August 2009

The automatic irrigation in the veg garden was running well, we had harvested our first aubergines, four varieties of tomatoes, courgettes and apples, and all was set for good crops: three types of melons, assorted pumpkins and watermelons, and much more. We returned across the mountains to supervise the re-roofing of our house.

The job was nearly done, and we decided to meet up with our friends Francis and Hanne for lunch on Tuesday 11th, two days before returning to the quinta to harvest and dry the huge fig crop.

As we were leaving Janet told me the light bulb in the office had blown, so I replaced it. The roofers were using the step-stool in the house, so rather than bother them I stood on the office chair. It has wheels, and if you wiggle, it skates from under you and you fall off. Which I did, and nearly passed out from the pain of a broken left femur. Bloody foolish. Too late to rewind time and use a stool instead. This simple mistake costs an enormous amount of pain over many weeks, painful sleepless nights, and lots of effort for everybody.

So, as I lay gasping in agony on the ground, the builders offered to ring the bombeiros (ambulance). Janet pointed out that we would need to eat before going to hospital, as we would be there for some time. We ate a sombre snack, me lying in half-light in the study, sick with pain. The bombeiros arrived (one of the two crew used to be our postman!) The run to Coimbra was far quicker than usual, as the driver (Fernando) likes to rally-drive with occasion blasts of the “nee-naw” and “do-WHEEE-ooo”. He attempts to get airborne wherever possible; I’m glad I don’t pay his driving insurance.

At the hospital we were straight into casualty and seen quickly, then the process slowed down with X-rays and orthopaedics, then ground to a halt so Janet left before seven. I stayed stretchered for the possibility of an operation during the night. At 11.30 they transferred me into theatre, as conscious as when I arrived, and gave me a regional anaesthetic (in the arm, I think). On went the monitor wires, up went a steel bar across the operating table, then my left forearm was taped to it (to prevent me from moving), as was a vent supplying oxygen. They got out the toolkit, and without any “with your permission?” in went the scalpel. Then the bigger tools, the chunky pneumatic saw, the drills, hammer and chisel(!), the usual carpenter’s stuff, only in stainless steel. Chiselling was the worst; the upward impacts kept banging my head onto a block fixed at the end of the table to prevent me being gradually knocked off. “You’ve good strong bones.” said the surgeon/mechanic. Evidently not strong enough, I thought. With a low conversation going on all the time, I eventually piped up with “Could you show me one of the pieces you’re putting in please?” A nurse obliged – a 4” stainless bolt with a complicated thread. My dad would have liked it as a good bit of engineering. Although it did occur to me, I did not have the courage to ask them to pass me my poor old bits of bone. That would have been too sickening even for me. The anaesthetist cheerfully observed that my heart was in good shape. Just as well, since five years ago I had surgery following heart attacks, and four years ago in the same hospital I had told my cardiac specialist that as I wasn’t taking his medicines any longer, this would be my last appointment. He replied by giving me his private mobile number for when I should need it.  The operation ended after midnight and the second surgeon enjoyed closing the wound with his staple gun, about thirty staples.

On Wednesday 12th I was moved from Recovery to a surgical ward and, numbed, I passed a very uneventful day. The guy in the next bed had the same op as I, but his fracture was caused by leaping from a runaway motorway construction tractor (290HP !! Mine is 35HP) on a slippery hillside. It makes me feel rather pathetic. A visit from Janet relieved the tedium for a while.

They turned off the lights at ten, then Our Old Lady of Doom and Pain started, at full volume. “Oh mai, oh mai” (mother) with every breath.  And for a change of chant, “Oh Jesoosh, oh Jesoosh” (Jesus). Although she persisted all night he didn’t answer. After a few hours of my own suffering augmented by hers I asked for a sleeping pill, for her, that everyone in the ward might sleep. Not allowed.

Thursday began just as I fell into an exhausted doze. A few injections, checks, a visit from the trainee doctors, followed by the decision to move me from the surgical ward. They packed my kit and took me away. As the ambulance cleared the building the sun blasted in and patchily irradiated my face and shoulder with the unwelcome ferocity of an over-run heat lamp. The air was hot as a hairdryer, the passing palm trees bleached silver by the glare, the insects chirped loud as chromed whistles, and I was drained. Quickly I was popped into a new world, rehab. As the bed rolled to a halt a therapist whipped off my thin bed sheet and, seizing my ankle and knee, yanked the shin up and asked if I was ready to get up. The tears and sweat from pain and from the journey drenched me; I had neither breath nor wit left to answer. “Tomorrow, then.” he decided for me.

Friday 14th August.

I woke when they turned the lights on. Not that the previous night offered me much sleep at all, with an aching thigh, painful down beyond the knee. Since I was already hurting, I decided to suffer properly and requested that I was helped out of bed and taken to the loo and for a shower. Was I attempting a swift blackout by pain overload, or was I just out of my mind? Imagine your thigh has had the ministrations of mechanics within, after having the muscles crushed and torn off the bone, all within the last two days. When you activate a muscle nothing useful happens but the shredded ends all zap in pain. The orderlies push your legs off the bed and pain from the injured limb has already gone well into the red zone before you try to move it. Yet everyone who has broken a thigh bone knows this story. You sit in a wheelchair with the poorly leg hanging off the seat and trundle over the gaps in the tiled floor, registering each as a new stab of pain, to a loo where you park above the seat. Wiping your bum is painfully not possible, because you can’t painlessly lean in any direction. Showering is as bad, being unable to reach anything, nor to stand. So much sweat did I release in towelling myself that I was no more dry than before. The air temp was 37degrees and the aircon was on holiday too. The sunshine was like a solar oven outdoors, brightly roasting the country.

Evening visiting time and Janet arrived, brought by Sr Machado (our roofer), his wife and his son. They know the hospital well; the son had received a kidney transplant three years ago, and numerous leg operations. This combination of personae made for a most enjoyable and fast-gone couple of hours. When the nurse did the last round and asked if I wanted a pain killer, I did. She returned with an injection and jabbed it into my good thigh, ”Because we don’t want to hurt your poorly leg, do we?” It had no effect other than to make the good thigh ache too.

15th August, a public holiday.

I’m seated at the window in a six-bed ward as I write now, hoping to keep my body cooler than yesterday. Through careful positioning of requests I have a dispensation to have the window open, although some orderlies deem that it should be “shut to avoid draughts and injure the constitution”. Lunch started with cabbage soup, as it does most days, followed by squid in gravy, cabbage and mash. The latter is a change from the usual over-boiled potatoes. Dessert was a slice of watermelon, followed down by an anti-inflammatory tablet which is injurious to the stomach. Every morning they inject each patient’s stomach with something to protect it from the drugs; maybe they know the food! My ward mates are all oldsters, Hannibal (89) Vitorino (70) and Adelino (75) whose wife Gabriela  is as devoted to him as a guardian angel and to us other three chaps by association. In the afternoon I am introduced to the Zimmer frame, my future ally as my atrophying muscles recover. In use, it hurts. Lights-out is at ten, and before that, the nurse on the last ward round arrives, I am offered pain relief and ask for a tablet not an injection so I can sleep (I was out of bed for thirteen hours today, so my leg is now swollen). She takes ten minutes to fetch one for me. By half past ten it is taking effect. Five minutes later it wears off. Again I lie awake in pain for most of the night.

Sunday 16th. The nurse arrived and I complained about the pain killer. She told me it was from a batch that was supplied as active but was later reassigned as placebo. Great! They wanted me to use crutches; so much for any mental preparations. They gave me Vitorino’s, as the hospital has no crutches of its own. You have to buy them for yourself, and they are not sold on site. These helped me to walk from one side of the bed to the other. That was enough. I sat, I read, I ached. Two hours later I set out on another slow walk and used up all my resources again. I have survived on flat batteries for five days now. My arm muscles have to develop. They ached too, as did the full length of both legs through the extra effort. My left thigh was so swollen that I sat lopsided. The oedema drained to the left foot which swelled up. After lunch (roast Nile perch, no sauce) I used the crutches to get as far as the door and back, pushing my limits again, and when I returned there were no staff around to help me put up my feet to drain. Francis and Hanne brought Janet at five and, in addition to dvd’s and books they brought a good helping of humour. We had a great laugh, more of a party, until a neighbour told us that the next ward was unhappy about our noise! This is Portuguese telling Brits off for noise??!  My guests left about 6.15 and I stood for a while to help relieve the pressure in my swollen thigh, to no effect, before ringing for help to get on the bed. Nearly an hour later an auxiliary happened by and I called her. She said she’d send a nurse to help. None came. Dinner was delivered at high speed and now “BENFICA  YAAYY!!!” came on the telly in the next ward and the whole world was glued to screens everywhere, its inmates totally involved, cheering and doing what football supporters do. And they told us off for noise? My three room-mates were asleep. I was still reading and aching in the chair. Benfica won. I lost out. It was well after ten when they arrived to shove me into bed.

I woke at dawn on Monday and waited two hours for any staff to appear. New week, new staff, the others off to the praia (beach). With my left leg swollen from sitting for twelve hours in my chair yesterday, I determined to put in some yardage on my crutches. I walked ten yards to the loo (5mins) then took a quick shower (20mins) before shuffling back and sagging into aforementioned chair. Then three repeats of the walk at hourly intervals and lunch. Also the arrival of two more  patients, one a former carpenter with a history of breaks and losses of body parts, The other, a chirpy 35-year old from Seia. On the first day of his holiday he popped into work – a Jiffy Bag factory – to help out his friend. Whilst operating a machine which makes bubble wrap by punching out round holes in plastic film and fingers. . . . and now his living bubble wrap has been sewn back on.

Gabriela arrived, an hour before official visiting time, but she was the only soul around until mid afternoon when the entire staff of six nurses did a ward round and cleared out all the visitors for a while. I was helped onto my bed where I slept for an hour. With G’s help I climbed off my bed and did a marathon twenty metres in ten minutes. All of my six-man ward were impressed, including me. The visitors left, except for one, and we all sat in silence, pensive, numbed (especially my bum) as dusk then darkness fell then Gabriella left.

Tuesday 18th.

Three nurses and an orderly did the morning rounds, engaging in close discussion with each patient concerning their health as today is possibly Release Day for those fortunate individuals deemed fit enough – which should include Sr Vitorino in the bed next to mine. “Para a casa” is the magic phrase they want to hear. I went for a walk and a long chat with an intelligent man from São Tomé (a former Portuguese colony, comprising two islands on the equator, 150 miles off the coast of Africa) until being told to return to base for the surgeon’s round.  I was repositioned on my bed as the doctor arrived. He looked like Pavarotti.

First to be considered was Adelino, who was clearly going nowhere, nor was Hannibal; then the carpenter with a plaster cast covering all his torso and half his left leg. Pavarotti turned to me and in theatrical style declared, “And what about this idea of going home to your family?” (When I was first seen by the surgeon I’d said that my family were arriving in less than two weeks and that I really want to spend this holiday with them). I answered apologetically, “I am starting to get around and can see that I will need a long time to recover. I understand that I might have to stay but next week I’d like to seriously consider returning home”. The doctor and Lionel the physio had a chat and the doctor gabbled a few stern words to me that I didn’t follow. Vitorino caught my eye and smacked his wrist to sign, “You got told off!” I queried Lionel with my eyes, “What?” and he motioned back “Just agree.“ so I said, “Thank you Sr Doutor”. He turned to Vitorino. A quick discussion and then “Para a casa!” I gave him a big smile and a thumbs up. Our bright young man was “Para a casa!” too, and the doctor cruised away. Smiles all round. “Next week, I’ll be off”, I announce to the escapees. The carpenter commented, “Well that’s good, all three of you off home.” I insisted “No, just those two.” “No, you too”, he asserted. He, like I, had clearly missed something. I quizzed Vitorino as to whether he thought I was going home. With a big smile he said “Yes!”  Lionel grinned and reaffirmed, “Para a casa! Didn’t you hear him?” and all burst out laughing. I’d been set up! This is Portuguese humour.

We hastily arranged for our local bombeiros to take me home that morning and Janet had to go and buy me a pair of crutches pdq. The same driver/pilot (Fernando on left, Paula on right) whisked me back on a stretcher in his flying machine and by lunchtime I was gald to be back on home soil, in the sunshine.

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