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Brace comes off. Compression fracture T12

IMG_3216I had expectations that at the hospital they’d take the brace off and check me out. No. Very little ceremony at outpatients clinic.It was routine for the spinal specialist, he could have just phoned or sent a pamphlet in the post.

He said the generic brand advice. Take it off for an hour a day for a couple of days and build up slowly to having the brace off completely within two weeks or a month.

Didn’t even require an xray unless I wanted one which I did. You’ve got to be assertive.

At the xray room I had a great personal moment and took the brace off while standing. Standing without a brace for the first time since 7.20am Jan 2, was a cool feeling.

The specialist had a look at the xrays but he wouldn’t have if I hadn’t asked him to. Basically he didn’t have any doubts that the brace had done its job and now I just have to wean myself off it.

Do whatever you want he said, you are the best judge of what you can do and what you can’t do. He obviously doesn’t know me very well. What about surfing? I said. That’s a bit unpredictable, not till June. Chin ups? No. Running? No. Walking? Yes. Swimming? That’s the best. Touch my toes? Why not, if it doesn’t hurt? Can I take it off now to go home. No. Take it off when you get home. Just as well I’m a journalist and I know how to interview people.

No bedside manner or extra tips in public health. But while I’m complaining about the impersonal service and the implicit requirement that I involve in my own recovery, I want to thank the hospital and the large team of staff who have been responsible to get me here. It’s been a journey. I’m ok. I’m walking. I’m gonna surf again. And it’s been free. Thanks.

Goals – recovery from compression fracture T12

Life can change so quickly. A minute before the surfing accident when I broke my back on a shallow sandbank at Burleigh, I had no idea what was coming.

I paddled against the sweep to get back to the point to catch another barrel. I passed a guy with long blonde hair on a short board on my right. We both smiled at each other with every cell in our body. One of those moments of connectness. No need or desire to talk.

My goal was to catch another two waves, go home and work on my confirmation paper.

A minute later my back was in half

My goal suddenly was to get to shore without doing anymore damage to my spinal cord. And a huge goal it was. My feet were working but tingling. I’d done some trauma to the spinal cord. After a discussion in my head I decided when I got to the beach I’d need hospital and an ambulance.

It was humbling. From that scene of me on the beach, broken, face-down surrounded by people in the shallows until now, I owe a large part of my recovery to the people, the community, the friends and family, the volunteers, medical staff and specialists who were there to help me. As much for the need for practical necessity as for respect for the help of countless people, my goals needed to become much simpler than had my T12 not been crushed. Smaller though they were, they were equally challenging.

Once in hospital relatively comfortable and safe, I needed to find out what damage I’d done, get into contact with someone to let them know what’d happened and sort out my phone, car, surfboard and flat if needed.

Then with the news of a week stay in hospital, I wanted to regroup, get my research materials and some clothes up to me. Getting back to work and getting on with my confirmation paper were goals at the forefront of my mind.

Finding out smaller details of my injury was a goal. I really wanted someone to tell me about the damage to my vertebral disks,

I asked a blonde senior specialist who’d brought in a group into my room on a ward tour. You’re very interested in your disks aren’t you… Well it’s my back… I’ll have a look at your scans and come back later…

You learn in hospital that when someone says they’ll come back later you’ll never see them again. Getting information from specialists in hospital is not a practical goal.

I had goals like spacing out the pain relief. Push the 10mg of Endone to every eight hours instead of four. Often it felt like seven hours but it was only three. Sometimes I called for a bed pan. Thanks to Endone I was filling up with the hospital food I was forking into my horizontal mouth. Dumping that gutful was a goal.

The back brace arrived after six sweaty days on my back on the plastic hospital bed and pillow covers. I wanted to get to my feet.

Mr Smith would you like to try to put the brace on yourself. Not at this stage thankyou Nurse. You do it.

To put the brace on the two nurses rolled me on my side and slid one edge of the rounded U shaped brace under my ribs. They scooped me into the white plastic then rolled me onto my back and fitted the front of the brace over the back half. Both nurses did the straps, pulling tightly, securing the front and back sections with velcro.

“Sit up slowly. You’re going to feel a bit dizzy.”

To sit up I lay on my side, brought my knees up and hung my feet over the side of the bed. I moved my left elbow under my body and reached my right arm over my head to press my hand on the bed. I pushed with my left elbow and right hand until I was halfway upright and rested. Vertigo struck. I fought a few seconds. Lay back down. I repeated it but made it to sitting upright on the edge of the bed. The room spun. I lay down. Did it again. Sat there for 10 minutes till the spinning stopped. With a nurse either side I stood and took a step. They wanted me to keep going but I said no. Lay down again.

Do you want to try the stairs. No.

They left. I sat up and had my first walk around the bed on my own. Each thing I could grip around the bed was a goal.

The next goal was getting home. I had a long discussion in my head about that. I decided to call a friend who lives nearby Karlene. I accepted her offer of caring for me for a week till I was more able.

The hospital released me to home, however I realised at Karlene’s I was too helpless to go home. The smallest tasks were impossible. I was just a skinny helpless body with a broken backbone. I couldn’t go home. I would have had to call the ambulance to go back to hospital.

My first shower for a week was wonderful. Though I’d had sponge baths from the nurse I smelled like a freshly fucked camel. That first shower was the best shower I’d had in my life. The water felt like a miracle landing on my skin.

I didn’t have to wear the brace in bed. For the first week out of hospital I spent a lot of time in bed. Getting into and out of the brace on my own was a goal. It hurt but I did it. The edge of the back section dug into my ribs as a rolled over it. Being able to get myself up on my own restored a huge amount of independence to me. It gave me self esteem. Gloves to fight with.

Making my own coffee was a goal. Having a shit was a goal. The nurses said once I was upright, shitting would happen. I believed them but it didn’t happen. I’d been out of bed a few days. My stomach was huge. Nine or ten days it was. Like lancing a boil. I’d been getting worried, I heard constipation could cause serious problems. I think shitting was better than the shower. Too much information. Aaaaaahhhh. I tightened the brace.

I had some work to do online. Doing that was meaningful for me. Sitting for a few seconds was painful.  The optimum position for my back was over extended, but in the sitting position I slouched forward slightly in the brace. It took grit to get an hour’s work done.

The times when I didn’t have the grit broke me. The emotional side of recovery was lonely. The thoughts of determination, defeat and the shame that came with looking at work and walking away wracked me on some days. Loss. The severing of continuity with my research. I’d already been sad before the accident because my mum was so ill. The new feeling of sadness didn’t run concurrent with the old, it added extra, and even made the first worse.

I wanted to go to work 10 days after the accident, but I assessed myself at eight days and I had a long discussion in my head about it. In the time between 10 days and 17 days when I did go back, I learned a lot about how work can support an employee to return with an injury. The freedom to wear comfortable clothes and thongs. That support from work is so great.

Getting off Endone was a goal. Panadol are you kidding. Aspirin no way. Despite relying on it’s pain relief, I stopped Endone during the day, unless I needed it. Overdoing it is easy with a broken back. An outing that goes too long. A drive that goes to far. A session on the laptop pushed too much. Endone was the go-to drug if I overdid things.

After a few days at Karlene’s I cut back to one Endone at night before bed. Soon I found I didn’t need it to go to sleep anymore. But I needed one when I woke with pain in the middle of the night. After a few nights I stopped doing that.

That next day, I had a runny nose and I just couldn’t lift my head I was that down. inconsolable I was useless, standing broken in the passage, halfway between the laptop and the bedroom. That night I woke up about 2am in pain and I took one. I never took another one. I went to work for the first time the next day.

Getting back to work was a victory. I asked a work mate to pick me up. Work arranged a flat couch in a colleague’s office. I lay down to take the load off my spine, half way through my work. Karlene picked me up after work.

Everything to that point since the accident had been about returning to work. I was pumped to have pulled it off. The next day I crashed. I was sore from the exertion, but more than that I was depressed.

I needed to make more goals.

 

 

Kirra BIG Saturday

all photos copyright mic smith. #kirrabigsaturday
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Gallery

Nice barrel sequence at Burleigh

Broken back – friends to the rescue

Compression fracture T12

Compression fracture T12

In Part 3 of a series on my experiences of breaking my back in a surfing accident, I had a bit going on for me on top of the T12 compression fracture but friends saved me. Read parts 1 and 2 by clicking on the links below.

https://micsmithgeographic.wordpress.com/2016/02/07/hospital-with-a-broken-back-for-a-week/

https://micsmithgeographic.wordpress.com/2016/02/04/copping-t12-compression-fracture-at-burleigh/

The moment the accident happened my life left its path. I careered (definition: move swiftly and in an uncontrolled way) away from what I’d been planning. I didn’t want to accept that. A minute after my back snapped on the Burleigh sandbank I considered paddling out for another wave. I surrendered and paddled in, but I wanted to paddle back out. As the ambulance physically took me away from my life – my surfboard, my car, my keys, home, my sick mother, friends, research, laptop and phone – I fought in my mind. I was going to hospital but I wanted to go home. I’ll get back to work. I will be back to what I’d been planning this afternoon. It’s just a quick detour. The paramedics asked me for next of kin – but I didn’t want them to worry my family while my elderly mum was back in hospital.

In Emergency I schemed. Maybe it’s just a bruised kidney. I’ll work on my thesis in hospital. I have to contact work. I need to get my car back home. I need to contact my supervisor. I need to contact my students. I can manage the pain with painkillers. I’ll be back in the surf by March.

Practical support

My neighbour Gary came Sunday the day after the accident. I was in denial of the seriousness of my broken back, dosed up on opiates. Grateful for his coming. He’d picked up my car and surf board from the surf club. He brought my books, research, phone, laptop, some dvds, clothes. He saw a man badly injured in pain. I wanted to keep doing what I’d been doing. Grateful for my books

Problems began the moment I got my phone. My phone credit was finished. A usually small problems to fix. Difficult. Drop the phone. Call the nurse. Solving that annoyance was a victory. Getting credit was a miracle. My sisters came down from Brisbane to clean my flat. A clean flat to return to. I texted people what had happened.

Midweek I realised I couldn’t organise the world from my hospital bed. It was nonsense. The most vital thing was to heal. After a few days I found myself crying. I couldn’t read without falling asleep because of the pain killers. I could only type a few words on the laptop one handed. I was like a blue tongue on its back, useless. My sister told me out aunty died. I cried for my mum, aunty, me.

Emotional support

Friends visited me. Neighbourhood friends, work friends, coffee shop friends, friends I didn’t expect. They sat. Saw a different me to before and to what I saw. Asked what had happened and listened. All of them said I was lucky. Brought hard drives full of movies and series. I didn’t feel lucky but they were right. I could walk. No matter what happened I was ahead. The nurse in emergency, the one who’d been initiated into his Aboriginal tribe, had said the right attitude is important. A friend or two came everyday. They gave me perspective and encouragement. The pain in my vertebrae was exhausting. I watched the complete Broken Bad and Game of Thrones both for a second time. Or I watched the ceiling.

Regular obs and pain relief 24 hours a day, an occasional scan.

A nurse offered to arrange a psychologist. No thanks. A few hours later – actually yes I will see the psych if that’s possible. It could be a help. The psych was wise for doe eyed girl in her mid 20s. I spoke about the road I’d been on when the wave broke my back. My confirmation due for my thesis. The crisis happening in my family? You’re goal driven. You need to change your goals to healing goals.

The brace came on Thursday night. The brace-maker fitted it to me on the bed. No I couldn’t get up. I needed the physio team to get up. They’d be here tomorrow. You’ll be dizzy. You’ll be weak. You’ve been on your back for a week. You need more than one person to walk with you in case you start to fall. Rod – a funny name for a back brace maker – was a warm hearted man with busy hands. The fingers moved quickly tightening and adjusting. He spoke with his eyes sharing his knowledge, preparing me. I wanted to go to work on Monday. ‘See how you go. But you’ll feel more able to at the two week mark.’ He was right. The medical support was great. Great care was taken to avoid pneumonia as I had fluid on my lungs

Burleigh February 17 #2


Photos by Mic Smith.

Gallery

Burleigh February 17


Rein taking a few shots. Vern got 8 stitches from headbutting the sandbank

Hospital with a broken back for a week

20160208_110547 (2)Continued from https://micsmithgeographic.wordpress.com/2016/02/04/copping-t12-compression-fracture-at-burleigh/

The day faded outside. The surgeon gave me pictures of my broken back. The black and white printouts showed the shattered vertebrae. A trodden on Tim Tam in a stack of good ones. The gravel of the broken pieces stuck in the discs that sandwiched the T12. 30 percent wedge compression fracture. Crushed anteriorly because I was in a slouching sitting position when the sandbank drove up my spine to meet the wave’s pile driver.

Ct scan 1

No way to contact friends

I’d arrived at hospital in wet board shorts. Nothing else. A total cell phone dependent: not a phone number in my head. My mother was in hospital, my sisters in Brisbane and my daughter in India. Who can help me? Finally I came up with a plan how to get my phone and wallet. I called information for my neighbour’s number. Gary’s wife Anne answered and was concerned. Gary called back.  Thanks to him my car and board was picked up from the surf lifesaving club in Burleigh. He used my key to get into the flat. That evening he brought my phone, laptop some clothes and books. I sent a delirious email to work and my students, typing with my left hand. i brok my bak, cant work tomorow

Painkillers

In the room the regime of Endone began. Like slow death on my back. Broken and aching , I watched TV on the claw that raked across the bed from the wall. My finger and thumb found the nurse button. They’d knock and enter. Beside the bed, their eyes on me in a chute of dim light. The nurses followed the protocol. What’s your full name and date of birth? Michael Smith … Are you allergic to anything? No. The nurse parade above and before me ranged from sweet to funny to friendly to dispassionate to humorless. Some missed some feared.

Every two hours I woke. Asked for pain relief every four. The plastic pillow and the plastic mattress sponged my sweat glands. My hair was wet and my voice dry. Nurses questioned my rolling eyes. Everything they did hurt. They rolled me. Harped on my oxygen saturation. They made me breathe. The ligaments that held the vertebra hadn’t ruptured. Saved from an operation. Bending my knee I rolled on my side. Reached for whatever was in reach like a man trapped a week in a car down an embankment. Things. Books, food, cutlery, water, urine bottles.

Over the week I had a cat scan, an MRI and a farewell Xray. Only ceilings I saw. The faces of wardsmen, who shared their jokes, discontent or larrikin masks on the way to the technicians, floated below the white ceilings at my feet. Using the dreaded tablecloth trick they transferred my useless body to the machine. I cursed. The Endone and Tramedo drugs made my moods dark. Hell blurred day and night. Visitors and professionals visited. I was hoarse and nodding, but thank God they came. Without them the black fish of broken surfers would have filled my ward like a sweaty grave. Sometimes depression replaced the courage they’d given. But more than ever attitude was everything and I tried to stay positive.

 

Copping T12 compression fracture at Burleigh

T12 compression fracture

The wave

Jan 2, 2016, Burleigh Point, 4-5 foot, Gold Coast, Australia, low tide, 7.25am

My first wave was a long barrel from the point to the rocky, four or five foot. It was pretty square and I felt the fin come out then catch, then I tucked in and it was a perfect peeling section. I flicked off and paddled back round with a big grin. There was a guy paddling beside me with a big grin, we didn’t have to say more. The banks were just perfect… or so I thought.

I was opposite the cove when a set came. Five foot, no one inside, right place, I couldn’t believe my luck, I could get in early. Same thing as the first wave. Into it easy, then it sucked out. I felt the fin come out, felt it catch as I went into the bottom turn, looked down the line. The nose caught in some greeny blue backwash or cross swell as I looked down. It didn’t clip. It dug in and I landed in the greeny blue water feet out, knees up, on my bum. Then the thing sucked me over and I felt myself falling in some viscious dark sandy noise, wondering if my board was going to brain me or impale me. I was relaxed in that same knees up position that the back wash had left me in, feet pointing at the point. Where was my board in this thick lip. If I didn’t get cracked across the head, I expected underwater gymnastics and salt water and sand for breakfast, but the sandbank had sucked too dry for that. My arse came down like a sack of dinner plates on concrete with an wrecking ball impact I had never felt before. I felt my sacrum hit like a ball hammer. The shock transferred up my spine to the middle of my back. I was cognitive as the sandbank’s force drove up to the vertebral body opposite my solar plexus and crushed it like a Tim Tam. At the same times as everything went black, big white stars shot down my legs out my feet.

The warning

I’d slept in thinking the surf had dropped off. It hadn’t. I found out when I did my habitual check at my end of the street at Nobbys. I ran back home in my thongs with my empty coffee cup like David Wenham in Getting Square. In five minutes the 8″ 3″ Dick Van Stralen Reef Runner was strapped on the roof. In 15 minutes I had a park at Burleigh in the parallel parking across the road from the Nook. In 20 minutes I was running across the road in my “Such is life” shirt to say Hi to Anthony from the boardroom. He warned me it was shallow. He’d broken his back some years before in similar conditions but he was ok now. He’d had fun surfing wide. Don’t hex me I thought. I walked up the hill. ZZ Top Wayne was up there in his Wayfarers with a few girls. “Five boards have snapped already I don’t like that board’s chances.” he laughed. I laughed. Jogged away. Quickly down the damp shaded path of the Burleigh National Park, careful not to skid on the wet leaf mold. Another surfer just behind me, till he turned off at the stairs to the cove. I jumped in at the point and paddled out without getting smashed, pretty much straight to the take off point.

The ambulance

I may have blacked out a few seconds while I saw the stars. The hospital said I had seawater in my lungs. Blacked out or not I thought the stars meant I was paraplegic so when I tried to kick and I could, I made a mental good news note. My face just broke the surface in front of the hill. No one up there realised I’d broken my back. I made no signs of distress, just pulled the board to me, climbed wounded and whimpering on top. The thought for a moment of continuing to surf came. I did a mental check on myself however and surrendered to the dismal truth. I paddled around the point toward the beach in more pain and fear than I can ever remember. I caught some white water and cut across to the shallow Rocky, went to far and was almost on the rocks. I was lucky to be able to get out of danger by paddling wide. No one paddling out seemed to notice me. I asked a guy to help. Why he said. I broke my back. I didn’t want to argue. He helped me and stayed with me till the ambulance came. He lifted me under the shoulders to stand me up in the shoulder deep water. I felt my top torso sitting on my bottom torso at this tender point in the middle of my back. Not right/nice. “I think its best if I just lie on the board and you push me in.”

On the beach I lay silently face down in the shallows. A crowd gathered. A girl put my head in a lock. The lifesavers came, left, came back with a back board. I said where’s my board? Ten of them carried me. One of them an Aboriginal boy. I saw faces and the sky. I answered their questions. Where’s my board? We’ve got it mate we’ll keep it at the club house for you. A woman walking beside called the ambulance. Call the ambulance, one of the lifesavers said. “I’m talking to them now”. A nurse came into the first aid room did some tests on my feet toes and legs. They asked me for my next of kin. I said my elderly mother is in hospital I don’t want to worry her. They asked if I knew anyone at Burleigh to tell. I said I can’t remember anyone’s name. A man asked me where I was parked – do I want anything out of the car? If I leave my car there I’ll get a ticket. I told him my key was tied into my boardies. He parked the car where the inspectors couldn’t fine me. I wasn’t worrying about parking tickets.

It was a long time after the ambo guys came that we left the surf club’s first aid room. I could just see the dotted ceiling and faces. They rolled me onto the gurney. A girl sat with me in the ambulance. She gave me some painkillers and I told her some stories. I don’t know half the shit I said.

Compression fracture T12

Emergency

The pain had started getting bad in the ambulance, and kept getting worse in Emergency despite the IV painkillers. They shipped me around, x-rayed me. I looked at the ceiling and their faces. there were a few other patients around at one stage. Some camaraderie. Maybe you’ve just got bruised kidneys. you’ve got no nerve damage.  I lay on my back and bent my legs. The doctor fussed waited and told me like he was telling me bad news. You’ve broken your spine. The surgeon landed beside me for a moment like a migrating bird on his long flight around the wards. You still have ligaments intact. You don’t need an operation. I asked questions. You shouldn’t bend your legs. They’ll know more in the neuro spinal ward. Save your questions for them. Hours passed. Painkillers came. Wardies and nurses shifts finished and started. Night came. Part 2 next

 

 

 

South African court rejects appeal making domestic rhino horn sales legal

South Africa’s North Gauteng High Court has dismissed the government’s leave to appeal a November ruling that lifted the ban on the domestic trade in rhino horn.

The decision came the day before the South African government announced rhino poaching figures for 2015  of 1175 and means that it is now possible for individuals to buy and sell rhino horn within South Africa. However, international trade in rhino horn remains prohibited under the Convention for International Trade in Endangered Species (CITES).

Dr Colman O Criodain, WWF Wildlife Trade Policy Analyst said there is no domestic demand for rhino horn in South Africa so why would anyone buy it unless they intended it for an oversees market.

“It is hard to see any positive conservation benefits from lifting the moratorium on domestic trade in rhino horn, particularly at a time when rhino poaching figures are at record highs.”

“Reopening South Africa’s national rhino horn trade will make it even harder for already overstretched law enforcement agents to tackle record rhino poaching.”

It also goes against CITES which urges all Parties to adopt and implement comprehensive legislation and enforcement controls, including internal trade restrictions and penalties, aimed at reducing illegal trade in rhino horn.”

Dr Jo Shaw, Rhino Programme Manager for WWF South Africa said it was a blow to conservation efforts.

“There is no market for rhino horn in South Africa so lifting the domestic moratorium can only encourage illegal activity, especially as it is likely to be misconstrued as a lifting of the current international trade ban,” Dr Shaw said.

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