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.
 

Monday 3rd September...No more Catheter or PCA Plenty of infection...

 This post is quite personal, they all are but I think bodily functions are always more embarrassing to talk about! I'm writing it anyway because this blog is also a way of me keeping a diary because I keep forgetting to actually write in mine (Im using it to write these because we had to keep one for the solicitors from day one). Also I want to capture every detail because these sort of things don't cross peoples minds when they think of crashes, so if you don't want to know about me going to the toilet by all means don't read it haha
  3rd September over two weeks since the crash. I had spent all of this time with a 'urinary catheter' this was put in when I arrived as it was pretty obvious I wasnt going to be able to go to a toilet anytime soon. Also while I was in a coma I was being pumped with fluids so obviously your bladder still needs to empty but you cant go so the tube goes all the way into the urethra (don't worry I wont be attatching any photos! aha) and continually drains into a box/bag. This stayed in for so long because my injuries were so severe i could not even use a bed pan regularly. But after over two weeks it had to come out because of the high infection risk. I was terrified. I thought it takes a few nurses and a lot of pain to get from my bed onto the commode chair and if theyre busy they wont answer my buzzer quickly. Plus I hadn't felt the need or gone for a wee in over two weeks, I think I forgot that you don't suddenly need the loo then wet yourself...So anyway they took it out at midnight (not something you want to be woken up for) I don't know if it hurt going in as I was in a coma but it stung coming out! You have to pee within six hours or you need another put in and I went at 5.55am I like to live on the edge! Anyway it wasn't as bad as I thought, I had a commode (basically a chair with a hole in that you can fit a pot under to be used as a toilet) luckily while I was in hospital the commode chair actually fitted over the toilet in my 'en-suite' so once I was on it the nurse could just push me in and it was basically the same as using the toilet I just had to buzz for them to come and get me out. They also had to pull my bottoms up/down for the first week because I couldn't move to lift or adjust like you normally could. Actually it wasn't even embarrassing I was so weak, so vulnerable and in constant agony I really didn't care. I didn't care when I had to be bed bathed naked and rolled over so someone could wash my back and I didnt care that someone had to wipe my ass at 19. But think about that when you think 'I'll just speed through here I'm going to be late' or think about showing off in your car. I didnt care because I didnt have the ability to care at that point.
  My PCA (patient controlled analgesia-morphine) was also taken away. Funnily enough they don't really like you to be filling yourself with an opiate for more than two weeks! Luckily I was still allowed Oramorph (drinkable morphine) whenever I wanted it because jesus did I need it. Skin stapled to a huge burn on your back, countless broken bones burst liver and road burns really fucking hurt. Plus my donor site on the back of my thigh was really starting to hurt...when my nurse took the dressing off it was pretty clearly infected! With pseudomonas to be presise.
  This meant I had to have betadine soaked gauze and a new dressing put on it and more antibiotics! Betadine either is iodine or has iodine in it (I cant remember!) but that means its bright orange and soaks through everything!
DRIVE SAFE, George xxx

Thursday 30th August Sitting in a WHEELCHAIR... meeting Gareth Gates...

   29th August was an exciting day! (not because I met Gareth) Two days after I had been sat up for the first time (and then remained flat for another 2 days) my physio's turned up with a wheelchair! Another thing I never thought would be exciting, but god I was happy! I had to use two physio's, a nurse, a banana board, a slide sheet and another nurse on stand by to get into the wheelchair but I did it! I had (and still do have) a special support cushion for my pelvis and my left leg had to be elevated because bending it even slightly was SO SO painful. Another thing people probably don't think about was all the attatchments I had! I had a catheter (pipe directly into your bladder continually draining) so they had to get me into the chair without catching it and then hang it on the side. I still had my first VAC box dressing attatched to my graft, so they had to unplug the box and switch it to run on battery, that then went in a bag on the back of the chair. I also had several canulars (needles into the vein for easy access with fluids, pain relief and antibiotics) one of which was attatched to my PCA of morphine (patient controlled analgesia) so that had to sit on my lap.
  So all in all I was looking pretty trendy with my bag of wee on the side and huge box of back fluid behind me. Did I mention the VAC makes noises as it sucks?!
   Anyway the physio's took me into the hall (first time I had left my room other than on my bed to theatre) and I had a feeble go at wheeling myself. Its hard to get used to (and i still had an undiagnosed broken wrist so it hurt). Then this receptionist, clerk person comes up and takes my handles and pushes me down the hall to meet Gareth Gates. What the hell? Now this blog may become world famous (very unlikely haha) so I will watch what i say, but lets just say I was a lot more interested in learning to move in a wheelchair! The military ward get a lot of famous visitors (something else I wont go on about but I dont think its fair on the other wards..)
DRIVE SAFE george xxx