Part 3: THE SECOND HOSPITAL ADMISSION
I had been prescribed Targinact, a Schedule 6 pain medication that recommended I could take one 20mg tablet every 12 hours. That was the only medication I’d been prescribed by the neurosurgeon that I’d been assigned at the Mulbarton Hospital.
An hour or so before I’d been discharged, a hospital physiotherapist had spent 15 minutes with me, showing me how best to get in and out of bed so that my spine didn’t bend or twist.
She also gave me some leg muscle exercises to do “because you need to keep the blood moving as there is a danger of clotting if you are prone or inactive for long periods”.
In my bed at home, I felt okay lying down, but moving slightly or getting up to go to the toilet or just for a short walk to get my blood moving, was agonsing. The pain medication seemed to dull the pain by about 50% for around seven hours but I was in great discomfort and pain for the next five hours until I could have another tablet.
I’d returned home on Sunday 16 September the day after my fall. On Monday afternoon I called the number on the neurosurgeon’s business card.
I managed to get hold of his assistant and I asked if I could speak to him.
“He’s in Europe now. You can’t speak to him but I can email him your query,” she said.
“Really? But I need to speak to him. I am not coping on this medication. Is there a different medication I can take between doses of this one to help me?”
“Ooh, no! You are on a very strong pain medication. You can’t take anything else,” she cautioned.
“Well it’s not working and I can’t wait so long between doses. I’m really struggling.”
“I suggest you take half a tablet every six hours then,” she said. “See if that makes a difference.”
I wasn’t filled with confidence after that phone call.
Joanne had been out all day and when she got home, she was very concerned.
“I think we need to get you to Olivedale Hospital. You aren’t coping.”
I said let’s wait and see how I felt the next day.
That night, Joanne and I had a FaceTime chat with our oldest son, Kalon who is in Vienna, Austria. I got frustrated because I was struggling to speak again. Struggling to speak normally without being out of breath.
Late that night, I inadvertently woke Joanne and Cade, our 12-year-old son in his bedroom a few metres away, when just trying to walk to our en-suite bathroom. I couldn’t move without making guttural, rasping noises, which seemed to stem from a combination of the severe pain I was experiencing right across the middle of my whole back and being unable to inhale and exhale because the pain was restricting my ability to breathe normally.
I struggled to sleep and the recommended half doses of the pain medication didn’t seem to work. It actually seemed less effective.
On Tuesday morning, three days after my fall, I felt worse. I took a full tablet after struggling to eat some breakfast and asked Joanne to take me to the ER at Olivedale Clinic, a hospital we had heard good reviews about and which is part of the Netcare group to which the Mulbarton hospital (the first one I’d been ambulanced to) also belonged. They should be able to share my injury info easily, we thought.
Arriving at Olivedale Clinic ER clearly in a very weak state and having difficulty breathing, I was quickly examined by a doctor.
She said she recognised my name.
“Are you a mountain biker?” I rasped.
“Yes, I am,” she replied as she set about thoroughly examining me. I realised later that this was the first time I’d been properly examined since my fall. The first ER doctor was obviously limited by my having to not move due to my obvious spinal injury. And the neurosurgeon probably only needs to look at the CT scan.
“The pain across my back feels muscular, I told her. It’s not limited to the areas around the two fractured vertebrae.
“It’s as if all back my muscles are in spasm,” I said.
“They seem to be in spasm,” she confirmed. But she was more concerned about my difficulty breathing and ordered an X-ray of my chest right there in the ER.
“You aren’t in a good way. I am admitting you to the High Care Ward and assigning you a lung specialist and a neurosurgeon.”
Shew. I felt a sense of relief. Both emotional and physical. The former because I was really worried that instead of progressing after leaving the first hospital, I was regressing. The latter because this doctor got me onto intravenous pain medication immediately.
My first few hours in the High Care Ward included a couple of trips to the X-ray section. The first for a CT Scan of my lungs, where they injected me with a metallic substance to be able to see where exactly there were problems. The second for a MRI 3D scan of my spine.
The first visit wasn’t too bad. The second one was rather difficult. I spent 40 minutes in that MRI capsule as the photographic equipment captured 3D imagery of my two fractured vertebrae. I wasn’t sure why this was necessary since I’d already had a CT Scan of my spine at the first hospital.
I’m definitely partially claustrophobic and had to really speak to myself a lot during those 40 minutes in that confined space with the instruction from the lady that I needed to be very still.
“You will have music on these headphones and you will get hot. If you need to come out, squeeze this little balloon,” she said, placing a soft rubbery thing in my hand before sending me into the capsule.
But she didn’t tell me how long I’d be in there for. A local radio station was playing on the headphones and I tried to focus on that while in there. Unfortunately I have a huge dislike for modern radio deejays who seem to think the listeners want to know their opinions on everything and this one did more talking than playing music...
After being rather cold when I went in, it did become hot as I’d been warned and, for about the last 20 minutes, sweat was leaking from everywhere.
I had to lie very still and a dim light shows the top of the capsule - about 15-20cm from your face.
I had to really work hard to get my mind away from thoughts of how awful it must be to be buried alive... Definitely some of the most challenging 40 minutes of my life. I was so relieved when I was finally slid out.
That night, a Specialist Physician, who specialises in lungs, arrived at the end of my bed and told me he was going to be my lung repairman.
“Let’s see how you go tonight. We may have to move you into ICU,” he said.
Shew. Was I that ill?
“Because you haven’t been able to breathe properly, you have developed pneumonia in both lungs. Your lungs are very important. We must get them mended,” he said.
I had a fairly good night, no doubt helped by the cocktail of strong pain medications. I was also put onto an intravenous antibiotic to combat the infection in my lungs.
The next morning a neurosurgeon appeared at the end of my bed.
“You have a 40% compression fracture of T6 and 25% of T9. Both stable. You should make a full recovery. We will get you a soft brace ASAP for support,” he said.
“Okay, is it possible that my difficulty breathing, which led to me developing pneumonia, is because my back muscles are in spasm? I have severe, ongoing pain right across my back,” I enquired.
“It is possible. I will prescribe a muscle relaxant to deal with that,” he said.
My severe back muscle pain and tightness subsided once I started taking the muscle relaxant medication and I finally began to feel I could breathe without restriction...
Could the incredible discomfort and severe pain over the past four days have been avoided if I’d been given a muscle relaxant on the day of my fall?
Could I have avoided developing pneumonia if I’d taken a muscle relaxant on Day 1? Or even Day 2? Surely it couldn’t be that simple?
Part 4: INJURY, ILLNESS AND INSULT (to come)