Broken

 Many years ago, when I was about fourteen and hit puberty I developed Idiopathic Adolescent Scoliosis https://www.sauk.org.uk/types-of-scoliosis/idiopathic-scoliosis.

Way back then there were no proactive mitigating treatments, it was just allowed to develop and was monitored, if by the late part of the pubescent growth period it looks like it may have life limiting effects, you have surgery. Nowadays if it caught early it’s both monitored and mitigated. In retrospect its ludicrous that I wasn’t braced early. Had I been, I wouldn’t have had to undergo five major spinal operations in my life.

In order from March 1986, it started with an Anterior release, followed a fortnight later by a long spinal fusion incorporating Harrington rods. The anterior release part involves breaking the ribs on the deformed side and off-setting them a little. You then spend a week in ICU having four hourly doses of morphine, you are encouraged to drink, and when you can finally make two litres in a day without vomiting and eat and hold down solid food you can go back to a regular orthopaedic ward (we’ll ignore the particulars of the specialist orthopaedic ward). Once back on the ward you are turned every two to four hours in an arbitrary fashion, left side, right side, back, rinse repeat. This goes on for just over week.

ICU I believe was around five days, though it may have been six. The morphine doses mentioned above take care of the time in the main. The following seven or eight days between anterior release and the main fusion, do eventually involve you mobilising. However, nothing can prepare you for how quickly the ligaments tendons and muscles in your legs shorten and how much they complain when you are finally stood up and told to take your own weight.

Again, it’s a different world today, nowadays you’re back on your feet asap, and if not, you receive in bed physio. In any event they wouldn’t just man-handle you to a sitting position and ask you to stand. And if they did, they would warn you that is likely to hurt and you may fall or may not be able to get your feet flat to the floor… but I digress.

At around the fourteen day mark you go back to theatre for your second operation. During this surgery your spinal bones are fused, your disks are removed, and metal rods are installed to hold all the bits together. Then you are back on ICU for five days or so. The second stint on ICU is harder. The morphine is the same, but you’re acclimatised to it, so it doesn’t have the same effects. Or put another way there’s a lot more pain.

Eventually, you go back to a ward and you go through much the same process as before. Dressing changes, being turned, being mobilised, and finally having your stapples removed (the is scarring is still something to behold).

Around a week before you’re discharged, you are put in plaster. The cast extends from your chin to your hips, just past your coccyx at the rear and in a line from hip to hip at the front. The cast stays on for six months. After wearing the cast for six months (it was changed after three months), you wear a spinal brace that looks like a skin-coloured tailored corset made of rigid plastic for three to four months.

After about three months, you start removing the corset at night and sleep without it. At the same time I started to first re-build of me from scratch. There was no follow up physio. I’m not kidding about that. You literally go home, wear a plaster, wear a brace, get on with it. The rebuild involved swimming. I remember phoning the Royal National Orthopaedic hospital to ask if it would be okay to go swimming while still wearing the brace during the day and being told by the consultants’ registrar that it sounded like a good idea and couldn’t hurt. That was the entirety of my convalescent physiotherapy advice.

Thank fuck I’m not an idiot. And thank fuck I’d spent years being a swimmer, being active and being busy, because If I hadn’t been, I can’t imagine the state I’d be in now.

I had worked out that I only had a couple of working disks left and that I’d have to look after them. I also worked out that swimming was without a doubt going to be the perfect route back to cardiovascular fitness, back to having muscle and maybe being able to `embellish’ the scars so they didn’t look so catastrophic.

Eventually I got back on a push bike, and some time after that I started running. Eventually I was running five miles three times a week, going to a running club, pounding a treadmill, walking, climbing, scuba diving.

All my own work.

Jump forward to 1996. I’ve broken the Harrington rods in a at least two places between my shoulder blades, and all the metalwork needs to be removed. Major surgery three, almost ten years today from the first one in 1996.

This is a long recovery, rebuild two… it’s more difficult this time I’m older have less time to myself, and my now ex-wife is about as understanding as a thing that doesn’t understand, doesn’t want to understand and really wants to be the one at the centre of attention. I get mostly back to where I was and I’m still relatively speaking young… still mostly invincible.

Jump forward 2001, something is wrong down in the lumbar, it involves the serious potential of a new surgery. I avoid it, I cut back on activities, things get better, but my fitness has suffered, I have to be a bit more careful, but I am still a fairly a new dad, and life has moved on. I can excuse myself not being quite so super fit..

Jump forward 2007, the thing that was going wrong in 2001 (a herniated disk) has been plaguing me on and off for six years. I’ve had an inverse table to hang upside down in, taken Pregabalin, had numerous but interment three monthly cortisone injections direct into the nerve roots at L4/L5 (lumbar spine), and L5/S1 (Lumbar to coccyx). These are Xray guided injections for obvious reasons. They do work, but degeneration is occurring, and much later I find out I’ve done a classic British thing and compromised my life for probably eight years longer than I should have, and that my surgeon should probably have been a little more forceful, in explaining that procrastinating has a price you pay, further down the line.

In the end the only thing for it is a `bi-lateral, hemilaminectomy, foraminotomy and micro-discectomy L4/L5, and a hemilaminectomy, foraminotomy L5/S1. These surgeries involve shaving bone from the Foramen and the Lamina and clearing disk material from the Annulus which is the hard outer part of a spinal disc. This is a major surgery performed by a Neurosurgeon. The major recovery time is about six months, the initial recovery time is about six weeks. I had been told to get it fused. I refused on the basis of not wanting to be rigid from waist to neck.

Rebuild three. I’m single having divorced sometime ago, and having split up with my most recent partner, now live independently. Recovery is quicker, the surgery while deeply invasive and fraught with danger is modern and clean, and all that bedrest crap from twenty years before is long gone. I am mobilised the day after surgery, I was walking the length of the ward the day after that, two flights of stairs with a physio the day after that.

Jump forward 2011. The L5/S1 disk had been left herniated too long it’s squished back into the nerve canal and I’m fucked for want of a better word. There is no alternative; in August 2011, L5/S1 are fused. It’s major surgery. Six weeks initial recovery, six months to fully fuse, there is new metalwork.

The scar I first had in March 1996, which starts just below my neck, now pretty much runs to the cleft between my buttocks. This is the surgery I should have had in 2007. I feel a bit of an idiot. It’s the same surgeon for 2011, as 2007… he told me so.

Rebuild four, this one is tough, the local pool is a shit hole I can’t swim there, so I find a tiny but useable pool in Leadenhall street under and office block and start swimming lunchtimes. Eventually, I’m in `not too terrible shape for a forty something’, but I’m stiffer and achier and more often.

Jump forward 2019. I’m repotting a big old Acer, I tweak something very badly. I spend three months crippled. It’s believed but never proven that I have probably just torn some adhesions or scar tissue in my mid-back, and lumbar area. It’s a setback but doesn’t require a rebuild, just a lot of care, a lot of anti-inflammatory medication. The pins and rods in the lumbar region are not damaged or dislodged, but it was a very worrying time. My fitness did suffer, but the local pool in Burnham-on-Sea is run by ex-professional Tri-athletes, they are serious about fitness, and making the Sports and Swim Academy about fitness first not leisure, it’s a perfect environment for recovery. The people there aren’t just staff, they are friends.

Jump forward January 2021, I’ve dodged Covid, I’ve avoided any injuries that may involve any kind of interaction with a hospital. And then one Saturday in January, early morning while going out to fill the bird feeders in our car park I step off a kerb, the left foot hits solid ground and is planted, the right however, is on invisible black ice. My right foot slides backwards as far as my leg can extend in a second.

I’ve tweaked my right lumbar somewhere and maybe my hip. I’m not swimming anyway as we are in Lockdown V.3. and the pool isn’t open. My cardiovascular fitness has been affected by that. Now added to that is the fact that I can’t walk more than three hundred and seventy paces…. yes I counted them. It has been six weeks of `laying-down’ sciatica. ‘Laying-down’ sciatica is the worst kind, because you lay-down to sleep, so for six weeks I’ve been getting maybe two or three hours uninterrupted sleep, while super-strong painkillers lay me out. Then, unfortunately, you spend three to four hours sleeping fitfully, tossing and turning and trying to find a neutral position. It doesn’t last, and give it half an hour and the pain will float you back to consciousness. In this state of pained consciousness, your primary concern (other than the pain), is that in a few short hours you have to go to work, in pain, in poor health, and in a terrible mood.

This is going to be re-build five. I haven’t been this unfit since 2011. A part of me (masochistically) is looking forward to the process. I know I can do it, I know it will be as different this time as the previous four times. I know I’m 53 and nine months old, I know I’m not 21 anymore. Doesn’t matter, I can get back on the horse, I can be fit again, I will walk the Quantocks again. I can’t wait for lockdown to end so I can swim again. In much the same way as I can’t wait for my first vaccine dose.

There are things in life, that you orbit perpetually. Mine is a genetic timebomb that went off when I was around 14 years old. I wish it wasn’t and hadn’t, but wishes are just thoughts even if they are said out loud. The fact is it happened. I’m physically broken, I’ve been broken all my life. But with age comes acceptance, wisdom and patience, and a certain grit that in youth was bravado and without wisdom.

Today 07/2/2021, I manged to walk five time around our cluster of houses, two hundred paces per lap, one thousand paces, this from three hundred and seventy a week ago (in between then and now it’s varied up and down dependent on who knows what). Today feels like day one of re-build five. Watch this space.