Episode 3: The Fight to Retain Consciousness

First, a warning: This post details a time where the realities of life were stark, the gruesome details of the operations were something which I needed to get used to very quickly to keep abreast of what was going on. I debated whether to include images from the operations here but in the end decided to keep with the idea of being as truthful about the journey as possible. Parental guidance is advised.

Me on Born into Struggle 7B+
Photo by: Unknown

My Memories of this time lack continuity, partly because the doctors gave me drugs to prevent me from forming memories and partly due to my own reluctance to continuously rebuild those memories. I will try to recall salient thoughts and emotions from this time as write but mostly the information I have has been taken from the accounts of the doctors involved and my own journal which I started keeping on the Tuesday. I was more recording a timeline of major events that detailing my emotional or psychological state, I didn’t really have the energy to do more than that.

Monday 14 July 2019

Firstly, I don’t really remember waking up for the first time. I don’t recall my sister and her husband seeing me awake on Sunday whilst still intubated, in fact I don’t remember being intubated at all. But apparently I did wake up on Sunday, albeit under serious drugs. The initial operation had ended early in the morning and I was in again on Sunday Morning. The first memory I have is of waking up on the Monday morning. Or at least being awake, I don’t fully recall the moment that I awoke. Rather like being in some dream, I was aware that I was conscious but with no real recollection of arriving there. I was alive and that certainly seemed to be a good thing, although there was serious pain. A kind of ‘this isn’t just going to go away pain’. I was also in some shock, there was a lot going on. On top of that I was also high. A kind of dull high Id never experienced before and it wasn’t altogether pleasant. My lips were dry and cracked, my muscles ached, my throat was sore and I could barely move. It was bad, maybe not the worst that there has ever been, but pretty fucking bad.

My bed in ICU (Taken during the second week)
Photo by: Carlien Wassermann

So what then had actually happened to me? When I arrived in Christian Barnard Hospital, I was in a state called pre-renal Failure, from what I understand its just before your body starts giving in and you get into serious trouble. I had lost a lot of blood, one doctor estimated I received around ten units of blood and a few units of plasma and platelets. About four and a half liters in total, an estimated 80%+ of my total volume of blood. The loss of blood combined with the dead tissue of my right leg was putting a lot of pressure on my body. There is a measure of lactic acid which they monitor during trauma, when I was put under my measure was 10 mmol/l where about 0.5 to 1 is average. This Lactic acid buildup is a reflection of the body’s oxygen consumption outweighing it’s ability to deliver oxygen. An inability to deliver sufficient oxygen and to remove a buildup of CO2 were starting to threaten my life. Apparently when I went under my blood pressure fell quite substantially and to keep me within limits the doctors had to use various vascular constricting and heart stimulating drugs to keep the flow of oxygen sufficient. Despite the drips and ongoing transfusion of blood, the anesthetist manually injected blood and plasma with a syringe to boost the amount of fluids going in and raise my blood pressure. In the end it was pretty close, they didn’t actually need to resuscitate me so I guess it could have been closer, but it was close enough that the doctors were concerned and also relieved when my vital signs showed a large improvement post surgery.

My Left Leg was smashed just below the knee. The head of the Tibia bone, which forms the bottom of the knee, had been broken into three separate pieces and most of the bone directly below it at the ‘fracture’ site was so badly damaged that they needed to remove it. The small shards of bone apparently don’t get sufficient blood supply, then die off and cause infection. Large pieces of the muscle and flesh had also been damaged. They had cut my leg open on both sides to relieve pressure caused by the swelling. The pressure had lead to compartment syndrome and was stopping blood circulation to the muscles. The Fibula had been displaced and broken at the top. The loose bottom section of the Tibia had been stabilized with an external fixation device using pins which screwed into the Fibula and the Femur above the knee, carbon fiber rods and bolted clamps kept the pins and bones secure. The wound was still open but covered in suction bandages to drain off the blood and plasma draining from it. The doctors were as yet uncertain as to whether they could successfully save the leg.

A video taken during the operation shows the extent of the damage
Video by Carlien Wassermann

My Right leg was amputated above the knee and the doctors were apparently trying to leave me with as much of a stump as possible although they were concerned with the amount of viable soft tissue available. The trauma had been contained but the leg was not yet closed. Again suction bandages were used to drain the wound.

The initial surgery to save my life and remove my right leg took around 4 hours and ended at 3:07 on the Sunday morning. I was then taken back to theatre later that Sunday by the orthopedic surgeon to fit the external fixator.

To say that I slept on that first night in ICU wouldn’t be quite accurate, its as if I continuously faded into and out of a nightmare. The nightmare part was when I was awake, pain, the effects of the drugs, the constant churning and beeping of the monitors and the machines that regulate the flow of drugs, the business of the nurses and patients coming and going and the shock of being in a hospital with only one leg which could still be amputated.

Tuesday 16 July 2019

Tuesday morning came, although in ICU there is scarcely a night time due to all the activity, and it was back to theatre at 08:20 AM for about three and a half hours, the doctors would continue to work on the left leg . Debriding the wounds, cleaning out more fragments of bone and removing more dead or dying tissue around the wound. Again I came out of the operation in pain and exhausted, it was like all the energy in my body had been depleted, everything I had was used up, maxed out. It was all I could do to try to get through that day moment for moment. I ate some bean soup that evening, although I was not allowed to eat the beans, my digestive system had shut down and the drugs almost guarantee that you get constipated, an issue which would prove to be a problem in the days to come.

Wednesday 17 July 2019

My father arrived from Italy and came to see me in the hospital. It was encouraging to have my family there and without their support during this time, I doubt I would have had the fortitude to continue.

I was taken to theatre again today for the vascular surgeon to do an angiogram of my left leg. Essentially they use an MRI machine and a dye to track the functioning of my blood vessels. They inject the dye into the vein in your pubic area and then uses a pressure bandage to close off the injection site to help stop the vein from bleeding. The anesthetist apparently used some kind of clearing agent drug to wake me from the anesthetic. The effect was to neutralise the painkilling drugs in my system. The procedure wasn’t long but I awoke fast and in considerable pain, post operative shock set in instantly. I was shaking, sweating, cold and breathing in gasps. It felt as if I had just been hit by the rock again, only this time I was already in Hell when it happened. Back in the ICU it took around two hours for me to ‘normalise’ again. Later that evening I had my first real food since the accident, Chicken (lets just leave it at that).

Thursday 18 July 2019

My mother arrived and I saw her for the first time, I also learnt of the amazing amount of support that I had from friends, acquaintances and colleagues outside the hospital. The realisation of how many people I had connected with in my life was staggering.

The doctors placed an ‘epidural’, which is essentially a continuous local anaesthetic applied directly to the spinal cord. They insert a catheter between the vertebrae and into the the area surrounding the spinal cord, a process which is quite unpleasant I can assure you. It did however, help with the pain. For the first time since the accident, my pain was lessened on a more continuous basis. Before then I had had moments that were pain free, but they would be induced by the doctors or nurses giving me some hectic dose of drugs that would reduce or even pause my consciousness. Sure, the morphine, ketamine and precedex were helping to manage the pain, but the epidural really improved things.

I was again taken to theater for around three and a half hours. They continued the process of closing my right leg, they sutured blood vessels and soft tissue and reapplied the vacuum dressings. They also worked on the left leg again, removing further bone and suturing more of the muscles and other soft tissue to try to save the leg. Again I awoke in pain and exhausted, I had this feeling that the world was happening to me and there was in fact very little I could do to change the course of events, I was a passenger on this rollercoaster through Hell and every operation was like a limitless fall further into the black, hot darkness.

My left leg at the end of the first week
Photo by Carlien Wassermann

Friday 19 July 2019 – Sunday 21 July 2019

Although I technically didn’t have surgery on the Monday, it still felt to me as if i had. I had woken up for the first time in recollection since the accident on Monday and it felt as if this Friday was the first day on which I had not been to theatre, and what a relief. To know that there was a break from this constant in and out of induced unconsciousness and that I could just rest was incredible. The journey to this point had been so dense and chaotic, new people, new experiences and a large amount of learning to stay informed on what was going on. For the most part I just lay there over the weekend reeling from the traumatic events of the past week. The nurses turned my bed inside the cubicle so I could look out the window, although it was raining and cloudy, I could still see the Hottentots-Holland Mountain range in the distance. Once my home and my passion, the mountains now looked like some far away land, beautiful and inaccessible, simultaneously alluring and jeering, as if the world was saying ‘Yea, you want this, well then suffer…’

There were no answers, there was no reason, my emotions ranged far and wide; Courageous, born out of my lessons in climbing; Grievous, born out of the complete devastation of the future; Fearful and frustrated from within the present moment. People often tell me how I was so positive during that time and that that’s what got me though, I can’t say I agree with them, I was just trying to stay with it, trying to hold on to some kind of sanity amidst the sudden and terrifying chaos which had so rapidly consumed me. Perhaps it is just such striving to overcome that is the core of positivity, it has occurred to me before that its genesis is such. There might have been no answers, but by the end of the weekend I was clearly faced with the question: Do you have the will to suffer? You can give up, but if you have the will to suffer seemingly without end, if you truly ask that question, in all its seriousness, through all the sacrifices you will need to make to learn the answer, you do not know what you could become. When all else is washed away, when reality is so overbearing that you get faced with this question in its full undisguised nakedness, the choice between two options becomes quite clear: Suffer bravely and voluntarily, or cast yourself down to the end of consciousness.

Rocklands
Photo by Jethro Watson

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  120. Can I simply say what a comfort to discover an individual who really knows what they’re talking about over the internet. You certainly understand how to bring an issue to light and make it important. More and more people must look at this and understand this side of your story. I was surprised that you are not more popular given that you surely have the gift.

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  123. An impressive share! I’ve just forwarded this onto a friend who was doing a little homework on this. And he in fact bought me dinner because I stumbled upon it for him… lol. So let me reword this…. Thank YOU for the meal!! But yeah, thanx for spending time to discuss this subject here on your web site.

  124. Having read this I thought it was really enlightening. I appreciate you finding the time and effort to put this content together. I once again find myself spending a significant amount of time both reading and commenting. But so what, it was still worthwhile!

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  130. Can I just say what a comfort to uncover a person that genuinely knows what they’re discussing on the net. You certainly understand how to bring an issue to light and make it important. A lot more people really need to look at this and understand this side of the story. I was surprised you are not more popular since you surely have the gift.

  131. May I simply just say what a comfort to uncover someone that really understands what they are talking about online. You actually understand how to bring a problem to light and make it important. A lot more people have to look at this and understand this side of the story. I was surprised you are not more popular because you surely possess the gift.

  132. Having read this I believed it was extremely informative. I appreciate you spending some time and energy to put this content together. I once again find myself personally spending a significant amount of time both reading and leaving comments. But so what, it was still worthwhile!

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  137. This is the perfect website for everyone who really wants to understand this topic. You know so much its almost tough to argue with you (not that I personally will need to…HaHa). You certainly put a brand new spin on a topic which has been written about for a long time. Wonderful stuff, just excellent!

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  142. Having read this I believed it was rather enlightening. I appreciate you spending some time and effort to put this article together. I once again find myself personally spending a lot of time both reading and posting comments. But so what, it was still worthwhile!

  143. Howdy! I could have sworn I’ve been to your blog before but after looking at many of the articles I realized it’s new to me. Regardless, I’m certainly pleased I came across it and I’ll be bookmarking it and checking back regularly!

  144. Can I just say what a relief to find someone who actually knows what they’re talking about on the web. You actually understand how to bring a problem to light and make it important. More people have to look at this and understand this side of the story. I can’t believe you are not more popular given that you definitely have the gift.

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  146. This is the right blog for everyone who wishes to find out about this topic. You know a whole lot its almost tough to argue with you (not that I actually would want to…HaHa). You definitely put a fresh spin on a subject which has been written about for a long time. Excellent stuff, just great!

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  148. Hi, There’s no doubt that your website could be having web browser compatibility issues. When I take a look at your web site in Safari, it looks fine however, when opening in I.E., it’s got some overlapping issues. I simply wanted to provide you with a quick heads up! Besides that, excellent website!

  149. When I originally commented I appear to have clicked on the -Notify me when new comments are added- checkbox and from now on each time a comment is added I get four emails with the exact same comment. Is there an easy method you can remove me from that service? Cheers!

  150. After I originally commented I seem to have clicked on the -Notify me when new comments are added- checkbox and from now on each time a comment is added I get four emails with the same comment. Is there an easy method you can remove me from that service? Thank you!

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  152. The next time I read a blog, I hope that it does not fail me as much as this one. I mean, Yes, it was my choice to read, however I genuinely thought you’d have something helpful to say. All I hear is a bunch of complaining about something that you can fix if you were not too busy looking for attention.

  153. You are so interesting! I don’t think I’ve read something like this before. So nice to discover somebody with a few unique thoughts on this subject. Really.. many thanks for starting this up. This site is something that’s needed on the web, someone with a bit of originality!

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  155. You are so awesome! I don’t suppose I have read anything like this before. So nice to find another person with unique thoughts on this subject. Really.. thank you for starting this up. This site is one thing that’s needed on the internet, someone with a little originality!

  156. I really love your website.. Pleasant colors & theme. Did you build this website yourself? Please reply back as I’m wanting to create my own personal website and would like to find out where you got this from or what the theme is called. Appreciate it!

  157. You are so cool! I do not think I have read something like this before. So good to find somebody with some genuine thoughts on this subject matter. Seriously.. thanks for starting this up. This website is one thing that is needed on the internet, someone with a bit of originality!

  158. Nice post. I learn something totally new and challenging on websites I stumbleupon every day. It will always be useful to read articles from other authors and practice a little something from other sites.

  159. An impressive share! I have just forwarded this onto a colleague who has been doing a little research on this. And he actually bought me dinner simply because I stumbled upon it for him… lol. So let me reword this…. Thank YOU for the meal!! But yeah, thanks for spending the time to discuss this subject here on your web site.

  160. I must thank you for the efforts you have put in penning this site. I really hope to see the same high-grade content by you in the future as well. In truth, your creative writing abilities has motivated me to get my own, personal site now 😉

  161. Aw, this was a really nice post. Taking the time and actual effort to generate a really good article… but what can I say… I hesitate a whole lot and don’t manage to get anything done.

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  166. I absolutely love your site.. Pleasant colors & theme. Did you make this web site yourself? Please reply back as I’m attempting to create my own personal site and would like to find out where you got this from or exactly what the theme is named. Thanks!

  167. After I originally left a comment I appear to have clicked on the -Notify me when new comments are added- checkbox and from now on whenever a comment is added I get 4 emails with the exact same comment. There has to be a means you are able to remove me from that service? Kudos!

  168. Can I simply just say what a relief to find an individual who truly understands what they’re discussing on the web. You definitely know how to bring a problem to light and make it important. A lot more people must read this and understand this side of the story. I was surprised that you are not more popular since you surely have the gift.

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  171. I’d like to thank you for the efforts you’ve put in penning this website. I am hoping to check out the same high-grade blog posts by you in the future as well. In fact, your creative writing abilities has motivated me to get my own blog now 😉

  172. Having read this I believed it was rather informative. I appreciate you spending some time and effort to put this informative article together. I once again find myself spending way too much time both reading and leaving comments. But so what, it was still worth it!

  173. I really love your website.. Pleasant colors & theme. Did you create this amazing site yourself? Please reply back as I’m attempting to create my very own website and would like to know where you got this from or just what the theme is named. Thank you!

  174. Having read this I believed it was extremely enlightening. I appreciate you spending some time and effort to put this article together. I once again find myself personally spending a significant amount of time both reading and posting comments. But so what, it was still worthwhile!

  175. You are so cool! I do not suppose I have read a single thing like this before. So nice to discover somebody with some genuine thoughts on this issue. Seriously.. thank you for starting this up. This website is one thing that’s needed on the web, someone with some originality!

  176. When I initially left a comment I seem to have clicked the -Notify me when new comments are added- checkbox and from now on whenever a comment is added I receive four emails with the same comment. There has to be an easy method you are able to remove me from that service? Kudos!

  177. A motivating discussion is worth comment. I do think that you ought to publish more on this subject, it might not be a taboo matter but typically people do not discuss such topics. To the next! Best wishes!!

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  184. You’re so interesting! I don’t think I have read a single thing like this before. So good to discover another person with a few original thoughts on this topic. Seriously.. thank you for starting this up. This web site is one thing that is needed on the web, someone with a bit of originality!

  185. You are so cool! I don’t think I have read through a single thing like this before. So wonderful to discover another person with a few unique thoughts on this issue. Seriously.. many thanks for starting this up. This website is one thing that’s needed on the internet, someone with a little originality!

  186. After I originally left a comment I seem to have clicked on the -Notify me when new comments are added- checkbox and from now on whenever a comment is added I recieve 4 emails with the same comment. Perhaps there is an easy method you can remove me from that service? Appreciate it!

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  191. You are so cool! I do not suppose I’ve read anything like that before. So nice to discover somebody with unique thoughts on this subject matter. Seriously.. thanks for starting this up. This web site is something that is needed on the web, someone with a little originality!

  192. I really love your site.. Excellent colors & theme. Did you make this site yourself? Please reply back as I’m planning to create my own personal website and want to find out where you got this from or what the theme is called. Kudos!

  193. After I originally commented I seem to have clicked the -Notify me when new comments are added- checkbox and now every time a comment is added I receive 4 emails with the same comment. There has to be a way you can remove me from that service? Kudos!

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  202. Having read this I believed it was rather enlightening. I appreciate you spending some time and energy to put this informative article together. I once again find myself personally spending way too much time both reading and posting comments. But so what, it was still worthwhile!

  203. The very next time I read a blog, I hope that it won’t disappoint me just as much as this particular one. After all, I know it was my choice to read, but I genuinely believed you would probably have something useful to talk about. All I hear is a bunch of crying about something that you can fix if you weren’t too busy searching for attention.

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  206. Next time I read a blog, Hopefully it doesn’t disappoint me just as much as this particular one. After all, Yes, it was my choice to read, however I genuinely thought you would have something useful to talk about. All I hear is a bunch of crying about something you could possibly fix if you were not too busy seeking attention.

  207. Good post. I learn something totally new and challenging on sites I stumbleupon everyday. It will always be interesting to read articles from other authors and practice a little something from other websites.

  208. A motivating discussion is definitely worth comment. I do believe that you need to write more about this issue, it might not be a taboo subject but generally folks don’t speak about such topics. To the next! Cheers!!

  209. Next time I read a blog, Hopefully it does not disappoint me just as much as this one. I mean, Yes, it was my choice to read through, however I truly believed you’d have something helpful to talk about. All I hear is a bunch of crying about something you can fix if you were not too busy searching for attention.

  210. The very next time I read a blog, I hope that it won’t disappoint me just as much as this one. After all, Yes, it was my choice to read through, but I really believed you’d have something helpful to talk about. All I hear is a bunch of complaining about something you could fix if you were not too busy seeking attention.

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  214. Hi there! I could have sworn I’ve visited this web site before but after looking at some of the posts I realized it’s new to me. Anyhow, I’m certainly pleased I stumbled upon it and I’ll be book-marking it and checking back often!

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