March 2011: CT Scan & Results

After waiting for three long months, taking it very easy, wearing the velcro corset every day, not lifting anything, doing everything slowly and carefully,  being told not to work at the regular visits to the orthopaedic doctor, by early March it was time for the CT scan to check how the bone was healing.

The scan itself only took a few minutes – waiting for the prints to be ready seemed to take longer!

The technology is incredible, the pictures from the scan were amazing! It looked like you could touch the pieces that they had installed.

Although there had been X-Rays in the hospital, I didn’t realise the size or exact shape of the metals pins or screws until I saw the prints from the CT Scan.

For example, on this view of the torso from the left, you can make out the vertebra of the spine and see very clearly where the pins and screws are - you get an idea of the size of the pieces of metal by comparing with the scale on the left hand side of the scan – the pins are almost 10 cms long!

This view from above shows the size of the screws that go into the vertebra above and below the broken one

These views show close ups of the metal bits from different angles (left, front, right, rear):

The doctors said they were very happy with the images when they saw them, and that everything was healing well.

Now it's wearing the corset less during the day, gradually reducing the time  over the next few weeks so that by mid April I shouldn't have to wear it at all.

Have started physiotherapy a couple of times a week to build up the back muscles and am already back to work full time.

There will be regular visits to the orthopaedic doctor and an X-Ray in three months or so to check things still look ok .

I plan to post more updates with progress; in the meantime, if would be good to hear from you if you have any comments or questions.

14-21 December 2010: Back on Station Seven

Arrived from Intensive Care back in the same room on Station Seven mid afternoon – the sun was shining and I was very happy to have escaped from the intensive care ward.

My wife and mother were waiting for me in the ward, with two physiotherapists who were going to see if I could walk – and first, to see if I could stand.

Sitting up on the bed seemed to be easy enough, we found the corset and fastened up the Velcro straps.

Helped by the physiotherapists, standing up was successful, no pain or problem at all – now for the interesting bit: walking.

The walk around the room was incredible – being able to move again was like being able to fly! They insisted that I did not overdo it though and I was soon back in bed.

The other beds in the ward were empty and the room was quiet when everyone had left. That didn’t last long though, as later that evening an emergency admission arrived, a young German with a very painful back, who needed the strong painkillers that he couldn’t get from anywhere else than the hospital. He was in a lot of pain and spent most of the evening moaning in bed.

The next day, I walked some more, up and down the corridor without any ill-effect – that would be the pattern over the next days, increasing the amount of walking I did, in the beginning just up and down the corridor. The corridor was around 100 paces long, so 10 times was nearly a kilometre, after a few days I’d built up to this and then started to explore the rest of the buildings in the clinic complex.

The surgeon came to see me and said as far as they could tell from the X-Rays that everything looked good and there weren’t complications, which was very good news.

The young German spent a lot of the next day on his iPhone, and eventually told me that the clinic weren’t happy about treating him as they thought he was a junkie. One of his friends knew someone whose father was a surgeon at the hospital and he soon got the painkillers.

A couple of other patients moved into the ward during the next days, a lovely old German and a young guy of Croatian descent.

A lovely present (see the picture) from my colleagues at work was brought in by my boss; she told me that, as I wouldn’t be visiting the Christmas market that year, she had got things from the market for me! See the photo with present, note the sexy anti-thrombosis stockings L

Later in the week, other colleagues came in to see me - it was great to see them. 

My mum flew home to England the day after I returned to the ward so my wife came in to visit every day on her own, even when the weather was awful and the trams were cancelled or delayed.

The doctors told me I needed to be under observation in the ward for a week before they’d let me out which meant I should be home before Christmas – it was also clear that they wanted as many patients as possible to leave before Christmas, so that they had as few people in there over the holidays.

The young German was a funny guy, full of stories and jokes. For example, when the old guy started to talk about his experiences in the war, he said ‘be careful what you say about the war – my grandfather died in a concentration camp. He got drunk one night and fell from a watch tower.’

The Croatian claimed he was there for therapy - we weren’t so sure though, we thought he was maybe on the run, perhaps from the Mafia, as he didn't seem to get much therapy. He disappeared for most of one day to a ‘business meeting’ near Cologne, and then to a ‘sauna club’ for most of the Saturday evening and night, returning to the ward at around 4 in the morning!

Each day I was out of bed early and walking the corridors well before breakfast time to show the doctors on rounds that I was fine and ready to be released.

Lots more walking every day, including regular visits to the shop/café in the clinic and, by the end of the week, enjoying a beer there with my wife when she visited. J

The day before I was due to leave, the rounds were quite late in the morning – the reason was that it was being led by the chief surgeon of the department, who was doing the job properly, taking lots of time with each patient, answering their questions, explaining everything and making sure that things were being well taken care of.

He told me that there needed to be one final X-Ray before they let me go, this time I could walk to the X-Ray room. Later in the day, they confirmed that everything looked ok and so I could go home the next morning.

All the paperwork I needed was prepared soon after breakfast time; I made sure that everything was packed and ready to go as soon as my wife arrived. A taxi was ordered and we were soon on our way home J

10-13 December 2010: Operation & Intensive Care

It was difficult to sleep the night before the operation, but tried to get as much rest as possible – watching the German TV certainly helped me to loose consciousness during the evening……

The surgeon told me although there were some risks with the operation, it was a procedure they did on a regular basis and the risks were minimal – no worse than driving on the Autobahn, he said, which wasn't that reassuring as we’ve had a few scary experiences with speeding Porsches on the roads here………

My wife texted me to say that she’d was sure everything was going to be ok and that she’d be there to see me the next afternoon, straight after the operation.

From the lunchtime before, it was no food and only water to drink - they told me to be ready at eight am for the operation, and I was rolled off to the operating area of the clinic.

Then I had to scramble through a kind of window from the normal hospital bed onto the bed for the operating theatre. Then off to a pre-op room, where the anaesthetist talked to me and started to put some tubes in, then it all went blank…..

….until I was being wheeled through a ward - my wife was there, next to the bed in what turned out to be the intensive care unit. I could move my feet and legs, which was really good news, given that they had been operating on my spine, and seemed to indicate that the spinal cord was not damaged.

It turned out to be around late afternoon, I’d been out for most of the day. Taking stock, I found that everything felt ok, but that there was a large number of tubes attached to me, including a catheter. I was given water to drink – out of a plastic baby cup with a straw.

Because of all of the tubes, it was impossible for me to move much in the bed, but I could turn my head to watch the information on the monitor (pulse, blood pressure, temperature), which was reassuring to see and an improvement on the German TV.

Stuck into the ribcage on my left hand side was a heavy piece of metal which was helping to drain my lung – this was pretty painful and meant that any twisting or movement of the body was difficult.

In and out of consciousness for the first night in intensive care – everything seemed to be ok – the bags connected to the catheter and the drain were examined and emptied and the drip changed regularly.

The ‘portable’ X-Ray machine arrived the next morning to take a picture – without asking for help from the carers in the intensive care ward I was rolled onto my side, then the person taking the X-Ray forced the cold metal plate under my back causing a lot of pain, then the long-necked X-Ray machine was rolled into place above my body. The X-Ray plate was then pulled out from under me, causing more pain, and off they went.

Discussing the situation with one of the carers later in the day, it appeared that there was some dispute with the X-Ray people in the hospital at the weekend and that the person was from a different department in the hospital and wasn’t happy about having to cover this area too. He also told me that the X-Ray people didn’t work on Sunday, which meant that I’d have to wait until at least Monday for another X-Ray before I could leave intensive care.

The visiting times in the intensive care ward were much more restricted than in the normal ward, just an hour or two in the afternoon, but with the painkillers and recovering from the operation, I don’t remember much about the weekend in there, except it was not an experience I’m keen to repeat any time soon – so maybe I don’t want to remember much about it.

After a while, they gave me a button to administer my own painkiller which saved having to call the carer and wait for them to sort it out. The drugs did seem to reduce the pain by giving me a feeling like a protective blanket around me, but also some other strange mental affects too. On the Sunday night, it felt like there wasn’t too much pain so I stopped using the button – there were some odd effects of coming off the drugs, lots of sweating, it felt like time stopped, the hands of the clock on the wall seemed to not move, I’d close my eyes and think about something for what felt like minutes, then open my eyes again and the clock hadn’t moved!

Apart from the heavy metal drain in my side, and uncomfortable of my back against the sheets on the bed, there didn’t seem to be much pain and the hands on the clock slowly dragged themselves round to Monday morning.

A doctor came to look at the various tubes that were still in me and to remove the big metal thing on my side. I asked if they could take the catheter off as well – the carer said it was normally done later in the ward but the doctor told her to take it off then, so, with a quick pull, (OUCH) it was off.

Then, all that was needed was the new X-Ray, an all clear from the surgeon and I could escape from intensive care.

A much more caring X-Ray guy arrived, and with help from the carer, managed to put the plate under me and to remove it again without any pain at all; another couple of hours of waiting, then the word that the X-Ray looked good, so a couple of people arrived from the normal ward to wheel me away and out of the intensive care ward – it had only been three days but it felt like it had gone on for ever…..

December 4-9: first week in hospital

After my wife and mum left it was mealtime – I’d missed the main meal of the day at lunchtime, and for evening meal it was bread with assorted meat and cheese and tea to drink.

There was a folder in the room with useful information and instructions for life in the hospital, what the typical day would be like, there was as much bottled water as you wanted, a coffee machine in the patient’s kitchen, you seemed to be able to use a mobile phone as much as you wanted.

The other three beds in the room were occupied – there was one heavily built guy of Polish descent, a slim young-ish Russian and a guy who looked like he had been a sailor – wiry and with a full grey beard.

They were all having intravenous treatment for pain with their discs – none of them wanted this treatment, they all wanted to be operated on but the doctors were insisting on this treatment first - they were all in no doubt that it was useless, the Pole told me that he thought it was ‘Geldmacherei’ – just a money making ruse for the hospital. They were all convinced that they would be back in hospital after a few months of pain at home for the operation they should have been having now.

There was a TV in the room, mounted high up on a wall – the remote control was normally held by the Russian, and the TV was on from breakfast time for most of the day and evening.

Smoking was not allowed in the ward but there was a small smoking area in the garden along the corridor and down some stairs. They asked me if I smoked and sounded very pleased when I said I didn’t – very good, very sensible, they said. However, all three of them disappeared at regular intervals for a smoke, in spite of the garden being covered in snow and the temperature always below zero that week.

The highlight of each day was the visits from my wife and mum - my mum had been due to fly home on the Tuesday but extended her stay for an extra week, until after the operation.

First thing in the morning, normally even before breakfast, were the rounds by the doctor, sometimes doctors, and when it was a senior enough doctor, there could be quite a crowd, with what looked like trainees hanging on every word of the great man (there were some female doctors but all of the senior ones were male).

Rounds over the weekend were pretty quick affairs – it was clearly the senior guys who decided the rota and the junior guys who got the weekend shifts – and there was not a lot to be said, as there wasn’t much in my file except for a couple of X-Rays and that I needed an operation next week and was due a CT scan on the Monday.

I had some painkillers prescribed and was told to stay resting in bed for as much of the time as possible – lying on my back or sides was fine, keeping my back straight was important.

Rounds on Monday were by a quite senior guy with a medium sized retinue. After he’d finished telling me nothing new, I asked if they knew when the CT scan would be today – he said what did it matter, did I have something planned today? The retinue found this very amusing.

After he’d left one of the nurses came in and told me that the doctor had decided I needed to have complete bed rest until the operation, although I would be able to walk to the bathroom when I needed to. The bed rest meant that they were worried I’d get a thrombosis so I had to wear very fetching white stockings for the rest of my stay in hospital and have a small injection in my stomach each evening.

The days seemed to merge into one as the week went on – the CT scan showed nothing new so the operation was set for Friday. I asked the doctor if there were alternatives - he told me that the only option was not to have the operation, and then I'd be in constant pain, the curvature of the spine would deform and I'd end up walking like a crippled old man, so there wasn't any option.

My wife and mum had discovered a small bar and shop in the clinic and broke up their visits with a walk down there while I rested for a while – I got progressively more tired through the week, and this was a good reason for them to go for coffee and cake.

Although most of the time was spent sleeping or reading, I did watch some of the TV, especially the news in the morning, with regular reports of British airports being closed by what looked like light dustings of snow, although to be fair they were also very critical of the disruptions at Frankfurt and the explanation of the Frankfurt airport operator that the problems were caused by the wrong type of snow! The shows in the evening all seemed to be  instantly forgettable German remakes of instantly forgettable British or American shows….

Eventually, the week wore on and the operation drew closer and on Thursday afternoon, I had visits from an anaesthetist and two surgeons.

The anaesthetist explained that it would be a general anaesthetic, I would be under for a number of hours but there would be constant monitoring and I could be woken up almost instantly if necessary, he had a long form we went through together about me understanding and accepting the risks and both signed it.

I’d not really thought much about how the operation would be performed so it was a bit of a shock when the first surgeon showed up and told me that there would be an incision from the left hand side of the body, along the ribcage, as well as from the back; this incision from the side would probably mean that they would have to do partially collapse my lung and would have to install a drain in it which would be there for a few days after the operation.

The second surgeon arrived when my wife and mum were there and they listened in, he said that it was the kind of operation they did all the time, and that they would be building a cage around the broken vertebra, using the vertebrae above and below to help support the cage and stabilise the spine so that the broken bone could heal and gain strength; he said that I should try and get as much sleep as possible that night, but I replied that from my point of view it was much more important that he slept well.

December 3 - in the Krankenhaus

Less than 2 weeks to go now until the trip back to the hospital to see the specialists – next week it’s the CT scan.

Meanwhile, returning to the first day in the hospital last year, when I registered at the admissions area, although we started the conversation in German the guy who processed me at the emergency accident reception turned out to be from Arizona and the conversation finished in English/American.

Waiting in the reception area of the spine specialists where I met up with my wife and mum, I was called in to see the doctor, and my wife came in with me.

The specialist told us in German that he’d looked at the X-Ray and that it was almost certain that they would have to operate - I told him that my wife couldn't understand much German and he immediately switched to almost perfect American English - if that's not an oxymoron.

The first thing my wife says to him is: ‘can we see the X-Ray?’ (the orthopaedic doctor I’d seen earlier in the day had sent me off (at a cost of 5 Euros!) with a CD of the X-Ray to show the hospital) so he brings it up on his PC monitor, and he shows the fracture in the vertebra, he’s not sure if it can be repaired by having some cement-like stuff injected into it to help it heal, or whether it will need to have metal supports; either way, they would find me a bed and admit me immediately.

Then I’m off to another room to fill in forms (including signing a long declaration that if my medical insurance is not valid, that I will pay for the treatment myself!) and do the rest of the admission stuff, like having blood samples taken and having to estimate what my weight and height are in metric (around 1.80 meters and 90 kilos at that time).

Then I'm off to a ward (on a floor called Station Seven) and assigned a bed in a four person room with a view over a car park with a helipad in the middle of it (the middle of the car park, that is, not the ward).

Then they tell me that (although it’s only mid Friday afternoon) I’m probably just in time for X-Rays but that the people who operate the CT equipment have already left for the weekend so I have to wait until Monday for a CT or MRI scan if I need one!

A grumpy guy comes in to wheel me off to the X-Ray department, which turns out to be only around the corner on the same floor as Station Seven – more X-Rays are taken, one from the front and one from the side, and then I’m wheeled back to the ward, I thank him for the excursion and he grunts.

After a while, the doctor re-appears and tells me that they will order me a corset today – they are normally only given after the operation but it will help to keep my back straight until the operation is scheduled.

Shortly after, two other guys appear with the corset – they show me how to put it on and then say that they’ll have to come back after adjusting it. One of them asks me where I’m from – when I tell him from near Liverpool, he tells me he was there once, to catch the ferry to the Isle of Man – I ask him if it was for the TT races, he replies to say why else would you want to go there! I say that there are lots of other reasons.

When he returns later with the adjusted corset, he says that he has lots of good memories of the Isle of Man, including the big water wheel and the beer, although neither of us can remember the name of the brewery. It took me a while to remember the name, but it came to me later: website of the Brewery

The doctor then returns with a colleague (who turns out to be the surgeon who will operate on me) and they say that they have checked the X-Rays and it’s certain that they will have to operate, but they will need to see the CT images on Monday before deciding exactly what will happen. Depending on the schedule, it looks like they won’t be able to operate until the following Friday, which is a whole week away – in the meantime, I have to wait and rest and wear the corset…………….

3 December 2010 – diagnosis

My back was really stiff and painful when I woke up the next morning – it took a while to work out a way of  getting out of bed after many too painful attempts.

Once I’d started moving around, the pain eased off a bit and I rode the train to the office as planned the next day, even walking into the city at lunchtime, to go and buy some bath salts and check out the Christmas market.

Found a sitting position that made it OK to work at the desk, with regular trips to the coffee machine when the back started to stiffen up.

On the second day back in the office, as there seemed to be no improvement, a colleague recommended an orthopaedic doctor that she had used in the past; she even rang them up for me and booked an appointment for the next day, when I was due to be on holiday as my mum was arriving for a long weekend enjoying the Christmas markets, sampling apple wine and green sauce.

At the doctor’s the next morning, I was expecting him to say it was bruised muscles and to recommend some painkilling cream and lots of massages.

He didn’t say much as he examined me and watched as I stretched and tried to turn. He had an X-Ray machine in the practice though, and it was a complete shock when he showed me the picture on his PC monitor – one of the vertebrae was completely fractured and unstable L

The fracture was of the 12^th Thoracic vertebra marked ‘Th12’ on the diagram 

The doctor told me that there was no choice and no time to waste – I had to go immediately to the hospital, he expected that they would need to operate to fix the fracture and stabilise the spine. The receptionist had already called a taxi to take me to the hospital.

I called my wife and told her what was happening - she caught a tram with my mum to the hospital where we met up in the waiting area outside the surgical department.

It was becoming very clear that this was extremely serious and could end up taking a while to be sorted out……….

30 November 2010 - the accident

After a long weekend in England visiting family and going to the wedding of friends, it was a very early start, around 4am, leaving the house to set off for Manchester airport and a 7am flight to Frankfurt.

Stepping out of the front door carrying bags in both hands, I lost my footing going down the steps and slipped, falling straight backwards and hitting my back on the steps. Ironically, one of the bags was a rucksack and if I’d only been wearing it, instead of carrying it……….

It was pretty painful, but I could get up straight away and move around. So, after lying down for a few minutes and deciding that, as everything seemed to be working ok and I could sit down without it hurting too much, we should drive to the airport to return the hire car, check in for the flight and see how it went.

We got to the airport safely, returned the keys for the hire car and got through to the departure lounge without any problem, it was painful walking and moving around, but I could seem to manage to find a comfortable position when I sat down.

Everything went ok getting onto the 7am flight, we were the last onto the plane and were offered seats with extra leg room at the front of the aircraft – the pilot told us it would be around ten minutes to have the plane de-iced and we’d be off. Ten minutes or so later, he told us that Frankfurt airport was closed because of snow, the plane was flying to Norwich instead and we were all retuning to the terminal.

Made it back to the check in area and – excellent service considering it was a budget airline – within half an hour or so we had new boarding passes for the afternoon flight to Frankfurt.

Still no let up on the pain, so got to the helpdesk in the airport and asked them if there was anything they could do to help. Within quarter of an hour, a paramedic arrived and filled in a long form; he seemed to agree with our conclusion that it was just bruising and I needed to keep moving to stop it from stiffening up. He said that ambulances were very busy that morning and if we wanted to be on the safe side, we could take a cab to the A&E at the hospital a few miles from the airport – he didn’t seem too concerned though (I got the distinct feeling he thought I was wasting his time and that he had some real emergencies he should be taking care of).

Spent the next few hours (it felt like more than a few though!) around the airport, visiting all of the terminals, reading newspapers and eventually took off late afternoon; the plane was much fuller this time (with lots of others from the cancelled early flight) so no chance of an extended leg room seat at the front.

Landed on time in Frankfurt, took the bus across the airport to the railway station and caught the train home, changing in the city centre. Carrying the suitcase was painful but wearing the rucksack seemed to be fine. Got home early evening and everything seemed to be ok, the pain wasn’t getting any better though, so went to bed and seemed to manage to find a position where it didn't hurt too much.

Hi and welcome to the BBB!

Hi and welcome to the broken back blog – details of what’s happening to me and my recovery from a fractured vertebra that I suffered at the end of last November.

This post is a quick summary of what’s in store over the next few weeks, heading towards a return visit to the hospital (Uni-Klinik Frankfurt Friedrichsheim) on Monday 21^st March for a review with the specialists who operated on my spine last year, and the day after to the orthopaedic doctor who has been looking after me for the past couple of months since escaping from the hospital.

Before then, there’s a CT scan in a couple of weeks to check out how the spine looks and especially how the fractured vertebra is healing.

The operation involved insertion of a metal cage screwed into the vertebrae above and below the broken one to hold the broken bone together, supporting the spine and helping the fractured parts of the broken vertebra to grow back together.

In the meantime, I have to continue wearing a big velcro corset L like this one:

which keeps my back straight and stops me from twisting during the day. It’s no different to wearing a tight-ish rucksack (with a big piece of metal up the back) and wearing a big sweater pretty much hides it. Fortunately, the corset gets taken off in bed J - I shouldn't complain too much though as the corset is a lot better than the alternative that they offered me: a full plaster cast around my torso for three months!!

So enough for the first post - it would be good to hear from you if you have any comments!