9th November 1999
Today I had another visit from the CPN (Community Psychiatric Nurse). Not to cast aspersions upon these trained people, but I sometimes do wonder......
Whilst I accept that many people are not aware of the real problems dogging their attempt to regain their mental well-being, I find it , shall we say, annoying that a medical professional appears unable to comprehend the how or why that an Ilizarov frame makes one feel vulnerable.
For the record, I live in a rural area, along an un-made, pot-holed road, covered at present in piles of fallen leaves, there is one single street light and I have 18 narrow, concrete steps to negotiate from ground level to my front door. And even considering all this, I am asked why I feel unlike going out at night.
Of course, prior to the accident, I took all this in my stride (literally!), but so many people seem totally unable to grasp the concept of fear when it's with reference to things they regard as normal and easy.
Similarly, I grow mildly(!) irritated, when questioned as to the reasons that I feel insecure amidst large (or not so large) crowds. This applies to shops, stores, supermarkets, pubs and most places where people gather in large groups. Is it really so difficult to understand.
However as it appears that, for many, this is a difficult concept to grasp, I offer the following for their edification.

  1. Because someone seems to 'handle' their fixatored situation in their own home, do not expect that this apparent security will automatically extend more than a few inches past the front door.

  2. Large groups of people appear to exhibit being cloaked in what author Douglas Adams refers to as an S.E.P. field where S.E.P means,
    • Somebody
    • Else's
    • Problem
    Ergo if you are on crutches or in a wheel chair or exhibit any non-normal method of mobility,

    YOU WILL BE COMPLETELY INVISIBLE!

    and thus, apparently you become a perfectly reasonable target for assault with shopping carts, boxes, bags, loose children, wet floors, poorly arranged point-of-sale displays. Need I continue????

  3. Darkness hides all manner of potential problems, be it unmade roads, dog excrement, loose paving stones or distant relatives of Dick Turpin (Who's probably revolving in his grave the way footpadding has degenerated.). Therefore, despite the majority of accidents always supposedly occuring at home, I, for one, would rather take my chances with a dangerous comfy sofa than a wet sidewalk.

  4. And finally, just because it causes YOU no concern, remember one man's meat is another man's trip to casualty with salmonella!

Sorry for the rant, call it webwriter's rights.

11th November 1999
Today King's College Hospital hosted an orthopaedic nurse's seminar on the management of trauma
[Click
Here to see the agenda]
I was asked if I would like to attend as sort of a demonstration model, the Ilizarov in the flesh so to speak.
And as there was free food, what could I do but say yes!
I arrived at about 12:30 as lunch was beginning (wonderful timing). It was good to see most of the medical staff who had ministered to me on my two stays at King's. I even met one of the nurses who'd been working at Bromley hospital when I was originally admitted after the accident in '97.
During the afternoon, after lunch, although invited to sit in, I chose not to attend the lectures. [Yes I freely admit to biological visibility cowardice = I don't like blood!] but sat and talked to the representatives of Smith and Nephew, Ilizarov frame distributors and Tyco Healthcare, distributors of sequential compression systems. These are similar in function to the AV impulse machine that I tried [See the page AV Impulse therapy] but they cover the entire leg length and 'massage' the blood flow along the leg by a series of sequential, intermittent, circumfential compression waves. Lots of words for something that basically helps the heart by pushing blood around that otherwise could become fairly static in the veins with the inherrent risk of deep vein thrombosii.
And it feels good as well. Well, I had to have a try didn't I?
Anyway Later in the afternoon, the workshops were held. At this time I took my seat where Nicky, the Senior Physio was giving her talk on the role of physiotherapy in assisting trauma victims and those with external fixation specifically.
Some of the nurses had not seen an Ilizarov frame before, at least not actually hanging off the end of some one's leg! I am pleased to say that I was able to answer all the questions that they had regarding my views as a fixatored patient.
As always I painted no glowing picture of pain free wonder cure. I am the first to admit that, barring my infection problem this year, I've been very lucky with the level of pain I've had to tolerate. But the Ilizarov is most definitely worth a try if amputation is the only other choice, in my view anyway.
Many were amazed at the amount of mobility I have over the frame. Indeed I am still certain that if it were not for the foot pins, I'd have been walking, maybe even without crutches, quite some time back.
I handed out a lot of cards for the web site and was pleased to hear that some of the nurses had already found the site and felt it most helpful. I finally got my transport home at about 18:00. I must admit to being exhausted, and that my leg ached a bit around the knee, but I suppose that, considering the fact I kept hauling the thing into the air for Nicky to point something out, then really, it did quite well.
I had a good day and so, it seemed, did the nurses. My thanks to both Phil & Nicky for inviting me and for their kind letters of thanks that they sent to me later. It was my pleasure to help.

1st December 1999. ONE BIT DOWN, THREE TO GO!!!!!!
Well today was the day where I might have become un-framed. I didn't know if I would for sure but Mr Groom had said there was a definite maybe.
So up with the crack of dawn, all washed and polished and ready by 7am. Last time the transport turned up for me at 07:25 so this time I'll be ready.
My appointment was at 08:45 but by 09:00 I'm still sitting in my front room waiting. I rang the hospital and told Sister Phil that I was going to be late and then I rang the transport section to find out where my car was. Apparently he was on the way. Suffice it to say that he finally got here at 10:15 to collect me and still with 2 more pick ups to do!
I eventually got to hospital at 11:15, some 2.5 hours later than my appointment! AAAAAArrrgghhhhhhhh!!!!!!!!!
Any how I get my x-rays done and go in to see Mr Groom who looks at them and says he's very pleased. Then those fateful words
I think we'll get the foot plate off!

So in I go to the treatment room whilst Sister Phil goes off for the tool kit.
When she returns and starts setting out the other bits and pieces, I set to loosening the bolts on the foot plate wires and pillars.
It's quite an odd sensation as the tension on the wires is released, odd but not painful.
Having removed all the nuts and bolts, Phil then set to, cutting the wires so they could be pulled through. And of course, me being me, the first one we try, through the front of the foot, won't even move. In any direction.
So Phil tries the two in my heel and they come out like a hot knife through butter. There's no pain as such nor any blood at all but at least I now know what a kebab feels like when it's pulled off the skewer!
And so attention returns to the front pin. Phil pulls it to the left, pulls it to the right, tries turning it, Pulls it from one end while I hit it with a spanner on the other.
It won't come out. What's more it's not even moving. Mr Groom was dealing with someone else so Miss Phillips, the other consultant comes in and has a try and neither she and Phil combined can shift it.
So I'm sitting there with and inch of metal sticking out either side of my foot thinking 'This is fun - not!'.
Now if you've ever seen MAD MAX 2, there's a bit at the beginning of the film where one of the Humungous warriors of the Wastelands pulls a cross bow bolt out of his arm. Now that has always made me cringe especially as he appears to give it a good twist before he frees it. OK I know it's all just special effects, but it works for me!
Any how I suppose I must have taken leave of my senses because I had a go at shifting my pin in a similar way. With a vice-like, if sweaty grip on the pliers I found that I could just, and only just, get the damn thing to turn by heaving on it in the general way you'd haul a rusty nail out of a piece of timber.
You could actually see that it was moving. Therefore it should come out! But it wouldn't. So with a bit more discussion and after a few more complete rotations had been applied by me with the pliers, with Phil pulling hard one way on the pin, me forcing my leg in the opposite direction and applying an upward pressure to the pin with one hand and tapping it with a spanner with the other, finally it came free.
I'd like to say it was painless and bloodless, but my mother always told me not to lie so I wont.
It wasn't and it wasn't!
On checking the wire afterwards it could be seen to be slightly bent and that was why it didn't want to come out. Still it was out and barring a bit of swearing and sweating, all in all it wasn't too bad.
Phil put some sticking plasters over the six pin holes only one of which bled, and for the first time in 15 months, I put a sock on!
I couldn't wear a normal shoe yet as the pin holes were going to be too sore for that for a day or so. And did the foot feel strange, freed from it's frame? It sure did. It felt weak and vulnerable. all the muscles complained but the ankle actually moved. It ached like hell, but it moved.
And now there's only 3 rings to go. Next time I must take the camera and get some pictures. Yes it's true, I am really quite strange I suppose.
Interim update
For a while it felt really strange to have this wobbly appendage (my foot!) which didn't quite seem to belong to me but more to some drunk.
The ankle did ache but I reckon it has a right to, all things considered. However it settled down quite quickly and I was soon able to wear a shoe. A REAL SHOE!. Incredible.
Also a real boon, has been the invention of trainer socks (At least in the UK) they are socks with no ankle cover, just fitting on the foot without meaning having to roll down the excess sock which I found caused discomfort and cut off the circulation a bit too much.
I have actually modified a pair of high-side training boots as well. These needed to but cut about to go over the remaining lower pins. I'll get some shots of that up on the site soon.
I also have made a small adaption for an improved physio 'thingy' to work my ankle as well as the foot and added a foam wedge to my shoe to level up my leg lengths. Click Spring driven doodah. to read about them
December 29th 1999.
Had a nice leisurely ride up to King's today. Since the Christmas holiday in the UK is turning out to be nearly two weeks long, the roads were virtually abandoned. So I got to the hospital fairly near to my actual appointment.
Got chatting to a couple of people who'd only been wearing their frames for a couple of months. Proudly demonstrated how my new spring thingy worked (Pictures to come!) and how my build-up in my shoe meant that I felt a lot more secure than I had for ages.
Firstly I had my obligatory 6 new x-rays and then waited to see Mr Groom.
Had a quick chat about our relative Christmasses. I explained that, sadly mine had bee rather quiet following news of my Mother's illness taking a further serious downward turn. She now had pneumonia on top of everything else and was in a coma. Not the way to finish one year and to start a new millennium really.
As regards me, however things were much better. Mr Groom is very pleased with the continuing appearance of new bone at both sites in the leg.
I have been asked to do a further slight compression at the distal fracture (nearest the ankle) of 3mm on 1 adjuster and 1.5mm on two others. This is to be done over a 3 day period with strict instructions to stop if it hurts. I don't need telling twice, believe me. When they were giving out cowardice, I went round the queue several times!
And the best news is that, fingers crossed, the plan is to remove the frame completely in early February 2000. One hell of a terrific New Years present.
So before then I aim to get as much mobility in my ankle and foot as I can. If I can manage to be walking with just a stick, then I will be. I want as much muscle built up as possible in case I do have to go back into a cast for a time, to finish it off so to speak.
And finally for this year

HAVE A VERY HAPPY, HEALTHY AND HEALING
NEW YEAR AND NEW MILLENNIUM


My story continued (January 2000 onwards)

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