Feburary 22nd - D+5 The Descent of Mann

I was dreading this. The inevitable onset of lethargy and a jelly like mass around my waistband. It’s hardly surprising since I’ve spent the last 5 days sitting on a sofa, the main ‘activities’ of the day being mealtimes and periodic trips to the bathroom (which take a surprising amount of effort – doing anything on one leg requires considerable concentration and balance control).

I’m obliged to keep my leg elevated for the first 2 weeks to prevent pain and infection which further limits me to the same sofa which has cushions and pillows arranged accordingly. Which means my entire world consists of a 15ft by 20ft room with occasional trips to the bathroom. Or should I say ‘latrine’. For this is starting to feel like a prison. True, I have my mum’s finest food, tea and snacks delivered to my lap but I’m confined nonetheless. It’s a gilded cage – or rather, an embroidered cage.

And just like a ‘correctional facility’ or ‘penal institution’, I had my own unsavoury episode in the shower block (ok, the ensuite shower room). Fortunately, there was no-one third party involved in my mishap. Sans crutches as I stepped out of the shower, I leant on a towel rail for support. Underestimating my own weight (or strength?...) the rail promptly came away from the wall bringing fair sized chunks of plaster with it. I held the rail in my hand and looked at it for a couple of seconds before realising I’d put all of my weight on to my plastered foot – which was now in agony. I dropped the rail, cursed and hobbled out of the bathroom.

Something didn’t feel right under the plaster. Nonetheless, I dressed and hobbled downstairs to my cushioned cell, calmly telling my mum that I’d detached some of her bathroom furniture from the wall. As I lifted my leg up to the sofa, I felt something warm and damp squelching under the plaster. Blood. I was pretty sure I’d burst a stitch. Unfortunately, I have prior experience of bursting stitches under a plaster cast thanks to an unsavoury episode in Tenerife some years ago. And this felt the same. I plugged myself with painkillers as my brother went to upstairs survey the damage.

The upside of my ‘incarceration’ however is the ample opportunity to make inroads into the mini skyscraper of books transported from London. As well as having plenty of time to organise stag-dos, arrange pre-season football tours and other personal errands. Daily ‘visiting time’ has also provided light relief with my 9-year old nephew popping round regularly with his PlayStation football game. Yesterday I thrashed him 11-1. And then 7-2. As I said to his dad, it’s important that he learns how to take defeat.

So here I am in my own personal prison. Lying on the sofa worrying about my expanding waistline, turning away larger portions of home cooked food and bemoaning the lack of football on TV during the daytime. I imagine it’s exactly how Mandela felt.

Highlights & stats:
DVDs watched: 1 (The Departed)
Cups of tea per day: 5
Pills per day: 22
Stag weekends missed: 1
Days until plaster removed: 8
Current reading: A Most Wanted Man
Music: Rags to Riches, Tony Bennett

February 18th 2009 - D+1 "We can rebuild him..."

I feel euphoric. That’s not a personal opinion, it’s medical vernacular. According to the leaflets accompanying the cocktail of painkillers that I’m filled with, ‘euphoria’ is a likely side effect. And I do feel incongruently pleased with life.

I finally had my ankle operation yesterday. Having had the original appintment postponed by two weeks due to snow(!!!), I had a peculiarly macabre sense of excitement and anticipation at being sliced open. I imagine it’s the same ghoulish glee a serial killer feels prior to finishing a victim. But really, I was keen to get it out of the way so I could start on my recovery. With weddings and stag weekends on the way, I’m not enamoured by the thought of dragging a useless limb around dancefloors like a bad impersonation of Verbal Kint in The Ususal Suspects.

Nevertheless, my surgeon clearly thought I was a tad unusual when I asked if he could take a photo of my exposed ankle joint mid procedure. His quizzical look prompted an explanation: “Just morbid curiosity, you know, and something to use as a motivator in recovery.” He raised an eyebrow and laughed nervously, probably making a mental note to self – ‘if there’s a spate of surgically themed murders in London, report this guy to the cops’.

Everything seemed to go remarkably smoothly. Arriving at The Hospital of St. John & St. Elizabeth at 7am, my surgeon and anaethetist visited my room to explain what was going to happen. The surgeon’s explanation was more appealing than the anaethetist who highlighted some of the potential side effects of going under: dizziness, sore teeth, vomiting, death.

Shortly after discussing the likelihood of death (about one in a million apparently), a nurse handed me a gown and a pair of thin paper underpants. Yes, paper underpants. I was beginning to wonder if the anaethetist had missed a scatological risk from his briefing – massive potential for a loss of dignity. I was being wheeled into theatre at about 9.30am and found myself waking up around an hour and a half later. Confused, I thought I was still waiting for my op and sat up only to see my foot encased in plaster and bandages. I looked at the nurse next to me. “Will I be able to dance the tango?” I croaked. She gave me a weary and polite smile, but declined to respond. She probably hears that gag twice a day.

Half an hour later, I was in my bed devouring the enormous breakfast I had ordered. I was inordinately pleased that I hadn’t vomited. A friend who recently had knee surgery had managed to fill two cardboard bowls expelling the contents of his bowels post-op. His shame was compounded by the grimacing “fit nurse” holding the receptacles to his dribbling face.

The next few hours were hazy and surreal. I drifted in and out of sleep, trying to read whilst awake and having strange dreams and hallucinations in sleep and semi-consciousness. My blood pressure and pulse were checked regularly, seemingly by a different nurse every hour. “I don’t feel any pain at all” I said to one, “Did they give me some painkillers in post-op?”. She smiled. “Oh yes. You’ve had all sorts! Particularly morphine.” No wonder I felt so good/strange. By early afternoon, I had already made several garbled phone calls to friends and family, delivering rapid one-minute rhetorics before passing out again.

Later on, my surgeon popped in to let me know that all had gone according to plan. My peroneal tendon had been flattened so was stitched back into a tubular structure. Small metal pins were used to secure the retinaculum ligament back over my tendon. Finally, sutures were used to reinforce this and reconstruct the lateral ankle ligaments to stabilise the joint. “Oh, and I took some photos for you”, he said on his way out. Lovely.

Having popped enough brightly coloured pills to make Shaun Ryder blanch, my final medication for the day was an injection into my stomach to prevent blood clotting overnight. The nurse commented on how eagerly I was watching ‘The Silence Of The Lambs’ whilst this was administered - probably adding to my reputation as the weird sicko in Room 4.

I managed a few hours of sleep, more often finding myself in a strange no-mans land between sleep and awake, having more strange visions and dreams. It probably wasn’t helped by the nurse who measured my vitals during the night and told me my heart rate was worringly low. I concluded it was the blood thinning injection.

After another enormous breakfast, I was discharged this morning to return in 2 or 3 weeks to have my cast removed. My brother drove me to my mum's home in Kettering, trying to engage with my jumbled stream of consciousness. During a pause on the motorway, he suddenly said “So, I guess that’s the end of football for you then.” I glared at him. “What do you mean? Of course not. It’s the pre-season tour in six months. That’s my target.” He laughed. “You’re an idiot.” I like to think it was meant as a backhanded compliment on my bravery.

This wasn’t the end of it. As I finished my last mouthful of the vast lunch my mum had cooked, she said coyly “I think it’s time you stopped playing football”. I bit my tongue for a few seconds. “I’ll be fine in a few months, this was just bad luck”. She sighed and started reeling off the number of times she’d heard me say that before. I tuned out.

Finally, my eldest brother came over for dinner later on. After he’d settled himself on the sofa, he said “Well, that’s the end of your football days then.” I erupted. “Is this some sort of conspiracy???”

Highlights & stats:
DVDs watched: 0

Cups of tea per day: 5

Hours of football watched: 0.5 (Luton Town vs. Brighton)

Current reading: Fiesta – The Sun Also Rises
Music: Let Your Love Flow, The Bellamy Brothers
Annoying: Trying to have a shower on one leg.
Pleasing: The artificial high from my painkillers. I’ve got to get some more of these.

Early December 2008 - Diagnosis

Unconvinced by the NHS diagnosis, I booked an appointment with a private physio I had used before and trusted (Regan at Balance Physiotherapy in Clapham). It was back to square one – a wincing and concerned expression on her face at the abnormal shape and colour of my ankle, a reaction I was now familiar with. After a thorough assessment, she asked me to run barefoot across the gym, an experiment which lasted two steps. I was in agony. She suspected tendon and ligament damage, and potentially an internal fracture, and referred me to a specialist at the London Foot & Ankle Centre.

Finally, two days before Christmas 2008, I saw the specialist at LFAC. Within minutes and using a simple test, he diagnosed a sublaxed peroneal tendon. An x-ray and MRI scan confirmed it – there was damage to the peroneal tendon which runs on the outside of the ankle; the ‘belt’ of ligament holding it in place (the retinaculum) was ruptured; and the lateral ankle ligaments needed reconstruction. The medial ligaments were also damaged at their anchor points to the bone. The surgeon explained that I needed an operation that would open up the outside of my ankle to make the necessary repairs. This will mean two weeks in plaster, four to six weeks in an aircast boot, a return to running after 3 months and if all goes well, playing football again in six months – August 2009! There is a standard 5% chance that I won’t be able to play sport again, but I prefer not to think about that. I couldn’t believe one tackle had done so much damage! I had put in what Big Ron would call “a trademark reducer”..... on myself.