Community – Chris’s Story

     I’ve been meaning to write this for a few years…

So apologies it’s taken me so long to get around to it.

Forgive me also as the exact chronology is a bit hazy now but hopefully my story will provide some hope and inspiration to others in similar situations.

Back in October 2014 I was out jet-skiing off the North Devon coast. My friend and I were with a larger group of riders who use custom made stand-up jetskis and do back flips and other tricks by jumping waves. I don’t do any of that fancy stuff but was just out riding around and watching them. I was on a stand-up jetski and my friend on a sit-down. The conditions were a bit rough (that’s what the other guys want) and my friend was finding it a bit tough even on the sit-down so I rode with him back to the harbour. I then took the sit-down and went back out for a bit longer to watch the other guys before they came back in. I wouldn’t normally go out alone, but I was only heading out around the headland before I’d meet up with the others again. As the estuary opened up I began to accelerate until I was flat out, just under 60mph on water is fast.

At this point I should probably also mention that three months prior to this I’d managed to go over the handlebars of a mountain bike and break my arm. The surgeon then had decided to put a metal plate in to fix the break and I was told that I could ‘resume normal activities’ after three months.

Now, I’m not sure they had jet-skiing down as a ‘normal activity’ so as a wave came up suddenly which was a bit bigger than I was comfortable hitting at that speed with a 3 month old fracture I had a split second decision to make, hit the wave and risk injuring the arm again or jump off. I chose the latter. I braced for the impact with the water and jumped off sideways, as though ‘shoulder barging’ the water.

Slightly winded, I caught my breath and looked to swim to the jetski which had continued on a good 10-20m away but here was a burning tingling sensation down my right arm and I couldn’t move it. I wondered what the hell I had done. Had I dislocated my shoulder? I didn’t think I’d done anything to the previously broken forearm. I’d never experienced anything like this.

Unable to move the arm I struggled to make much progress swimming towards the jetski. Realising I had a problem I decided I was going to need some assistance. My friend probably couldn’t see me from shore, I didn’t know how long it would be before the other guys came back in so reached with my left hand for the marine VHF radio in the purpose made transparent dry bag attached my buoyancy aid to call on channel 16 for the coast guard/lifeboat.

But there was a problem, there was water in the dry bag. The force of the impact with the water had put a small hole in the dry bag where it had been tucked under one of the buckles on the buoyancy aid. The bag was slowly filling with water. I tried to keep it up out of the water while floating with one arm limp as I switched it to channel 16, pressed the transmit button and called ‘mayday, mayday…’ there was a brief crackle and the radio died.
Fortunately, I wasn’t left floating around too much longer before a wind-surfer spotted me and came over to see if I was alright. He was able to help reunite me with my jetski and found it quite amusing watching me try and mount the machine one handed (which I eventually did) and ride it one handed back to the harbour.

Ambulance was called, ambulance crew thought I may have momentarily dislocated my shoulder which then, they surmised, popped back possibly trapping a nerve. They suggested I take myself to A+E to get checked out once my friend had helped me load up the jetskis!

Cut a long story (as) short (as I can), 4 hours in North Devon A+E waiting room before getting admitted, triage doctor showed no sense of urgency but also no sense having much of a clue about the ‘Brachial Plexus Injury’ he suspected. A phone-call to Plymouth and they decided to give me some Dexamethasone and do a CT or MRI. An anxious night or two there with no info from the medical team on the course of action or whether surgical intervention was required. They seemed nonchalant.

I was then told I’d have to be transferred to Plymouth, further in the wrong direction from home, so I asked whether one of the Bristol Hospitals had the necessary facilities/staff to take me. This was seemingly a bureaucratic nightmare. Eventually, at some ungodly time of night, I was put into an ambulance and driven to Southmead, Bristol. Here, the following morning, a leading neurosurgeon was performing brain surgery, removing tumours and saving people’s lives. Clearly a genius, he gave the impression that he either wasn’t very interested or very well informed about my ‘trivial’ BPI but knew a couple of people who specialise in these things.

I was discharged the following day with still almost no information on the course of action to be taken thereafter. I asked, “what are the chances of recovery”? 50:50, came the reply. “Is there any surgery available or any other tests you need to do?” I asked. Bear in mind I’d been told they would do a more accurate MRI at Bristol which they didn’t. Still very little info beyond, we’ll see you in a month.

The outpatient appointment a month later was a waste of time, I was supposed to go for a Nerve Conduction Test which it turns out hadn’t been booked, the registrar wasn’t the one on the appointment card and obviously hadn’t read the notes. The test was re-booked another month later, I didn’t hear anything more about the results but knew they weren’t good as I still had no movement’ in my upper arm.

Come Christmas I was getting fed up with Bristol and my own research had suggested that there was a ‘window of opportunity’ beyond which surgical intervention would be less likely to succeed. As I didn’t seem to be getting any interest or news from Southmead, I found out about the Royal National Orthopaedic Hospital and a couple of the specialists there. I ended up making a private appointment for a consultation with Mr. Marco Sinisi at the Wellington. He suggested we give it a little bit longer to see if there is any recovery.

On a personal note, I was coping reasonably well. I’d been back to work since a few days after first being discharged from hospital. I’m fortunate that I do an office job, my hand and wrist was unaffected so by lifting my forearm onto the desk I could still use the mouse and keyboard. I’d swapped cars with my father who had an automatic and was still able to drive. Mentally I was coping better than I thought to the adjustment. I got frustrated with a friend one day winter walking up Snowdon as I had to ask for their help putting a jacket on and they ‘weren’t doing it right’. But generally, I just got on with stuff. The only time I remember getting a bit down by the situation is when my god-daughter wanted carrying on my shoulders and I had to tell her I wasn’t strong enough anymore to lift her.

The time came for a second appointment with Mr. Sinisi and he saw that there hadn’t been much progress. It was then that he recommended surgical intervention. I didn’t have private health insurance and couldn’t afford to continue privately so a letter was written to my GP asking for a referral and fairly soon I had an appointment for surgery at the RNOH.

When I say ‘much’ progress, there had been some. A brief twitch of the atrophied bicep. I hadn’t been given any physio advice but had devised my own system which seemed to be helping.

Laying on my back on the bed with my upper arm horizontal and my forearm vertical (elbow at 90 degrees) and would let my forearm extend forward slightly, just a few degrees and then try and return it to the vertical position. If I extended it too far it would just flop onto the bed and I wouldn’t be able to raise it. But gradually, I began to be able to lower it a bit more and a bit more and still return to the vertical. I would do a number of repetitions of this exercise each time. Once I could lower my arm all the way and raise it again, I began introducing weights. Now, you can put your dumbbells away for the moment; these were the weights from my mother’s old-fashioned kitchen scales. Half an ounce, then an ounce… gradually and over time I moved up to 500g.

As the date for surgery approached, I became increasingly concerned about the potential outcome of surgery and, after all, all surgery comes with risk. Would I lose all movement all together, how long would the recovery be, how much improvement could I expect, might I experience nerve pain (which I hadn’t before) could I now manage like I am…etc.

I phoned Mr Sinis’ secretary and explained my concerns and my recent improvement. Mr Sinisi asked me to come and see him again. He took one look at me a declared he was unlikely to be able to make any significant improvement through surgery. He said clearly it is not an avulsion (nerve completely severed) as he previously wasn’t sure. He thought I’d continue to make some further recovery but couldn’t say for sure how much.

My arm was still weak but my exercise regime was praised by the physio I briefly saw while visiting the RNOH so I continued with it. Mr. Sinisi warning me not to try too hard and take it steady as he explained that you can force some unnatural movement as you try to make other muscles do things they were never meant to.

I’m pleased to say that after about 18 months I was 90% recovered. Some weakness but for most day to day things I didn’t notice much difference.

Slowly, slowly the nerves and muscles recovered further, after a couple of years I am able to still do all of the things I did before, including even a bit of rock climbing!

Now I don’t want to get people’s hopes up too much who might be in the situation I found myself in 5 years ago as I was one of the fortunate few. I’m not really a religious person but whether you call it a miracle or whether you call it the marvel of nature, I count myself very lucky as I know that my outcome is not the outcome that everyone gets. But, for anyone with a recent injury, have hope, be brave, don’t give up, adapt and eat healthy to give yourself the best chance of recovery.

Chris.