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

  123. An impressive share! I’ve just forwarded this onto a colleague who had been doing a little homework on this. And he actually bought me breakfast simply 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 matter here on your website.

  124. An outstanding share! I’ve just forwarded this onto a co-worker who had been doing a little research on this. And he in fact ordered me breakfast because I stumbled upon it for him… lol. So allow me to reword this…. Thank YOU for the meal!! But yeah, thanks for spending some time to talk about this issue here on your internet site.

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  132. The next time I read a blog, Hopefully it does not disappoint me just as much as this one. After all, Yes, it was my choice to read through, but I truly thought you would probably have something useful to talk about. All I hear is a bunch of whining about something that you could possibly fix if you were not too busy searching for attention.

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  136. Your style is unique compared to other people I have read stuff from. Many thanks for posting when you have the opportunity, Guess I will just book mark this blog.

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  139. An impressive share! I’ve just forwarded this onto a co-worker who has been conducting a little research on this. And he in fact ordered me lunch simply because I stumbled upon it for him… lol. So allow me to reword this…. Thanks for the meal!! But yeah, thanx for spending the time to discuss this topic here on your internet site.

  140. I would like to thank you for the efforts you have put in writing this site. I’m hoping to see the same high-grade content by you later on as well. In fact, your creative writing abilities has inspired me to get my own, personal site now 😉

  141. When I initially 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 four emails with the exact same comment. Perhaps there is a means you are able to remove me from that service? Thanks a lot!

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  148. I seriously love your site.. Pleasant colors & theme. Did you build this web site yourself? Please reply back as I’m trying to create my very own website and would love to know where you got this from or what the theme is named. Thanks!

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  152. I have to thank you for the efforts you have put in penning this website. I’m hoping to see the same high-grade content from you in the future as well. In fact, your creative writing abilities has inspired me to get my very own website now 😉

  153. Having read this I thought it was very enlightening. I appreciate you finding the time and energy to put this content together. I once again find myself spending way too much time both reading and commenting. But so what, it was still worth it!

  154. I blog often and I truly appreciate your information. This article has really peaked my interest. I am going to book mark your website and keep checking for new details about once a week. I subscribed to your Feed too.

  155. Hello there, I do think your web site could possibly be having internet browser compatibility issues. When I take a look at your website in Safari, it looks fine however, if opening in IE, it has some overlapping issues. I just wanted to give you a quick heads up! Other than that, excellent website!

  156. Next time I read a blog, I hope that it won’t fail me just as much as this one. I mean, Yes, it was my choice to read, however I genuinely thought you would probably have something interesting to say. All I hear is a bunch of complaining about something that you could fix if you were not too busy looking for attention.

  157. Right here is the perfect blog for anybody who wants to find out about this topic. You know a whole lot its almost hard to argue with you (not that I actually would want to…HaHa). You definitely put a brand new spin on a subject that’s been written about for a long time. Great stuff, just wonderful!

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  159. I must thank you for the efforts you have put in penning this website. I really hope to see the same high-grade blog posts by you later on as well. In fact, your creative writing abilities has inspired me to get my very own site now 😉

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

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  179. When I originally left a comment 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 recieve 4 emails with the exact same comment. Perhaps there is a means you are able to remove me from that service? Kudos!

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  182. When I initially commented I seem to have clicked the -Notify me when new comments are added- checkbox and now whenever a comment is added I recieve four emails with the same comment. Perhaps there is a way you are able to remove me from that service? Cheers!

  183. Having read this I thought it was really informative. I appreciate you spending some time and effort to put this information together. I once again find myself spending way too much time both reading and posting comments. But so what, it was still worthwhile!

  184. Hi, I do believe this is an excellent website. I stumbledupon it 😉 I am going to return yet again since i have bookmarked it. Money and freedom is the greatest way to change, may you be rich and continue to help others.

  185. Hi there, I believe your site could possibly be having web browser compatibility problems. Whenever I take a look at your blog in Safari, it looks fine however, if opening in IE, it has some overlapping issues. I simply wanted to provide you with a quick heads up! Aside from that, great blog!

  186. An outstanding share! I have just forwarded this onto a co-worker who has been conducting a little research on this. And he in fact ordered me breakfast simply because I stumbled upon it for him… lol. So allow me to reword this…. Thank YOU for the meal!! But yeah, thanks for spending the time to talk about this issue here on your web site.

  187. May I simply just say what a comfort to uncover someone who actually knows what they’re talking about on the web. You actually know how to bring an issue to light and make it important. More and more people ought to look at this and understand this side of the story. It’s surprising you are not more popular because you certainly have the gift.

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  189. Having read this I believed it was very enlightening. I appreciate you finding the time and effort to put this content together. I once again find myself personally spending way too much time both reading and posting comments. But so what, it was still worth it!

  190. An impressive share! I’ve just forwarded this onto a co-worker who has been conducting a little research on this. And he in fact bought me lunch because I discovered it for him… lol. So allow me to reword this…. Thank YOU for the meal!! But yeah, thanks for spending the time to discuss this subject here on your web page.

  191. A fascinating discussion is worth comment. I do think that you need to write more on this subject, it might not be a taboo matter but usually people don’t speak about these topics. To the next! Best wishes!!

  192. You’re so cool! I don’t believe I’ve read anything like that before. So good to discover someone with genuine thoughts on this subject. Seriously.. thanks for starting this up. This site is something that is required on the internet, someone with a little originality!

  193. You are so awesome! I do not believe I’ve truly read anything like that before. So great to discover another person with unique thoughts on this subject matter. Really.. thanks for starting this up. This web site is one thing that’s needed on the internet, someone with a little originality!

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  195. I must thank you for the efforts you have put in writing this website. I am hoping to see the same high-grade blog posts from you in the future as well. In truth, your creative writing abilities has inspired me to get my very own blog now 😉

  196. Hi, I do believe this is an excellent site. I stumbledupon it 😉 I may revisit once again since I saved as a favorite it. Money and freedom is the best way to change, may you be rich and continue to guide others.

  197. May I simply just say what a comfort to uncover an individual who really knows what they’re discussing on the net. You definitely realize how to bring a problem to light and make it important. More and more people need to look at this and understand this side of your story. It’s surprising you’re not more popular given that you certainly have the gift.

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  201. I have to thank you for the efforts you’ve put in writing this site. I am hoping to view the same high-grade blog posts from you later on as well. In truth, your creative writing abilities has motivated me to get my own, personal site now 😉

  202. Next time I read a blog, I hope that it doesn’t disappoint me just as much as this one. I mean, Yes, it was my choice to read, nonetheless I truly believed you would probably have something helpful to say. All I hear is a bunch of moaning about something you could fix if you were not too busy searching for attention.

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

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  205. I’m amazed, I must say. Rarely do I come across a blog that’s equally educative and entertaining, and without a doubt, you’ve hit the nail on the head. The issue is an issue that too few folks are speaking intelligently about. I am very happy that I stumbled across this in my hunt for something relating to this.

  206. When I initially commented I appear to have clicked on the -Notify me when new comments are added- checkbox and now each time a comment is added I recieve 4 emails with the exact same comment. There has to be a way you can remove me from that service? Thank you!

  207. After I initially left a comment I appear to have clicked on the -Notify me when new comments are added- checkbox and now whenever a comment is added I recieve 4 emails with the exact same comment. Is there a way you can remove me from that service? Appreciate it!

  208. Next time I read a blog, Hopefully it won’t disappoint me as much as this one. I mean, I know it was my choice to read, however I actually believed you’d have something useful to say. All I hear is a bunch of whining about something you could possibly fix if you were not too busy looking for attention.

  209. This is the right web site for anybody who wants to find out about this topic. You realize so much its almost hard to argue with you (not that I actually would want to…HaHa). You certainly put a fresh spin on a subject that has been written about for decades. Wonderful stuff, just wonderful!

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

  211. An outstanding share! I’ve just forwarded this onto a colleague who was conducting a little homework on this. And he actually bought me breakfast simply because I discovered it for him… lol. So let me reword this…. Thanks for the meal!! But yeah, thanks for spending time to discuss this matter here on your website.

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  213. An interesting discussion is worth comment. I do think that you should write more on this subject, it might not be a taboo matter but typically people don’t talk about such subjects. To the next! Kind regards!!

  214. The very next time I read a blog, Hopefully it doesn’t fail me just as much as this particular one. After all, Yes, it was my choice to read through, however I actually believed you would have something interesting to say. All I hear is a bunch of crying about something that you could fix if you weren’t too busy seeking attention.

  215. Oh my goodness! Impressive article dude! Thank you, However I am going through troubles with your RSS. I don’t know why I am unable to subscribe to it. Is there anybody else getting the same RSS problems? Anyone that knows the answer can you kindly respond? Thanks!!

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