my patience is wearing thin, infact I’ve cracked a couple of times,

but timeline as follows

18th Monday
• Fall off bike just before 10am – foot poking in wrong direction
• 1020am, first responder arrives, 11am ambulance collects deliver to A+E
• 230pm first xray – 2x breaks to fibula, 1x break to tibia, possible ligament damage, but will not know until op
• 3pm – plaster room, reset, back slab fitted
• 330pm – 2nd xray
• 430pm – transferred to ward 11
• leg iced and elevated form 4:30pm

19th Tuesday
• nil by mouth from 3am
• consultant says no operation today, op will be open reduction, internal fixation, its too swollen to be reviewed later in week
• 24 hours in bed, leg elevated and iced

20th Wednesday
• no consultant contact
• 24 hours in bed leg elevated and iced

21st Thursday

• 8am consultant, still too swollen
• late afternoon moved from side room to dorm
• 24 hours in bed, leg elevated and iced

22nd Friday
• woke by staff member at 2:20am to take BP
• no am consultant contact, visits later in day, still swollen to be reviewed during weekend by on call
• 8pm fever, temp spikes to 38.9
• moved from ward 11 to ward 10 as its busy
• woke at 11pm by staff member to take BP, asked why my curtain was closed,
• 24 hours in bed, leg elevated and iced
•
23rd Saturday
• nil by mouth from 3am
• no consultant contact,
• nurse states at 12:20pm OP cancelled as theatre is busy
• 24 hours in bed, leg elevated and iced

24th Sunday
• nil by mouth from 3am
• 830am, consultant state incision point still swollen, to be reviewed Monday 25th

so ive been sat here, it will be a week since the break tomorrow, i feel like I’m being fobbed off, or down the list because its deemed non urgent, how long are they going to leave me? the swelling is right down, how much do they expect it to go down seeing as its broken,

Sorry to hear DR, and I hope you get sorted soon

Not sure if it’s your point, but it’d be crazy for them to operate if they feel the condition of your leg makes it inappropriate

Maybe you could ask about day leave, assuming you can get into/out of a chair ?

Lot of sympathy for you. Must be doing your nut in. But there must be a good reason why the consultant doesn’t want to operate until the swelling goes down. What did he say when you told him just now that it had gone down in your opinion?

No medical experience, but that sounds like a mare. Hope the pains not too bad and you get sorted soon. Healing vibes bud 🙂

Sorry to hear you’ve hurt yourself badly, try to keep calm though, I know it isn’t likely what you want to hear but if they need to wait for the swelling to go down before op there isn’t much point in seeing you lots of times, they need to spend their limited time and resource on patients who are more time critical.

Stick with it, and do your best to rest.

If it helps I’m just out of hospital (wife and baby) after a few days, the level of care and support was a level above I expected, given my only engagement with the NHS has been a&e. Where if you are a fit heathy bloke with a self inflicted sports injury you sit for effing hours….even so I would rather more urgent cases were dealt with.

Which hospital you in? Maybe some STWers could drop some mags off for you? Let me know if you are in southampton…

Maybe you could ask about day leave, assuming you can get into/out of a chair ?

they wouldn’t let the wife wheel me to the café,

just the general tone of the consultant earlier in the week felt like he was really saying “I’m busy this week, the on call will review you on Saturday”, which never happened, he popped in today, said its “nearly ready” which feels like he’s bouncing it back to the original consultant on Tuesday as its bank holiday, i can almost bet my life he won’t do it tomorrow

In answer to your first question if they fitted a catheter then they probably are.

Just got a temp plaster on my hand as ct is busy tonight

A work colleague got bumped up the heart bypass queue ( been in a hospital bed for over a week) by bribing the senior consultant with a bag of extra strong mints.

It’s a bit of long story but culminated with the senior consultant arriving at the foot of his bed “NEVER in all my years of medicine has anyone tried to bribe me, let alone with a packet of extra strong mints, are you free tomorrow afternoon?”

It’s not uncommon for surgery to be delayed my wife works in a children’s surgery ward and often has irate parents due to delays.
I’d rather wait for the swelling to go down and have one op then risk several ops.

Taking the pee? – Not likely.
Understaffed? – Probably.
Not quite as empathic as they could be? – occasionally.
Demoralised? – more than likely.
Frustratingly hard to get a straight answer from? – more often than not.
Keeping you awake at night? – if so, it’s because they have concerns enough to check on you more frequently.
Got your best interests at heart? – absolutely.

Very common situation. The soft tissues around an ankle fracture often swell and if an incision is made in them then at the end of the procedure the skin is closed under tension, which compromises the healing of the wound. A poorly healed wound over metalwork is not a good thing. Nothing to do but wait until the swelling settles. Sometimes an external fixator is applied to speed up the proces but this has its own risks. I’m sure your team will have considered whether this was appropriate in your case. Simply going home for a bit isn’t a great idea as inevitably the swelling will worsen as soon as you move around out of bed. I see lots of people really pissed off waiting for their ankles to be fixed but it is unfortunately just the way it goes. Hope you get sorted and home ASAP.

sounds like the leg is too swollen to operate, which is fair enough. What they need to do is clearly manage your expectations, which IME the NHS is pretty poor at. Last two times I’ve been in for hospital treatment it took far too long and wasn’t managed particularly well, although actual ‘health’ decisions were fine. Coming from a (management) consultancy background if I managed my clients like they do then I’d wouldn’t have many clients. As said, it may be systemic, may be staff based, may be cultural, or a combination of them all.

They’ve got a sweeper running to see how long it takes you to pop up a ranty post on STW.

😉

sounds like the leg is too swollen to operate, which is fair enough. What they need to do is clearly manage your expectations, which IME the NHS is pretty poor at.

You’re probably absolutely right, but could you imagine the Daily Mail induced furore if it came out that staff were being employed/trained in what could effectively be interpreted as ‘spin’? It’s head line writing manna from heaven…

Would you prefer for them to make an incision that they couldn’t close leaving them no option but to amputate? The theatre to busy thing happens a lot in trauma orthopaedics. Some people injure themselves and need operated on immediately such as WCA from here. Others are not suitable for intervention straight away. I.e. You.

A poorly healed wound over metalwork is not a good thing.

I can confirm this from experience (it may be some comfort to the OP that they are trying to avoid the problems I’ve had). I broke my ankle (Potts fracture, end of tibia in about 30 bits) in 1979, in France. I suspect because of the number of bits, they operated immediately. They did a good job on the jigsaw puzzle, but 8 days later an infection occurred – fortunately I was able to get back to the UK at the this point, as it was the start of 3 months antibiotics and boredom; debates about taking the metal out to clear the infection v not taking it out until the infection was cleared. Eventually sorted, but with a hole in the bone where the infection was. 5 years later the infection re-occurred in the damaged area, two more ops. Mostly OK since; hope yours goes better.

Would you prefer for them to make an incision that they couldn’t close leaving them no option but to amputate?

no of course not, but there comes a point where the swelling isn’t going to go down anymore, hell leave me laid in bed for 6 weeks and it will sort itself albeit poorly, i feel that point of swelling reduction arrived a couple of days ago and because of the bank holiday I’ve been past from pillar to post,

and surely if it was deemed ok to operate on yesterday (i don’t know who made that call), as i was nil by mouth, only for them to say at lunch “its too busy”, surely there was a theatre list, was i ever on the list? then for them to says its too swollen the day after,

Not operating for swelling is right thing to do – get that wrong and it can go very very wrong.

Weekend trauma lists are life or limb and also for various reasons little old deals with broken hips get prioritised over young healthy folk. That’s a national level decision not a local one.

From the info given it sounds like the right things are being done and it is all sensible. The communication over why sounds like could be better – may be reasons why but who knows.

Not seeing consultant every day is standard – they don’t do rounds every day.

Hope you get fixed soon. If it helps a fracture fixed at ten days well so far better than one fixed at one day badly with swollen tissues. Doesn’t relieve the frustration and boredom though.

James (orthopod)

Sounds shite, chin up.

I’ve been past from pillar to post,

Unfortunately this is a frequent patient experience.

Remember, whilst your a patient, you do have choices, they can’t starve you, if you want to eat then eat, i would until the ankle is approaching surgery. If you want to head to the cafe then ask for a chair with leg elevation on it.

Take their advice & make yourown informed decision on what you want to do.

When I broke my wrist (and holed my leg) I waited for 3 days for the theatre to become clear – full of emergencies and old folk.

Consultant said I was low priority as a delay wouldn’t be life-threatening like it could for other folk.

Cheered up when I found out that the private health we had a work paid out for every night in a NHS hospital 🙂

Really sorry to hear your experience this week. Another OP has nailed it. This is about communication and managing your expectations. Clearly they haven’t been met.

It is not unusual to have to wait in hospital for 7-10 days whilst the swelling recedes. It would be dangerous management to take you to theatre and make at least 2 incisions around your ankle if it is too swollen. The skin won’t then close/sew back together and you are left with exposed metalwork near a broken bone. Perfect conditions for chronic infection. So, in this respect I would recommend playing the perfect patient to aid your own progress. Ankle higher than your heart at all times but when you need a wee. Regular ice. If you are so cabin fevered then a short break to cafe might do you some good though.

You won’t get a daily consultant review because the consultant will decide in his mind that the swelling will take X days to settle and will then review you. It seems this has happened.

The slight problem you face is that you are not an emergency patient. You will not die if you don’t get your operation at a certain time. Old people with hip fractures do die and will bump you in priority.

The caveat to this is – the fracture can move in the plaster especially if it has been opened for ice. The swelling will never go down if the boney bits are very displaced/moved out of position. It might be worth asking for another X-ray to see if this has happened. You might need an external fixator whilst you wait. Lots of pros and cons, and I haven’t seen the X-rays etc so this is only general guidance.

I know it’s shite. But the more you get grumpy at the staff who are overworked/usually trying their best at a weekend with skeleton staff, the more you will be highlighted as a problem patient. Try to constructively request 5 minutes with the registrar or who to explain the medium term plan, reminding them that you are getting frustrated and just need a plan, rather than feeling left behind,

(Mrs FD DOI orthopaedic registrar)

The caveat to this is – the fracture can move in the plaster especially if it has been opened for ice. The swelling will never go down if the boney bits are very displaced/moved out of position. It might be worth asking for another X-ray to see if this has happened. You might need an external fixator whilst you wait. Lots of pros and cons, and I haven’t seen the X-rays etc so this is only general guidance.

original cast was in place for oh less than an hour, i went to the plaster-room, for an X-ray then as soon as i was on the ward the consultant cut it from toe to about 3″ from the top to have a look at what was going on, the remaining 3″ was cut a couple of days ago,

and it’s a Bank Holiday w/e…

Weekend trauma lists are life or limb and also for various reasons little old deals with broken hips get prioritised over young healthy folk. That’s a national level decision not a local one.

This is because the mortality rate for older people with broken hips is very high

or down the list because its deemed non urgent

Quite possibly as you’re not going to die from a broken leg – whilst someone else might die unless they get an urgent op.
It sounds like your leg just isn’t ready to op on yet, plus you’ve got tied up with a BH w/e.
They really don’t want you taking up a bed any longer than you have to so they’ll be keen to get you operated on and out of the door – but only once it’s safe to do so.
I was in for 10 days once (5 without any food at all) and it certainly is frustrating.

I really did try to restrain myself but failed.

You have been given an opinion by an expert in the field.

And yet you think you know better?

Might I make a suggestion? Do what he says and say thank you when your ankle is healed.

dirtyrider – Member

no of course not, but there comes a point where the swelling isn’t going to go down anymore, hell leave me laid in bed for 6 weeks and it will sort itself albeit poorly, i feel that point of swelling reduction arrived a couple of days ago

Obviously they don’t. No nice way to put this- you think you know better than highly trained professionals, when in fact you know nothing at all. I totally understand, I’ve been there, it’s frustrating and unpleasant and yes sometimes communications are bad at a time when you really want reassurance and encouragement. (and sometimes, the absence of information is because they really have nothing to tell you)

But I’d rather my consultant is good at fixing legs, and be an iffy communicator, than the other way round- most industries are full of enthusiastic bullshitters who’ll promise you the world, that is not what you want in from a doctor.

Serious injury never operates on a convenient timeline, it turns your life upside down, reducing disruption is simply not part of the measurement of success- recovery is, on its terms. I should know. It’s really essential that you get used to that or the entire healing process will be a mare and there’s a fair chance you end up doing yourself harm.

Healing and recovery is a head game as much as it is a physical thing. Strong willed people ironically seem to find it harder, a bit of fatalism helps no end.

I really hope it works well for you! The plus side is, you have no trouble at all figuring out where you are on the Kubler-Ross scale.

If in doubt when feeling frustrated with the situation, remember whose fault it is that you’re there in the first place, and blame him instead…

If in doubt when feeling frustrated with the situation, remember whose fault it is that you’re there in the first place, and blame him instead…

you mean whoever saw fit to screw a 6 metre long strip of metal thats about 20mm in height and 50mm in width to the kerb outside their driveway?

got ya

woke by staff member at 2:20am to take BP

Presumably its the fever blurring your memory, but they’ll probably have been doing that every few hours. I had the same, id be convinced they’d already been round once.

I used to look forward to it as the night shift nurse was jaw droppingly hot!

Be patient, it was almost 6 weeks before I got my ORIF surgery on my broken arm last time as we were waiting for a particular surgeon to be available as I’d made such a mess the general orthopaedic surgeon nor the consultant were prepared to touch it.

you mean whoever saw fit to screw a 6 metre long strip of metal thats about 20mm in height and 50mm in width to the kerb outside their driveway?

Well, make yourself feel better with a We Buy Any Claim discount lawyer on Tuesday.

I’d say in some cases I do know better than some of the highly trained members of staff, like when my wife got a huge infection at the foot end screws of her intramedullary nail a few years ago.

Ortho Registrar fobbed us off with “just soft tissue damage, not an infection” but, oddly, when we turned up the next day at A&E they agreed with us and admitted my wife there and then. Later that evening they expressed surprise that the infection site hadn’t burst already.

These days, I take everything a doctor says with a pinch of salt.

Presumably its the fever blurring your memory, but they’ll probably have been doing that every few hours. I had the same, id be convinced they’d already been round once.

fever was the day after, there was no reason to wake me at that time, nor had they done so prior,

you think you know better than highly trained professionals

nope not at all

But I’d rather my consultant is good at fixing legs, and be an iffy communicator,

he might be iffy at both, I’ve just ended up on his list, 😉

ask for their name of everyone who administers care

personally I would take notes for every bit of care given and what you are told

I would repeat your understanding of the care plan (or the bit they are doing) to the person administering the care to check you understand why

if they don’t know why they are doing what they are doing , ask for someone more senior to explain

Got your best interests at heart? – absolutely no, they are managing the demands on the service, you are just another person in the sausage machine

arguably a pessimistic view, the NHS is like any large organisation they are good bits. less good bits and parts that are where you wouldn’t want to be to get the best outcome for you

you need to work out where your service is on that scale in so far as you can

Forgot to say earlier, good luck when you get the op. Heal well and quickly and make sure you post before and after x-rays for us!

you mean whoever saw fit to screw a 6 metre long strip of metal thats about 20mm in height and 50mm in width to the kerb outside their driveway?

Absolutely. Better that than the Drs and Nurses looking after you…

update,

i had surgery last night,

reviewed by the on call consultant yesterday morning, in his own words “its not great, but it will do”

at 930am i got as far as the nurses station 20m down the corridor before they said the anaesthetist was busy, back on the ward, 40 minutes later I’m told the theatre is busy, 3:50pm they send me up, while waiting for the general anaesthetic they said “oh we was expecting you at 2pm, but the ward sent up a wrist injury for some reason”

had been told prior that they may have to put something in there to stabilise the joint/ligament which would be removed 8 weeks post op, work down and back on the ward at 7ish, had a sleep

physio visited for crutches

told i was booked in for an X-ray as doc wants to know everything is where is should be
xray and returned to ward

doctor visits, tells me original consultant is on annual leave this week and she has concerns as they didn’t put in the stabilising piece and the X-ray shows a bigger gap around the ligament than she would like, she will have to find someone to review this afternoon/early evening/tomrrow at the latest and if they agree it means ill have to go back to surgery

Healing vibes to you OP. We have the NHS we are willing to pay for.

Good luck and all the best.

…and dirtyrider’s next post will be the one where he says how grateful he is for the care he is getting. 😆

(not the Orthopaedic Reg here)