If you don’t want to read about cannula’s, surgery, NHS hospitals, and achilles tendons (and who can blame you) have a look here http://www.wintercampers.com/ and I’ll see you next time

[Tuesday 20th January 2009]

I got shown into what was described as the day room. This didn’t inspire much confidence. It had physiotherapy equipment and an old pair of crutches. There was an old bookshelf with half a dozen books, a round table and 4 plastic chairs. The room was no bigger than a standard dining room. I saw no TV or anything to make it mildly welcoming. It could have done with a coat of paint.

The last time I was in hospital for an operation was 30 years ago. I was quite shocked how things had changed for the worst. At least I had come prepared and instantly whipped out my novel. I knew what to expect in NHS hospitals now. It was “wait” – with a capital “W”. I had been asked to report at 7am. I had been up since 5am.

After an hour I saw the cheery face of my consultant. Despite a tendency to be skeptical and slightly critical of all things medical in the UK, I had warmed to this chap and had confidence in his abilities. That was until he drew an arrow in indelible ink on my calf.

“Don’t tell me, that’s so you you don’t operate on the wrong leg,” I chuckled.

“Correct,” he replied. I found it hard to resist saying that one leg had a prominent Achilles tendon and the other didn’t. You’d be hard pressed to miss the damaged foot. I was also concerned that the arrow seemed to be pointing up my calf and not down to the proposed incision point. I gave him the benefit of the doubt and ignored it. We went through a few other details and I was left alone again with my novel.

Another 45 minutes passed and in came a young chap who introduced himself as an anaesthetist. He went into huge detail about what I was going to expect. My mind drifted and for the first time I started to get nervous.

“… some bruises on your face. So don’t be surprised.” I caught the tail end of the sentence.

“Pardon? Bruises on my face?”

“Yes, because you will be face down, there may be some bruises to the face. But we will pad you up as much as possible.” And I forgot my piece of wood to bite on!

This was turning into a nightmare. Luckily things moved on pretty quickly after this, which stopped me dwelling too much on wrongly placed incisions and being beaten up in theatre.

I was shown to my bed and efficient nurses buzzed about one at a time checking blood pressure and temperature, providing surgical gowns and strange paper thin undergarments (did I detect a smirk from one of the nurses?) and firmly but politely conveying orders, which I obeyed without question.

“Are you chewing gum?” said one nurse.

The whole ward became silent and a dozen eyes looked at the perpetrator of this heinous crime – me!

My neighbour sniggered loudly behind his hand.

“Umm… yes,” I replied. I’d taken to chewing nicotine chewing gum to help me stop smoking. “Nil by mouth means exactly that!” barked the nurse.

I considered challenging the comment by saying that it actually stated on the leaflet “no eating or drinking,” which in my mind meant no actual consumption of products.

I decided not to. Such was her physical presence in her own domain. Besides, ” I was only masticating” might not have gone down too well. I followed the pointing finger and limped over to the chewing gum receptacle with a bowed head.

I had just hopped back on the bed when almost immediately two stern-faced, blue-shirted porters came in and after the standard identity checks they started wheeling me away. I felt a twinge in my stomach as I knew that my time had come.

The hospital corridors sped by and I watched the sympathetic faces of patients, visitors and staff as I approached the theatres. I wanted to call out, “It’s nothing serious, honestly.”

Despite good timing so far, the theatre prep room harboured a delay. An embarrassed theatre nurse who was obviously briefed to guard me, tried to make small talk as she went through the identification procedure again and confirmed that I was “The Achilles”.

We talked about cats and dogs, neither of which I knew a great deal about. I watched as my pulse rate on the monitor swung between 75 and 95.

“How many theatres do you have?” I opened up some small-talk.

“Fourteen,” the nurse replied. “Well, actually we have thirteen but they are numbered one to twelve, missing out number thirteen and then number fourteen. So, yes, that makes thirteen but we say fourteen.”

I tried to keep up and dared not ask which number theatre I was in… just in case.

As if to divert my attention from the maths, she looked at the arrow on my leg. “Ha ha. He’s drawn the arrow upside down. Ha ha ha”. I didn’t laugh.

Eventually, the young anaesthetist came in. Here we go. I took some deep breaths. I couldn’t help try and follow his every move.

The first injection was to make me feel like I’d had a pint or so. Hah! He should go to some of our meets! I felt very little, but nevertheless tried to relax. A mask was waved in front of my face and something was injected into the cannula on the back of my left hand. “This will sting a bit but it won’t last too long”.

It did sting and it didn’t last too long. I was out.

[part 3 soon]

The last thrilling (?) instalment.

Was I awake or was I just dreaming? I was conscious of somebody over my left shoulder.

I still wasn’t sure where I was until I saw a large figure at the foot end of the bed. It was the consultant still in theatre garb.

“All went well,” he said. “We did the basic fix and just sewed it up as the tendon hadn’t shortened very much. It’s looking good. Oh, and I scraped away some of the old scarring.” Ha! What a bonus! An optional extra thrown in for free.

My heel twinged as he said it, but I’m sure it was just psychological. I thanked him and then nodded off again thinking how unbelievably clever these people were. I think I woke up a couple of times. I tried to take in details of the recovery room. It was a long room with lots of staff. I can’t remember seeing any other patients. Perhaps I was in the tea room.

I remember being wheeled back onto my ward and I was propped up. My mouth was dry and my eyes were unfocussed. Two oxygen straws protruded from my nose and led to the oxygen outlet at the wall. After a few short minutes, I was fully compus mentis. A nurse came to perform the usual monitoring duties. I looked at my watch. I’d been away 3 1/2 hours, which meant I had been under the knife for about 2 hours.

I looked at my foot to make sure it was still there and that the surgeon hadn’t made the mistake of operating on the wrong one. Excellent! They’d got the right one. Even though I expected it, I was a little dismayed at seeing the familiar white cast and my toes pointing toward the floor like a ballet-dancer.  Well, that’s it. No weight on that for 6 weeks!

With mixed emotions, I picked up my novel and read. I was still tired but I didn’t want to sleep again or else I wouldn’t sleep that night. One advantage was that there was absolutely no pain.

I sent a text to Mr P to say I was awake. Her reply, “You’re alive Number 5!” made me chuckle for hours until she came to see me. Unfortunately, as expected, she had eaten all the grapes by the time she arrived and left me with only the dregs of a fresh fruit salad. She also insisted in taking a photo, which was revenge for me taking pictures of her surgical experience a couple of years ago. After an hour of wrecking havoc but making everyone smile, she left me with the promise to be on one hour’s standby to exfiltrate me the next day.

I was ready for my main meal at 7pm and eagerly scoffed it down. All 5 spoon fulls of it.

Mrs P and I had tried to get the TV monitor working. It was a pull round plastic affair with a flat screen. Apparently it had TV, radio and an integrated phone. We played around with the settings but couldn’t get anything to work.

I caught the eye of the chap opposite me. A nice elderly man who had obviously had some hip surgery.

“If you want to use that, be prepared to pay out a lot of money,” he said dryly. I pushed the monitor away in disgust. Is there nothing that doesn’t cost?  I thought about the £3.50 an hour car parking fee. I wondered if there was a private option so I could get a decent meal.

I lasted until 10pm when at last the lights dimmed. As soon as they did, the patients’ buzzers started. As I was at the staff desk end, I couldn’t help but hear the incessant buzzing, which had a habit of staying on until cancelled. I’m not exaggerating when I say that for 2 hours, someone was calling out “Help me ” in a distant side ward. My scowling glare at the staff was answered with, “Now, don’t start this all night Mrs ***. We know there’s nothing wrong.” I finally managed to get to sleep about 3am.

At 7 o’clock the prospect of going home spurred me into action. In the confusion of shift change I got dressed and planned to make my way to the bathroom. I had a sneaky suspicion that I would be challenged and get caught like a potential escapee from Colditz. I planned the most un-noticeable route and went into staking mode. But I was right. I got nabbed!

“Not until you’ve been seen by the physio’s” was the explanation.

“As good as they might be, I don’t think even they will be able to make me walk that quickly,” I replied.

“No, but they’ll tell you how to use those crutches. It’s Health and Safety.”

There was no point explaining that I’d been using crutches for the last 8 weeks.

I was sent back to bed with a plastic bottle. I considered its value  for use in bushcraft circles. Man, could that thing take a lot of fluid! Great for hammock users! I didn’t think that it would fit in a pack that well though. Wrong shape.

At last the consultant came round. We went through post-surgery procedure and a date when the stitches would be removed. He confirmed I’d eaten, drank, and urinated. I was tempted to proudly hold up the fliud container. He seemed surprised that I had not taken pain killers. I assured him I was no hero and it wasn’t a ruse to expedite the escape. I was cleared to go subject to approval from the physios who subsequently assessed my crutch management skills as A1 (!) and gave me the green light. A nurse extracted the cannula from the back of my hand (“Don’t want you walking away with that do we?” – No, we don’t.)

I was free! I thanked the staff and sped-off down the corridor as fast as my crutches would carry me; out of the hospital and into cold January day.

I’m getting irritable. Twitchy, moody and irritable. There’s talk of Birch tapping. The sun has been out. The temperature is up and the catkins are drooping in their fresh green finery. I even heard a lawn-mower going a few days ago. And I’m still sitting here with a cast on! Is it really 128 days (a third of a year) since the original Achilles Tendon Injury?

I am forbidden to put any weight on this last cast under any circumstances. The last time when my foot was manoeuvred into the “neutral” or flat position I was given a shoe and I was allowed to wander around. Not this time.

Well, the good news is that there’s only one more week to go. Next Friday I will have the final cast removed. The consultant warned me that I will be going back into the Aircast for a while, but at least it will be weight-bearing and I will be mobile again. I suspect I will be able to take it off every now and again to build up the muscles around the injury. I agree that this time I’ve got to be ultra cautious and for a month or so the Aircast will be staying on when I go on any trip to the woods.

Of course I’m glad that this is coming to an end. So is my bank manager. I’ve spent a small fortune on leather-making stuff! Mind you if it wasn’t for the injury I wouldn’t have discovered it or had the opportunity to practice.

So far I’ve made a sheath for my EKA W11, a laplander saw holder, a large possible pouch (in a sporran style) an axe holder and a notebook cover. They could all be improved especially the stitching.

I’ve called this series “Antique Oak”. I’ll now move on and produce something in a different style. Not sure what yet. The Badger print embossing tool was kindly manufactured by Jim (Kerne) over at BCUK.

Thanks for the visit.

Pablo.

Last month I visited the consultant who allowed me to take off the Aircast “… only if you’re not going to do anything stupid. “No, sir,” said I, imagining myself screaming around the woods shouting “I’m free!” He also added I shouldn’t lift anything heavy, nor should I walk long distances. If I were going to do any one of these things, the Aircast should go back on; “…and I’ll see you in 2 months.” Yes, sir.

He gave me a referral to the dreaded physiotherapy department or better named (at least in my day), the torture chamber!

Let me explain. Having been a Physical Training Instructor in a previous life, we were trained somewhat in the art of remedial gymnastics. This involved rehabilitating injured patients using exercises under the supervision of a physiotherapist. The line between trained remedial gymnasts and physios were so narrow that many of us went on to become fully fledged physios. Alas, I was not one of them.

Knowing what pain I inflicted on unknowing soldiers (all in good faith of course) I waited with trepidation for my name to be called. I was going to be seen by Hazel; no doubt a 7 foot tall Neanderthal, all-in-wrestler with a 5 o’clock shadow.

Hazel wasn’t 7 foot tall, nor was she a Neanderthal nor was she a an all-in-wrestler, nor did she have a 5 o’clock shadow. She was young and extremely pretty. “We’re going to stretch the achilles gently.” Gently? Surely there’s no such word in the physio-dictionary. I searched my brain for a word that was close enough to have been misunderstood. The nearest I could come up with was genitals; but surely that couldn’t have been it… could it? “After we’ve stretched the muscles and the tendon, we’ll strengthen up the whole ankle joint,” she said. Seems like a plan.

Garlic mustard

In fact Hazel offered the most sensible theory of causation I’d yet heard. The impact of the heel striking the ground was obviously the main cause; however two previous ankle injuries rupturing the lateral tendons of the foot quite a few years ago had not been properly repaired. This may have led to a weakening of the whole joint. To prove this I had to stand on one foot and close my eyes. Sure enough, when I tried to stand on my injured foot I lost my balance within 2 seconds.

It’s all to do with the proprioception sensors located in the joints and muscles. Try this test yourself. Try standing on one foot for about a minute. If you can do that, try it with your eyes closed. You may find you can stand on one foot longer than the other without losing your balance.

You can train your muscles if there is an imbalance in one foot. Just practice balancing on the other one (or take up Tai Chi). It will help you when stalking and improve your overall balance. The sensors allow the body to sense the position and movement of our limbs. The tiny muscles and tendons make minute movements to compensate for where it thinks the body should be to keep it balanced. In my case, the left side is out of kilter making the whole ankle joint unstable and more susceptible to injury. But it’s nothing that can’t be fixed.

To celebrate the fact that I was allowed to wear two shoes and that the physiotherapy sessions were going to be a “gentle” affair under the  skilled hands of Hazel (!) I went to Outfield woods where, on that fateful evening of October 31st 2008, I slipped down a slope and ended up with a ruptured achilles tendon.

If I was at all spiritual, I would have offered something to the woods spirits as an appeasement. Instead I sat in the ditch and had a cereal bar and a cup of coffee.

So ends this chapter of my life.

Pablo.

A not quite so happy anniversary this weekend as exactly one year ago, I ruptured my Achilles tendon. It’s been a long haul getting it fixed and after a re-rupture in January, I was finally signed off by the physiotherapists only two weeks ago.

It was a scary thought (and not just because it was Halloween) that this time last year, I was sitting in a plaster cast wondering how I was going to get to the woods let alone to Africa.

I will never forget everyone’s kindness in sending best wishes, DVDs, books and even a walking stick from Ashley at Natural Bushcraft. The only benefit of that experience was that I started making leather bits and pieces.

I was probably a bit critical of the NHS at the start and rightly so with a series of appalling administrative errors, but they certainly came through at the end by providing top class after-care in the form of two wonderful physios, Hazel and Suzie. I know they will be following my adventures in Namibia starting next Saturday. They went out of their way and battled to get me fit knowing I was making the trip.

This weekend, as with last weekend, I was striving to get some photos of the rut in my local woods. After identifying the stand, I waited and waited and waited for some activity, but only saw fleeting glimpses of the dominant buck. The does were also elusive and I just couldn’t get any decent shots at all.

This year’s rut didn’t seem to have the same intensity as it did last year, where many tree trunks were frayed and gouged. This year there was none. I tried various tactics such as stalking, laying up and high seats but it wasn’t to be. And now I’ve run out of time before I go to Namibia next week. Never mind. There’s always next year.

Mid week post – ‘The Final Countdown’.

Thanks for the visit.

Pablo.