Ouch (possible NSFW pictures of my rear to follow)

Ouch (possible NSFW pictures of my rear to follow)

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psychoR1

1,069 posts

187 months

Friday 13th July 2018
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Chin up Dibble and keep dropping the logs off!

Lots of support for you on here and lost of silent followers..

If you're like me you'll find that when you've fully recovered (and that day will come!) that you have very different concept of pain than most people....


WinstonWolf

72,857 posts

239 months

Friday 13th July 2018
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Dibble said:
I “did” some physio today, which consisted of the physio taking the weight of my leg over the edge of the bed and bending it at the knee to about 40° while I winced, sweated, huffed and puffed a bit and tried to think happy thoughts. I then slept solidly for three hours.
If I can offer you one piece of advice it's to focus on getting your knee bent above all else. Don't sweat it, but if scar tissue builds you can end up with restricted movement. Listen to the physio, go through the pain barrier when they advise that it's safe to do so. Strength etc can come with time but you need to get the knee bent and be able to do straight leg raises.

I've 'only' got 110 degrees of flexion, it's just enough to live normally. Any less and I'd have real trouble.

When you wake, bend the leg, when you're bored, bend the leg, before you sleep, bend the leg. You'll lose a small range of movement over night, take it back in the morning.

Dibble

Original Poster:

12,931 posts

240 months

Monday 13th August 2018
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A bit of an update, from a Facebook post I did a few days ago. Sorry it’s a bit lengthy thank you to everyone who has continued to message me, I really do appreciate your good wishes and apologies to anyone I’ve not messaged back, or taken an age to reply to.

[i]Plan... “B”?

For those of you that may be interested, I thought a short update on my leg might be in order. That said, it’s a bit involved, so it’s not going to be short (unlike my right leg, but more on that later). It’s lengthy, because there’s quite a lot been going on over the last few weeks. Here goes...

Rewinding to last year, one of the suspected causes of the non union of my femur was the infection in my leg, with bugs gathering around the metal work like recently divorced sales reps on their first singles night at the bar. This needed a “wash out” and six months on oral antibiotics.

When I had the first reconstructive surgery in April this year, all the swabs, blood tests and samples came back as clear, with no sign of infection. Despite this, my consultant said she wasn’t happy there wasn’t something still lurking in there, despite everything being negative. She said it was nothing more than a hunch, but she wasn’t convinced by the test results, which completely went against her experience and everything that had gone on with my leg thus far.

Everything was going - mostly - to plan. The initial two surgeries were as scheduled, although the second left me with a couple of bent pins and a misaligned femur at the top, where the surgical break (osteotomy) had been done. This caused quite a bit of pain, but was easily rectified by surgery number three and the acquisition of some unexpected scars, but hey ho, I was back on track, albeit with a ten day or so delay on the bone lengthening and transport to regrow my femur from the top down and fill the gap where all the dead/infected bone had been taken out above my knee.

Once the bone was realigned, I was good to go with the lengthening, which was a quarter turn of each screw on the fixator, four times a day. Each quarter turn equates to 0.25mm of lateral movement, so one complete turn meant I was lengthening my femur by 1mm per day, while closing the gap at the bottom by the same amount, meaning my leg stayed the same length.

About five weeks ago, the pain in my leg started getting worse. All along, I’d been told the process would be painful, so I put this down to the fact I had a broken leg, albeit a planned one this time, as well as eleven pins going through my skin, fat and muscle into my bone and the bones inside my leg being forced into place through the lengthening process.

Then my leg started swelling up, getting redder, hot to the touch and oozing “gunge” through the pores. I’m no expert, but I guessed the infection might have returned, so off to A&E I “trotted”. Top tip, don’t get ill on a Sunday and go to Southport A&E. They’ll keep you in for “close observations”, which in reality means taking a blood sample for them to lose and then taking your temperature at 0630 the next morning. No pain relief, no antibiotics, nada. I’m fairly underwhelmed with Southport Hospital and it seems I’m not a lone critic.

First thing Monday morning, I got on the phone to Broadgreen Hospital, so when the ward round took place, I was able to give the Southport team some “direction”, which resulted in me going straight from there, back to Broadgreen as an “emergency” admission. One look at my leg by one of the consultants I’ve been cared by saw me in theatre first thing the next day for a washout and debridement (surgery number four). A blood test showed my CRP (a marker for inflammation and infection) was at 307. Normal CRP is around 10...

I had over 350ml of “gunge” (think can of Coke size, plus a couple of shots of spirits) drained from my leg, taken from the void where the bone had previously been removed. As soon as I woke up, I felt loads better, even though my leg had been sliced open in the same place for the sixth time. I should probably look at getting a zip or some Velcro fitted... The issue now was that there obviously had been bugs lurking all that time, so The consultant I’m under had been right all along. Over the next couple of days, another 50ml or so came out through the surgical drain in my leg.

Leaving the void was no longer an option, as it was giving the bugs somewhere to hang out and gather and I was likely to keep getting infections, which could seriously jeopardise my femur ever healing. If my femur doesn’t heal, the second worst case scenario is I have a very real risk of having my leg amputated, above the knee. Worst case scenario from repeated infections is that I develop sepsis and die. Call me a bluff old traditionalist, but I don’t find either of these options that appealing.

The week after surgery four (the wash out), I was back to theatre for surgery number five. At this point, had I still been on Plan “A”, I would only be at surgery number two. This surgery was to “shorten” my leg by about 4cm, reducing the size of the void. I also had some more antibiotic laced cement put in there as well. The reduction of the void means there is less physical space for bugs to hang out, with the cement making the space that’s left a more hostile environment at the same time. Having got used to managing the external fixator, I now had to learn how to deal with one leg being shorted than the other. I’ll cover that by saying “It’s a bit of a faff”...

Even though up to this point my duff leg has only been “toe touch” weight bearing, it’s surprising how useful it is for balance and taking some of the work away from my good leg. Having to rely completely on one leg for support and balance is really hard work, even using crutches to get around. About a week or so after surgery five, I was able to start lengthening my femur at the top. It’s important to keep doing this, because if I stop, the gap the new bone is growing in will form fully hardened bone and the only way to get the lengthening started again would be more surgery to perform another osteotomy (surgical break). Not ideal.

The problem is that there is nowhere for the other end of the “floating” portion of femur to go to, so in a few more weeks, my duff leg will be longer than my good one. I was always going to need more surgery to join the “knee end” bits of femur together, but now, it’s going to be another shortening, to make both legs the same length, as well as joining my femur at the bottom, so more complicated as it’s a bit of a BOGOF deal, with two ops in one. The consultant is happy she can accurately match my leg lengths so I’ll be matched up and back to “normal” (yes, I know, it’s all relative...).

At the moment, I’m also lengthening my femur by six quarter turns (in three lots of two) each day, so 1.5mm a day. I’m already at the point where I can sort of get my right foot flat on the ground and I’m also able to use my duff leg for “partial” weight bearing - 30% or so... it makes a huge difference to what I can do, just around my flat, but I’m holding off signing up for any 10k fun runs for the time being.

Because of the infection, I’ve been put on a course of IV antibiotics. Getting these in hospital is no problem, the nurses just hook me up and away I go. Even better, I’ve had a PICC line inserted in my arm, which, while it looks a bit gruesome, is way better than being cannulated every three or four days. Cannulas hurt way more than they should. The PICC line goes into a vein in my upper arm and then to the superior vena cava, a blood vessel right behind my heart. The PICC line is used to both administer the IV antibiotics (or any other IV drugs I might need) and to take blood samples, so no need for needles there, either. Win win win.

The (sort of) downside is I have to have a visit every day from the community IV team to administer the drugs, but because their list of patients changes daily, they can’t give an actual appointment time. I just have to be up and ready from 8am onwards, as they normally come in the morning. As my sleep pattern is absolutely buggered, getting up and washed every morning at 7.30am isn’t my favourite thing. The real downside is I’m not supposed to drink alcohol, although the nurses have said a small amount every now and then is ok. I’ve actually found a low alcohol cider (Stowford, 0.5%), which is actually quite drinkable, as long as it’s chilled. It’s nice and dry, so it’s not too bad (I’m trying to convince myself here, don’t ruin it for me). Hopefully, I’ll only need the IV stuff until the end of August, but it all depends on blood results.

The other issue is that once my femur is at the right length and joined, the options while it heals are to have a metal plate attached to the inside of my femur to keep everything in position, or to keep the external fixator attached for another six weeks, then a final surgery to remove all the pins and fixator. The internal plate would stay in my leg permanently. You might remember the cause of all the infections to start with was the metal work inside my leg... it’s looking like I’ll be keeping the external fixator for that extra six weeks. To be honest, it’s doable and to me, an absolute no brainer to keep it, rather than risk yet more infections with internal fixation.

The good news is the bone is growing really well and is nice and strong/dense. My infection markers are back where they should be (CRP is down to 7), physio is going well and I can already tell I’m regaining some of the function in my duff leg. Once the bones are all grown and joined, the fixator is removed, it’s physical rehab time. I foresee quite a few weeks being spent in Harrogate over the next few months or so. I’ve nothing but praise for all the staff at Broadgreen. They continue to be unfailingly brilliant.

I’ve even been given the go ahead by my consultant to start working from home, which will get me off half pay and start my brain turning over again. I finally feel like there is some actual sustained progress on a few fronts. The Idiot is back out of kennels and at home with me, which again, is a huge boost for my mood.

TL;DR - I’ve had some complications with infection, again, so I’ve had to have extra unscheduled surgeries, the original plan has been changed, but I’m still heading in the right direction, although it’ll take a bit longer than if I was still on plan “A”. I’m still upright and breathing, so it’s all good.

Sorry for the lengthy post, but a few people have asked where I’m at, so I thought this would be the easiest way to let as many people as possible know what’s happening. Thanks also to all of you who have messaged, visited and helped keep me sane(ish).[/i]

The down side is I’m probably looking at February next year before I get rid of the external fixator... meh.

On the plus side, from last week’s physio, I got to “measure” just how much 30% weight bearing is. I got weighed (115 kilos, still a fat knacker), so 30% of this is about 38 kilos. The way they measure this is to stand with your good leg on the floor, then push down with my duff leg on a set of bathroom scales until the needle hits 38 kilos. The amount of “force” needed to do this is way more than I’ve been using to date and despite this having been going on since May last year, this is actually the first time anyone has actually every shown me what 30% weight bearing is/feels like, so it was really useful to get a sense of it.

I hope everyone’s had a good weekend, I’m going to have a trawl on the BB threads and catch up with what everyone is up to.

NDA

21,565 posts

225 months

Monday 13th August 2018
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It has been a long and slow road to recovery..... keep smiling. smile

MotorsportTom

3,318 posts

161 months

Monday 13th August 2018
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Great post Dibble and puts things into perspective.

It's easy to think of it as "just a leg injury" but it can be way more life changing than that! Glad to hear it is going back in the right direction and I can only commend you on what appears to be a very positive and sane outlook on it all.

Best wishes with it all

Dibble

Original Poster:

12,931 posts

240 months

Monday 13th August 2018
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NDA said:
It has been a long and slow road to recovery..... keep smiling. smile
Cheers mate.

I’ve finally managed to get a bit more mobile, so on Saturday, I took myself for a haircut (all of 0.7 miles, but by taxi). The barber’s is next door but one to a local bar, which just happens to be owned and run by a former colleague (which I only found out when I saw him in there after a few visits). I had a couple of beers and a spot of lunch, which was very pleasant.

Same deal yesterday, I had a social visit from a colleague and I treated him to lunch in the same place, so I managed to get out for a couple of hours yesterday.

Both jaunts have knackered me out, even though I’ve only walked about 50 yards in total each day, so I had to have a “nanny nap” when I got home!

catso

14,784 posts

267 months

Monday 13th August 2018
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Progress maybe slow but it's still progress, long may it continue & get well soon. beer

Krikkit

26,515 posts

181 months

Monday 13th August 2018
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Great news Dibble, even if it's a bit of a circuitous route to recovery. I was reading the first half thinking "Oh st!", especially when you casually dropped amputation in... Glad to hear it will hopefully work out, even if it means more surgery and discomfort.

Sounds like the consultants doing it are real wizards.

NDA

21,565 posts

225 months

Monday 13th August 2018
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Dibble said:
Both jaunts have knackered me out, even though I’ve only walked about 50 yards in total each day, so I had to have a “nanny nap” when I got home!
I had a heart operation two years ago today.... in fact, as I write this, two years ago I was being prepped for the 1pm surgery.

After the op I was a few days in ICU and it took a while to be able to shuffle a few yards up the hospital ward... I couldn't imagine I'd be strolling about quite normally (eventually).

It'll be the same for you... although you've had a much longer recovery period because of the complexity of the injuries... but you'll look back, as I do, and smile at the past drudgery!

I have to also say, that PH was one of the things that kept me feeling vaguely human - the silly banter in the Lounge particularly. smile

Hungrymc

6,652 posts

137 months

Monday 13th August 2018
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Thanks for the update Dibble. Sounds stupid but I worry when you go quiet for a while.
It sounds like they have a good plan now and that you have a consultant who will own it and see it through. We're all wishing you the best mate.

tvrolet

4,262 posts

282 months

Monday 13th August 2018
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Not a regular poster on this thread, but an avid reader - I'm waiting for the day when you post and say it's all back to normal(ish) and all the ops are over.
Many thanks for the update - I have to admire your stoicism and good humour in the face of challenge after challenge with this. I doesn't seem to have run smoothly at all frown

Best wishes - keep the chin up (I'm sure you will), and keep the news coming.

Bobberoo99

38,548 posts

98 months

Monday 13th August 2018
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Always good to hear from you chap, and good to hear you're starting to weight bear on the duff leg!!

Dibble

Original Poster:

12,931 posts

240 months

Monday 13th August 2018
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Thanks again for all your comments and good wishes. I really can’t tell you just how much I really appreciate each and every one of them and how much they really do help. I’d happily buy you all several beers!

It’s not been plain sailing and I was pretty cheesed off a few weeks ago to find myself back in hospital (yet again), having more surgery (yet again) and the plan changing (yet again)... The consultant really is fantastic. She helps me keep (or rather, get) things in perspective. She’s said that these aren’t particularly unusual complications, while understanding how frustrating I’m finding it, but that they aren’t anything they haven’t encountered and more importantly, successfully dealt with, numerous times already.

I’m also lucky I’ve only got a rail attached to me, rather than the Ilizarov/halo frame. That would be even more of a pain in the arse (and of course, it is still an option if it’s needed, as are a few other treatment options).

A colleague from work, not someone I was close to, more just to say “hello” to around the building, was diagnosed with gall bladder cancer a while back. He had chemo, but was told although it had slowed the cancer down, it hadn’t cured it and the cancer would kill him, but he had “a while” left, the inference being years rather than anything else. He was back at work and doing “ok” (as ok as anyone can, I guess), then about six weeks ago, he got very ill, very quickly and within a month had died. Recently married, two kids of about 8 and 10... so I’ve really not got much to complain about in the grand scheme of things.

I’ve got stuff to look forward to, like getting rid of the frame at some point, being able to go away on holiday, driving, doing my own shopping in actual shops, not wearing the same “altered” jeans all the time, potential new motorbike shopping. I’m in the early stages of planning a trip to the US next year to meet up with a couple of people, eat lots of meat based food, drink too much craft beer, visit some random museums and galleries. It’s already being dubbed “FemurFest ‘19”. T shirts and other merch will be available...

Despite the contact from work being a bit lacking and being generally fairly bored, I’m lucky that I’ve got good sickness benefits and insurance to cover my half pay, which I’m now on, so financially, I’m not struggling, which is a huge load off my mind. I also qualify for some benefit payment (Personal Independence Payment, what used to be called Disability Living Allowance). It took a bit to get my head round claiming benefits, but I’ve worked all my adult life and paid taxes. There are plenty of people who haven't/don’t, so if they’re claiming, why shouldn’t I? I’m certainly not going to be claiming it long term or when I no longer qualify, but while it’s there, I’ll use it.

Mothersruin

8,573 posts

99 months

Monday 13th August 2018
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Thanks for the update mate. Keep at it thumbup

Where are you holed up at the moment, what part of the world?

RizzoTheRat

25,140 posts

192 months

Monday 13th August 2018
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My friend who had a similar external lengthening brace thing on for ages managed to fall over and break the new bone the week after they took the thing off, so be bloody careful when they take it off!

Krikkit

26,515 posts

181 months

Monday 13th August 2018
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Dibble said:
Despite the contact from work being a bit lacking and being generally fairly bored, I’m lucky that I’ve got good sickness benefits and insurance to cover my half pay, which I’m now on, so financially, I’m not struggling, which is a huge load off my mind. I also qualify for some benefit payment (Personal Independence Payment, what used to be called Disability Living Allowance). It took a bit to get my head round claiming benefits, but I’ve worked all my adult life and paid taxes. There are plenty of people who haven't/don’t, so if they’re claiming, why shouldn’t I? I’m certainly not going to be claiming it long term or when I no longer qualify, but while it’s there, I’ll use it.
Exactly what it's there for! I feel the same as you about benefits, but that's why we're good little boys and girls paying Tax and NI every month - when we get really stuck, the state gives us a (usually small) hand with it.

redback911

2,717 posts

266 months

Monday 13th August 2018
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Good to (see) hear an update. Glad things are improving.

We take good health for granted, a huge dose of reality when things go pear shaped. Really important to make the most of the time, mobility, and health we have.

Krikkit said:
Dibble said:
There are plenty of people who haven't/don’t, so if they’re claiming, why shouldn’t I? I’m certainly not going to be claiming it long term or when I no longer qualify, but while it’s there, I’ll use it.
Exactly what it's there for! I feel the same as you about benefits, but that's why we're good little boys and girls paying Tax and NI every month - when we get really stuck, the state gives us a (usually small) hand with it.
Too right..!

Stone Cold

1,545 posts

173 months

Monday 13th August 2018
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Good update Dibble and glad to hear it’s going in the right direction.

I have been using you to help keep a mates pecker up who is in a similar position (nowhere near as bad) but a break that won’t heal and keeps getting infected, he’s on a permanent drainage pump. So your story is having a small positive impact on him, so thanks for sharing.

crofty1984

15,848 posts

204 months

Monday 13th August 2018
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I've probably got some old bike/car mags you're welcome to of you want to PM me your address. I have a load to my local bike cafe but I'm sure I have some more.

Dibble

Original Poster:

12,931 posts

240 months

Monday 13th August 2018
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Stone Cold said:
Good update Dibble and glad to hear it’s going in the right direction.

I have been using you to help keep a mates pecker up who is in a similar position (nowhere near as bad) but a break that won’t heal and keeps getting infected, he’s on a permanent drainage pump. So your story is having a small positive impact on him, so thanks for sharing.
Something tha5 was suggested to me was treatment in a hyperbaric chamber, which may be worth him looking into.

Another option is an ultrasound machine called “Exogen”, available on the NHS. Unfortunately it didn’t work for me, but it usually has about an 85% success rate and is approved by NIHCE.

Reconstruction surgery is hard work as a patient, but there is a lot they can do now, that they couldn’t, even a few years ago. You have to keep pushing for referrals/second opinions though. Basically, you need to be just enough of a pain in the arse that they want to get rid of you by referring you “up the chain”, but not so much of a pain you become “that patient”...