4 - The delicate internal system

"organ damage can be a real setback"

Of all the injuries I sustained, the one on the list that has taken its toll more than the others have been the internal ones. Bones eventually heal, skin eventually heals, even nerves can heal (all be it at a millimetre a day when the nerve isn't fused to the metalwork they had to build into my elbow - see below image), but organ damage can be a real setback.

Left arm metal holding my elbow together

Injury number 11 on my list was the primary hurdle and one that has caused me the most anguish across the course of my continued rehabilitation. With a torn bowel, in several places, the absorbtion of nutrients, minerals and proteins to keep my body running at a bare minimum was impossible.

"..was noted as being the sickest patient in Critical Care"

For many weeks following, I was noted as being the sickest patient in Critical Care. I was treading the fine line between life and death, light and dark, and a step too far into the dark would have been the end of my time on this planet. The countless problems that ensued (for example air bubbles in my chest cavity that needed escape holes in my upper chest), the many x-rays and CT scans that I went through, all added to the stress of the whole situation that my wife suffered.  Day after day, she was taken into a side room to discuss the latest problematic encounters and days without these talks became few and far between. My head injuries were of initial concern, the professionals not knowing if the impact to my skull had caused sufficient bleeding on my brain to cause damage. The only way of discerning that that terrible scenario hadn't occurred was to wait for me to wake from my coma. That was one of the more discouraging meetings that my wife endured in the 'discussion room' with the senior nurses and doctor.

When I was first admitted following the collision, the first few weeks of my coma I was fed nutritional intravenous feeds. However, the normal x-ray processes to identify initial damage was not adequate enough to detect the tear in my bowel. Subsequently, all the waste products my body was trying to kick out were leaking into my body cavity, all unbeknown to the healthcare professionals.

With all the poisons now coating my internal organs, they had begun to shut down hence my deteriorating palour and my rapidly increasing stomach size. I was dying.

Having spent a day at my side and being told by the doctors that I was too weak to have any further surgery, she was told hesitantly that they had little choice but to rush me to theatre to perform a laparotomy to discern the cause of my failing health before I passed away.

"..time would only tell if I was able to survive."

Again, time would only tell if I was able to survive. My wifes mother had only just returned home from the hospital that evening when she received a call from my wife advising that surgery was inevitable for my survival.  Rushing back, my mother-in-law returned and the long wait for news of the surgery, either way, was anxiously anticipated. At 9:40pm I was taken down, followed swiftly by the crash cart and life support equipment.

The door to the waiting room opened after a gruelling 4 hours and the nurse came in, announcing with a tear in her eye my imminent return to the ward. A phalanx of surgeons with an astonished look came in to the waiting area, sat down and looked at my wife, "He's remarkable, he was stable throughout. Truly remarkable."

The only result that saved me was an ileostomy. The online definition of which, for those unfamiliar, is:

"An ileostomy is a surgical opening constructed by bringing the end or loop of small intestine (the ileum) out onto the surface of the skin. Intestinal waste passes out of the ileostomy and is collected in an external pouching system stuck to the skin. Ileostomies are usually sited above the groin on the right hand side of the abdomen."

However, the location of the tear in my ileum was on the upper left of my abdomen, almost literally on the stomachs exit. Much later, when I was able to eat, consumed food would take 20 minutes to go through my internal system. A time, you'll agree, is not really adequate for my body to absorb much in the way of nutrients at all.

As a consequence of this, I lost dramatic amounts of weight. Prior to the accident I weighed in at just under 14 stone. After the trauma and stay on Critical Care, I lost half my body weight in a matter of weeks. After I had awoken, the count of my surgeries numbered to 16, and prior to any surgery (as most who have undergone any type of operation) the term Nil By Mouth is used which prohibits both food and drink up to a period prior to theatre. So, all those Nil by Mouth scenarios, coupled with my bowel injuries, is it any wonder my weight was reduced to radically low levels.