Six Weeks On

It's now 6 weeks since I was united with my metalwork. Things are still progressing to plan as best I can tell. Without wanting to tempt fate I haven't yet acquired a pin site infection and my painkiller regime seems to keep me pain (but not discomfort) free most of the time.

On a really positive note I am now feeling much more alert and have just been reunited with my work laptop and can now pick up emails from my office. The next breakthrough will be to get back to doing something useful even if it has to be done remotely as I don't intend to go back into an office environment until my leg wound has healed properly as that is the biggest risk of infection, much more so than my pin sites.

Perhaps now is a good time to reflect on what I have learned over these 6 weeks. In no particular order I offer the following personal guidence:

1. Get over it! Once I had realised that it wasn't a dream and that I wasn't going to wake up without broken bones I realised that I had no option to accept what fate had delivered. Be positive, everyone is doing their best to help you, but ultimately your attitude and actions will be the biggest factor. If nothing else, just remember that the alternative is far worse.
2. Seek help. This will naturally come from friends, family and colleagues, but also from the various agencies both government and charity funded. Before I came home we were loaned various items such as toilet frames and bed levers to make it easier for me to manage. I have just had a Social Services assessment to see what assistance they can provide to make it possible for Maggie to go back to work. I also have an emergency alarm button around my neck which will automatically connect to a 24x7 call centre in case I need assistance. This is important for Maggie to make her comfortable to go out and leave me without chaining me into a chair so that I can't hurt myself. There are other agencies who focus on getting the injured party i.e. me, back to work by offering such services as transportation, specialist furniture etc. I have also previously mentioned Slim's website but he also moderates a Yahoo group which is very active and can provide much needed moral and practical support - http://finance.groups.yahoo.com/group/Ilizarovs-and-fixators/. Bear in mind that positive support from whatever source is a force you can channel to strengthen your own resolve should you ever need it.
3. Be realistic. Don't set yourself targets that are either too ambitious or so far away that you can't see how close you are to achieving them. Try to take things a week or two at a time and guage your progress on that basis. One really powerful measure is your response to any physio you are having. You will be able to see the increase in repetitions and how much easier it is to do certain exercises. If you don't have any externally imposed targets then try and invent a few yourself to keep you focussed.

OK then, what practical hurdles have I had to overcome and what is still giving problems.

1. Pin sites. Although I have had no infection as yet, they remain a source of wonderment. I am on a weekly regime of changing dressings which Maggie does for me. This takes about an hour and involves cleaning with Hydrex and replacing the dressings over the wounds. This is complicated by the open wound which keeps bleeding. Depending on whether and to what degree my leg is elevated I get blood flow over a number of the pin sites. By agreement with the nurses we do not put dressings onto those pins but just clean the worst off the pin with hydrex and leave it. The wound itself is not dressed. This process is a chore and different hospitals advise different procedures but we are now into a routine and it does give a regular opportunity to note any changes in the appearance of the sites.
2. Clothing. Slim's sites have some really useful patterns for adapting trousers to go over the frame. Even in my youth I never had flares quite as wide as those necessary here, but I guess fashion is fickle. Personally, rather than cover the frame fully, we have adapted a pair of jogging pants to open down the seam and put toggles and loops on the sides to fasten them with the leg terminating part way down the frame. This is mainly to give the wound some air circulation unless I need to cover it when going out.
3. Protection. The leg itself needs protection from extremes of temparature (in England this means cold as we rarely have to worry about overheating our Lizzie). You can get covers made up which fasten with velcro, but because I have a foot fixing on the frame this wouldn't work well so we use a quilted pillow case which is put over my foot and leg and fastened with string or velcro above the frame. Not really suitable for walking in, but at present I am only going out to hospital appointments and have ambulance transport which involves wheelchair transfers so not an issue. Protection is also needed for anything that might come into contact with the frame as it has several sharp points. We have managed to find a suitable rubber sleeve to cover a sharp end of screw threaded rod which sticks out the back of the frame. I think this came off Maggies sewing machine, but I'm sure there are more conventional sources. Bear in mind that when elevating your foot the frame will be resting on something that you probably don't want to puncture so look for, and do something about, any sharp projections from pins and frame components. I do not concern myself too much about protecting the public from my frame, at present I need all the advantages I can get.
4. Footwear. This is still an on-going saga. The OT unit made me up a platform shoe for my left foot to compensate for the bone they removed. This was fine initially but as I walk more I am noticing its limitations. I am currently supplementing this with a footbed from an old pair of trainers but we need to improve on this. I have studied Slim's solutions (from the website) and plan to try and adapt these to fit my foot. My problem is the pin directly into my heel and the position of the side pins which make it necessary to remove the whole heel cup of the shoe. I am afraid that this will make the shoe liable to fall off which will be a problem half way up the stairs. I will provide details when we solve this problem.

My other challenges have been more related to my other injuries than to the frame. It has taken ages to get comfortable sleeping on my back. Last night was a revelation as Maggie bought and fitted a foam "egg roll" between the mattress and the sheet which spreads the load wonderfully and stops me sliding down the bed as quickly as I was doing without it. Since bed is the only place where I don't need to wear the brace for my broken back this is a real bonus.

Apart from some more visits from friends & colleagues (it's costing a fortune in tea and biscuits but I wouldn't change it for the world), there's nothing to look forward to now until my next visit to Sheffield on 19th January. They are going to check my back and it may see the start of the end of the brace. I have a new physio exercise to tone up the muscle that acts as a corset to support the back which may be important when I start to get used to life without the brace. I still can't put my full weight on my broken right leg, but it is getting stronger every day and you can almost see some of my leg muscles again.

Finally, since joining the Yahoo group (see above) I have been contacted by Patrick who, following a nasty motor bike accident, was treated at the same hospital and by the same staff as I am. He now has his frames off after 7 months and is continuing his recovery. I take such communication as a positive inspiration and look forward to being able to pass on similar encouragement to others