NOV '12 - My 20th birthday, another bad review, compression garments and more surgery on the cards... (graphic photos!)

 So November was actually quite eventful and I am very thankful I kept a diary until I started this blog so I can back date everything so accurately!

 Joss now has another motorbike as it was written off in the crash. I feel very anxious about it, on one hand I don't want the driver of that car to stop me from getting back on a motorbike on the other it absolutely terrifies me to the core. He needs transport to get to work and has every right to continue riding especially as none of this was in any way his fault. But I am terrified that he will be injured or killed, if you get hit on a bike you have no exterior to protect you as I experienced. But for now he texts me whenever he leaves/arrives somewhere and it gives me some peace of mind.

In November quite a few things happened actually -

1. On the 3rd me and Joss took a trip to the Sealife center in Birmingham - The first and last time we went anywhere similar was the safari park on the day of the collision and I did feel strange about it. But we got there and back ok and luckily they had good wheelchair access there so we could enjoy it!
2. On the 7th I finally got the right size wheelchair! - In hospital I was given a wheelchair which was too wide for me and promised a smaller one, I was discharged with the large one but when I got home found it barely fit through our door frames. We rang up but they said they couldn't change it. This is when the fact it was someone else's fault is of benefit, because we have a legal claim going on I have an amazing lady who's job it is to make sure I have things I need and she ordered me a brand spanking new wheelchair that is my size and can still fit my special pelvic support cushion and here it is!  

MY wheelchair!

3. On the 5th (I realize I have gone backwards here oops!) my injuries caused another injury!.. - In the crash I dislocated my collar bone, when making a flipping pot noodle of all things it gave way and the freshly boiled kettle poured over my leg. The left, smashed up leg to be precise. It was excruciating. Imagine doing that and not being unable to jump up. If I hadn't of had this accident I would of gone straight to A&E but I thought I would be wasting their time and I'd had so much more serious burns. When I showed my scar therapist she took me straight down to the nurse clinic (It pays to have contacts haha) and they dressed them one part was actually second degree. You literally couldn't make this stuff up, nearly die in horrific accident - get discharged - shoulder injury gives way and causes more burns!

                                               This is actually the kettle burn 2 weeks after I did it...

4. On the 16th I had some of my scalp cut off with scissors... - So I was currently seeing the nurses once a week for dressing changes on my back (burn/skin grafts), leg (water burn) and head (scalped by road). Today went as usual until my mom decided to query why I still had a HUGE scab on my scalp injury nearly 3 months on. I have put a picture on but basically the bald patch you can see was scraped off down to my skull by being dragged along the road (my helmet was driven over and smashed). The nurse decided to pull the scab off and have a look. Then I had several nurses all mmm'ing and ahh'ing around my head, apparently there was a big lump under the scab and they needed to cut it off. YES cut it off with scissors while I sat there YES it felt exactly as you would think! Then they needed to burn the stalk down with silver nitrate sticks, I've had them used on my back but that burn went so deep I couldn't feel them doing it, this time I could and it REALLY hurt! MORE cream and more dressings!

My head before scab removal. The pink area was mostly open down to my skull in the crash and all the uneven short hair was cut by the paramedics and then shaved in theater.

5. The 22nd was my birthday and a trauma review - Neither went well, I went for my review had Xrays and then saw a doctor It didn't go so well, they still aren't very happy with my pelvis or leg growth and have only agreed to me starting 50% weightbearing on the right leg and still 100% not on the left (which basically means I still cant even stand up. Then my mom took me shopping but it was not enjoyable. I couldn't get around the shops easily in my chair, I couldn't buy clothes I used to like because I need them to be comfy and I'm extremely self conscious of how I look now. I wear a scarf on my head everyday to cover up the hair removal and wound/scar. I feel very ugly and nothing like myself. I had all of my piercings taken out, half of my long hair cut off, have gained weight since leaving hospital but my legs are empty from muscle wastage and I have a lot scars.

6. On the 24th I was fitted for my compression garment and went out with friends for my birthday -  I have to have a compression top to help with my burn and other scars. It is extremely tight and does up with a zip, it basically tries to flatten the scars as much as possible and it covers my shoulder scar (skin removed even through leather jacket by being dragged down road), both of my lung drain scars, my full thickness burn on my back (melted to the cars exhaust) and my hip (similar to shoulder but with added stictches!) it's not comfy but it has to be done! After that I went into Birmingham with Joss, his sister and her boyfriend at the time to see the German Christmas market which was really nice. Then we met a group of friends for a meal in the mail box in Birmingham to try and celebrate my birthday. First off we arrived to a gormless waiter 'you can get up a step can't you' YES THATS WHY I ASKED FOR A WHEELCHAIR ACCESS TABLE! So I had to be lifted up a step to our table which was extremely embarrassing and degrading. THEN when I asked about toilets I was told it was downstairs so had to be lifted back down the step and use a tiny staff lift   platform to go down and back up. It was frankly horrible.

7. On the 26th I saw my burns consultant - I'll keep this one short! My compression garments are being altered and then posted to me and it is now official that I am going to need another 4 or 5 operations on my burns including my back and head but that wont be until the skin has healed more to lower the infection risk.

                                                                             Here I am in my lovely compression garment!

So it was a busy month and not really in a good way! I hope that didn't bore you to death and the photos weren't too gross!

DRIVE SAFE, George xxx

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

 

Tuesday 18th/Wednesday 19th September - Skin graft 2...

    On Tuesday 18th my 3rd day on the burns unit, I was woken up at 5am to have my water taken off me and be told I was going to theater that day for my second skin graft. When you're having surgery you get a 'Nil by mouth' sign on your door, literally meaning 'the patient cannot drink or eat anything'. So I was given my tablets with the tiniest sip of water after my obs and told I was second on the list for my operation. I was terrified of going 'under', less so than the first graft as I explained in the earlier post but after pulling myself out of a coma the thought of being put to sleep frightens me to death. My mom arrived at 10am (on the dot every day!) but at about 2pm my burns consultant (Mr VN) came into my room in his scrubs. His first operation had taken longer than he thought and he couldn't perform my graft today. I was gasping for a drink and gutted. I was so desperate to go home that when he said I could either wait for him to do it Friday or have his colleague do it tomorrow I opted or his colleague. I regret that slightly now.
   Wednesday 19th exactly a month to the day of the accident I had my second graft. I was taken down before my mom arrived and I was very anxious. I was less vulnerable than the first time, as in I could sit myself up and before I didn't even know where I was but I was very scared. I was scared about where they were going to take the donor skin from because that creates a scar in itself, I was scared about waking up, I was scared and so sad that I was even having to do this. My favorite health care assistant came down with me and I woke up a few hours later in the recovery room. After the first one I was so vulnerable and weak I used the bit of energy I had to thank the nurse for looking after me while I woke up but this time I felt more ok. I tried to feel a bandage and dressing to find where the skin had come from but I couldn't move my arms. When I got taken back to my room my mom came and sat with me.
I hate that the first operation I had they didn't wake me up, I remained in the coma and was wheeled back to my space in ITU still on life support.It frightens me and makes me feel weak, is any of this really happening?

First glimpse of the burn...(fairly graphic description)

     The last post and this one do not have dates in the title as they either span a period of time or I can't remember the exact day.
    The week they were desperatley trying to clear the infection from the failed skin graft on my back was about 3 weeks after the crash. But I still hadn't really seen the extent of any of my external injuries and they were dressed or in places I couldn't see. I couldn't even turn my head enough to see my shoulder when they changed the dressings and obviously not my scalp, so I had NO idea what the situation with my back was really. Infact it hadn't even occured to me that they would all obviously become scars I would have forever.
    As I explained last post, the daily infection routine involved being put in the wet room and my burn undressed and washed. On this particular day my nurse left the room after washing the burn to find some more dressing packs. The water turned off and I felt instantly cold so I reached for the shower 'on' button. The shower was turned on and off by this large silver 'button' type thing. (I happened to find a picture of a bathroom on ward 412 which I was on...below)

     As I put my arm forward I caught a glimpse of my side in the silver. I thought it was someone else and looked behind me, obviously there was no-one there. The burn is from my left side on my waist/hip and follows round my back to my spine, it is rectangular as it was caused by my back becomming stuck and melted to the drivers exhaust. The only way I could describe it was 'zombie bite'. It wasn't just red, it was green, yellow, white, black, bubbled, mangled and oozing. It looked like it had been chewed . The burn was full thickness and so went through every layer which meant it also 'scooped' in like something really had just bitten a massive chunk out of me.
   I felt shocked, horrified, scared, alone, ugly and mostly like none of this was really happening.

Treating the infection...an hour in the bathroom...

  The day my infection treatment started (over 3 weeks after the accident) was pretty eventful...
So incase you havn't read all the posts very briefly, by this point I had had my urinary catheter removed and when I needed the toilet I was transferred to a commode which luckily fitted over the toilet in my bathroom, then I had to use the buzzer again to be brought from the toilet and put back into bed. Anyway on this day (12th september) as most days, my mom left before afternoon visiting and put me into/onto the toilet before Joss arrived. (I got her to do this because I hated buzzing the nurses everytime I needed the loo as I felt they were busy doing more important things) So when I was ready I tried to see if I could reach the flush myself yet, I still couldn't and noticed that the seat was covered in blood which was dripping off the side. It was coming from my back/burn. I pulled the buzzer cord and waited about 5 minutes. Then a male health care assistant came in and looked shocked like he'd walked in on someone by accident. I explained that people had to bring me back to bed and that I was worried as there was blood pouring out of me. He said he would go and get the nurse (could of taken me off the loo first!), so I sat waiting, and waiting...eventually I heard Joss's voice which meant I had been on the loo waiting for 45 minutes. He came in, I told him about the blood and he went into the corridor ''my girlfriends been left in the toilet nearly an hour''. Don't get me wrong the nurses were horrified and it had been a miss-comunication, the sister thought he had brought me back to bed!
   She came straight in got me out and into bed and looked at my back, the bleeding had slowed but she decided now would be a good time to take my staples out. Having staples pulled out feels exactly like having staples pulled out of your skin. I don't know how many there were but they went the entire way round my burn holding the skin (which died) on. So I'd say 30 or more probably. It hurt like fuck, I could feel them being pulled out of the healthy skin they were anchored into.
  After this and the meeting with my new consultant mr VN I needed daily infection treatment. This involved being put onto the commode chair in the morning, wheeled into the bathroom under the shower area. The nurse then had to remove my pjamas and underwear, put a towel over my crotch for 'dignity' *what's dignity again I cant remember anymore? then a carier bag over my wrist cast and angle me so other dressings didn't get wet. They soaked the dressing so it hurt less to pull off, showered water over the burn and washed it with special stuff. That REALLY hurt every day, I always said it was fine because i hate making fuss at nurses but JESUS having someone rub a massivley infected full thickness burn is the second most painful thing I have ever experienced (second to being rolled onto a smashed pelvis and snapped leg). Then they washed my hair and body, dried me and dressed me. People probably think, 'oh god how embarrassing' but having my hair washed under a real shower instead of in bed in an inflatable bowl was incredible. I was in too much pain and too vulnerable to care about these amazing people having to see me naked and wash and dress me and wipe my ass. THEN once dried and partailly dressed came the infection clearing wound dressing, I had to have betadine soaked gauze strapped all over the burn. which always soaked bright orange through my pjamas, bedding, everything!
  I actually didn't mind the dressing part of the day as I always had a joke with wichever nurse I had as they got orange everywhere and competed to see who could strap it better so less leaked out, one of my favourite nurses frank even joked about seeing me naked on our first meeting. He was quite young and little things like that, that genuinley made me laugh made me feel a little more human again.
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

Tuesday 28th August, SITTING UP!...

  On Tuesday the 28th August - 9 days after the crash, 5 days after skin graft 1- It had been a rough weekend. I had my skin graft on the friday and then it was bank holiday weekend, now what most people (including myself back then) don't realise is doctors and consultants don't really work bank holidays. Technically they do but where there will be the exact same number of nurses on duty day and night everyday of the year, there are a lot less of them. There are still plenty on call and around for emergencies but not as many. I was still in a lot of agonising pain, it still felt like there were bricks on top of me and I had been lay in the same position able to just turn my head for 9 days. I was constantly boiling and then freezing and I was put on IV (through the vein) antibiotics.
  Despite all of this my physiotherapists decided to try and sit me up that day, to make me smile if nothing else. Its hard to explain my progress because things like this 'sitting up' it's not the same as you would just sit up. Infact sitting is something I got very stressed about and no-one could understand, weeks after this day I still had to be pulled up the bed with my sheet and two nurses whenever I had slid down too far. But even after that with the back of the bed sat up I still was adament I wasnt SITTING but they didn't get it. Now I know that its because I was sort of sat on my tail bone (which was incidently snapped) not on my actual bum! Anyway back to being sat up! I had three physio's and a sheet for this. The sheet was put under my bum with the help of some agonising rolling, then the back of my bed was sat up to an upright position to bring my back up. Two of the physios took my back and arms and pulled me forward, then using the sheet aswell I was slid round so my feet could be carefully rested over the side of the bed. That doesn't sound like much and I couldnt do it alone for weeks but I cried. It was so overwhelming, not even the actual sitting up, I think 1. I felt 1% more human because I wasnt flat on my back and 2. It kind of sunk in that it had really happened. Even today 7 months on it hasn't fully sunk in at all but that point I think I finally realised I wasn't going to wake up...
BE SAFE, George xxx

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.