Saturday 31 January 2009

Where were you on the 31st January 2009?

73 days on and I have my first shower. Picture the scene. White plastic bath board across the bath. Towels everywhere to prevent flooding. Strategically placed stools (two) and a chair. Getting naked. Sliding backwards, with the crutches, onto the bath board. Hauling legs over (back to the shower head) careful not to put any weight on my right leg. Left foot planted firmly on the new (hideous) rubber bath mat bought from John Lewis. Watching my right foot go purple. Turning on the shower. Hurrah! Washing - sort of - for ages. Scrubbing my right foot (which turns it back to a normal colour temporarily). Don't wash my hair - too ambitious for first date with shower head - save that for next time.

Drying is an art. Can get to most places on the bath board. Then have to get out with the crutches. Finish off the ablutions with a few fancy products. Then, the piece de resistance, hopping naked, bar the moonboot, to my bedroom. Pause to look in the mirror. Grin and laugh out loud - there is nothing sexy about a moonboot - not even S and M - god, I'll never get a husband at this rate....

Will it be remembered along side Obama's inauguration, Diana's death, or the tsunami? Kennedy's assassination or the moon landing? The day Blair came to power (gosh - remember the optimism then?). I guess not - but my first shower was a momentous thing - and when I'm queen, the occasion will be celebrated by dancing girls and bunting - with Bath Board Day an official public holiday across the land.

Monday 26 January 2009

Flying solo

68 days in and I'm on my own in my flat - officially flying solo - my only extra technical assistance a perching stool for the kitchen and a bath board on order. The community OT referral never came through - despite being marked 'urgent' two weeks ago. Instead, we (my trusty solution orientated Physio and myself) cajoled a hospital ward OT to break the rules and bail me out with some equipment. Without this I would have come home with nothing. And 'nothing' would have meant no cooking (and thus poor nutrition), and no shower (enough said!).

S0, going solo - what does it mean? Ever tried to spend a few weeks on your own on crutches - forbidden to put any weight on your right leg? Well - on the upside - its great to be home - fabulous views of the sea from the bedroom window - shame that I can't get outside at all without assistance. My prison is pleasant but oh to run along the beach...

We often talk about the isolation of the elderly infirm - but seldom stop to think about others who might be stuck indoors. Thank goodness for my fabulous neighbours who are rallying around to ensure I get some fresh air, not to mention my pals who turn up regularly with their (or their parents') cars to take me on a wee outing.

Then there is the problem of food. Great - I can choose to eat whatever I want, whenever I want it. But cooking on one leg is tiring, frustrating and dangerous. Perched on the aptly named perching stool I can swing round and reach most of the kitchen (just as well I'm not rich - a large kitchen would be impossible). I can put things in a pot and stir it. I can eat out of the pot (yes I know - dreadful - but washing the dishes is a drag - literally). I have to put my leg up on the bench to prevent it swelling and hurting - which means I have to hold whatever vessel I'm eating out of. I also have to eat where I cook because I can't carry hot food out of the kitchen - nor hot drinks.

If I run out of something I cant just pop out and get it. And the supermarket is so stressful in a wheelchair that I seldom remember to get what I need. The oven is dirty and I can't clean it without a perilous lean off the stool - although abseil clips could solve that one.

A cup of tea in bed is impossible - unless someone buys me a teasmade (do they still make those?). But I can drink the orange juice out of the carton and no one will know. Cleaning the cat litter tray has me beat - but asking someone else to do it isn't that pleasant either. Hoovering is out of the question, although I did manage to sweep the kitchen floor with a small brush.

So I sit here on my couch, the place a mess because moving anything bigger than a cup is ridiculously difficult, enormously grateful to my relatives who took such good care of me over the last nine weeks - and ponder the case of the man allegedly left to die by a couple of ambulance men some weeks ago. Apparently his home was a dreadful mess - and they judged him for it. Turned out he was simply proud, had cripplng arthritus, and couldn't clean his own home. And here's me - with a temporary gammy leg - unable to clean. Impossible to imagine until it happens to you. Tomorrow I'm ordering in a cleaner that doesnt mind emptying out the cat litter!


Wednesday 21 January 2009

Obama Mania

In years to come we will all remember where we were on the 20th of January 2009 - the inauguration of the 44th President of the United States of America - Barack Hussein Obama.

Alongside billions of others across the globe, I watched the proceedings on television (only the second programme I've watched in months - the first being the xmas edition of the Royle Family - not sure what that says about me??....). Felt vaguely embarrassed as my eyes welled with tears - hanging on to every word - wanting to believe that this extraordinary man, with his clever colleagues and his pretty daughters, and his fabulous wife, is going to change the world.

Wondered at his oratory powers, his unenviable in-tray, what on earth he said to Bush in those last moments as the previous incumbents walked up to the helicopter...
And where was I? On my bed in my temporary quarters, my leg still in its moonboot elevated on a blanket, my crutches still leaning against my pillow, my bag of prunes half empty. Obama unfortunately can't do much for my sodding leg, but he may just might be able to save the world - God bless America!

Monday 19 January 2009

Measurable progress

Today my right knee bent 123 degrees - is this good? Well, yes and no. Compared to three weeks ago its a miracle. Three weeks ago I could barely bend it to get into the car. Nothing intrinsically wrong with my knee though, it just froze from lack of use (and presumably fright from having a large orthopedic nail put through it).

To get to 123 degrees, my physio has put me through low level torture. Which I had to repeat at home four times a day. Not the torture experienced by the prisoners in Guantanamo - nothing like that - but still, in relation to my normal day to day existence, its been pretty painful - even bringing tears to my eyes. And of course, this low level torture is not being used to try and illicit information which I may or may not have, but simply to get me back on my feet - because if my knee doesn't bend, I wont be able to walk, or climb stairs, or even ride my bike. So the incentives are pretty good...

My knee exercises at home have been masterful in their creativity. No treatment bench? No problem! Just lay a mirror on the bed, then slide the right foot up and down on a little doughnut shaped cotton ball over the shiny surface - pushing the knee back a few more degrees each day. No physiotherapist on hand to give a helping hand? No problem! Just take a rolled up sarong, wrap it round the right thigh, and pull hard, holding the stretch for 30s into the pain threshold. Pull a little further each day.

On Friday we were at 110 degrees - three days later at 123. So back to the question. Is it good enough? Apparently not quite. For although I can now master most normal movements with my right knee, and probably have more movement than many other people, my goal is symmetry rather than some nationally agreed level of function. What does this mean in practice? I need to get to the level of my left knee. And when I sit on the bed with a bent knee, I can touch my heel on my thigh. And unfortunately, I made the mistake of showing off this movement to my physio. Lesson learnt - do not, on any account, show off to medical professionals. My knee torture thus continues...

And on the less measurable progress? Today I got up the stairs to my flat with both crutches - an improvement on the weekend's effort. Ironically, I was able to do this because of my non slip mountain bike gloves - highly recommended for hanging onto two crutches at once. And, apparently, the Occupational Therapist collected my referral (marked urgent) today from the clinic out tray - only 4 working days after it was put there. At this rate, I might even get the OT visit while I am still non weight bearing... Watch this space.

Saturday 17 January 2009

Another milestone

59 days on from my accident - and finally I scaled the heights of my tenement stair - and got into my flat. OK - I did have a rest and a cup of tea on the first floor with my pals, and a quick break on the second floor - but it was surprisingly easy. Its all about technique and confidence. Left arm and hand on the banister, crutch in the right hand, push down on the crutch and hop up. Remember that the crutch follows on the way up - and has the lead on the way down. Coming down I even managed to carry the spare crutch with me - not an easy feat (I cheated on the way up - had my spare crutch carried up).

Strange to be in my flat - sunny, tidy, unlived in. Like coming back from a long holiday, hopping round, picking things up, wondering why things are out of place, trying not to slip on the rugs. Noticing that the neighbours' children have started learning the trumpet (is there no justice?), that the stair is filthy and covered in sand (trip hazard), that the plants are still alive.

So, stairs conquered, I can technically now move back in: bar the small detail of my OT referral (no idea the waiting times for this) and having to rely on patient transport for clinics and physio appointments (allow half a day for a 30 minute appointment). And of course trying to weasel a third crutch from the physio department so that I can leave a crutch at the bottom of the stair - chained of course to the railing.


Friday 16 January 2009

Freedom from attachment is the cure for suffering

In Buddhism, three concepts are said to characterise all things:

  1. Anicca - nothing is permanent, everything changes
  2. Anatta - there is no separate self - what we experience as identity is a changing constellation of many influences
  3. Dukka - to believe otherwise, to cling to some thing or someone or oneself and expect it to be enduring is to create and amplify suffering.

It will surprise no one that I have turned to Buddhism in my days of immobility - goes with the territory really - fold up bike (trashed), shiny mac powerbook, green energy tariff, right-on recycler, reader of broadsheets, organic veggie box, frequent visitor to South East Asia, and a three month stint on a small farm with a Buddhist family back in 1999. Not that these things have made me a better or happier person - the beautiful irony is of course my very public attachment to this identity, this lifestyle, and the (expensive) shiny things that go with it.

I got to thinking about attachment a few days ago when I discovered, with dismay and disappointment, that my physiotherapist is transferring to another hospital at the end of the month. The frustration of having to meet someone new, to tell my story again, to develop enough trust to accept significant levels of pain, and my toddler like fury at the unfairness of it all, prompted a rethink. My journey through the NHS system is going to require many changes in personel, deviations from planned approaches, setbacks and unexpected successes. I know that I cannot afford to become attached to people or plans - it will only cause more misery and anxiety.

And as I must try to reduce attachments within the NHS, so I must severe the ones that are causing my current frustration. Cycling, cooking, popping out to get a paper, washing my own hair, having a bath, walking on the beach, having two healthy legs and feet... But then, damnit, I need to ensure I don't develop new ones - my moonboot for example is already a not so subtle extension of my right leg, my wheelchair a new bicycle, my crutches a right leg, my status as victim elicits sympathy and visitors, the comfort of my temporary home much preferable to the difficulties of going back to my flat (if I can ever get up the sodding stairs).

Freedom from attachment is the cure for suffering. It sounds trite. It even looks trite. But there is something in it. Lifetimes are required to reach Nirvana - not a couple of years going through the NHS. I guess all I can do for a start is to try to avoid some of the clinging - and give a huge welcoming grin to my new physiotherapist instead of an ungrateful grunt when we finally meet.

Wednesday 14 January 2009

Shiny new wheels


Today I took delivery of a shiny red wheelchair - its not a bike - I can't jump it up or down curbs (yet) - but in the few hours I've had it - Ive already been to India and back...

And so easy to obtain. My secondary carer (the one who brings me breakfast) dropped me off at physio today. And while I was being soothed and pummeled and stretched and soothed again, he talked to a couple of folk, made a couple of phone calls, and an hour later - on our way home - we picked up the wheels from the Red Cross, round the corner from Dalkeith's Masonic Lodge. It came with three feet attachments: two the usual right and left foot plates; and, the piece de resistance - a right attachment to rest my leg in.

This, for the uninitiated, allows me to sit in the wheelchair and watch a movie without my foot swelling and turning an angry purple. And having this wheelchair means I don't have to carry a stool for my leg, can take a pal to the movies for free (the cinemas generously offer free tickets for carers), and critically, don't have to be driven to the door of where ever I'm going. Without a Blue Badge for the car I've been defeated more times than I can shake a stick - and that's saying something these days... So now its just a bit of work on the upper arm muscles and I'll be off...

Tuesday 13 January 2009

Meeting my consultant

Well - I waited 2 hours, my carer couldn't get a car park and so had to leave me and return later - and almost everyone had left the department by the time I saw my man. Even the lights had been turned out.

We had about 15 minutes. I took the moonboot off, he tested the movement in my ankle and foot - and pronounced another 4 weeks of non weight bearing. He also said that it was likely I would get back around 80% of full movement - and would be under the care of the hospital for 2 years. Cycling could be a problem - but maybe if I raised the seat a bit it might be possible? There may or may not be another operation - a bone graft - and this would involve lifting up the skin flap - while avoiding the artery to ensure the flap doesn't die in the process.

We talked about getting me back into my flat - and I now have an OT (occupational therapist) referral to sort out kit for (for washing and cooking). I will also need patient transport once I am at home - public transport impossible and taxis too expensive. given the three trips a week to the hospital. I will need chummed up my stairs as I'm too afraid to do it on my own - would be like a solo trip up Everest...

I am bitterly disappointed. Another 4 weeks of relentless physio (not including the physio that will continue once weight bearing starts) continued total dependence on pals who have cars, (I can't even get into a black cab at the moment) and a prognosis that doesn't sound as good as I was hoping - particularly in terms of the bike. Is it time to reinvent Kirsty - or do I just crack on with the original plan? Lets just hope that the motivation for all the work needed now is biological - because if it isn't its going to be very tough!


Sunday 11 January 2009

So near - but so far....


A momentous day. Today I managed to get up to the first floor of my tenement. OK - so I live on the third floor - not the first - so I didn't actually get into my flat. But my chums live on the first floor - and they had brought my cats down as well as laying on a digitalised version of Yellow Submarine (circa 1968).

I have two cats (known affectionately as the pirates): Jack and Betty. Jack has spent most of his time since my accident under the bed in my flat. Betty, being an outrageous flirt and far more fickle, has befriended everyone who has fed her (and there have been many).

To Jack's eternal credit, he remembered me, and despite the strange surroundings, hopped onto my lap and purred like a purring thing. Why was this important? Well, not only am I dotty about the pirates - but apparently, if you are recovering from an injury, you should hug a purring cat. Consistent vibrational sound frequencies of 25-150 Hz, which is the range of a cat’s purr, aid in the healing of bones, tendons, ligaments and muscles, as well as providing pain relief.

Jack doesn't like being hugged too much - but I kept him close by just in case there is something in this milarky... So, only two more floors to go to get to my flat and, how lucky am I, but I have more chums on the second floor who also have cat. Their cat, Smokey, is not much of a purring thing. He is however, terrifically mean - so mean that no Black Dog will come within sniffing distance. So now its just cats, physio and a few stairs - and I'll be home!


Saturday 10 January 2009

Black Dogs


Churchill had one, there is at least one clinic named after them, as well as several pubs, a tavern, a Led Zeppelin song, a children's website, a film starring Patrick Swayze - and, strangely Black Dog is slang for bad credit in Cork....

I first came across the term when my my friend Helen referred to her Black Dog day on a particularly gruelling pedal up a dirt track at around 4000m close to the Chinese border on the Karakorum Highway. She dropped the bike in the sand, sat down in the dirt and rolled a fag - sending us on without her...

Before my accident I had my own occasional Black Dogs - they came and went with the blasting northerly winds, whipped up by issues as serious as my opposition to the UK's invasion of Iraq and as ridiculous as my fury over the parasitic Boris not replacing the peanut butter. In those days, the good old days before the 19th of November, I got hold of the Black Dog, hauled him onto the beach (or equivalent) and took him for a savage walk in the sand, until he melted away - replaced by more mundane and positive thoughts - of past and yet to be had cycle adventures, of naughty food and fine wines, or just a bloody good read.

But now the Black Dog is different. He comes padding in at the strangest of times - hanging around the bathroom door, lying under the bed, gazing out the window. This Black Dog can't be dragged away with the usual method. His baleful eyes know that I'm not going out without help, that I can't get on a bike or go for a walk on the beach, that there are no planned adventures, that books are still difficult, that I can't pop out for a haircut, and can't even get into the bath.

This Black Dog also senses my pride, my stubbornness and frustration - that he is unlikely to be beaten off by medication - because the side effects of medication draws on his pals - smaller black dogs (black dogs are never puppies - only dogs - which raises a series of very difficult questions!) that hide under the pillow and keep you drowsy, or get in the way of your crutches forcing you to sway dangerously and trip, even pawing at your mouth so that your words are strangely slurred...

And this Black Dog is private - he knows that I need to appear cheerful and well - calm and enduring in my crisis, undemanding of others despite my almost total lack of mobility, grateful that I was lucky (ie, not killed) rather than unlucky to be run over at all.

But my Black Dog has a secret life (other clients?) - he isn't here all the time - laughter seems to banish him as does the presence of pals, he trots off when I focus on my knitting or get an unexpected card in the mail. He's afraid of the little cat that sometimes sleeps on my bed, and he definitely doesn't like the scent of chocolate. He doesn't come with me to physio appointments although he is less shy around my consultants. He doesn't like Scrabble although he does turn up when I'm losing.... He's not sure about shopping - cowering if its enjoyable but baring his teeth at any obvious rampant consumerism...

I guess my Black Dog will stay around a while yet - as long as I keep feeding him - trouble is - if I don't - I'm worried that I'll be done by the RSPCA for cruelty - and that would never do...





Thursday 8 January 2009

A trip to the office

Yesterday I went to work. For those of us lucky enough to have a job these days, this would be a normal activity, largely tolerated, often enjoyed, several hours in meetings, in front of a computer, answering emails, phone calls, writing reports, analysing data, preparing advice, and generally doing out best to help make the world a better place. However, for me, currently signed off work until March, my visit to the office was not a normal trip. I was going in to say hello to colleagues and pick up a few things from my desk - not to undertake any paid labour.

The first abnormality was my transport in - we drove, well, my aunt drove. For someone whose job is to reduce single occupancy vehicle trips to reduce congestion and GHG emissions- this was very strange. I felt guilty. Old habits die hard! Once in reception, I collected my reserved wheelchair, and sat down. Immediately the familiar feeling of my workplace changed. I lost half of my height, and any sense of gravitas I once might have thought I had. The helpful man in reception was nervous of working the wheelchair, and his colleague adjusted the brakes - and then I was off. With a couple of colleagues we mastered the lift (lift controls easy to reach) although I had to reverse the wheelchair out. Then through the swing doors - and into my office.

My colleagues were warm, friendly and gathered round. Low in my wheelchair I was nervous - everyone seemed so tall - the furniture bigger, the corridors longer. I was the centre of attention - this should have felt good - but I was faintly embarrassed. People so obviously cared. This is astonishingly humbling. Of course I knew that - from the cards, and flowers and gifts sent to me in hospital - but still, I am a few weeks on from that now - and one imagines that interest diminishes. I told my stories, and we laughed - but inside I was tremulous - felt like I was slurring my words. Someone asked me about my prognosis - and I had no idea how to reply - I've been too cautious (superstitious really) even to write about that, never mind explain my uncertainties out loud.

The old adage ' no one is indispensable' is completely true - everyone is getting on just fine without me. That should have been difficult for someone as controlling and hands on as me - but somehow I am less bothered than I expected. If so, this has to be a good thing - how wonderful to be able to let go, trusting that other people will do what needs to be done, without interfering. or adding my 'personal touch'. I can only hope that this is a change for the good and not simply the painkillers addling my mind....


Friday 2 January 2009

Being 'disabled'

Today we went to the Richter exhibition at the Scottish National Gallery. In my pre accident days this would have meant a simple pedal to the gallery, chaining the bike up outside, purchasing a ticket - and then wandering around, looking at the paintings and feigning an intellectual understanding of the arts. But not now.

First we had to phone the gallery to find out about access, parking and wheelchairs. Then we had to navigate Edinburgh's tourist infested streets and tram works to get to the back of the gallery. After an illegal left turn onto The Mound (sorry officers - but it would have been impossible otherwise), we encountered a set of bollards blocking our way. A man in tartan trousers (uniform of Scottish gallery workers) quizzed us. We don't have a Blue Badge so don't have legal access to the disabled parking areas. After a bit of discussion, and a wave of the crutches to prove our case, he dropped the bollards and we drove to the back of the gallery. A short hop up the ramp, a minute's wait for the wheelchair and I am set - well almost. We have to be accompanied to reception for our tickets.

Then into the first gallery. A couple in their 30s smile at me, and then, thinking they are out of earshot, are overheard to say 'skiing accident'. I'm outraged (skiing accident tends to come without sympathy - generally deemed self imposed and justly deserved) - but also perplexed - after all - I don't have a sun tan. What prompted the interpretation? Was it my red fleece? Or my shapeless brown cotton trousers? My perhaps just my radiating good health?

In the next gallery a rather smart woman in her 60s walks straight up to me and asks me what Ive done to myself - 'run over by a truck' I say surprised. 'Looks like it hurts' she says and heads back to her male companion. Very odd. Would this woman walk up to me if I wasn't in a wheelchair and ask me a similarly personal question? Was it just her way of connecting with me - a kind gesture but actually totally inappropriate?

Its all very strange. Later in the restaurant my good friend attempts to help me into out of the wheelchair - I am brusque and independent - refusing the help. Half an hour later I am critical of a stranger who doesn't open the door for me. I pondered this apparent hypocrisy later with a friend on the phone (my friend has a colleague with MS who has to use a wheelchair). We concluded that, in general, people are generally kind and they want to help. Those of us on the receiving end, however, have set an invisible line - on one side - this help is gracefully received - on the other it is refused. But the line is not obvious - and it may change from time to time - or in different circumstances. I resolve to be more gracious with those offering me assistance - to consider it not as a patronising act - but as a gesture of generosity and good will. I wonder how long I will last!