So much has happened in the last few weeks it’s hard to know where I left it all in the last blog so I had to look back and read it through – well, all I can say is a bucket-load of things have happened since then!
The appointment that next day did happen, for me it was all about getting that bloody hardware out and getting on with my life. Suzy came with me for emotional support mostly, and the case manager also was in attendance albeit late. The initial conversation went well and the doctor definitely seemed to know what was going on, he had a lot more information and images from the first CT Scans and X-Rays – more than I had ever got my hands on. He was quite laid back about the procedure requested and he & the case manager discussed procedure codes and costings whilst myself & Suzy were simply waiting for the important part – The Date!
He explained what he would do – hardware removal via the original incision and then a keyhole procedure to tidy up the knee joint. “Great” I said “That seems simple enough – let’s get on with it, can you fit me in soon?”. He said he could and it looks like February….
“Wait, what?”
“Yeah February I think, the NHS waiting lists are increasing so it’s pushing out the private operations”.
“But you said soon?”
“That IS soon”.
Suzy was in tears, knowing what this meant to me and how it would affect me mentally. She’d seen me fall apart recently and didn’t want me to fall deeper into depression with this news. We had planned on going away into the New Year and this uncertainty just put things off even longer.
The fact he could do the Operation was my only salvation and I clung onto that fact for dear life in an attempt to be strong for myself and Suzy who had started to absorb the reality of it all. We left the hospital deflated but also positive that there was some kind of light at the end of the tunnel. If I’m being honest I’ve become a bit numb to it all now, the constant ups and downs fail to affect me as much as they did in the first few months – it’s a resilience that I’ve built up from my recent experiences. I’m not being heartless – I’m just learning to deal with it in a different way. The “denial” route has definitely passed!
Sure enough, within a day or two the private health company contacted me and told me the next available date was March 4th. Pretty much what I had expected. With this I instructed the case manager to start looking elsewhere as surely there must be someone else in this line of work available to take me on and get this “simple” procedure over & done with?
Within six weeks I heard of a consultant in Cambridge who might be able to operate in the first week on 2022 so, I jumped at the chance of having a 2nd opinion and an earlier surgery date. Suzy offered to come along but the COVID restrictions of this hospital meant she would sit in the car park whilst I was being seen – in the long run it would be 5+ hours of her sitting in the car for nothing so I decided to go alone.
I got there and all seemed straightforward, I sat in the waiting room contemplating how quickly he could operate and indulged myself in a full recovery by April so that I could (perhaps) have an “ok” season either riding a bike or maybe a couple of Aquabike races to get me used to that “race buzz” again. He invited me in and we began to discuss what happened in the incident. He explained in-full about arthritis being part of my knee since the day of the incident and the only hope I had of slowing it down was by being active and living a healthy lifestyle. He spent what felt hours looking at the X-Rays and then told me straight he wasn’t prepared to operate on me because he wasn’t entirely happy with the images he had. He explained 2-dimensional pictures only show a certain picture of what could be going on inside my knee and that a 3-D picture – a 3d CT Scan would be a more thorough way to go before surgery. With this suggestion I agreed but thought that there’d be no way he’d give me that early-january operation slot if there’s going to be more diagnostics first. I left with no real idea on what would happen next so drove home only to get indoors and then absorb what had just happened – the 2nd opinion didn’t agree with the 1st – it wasn’t that simple at all.
Literally the next day the imagery department call me from the Cambridge hospital and asked me to come in the next day (Christmas Eve morning). I naturally said “yes” and had the CT Scan done. My case manager hadn’t sought approval, if I’m being honest I didn’t care, I just wanted it done so was prepared to pay the fee. As it was the insurers had left for Christmas and weren’t back until early January and there’d be no way I was going to wait!
In the afternoon of the scan I was called by the hospital again and they had organised a follow-up consultation with the doctor for the 4th January – I bit their arm off still hoping for that surgery to put 2022 as a distinct possibility.
That consultation came and the doctor showed me the CT slides – not good news. The fracture, although showing it had completely healed in the X-Ray was not completely healed in the CT Scan. This meant that the hardware could not be removed because there would be a very small risk that the fracture would open up again. The doctor suggested a few months’ wait and then another scan to see if it has healed. He then showed me several slides of the knee joint itself – the hardware, being metallic plays havoc with the scanner so the picture was a little distorted. Nonetheless, you could see a lot of gaps where the articular surface should be, in short my femur was sitting on jagged rock – no wonder I was in pain whenever I stood on that leg!
The suggestion was that the consultant would talk to his fellow consultants at Addenbrookes Hospital in Cambridge – widely known as pretty much the best orthopaedic trauma unit in the country and he would come up with a “plan”. This plan no doubt would involve at least two more operations – one to remove the hardware (at least they all agreed with that part) and another to deal with the non-existent surface of my tibial plateau. So, back home I went with even more “bad news” but perhaps in a weird, twisted way our travelling plans wouldn’t be affected by an operation or recovery period so maybe it was “good news”???
True to his word I received a phone call from the consultant yesterday and a fourth consultation with another doctor has been arranged for next week to see what he can do as he believes he can help my and my “funky physiology” (his words, not mine).
Ironically I received an email from the first doctor to say there had been a cancellation and he could operate on me earlier!! I think it’s safe to say, with all the information I have now, that boat has well & truly sailed as I’m more inclined to go with the thorough diagnostics.
So that’s where we are.
Back to the training aspect, the hum-drum of daily/weekly training has kept me occupied. The weekly totals are close to when I was training for triathlons but there’s a different angle to the training now. It’s all about stability, low-intensity gym work. Very low intensity cycling due to the pain in my leg when I press hard on the pedals (I’ve learnt the wrong-way) and Swimming. In fairness the swimming hasn’t been affected at all and recent CSS tests have shown a vast improvement in my swim speed – something I would’ve never even considered 6-months ago.
I see my Personal Trainer once a week to work on the problem areas, she’s still working me where it’s needed and although there’s that mutual frustration that we cannot progress as quick as we’d like we’re just getting on with it as best we can. It’s quite clear that if & when my knee issue has been resolved we’re going to hit it hard and get me back to how I was quicker than ever…and better.
I’m not seeing my physio as much due to the lack of progression – but we’re touching base every now & then to make sure there’s no regression and to make note of the strength & range of motion increases.
Then there’s my triathlon coach who’s been immensely supportive, I can only assume there’s a sense of frustration on his part because the 2022 season is looming and I’ve go no targets at all at the moment because of the uncertainty. We talk to each other weekly and we’re at least on the same page with my intentions and he’s always advising me of what I can do, as opposed to my negative mentality thinking about what I can’t do.
A new introduction to my “team” is a psychiatrist who’s been really helpful in Acceptance & Cognitive Therapies. There’s always that resistance when told you might need their help but I entered into things with a very open mind and it’s been liberating. There’s an understanding of how I used to think, how I should approach things and how I can deal with it and process emotions that have been bottled up since the injury. It’s no surprise I’ve been affected not only by the injury and my restrictions but by the circle of friends what have rallied round in my “moment of need” or more importantly those who haven’t. The bereavement involved in the loss of “Nick the Triathlete/Cyclist” that fateful day has been hard to process. Equally so, the frustration & disappointment in others’ actions (or inaction) has paid a heavy toll. It has been explained to me that this has affected me so much that I’ve rarely wanted to go out of the front door for fear of bumping into those individuals I held with such respect. My therapy has shown me that this is a normal reaction to this upset and we’re currently talking through situations and what could help.
One situation was facing the cycling community after being housebound for so many months, something which I tried to address last week. I took part in an organised ride by the local bike club – a 50 mile “Reliability Ride” which requires riders to pace themselves round in 4. 3.5 or 3 hours. My indoor sessions could put me in the 3hr group but my experiences of past rides at this event meant that those groups clock-up around 23-24mph average speeds, far faster than 3hrs and my knee wouldn’t take that.
Instead I rode with the 3.5hr group and made friends pretty quickly with some new riders. A few riders noticed me as part of their group (I was riding in plain colours) and it was very refreshing and rewarding to be noticed and to be told it was amazing that I was on the road considering what I’d been through in the last few months. Conversely, during the ride I heard a few comments from some riders who in reality had nothing good to say about my absence over the 2021 racing season. They were quite clear about what they’d heard in the local groups and from certain riders, or what they thought about my injury and revelled in telling me their opinion. It was only when back at the event finish did it start to sink in what had been said. In an attempt to avoid any eye-contact or conversation with these people I simply just rode off without saying “goodbye”.
Looking back in my cycling history there was a time where I’d react immediately and call them out right there & then but I didn’t have to prove anything to anyone at that event. My “takeaway” from that ride was helping a few new riders get round the ride. The other negative bit – well, the therapy explained that part pretty quickly – “not my problem”.
I think that’s it for now – there’s probably a lot more to the past month but there’s enough in there for this month’s journey. I have no doubt there’ll be more ups & downs in the next month too. We’ll see…