Life on A Broken Leg

my horse-falling-off adventure, my broken bones, my ilizarov frame, and my gradual recovery


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5 Months and counting!

Last Wednesday marked the 5 month point since the x-fix frame was fitted, and obviously that made me reflect on how progress has gone and on how well (or not) I’ve handled the length recovery process.

But first news of yesterday’s trip to hospital with more x-rays and meeting with the consultant.  A summary of the latest situation is that I have to wait another month and then go back for further assessment end of February. It could be that at that assessment they give a date for frame removal and at the best that’s going to be early March. Maybe in time for my birthday!

The X-rays show that the bones continue to mend well and new bone growth at the top of my tibia explains the lump under my skin! The consultant felt things were progressing well and we spent some time discussing next steps and in particular timing for removal of the x-fix frame. According to Mr Doyle, the very nice irish consultant, this is an art and not a science. No two complex fractures mend in the same way and so the main worry remains that they could take off the frame too early and my leg won’t be strong enough. If it fractures again then we are not back to zero, we are back to -zero and serious complications.

I was really interested in some of the other information which he explained to me, and grateful that he took time to over lots of questions from me – including -

- because my injuries involved ‘segmented fractures’ (i.e. both bones broken badly in two places, top and bottom), the body has a tendency to put lots of energy and dedication into mending one of the breaks really well and then slows down or even stops because it thinks the mending is done!

- my fibula bone has never fused back together properly and I was worried about how that’s going to work in the long-term. He explained that fibula bones are not at all important and don’t help with weight-bearing at all. In fact they might even consider removing it altogether if its holding up the mending process in the tibia by acting as a splint and not allowing the bones to fuse well. In bone graft situations surgeons often remove a fibula bone to create a graft in another leg bone. Who knew!

- in most situations where an x-fix frame is fitted and a long recovery process is expected, patients should be offered psychiatric treatment and counselling support – and now they tell me!

Anyway, looking forward then I am going to try and increase my exercise routine over the next four weeks and lose some weight at the same time (and as much as I can!), so that with everything being positive on 22nd February they’ll set a date for frame removal and then (after a week in bed to rest)  I can think about being much more active again, about going out for walk with the dog, about not flinching everytime someone bumps into my metal leg, and about riding, driving, swimming,…. having a bath! mmmmmmmm! yes please!

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Good news, and bad news .. a bucket-full of patience needed

So hospital today and ‘frame clinic’ which was a good opportunity to chat with a few other people with similar contraptions mending their legs.

Here’s the update I’ve posted on Facebook earlier to let everyone know -

“Just back from hospital and updating you all on progress. 
My bones are mending slowly and they are happy with improvements in joint movement and infections over the past few weeks. But, the frame will need to stay in place for a few more months yet. The consultant has explained that they have to balance the risks of further injury (including potential re-fractures) with the timing of frame removal to help with recovery. In my case because of the severity of the injuries and complex bone breaks he wants to take plenty of time to ensure bones are in the best shape when the frame is removed.  He also said that a re-fracture situation could still result in amputation! And that kept things in perspective for me. So, I have to be patient for a while longer yet! (can someone send me a bucket-full of that please?)
Thanks to all for support and encouragement so far. And keep it coming! x”

And that’s it in a nutshell. I arrived at hospital this morning thinking the worst-case-scenario would be another 4 weeks with the frame, and I left contemplating another three months!

And on Twitter I posted a brief update and the wonderful George suggested giving the frame a name in order to make it more positive – and then we developed that into Twitter competition ” #nametheframe  ” – entries now welcome!

                                  

My consultant was very clear in his explanations and reasoning for these next steps, and also he didn’t pull any punches in how he described the risks involved in rushing the recovery. I felt angry, tearful and upset having believed I was well on my way to frame removal time and into more physical/physio recovery stage very soon. But on balance and fully understanding the need to ensure my bones are well healed and fused before the frame comes off I know I have to get over those feelings quickly and turn my mind to positive developments I can achieve in the next few weeks.

But of course it also means that I have to plan work, family commitments ….. Christmas in the frame!! Arggghhhhh


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Charlie and My FAQ

OK so of course people are curious about my accident, what happened to cause such bad injury, the nature of my treatment etc. And I genuinely understand that some people are not at all keen to learn about or see the full extent of things – some find the sight of the frame enough to make their knees wobble – unfortunately that includes my daughter!

Here’s my list of frequent asked questions and possible answers (depending on who’s asking!) -

- how did it happen and cause so much damage?

I was riding in open country, going fast, Charlie horse shied (ie swerved really badly), I went one-way he went another. Charlie is a large, 17hh Irish Sports Horse. He is gorgeous!  And I landed almost entirely on my right leg, twisted as I landed all of my weight (and there’s lots of it!) went through that leg. Speed + impact + weight = badly broken leg! Simples!

- does it hurt?

The best thing to think of here is – ‘relative to what’? or ‘how much at its best’? People don’t want you to tell them just how much it hurts at its worst, and also you need to know that people experience pain differently and we do have different levels. My pain resistance level is high. I’ve usually said “not as painful as it looks”.

- will you ride again? how is the horse?

Its great that people are keen to learn from my own experiences and reflections, but most people who haven’t got the horse ‘bug’ simply will never understand that yes, of course I’ll ride again (if I can). I cannot imagine living the rest of my life without being able to enjoy a ride around the lanes. But even if that wasn’t possible I’d want to be back at the farm grooming and fussing over Charlie. And yes, he is just fine. None the worse for the whole experience and back with my sister-in-law who is thoroughly enjoying bringing him on again. They make a very gorgeous team!

- how long will you have to wear the frame?

This is a difficult one because I really don’t know and it all depends on how well my bones mend. And of course my mental state some days mean I want to scream back at them saying “how do I know? I’m not going to keep it on for fun!”….  but mostly my response is  “I hope it will be soon, but probably a few more weeks yet”

- how are you managing?

Again tricky to give an honest answer on this one – because mostly I don’t think I’m managing things well at all. But be positive and reflect on how much progress I’ve really made and I can usually give a good reply- with the help of hubby and the kids. I’ve been very well looked after.

- what about sleeping and showering

Early on when I came home the answer was easy – I didn’t do either!  And even now 8 weeks on I am still sleeping/resting on the bed in the living room, and only showering when I have energy and assistance to climb the stairs.  Baths are out for now – and the other day I wondered what happens if you bath when you’ve got pins through your leg – a funny picture came to mind of my leg acting like a watering can when lifted out of the bath!


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Pin-site Care

Well this has become the main feature of my recovery in the past few weeks. Gradually the pin sites have got worse – oozing fluid, itching like mad, and red around the pins. The smaller pins are worse that the larger ones. And the ones closest to my skin are better than the ones where my skin is stretched.  There are three at the top and one at the bottom which have proved particularly nasty.

And so I have to cleanse all 14 pin sites every day. I’ve been given gauze wipes to use, and either saline solution in little plastic packs, or Stericlens which is sterile water in a large aerosol can (I can also use cooled, boiled water). Being really careful about clean hands has been stressed all the time as this is the main way that infection spreads apparently. So far none of my swabs taken have shown evidence of the really nasty infections and so its just a case of continuing carefull cleansing daily.

I also use Inadine patches to cover the worse pin sites once they are clean. This is medicated gauze which soaks up the discharge from pin sites and disinfects it.

I didnt know before, but have since learned, that its also a good idea to use the clear vaseline stuff to wipe around the pin sites before I put Inadine on top. I had noticed that a couple of place had developed a red/orange rash of small lumps and the nurse tells me its because the infected material in the inadine strip is sitting against my good skin and its reacting badly to that.


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Infections and Antibiotics

I’ve been to hospital again today and things are going well so far. X-rays show bones healing slowly and steadily. I am worried about the smaller bone (fibula) which doesn’t seem to have lined up well – but consultant says its nothing to worry about.

The main concern still is the pin sites and infections. My last swabs have been analysed and nothing serious to worry about, but there is still evidence of infection and so consultant has put me on full-time broad-spectrum antibiotics (flucloxacillin) for the next 6 weeks now.

I don’t like taking all this medication, and the combination of antibiotics and variety of pain relief is causing my body balance some issues! Feeling sick (and being sick) is a regular occurrence, thrush, giddiness and constipation all continue.

I just have to keep reminding myself that the drugs are helping.  A serious infection in my leg would be dreadful – potentially much worse than broken bones! … and although I could try and cope without pain relief some days, it just makes me miserable and knackered.

And so my attitude at the moment – Give in to it all and try to enjoy the good days (sleep more on the bad days)

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