I’m back home from a week in hospital and I’m supposed to be taking it easy before returning to work later this week, so I thought I would write a short follow-up to my report on the Thames Ring 250, a race that resulted in me being taken to hospital by ambulance three weeks after it finished!
The race:
I was just over two days and 156 miles in to the TR250 when I noticed I had some localised swelling on the shin of my left leg, about six inches above the ankle. Maxine, the race medic was fixing some minor blisters on my left foot while I was preparing to leave checkpoint 6 and I noticed the swelling.
When I asked Maxine whether I should be concerned, she said that the only way to stop the swelling would be to stop doing what caused it. We both knew that that wasn’t an option. At least, not for another 94 miles until I reached the finish line.
Now, don’t get the impression that I am blaming Maxine for what happened next. Far from it. There was some localised swelling, about the size of a small matchbox, but no pain. There was no indication that the problem would get worse, and even if there had been, I was in the middle of a race that I fully intended to finish, and I would not have listened to Maxine or anyone else if they had told me to drop out of the race because the injury might get worse.
36 hours and 75 miles (many of which were very painful) later, and I’m being rescued from the race after getting to the stage where I couldn’t take another step without severe pain – the worst pain I had ever experienced or would experience again – until three weeks later.
Initial diagnosis:
I ended up at Kingston Hospital the following afternoon and initial x-rays indicated a possible bone bruise to my left shin. Stress fractures often don’t show up on x-rays until 10-14 days after they occur, and bone bruises don’t show on x-rays either, but based on the evidence, at this stage it appeared that I had a bone bruise. Oh, and I also had some infected spider bites on the same leg. So a dose of antibiotics for the spider bites and some painkillers for the shin. I was told to rest and keep my leg elevated as much as possible, and to make an appointment to see my GP in two week’s time. I was also given some crutches for when I had to move.
10 days later and the pain was still severe, so I brought the GP visit forward and ended up back in hospital for more x-rays. This time the diagnosis was that maybe I had torn a tendon away from the shin and possibly a fragment of bone had come away too, which would explain why I was still in sever pain. As the pain was at its worst when I tried to walk, I was given a medical boot to stabilise my foot. The boot came with some documentation about how immobilisation of the lower leg (which is what the boot is designed to do) can, very rarely, cause DVT (Deep Vein Thrombosis – or blood clots in the leg) and I was told to ensure that I only used the boot when I needed to, and that I took the precautions mentioned in the documentation.
Thanks to my medical insurance, I had an MRI the following week and learned that there was indeed some severe tendon damage, and some indication of minor bone trauma, but the damage was more to the tendon that attached to the front of the shin than to the bone, and the only cure was rest.
So end of story. Take three months rest. Cancel the races I had planned for the summer, and resume training in September or October.
Or at least that is what I thought until about 10pm on the night of Saturday 20th July, almost exactly three weeks after I was forced to withdraw from the TR250, when the right side of my upper body, which had been sore all day, when into uncontrollable spasms.
Ambulance ride:
Not that I have a ‘bucket list’ as such, but I can now tick ‘ambulance ride’ off my bucket list.
I thought the pain I had been in with my foot in the final minutes before pulling out of the race was the worst pain I had ever felt, but this was 10 times as bad, and was non-stop. And the language coming out of my mouth was like nothing I had never heard myself say before. I’ve heard that swearing helps relieve pain, but this pain was intense.
My wife, Ruth, called an ambulance. The 20 minute wait for the ambulance felt like hours. The spasms kept coming and coming. When the ambulance arrived, they spent well over half an hour getting me under control and reducing the pain using gas, and then once in the ambulance they spent another 30 minutes doing tests including an ECG before we drove to the hospital. I have to say, the service I received from the ambulance staff and the staff at Kingston Hospital during the following week was exceptional.
1am on Saturday morning in A&E. I think I was the only non-alcohol related casualty in the department. Fortunately, it was a reasonably quiet night. I had various tests, another ECG, some x-rays, etc. There was no obvious cause of the pain and as the painkillers appeared to be working, I was sent home at around 4am and asked to come back on Monday morning for a CT scan.
Blood clots:
It turns out that I am one of the rare few people that wears a medical boot AND ends up with a blood clot. In fact if I had two. I would rather be one of the rare few that wins lotto, but not yet.
The blood clots had started in my leg and made their way to my chest, but I was lucky that they hadn’t reached the heart or the lungs and were now stuck where they were and would not be moving. Blood clots can be fatal if they reach the vital organs, so I count myself very lucky.
As a result of the blood clots, my heart had been under pressure and this had resulted in fluid ending up in my lungs, and it was the damage to my lungs that was causing the pain down my right side, which then caused the muscle spasms. Again, I look at this as being very lucky. If I hadn’t had the muscle spasms, I wouldn’t have ended up in hospital and wouldn’t know all this, and the next blood clot could have been the fatal one.
Instead, I am now on blood thinning medication for the next, up to six months, and am on antibiotics to clear the remains of the lung infection.
What next:
My left leg is still sore. The swelling hasn’t yet completely gone, and it has now been a month since the race. I am told that I won’t be able to resume any training until at least September – because of the leg – but some mild exercise will be OK, once I feel up to it, to start strengthening my lungs again.
So any plans for any more races in 2019 are now completely cancelled, and I am starting to think about goals for 2020. I won’t commit to anything until I know I am fit and healthy again, but I am thinking that I might join a gym and start swimming and working on upper body strength during the reminder of this year.
