(Repost) Elbows and horses do not mix…

…take it from me. I get asked a lot about my elbow and it can be hard remembering everything so now that it might finally be improved somewhat, I figured I’d document it.

(This is an old post I’ve moved over from a blog I used to have. I wanted to get rid of the blog but save some of the posts. The original was posted on 31/07/2009.)

I found out that I had arthritis in my elbow the day before my 18th birthday, 1st March 2002. What a birthday present to get, huh? It turned out that it wasn’t an entirely unexpected turn of events though; my parents had been warned that I may suffer from arthritis due to the injury I’d received but they of course hadn’t told this to a ten year old. The pains that winter had been unexpected. I’d never regained full movement of my arm since the break, but I’d never experienced any pain with it until then and it seemed to occur so randomly. One day it would be fine, the next three would be unbearable aches. At first I thought I’d strained it at aerobics or during horse riding, but when it started to occur randomly days after I’d done any exercise, I knew there was something odd going on.

The fall happened in the late summer of 1994. I’d been horse riding for 5 years and had my fair share of falls in that time but never anything like this one. Our instructor, Lesley, had set up two sets of jump stands, ready to turn the fairly simple cross pole into a double and unfortunately I was riding Molly, a pony inclined to rush round the school as fast as possible and as flat as you could imagine. For those not into your equestrianism, this all means it’s nigh on impossible for the horse to jump well. So she didn’t. That didn’t stop me however, as I flew over her head and landed on the other side of the fence. With my right arm directly between the jump stands.

I don’t remember the pain. Perhaps it was the shock, or perhaps it is true when people say that a broken bone doesn’t hurt as much as you’d expect. Don’t get me wrong, I know it was no walk in the park and I also am not exactly great at dealing with pain but this is why I believe it was just the shock.

Lesley forced me to get back onto Molly and ride again. We still had 40 minutes of the lesson left and I remember crying whilst trying to re-mount. It’s unlike me to cry, particularly after falling. I didn’t even cry when I was kicked in the foot whilst riding once. But Lesley, despite having taught me for 5 years and being aware of this, was convinced I was ok and was just being pathetic. So without even checking me, she gave me a leg up and sent me on the way again.

For 40 minutes I walked, trotted, cantered and jumped. The tears soon dried up although I started out riding with my arm limp at my side. This however got me a telling off from Lesley and so I managed to somehow use the motion of the pony to ‘bounce’ my arm up onto my thigh just enough to grip the rein. I don’t remember Molly pulling too much then. Perhaps she understood or perhaps I was just holding the rein too loosely for it to hurt me.

You read stories of all these incredible things that people manage to do when in extreme pain or danger. They don’t seem believable. People crawling for miles with broken legs in order to get help. Surviving for days under tons of rubble after an earthquake. Whilst a broken arm is nothing compared to that, it is astonishing what I managed to do with it. Not only did I ride for 40 minutes but I also managed to dismount on my own, lead Molly into the stable and begin to untack her. This was when my arm was finally noticed. I’m not sure how, but I’d managed to get my arm up high enough to grab the loose end of the throatlash and hang from it, whilst undoing the buckle with my left hand. I was dreading taking the saddle off and grooming Molly. Luckily for me, the owners mother, Mrs Bowser, came down to the stables at that point and saw me struggling.

I was immediately taken straight down to the house and put into the living room to rest. My Dad wasn’t there yet, knowing we always took 15 minutes to sort the horses out after the lesson and by the time he turned up I was feeling pretty exhausted from it all. I don’t remember the journey back home to Driffield, I simply remember being on a trolley in the Alfred Bean hospital with nurses rushing round. Oh and I had a painkiller injection in my backside, the only injection I’ve ever had there (and the only one I was grateful for!) I was dozy from both tiredness and the pain now and didn’t want to be disturbed. Mum was still at work but Dad had left her a message to let her know I was going to Scarborough hospital. All I remember of the ambulance journey was throwing up a couple of times from the shock (and Dad making comments that would put me off mushroom soup for life!)

The way Lesley had handled the whole situation was, quite frankly, appalling. I remember sometime after my arm was sorted out that there was a brief mention of suing her. I’m not a fan of suing everyone under the sun and never have been, but I would have liked to know that she at least could never teach anyone to ride again. I dread to think how many others may have ended up with serious injuries thanks to her. In such a dangerous sport you need someone who is practical and well trained in the event of an emergency and she clearly had no clue. I don’t know what ever happened to her, I don’t even know if she got sacked. I sincerely hope that she did.

My stay in hospital is none too clear. I remember vague bits of it. Mum barely left my side the entire time, only when Dad was there to take over and even then she’d just go for a ten minute walk to stretch her legs. My bed was the first on the right as you walked into the children’s ward. The walls on the way into the ward were brightly painted with characters and just before the ward were 3 or 4 private rooms for parents to stay in, and a couple of bathrooms with showers. I had a favourite nurse though I forget her name (but my Dad took her on as one of his financial clients a few years ago and she apparently asked after me). Oddly enough I also loved the food there, particularly the turkey sandwiches. It turned into a long running joke whenever we visited Scarborough and wanted to eat out that we would go to the hospital for turkey sandwiches. I remember there was a boy in the bed next to me who was always on the wheel-in NES (or was it SNES?) playing Mario. This was the first time I tried Mario in fact, and I was as rubbish at it then as I am now! He had a broken leg, something I didn’t envy him for at all. At least I was still able to get up and move around, and do pretty much anything I liked provided it only required one hand.

Apparently on the ulna (the larger bone in the bottom half of your arm) there is a small spike of bone by the joint. I believe this is what stops the ball leaving the socket (the elbow joint is incredibly complex) and this is what had broken in my elbow. The doctors believed that this would have been the full extent of my injury had I not been forced to ride again after that. Due to riding (and I assume to the fact that this spike had snapped off leaving a gap) my elbow had also become dislocated. The spike was not a problem, the dislocation was and so they simply put me under anaesthetic for long enough to pop it back into place. The cast was put on and I was sent home.

Everything seemed fine, it was still the summer holidays and whilst it was annoying to have a cast on, the elbow didn’t trouble me too much. So the day before I went back for my follow up appointment, I took Millie, my golden retriever, for a walk on the field near our house with Dad. I was walking her as she was a pretty calm dog, as long as we didn’t see any other dogs and there was no one else around. She always walked on my left, so I was holding her lead more tightly than I usually would with my left hand and only really had the rest of the lead in my right hand so it wouldn’t drag on the floor. To this day I don’t know if there was just a tiny bit too much of a pull from that, or if it had happened beforehand, but the following day in my x-ray it was shown that my elbow had dislocated itself again. I had to go back to have temporary pins put in.

I remember little about this hospital trip either. My bed was the first on the left this time, and the boy had gone. The longer anaesthetic didn’t agree with me and Mum had to sit up with me through the night as I kept throwing up. Once again she never left my side. I only recently remembered that I woke up to see the TVs were on that evening (there were TVs hung from the ceiling right down the middle so every bed could see one) and Labyrinth was on, though I wouldn’t know what movie this was until years later when I watched it with Steve and remembered one bit. Until I watched it, I actually thought the memory of the scene was a dream (a rather creepy one might I add!)

Soon after this hospital trip I was back at school. I had in fact missed the first week of Year 6 but luckily there wasn’t much to catch up on. Writing left handed was hard although I soon acquired enough skill that my work was legible and I could work fairly quickly, something that I have long since lost the ability to do. The cast was itchy as my cut healed and I wanted to scratch it. I remember doing exactly what you shouldn’t, and trying to stick pencils, pens, the ends of cutlery, anything long enough down there to relieve the itch.

When it was time to remove the pins I remember being fascinated by the saw they used. The (nurse? surgeon? doctor?) who was doing it set the saw going, then told me to hold out my hand. I did so and he placed the running blade on my palm. Not a scratch and yet it went through the cast like butter. That was the coolest thing I’d ever seen! Oddly enough I was also quite happy to watch as he removed my pins. I had two of them, and they were sticking out of my wound by about an inch. It looked pretty disgusting, covered in old iodine and cast dust.

The removal was an odd feeling. There was no pain and no blood. Just the sensation of the sides of those metal pins sliding past my bone. I watched the entire thing with no odd feelings whatsoever and yet when Steve had stitches in his chin I was the one feeling faint because of the needle! I think Mum still has those pins somewhere. They seemed huge at the time but I recall looking at them years later and they were actually quite small. Of course, my elbow was a lot smaller then.

My elbow has never fully recovered. I’ve never been able to fully straighten it, due to the fact that in the second operation they had to reattach the muscles in different places to normal. If you ever get the chance, look at my arm bent. The biceps bulges near the inside of the joint, whereas on my left arm it is fairly flat in comparison. I also cannot bend it entirely. I can easily touch my shoulder with my left hand whilst keeping the elbow close to my side. However even if I lift my right arm as high as I can, I cannot touch my shoulder. I come fairly close, but I just can’t touch it. On top of this I don’t have full rotation of my lower arm either!

So eventually, 8 years later, I found out that arthritis has developed and will get progressively worse until at least my mid twenties. It hasn’t been so bad to live with. Most days I’m fine. I have days where even the strongest over-the-counter painkillers (600mg Ibuprofen + Cocodemol) don’t do a thing aside from make me incredibly sleepy. My arm is of course not as strong as it should be, which is a real nuisance, but it works well enough. If I leave weight on it for too long it gets stiff and takes a lot of painful stretching to get it moving again but I learnt to live with this and avoid too much leaning.

Until recently. This past summer, the summer of 2008, my arm has just become too much to bear. Even if I sleep on the wrong side my arm becomes unbearably stiff, I lose feeling in it quite regularly and seem to have poor blood flow. My right hand is often colder than my left. This was the first winter I had to resort to 600mg painkillers (and they just didn’t work); usually I cope with 200mg. So I went off to the doctors to ask if I could get an x-ray, since the last one had been back in 2002.

Good old NHS. It takes them forever to do anything. I went to the doctor in August, who seemed very shocked at my limited movement and referred me to the hospital for an x-ray. It only took me about 2 weeks to get an appointment for that, and early September I was back at the doctor for the results. He had only taken a brief look and decided to refer me to Dr. Shah, an expert in upper limbs (the only one in the area in fact). I didn’t get an appointment with him until 26th November where they took another x-ray before sending me in to see him.

It turns out that arthritis is the least of my problems. He explained that the x-ray showed my bones were now abnormally formed. My humerus (the bone in the top of your arm) should be straight on both sides, like this: |   | by the joint. However mine is more like this: |   \ so this extra wedge of bone is of course limiting movement. Not only that but the actual socket is apparently quite rough instead of being smooth as it should be (this is probably where the arthritis comes in as it is a deterioration of joints and the cartilage that helps them to work well).

So we have two options. Option one is the easiest and will be carried out on 23rd March. Yes, it has taken 4 months for the NHS to get it sorted. Yay NHS. From what I understand, it will require only keyhole surgery into my elbow, where they will look around with a camera to get a better, all round picture of the joint. From there, they will then shave off some of the bone inside the joint to attempt to make the ball and socket smoother, hopefully freeing up some extra movement and reducing pain.

If that doesn’t work, we go on to option two. Option two will consist of a proper operation to straighten out the bone. A wedge will be removed from one part of the bone (I believe he pointed a bit higher up the arm) and reattached further down to straighten it out somewhat. Who knows what will happen if that doesn’t work.

So fingers crossed I will get some help from this. My arthritis is always going to be there and will get progressively worse. But if this/these operation(s) can help me somewhat in the meantime, I’m all for it. My pre-assessment is on 17th March and the first operation 23rd March. So if I can type well enough afterwards, I will of course post an update.

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