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Arlo : Amputation Deliberation
Diary entry posted Mon 9:08am 10 October 2005

The ER doctor comes up to me and says that my leg is going to need an operation to sort it out as it is badly broken. It is a grade 2 compound (open) fracture (mid-shaft) of the tibia and fibia. They are also concerned about the poor circulation to my foot where the pulse is very weak. At this point, I'm starting to feel tired and bleary eyed which is probably due to the morphine that I've been injected with.

I'm also told that I've sustained a fracture of the proximal humerus in my shoulder (the "neck" of the bone that goes into the shoulder from the arm). This bone has punched through my deltoid muscle in my shoulder and literally as each minute goes by, my entire shoulder (front and back) is turning black with bruising. It hurts more than I could have ever imagined.

A consent form is waved under my spaced out eyes and I sign it. This is the first of the two ops that I will have on the leg. I ask the ER doctor if I can make a couple of calls to let people know what is happening. I firstly phone my mum and I'm obviously that carefree in the manner of my speech that she doesn't really know that anything is wrong until I tell her in a "matter of fact" voice, "I might be a bit late home mum as I'm just off to theatre to have my broken leg repaired!!". She is too shocked to say anything in reply as this is a bolt out of the blue for her and major deja-vue after the death of my brother some 20 odd years ago. The next call I make is to my best mate and work colleague Gary who I inform in the same matter of fact tone that "I won't be into work tomorrow, Gary because....". He too is shocked because I'd told him this in such a light-hearted way.

I'm whisked off to theatre and after a while, I'm awake again with my whole leg wrapped in bandages but with these weird metal contraption seemingly balanced in the middle of it all. I haven't at this point clocked that this is an external fixator that is screwed through my leg and into my bone!!

The first operation, apparently, is merely to clean out the wound (debridement) and flush all the bits of the road that my open leg wound had scooped up on my unscheduled seat of the pants slide down the road. They don't close the open fracture at this stage because of the risk of what is termed compartment syndrome. This is where pressure builds up in a part of the leg due to trauma and the excessive pressure causes blood vessels and veins to collapse, thereby cutting the bloody supply off to the lower leg and foot - not very nice. Leaving the wound open after being stablised allows the swelling and pressure to subside naturally.

So I spend the next three days staring at this metal bar on my leg, still trying to accept that it goes right through my skin and flesh into the bone itself!! It's a weird thing to try and understand, but the weirdest thing of it all is that there's no pain at all from it!! It's my shoulder that's giving the major grief and the surgeons have seen fit to attach a plaster of paris "hanging" cast to my shoulder. It weighs a ton and it's sole purpose is to drag my shoulder down to keep the fracture in my arm stable. It certainly does that, but pushes my pain barrier through the roof!! I'm hooked up to a morphine PCA (Patient Controlled Anaesthesia) pump to dispense timely doses of morphine to keep the pain wolf from the door. Thankfully, it helps.

I am also relieved to hear from the consultant 24 hours after the operation that a nice healthy pulse has returned to my foot and he casually tells me that I now do not need an operation to amputate the foot! I don't know whether or not to laugh or cry, so I simply fall asleep on him!!



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 Mon 9:08am 10 October 2005
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