I was awoken in Recovery - feeling groggy - a bit like a really bad hangover. I had no feeling from the waist down and had an oxygen mask on. Although I had no pain, I was uncomfortable and through slurred speech requested a pillow to go under my leg.
After an hour or so and drifting in and out of consciousness, I was returned to the ward and met by my parents. The operation had gone well, I was only under for two and half hours. I spent the rest of the evening trying to get my voice back and trying to get rid of the taste of the anaesthetic. Still fairly out of it, I had a surprisingly good nights sleep.
Thursday, 17 September 2009
8th June 2009...
Before I knew it, I was sitting in traffic on the M25 on my way to RNOH - the 8th June was finally here. I had finished work, rented my room out, drunk all I could drink and bought numerous pairs of new pyjamas!
The day started well, I had been allocated my own room - which Mum set about cleaning frantically and before I knew it, I had was changed into my gown and paper pants and being wheeled into theatre - sobbing.
I opted for an epidural, which was put in before I was put to sleep. Post-op pain control would consist of tramadol tablets - fairly strong opiate based painkillers, which I would start to take once the epidural was removed. As my cannula was put in, I was asked to count to ten, I think I made it to 3....
The day started well, I had been allocated my own room - which Mum set about cleaning frantically and before I knew it, I had was changed into my gown and paper pants and being wheeled into theatre - sobbing.
I opted for an epidural, which was put in before I was put to sleep. Post-op pain control would consist of tramadol tablets - fairly strong opiate based painkillers, which I would start to take once the epidural was removed. As my cannula was put in, I was asked to count to ten, I think I made it to 3....
Tuesday, 11 August 2009
2009
With the prospect of the year ahead, I decided to make the most of the first six months. I saw in the New Year in skiing - which was great fun and then had a further two skiing trips throughout the winter. The last trip was not quite so success as on day two, skiing some great off-piste powder I managed to slip and twist my knee causing me to be bloodwagoned off the mountain - this put an end to the skiing for this year. Slightly concerned about any ramifications this may have on my imminent surgery - after all it was my right knee - I undertook loads of physio. I am still not exactly sure of the extent of the damage, but have decided to get this over and done with first and then face any knee problems once my legs are sorted!
In advance of my next meeting with Mr Calder I had an appointment with the Clinical Nurse at RNOH. With my previous history and experience regarding the TSF I was going to need some help coming to terms with what I was faced with. I decided to attend the appointment on my own which surprised the nurse! Within minutes I was in tears, finding the whole situation very stressful. We talked about what went wrong the first time around and the fears I was facing this time. She found it very hard to believe the problems I had with the pain control and assured me that there was a dedicated Acute Pain Team on hand at RNOH who would be consulted before my surgery. We would able to discuss the best options available for me throughout the course of my treatment. I then took a look around the hospital - which stressed me out even further. Stanmore is a very bizarre place, it looks a bit like a Second World War field hospital than a centre of excellence - but, I told myself not to judge a book by its cover. There was a central corridor, with all the wards coming off it. The wards were large nightingale style wards, with 10-20 people per ward and they were really really hot. The majority of the patients were all old and frail - it was my worst nightmare. It made Harlow look like a private hospital. I was told the chances of getting my own room were limited, but it could be requested via the Bed Manager a week prior to my admittance. I left absolutely petrified and no less assured of what was ahead of me - the nurse asked if I had to wait until May to have the surgery as she thought it would be much better for me have it done sooner rather than later and get it over and done with - this was not an option.
My second meeting with Mr Calder did not highlight any surprises. The date was set for 8th June. I told Synergy who took the news very well - I would see through the GUINNESS PREMIERSHIP season and then finish - expecting to be off for the rest of the year. They were very understanding and supportive, which was a huge weight of my shoulders.
In advance of my next meeting with Mr Calder I had an appointment with the Clinical Nurse at RNOH. With my previous history and experience regarding the TSF I was going to need some help coming to terms with what I was faced with. I decided to attend the appointment on my own which surprised the nurse! Within minutes I was in tears, finding the whole situation very stressful. We talked about what went wrong the first time around and the fears I was facing this time. She found it very hard to believe the problems I had with the pain control and assured me that there was a dedicated Acute Pain Team on hand at RNOH who would be consulted before my surgery. We would able to discuss the best options available for me throughout the course of my treatment. I then took a look around the hospital - which stressed me out even further. Stanmore is a very bizarre place, it looks a bit like a Second World War field hospital than a centre of excellence - but, I told myself not to judge a book by its cover. There was a central corridor, with all the wards coming off it. The wards were large nightingale style wards, with 10-20 people per ward and they were really really hot. The majority of the patients were all old and frail - it was my worst nightmare. It made Harlow look like a private hospital. I was told the chances of getting my own room were limited, but it could be requested via the Bed Manager a week prior to my admittance. I left absolutely petrified and no less assured of what was ahead of me - the nurse asked if I had to wait until May to have the surgery as she thought it would be much better for me have it done sooner rather than later and get it over and done with - this was not an option.
My second meeting with Mr Calder did not highlight any surprises. The date was set for 8th June. I told Synergy who took the news very well - I would see through the GUINNESS PREMIERSHIP season and then finish - expecting to be off for the rest of the year. They were very understanding and supportive, which was a huge weight of my shoulders.
Monday, 10 August 2009
Shock news
Our first meeting with Mr Calder did not go to plan... We arrived at Stanmore with plenty of time to spare - checked in with the receptionist only to discover that we were due in the outpatients clinic in Bolsover Street, central London and a ten minute walk from work! We hopped back on the tube and dashed to Bolsover Street, arriving only 50 minutes late!
Following a series of more xrays, I was once again stripped to my pants and asked to walk across the room so everyone to have a look at my funny legs. Mr Calder and his registrar were openly surprised at the current angle of my leg.
As expected, the xrays displayed an angular deformity, which could be corrected with the use of yet another Taylor Spatial Frame - this was shock number one... It also became clear that it was not just my tibia which longer on my right side to my left. My right femur is around 2cms longer than my left one - this is a a result of the very early surgery, where my growth plate in my right tibia was destroyed by the femur was allowed to continue to grow. Therefore, using another TSF to correct the deformity of the tibia would once again cause bone growth on my right side, which would increase the discrepancy by a further 3cms or so - therefore ultimately leaving me 4+cms longer on my right than left. This was something which was very hard to get my head around, as I was already 2cm longer on the right side and this was causing me problems with my walking and lower back. Mr Calder advised that the best way to manage this was once the TSF was removed, break the right femur, remove the required amount of bone to ensure equal leg length, rod the bone with an internal nail fixation and compress the break. This was yet another invasive and painful procedure which would see me in hospital for another five days and non-weight bearing for a further 4-6 weeks. I was looking at a six to nine month stretch incapacitated...
I decided that I would not do anything until the end of the GUINNESS PREMIERSHIP season in May 2009 as I was really enjoying the account and looking forward to managing the Final at Twickenham. We agreed to meet Mr Calder again in February 2009 to finalise our plans for the year ahead.
Following a series of more xrays, I was once again stripped to my pants and asked to walk across the room so everyone to have a look at my funny legs. Mr Calder and his registrar were openly surprised at the current angle of my leg.
As expected, the xrays displayed an angular deformity, which could be corrected with the use of yet another Taylor Spatial Frame - this was shock number one... It also became clear that it was not just my tibia which longer on my right side to my left. My right femur is around 2cms longer than my left one - this is a a result of the very early surgery, where my growth plate in my right tibia was destroyed by the femur was allowed to continue to grow. Therefore, using another TSF to correct the deformity of the tibia would once again cause bone growth on my right side, which would increase the discrepancy by a further 3cms or so - therefore ultimately leaving me 4+cms longer on my right than left. This was something which was very hard to get my head around, as I was already 2cm longer on the right side and this was causing me problems with my walking and lower back. Mr Calder advised that the best way to manage this was once the TSF was removed, break the right femur, remove the required amount of bone to ensure equal leg length, rod the bone with an internal nail fixation and compress the break. This was yet another invasive and painful procedure which would see me in hospital for another five days and non-weight bearing for a further 4-6 weeks. I was looking at a six to nine month stretch incapacitated...
I decided that I would not do anything until the end of the GUINNESS PREMIERSHIP season in May 2009 as I was really enjoying the account and looking forward to managing the Final at Twickenham. We agreed to meet Mr Calder again in February 2009 to finalise our plans for the year ahead.
Monday, 20 July 2009
Next steps
As the prospect of future surgery hung-over me, I began to realise that I would not be able really get on with my life until I had it all sorted. Realistically I was unable to change jobs, as no new employer would take me on with this on the cards. As Synergy had supported me once, the chance were high that they would support me again - for which I was very lucky.
Once again, I found myself getting back in touch with Mr Hill. At my last appointment, he had said that he would happily see me in the future to further discuss my options - be it for him to undertake any more surgery or to point me in the direction of someone else. It transpired that he no longer ran his clinic at Harlow, but now focused on his Private clinic at The Portland Hospital and his paediatric clinic at Great Ormand Street. He agreed to see me at The Portland. He told us nothing new - on reflection I am not sure what I was expecting to hear, although I had decided that I did not want him undertaking any further treatment and I simply did not trust him. He reiterated the options he thought best and suggested that we get in touch with a colleague of his at the Royal National Orthopaedic Hospital (RNOH) in Stanmore. RNOH is a centre of excellence for all things bones and therefore if they could not get it right there... we were stuffed.
Mr Peter Calder was the man for the job and within four weeks of the referral, we found ourselves in yet another outpatients department.
Once again, I found myself getting back in touch with Mr Hill. At my last appointment, he had said that he would happily see me in the future to further discuss my options - be it for him to undertake any more surgery or to point me in the direction of someone else. It transpired that he no longer ran his clinic at Harlow, but now focused on his Private clinic at The Portland Hospital and his paediatric clinic at Great Ormand Street. He agreed to see me at The Portland. He told us nothing new - on reflection I am not sure what I was expecting to hear, although I had decided that I did not want him undertaking any further treatment and I simply did not trust him. He reiterated the options he thought best and suggested that we get in touch with a colleague of his at the Royal National Orthopaedic Hospital (RNOH) in Stanmore. RNOH is a centre of excellence for all things bones and therefore if they could not get it right there... we were stuffed.
Mr Peter Calder was the man for the job and within four weeks of the referral, we found ourselves in yet another outpatients department.
Tuesday, 14 July 2009
The years between
Following the outcome of my surgery, I decided to get my life and career back to normal. December 2006 I hit the ski slopes which was fantastic!! Only four months after having the frame removed and I was skiing!! I got myself back to the gym and threw myself back into work. I loved being back in London.However, the results of my 'bodged' surgery were never far from my thoughts. My 'new' leg looked terrible. Totally out of shape - which made me very self-conscious. Finding suitable trousers became even harder than it had been initially. I had a constant limp due to having one leg longer than the
other, which people always commented on and I could not get a full bend through my leg. The limp soon lead to backache and I was unable to stand for long periods of time, making going to the pub, cocktail parties or standing in queues very uncomfortable. I was given an instep for the left shoe, to lift my left leg slightly, however this was not enough and I could not have anything larger as I would not be able to hold it in my shoe. However, I continued with life as normal and started to train for a 10k run, went to the gym regularly and was back on skis!My father was particularly disgruntled with the result and wanted to explore the legal possibilities and compensation which we may be entitled too. Our reasoning behind this was not purely mercenary, but if I was to have to have future surgery, then more time would be required off work and I would suffer loss of earnings. We also wanted to look into the private facilities available, however could not consider this as an option without some kind of financial assistance. We instructed a lawyer and started the legal ball rolling. Once we had received copies of all my medical records, we enlisted a medical expert to pull together a full report on my case. He would write a paper on my history and the operation and post-operative care and draw a conclusion on my care and if any negligence can be pin-pointed.
Several hundred pounds later (legal fees are expensive), we saw the report. I was not really sure what to expect, however it was far from conclusive. We felt that many of the questions and issues we raised had not been answered. The conclusion drawn was that my 'varus deformity had been corrected, which it had, but in the process I had been left with a valgus deformity' (the new shape of my leg). It stated that if this 'new deformity had been identified whilst the frame was in place, then it would have been a relatively straightforward to correct by re-programming the frame... However, a valgus deformity occurred and this should have been avoided if a careful eye had been kept on the patient in outpatients.' This is what we were hoping to hear, there had been some element of post-operative negligence throughout my treatment. However, the paper went on to say that 'despite this, the end result has been much better for the patient than the preoperative state'. So, medically I was better off than before the operation, in terms of a reduced risk of osteoarthritis, but I had been left with a limp, a leg length discrepancy of more that 2cms and I was starting to get associated pain in my lower back, my quality of life had been significantly reduced, not to forget that I would need more significant surgery in the future. How was this considered 'better off than previously'?
We decided to take the case to a medical negligence specialist to ask their advice, it agreed that a degree of post operative negligence had taken place - my leg was 8 degrees out of line with my hip and ankle, but this would be a very hard case to prove in a court of law. As the frame was self-adjusting it would be easy for the defence to flip the case around and blame my parents for the over correction. It was also advised that it would cost thousands of pounds to get this to court, it would be hard to create a solid case and if we were lucky then the settlement received would be minimum, especially in relation to the amount to get it through the courts.
We thought long and hard about the course of action we would take and we decided not to pursue with any legal action. The cost, stress and high chance of a negative outcome strongly outweighed any of the positive points. This was slightly frustrating as it was a dead cert that I would have to go through it all again in the future and therefore my career and life would once again be interrupted.
The results
Well, as anticipated the odd shape of the leg turned out to be slightly more problematic than any of the doctors were letting on. At my post-op consultation with Mr Hill it became apparent that my leg had been 'over-straightened' and therefore stuck out at the bottom and a rather peculiar angle. This, coupled with the new leg length discrepancy which I now had - my right leg now 2cms longer than the left, meant that I was considerably worse off than when we started. This was horrendous news to hear - the last three months had been a complete waste of time.
Mr Hill was relatively apologetic and admitted that this was not the ideal outcome. He did not exactly confirm that a mistake had been made, but did advise that further corrective surgery would be required to prevent degenerative arthritis in my right knee.
We traced back the appointments and the consultations we had had over the last few months. Everything pointed to the appointment we had with the registrar, when Mr Hill was not present and the re-running of the programme. If over-correction had been picked up at this stage we would have had the chance to correct it.
I left the hospital totally deflated, with the knowledge that I would have to go through everything again in the years to come.
Mr Hill was relatively apologetic and admitted that this was not the ideal outcome. He did not exactly confirm that a mistake had been made, but did advise that further corrective surgery would be required to prevent degenerative arthritis in my right knee.
We traced back the appointments and the consultations we had had over the last few months. Everything pointed to the appointment we had with the registrar, when Mr Hill was not present and the re-running of the programme. If over-correction had been picked up at this stage we would have had the chance to correct it.
I left the hospital totally deflated, with the knowledge that I would have to go through everything again in the years to come.
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