Taking stock – living with injury

The pain was excruciating. I collapsed to the ground as the soccer game came to an abrupt and confused halt around me. An ambulance was called. Unable to bear my own weight I was lifted onto a stretcher and rolled into the vehicle. Due to bad advice, a lack of information and a deficient public health care system my recovery was slow. As a result, within a few months I found myself on a surgeon’s table. At fifteen I had my first knee operation. The surgeon decided to perform a lateral release while he was poking around in there. A lateral release is now considered by many surgeons as an outdated and barbaric form of torture.

Hindsight and experience have made me extremely bitter about my first knee operation. A scared and confused young kid just needed good advice and physiotherapy to fully recover. The operation was completely unnecessary.

The pass was fast and accurate. I snatched the ball from the air, landed, pivoted and prepared to shoot. An explosion of pain radiated out from my left knee. My opposing team member had failed to stop in time. The angle of impact was such that his weight forced my knee to dislocate. As I stumbled in pain to the side of the court I promised my team that everything would be ok and I’d be back on in a few minutes. A few minutes later it was clear that I was full of shit.

That evening, while massaging my sore and swollen knee I felt solid floating pieces flicking out and moving around under the pressure of my fingers. I had shattered something in my knee. The follow day I had a snowboarding trip booked with my housemate. Fully aware that I’d already need a knee operation I decided against all common sense to still go. My good friend had an articulated metal knee brace that I borrowed. An oft-prescribed medical treatment for new injuries is R-I-C-E (Rest, Ice, Compression, Elevation). I figured I had these four elements pretty much covered. I rested my leg on the 3hrs drive there and back as well as on the chair lifts. I was surrounded by ice – like all day! I had a heavy duty knee brace that offered good compression. And the elevation was a bit of a no brainer, being up a mountain and all. A lot of painkillers helped as well. I survived the day intact.

My operation was booked with a Canberra surgeon. We had set the date two weeks before I was to go on a trip through South East Asia. My surgeon assured me how simple the operation would be and that I’d be fine for my holiday. I would be walking unassisted out of the hospital… Not quite… I woke up in a full leg brace. When the surgeon eventually visited me he stood as far from my bed as he could. There had been a complication. While day dreaming about his golf game later in the day (I am not kidding about the golf game) he slipped and cut something that was not meant to be cut. My meniscus then needed to be sown back up. After the surgeon had dropped his bombshell and hurriedly left (his caddy in toe) I broke down, crying uncontrollably. The following morning, the nurse leaving me naked and helpless in the hospital bathroom is, well, is an embarrassing story for another time.

Five weeks in a full leg brace with no weight loading on my leg and over a year in rehab to build my leg muscle back up was the result of my surgeons simple slip. Suffice to say I never made my holiday, a holiday I had paid for in full. No refund was given, although after I expressed my anger very vocally at my surgeon he was kind enough to lower his fee.

Two years later my right knee finally got sick of having to do all the heavy lifting and gave in. This time I did a lot of research on surgeons and found a fantastic one in Sydney. I treated it like a project to manage. I took emotion out of the equation. The surgeon was impressed by the damage I had done. I had shattered the underneath of my kneecap. He removed over twenty floating pieces. I limped out of the hospital. I was driving my car the next day. I was back at work within a week. And, in the recovery process I completely forgot how to run.

Because the damage was under my knee cap and a lot of the cartilage shock absorber had been removed this meant that running was very painful. My brain’s natural protection mode was to disengage my quad muscle to prevent the pain, resulting in my leg buckling everytime I tried to run. Eventually I went to see a physio who trained me how to run again. Running is something that most people take for granted. The concept of having to re-teach my body to run again was a very strange experience.

Two years later I hurt my right knee again. This time from standing up from a chair. A frayed piece of cartilage was sheared off. This piece would get stuck in the joint when I walked, causing horrible sharp pain. After my last knee operation my surgeon had warned me that I may need a clean up operation in a few years due to the extensive damage I had done. I was in London at the time and quickly discovered how deficient the English health care system could be. It would be at least four to six months to get an appointment with a surgeon and at least six months after that for surgery. I had an upcoming trip home to Australia for a wedding. I rang my previous surgeon in Sydney and booked in my operation during the week I was visiting the east coast. Upon arriving in Australia I visited a GP to get the necessary referral for an operation I had already organised.

These are images from my right knee arthroscopy in 2010. The soft fibrous parts in these photos are signs of degenerative damage. These areas are meant to be smooth. Unfortunately this is not repairable.

My recovery from this operation was strange. Each day I was waking up in more pain. My calf muscle was in agony and seemed to be getting worse. Walking was getting harder. I contacted my surgeon and he demanded that I immediately have scans to check for a blood clot. What I was describing was an emergency situation. If it was a blood clot it could easily travel to my brain.

A lot of money and stress later it turned out that my calf muscle had been torn in surgery. This was supposedly not an uncommon occurrence. Although how this happened I am sure has more to do with the doctor and nurses bending my legs over my head and taking photos of me in compromising positions while I was unconscious…

Within a week I was on a plane to China. Injections of Clexane (a blood thinner) and wearing sexy circulation socks were required to ensure that I didn’t actually develop a clot during the flight. I wasn’t allowed to sleep either. It was a terrible journey. When I arrived in Hong Kong my lower calf and foot were swollen and bruised black. Keeping calm took all my mental capacity.

A week into my China trip I visited a famous Chinese doctor who sucked the bad blood out of my leg. This was an excruciating experience in which she hammered hundreds of holes into the bruised area and then used bamboo cups to suck the blood out. I cried a little bit. I’m still doubtful that this was beneficial at all.

Over the next few days the simple joy of hiring a bicycle and riding around Yangshou, then later climbing to the top of Emei mountain and walking one of the harder stretches of the great wall of China within weeks of my operation was liberating. Probably also slightly stupid… Conversely the most humiliating and horrible experiences in China revolved around squat toilets. Never for an instant did this factor into my planning, but it became one of the biggest challenges of my trip as I was unable to squat at all. Overnight trains were the worst due to the movement and lack of cleanliness. In some instances sitting directly on top of the crude hole was my only option. Thank god for hand sanitizer.

Since my last operation in 2010 I have regular scares with my knees and sometime have severe pain that can last weeks. I’m highly restricted in what I can do and always have problems with my right knee. The energetic dance moves of my early twenties are a distant memory and quietly I am resigned to the fact that eventually I will damage one of my knees enough again that I’ll require another operation. It’s a depressing mental state, but a reality that I live with. A goal of 2011 was to be able to run again. I missed my target by two months but I am now able to jog short distances. I also still snowboard as often as I can.

Fast forward to March 2012 and I find myself struggling with a completely different but equally debilitating injury. After moving back to Australia in mid 2011 I quickly found myself fulltime employed and working 50-60 hr weeks in a stressful environment. A combination of severely bad ergonomics, long hours, static position and poor posture culminated in an injury I am struggling to deal with. Each time I have damaged my knee its been a clear case of having an operation followed by physio, exercise and a easily trackable graph of recovery.

It started with my wrists becoming very painful while working. Over the years I’ve had wrist problems from repetitive strain injuries but never both at the same time and never both acting up so badly. I’ve also managed my wrist pain pretty well over the years. But then the pain moved into a localised area in my left forearm muscle. Initially I ignored this and continued working through it. In my weekends it would get better and I’d be fine for work again the following week. My wrists started to settle down but my forearm muscle pain got worse. Then it hit a threshold and my left arm became virtually unusable. This was accompanied by strange nerve sensations down my left arm. By this stage I was seeing a doctor, a specialist, a physio and a chiro. It became a work cover issue within a month of onset. By the end of December I was getting shooting electric shocks down both arms and was struggling to work. I was still on probation at my new job and was highly stressed about this fact. Soon I was reduced to only 5hrs a day of work. Even this proved difficult.

As time progressed I was getting more and more muscle problems with my right forearm as well, although the nerve sensations were mostly limited to my left arm. This injury affected every aspect of my life. Simple daily tasks became harder. Shopping baskets hurt to carry so I used trolleys and carried home everything in a backpack. Using my laptop at home became painful. Doing a lot of other normal activities now seemed like too much hard work or would aggravate the problem. Drinking more alcohol and sitting on the couch watching TV became default. I was more withdrawn and less social. I found acknowledging the injury at work hard, especially as I was still on probation. I needed my job but through my job I had sustained this injury and by continuing at my job I was ensuring that it would take longer to heal.

Now five months into having a damaged nerve it’s clear that getting better is a long way off. Consistently I am having more ‘better’ days, but for every good day I still have a lot of bad ones. In the past few months I have spent more time seeing and being treated by specialists and professional in relevant fields than at any other time in my life. The worst part has been the mental strain and depression. I am rethinking my entire career. I’m trying to comprehend how at 31 I am meant to spend the next 30 to 40 years of my life working in this industry if I am having these problems at such a young age. The growing realisation that I sustained this injury while doing something I no longer feel any connection with, nor have passion or love for is sobering – and it’s been hard to sober me up lately. I am now stuck in a position where leaving my current job would be pure stupidity as I am being supported very well by my work and also by the government’s work injury scheme. Yet at the same time it is only when I am working in that environment that my symptoms and pain significantly flare up. And it is only when I am away from that environment and work that my symptoms dissipate. Each and every doctor, specialist and treating physician I have seen have all quietly informed me on the side that at the least I should be entertaining the possibility of a new job if not an entire career change. What has been startling about this is that it hasn’t been just an isolated medical professional advising me this, but every single damn one of them.

My list of alignments and injuries seems to grow exponentially. In 2009 I was involved in a car crash where a car went straight through a red light and collected me. I was rushed to hospital, my own car was written off. The point of impact on my body was my hip. The phone in my pocket was crushed between my hipbone and my car door. My groin and hip area still get sore every once in a while and I’m now a prime candidate for early onset osteoporosis in that area. The list continues, but seems pointless to reiterate all of them here. I have a good friend who goes to the doctor once every few years, he continually struggles with his weight, but apart from that is basically never sick or injured. He is baffled by my fragility while I am equally baffled by his seeming imperviousness. At least I can eat cheesecake to my hearts content!

I was kept in hospital for a few hours after the car accident. They did every scan possible while I was there. The female driver of the other car was in a hospital bed beside me, appologising profusely. That is until her chest started swelling uncontrollably, she started moaning in agony and suddenly all the curtains were drawn, nurses and doctors ran to her aid and then she was rushed to an emergency surgery theatre...

The worst aspect of all this is that I have become resigned to injury. Resigned to the regularity of seeing doctors and specialist and resigned to a constant cycle of injury, treatment and rehabilitation. The perverse flip side to this is my need to then push my limits, to prove to myself that an injury does not define me or restrict me. This recent period has been harder than previous ones to look at the positives and work towards them. It’s been harder not to succumb to the destructive and darker thoughts that ravage your motivation, stunt personal growth and damage your sense of self worth. Things have not been going to plan since returning to Australia. I have some tough choices ahead.