Friday, March 8, 2013

Road to Recovery


So much has happened since 3 weeks ago. I’m still trying to piece things together with the help of my parents and Ash. At first I was not keen to share my experience. Although there were some good moments, a lot of it was an awful and frightening nightmare for me, particularly in such a fragile and vulnerable state. I feel it was even worse for my parents, Ash and closest friends, who spent extensive hours by my bedside, sleep deprived and worried but still managing the strength to stay positive and care for me.  So now, after time and hearing stories from others who went through similar and more serious injuries, I feel it is helpful to share in the hope it could potentially benefit someone else going through a similar experience. It is also good for me to be able to look back and see how far I have come.  

 My season so far had not gone to plan. A back injury obtained in the second round of the National Cup series put me out for the rest of the series, and by the time the National Championships came around I was still out of contention. Luckily for me, I had other options and I set my sights on two races that had respectable prize money and I had a good chance at winning, the ‘Skyline Warrior’ and the ‘2W Gravity Enduro’. The first race, ‘Skyline Warrior’, was a new downhill course next to the luge. The track itself was handsomely sculpted, smooth and fast, with impressive berms and big jumps. I had borrowed a bike for the race, and during practice was trying to psych myself up for the jumps - the biggest one had a 6 metre gap. Luckily for me, I had my friend Kris, from Cycle Obsession, there and he took the time to show me the jumps and let me follow him in. I was on top of the world, with a goofy grin permanently plastered on my face from the exhilaration of flying through the air, especially now as I was considered one of the favourites to win. Here is a link to a short video showing some of the track http://www.youtube.com/watch?v=Ke-ITYpFuyI

It happened on the last practice run on the last jump. I was wanting to go fast and get some ‘big air’, so coming into the jump I preloaded and jumped. My inexperience and ill judgement meant that when I jumped, because I was clipped in, the back of the bike came up while the front stayed down – in a spectacular endo. I remember thinking “oh shit I’m going to crash” and “I can’t damage the bike” before I hit the ground. I don’t remember how I landed, but I immediately felt my left hip pop out and my left leg go completely numb with pins and needles and pain shooting down into the foot. Luckily for me, my hip relocated after rolling over, which I later read is something that is difficult to do after dislocation.
The First Aid response was awesome. I was immediately surrounded by people securing my head, neck and body, while asking where it hurt. I’m not sure what I responded, but I remember that my main concern was that I was blocking the track for other competitors, limiting their last practice of that jump. I was prepared to crawl out the way if I had to. Although my hip was now back where it should be, the pain in it and into my leg was crippling and I couldn’t walk. I was carried off to the side of the track and given oxygen, as I began feeling dizzy and faint.

Ash had just arrived in Rotorua and was at the bike shop when he received a call. “You better get here quick, Rae has fallen off and might be headed to hospital.”

Injured on the sideline but still smiling for the camera

I had made the decision with the help of the people surrounding me to not wait for an ambulance or Ash - the pain was increasing as the shock wore off and I wanted to get to hospital as soon as possible.  I was lifted into a ute by four strong guys and driven through the bumpy grass paddock to pick up two other injured guys. We then had an agonising wait for one of the guys to find his phone before we could leave. To finish it off, after the long wait, we drove through the roughest road works and speed bumps I've ever seen. 

At last we reached the hospital. I was so desperate to get in that I couldn't wait for the hospital orderly to help, so Ash ended up just carrying me to the wheelchair.  Now things started to happen. I was pushed into A&E, went straight through a very full waiting room and was put onto a bed and given an IV line where morphine was immediately administered. Relief at last! I was lucky to have Ash and my good friend Janine to keep me company that evening. All the x-rays taken came back normal and fracture-free, which was a relief to us all. Now it was time to get discharged, which I could only do if I could walk. After three failed attempts of the doctor to get me up and walking due to almost fainting, the decision was made at 11pm to admit me over night and reassess things in the morning.

Rotorua A&E: Janine & me
My parents had driven up from Wellington that night after receiving a phone call from Ash - “Rae has fallen off her bike, we are in hospital but she is ok”. That morning I was taken down for a CT scan, which unfortunately showed a significant displaced fracture to my acetabulum (part of the pelvis that forms the hip socket).  The CT also showed a path of destruction where I had dislocated my hip, as well as chipped off bony fragments floating around inside the joint. I was warned that there was a high chance I would need surgery which unfortunately is one of the more complicated orthopaedic operations. This is due to difficulties accessing the bone and because of the close proximity to major blood vessels, nerves and vital organs. For these reasons, the orthopaedic surgeon did not want to do my surgery and it was agreed that I would go to Wellington Hospital.

My support crew: Mum & Dad

Some of the scrapes and bruises 















At first, the Rotorua surgeon wanted me to get up walking on crutches and to increase my sitting endurance from 5min to 5hours so that I could drive down to Wellington. I started to walk myself to the toilet, but in the end needed someone to hold my leg to limit the pain and the horrible clicking and grinding feeling with the sensation that my hip will pop out again. Luckily I had a very good nurse who took one look at me and said there was no way I could sit in a car for that long. She organised a transfer on the air ambulance.

On Monday night (4th day in hospital), a crew flew up from Nelson to pick me up from Rotorua and flew me to Wellington hospital. I felt like a VIP, with my own private plane and crew. Because I lived in Nelson, the Nelson team had to take care of me. It was a small plane with two pilots, an air nurse and me on a stretcher still hooked up with morphine.

Wellington hospital was a big contrast to Rotorua. As soon as the surgeon saw the CT scan, I was put on bed rest and placed into traction to stabilize my pelvis and help with the pain. That was the first time I cried, as the realization hit me that this is serious and I might never ride my bike again. I was only in traction 2 days, but it was demoralizing being unable to move or wash myself and having to use a bedpan. I lost all my dignity and modesty.

Wellington Hospital: Setting up the traction
My surgeon, although lacking some interpersonal skills, was a great surgeon and before I knew it I was saying goodbye to Ash, Mum and Dad while being carted off for theatre and put under general anaesthesia. For on-going pain relief, they were going to put in a nerve block or an epidural while I was still under.

Pelvis X-ray: plate & 6 screws


My next memory is of waking up in an excruciating amount of pain. The pain was centred at my hip but rippled through my whole body. The nerve block (an injection of anaesthesia into the spine) was meant to limit pain after surgery for up to 24 hours, but for some reason it had not worked for me. I was in absolute agony. The Pain Team, made up doctors, anaesthetists and nurses, kept pumping drug after drug into me, but nothing seemed to help. At one stage, I remember a Pain Doctor saying to me, “If you had no pain, the amount of drugs I’ve given would mean that you would have been unconscious ages ago.”

At one stage, Ash came in to join me. My parents and Ash had been waiting a long 7 and half hours for me. After enquiring, they found out I was still in the recovery room due to issues with pain management. Ash was due to catch the ferry back to Nelson soon, so they sent him in to spend some time with me. Ash told me later that he barely recognised me when he saw me. My whole face apparently looked plastic and puffy. I don’t think he talked much, but just sat by holding my hand.

Before surgery
After surgery: Looking plastic and puffy




















I was finally released and wheeled back to my room, where my parents were waiting. I looked so terrible that mum stayed with me the whole night. I was on a PCA (patient controlled analgesia) where I could push a button every 5 minutes to get a hit of morphine. Problem was I was in so much pain and too groggy that I wasn’t capable of pushing the button. Mum ended up sitting there the whole night, sneakily pushing the button every 5 minutes for me. I didn’t sleep much that night, but we both made it through and in the morning the ‘Pain team’ came to the rescue. I was very teary that morning with both the pain and relief that something was going to get done about it. The initial dislocation and fracture felt like a tickle compared to what this pain was. A concoction of strong drugs was put together that finally made things bearable.

Pale and in pain but still trying to smile

That day was a blurred. Dad came in at some stage to take over care.

The following night was the most traumatic and horrific moment of my whole life. Dad was pushing the button every 5 minutes, so that the pain was controlled enough for me to get some sleep. At around 4 am, the nurse came in and told us that I wasn’t breathing enough. Despite being on supplementary oxygen, the oxygen levels in my blood had dropped because I was so drugged up and my drive to breath had reduced. She was concerned about the effect of the PCA and instructed us not to press the button for an hour, which we agreed to. My pain would previously get harsh at about 4 minutes and I would have to wait an agonising minute for the button to be pressed. Now to wait a whole hour was going to be intolerable. I gritted my teeth and tried to concentrate on my breathing to increase my oxygen levels. The pain was at a whole new level, but somehow we got through. We called the nurse and she said we could use the PCA again, but unknown to us she had actually turned it off. I eventually started crying- the first time I have ever cried due to pain- and asked for her to call the pain team for advice. She called them and came back saying that they agreed with her and gave me some ibuprofen.  She said that if the pain hadn’t reduced in half an hour, she would call them again. I silently cried to myself. I was being tested to my absolute limit waiting for that long 30 minutes to pass. It took every ounce of strength I had. After half an hour, we called for the nurse again. She came in and lied, telling us it had only been 10 minutes and to keep on waiting. I had used everything I had and had nothing left. I remember wishing my dad would just smother me with a pillow and put an end to this torture.  I then had a full blown asthma/ panic attack. I couldn’t breathe. I was aware of making a lot of noise waking up everyone else in the room, which I shared with another three patients, but I couldn’t stop. I was a mess, crying, gasping for air and in an absolutely panic because I couldn’t breath. The nurse couldn’t handle it and just kept telling me angrily to listen to her and slow down my breathing. She ended up going for help and came back with another nurse, who was an angel. Very calm and confident, she controlled the scene and was able to slow my breathing down and find out what was going on. She asked my pain level and I cried “10 out of 10”. She asked what the pain felt like and I said it was as though someone was stabbing me. I felt so small and helpless being in so much pain and needing that pain relief just to keep it at a tolerable level and then having it just taken away by one incompetent nurse could have had such severe consequences for me. The angel nurse sent the other nurse out of the room and told her to call the pain team right now and get them here urgently. She then apologised to me, which I really appreciated.

An anaesthetist, who was part of the pain team, eventually came and injected some powerful drugs right into my veins. The effects were immediate. My pain was instantly gone, but now I was suddenly hallucinating. The hospital bed was gone and I was in an old wooden cart going high speed down some rail tracks in the middle of space and into the mouth of a big dragon like some sort of dodgy roller-coaster ride. I could feel the cart get tipped upside down, doing summersaults, turning too sharply and me almost falling out into nothingness. I was desperately hanging on for dear life and scared because, even though I knew this couldn’t be real, when I looked down I couldn’t see my legs, just blackness. Dad told me afterwards that, as soon as the drugs went in, I raised my arms in front of me and just held them there. Then I began asking him “where am I?”, “where is my leg?”, “where is my other leg?”, “I don’t like this”. He answered all my questions calmly and, although I was spaced out, it was a relief for him as my face had relaxed and he knew I wasn’t in pain any more.

That morning I was exhausted and still sore, but it was nothing compared to that night. The doctors and pain team came during rounds and were surprised and appalled by what had happened that night. After that I was given my own room and some hospital feedback forms in case I wanted to make a complaint against the nurse. Luckily that was the last time I saw her and I now had great team looking after me.
Things started to improve. I wasn’t strong enough for visitors yet, but the pain was being managed and I finally started sleeping. Friday night I had my first solid sleep, it was only 3 hours but it made a huge difference.

Mum watching over me: Checking my breathing regularly 

On Saturday, I had my catheter out which meant I had to start walking to get to the toilet. By the weekend, I had recovered enough and was motivated again. Every little achievement felt like I had won a race. Friday I walked for the first time with a walking frame, Saturday I sat out of bed for 10 minutes and sent my first text (though needed a power nap afterwards), and Sunday I could cope with my first visitors since the surgery. I was very fortunate to have a lot of support and visitors throughout my time in hospital. I was so grateful for all the visits, flowers, magazines, baking, gifts, texts and messages. After the trauma of Thursday night, I was back to being strong, positive and happy, and I owe most of that to the support that was given to me. I got on well with a lot of the staff as well and they seemed just as pleased as me that I was starting to feel better. Dad had also made friends with the food lady, so after finishing off my meals he would then be offered extra food and drink. I was recovering very quickly every day, so on Monday I had my PCA removed and was upgraded to crutches.


Enjoying my friends company and humor

Jelly snakes for visitors and bribing the staff

The time had come to get back to Nelson. On Wednesday I was transferred by the air ambulance to Nelson hospital by an awesome team. Since I had come from a different hospital, I was kept in isolation, which meant a single room with a TV. Score! By the weekend, I was good to go home with some extra equipment to help out at home.  This was after 15 days in hospital where I lost 7kgs. Mum and Dad stayed the first week with me at home to help out and set things up while Ash went to work. There is no way I could have managed this on my own and I’m just so lucky and grateful to have such wonderful parents. I still have a long road ahead, but things are looking promising. With the help of my work, Active Body Centre, I’m getting the best rehab available. I am still non weight bearing on two crutches and can only walk short distances, but I have started doing my rehab in the pool which is keeping me sane. I am also extremely lucky to have Cath Cheatley, who has been through a similar injury, advising and encouraging me through this journey.

Nelson Hospital: Struggling to do a Suduku

I’m unsure what the future all bring, but I am 100% determined and motivated to get back to racing on the bike. After a lot of downtime and thinking, at this stage I have decided to give the National series a miss next year. I didn’t enjoy it this year except for the social aspect and financially it is very taxing. Instead I will concentrate on enduro and Super D racing where next year I hope to start racing on the international circuit for the first time. Furthermore, to the dislike of many of my mountain bike friends, last year after a taste on the road and track, I have become a big fan and would like to see how far I can go. So having my finger in many pies at the moment, hopefully I have a big future ahead of me. Thanks again everyone for your generous support J I couldn’t have got through this without my friends and family, 

Freedom at last: Discharged from Nelson Hospital






Enjoying being at home