Hit by car as a pedestrian, and coping with external fixator and skin grafting for over 7 months

I wanted to share some of my insights and experiences from an incident that happened to me over a year ago, in the hope that someone can benefit from my journey.

On April 2nd, 2018 , my right leg was run over by a car twice!  (the front and rear driver's side tires).

I looked down in horror to find my right leg crushed, flat against the pavement, with a wound about 

2 x 5 inches in diameter of skin loss due to the tires removing the skin.

Out of nowhere, a neighbor came running up the street, removed his belt, and placed around my knee as a tourniquet ( a life-saving procedure, in the view of the Trauma Surgeons who operated on me).   I was taken by ambulance to a hospital with a trauma center and prepared for emergency surgery.

I was awakened to find my right leg in an external fixator, with rods sticking out of my ankle and below my knee.  The rods were in place to assure correct alignment of the broken bones as they healed. A screw was placed inside my leg just above the ankle to keep the many bone fragments in place while they healed. The surgeon informed me that the very first thing that needed to be done in surgery, was to irrigate and clean the wound from the debris (rubber, asphalt, grass, etc.).  The possibility of infection was high, and I was on antibiotics around the clock.

The second surgery took place two days later.  A mesh graft was placed over the wound site.  I spent about two weeks in the hospital.  At home, my living room became "ground zero," as hospital equipment (a bed, a walker, a wheelchair, urinal, etc.) was brought in.  There were regularly scheduled home nursing visits for wound care.  

After being home for a month, I found myself scheduled for the third surgery with the skin graft surgeon.  The surgeon harvested skin from my right upper thigh to cover the wound.  This took seven months to heal!  During this time, I remained in the fixator, but was non-weight-bearing (on my right leg).  To move, I had to "hop"... literally on my left leg on a walker while doing my best to not put any weight on my right leg.  

***PAINFUL!!!  It's painful if any weight was placed on the fixator leg! 

To complete my story, the fourth surgery was for removal of the fixator, SEVEN months later!!   I wore the following items on my leg in this order:  soft cast, walking orthopedic boot, and orthopedic ankle brace. 

I would like to offer some tips to navigate through a lengthy time of recovery and healing....

The items below were written to help you… but they are NOT done in any particular type of order or timeline…

1. NO WEIGHT ON FIXATOR LEG!!

   2.  Keep leg elevated while in bed to prevent swelling (which can be painful!)

3.  Have someone near you whenever you get out of bed.  (I fell twice....ZERO FUN!)

4.  Keep a record of who can call or visit you... I found that some people who called or visited felt it necessary to explain "WHY" this happened to me... TRUST ME... you do NOT want to listen to these negative thoughts... so my wife kept a list of who was "okay" to come over and who was "black listed" (unbeknownst to them of course)...   You may wonder what I mean by "negative" stuff... here goes:

*  "God is trying to teach you something."

*  " You must have done something terrible for this to happen to you."

*  "Satan must have had a hand in this."

*  "You are meant to learn something from this."

*  You get the idea, right???

I'm not kidding. These words came out of the mouths of Friends!

5.   Keep the pin sites from the fixator AS CLEAN AS POSSIBLE to prevent infection!!

My wife/ also my best nurse, was almost obsessive about cleaning the pin sites with hydrogen peroxide.  If you feel burning, see redness, or are experiencing pain or extreme sensitivity near the pin sites, CALL THE DOCTOR!!  You most likely have a pin site infection.  The doctor can prescribe an antibiotic and this will IMMEDIATELY help you and reduce the pain!

6.  Supplies that were necessary near your bed:  plastic gloves, bottle of hydrogen peroxide, kleenex, a small table near your bed for your phone, computer, medications, water/food, a radio, a steady supply of batteries for your TV remote!  I was a regular Netflix watcher!

7.  People will suggest to you "how to spend" all of the time you have now in bed... Examples: read a book, write in a journal, write a biography, take music lessons, etc... These are all good ideas, but for myself, I have to be in a "happy space" in my life  in order to tackle some of these great ideas. 

Do what comes natural to you with your recovery time in bed.... Since my living room became my new bedroom, I had the luxury of looking out daily into the backyard.  My wife was quick enough to purchase a wheelchair ramp so that I could come down the step from the living room to the backyard patio. 

I found it invigorating to be outside, and be outdoors taking in nature.  My wife purchased a hummingbird feeder and I literally watched birds nourish themselves and hum around for hours.  I used the outdoor patio time to correspond with family and friends who had written get-well notes to me.  I needed to be OUT of bed and in a different area to write those notes.  I often listened to the radio outside whether it was sports talk or baseball games.  Sometimes, I would read the newspaper, or meet with visitors on the patio vs. being stuck in bed.  This was a nice change of pace. 

My wife was wise enough to ask me what would, “make me happy" during this time of convalescence in the fixator? I decided to buy a used car on-line and make many of the mechanical and cosmetic improvements to it from the confines of my bed. You would not believe how many parts can be purchased on Amazon and Ebay alone!! I needed to see something physically transform before my eyes, like this car. It was time well spent.

8. Once the fixator comes off... be very careful about what type of physical therapy you do.  I did land therapy for about 6 weeks and my doctors were in agreement and suggested for me to do a stint of aqua therapy for my second round of PT.   Unfortunately, I contacted an infection through use of the therapy pool., ,the very first day in the water.   "Remember" , the skin graft surgeon would say, "the skin graft is like baby skin"... it is very, very thin and can get infected easily.   I contracted cellulitis, and a horrible rash over my back, chest and scalp!  It took two separate stays in the hospital to rid myself of the cellulitis and the rash all over my body.  I am currently doing another round of PT (LAND-BASED!!) and this is now 13 months since the original incident.  

9.  Try to establish a routine.  As difficult as it was, my wife helped me daily to take a shower while keeping the leg dry and dressing me.  Shaving and grooming is an integral part of feeling good about yourself.   Daily reading of a newspaper, checking emails, keeping a laptop or Ipad nearby keeps you in the loop for the people YOU want to touch base with...  

10. Once the fixator is removed, swelling of the ankle will occur well after a year.  You can find compression socks in orthopedic stores, or in on-line stores.  You can also find them in places like TJ Maxx, Ross, Walmart,  Ebay or Amazon.  While you need the compression socks for the swelling, the   graft site won't appreciate this and will be irritated.  Thus, you'll need to carefully place some gauze pads and "cushion" the graft site.  Non-sticking Telfa pads are okay for this, too... but don't leave them on too long, as your skin needs to "breathe."... 

11. Traveling in a Car: 

    *  I found it easier to sit down in the back seat, and slide in to the opposite side, while keeping the leg up on the car seat.  Don't try this by yourself!!  A home health physical therapist helped me to practice the transfer from the walker/wheelchair to inside the back seat of the car until I could do this with my wife assisting me. 

    *  Whoever helps you should have prepared the back seat for you by placing a  positioning pad so that your partner can slide you backwards.  (In my case, my back was against the rear passenger door so that my right leg (the one with the fixator) would be on the inside position.   

    *  You'll have to stand up (from your wheelchair) and transfer to the back seat by sitting down on the right passenger side, facing the car door.   

    *  My wife bought a  car cane ( see Amazon: The Original Emson Car Cane) for about $12.  This is very helpful as you transfer from the walker/wheelchair.

    *  Pillows should be strategically placed for your back and especially under and around your injured leg.

12.  Home Health Care:

• If you are unhappy with the home health care you are receiving (PT, nursing, social worker, etc.), DON'T HESITATE  to call the home health care office and REQUEST A CHANGE of provider!! 

13.  Mail:

• You will need assistance with the mail!  You'll need someone to help you keep track of it, sort it, pay bills, etc.  There will be some nice "get well" cards... but there will also be bills!   I found myself in no position to handle the barrage of mail.  Ask for help!  You won't be able to keep up with the volume.  

14.  Pain Management: 

*  Rule of Thumb: KEEP AHEAD OF YOUR PAIN!!   Don't wait until you are hurting really bad before you take that pain pill!!  It will take much longer for the medicine to control your pain if you wait too long!!  Have someone help you with this... someone has to remind you to take the medicine, and to manage it so that you don't run out in the event that you need a new prescription.   Don't be afraid to call your doctor's office AT ANY HOUR OF DAY OR NIGHT if you're experiencing PAIN or have a serious concern (swelling, redness, leakage from the wound site).   Every doctor has a paging service, and they WILL call you back... Keep the line free once you call!! Sometimes you may need to page a doctor a second time.  Better to page the doctor than go to an emergency room, as the doctor will get back to you MUCH sooner.  If he or she thinks you need to go to the ER, they can facilitate this for you as well by calling ahead!

15. Driving A Car

    Once I got to this stage, a full year later…. I found myself nervous whenever I was near a truck or a loud muscle car engine or noise on the road. I found that small trips to the local store, to the local post office, to the bank, to the pharmacy were better than long trips. Avoid putting many things on your agenda for the day! You will tire easily and your leg will swell… causing pain! It’s better to do one thing each day than to do five things in one day. Your leg will thank you!! You’ll also get more comfortable, and gain more confidence as a driver. The noise of other cars won’t bother you as much, and your sensitivity to it will decrease in time.

16. Reaching Out

    Do not hesitate to come up with a list of people who you want to talk to about your experience. It was TRAUMATIC!! You can talk to a clergyman, a friend, a social worker, a psychologist, a therapist… There are on-line groups of people who have survived and experienced a trauma. There are also groups that meet face to face regularly, too. The Internet and Facebook are good resources for finding these groups.

Initially, I experienced night sweats, recurring nightmares where this car was coming straight towards me…I was jumpy when going to Doctor’s appointments in the parking lots or on the sidewalk… you may find yourself irritable, anxious, angry… maybe you have difficulty sleeping, or feel resentful of people who are healthy and walking as the life you knew has been taken away…TALK TO SOMEONE!!

17. Weight Management

    You’re stuck in bed, so it’s easy to gain weight. Watch your calorie intake. I wasn’t that good about it. Remember, some medications may increase your appetite, or affect your weight. Anti-depressants or steroids while helpful, may increase your weight as a side effect.

So, I have found this a good experience to write about my injury, and the long road back to walking. The experience will be different for every person, as no two injuries are exactly alike.

I wanted to share what I experienced, in the hope that I can help others who, in an instant, find that their lives have been radically changed,.

18. And Last..........THERE IS LIFE AFTER THE FIXATOR!!! Saying, "take it one day at a time sounds trite, but really, that's all any of us are given. Today. The present moment. What you do with it will make or break your journey to recovery and embracing life outside the confines of a hospital bed.

Be Well,

Donald84133

0 likes, 3 replies