Nick Y

Age at interview: 68

Brief Outline: Nick was cycling home from a shopping centre one evening when he had his injury. A bus ran over his ankle and foot. The damage was extensive, so he had to have the lower part of his leg amputated below the knee. This was not Nick's first experience of a life-changing injury; his son, Jamie (Interview 34) sustained a traumatic brain injury in a road traffic collision.

Background: Nick is a retired chartered surveyor. He is divorced, lives alone and has two children, age 37 and 35. Ethnic background' White English.

More about me...

Over two years ago (in 2010), Nick was riding his bike home from a shopping centre and decided to take a different route than normal. He was injured when a bus ran over his foot. Although he did not believe it was his fault, Nick apologised and claimed responsibility for what happened at the scene of the accident. This was later used in court to prevent Nick’s compensation claim being successful. 

 

In hospital when Nick was “drugged up and still in a lot of pain”, the staff told him he needed to decide whether to have reconstructive surgery or have his lower leg amputated. Initially he thought, “Of course I want a reconstruction”, but with his friend’s help he decided to have an amputation. 

 

Nick describes feeling incredibly depressed in the early days after his injury and amputation and owes a lot to his friends and his son, Jamie, for their support. Jamie (TI34, who was also interviewed for this research) sustained a traumatic brain injury in a road traffic collision about 12 years ago in 2009. He sent Nick encouraging text messages, which Nick said inspired his recovery.

 

Nick would have liked more information about life after amputation and how to take care of his stump (also called residual limb). When he was discharged he treated his stump the same way as the staff in hospital and covered it when he showered. As a result he developed pain, which he “assumed was part of the healing process”. His physio, with whom he had daily appointments at the rehabilitation centre, pointed out that he had an infection. 

 

Following amputation, Nick’s stump gradually began to shrink and he has had his prosthetic leg re-fitted several times. He now uses a pin and sleeve prosthetic, which he finds very cumbersome. He says' “It’s not the same as when you’re fit, but I can get around. I can walk. I still ride my bike and I can do most things around the house. I just can’t do them as quickly as I did before”. He wears a cosmesis (a skin-coloured foam covering) over his prosthetic leg which disguises it and stops people “staring at it”. 

 

Nick says there are a lot of things he can still do despite having lost a limb. He can ride his bike and swim, and is doing up his house. His very grateful to the hospital staff as he “could be dead, but for their skill”. However, he felt he would have been reassured by meeting someone who had been an amputee for a long time and could tell him what he would be able to do and what the future would be like. 

 

In the confusion after his injury, Nick Y took responsibility even though he was not sure who caused it. He was later denied compensation because of this.

Well as the driver came over I’m in this sea of pain because a 12 tonne bus has just run over my leg. I was absolutely in agony. I was in and out of consciousness I think and also my mouth tasted of tarmac. I sort of hit the road and banged my, you know. I saw this shape coming towards me and I said to him, “I’m sorry. It was my fault. I’m sorry.” And I think I was really saying, “Please help me.” Anyway I mention that because when it came to a criminal prosecution that excused the driver. They said, “Mr Black said it was his fault. End of case.” 

Nick Y didn't feel he had enough information to make an informed choice about whether to reconstruct or amputate his leg. A reconstruction would have been less likely to succeed because of his age.

What I really needed was somebody to tell me what to do, what to say to this question, “Would you like a reconstruction or do you require an amputation? It’s your choice” And I think I would certainly advise anybody else in that situation to insist that you go and see the doctor on their own, in an office, not surrounded by lots of other people, confidentially and just go through the options, which I didn’t do. I think the reality is the doctors know better than you what they should do, particularly at a world class hospital like [hospital name]. But I think they had this, probably quite correctly, this culture – can I call it that? – Of offering you a choice. This word ‘choice’. I’m very cynical of the word ‘choice’ because you’re not informed enough to make a choice unless you are of extremely clear mind and not bursting with pain and all the rest of it. So I would have welcomed somebody just saying to me, “Look mate, you ain’t got no option, you’ve got to have an amputation”. And in the end it was a very good friend of mine, a woman, who said, quite forcefully, “Look, Nick, the doctors are saying to you you’ve got to have an amputation, that’s what they’re saying between the lines. So just get on with it. And so that’s what I did, thanks to her advice. 

 

And what would the reconstruction have involved?

 

Well you see, I only I know second hand. Nobody actually sat down with me. And this is the one criticism I do have of my particular circumstances. Perhaps it would have been different say if I’d been younger. I think my age was a factor in this. Because as I understand it – and I understand bits and pieces – a reconstruction involves having some sort of metal cage built around your leg to help to straighten it out and to rebuild it. And it’s a process that can take one, two, three years. And the disadvantages are' one, you might get an infection in this very slow healing process and secondly – and this wasn’t actually said to me but I’m pretty sure that this is the case – that as I’m old (I’m 66) the chances of it healing quickly and thoroughly and properly are much less than if you’re 26. And I think the other thing is that prosthetics have advanced a lot in the last few years, and I suspect that it’s felt that the prosthetics are as good an alternative in some ways as a reconstruction. 

 

Nick decided to wear a cosmesis because he did not like people staring at his leg, though he said he was beginning to feel more relaxed about this.

May I show you this? Do you want to see it?

 

Yes.

 

Can you face it?

 

I can.

 

Are you sure?

 

Absolutely. So long as you don’t mind.

 

No. I don’t mind. I minded tremendously to start with. I didn’t want people to see I’d got a tin leg, you know, which is why I’ve got this. This is called a cosmesis. There was a metal pin, you know, you may have seen guys, particularly army guys, they have just have a steel leg.

 

Yes.

 

Well I’ve got this cosmesis, this sort of foam as a pretend leg. Because I found, when I was sitting on the tube particularly when I first had my leg, there’d be this bit of steel poking out, and I found everyone sort of staring at, you know, my leg, and I didn’t want them to do this. So I got this sort of, it doesn’t look quite so artificial now.

 

Nick found out about benefits from a volunteer at the limb fitting centre who helped him to fill in the form, and through chatting to others at the centre.

How did you find out you were eligible in the first place for that?

 

That’s a good question, Anne-Marie. I had no idea about this. I honestly didn’t. I’ve never ever claimed anything in my life, honestly ever. Ever. Apart from my pension, I get a State Pension. And I was sitting in the hall of the limb fitting centre and this woman came up to me with a whole bunch of forms and she said, “I’ve come to help you claim your benefit.” And I said, “Have you?” And she said, “Yeah.” So that was it. Otherwise, I probably wouldn’t have found out about it. This was about two months after the operation. But it was the first I knew about it, it really was.

 

And so how did you go about applying for it?

 

Well she filled this form in for me. She said she’d fill in the form; I just signed the form at the end of it. Sent it in and the next thing I knew I was getting £47 a week. And then I filled in another form about a year ago, where you had to tell them what your progress is and I probably should have been more pessimistic about myself, which is probably why they stopped it, but anyway.

 

What kind of things did they ask you about?

 

I haven’t got the form here, but it says in big letters, ‘You must be honest about any changes to your condition’. When it first happened I was in a wheelchair. I couldn’t do anything, honestly, I really couldn’t. Could I cook for myself? No. So they ask you, ‘Can you cook? Can you clean? Can you go shopping? Can you make a bed?’ Well all those things I know I put yes to. ‘Yes, I know can do all these things’. Whereas previously the woman had probably put, ‘No, you can’t do these things’. So the lady who filled this form in, I later learned she was a volunteer and I have also later learnt that she has now given that up, so I don’t know what people do now. Well I’m not sure, is it the hospital’s job to tell you about your benefits? Not really, I wouldn’t have thought. I don’t know whose job it is.

 

It seems to be people don’t know that they’re entitled to anything and what they are entitled to.

 

I didn’t know. Having said that, I mean I just didn’t know but I must say as time went on I’d be talking to people in the gym and there’s a thing called the people’s transport lounge where you sit around for hours after gym waiting for an ambulance to bring us home. And it began to dawn on me everybody else was pretty well alert to benefits actually. I mean there’s much more alertness of benefits than we think. People like me at my age probably it’s a matter of pride. I don’t want any help. I’ve never had benefits. But I think there’s a much more sensible attitude amongst younger people. They are more aware that they may be entitled to claim something. So I think there’s more awareness out there. I really do actually. 

Since his amputation, Nick Y is still learning about his limitations. He sometimes pushes himself too far.

Before perhaps you wouldn’t have thought twice about kneeling down and decorating for a long time?

 

No, absolutely.

 

Did you know that that was something that you shouldn’t do?

 

No. I should – if I had thought about it for two minutes. I should have thought, shouldn’t I? Hold on you’ve got a dodgy leg and kneeling on a hard bit of plastic, of course I should have thought. Yeah, you do have to think through, and I’m getting there gradually.

 

I was talking about this last night with somebody actually. There’s a fine line between knowing to push yourself, but do exercises and go for a walk, go for a bike ride, but not overdo it so that you mess up either your good leg – put too much strain on it, muscular imbalance or whatever it’s called – and similarly put too much strain and stress on your residual limb. I guess it is a learning process yeah because it must vary with every individual. It is quite difficult. And I think the net result, certainly in my case – and I don’t know how other people find it – I tend rather than take a risk, I tend now increasingly, as the years have gone by to not take a chance. For instance, [builder’s name] is out doing the building [at the back of my house]. In the old days before my accident I would have been out there, sweeping up, lifting stuff to make the job go quicker. But also to get them out of my house, get them out of the way, and save money – they’re being paid by the day. Now I wouldn’t even dream of that, because I don’t want to risk say lifting up a pile of bricks or lifting up a bag of cement or whatever. I don’t want to risk doing anything that might cause this to go. So I think the net result, what I’m trying to say is that I actually do less, I tend not to push it.

 

If you overdo it what are the consequences?

 

Well they can be inflammation of the skin as I was saying earlier on when I had the bad leg on, or the swollen knee. So the problems I’ve had are inflammation of the skin and then this fear at the back, I thought have I got an infection? This burning sensation was it an infection? Swelling of the knee? What other problems have I had? I think they’ve been my problems personally. I’m sure other people have others. And also I really was in some pain a few weeks ago to do with the hamstring of my good leg. I’d somehow done something with this leg that had caused the hamstring to sort of, like footballers get, so it seized up. And it gradually got better so it was okay.  

Nick Y and his son (Jamie) both had life-changing injuries. His way of making change was to take Jamie out and ensure he feels part of the world.

You hear about these wonderful people who see things are awful and then go and do something about it, you know, run the London Marathon to raise money or whatever it might be. I never actually did anything. My way of doing something was to do as much as I could with Jamie. Not as any kind of hero because he has minders who look after him. But he would come over here for instance for the day. I’d take him out. We used to go down the coast. I took him to the cinema, the theatre, you know, out for a posh meal. I took him for a meal several times to the Dorchester, posh hotel in London, because it kind of boosts his confidence, makes him feel he’s part of the world. 

Nick Y worried about the way children are taught road safety by their parents.

I feel quite strongly about this. When the river, I cycle along the river tow path and a lot of parents are with their children on cycles, you know, cycling along a busy tow path. And I’ve noticed often the kids on their bikes with their parents will go to their right as they are coming towards me, which is suicide if you’re doing that on a road. I really am nervous that children are not learning to keep left on roads. Anyway, so as an old git, whenever I’m cycling on the river path and I see a child – particularly a child; I don’t say this to grownups – if I see a child coming towards me on their right, i.e. coming headlong towards me. I say, “Go to the left.” And I often then find parents staring at me you know, being rude to their child. 

Nick Y uses a walking stick on the tube which indicates his impairment to others. Initially if he was offered a seat he would politely decline, but now he accepts it.

You said you sometimes walk with a stick.

 

Well only very occasionally now actually. I did for the first year or so, but I hate walking with a walking stick. And the only time I do it now actually is if I’m going on a crowded tube.

 

So what I do now, if I’m going on a crowded journey I carry a walking stick, which acts as a sort of signal to the busy person rushing for the train coming the other way to keep out of my way a bit. So if they see and old bloke coming towards them with a walking stick…So it’s a defence mechanism, it’s a signal to other people. But I don’t like it. I hate it. I don’t want to go round with a walking stick if I can possibly avoid it, certainly not with crutches for instance. I don’t know other people find this; it’s much more difficult to skip out of other people’s way, you know, because I’m not quite so nimble as I used to be. I never used to think about crowds before. I just did it.

 

Can you easily stand for the journey on the tube or the train or do you have to sit down?

 

I can stand absolutely. I don’t do long journeys I must admit. We’re talking here of perhaps into Central London, for instance, probably no more than 20 minutes. I can stand if necessary, but I have found people are extremely polite actually. I have found that, contrary to what I’ve heard, sort of breakdown of courtesy and stuff. I’ve had kids stand up to give me a seat on the tube. At first I’ve said, “No, no, it’s okay, I’m all right. I’m all right. But now I’ve said with grateful thanks, “Thank you ever so much. Great.” And I find people are generally pretty good actually. Partly age, and partly when I’m carrying a walking stick.

 

You used your stick for the first year?

 

Yes, about that, yes.

 

And why did you need it?

 

At first just to balance, just for reassurance. That was all. A stick just gives you a little bit of reassurance, so that if you stumble you can catch yourself with it. I just don’t want to go around with a walking stick, which is a pure stupid vanity thing. But as I mentioned it’s quite useful on a crowded tube.  

Nick Y's son, Jamie, also had a life-changing injury and has given his father a lot of support.

Anyway when I was in hospital he sent me a succession of texts on the mobile and he writes in this really strange style. He’s got a language all of his own, he really has. So I typed them up because I want to keep them. So this is a guy who’s quadriplegic, in a wheelchair. So this is February 11th, this is the day after the amputation or a couple of days after it. “Bonne nuit, goodnight, or good morning, amazingly brilliant Dad.” “Please keep motivated, be strong, as in the near future I’m looking forward to being your boson crew on the boat we’re hounding. And only if you think I’m capable…” I can’t read it. I still can’t. “Only if you think I’m capable of additionally being a co-pilot for our boat.” “Be it in sunny Cornwall or elsewhere.” I can’t read it. “I really don’t mind. Because is no matter life’s little injuries thrown our way we’ve strongly survived and we’re together wherever we are.” I can’t read it. Sorry. It was so nice I couldn’t believe it. He really wrote that from the bottom of his heart. “We’ve strongly survived and we’re together wherever we are I won’t care or mind. Lots and lots of adoring love. Jamie xxxxxx” Yeah. And I’ve scribbled a note here, “Cheered me up reading this going to and fro the hospital by ambulance”. This is when I was going back and forth to rehab yeah. 

Nick Y's son, Jamie, also had a life-changing injury and has given his father a lot of support.

My main feeling in the hospital, not suicidal exactly, but incredibly depressed. I knew something really serious was wrong and so it seemed that my life was going to come to an absolute stop. My son, doing up my house, sailing my boat, riding my bike, seeing my girlfriend, my woman friend. I mean all these things that I’d retired to do. So it was a very depressing time, extremely depressing. I was absolutely very depressed, and I owe a lot to my friends and particularly my son for trying to cheer me up. 

 

Anyway when I was in hospital he sent me a succession of texts on the mobile and he writes in this really strange style. He’s got a language all of his own, he really has. So I typed them up because I want to keep them. So this is a guy who’s quadriplegic, in a wheelchair. So this is February 11th, this is the day after the amputation or a couple of days after it. “Bonne nuit, goodnight, or good morning, amazingly brilliant Dad.”, “Please keep motivated, be strong, as in the near future I’m looking forward to being your boson crew on the boat we’re hounding. And only if you think I’m capable…” I can’t read it. I still can’t. “Only if you think I’m capable of additionally being a co-pilot for our boat.”, “Be it in sunny Cornwall or elsewhere.” I can’t read it. “I really don’t mind. Because is no matter life’s little injuries thrown our way we’ve strongly survived and we’re together wherever we are.” I can’t read it. Sorry. It was so nice I couldn’t believe it. He really wrote that from the bottom of his heart. “We’ve strongly survived and we’re together wherever we are I won’t care or mind. Lots and lots of adoring love. Jamie xxxxxx” Yeah. And I’ve scribbled a note here, “Cheered me up reading this going to and fro the hospital by ambulance”. This is when I was going back and forth to rehab yeah.

 

Nick Y didn't fully understand the implications of choosing between reconstruction and amputation of his leg. He wanted more verbal information.

My main recollection after that is of waking up every morning to a group of medics and the doctor would be saying to me – I was quite drugged up and still in a lot of pain – and they started saying to me, “Well, Mr Black, you can either have a reconstruction, or an amputation. It’s your choice.” And I just remember saying, “Don’t be stupid, of course I want a reconstruction.” But as the days drifted by, it became increasingly apparent to me. And this is another lesson for anybody – somehow get some proper advice. I do feel that I need a one-to-one consultation with a doctor. Instead of talking to a group of people, first thing in the morning in a crowded ward.

 

I was absolutely very depressed, and I owe a lot to my friends and particularly my son for trying to cheer me up.

 

What did they do for you?

 

Well talked to me basically. Talked to me and came to see me. But the problem is with this, is that what I really needed was somebody to tell me what to do, what to say to this question, “Would you like a reconstruction or do you require an amputation, Mr Black? It’s your choice.” And I think I would certainly advise anybody else in that situation to insist that you go and see the doctor on their own, in an office, not surrounded by lots of other people, confidentially and just go through the options, which I didn’t do. 

 

I think the reality is the doctors know better than you what they should do, particularly at a world class hospital like [hospital name]. But I think they had this, probably quite correctly, this culture – can I call it that? – Of offering you a choice. This word ‘choice’. I’m very cynical of the word ‘choice’, because you’re not informed enough to make a choice unless you are of extremely clear mind and not bursting with pain and all the rest of it. So I would have welcomed somebody just saying to me, “Look mate, you ain’t got no option, you’ve got to have an amputation”. And in the end it was a very good friend of mine, a woman, who said, quite forcefully, “Look Nick, the doctors are saying to you you’ve got to have an amputation, that’s what they’re saying between the lines. So just get on with it. And so that’s what I did, thanks to her advice. 

 

Nick Y joined the Limbless Association to get more information. He got lifelong membership after saying to himself; 'Accept it. You know you're limbless mate.'

You just said you joined the Limbless Association. What was your motivation behind that?

 

Information, I want to get information. I found the magazine that I happened to pick up very informative. There was mention of you. I think that was on the front cover. I’ve just have a package of stuff actually delivered from the Limbless Association, because I joined. I paid £200 to be a life member. I thought, “Accept it, Black. You’re limbless, mate. Just do it”. So rather than pay ten quid a year I did the life one.

 

And in this month’s edition were four very interesting things. There was you, there was an article about Blatchford’s, which is the limb fitting company that does the limb fitting, you know, it’s a contract deal with the NHS you know, but there was an article about Blatchford’s that I found really interesting. It’s a British Company, for once they are actually doing things that are made in Britain. It’s quite an informative magazine, much more so than the others, which are called things like Disabled and something else and they’re full of, they’re quite good, but, you know, buy a Volkswagen and get your wheelchair in the back – that sort of article.