Case 2 - Patrick O'Reilly

In October (2010) while visiting Norfolk on holiday my son and I were climbing a large tree and as I was getting down from the tree I lost my footing and fell feet first out of the tree. I landed on a large root with my right leg and felt a sudden incredible pain. Looking down at my leg it was obvious that it was broken. I was taken to the Norfolk and Norwich hospital for treatment where the doctors in A&E confirmed that I had fractured my right tibia and fibula. An initial operation was performed to relieve a build-up of pressure (compartment syndrome) in my leg after which Mr Davis explained the courses of treatment available to me. Between us it was decided that it would be best to fit an external fixator onto my leg. I went into theatre and soon awoke back on the ward wearing an Illizarov Frame!!

Early Days

It was quite a shock to wake up with the frame on; I don't think anything prepares you for the size and weight of the frame till you have it on. I felt frightened at the prospect of wearing this 'thing' for a period of months and to be honest felt like giving up there and then. Talking to the doctors and other staff on the ward though helped me through these initial feelings. They had experience of looking after people with these frames on and their confidence in my ability to make a full recovery was comforting.

I spent a total of 10 days on the ward and was thankful for this time to be able to get used to the frame. The physios got me up and moving early on with the use of a Zimmer frame and crutches and once safe I was on my way home.

Home

This is where I consider the wearing of the frame to really have started, the artificial nature of being in hospital, with lots of people to help me do things was very nice and much appreciated but it would be at home that the true test would lie.

I live with my wife and 2 children and it was a massive job to work through this time wearing my frame. It has tested us all and has been difficult but I have come through it and I hope anybody out there reading this that is doubtful will too.

I will go through a few of the problems I faced wearing my frame and how I dealt with them:-

COMFORT - Getting comfortable both when awake and asleep is probably the first thing that I had to deal with when returning home with my frame. I soon realised that pillows are your best friend here and made sure I was always surrounded by many of them. By putting a pillow under my frame and then one between my frame and my other leg I was able to lie on my side which often eased discomfort and made me more comfortable. A pillow on top on my frame at night also helped prevent my wife from bashing into the frame in her sleep, though she did manage it a couple of times! I made sure wherever I was that I was able to elevate my leg whenever I could and found that this really did help reduce discomfort and swelling - this is probably the biggest tip of all I could give out

CLOTHES - Finding clothes to wear whilst wearing my frame was a problem. It is only possible to wear leg wear that comes over the frame so all of my trousers were useless as the legs could not fit round the frame. I purchased some tracksuit bottoms and cut the right leg off so I could wear these whilst wearing my frame, they were cheap and cheerful but did the job fine. I also cut the leg off a pair of combat trousers which were really good as they had large pockets on the legs which came in handy as when using the Zimmer or crutches I was struggling to carry things. Once it got into spring time I was able to wear a lot of my shorts that I wear for summer and the combination of all the above clothes got me through.

MOBILITY - My main modes of transport were crutches and a Zimmer frame. In the early days I found I needed the Zimmer as it was difficult to balance on crutches, the weight of the frame on one leg really affected my balance. About a month or so in though I was able to use the crutches. I was lucky enough to get given a wheelchair from my local wheelchair services with a leg rest for my bad leg. This enabled me to go further distances than the crutches allowed and was important for continuing to do things that I enjoyed... plus it enabled my wife and I to get into the cinema 2 for 1! As Ben states elsewhere on the website it is really important to keep moving and to get weight bearing on the limb affected - this speeds up healing and promotes bone growth. It is scary at first to get moving and the temptation is to just lie around all day but keep in mind that it is doing your limb good to move around and keep going. Plus I think there are many benefits mentally from getting outside and meeting people, as being stuck inside for 6 months is a challenge in itself.

BATHING - I did not feel comfortable with trying to get in and out of the bath to have a shower whilst wearing my frame so opted for the duration of my frame time to have a wash at the sink every day instead. By putting a stool in the bathroom I was able to wash myself and keep clean. The dream of being able to soak in a hot bath when the frame came off was one of the motivators I used to keep me going especially when I felt things were getting on top of me. I had my first bath since having my frame removed the other day and it was so nice I was in tears as I lay in the water!

PIN SITE CARE - There are instructions already on the website for maintaining the pinsites and I wholeheartedly agree with them. It was stressed from day 1 that it was of the upmost importance to keep my pinsites clean and free from infection. At first it seems a daunting task to clean them but it soon becomes second nature. The method of cleaning recommended by Ben served me well and I had no infections at all whilst wearing the frame. I would recommend keeping a good stock of both swabs and chlorhexidine solution and making sure you keep to your cleaning regime. If any of my sites looked dodgy I cleaned them each day until they looked better.

FURTHER TREATMENT

I saw Ben a few times over the 6 months that I was wearing my frame where minor adjustments and tightening of the frame were done and after 6 months it was time to get the frame removed.

I was given a choice between it being taken off in theatre with anaesthetic or in the clinic with gas and air - being a bit of a coward I chose theatre, going into a plaster cast for 2 weeks afterwards. There was some trepidation after the frame came off, it had been such a big part of my life for many months and I suppose there was a fear that my leg would not be able to cope without the frame on. The first steps with the plaster cast were hesitant, though I soon realised that there was no problem and when the cast came of I had my leg back!

I'd just like to say how grateful I am to the staff at the Norfolk and Norwich hospital, and particularly Ben Davis. When I looked down at my leg at the bottom of the tree I never thought it would be fixed, yet here I am with no frame on and nothing else in my leg at all. This is all down to Ben and his team and they are amazing.

I hope that if you are reading this and you have recently had a frame, that this has helped you in some way. To anyone with a frame I would say, keep going, keep walking, keep laughing, it will be off your leg in no time and you will be back on your feet.

Patrick O'Reilly

Lincolnshire