Thursday, 3 February 2011

The bit after the credits...or 'My last turbo session nearly killed me'

Just when you thought it was all over, like the bit at the end of a horror movie, after the credits have finished, when the dead evildoer winks at the camera (leaving the way open for Generic Moneyspinner II- how can there only be one when the royalties were that good?)...

the Atomic Hamster blog returns from the dead.

For those who have become used to the feeble punnery, the obscure song references, the taking the piss out of Erwin, this may come as a slight surprise; for the tone is dark and angry, the jokes fewer (stop sighing with relief at the back) and the tenor more serious.

First, a quick recap; when we left it, our heroes (well, OK, Dave and I) were triumphant, having completed the Transalpine Run a mere 30 hours behind the leaders, despite assorted injuries and illnesses; I was relieved to find that the damage to my tib. ant. (or ‘shin’ as it’s colloquially known) wasn’t as serious as I first feared. Jokes such as “‘I’m sorry, sir, we don’t serve time-travellers’ A time-traveller walked into a bar “were still being cracked.

In fact I was more concerned about my calf pain. I mentioned it to the physio, idly voicing my concern that it could be a deep vein thrombosis (or DVT, So Very Tired’s less handsome brother.) She soon reassured me that this wasn’t the case as there was no redness or swelling. As my shin was so much improved, she recommended some gentle mobilisation on the turbo trainer (you can see where this is going, can’t you?)
So the next day, I sat on my bike (odd thing, two wheels, saddle, gathers dust in the corner) and did 10 minutes’ gentle spinning on the turbo. Returned to the house, showered off, sat down and began to notice a sharp pain under my bottom rib, left hand side at the back; ‘you dopey uninteresting-German-bloke-despite-wearing-a-hat,’ I thought, ‘you’ve tweaked an intercostal muscle lifting your bike off its hook on the wall.’ The rest of Thursday passed; I was managing the pain with 800mg ibuprofen every 8 hours, interspersed with paracetamol...but it wasn’t getting any easier.
Friday arrived and I didn’t go to work; by now I was beginning to suspect a kidney infection as they’re supposed to be pretty uncomfortable; pain relief wasn’t helping much.

Saturday came; a visit from Bassy took my mind off the pain a little; by now it had spread across to my right side too.

By Sunday, I could barely move; video footage of me attempting to get into and out of bed would have been a YouTube all-time great; my antics were making Squish laugh, which was making me laugh, which was not entirely comfortable; at one point I had to send her out of the room so I could stop giggling before I passed out.

Sunday, 5am saw me taking half an hour to move from the settee to the kettle. It was about this time that I noticed that my calf pain had disappeared somewhere over the last few days; the penny began to drop. Squish wanted me to go to the hospital but I declined as there was a high risk I’d be seen by an idiot at the weekend.

Squish called the doctor out on Monday morning. I told him the whole story; he was immediately on the phone to the hospital, arranging me an appointment at Medical Assessment for that afternoon; we’d decided that this would be preferable in the long run to rocking up at A+E then spending hours on a trolley. He said that as I had an appointment, I couldn’t have an ambulance. I said I’d be fine to get there as long as I had some industrial-strength painkillers; God bless Dr Smith, the Pershore Medical Practice and the makers of Tramadol, I was able to be driven to the hospital in relative comfort...

Despite my theory that idiots only work weekends, I was confounded when treated by a Grade A specimen. She decided that I’d pulled a muscle. I explained to her that I’d played contact sports for 10 years, then endurance sports for 10 years; during that time, you name it, I’d pulled it, bruised it, snapped it, chipped it, sprained it, broken it, torn it, ruptured it, fractured it or dislocated it and no musculo-skeletal injury had ever not responded in some beneficial way to three days of anti-inflammatories and painkillers. She said that my oxygen saturation was OK at 95% and my heart rate was fine at 85; I explained that I had just been running a multi-day stage race through the Alps and so might expect a number nearer 99%; I explained that my normal resting heart rate was in the mid 40s; I explained that 85 for someone who’s normally at 45 is like a rate of 130 for someone normally at 70. At this point we’d have been having a stand-up row, if I’d been able to stand up. Squish asked her repeatedly if it could be a pulmonary embolism; the doc said that it couldn’t. She told me that my symptoms didn’t match anything in the text book. Hmm, pain on breathing in, raised heart rate, preceding calf pain after trauma to lower leg, plus dehydration and repeated exposure to altitude; that wouldn’t be classic, then? I told her I could always go away and come back with some different ones. She then decided I’d trapped a nerve. As well as getting a private scan arranged to locate my trapped nerve, we finally prevailed upon her to investigate the remote possibility that this could be a PE; she ran a blood test.

She was all set to send me home with more anti-inflammatories, but I said I’d wait for the blood test results; the bed was comfortable and the cubicle warm.

If they ever have to test your d-dimers (go google!) they’re supposed to be no more than 500; mine were 2286. Jaws hit floors, cork legs were dropped, an anti-coagulant clexane injection was quickly jabbed in my gut. They wanted to keep me in for observation; oddly, I declined. An appointment was arranged for the following afternoon for a second clexane jab.

I was getting worse not better by the next day, so we went back to the hospital a couple of hours early; I must have looked a tad poorly, because when I gave my name at the desk, I was swiftly found a chair, followed rapidly by a bed. A scan for a possible pulmonary embolism was arranged for the next day, Wednesday.

At this point, a random passing consultant with a portable ultrasound machine (deus ex machina? Deus cum machina? It can happen) had an internal peek at my lungs and decided that there was a small amount of fluid present. I asked him how much; he said around 100ml. Now that may be a small amount by lung standards, but I regularly see the amount of pressure that 2.2ml of local anaesthetic can cause, so I wasn’t surprised it was hurting a bit.

Cue long needle between the ribs to aspirate some of said fluid. Inevitably, he missed the first time, so had to have another go...

It looked like I was getting admitted, so a House Officer was then instructed to take a spot of arterial blood for blood gas analysis; she missed and hit a vein. She also popped in a butterfly canula at the third attempt. All this while sniffing and snotting with the world’s most spectacular cold; just what you want when you’ve got a lung infection.

Just like the shopkeeper in Mr Benn, another consultant appeared; he decided that a scan for pulmonary embolism was unnecessary as it was vanishingly rare for someone to have pleurisy and pulmonary embolism at the same time (you can see where this is going too, eh possums?) He said my heart rate and oxygen sats were fine; I explained again that they weren’t at all fine for me; this was to become a theme of the next few days.

In all the excitement, just like Dirty Harry, they couldn’t remember whether they’d given me one clexane injection or two; I wasn’t feeling lucky, so we forcibly reminded them that I was due another jab.

I ended up in a nice single room; they took my thyroxine off me and wouldn’t let me have it back until it had been prescribed by one of their doctors. They were beginning to be even less interesting than Erwin...

The next day another consultant rocked up, with a band of medical students in tow; I think he was Italian; he certainly has a piss-poor command of English; he asked some questions about my problem; I explained that it was now worse on the right than on the left; I asked about my scan for PE; he looked puzzled; he left, mumbling about my left-sided problem. It’s a good job he didn’t have to do anything to me...

On Wednesday afternoon, a porter turned up to take me for my scan; they couldn’t work out why I hadn’t attended earlier. I explained I was stuck in a bed, attached to a couple of drips; they had thought I was an out-patient. At least no one had cancelled it.

Ooh, nice scan, I’d been warned that the contrast medium would make me go all warm and want to wee; instead it was just like an IV of a nice single malt; lovely!
Jaws once again hit floors; turns out I had ‘several’ PEs, neatly distributed in the lower lobe of each lung.

Another day of IV antibiotics, anticoagulants in the abdomen and lots of pain relief; at one stage the canula pinged out; the nurse was now injecting IV antibiotics sub-cutaneously.
‘Ow!’ I said, ‘that’s not going in properly’
‘It’s just a bit cold,’ she replied.
‘No’ I said, ‘I think you’ll find that it’s extra-vasating’...sometimes, a little knowledge is handy. She stopped, looked, stuck the canula in a vein in the other hand, then completed the job properly.

By this time, they were giving me only co-codamol for pain relief and it wasn’t enough. Squish appeared for a visit and asked why I was in so much pain; she was promised that I’d get immediate pain relief. We waited...and waited. She asked again. We waited...

Eventually, well over an hour later, the immediate pain relief arrived. Now I know that sometimes nursing staff are busy, but I don’t class sitting round the nurses’ station gossiping to be ‘busy’; my room was adjacent to said nurses’ station and we could hear every word...

By Thursday, I told them I was discharging myself. A doc dropped in to ask why. I told him the full story; he apologised for the ‘Monday Incident’ but explained that as I’d gone home on Monday night, that was a different episode of care to the current one. He said that I’d not asked for pain relief; I said that how was I supposed to know that I had to ask if they didn’t tell me this. He said I should cut down on the tramadol as it can cause constipation; yeah, buster, so can the co-codamol; don’t come the Mister British National Formulary act with me...and do you know that tramadol can potentiate anti-coagulants? Thought not! Sometimes it’s tough being a stoic...

He said that it would be sense to stay as I’d been put on new drugs and they needed to monitor me; like a fool, I agreed. ‘Monitoring me’ consisted of one person sticking their head round the door the next morning to check my INR; otherwise, I saw no one.

I escaped on the Friday evening, armed with a supply of warfarin and a set of clexane injections for DIY stomach-stabbing. I barely escaped with my life.

I’d like to thank all my most fabulous friends for the kindness shown to Squish and me during the events above and the weeks that followed: it’s invidious to single out so few when kindness was shown by so many, but I will anyway:

Mrs Funkin, Debbo and Mr Gizzard Puke for their invaluable medical advice
Wotsit and Wickett for the dinner, the offers of help and transport
Bassy for the company on ‘that’ Saturday morning
and all you other lovely possums for the cards, the emails, the phone calls, the faceboookings. Yes, Mousers, the GOMs and knackeredknees, this includes you!

And of course, my darling Squish, for one more time delivering above and beyond the call of duty; not least on the night her husband, mother and father were each in a different Worcestershire hospital...

My lungs are now scarred for an ill-defined period of time; it’s going to be a long hard road back. I leave you with a thought from those great philosophers, Chumbawumba:

I get knocked down, but I get up again.

The Other Atomic Hamster


  1. It'll take more than a few life-threatening clots to stop you getting back up, Sir Crashie of Hamsterling :) I am just very glad (OK, that's an understatement!) that you are here to tell the tale. Much love to you and the Squishy one xx

  2. This was all going on when my net access was limited - I had no idea how poorly you were and am most ashamed at my seeming lack of support!! Thank goodness you are on the mend and have some medical knowledge with which to stand your ground!!