So that's the guy in casualty (real casualty, not the TV show), one GP and three physiotherapists. Over the course of 13 (thirteen) months that's the list of people who'd examined and/or treated me and not picked up on what was really wrong. Most of them had seen me several times, too.
I'm not someone who is in favour of the compensation culture that currently typifies swathes of British society. I see it as opportunistic profiteering, both on the part of those seeking compensation and the no-win no-fee lawyers who represent them. That's not to say every case is like that, but generally people who slip on wet floors or get "whiplash" or run over their own heads because they've left the handbrake off are looking to make a quick buck. And that, in part, makes it difficult for people who really have suffered at the hands of somebody else's wrongdoing or mistakes.
I'd not thought to pursue a claim of medical negligence before 1996 but my frustration had continued long after the actual diagnosis some two years prior. It was still a rare thing to claim against an individual doctor or the NHS as a whole, but given the circumstances I felt that I wanted to try. Now, they say, where there's blame there's a claim but this wasn't about receiving thousands of pounds of "compo". Although that would've been nice, obviously. There were some cracking Air Max knocking about in the mid-90s so that would've been a cheeky bonus. The motivation for me, though, was just to have someone be wrong.
I'd lost a whole year of sport, received school reports suggesting I was bluffing and spent the majority of the time wondering if this was something in my head, self-induced or not as bad as I was making out to myself. Surely one of these highly-trained professionals should've been able to spot what was wrong and fix it. Or even if not fix it then at least be able to tell me that there really, really is something wrong. Even just a letter to take in to school for my teachers to eat would've been fine.
The Birmingham Evening Mail took an interest too. That was the thing back then. Probably still is now, to be honest. Been wronged by someone? Contact the press. Nothing helps to garner a bit of sympathy like a local press report and the ensuing moral outrage at the state of Broken Britain. The Mail sent someone to interview me, and a photographer too. I perched on the edge of my bed with my cricket bat and a football and a clutch of medals I'd won for running and playing football. They asked me to put a disconsolate look on my face so I did my best to look all wistful for the nice people of Birmingham. In reality I looked a right soppy sausage but it seemed to be for a good cause. Alas, having the support of the mighty media didn't help me achieve any success. Mobile phones and voicemail were still a rarity then too, so they weren't able to help my get any extra evidence.
Fifteen years ago there were two problems with suing the NHS for a mis-diagnosed fracture of the ischial tuberosity. The first was that, unlike in the USA where the culture of claiming is even more embedded than it is here, it was very difficult to find doctors who would speak out against their fellow practitioners. The UK is a relatively small country and as such there is a higher likelihood that two doctors could work together in the future once one has agreed that the other may have been negligent. In the States it's easier to find a doctor in, say, San Diego, who would offer an opinion against a doctor in New York. As such, and despite the best efforts of my lawyer, I was unable to find someone who agreed with me that this wasn't right. Or at least someone who was willing to have it in writing with their name against it. There was no option but to give up.
So that was the first hurdle fallen at. The specialists whom Mr McLarney had turned to had suggested that it was a rare injury and therefore it wasn't negligent for medical professionals to suspect that it could be the cause of what I was presenting as symptoms. I was professionally advised that even if it were possible that negligence were the case it would be incredibly difficult to find someone who would openly state that. Especially given that it is, indeed, a rare injury.
A quick Google search today proves this to be true - "Complete hamstring avulsion from the ischial tuberosity is a rare but serious injury and warrants early surgical repair. The mechanism of injury involves a violent eccentric hamstring muscle contraction with the knee extended and the hip flexed. Clinically patients have a posterior midthigh mass and a palpable proximal defect, which is accentuated by hamstring muscle contraction in the prone position. Magnetic Resonance Imaging is useful in estimating the extent of injury."
I didn't have any qualms with the notion that these five people hadn't themselves identified what was wrong. My frustration was that they never pushed it further to find out why the supposed pulled hamstring wasn't repairing. Why did it take over a year, and a huge amount of pressure from myself, to be referred to a specialist? A specialist who identified the problem immediately and sent me for x-ray. I can't help but wonder what might have been, even now, if someone had been inquisitive enough right at the start to seek a further level of examination or a more specialised opinion than their own.
Apparently there would have been a reluctance to x-ray the area given the dangers of radioactivity in such a sensitive area at my tender age. I could have done with someone as brave and confident as my surgeon Adam Hoad-Reddick because in hindsight I think the risk was worth taking. Having glow-in-the-dark privates might have been a benefit if anything. Like a teenage, human light sabre, it'd have been quite the trick at boozy, parents-away parties. It would've been nice to have been a bit more of a hit with the ladies. At least I'd have still been half footballer.
So that was it. Despite my efforts to gain some sort of "justice" - to have someone be accountable that I shouldn't have suffered or been doubted and maybe, just maybe, if it had been caught earlier, I might have been surgically treated and be playing football all these years - it was to no avail. No shiny new Air Max, no Luke Skywalker impersonations after a few bottles of Diamond White (this bit's a joke - I never really drank before I was old enough, honest Mom!) and nobody or nothing that could have been done to catch my problem and treat it.
It was just one of those things. A twist of fate. A shame. It must be true because that's what the doctors said. I'm still not so sure, but everything certainly does happen for a reason and it feels like I did find the reason why all this happened the way it did. The ony legal option was to give up, but in many ways I was galvanised. Through the treatment I received and being denied the chance to play sport I developed an early interest in one of two career paths - physiotherapy in order to help those who'd been injured like myself, and the design of performance sporting goods in order to help those who hadn't.
Perhaps, in hindsight and after all this time, I should be looking for someone to thank rather than someone to blame.
Saturday 13 August 2011
Thursday 4 August 2011
They think it's all over...
That was a blatant kick in the arse and the referee hasn't even blown! Unbelievable! In the meantime I'm rolling on the floor in agony.
It's early on in the match, probably no more than about fifteen minutes on the clock, and I've got a sight on goal about 25 yards out. I'm running diagonally to my right, from left of centre, with the last central defender my only obstacle. Apart from the goalkeeper, but I don't usually worry about them. They're just a minor distraction. Just outside the box and with the goal now slightly to my left I pull back my right foot and strike across myself powerfully, with a solid connection on the ball. The central defender had closed me down well, though, and blocked the shot just as I connected. It would've been like kicking one of those atlas balls that the fat lads carry every Christmas on "World's Strongest Man". The pain is excruciating.
But the source of my agony wasn't in my foot or ankle, it was directly under my right butt cheek at the top of my hamstring. It felt like a midfielder had chased me down from behind and belted me in the arse just as hard as I'd been looking to hammer that shot at goal. There was no whistle. There was no midfielder. Just me, on the floor for seemingly no reason, rolling around like Cristiano Ronaldo under artillery fire.
Today, August 4th 2011, I received my letter from the Alexandra Hospital in Cheadle confirming my admission for surgery in a month's time. It's got some forms for me to fill in so I can tell them I don't have a pacemaker and I'm not HIV positive or allergic to plasters, and it also has three booklets - "Preparing for your stay", "Reducing the risk of blood clots" and "Your guide to pain control". I could've done with the last one 18 years ago to be honest, but better late than never. Either way, I certainly never envisaged this would be the outcome, and so long after what, in my head, had been a kick up the arse.
I got back to the changing rooms, which were so far away from the pitch itself I could barely see what was going on through the barred window, and felt guilty. I couldn't understand why I was in so much pain. I felt that I was letting my team mates down, and also wondered if people thought I was really injured. It had been so innocuous. After the match finished I climbed into my Dad's car and slid the passenger seat back as far as it would go. I couldn't put any weight on my right side and needed to keep my leg straight. And just as the changing rooms were miles from the pitch so the pitch itself was miles from home. About a 40 minute drive if memory serves me correctly. Which it possibly doesn't as it was so long ago...
At home I took a hot bath to ease the pain but to no avail. Mom (no spelling error, that's what us Brummies call our mothers) had her usual amazing Sunday lunch ready for us but I still couldn't sit so ate it standing up at the window ledge. Something really wasn't right so Dad took me to the casualty department at Good Hope Hospital in Sutton Coldfield. It's usually a very good hospital but in hindsight there was very little in the way of hope on this occasion. A long wait followed by a brief examination and I was told that I had pulled my hamstring and would be playing football again in about 6 weeks, after some rest. That's alright then. That's a proper footballer's injury anyway. I don't feel so bad about limping off after 15 mins now.
Despite a few days off school, barely able to walk (something I'll be repeating after the operation, no doubt) I was still in a lot of pain. A few weeks later and still unable to do any sport without severe discomfort I went to see my GP who referred me back to Good Hope for physio. Over the course of 3 months I had assorted treatment including ultrasound, repeated stretching and (this is the most unpleasant one) deep massage. It was the most unpleasant because since the start I'd described my discomfort as "like sitting on a golf ball". The massage was to "straighten out the pulled muscle", it being contracted and grouped up seemingly the cause of my pain.
Except it wasn't a pulled muscle at all. It wasn't even muscle that the physio was pummeling back into shape on a weekly basis, much to my chagrin. It was bone. Broken bone. An "avulsion fracture of the ischial tuberosity" as Dr Plewes told me when it was finally diagnosed some 13 (thirteen) months after the initial incident.
Many complaints to my GP hadn't worked. It took ages to break him down and have him refer me after the physiotherapy failed. Similarly my school offered little (mostly no) sympathy. I was pretty good at rugby but hated it. Hockey too. I'd been in trouble before after being selected to play for the school on a Saturday morning but opting to play parks league football and then go to Villa Park instead. At a grammar school you're not allowed to "opt" when it comes to rugby. So by being out injured for over a year with a "pulled hamstring" a few teachers thought I was "opting out". My school report even described me as "a willing non-participant". Cheers for that.
I don't suppose my old games teacher (I'll spare your name but you'll know who you are) is reading this now, but just on the off chance - you've got no idea how much that hurt me. I wanted nothing more than to be able to do sport again. The pain of not being able to play was more than the pain of the injury itself. And you said I was a "willing non-participant". You wrote it on my school report and signed your name next to it. You, and others at the school, didn't believe me. I've still got the report now, and although I've move onwards and upwards I can still remember how it felt to read that. I was heartbroken.
Mr Plewes believed me though. He sent me upstairs for an x-ray. I can recall the radiographer saying they were going to get an image of my pelvis and my reply that they should check as it was a pulled hamstring. Except it wasn't, was it. It was an avulsion fracture of the right ischial tuberosity. Imagine your skeleton, and the area at the base of your spine. The little round bones either side of that, the bones you sit on, they're your left and right ischial tuberosity. They are what your hamstring attaches to, and as my hamstrings were stronger than my bones (too much sport too young perhaps?), what would have likely been a pulled hamstring in an adult actually saw the muscle tear a lump of bone away from it's normal home. That would be the golf ball I was sitting on in my description to the medical professionals whom I was trying to convince that my hamstring wasn't pulled. The golf ball I still sit on to this day.
It was Mr Plewes, too, who delivered the news that I would likely never play competitive football again. At fourteen years of age (nearly fifteen - it's important when you're growing up) I would likely never play competitive football again. The bone fragment should have reattached itself by now, really. The only course of treatment at this stage was a steroid injection into my hamstring. This would inflate the muscle and push the bone back into place in the hope it would knit back together whilst it was there. It was as painful as it sounds and it didn't work. With an attractive student nurse in the cubicle too (just to add to my dismay) I lay with my boxers round my knees and had the agonizing, fruitless treatment that would ultimately signal the end of all of my childhood footballing dreams.
Villa were to play (and beat) Manchester United at Wembley in the Coca Cola Cup Final in a few weeks time and kit suppliers Asics had released a special edition shirt to mark the occasion/make a few extra quid. So on the way home from the hospital Dad took me to Villa Park to get one - a scant consolation for my devastating news, but something I could wear with pride as I limped down Wembley Way.
Looking back it was kind of ironic that my placebo was a football shirt. On the day that my dreams of wearing one for a living ended it's possible that the seed of designing them for a living was planted instead...
So now we know what the injury is, my next couple of blogs will talk about how I felt over the years of being an unwilling non-participant, my attempt to seek justice for so many misdiagnoses in the days before "no win, no fee", and how I wound up designing a football shirt that would be worn by Fabio Cannavaro as he fulfilled my childhood dream.
It's not all comic book stuff, but there might just be a Roy of the Rovers ending yet.
It's early on in the match, probably no more than about fifteen minutes on the clock, and I've got a sight on goal about 25 yards out. I'm running diagonally to my right, from left of centre, with the last central defender my only obstacle. Apart from the goalkeeper, but I don't usually worry about them. They're just a minor distraction. Just outside the box and with the goal now slightly to my left I pull back my right foot and strike across myself powerfully, with a solid connection on the ball. The central defender had closed me down well, though, and blocked the shot just as I connected. It would've been like kicking one of those atlas balls that the fat lads carry every Christmas on "World's Strongest Man". The pain is excruciating.
But the source of my agony wasn't in my foot or ankle, it was directly under my right butt cheek at the top of my hamstring. It felt like a midfielder had chased me down from behind and belted me in the arse just as hard as I'd been looking to hammer that shot at goal. There was no whistle. There was no midfielder. Just me, on the floor for seemingly no reason, rolling around like Cristiano Ronaldo under artillery fire.
Today, August 4th 2011, I received my letter from the Alexandra Hospital in Cheadle confirming my admission for surgery in a month's time. It's got some forms for me to fill in so I can tell them I don't have a pacemaker and I'm not HIV positive or allergic to plasters, and it also has three booklets - "Preparing for your stay", "Reducing the risk of blood clots" and "Your guide to pain control". I could've done with the last one 18 years ago to be honest, but better late than never. Either way, I certainly never envisaged this would be the outcome, and so long after what, in my head, had been a kick up the arse.
I got back to the changing rooms, which were so far away from the pitch itself I could barely see what was going on through the barred window, and felt guilty. I couldn't understand why I was in so much pain. I felt that I was letting my team mates down, and also wondered if people thought I was really injured. It had been so innocuous. After the match finished I climbed into my Dad's car and slid the passenger seat back as far as it would go. I couldn't put any weight on my right side and needed to keep my leg straight. And just as the changing rooms were miles from the pitch so the pitch itself was miles from home. About a 40 minute drive if memory serves me correctly. Which it possibly doesn't as it was so long ago...
At home I took a hot bath to ease the pain but to no avail. Mom (no spelling error, that's what us Brummies call our mothers) had her usual amazing Sunday lunch ready for us but I still couldn't sit so ate it standing up at the window ledge. Something really wasn't right so Dad took me to the casualty department at Good Hope Hospital in Sutton Coldfield. It's usually a very good hospital but in hindsight there was very little in the way of hope on this occasion. A long wait followed by a brief examination and I was told that I had pulled my hamstring and would be playing football again in about 6 weeks, after some rest. That's alright then. That's a proper footballer's injury anyway. I don't feel so bad about limping off after 15 mins now.
Despite a few days off school, barely able to walk (something I'll be repeating after the operation, no doubt) I was still in a lot of pain. A few weeks later and still unable to do any sport without severe discomfort I went to see my GP who referred me back to Good Hope for physio. Over the course of 3 months I had assorted treatment including ultrasound, repeated stretching and (this is the most unpleasant one) deep massage. It was the most unpleasant because since the start I'd described my discomfort as "like sitting on a golf ball". The massage was to "straighten out the pulled muscle", it being contracted and grouped up seemingly the cause of my pain.
Except it wasn't a pulled muscle at all. It wasn't even muscle that the physio was pummeling back into shape on a weekly basis, much to my chagrin. It was bone. Broken bone. An "avulsion fracture of the ischial tuberosity" as Dr Plewes told me when it was finally diagnosed some 13 (thirteen) months after the initial incident.
Many complaints to my GP hadn't worked. It took ages to break him down and have him refer me after the physiotherapy failed. Similarly my school offered little (mostly no) sympathy. I was pretty good at rugby but hated it. Hockey too. I'd been in trouble before after being selected to play for the school on a Saturday morning but opting to play parks league football and then go to Villa Park instead. At a grammar school you're not allowed to "opt" when it comes to rugby. So by being out injured for over a year with a "pulled hamstring" a few teachers thought I was "opting out". My school report even described me as "a willing non-participant". Cheers for that.
I don't suppose my old games teacher (I'll spare your name but you'll know who you are) is reading this now, but just on the off chance - you've got no idea how much that hurt me. I wanted nothing more than to be able to do sport again. The pain of not being able to play was more than the pain of the injury itself. And you said I was a "willing non-participant". You wrote it on my school report and signed your name next to it. You, and others at the school, didn't believe me. I've still got the report now, and although I've move onwards and upwards I can still remember how it felt to read that. I was heartbroken.
Mr Plewes believed me though. He sent me upstairs for an x-ray. I can recall the radiographer saying they were going to get an image of my pelvis and my reply that they should check as it was a pulled hamstring. Except it wasn't, was it. It was an avulsion fracture of the right ischial tuberosity. Imagine your skeleton, and the area at the base of your spine. The little round bones either side of that, the bones you sit on, they're your left and right ischial tuberosity. They are what your hamstring attaches to, and as my hamstrings were stronger than my bones (too much sport too young perhaps?), what would have likely been a pulled hamstring in an adult actually saw the muscle tear a lump of bone away from it's normal home. That would be the golf ball I was sitting on in my description to the medical professionals whom I was trying to convince that my hamstring wasn't pulled. The golf ball I still sit on to this day.
It was Mr Plewes, too, who delivered the news that I would likely never play competitive football again. At fourteen years of age (nearly fifteen - it's important when you're growing up) I would likely never play competitive football again. The bone fragment should have reattached itself by now, really. The only course of treatment at this stage was a steroid injection into my hamstring. This would inflate the muscle and push the bone back into place in the hope it would knit back together whilst it was there. It was as painful as it sounds and it didn't work. With an attractive student nurse in the cubicle too (just to add to my dismay) I lay with my boxers round my knees and had the agonizing, fruitless treatment that would ultimately signal the end of all of my childhood footballing dreams.
Villa were to play (and beat) Manchester United at Wembley in the Coca Cola Cup Final in a few weeks time and kit suppliers Asics had released a special edition shirt to mark the occasion/make a few extra quid. So on the way home from the hospital Dad took me to Villa Park to get one - a scant consolation for my devastating news, but something I could wear with pride as I limped down Wembley Way.
Looking back it was kind of ironic that my placebo was a football shirt. On the day that my dreams of wearing one for a living ended it's possible that the seed of designing them for a living was planted instead...
So now we know what the injury is, my next couple of blogs will talk about how I felt over the years of being an unwilling non-participant, my attempt to seek justice for so many misdiagnoses in the days before "no win, no fee", and how I wound up designing a football shirt that would be worn by Fabio Cannavaro as he fulfilled my childhood dream.
It's not all comic book stuff, but there might just be a Roy of the Rovers ending yet.
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