5pm

What the hell is a police car doing driving at speed up our drive ? Thankfully the dogs were in the back yard so the policeman approached without fear. I opened the patio window and went out to greet him.

PC: “Mr Pollard”
Me: “Yes – is something the matter ?”
PC: “Can I come inside? I have some bad news for you.”

I immediately thought of Karen. I had sent her a couple of texts on the afternoon and had no reply. Didn’t think twice about it at the time, but now it had meaning.

He went on to explain that kp had been involved in a car accident and had suffered multiple injuries and he was here to get me to the hospital. My mind was running on overdrive.

Me: “How serious ?”

He showed me a fax detailing her injuries. Serious !

Still in fast forward mode, I got the dogs in, grabbed the mobile and sat in the policecar. I had left a window open and the dogs had no food. But, I wasn’t thinking straight.

I couldn’t think about anything but kp.

I probed the policeman for as much information as I could, but he only knew what was on the fax. I asked him “What does critical mean ?”. Dumb question, but hey. I was gearing myself up for the worst scenario. After 10 minutes in the policecar, I was talking about the latest Dr Who episode and the policemans shift patterns. Anything to take my mind off the worst fears.

Arriving at the hospital, he took me into A+E. Everyone in the waiting area looked at me. It felt as if I was handcuffed and in “bother”. Then whisked through to the relatives area to meet up with the PC who attended the scene (Ian Clough, lovely bloke). He explained the crash a bit more. 3 cars were queuing. kp was in the back seat of the back car, when a van piled into the back of her car. 50mph was mentioned at some point by someone.

After explaining this, he took me into a private relatives room

Me: “This looks ominous”

I thought the worst had happened and they were going to tell me kp was gone. I was sh+tting myself.

PC: “No, its just to get you out of the public corridors”

Was that a line ? Or was it being truthful. I felt he was being truthful.

What felt like an eternity passed until a doctor appeared. I have no recollection at all of who came. I just jumped onto everything he/she said and let it sink in. The gist of it was :-

Karen had multiple injuries.

Shattered Pelvis
Dislocated Hip
Broken Femur
Head Injuries
No feeling in her left side.
Broken arm.
Severe Bruising to her thighs
The rest I can’t remember.

I asked how serious these were (dumb question in hindsight).

Life Threatening.

The doctor said if I wanted to see kp before she went down to theatre I needed to come now. She was going to theatre to stem the blood loss she was experiencing because of the pelvis. I approached gingerly psyching myself up for a kp I couldn’t recognise.

But it was the Karen I love with a bad gash on the top of her head and lots of blood in her hair. Everything else was covered up.

Me: “Hiya love – how u doing?”
kp: “I am in agony” (said in kp’s normal voice as if she wasn’t in agony, very weird)
Me: “You’re going down to theatre and they are going to sort you out”
kp: “Make sure there is someone with you”
dp: “Yes I will don’t worry. I am fine.”

We told each other how much we loved each other. I did my normal kissing routing and finished by ensuring I said “Love you” at the end. I always try and say “I love you” as the last thing I say to her before we part even if its just going to the shops or work.

I rejoined Ian (the policeman) and he started handing me his business cards and explaining things a bit more, at which kp was being wheeled past us. The nurses asked if I wanted to kiss my wife again. I remember saying “No, she doesn’t like being kissed” or words to that effect. Which is a known family in-joke. This would become very key later on

I was left alone for a while and immediately phoned Jane Burns (kp’s best friend). Jane was shocked but dropped everything to come straight to the hospital. I then phoned Marie and her words were “You lie ! You’re having me on”. I can’t remember who else I phoned apart from my Dad who said “Will you both still be coming to Devon this weekend ?”. This angered me at the time and I said something like “No, but I’ll let you know if Karen pulls through or not !”. Within a few hours I understood that he was in shock just like I was.

Within an hour or two, family members (including Jane Burns) started arriving at the hospital and we all convened in “The Green Room”, a small visitors area next to the Intensive Care Unit. Little did we know how much time we would be spending in that room. How much laughing we would be doing and how much crying.

Then began the longest night of our lives.

This blog includes facts from the night of the 27th which includes details from the early hours of the 28th.

Nervousness was abundant on the first night. Michelle was doing her foot-tapping routine. I was very quiet. The first event I recall on the evening was Frank McCaulay (the consultant) coming to see us. He explained the direness of Karen’s situation. He holds no punches and tells it like it is. Things I remember him saying include :-

“We nearly lost Karen on the table because of the massive amount of blood she lost”

I asked for him to be as blunt as possible and told him I am the kind of person who appreciates frankness (no pun intended) and could he give us odds.

“With the pelvic issues alone, she has a 50/50 chance of walking out of the hospital alive. But she also has contused lungs, one side of her heart isn’t working correctly, she has lost feeling in one side of her body, she is at risk from fat embelli (marrowbone from the broken bones clotting in key places) etc…”

It was dire. And he went on to say :-

“You need to be getting ready for the worst news”

At some point later in the evening things got worse. Frank was due off shift at 10pm and stayed on until 4pm the following day to sort Karen out. He is our hero !!! At about 3am in the morning, she underwent another operation to try and stem further bloodloss. Noone knew where the blood was coming from. They suspected the pevlis, but she also had a damaged liver, lungs and heart. Frank did the op with orthopedic colleagues and karen (to our great relief) came out of theatre with a meccano set in her pelvis protruding about 3-4 inches above her skin. This kept the pelvis temporarily pushed together stemming blood loss. Had this not stemmed the blood flow, Karen would have died (according to Frank) and he and colleagues let us know before the op that they were not sure where the blood was coming from. In the last op, they had stuffed loads of wadding in Karen’s abdomen to absorb the blood and they had left her unstitched so as not to put pressure on her lungs. This hadn’t stopped the bleeding. The X-Fix (Meccano Set) appeared to have worked.

Rejoicing all round. We were pleased to be left with a 50/50 chance (at best) of kp pulling through. I think we all were expecting the worst before the op.

End of Day One

At some point on the second day, a nurse came to see us and asked us what faith Karen was.

Well, she is Catholic but not a church-goer.

The nurse suggested that if she was Catholic, you may want to consider giving Karen a blessing. (The Last Rites is what she meant of course).

This confirmed my worst fears.

She was going to die. I had awful thoughts at that time, awful !

We then, as a family, had a discussion. I am a firm believer in there not being any gods (I am a “humanist”) and I knew kp was a believer just in case there were. Some of the sisters are strong Catholics. So, I was of the opinion that kp probably wouldn’t have wanted “The Last Rites”. Yvonne and Marie thought she should have them. Michelle agreed with me and felt kp would say “Don’t bother with that”

This isn’t the time to have a family disagreement.

“There is nothing lost by having them” were my thoughts. And if it made Marie and Yvonne feel better, then kp would have liked that.

Michelle, Yvonne and I weren’t there for The Last Rites, but Marie I think really appreciated it.

It is hard to put into words our experience as the family and friends of someone critically ill in an Intensive Care ward and someone who we loved very much. The following days and nights lasted an eternity. We cried like babies and laughed like hyenas, experiencing the widest range of human emotion possible.

Karen’s first op was on the Wednesday (27th) evening at 6.35pm. All the family arrived during the operation and we convened in the relatives room, a small room just inside ICU. I had the only one to have seen her before she went in. It was a very anxious wait and the conversation was quite low. To get to the intensive care unit, she would have to be wheeled right past us, so I can remember being very attentive to everyone going past.

At 2245, she was wheeled past us into the Intensive Care Unit (ICU). She was alive. Relief was abundant. Only 2 people could go and sit by her bed in ICU at one time, so Jane and I went in to see her. We had to go through a washing hands, wearing aprons and gloves routine every time we went on to the ward and washing hands on the way out.

I think it’s about week 2 when I started the blog so it’s over 15 months since this day when I write this.  I can’t recall how she looked after the first op, but I think she had started to swell up in her hands/face/neck. She was heavily sedated and would be for at least a week. We were told that some people COULD recall conversations that they had heard whilst they were sedated, so Jane and I set about telling her that the operation had been fine and that she would have to “fight” over the next day or so.

Jane :- If anyone can do it, you can do it Mrs P.

We talked for a while and then let Karen’s sisters and other family come in pair by pair.

There was no point us all staying overnight as she had come through the worst (or so we thought), so all the family went home apart from Me, Jane and Marie.

Marie and I went back in again to see her and then Jane and Marie alternated so that I could be there all the time. Whilst Jane was in, Frank (the head anaesthetist honcho and our hero) had stayed on to see her through the night came in to see her whilst we were talking to her. He touched her toes (we thought it a little strange) and then all of a sudden it was action stations. He calmly called people over and then, in his words, further….

“examined karen. Increased Pelvis displacement, increased fluids, discussed with orthopod, recommended to XFix Pelvis.”

She was then ….

“returned to theatre…….unstable……continued blood loss”.

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This was 2.15am

We phoned all the family who had just arrived home and told them that there had been problems and Karen had been returned to the theatre and it wasn’t looking good. They all set off in another taxi to come back.

Whilst she was in theatre, Catherine came to see us (Frank’s anaesthetist colleague). By this time, the amount of family that had turned up for Karen was too big for us to fit into the small relative’s room inside ICU and we had moved to our new home (The Green Room) just outside ICU. This would be our home for the next few weeks.

Here is how she recorded the conversation to us…..

“Husband and family spoken to by Frank and myself several times overnight to update them on her condition. They are fully aware of her injuries and that they are ON THEIR OWN life threatening. However this does not seemed to have been absorbed so we continue to reinforce that there is a real possibility of death”

Whilst in theatre…..

“4.20am – Clots founds on liver, 4 packs placed in”

“4.30am – Was given 10 Units of Blood and 7 Units of Colloid/Crystalloid”

“5.00am – Returned from theatre. X Fix in place. Good reduction on screening. Increased airway pressures in theatre. OK now, Needs blood and platelets”

“5.15am – Discussed with husband and family. Major setback. Good reduction of fracture but no guarantee that this will stop the bleeding. Given her lots of blood products which means she has an increased risk of lung failure. The pelvic fracture alone now carries a 50% survival rate. No questions asked [by relatives]“

Loss of blood was the key danger to Karen at this time. Her toe being cold had tipped Frank off that she was bleeding internally, hence the rush to theatre.

She was still losing blood at 7.30am…..

“7.30am – Heavy blood-stained urine”

Frank had mentioned, in the night, that they were going to order a special bed for Karen so that she wouldn’t get pressure sores. She was starting to swell up everywhere. Her head ended up being the size of a medicine ball (that sounds like exaggeration, but it’s not), with no neck visible. Her arms and legs were the same, and they were frightened that if she stayed in the same position all the time, her skin would split. This would lead to infection, which would be the last thing she could tackle at the moment. They took Karen’s wedding and engagement ring off at this point as soon they would have to cut them off. I took them and swore to wear them on my little finger until Karen was well enough to have them back. It looked a little (cough) camp, but I didn’t care.

The bed arrived at 8.45am. It was like a medieval torture rack. Karen was placed in it and clamped into position. She was literally clamped in, so that she couldn’t move at all. Her legs were constantly in a v-shape, her arms down by her side, held firm by clamps, her head was also clamped in place by two boards either side. There was no room for any movement, not that she would be doing anyway because of the sedation. Her head was so tightly clamped that she still has scars either side of her head today and probably will for the rest of her life.

Once in this bed, it was switched on, and every 20 minutes, it rotated her from 45′ to the left to 45′ to the right (along the long axis of the bed). Throughout the morning, we spent turns next to Karen’s bedside. She had so many machines all around her. One for monitoring her lungs, one for keeping them going, 2 for her heart, the main vital stats one you see on the tv, 1 for drugs, etc etc……Each of them made strange noises every now and then which got us worried at first, but within a few days, we knew the basics of each machine and had a layman’s understanding of what alarms meant what.

I needed to go home to let the dogs out. Tommy and Eileen (our ace neighbours) had been letting the dogs out last night, but I was going to have to be at the hospital 24/7 for an unknown amount of time, so Jane and I headed home to freshen up and I took the dogs into Kennels so they were no longer a worry. On the way home, Jane and I tried to find Karen’s car so that I could drive it home. Everyone was concerned about me driving, but I was fine. Jane spotted her car at Chester-le-Street and we went home. Poor Dogs didn’t have a clue where their mum was. Feeling refreshed we headed back to the hospital.
The consultant’s notes carry on reading grim………I don’t know what some of this means, but the last part sounds bad either way….

“1.20pm – Frank discussed (D/W) with [another consultant]…..traumatic SIRS”

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SIRS is Septic Inflammatory Response Syndrome and it is a precursor to MOF (Multiple Organ Failure) which is a precursor to D (Death). You’ve got to laugh when you read all these notes. They abbreviate everything. Death isn’t actually “D” – it’s the sign of the cross. At least you can read it, I suppose.

“1.20pm – Current Scenario – Increased Fat Emboli, recommend treat with prostacyclin especially if acid base worsens = this will result in ARF (Acute Renal/Kidney Failure) – probable ANYWAY.”

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One of the problem with broken bones, especially the pelvis and leg bones (because of their size) is that the marrow can escape into the blood stream (they call it Fat Emboli) and the danger is that they can travel to the brain, heart or lungs and cause death. So this was a big worry for a few days. Aware of this, they put her on blood thinning drugs, but this was the big balancing act. Too thin and she was going to rebleed, which would be fatal, not thin enough and the Fat Emboli could bung up the brain, lungs or heart, causing death … very much the old “rock and a hard place” scenario.

At 2pm, Frank came to see Jane and I ……………..

“Husband David and friend Jane spoken to by Frank re Karen’s further deterioration this afternoon. Explained about possible failing kidney and probable need for filtration which itself carries great risk re further poss of bleeding. Explained that the right side of karen’s heart is struggling due to high pulmonary circulatory pressure”

At 2.20pm, things were still looking dire……..

“Urine still blood stained”

The afternoon dragged on……………things were getting worse…………..

“4.30pm

Discussed with husband, increasingly life threatening condition.
1 – Increased abdomen pressure
2 – fat into lungs (increased back pressure), being put on nebulizer and viagra
3- Kidneys failing, risk of bleed

Asked risk of death, advise risk of death > 75%”

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More waiting……………….

These waiting times need some explanation. They were a very memorable time for all the family. Mentally, we were all gearing ourselves up for the worst news, and obviously this came with a bucket full of tears. With a few exceptions, we didn’t use to cry in the Green Room, we would take it in turns to go outside to what we later called “The Crying Bins”.

But, we used to laugh as well. Boy, did we laugh. Marie was chief food supplier for the hospital Pollard relatives. She used to bring in Quiche. She’d offer it round and Glenn (Marie’s husband) would decline it as would I.

Marie:- What is it with Quiche and men ?
Dp:- Quiche is more for homosexual men. Men eat Pies and Pasties, but not quiche.

So, of course, this became the running joke to any other male visitor who came, unaware of our in-joke, they would be offered Quiche, and if they said “Yes”, we’d all snigger.

Marie would also always have about 10 newspapers/magazines every day for everyone. She’d look for horses with Karen references in them and place a bet. I don’t think they ever won.

Another in-joke was the Handy Tips section of the women’s magazines. We would howl when these were read out. Things like…..

“Wrap your underwear and socks in your tights before putting them in the washing machine. That way, they’re all together when you empty it.”

“Don’t throw your old socks away, use them as gloves for dusting the house”

“If you’re getting your bathroom renewed, don’t throw your old toilet basin away, use it as a plant holder in the back yard”

Etc etc…

I hope that sets the flavour of “The Green Room” experience.

By 8pm on Day 2, I was getting anxious for news, so asked to see Frank for an update. Here’s how they recorded it…..

“David asked Frank what chances Karen had of surviving and was told at present 20-25% chance of survival maximum. Told them we are currently starting a medication to help with KP’s high pulmonary pressures and await effects.”

At the same time, they also recorded………

8pm – Becoming more acidosic … possible blood filtration tonight

By 9pm, she was on the Kidney Dialysis Machine.

Frank came to see us before going off for the weekend. He spoke to the family and as always I would push him for percentages of survival and along with an update said……

“I am back on Monday and I would be very surprised if Karen is still here then.”

Jane, Marie, Glenn and I had pretty much been at the hospital since we found out about the accident and all of us were very tired. We could catch the odd 30 minutes sleep in the chairs in the Green Room, but it wasn’t ideal. The hospital were great. They sorted us out a room that we could take turns in using to get some sleep. It was heaven-sent. Marie went first. There was a phone in the room, so if anything went wrong, we could ring her straight away. Jane went next. Unfortunately, Jane has a gammy leg and struggles with long distances and steps. This room was at the furthest point of the hospital (probably about 1/3 a mile away and up 6 flights of stairs). Poor Jane. It was great just to put your head down. We were all out for the count straight away.

In Karen’s first op, they had placed 4 packs in her abdomen area to absorb the blood that was leaking out (of somewhere). They needed to be removed between 24 to 48 hours after placement. So, we were told the plan was for Karen to go back to theatre and to have the packs removed at some point today.

The night wasn’t without its problems………….

“1:50am – Problem with oxygenation. Despite increasing oxygen to 100%, sats only 90%”

Sats are how much oxygen you are able to absorb in your lungs. Normally, it would be about 96% + without being given any oxygen. Karen was being given 100% oxygen and it was 90% – not good.

Marie had a chat this morning with one of the nurses. Here’s how it was recorded…..

“9:00am – Spoken briefly to Karen’s sister Marie and close family. Waiting for review by Catherine with regards plans to remove packs today. If safe to mobilise from bed to trolley. Marie has been expressing concerns regarding resuscitation status and the possibility of organ donation in the event of Karen’s death. Family are aware of high risks involved and minimal chance of survival and wish to discuss “Do not resuscitate” status and potential for organ donation with Catherine in order to make a unified and informed decision. Karen’s husband David is recovering from a recent nervous breakdown and therefore requires adequate support from family, friends and staff during this difficult time.”

It is so hard as I write this now (16 months post accident) to think we were contemplating discussing “Do not resuscitate” Karen. I feel a lot of guilt relating to it. But things were THAT bad. I’ll say no more, or I’ll get upset.

Karen was still very unstable………You’ve heard of the term “Critical, but stable”. There’s only one worse than this and that’s “Critical, but unstable”

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“1.30pm – Kidney Dialysis Machine clogging up with fat”

This happened time and time again. This machine used these long cylindrical tubes packed with what looked like narrow carbon fibres, through which the blood passed. But the filters continually blocked up with fat, which meant the dialysis stopped and they had to replace the filters at 60 quid a time. They weren’t begrudging the 60 quid, I was just curious. The rotational bed she was in was costing 5000 quid PER WEEK to hire !

Karen was getting oxygen through a mask, and had a tube in her nose (for feeding) and a tube going down her throat so they could keep the lungs clear of fluid. This meant her mouth was constantly open. I recall her tongue looking horrendous – it had lacerations all over it and looked like it had a layer of carpet covering it. The nurses continually were putting Nystatin in it, until we took over and did all the oral care. Her tongue got so bad that in the end, they had to put a trachy tube in so they could remove the tube in her mouth to allow her tongue to heal.

We knew at some point today, they were going to remove the packs from her abdomen. Jane and I were sitting besides her bed. We were a bit stupid for the first few hours. What we’d do is both grab a chair and sit on the side of the bed that Karen was tilting towards. Remember the bed tilted 45′ to the left and then 20 minutes later, it rotated 45′ to the right. So, Jane and I would be holding Karen’s hand and talking to her and then the bed would start it’s slow turn (lasting a minute) to the other side. At which point, something like this would go on…..

Jane :- right Mrs P, your bed’s started to turn, so we’re just going to leave you for a few seconds and go round the other side. We’ll see you when you’re over the other side.

dp:- Yes, won’t be long love. see you round the other side – love you

Jane and I would pick up our chairs, move position and relocate around the other side of the bed.

Jane :- hi Mrs P, welcome back

This would recur every 20 minutes.

And then……………..it dawned on us. Why didn’t one of stay on one side and the other on the other side. So simple, but obviously too much for Jane and I. The nurses must have thought we were stupid !

Anyway, on the afternoon, Jane and I were sitting around one side of her bed and we were watching the cleaning going on around the Intensive Care Unit. We remarked to each other how impressive it was and how thorough they were. There were 2 staff cleaning every surface around the whole ward, even the walls and ceiling !!

We didn’t think anything of it and exchanged positions with Marie and Glenn. When we went back in for our shift, they were finishing up the cleaning. I am sure we made a funny remark about “Do they do homes ?”

Then, out of nowhere, in waltzed about 7 or 8 operating theatre staff with loads of equipment and they started setting it all up around Karen. We were told that they were going to do the operation to remove the packs in here as it wasn’t safe to move Karen to theatre (it was only 50 m away)

dp:- Should we leave ?

Operating Theatre person :- No, you’re ok for now

And then Jane and I experienced the most surreal experience of our lives. We were sat together in our aprons and gloves in the middle of Intensive Care (about 10 feet from kp) as they built an Operating Theatre around Karen. It was amazing. And we couldn’t believe they were just letting us sit there. It looked like they were about to start operating and we were getting worried that they had forgot about us, but thankfully at that moment, they ushered us out.

Little did we know at the time, how close to death Karen was……………

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The operation went fine………..

“Abdominal wound opened. Large amount of xx fluid. NO bleeding areas, liver, spleen, bowel looked healthy, all four packs removed. Rectus sheath not closed in otrder to prevent abdominal compartment syndrome.”

The rectus sheath are basically your stomach muscles that keep your insides in. So basically, for the next 15 months, Karen had only her skin between the outside and her internal organs.
At about 4pm, Catherine (Consultant Anaesthetist) came out to see us in the Green Room……………Here’s how she recorded the converastion….

“Discussed with husband and large family….. 1-Explained persistent acidosis
2-reduced blood pressure
3-fat emboli
4-increased O2 needs.
5-Increased risk of death – more likely than survival.

Worst case, will die of worsening acidosis over next hours to days.

Best case…..
1-survives this episode
2-long ICU stay
3-develops ICU neuropathy/myopathy
4-prolonged ventilation
5-long term, even permanent kidney failure
6-Increased risk of complications …….
7-MRSA
8-pseudamonas
9-DVT/PE’s
10-Pressure Sores
11-Ventilator acquired pneumonia etc etc..

Family very aware of risk/chances”

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At this, Adele stormed out of the Green Room visibly upset.

The nurses had left a note in her records saying………….

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Karen and I had been due to go down to Devon for the weekend with Mum, Dad, Jane and family, so given the events, they changed the location to Sunderland so they could come and visit Karen.

Jane and I had spent the night at the hospital. Still no improvement.

“5am – Had been doing well respiratory-wise (relatively). However after 4 hours of above Sats dropped (over minutes) from 97% to 87%”

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Not too clever……….then her blood pressure started to get lower……………

“bp currently dropped to 100/55 (varying with bed position)”

Heart rate dropped to 52

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An orthopedic surgeon (orthopod) came to see her at 9am….Things were getting worse…….He recorded……………

“General condition remains rather critical. Still on ventilator and sats 81% – need x-ray before I can do anything – x-ray was tried this morning without success”

They couldn’t x-ray Karen, because of this rotational bed she was in. It was all metal with some trap doors that could be removed to allow for x-rays, but the positioning of the trap doors was bad for the x-ray they wanted to achieve.

The downward decline continued……..

“Harsh Upper Airway Sounds, Respiratory Failure, Continued Kidney Dialysis, Fat Embolus Syndrome, Traumatic SIRS, Unstable Right Hip, Right Upper lung collapse”

About 8pm at night, her sats picked up a little…..

“Sats to 83% despite 100% O2, Few Harsh Sounds bronchial breathing right upper lung, suggested bronchoscopy for right upper lung collapse, felt should repeat central x-ray and discuss if worsening”

“9.05pm – Remains on pressure bed. Right hips black and blue bruises, blister on right flank”

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The night saw no deterioration and if anything a little improvement. We were very grateful for that.

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