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People treat you differently when you break an ankle

As I’ve said in previous posts, I recently broke my ankle. Badly. A dislocation, the end of the leg bone sheared off, at least 5 fractures, the surface of the bones shrapnel. The consultant I saw said it was one of the worst injuries he’d seen, and he wasn’t optimistic that I would ever walk again. I did not tell people this tidbit, as I did not want people’s sympathy; I knew I would walk again.

When I was at University in Lancaster, I injured my knee while playing Lacrosse. Patellofemoral pain syndrome, it made walking agony. I spent 3 months using crutches to get around then. I spent the first month or so of the injury skulking around my flat, not wanting to walk because of the pain. This spread to a general fear of leaving my flat, I came to associate it with hardship and pain. I hit rock bottom, and ended up turning to a Doctor. I was diagnosed with severe depression, and put on the big boy antidepressants. I became an emotionless zombie, but it gave me the get up and go to work on my physiotherapy exercises, and eventually I began to see the light at the end of the tunnel. The exercises were hard work and the associated physiotherapy was very painful, but I got through it. My prize was being able to walk again unaided. Every now and then since then I’ll have a go at jogging, but this seems to always cause my knee issues to flare up. Still, I could walk.

Being on crutches for 3 months does wonders for ones shoulder strength. I decided to monopolize on this by taking up rock climbing. I quite enjoyed it, and continued it when I moved back down South after graduating. My life was going well. I had left a relationship which was frankly making my life a living hell, had moved in to a beautiful new house, and was spending the summer months enjoying the great outdoors with friends. I’d even been offered a 3 month job in Italy, which would allow me to tick off “work in a country that speaks another language” from my bucket list. I went climbing with friends from work, as I did almost every week. I had taken to climbing using the auto-belays, but a group of small excitable children were climbing there. So, I decided that I would try doing some bouldering (a shorter wall, with no ropes). I know I tend to fall poorly (in part due to my injured knee), and so generally I tended not to climb too high when I bouldered. Perhaps it was because I seemed to be taking life by the reins, but I was feeling very overly confident. I climbed to the top of the 5m wall, and I fell. I shattered my ankle. I was taken to hospital.

The pain of the injury was quite severe, but I could handle it. I believe I have a quite high pain tolerance. The psychological pain was worse. The hospital has become my prison. I cannot wander over to chat to people I know. Often times, the internet doesn’t work well and so I cannot indulge in my usual creature comforts. The osteopathy wards tend to be populated by older people, who often have dementia. They cry for their loved ones in the night, ones who are long dead. I went in to hospital with an irrational fear of injections. I had been starting to get over this fear via donating blood, but I still found it very distressing. After my first night in hospital, I woke up with an external fixation on my ankle. This is a metal frame, reminiscent of a child’s Meccano set, which immobilises the joint by being screwed in to your bones. The general concept made me anxious, and any time it was knocked (as it inevitably was multiple times a day by me or the nurses), it was agony. I had further surgery, to insert 2 metal plates and a whole bunch of bolts in to my ankle. Waking up after that surgery was the worst pain I have felt so far. I was given a morphine IV which I could control with the press of a button. I used it to push myself to the brink of consciousness, and hold myself there. It was the only way to survive the pain.

I found many aspects of the hospital trip to be incredibly difficult, but I worked through it all. Little did I know at the time, but this would be only the start of my hospital Odyssey. It had been mentioned in passing that there was a risk of infection associated with my surgery, but I suppose that there is with every surgery really. Call me pig-headed, but I didn’t think it would happen to me. How wrong I was.

First came the minor infections. These required me to take antibiotic tablets. These were a mild annoyance as they required me to carefully schedule taking them around my eclectic eating habits and gave me heart burn, but did not cause any real issues. Around the time of the first infection, I realised that I was running out of dihydrocodeine. Codeine, as you may know, is an opiate. It is metabolised by the body in the same way as morphine, meaning that my hospital-induced morphine addiction was transferred to a codeine addiction. In life I believe in ripping the band aid off when it’s needed, and so I elected to quit the codeine cold turkey over a weekend. This was not a pleasant weekend. I felt cold, I shook, I ached, I vomited. I still made it in to work Monday.

After a few rounds of at-home antibiotic tablets, I began to get worse infections. Perhaps because I was used to living in constant pain, I ignored them for longer than I should have. I was dragged by a friend back to hospital, and after a quick inspected I was immediately admitted and put on IV antibiotics. Thus, my hospital hell resumed. On this particular visit I was in a side room, and so mercifully had quiet. However, I still experienced the loneliness that comes with hospital stays. When you’re kept high on morphine all day every day, you don’t feel it so much. You can pass the days in a cheerful blur, reading magazines and dozing. When you have no opiates, your mind is clear. And yet, your body does not work. You are connected to a plastic tube, and cannot move. When you are disconnected, you are allowed to hobble around your small room. I took to standing in the corridor outside of my room, just to escape the loneliness slightly.

The most recent re-admittance to hospital was the worst. The pain in the day prior had been on levels similar to how it had been post surgery. I had spent the night sobbing, and watching the clock until I could take more paracetamol and ibuprofen. I based my doses off of Google searches for how the minimum amounts of these substances required to potentially overdose, and using around half of this value as my maximum cumulative dose. I still hardly slept due to the pain, instead passing out for short amounts of time due to exhaustion.

After arriving at the hospital, it was once again pointed out that my ankle appeared to be heavily infected. A blood test confirmed this. Apparently in a test which looks at infection markers in blood samples, a normal person scores 4. I had 120. I was re-admitted. Once again, I was looking at a limb-threatening infection. An x-ray was performed of the joint. This x-ray revealed that my ankle had not been healing correctly. Some bones were doing OK, which was why I had been able to walk using the leg. Some breaks had however not really even begun to heal correctly, with my body instead opting to fill the gaps with a fibrous tissue. The joint was full of pus, which was lanced off for tests. Due to the recurrent nature of the infections, and the presence of the pus, it was decided that the metal work in my ankle was most likely harboring the infection. I was given the choice between having my ankle opened up and the metal deep cleaned, or having the metal work removed. Cleaning the metal work did not guarantee removal of infection. If the infection remained, I would be looking at losing my leg. Removing the metal work would mean the joint was greatly weakened, and would most likely need further surgery at a later date to insert more metal work (which would once again be susceptible to infection). I signed the consent forms to have the metal work removed.

I was back on the ward this time. The lady opposite/one over suffered from dementia. She did not know where she was, and was terrified. The other two ladies on my ward were quite nice; we traded magazines and newspapers, and chatted a little. After being back on the IV antibiotics for a little, the pain in my ankle subsided. With the infection under control, I once again felt better in myself. Enough to appreciate how much I disliked being stuck in hospital. Friends visit and bring you food and entertainment, but being trapped in hospital has become my own personal hell. I am a spontaneous person. I like to get in my car and drive. With my ankle as it is, I cannot. In hospital I am a bird which is not only caged, but has it’s wings clipped. There is no respite in how trapped I feel. I had my surgery, and a couple of hours after it I was out of bed wandering around the ward on my crutches. The day after I was doing stairs in my protective boot so that the physiotherapists would sign me off on going home, where at least I was more comfortable. I declined all opiates. A few days after the surgery I no longer even needed paracetamol. The pain of this surgery paled in comparison to the pain I was frequently in from the infections.

Although I am now quite used to being a human pin cushion, I had numerous issues with my IVs on this particular hospital stay. I suffered a collapsed vein, and experienced two clots in a cannula in a different vein. These, predictably, all hurt like hell to be dealt with. I became quite fearful of getting my IV antibiotic doses. The antibiotics always had burned when they went in, but more often than not they seemed to be associated with an issue with the veins, and therefore a great deal of pain. I was thankful to be discharged from hospital with oral antibiotics.

Predictably, the threat of needing more surgery at a later date has scuppered my plans for taking a 3 month job in Italy. I made peace with that. This brings me to my current situation, the one which inspired this post and it’s title. People treat you differently when you break your ankle. I first noticed it when injured my knee. People I did not know would speak slowly and loudly to me, using simple language. It was plain that they somehow thought crutches=mental impairment. This time I have not experienced this issue. I assume that this is because I have a large plastic shell on my foot now, clearly marking the source of my injury. This time, I have a different issue. People try to protect me- they will dash to open doors for me, offer to carry things for me, constantly offer to help me. The writing is on the wall for me. In my current state, people assume I am weak. This to me has been so much worse than the slow and careful speech. In part, because I am on the receiving end of this treatment from people who know me. My colleagues, my friends.

I was supposed to go to a conference in London next week. I was to get the train there, and get a taxi to the venue. I would then sit in a room all day listening to interesting things, walk a short distance for lunch, and resume sitting. It would have been a trip of sitting. In some ways, I looked forward to this more than the trip to Italy. Although this was only for two days, it made me feel like a normal human being. It would not be physically strenuous; it was just -sit- move short distance -sit-. I want to return to normalcy, but for me normalcy is not being trapped at home. It is going out and about on day trips where I get to meet new people, and learn new things. After the misery of being back in hospital, I needed this trip. It would allow me to turn over a new leaf, to prove to myself that I can still live a normal life, and do normal things. Today, 2 days before I was due to depart, this dream of normalcy has been taken from me. The powers that be at work have decided that it would be too strenuous for me. Walking to the bus to work, walking around site all day, going up and down stairs? Fine. Spending 2 days sitting in a different environment? No. After all of the trauma I have been through courtesy of my limbs, I have a very good handle on what I can and cannot do. I had zero concerns about this trip. I was even intending to take a taxi to the venue, as opposed to catching the tube.

Because I have a dodgy leg, that means that I am weak. That is the message I am being given. I cannot be trusted to know myself, and know what I can and cannot do. An on-site doctor has inspected my ankle/is aware of my situation. He sees this conference as being an easy task for me. It encompasses things which I normally do in my day to day life, and would not bring me any greater physical stresses than any other day. Perhaps it is because of his training as a Doctor that he can see me as I am. I am someone that has just broken an ankle. In the grand scheme of things, it is a relatively minor blip on the radar in life. And yet, I have this lump of plastic on my leg which marks me out as broken, or somehow lesser. My mind is fine. The rest of my body is fine. I fear that until I am free of this physical marker of injury, I will be treated differently. Much like when I injured my knee, as soon as I was rid of the crutches, no-one assumed I was mentally impaired. With the risk of needing future surgery, I wonder how long I will have to endure this for. I now see why people give up and just take long-term sick leave after an injury. People treat you differently, and in my mind, it’s worse than everything else that I have described in this post.

I am not a weak person, please do not treat me as one.

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