"Hey man... what happened to your leg?"

in #amputee7 years ago

I administer a discussion forum for amputees to ask their questions and share their stories and ideas in an effort to take some of the mystery out of the topic. I started a thread to tell my story and answer the questions I'm often asked, "Hey man... what happened to your leg?!"

I need to preface the story a bit with what had happened the summer before I actually had my accident.

When I was between years at the technical school from which I trained to be an architectural draftsman, I worked at the pulp mill that employed (and still does) my Dad located near my home town. The first summer was after high school and before technical school - (1992) was pretty much grounds activities. Alongside a childhood friend, I did a whole bunch of cleaning of the mill and grass cutting, cleaning train tracks of mud, organizing a ‘bone yard’ etc… it was a good job.

The second summer (1993) I was a millwright’s helper. That was good, but proved to be dangerous on some days. On one particular rainy day (June 10, 1993) we were working on a maintenance shutdown of the wood room – a generally more dangerous part of the mill than the rest of the plant. I was working about 100 feet away when a gentleman was crushed to death on a catwalk as a crane load fell on top of him. When it happened, everyone ran for safety, assuming Marvin (said gentleman) didn’t survive the accident. It turned out that I was the only one trained in first aid and I - an 18 year old kid - walked out on to the catwalk that had sustained considerable structural damage, 30 feet off the ground on the outside of the building to check to see if Marvin was in fact dead. I won’t go into detail of what I saw, but it was very clear from what I saw of the body that there was no life there. This was a very traumatizing experience. This said, we finished up the summer and headed off to the second year of post-secondary education. All year – the experience played over in my mind. I had problems sleeping, and found myself reliving the experience in nightmares and daydreams during the days… The details I can remember about those few minutes continue to amaze me to this day. I can remember what I heard / saw / smelled as I crawled out on the twisted steel in the pouring rain in perfect detail as if it happened last week. I don’t think it helped that the employer did everything they can to cover up their fault in the accident – and it was pretty substantial. They did their best to blame the deceased worker and deflect any blame from themselves. It worked out for them, not so much for Marvin.

Fast forward to the next summer. I had graduated from one technical program, and enrolled in a second, because the job prospects for newbies were not great. I got another summer student position at the pulp mill. When you get a job, you don’t know what part of the mill you’re to be assigned to until your first day on the job. I learned upon reporting for work that I’d be working in the wood room – the same place where Marvin was killed the summer before. I really wasn’t pleased, but I had a job and it was 1994 – the Canadian economy wasn’t that great and if I wanted to make some decent money, I’d better grin and bear it.

Everyday I’d work around the spot where Marvin was killed, and I would find myself physically working, but not really being there mentally to pay attention to what I was doing. When I was in that fateful spot, I’d find myself looking for evidence of the damage to the building and catwalk from the previous year. My dad was one of the guys who helped repair the damages, and did a great job, because I never saw any evidence of it.

The mill was planning a memorial for Marvin on the one year anniversary of the accident, and it was a much contested topic of conversation as the workers were still not happy with the way the employer conducted themselves when the investigation was being conducted, even nearly one year later.

My morning duties consisted of a routine of cleaning the conveyors around the mill and after that was done, I’d do some maintenance items which were left over from the construction of the mill five years earlier. When the mill was under construction, the price of pulp was very high and they started up while the buildings were still under construction. There came a point where the corporation decided that it would be easier to make pulp if the construction guys weren’t around, so they cut the scope of construction work and cut the contractors loose as soon as they could. Part of the missing work was nothing on the inside was properly painted. So – one of my jobs was to paint the unpainted equipment.

On one particular wet and rainy day (June 8, 1994), I finished my cleaning routine relatively early, and went for the morning coffee. After coffee, my assigned task was to paint the underside of a refuse conveyor on a production line, and in the afternoon, I was to assist a welder in making a repair on a broken chute wall that was pierced by a log. I ventured over to my scaffolding on which I would climb up to paint the refuse conveyor which was about 12’ off the ground floor of the building. I was working under the barker – a big drum machine that strips bark off trees. The barker is a very loud machine and very maintenance intensive. It sprays oil everywhere as seals are constantly breaking. On the ground floor, there was an oil puddle that gels up as saw dust and bark dust get caught in it. Near the oil stain (see illustration) there’s a ramp of sorts that crosses a return tray in which the conveyor chain slides for the refuse conveyor overhead. The ramp makes it easier for the maintenance guys to bring carts and equipment over the return trays.

Travelling in the direction of the blue arrow, I slipped and fell due to the oil pool, and actually landed on the slow moving chain sliding return tray. The gap between the slow moving chain and the underside of the ramp that crosses the tray is about 2”. Before I was able to get up and off the chain, my left foot got caught in the chain and pulled in to the small gap between the tray and the chain. (Red space on the illustration). I was laying on my right side on the chain. My foot was caught in a link on the chain, and I was being pulled into a very small space, crushing my foot. It didn’t really hurt – my biggest concern was that although my foot was crushed, I was still being sucked into this very tight space, as my ankle was being sucked in too… I knew that this chain, although seemingly slow, could conceivably pull my body apart. It was designed to move tons of material to the refuse incinerator – tearing up the human body would be quick work if I didn’t stop myself from being pulled under the ramp.

I tried to pull myself out but there was nothing really for me to grab on to. I lifted myself up, noticing that my leg had a new flexibility to it – sideways… and brought my right knee behind me and wedged it onto the yellow marked piece of metal and straightened my body in order to make it rigid. This was enough to cause the box chain to slip under my mangled foot. So – I’ve stopped being sucked into the tight space, the edge of the horizontal part of the ramp was just above mid-calf when I stopped being pulled in. I noticed that it was taking a lot of strength to maintain the rigidity of my body in order to keep myself from being sucked in again. I learned later that it was beginning to tear the seam of my coveralls at my shoulder it was pulling so hard…

With every passing link of the chain that slipped under my mangled foot, the bones in my foot and ankle were broken up just a little bit more. It felt like I was pouring blood into the tray and I kept looking up to see if I was losing blood down the conveyor… I wasn’t. It felt like warm water gushing around my foot. I’d look up and see another part of my steel-toed boot rolling down the conveyor chain. The machine was doing its job…

There I waited to be discovered. I was alone in a very loud room, the nearest co-worker was in the control room, which was a couple hundred feet away. I was one level down under the loudest machine in the wood room. Even though I screamed until my voice was raw, no one heard me… I was beginning to get tired. Very tired… Sleepy. Still not a lot of pain – just intense pressure and warm soothing water sensation gushing around my foot. I took an inventory of what I had on me… I had: two gloves, a set of earplugs a pair of safety glasses and a bright orange hard had. I was about 40’ from a staircase to the upper level. I threw one glove in the direction of the stairwell. It made it about 15’. I threw one glove in the direction of the spot at which I’d be helping the welder later – it was about 50’ from my location. He wasn’t supposed to be there for another couple of hours. Futile. The glove didn’t make it very far either. My hard hat – I tossed it aside… It turns out – that was the lucky toss, as it took a funny bounce off a structural column and bounced out in to a breeze way which was behind a wall. The overhead door was open for relief air. Not long after, one of my co-workers saw a hard hat on the floor of the mill and came in to see who it belonged to, as the wood room had strict rules about protective equipment. If you’re caught without it, you might be fired. My hat had my name on it, so he collected it and came looking for me to investigate.

Just about fifteen minutes had passed since I first started getting pulled in, until I was found. Joe (co-worker who found me) got onto the radio, called for the conveyor to be shut down and called for the first aid crew (which was recently formed in reaction to the lack of trained personnel during Marvin’s accident). My dad was working in the main mill that day. He heard the call on the radio and made his way up to the wood room (about 300m from the main mill) after they wouldn’t answer him with who was injured or the nature of the injury. Now… they onerous task of getting me extricated from the conveyor was commenced. What it took was a welder (a close friend of the family) with an oxy-acetylene cutting torch to cut the ramp. It took nearly an hour because they had a fire hose spraying water under the ramp next to my leg in order to keep me from being burned – the water kept extinguishing the torch. They guy holding the hose was asked during the process to hand a crowbar to someone else, and for a split second he shut the hose off… well – the result was full thickness burns.

When the call was made for the first aid crew, the mill called the ambulance from town – about 20kms away. When the first aid team arrived on site, they decided that the ambulance call was premature, as they would have had to remove me from my predicament. They called the ambulance and cancelled the call. The mill has its own ambulance, and someone had the bright idea to use it to transport me to hospital. They went down to retrieve it from the main mill, and pulled it into the wood room lot. With me just removed from the conveyor, they went to get a stretcher from the ambulance. There was none. All that was in the back of the ambulance was an aerial rescue basket, and a blanket, that happened to be covered with dried blood and brain matter from Marvin’s accident in the previous year. I can’t imagine how it would have ended up back in the ambulance. There wasn’t even a first aid kit. It was effectively a mini cargo van, painted white with a red cross on the side.

They decided it was time to call the town ambulance again!

Someone else decided it was time to get me on the road, so they loaded me up into the aerial basket, and threw me in the back of the mill ambulance. They went to start it up, and discovered it was out of gas. No problem – fuel tanks nearby… they threw some gas in the beast and got me rolling.

Someone called the town ambulance and told them to turn back, as the mill ambulance was on the road. We made it about a third of the way to town, when the town’s paramedics and ambulance met us. They ignored the latest request to turn around again. I was transferred into the care of the professionals. After getting me somewhat stabilized on the side of the road, IV and morphine on board, we were on our way to town.

Upon arriving at the local hospital, I was told by the mother of one of my high school friends, that I’d be shipped off to Edmonton, about two and a half hours away, because the “break was a compound fracture.” She was being kind, and did a good job of it. She was the radiologist on staff, and later told me that she had never seen anything broken up that bad. At this point, I thought I had a broken ankle and wasn’t aware of the burn. She said she couldn’t imagine how I managed to break bones that bad and manage to obtain full thickness burns. It haunted her for the summer until I could meet up with her later and tell her the whole story. When I do something, I do it right I guess.

I was in an immense amount of pain. More morphine on board. They did a bunch of stuff to me… asked me 1,000 questions, examined me for other injuries, cut off clothes, I was relatively washed up, my contact lenses were taken out, I was transferred to a real transport stretcher, the brain and blood affected blanket was disposed of, more morphine… but I still hurt. Then it was time to set off for the airport. Back to the waiting ambulance. It seemed that the paramedics left all of the accessories running in the ambulance with the motor off. The battery was dead. Now… the town I lived in is a small community. They have two ambulances and crews to serve the town and surrounding communities. It was now the noon hour, and the other crew was off their radios at lunch somewhere in the town of approximately 7,000 people. And this was before the days of cell phones. One of the ER nurses got in her car and proceeded to search the town’s restaurant parking lot for the other ambulance. Once found, she had to go into the establishment, ask the crew to finish lunch / settle up the tab and bring their unit back to the hospital.

Once this happened, I was finally off to the airport, to be flown into Edmonton. Much of the rest is a blur, as the morphine took hold, finally. At one point I woke up and a paramedic was taping a plastic bag with a needle in it to my chest. I found out later it was a drug called narcan, which counteracts the effects of opiates, which morphine is… Apparently the doctors at the hospital totaled up the morphine I was given and were concerned about the possibility of an overdose. My mom was on the flight, and said I was out of it for most of the flight, with the exception of the moment where I tried to sit up to look out the window of the plane, asking to see the sunshine. It had been raining and/or overcast for nearly two weeks.

Once in Edmonton, I remember waiting in the ER for hours, waiting for an OR and surgeon to be freed up so they could “set my broken ankle”. My mom was there to keep me company and to keep downplaying what she saw under the bandages as doctors, interns and nurses came in to see some “crushing trauma.”

I don’t know who said it or what their role was, or even if they were kidding, but before my first surgery, I was led to believe that I’d wake up with a cast, be in the hospital for a couple days, and be on my way to recover for the summer. After the first surgery which lasted into the wee hours, I remember being harassed by the recovery room nurses, and just wanting to sleep. I didn’t care what was up with me. After that, I remember waking up in the middle of the night, and trying to see (I didn’t have my glasses) the cast on my leg. I couldn’t make out what exactly was up, but whatever that was, wasn’t a cast, and I was in an immense amount of pain again.

It turns out that I was attached to a device called an external fixator. This was certainly no cast. The next morning I learned about the burn, and the extent of the injury. I had the best plastic surgeon and the best orthopedic surgeon in Western Canada on the case (seemed some strings were pulled… long story…) Anyway. Having the best of both disciplines proved to be both an advantage and disadvantage. On one hand – they are the best at what they do. On the other, they couldn’t agree on whether or not the leg could be saved.

The next three weeks are a blur… I don’t remember much, because they kept me pretty drugged up, but after six surgeries for debridement, a very serious blood infection that was threatening my heart muscle, skin grafts to cover gaping holes left by fasciotomies , the big toe being amputated, gangrene taking up residence, I had had enough. I was witness to the two experts argue extensively in front of me with their entourage of interns and resident doctors. The plastic surgeon thought the leg was a write off… The orthopedic was sure it could be saved. I asked them to unwrap it together in an OR and come up with a determination of whether or not the leg can be saved. In the ensuing surgery, I was being prepped, and as they were putting me out, I heard the argument fold out. The last thing I heard before going under was the orthopedic surgeon say, “Maybe you’re right…”

I was debrided and sent back to my room, where I was given a choice. The orthopedic surgeon explained that he still thinks the leg can be saved, but I’d be in the hospital for a minimum of two years. I’d suffered severe nerve damage and would never feel my foot, my ankle was fused. I’d walk with a limp, and there were no guarantees. Basically my life would be ‘on hold’ for an undetermined period while we worked on it. And in the end – a hangnail could result in my losing the foot, because I had no feeling down there, the brain wouldn’t be aware of new injuries…
The picture the ortho doc painted for me was bleak, and although it offered a glimmer of hope, I recognized it as a really rough road that I wasn't prepared to travel. I have a feeling that ultimately the result would have been the same if I would have tried to save it. And who knows how much more damage I'd have done to my residual limb by making the attempt and exposing myself to who knows how many more infections and risk of further injury.

So – the decision was easy. One more 4 hour surgery and I was a foot short. About mid-calf is where they took it. I was still quite swollen from the initial injury, so I was sent back to my hometown to recover for about 6 weeks until I was fitted with my first prosthesis. I made it to school in the fall for the second technical program I was enrolled in, however, in February of the next year, I over-did it one evening tending bar where I worked part time. I ended up getting wearing a hole in the remaining skin graft on my stump. My prosthetist gave me a choice - stay off the prosthesis for a minimum of two weeks or lose another section of leg. I dropped out of school and looked after the stump. After about three weeks, I hit the job market hard and ended up starting my career.
Shortly after the amputation I was having a hard time dealing with it. But about a week after, I was sent to a nearby rehabilitation hospital and put in a wing with other amputees. Until then, I thought there was no one in the world who could understand what I was going through - and there's no way life could get worse. But the first day on the ward in the rehab hospital I met many patients that were way worse off than me. And it sounds like a crappy thing to say… but that’s what made me feel that life wasn’t so bad. There was an elderly gentleman in there who was a total inspiration to me. He had lost one of his legs two years prior and was in “getting the other one trimmed up to match!” His attitude was a total inspiration and put me on the road to changing how my mind was dealing with it.

So – in the months and years that followed, when people ask me, “What happened to you?” I give them a reader’s digest version of the above, and try to describe it as one day in my life when I had a real bad day… everything that could go wrong did. When young kids ask, I answer their questions… they are so curious. I don’t describe to young kids what happened in detail - just that I was caught up in a machine and got hurt real bad.

Talking about it to me is therapeutic. I get more amped up emotionally by talking about what I saw in Marvin’s accident. I can’t help but think that for some of us, me included, that the powers that be thought that maybe you and I needed a little course correction in our lives. I do think that things happen for a reason, and maybe you and I were heading down the wrong road.

It’s now been 23 years since the accident and I’ve reset my life. I’ve gotten married, have a reasonably successful career, bought and sold houses, and had a child. With the exception of a revision surgery in early 2012 to correct some lasting effects from the original trauma, I haven’t stopped since!

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Go back and edit this to include # introduceyourself. I put a space so I didn't get flagged.

Well described

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