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NHS – The John Radcliffe Experience

World renowned it forms part of the Oxford University Hospitals NHS Foundation Trust and is named after John Radcliffe, an 18th-century physician and Oxford University graduate, who endowed the Radcliffe Infirmary, the main hospital for Oxford from 1770 until 1979. (JR) is Oxfordshire’s main accident and emergency site. The JR provides acute medical and surgical services including trauma, intensive care and cardiothoracic services.

Another Covid test and more entry vitals taken continued in frequency into and overnight not having eaten since Tuesday lunch time I was allowed to sneak in evening tea time meal in who ever ordered the day before I was just pleased to eat anything by this time and have a cuppa before the 2am nil by mouth kicked back in again apparently I was booked to have an MRi scan Thursday. The JR Experience!

I had been put into a single private room just off ward, felt very privileged but also cut off again not being able to see anyone only nurse staff when they came in and no contact with Anita although I hope MK had told her I was now here?

Mornings start early in hospitals I should have remembered, circa 6-6.30 am first vitals followed up by meds, if you’re lucky you can grab a power nap again before the breakfast trolley and cuppa arrives alas not for me this morning “bloody starving”. Noise levels kick up as the night shift exchange with the day shift, they again seem to come around for another vitals check in and offer of a wash to get you looking nice n shiny for the senior consultants and surgeons visit. Still in my cycling under padded shorts and ride shirt, there was no way they was getting my shirt off over the neck brace so finally they cut it off to reveal more dirt and forest floor assortment, oooh and new one on me anal swab ! You gotta be f-king kidding, this has to be You’ve Been Framed, c’mon where’s the camera crew? Apparently MRSi related and SJR procedure, OK cotton wall bud up the jacksy it is then.

Feeling more refreshed with just my CK’s for modesty now pain killers and morphine doing a grand job as I met the consultants who went over vital stats, the CT scan results and advise I’ll be in for a MRi scan later that day and from then on they can advise the correct procedure to get me up and running again. Knowing also by this time Anita could come pay a visit and bring me up to speed with the outside world. The JR experience!

“CT Findings: Mr James sustained a mountain bike accident and fractured sublaxaled his C6-C7-C4 and also T1 and a strain of the posterior band between C3
& C7”

2 days in and finally Anita is allowed to visit

The leaded hands of the clock hardly seem to move as the lunch service came and went, so jealous at this point I could have eaten a dry Jacobs cracker and it would have been Michelin 5 star rated. Think it was about 3pm when that amazing lady, my wife, walked though my room doors looking fab, a brief rest bite from my own thoughts finally she was here to hold and take some of that anxiety away; sods law they only rocked up to take me for my MRi scan!! Benefits of a private off ward room Anita was allowed to stay past the allotted 1 hour permitted time slots as I was gone for 55 mins. The JR Experience!

Now MRi this was a new one on me never quiet making it into one, not that I was hankering or anything, but they prepped me and advised Karen (lovely nurse on the ward) I’d be about 15 mins. “Ok Mr James we want you to keep very still and you’ll hear lots of loud noises so here are some ear plugs and if you feel anxious at any time press this button – insertion of pad into hand – and we’ll pop you straight out”. Hold tight here we go, slight purring as I was fed into the space tube like a human torpedo, all seemed very Star Wars at this point as you just listened to all the noises as things engaged. Then the techno sound check started and I’m sure some of these noises had been sampled by some of the worlds finish techno DJ’s! Well that was some 15 minutes, transpires it’s was 50 mins. Karen had gone, replaced by another nurse who appeared to seem nervous about conversing unlike Karen who could have been a lifelong mate, still awkward conversation better than none and that wasn’t as bad an experience as it’s made out bonus going back to see Anita it’s all good. The JR Experience!

Back in the room I was allowed to nibble some cookies, grapes and have a cuppa before Nil by mouth kicked in again at 2am. Great catching up with Anita and what had transpired that fateful evening still not coming to terms with what had happened it most definitely was on the distorted 2020 script for sure as we had so many bike plans crammed into the latter part of the year due to the pandemic putting pay to everyone’s early 2020 plans. I was glad the visit seemed to drag in a very good way but all good things come to an end and I had to say a tearful goodbye to wifey, knowing at least she would be in tomorrow, Friday I think?

A bit out of the norm, a second visit from Head Surgeon Nikolaos and Trainee Surgeon Katarzyna with feedback from the MRi scans. If hospitals had air steward training they would have instructed “Brace! Brace! Brace!”. At this juncture as Nikolaos advised the findings and what they proposed to do “yes it was serious, more serious than the CT scan had shown” and “yes it was surgery” with fractures and damage to various vertebrae C7 & C6 fractured and displaced by 7mm fractures to C4 & T1 and a whole array of other issues highlighted in this report. Emotional wreck would sum me up nicely as the surgical procedure sounded horrendous and they both knew it was a lot to take in no matter how much they tried to comfort me their worry was paralysis at this juncture and to stabilise my neck paramount, going in via the throat, with all its gory sounding issues, and bone grafts etc. way too much to take in drugs or no drugs, again left alone to comprehend all that was laid on the table, with this looming the very next day scarred was an understatement. The JR Experience!

“MRi Findings : Patient was discussed in MDT and posterior long fixation was recommended. Un-displaced spinous process fracrure at C4 and bilaminar fractures at C6 with fracture extension into the right C6 facet, fracture dislocation at the right C6 C7 facet joint with perching of facets. There is a grade 1 anterolisthesis of C6 on C7 with circumferential disc bulging and fracture throughC7 superior endplate with anterior displacement of the anterior corner. Further superior endplate oedema seen at T1,T2 and T3 with oedema extending into T1 pedicles associated with acute bony injury. Extensive soft tissue oedema extending along the anterior longitudinal ligament through this region – into C3 to C7 consistent with high grade acute ligament injury. There is discontinuity of the ligament flavium C5 and C6 with a defect measuring up to 7mm in keeping with rupture (sag series Im: 5-6)”

A short text to Anita telling her about the consultation, fat fingers stabbing at the phone pad through tear stained eyes the severity VERY REAL now and any thoughts of riding again seemed torn up and thrown out the window. Emotions are very powerful more so when left alone to dwell but positive messages came flooding in as the news broke in the outside world, better than any drugs the thoughts and well wishes took the edge off a bit. The JR Experience!

The plan was an early morning or “first thing” as they said, I now know that could mean anytime depending on surgeons shift so Anita hadn’t booked a visitors slot knowing I’d be in theater most of the morning and recovery ward thereafter. Still Nil by mouth hours drifting away, the anaesthetist came took some weights and dimensions promptly followed by Nikolaos, Head surgeon and Katarzyna “Ok Mark we still plan to operate but after further consultations we feel we need to go in via the back of your neck, less complications but priority being stabilisation of the fractures better recovery options too OK, please don’t worry all will be fine”. I did feel a little wave of relief wash over me as the second procedure sounded a much better option, quick message to wifey then back on the waiting game and running over in my head… by this time tomorrow it’ll all be over operation wise, bit of a sadistic way of looking at it but it meant the start of mending, the damage would be fixed-ish, I’d see Anita positives. The JR Experience!