Recovering from wrist fracture: ten weeks on

Recovery demands a lot of patience, but there have been several positive changes since my last post five weeks ago. I hope writing these updates will help me to appreciate the progress made, and be useful to readers recovering from similar fractures.

My cast was removed about six weeks after the injury. I was anxious about seeing my wrist again, knowing that the two attempts to reset the displaced bones had been only partly successful and the final position would not be perfect. It did indeed look crooked and thickened compared to the other side, and still does, though I hope some of the swelling will go down in time. It was a relief to have the cast replaced by a removable lightweight splint.

I see a physiotherapist once a week, and carry out the prescribed exercises four times per day. I can’t manage the full range of movements but measurements have shown a slight improvement at each clinic visit. Gently massaging the skin with herbal or homeopathic creams, and essential oils, is comforting. I no longer feel any need to take analgesics, but the ulnar side of the wrist is still stiff and tender, and I understand this can be a persistent problem which might require surgery later on.

As regards daily activities the the most significant advances include being able to drive the car and cut my own nails, though I still can’t use a knife and fork. My general vitality, which was impaired for weeks after the injury, has recovered now and I hope to get back to creative writing soon.

On the negative side, the Dexa scan carried out as part of the follow-up showed reduced bone density. This was disappointing because I take plenty of outdoor exercise and eat the right foods. Before considering medication I shall try extra vitamins and sunbathing, and be more careful about avoiding falls.

All the aftercare is free of charge under New Zealand’s generous Accident Compensation scheme.

Recovering from wrist fracture: five weeks on

Five weeks have passed since I fell on a rock and fractured my wrist, as described in my previous post Trauma on Cheltenham Beach. Progress has been frustratingly slow, but there are definite improvements. I no longer take painkillers. I have a synthetic cast which is lighter and more comfortable than the plaster one. I can walk the dog using a harness, and fasten my own watch and wash my own hair. I still can’t cut my nails, drive the car, make beds, cope with tight screw tops or plastic packaging. I type and play the piano with one hand.

Colles fractures are common. While I am out walking people often ask me what is wrong with my arm, and a surprising number of them have gone on to tell me that they or someone in their family have had a broken wrist themselves. From talking to them I have learned that the outcome can vary a great deal. One woman, who had the same operation that I would probably have had but for the Covid lockdown, reported an excellent result and showed me the barely visible scar. Another had a similar operation which appeared to have worked well until she experienced a return of pain, found to be due to displacement of one of the screws used to secure the metal plate, and is awaiting further treatment. A third, whose fracture was treated conservatively several years ago, has persistent pain and weakness in her wrist. A couple of others, however, have recovered well after conservative treatment. The only man in my little sample, whose injury was very recent, is scheduled for surgery this week.

Clearly the prognosis for each individual depends on details of the fracture and the general health of the patient. There will be many months to wait before I know what it will be like for me.

Trauma on Cheltenham beach

One of the loveliest walks on Auckland’s north shore, only possible at low tide, goes around the headland between Cheltenham and Narrow Neck beaches. Three weeks ago I set out on this walk but slipped over backwards on a wet rock and automatically put out my hand to break my fall. A sharp pain, accompanied by faintness and nausea, told me I had broken my wrist. A kind passerby helped me walk to the road, and a kind friend drove me to an emergency clinic where Xray confirmed a displaced Colles fracture of the radius and fractured tip of the ulna. Over to the public hospital, and a long wait to have the fracture reduced under local anaesthetic. Home at midnight with swollen fingers peeping out from a pink plaster cast.

Having had previous injuries that recovered quite easily, I wasn’t prepared for the long haul ahead. For the first fortnight I was constantly in pain, and struggled with basic self-care. It was a great help to have my husband taking over household tasks, and relatives and friends providing meals. I expected the worst would soon be over, but met with a setback. A followup Xray at the outpatient clinic showed that the bones had slipped back out of place and a further attempt at reduction, this time without local anaesthetic, was unsuccessful.

Surgery was proposed. I packed my bags and spent an anxious few days awaiting the call to come into the hospital, after starving from midnight. But apparently, discussion within the orthopaedic team had reached the conclusion that the likely benefit of the operation was too marginal to justify the risks (and New Zealand had just gone back into another Covid lockdown, limiting hospital services). I’ll find out more at my next appointment this week, but from what I gather so far the recovery will be a slow process and I’m likely to be left with some permanent deformity and weakness. Things could be far worse, I know, and I hope to be able to return to my former activities of dog-walking, cathedral choir, swimming and driving before too long. Meanwhile I can still go for walks, and enjoy the glorious summer weather. And in theory I have plenty of time to work on my next novel, though typing with one hand is cumbersome and inspiration lacking.

I’d like to be able to say that my recent exploration of Stoic philosophy is helping me to cope with all this. A recent article https://classicalwisdom.com/philosophy/stoicism/marcus-aurelius-stoicism-and-pain/ emphasises the basic precept of focusing only on those aspects of an illness or injury that are under personal control – for example making informed choices about treatment, and taking general steps to maintain a healthy lifestyle. There is no point dwelling on the negative aspects, or getting stuck in feelings of resentment, frustration or regret. The aim is to accept the situation and develop a constructive response. Simple basic advice, not so easy to put into practice.

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Jennifer Barraclough, originally from England and now living in New Zealand, is a retired doctor and a writer of medical and fiction books. Details can be found on her author pages: https://www.amazon.com/Jennifer-Barraclough/e/B001HPXGZI (US) and https://www.amazon.co.uk/Jennifer-Barraclough/e/B001HPXGZI (UK).

“Beautiful Vibrations”: Living through medical illness with Bach flower remedies

Dr Edward Bach described his flower remedies as having “beautiful vibrations” capable of promoting positive mental states such as hope, courage and calm. Established as a safe and natural therapy for almost 100 years, they can help to relieve the emotional distress often associated with physical illness. This short practical guide explains how to select and use the remedies as part of a holistic approach to healing. There are sections on common problems such as anxiety and sadness about the medical condition and its treatment, and difficulty in adjusting to changes in lifestyle and relationships. Despite all its negative aspects, serious illness can have “silver linings” and the flower remedies can help to bring these out.

Dr Jennifer Barraclough is a former consultant in psychological medicine with many years’ experience of working with patients and their families especially in cancer care settings. She is also a qualified Bach flower practitioner, life coach, and author of fiction and nonfiction books.

Beautiful Vibrations is available from your local Amazon website:

Amazon US: Kindle, Paperback

Amazon UK: Kindle, Paperback

Amazon AU: Kindle

Letters from the past

Over four years have passed since my mother died. The financial side of her estate has finally been settled, following prolonged correspondence with accountants and lawyers. A personal aspect, namely the letters in two of the box files I discovered in the spare bedroom when clearing her house, remains unresolved. I hope this is the last weekend of the Covid-19 lockdown, which would seem an ideal opportunity to deal with these boxes before my life gets busy again. But I still can’t decide what to do with them.

One box contains a series of letters written to my mother during my childhood in the 1950s and 60s, regarding a situation of which I was only dimly aware. I don’t know whether she intended me to find them after her death, but as she was a very “private person” I suspect not. I did read them, while feeling somewhat guilty about doing so. I think it likely that she intended to destroy them one day, but having become weak and unwell in the last months of her life, either lacked the energy to do so or forgot they were there. I haven’t shown the letters to my husband, but he knows something about their content, and suggests that it could make a good basis for my next novel. This may be true, but writing such a book would seem disloyal however heavily I disguised the plot. I have several options. I could destroy all the letters now. I could go through them again and copy selected extracts into a file on my computer for future reference, then destroy the rest. I could leave them in the box, with a note asking whoever finds them after my death to destroy them unread.

The other box contains the letters I sent home to my mother and grandparents in Yorkshire when I was a medical student in Oxford in the late 1960s. I have only reread some of these, having found the style embarrassingly naive, but some contain descriptions of the course which might perhaps be of interest to a medical historian. I was shocked to find that I remember nothing about most of the people and events described. What a contrast to my husband Brian Barraclough and my friend Jean Hendy-Harris, who can both recall their past lives in great detail and have published memoirs about them. I wonder which of us is the more unusual.

Update December 15 2020: With the fifth anniversary of my mother’s death approaching, it was time to make decision about her letters. I destroyed them all yesterday, not without regret, but felt it was the right thing to do.

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Jennifer Barraclough is a retired doctor, originally from England but now living in New Zealand, who writes medical and fiction books. Her latest one You Yet Shall Die, a novel about family secrets and a long-ago crime set in southern England, is available from Amazon and other online retailers, or can be ordered from bookshops and libraries.

A psychiatrist remembers

Many friends and former colleagues of my husband Brian are already reading A Partly Anglicised Kiwi: a psychiatrist remembers, the newly published memoir about the first 32 years of his life. The main focus is on Brian’s experience of the psychiatric training programme at London’s Maudsley Hospital in the 1960s. There are shorter sections on miscellaneous topics such as being a patient in a TB ward, and tramping in the southern alps of New Zealand.

To quote from Brian’s Introduction:

“In 1962, aged 28, I left my home in New Zealand and sailed to England as a ship’s surgeon. I was on my way to apply for the world’s foremost training programme in psychiatry at the Maudsley Hospital in London. 

“Part I of my memoir describes growing up in Auckland, studying at Otago University Medical School, and practising as a doctor in New Zealand. Part II is about my three years at the Maudsley, where I worked in general psychiatry and some subspecialties. Given my modest beginnings, the intellectual and cultural life of London came as a revelation. I received a liberal education from my peers, took holidays in Europe, had a psychoanalysis, and a bad trip with LSD.”

The book was mainly compiled from the essays Brian has written over the years, originally for his own satisfaction rather than intended for publication. My role as editor was to arrange them in a logical order, check for consistency of style and grammar, and discuss with Brian how much material needed to be removed as potentially offensive or libellous. In my experience, writing or editing books is easier done alone than in collaboration with others, and we didn’t always agree. However we are both happy with the finished product, and hope readers will enjoy it.

A Partly Anglicised Kiwi (ISBN 9798623114792) can be purchased from Amazon websites including Amazon.com, Amazon.co.uk and Amazon.com.au. Shipping restrictions at the time of writing may prevent readers in some countries from buying the paperback version, but the Kindle ebook is available worldwide.

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Jennifer Barraclough is a retired doctor, originally from England but now living in New Zealand, who writes medical and fiction books. Her latest one You Yet Shall Die, a novel about family secrets and a long-ago crime set in southern England, is available from Amazon.comAmazon.co.ukSmashwords.com and other online retailers, or can be ordered from bookshops and libraries.

Biographical writing

I am editing my husband’s memoir, to be published shortly, covering the years from 1933 to 1964. It is compiled from various essays that Brian, with his vivid memory and fluent style, has written over the years. Focused mainly on his medical career, the book contains first-hand information about the history of psychiatry in New Zealand and the UK. It also includes sections about topics of general interest such as being a patient in a TB ward, having a bad trip on LSD, and tramping in the Mt Cook region (photo by Florian Schulte on Unsplash).

Working on Brian’s book has made me think about biographical writing in general. I doubt that I will ever write my own autobiography, although I have often drawn on personal experience for my novels. I have forgotten a lot about my earlier life; many of the things I do remember would reflect badly on myself or others if they were published. And as I haven’t achieved anything remarkable, or had anything remarkable happen to me, I don’t think the content would be of interest to anyone else.

One reason for autobiographical writing is of course the wish to understand and come to terms with one’s past, a sort of do-it-yourself psychoanalysis. To quote from the finale of the musical Candide: “And let us try, before we die, to make some sense of life.” However the lyrics of the same song, Make our garden grow (which I enjoyed singing in a New Zealand Opera workshop last year), go on to imply that longterm satisfaction is best sought from simple domestic activities – easier than writing autobiography.

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Jennifer Barraclough is a retired doctor, originally from England but now living in New Zealand, who writes medical and fiction books. Her latest novel  You Yet Shall Die is available from Amazon.comAmazon.co.ukSmashwords.comand other online retailers, or can be ordered from bookshops and libraries. A selection of comments from readers:

A wonderful book which I learnt a lot from as well enjoying immensely.

Both intriguing and unusual. I could hardly wait for the story to unfold as family secrets, crime and murder came to light – the ending was totally unexpected. An absorbing read.

I couldn’t put it down. I was wondering about the twists and turns all the way through. I’m not a cat person and thought I was going to be put off by all the cats, but no …

The way the story was told from all the characters’ personal viewpoints made the story deeper and more exciting. The twist at the end was great.

Well done, it was superb. Great twist that you didn’t really guess.

A revelatory read.

I loved it! I really liked the characters and the sense of buried secrets gradually coming to light. And the twists were excellent, very clever!

Loved your book.  Enjoyed it right to end (including ending).

Beating post-publication blues

One of the sections in my little ebook Wellbeing for Writers draws some fanciful parallels between writing a book and having a baby. There may be feelings of depression following publication (“birth”), and a time interval before being able to conceive another book (“child”).

Some writers manage to avoid such problems by keeping two or more books in different stages of completion on the go at any one time. I have never managed this myself, preferring to focus all my energies on a single project. I felt quite euphoric after my latest novel You Yet Shall Die had been published and received positive reviews. But my mood slumped after the initial peak of sales had subsided, because I did not have another novel in mind.

However, knowing that the best remedy for post-publication blues is to keep writing, I asked my husband Brian if I could edit some of his autobiographical essays and collate them into a memoir. So that is what I am working on now. Brian grew up during the 1930s in what was then a downmarket seaside settlement on Auckland’s North Shore. His ambition to become a doctor was inspired by an inpatient stay in a tuberculosis unit when he was 18. He graduated from the University of Otago, and having decided to specialise in mental disorders, obtained a training post at the Maudsley Hospital in London. During his three years there he worked for some of the most eminent psychiatrists of the day, and had experiences ranging from daily psychoanalysis to taking LSD. After leaving the Maudsley, Brian joined the Medical Research Council’s unit in Chichester, to study the clinical and epidemiological aspects of suicide.

Another remedy for the post-publication blues is to take a break from writing and do something completely different. Outdoor activities here in Auckland are a pleasure now that spring has arrived; the flowers are in bloom, and it is (just) warm enough to swim.

marigolds

Two brave women

My list of non-fiction recommendations for 2019 will include two biographical books about women who sustained life-changing injuries in middle age. By coincidence, both books arrived together from my local library last week, and I noticed several similarities between their subjects: both were born in the late 1950s, grew exceptionally tall and athletic, worked as journalists for the Times newspaper group, and were injured as a result of their chosen activities. But the nature of their traumas, and their ways of coping, were very different.

My former medical career brought me into contact with many people recovering from serious illness or injury. Emotional responses varied tremendously. Initial distress usually resolved, being replaced by the capacity to accept and cope even with longterm impairment, often including some positive changes in attitudes, beliefs, relationships or way of life. But not everyone was able to adjust, and some were left with ongoing psychiatric symptoms. Given the complex interplay of biological, psychological and social factors unique to each case it is unwise to generalise or to predict individual responses, and blanket advice to “think positive” or show a “fighting spirit” can be unhelpful. The stories of the women in these two books illustrate this diversity. 

Melanie Reid (1957 – ) was thrown from her horse in 2010 when he refused a cross-country jump. She sustained spinal fractures which rendered her tetraplegic apart from having limited function in her right hand. Her memoir The World I Fell Out Of describes the months she spent in hospital, and subsequent years back at home with her husband. The practical limitations of being largely confined to a wheelchair mean that the mundane essentials of living – washing, dressing, toileting, eating and drinking – require assistance, and occupy a large part of each day. The inability to move, the bodily disfigurement, the loss of sexual attractiveness, being deprived of the sense of touch, have a huge emotional impact for patients themselves and for those close to them. To a healthy person all this might sound so horrific that it would inevitably lead to deep despair and the desire to end it all. Spinal cord injury is in fact one of the few medical disorders shown to be associated with a raised suicide rate (Harris and Barraclough 1994). Melanie Reid does make brief reference to considering a one-way trip to Switzerland, and to taking antidepressants, but on the whole her mood stays upbeat. With tenacious determination to work on rehabilitation, her physical function improved much more than her doctors predicted. She was eventually able to drive a car, and even return ride a horse until she was thrown off again and suffered further injuries. She has overcome this setback, and continues to channel her mental energy into writing. This book, and her “Spinal Column” in The Times, contain frank and often darkly humorous accounts of life following her accident.

Marie Colvin (1956-2012) lost the sight of one eye after being shot in the face and chest by snipers in Sri Lanka in 2001. In Extremis: the life of war correspondent Marie Colvin, written by her friend and colleague Lindsey Hilsum, gives a comprehensive account of her life and complex character. Described as brave, passionate, driven, intellectually outstanding, beautiful, glamorous and generous, she has been hailed as the greatest war correspondent of her generation. Yet quotations from her diaries reveal an inner insecurity and her personal life was tumultuous, marked by heavy drinking and smoking and a succession of doomed love affairs. The optic nerve injury, though not the main focus of the book, was a watershed. Her blind eye had been preserved and looked normal from outside, but she always covered it with a large black patch: “part of me in a way, something that would make a clear division between life before and after”. She also replaced all her clothes with those of a more “architectural” cut than her previous “lacy or flowing styles”. As soon as she was physically fit she resumed assignments in the Middle East but worsening nightmares, panic attacks, anxiety and depression eventually forced her to take leave and undergo psychiatric treatment for post traumatic stress disorder. Over the next few years, while her intrepid forays into war zones and graphic dispatches brought international acclaim, her private life became increasingly miserable and chaotic. She was killed by a rocket attack in Syria in 2012.  

Inevitably, reading such stories makes me wonder how I would cope with a life-changing injury myself. And it could happen to anyone, even someone like me who is neither athletic nor adventurous and is not attracted to extreme sports or situations. My most demanding activity is dog-walking and even this can be hazardous – I have already had two bony fractures due to being knocked or pulled over by excited canines. Both injuries have healed perfectly but I know they could have been much worse, in which case I very much doubt that I would have been able to marshal such courage and determination as that shown by Marie Colvin or Melanie Reid. But none of us can predict how we will respond if faced with a health challenge of such magnitude as theirs. 

 

 

Our “Optimum Wellbeing Retreat”

Brian and I spent five days at Gwinganna, an upmarket “lifestyle retreat” set in 200 hectares of native bushland high above Australia’s Gold Coast. We stayed in the Billabong Villas.

Billabong Villas Gwinganna

I was apprehensive about being woken at 5.30 a.m., deprived of caffeine, alcohol, sugar, dairy and gluten (any guest caught smuggling in such items is sent away without a refund), and having only limited access to my iPhone. I had cut down on coffee and tea beforehand in the hope of avoiding withdrawal symptoms but, in common with several of the other 50-odd other guests, I had a mild headache for the first two days. Then I felt well for the rest of the course.

The environment is beautiful, with walking tracks traversing the woodlands and valleys, and two outdoor swimming pools. There are plenty of wallabies and birds, the occasional koala and one sociable peacock.

 

The morning timetable is intensive, with just a cup of herbal tea at 6 a.m. before the qi gong session held in a field overlooking the sea. Then a choice of activities: an energetic walk, a gentle walk, or a guided tour of the orchards and vegetable gardens. A substantial breakfast at 8 a.m. is followed by a stretch class, then again a choice of activities such as yoga, Pilates or dance. More herbal tea at 11 a.m. and then a talk on nutrition, exercise or managing stress. Lunch at 1 p.m. includes fish or chicken with large salads and sometimes vegetable soup. Afternoons are free to rest, swim, or experience one of the many special therapies. A massage and a facial are included in the price of the retreat, and over 80 other modalities ranging from Reiki to colonic irrigation are available at extra cost. Missing my own animals, I had a session of Equine Assisted Therapy.

Horse therapy Gwinganna

Dinner is at 7 p.m. with fish or meat or vegetarian options. After that most people are ready for bed, though on some evenings there are group meditation sessions.

All the staff are passionate about Gwinganna’s approach and most have worked there for many years. Several of the guests are also old hands, attending once or twice each year because they are stressed by high pressure jobs or coping with chronic illness. Brian and I had already been feeling alright before we went there, but we both enjoyed the experience, and returned feeling refreshed and relaxed. Pleased that my body composition analysis showed a normal bone mass and low belly fat, I decided that my usual diet and lifestyle are healthy enough, and do not intend to make any major changes although I feel less desire for coffee and wine. My muscle mass was a bit on the low side so I am back to cold water swimming.