18. Hospital Dispatches

The first week post-amputation...

Another “written from a combination of memory and notes” post today - and published about 2 weeks after the events. I’m gradually catching up with ‘present day’ and some sort of contemporaneous publishing; bear with me. Plenty of time to write, just very little motivation to do much more than Netflix binge and eat high-calorie comfort food. I was more active a week or two ago but that backfired a little (future blog will explain) so for now I have to make my peace with being super lazy (sorry, ‘healing-focussed’) and you have to make peace with delayed posts. Sorry! Anyhow, hope you enjoy this slightly more cheery one.

Previous blog

I’ve just had one of legs cut off and, frankly, the most painful thing about this whole escapade is the urinary catheter. I feel very strongly that my gentleman’s paraphernalia remains my exclusive sovereign property. Not sharing it with an interloper tube which catches agonisingly every time I adjust position, sheets, or even breathe too enthusiastically. Still, it comes out 3 days post-op so I have only a few more days of additional discomfort.

I am very happy to confirm (although you probably guessed from all the social media activity and the conspicuous lack of negative updates) that the amputation went very well. Unexpectedly well, actually. Plastics team were on hand in theatre in case we needed an emergency skin graft to help seal the stump, but were not needed. It turns out that, despite initial fears, I had sufficient volume and quality of calf muscle to round out the stump, so extra ‘material’ not required, and a very normal Below-Knee Amputation was carried out.

This is great news because it’s the standard procedure, performed countless times, great outcomes, great healing, great prognosis, etc. All great. In fact the only people who don’t think it’s great might be my superb surgical team who were quite excited about the slightly experimental graft ‘back-up’ option which, apparently, hasn’t been done before in Exeter, or maybe even South West. Ah well. Maybe they’ll get their chance on August 6th when the Left leg comes off- it has more damage and less muscle than the R, so graft skills may still be needed.

Life with the stump in hospital settles quickly. I have ample reading material. I have liquid morphine which is a helluva drug. I still flip the sheets regularly to look (gaze lovingly? Would that be weird?) at my stump. In classic Staniford-Miller tradition, my wife Alice has insisted ‘the stump’ has a name. Why not, eh? I’ve already anthropomorphized him as a beloved addition (or subtraction… this is very confusing), so let’s go ahead and christen the little fella. When I was first wheeled back to the ward the previous occupant of my berth still had his name written in marker on the whiteboard - Trevor. So ‘stump’ has become Trevor, or as my friend Caspar says ‘big Trev’. It seems fitting.

On a pre-emptive basis, we’ve also named his future stump-mate, for the Left leg op happening in August. When I first showed Caspar and his partner Cassie the video of ‘Trevor’, Cassie immediately laughed and said ‘Roger Roger’ - because admittedly Trev does look like one of the droids from the Star Wars prequels and this is their fallback expression. So, future stump naming completed, subtle nod to Star Wars nerd-dom included. Roger and Trevor.

One final bonus of ongoing #OpChop is that my discarded limb has been shipped to Edinburgh into the waiting hands of Professor Robert Semple. Among his numerous research interests are lipodystrophies and my own MDP Syndrome. We are fortunate that when I was a kid, long before diagnosis, they took various bio samples from me. They’ve taken samples from me recently, too. And, lo!, we have the world’s first 20yr+ longitudinal study on the effects of MDP syndrome on the genome. And with a whole leg in a climate-controlled cupboard somewhere, we now also have a huge source of extra skin, tissue, hair, bone, marrow, etc samples available for testing to their hearts content for all sorts of things. This might help in all sorts of ways for helping us understand MDP, lipodystrophies, and their genetics, better. So, lose a leg, contribute to medical science. I am just too generous. So generous, in fact, they can have another one in two months. I should start charging.

Continuing with this round-up of hospital experiences, I can confirm that NHS catering has not improved in recent years - but I’m there for calories, not a Michelin star. The saving grace has been custard. I happen to like custard. So the fact it appears, regularly, in accompaniment with crumble or sponge, as a dessert option at both lunch and dinner, is spectacular scheduling. Twice daily custard is pretty much guaranteed to heal even the most pernicious wounds. Well done NHS.

A few days in and the physio comes round. They are happy with my transfers from bed to wheelchair to chair and any combination of these. I have good upper body strength for a weedy cyclist, having spent the last year preparing for this with very slightly progressively heavier modestly-heavy weights in the garage. The transfer process is somewhat complicated by the fact I am led around by my willy (some would claim all men are, in any case) and the still-attached urinary catheter. I explain this, apologetically, to the female physio and she seems largely unimpressed by my plight. With the catheter line, and the line from the nerve block taped to my thigh, I am more concerned about strangling myself than falling on my stump. (speaking of which… *future blog post klaxon*)

The daily routine of drugs, injections, bloods taken and further sharp things being stabbed into me continues. I wouldn’t mind so much that not a single person has offered me a sticker or a lollypop for my time. Things used to be different. Cutbacks, no doubt. One of the nastiest injections is from the one they give you to stop clotting while you’re spending so much time immobile in bed. It is a tiny little needle, aproper little prick, and a few seconds/minutes after they’ve given you it you get this really odd uncomfortable bruising feeling. For some reason it has to be injected into the stomach, so the nurse(s) have to pinch a small roll of belly fat and have at it. Cue the following exchange:

“Your stomach is really hard. Is that normal for you?”

“Yes.”

“What’s that called?”

“I believe they’re called abs.”

I suppose there must be some benefits to lipodystrophy. The lack of subcutaneous body fat means the Staniford six-pack remains in place come rain or shine, feast or famine, and any exercise(s) to sculpt simply makes it look even better.

Which is a great time to wheel out one of my favourite stats. I’m 35 now. Do you know how many men 35yrs+ have a visible six-pack? Out of a million? Have a guess.

40.

Not a typo. 40 out of 1 million men older than 35 have a visible six-pack.
How many men in the UK are over 35? Maybe 20 million? So there are just 600 of us chiselled lithesome morsels around. Incredible. If you’re one of them, hello fellow Adonis, give yourself a pat on the back. And maybe a cream cake. Just this once.

Stomach discussions aside, there is something nice about enforced medical stays and serious healthcare interventions - beyond the obvious fact that, you know, it has hopefully nudged you along the way to better health. I’m talking about concentrated living again. We live in a tumultuous world of distractions and competing interests, fleeting dopamine hits, throwaway materialism and erratic focus. Being in hospital often changes that, as your interest narrow to a) when is my next meal and what is it?, b) when/where can I go to the toilet?, and c) when do they plan on turning the lights out so I can sleep?
There’s something to be said for this return to humble priorities and simple existence. Some might call it mindfulness. Some might pursue it with bikepacking or “van life”, or a hyper-focus on a specific hobby or minimalism. I’m always grateful for my stays at the NHS’ pleasure because it helps me celebrate the small, but important, wins. Like going to the toilet without a tube in my willy.

The final few post-catheter days pass peacefully, with healing happily ongoing. Somebody on the Consultants round foolishly mentions that 7 days would be normal post-amputation before discharge. My raging competitiveness kicks in. I’m out in 6.

Thanks for reading.

Next Time: Home Comforts