Ahem-hem: 'Convert from back-slab to brace at 2 weeks. Brace set at 0-30 degrees for 2 weeks.'
Oh, thank god. This back-slab was REALLY starting to hurt me. All the padding underneath had slipped down, and it was now just bare POP rubbing against my skin, and more importantly, against my frickin' surgical clips, OUCH! Add to that the fact that it now smelt a lot like how I imagine a dead badger left out in the sun for a week would smell. I could not wait to be rid of the damn thing!
I woke up on Thursday morning feeling like a child on Christmas day. My fracture clinic appointment wasn't until 16:10, so I had to spend the day amusing myself whilst I mentally bounced off the walls in excitement. When the time came to go to my appointment I nearly rocked up with my own pair of scissors!
I was waiting outside clinic and was met by Kirsten, one of the lovely people I know from my time in the T&O department. Kirsten is awesome, like a cross between a big sister, a mate and a partner in crime. It was so good to see her and the other lovely people in fracture clinic. I do feel lucky to be under the care of a department where I used to work, and in a hospital where I know so many people. while I sat waiting I must have got 'Hello, what on earth are you doing here?' from about 6 different members of staff, from consultants to porters. It really is like a big (slightly dysfunctional) family!
So, into fracture clinic. I can't describe the moment of ecstasy when they took the backslab off! I can only imagine what it is like for people who have to be in cast for 6 weeks!! The surgical clips came out. (a quick note, I'd been warned about this by loads of people...'oh, it really hurts, really stings when the clips come out'. It really doesn't! Out of around 20 clips, maybe 2 of them stung a bit. So, if you ever have to have surgical clips out, don't sweat it. You may well find it completely painless!)
The wound was looking good, and the 2 ortho SpRs who were running clinic (one of whom I know as a runner and one of the nicest surgeons you could hope to meet!) were happy with the wound and so happy for me to be fitted up with the Donjoy brace.
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| Donjoy brace with hinge set from 0-30 degrees of flexion |
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| "Sad wounded pixie" face. Used in an attempt to look pathetic so people do stuff for me/give me free stuff. |
Brace time. The clinic physiotherapist fitted me with the brace. As it went on, all I could think was 'oh my god, I look like a Borg, this is COOL! Mis-spent youth). She then told me that my quad strength was non-existent.
I'm sorry, what? I think anyone who knows me would know why this would ruffle my feathers slightly. I told her that I was a long distance and mountain runner, and my quads were my best feature. Her answer was that, as soon as the patella fracture occurred the quads would have lost strength, and now 2 weeks down the line, they would need building up from scratch. Fair enough. I asked how, and she described the static quads exercises that I had already been doing. I told her that I was already doing those. Her answer was 'fine, then carry on'. I said that I was a competitive runner and that I was keen to keep my overall strength as much as possible during the rehab period. She just shrugged and told me to do the exercises. I asked how often, she shrugged again and said 'until it hurts'. I asked if there was anything else I could do to maintain base fitness while I was TWB only. She said no. I asked when I would be able to start swimming. She said not for another month and even then I probably wouldn't be able to swim, it would just be aqua-jogging.
Basically, this girl really pissed on my enthusiasm.
I left fracture clinic feeling like the whole thing was a massive anti-climax. I spent the evening in a really bad mood, and the brace was hurting like hell. I have 30 degree flexion now, but suddenly it seems like an age until I will be trying to ease back to normal function. I know that it is early days, and I know that I have progressed so much even in the short time since the accident. But in the space of 24 hours my mood has dipped from positive and enthusiastic to so negative that I could barely be bothered to get out of bed the following day.
Reflecting on all of this, I know I set myself up for a fall. I was so excited and fixated on the cast coming off I didn't think about the other side. But the whole experience was made so much worse by the negativity and thoughtlessness of one member of staff. All I can do is take it as another lesson for myself for my own practice. Negativity is sometimes a necessary thing in communication with patients but it HAS to be tempered with a balance of positivity and empathy, or you do more damage than good.
Victories:
Cast coming off and my body having dealt nicely with the surgical wound.
Reflecting on the situation and working out how I can put the lesson into my own practice.
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