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Part Two: Somewhat unrealistic

Apparently, I woke up in the ITU (Intensive Therapy Unit) several hours after the operation, but I don’t remember anything from there. I do remember waking up in Ward 12D, on my back, with some tubes and lines stuck everywhere and with some intense pain in my lower abdomen. Yael was there and told me about the day’s events: The op took a few hours and they have managed to re-align the two sides of the pelvis, fit in those two big screws (can be seen in the x-ray at the bottom of the previous post, the top one is 18cm long!), fit a fairly large plate at the front of the pelvis that holds together the pelvis bone and the smaller bones next to it. I also had a Supra-pubic catheter – this is a tube that goes into your bladder through the wall of your tummy allowing for free drainage of urine and in my case, also blood. It also became my close friend for the next 8 months…we’ll get to that later. The other catheter was the more common one…

Then there was a line in my left arm for intravenous antibiotics, and in my Right arm I had another line with another, magical IV…I say magical because this was morphine and it came with a plunger-type remote control…basically this means that when you feel the pain you press the button and it just pushes another dose of that opiate drug straight into your blood stream. It takes some of the pain away and if you do it more than 2 or 3 times in a row it sends you to sleep. So you can imagine (can you?) that the next couple of days I was sort of playing with this wake-sleep-wake-sleep thing…

The following 10 days I wish I could forget, but I can’t. One side effect of taking opiates and being static is constipation. They want you to start eating so that your system can start working again and that you can gain some strength back. It is worth mentioning that due to the trauma and the lack of food, I had lost 13 kilogrammes in the first 4-5 days, that’s 29lb or 2 stone in British money…the view most of the time was of the Beige curtain surrounding you. Since you lie flat on your back the whole time, you basically loose any visual perspective…everybody look really tall.


Four badly injured men in one room, each cocooned in a curtained cube, busy dealing with their own suffering and trying not to hear and not to be affected by the others’ crying and screaming…it’s all about pain handling and management, or rather the lack of them. When pain kicks in you first try to analyse it and figure out where it’s coming from: is it the legs? The back? The backside? Constipation? Or is it the bladder that is going into spasm again? If you’ve never heard of bladder spasms I hope you’ll never, ever get any. They can last hours (or days in my case) and make you produce some impressively loud, high pitch groans and whines. Every now and again One or both of the catheters would block up with blood clots and would stop draining…It takes a few minutes to realise that this has actually happened and call the nurses. The way to “unblock” the tubes is quite simple: you (or the nurse) use a 50ml syringe full of saline water, connect it to the catheter and push the water through, then carefully start pulling. If the blockage is only caused by some small clots or “debris” then one pull might be enough but sometimes you can end up spending an hour pushing and puling and sometimes you do it on BOTH catheters, all while trying to battle or to just ignore the pain caused by the spasms…and ending up with these long, stretchy bits of clotted blood filling up the syringe. This is the kind of experience I would not wish even to the worst of my enemies!!!

Doing your “business” involves calling & asking someone to bring you a bedpan. They then help you roll over to one side and rolling back until your somehow positioned over it. When you’re done you call again and have your backside wiped. Later on when I gained a bit of strength it evolved into manoeuvring your body from being flat to somehow bridging over the bedpan. I keep telling people that when you go into hospital as a patient, at least as a trauma patient, you leave you dignity and any sense of privacy at the reception upon checking in. You find yourself lying on the bedpan, huffing and puffing and have your blood sample taken at the same time or even funnier, have a group of nurses and doctors doing their round or doing a handover. They all claim their not sensitive to the smells…I somehow doubt it!

There’s also the human side in all this…nurses, doctors, phlebotomists, pharmacists, cleaners, caterers…and they all have personalities, characters, hierarchy, politics…and you are right there in the middle, trying to figure out how to get the best “service”, how to get all the information you need, how to provide feedback and how to prevent mistakes from happening. And those DO happen because we’re all human and because a hospital is a large organisation and a very complicated one at that.

As a trauma patient you can find yourself in some rather awkward, intimate, embarrassing situations and some of these people can be absolute angels, giving so much support far and beyond what they are trained or paid for and still being humble and polite even when under a lot of pressure. As a patient you can be very sensitive, or abusive, or appreciative and they still have to do their job and take care of you.

However the biggest angel by far has been MY angel, otherwise known as my wife, Yael. She was there every single day,  from morning till night. Looking after me and doing the legwork to ask, beg, find, harass, cry, shout, argue, thank…whatever it took to keep me going. All that while managing a house with three young children, with their needs and she still had room left to care about my neighbouring patient, ask them how they do and call someone when they needed help.

We eventually went home after 4 weeks. I was in a wheelchair, equipped with a bag full of medications, a suprapubic catheter (the one stuck in your tummy), a care plan that meant a carer was coming in every day to help me wash myself, on a chair in the kitchen.

Here’s me being rolled into the house, the journey in the ambulance was knackering as the image tells…

We’ve set up the living room so that I can live downstairs and we had an appointment set for a week later were they were looking to see if I can stand up and start learning how to walk again.

Coming home for me was a happy yet difficult experience for me and perhaps more so for the family. At the hospital you feel “safe”…you have a button for everything and there’s always a team who can rescue you should bad things happen. You are in the centre. At home you are obviously a king but even as a king you have to fit into the house’s routines, you also try to be a part of it again. We soon realised that there are times when the Post Troumatic Stress Disorder (PTSD) raises its ugly head and can make you burst into tears, or burst in anger, or just shrink into your own bag of self-pitty and not talk to anybody for hours and days.
The story did not end there, unfortunately.

I’m signing this part off on December 31st, the last day of 2016. I’m at home with my family and we’re looking to spend a quiet couple of days and to kick 2017 off with some good energy and big hopes. I’ll be back soon with the next hospital adventure. Happy new year everybody!

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Got a free helicopter ride!!!!!

It’s taken me a good few months to get to the point where I am able, physically but more-so, mentally, to sit down and put in words what has gone with my body and through my mind since that horrible, horrible morning on April 7th, 2016.

There are hundreds and thousands of cyclists having accidents every year, some survive them, some don’t but not many carry on to tell their story. I feel that sharing my story may, or can help raising awareness, for cyclists but hopefully also for drivers and may help saving lives.

Cycling for me is much more than a way of keeping fit. It’s a life style…in fact if I look at my statistics over the past 10 years it shows that I had spent more time on my bike than I did driving, walking, running and travelling by air and by rail altogether!!!

The accident changed it…as things are, we do not yet know if, how and when I’ll be able to cycle “normally” again. I have all the will and intention to do so, though!

The last 8 months have been a tough and scary journey for me and for my family and friends. The accident, the operations, the treatments, physiotherapy, depression, psychotherapy, medications and the pain that takes over everything else, for days and weeks. Three admissions of 4 weeks at a time, going home 3 times…The journey is not over yet and there are things I may not be able to do again. It has affected all of us but we are a strong bunch and we’re not giving up easily.

As the story is long and as it is still ongoing, I’ve decided to publish it in parts.

Part One – the crash

It started like any other normal day…it was a chilly, clear, early-spring day and I was on my regular training ride exploring the country roads of Hertfordshire. The kids were on school half term break so I was in no real rush to get home and approaching THAT junction I decided to turn right and extend my ride by another 10 miles or so.

I saw the Blue Skoda standing at the junction and there were a couple of oncoming cars, so I signaled, slowed down and stopped in the middle of the road, standing 4 metres in front of the Skoda and waiting for the oncoming cars to clear the turning. Once it was cleared, I turned my head to look right and placed my right foot on the pedal, preparing to set off, when the driver of the Skoda started moving…I screamed and pushed forward thinking that I might get out of his way…BOOM!!!! He hit me side on, dropped me on my Left side and believe it or not, continued to move and did not stop until his front wheel was nicely positionned ON TOP of me…I heard that horrible crunching noise…thinking SHIT that’s my BIKE being smashed…

Silence…just my heart beating loudly. OK let’s see if I’m OK…I can move my head, hands, toes, great! So let’s get up and check the bike shall we?

OUCH! I could not sit up…in fact I could not move at all and only then I realised what that crunching noise was…it was MY BONES being smashed…and then the pain kicked in…nothing like anything I have felt before…and then “Sorry my friend…so sorry my friend”

I’m not your friend! That was the driver…the guy later claimed he did not see me. For the record, to date he has not made any kind of effort to approach us or to check how am I doing or if I’m even alive…but he did say sorry, right????

Women’s voices…quick, get that Medical ID bracelet off and tell them what’s going on..tell them to call your wife on the number in the note. Tell them that you are on blood thinners too…Since the open heart surgery I had 18 months earlier I’ve been carrying a bracelet that has all my medical history on it, as well as emergency contact details.

A Siren, two sirens maybe three even, and more voices. Good, the ambulance is here so they can get me off the road, fix me up and maybe give me a lift home?

Make sure they know about the blood thinners and the heart surgery. If I’m bleeding they should know that it may take longer to control. Now I’m starting to feel cold…guys please don’t cut my kit! These bib shorts are only a few months old and they’re the best I’ve got!!! Too late…they’re cutting everything and now everybody can see what’s going on…

Neck brace – check, Gas & air – check, Morphine – check

“We’re getting you into the ambulance mate, that can be a bit painful”…really? YIKES that hurts!!!!

Onto the ambulance we pop…a few clicks and clacks…are we heading to the hospital already? Err…apparently no we’re not…my situation is pretty bad it seems…worse than we would have hoped…they are concerned that there’s a serious internal bleeding and realise that the pelvis is broken in more than one place…

I can hear the sound of the helicopter…they’re getting me out of the ambulance as they need more space around me. Simon, the flying doctor is telling me that they are giving me Konakion (vitamin K) which reverses the effect of Warfarin (a blood thinning medication that I need for my mechanical heart valve) and need to put a special device into one of my main arteries, with a balloon they can inflate and that will stop blood flow to my lower body if needed.

OK we’re going to take you to hospital now, in the helicopter…YAY I’m getting a ride in a helicopter!!! Getting you on board and flying over is going to hurt and we don’t want you to move (as If I can move…seriously) so we’re giving you Ketamine…that’s a strong drug that will stop you from moving and will help with the pain. Fine at this point I’m happy to take ANYTHING that can take this pain away.

it did stop me from moving but the pain remained…a few more clicks and clacks and we’re airborne. It’s only a short 8 minute flight. That was when I thought I was having a near-death experience, and still think maybe I did…I was looking through a hole, seeing what looked like the inside of a working engine or a machine, in black&white…the sort of visuals we know from The Matrix…I DID NOT like it and I just wanted it to end!

Shortly after landing on the helipad at the Royal London Hospital, one of Europ’s largest trauma centres, I was wheeled down to resuscitation.

During all that time I kept asking about my wife, Yael, and if somebody had spoken to her…they kept telling me “somebody’s taking care of it”…they’ve eeventually let her see me about 4 hours after the accident. I cannot even begin to imagine what went through her mind all that time! She drove to two different hospitals, chased ambulances and eventually got a lift in a police car.

The rest of that day, when I think about it, was actually quite pleasant…surgery was scheduled for the next day, I had tons of morphine on demand so pain was more or less under control and they sort of left us alone to digest it all and to prepare for the next step.

Friday, April 8th, day of surgery

As someone who’s been through major surgery only 18 months earlier…it was pretty much “things as usual”…fasting overnight, early start…roll into theatre, general anaesthetic and wake up several hours later with horrible hangover, cold sweats, nausea etc. etc. In addition to the two cannulas they’ve fitted in my hands yesterday, I now have 2 catheters (one stuck in my belly) and the doc who came to see me says they’ve fitted two big screws across my backside, that also go through the two lower vertebra and a large plate with 4 screws holding the front of my pelvis. They say that I’ll be “non weight bearing” for a few weeks, meaning that I can only lie flat on my back…lovely…

The next chapter will be ready in a couple of weeks and will cover the first 4 weeks in hospital…the good days, the bad days, the pain and the outcome.

These two images are x-rays taken before surgery and a few months later. These screws will stay there as a souvenir for life…

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Happy 6 months birthday

I guess that, as the saying goes; time flies when you’re having fun!!!!

October 29th 2014 was the day I went under the knife and today, April 29th 2015 (which by the way happens to be a Wednesday as well) we are celebrating 6 months…yes! 6 months!!!!

A lot has happened in the past 4 months since my last post; there was winter, which came and left (thankfully). I started traveling again and have visited France, Germany, Denmark, Israel and the Netherlands for work, in a new role with new challenges.

Sport has played a centre part in my recovery process. It is the way I chose to stay focused, to tell myself and the world that there IS life after such a traumatic experience and that anyone who has to go through such an event, can go back to leading a normal, healthy and busy lifestyle.

As soon as I was given the green light, I abandoned the cycle turbo trainer and hopped back on my road bike – I cannot tell you how exciting that day back in January was! Since then I’ve done nearly 2000 kilometres (inc. about 200 on the mountain bike), which is more or less on target for this year.

The longest ride so far was a 121km sportive up in Cambridgeshire and I was well pleased with the 4h42m time I posted.

The BHF also has a part in the story. Before surgery I took part in several of their cycle events: London-Cambridge, Oxford-Cambridge, London-Southend, London-Reading, Dorset and a few more. We donate clothes, toys and books through our local BHF shop on a regular base and have also helped organising a few fundraising days at school.

After surgery I have joined their online community where people can share their stories, experiences and concerns. I also visited their headquarters in London and took part in a photoshoot with a few other heart patients who love sport.

Sure, there are a few things that have changed…like having a blood test every 2-4 weeks, and like taking medications twice a day at a regular time, and like carrying a medical ID card everywhere and wearing a medical alert bracelet. Sleeping more than 2 hours straight is still considered a privilege and the ticking sound of the mechanical valve can be annoying at times but it is something I am growing to like and appreciate as it constantly reminds me that the alternative could have been a lot worse…actually there was NO alternative…so, it’s all GOOD!!!

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Photographs © Copyright Sportivephoto Limited

Photograph © Copyright Sportivephoto Limited

Recovery….

It is now 10 1/2 weeks since my surgery and recovery in general has been going well…there were a lot of ups and downs during the first few weeks (mostly downs) but as time passes I feel stronger with less pain (no more pain killers), Sleep (pr the lack of it) is something I will have to work on, long-term, as is getting used to the loud ticking noise coming from the mechanical aortic valve…

I am a lot more mobile (I can drive long distances!), taking daily exercise and all (or most) of the signs say that I am going to be OK…

And since I am still not allowed to fly and as I have to do regular blood tests etc., we had to settle for short local outings during the holiday season…so you are not going to see any wonderful, warm, sun-spelled photos but here is a small collection from a few trips to the RAF Museum in Hendon, to Trent Park and to the South coast; Milford On Sea and the National Motor Museum in Beaulieu. I was in a “One camera, One lens” mood so all these images were taken with the Mamiya 645DF+, Leaf Credo 50 Digital Back and a Mamiya 35mm/f3.5 D lens, a very versatile and capable combo that lets me shoot handheld at high iso and get some wonderful colours (yes also in B&W) and details. Images processed in Capture One Pro 8. Click on an image to view a larger version…Enjoy!

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                                 All images ©yair shahar and cannot be copied, printed or displayed without the author’s permission

Reset

It’s been MONTHS since my last post…for lots of different reasons like work and other things I was busy with, but those were all just side-stories…

I continued to work a lot, traveled a lot (mostly for work, naturally…), cycled plenty (how about >6000 km in 10 months?) but I was also busy with preparations for the main event!!!

The main event was an open heart surgery (OHS) which I underwent on October 29th 2014, Just 7 days ago. I am writing this post sitting at the dinner table at home!

They replaced the defective-from-birth aortic valve, with a new one made of metal and carbon fibre. They also had to replace about 5cm of the ascending aorta, called the Aortic Root, which was showing severe dilation creating a huge risk of aneurism…

The situation was compounded by a rare blood disorder which they’ve found a few months ago, causing my blood to clot a little slower than usual and leading to a long series of blood tests. Eventually the green light was given, under the assumption that this disorder could actually be caused by the defective valve.

So we went into St. Bartholomew’s hospital on the 28th after lunch. In the morning I felt like getting out one last time, you know…just in case…and did a 39km on one of my favourite local routes, which was lovely 🙂

After checking in, the nurse at the Vicary ward showed us around, talked us through the pre-op stuff and showed me to my bed. I was chosen to get on the table at 8am the next morning so after dinner I had to take a shower with a special antibacterial soap and was handed a shaver, which I had to use for removing any trace of chest hair…they do not want any hair to be dropped into the chest cavity during the operation!

They gave me something for a better sleep, I said goodbye to my wife Yael and that was it!

05:45 wake-up, into another thorough shower and at 07:30 Yael escorted me to the lift, gave me a big goodbye hug & kiss and up I went to the 5th floor where the operation theatres are located.

I remember rolling over onto a narrow bed and going into a small room with a small team who were all joking with me while fitting various needles into my hands and into my neck and after that I do not remember ANYTHING!

I woke up about 11-12 hours later, in the Intensive Care Unit. My first memory is from High Dependency Unit a couple of hours later, that was already after they removed the airway and the camera that were stuck in my throat, my lungs and heart were already running on their own and Yael says that I was even able to talk…nothing sensible obviously, but still…

The next 3 days were not easy…I moved out of the HDU very quickly, only 2 nights there but the help and care of the staff there were unbelievable! I was still hooked to various drips and wires, mostly for monitoring but also with a tonne of painkillers, and those come with all sorts of side effects such as sickness, dizziness, drowsiness and various other “nesses”…

Back at the Vacary Ward, I was put in a large room with a funny bunch of male patients, all in their late 60’s…”veterans” of various heart deceases, strokes, bypass surgeries, lung cancer and whatnot! I was the youngest and the only one who could not say a word…due to the camera that was stuck in my throat I lost my voice and we are still waiting for it to come back (personally I am not in a rush and am quite happy to stay silent for a little while).

I was determined to leave the hospital as quickly as possible. I mean the staff, care and service were all fantastic, but I kinda didn’t like being a patient, wearing a pyjama, having a constant bad taste in my mouth and listening to old people’s conversations…

So on Monday, November the 3rd, when the doctors did their morning round, I shared with them everything I was still struggling with but I also told them that I feel like I’m taking valuable space in the ward and that they will be much better off without me. 10 hours bureaucracy-littered hours later and we were in a minicab heading home!!!! Yael and my daughter, Arielle, came to fetch me.

Today, just 7 days after the operation, I walked my children to & from school, Yael and I took the tube down to the hospital for a blood test (I will have to do lots of those in the coming weeks/ months) and to change the dressing on the wound. We continued to meeting my parent for lunch at the nearby Hummus Brothers restaurant.

I expect to remove the dressing in a couple of days and to have a nice looking, 20cm-long scar on my chest. The wound is healing quickly, although the chest bone underneath it (the sternum) is going to take a couple of months to become one piece again. I have to be very careful with movement, lifting etc. and it will be a while before I can cycle outdoors. I was happy to find out however that the turbo trainer is great for getting back in shape, along with walking, walking and more walking.

I am utterly amazed at how today’s medical developments and the ability of the surgeons to mend you in such a way that you can go through this trauma one day, and a week later you can sit on the sofa with your loved one and watch Downton Abbey….I only missed One episode!!!!

I chose to call this post “Reset”. My odometer was reset on October 29th 2014.

 

Reset