Rehab

 I have been busy, mostly gossiping with other cripples.

Mr. Knight had a couple of brief excursions into human powered flight, both successful other than the landings, where he discovered that skin works as an undercarriage but rather limits the number of times you want to take to the air. He now has a new Red Bicycle to hoon around on, and:

"predicted it would take me 3 hours to do the 75km. I was wrong, it took me 2 hours 59 minutes and 56 seconds but it was only 72km so my average was a little slower than predicted. The two climbs were *fantastic* with the second one being the better of the two. These are public roads and yet I saw 1 car in the first 27km and then only 4 cars in the last 40kms, none of which were on the climbs. The gravel was in *perfect* condition and I could ride the downhill sections very fast despite my speed being tempered by the knowledge of your recent misfortune. Fortunately I was wearing my protective lycra. Actually I got quite cold by the end, the sun sets earlier in the mountains and the road is in forest for a lot of the route. Did I mention how good the last climb was? I will definitely be riding Maruia Saddle again."

A red bicycle. Mr. Knight's.


Mr. English, it will be recalled, got bored with aerodynamics & tried lignodynamics, the science of the resistance if you cycle through a tree.

Site of Mr. English's excursion. Probably.

Afterwards he used his recumbent tandem on a trainer for his exercise-based-pain-relief. He rested his left arm on a stool and sat and pedalled, and when bored used the same setup for arm exercise too - a chair in front of the bike, turning the cranks by hand. He couldn't pull back with the left arm (no bicep), but could do about 70% of the stroke, then carry it around with the right arm. Lots of ingenuity working out exercises - his therapist said he was the most inventive person she worked with in thirty years but then perhaps she didn't know that Mr. English was contemplating building a complete bicycle out of steel weighing under ten pounds. He now has some stiffness in the shoulder (not doing his exercises, bad boy) but the strength and function of his left arm is pretty much back to normal wi' just a slight reduction in range of motion. He has a band of numbness running down from shoulder into the pad of thumb and first finger, and after his flail chest, a complete recovery with no chest pain or breathing issues.

My own progress comes on in little wriggles rather than leaps and bounds but I can now accomplish my right sock i'the mornings and therefore feel Very Proud. Anyone who can dress himself is a man to be reckoned with. And though a bit wobbly, I can now walk without crutches. For a dozen metres. But then I'm told to be sensible.

The rehab business is interesting. My pain vexingly got worse as the normal leg muscles weren't getting properly worked, and they developed a tendency to go into spasm. An hour of cramp, hourly through the night is no fun, and painkillers don't work on cramping muscles. I was having to get up and do stretching exercises to stop my Achilles tendon contracting the whole time. That episode, thankfully, is over now that I'm walking more - already up to a couple of languid miles a day, pausing occasionally to watch some courageous soul from the aero college doing loop-the-loops in a Cessna. So despite an unuseful visit to the physiotherapist ("Mm, do those hospital exercises oh, until you don't feel like doing them. That'll be $25.") I am much encouraged and since Mr English is now winning the occasional criterium and beginning to train for time trials I am beginning to have faith in the chirurgeon's calm declaration that I'll be back to normal in four months.

Accordingly I have resurrected the Penny Trike, and with a view to giving myself a gentle small pedalling circle, found a pair of cranks just 3 ½" long from an infant's bike. The cotter pins being all wrong some filing had to take place to get them to jam, and I had to make shims (beer cans, duly scissored) to achieve a decent fit. One side had rusted up and lacking a left-hand tap, I improvised one by heating an old pedal red-hot and plunging it into cold water to harden it, and then cutting half-a-dozen grooves across the threads with a Dremel. Worked tolerably well, too.

Improvised pedal tap on 3 1/2" crank

Then to the business of chopping up the penny trike and re-welding it and including cross-plates inside the weld to stop it splitting later.

 Improvised mitre box

135 degrees. Plus my splendid feet.

Internal crossplate

 Trike for cripples

And now Mr. L. tells me Mr. Burrows has bust a femur too. Contagious broken skeleton syndrome.

Adaptation

Hospital being dull I begged them to let me out and since it costs $700 a night they were pleased to be shot of me. Had to learn to walk up and down steps before they'd let me go, though. The physio was called Matilda and she confirmed that she was indeed extremely bored of what patients considered their mastery of wit and ready repartee.

Option one for the fresh cripple is to loll in bed and groan like Mungo. Option two is to see what can be accomplished in the absence of a full cluster of functioning limbs. Natch you overdo it the first two days but at least you replace the huge step into Maud with two smaller steps that you can navigate in your reduced state of agility.

First day is spent shuffling round the sheds locating and measuring the available planking, and the second day spent calculating exactly which planks could be sawn into which lengths to attain the required goal. The third day is spent cajoling Peter Bradley into cutting the planks on your mitre saw that sits on the ground and that you can't quite reach.

Two small steps for mankind, replacing one giant leap hitherto

Then, exhausted, some bed-lolling takes place. From this you awaken when you discover said Peter Bradley, volunteering gratis to mow all your lawns, has extended this to asking for your chainsaw to cut down the horrible pink tree in the garden.
"Can you use a chainsaw, Peter?"
"What d'you mean, can I use a chainsaw? I'm a Kiwi."
But when suitably knackered you'd be surprised how much sleep you can accomplish with a chainsaw zinging away outside the bedroom window. It's the shredding of all the branches in your Honda-powered garden shredder that wakes you up.

Peter, shredding.

 A series of visitors bring grapes and light reading and bicycles for redistribution (if you can locate appropriate-sized children) and after a while you cease to be surprised to find at the back door an anonymous bag containing venison sausages or an ice-cream container full of figs.

Random gifts. Sausages, in this case. Later traced to Caillin Trainor LLB and his .308 hunting rifle

The fact is, when crippledom hits, everyone rallies round.

Nevertheless the chief attraction of the adventure is to see what you can manage, and yes it does take more time but what else would you be doing?

First, holsters on the crutches. Some kind of juice bottle, top cut off, and a bike pump clip reversed and screwed to the bottle, the crutch diameter being serendipitously the same diameter as the bike pump. Rubber band on the handle and then you can carry your grabber around without it clattering so much. Loop of webbing to lasso your foot and tug it onto useful things like beds or sofas.

Hanging out the washing is done using crutch-drive. I got the children's wagon and put a strap round the handle and harnessed it to my waist. With crutches as ski-poles it was easy to tow it to the line, and the wagon meant I didn't have to bend down to peg up the clothes.

In the meantime I informed the rellies of the accident:
Went round corner at bottom of road too fast. Leaning heavily to left . Pedal struck road. Lost control & landed inexplicably on right hip which broke off. Operated on next day. Five grim nights in hospital, sleeping only under morphine; glad to be out. Mobile on crutches but very slow

and received an immediate analysis from my brother who, like Mr. Larrington's friend Mr. Ferrari, is an engineer:
High side crash usually caused by loss of rear traction; pedal lifting the back wheel off the road most likely in your case. Next, traction is suddenly regained (pedal no longer on the road) and the bike rotates about its contact patches because the back end slides away tangentially to the turn and is no longer able to roll in the direction the front wheel is pointed. Simply put, lose the back end when leaned over, regain traction and flip over. More energy with higher CG, so I presume this was on an upright, not a recumbent. On motorbikes, a HS crash is generally associated with race tracks, not road crashes. Happens very quickly and is usually painful. - Makes my current bad cold seem like nothing at all.

One rather alarming thing was a brief examination of my crash helmet, which had smashed a chunk out of where my lower rear cranium was, so it could've been lots worse, like dribbling and wheelchairs for evermore. Or, as Dr. Saunders said when he popped in at lunchtime, a box.

Bowels

The most frequent question you get asked in hospital is whether you've moved your bowels. (Yet.)

Early on my first post-op morning Richard, the rather brilliant young registrar, turned up on a ward round.

"Hello Richard, I'm Richard," he grinned, and for a moment I was confused. Then I recalled him.

"Yes! I remember! You came to dinner at our house once, when you were a medical student!"

"That's right - six years ago."

He was something of a star was Richard even in those days, a tall, athletic, slim, very handsome Maori boy that even his peers sang the praises of. It was Richard who Perry, the consultant, told off last month to sew Dr. Brewer's crushed ankle back together.

"Still playing rugby?"

"No. Don't want to get in a ruck."

We shook hands, and the nurse asked the inevitable question.

"Have you moved your bowels yet?"

Richard has a marvellous smile but you never know whether he's laughing at or with you.

"Why is it," he asked, "that everyone comes in here with a broken bone and all they worry about is their bowels?"

But as a matter-of-fact, it's quite true. Morphine may well be a dramatic pain reliever, but it has a soporific effect on your innards, and peristalsis largely gives in, tidies its desk, and goes home for the duration leaving your bum with little else to do than occasionally issue audible existential reminders. Everyone knows about it, and after three days nobody's embarrassed any more and you find yourself having animal function conversations with elegant ladies as you both push your wheeled frames into adjacent cubicles - "I hope it isn't just going to be passing wind again - how are you getting on, young man? Anything yet?"

But only when they let you out and you stop the morphine tablets does the storage facility give way. Then the world falls out of your bottom. You are so startled by the size of it that you phone the vicar to have it baptised. You don't want the constipation again so you resolve to stick with just 2 ibuprofen & 2 paracetamol every 6 hours as pain relief, and you avoid codeine which has a bad press in that department. Little 100gn aspirin to stop your blood congealing into Campbell's soup. Lots of fruit so you don't have to eat little brown tablets. You find, what with the difficulties associated with normal trouser security but a non-functioning leg, the best source of mictural relief is to whip it out and piss on the lawn, and a foolish attempt to use a fruit-juice bottle at night, plugging it demonstrably airtight with the end of the relevant organ, gives way to an altogether more successful bucket balanced on a stool (the sort you sit on, not the sort you do) in the bedroom, with garden litter inside both to prevent back-splash and to absorb everything into future high-nitrogen compost. - Thus is reinvented the Earth Closet.

Anticipating that not everyone wishes to read any more about this particular aspect of injury, we will move on to more socially acceptable highlights shortly.

Fellow patients

A patient whom for the purposes of this account I have dreamt up the name Mungo, was in the bed next to mine, and keen to know all about my accident and my treatment and my occupation, but rather keener to inform me about his, and indeed to keep me abreast of his suffering.

Which was considerable.

He'd had more-or-less the same injury - his involving painting the house from scaffolding - or rather the descent therefrom - but his agonies were evidently of a deeper order than mine. And indeed of anyone else's. Luckily he had a very good sense of humour, and was always ready to laugh at anything he had to say.

"Did you say you aren't in pain - wait till you have exercises, hah! hah! hah! - Oooh, ooh, ooh. - Hullo, mate - what are you in for? A cut finger? Where did that happen? Stewart Island?"

Mungo's inquisitiveness at every new patient and his groans of pain and the details of his life story, always related at double-forte, became something of a fascination for all of us, though I believe I was the only patient who kept notes. Among much more I learnt that he had been a journalist, had been asked to stay on after retirement because he was so good at his job, and that his wife wanted a new door; but I only discovered his date of birth and his middle name from the fact that we each of us had to repeat it to every nurse who gave us any drugs, to make sure there were no mistakes.

Mungo coached all of us on his medical history so thoroughly that we half-expected a Test at the end. He taught us that his normal bowel motions were once in five days, that his other leg had been broken, got infected, and that the doctors had had to remove so much from it afterwards that now one of every pair of shoes had to be built up for him to walk upright. "And they were experts! hah! hah! hah!"

His social familiarity with the surgeons was something we came to admire. "Hi mate! - that was my first consultant, the one who just walked by. He must have not recognised me. Hah! hah! hah! - That's why he didn't stop, I expect."

Whenever a new patient was admitted his suffering abruptly became acute, necessitating a great deal of groaning, and the groaning was exacerbated by any enquiry of the nursing staff. But luckily he kept his sense of humour and was always ready with a witty quip -
"How are you getting on, Mungo?"
"Oooh. Ooh. Ooh. Not good at the moment - hah! hah! hah! hah! hah!"

His knowledge of the world, and especially of officials, was all-encompassing, no doubt because of his extensive journalistic experience. He had scant regard for officials, and indeed for any expertise at all, and was happy to intersperse this information between his  remarkably frequent calls for the nurse.
"Oooh, ooh, ooh. Sorry, love, it's all a bit wet - didn't quite get to the bottle in time. - I was painting the bloody house, hah! hah! hah! - as soon as I found out the cost - hah! hah! hah! - thirty thousand dollars they wanted - hah! hah! hah! - the bloody Health and Safety! You just have to stretch one metre and it's obligatory scaffolding! And you know how much that costs, hah! hah! hah!"
I did wonder if it cost less than the repair to his femur, but then the Accident Claims Corporation are paying for that, the luxury of living in a first world country with health care that isn't run by Americans.

Unluckily for him a friend-or-relation had provided me with green earplugs and when he addressed me directly through the separating curtain I was able to affect deafness, although on the one occasion he suddenly jerked the curtain apart and demanded "How long did the doctor say you'd be incapacitated?" I was forced to reply "I'm sorry, Mungo, I don't feel like talking just at the moment" and he as abruptly jerked the curtain closed.

On his last night he put on a virtuoso performance for us all. A lovely Maori bloke had been admitted after a hip replacement, and a boy had come in with a double-broken leg from a scooter crash, and we were all uncomfortable but we all put out our lights at nine to sleep. Except for Mungo.

Mungo so far had managed to awaken everyone every single night by switching his light on at 3 am to read, and to ask the nurses for a coffee, and another morphine tablet, and it even got to the point after a particularly well-enounced display of groaning, where one nurse actually lost her professional equilibrium when asking the standard
"Did you have a bad night then?" by adding "Do you ever have good nights, Mungo?"

So on his last night he kept his light on.

Till eleven.

Till twelve.

Till 1 am.

Then he switched it off.

Lulled into a sense of complacency we all started to drift off but five minutes later the light came on again.

Then off.

Five more minutes, then on again.

Off.

And then he summoned the nurse. Most patients try to whisper at night but Mungo didn't want anyone to miss out on the action so he announced loudly,
"Hello dear. Could you just reach my bottle. I just thought it was time I got some sleep.  Can I have one of those blue tablets? Thank you dear. Oooh, ooh, ooh." This was at 1.25 am.

At 2.25 his light came on once more and he called the nurse again. "Oooh, ooh, ooh. Can you rub my back with a wet flannel love. It just won't stop itching." 

Exactly when Mungo called the nurse and asked her to make him a cup of coffee I don't know - I was finally beyond taking notes. But the new kid then rather cheekily said
"Seems like hospital's not a good place to get a night's sleep," and the Maori bloke burst out laughing.

In the morning Mungo was a different person altogether. The thing that appeared to turn him into a quieter character was the appearance of his wife on discharge from hospital. Apart from making her go and get a wheelchair  - not sure why, because you don't get let out till you can walk up and down stairs safely on crutches - it did rather appear that she was the dominant partner in their relationship. It also appeared that she wasn't best pleased at the prospect of having him at home.

My sister-in-law, a specialist orthopaedic nurse in Australia, said a very odd thing when she telephoned to see how I was.
"Yes, Richard, every Ward has one."

Broken femur

Pride comes before a fall.

Tubes and a machine and everything

On Sunday last I set off on my natty little Peugeot to do Marahau Hill and, with a gentleman on a perfectly good mountain bicycle behind me, found myself pedalling with increasing vigour and exuberance in the pre-lunchtime sunshine. At the LH corner of the road this translated into disaster. My pedal hit the road, I flew briefly into the air, and as Mr. Larrington would put it, I landed on New Zealand.

I lay for a shocked moment and a father playing with his youngsters on the swings from across the road called to see if he could help.
"No, I'm alright. I'll get up in a moment."
This proved to be incorrect. I tried to move and immediately didn't.

Two more gentlemen on perfectly good mountain bicycles came the opposite way, stopped, and attempted to help me to my feet. I have not known such instant pain, and my screams were loud enough to alert Dr. Brewer in the house opposite, who came hopping out in his moon boot fresh from his own recent ankle-crushed disaster. The father had meanwhile wisely ignored my overconfidence and had alerted Danny, the ambulance driver who lives down the road and with whom I exchange daily waves, and Danny assessed the situation and called an ambulance. A policeman appeared out of the ether and stood in the sun to keep me in shade. Someone recovered the shards of my helmet and the scattered (prescription, so valuable) lenses of my sunglasses. It was all very civilised and friendly.

Annie and Liz appeared with the ambulance and applied gas-and-air while they scooped me up onto their person-scooper, and with the movement once again my screams of pain alerted the entire nation that I'd had a mishap. Liz was sweet and kept me calm and said she was sure I'd be okay, but though they didn't tell me, they all knew I'd broken something.

You have little geographical sense on your back in an ambulance but in forty minutes I was in Nelson Hospital and within another ten had had an x-ray and a fairly large amount of morphine, blurring the period when Monique or Annie or Clare or Millie or Steph or Jill or Mary or Helen or Hannah or - crumbs, the number of nurses who care for you in a short period of time is phenomenal. Dead nice they were, too. Kept taking obs and feeding me painkillers and even had a machine that goes bing!. Daniel admitted me and Perry was my consultant and Heath operated and Katy and Kerry or it might have been Karen were my anaesthetists and they oozed intelligent confidence and experience and I knew I was going to be alright even though anaesthetics is the business of nearly killing you.

The interesting experience was the ketamine when they knew they'd have to roll me onto my crippled side to do an epidural. My world turned antiaesthetic and the inside of my brain became a weird fluorescent blue and my existence shrank into a series of small blue cubes as I sank to the bottom of a swimming pool full of air and I became nothing more than two tiny dots of light inside my mind, and I thought "This is death, and it seems odd that I'm not even slightly afraid", and I knew for a fact I was dead even though I went in and out of being able to hear the constant murmur of cheerful voices and even laughter of a confident team of nine people calmly going about the business of pulling a person apart and screwing large pieces of R9 steel into his skeleton to fix it. And all of a sudden there was Katy the consultant anaesthetist calmly saying into my now wide-awake ear "It's all finished, Richard, and it went perfectly." And Erika - yet another of the myriad of nurses who made me feel cherished - chatted me cheerfully through Recovery, and eventually I was wheeled up to Ward 9 station B which was to be my home for the next five days.

There I met Mungo, whom we shall discuss shortly. I'm too achy at present to do him justice.