…and I happily obliged.
I was incredibly lucky to be transferred from hospital straight to a 12 bedded inpatient rehab unit. It was all a bit of a blur and happened very quickly, and none of the staff in the hospital I was in really knew anything about it, so no one could give me any info other than that others had said it was great. So I was picked up, taken over and the transport man put me on the bed and left with my new roommate, 86 yr old P. I had no idea what was going on and she couldn’t explain anything to me either. She was a character. Of all of the patients, I was the youngest by about 40 years and we were the only two females in the ward. One of my friends came to visit and was devastated that there were no young, fit army men on the ward… “I came all this way for this?! You should ask for a transfer!” There is some truth behind it though, because without having other people to set benchmarks and to compete against, you don’t know what you’re aiming for. It’s not a competition, of course, and it’s not a race, but I’m rather competitive and enjoy having other people to push me along and make me work harder. (We did have some good basketball shootouts though and I recall at one point when side planking in exercise group, one person tried to hold it longer than me, saying “Must not be beaten by a girl”)
Immediately, I was struck by the totally slowed-down pace. There was just no urgency at all, to the point that I demanded to self medicate on the second day there. Otherwise I knew I wouldn’t get the drugs I needed for hours after they were due and when you’re as obsessive about sticking to the pain management plan as I was, that’s not acceptable. However, this relaxed atmosphere was perfect for healing and although I worked very hard in physio sessions, outside of that it was the most wonderful place for rehab. We had communal meals in a dining room, set up high with a view of the beautiful gardens and a couple of London landmarks. Visitors could come and go more or less all day and all of the staff were brilliant and had the time to get to know patients, which was a lovely change from the bustling pace and constant pressures of primary care.
I could make it feel as homely as I liked
Every patient had an individual timetable for the week, with two hours of daily physio and a weekly “breakfast club” session (an OT led session where we would make breakfast of our choice). My daily routine consisted of being woken up at 6.30am for observations (why they need to be done at that time totally defeats me), breakfast at 8, a physio session in the morning, lunch, more physio, then visitors in the late afternoon and evening and dinner at 5.30pm. Psychologically, it was the perfect place for me to be. Whilst in hospital, everyone around me was in for knee surgery, hand surgery etc. and when comparing them, mine was the most “severe”. However, in the ARU my amputation level, age and comorbidities all meant that I had, by far, the most “minor” problem or, by far, the best potential outcome. My first roommate had a much higher amputation, couldn’t transfer herself and would never get a prosthesis, whereas I was signed off as independent with all transfers within an hour of getting there and not getting a prosthesis and not walking was never an option for me. Amputation was the norm, nobody batted an eyelid and I was forever being complimented on the beautiful job my surgeon had done and how well it was healing.
Physio started off as using the PPAM aid once a day and exercise class once a day. The exercise class was pretty much an hour’s personal training session and I was worked very hard. This was absolutely ideal for me because I was challenged, kept busy and got stronger. The PPAM aid is a pneumatic post-amputation mobility aid, an inflatable sleeve which you put into a metal cage to allow you to mobilise. It improves balance and circulation, reduces swelling and prepares your residual limb, somewhat, for a prosthesis. Psychologically, being upright and moving around is also a big thing for some people. I quickly moved out of the bars and did assault courses, stairs, ramps and anything else that could be found to keep me entertained.
I was cast for my leg at 13 days post op and received it on day 20.
This was my first time using the prosthetic.
I wasn’t very different from walking with two real legs, and as that had been quite painful for a few years, the pain of starting to use a prosthesis wasn’t an issue. What helped, in my opinion, was having obsessively done the prehab and rehab exercises that built up my strength to the point where I was able to control this thing that wasn’t part of my body. Before going in to hospital, I physically prepared myself for post-op rehabilitation with “prehab”. Prehab-wise, the advantage I gave myself was mainly my own doing in the gym, because the prescribed prehab exercises I had from the limb fitting centre were poor – just a few pilates exercises with a big emphasis on breathing. Don’t get me wrong, I think pilates is incredibly valuable and I do it 2-3 times a week, but I needed a lot more than that. I think this is a real shame, the physios had a golden opportunity with me to make a difference to my rehabilitation, but they seemed to miss it. Fortunately, I was able to strengthen my core, legs and back myself, but if I hadn’t had that awareness or access to a gym where I could get some help, learning to walk again would have been slower and more difficult.
I’d got close to my roommate over my two weeks with her. She was discharged and went into a home the day after I got my leg, but was so excited for me and so eager to see it that it was wonderful that she got to. She had a wicked sense of humour. When I asked how I’d cope without her, she replied, “quite well I expect.” One morning I woke up to her saying “come back here you little bugger”. I thought she was talking to me. “Oi, turn around.” It dawned on me that actually she was chatting away to a balloon I had. This continued the whole time and she named him Mr Man. Whether she did it just to make me laugh or not, I don’t know, but it did make me chuckle. I gave her the balloon when she was discharged and I’m sure that he brightened up her new room a little. That week having the room to myself gave me some much needed peaceful sleep due to the absence of the little help alarms going off all night, that was something that I’d seriously missed. I soon had a new roomate in Penny, who, at only 40 or so years older than me, was more my age and I like to think I showed her the ropes of rehab. I still see Penny now at the limb fitting centre we both go to and sometimes I pop in for a cup of tea and a catch up.
Stairs at 3 weeks post-op
22 days post-op
We were free to come and go as we pleased, as long as we signed a disclaimer saying that it was our fault if something happened when we were out. So when in need of some time out, I often escaped to pub round the corner with whatever visitors I could find for dinner and one evening my aunty’s dog hitched a lift.
There was also a very friendly local cat, who we shooed out whenever he sneaked his way in…
Some of those first few longer walks were difficult and sore, but I ploughed on and over time it because easier and less painful. Some of it was down to confidence, I’d had issues with blood blisters on my scar after a few days walking on my new leg so had to come off it for a week. When I started walking on it again I was apprehensive about going far and didn’t want to have other problems. One of the physios asked if I was ready to go out a bit further and get on a bus and I wasn’t keen. I said no not today, can we leave it until tomorrow? I’ve only been walking on it like three days. She said yes, that’s fine so we just walked the shorter distance to the pub. We then practised crossing the road, then walked down the road and by sheer coincidence (!) we ended up at the bus stop. Haha, I thought, this might work with all the older patients, but you can’t fool me – you can’t use money on buses now and I don’t have an oyster card with me. But again, due to another stunning strike of luck, she had a spare oyster card in her pocket so I had no choice but to agree and get on the bus. It was fine, of course, and I was just being a bit of a wimp. Those little pushes meant that at five weeks post op, I was up, walking and ready to go home.
I feel absolutely honoured to have started off this journey in such a wonderful place and I cannot thank the staff enough for their kindness, expertise and enthusiasm.