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What to expect from a broken pelvis: Part 2 – before surgery

Posted by Lloyd | January 30, 2024 | 3 comments so far

Lloyd in hospital
Continuing Lloyd’s story of a broken pelvis in 2014. After diagnosis comes the need for surgery.

This is Part 2 of Lloyd’s experience of a broken pelvis. Part 1 of what you can expect with a broken pelvis covers the accident and immediate aftermath.

The next morning the Surgeon came round and said that after looking at the MRI scans and x-rays that they were going to send me to St Georges hospital in Tooting. There they have specialists in major pelvic trauma with the necessary experience to tackle the repair.

St. Georges Hospital, Tooting

It was then off in an ambulance for the trip across to Tooting. In hindsight I was grateful that the surgeon did not attempt to perform the operation; at the time I cursed the poor state of UK roads. I felt every bump on the road on the long journey to Tooting.

Very much to my surprise I was put in a private room and not a general ward. They had also found me an airbed as they thought that would be more comfortable. This was the first example of what was to be exemplary care and attention I received at St Georges.

Unfortunately, in this case the airbed was pure agony.

I sank down into the mattress and so it pushed up onto the side of my pelvis. They were quick to swap it out again for a normal bed.

The other critical thing they did was to put my leg in traction. The ligaments are designed to pull your leg up and hold it in the pelvic socket and so the ligaments were pulling the leg up into the broken pelvic bones. By putting me in traction they pulled the leg away from the broken area and this had a huge positive impact on the pain levels and allowed them to reduce the morphine.

After diagnosis, prognosis

St Thomas is a teaching hospital and the next morning my surgeon – Dr Rickman – comes round like a scene from Scrubs trailing a gaggle of junior doctors. He was very direct, practical and to the point (as I was to learn, absolutely spot on in everything he said).

Pelvis scan in 3d

It was bad, pelvis is in six pieces and a wedge of bone has pushed out the big hip bone. They would need to repair with plates and screws. Dr Rickman said he would go in through the front and try do all the repairs in one operation, but if he couldn’t I would need another operation from the back to complete the repair. They would need to ‘move’ some internal organs (like bowel, bladder etc) to get access and there is a risk of something being ‘nicked’ which would also need to be repaired.

I would be in wheelchair/crutches for 3 months with no contact allowed of leg on floor, followed by 3 months rehab before I would be able to walk without any aid. Then six months to build up strength: so a year before I would feel anything like normal.

Dr Rickman recommended I didn’t work at all in the first 3 months if possible as I should not underestimate the energy needed for the body to heal.

He was confident they would get me up and walking again but cautioned that this was a life changing injury and I should not expect to get back to how I was before.

The operation would take all of a morning or afternoon surgical register and he was hoping to get me in the next day for the operation.

Then he and his retinue swept off to the next patient.

Shock, and decisions made

In my normal positive way, over the previous 2 days I had somehow convinced myself it was all going to be fine. I would have the operation, do the rehab and would be back to normal, no problem.

The shock of the prognosis from the surgeon, the shock of the accident (thus far repressed) and the reality of the year ahead all hit me at the same time and completely floored me. For the first time in a long time I cried.

Fortunately, that was to be my lowest ebb. The moment passed as I now had something positive to focus on. I had the next 12 months to plan for. It was at this point that I made some key decisions that proved invaluable, namely:

  • Get my mindset right – no self-pity allowed, no ‘why me’, ‘what if’, or ‘if only’. That has held firm to this day and has been key for me;
  • Listen to what they tell me to do (a challenge for me!), including taking 3 months out from work.

One other decision made at the time proved not to be necessary. I figured that if I was to be largely immobile for 6 months, I needed to control my weight – so choose healthy options and no sweet treats. As it turned out I had no appetite for many weeks due to the drugs and thereafter muscle wastage meant I lost rather than gained weight.

I now needed to call work and tell them I would not be in for 3 months and then part time in the following 3 months around my rehab. My employer (a large accountancy firm) were brilliant.

Given this was January just before busy season kicked off and I had a full portfolio of clients this would be a big logistical problem. But they said don’t worry, focus on getting well and they would not contact me unless it was an emergency. Other partners picked up my clients and my teams stepped up and there never was an emergency that needed my attention – amazing.

Nature calls

Another more basic problem now arose.

The morphine meant I was badly constipated and they needed me to ‘clear out’ before the operation given what they needed to do. But the old problem arose in that the pain was too great when they tried to get me on a bedpan.

They then brought a commode chair in hope this might help. With one nurse holding my leg as stable as possible, one holding the catheter and bag out the way, I lifted myself up on my arms shifting across the bed to the chair like a (very poor) gymnast doing a pommel horse routine.

I ended on the commode drenched in sweat from the effort and in pain but now trying to relax and have a poo! Fat chance.

We then did it all in reverse back into bed. We tried this several more times with the same result.

Time to stop messing about and get the big gun out – namely an enema.

Yikes!

Enema duly inserted, I was told I had to hold it for minimum 20 minutes otherwise it would not work. Bang on 20 minutes I was desperately ringing my buzzer to get the nurses over as the dam was about to burst. This time we did the leg hold, catheter move, pommel routine in record time, sod the pain and they beat a hasty retreat.

Well, enemas are very effective. My appreciation for nurses soared as they had to return to the distinctly musty room to clean up.

If there was an event for moving across a room from door to window then the nurse would have broken the world record. Although I thought hanging out the window gasping for air was a bit unprofessional.

Three time’s the charm

Next morning, nil by mouth, all prepped and ready to be taken down for surgery. All set, a bit tense and nervous. Morning comes and goes until mid afternoon news arrives that urgent cases came in that took precedence.

Stand down, light dinner and wait for tomorrow.

Next morning, nil by mouth, all prepped and ready to be taken down for surgery. All set, a bit tense and nervous. Morning comes and goes until mid afternoon news arrives that urgent cases came in that took precedence.

Stand down, light dinner and wait for tomorrow.

Next morning, nil by mouth, all prepped and ready to be taken down for surgery. All set, a bit tense and nervous.

Morning comes and goes, then hoorah!, news arrives that I am being taken down to surgery…

Filed under Mutterings in January 2024

Lloyd

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There are 3 comments on ‘What to expect from a broken pelvis: Part 2 – before surgery’

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  1. Chris dykes says:

    Thanks for the insight and wonderfully chipper tone all things considered. I had reconstructive surgery last year and trying to laugh and keep an insightful mind through the morphine was the most useful thing for me, not easy on the levels you must be on I’m sure. Impressive work and thanks again

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