It takes a lot to laugh, it takes a sternum to cry

I've had a spot of trouble with my sternum wound. Big trouble.

Some basic info first. The sternum is the breastbone running down the chest, with ribs attached to it.

When I first had surgery to attach the Impaler, back in September, my cardiac surgeon cut the flesh and sawed through the sternum to give him a big access hole for open heart surgery. I was of course blissfully asleep.

My cardiac surgeon is a bloke called Bruce Thomson. He should be a national treasure. He is skilled, humble, approachable, compassionate and cool as a cucumber. He has saved my life a few times. It's what he does every day. Dr Thomson is one of a select club of cool guys called Bruce. Like Springsteen, Willis, Lee and my Managing Partner, Bruce Humphrys. I trust Bruce, the doctor and my partner, implicitly and have every confidence in their skill and judgement. Bruce (the doctor I hope) is likely to do my transplant, so I sleep pretty well. These medicos are the real professionals; not bozo commercial lawyers who get paid to bring about what are essentially transfers of money. We don't save lives or, at the other end of the spectrum, tell families we've done everything we could.

The other cardiac surgeon is a bloke called Peter Tesar. He taught Dr Thomson the trade so I'd be more than happy for him to do the surgery if need be. He's a great guy as well. No god complexes in this place.

Anyway, about seven weeks ago my sternum wound began to break down. It had healed up almost completely, but then decided to start anti-healing.

I must point out that my sternum had actually been sawed through twice again after the initial surgery. The second times was so that Dr Thomson could urgently remove a clot that had formed near my heart, which had caused what I understand was a stroke. The third time was my fault. At some point during my two month coma, whilst still asleep, I decided to get out of bed and run to freedom, leaving the Impaler behind. And the dozen other machines to which I was attached! I fell face down and mangled my healing sternum. Dr Thomson went in again and fixed it.

Despite three major surgeries, the sternum wound healed pretty well from October to February. Then, around my fortieth birthday, it started anti-healing. It turned into a wide deep chasm, a bit like the grand canyon on a 3D topographical map, oozing blood.

My doctors were baffled. They suggested a few plausible explanations, which we tested. I was sent to the Royal Brisbane Hospital for a punch biopsy and an incision biopsy. At one stage I had six dermatologists clustered around me peering into the crater. They ruled out pyoderma gangrenoma, a nasty autoimmune disease, which was good. They ruled out an allergic reaction to the titanium stitches and plate under my sternum, which was also good. They failed to culture any nasty pathogens, which was really good.

My doctors then decided to call in a plastic surgeon. She too was baffled. However, she knew how to fix it. She decided I needed pectoral flap surgery. This is a procedure whereby the pectoral muscles are unattached and then crisscrossed and reattached in new locations. I told her I wanted a manly, Chesty Bonds chest. Chesty Bonds is a cartoon man who advertises Australian singlets. He looks a little like Butch Peacock, one of my partners who has now retired. Google him if you need to. Chesty, not Butch.

I was pretty upset about further surgery before the transplant, but took it like a man (as Chesty would). I then had a chat to one of my physios about what the post surgery would involve. She is not my regular physio but had been rostered on to see me. She told me what would happen. She gave me a hospital pamphlet about it, bearing the Hospital's livery. The trade practices lawyers will understand that one.

Well, in short she told me a horror story, fully corroborated by the horror pamphlet. I would be put into a straightjacket like vest with my arms pinned at the sides for six weeks. I would need a nurse to get me out of bed, feed me, toilet and brush my teeth. For six weeks! Perhaps I would be able to flap my hands like a penguin.

This made my highly agitated and I became evil to be around. I yelled, I ranted. Todd, the psych nurse came to see me and I cried first the first time in my adult life. Like a baby. I told him that I couldn't do it. I had done everything asked of me for seven months without complaint and now this. Todd tried hard and told me that I was the most resilient person he had met and if anyone could do it I could. He told me to talk to Dr Thomson about the possibility of alternatives.

I had already built up my body from my post coma state (being as weak as a kitten) to a colossus of strength ready for transplant surgery. I would now need to a full rehab again, after somehow enduring the straightjacket, delaying the transplant for many months.

Later that day I spoke to Dr Thomson. He was, as usual, calm and measured. He told me that I had been misinformed. I gave him the horror pamphlet. He read it, twice, and said that it was wrong. This would be the rehab for a frail person who would need the sternum removed, or whose sternum was weak and brittle. There were degrees of pec surgery and degrees of recovery. My experience would be less dramatic than the straightjacket. A few days of some arm immobilisation, but by no means total. A few days off the transplant list, if any. No serious wasting of the colossus. I was relieved and bought him a new car. He likes it very much.

I don't think I have ever been as happy as I was at that moment. More surgery is a hassle but this I can do!

That night I decided to write this blog. I also decided that I would collate the posts and responses and try to get the thing published as a book, to raise some funds for the transplant research they do at this hospital, and the amazing work they do at Charlie's autism centre.

So be warned. Your responses may make it to print.

Yesterday I went back to the Royal. The good news continues. The sternum wound is now healing fast. It has now had a special vacuum dressing applied, at the request of the plastic surgeon, and it is doing well. Pecs surgery is still likely but there is a slim fighting chance we can avoid it altogether.

I haven't got my hopes up and am prepared for pecs surgery next week. Realistically, it will still happen. That's a call for the surgeons and if they say so, it will be once more into the fray.

I am no longer evil to be around. Still a long and tricky road ahead, but by God it will remain interesting.


Until next time,