My New Titanium Elbow

“You’ve got your bum out” a nurse said.

“I know” I replied. They’d given me a broken bloody gown and I had a broken bloody elbow.

How was I supposed to tie it? I had run out of clean knickers and I wasn’t about to put dirty ones back on.

“Your bum’s hanging out” a middle-aged patient said, offended.

“I know, they gave me a broken gown!” I replied. A shower would sort it.

A wet wipe clean had never looked so appealing.

Your mission was to heave yourself out of bed with your abdomen and your good arm, without making your elbow spasm, causing a horrific shooting pain.

Then you had to get to the wet room down the hallway to the left, again without moving your bad arm, and early, otherwise it was always occupied. Annoyingly, you had to hobble past a closer shower, which was out of order the whole four days I was on that ward.

“‘Scuse me” the nurse looked flustered.

“Can you tie my hair for me please?” relieved, she obliged.

I had been told that I was definitely having surgery today (day three) and I was determined to be clean for it.

Somehow I washed everything using one arm and a bit of creativity (resting a leg on a grab rail, keeping liquid soap steady on your shoulder…). I wondered how I was allowed to risk another fracture on a daily basis. Later I was not surprised to find that falls were the most commonly reported health and safety incident in England and Wales in hospital, with over 240 000 a year reported.

If I had fallen on my bad arm before the bone was healed, I would have had a “comminuted peri-prosthetic fracture” – a particularly complex fracture made worse by the interaction of internal metalwork on bone.

Nurses only had time for observations, support workers only had time to help with meals and making the beds. And my ward had a “very good” level of staffing according to the Royal College of Nursing.

A support worker came round and fussed about my table being “messy”.

I had most of my belongings there because that was the only way I could access them. But without asking, she chucked everything in a plastic bag saying it was a hazard, and shoved it in a cupboard out of reach.

I had a felt tip arrow drawn on me and three visits from various members of the surgical team.

They were so kind, helpful and understanding. They also explained that the reason I was in so much pain was because when my arm muscles contracted they were pulling my fracture apart.

ORIF surgery was Open Reduction and Internal Fixation.

I was going to have a titanium plate inserted over my elbow and that would be screwed into the bones to hold it together. They would clean out the wound first and remove any smashed bone. I would need months of physiotherapy. I was reassured that I was first on their list after lunch.

I was given the option of an uncomfortable one and a half hour surgery lying on my side conscious, being pushed and pulled about, or general anaesthetic, so I opted for the latter. They said they might have to insert a breathing tube but I didn’t want to be intubated so they said they would use a mask instead.

“You’ve become sensitised to pain” the anaesthetist observed, “that’s understandable given the nature of your injury.”

They looked enthusiastic and alert and and appeared to enjoy their work. I was even allowed to gingerly climb onto the operating table so I didn’t have spasms from being transferred. The mask was placed over my mouth and nose with an air gap but the anaesthetist saw that I was still conscious and sorted it.

***

I came to with a jolt in an unfamiliar white ward, like some kind of afterlife.

There were no curtains, just rows of beds, except I couldn’t see the other patients. Two curious faces loomed above me in green scrubs. Suddenly my body started convulsing.

The figures above me said something about pethidine and I was injected. My body relaxed and I felt much better as they whisked me back to the Trauma Ward.

The Traumatic Trauma Ward

Two cheerful young men in green scrubs came by in the early hours and introduced themselves as orthopaedic doctors.

I said “hi, can I have some morphine please?”

Codeine was not making any difference, there was an intense burning pain in the joint and if I moved my arm it was so strong I would cry out. Then there was the constant ache.

They exchanged glances. “Yes we can sort that. We have had another look at your X-rays and we think you probably don’t have an open fracture after all, so your operation can’t be prioritised. We might send you home for a week or two and bring you back in for the operation.”

I thought about trying to manage the agony with codeine.

“I want to stay in hospital until the operation.”

The medics acknowledged this and left.

I needed the toilet but I was on my own. I wasn’t prepared to pee myself and I couldn’t reach the buzzer.

Fortunately two support workers down the corridor heard me scream from the shooting pain of my muscles pulling my fracture apart, and one had to help me off the toilet.

After that I finally got morphine, but then a high-pitched voice jarred me awake. It was coming down the corridor accompanied by the squeak of wheels.

Lily was an advocate of LGBTQ rights, she said, and she wanted to be a counsellor for the LGBTQ community because one had really helped her.

She had been using a pedestrian crossing because the traffic lights had changed to red. A taxi had sped through and over her, breaking her back and legs. The driver had got witnesses to agree with his side of the story, that the lights were actually on green.

When she was not telling everyone about it, she was moaning in agony.

I was kept nil by mouth the next day, so I missed breakfast and lunch.

In the morning I waved goodbye to the smiley staff who had helped me, as I was wheeled out of the Theatre Recovery Unit and onto the orthopaedic ward. I hoped it would be quieter. It wasn’t.

The orthopaedic ward was larger and open plan, with a blocked dirty toilet and one shower serving 12 patients. The spare toilet and shower were both broken. Unlike the Theatre Recovery ward, it was usually fully occupied and half staffed.

My four day neon hell of noise and pain had begun.

It was Sunday morning and a woman was being gently and firmly reassured by a nun.

Next to her was 88 year old Brenda, who was visited by her son and the two laughed together. She was outspoken and her bright eyes took everything in. She beckoned me over and we had some good chats. She had survived breast cancer and then she had had a fall. She said she would probably die soon. “You seem pretty healthy, I don’t think so” I said. “Oh love” she smiled, “I’m not afraid of death, I know I don’t have long left, that’s just how it is. My husband passed eight years ago so I don’t mind, I’m ready. I’ve already survived breast cancer” she said proudly.

The table was put on the side of my broken elbow, so I could not reach anything and no staff were available. They had even put the call bell out of reach. I lay there looking at the clock, counting the hours until my boyfriend would break the monotony.

Finally, my first meal of the day was served, a flavoursome beef curry. My boyfriend brought home-made banana cake for dessert and it was so comforting to see him.

He brought in my medication which I had not had for two days. A nurse had not arranged it as she promised, when she refused to let him bring it in onto the Theatre ward.

Night fell and so did the staffing levels. Once again I was without morphine for hours and I couldn’t help making a noise about it, it was the only way of processing the mental stress of being in constant agony and helpless.

I apologised to my fellow inmates as I groaned through the hours, waiting for two nurses to be able to sign off the only thing that would let me sleep.

I played a pain management meditation and calmed down as I watched the clouds lighten. Pain was part of life, it was temporary and it wasn’t always a bad thing. I shouldn’t resist it or be worried about it.

A bed pan was brought but I somehow wet myself and an exhausted zombie nurse had to change the bed. She said how she was on her fourth or fifth 12 hour night shift.

The closest patients both had dementia, one lovely lady was unsettled by my moaning and repeatedly asked if I was ok. The woman opposite repeatedly asked for help even though she didn’t need it. Flustered staff checked and eventually she was ignored. This seemed to increase her harassment of them.

When I finally got morphine I was still in too much pain to sleep, so I got the nurse to get the doctor. Finally, a girl in her 20s sympathetically doubled the dose so I could finally drift off. As the dosage increase hit my system I suddenly vomited, and then spilt some on myself putting the bowl on the table. I had to sleep in it as no one was available to change the bed again.

Maybe I would get surgery tomorrow…

Unemployed…again.

Since my last blog post, my life has changed completely.

In November 2017 I decided to apply to do a postgraduate nursing diploma. I had spent years working my way up to a well-paid steady job as a civil servant. But I wanted to have a job where I could help people. It was a gamble but it was the last year of the bursary – it was now or never.

“My bursary was £450 and rent is £380 – all activities were limited by my budget.”

I am no longer on the course but I hope that I can start again, because I really enjoyed both the academic and practical aspects of the course. It involved military discipline and if I wasn’t passionate about nursing I wouldn’t have managed it. I woke up at 6am to go to placement, got back at 5 or 6pm, ate a sandwich for dinner and then wrote a 6 000 word essay in the library until it shut at 9pm…for over a month.

My bursary was £450 and rent is £380, so all activities were limited by my budget, even food shopping. Gone were my flights of fancy at Waitrose. Now it was Aldi or Co-Op basics. The 30p bag of pasta and the £1 jar of pesto with some defrosted peas or carrots became my go-to meal.

Despite the long hours and low budget, patients kept me strong, smiling and focused and made the experience enjoyable. Being able to provide care was a privilege and gave me a deep sense of contentment.

It made me realise that caring for others is not just what I do, it is a fundamental part of who I am. It gives my life more meaning and purpose.

This is why I volunteered to help at a Dementia Cafe with a wedding theme this week. I immersed myself in the experience, from blowing up confetti balloons to hearing people’s life stories. It was a welcome relief from the stress of feeling lost, confused and worrying about the future.

If I don’t get another chance, what am I going to do?!

Things couldn’t be tougher. The intense combination of university and placement have been replaced by throwing myself at the job market. My bursary has been stopped but I still need to pay the rent. I have already had to endure two consecutive days of rejections from two job agencies.

“I didn’t get off the sofa most days.”

If I don’t find work in June, I will be forced to give up my independence and move back in with my parents. My housemate couldn’t believe it. “I love living with you” she said, “please don’t move out.”

I never thought I would be in this position again. It has been two weeks so far. The first week I was an emotional wreck and I came down with a sore throat and a cold. Exhausted and drained both physically and emotionally, I didn’t get off the sofa most days, crying, blowing my nose through a full loo roll and watching TV. I didn’t have the energy for anything else.

But when you’re at your lowest, you realise how lucky you are to have so many good people around you. Everyone gave their time to listen, offer advice, meals, and a shoulder to cry on. With their support my week gradually improved, and I was able to focus instead on my birthday celebrations.

I have already tried to get care work but sadly it wasn’t possible. I have no formal qualifications in it (despite years of experience) and I can’t afford a car.

A few days ago I decided it was time to stop crying and get off the sofa. Partly because I had watched everything remotely interesting on TV catchup, from the BBC to More4 and ITV. There was only dreary daytime TV left.

I started by creating a more positive and restful environment. I tidied, cleaned and hoovered the house. The saying “clean space, clear mind” is confirmed by research showing that messy rooms cause excess cortisol production and can be distracting for the brain.

I then began a Post-It Power Plan, where I brainstormed ideas to find a way forward. It was a good method to get some clarity in the chaos.

I am either too qualified or too unqualified – I am stuck in Catch 22 limbo.

Yesterday my job mission continued. I rang up three job agencies and applied for admin work online. So far I have been turned down by two job agencies on the basis that although I have experience, it is not recent enough. This is a new level of competition compared to the “you don’t have enough experience” response when I was last unemployed some five years ago.

But persistence is key if you are to break through the increasingly reinforced walls of the current job market. The next day I ramped up the pressure by going in person to other job agencies with my CV and even going into various businesses with it. It is always more effective going to a job agency in person than contacting them by telephone or email. In person they can practically smell your desperation as you offer to give their employers your time on any basis, working for any pay and at any level, as you hand them your CV, your passport, your CRB certificate and your dignity. They can see that you’re tired from walking around all afternoon in the pouring rain in your business power dress.

Next week I am going to a job fair where up to 25 companies will be hiring and I will be spamming companies with CVs. By the time I’ve finished, I will be surprised if there is a business in the city that has not heard of me. Short of walking around with a billboard strapped to me, reading “AVAILABLE FOR WORK NOW” and my phone number, there isn’t much more I can do.

I now have a busy week of job-hunting to look forward to next week. I have signed up with one agency and I have an appointment with another next week. I also have an appointment for Jobseekers Allowance. I am dreading going back to this handout again, it is so shameful that at my age and with my experience I will now have to sign up to weekly harassment involving job skills workshops, when I got a first in a careers development module at university. I know how to gain employment. The problem is that I am either too overqualified, or too underqualified – I am stuck in Catch 22 limbo.

I was in this desperate position when I started this blog in 2013. The blogging community spurred me on and eventually my documented struggle to find employment attracted over a thousand views a month from all over the world.

If you are in the same boat and you are struggling to keep your head above water, read this article about the importance of learning from failure and being patient until you succeed.