Systematic neglect & lack of treatment!

Sat here this morning, following another sleepless night of pain and discomfort, I can’t help but wonder how things have gotten this bad again. So I started to think about it. I certainly know that I’m not the only person who is suffering like this. There are so many others. Then something dawned on me. There is a distinct lack of action and compassion which our care system and givers are showing us.

As an NHS Registered Nurse myself (at least for a few more months, until my retirement is finalised), it is hard for me to look at or admit to the systematic failure within certain areas. My experience, as some of you are aware, is that of disregard and systematic neglect. Other than my acting GP, and the amazing treatment at kings veterans hospital in London, most others have done nothing but lend accusations of me lying about my condition, accuse me of self mutilation, or ignore me entirely.

My typical day. Spending all day with boiling heat packs to try to help with the pain.

Over the past 14 months, I have received no appointments, No investigations, & No treatment despite numerous visits and phone calls to my GP, which resulted in numerous referrals by him, and yet no appointments, investigations, treatment. My leg has never been examined or looked at at all. Instead I have been left trying to self treat the most painful condition known to human kind.

My condition, returned within weeks of my amputation for the condition itself. How do I know? Trust me, when you’ve had CRPS once, then opted for an amputation to rid yourself of it; there’s no greater fear than that of its return. Believe me; once you’ve had it, you will never forget it. To put it into context for those of you who are lucky enough not to know CRPS, I would ask you to imagine the following: Stick your foot in the oven and turn the temperature up to 300 degrees, and then sit there until you can’t stand anymore, but you can’t remove your foot. That pain and sense of urgency you feel to make it stop, is what any CRPS sufferer is living with every day. There is a reason it’s nicknamed ‘the suicide disease’.

I am sure we have all heard and seen many excuses for the actions, and lack there of, from some care givers. Well I say that there is no excuse for any of it. Refusal to treat, to act, to listen is simply neglect.

I am not writing to elicit a complaint, but to show solidarity to those who have suffered, such as I, at the hands of the Illinformed, and frankly neglectful people. Rather than ignoring us, hurling accusations toward us, stripping us of our medications, and leaving us in unbearable suffering; would it not be a better use of time to look into this horrific condition. My belief as a care giver is to learn and research any conditions which are new to me, and understand them….not make a judgement of ‘it’s all in your head’ It is not.

I had a physiotherapist acuse me of lying about my condition because I needed a wheelchair (and this was after my below knee amputation). A GP spent an hour detailing various similar stories to try to elicit a response from me, which matched her beliefs; that my condition was all in my head. An experienced pain Doctor, who had me in tears, when she told me that she thought amputating my leg because of the agony I was in, was ‘self mutilation’. Even someone I called a friend, tried to tell me I couldn’t possibly have the condition I have, because I don’t make a Broadway show of the pain I’m in. Newsflash idiot: the only person who gets to see me like that is my wife. If I’m having a flare up, I don’t go out or see anyone!

So what can we do? I wish I knew. But I do know that sitting back and letting this happen time and time again is not the answer. We need to build more awareness of our condition. We need to stand up to those who deny our condition exists.

I had the privilege of attending a pain management course which was organised by BLESMA at Kings hospital for veterans in London. The course was via zoom and it was completed a few weeks ago. I had the opportunity to learn more about the science behind pain, and techniques to help. I was told every day that it is not in my head. They were and have been since, incredibly supportive. This is the kind of treatment we deserve. I find myself very fortunate to have been accepted on the course.

This is the kind of treatment we deserve and are in desperate need of. We need to educate ourselves with an armour of informed responses, for those who do not know or understand our condition. Know our treatment options, so we can give our care givers options and ideas, and question when treatment is not given. Then maybe combined with our knowledge we can back up the need for them.

This condition is rare. It is not widely researched or known about; so those of us as the sufferers have the opportunity to educate, I form and help with the treatment we are lacking.

This simply shows where CRPS sits amongst other pain conditions. Enough said!

The Surgery

Photos taken before and after my surgery.

As you can tell, I finally got a new date. I was to go into hospital on the 01st of April 2019. Typical, I thaught. April fools day. Says it all really! The couple of months leading up to this date were really hard. Things took a steady decline, and I was in more pain than I could handle. So when the date finally came, it was such a relief. The plan was to go in to hospital on the 01st and have my amputation on the 04th. My surgeon wanted to get me in early so that they could get my pain under control before the surgery.

So I sat in hospital and waited, and waited, and waited, then got dressed for my block in my leg that was going to relieve my pain, but this was cancelled. So I waited some more, and before I knew it, it was the night before my amputation, and still no block. Well this was a bit disappointing. My surgeon was equally dissapointed. The pain doctor diddnt book me in for the block, like she was supposed to, so I had to be put on the emergency list. But there was always bigger emergencies than my block (which I understood).

The night before surgery was absolutely fine. I thought that I wouldnt sleep. But I had my usual amount of a few hours around pain killers. I was 1st on the list, so my wife came to the hospital first thing. We sat and waited, and waited, and waited, and then all of a sudden a friend arrived who I used to work with in theatre. She had come to take me. It was so strange. Almost all of the staff were ones who I used to work with. From the lady who collected me, the scrub nurse, my surgeon, and my anaesthetist. I was in the anaesthetic room for a while. I was really nervous about the block, but it was fine. I diddnt feel much at all. Once that was done I dont remember much. Normally I remembered the bit just before I went to sleep, but this time I diddnt. I remember waking up though.

Just after my surgery. Back on the ward.

I woke up in recovery in what I can describe as absolute agony, but with itchy toes too! (Strange considering they were no longer there). The block had worked on half of my leg, but not the other half. I was told this may happen. (I should know by now, that if there is a complication, I will probably get it!). The recovery nurse was also one of my old nursing friends. She was great. The anaesthetist came strate away and put up a morphine pump. This helped a bit, but not much. It made me sleepy. But id been living on a high dose of morphine for years leading up to this, so it was not very effective. I spent what felt like, forever in more pain than I thought possable. The doctors and anaesthetist coming in and out of my bed space. They eventually took me back to the anaesthetic room, and did another block. But this still diddnt help. I was still in alot of pain. My wife took a picture of me when I was quite bad. (As you can see below. Not my best look!). That night was just awful. Doctors were coming in as my blood pressure was really low and my heart rate high. This was mainly because of the pain and morphine. Alot of that day was spent in pain. I eventually saw a lovely anaesthetist who decided to do an epidural.

Before the surgery I was given the option of a block or epidural. I opted for a block as I felt that the risks of epidural were too high for me, with the fact that I seemed to get complications with every surgery. But after spending over 24 hours in writhing agony, I quickly changed my mind. I just wanted the pain to go. So back to the anaesthetic room I went.

Not too flatering, but this was when I was in alot of pain!

I felt the pain ease after a few minutes. I was so much happier. I still had pain, but not as much. So, this is how I spent the next 5 days. Which is the maximum amount of time that an epidural can stay in. The doctors had to keep topping up the epidural as I was still in alot of pain. But it was gradually easing. Then the day arrived for my epidural to come out. I was warned that one of the side effects was something called an epidural headaiche. I diddnt think much of it at the time, but of course, in true Lexi fashion, 12 hours after the epidural was removed my head was killing. It was unbearable. Id had migranes before, but this was far worse. I kept vomiting every time I moved. No pain medication helped. So again, I was a conundrum. Nurses and doctors kept trying their best to help, but nothing did. It did takethe focus off my leg though.

So I spent over 24 house writhing in agony, again! Then eventually a nurse put up IV paracetamol, and I was given an anti sickness injection, and The pain went. We will never know if it was this combination, or it was just time for it to end, but end it did. Oh my goodness, I was so happy. The next morning, the physio came and got me out of bed and I wheeled myself in the wheelchair they had given me, to the cafe amd back. I thaught Id go for a coffee. But then disabled life showed me my 1st limitation. I couldnt reach the bloomin cups! So I settled for a 7up. The sense of achievement was just amazing. I was mobile again, and really happy.

Im mobile again 😁

From then to now!

I wanted to document my journey from before my amputation, when my life changed forever, to my decision to complete my Wheely big challenge.

Before all the surgery started and the pain followed, over 6 years ago, I was quite active and fit. I used to run (alot) and cycle, swim and climb, lift weights and play tennis. Id pretty much try most sports, and loved all of them. Then one day after a long run my left foot started to hurt. At this time my day job was as a Theatre Nurse at an Orthopaedic Surgery day surgery hospital. I asked one of the surgeons to look at my feet. He said I had hammer toes, and would require surgery to sort them out. I had seen this surgery alot, and scrubbed for it many times. Although it was quite brutal (orthopaedic surgery is. Its the carpentry of the medical world). So I saw my GP, who refered me to an Orthopaedic doctor. He took Xrays and said that 4 of my toes on both feet needed surgery. He opted to start on my left foot, as it was the worst one. He said that I could either wait for surgery, or have it done now. He advised that it would be better to do it sooner than later, as I was young and fit, and would heel well. He said I should be back to running within 3 months. So I had the surgery. It took considerably longer than the 45 minute surgeries that I had been part of. Mine took about 3 hours. I was told this was because my foot was hard to dissect.

So I went home that day, and felt fine. I had a block in my foot to make it numb for a few days. When the block ran out I was in quite alot of pain, but managed to handle it ok. It wasnt until about week 12 that I started to think that something was not quite right. My woulds healed fine, and the bones fused, but I was still in alot of pain. As the Nurse put it, a disproportionate level of pain to the stage of healing which I was at. So I started to think I must be a complete wimp. Others were walking without crutches by now, and I was still completely dependant on them. I remember at about 14 weeks, taking a trip to Sainsburys, and whilst crutching my way around, I saw one of the Orthopaedic Nurses who was involved with my surgery. He hollared across the shop, “you should be off those by now”. Well, this made me feel terrable. I started to think that the pain must all be in my head, and that I had to get off my crutches.

At this point I was still on alot of pain killers and could not reduce them, if I wanted to sleep!. So I stayed on them. I could not reduce them. I started trying to get used to pain, and trying to walk without my crutches. After 8 months I had no choice but to go back to work as a Nurse. Pay had run out and we were facing living in a cardboard box if I diddnt. So I went back, but has to reduce my hours from full time, to 22 hours a week. A huge pay cut, but better than no pay at all.

Work was hard. Alot of walking, and although the Nursing profession is supposed to be a caring one, after being off for the whole of summer, I found that there was not much compassion at all, and alot of comments like “enjoyed your summer off did you? “, “it’s alright for some, being off all summer!”. This made life for me quite difficult. I had always been a very competant Nurse. I had alot of experiance in scrubbing for very complex surgeries, and so when my training and development was halted (“because id had surgery, and been off for so long”). This was a little hard to take. Especially as my foot was getting worse. I diddnt tell anyone. I was hoping it would just start getting better. But it diddnt.

So after being back at work for a couple of months I requested to see a new Orthopaedic surgeon. I was convinved that something must have happened in the surgery, because it took so long, and that must be why I was still in pain. So I thaught that a second opinion was best. I was refered to a lovely Doctor. Not that my other one wasnt nice, because he was, but this chap made me feel very comfortable and at ease, and put my mind at rest that the pain was not in my head. He took more xrays and saw that the toes id had fused, had not fused entirely straite, and I needed the same surgery again (a revision). So I had this done. I remember waking up in alot of pain. The poor nurses in recovery struggled to get on top of it. Eventually after having most of the pain medications in the drug cupboard, and after being in hospital all day, I went home with more pain medications.

The recovery was pretty much the same as the first surgery. My foot in a large bandage. An appointment to have my stitches out. Me explaining that I was in alot of pain. More than before. Being told it would get better, and that I just had to be patient. It diddnt get better. I was off work for 10 months this time. All the while, trying to adapt myself to being in pain, and accepting that this was going to be my new life.

So after 10 months I returned to work. The same reception met me as before. I started to feel like I was being punished for being off sick. So the last thing I needed was to still be in pain and having to have more surgery. Id spend every day at work trying not to limp. I certainly would not complain.

But as before, after trying my hardest to live with the pain, it became unbearable. Alot of it was centred around 1 toe. It was migrating to the left. So I had surgery to remove the joint. This diddnt work, so I asked my doctor to remove the toe. This still didnt work, and the pain was moving to the next toe. Well, all over the foot, but I thaught it was around that toe. So I asked for that one to be removed too. This was done in April 2018.

This was my last Orthopaedic surgery before my leg was amputated. Needless to say, I had been off work alot, and although at this point I had been there for 7 years, people who had just started and been there for 6 months, made more career progression than I was aloud. So life was pretty rubbish.

Im hospital 3 days to amputation

I was fed up with being in pain. Fed up of not being able to run. Fed up of my life taking a path that I had not planned for. So I decided that I wanted my foot off. This was causing all of my pain. I was living on maximum pain killers. Not sleeping. Could not walk at all, and I was getting to the point of being totally dependant on being wheelchair bound. I could not have my foot dangling at all as it was too painful. I was asked alot what the pain was like. Id simply say ” have you ever stubbed your toe, and remember that gut wrenching pain that makes you want to throw up?”. Well it was like that, all of the time.

The stages of my foot decline 😁