that it was at this point a feeling, a kind of 6th sense, something I experienced just once more a little later and thankfully never since. Difficult to describe a real dread. Now due to some extreme wet weather recently, the normal A & E department was out of action, there was a temporary makeshift emergency department where the usual separation of serious / less serious incoming emergencies were for a time at least, lumped in together. I mention this as I later learned this fact when recovering for weeks on the ward, but I did feel for the other patients who were sitting waiting just beyond the knee high curtains hurriedly drawn around my trolley bed thingy. I was lifted bodily by the porters and slid over on the split stretcher and ‘metal box device’ sideways onto another bed. It was here that I discovered the function of the ‘metal box’, it was a contraption for collecting blood. My blood, lots of it, as I was moved it spilt it’s contents onto the floor, the first sound of blood splattering onto the shiny hospital flooring, what a nightmare for those poor people sitting close by waiting to be seen with their minor injuries!

“Every new professional I saw I asked (pleaded) for pain relief”

Semi organised chaos prevailed from this point on. The porters & ambulance men departed and a gaggle of nurses uniforms & white coats fussed around me, cutting off my clothes, shoes everything except underpants. Blood pressure cuff on on one arm, and the other (left) arm held out straight by two male nurses, (meaningless at the time) blood pressure readings were being called out & the two male nurses commanded me to make fists etc, there was a sense of professional panic or perhaps just haste and I was aware that my leg seemed to be less of a priority than the plans they had for my left arm! On went a tourniquet, one of the male nurses started tapping, banging then thumping my inner arm at the elbow, there was an urgency and the nurse taking blood pressure continued to call out numbers that meant nothing to me but their professional concern and tell tale glances to each other conveyed that there was a problem to be sorted. I later learned that this initial problem was quite a simple, basic but potentially life threatening problem, I was bleeding to death. The artery in my lower leg had been severed by the broken bones on their way out through my leg and into the open air, I had lost so much blood (which is confirmed by the falling blood pressure) that my veins had collapsed and therefore getting a ‘line’ in was very difficult. Thankfully, those doctors & nurses in A & E struggled to find a vein in my arm, they cared, they fought hard and they re-assured the frightened 18 year old boy lying before them. More doctors appeared and peered at my leg, there seemed to be a succession of doctors appearing, looking, whispering to each other and more than once asked me what exactly had happened? Had my leg been ‘run over’? All I could say was that I didn’t think so but didn’t really know either! Everyone new I saw I asked (pleaded) for pain relief, no sorry, was always the answer due to imminent surgery. About now the porters reappeared, painfully & messily (another huge splash of blood onto the floor) as the blood collecting contraption was moved with me, the stretcher and now bags of blood being transfused into my arm all en-route for x-rays. So I was on the move, fluorescent lights passing by again on the ceiling, me the porters and a young nurse escort who held my hand, explained and reassured me from this point onwards. The x-rays were a horrendous ordeal, those poor radiographers had the delicate & very messy job of x-raying my mangled leg. I was so grateful to the young nurse who held my hand and joked to take my mind off of the horrendously painful procedure. Often think of her and just by her manner, words and genuine caring, she helped so much. The 18 year old me in 1979 owes much to these professional people.

(I learned later [Warning Some Links Graphic] the X-rays revealed several open comminuted fractures to the Tibia with two open ‘compound fractures’ broken fibula again compound, severed Anterior Tibial Artery,

severed Tibialis Anterior ‘lower leg muscle’, dislocated ankle and fractures to the knee)

The image below shows a comminuted fracture (basically shattered into many pieces) My own injuries were complicated by being ‘Open Comminuted’ where the shattered bones were exposed having been forced out through the flesh and muscle. Many months later I would require further major surgery for ‘Bone Grafting’ (Basically replacing the missing pieces with bone removed from my pelvis) … this was due to ‘delayed union’ and in my case ‘non union’ due to all the soft tissue damage which compromised blood supply to the bone.

$comminuted-and-compound-right-lower-leg-fractures-pilon-fracture-ADTTN0$

The bags of blood were in duplicate. As one drained it’s contents into my arm the valve on the other would be opened and the empty bag replaced with another full bag. The blood capture contraption was failing miserably and the x-ray table, plates & floor were getting covered, the now familiar ‘splash’ on the floor was heard again in the x-ray room. I learned later that the successful start of the blood transfusion is not in itself a life saving happy ending. In my case, the blood was haemorrhaging from my severed artery faster than the top up from the transfusion bags. I was still bleeding to death basically. Of course I didn’t know this at the time, or did I? I’ve wondered if it would be possible to articulate the next part of this account. It may be the reason I’ve felt compelled to write it all down. Somewhere about now in the timeline of this few hours on that Monday morning/afternoon, I became overcome by a feeling I’d never experienced before or since. A real creeping feeling of dread. I guess it is a primeval instinct or awareness of hopelessness. I believe at this point, something happened within my mind, brain, consciousness, whatever that is. I became aware that there was a real, unsaid, instinctive realisation that I might not survive. But no panic or hysteria, I was too weak perhaps for that, but I had lost so much blood (I learned later) I was in mortal danger now. I could literally feel the life draining from me. An awful feeling that perhaps like the pain cannot be communicated to anyone who has not been in that same situation. I remember thinking that this was a crazy way to go, a road traffic accident, how pointless, ridiculous, what a waste, only a couple of hours earlier I had routinely closed my front door behind me and set off like any other day. But that feeling, that feeling of indescribable dread and hopelessness, I couldn’t move, I just lay there, the life draining out of me with absolutely no control over my destiny whatsoever. Perhaps this is why to this day I love and respect those people who dedicate their lives to helping others. I have absolutely no time for those who, I suspect with no experience themselves, knock and disrespect the NHS and it’s staff. They simply have no idea, without those wonderful people I would have died and from something as ‘comical’ in some contexts as a Broken Leg. Anyway, whatever that instinctive feeling or sense was, I would not wish it on anyone.

The medical talk around me now was of imminent transfer to the operating theatre. They had looked, they had assessed, seen the x-rays of the internal damage not obvious, and the gory external protruding bones, muscle, flesh and blood. The porters re-appear and proceeded to take me and an escort of nurses, doctors to the theatre. In the anaesthetic room I was parked between benches and shelves of equipment, the double doors with their circular ‘port hole’ type glass windows waiting closed. A man approached in full surgeons gear, with his assistant. He introduced himself as Mr Ono, he was very jolly and down to earth, he proceeded to explain that he was going to ‘clean up’ the ends of the broken bones and put my smashed leg back together. In a more serious tone he told me that he could not ‘promise’ anything, but he would do his best. At least once more he repeated ‘No Promises’. I’m not sure that I really understood what he meant by that at the time, later I realised he meant that I may or may not wake up with two legs, but I do know that despite that impossible to describe feeling of dread I’ve already mentioned, I never once doubted that I would wake up (Was that the Fight for life of which people speak?). Things happened very quickly from here, still conscious I was manoeuvred into the theatre and onto the hard and very narrow ‘table’ everyone here hatted, masked and gloved with only eyes showing, the anaesthetist was fussing around and I was petrified. It is now approximately 12:45, the last two and a bit hours had been a living nightmare for me. As the longed for relief from the pain, the tension, fear and dread all all began to fade into a blissful pain free sleep, the 18 year old boy drifted off into the dark unconsciousness to awake several hours later a physically, emotionally and mentally changed man.

Thank you for reading

Next: PhysicalRecovery – The First Three Days …

I write this stuff as therapy. And it works for me. Somehow getting the thoughts out of my head and into written words reduces the frequency of unwanted flashbacks. I like to think, and from feedback I know that to some extent these accounts help people who have experienced similar. And for those who have not, I hope you never do but encourage empathy maybe for many who suffer in silence. However, these experiences are what have made me the person I now am, for that I am strangely fond, even grateful for having selected by fate to join this exclusive club.

There will be more of this story and my recovery. Life threatening shock. Months in hospital. Bone grafting, learning to walk again and the psychological effects.

(1) – belated thank you to the neighbour/nurse. was it you? Here: maps / junction, and the shirt & tie man.