Chapter 43

Southmead Trauma Team - Season Ticket Holder  - 2020/21

‘This place looks rather familiar’

Six years earlier, I’d arrived on an ambulance with a smashed pelvis and broken arm.  At least this time I could walk in.

It all looked vaguely familiar. The curtained cubicles, the clean smell, the equipment and trollies, and the quiet, reassuring efficiency.  On the other hand, there were some differences.  I was sitting on a chair rather than lying on a bed.  I wasn’t wired up to anything and I’d managed to arrive via bike and car rather than by ambulance and had actually walked into Southmead A & E. It felt deserted with only a few walking wounded, any friends or family excluded by the ongoing Covid restrictions.

Within ten minutes, a nurse had completed his initial assessment, walked me to X-ray and back, got me a cup of tea and started to clean up the road rash on my back and shoulder.  I briefly contemplated asking him to look at the hip and bum I’d scraped in an earlier spill that week but decided against it.

The X-ray result confirmed Sue’s opinion, my amateur guesswork and his expert assessment.   A dislocated index finger and a broken clavicle (collar bone).

The fix for the finger was easy: ‘Are you OK with needles?’ he enquired, as he injected the anaesthetic.

‘Let me know when you can’t feel anything. Good. You might want to look the other way for a minute,’ as he pulled the wonky digit back into alignment and bound it up to its neighbour.

‘The hand team and physios will take over from here. You’ll see someone before you go.’

The collar bone didn’t look so straightforward.  Even I could see it was in three bits. ‘I’ll get you an appointment in the morning with the orthopaedic guys.  In the meantime, let’s get the arm in a sling.’  And with a doubtful look added

‘Did you really continue cycling  for 40 minutes in that state?’

Funny thing adrenalin. It’s powerful stuff.  Ask my orthopaedic consultant who said it wasn’t the first time he’d come across similar feats but was nevertheless quite impressed.

Ask the Black Knight in Monty Python’s Holy Grail.  ’Tis but a scratch!’ as his leg was chopped off.

Within an hour I’d rendezvoused with Sue, who had no doubt realised by now that she was back on taxi duty for a few weeks, and we drove gingerly home.

The day hadn’t quite turned out as expected.  The plan Chris the Coach had left me on the Training Peaks calendar was clear.

‘As we discussed, Pete, we'll introduce some longer race pace intervals now. So keep it controlled in middle of your Z3 power for the time being. It may feel little too controlled but it's the realistic effort you'll be using on the bike leg so you do need to get used to the feel and the sustained but achievable effort. 2 x 20 mins of these efforts within your ride. I would keep the overall ride to around 2 hours. The intervals are the focus, not more endurance work which will give you precious little benefit but produce unwanted fatigue.’

The ride had gone well: the Z3 tempo efforts at race pace had confirmed that I was on course for my speed targets at the Cotswold Half Ironman at the beginning of August.  Only half an hour home at a steady cruise, aero position, hands on the tri-bars, passing through Rangeworthy village.

‘Car on the right.  He’s seen me and isn’t pulling out.’

Eyes drifted elsewhere, maybe a pothole check, maybe a power check.

‘Shit!  He’s going!’

Instinct.  Hands sought brakes.  Found.  Squeezed.  Too hard.  Uncontrolled.

The brakes were good. Too good!  Thirty kilometres per hour reduced to less than ten in an instant.  Only attached by pedal-cleats, Newton’s ‘Laws of Motion’ dictated that I carried on forwards, somersaulting over the handlebars and landing with a thump on the road.

I stopped a good few metres short of the hatchback and within seconds had struggled to my feet in a mixture of surprise, annoyance and embarrassment.  The elderly driver got out, nervously asking if I was okay, whilst I was still trying to rationalise his daft manoeuvre and the consequence of my instinctive grab at the brakes.

Avoidable?   Yes.  Damage?   Nothing I could see.

In fact as we stood there, holding up the traffic in the middle of the road, there wasn’t much I could really do about it other than suggest he might now have learnt a lesson about cyclists and speed that would prevent him from repeating his actions.  We parted company and I tentatively remounted, miffed that my two hour average pace was now going to be down a bit for this ride having previously been looking good for a training best.  I flicked the gear down a notch, except I didn’t, because my index finger tip wasn’t where it was supposed to be.  In fact, from the second knuckle the finger was loose and pointing in a different direction.  I mused in a curiously, detached way, on why it wasn’t hurting, and pulled over to have a think.  Clearly dislocated, I wondered if it could be temporarily fixed.  Oddly, I still couldn’t feel any pain, so gave it a little pull and straightened it up. It looked better and, whilst not being completely right, should at least let me manage to get home if I could work the brakes and gears.  I didn’t really want to call Sue and anyway, I’d be home by the time she’d driven out here.

Twenty minutes later I began to notice a few aches, especially around my left shoulder.  Must have really whacked it, I thought, and resigned to some road rash and bruising, hoping it wasn’t a rotator-cuff problem that might immobilise the arm for a fortnight.  At the traffic lights in Frampton I experimented with the arm.  It was tight but could be lifted at least to 60 or so degrees before it hurt and I seemed to be gripping the bars okay.

Another 15 minutes and I was home.  Remembering to press ‘save' on the Garmin, I left the bike in the garage and wandered into the garden to find Sue.

‘You okay?’  she looked up, admitting later that she thought I looked a bit grey.

‘Not really. I’ve come off.’

Helping me off with my shirt, it didn’t take long for us both to reach an obvious conclusion.  There was a lump near my shoulder and an alarming grating noise when I lifted my arm.  Suddenly the finger injury seemed quite minor.

Frustration

How do you deal with the sudden realisation that that’s it for the season?  The X-ray had confirmed the worst and, even with my limited medical knowledge, I knew this was going to mean a few months out of action.  What had become a frustratingly empty racing calendar due to Covid cancellations was now completely blank.  The revised plan to target the surviving Cotswold Classic only four weeks away could now be torn up as well.  FFS.

At least I wasn’t missing out on wearing a GB vest at the rearranged Euros in Bled, Slovenia.  Only a couple of days previously, GB Triathlon had been in contact to say the event was off until 2021 and I’d barely stopped being grumpy about that.  With the Worlds in Holland also having fallen victim a few weeks earlier, the dreams and plans for summer were now in tatters anyway, so missing out on The Cotswold, originally entered as a 'B’ race to form part of the build-up to Holland, just added another layer of disappointment.  The fact that my place in every race was guaranteed for the revised 2021 dates was a positive to hang onto but ……it was all so far away……..

And all that work!  Since December I’d been training, sometimes long, sometimes hard, in a more structured way than ever before.  Strength work at the gym, flexibility and Pilates, turbo sessions and interval work under the guidance of Chris the Coach, and running miles along muddy paths and around the streets during dark rainy evenings.  The data was looking good early in the season.

Then along had come coronavirus and the training regime was forced to change as pools and gyms closed and training runs and rides became solitary pursuits.  In frustration, I laid down a few markers and just went out and pushed a half-marathon and a 90km ride.  The times were really good and the power output encouraging but, with the Austrian Euros in serious jeopardy, we had lowered the intensity for a few weeks.  It was June before Chris allowed me to turn it up again.  The Austria cancellation was a big disappointment, especially as a few fellow club members were also on the team and the location looked stunning, but there was still hope for Holland.  Except there wasn’t.  It was called off in mid-June, leaving just the Cotswold and now I’d gone and blown that one.

So I wouldn’t find out that year how all the focused training and hard work would have translated into race results.  The training data had been encouraging and we were just approaching the last few weeks where the emphasis would be on even more speed.  On the fateful Friday I’d hit two half-hour intervals at race speed and felt comfortable at a pace at least 10% better than the previous year.  What would I have delivered at the Cotswold, or the cancelled GB events?  These unanswered questions have niggled me every day since but, equally as frustrating, was the awareness of the effort that would be required to try and get it all back again the following year.  For all my upbeat approach I knew it was not that easy to push a 61 year-old frame to re-gain the required performance levels.

On the ‘pissed-off' scale, I hovered around 8/10 for a few weeks.  I knew this was a bit selfish at a time when everyone else was also missing out on cancelled events and, in a broader context, there were thousands of folk dealing with mortality, health and employment challenges.  But in my own little microcosm, I was still hacked-off, despite knowing I’d eventually get over it.  Most of the annoyance was still directed at the invisible coronavirus but right then I was pissed off about the whole thing and the crash had just upped the level.  And all I could do for the moment was fret about the muscle-mass being lost and watch the hard-earned fitness levels drift slowly downwards on the Training Peaks charts.  How low would the line go before I could start to turn it back uphill?

Surprise and statistics

Have I mentioned it was my second crash of the week?  Only four days earlier I’d hit a pothole, losing control as the front tyre burst, and I’d hit the deck at speed.  That time I was lucky and suffered no more than some scrapes on my bum, elbow and finger.  A little bruised, I grumbled to myself about the state of our roads whilst standing alongside the fast Wickwar Road, changing the tube.

But here’s the thing…it was 2014 when I got knocked off by the dog and, having just checked my Strava records, I can reliably report:

In the two and half years since retirement I’d cycled 1,200 hours and 25,000km.

Between 2015 and 2017 I’d managed a further 500 hours and 7,000km.

So, totting that up, it’s 1,700 hours (nearly 300 days assuming 6 hours solid cycling a day).  Even more interesting is the 32,000km.  It’s 80% of the earth’s diameter if you ride along the equator and it’s easily inside the distance you need to reach to qualify for a Guinness World Record Round the World attempt.

In all that time and distance, the only tumble, until last week’s episodes, was in France when Sue and I collided on a bend and a scraped elbow and hip were sore for a few days.  To me that’s huge amount of cycling with no issues and I’m not sure what odds you’d have got on two crashes in a week.  Pretty long I would suggest.  I’m not sure friends and family appreciate this; in fact I wonder if some think I’m accident prone!  But the statistics suggest otherwise. (This view might need revising by the end of the chapter!)

Recovery  #1

The first few days were uncomfortable and awkward rather than particularly painful.  My left arm was in a sling and two fingers on the right hand were bound up on the other arm.  I had sore scrapes on both shoulders, elbows and hip and a muscle ache in the lower back and both hips.  Moving around in bed or rising off a chair needed a bit of forethought and some low-key grunting and grimacing.

A week later it was easing as my somewhat abused body started its own clever DIY repair job.  The finger was doing well and was now in just a simple splint; the scrapes were healing and I was getting used to the pain tolerance range when moving the arm and had figured out that I could still use the right hand in certain positions.  Some colourful bruising appeared around the shoulder and chest and the lower back was still tender but I could sense I felt slightly less battered.  I tried different sleeping positions rather than lying propped up which I didn’t think was helping the back.

Sue and I drove out to Portishead one night and walked to Battery Point to watch the sunset over the estuary, although the hour’s stroll we took was enough; the body was definitely telling me I’m was still in recovery mode and not to push it.  Interestingly, the HRV App’ (heart rate variability) was giving me the same message.  The last seven days had seen a 20% fall in the indice that measures 'readiness for training’ and the App had been telling me 'have a recovery day’ each morning after I took the measurement.  This was reassuring as I’d have lost confidence in it if the suggestion had been anything else!

As usual, Sue was being the perfect nurse; luckily I’d not compromised her activities and was even trying to show willing with any housework that was possible.  I was being pretty undemanding and had quite happily wiled away a few hours watching the cricket or football, reading or writing.

Friends helped with the mindset.  Mike and Bridget popped round for breakfast croissants and later in the day Pete, Di, Kate and Malc joined us for a pleasant evening meal out on the patio.  The chit-chat was a welcome distraction and the agreement we made to have another attempt at going to Mallorca the following March would be another small step in the mental rebuilding for the 2021 season.  Chris the Coach called in.  That was good of him, although I guess I was still paying for his coaching services at the time so his words of encouragement were quite costly!  I’d have to make sure I got some value back with a heavy physio programme during the autumn.

The big issue on my mind was the shoulder.  Would I need an op?  Could there be complications? What strength and movement would I recover?  Specifically, would my swimming be impacted? Would it be for life or just a few months?  I was concerned but couldn’t do much about it and the thoughts just kept looping around in my head, especially at night when it was seriously uncomfortable and I couldn’t sleep, knowing I’d just got to wait to hear what the consultant had to say.

The word came from the hospital.  They’d decided to operate but I needed to wait a couple more weeks until the cuts and grazes had healed.  At least I knew where I stood but that would be another fortnight of declining fitness.  Tidying the garage with Sue, as we relocated the DIY set of weights I’d used for strength training earlier during the lockdown, I ruefully reflected on all that enthusiasm and effort over the last six months now swirling steadily down the drain. I could even track my fitness decline on Training Peaks that unhelpfully sent me an automatic weekly update email.

To make me feel more grumpy I received the e-mail circular from British Tri’ announcing that clubs could start meeting again and events resume as Covid levels declined and within a few days I was irritated further by the Facebook traffic from my buddies in the club celebrating this good news.  I knew I shouldn’t but I made the mistake of looking at Strava.  The Tuesday Gang had enjoyed a 90km trip to Usk and back and others were doing stacks of activity during the evening.  And then the email arrived from Cotswold with the final race notes for the August race I’d now deferred.  Great!  Just what I wanted to know!

Things weren’t helped by difficulties in sleeping. One particular night it felt like something weird was going on.  I was regaining some flexibility in my waist and legs as the back stiffness eased but, on the flip side, new aches had appeared down my right-hand side and the hip and bum were uncomfortable again as I tossed and turned awkwardly through the night, my mind whirring in a constant loop of unhelpful thoughts.

After a couple of painkillers for breakfast, I felt okay for the rest of the day and managed a stroll to Frenchay Common with Sue.  But I needed something else to help with the mood so the next day we joined  Ade, Sue, Jerry, T and Malc and, whilst the guys went off for a mountain-bike ride (grrrr), I had a long 12km walk with the girls around the fields and hill forts of Doynton and Dyrham.  It was a pleasant day, rounded off with pint at The Cross and, despite feeling quite weary, I was more positive when we got home.

The next day was Op day: 07:00 at Southmead.  As ‘wasted’ days go, this was up there with the best.  I knew it was a Trauma Unit so wasn’t overly surprised when, after a couple of hours of waiting, I received the ‘Sorry, not today’ message, especially having observed a few individuals being wheeled in looking rather the worse for wear.  However, I was just about to leave the building when I was called back.  Apparently the surgical team thought they might still be able to fit me in later that afternoon.

This was good news, even allowing me a few hours to kill watching cricket and reading.  By 5.30pm even my patience was wearing thin, but I was finally seen by the anaesthetist, who administered my pre-med pills, followed by the consultant’s assistant.  He looked at the wound and was a bit concerned about the infection risk as it hadn’t fully healed.  Off he trotted to discuss with the consultant and they decided it wouldn’t be worth the infection risk and it would be better to stall another week.

Marvellous.  My frustration wasn’t helped by that fact that I’d not eaten for nearly 24 hours and had barely had anything to drink.  I know it wasn’t anyone’s fault, and I could see they’d been full-on but …..I called Sue and arranged to meet her halfway home then set off to walk and clear my head a bit.

That was yet another week of fitness decline on the TP chart.

Probably the lowest ebb was the following week; unusually for me I was miserable.  Tuesday had been a beautiful day and I knew the Tuesday gang would have had a great ride.  To add insult to injury, I’d had to start on a big admin task thanks to my dubious honour of being our Triathlon Club’s Welfare Officer which now included responsibility for Covid.  This meant I spent a lot of the day preparing Covid risk assessments and action plans to allow all my able-bodied buddies to resume their formal training sessions in the next couple of weeks.  I couldn’t help but feel envious.

Sue drove us up to Tog Hill to watch a spectacular sunset to try and help lift the spirits but I couldn’t avoid ruefully thinking of my Strava times on this ‘climb segment’ and how they’d been steadily improving.  It was going to be awhile before I could register a ride on this stretch again.

Now…..You know those few moments when you first wake up and haven’t yet switched onto your current status, where you are, or remembered what the day ahead holds in store?  The Thursday morning of that week, just for a nanosecond or two, I was still blissfully unaware of two major issues.

Firstly, the fact that I was still crocked and hadn’t even started on the rehab’ plan to get back in shape.

Secondly, the horror show that was the performance of Forest the night before and our unbelievable failure to hold onto our position in the Play-offs. How can anyone concede four goals in the last ten minutes?

I’d laid there, letting the reality of these two calamities sink in, and re-activating the mental strategies I’d need to deal with them.  I shouldn’t really have listened to Radio 5 that morning. It was full of the incredible stories from the previous night’s final Championship matches and how Forest had thrown away their unassailable position over the last few games.  I still find it hard to accept and our Beeston Lads WhatsApp group had been forced to resort to black humour to mask our wounds.

On the positive side, it was now four days since I had needed a painkiller and I perked up over breakfast when the hospital called to apologise for Monday’s mess and to rearrange for the following week.  I headed down to the Doc’s for yet another dressing change, although this time the nurse decided to leave the dressing off as ‘It’s ‘nearly there!’  I hoped the surgeon would agree when he saw me.

Operation

It finally all happened.  I was called in at 9.00 and, after another run through with Amanda (the surgeon) and Sophie (the anaesthetist), it was off to theatre a couple of hours later. They were both young thirty-somethings but oozed a relaxed confidence as they joked, in a vaguely respectful way, about their boss, Iain Packham, the highly-regarded consultant, who would be overseeing things.

Isn’t it amazing how you wake-up and find yourself back in the ward?  No dreams, no feelings, just fixed.  I was a bit light-headed and thirsty but within an hour they seemed to think I’d be okay to be despatched.   Amanda popped by to say it went well; they’d opted for the permanent plate option and inserted a new artificial ligament apparently, for reasons I couldn’t quite understand, called a ‘tightrope.’

Being my usual greedy self, I was too keen to eat and promptly threw up the cup of tea and sandwich the nurse had kindly fetched, but eventually I got the all clear and Sue picked me up at about 7pm.

Observation: the nurses that day were from Poland and Jordan; the Admin’ who coordinated everything was from India, and the anaesthetist was from South Africa.

Surgical notes: Tightrope surgical application

Clavicle fractures are characterised by disruption of the coracoclavicular ligament with wide proximal fragment displacement. There is a high risk of non-union, ranging from 22 to 30% for non-operative treatment so surgical treatment is usually indicated, as it is difficult to establish and maintain reduction with more conservative measures. Various techniques have been described for treatment of these fractures, but the ideal method of fixation remains to be ascertained. This is probably due to the associated complications of many of these surgical techniques.

Originally designed for syndesmotic injury of the ankle, the Tightrope system has been used for anterior cruciate ligament reconstruction and stabilisation of acromioclavicular joint dislocation. To the best of our knowledge, there is only one published study regarding the use of the Tightrope system for distal clavicle fracture. The system has been used as an adjunct for closing the coracoclavicular interval in addition to fixation with plates. The Tightrope system consists of four-strand #5 fibre wire interlaced between two titanium endo-buttons. The so-called ‘snow-shoe’ hold of these buttons on cortical bone enables the implant to withstand cyclic load without cutting out of bone. This type of fixation provides good apposition of the fracture fragments for union by maintaining the reduced coracoclavicular interval. This also allows the injured coracoclavicular ligaments to heal better with anatomical reduction. As the acromioclavicular joint is not violated, complications such as arthrosis are avoided. There is no risk of shoulder impingement as no hardware is placed into the subacromial space as may occur with use of a hook plate. The implant is relatively low profile, and thus obviates the need for a second surgery for its removal. Another advantage of this technique is that it may be performed arthroscopically.

The main drawback of this technique is that the coracoid process must be exposed thereby placing the nearby musculocutaneous nerve at risk. Cost may be another consideration when compared to other cheaper alternatives.

There is a need for fixation method that offers adequate stability for early shoulder mobilization, yet avoids complications associated with conventional fixation methods. The Tightrope system is a promising option for displaced distal clavicle fractures as a stand-alone fixation.

Recovery  # 2

So a month after the crash I could actually make a start on the recovery.

They’d obviously given the physio allocation a bit of thought. I’d been assigned a physio: Jethro Mendola-Byatt was young sporty guy who told me the consultant would be after him if I wasn’t swimming again within three months.  The take-away from my first video consultation with him was to push things to the point where it started to hurt.

‘Em, it’s supposed to hurt a bit is it?’  I pushed a little bit harder.  To a UB40 soundtrack, I had begun with the exercises and the music had morphed into Bob Marley’s Greatest Hits by the time I’d finished.

Over the next couple of weeks, the hottest of an already baking summer, I had a couple of physio video sessions and, encouragingly, had crept ahead of expected progress for shoulder mobility.

‘It’s a balance. You’re coming on fine but the bones need to set and soft tissue has been pulled all over the place so needs to settle down.  Keep taking the pain-killers but don’t over-do it.’  We didn’t know it then but a year later I would still be his patient.

‘Pick up my guitar and play…just like yesterday.’  It had been looking at me forlornly for a few years, begging to be played, despite knowing that it might only be a few beginner’s strums.  I thought it might be a good alternative exercise for a recovering finger and shoulder.  It was a bit tricky as I couldn't extend the left arm properly but it was possible.  I’d been mulling over a writing a paragraph or two on seagulls for the book so, on a whim, I tapped ‘Play ‘Seagull’ by Bad Company’ into Google and picked the ‘easy’ option from the range of choices on YouTube.  D, A, G, C.  Even I could attempt this and proceeded to fiddle around for half an hour trying to find some muscle-memory in my fingers.

It was so hot, hot, hot.  Sweaty fingers stuck to the splints; healing wounds itched under the dressings and sleeping was so uncomfortable, but little by little, the pain killer dose was reducing.  Sue was encouraging; friends were a supportive distraction, and things were slowly improving.  After three weeks, Southmead reviewed progress; everything was still attached, bones were knitting, the wound was healing.  The dressing could come off, revealing a gruesome mix of yellow and purple.  The basic theme remained: 'Just be patient.  Don’t bugger it up!’

Sue and friends did their best to keep me upbeat.  It was the summer for evening walks, eating outside and making the best of the Covid restrictions.  They all helped massively but I’d had enough of walks and watching others maximising the warm weather to ride and run.  In the end I figured out a way to get onto the turbo one-handed and ride for half an hour in a sit-up-and-beg position.  It was plenty long enough but at least, for the first time in 50 days, the decline in the fitness curve had been halted.  A few days later I’d started jogging, despite the sling, and by the time we headed over to St David’s for the usual August Bank Holiday week with the gang, I was up to a steady- paced 5km.

Retrospectively my coach and physio gave the all-clear to start back up.  It wasn’t to be a smooth climb back up the fitness slope.

Stupidly, a week into September, I went for a run only an hour or so after a whopping pub lunch and couple of pints.  Hardly surprisingly my stomach didn’t like it and for the next few days I had a sharp pain just under my ribs which pulled me up short any time I tried to jog.  A fortnight later it was still aching so, concerned it might be something more serious, (I really shouldn’t self-diagnose on the Web,) I visited the doctor.  Dressed in full biological warfare gear, he prodded and poked but thought it was probably just a diaphragm strain and expected it to ease in another week or two. Correct.

Next I overdid it on the upper body stretching and the shoulder protested, tightening up and throbbing in low, dull ache sort of way.  I called Jethro and sought Chris’s opinion; neither seemed too concerned because it wasn’t a sharp specific pain, telling me to keep everything below shoulder height for a fortnight and give it a rest.  Bugger - that ruled out any cycling on Dartmoor where we were heading with Sue and Ade, Jerry and T for a week.  It was great walking and weather but, whilst the others went off on their MTB’s, I had to opt for a few jerky runs.  At least, with my ‘just ‘effing-do-it’ headset on, I knocked off a slow 21km run along the Granite Way.  It was a mini-milestone but the shoulder still ached and I continued to have a nagging concern that all wasn’t well so reluctantly opted to take it steady and have a few rest days and push back the outdoor ride start date.  Again.

There were further mini-milestones.  At the end of October I re-joined the weekly club run, catching up with some faces I hadn’t seen since pre-lockdown days, and a fortnight later I finally got back on the bike outdoors, purging the demons by repeating the route I’d crashed on.  Shoulders, neck and arms started to ache halfway through the two-hour ride, but who cared?  The fitness line was finally moving upwards again.  Two more weeks, back in the groove.  Cycle, run, Zwift indoor ride, cycle, Zwift, run.   The pool hadn’t re-opened so I couldn’t do much about the swimming but had tentatively started to build back the shoulder strength using dumbbells at home.

Then Sue announced one morning, ‘I’m not feeling great; think I’d better get a Covid test.’  She was positive.  Forty-eight hours later I felt like I’d got a dose of flu’.   Hardly surprisingly, I was positive too.   ‘FFS!   FFS!!   FFS!!!’

I wasn’t up to any sort of training for a fortnight so the fitness curve dived south again.

NHS letter:

Dear Peter Sheath

Birth date – 29 March 1959

Test date: 29 November 2020

NHS Number: 4822965252

Your coronavirus test result is positive. It means you had the virus when the test was done.

Try not to worry. You can often ease symptoms at home until you recover.

And now we were into winter.  ‘There’s loads of time’ said Chris and Jethro encouragingly. ‘You’ll get there.’

Alright for them to say.  I was the one who knew how much effort had to go in.  Again.

Just before Christmas there was another small milestone. The pool opened and it was back in the swim at last. 1500m and the arm didn’t fall off.  In fact it felt better than I could have hoped and luckily had no real post-swim reaction.  Covid restrictions meant only three in the lane and just a 45 minute session but it was more than enough.  And the following day I was signed off by Southmead.  The latest X-ray showed it had healed and the brakes were fully off.

THANK YOU NHS.

Great.  Let’s hope 2021 will be trouble free.

Southmead Re-Re-visited

By the New Year, things were heading back on track.  A long ride or two with Murray, down from Scotland for a week, would keep things moving over the holiday period.  Unfortunately I hadn’t factored in some crap on the road as we rode on a Sunday afternoon along a back lane close to Sodbury Common.  There was a small family group of walkers on our side so I moved out across the centre of the road, swinging back just before a bend. ‘Careful here!’  I alerted Murray. ‘It’s mucky.’   Too mucky.

The front wheel skidded and down I went.  A hard thump followed by a slide through all the gravel, and assorted other crud you find in winter on country lanes.

'Ouch!  Shit!’

Lying there under Murray’s concerned gaze, I performed a familiar post-crash damage assessment.  Head okay; arms and shoulders seemed okay; no obvious blood.  The leg had taken a bang and my foot felt weird, strangely loose in my shoe when it clearly couldn’t be, and not responding to the ‘unclip’ instruction I was sending?   Ummm….

Murray helped me shuffle to the verge on my bum where I tried to stand. I struggled up but didn’t feel like I could put weight through it.  Ummm… 

A doctor, out for a jog, stopped to check how I was, her face not giving anything away when I described the odd sensations and mentioned I had a pelvis titanium repair on that side from an incident six years earlier.

‘Best to get it X-rayed,’ she suggested. ‘Is there anyone who can take you to the Yate Walk-In Centre?’

Murray phoned Sue who came to the rescue.  Within 30 minutes I was carefully bundled into the car and deposited in a wheel chair outside the Centre, Covid restrictions meaning I had to be left on my own.  Sue and Murray headed home to await the news.  The assessment at Yate was inconclusive; there were no obvious lumps but the X-ray machine wasn’t big enough to cope with hips and I had reached the ‘any chance of some painkillers please’ stage.

‘I’m going to order an ambulance. Let’s get you to Southmead,’ said the chap in charge.

And so the ‘Southmead Hospital rewind button’ was pressed yet again.  By now I could write the procedure manual for them.

1. Arrive in A&E on a gurney.

‘Name, DOB, what’s happened to you then?’ ask the reassuringly calm staff. ‘Let’s clean you up, check your BP and get you to X-ray.’

2. Accompanied to X-ray.

‘Can you lie down here; just wriggle a shade more this way.’  I know there’s no point asking what she can see and her face gives nothing away.

3. Waited in A&E.  Constant checking of vitals until the main Trauma Nurse came along.

‘You’re in luck I’m not normally on today but my specialism is orthopaedics.  The good news is that the original repair seems okay; the bad news is you’ve broken your femur, right at the top.  Afraid it will need surgery so you’ll be with us a week or so.’  ‘F…ing great.’

4. Moved to the ward.  As previously I’m given my own ensuite room.

‘The doctor will be round later.  In the meantime let’s give you some painkillers.  Sorry no food or drink until we know what’s happening.’

5. Phoned Sue.  I needed some overnight stuff and the iPad.  Waited.  Snoozed. Tried not to dwell on it.   Blocked out thinking about the consequences until the consultant’s verdict.

6. Consultant breezed in the next morning.  We recognised each other.  Non-judgemental. 

‘It should be a standard fix. You’re scheduled for tomorrow. Four/five months before you can run again.  Ironman?  In six months??  Are you serious?  Best see how it goes.’   At least he hasn’t ruled it out !

7.  Pee bottles, painkillers, temperature, blood pressure, covid test, breakfast, lunch, dinner.  A constant stream of nurses and auxiliaries. Repeat.  Day and night.

‘Hello. Here’s the menu for today.  Hello, what’ve you been up to then? Hello, do you want the curtains drawing?  Hello. Another pee bottle?   Hello. Cup of tea love?’

8. Tried to block off the negative thoughts. It had happened, deal with it, adapt. June was still six months away.

9. Surgery.  As usual a day later than originally forecast due to more urgent traumas.  I was surprised at the size of the team when wheeled into theatre.

‘Breathe normally, count down from ten.’

10. Later.  The consultant delivered the verdict.

‘All went okay. We put a plate in.  The physios will see you later.  My team will check tomorrow.’  Phew!

11.  Two physios arrived. With a Zimmer. Young, attractive and insistent.

‘Right let’s get you up.  Touch pressure only with that leg.  Reckon you can make it to the loo? Here’s some exercises you can do in bed.’

‘Seriously?’  It was only a few hours since the op.  ‘Well if you say so.’

12.  Surgery plus one day.  The physios came back.

‘Can you get up on your own?  Forget the zimmer.  Let’s see how you manage on crutches.  That’s it, remember to look where you place them.  Can you make it to those doors just along the corridor and back?’

You bet I can.  Twice.  Success, but I was whacked after 50m. 

13.  Exercises, doze, painkillers, read, eat, chat to Sue and friends, chat to staff, crutch walk. Repeat for three days.

14.  Surgery plus four days.  The physio’s challenge.

‘The consultant is happy.  If you can pass the stairs test we’ll discharge you today.  We’ve agreed for Jethro to be your ongoing physio contact when you get home.  Oh and you need a bowel movement before the nurse will sign you off.’

Sue picked me up late afternoon. One test was easy, the other required medication assistance.

Recovery  #3

And so the ‘home recovery’ button was pressed yet again.

Supervised, hairy, descents of the stairs.  Eat, read, exercises, write, painkillers, chat, exercises, guitar, injection.

Sue fussed like a mother hen. ‘Don’t try and be a clever dick.  Give me a shout if you need something.’

I was having some guilty qualms. ‘I’m sure I can manage to cook the dinner.’

Friends kept popping round.  Daily, Sue nervously accompanied my crutch expeditions to the bottom of the road.  And then round the corner.  And then up the road to the lights.

Mike and Bridget came round for a walk.  ‘Let’s aim for a coffee in the High Street’.

A week later they came round again.  ‘Let’s aim for a coffee in Page Park’.

Jethro ‘zoomed’ in again within a few days.  ‘Right where shall we start?  Shoulder or leg?  Show me how far off the carpet you can lift the leg.  Let me see you ‘walk’ to the window.  Remind me when your first race is.  June.  Em..I think we can do this.’ 

Chris the Coach came round.  ‘Just take it steady until everything’s knitted.  There’s no rush, you’ve got great endurance so that’ll come back.  June.  Em.. I think we can do this.’

Hallelujah!

In the background, recovering from orthopaedic surgery for the third time wasn’t so nice.  Here’s the bits that don’t tend to get mentioned when describing a rehab experience, the things that just have to be dealt with inside the head, without whinging too much, that just needed to be toughed out.

In no particular order.

Legs and feet would swell and ache, especially after a few hours on the sofa. They turned an unhealthy, puffy pink like some geriatric and needed elevation and movement to slowly revert to something more normal.

There was so much excess fluid in my system I was continually heading for the loo.

Skin dried and flaked off everywhere.

Daily self-injections were required into my stomach for a month to prevent the risk of clotting.

The wound takes a few weeks to settle down and in the first few weeks you can’t get the dressing wet so showering is a complicated balancing act.

It was uncomfortable at night. I didn’t like sleeping on my back. It ached, throbbed, protested, seemingly troubling a different part of the body each night.  And I needed to get up several times in the dark, forcing the leg out of bed, trying not to grunt, fumbling for the crutches, urgently lurching to the loo.

I was coating myself in Deep Heat and Ibuprofen gel each evening.

The physio routine wasn’t easy and most of the exercises hurt a bit or were, at best, uncomfortable.

‘Do it to the point it starts to get painful,’ said Jethro, ‘and hold it there.’

But what does that actually mean?  Clearly not to the point I would have tears in my eyes or scream in agony but I could hold an ‘Ow’ position for probably ten seconds and an ‘Oooh’ position for at least half a minute.

After a couple of weeks he assessed progress.  ‘We’re way ahead.  What are you taking?’   I didn’t tell him I’d self-committed to doing double the regime I’d been given but sometimes it wasn’t easy….It sometimes required a little battle in the head.

And the head is really where it’s all at.  It was so ‘effing frustrating.  Why is it when you’re injured there always seem to be folks out running and cycling?  And whilst my buddies were out on their bikes or jogging across fields, June was crawling closer.

All that wasted effort.  ‘Yeah but you might still be able to get it back?’

Seriously?  Somehow I’d got to add back a minimum of 60 fitness points in 5 months - remember it’s a rolling daily average so needs to be building each week.  ‘I’ve worked it out on Training Peaks.  It can be done.’

But it’s so hard.  ‘I thought you were an ironman.’

I won’t be as fast.  ‘Who says so?’

I’m sixty-two.  Not many more opportunities for GB. ‘True, so let’s focus on getting there this year.’

What if I crash again?  ‘Stop it.’

Is all this fair on Sue?  ‘Well she’s not said don’t.  Maybe I’ll get through this and rethink…maybe.’

Why’s the other shoulder been twinging for three days now?  ‘Don’t know, better ask Chris or Jethro next week.’

Just one more set.  ‘Yeh but it’s killing me.’  No pain, no gain.  ‘Cliché.’ ’True.’.  ‘Okay….you bastard!’

More mini-milestones

Monday 8th February.  Four weeks after the surgery, I figured out a way, under Sue’s beady eye, to get onto the turbo.  The leg could manage a full rotation so we were back in business.

Six weeks after surgery, Southmead had me back. The x-ray showed good calcification and a doctor I hadn’t met previously (must be new) asked about whether I was still aiming for my events. (He must have read my notes.)

Thursday 18th March. Ten weeks after surgery, I slipped my running shoes on and managed it round the block.  Fifteen minutes and not a pretty sight but it was a start.  At least I could run in a stiff, lolloping, sort of way. 

Monday April 12th.  Back in the pool and gym.

April 22nd to 25th.   Walked 50k along the SW Coast Path with Sue, Ade, Mike and Bridget.  A tonic for the mind and could almost feel the strength starting to come back.

April 29th.  Rode 90k to Sudely with Pete W.   That was a 1/2 IM ride distance clocked.

May 17th.  Climbed Ben Venue with Sue and Murray.

Six months after surgery, Southmead declared me healed.   ‘Don’t come back!’

June 28th, the day I was supposed to have been doing the Euros in Austria.  ‘Luckily’ for me, GB had pulled the team so my spot was rolled to Bilbao 2022.  Celebrated by running a steady 15k around Eastville Park.

July 14th.  Seven months afterwards.  Cotswold Classic Half IM distance.  It wasn’t super-fast but the pace was roughly the same as in 2019.  Not bad. 

Now what about twice the distance in seven weeks?  Wearing a GB vest.

(See another chapter)

THANK YOU AGAIN Southmead, THANK YOU AGAIN Sue, THANK YOU AGAIN friends, THANKS Chris, Jethro…

Collar bone aftermath.                                                                                                                                                                                             Rehab underway.                                        Chris and Jerry in support.