A bit sore

My calf muscles have been a bit sore this week after a jump in intensity for the week. I hobbled around a bit for a few days and had nasty cramps in both calves and feet while swimming for the first part of the week. 

In fact I don't think I can put all of the soreness down to just the lift in intensity. I am pretty sure that poor hydration has a lot to do with it as well. I came to this realisation yesterday, when I tried to give blood and the nurse said that she couldn't find any veins (fortunately she only stuck me with the needle once before giving up). I asked her if it could have anything to do with my training, she gave me an 'absolutely, yes' response. "You are dehydrated. When you are dehydrated your veins tend to go deep." That will explain the soreness and definitely the cramp. No cramp this morning after hitting the water bottle hard yesterday and the legs were much fresher.

The soreness this week pails into insignificance in comparison to the pain that I experienced a few days after my accident in 2001.

24 August 2001 (three days after the accident)
The sun is shining this morning and my room seems a little more cheery than usual. There is a new nurse doing the rounds. She seems quite young and she's a little bit matronly, with chest puffed out and an air of self-importance. She's nice enough though and was quite chirpy when she opened the curtains to reveal the sunny day outside.

"I am going to be changing your dressings today," she informs me. "We'll do it before your visitors get in." "Okay", I reply. She tells me to stock up on morphine, so I merrily push away on the button on my PCA. I know that no matter how many times I push the button it stops at an hourly maximum dose as soon as its reached, but I am keen to make sure I reach that dose as I am acutely aware of how painful the whole dressing change process is.

About 30 minutes have passed since the new nurse left to get all of the gear and she's returned with a small army of orderlies and nurses who are here to turn me over. It's a bit of a major mission as by now I have swollen to almost the entire width of the bed. My torso and thighs are bulging to the point of bursting and when they turn me all the fluid moves with me. The movement of the fluid puts pressure on my broken bones and my external fixators (the scaffolding holding my pelvis together) need to be kept stable so its a slow and extremely painful process just to get me in position to remove the dressings that cover about 20% of my body.

On my right side the dressings are in two sections: the outside of my entire right thigh and then from the back of my hip to my ribs. On the left there is just one dressing about the size of an A4 sheet of paper around my hip and lower back. All the dressings cover the area of gravel rash, where layers of skin and, on my right side, about a 1cm depth of flesh at its deepest were removed by the pavement as I was spat out the back of the truck.

The nurses and orderlies are in position: two on the right of the bed and one on the left to roll me and the new nurse ready to remove, clean and replace the dressings. They grab my bulging left hip and begin to turn me on to my right side. I scream in pain as the fluid surges across to the right of my body and the weight presses on my still freshly broken pelvis. "STOP! STOP! Can you go slowly, PLEEEASE!" "Sorry, sorry, we'll be more careful", a male orderly comforts. They gently begin rolling again and, even though it is still pure excruciation, I am able to bear the pain this time.

The new nurse begins to peel back the dressing and, as she does, the build up of  'ooze' from the wound begins to run through the opening, down my back and on to the plastic sheet placed underneath me to catch it. The air rushes in, just like it did in ICU (see Back in land of living) and the pain is instant. I wince and grit my teeth, but don't make a sound. The nurse removes the dressing and begins to clean around the edges of the wound. I can't help but hold my breath and clench my fist as the pain intensifies. Then I start to zone out a little and, I know that people are talking to me, but I have no need to hear what they are saying; I am trying to block out all sensation. This nurse is certainly making sure that everything is clean - that matronly character is really coming through in her thoroughness and it's excruciating.

'Just 5 more minutes', I keep repeating over and over in my head and eventually I am turned on to my back. "Half time, change sides", I manage to squeeze out with a forced smile. "Pump up your morphine before we start on the other side", one of the nurses suggests. I pump my thumb on the blue button frantically as if my life depended on it. They give me a few moments for the drugs to kick in.

They roll me gently and slowly on to my left side. I am facing away from the window now and steering at the side of my bedside cabinet. Matron  peels back the dressings and I wince again. I clench every sinew of my body as I brace myself for the abrasive wipe of the gauze as it is rasped across my wound. The pain is impossible to describe - try to imagine a graze on you face being cleaned with coarse sand paper ... with a high speed orbital sander!!!! It's too much. I scream again at the top of my lungs - there is no way I can hold back. "Sorry, I have to do this", the matron implores. "No, no, please no," I sob like someone begging for their life. "I'm sorry, I have to." I feel the grip of the orderlies and nurse tighten to brace me for what is about to come. This is pure torture. This can't be right. With every wipe of the gauze the pain magnifies ten fold, until I can take no more and then, for a moment, everything goes black. The only noise is white noise ringing loudly in my ears and am no longer conscious of what is going on around me. Then, another wipe or two and the dressing is replaced.

As I am rolled on to my back again, I am now more aware of my surroundings. An older nurse comforts me as the matron cleans up the used dressings and leaves the room. I lean over the remaining nurse and beg her not to let the matron do my dressings again. She reassures me that she will pass on the message.

The matron never changed any more of my dressings!