Monday 24th September - Graft review...

   Monday 24th September 2012 I woke up nervous! I was having my second skin graft reviewed today. The first one as I explained here, was traumatic first I was told it had taken then I was told it had completely failed, was massively infected and I needed another one as soon as the infection was gone. My burns consultant came to see me the day before and told me that if it had failed again I might be able to go home for a few days but then come back for another graft.
   Even though I had gone through ALL of this and one failed graft I still thought 'It wont be failed again, it wont happen to me'. I was given lots of morphine and sat up and my Vac dressing taken off, the curtain around my bed was shut and I had to wait for my consultant. My mom was texting me trying to find out what was happening, this was a BIG event. The outcome of this affected my future scarring, whether I could leave hospital, Operations...
   Eventually Mr V arrived with a bundle of medical students and junior doctors. A nurse came in to hold my hand while he looked at my back. It was silent for about a minute and then I heard him say 'where is the graft?..' I felt sick, completely devastated. After some discussion between themselves he asked them all to leave so he could speak to me privately. (something I really value in this consultant) He looked sad, he specifically chose to take over my care and knew what I'd been through and how much I wanted to go home. He explained that it had almost all failed again, I asked about having another but after a chat with my nurses and their colleagues they decided I had to stay in a few more days but we'd treat the burn with dressings soaked in beta-dine again and try and avoid another graft. I was happy because I wanted to go home and couldn't face another gruelling skin graft operation but it meant my scarring would be worse. It also meant that again my body had failed to accept its own skin, it may be silly but that in itself is hard to accept.
   Now I had to have the dreaded staples out again, I was going to attach a photo of a similar graft but thought you may prefer just the staple instruments for less gore!

I wont ramble on about how much having the staples out hurts again but Just think - big full thickness burn, open wound, actual staples being pulled out...The only benefit to having such a severe burn is that it has burnt through everything including nerves so I could only feel the ones around the edge being taken out not the ones imbedded in the burn!
DRIVE SAFE, George xxx

 

Sunday 16th September - Moved to the Burns Unit...

  I had now been in hospital for exactly 4 weeks, most of which I had spent on the military trauma ward. I didn't want to be there but I had subconsciously become VERY attached to the ward namely the nurses. After my back was confirmed failed and infected it became clear that I needed to be moved to the hospitals burns unit for more specialist care. I needed to go but I didn't want to. When I left intensive care I was put in the Military trauma and orthopedics ward because I was a 'Poly-trauma' and had received SO many life threatening injuries - internal, external, structural...I had about 20 injuries.
  Anyway on Sunday the 16th September My mom had gone home and my step brother and his wife were visiting before my boyfriend Joss (rider of the bike) came in the evening. Half way through visiting my nurse for that day came in and told me they had a bed free on the burns unit so I was going down. I acted calm and OK because I didn't want to stress my brother out as they had to leave soon anyway. Inside I was freaking out though, I didn't want to leave my nurses that had become like a cross between medics and friends. I had LIVED in that room for almost 4 weeks, it was where I went when I was taken from the intensive care unit - a vulnerable, battered body that could barely speak.
  My nurse (the male one I mentioned last post) insisted on coming down with me to settle me in instead of just being taken by a porter. He stuck his head in before we went and said 'Im really going to miss you' and I could of cried it was such a strange emotion like I was leaving my family almost. He packed all my stuff up and I was taken to the unit on my bed so that I could keep the same bed. He took my wheelchair, transfer board and even the commode chair so I could have the same things.
  The burns unit is a unit not a ward. My room was still a private room and was in the high dependency area. It had no windows. The Burns unit is in the most appropriate place in the hospital in terms of critical care and theater proximity but this means there is no natural daylight. My room on 412 had a whole wall of glass, I could only see car park or road and I was so high up but it is invaluable. I even slept with my curtains open, you can't know claustrophobia until something like being completely trapped DYING underneath a car happens to you. So my room had NO windows it was literally a concrete box, the unit was a square with the nurses station/desk in the center like an island so even if my door was open I could just see a desk and more room doors. Upstairs I had my laptop so I could watch iplayer or look at facebook but here there was absolutely no signal even my phone could barely text. I was the only patient on the unit in a wheelchair with numerous broken bones as well as burns and wounds so I couldn't go off the unit unless it was visiting and I was able to get into my chair. I'll also point out that the toilet in my room which had the disabled sign on it was the size of a wardrobe so my wheelchair didn't fit and I had to remain buzzing to be put onto he commode and wheeled into the toilet and vise versa. It wasn't a bad place at all and you didn't have to pay for the telly (most wards like my other were about £20 for 3 days and I was in a LONG TIME) as there was no internet signal and the telly's weren't very reliable. That night was very hard, Joss left me his hoodie and as soppy as that sounds I really needed it. I was very lonely, my nurses were lovely but I didn't know them yet and they were reading my notes whereas upstairs had had me from ITU. I couldn't see anything but walls and I was so frightened they wouldn't let my mom in the next morning as she had special allowances on the trauma ward as I was so young and had so many injuries.
DRIVE SAFE, George x

Wednesday 5th September - 10th September Ups and DOWNS...

  It may read as though I'm skipping days throught this blog, I'm writing it from a diary my mom kept whilst I was in hospital to keep track of what happened when, for the solicitors.
  These were a stressful few days (everyday was but these more so...). On Wednesday the 5th September DAY 18 in hospital, my Vacum dressing was removed from my back (full thickness burn and graft) again. Once again this happened out of nowhere for me as a team of doctors, students and a consultant came into my room and talked about me to eachother while my nurse came in as fast as possible to try and get down what they were doing, so that I would know and so it would also be in my notes! They made me sit forward for this which was marginally better than being rolled but I had to hang on to my nurse to hold myself up and it killed my back, my pelvis, my legs everything. The removal itself hurt a lot, they peeled it off pretty fast but the thing is completley, air and water tight so it sticks pretty hard. They peered at the burn and muttered to themselves that it didnt look good 'here or here' but was probably 80% taken. That means 80% of the skin stapled onto the burn had survived and was doing well. They re-dressed it with a fabric dressing and special pads. They also pulled the dressings off my head, shoulder and hip and left them open for the nurse to try and figure out what they wanted doing with them! That was the first time I had seen my shoulder and hip injuries and they were pretty nasty. They called it 'road damage' or 'road burns' and basically where I had been dragged 10m under a car the tarmac had ripped through my jeans and 100% leather jacket and basically dragged and rubbed big patches of skin off me. My hip skin was hanging off and so was stitched back on and I have large areas of scar tissue which were once essentially gaping holes. The same happened to my head, my helmet was driven over and ripped up at some point and my scalp was rubbed away to my skull on the right side. Hense the hair removal, LUCKILY my hair has grown back through some of the scar tissue on my scalp and so they can cut out the remainder of scar tissue and pull it together to create a straight line scar. Which if you'd seen my head in A&E should be absolutley amazing!
  On Friday 7th September my wrist was comfirmed broken. One of the first things I recall when I came out of the coma was telling the nurses my wrist hurt (I couldnt feel my lower body so it didnt hurt at that time) they told me it was probably just a sprain because they had done a full body scan...Nope 3 weeks later it was 100% broken and put in plaster! Meaning I only had one un-damaged are (my left arm).
  Monday 10th September was heartbreaking really. It was DAY 23 and I was told I may be able to be transferred to a nearer hospital if I carried on progressing well, I was desperate to go home and really hoping for that. I met Mr VN (Im not sure if Im allowed to use his full name so I wont!) this day, he is a very senior burns and plastics consultant, he's also a wing commander in the army and runs private plastic surgery clinics in london. He had been told about me and wanted to take over as my burns consultant. He looked at my back, didn't order someone else to take off the dressings and actually spoke TO me! Sadly he took one look at my back and was absolutley certain the graft had completley failed and that the wound was becomming extremley infected. He was furious that someone had looked at it and told us it was 80% taken becuase it was 0% taken. They told me I'd have to go straight onto antibiotics, have my back treated everyday and when it was clear repeat the whole skin graft procedure. I was completley devastated I couldnt believe any of this had happened and just wanted to go back and never leave the house that day. I still do.
 

Skin Graft Number One...

  Thursday 23rd August (My first full day on the military trauma ward) it is safe to say I didn't really know what my injuries were. I think I was told in brief detail but it didn't go in and they tend to just say things like 'you're very poorly' when you've been through something so severe and clearly wont be able to understand yet. Also at this point I knew we had been in a motorbike accident that a driver had hit us at the island but no idea that I had been driven over and dragged 10 metres and had no memory at all.
  That afternoon my mum went home to sleep and Joss (my boyfriend and the bike rider) and Rhianna (his sister and my friend) were with me when a woman came into my room. I remember this clearly - she did not introduce herself and she was with a few students, she said some crap and then said ''So we're getting you in for your skin graft tomorrow''. The minute she said that sentence I went into massive panic. I couldn't breathe I started asking what she was talking about that I had no idea I was having any operations and she said ''yes you need a skin graft on your back from where you were stuck to the cars exhaust pipe'' This is where consultants and doctors fail. I had NO idea I had been under the car at this point, NO idea I even had a burn let alone how severe, NO idea I was having any operations. Then she tried to claim it had been decided on friday (IMPOSSIBLE my accident happened on sunday 2 days AFTER friday). After waking up in ITU I was terrified of even falling asleep the thought of being put under was more horrifying for me than I can even explain.
  During this panic attack she just left and luckily my wonderful nurse Laura came in, I was in an awful state crying and screaming yet trapped in my body unable to move. She assured me that I had to give consent and so I could refuse but I really needed the operation, that waking up wouldnt be like in ITU (ive never had an op or even been in hospital before this).
   I didn't agree/sign to the operation until I was in the anaesthetic room, I pressed my morphine PCA the whole way down hoping i would fall asleep before they could put me under. The assistant in there was wonderful she held my hand and stroked my head like i was a vulnerable child. I didn't feel myself falling asleep next thing I new I was opening my eyes in recovery. I remember I couldnt move (combination of my injuries anyway and the general anaesthetic wearing off) but I managed to say 'thank you for looking after me' to the recovery nurse I felt so thankful and vulnerable.
  I had a Split Thickness Skin Graft because they can cover a larger area. The skin was taken from the back of my right thigh using what is essentially a peeler (which as a wound itself is so painful) and literally stapled over my burn (with a little more complexity!). I had a NPWT or Vacuum dressing placed over it, applying a vacuum through a special sealed dressing attatched to a tube and a container box. The continued vacuum draws out fluid (gross!) from the wound and increases blood flow to the area. I also had my shoulder, hip, chest and head wounds washed and dressed and my hair properly shaved to keep my head injury more safe.
 I'm going to attatch some photos of skin graft 'implements' and the NPWT dressings THEY ARE NOT ME THEY ARE EXAMPLES FROM GOOGLE hopefully they wont upset anyone!
DRIVE SAFE, George xxx

                Example of a vacuum dressing - this person has a knee injury mine was obviously on my back.

                                  Example of the box and tube attatched to you and the dressing.

                                   How the donor skin is taken for applictation to the burn/wound.

19th August - The accident - What happened...

Photo's from online

Sunday 19th August 2012. Me and my boyfriend of 5 years, Joss, had free passes to WestMidlands Safari Park. We had had these passes for months for this specific date and had never been together before. We travelled there on Joss's motorbike as we did to most places. We spent the day there in the sunshine and travelled in one of the jeeps around the animals (obviously you aren't allowed to ride a bike through a field of tigers!). We left late afternoon and decided to stop off at Joss's home to collect a pair of my boots for a night out we were planning for the next day. We arrived at Joss's and I spoke to his dad about the safari park whilst Joss got the boots...that is the last thing I remember. Apparently we left soon after to go to my house - a 5 minute journey we took almost daily. (the rest is what I am told) We entered the same roundabout as always. We travelled round the roundabout to take the 3rd exit into the Oakalls housing estate, A woman was coming off the Redditch bypass, she did not slow down, she did not stop. We were in the right lane, we were indicating correctly, Joss saw her and tried his best to swerve. She was too fast and collided with us, at this point Joss and the bike hit the floor, I am told I was thrown into the air, landing on her bonnet before I hit the floor and somehow she managed to drive over my body, she drove a further 10/12 metres dragging my body with her. Eventually she stopped and her and her passengers (including a young child) got out. When Joss realised where I was, he saw me trapped under the car and believed I had died. Police, fire crews, 3 land ambulances and a rapid response team were called and Joss called his dad who arrived soon after. The Island was shut off at every exit and entrance and at one point I remember regaining conciousness. Another driver was laying on the floor infront of me holding my hand trying to keep me awake, I couldnt converse with him then but I would love to thank him for that. I was screaming that I couldn't breathe and I couldnt move my legs, the only pain I recall was the side of my face on the road and I can remember my mouth was full of blood. The fire crew used inflatable bags to lift the car and an air ambulance with a trauma doctor on board arived and administered emergency treatment and decided to anaesthatise me on the road. Joss was taken by ambulance to the Alex where he was eventually diagnosed with a dislocated collar bone (something they can't do a lot for) he was given a sling and sent home. My mom was visited by the police and Joss's dad and told she needed to get the the Queen Elizabeth hospital in birmingham as soon as possible as I was likely not to make it. When they arrived they were attempting to stabilise me in A&E and I was in an induced coma, waiting for a bed in the intensive care unit......I wont write anymore today and I hope this doesn't upset anyone, please feel free to ask any questions below or email or whatever, drive safe, George xxx