Broken Leg, Disability

Broken Leg Part 4- Two Years on All Change. 

20th December 2015 will be a date I’ll remember for the rest of my life. Two years on I’m now at the stage, where I can reflect objectively on the experiences.  Those of you that are regular readers on my blog will know this is my 5th post on the subject.

https://otrach.com/2016/01/05/from-the-other-side-what-i-have-learnt-part-1-the-break-and-wait/

https://otrach.com/2016/03/31/the-broken-leg-part-2-what-does-independent-really-mean-do-prescriptions-differ/

https://otrach.com/2016/07/02/the-broken-leg-part-3-six-months-on-and-getting-back-to-work/

https://otrach.com/2017/06/29/loving-the-dead-leg-again/

My thoughts and feelings about the experiences have fluctuated, often due to the treatment I received when I initially broke the leg,  and the on going pain I have been in, but I’m also thankful for the experience.  It has made me re evaluate, what I want from life.  Two years on I’m in a better place than I was even before I fell down those pesky stairs.

Following on from the last blog — loving the dead leg again,  where I talked a lot about the pain I was in on a daily basis, I have had a further operation which removed scar tissue from my ankle.   This has made a difference,  I still have pain,  but there are some days where I’m pain free, and I can walk a little longer and tolerate standing up in the morning meeting at work.  Pain will always be a part of my life, I’m struggling to remember what my pain was like before, so I can’t really compare it.  But my weekends are no longer waisted resting in bed,  I have enough energy to do something.  Those that know me well will know during the worst times I would just say I want the leg chopping off,  and joked about chain saws, and what sort of blade I wanted to replace my leg.

I have a lot of people to thank, my family, friends readers of this blog who have often sent messages of support, and of course the OTalk* girls who have all been a consistent support.  I know I have not always been easy to get on with, at times shutting people out.

In my revaluation I looked at want I wanted from life,  and what I had already achieved and had.  The career I love, a home, close friends and family,  but no one to share this with.  With the support of The Otalk girls I ventured into the world of online dating,  something I would advocate, if you have ever thought about it,  it’s an odd world and you need to be careful.  I had some weird conversations and dates,  which created much amusement within the Otalk WhatsApp group.

Five months again I found someone very special,  who shares my hopes and dreams. He is caring, supportive and has quickly become a firm fixture in my life.

So without falling down the stairs I don’t think I would be in the place I am right now.  I hope to draw a line under this experience and move on to a new chapter.  I have recently become an Auntie for the first time and although I have fears about how my physical health impacts on my ability to help care for her, I’m learning every day.

If I have learnt anything its that Life is good – live it, you can always work around the barriers life throws at you.

Thank you for reading, Merry Christmas and Happy new year.

*OTalk is a weekly twitter chat planned and organised by myself and 6 other occupational therapist across the UK and Ireland. https://otalk.co.uk/about-2/

Broken Leg, Recovery

Loving the ‘dead leg’ again

I was recently listening to a woman’s hour podcast, in which the photographer and author Laura Dodsworth was being interviewed along with some of the models from her most recent book. Manhood the bare reality.  The book focused on one to one interviews with men and how they felt about their body along side a photo of their penis.  This is the second book in the series, in 2015 Laura published Bare Reality 100 woman — their breast theirs stories.

When I got home I ordered both books, as I flicked though them both (I have to confess I have not read them cover to cover.) There was plenty of interviews from cancer survivors or how changing the function like having a child and needing to breast feed changed the persons view of their bodies.  I came across one interview with a man who as spina bifida, he stated his impairment disables him when he interacts with society and states sexuality is more complex when you are disabled.  I began to reflect on how I feel about my ‘disabled’ body and in particular that leg, the right one the one that causes me all that pain.

Over the years I have explored how I feel about my leg, within poetry and a few years ago for an art exhibition at work.  I took a series of photos of my feet in various situations to reflect how different they looked and how I managed different occupations.  For this blog I have decided to revisit this idea.  As a child I used to refer to it as the ‘dead leg,’  but do I need to readdress my relationship with my leg and embrace it?

Its swollen, bruised, scarred, I don’t have an ankle,  it looks and feels odd,  its on my mind all the time as every movement I make is a painful reminder its still there.

Some days it tells be to stay in bed, other days I ignore it and carry on regardless,  but every now and again it catches me out,  with a good pain free day or a day of tears and feeling sorry for myself.

  • I hate that in makes me wear flat sensible shoes that don’t go with the outfits I would like to wear,
  • I hate that it sometimes stops me from doing the things I want to, need to or that I am required to do.
  • I hate that I have to rely on others, during this time.
  • I hate having to justify myself to health professionals as I go to yet another appointment that does not solved my problem.
  • I hate that people give me advise all the time as if you have not researched it and tried everything yourself.
  • Most of all I hate how it dominates my thoughts I feel the need to talk about it all the time —  it must be so boring for others.

But these are bad days and there not everyday.

  • I love planning out my day in detail to minimise the amount of walking,
  • I love a duvet day,
  • I love the unique insight into the world it gives me in particular how I look at each new environment, to work out how can I do this.
  • I love the comforting conversations its allowed me to have with others,
  • I love how it has brought me closer to friends and family,
  • I love how it forces me to think differently, and creatively,
  • And I confess I love the opportunities it gives me to talk about myself.

I’m not ashamed of my body the leg or any part,  it is what it is.  These series of photographs help me love the leg again.

 

Blog Post, Broken Leg

The broken leg Part 3 – Six months on and getting back to work.

For regular readers of my blog you will know I fell down the stairs and broke my right hemi leg just before christmas last year, however if your new to this blog you can read more here Part 1 and Part 2.

Since my last blog post a lot has happened, however the effects of the brake still have a an impact on carrying out daily occupations, and managing my emotions.

My biggest frustration has been foot wear,  my right foot and leg remain very swollen despite daily stretches and exercises given to me by the physio. This has limited me to one pair of shoes.  It surprises me how something as small as not being able to choose foot wear to match what your wearing or how you feel, can effect your mood.  I have not wanted to go to the pub with friends, felt I have not looked professional at work,  and just broke down in tears at the thought of needing to dress up.

One large change has been my bathroom, I have had a wet room put in.  You can read a blog I wrote about it here for Impey showers http://impeyshowers.blogspot.co.uk.  In short it has changed my life,  feeling safe in the bathroom, has given me my confidence back.  Plus it looks amazing.

IMG_1871

In the weeks leading up to returning to work I set myself a number of challenges to increase the amount of walking I was doing,  however the weather was rubbish so I had to be creative. Museums and art galleries were good spaces to use with plenty of places to sit for a rest.  The apple watch as come in handy again,  as you can monitor how much walking and exercised you do. I have used it to set myself targets and increase them weekly, I find it motivating.

I’ve been back at work for 6 weeks now,  the first 2 doing half days building up to full days, I’m now work 4 days a week.  I can walk around inside unaided however still feel the need to use a walking stick outside.  I’m trying to lift my foot fully off the ground to prevent tripping however I have had a few close calls and without the stick to support me I would a fallen again.

I missed work whilst I was off,  but found getting back into the routine difficult, I found myself forgetting things,  not being able to concentrate in meetings,  and overwhelmed with emails and new responsibilities.  I questioned if i could still do the job feeling inadequate most days. However my team has been very supportive, there were days I felt like not going in, but stuck with it.  By about week 5 these feelings of inadequacies began to lessen.

Last week I attended the COT conference in Harrogate,  a big challenge both physically and for my attention span.  I decided to take the wheelchair just incase I needed it,  but set myself a goal to walk as much as I could.  I felt a little stupid walking a round with an empty wheelchair, however there is no safer place to do that, than at an OT conference,  full of friends and colleagues from both real life and those I have met online.  I had lots of positive chats with people about my blogs and experiences, and as always the conference itself gave inspiration  and hope for the future of the profession.  I will return to work with fresh eyes to face to next challenge.  However physically it was difficult, determined not to complain I took pain killers, ploughed through and on the odd occasion had a quick cry to myself (but that currently is normal).

IMG_2231

The last six months as been one of the biggest challenges so far.  To readers I would like you to take away two messages.   Remember to work with the whole person,  assessing how whatever you’re treating them for effects them both physically and mentally.  Trauma no matter how small can have lasting effects,  the trauma might not just be the event that started off the need for your input, it can also be the process of getting through it,  don’t be part of the trauma be part of the recovery.

Rachel x

Blog Post, Broken Leg, Occupational Therapy

The broken leg part 2 – What does ‘Independent’ really mean?

IMG_1121

 A dictionary definition of the word independent shows it has many meanings, including ‘not influenced or controlled by others in matters of opinion, conduct, etc.; thinking or acting for oneself.’  ‘Not dependent; not depending or contingent upon something else for existence, operation, etc.’ Not relying on another or others for aid or support, and in Politics. a person who votes for candidates, measures, etc., in accordance with his or her own judgment and without regard to the endorsement of, or the positions taken by, any party.’

http://www.dictionary.com/browse/independent

But in the world of occupational therapy what does independent mean, to the therapist and to the person they are providing a service for?  This is something I have been thinking a lot about as I recover from a broken leg.

This recovery has been complicated by my existing disability, a right hemiplegia from cerebral palsy after a lack of oxygen to the brain during my birth.  The last three months have been some of the toughest of my life so far, and it’s all been down to my ability to come to terms with the lack of independence.

The issues of independence first began to play on my mind, after sadly a poor experience of occupational therapy whist in hospital.  I don’t think it would be appropriate for me to go in to this is to detail, but I will say I was concerned with their interpretation of independence.

After my operation I was having difficulty standing and began to transfer using a banana board, however my right leg was stiff and heavy with the extra weight of the pot, I could not transfer without someone holding it.

This was observed by one of the four OT’s I saw over the 16 days I was in hospital.  On discharge I ran in to difficulty and rang the OT to come out to do a home visit to reassess to my needs.  We disagreed on the help and assistance I required.

This mainly focused on the OT’s opinion I had independently transferred from the hospital bed to a chair.  I pointed out that the OT had held my leg during this transfer.  For me this was not an independent transfer. I must stress this is just my opinion and how the treatment I received felt.  But the OT service saw a broken leg and not the added complication for the hemiplegia and bariatric needs.

Discharge was not planned on admission, and unfortunately, in my opinion discharge from hospital was delayed due to the lack for forward planning by the OT team.  At this stage I cut ties with the OT service and sourced my own equipment paying for it myself, getting it in a timely manner with the help of some friends and family.

Interestingly enough whist in hospital. I was asked by the OTalk team to become a full team member. The first twitter chat I supported was ironic.  It explored if OTs within acute hospitals assessed and treated the mental health needs of their clients.  This again in my opinion was an area not addressed by any profession during my admission. #Otalk Blog

The affect of the broken leg on my mental health has been the most difficult part, those who are familiar with hemiplegia will also know that it is not just a physical disability and some of the symptoms include feeling depressed, heightened emotional sensitivity with inability to handle stressful situations.

Whist in hospital I found it incredibly difficult to manage my emotions, this was possibly made harder by the fact I was in over Christmas and New Year.  Social media, the tool I love became a focus of paranoia.  I made some mistakes in taking this out on people I love, something I am still dealing with the repercussions of 3 months on.  I was tearful on a daily basis’s and of course bored beyond belief. Friends and family did their best to visit and entertain me, during this time.  I am an extremely lucky person to have people in my life that have managed the moods, the tears and the frustrations.

Admitting and asking for help can be a hard, as a person with a disability you spend your life fighting systems and working hard to achieve despite the obstacles.  This might be some little victories like having a trampoline party as child because you were not invited to one earlier in the year as that’s child’s parents did not think you would be able to use the trampoline.  Or the large things like finish a degree, despite being turned down for your first placement because the educators had preconceptions about your physical abilities.

Some readers maybe thinking, I thought this blog was about independence, so sorry if I have gone off topic slightly, but I wanted to set the scene.

Those that have studied or have read about independence within OT will understand about codependence.  You might question is anyone truly independent? We all rely on others for something.  I found myself asking questions like, If I can use the toilet without assistance but need to be wheeled to or use a walking frame to get to the toilet is this independent??

Where does choice come in to this? can you or should you chose which parts of your life you want to be independent.  One example I have for this is prior to the fall, I would only wear flat slip on shoes without socks, as I find manipulating my hemi foot in to socks and shoes difficult.  However, after the operation my foot and leg have been very swollen. I’ve brought a wide fitting pair of shoes but due to the type of shoe I need to wear socks with them.

My first visit to the hospital physiotherapist, (10 days after having the pot removed) we had a discussion about putting my shoes and socks on, her priority for me to do this myself, however putting on this type of shoe is not something I would not normally do, although its something I know I need to work on it was not my priority at that time.

Over the past 3 months my independence abilities have changed on a daily basis some days I was more independent than others.  The equipment I’ve needed to assist me has changed dramatically from my initial thinking.

Facing getting out and about was one of the biggest challenges, for both myself and my family.  I became dependent on them when ever I wanted to leave the house, and a trip out needed to be planned in detail, much like a new mother with a new born baby.  I found I needed to plan longer rest periods than I did before the fall.

Tools like social media and the internet have helped with this I found I liked to look up where we have planed to go in detail, I look at pictures to help me understand the access issues and the distance I might need to walk, the anxiety of the unknown began to consume me.  My current challenge is to begin to go out without the safety net of the family, although I still require assistance to get my walking frame or wheelchair out of the car, I’m beginning by meeting a friend for lunch.

So I’m independently planning trips out with the toosl available to me, however I still require someone to accompany me, is this independent?

To help me explore independence in the future I’m planning on hosting a #Otalk on the subject on April 12th at 8pm I hope to see you online then.

 Rachel @OT_rach

 

 

Blog Post, Broken Leg

The Broken Leg Part 1 – From the other side –  What I have learnt.

For none regular readers of my blog,  I’m a occupational therapist who works for a mental health trust,  but i also have a disability – if you are interested to can read theses below post to give you an insight in to my life before this event.

A week in the life of an occupational therapist with a disability for OT week 2015

#otalk 14th October 2014 hemiplegia

occupational therapy professionals with a disability

What to call this blog, many titles have come to mind as I’m laid staring at a pink wall and clock that says the wrong time and date.

Among the ideas –

  • Thank you Apple watch
  • The waiting game
  • Mothers are the best
  • How small the world can become?
  • Communication feels like the hardest thing to do
  • Beep ………….beep ……………beep

 

But I settled with from the other side – what have I learnt.   As much I’m hating this experience I’m trying to find the positives.  I’m learning lots that hopefully will improve my practice and maybe that of the the odd blog reader.

What happened  – Sunday 20th Dec 2015 I was busy getting the house ready for hosting a party.  About 11am I was walking down the stairs with the washing when my right foot lost its footing about 4 steps from the bottom, the basket went forward and I went backwards, I heard a cracking sound as I lay there for few seconds to catch my breath, I know I had broken my leg.

My mobile phone was in the washing basket and had actually landed under the foot of the broken leg. Luckily I was wearing my apple watch.  I knew I needed to get the door open before an ambulance came.  My brother has a spare key so a tried him first however he did not answer.  My neighbour had a key, but she has just given birth to a little girl, using the ring feature on the apple watch, I rang her first to make sure she was in, and then some friends who live round the corner.

Whistled I waited for friends to arrive I rang the ambulance, again on the apple watch. I also tried to ring my mum but she was away at a friends, rang my dad to let him know, and then my brother rang me back.  My friends arrived and open the door, my brother shortly after.

Then we waited for the ambulance.  I’ve done a lot of waiting this week, but the three hours waiting laying on the stairs was the worst.  My friends and brother did their best to make me comfortable placing pillows under my head and back.  We tried to stand me twice but the pain was too much.  Laid there I was convinced I would be home in time for the party, (how silly that seems now) so instructed the boys to get the desserts out of the freezer, and told them where they could find something to eat, (I was nil by month of course).  Mum had also rang and set off on the just over 2 hours’ journey from her friend’s house to mine.  She arrived at my house at the exact time same time as the ambulance.

I need to praise the paramedic’s once they arrived. They were so patient and kind. I was in a difficult position on the stairs and had little strength left after supporting my self with my left leg for 3 hours.  They had great problem solving skills and used a slide sheet to move me up the stairs enough to stand on one leg and be move on to a stretcher.

At this point I’m still convinced I’ll be home for the party if not a bit late, so sent a message to everyone, saying I would let them know.

I don’t remember much once we hit the hospital, other than the x-ray showed I had fractured my tibia in several places and also broken bones in the ankle.  I was going to need an operation, they gave my drugs whilst they reset the ankle and then moved me to the ward.  I cancelled the party.

The waiting starts – Its difficult for me to write the next paragraphs, I work in and love what the NHS is, but unfortunately not all care is perfect, and when you’re on the receiving end even the smallest thing can be seen as so wrong and big.

Firstly, I have received some first class care, from a few staff members, these are the things they did that made the difference.

  • Told me their name. (more than once)
  • Stop for a brief chat.
  • Took their time when helping me move, wash or help use the toilet
  • Listen to me
  • Asked what I could do and what I needed help with.
  • Just pop their head in.
  • Told me everything they were about to do before they touch or moved me.
  • Gave me encouragement
  • Made sure things were put back in my reach before they left.
  • Asked if there was anything else they could do for me.

 

However unfortunately this was not always the case, the most frustrating was communication issues.

When I came on to the ward I was swabbed in the month and nose, no one told me why then at 2.30 in the morning I was woken and moved to a side room, told I had tested positive.  I had to ask for what.  MRSA was the answer. I was given stuff to wash with every day and told I would be re swabbed in 5 days,  by day 7 this had not happened,  I had to asked,  2 days later I had to ask for the result,  I was clear.

From admission I was nil by mouth waiting for an operation, however when the surgeon came round at 10.30 on day 2, I was told I would not be operated on that day.  However, this message did not seem to be passed on to the ward and I was not fed at lunch time, again I had to ask.  I ordered tea, but it never came.  The nil by month went on until day 8, having to remind people every day I was nil by mouth became frustrating, staff were often putting water within my reach and asking if I wanted lunch or not giving me any when I could have it. coupled with the problem of being told I was on/off the list for an operation. Sometimes the nursing staff informed me and offered food,  but often I had to ask.  On one occasion the nursing staff were told at 1pm,  but no one told me until 3.30pm.  I went without food and water unnecessarily many times.

Day 3 I heard the ward round outside my door but they never came in, I complained, but just felt like the buck was passed.  There was not enough time.

Lesson number 1 Not having enough time to communicate with your service user should never be an excuse, you might not have time but it’s likely that’s the one of a few things they do have.

The nil by month went on until day 8, having to remind people every day I was nil by mouth became frustrating, staff were often putting water within my reach and asking if I wanted lunch or not giving me any when I could have it.

I had some bad experiences will staff manually handling me.  Before the operation the leg was in a back slab, it was painful when moved and the heal rubbed constantly on the back slab, which kept me awake at night.

You learnt pressing the nurse call could mean anything from a 5 to 15 min wait, whilst it beeps continuously at you, the longest I waited was 25min.    On one occasion a staff member took the bed controls without me noticing or her saying anything, the bed was suddenly moved and I scream out in pain shouting, ‘let the patient use the controls’ –  she shouted back – ‘we never let the patient use the controls!!!!!!!!!!’  She also refused to use the glide sheet provided.

Lesson number 2 – The patient is the expert in how they feel and want to be treated.  Always inform the patient before doing anything around them, and if they can and it suits them let them have the control.

In part 2, I plan to explore, the therapy, how to be an occupational being in one room, the emotional roller-coaster and more waiting.