As it is-A report with pics.

December.
I've been into hospital again, for the forth time.  This visit was another 'debridement of the wound to the left thigh'.  A short stay. Two nights. Light general anesthetic. 


The wound would not heal.  Radiation has made it difficult for the natural healing process to complete.  A centimeter long section of the original incision would not bind leaving an opening, leading to a tunnel of necrotic fatty tissue under the path of the wound to the drain site where a yellow fluid oozed.  I changed the dressing twice a day. 

With stiches,

and without

We, the surgeon, my carer and partner Jo and I decided to fix the problem surgically.  I was wheeled in on November 24th to the same operating theatre as the first, on September 29th. I was dispatched to the place where memory does not keep records and two thirds of the wound was superficially cut open.

The cleaned superficial incision. A shot taken of the theatre screen monitor.

A saline solution blasted the 'non-viable' tissue away and the wound was prepared and then stapled with 20 stainless steel staples spaced at about 8mm along the length of the cut.

Taking care of the wound.

 I stayed in the same ward, at the same hospital blessed with same crew of nurses in a different room. I was comfortable and tender and on a steady does of analgesic, (Endone). I am now at home on a course of antibiotics too treat two bugs which showed up on the culture which they grow from a swab taken routinely at the time of surgery. The body reacts to bacteria by inflaming the site with fluid and white blood cells.  The penecillin will kill the bugs, the inflamation with settle and the wound will dry and heal. Bedrest and a positive attitude will give the best opportunity for all of this to happen.  Bedrest is not as easy as you might think but its worth the effort. I know you know I am right.   

Another thousand words.



Grattitude in my Attitude.

Crikey-How long has it been?  Compared to the young man in the Bali goal for 2 more weeks after found in possession of 25 gams of cannabis, about the same.
Or disappeared political prisoners awaiting a trial in China, not very long.
Or road trauma victims where the carnage is so easily avoided and the pain is so harsh on friends and  relatives, for all of whom the recovery is so difficult, also not very long.  Long enough however to consider carefully the attitude with which I approach all of my experiences. 

As far as pain is concerned, I found it is the work of the mind that sets the disposition.  My attitude is drawn from a combination of my values and my pride. My ego requires that I identify with personal qualities which comply with my chosen values. Therefore,  I am strong in the challenge of overcoming a radiated wound, nearly 3 months without earning a wage and learning to walk with dexterity and strength.  I am proud and strong sayeth me from the mountain of my blog. What is this strength?  Will power?  Force of personality? An association of images that I like to like?   I sense a veil here.  I smell the smoke and see the mirrors. I am a searcher and I seek a shift in attitude so that I fly better. 

Grattitude is grace in understanding a source of energy with us and around us and is what we are.  Grattitude is thanks for that presence in the awareness it is love. Love is the mystery, the binding force, the infinite incarnations.  It is the incomprehensible night sky.  I for one am deeply grateful for the presence of this mystery.  I cannot hope to understand how love weaves into suffering like white lines on the highway at night, or where it is going, but I can give thanks.  

My mind is released from the fight.
Desire is a fire smoking nearby.
Fear is a movie showing everywhere.
Anger is angry and shows up from time to time with a gang out to create harm. 
Grief lurks behind dragging pity along to see the show.
Love is presense, always has been, always will be.
For that I am grateful for it gives my mind a bed to sleep on.

The Mongrel Hour

I did go to hospital from Thursday the 3rd to Sunday the 6th of November.  Like a tax on my system a lot of my physical resources were taken up building new tissue for the unfinished gnarly section of the wound (shown earlier).

As son as the 'dirty' section was cleaned up and sewn together allowing new healthy tissue to bring the wound together, I felt better.  I was last on the surgery list since the wound is technically referred too as 'dirty' due to the necrotic (dead)  material.  The ice cold anesthetic took the journey from my wrist up my arm and in the last moment I felt a rasp in my throat and I was gone. In Post Op (post operative care) I had a drain from the wound and a little more swelling and a tight feeling where the new stitches were sewn, but I felt lighter, still tender but not burdened. A man next to me was struggling as he came to consciousness. He wanted to stand but couldn't. He seemed to be in pain.  There was so many of us.  I was in a section where eleven operating theaters were available and all were in use.

Surgery for the third time, showing the surgeons signature which marks the spot.

Now the work begins.  In hospital I had a couple of meetings with the in-house physio therapist  who advised how to progress with rehabilitation.  The wasted, hard muscles of my thigh and those around my knee (Rectus Femoris, Sartorius, Vastas Medialis and Abductor Brevus), have stopped working for the moment and encouraging them back into service is all about pulling at scar tissue, within the wounds tolerance.  I do several stretches every 2 hours and then cool it down with ice.  I can feel progress but its a dog of a job.  Last night I woke in a dream at midnight watching a list of names for 'wound' in a thousand different languages.  Together with the image was a pressing urge to get these stupid muscles working.  I pushed, prodded, iced, strained and entreated the dead leg to wake.  By 2.00 am I felt the leg had noticed the urgency in my tone and had responded positively.  I am able to walk in a fashion without the aid of crutches for half a dozen steps.  If I can get my leg to bend at the knee past 90 degrees I will be able to explore what might be possible on a stationary bike.  Once on the bike, I fancy things will start to get better a quicker pace.

Balancing pain with rest is a careful calculation.  If I can avoid the painkillers by ensuring that I do not over exert myself I sleep better and heal better.  However there are times when I have felt stressed by the discomfort and popped a couple of pills which in general are opiates or similar.  I sleep around two hours at a spell and move around then sleep again.  Its a mongrel of time and nothing seems easy.  A carers job must be at least as difficult as the nong getting things right again.  It's  a testy difficult, ornery, painful,stupid, frustrating, aching, dip-shit mongrel hour and I can see the seconds pass in a time zone I have never seen or heard before. 

A Step Back

When the Lump was removed it was sent to the lab for analysis. The results came back confirming what the surgeon felt from touch. It was 95% dead. 


I saw him on the 26th of October. He removed the dressing which was letting off an odor that even the dog avoided.  He (the dog), has been very attentive, sleeping by my side, checking up on me and being generally very companionable. But while that dressing stank he took to the other room.


On seeing the surgeon who, as far as I am concerned still owns my leg until it gets healed, removed the dressing.  Underneath was a 250mm scar 80% of which was nicely healed, however 20%,  about 50mm was a gnarly, granulated gash of rotting skin.  Hence the stink. I wasn't feeling that flash either.  The photograph is below, placed out of view since it's not a pretty sight. Scroll down if you must, it's there.  I am resting and taking penicillin every 6 hours, letting nature do its work. I see the Doc again on Monday the 31st October when, I hope, he will declare good progress and I will not have to go back to hospital. 


This blog will come to an end soon.  The story of the Lump is nearly over.  With this set back, small and not unexpected, I feel an increased resolve to  get through it.  Right now, it is something of an ordeal. I can manage about two hours of sleep and then I have to find ways to distract myself from the discomfort.  I'm watching the iconic series 'Roots' which is captivating.   


























A little lower-you will smell it about now........

Rehab-Go Go Go

I did not know the condition of my flesh following  radiation would delay healing and  rehabilitation.  See the image to the right showing blistery, sore, dry and mottled skin; that's how it is all the way through.  What the picture shows is the place where the radiation exited after being targeted on the front side of the thigh. 

Now in my fourth week since the final night of surgery I am completely dependent on crutches. I cannot allow any weight on the wounded leg since it simply cannot take it.  The muscles are not responding as a response to healing. They have switched of for the time it takes for everything to knit together.  When I was first out of hospital the leg was a weight I nursed and carried short distances within the house.  Now I can simulate walking by placing one foot in front of the other however my heel will not touch the ground first because the muscles are not in service.  Each day a small improvement is noticeable. I wriggle a little more or move my hips and bend the limb up a little and down. My general endurance is slightly better.  I can go for a 100 meter walk and require a solid 30 to 40 minute rest to recover.

And it hurts.  Not an unbearable discomfort but a dull ache that ranges from 4 to 7 on the hurtometer depending on the measure of activity.  Anything over 5  requires a response. Recently I have found resting with the ache gives relief.  Sleeping is quality time for the forces at work.

A surge of activity,
An army of volunteers,
A mass of work,
While I nod off in the sun, in the window seat.
Flat out and crutches, the good leg heavy lifting for the wounded one.
A dream illustrated an exquisite piece of work, worth waiting for.

Nothing short of the absolute best.

The Aftermath-Sunday 2nd of October

This morning, the day after the second round of surgery I was out of the woods.  The pain was not present and I found myself pressing the morphine button out of habit rather than a response to pain.  I was glad to let it go and stopped around lunchtime.

I had many visitors this day, family and friends bringing goodwill, chocolates, flowers, children and their love and support.  I became very tired by the end of the day and started to fray. At last I slept only to wake at around midnight to a frightening display of hallucinations induced by the morphine.

On my back and unable to move other than to wriggle to a more upright position the moon outside my window was crescent shaped and half way across the sky.  The Fitzroy Gardens bathed in moon light and the city lights were a comfort. It was a beautiful sight. As I rolled my head away from the view and closed my eyes an intense world revealed itself.  An interior view of existence which described my return from an emotional experience during which I had successfully survived the bloody removal of a 'thing' that had held on violently to the fabric of my thigh.  The sense was that it had not gone willingly.  The wound felt like a battle ground soaked in dark red blood, my body felt gutted and with the recollection of the event tears welled in relief, grief and exhaustion. I felt bonded to the surgeon in blood and tears as though together we had fought bravely.  My sons and their mother appeared, in my hallucination, lined up and pressing into my awareness like a singers in music video, brand new, amplified, with natty clothes and accessories, happy and explosive in their egos.  My family and friends all pressed into this one small space which was also an entire landscape illuminated by the visceral reflection of light bouncing from the walls of my wound.  Everything was oiled, moist and smeared in blood so that a vast range of reds provided contrast and depth.  A great deal of activity was crammed into the vision, peoples from new lands, past times and the future on a road to somewhere going about their business with little regard to me, surviving, dying, arguing, walking from one horizon to another.  I saw the ground was a swamp of perished humans their buttocks rolling into the landscape making history and a road for the mass of living humans making their way through life.  I opened my eyes shocked at what I was witnessing.  I felt emotionally raw and overwhelmed by the range and breadth of human experience. I felt disengaged with the oily morass of humanity and frightened by its suffering.  I lay my eyes back behind my lids, allowed my right hand to touch the place where my heart beats  and from within a voice, "just be grateful" and I was so deeply grateful for being part of it.

I started to understand my re-engagement with life and all its living things, lump-free, would be through the eyes of those I meet and love with gratitude, knowing each and everyone has their story just as I felt my own so emotionally.  First and foremost was my partner, Jo who I knew had been present burning the midnight oil, waiting for my return from the fields of blood.

As the night started to give way to dawn I closed my eyes once again and saw a wide river of viscous, silted fluid flowing over a small dam draining a vast tract of flooded land.  The peaceful flow of the floodwater soothed my heart and I slept for a while until day break.

The Grand Final-Saturday 1st October

In the morning the hospital routine started around my bed and with them came another bout of pain. The routine involves getting blood tests, cleaning the room , cleaning the patient, giving medication, delivering breakfast, offering tea, morning papers, the noise of people waking, new people arriving, cleaners orderlies and with the stress came the pain. Every movement created a pump action throb that yelled.  I entreated myself to find a new attitude, one where panic would not roost.  With that entreaty came a long flash in my peripheral vision, sharp and welcome for I knew it was relief. Another 10 mills of analgesic. Analgesic from the Greek;  an ('without') and algos ('pain').

The surgeon turned up with his son in his Saturday best and explained the wound was bleeding on the inside. A bleeder;  he would be back later that day to go in again, undo his dressing, snip away the stitches and find the place of the bleed and the source of my pain.

Jo, my partner stayed with me all day and into the night. We watched Geelong beat Collingwood, a fair win and an honorable loss.  I nodded my way through the four quarters pressing the green button whenever it would let me. We tried to read to each other, we hung out, she stayed with me as my attention span reduced to seconds and when it was time to be wheeled up to the operating theatre, not so gay this time, she stood vigil in room 216 until my return.

The morphine makes you dry but you can't drink or eat because the risk of food returning to the bronchial tube during surgery is life threatening.  Moments before being taken up that now sombre rd she kissed me on my parched lips with life giving passion.  In my darkest hour she moistened my spirit with a life giving nectar and I went in thinking "it's good to be alive".