Injuries suffered and the treatment

In the crash I suffered multiple injuries:

Treatment for the above is listed below #operations

 

The following notes were made in 1998, to show that the treatment received on the NHS can leave a lot to be desired although overall it was marvellous

I had is that I stopped taking painkillers (t is over 2 years after the crash and my treatment consists of an Ilizarov frame fitted to my left femur. I have now been told that the leg appears to have healed and I am on the waiting list to have the frame removed. However, there is still a possibility that the bone has not healed correctly yet so the surgeon will manipulate it whilst under General Anaesthetic and if there is any movement, he will fit another frame, this time enclosing my knee, preventing me bending it.  I told him that I didn't want this but wanted it amputated if it hadn't healed.

All being well, that is, providing that no serious crashes occur in the Bristol area over the weekend 11-12 July, I am going into Ward 2 of the BRI on Monday 13 July to have the frame removed.

Forget what you've just read.

Due to our brilliant NHS, and Care in the Community in action, there was an unbelievable f*** up. I was allocated a bed OK, in Ward 17, a brand new short stay ward. I signed my consent forms, spoke to the anaesthetist, got dressed in the stupid hospital gown, was wheeled down to the theatre at 13:20, wired for sound, etc., canular inserted into left arm, chatting with the Registrar, when the Consultant asked "Where are the X-Rays?".

It turned out that some mental incompetent employed in the X-Ray Department of the BRI had sent my original X-Rays to a private consultant (acting on behalf of my ex-employers insurance) instead of duplicating them and they were not available. As my Consultant required the history of X-Rays taken, the operation was cancelled and I was sent home.

 20 July 1998 - into hospital again, all prepared and waiting to go to the operating theatre as first patient on the afternoon list when I am informed that it is cancelled AGAIN, this time because they have sent the wrong patient to the theatre and the Surgeon will not be fit enough to perform my operation after this first one!!!!

21 July 1998 - First on the morning list and ............the operation was a success as the frame has been removed.

as I write this on 23 July, the leg feels great and I've only one dressing on now on one of the holes - the only problem I've got cos it don't hurt for the first time in 2 years and last night I had cold turkey, very hyper etc. Just spoken to my doctor who has advised I come off them slowly as they are synetic morphine!!! You just can't win!!!!!!

 Oh it's only too true - 1 step forward - 3 steps back - for 1 week it was great, no pain, driving, beginning to weight-bear, anti-biotics finished so because the frame (the reason for the anti-biotics) is now gone, no new course started and BAM, Tuesday, 28th July - pain in left knee which developed into a swollen knee, twice usual size. Yes, an infection. Anti biotics started again and as I write this the swelling has gone down on most of the knee which an absess-type swelling the size of half a grapefruit left. This appears to be forming 2 peaks (see picture below) and yes, it is as sore as it looks!!!

 

well, after 2 weeks it all came to a head - ha ha - and yes, it was all disgusting with all the infection pulsing out (half of it over the carpet - can we claim for that, I wonder?) But it gradually went back to normal, or what is normal for that knee, and as I write this on 1st September it appears to be OK again. I'm still taking anti-biotics as I'm afraid to stop.

 On 11 September I went back to the BRI Clinic. After further X-Rays, the Consultant declared that he could do no more, the femur was fully united, and that I did not need to return to the hospital unless I had problems. There was still a weakness there, which may improve with time, and I still had to be careful but after 2 years, 7 months and 9 days, I was now "healed" (physically if not mentally)

 On the following Tuesday, my knee came up again and on Thursday it was confirmed - the infection was back. Next appointment at the BRI, Tuesday 22 September in a hope to locate the "hot spot" and maybe go into hospital for another operation to remove whatever is causing the infection.!!!

 At the clinic on Tuesday 22 September I was admitted into Ward 2 for a further operation. I was warned that it was not 100% that it would be performed the next day, and, true to form, it was cancelled at 4:30pm. But I was first on the list for Thursday 24 September and was operated on again. The site of the infection was opened up and flushed out although it was virtually clear by now. I have been warned that because the knee is so badly damaged, and there are connections and gaps where there are not supposed to be gaps, I may get these infections in my left knee for ever. Oh joy!!!

 The infections did go on for ever and we found that I/we had no quality of life - 3 weeks of antibiotics, 2 days "healed" then the infection again including the sweats and shivers. I transfered back to Gloucester under my previous Surgeon who took a sample of the infection, analysed as Staphorious again (the same as a year last November). We decided to try 2 lots of antibiotics for 6 weeks and then make a decision. The antibiotics make me feel very sick and the infection just won't go so a decision was made on 23 December that my left leg would be amputated in the New Year!!! This is at my request but deemed to be the right course of action by my surgeon.

 

- following a discussion with my surgeon, I am due to go into GRH Ward 15 on Wednesday 13th, 1999 for the operation on the following day.

.although I went in as planned, the operation was cancelled at 5 minutes notice. Rescheduled for 21 January

 

21 January - the operation to amputate my left leg above the knee went as planned. The epidural (the original plan was to perform the operation whilst I was wide awake), didn't work properly so it was carried out under a GA. I needed 3 pints of blood afterwards as the veins and arteries were not as straight forward as normal due to the damage to the leg. I needed another 2 pints on the Saturday but actually felt great as the infection and pain had now gone. I actually came out of hospital on the Wednesday evening, 6 days after the amputation and drove myself home.

First fitting for the artificial leg should be 3 March.

View from the front. The lower ring is carbon fibre. 3 wires pass through the knee to support the leg, with 2 at an angle through the leg from inside the knee to the side metalwork. The 2 rings were compressed using bolts which are attached and the break compressed using the 2 wires.

 

View from the side (without dressings) The 3 wires can be seen at the bottom of the picture and the 6mm pins are drilled straight into the femur (x4)

The other man in the metal covering

28 May 1999 - my leg is finally ready. It is polished aluminium at the top with a stainless steel calf and a wooden foot. At the moment it is straight kneed but the handle on the side is to release the knee when I sit so that it bends at 90 degrees

Everything seemed to be going fine medically.  I was using my leg when I needed to, climbing steps to my Solicitor's office for example, and using the wheelchair all other times.  We went on a holiday to South Africa (more later) and in the last week I became very thirsty.  On my return I was diagnosed with stage 2 diabetes.  This can be caused by being overweight, hereditary (my grandfather was stage 2 diabetic) trauma or infection so I didn't stand much chance.  

It is being controlled by diet and tablets but I have lost weight (over 3 stone since March) so the leg is too big for me now but once my weight has stabilisedI will be getting it altered.

Change of plan again - as my old leg was fine for the limited time I used it, I am keeping the lower part and having a new "thigh" and socket made.

 

I had 12 operations:

Operation #1

2 February 1996 - After the crash, and initial treatment in Casualty at Warwick Hospital, I had a 4 hour operation. A metal plate was screwed to the left femur and the leg encased in plaster, an external fixator was fitted to the right tibia (6 pin) and the abdomen injury was sutured.

Operation #2

5 February 1996 - a hour operation just to clean the hole in my right calf where the bone had ripped through the flesh. This hole was about 6 inches across and roughly teardrop shaped.

Operation #3

16 February 1996 - a 4 hour operation at Frenchay Hospital to repair the wound in my right calf. Technically known as a gastronemius flap, the surgeon split the calf muscle at the back of my right leg, swung it round to fill the hole whilst leaving nerves at blood vessels intact then covered the muscle with a skin graft taken from my right thigh. The external fixator was realigned to allow him full access to the wound.

Taken just after I came out of hospital 1 April 1996. The right thigh is where the skin graft was taken from to cover the plastic surgery lower down the leg. Compare the sore look with how it is now below. A great job was done on the right leg.

a view taken from above looking at the scar from the operation described above on the right leg and the frame on the left leg

Operation #4

7 March 1996 - The break in my left femur was so large (loss of bone) that, in a 6 hour operation, the internal plate was removed, and double internal plates were fitted at Gloucester Royal Hospital. In addition, a bone graft was taken from my right rear illiac crest and put into the gap in my left femur.

Operation #5

21 March 1996 - The external fixator was removed from my right leg and an internal plate was screwed to the tibia. Again bone loss was in evidence so a bone graft, this time from my front right crest was used. The operation, lasting 1 hours, was performed under a spinal block as the Anaesthetist was reluctant at a General Anaesthetic so soon after the last one operation. This meant that I was awake for the full operation.

Operation #6

20 June 1996 - X-Rays showed that the bone graft to my right tibia had not grown so the operation, lasting 4 hours was repeated, and the leg re-plated and a further bone graft from my rear left illiac crest was used.

Operation #7

10 October 1996 - As the previous operation, the work done on my left femur had not produced results, therefore a repeat was made in a 4 hour operation. A 95 angular blade plate was screwed to the femur and a bone graft, taken again from the right rear illiac crest (see operation #4) was inserted as well as donor bone.

Operation #8

24 November 1997 - After a good year where progress appeared to have been made, the right tibia declared healed and weight bearing was permitted on the left leg, the plate fitted to the left femur started to slip. As nothing more could be gained repeating this treatment, I was referred to Bristol Royal Infirmary for the fitting of the Ilizarov frame. In this operation, lasting 3 hours, the plate was removed from the left leg.

Operation #9

8 December 1997 - In a 4 hour operation, the frame pictured above was fitted.

Operation #10

21 July 1998 - the frame was removed after the Surgeon plus one tried to move the bone (without success) whilst I was on the table.

Operation #11

24 September 1998 - the infected left knee was flushed and scraped out.

Operation #12

21 January 1999 - amputation above knee of left leg.

In case you are wondering what happened to the other injuries to my upper body, the wound in my abdomen healed with scarring and my hands and arms healed on their own leaving very little scarring. The collar bone and ribs, which were the most painful of the injuries (until I started to have the bone grafts, where the donor site is far more painful than anything else) healed after 4 weeks. The big toe healed but bent to the left. This caused it to rub against the next toe which caused the toe nail to in grow and become infected. Eventually the toe nail was removed.

 

Plus I have been diagnoised as suffering from post traumatic stress and Concusive Brain Injury