Picking up where I left off

I think this is where I left my recovery story - I will read on to see if there is more, but I think this is where I need to pick up the story... More soon.

The following was first posted 6 December 2010

Unfortunately, I picked up a bit of an injury over the weekend that has interrupted training. I have strained a muscle in my right shin which is causing quite a bit of a haematoma (bruise) in my lower leg. It's quite painful when I run and, even though I managed an hour long run on it on Saturday, I had to miss yesterday's long run. This is the second time I have had this type of injury - the first being when I was training for the Southland marathon last year - but this time it seems to be less severe.

Thankfully today is a rest day and I don't have another run scheduled until Wednesday. I'm hoping it will be okay on the bike tomorrow evening and it should be fine in the harbour (at 7am tomorrow).

Plenty of rest, a compression stocking and regular icing seems to have accelerated the healing process and it is starting to loosen up already. When the gall bladder infection settled down in August 2001, though, the haematoma I had then was a little more serious and in need of a bit more attention than a bit of rest and some ice.

31 August 2001, Austin Hospital

My condition has stabilised now and I haven't had any gall bladder attacks or fevers for about 36 hours. The nurse was in about half an hour ago to tell me that they would be transporting me back to Bethesda Hospital later today, but that they first wanted to change my dressings.

Changing my dressing is still pretty painful (see A bit sore) but I have become used to dealing with it. The major problem at the moment is that the swelling around my abdomen has become so bad that the cross bars on my external fixators have begun to rub on the wounds where the fixators enter my body. As a result I have developed a couple of really nasty ulcers around the base of my fixators that are now also requiring some attention. When I am rolled on to my side these new wounds are enlarged ever so slightly as the weakened skin and flesh tears a little. So, by now the wound around the right fixator is about the size of my thumb and very ulcerated (just like a mouth ulcer).

The swelling is now also making it extremely difficult to roll me to redress my gravel rash wounds on my torso and it takes several people to undertake the whole operation: two or three to roll and hold me and one to dress the wounds.

The team have just come in and they roll me to the right to reveal the wounds on my left. They are dressing the wound as normal and finish without a hitch. I'm back on my back now and I'm pumping the morphine button (PCA) to make sure that I am ready for the wound on my right which is much bigger and sensitive than the one on my left.

"Okay, ready?" says the nurse. "As ready as I'm going to be," I reply. I'm being rolled slowly and carefully on to my side. "STOP!", I shout, "I can feel a tearing by my fixator!" They stop and check out my fixator wound and it turns out that there is a small tear in my wound. It's not really painful and it's not bleeding, but there is a small amount of clear fluid seeping from the wound. "I think we can carry on with the dressings now," says the nurse as she mops up the fluid.

The rest of the dressing process goes without a hitch and they turn their attention to the new/expanded  wound around my fixator. It's 'oozing' (as they describe it) quite a lot of fluid so they pack it with gauze to soak it up.

An hour passes and they come back to check it. As they remove the bandages covering the gauze, the full extent of the oozing was revealed. It has soaked right through the gauze and is beginning to pool in the plastic undersheet lining the bed. A quick discussion and the charge nurse decides that the underblacket and plastic sheet will have to be replaced even though I am being relocated later today. So, here we go again, more rolling and more pain...

This is going to be quite complicated as they are going to actually lift me off the bed and the swelling hangs off my backside whenever that happens. It's bloody excruciating and, without the crane that Bethesda has, I am not sure how they are going to manage it.

Step one: they roll me one way and bunch up the blanket and plastic sheet as far as they can. Step two: they roll me the other way and bunch the rest up. Step three: lift and remove. Problem: It's impossible to lift me. "One last try," says the charge nurse, "it has to come out." "One, Two, Three, Lift!" They all lift and the charge nurse pulls as hard as he can. "Ahhhh! You ripped me!", I yell. All at once they replace the plastic sheet and return me to my back.

Now there is a real problem. The ooze is coming out really quickly. The gauze is becoming sodden as soon as they pack my wound. They keep repacking it and eventually it slows a little. Any time I move I can feel it running down the inside of my thigh, but there isn't much pain so I ignore it.

A couple of hours have passed and I am in the back of an ambulance being transferred back to Bethesda. The ooze is pretty disgusting by now and I am soaking wet. The ambulance arrives at Bethesda and I am wheeled back into the rehab ward. It feels great to be back. I've only spent a couple of days here, but it feels much more welcoming than the Austin, perhaps because I know it's going to be home for a while.

The ambulance drivers hand me over to the nursing staff and explain about the ooze. A nurse takes a look. "Oh, my God!", she says. I am sure that can't be a good thing. A few minutes later Mary-Lou, the registrar, appears and looks at the wound. There is an instant look of shock on her face as she realises what is happening. "Righ,t let's get this sorted", she exclaims. "I can't believe they sent you back like this. How long has this been like this?", she asks. I explain what had happened.

"You have a massive haematoma in your torso and now it has direct access to the outside. We are going to have to milk it. Are you okay with that?" Mary-Lou explains. Of course, I agree but I ask for a quick explanation of what they are going to do. In essence, she explained that it would be like squeezing a massive pimple.

The process begins and litre after litre or haemoserous fluid is milked from my body. It is caught in a funnel held against my hip and placed in a bucket. After about an hour of milking, 9.5 litres of fluid is collected in the bucket and the oozing has largely subsided. The swelling that has plagued me since my accident is now gone and bags of limp skin hangs from my side. What a relief.

Post script: This event turned out to be a turning point in my recovery. Now I was unburdened by the swelling that had caused so much pain. It was also the source of my infection as this massive abdominal haematoma caused by a closed internal de-gloving injury had been communicating through my wounds with the outside world.

That night I underwent surgery to clean the ulcerated wounds around my fixators, insert six suction drains that would continue to drain the haemoserous (the clear fluid that you get on wounds that helps the healing process) from my torso and to do a thorough cleaning of my gravel rash wounds.

The whole process gave me a new starting point. A new lease of life. A renewed determination to get through this. Tomorrow is a new beginning.