Sunday, July 29, 2007

Rehab Week 6: Weighty Matters

Another week, with Room 12 being my home for these past three and a half months. For some reason I managed to score the exact same room position in both wards I’ve been in since leaving the High Dependency Unit.

The bright spot of the week was my surprise birthday party on Thursday evening. Of course it meant a couple of birthday cakes from friends and relatives. There was lots of cake so the nursing staff scored well and I got plenty of brownie points for sharing around. It was a fun night, thanks to Sam and Tanya for organizing and the rest for popping in to share.

Wound continues to do well, gradually getting smaller and staying nice and clean. Seemingly there’s no further sign of infection, so that’s good. If this keeps up I might be outta here in a few weeks. In the meantime I’m still on the vacuum dressing.

Since coming out of the dark days, I’ve put back on all my weight and some more. At the lowest point I had lost 14kg after entering hospital already in race trim having finished the Australian Masters championships a couple of weeks earlier. I was nearly as skinny as Rasmussen!

I’ve regained a lot of strength and now having a bit of fun wheeling myself about in the chair. I’m also about to have my first full day/night without any painkillers.

So a pretty good week.

Nice ride Cadel, we’re proud of you.

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Sunday, July 22, 2007

Rehab Week 5: Glowing in the Dark

Whatever you want,
whatever you need,
you pay your money you take your choice.

For those still wondering, that’s some lyrics from an old Status Quo song. Status Quo being the operative words. Not much change to report but a few things on the positive side, I mean I’m not sick nor has the wound got worse.

On Monday I had an irradiated white cell gamma radiation test. What the hell is that?

Well it goes like this: First withdraw 70ml of blood, two lots, 50ml and 20ml. The 20ml sample goes for a range of standard blood tests. The 50ml is then put through some processes to separate out the white blood cells (they’re the ones that attack foreign bodies and bugs inside your body).

The white blood cells are then irradiated using nuclear medicine products (probably produced at the Lucas Heights nuclear reactor in Sydney) to make them carry radionuclides. That means these white cells are now emitting gamma radiation. The cells are then reinjected into my blood stream.

White cells, being what they are, will congregate around infections. So a couple of hours later, I’m lying on a table with this big gamma camera slowly circling my leg picking up the gamma radiation emitting from my leg. The 360 degree gamma ray picture then matches to a CT scan to form a 3-D picture of where the white cells and possible infections lie.

So what did it find? Three clusters or “hot spots”. One around the wound, one at the top of the tibia and another around the screws in the metal plate just below my knee. However at the moment there aren’t the other markers (pain, inflammation, fever, blood test markers) to indicate these are serious. If the wound continues to heal, that’s means I’m in control and not the bug. So far so good on that front as at each change of the vacuum dressing has found a very clean and smaller wound. Let’s hope that trend continues. Otherwise they’ll have to open me up again. We don’t want that.

Also, no more IV antibiotic. The Vancomycin I was on is a powerful drug and two weeks is the maximum time the Docs would let me be on it, lest it do more damage than good.

So what about those radioactive white cells? Well the radiation doesn’t last long as the rarionuclides have a half life of six hours and the total radiation exposure was less than for a typical x-ray image. Just as well, otherwise I might have started to glow!

Catch you next time!

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Sunday, July 15, 2007

Rehab Week 4: Waiting for Godot

Yep, another week in paradise! Still on the inside wondering if it will ever end. While I’m not a Beckett fan, nor profess to really get what his plays are about, I sometimes wonder if there is anything out that window…. (OK, so I’m getting my plays mixed up, call it poetic license).

This week marked my 3-month anniversary inside the hospital.

OK, it’s not all that bad. Last week I talked about the new hole in my leg and the infection. On Monday this week, a new dressing was fitted – a vacuum dressing. It’s a seal put over your wound and hooked up to a vacuum pump that keeps sucking away. Along with some special foam-like dressing inside and around the wound, it drags out the bad stuff and encourages new flesh to grow. The downside is I am now hooked up to a machine via a hose and mobility is much more limited again. I have been on vacuum dressing before but that was when I was far less cogent and when the docs were trying to save my leg.

My first progress check was on Thursday when the wound dressing was changed. Good news – the wound had halved in size since Monday (the previous week it had hardly changed at all). It was also nice and clean. Tick one to the vacuum dressing. It also enabled the nurse to shave a little more hair from the leg around the wound - ripping off the op-site dressings frm a hairy leg ain't fun! Yeah - that's right - my legs are hairy again. Yuk!!

Other signs, blood pressure, temperature, pain have all been steady and good and blood test infection markers are low, so it looks as though I have the infection in check at least, if not beaten. I’m still on the IV and oral antibiotics though, presumably until the wound heals. How long? Who knows.

Next check of wound is Monday, so will be really keen to see if progress has continued.

Otherwise all is OK and watching Le Tour is a great distraction.

Ride safe

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Sunday, July 08, 2007

Rehab Week 3: I.V. League

No, not Yale or Harvard, I mean the intravenous kind. Yep, I’m back on an IV antibiotic drip this week along with some other oral antibiotics.

See I've had a bit of a set back this week – the one remaining patch of wound stubbornly wasn't healing so they dug it out leaving a half inch wide hole an inch and a half deep - and now I've picked up an MRSA infection or commonly known as Golden Staff. If it makes its way to my metal work or bone I'm in trouble.

I'm now being hit with big time antibiotics in a shock and awe campaign to try to knock this bug over (hence back on an IV drip) plus some other oral drugs (I've been through about half a dozen different antibiotics). I have to admit I am pretty worried about it. Hopefully it will all clear up but the downside is not worth thinking about (more surgery, possible further removal of leg).

Otherwise I'm going OK - getting stronger, crutch walking with confidence (up and down a couple of flights of fire stairs) and pushing myself around in the wheelchair when we go for trips out of the building.

At least le Tour has started although I’m not sure I’m gunna manage to stay up every night to watch!

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Sunday, July 01, 2007

Rehab Week 2: Waiting for one patch

OK I made it through another week. Energy levels are up on last week and gym work/exercise is now regular although still not huge by my normal standards. On Friday I had my biggest day, with 6 minutes of pull downs, 9 minutes on the hand cycle ergo (3 x 3min “intervals”), climbing two flights of fire stairs (and down again!) along with the usual one-legged balancing and stretching exercises and a lap or so of the ward on the crutches.

On the weekend the ward gym is closed, so yesterday I made it a rest/recovery day (you know, let’s watch the footy kind a day) and today I simulated the effort by pushing myself in the wheelchair down to the ground floor cafeteria and outdoor eating area and back up to my ward/room again. For experienced chair users that’s barely a warm up but for me that was a big deal. Then I managed a couple of laps of the ward on the crutches.

One funny “exercise” is lying prone on a special bed/table, which has a hole in it so your face can look straight down and not ruin your neck with it jerked sideways (bit like a physio’s massage table, just a lot wider). The idea is that it helps to straighten out your knee and other muscles that have been lying the other way for a couple of months. Mine knee’s got to 13 degrees so far, I need it to get as close to zero as I can as that helps to fit the prosthetic and re-learn to walk.

Remembering I had smashed up my tibial plateau (the big round bit at the top of your shin bone) and fractured the top of my fibia (the smaller shin bone). There are a plate, rod and lots of screws in there, which went in on day 1. After all those weeks of being confined to bed, it’s no wonder the knee joint is a bit restricted in movement.

The leg closure wound that I’m waiting to heal up has progressed OK, although the stubborn patch is still there and will probably take some weeks to finally close up. That’s a bit disappointing as I was really hoping I’d be fitted with a prosthetic before I leave hospital but it looks like I’ll be home before that happens.

Nevermind, life on crutches for a while won’t be so bad. Each day I grow more confident but ever watchful that I remain careful, I don’t want any falls jeapordising my progress. One problem will be the house renovations going on at the moment, there are builders’ tools, materials and furniture everywhere apparently and I wouldn’t be able to go back until that is substantially completed. I’m hoping for some good news on progress this week. Fingers crossed.

Stay safe out there folks.
Catch you next time.

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