Recovering

There has been some talk in the papers recently about the painkiller Tramadol . Its widely used in muscular and orthopaedic injuries. After some discussions (see "Snap 2"), I was given 16 Tramadol (two days at maximum dose) and two days worth of Diclofenac, another painkiller that reduces swelling.

I needed to organise a sick note for work, so I booked an appointment at my GP in Horbury. She knew I had been to hospital but didn't know what for as the notes hadn't arrived. She gave me a three week note which would take me up to half term and I was hopeful that I could return to work after then. She also gave me 200 Tramadol and diclofenac!

Tramadol are an opiate based drug that are widely available. Initially they certainly remove the pain but after a few hours the side effects make you extremely tired and you have strange dreams and even start talking to inanimate objects! I did need the maximum dose for a few days but as soon as I could I reduced the dose to the minimum. after a few weeks I was just taking them before bedtime. I switched to paracetamol and ibuprofen as my main weapon.

It was great not having a pot on, as it allowed me to move the arm as much as possible. By the time I went to fracture clinic (a week after the op), I could rotate my wrist about 75% of normal but using the elbow was very hard and my movement was restricted.

Two weeks later and I had some very bad news! My wrist movement was completely back to normal but the elbow hadn't improved at all. The physiotherapist really pushed it hard and it was extremely painful. I was told it was unlikely that I would regain full movement, and that I wouldn't be able to ride again. I was also told to stay off until my next appointment,

I called in at work the next day. Everyone was fantastic, right from the head to my colleagues in the Maths and ICT staffroom and I felt greatly valued and supported. 

When I said that I wanted to return after half term, the general advice was that I should listen to my doctors! My GP confirmed that it wouldn't be sensible to return early and so I have another four weeks off work!

I am gradually working on the elbow movement but it is really painful and I have to occasionally hit the dreaded Tramadol tablets which just knock me out. I am determined to ride my bike to work when I return!

Nexus 7 Aluminium Keyboard and Case

Mini Laptop?

Just a quick review of a new case I got for my Nexus this week.
The case is available from several outlets, but Infinite Zone sell it for the very good price of £13.99 and delivered it two days after my order.
This review is going to be quite easy, it one of the "does what it says on the tin" kind of situations. This keyboard is good quality, similar to a high end laptop although obviously much smaller. It connects easily via Bluetooth and is therefore completely wireless and doesn't need to touch the Nexus 7 in order for it to work.  The keyboard needs a separate charger which can be a problem - I am going to investigate some form of "Y" lead to split the normal micro USB into two.
Normally, you sit the nexus 7 on top of the keyboard which makes what is basically a small laptop. I thought that I would miss a mouse or touch-pad, but actually it is very easy just to touch the screen when you need to.
As a keyboard, I would rate it as 8/10, the only limiting factor is the smaller form factor, but unless you want to carry a large keyboard around with you, I dont see how this could be improved. The keyboard also makes a very good nightstand with the Nexus at just the right angle for bedside clock, if that tickles your fancy.
As a case, it is very good. The style of the cover is identical to the Nexus 7 so you effectively get a double sided Nexus 7 that can cope with most of the rigours that the Nexus is likely to encounter when in your pocket of bag. The Nexus clips into the cover but is easily unclipped. It does add to the bulk quite a lot, making the combined tablet and case 20mm thick as opposed to 10.5mm for just the Nexus. It does mean that if you use the Nexus as a normal tablet and just use the cover for protection when not in use, then you will be using the beautifully thin and light Nexus on its own, a definite advantage compared to other case designs.
Weight is also a factor, the combined tablet and case are 550g compared to just 340g for the Nexus on its own. I don't see this as an issue, as the combined weight isn't too bad and you wouldn't really notice it when you are carrying it around. Its a different story when you are using the tablet though, but as I have already said, you use the tablet completely uncovered so it isn't really a problem.
As a case, I would rate this as 8/10 - it provides good protection but could be lighter, which would probably mean it would be as good as a cover!
So, two scores of 8/10 would surely mean that I give this case 8/10 overall, but I would actually go one higher and say 9/10. The whole concept of a mini laptop and also the very high build quality without adding to the cost make this cover a steal.
http://www.ebay.co.uk/itm/New-Slim-Mobile-Bluetooth-Wireless-Aluminum-Keyboard-Case-for-Google-Nexus-7-/390528385359?ssPageName=ADME:L:OU:GB:3160

Snap part 2

Pinderfields

The time is flying by, I'm very tired and sleep quite a lot which is a poor excuse for leaving part 2 so long!
Once I had been robed up, the nurse walked me through to the pre-op room and I laid down on the bed. It was obvious that her role was to monitor my condition and engage me in mindless banter. The two anaesthetists used ultrasound to locate the nerves in my neck and shoulder and block them one at a time with an injection.
They worked quickly and very skilfully but when they took the pot off my arm, I was surprised to find that I could still feel it, in fact it was quite painful. They were too!
The pre-op room is a short corridor with a double door at each end. My bed was pushed through the second set of doors into the theatre. There were half a dozen people in there, all busy with their own tasks. A stand was fitted to the bed just above my chest and I gathered that my arm was going to be strapped to that whilst they did the operation. The problem was the anaesthetic wasn't blocking the pain, my arm had gone numb but I could still feel my whole arm. They gave me an injection and asked me how I was - nothing to report.
What seemed like sixty seconds later I was in a recovery ward with about thirty other patients, all post-op!

The broken olecranon
is clearly visible here

A view from above

After the op

Four torsion bands

23 metal clips and a lovely scar

Not only had I no recollection of the operation, but I didn't even remember drifting off to sleep! I'm really very glad as I think it would have been an awful experience having your elbow opened up a few inches in front of your face! The operation seems to involve exposing the joint and fitting the metalwork and that isn't going to be pleasant!
I could feel my fingers but the strange thing was I couldn't move them, no matter how hard I tried.
I can only describe the sensation of post-op as euphoria. You seem to be floating in a lovely warm cloud!
After a while, they moved me to a separate room on a different ward. The nurse kept coming in every half an hour or so and doing my observations and she said it was all looking good. I was still very sleepy when they moved me into a ward with three other patients.
My overall impression with Pinderfields is extremely good. The teams of staff were proficient, well equipped, extremely skilful and above all, gave me first class treatment. A&E in particular were superb and the fracture clinic and physio clinic were first class. You can probably guess that there is a "but" coming here!
At seven pm, they gave me a huge antibiotic injection and said it was the first of three which were to be given every six hours. I fell asleep as soon as the lights were turned off and woke up at three minutes to one. No point in falling back to sleep, I thought, as they will be giving me another jab soon. The ward was extremely quiet and I couldn't hear anyone moving about so at about 2am, I buzzed the nurse and asked her about my antibiotic. She said they had been very busy with admissions and that she would bring it.

Nice card from work!

I woke up at seven am in quite a lot of pain. The nurse gave me two codeine tablets and said that the drugs run would be round at eight am so I could have more then if I needed it. As it happened, the run came round much later and they only gave me one tablet despite me asking for more. The arm was quite painful!
The man in the bed next to me was admitted at the same time. He had fallen into a trench and got his foot caught, badly breaking several bones in his ankle. He was in agony and they gave him some morphine. This worked and he went to sleep. A few hours later he woke up and asked the nurse for some more pain relief and was told that the drug trolley would be around at dinner time. When it came around they said there wasn't any for him and that they would check. They didn't and when I left the ward at six pm, he still hadn't been given any!
The doctor confirmed I could go home just after dinner. I asked the nurse what pain relief I would be given and she said she would check. Initially, they said I would have codeine which I knew wouldn't be strong enough so I asked for something stronger. I was in quite a lot of pain but they couldn't give me anything because my notes had been sent down to the pharmacy.

Looking wasted1

My wife arrived but I couldn't really talk to her very much because of the discomfort. When the nurse eventually brought me a pack of drugs to take home, she was very dismissive and said that she thought we were "having a go at her". Something was very wrong that day, pain relief is essential and it wasn't being properly managed! I was also concerned that when it was tie to go home, they just said "theres your drugs, you can go". I wasn't told what to expect, when they would be in touch, what to do and what not to do etc.
Its a real shame because I would rate the rest of my experience at Pinderfields very highly.
As I can type (slowly!), Ill add another post in a couple of days about how the recovery is going.

Snap

Oddly shaped elbow

Last Friday was not a good day! The weather had been very cold all week and the inevitable snow had started to fall at dinnertime. It cleared from the main roads very quickly and I didn't feel at all at risk on my journey home. I normally travel down a small and interestingly named road called "Blue Butts" which is an old Yorkshire flagged horse cart road at the bottom of my street. The snow had not cleared on this road and the few vehicles that had been down had packed it into a thick layer of ice. I slowed right down, almost to a complete stop.
Click here to read more...

My wheel slipped so quickly that I don't really remember going down. I lay there on the road thinking to myself, "Mmm, that hurts..." When I checked my helmet later, it had taken a fair whack on the side, enough I suspect to have caused some damage in its own right if I hadn't had it on.

It was only a hundred yards to my house so I managed to limp home and ring my wife from the sofa. She didn't really think there was a problem until she got in and saw my arm!

We drove to Pinderfields A&E department, not looking forward to the experience as the hospital trust had been slated in the press recently.

I was sent for an xray very quickly and a male nurse saw me soon after that. The xray showed an "anterior displacement of the right olecranon", which basically means that the "funny bone" part of the elbow had snapped off. I've tried to find a similar xray image but all I have found is that it is a common break and that none of them are quite as displaced as mine. The nurses reaction was an immediate "this will need an operation" which was when the full implications started to hit home - up to that point, I had been thinking how I would ride my bike to work!

Two other nurses came and they put my arm in pot, almost straight and with a C shaped section to make it easier to remove and allow for swelling.

A cat shaped pot!

Next, I had to wait for the doctor to arrive, which took about 75 minutes. We had arrived at casualty at just the right time on a busy, snowy, Friday night and we later found out that they had 955 patients that night. We only saw half a dozen whilst we were waiting.

The doctor discussed the operation and I signed the consent form as best as I could. She said they would ring on Saturday and sent me home.

As it turned out, they couldn't fit me in until Sunday, but even that was literally a dress rehearsal where they got me all robed up before telling me that some more serious cases had come in and I was sent home again.

Getting to hospital for 7:30am on the Monday was a serious challenge. There had been a heavy snowfall and we were the first car to go down the street. Tracy doesn't like driving in slippery conditions so I had to get the car out onto the more open busy roads.

The Monday experience of Pinderfields shows just how well organised the system runs. The car park and paths had already been cleared of snow and the hospital was already busy when we got there. I was booked into a day ward which had about forty patients in the waiting room. Because of the icy conditions, I didn't fancy my chances of being "done" so I settled in for a long wait. I was third on the list and they decided to only do two patients - but number two hadn't arrived yet so there was hope! They called me in just as she arrived so it was a very close call!
Its taken me forever to write this blog post, and I'm only half way there! Part two will have to wait until tomorrow!

Aftershokz SportZ M2

The headphones come with a great case with storage for
cables etc.

I often have headphones on when I am cycling and always wear them when I am running. I aren't aware of any problems this has caused when cycling, but that might be because they are nearly always only used so I can hear and make phone calls and text messages.
Running is a different issue though, and I do like to have a strong beat with often quite loud music playing. This does mean that I cant hear and respond to my environment which can lead to safety issues.
I decided to pool together some gift money that I got this Christmas and but a pair of bone conducting headphones. These work by placing a transducer directly on the jawbone which transmits the vibrations to the ear without having to block the ear to other sound.
Aftershokz have made a bone conducting headphone for a while now and they have just launched two new models, a bluetooth one and also their Aftershokz Sportz M2.
I tried to have a look at the headphones in two branches of Evans Cycles, but neither had them in stock, in fact they did not know that Evans stocked them. This meant I had to order them online. I aren't a fan of Evans online service - they are often the cheapest and delivery is free but it always irks me that they charge extra for a fast delivery when in fact all they do is put it in the post later for the free service. I ordered the headphones last Monday, got an email saying they had been dispatched yesterday and they came today. Why couldn't they have just dispatched them sooner?
As I am waiting for a new phone, I wont be able t test them for a while, but they do sound good and I can hear what is happening around me when I wear them, which is what I wanted. My wife reports that they are quite loud and has asked me to turn them down a couple of times so obviously other people can hear you and they probably wouldn't be much good in an office environment! Once I've had chance to test them properly, I will report back!