So how do you break a hip… you fall on it very hard basically, unless you have osteoporosis, which actually accounts for most hip fractures. Then you don’t have to fall that hard. In fact statistics say sadly that 30% of hip fractures over the age of 50 are fatal due to complications… such as pneumonia & blood clots. The femur is the biggest bone in the body & needs 4000 Newton’s of force if healthy to break.
So on a sunny Thursday I was out cycling with my son and an old sporting friend. We had done 25km, stopped quickly for coffee & on our home straight, in fact my gate was practically in view.
My 12 yr old son being just ahead as he’d set off first from the cafe, had raised that old competitive spirit & we were determined to catch him. We were both coming down the hill to a mini roundabout fast, the road was clear so we took the curve at speed. Not 100% sure how it happened, it was in a flash, but my inside peddle touched the raised lip of the mini roundabout and caused a momentary stutter & wobble, sadly my friend being heavier & faster down the hill was right behind me and basically ploughed right into me at speed. Everything went into the air and landed in a pile of peddles, handlebars and bodies, on top of me, on my left side, which still had my foot cleated into the peddle. Luckily there was no traffic.
One of those slow motion moments you don’t remember well, but I do recall thinking this is going to hurt. My helmet was a god send (please wear cycling helmets, they save lives). I hit the floor hard with my head. I don’t recall a crack but there was a lot of clattering of bikes.
My friend rolled off onto the grass verge and I ended up in a semi sitting up position. My left leg was falling oddly to the side and I was pretty sure I’d broken it immediately. The pain was horrid. It was the collision of bodies that caused the damage as I didn’t really sustain any bad scrapes or bruises apart from a very sore left elbow and my sternum bending the carbon fibre handlebars of my beloved Boardman road bike.
The next car stopped and called the ambulance service. Finley wheeled the bikes back, one by one, and my friend sat back to back with me as I tried to support my weight with my arms.
Every time I moved it was agony. I pride myself on my pain threshold having had 3 long deliveries, 2 at home only using a tens machine, and a birthing pool, as well as braking both my arms (falling off a tree swing) at 11 & walking home alone, then swimming three months with plaster casts on.
The ambulance took 40 minutes to get to us. Several people stopped and offered help. People are kind. One lady was a nurse and she stayed with me as well as a gentleman who directed the traffic around us. When they arrived I was so pleased to see them but at the same time knew it meant they had to move me. I kissed the nurse goodbye and thanked her. I was conscious & chatting but definitely suffering a little with shock.
An IV was put into my right hand and presume morphine was administered, along with gas and air. I’m not great on opiates. Years ago when I had my ACL knee reconstruction I’d had a morphine seizure which had scared me, but at that moment I just needed some pain relief so they could roll me onto a board and into the ambulance.
Finley stayed at home with the dog and my friend came to hospital with me, my daughter was rung and came into the RUH in Bath straight from work. Of course it was busy as every emergency department seems to be these days. Bless our wonderful NHS. It was confirmed via X-ray I had indeed broken my hip (the femur bone just under or in the hip socket), the good news was – it was just outside the socket, so they hoped to save the joint. It was what’s called a interchronchanteric fracture. Right across the top of the femur. I was given a femoral nerve block injection into the joint and scheduled for surgery the next day (Friday) then moved to an orthopaedic ward, and a catheter was fitted. All dignity goes out the window. We later found out they’d had a bumper Thursday with 7 hip fractures. Though I was the only high impact trauma case that day.
After a very uncomfortable night where nurses came in every hour to take blood pressure, temperature, and oxygen levels I had meetings with surgeons and anethatists to talk about what they needed to do. They intended to use what’s called a hip compression screw, a large screw going in the socket direction, a plate and a number of smaller screws to hold the plate, to stable up the broken femur bones. They hoped not to have to use the nail system which was longer steel rods crisscrossing the joint and went much further down the bones. The main aim was to preserve my hip joint.
It was suggested it would take about an hour and I’d be put in traction to get my legs the same length, pretty important. Anaesthetic was discussed and We decided instead of a full anaesthetic I’d have another femoral nerve block, a spinal block and sedation, so quite a few needles, which I was by now getting very used to. This would hopefully leave me with slightly more pain relief after the operation, as the spinal block wore off over a number of hours with less residual opiate sickness which I really suffer with. I was truly nervous as I was wheeled into theatre and manoeuvred for the different injections. My team were amazing of course and kept me informed all the time. Forever grateful to these wonderful people who are there in times of crisis.
Sadly once in there it was messier than they’d hoped and three and a half hours later I came round in theatre to see and feel the team stitching me up, though I have no memories of the bone being set or any traction or screws being placed. I remember asking a few questions but I’m not quite sure what I asked. I went into recovery and immediately had a shock or opiate reaction and madly started to shake, my teeth knocking wildly together. A nurse piled more blankets on and eventually I was wheeled back up to the ward where my kids were waiting.
Both the surgeon and anethatict visited that day and I was shown pictures of my operation. The complication of a broken greater trochanter was explained to me, which is the outside nobble at the top of the femur bone. It had also got crushed in the crash & pushed up into the hip joint, and they were hoping if I stayed religiously off any abductor/outwards movement (the piriformis muscle attaches to it) it might start to repair by its self. The bad news was having such strong muscles meant that it was risky and painful, as well as the level of spasm all my strong hip muscles were producing (gluts, quads, abs and ads). It truly was a painful time, to add to that I was determined not to do any more opiates ( morphine, codine etc) and survive on paracetamol & ibuprofen. Being in pain was bad enough without feeling that awful morning after the biggest night sickness feeling I get.
The cathatore stayed in that next night and again I was checked all through, getting pain relief and blood thinning injections to stop blood clots. I ate my first half a sandwich in 48 hours, and tried to drink fluids to flush out all the anaesthetics. I was able to rotate my feet and did this over and over again to keep my circulation going. Next morning the cathator was making me very uncomfortable so asked for it to be removed. I was also being given large intravenous doses of antibiotics that rather stung. My neck was killing me from the whip lash from either colliding with my friend or the road, or both. Moving my head hurt. With my hip fracture there is no plaster cast so I could see the outline of the raised 5/6 inch cut on the outside of my left thigh under a white bandage.
Now here’s the thing with being an elite athlete…. over years I’ve had a few operations….excessive training tends to over use joints….twenty years of 4-6 hours a day has had its consequences: lower back has two prolapsed discs from my 30s, which had to be injected to shrink because swimmers, as a breed, have very long, flexible backs which we over tax especially in butterfly. I’ve had rotator cuff issues on both shoulders with several cortisone injections and one rotator cuff repair, about three years ago. Cracked two ribs doing Dancing on ice. My right knee had an ACL reconstruction in the 90s after a Gladiators incident and subsequently 8 operations to remove torn cartilage by arthroscope. I’m often seen wearing my brilliant Ossur unloaded brace which keeps it going. At 11 I broke both bones in both arms, falling off a tree swing, and walked home alone as out playing by myself. At 8 I broke my collar bone, playing in a box. By now I’m sure you’re thinking what a Tom boy at best! Last year on a ranch in Arizona whilst rounding up cows at a rodeo I crushed three vertebra and herniated two more discs in my mid back, that annoyingly where very slow to heal because I kept doing sit ups! My point being the joints I had no issue with where my wonderful, strong and flexible hips, till now!
So back to lying in bed. And it was time to have a normal wee. Something I’d been putting off. How on earth was I going to manoeuvre my pinned hip. My daughter had been in and out with supplies, a fan, wash stuff and clean cloths, though I stayed mainly in a vest top and pants as we were having a heat wave bank holiday weekend and my room was over 30 degrees. My shoulders were aching from pulling my body weight around, as was my very sore bruised elbow. My head felt like it weighed a ton due to the whiplash. My elbow bursar (fluid protector pad) had swelled to half a tennis ball size. However I was very grateful for my upper body strength. Between us we got a bed pan under my bum, but it goes down as my most difficult pee every. Again all dignity goes out the window. Grace was amazing, after waiting 40 minutes one day for a super busy nurse to come in with a bed pan she decided to move in. She slept on three plastic chairs pushed together and did everything she could for me. Physios came in the day after my operation to see if I could get up but after quite a few tears which resulted in dropped blood pressure, heaving over a frame and sweating like a pig, we decided it was a bit soon. I was frustrated.. and hurting.
My other children did a relay and popped in to let Grace go home to collect stuff or pick up work. Her bosses were great and let her be with me. Fin wanted to stay too but he’d not seen me in that much pain and it was too much for him I thought. Elliott moved him about between trips to his work in Bristol. I was feeling incredibly guilty. We had booked an exciting zip wire Adrenalin jump off one of the tallest buildings in London on the Friday & I had hospitality tickets for England v Ireland at twickenham on the Saturday, both of which we’d missed.
I was determined to do everything I could to be better the next day with the physios so they’d let me go home. I did all the ‘in bed’ exercises they left me with every twenty minutes. After another very hot 24 hours the physios were back with crutches. It was explained to me that my compression metal work moved with my fracture so my bones could grown in and around, which helped to reassure me why there was still so much pain, the fracture was moving as well as the broken unrepaired greater trochanter ( large nobly bit at the top of the femur). I had to keep a wide foot stance, put no more than 50% body weight through my left leg, and work in parallel with my feet as much as possible, and absolutely not use my abductor (outwards) muscles at all. My bad leg had to be lifted and moved round the side of the bed whilst I swivelled my hips as best I could. I gingerly got up, took slow steps down the corridor & was shown how to get up & down stairs with crutches. Shaking with determination I could feel my sternum every time the weight went through my chest, but I was so happy to be up right. I made my first private loo visit in four days, lowering myself onto a raised seat, and putting my weight through my pelvic bone not my femur. I was ok’ed to go home.
The kids walked me out, with all my flowers & my fan. Elliott drove, with the passenger seat as far back as possible & avoiding every bump he could. It took me an age to get in. Corners were challenging & brought sharp knife like pains even though I padded my bad leg & tried to wedge it with the other. It was wonderful to get home on the Sunday night. Elliott cooked the most amazing meal as I ordered a number of home help items on amazon prime (local authorities do loan them) … perch seat (much higher) raised loo seat, loo seat bars (to lower yourself), Velcro gel ice packs, rotator pad (swivels for the car) large bum bag to carry my phone & pills. On another more personal note I was dreading sitting on the loo without these items, which were in the hospital, with terrible constipation. A side effect of pain relief & anaesthetic is to slow your system, basically your bowels go to sleep. Tons of fresh fruit & vegetables were bought. I only wanted to eat super healthy food. It was a real challenge lowering myself with my bad leg out straight, with my hands behind me on the back of the toilet seat. I wondered what would happen if I slipped? It plays with your head sitting with your weight anywhere near the broken bone. Clean sheets, a huge fan & my own bed however was heaven.
Broken sleep with paracetamol top ups was uncomfortable but more peaceful than a busy, hot hospital. I tried one time to move on my good side & got stuck. I had promised I’d judge a fun class at the Bath cats & dogs home where I’m an ambassador on the bank holiday Monday. Finley loves dogs & I didn’t want to disappoint him again so after breakfast, loads of icing, vigorous rehab exercises & a pile of Amazon deliveries I managed a shower & to manoeuvre myself back into Elliott’s car. Grace went off to enjoy herself at a much deserved Notting hill carnival. It was 34 degrees & there were giggling children & bouncing dogs everywhere, probably not an ideal first outing on crutches. The kids tried to encircle me but it surprised me how many people sometimes just don’t see crutches or wheel chairs if having fun in the sun. I’ll be better at spotting others and giving a wide berth in future. It was a little nerve racking but a nice change of scenery. Flash won best hand shake (paw) & we judged young rescue dog where I felt every owner was a hero. We stayed from 12-2pm by which time my leg was swollen & throbbing & it was time to re ice, elevate and do more exercises.
This is where the athlete brain comes in useful … Tuesday I started a very strict routine of ice, rehab, elevate, walk, pain relief (mainly paracetamol) repeat….if I was up right too long my left calf would get so full of fluid it became twice the size of my good leg. You could bounce pennies off it. My quad muscle felt like an electric band that was stretched to breaking point. Sciatica ached down my backside and into my thighs, and shins. Little my little I was trying to get more bend out of my knee. Outward motion had to be done by Grace daily to mobilise the joint but without me using my muscles, so we did it nightly lying on the bed. The first few days I didn’t see much improvement and I was still very swollen. A huge purple bruise the length of my whole thigh appeared on the back of my leg to go with the few I had from the fall. On the plus side the elbow was getting better but my sternum was still hurting. I spoke to a surgeon and he suggested it might be cracked but there wasn’t much they could do and after two weeks he hoped it might settle down. It hurt when I coughed or sneezed.
More gorgeous flowers & fruit parcels arrive, more friends popped in with gifts of food & hugs. Truly grateful for my wonderful fiends and family. I watched what I ate carefully as I wasn’t very active. I only wanted really healthy stuff, especially Alpen, soup and ice cold fresh orange juice. I took the odd ibuprofen but still mainly paracetamol. I did however (for a month) still have to give myself a daily injection into my stomach of a blood thinner to stop clots. After four years of ivf I’d done that before. It was a challenge to try not to make another bruise on my already purple tummy.
By day 10 I’d progressed to doing the stairs twice a day, and getting a 90 degree knee and hip bend. Up to that point I’d only come down in the morning and gone back up in the evening. The kids took my book, glasses, diary, phone etc up and down but now I felt confident enough to be left as they had to go back to school/work. Using a wide stance I could stand at my kitchen island and keep my weight off my bad leg whilst shuffling to make a cup of tea. Using a small back pack I could move my own stuff. Every time I made a tea I made myself do twenty mini squats and a few leaning press ups. My routine was still rehab, ice, elevate, walk, repeat. A lot of glut and quad clenching.
