Immigration Detention

Yesterday, I had the most depressing interchange, on Twitter, with a fellow called @StreetSmarts111 . His profile called out his conservative political bent. The reason the interchange was so depressing, and indeed the reason I ultimately blocked him, was that there appeared no intent on his part to engage in an exploration. This Tweeter simply wanted to pound a mandatory detention path.

What frustrates me also is that 140 characters is only the first intake of breath on a subject like this. So here goes.

Firstly about Tony Abbott and Julia Gillard. Reprehensible is the only word that works for me when I think about their refugee policies. They and the parties they lead continue to chase each other to the bottom of a very unpleasant slope. They are both playing to first world paranoia. They are seeking to garner even a few voters by playing to anxieties and misapprehensions amongst the population. They are doing this by causing irreparable damage to the lives of asylum seekers and, increasingly, damage to Australia's international reputation.

@StreetSmarts111 stubbornly equated mandatory detention with the need to "process" people. Let's just unpick that. Australia engages in mandatory, indeterminate, arbitrary detention of asylum seekers arriving by sea.

• Mandatory - you come in by sea, you must be detained;
• Arbitrary - the mandatory nature of detention means that, no matter who you are and what your risk, origin or claim you are nevertheless detained;
• Indeterminate - it is impossible to say how long you will be detained for.

Now @StreetSmarts111 argues that all that is necessary in order that we be able to "process" what he chooses to call "illegal immigrants". Firstly let's put the illegal to bed. It's anyones' right to seek asylum in another country. That other country has the right to determine their view of the veracity of that claim. These people are not "illegal immigrants" they are asylum seekers.

So let's look at processing. What does Australia need to do in this regard? I'd argue that the necessary components of a processing system are:

• It focuses firstly and quickly on simple things like "who are you?", "where did you come from?" and "who came with you?". That check is done daily at our airports to thousands if not hundreds of thousands of people. Not all of them have pre-issued visas. That system does not lack integrity suggesting that such immediate information should be accessible, even for quite large boatloads in 24-48 hours. That information also allows the commencement of security checking (more on that later);
• Health checks. We would reasonably want to know whether arrivals were suffering from a communicable disease. We would also want to know, for the sake of the arrival, whether they were suffering from medical conditions requiring treatment;
• The next step is to determine the nature of the claim that each person is making for asylum. This is a longer step, but in fact does not require continued detention for its conduct. By now we should be in a position to know who each arrival is and to have made an accurate assessment about whether they pose a security risk, or whether there is a high level of uncertainty about their identity, or the risk they pose. In default of such risks they are ready to be released from detention. That is not to say that they have a place in Australia as a refugee, it is not to say that they are in fact a refugee. It's simply to say that we have adopted a risk-management approach and formed a view that they can be released into the community pending a decision on their status and whether they will be granted Australian residency.

Such an approach would leave the vast majority of arrivals in our community within a month or so. Some small proportion would be detained on the basis of their risk and perhaps even removed to their country of origin (after the exhaustion of their avenues of appeal under Australian law).

So what are the risks to Australia from such an approach, rather than mandatory detention? There are none. You are more likely to be run over by a car on your way to work than harmed in any way by one of these arrivals with such a sensible managed, streamlined processing system in place. There is no physical risk beyond that which already exists through homegrown extremists, organised crime and bikie gangs - none of which have anything to do with people arriving by boat. There is no economic risk. These people in the main are hard workers, delighted to be in a place of opportunity. They contribute to economic growth which we all benefit from. They do not steal jobs from "Australians".

But there are a couple of issues. Firstly the government needs to deal with both the legislation and the performance of ASIO with respect to security vetting. As I understand it, if you receive a negative security vetting you cannot find out why and on what it is based. You simply have a negative vetting. Why is that acceptable in a democratic country? Where is ASIO's accountability to parliament, the courts and the populace? How do we know what standards are being applied by ASIO? How can we know whether their standards are hopelessly laissez-faire, entirely appropriate to the needs of modern Australia or based on utter, unfounded paranoia? We can't under the legislation and the recipient of a negative vetting is unable therefore to effectively challenge it. The legislation needs to be changed to allow proper scrutiny and review of decisions.

Equally as important, the process of security vetting needs to take place at a brisk clip, not the current inefficient, glacial pace. If it's a matter of resources then the government needs to act. If it's a matter of priorities then the government needs to set ASIO straight about what's required. In any event the current pace and framework seems unacceptable.

So what would be the benefits of ending mandatory detention and briskly processing arrivals?

• The massive cost of mandatory detention - the financial cost - would end;
• The irreparable human damage caused by indeterminate and arbitrary detention would be greatly reduced, perhaps eliminated;
• Australia would begin to benefit rapidly from the contribution of these people to our society and to our economy. Yes there's a cost - people need access to support and to healthcare and education - but that cost is minuscule compared to the costs of mandatory detention and it is a cost that accrues for every member of society.
• Australia's international reputation would cease taking the battering it is now.
• The politicians could focus on matters of real national importance such as overhaul of the health system, implementation of an appropriate carbon strategy and ensuring the country enjoys long term benefit from the "minerals boom" rather than ending up as a bankrupt hole in the ground.

Let's not either begin imagining a mass exodus from countries around the world, all attracted to Australia by these new arrangements. That's simply a paranoid fantasy. Asylum seekers are "pushed" to leave the place they know by circumstances we can barely imagine. They are not "pulled" from the comfort of their homes by some vision of an Australian nirvana.

Asylum seekers make up such a small proportion of the immigrants coming to this country each year, that even a doubling of the numbers would have an almost negligible effect...except for the massive burden that we have imposed on ourselves by our mandatory detention policy.

There is only one thing that is needed in order for this situation to change: some sensible, ethical and moral leadership from our politicians. Our politicians need to start informing the population, they should lead the change in thinking about this situation. Instead they resort to the politics of fear, they dog whistle to those who fear everything including their own shadow.

All we need is a clear political message that asylum seekers are a positive and welcomed part of Australian life for this whole issue to vanish.

That won't unfortunately happen whilst we have the current morally bankrupt political leadership that we have - on both sides of parliament. I'd rather spend a day with any of the refugees that I know than be caught in the same room as our current political "leaders".

Spinal Fusion - The end of stage one

The last week has been a bit of a milestone week in terms of my recovery from the surgery. It's also caused me to pause and reflect about the whole process. So this post is really a brief review of the achievements and a little bit of reflection and recounting of my learning.

First the milestones. I had my 8 week review with the surgeon. That was great. Many surgeons only want to hear the good, mine however listened to and explored both the good and the not so good. We charted a path forward - with two more milestones - and we worked through a list of dos and don'ts. The next milestone is at 4 months. Until then I'm allowed to flex (bend forward) but I can't lift, pull or twist and I can only extend (stretch backwards) in a very minor way. I got to do my own shoes and socks for the first time in his rooms as he examined me - that was so tough! I'm also only allowed to sail on calm days for the next two months. The aim being not to fall on my arse until the bone has had a little more time to heal. The great thing was I got to chuck away the orthotic brace I've worn since the surgery.

I left the surgeon's rooms feeling buoyed up and positive.

On Friday of last week I finally finished all the opioid painkillers. I'd been going through a process of tapering those off and that finished on Friday. That also felt like a huge achievement and the pain - such as it is - is easily managed with some paracetamol. This is a hurdle that I'm told many people find hard. Indeed a fair proportion find it too difficult to get over the painkiller hurdle. So that felt like an achievement and I feel more energetic now that they have gone.

On the Sunday I drove for the first time in exactly 9 weeks. I refused to drive whilst on the opioids, even though there was apparently nothing to stop me doing so. I didn't feel it was right. I also liked being forced to walk everywhere I needed to go. Not driving kept me walking.

The actual driving part was easy - like riding a bike - once learned never forgotten. What quickly became clear was that it was going to be very hard to find a comfortable driving position. The actual process of driving and sitting in the car triggered off all sorts of pain and I'm still working on the best driving position.

Monday brought a return to work. That was easier than I expected. The drive to and fro was hard but the actual process of going back was easy, made easier because the work environment demands a lot of walking.

So what are the lessons?

Firstly, would I do it again? The answer is a resounding yes! I had substantial pain and very limited capacity to stand and walk prior to the surgery. I could only stand comfortably for less than 5 minutes, sometimes less than 2. Longer became intensely painful. I could not walk 150 metres. After the surgery I have virtually unlimited standing and walking tolerance and I have walked up to 7 kilometres at one go. That is a great change and it's kind of returned my life to normal. I caught myself looking for the next seat and the next tram the other day and laughed when I realised that it was an old habit and I didn't have to do that anymore.

Is it a miracle? No! I still have, and probably always will have, some pain and some lack of flexibility and function. Having had substantial back problems for nearly 30 years it's simply silly to expect one operation to wash that away like some magic wand. What I have got is hugely improved quality of life and physical function. What more could you ask for?

What would I do differently? My surgeon prefers simple walking as rehabilitation for the first 8 weeks. That however left me on my own and without a lot of guidance for those 8 weeks. My GP had little experience of rehab from this surgery so he couldn't provide much guidance. When I had a new pain, or spasm or pain was slow to go, I had nobody to turn to, nobody to help me understand what was happening and whether it was "normal" or worrying. To counter that I took myself back to my physio in the first week out of hospital and started very gentle strengthening exercises and some massage to relieve muscle spasm. She also provided very good guidance about how fast/slow I was recovering, based on the many patients like me that she sees. That guidance included letting me vent and deal with my anxiety when things didn't go well. In retrospect I should have asked my surgeon to write to her when he discharged me from hospital so that she was "part of the team" and knew what the surgeon expected.

The other thing I'd do differently is to get into the pool earlier. From 6 weeks I've been going to hydrotherapy sessions with a physio at a local hospital. These sessions are fantastic, they really aid strengthening and leave you feeling relaxed and flexible and tired. In retrospect I should have covered the one small part of the surgical incision that was slow to heal and got into the pool at 4 weeks - or earlier.

It's also important to understand that this is not just a physical challenge. It's an emotional challenge. At times I couldn't see how I would ever return to normal; I couldn't see how the pain would ever go away; I couldn't see how I would ever function "normally" (drive, tie my shoes, bend...); I couldn't see how I would ever return to work. I would get very depressed and emotional. I was also lonely. I spent most of my days walking alone or resting. I was alone with my thoughts most of the time, and when my thoughts turned dismal it was very hard to stay happy. A real blessing was ringing up my mates and arranging to have lunch with them. some weeks I had lunch with somebody every day! I don't know what they made of it, but it was a really important part of keeping me whole and happy and I thank them for putting up with me.

I think it was also much tougher than I realised on my family. Even though I had all these dark concerns about the future and about my recovery, I never felt overwhelmed by it, not after I left hospital. So for me ultimately it was a series of challenges that, in retrospect, were all pretty manageable. I've since found out how hard it was on my family and they didn't see it as very manageable for me. My wife has back problems. The other night I jokingly said to her that I could thoroughly recommend a fusion. She burst into tears, as a reaction to what she perceived I'd been through. Somehow I should have looked after them better. I'm never one to be stoic, I'd rather be truthful and accurate when someone asks how I'm going. Perhaps some more stoicism would have been better.

My final piece of reflection is that setting and knocking over goals is important and you need support for your goals and support to achieve them. For me, the biggest single challenge was to get the right strategy to taper the opioids without getting withdrawal. I didn't want pain and withdrawal together because I wanted to get it right and over with first time. I had a lot of support to get the right strategy and to implement it. The sense of achievement and of personal capability is really dramatic and in my view is the single most important step in my recovery - moving beyond artificial means to manage my pain and getting rid of the unwanted effects of the drugs.

DX before Dinner

Last year, in a fit of boredom, I decided (for reasons still unknown to me) to go off and do my exam to become an amateur radio operator. I've been qualified as a marine radio operator for years and also have flight radio operator quals. I wanted to do my amateur license though. First off I did a two day course and got my Foundation license. This is an "operators" license and the lowliest of the amateur qualifications. It allows you access to limited frequencies and you are not allowed to make or modify your radio.

For a quite small amount of money I bought a second hand HF set and got on the air - I made my own antenna. The antenna was quite a challenge - we have no external area where we live - so I needed a compact solution. I found a simple antenna that goes on my roof, made with a 9 metre fibreglass squid pole and some wire. It works brilliantly.

A little later in the year, in a further fit of boredom, and as it turned out a fit of madness, I decided to upgrade to one of the other licenses. I targeted the Standard license which is an intermediate grade license - more frequencies and able to build your own gear. So off I went with about a dozen other souls. For 15 weeks in the depths of winter we sat in a freezing cold classroom for 4 hours on a Saturday afternoon. It was beanie, jacket, jumper and still cold kind of freezing! I toted around heavy text books and most of the time wondered if I was mad. It was all new to me and I could make very little of the electrical theory, transistors, diodes and other stuff at first.

When it came time for the exam I decided (in a further fit of stupidity) to sit the Advanced exam. This is the ultimate amateur qualification and gives you free run of all the amateur frequencies and privileges. I thought I'd give it a crack and if I failed I could still sit the Standard exam.

The exam papers are selected from a question bank by computer - a fixed number of questions on antennas, a fixed number on electrical theory, propagation etc until you have 50 questions. What that means is that, by chance, you can get a simple paper - all the simple questions in the question bank, a medium paper or a really tough paper, within each amateur category. When I opened the paper to read through all I could think of was "Beam me up Scotty". It was a bastard of a paper and I couldn't work out many of the answers. I seriously thought of getting up and handing it back and saying "I'll just do the Standard".

I decided to knuckle down and do it and knocked it off as well as I could in well under the 90 minutes allowed. It was marked on the spot. The pass mark was 70% and I passed with a modest amount to spare...who knows how!

I was relieved not to have to sit the Standard and also to know that I had, in the space of a few months (5 in fact) progressed from nothing to an Advanced license.

My main interest is HF. I find it very satisfying to use a piece of technology that dates from the late 19th century and use it effectively to communicate. DX refers to radio exchanges with distant contacts. There are many DX hounds out there who work furiously to fill their log books and to chase all the weird and wonderful places. I don't work like that. I enjoy switching on before dinner at night, just as the sun goes down and making a couple of contacts from somewhere interesting.

Tonight I spoke to Orlando on Grand Canary Island, last night Chris from Inverness in Scotland. I've spoken to people in Italy, Hungary, Spain, New Zealand, Hawaii, the Ukraine and many more.

I don't know why this old fashioned technology makes me happy, but it does. It's something about the randomness of the contact, the unplanned nature of who you might talk to, the difficulties of propagation over distances up to 20,000km, or the fact that it costs nothing to chat.

I looked at my mobile sitting beside the HF set as I talked to Orlando tonight. I could use it to call anyone anywhere with much better quality than the conversation I was having. But I never would have thought to call someone on Grand Canary and I wouldn't have known Orlando to start with.

I usually don't hang around too long - chat to a couple of people and then dinner. But it's very satisfying!

Eight Weeks, has it really been Eight Weeks?

The first week of this whole saga was spent in hospital and it was a bit of a blur, the days and nights seemed to fly by, and in retrospect I suspect a fairly heavy drug load helped that. Since then you've been able to read about the ups and downs here on a weekly basis. This is the last weekly update unless there's something pretty interesting.

This week has been all about reducing pain relief quite dramatically. By next week I'll be down to zero as far as the heavy duty pain medication is concerned. I've had some withdrawal symptoms which haven't been nice - mainly gut cramps. In reality they've been pretty mild so far.

I've continued my walking, but in line with last week it's been more moderate than earlier weeks and that's been good. Total for the week is 23.5 km. I also did another session in the pool - some walking and gentle exercise. I came out feeling like I'd done a work out but very relaxed and flexible. It was great and I think I could get addicted!

As in previous weeks I've had ups and downs with pain and discomfort. It's become clear that this whole saga has been a big success. I've gone from being unable to walk 150 metres 2 months ago to being able to reel off 7 km at a reasonable speed if I need to. That's success if ever I heard it. It's also clear that after having had various back pains and problems for most of my life - starting as a teenager in the early '70s - a single operation isn't going to solve all of that. One or two other levels in my spine that had previously been problematic but which were fairly settled before the surgery are now complaining again. I think that will settle down over time. The lumbo-sacral area of my back is best described as "fragile" at the moment. It's not hard to trigger off unsettling localised pain and discomfort - low key but annoying. I think a lot of that is about a few bits of titanium being buried there and the muscles needing to get used to sitting over and around that. It's too easy to focus on that sort of thing when you've just had major surgery. It's too easy to become a bit obsessive about things, so I've been trying to ride with that stuff and it generally passes after a few days. In addition I've got a 16cm scar from the base of my spine. That's become more of an issue over time, feeling slightly tight and "catching" at odd moments when I move. Again I'm trying not to focus on that and just working instead to maintain flexibility.

The things I still can't/haven't done are interesting: I can't put on my shoes and socks, mainly as I don't want to bend and twist enough to do that; I haven't driven for 8 weeks - I refuse to do that whilst on painkillers even though I think I'm quite OK to do it; I can't sit for long periods, though that's improving - up to about 20 minutes in the right chair; I can't lift and pull or push; I don't think I can sail yet and want to talk to the surgeon about that; I haven't flown - I can't get into the aircraft and the drugs prohibit it anyway.

So that's it. I've got a review with the surgeon on Wednesday and I'm planning to start work the week after. It is a good moment for thanks though: to my daughter who has faithfully put on socks for her ageing dad for most of the last 8 weeks; to Sandy in a local shop who smiled and got down on her knees to undo my laces one day when I got trapped in my shoes with nobody to help me get them off; to Maddy and Dan for the lifesaving Red Cross parcel of books - thanks guys you don't know how much I needed that; to the surgical team - you guys rock; to the nursing staff at 3LP - I couldn't have asked for more care and support and all with a smile; to my mates for enduring lunch with me when I needed company; to my neighbour for his words of wisdom; to my physio for holding my hand when it all got too much; to Chris for his wisdom and support; to Graham who'd been there before and was a calming force and full of great advice; and to my wife for all her support and for putting up with me at all!

It's been a real team effort and I can't imagine how much more goes into something like winning an Olympic Medal!

People Smugglers, Refugees and Confusing Push with Pull

There's a continuing misguided swirl of political rhetoric in Australia with respect to the role of "people smugglers" and the issue of "queue jumpers". I'm prompted to write this, in part, by an ongoing conversation on Twitter with @kristinmoore2 and @timhollo. 140 characters simply isn't enough sometimes.

Let's try to get some clarity through the middle of this highly charged argument. Firstly to the issue of refugees. That's what they are properly called. The Australian political rhetoric is all about queue jumpers trying to get to Australia quickly. This is a "pull" argument and is both fatuous and wrong. It relies for its validity on some view that the allure of Australia is so great that there are queues of people around the world with their eyes fixed on the shiny attractions of Australia. Under this argument arriving by boat is simply unfairly jumping these veritable queues and is not to be countenanced. People must be made to see that they cannot jump the queue. It's simply crap and what's most disturbing is that it only takes about 10 seconds of thought to understand that.

The alternative and accurate argument is a "push" argument. This argument says that refugees find the situation in their homelands so intolerable that they have little option but to seek an alternative place to live. The "push" arises through war, persecution, torture or other substantial perils in their homeland. People do not uproot themselves and look towards an unknown future unless there are huge pressures that close off all other options.

I go to sea in small boats a lot. Each time I do I focus intently on the safety of what I intend to do. If I'm not the skipper, I carefully evaluate the vessel, the skipper, the plans and make a decision about whether the safety meets my standards. I have on more than one occasion made a decision to stay on dry land.

Imagine being a refugee in the hands of people smugglers. These smugglers are business people: for a fee they offer to provide transport, by sea, from one point to another. From their point of view it's a one way trip for the boat - it very probably isn't coming back. So the boat is a cost and of course they must be sorely tempted therefore to scrimp on that cost. As a refugee, you get no chance to check out the crew, the boat, the plans, the safety equipment (should there be any). You simply cast yourself on the services of your chosen service provider.

I have met very few people of any nationality who do not have a care and concern for their own personal safety and that of their family, particularly their children. How must it feel to put your lives in the hands of someone whose motives and track record are unknown to you?

As @kristinmoore2 has pointed out, this issue of paid escape has a long precedent in recent history, no more so than in the run up to and during World War II. What is wrong with paying a service provider if you are under threat of your life and feel that you have no option to escape? Wouldn't you if faced with that choice? Of course you would. The lack of payment does not therefore lead to some moral high ground.

Please be clear however that I am not arguing that the people smugglers are shiny philanthropists. I am not making that point at all. I suspect that many are shady and careless of the lives of their human cargoes. Nevertheless their existence and the service they provide should be of no surprise to any of us.

What is most worrying is that both major political parties in Australia seem intent on continuing their false rhetoric about a "pull" theory with respect to asylum seekers. Please, let's all do away with that fiction and deal with the real issue: The world is in turmoil, much of it is turmoil on our doorstep. Indeed Australia is involved militarily in some of that turmoil. Under such circumstances refugees are part of what we should expect. People are being pushed from their land and the things that they know. They are being pushed into the hands of service providers they do not know and onto leaky boats for a perilous sea crossing. These are people under enormous pressure, displaying grit and determination that we should all show due respect for. We should expect refugees to arrive by boat and we should provide a proper and humane welcome to Australia for them.

Week 7 - Up, Down, Up, Down...

After a pretty good week in Week 6 this week has been a bit of a mixture. Wednesday, Thursday and Friday were particularly bad days with a return to pain levels of a couple of weeks ago. The heat packs came back into use and my mood plummeted. I took things pretty quietly and just tried not to aggravate anything and it seems to be settling down.

I started the week pretty well with a long walk on Monday and a walk and a session in the hydrotherapy pool - my first - on Tuesday. The hydrotherapy pool was great, the water was warm and the gentle exercise with lots of my weight supported was great. Interestingly I clearly used muscles I hadn't used for some time as I could feel them the next day!

I'm not sure what caused things to go down hill later in the week but I found it particularly frustrating as I'd been going so well! Because of the progress in week 6 I'd also chosen Friday of week 7 as the day to start reducing my reliance on heavy duty painkillers. After a conference with my doctor we settled on a gradual reduction approach and the use of paracetamol as needed to take up any slack. Being stubborn I chose to continue with the plan and cut my daily intake by 25%. I've had to use paracetamol a couple of times to take up the slack but not in any continuous way. I also haven't yet suffered any untoward withdrawal effects from reducing the heavy duty painkillers. So that's all positive. Tomorrow I'm due to reduce intake by a further 33% so let's hope that goes as well!

Distance walked this week was 25.2 km which is a slight reduction on the previous week and reflects my "take it easy" approach over the latter part of the week.

Six Weeks - It's Magical!

The physio has been saying to me "the magic date is 6 weeks." She doesn't really know why but she maintains that 6 weeks post-surgery seems to be a big milestone for people like me with a spinal fusion. Well guess what? I think she's right. I walked into her rooms this week and she said just two words: "New man". She felt that I looked different, was walking much better and overall looked like I was making big progress. I felt the same.

Today is 42 days post-op. I've walked 28.8 kilometres for the week, not including local jaunts and coincidental stuff around the house and up and down stairs. I still feel like my back aches a lot, I still have right buttock pain but it all feels much more controllable.

Immediately after surgery my weight started a slow but steady decline as I had reduced appetite and was increasing exercise. That decline had stopped, and indeed somehow in week 5 I put on 500 grams, much to my disgust. However the weight loss has resumed this week and I'm feeling good for it.

The remaining issue is sitting, I can't do that for very long at all and somehow I need to do that in order to return to work. Six weeks was always the target date for return to work. That's not going to happen but there's nothing I can do about that!

I also had an unexpected experience on Friday. I attended the funeral of a fellow pilot, killed in an air crash recently. I couldn't sit down for that long, so I stood for a bit over an hour. Standing still for an hour, however, reproduced an old back problem that I hadn't experienced for at least 10 years and which is not associated with the levels that I've had surgery on! Go figure that one!!

So in summary a really good week. Next target is to start to get off the last 2 painkillers that I'm on.

Day 35...Progress?

This has been a much smoother week. I got some good advice at the beginning of the week and it has paid off with a smoother, though not trouble free week.

The good advice was delivered by a slightly exasperated friend who's "in the business" - that is he's closely involved in these sorts of operations. His advice was simple: "you need to treat yourself like you've been in a major car accident with multiple injuries and you are now in the recovery phase". I think he and those around me felt like I was behaving as if I was recovering from a stubbed toe, and having the same expectations of myself. That really was the big issue - my expectations of myself.

So, taking that advice on board I've had a better week, particularly emotionally. Not perfect by any means, but certainly vastly improved. I've also continued to demonstrate to myself the things that I can't do yet. The main thing is sitting. The more I sit, the more pain I get and the longer it lasts. I also get pain if I walk too far and so I've limited that as well. Having said that I did 22.5 km for the week and a rather epic 5.5 km in one shot yesterday. That was a mistake!

I've also ditched the anti-spasmodic drug this week, with no apparent negative effect. So now it's just two tablets a day. That feels like an achievement in itself!

As for the sitting problem, I'm trialling a Bambach Saddle Seat, at the suggestion of my ever supportive physio. The verdict is very much open on this still. I like the position, but it causes soreness in my inner thighs and if I sit long enough an ache in my lower back. However it has doubled my capacity to sit, from around 5-10 minutes pain free to around 20-25 minutes pain free.

I am seriously keen to hear from others who might have had a lumbar fusion and have direct experience of this chair. Please leave your experiences in the comments.

So the summary is: a much better week/ However the team at work will just have to wait. I'm not ready to start working today guys and it's going to be some weeks yet in my view!

Day 28...time ticks slowly

This has been a remarkably tough week. I think the biggest issue has been a huge gap between what I think I should be able to do and what I can do. I've walked 25.7 km, not including incidental walking - across the road, round the house, etc. That includes one day where I didn't walk at all, except around the house. My biggest walking day was yesterday where I did two walks totalling 7.1 km. I ended the day feeling OK, except for a persistent dull ache in the base of my spine and general aching and stiffness.

For me the tough thing is to remember that 4 weeks ago I couldn't walk 300 metres without sitting down 3 times (and still arriving a pale, shaking mess) and that it's been over 3 years since I've been able to walk 7 km in a day. So that's got to be progress of a massive scale.

Nevertheless I've absolutely been through the emotional wringer. Half way through my long walk yesterday I stopped for lunch and found myself sitting eating my lunch with tears streaming down my face, wondering how the hell I was ever going to walk home from there and whether the pain and slowness were ever going to improve. God knows what the other patrons thought! Anyway walk home I did.

The problem is that I then feel an overwhelming need for sleep. So I slept for a couple of hours before my next walk. This was supposed to be a short walk before dinner. I bumped into a couple of friends and spent some time chatting with them about their plans for a new house. It was a great end to the day and improved my mood no end. So from the deepest downs to a reasonable up. No doubt it won't be the last time that happens, but I am surprised at how emotionally labile I am.

The key stopper for me at the moment is sitting down. Basically I can't, except for very short periods. I do sit sometimes for longer periods (like writing this post) but the suffering that results is directly proportional to the length of time spent sitting. The optimal maximum seems to be about 5 minutes. Not much hope of a return to work any time soon at that rate.

My mental target for return to work has always been 6 weeks post-op. At the moment I can't see myself being able to front up to work in 2 weeks' time. We'll see.

I also desperately want to get into the pool, however there is one little area of the suture line that is healing by secondary intention and I'm not game to get into some foetid pool until that is completely settled.

For those who've had to put up with my intensely unhappy behaviour this week, in person, on the phone or on Twitter, my apologies. I hope I stop behaving like that soon. I'm trying. thanks for all your support.

Day 21...where am I up to?

For those of you still hanging in here, and more importantly perhaps for those of you considering an operation like this, here's a day 21 round up.

First some background. I caused injury to the L5-S1 level of my spine a long time ago when I ruptured the disc. I had a difficult period straight after the injury but since then things have travelled on OK. In 1991 I lost sensation in the front of my right thigh and at the same time I developed an intermittent deep nagging pain in the centre of the front of my right thigh. Those are all things that you learn to live with.

Over about the last 5 years I've developed intermittent bouts of lower back and buttock pain which have become progressively worse. They took up two forms. The first was a nagging pain of varying intensity which at its worst left me flat out on the floor unable to do anything. The other, more troubling, was pain in my buttocks legs and feet which got worse on standing. Towards the end 5 minutes was too long to stand and I couldn't walk either for more than a few metres. That meant that it was time for action.

The symptoms were caused by stenosis of the neural foramina at L5-S1. That means that where the spinal nerves exited the spinal column through a gap, called the neural foramen, they were being crushed. This was happening because the facet joints at L5-S1 were slowly collapsing leaving an ever smaller gap for the spinal nerves to exit. Those are the nerves that control parts of your legs and that's why I had troubles.

My surgery was minimalist. I had a laminectomy, where the laminae - bits of bone behind the spinal column - were removed. The facet joints were also removed and four pedicle screws were inserted - one on each side of each vertebra through an area of tough bone called the pedicle. Then the nerve root on the right hand side was gently moved aside and a piece of plastic (PEEK in fact) called a fusion cage was slipped in between the two vertebrae. The idea was to re-establish the gap which used to be held open by the disc. Saying that the fusion cage was "slipped in" makes it sound easier than it was. Quite a bit of force was needed to re-establish the original gap and to get the cage where it was supposed to be. The cage was packed full of munched up bone that had been removed from my spine and the space behind the cage was also packed full of the same bone. This bone will grow and fuse the two vertebrae together.

Then a rod was placed vertically between the pedicle screws on each side of my spine and finally a cross piece was placed between the rods and the job was finished, but for closing the muscle and skin layers.

When I woke up I was totally pain free at the incision line and on the left side of my back and in my left leg. All the pain I'd been suffering on that left side had gone and has never returned. On the right hand side I had localised pain, muscle spasm and some intermittent leg pain. That has remained, though it's improving.

So to day 21. Here's the situation:

• Walk 5 km;
• Shower and dress myself;
• Sit for up to 10 minutes without too much discomfort and longer with significantly more discomfort;
• I can get in and out of bed and roll over with no external assistance;
• I've been able to manage flights of 20 stairs since day 3 - up and down - unaided;
• I can stand for long periods of time, basically pain free;
• I can lay for long periods so long as it's absolutely flat.

Not bad considering where I've come from. Now to the bad bits:

• I'm still on 2 long-acting opioid pain killers per day plus 1 anti-spasmodic for the spasm in my right buttock. Can't see when I'll be off those, but on the other hand I've weened myself off a bucket load of other stuff already;
• I don't drive because of the drugs I'm on - personal choice;
• I don't know whether my right side will ever get better than it is now and that's not great;
• I'm a bit depressed - people work and do their own thing and I'm left either walking (slowly) or lying down. Movies are all crap, I've read all the decent books I can find and I've listened to my whole music collection I think!
• I'm frustrated out of my brain! I can't sit so I can't work and I can't travel. I feel like I'm in limbo.

The bottom line is I'd probably do it again in a flash, even though the outcome is far from clear. Next week, I'm hoping one last little area on the suture line will be healed and I'll be able to hit the pool. That'll be a new distraction for all of 2.5 minutes, but a new distraction nevertheless!

Two steps forward, one back...

It's day 18 from surgery. Since last weekend I've done another couple of long walks but I've finally had to admit that it's probably not the best thing I could be doing. Finally yesterday, after "good" advice from a range of sources, I took a day off and didn't walk at all. I did the normal walk around the house, read, get food, but that's about it. I did two other things though: I stopped taking all of the short acting opiate painkillers, leaving only two sustained released drugs and something for muscle spasm; and I slept.

I couldn't believe how much I slept, 2 hours, some food, then another 2 hours, then dinner and some TV and then off to bed and slept for 7 hours straight. My body must have wanted to tell me something! I also didn't get bad withdrawals from the painkillers. I'd been expecting worse, all I really got was feeling slightly hypersensitive and grumpy. Some who know me well would say "what's new about that?"!

Today I hit the road again with a small 2km walk and after talking to the physio I'm going to try and stick to a smaller number of shorter walks - around the 2km length rather than a 5-6km out and back marathon.

My surgical scar has one little area that's not quite healed, so I'm hanging out for that to sort itself out. Once that's healed I can do some deep water walking. I'm so bored at the moment that even a small change like that is something to really look forward to.

What's particularly wearing is that I can either walk, stand or lie flat. I can only sit for very short periods and I really suffer if I try and sit for longer. No trips in the car to speak of, no going out to lunch with someone (I tried and suffered afterwards). So life's pretty boring.

Still I should stop bitching. The signs for the long term outcome are pretty good and I managed through some contortions to put my own socks on today. Big win! Don't ask me how!!

Things will no doubt improve as I'm able to do more. Till then I'm like a caged lion!

Hey and thanks for all the support and suggestions on Twitter - you're champs, thank you!

Walking, walking

I'm used to walking at a pace that competes with the best of them. I guess that's at least 5.5 - 6km/h. Right now I'm only able to keep up about 2km/h. So that gives me plenty of time to sight see and smell the roses. I expect that speed will climb quite quickly but it's fast enough for now.

The surgeon had asked that I start off slowly and then build up to a reasonable walking distance each day. I'm not sure what that means exactly. I got out of hospital on Monday and managed to do a 1.0km walk that day, which seemed quite puny to me. That was in addition to all of the coincidental walking around the house and a visit to the super market. The next day was a little more at about 1.2km.

Then I stretched my legs and walked 1.7km the next day followed by a 2.0km day on the Thursday and a 2.1km day on the Friday.

All of this taught me two things: firstly I can't do speed just at the moment - I've still got a little bit of a drug load on board so I'm particularly careful crossing roads and checking where I put my feet. The second is much more galling: the run-up to the surgery was pretty rough, to the point that I couldn't really walk at all - 150 metres saw me out. Add to that a week in hospital, even though I did wear out quite a bit of the carpet walking after the surgery, and you end up with somebody who's seriously out of shape. I'm trying to put that right, but it's galling to raise a sweat just ambling somewhere at 2km/h!

My 5km jaunt yesterday left me pretty sore and sorry for myself so today I may slacken off a bit. We'll see. I can't see a trans-continental jaunt in my near future though - sorry Forrest Gump!

How do you do that?

So out of the ward, down in the lift, across the road and we're at the car. I'm not allowed to bend at the waist, I'm not allowed to twist and I'm not supposed to sit with my knees higher than my hips. So how do I get into the car seat? Well gingerly for a start...I got the car door open as far as it would go and sat on the edge of the seat facing outwards. Of course all modern cars have seat bolsters designed to retain you as you circuit the Nurburgring at 200+ km/h. All very useful in that situation but for my purposes a pain in the arse. Once perched on said seat bolster I then pivoted my legs into the car, after having somehow got my head inside without bending, twisting or doing any of the other forbidden things. The result, if done well is a simple pain-free entry into the car. The alternative is, well let's call it a mess. It works well though, so well, that a friend still uses it 17 years after his operation.

The ride home wasn't as bad as I thought it would be. The surgical site and my back are remarkably impervious to bumps and jolts. I'm simply not troubled by most of what a modern road can throw up.

Of far more importance was the problem of getting on top of drug management. I arrived home in possession of 7 different drugs, each with their own raison d'etre, timetable and regime. Up to that point I'd been rattling back about 20-25 tablets a day, not to mention various potions designed to keep the trains running in the face of the constipatory forces of the other 7 drugs. A spreadsheet was the only answer. Each drug, it's maximum daily dose, suggested dose and timing was set out in the spreadsheet and off we went on the magical mystery tour.

Quite quickly it became apparent that firstly my requirement for pain relief was falling and that the spreadsheet was allowing me to target my drug use to periods of need. Monday the intake fell to 15 tablets, Tuesday it was down to 10 tablets and by Wednesday it was down to 6 tablets.

Two things became apparent at that point: firstly my pain wasn't quite under control and so I was wasting my time a bit. Secondly I was having bouts of what turned out to be withdrawal. Shakes, shivers, sweats, anxiety...as I weaned myself down from the high levels of drugs.

Thursday the total number of tablets is back up to about 9 and that seems, for the time being to be the right balance. I'm hoping that I can carve into that further over the weekend.

The other thing that has to be tackled is my rehab programme. This can best be described as the modified Forrest Gump programme. Instead of "run Forrest, run" it's a case of "walk CA, walk". Basically the idea is to start off slowly and to build up to several kilometres a day over a period of weeks. Of course me, being me, the idea became fixed in my head that if small walks were good, then big walks were better. I'm currently paying the price for that as well!!

Overall though, this surgery is a miracle so far. The only thing I can't do for myself is to put my socks on. I can't work that one out yet. I can do anything else I've tried so far with some ingenuity including picking things up off the floor. That involves squatting, down on one knee, down on both knees, pick up the object and then the reverse the process. Stairs are no problem, though they're treated with due respect and driving is out of the question. I'm carrying too much of a drug load to want to be out on the roads at the moment, though from a purely physical point of view I think I would be capable of it, without the drugs.

More to come as I explore the niceties of a recovery as opposed to mere functionality.

The path to the exit...

What wasn't so great was that my right hand side, which had been largely pain free before surgery was now painful. It was as if I had swapped the pain from the left to the right hand sides! The explanation was pretty simple: I'm a big bloke and in order to get access to the various bits of my spine and to place the screws and the fusion cage it was necessary to use a fair amount of force, including retractors and a "scissor jack" style distractor to re-establish the old disc space. This led to some substantial bruising and perhaps some bleeding. I suspect that the "handedness" of the surgeon who inserted the cage from the right hand side also had something to do with it.

The upshot of all of that was that it was hard to get and maintain pain control. I kept getting muscle spasm in the right buttock and that is a vicious circle - more spasm = more pain = more spasm. At about the same time the line in the back of my left hand got knocked out by a clumsy movement and an attempt to re-establish a line in my right hand was unsuccessful. That left me without access to morphine. The whole situation culminated in me sitting on the edge of my bed in tears at midnight one night unable to cope with the pain. A phone call or two and a sharp increase in pain control medication got the situation back under control. In retrospect that was the nadir, life improved quickly from there.

Days three and four saw the return of the torturers (the lovely physios)! They had me out walking again, firstly with the frame then without, then climbing three "mock stairs" then out to the fire stairs for a scary unaided climb up and down one flight of them. At the end of that process they declared that they were finished with me and I was fine to go home!

Friday also saw me off to the X-Ray department for a quick picture to ensure that everything was where it should be. Only two things were holding me back now: pain control and the delicate matter of "opening my bowels". To put it bluntly you can't go home until you can control your pain successfully and until you've demonstrated your ability to have a crap! Opiate pain medication is not helpful in achieving the second of those goals!

As far as pain control was concerned I was getting about 2 hours between bouts of medication. My nights consisted of two hours sleep, some medication, half an hour's walking the circuit of the ward and another couple of hours sleep before the cycle started all over again. I could shower myself, dry myself, dress myself. The drain and catheter had been removed. I just wasn't really on top of the pain and it was now 7 days since I'd had a crap. Finally on Sunday night it all came together and on Monday morning - 7 days exactly after I'd entered the place I was kicked shakily out onto the street.

Working Back Through the Intervening Days

So what happened after coming out of surgery and leaving hospital on day 7? Well quite a lot really.

I vaguely remember this insistent voice in recovery saying "what's your pain now dear?". The scale is 1 (no pain) to 10 (unbearable pain, worst you've ever felt). I remember answering "7" every time. It sounded like a good number in my semi-conscious state. The unexpected result was that I arrived on the ward from recovery with 40mg of morphine on board and quite quickly accumulated another 4mg. Life was pretty painless at that stage!!

I also had various tubes and lines in place. A venous line into the back of my left hand, put there by Charles when he anaesthetised me and now being used for the Patient Controlled Analgesia (PCA). This is a marvellous device that delivers 2mg of morphine every time you press the button, limited to 1 press every 5 minutes and 95mg total over some time period which I never worked out.

I also had an arterial line in my left wrist, which soon came out leaving a big bruise; a drain from the wound on my back and an in-dwelling catheter in my bladder to remove the need to get up to go to the loo; and finally a further "spare" venous line in the crook of my left elbow.

The wound was dressed with a waterproof dressing which was in turn covered with a heavy "cushioned" dressing of something like rubber or neoprene. I never suffered the slightest pain from the suture line, however all tapes and adhesives give me some degree of inflammatory reaction so that was an issue from time to time.

Bruising after removal of the arterial line from my wrist

The first 24 hours focused on keeping pain relief up and helping me learn to turn with assistance from the nurses. I was allowed no water or food whatsoever until bowel sounds returned just the occasional wipe around my mouth and gums with a dampened swab. Once small bowel sounds returned I was allowed crushed ice to suck. What we were all waiting for was a full-blown fart! A sign that my gut was again working. Apparently surgery on the spine can cause your gut to go into a sulk. Taking food or drink in that situation leads to nausea, vomiting and other dire consequences so crushed ice it was. Finally about 50 hours after my last food I finally produced the requisite fart and was allowed to begin a light diet.

About 30 hours after I returned from surgery I was encouraged to hoik myself out of bed and into a vertical position. This involved edging towards the edge of the bed in lateral recumbency and then pushing up with my arms as I swung my feet to the ground. That happened all in one motion and got me to a sitting position with the minimum of twisting and very little pain. From there it was simply a case of using a small walking frame and what remained of my wasted thigh muscles to rise like Lazarus to my feet. The first thing I noticed was that my left side, that had been so painful pre-op, was now completely pain free.

That ws a huge milestone getting to my feet again and taking a few small steps.

7 Days On

Pedicle screws, rods, cross link and the radio-opaque markers in the fusion cage (from the back)

Pedicle screws from the side showing the hardware at the back and the radio-opaque markers in the fusion cage.

Last Monday morning, bright and early at the hospital for all the clerkly things to happen, then to be weighed, have blood taken, an ECG done and finally to meet Charles, the anaesthetist - and coincidentally the guy who was going to be keeping me alive for the next few hours. After those formalities and me grilling Charles, it was off to the holding bay. This is a little area just outside theatre and was the last walk I was to make for a few days. I was placed on a trolley with a big sign "Pre Warm". I was placed under a large bubble cell blanket that was in turn connected to a hot air blower. The idea being that I was going to be in a cold environment for the next few hours so I might as well get as warm as possible.

Next on the list of visitors was Tim, the surgical assistant. Tim was a friend of a friend so a nice chat helped to bust my mounting anxiety.

Finally Peter the surgeon came along for a chat and I was wheeled in for Charles to weave his magic. The next thing I recall was Peter telling me that he'd just rung my wife and that all had gone well.

Operative time was a very quick 140 minutes - we'd all been expecting 180 to 220 minutes, so that boded well.

During the operation Peter had removed the laminae from between the L5 and S1 vertebrae, together with the facet joints; cleaned out the intervertebral space; and inserted a fusion cage and finally placed 4 pedicle screws, two rods and a cross link. As well he had opened up what remained of the neural foramina on both sides to give a clear path for the nerves to exit.

So far, so good and I was off to the ward.

D-Day the early morning

Alarm went at 5:00am, I have to be at the hospital at 6:30. Currently making coffee for others! I'm hungry, thirsty and dying for a cup of coffee...and I can't have anything.

That saying "ignorance is bliss" has got a lot going for it. I think if I didn't know what was at stake here I might have had a decent night's sleep. Instead I tossed and turned and worried.

Soon it will be off to the hospital and I'll talk to you on the other side. Wish me luck.

D-Day minus 1

Tomorrow's the day. I'm having a single level spinal fusion - L5-S1 - with inter-body fusion cage, pedicle screws and rods. Doesn't sound too bad when you say it quickly.

For years I've had back problems firstly with a ruptured disc at this level and then as time has passed the facet joints have collapsed and I've developed stenosis of the neural foramen, particularly on the left side. In plain language that means that the nerves that run down my leg are being trapped and squashed.

Over the past 3 years or so it's become increasingly difficult to stand - 5 minutes is generally too long now, and increasingly difficult to walk. A couple of weeks ago it got to the stage that I had to sit and re-gather myself 3 times whilst walking a single city block. It makes life pretty limited. Going to the art gallery is out of the question, travelling is a problem if you have to queue at the airport or walk to your departure gate. About 2 weeks ago I went to listen to the MSO. It was all I could do to cope with the queue and get to my seat - a real feat of endurance that left me pale and shaking.

So to surgery. The problem with something like this is that no matter how intolerable the chronic pain and reduced function is, the prospect of surgery is not nice, not nice at all. You know that there are risks, anaesthetic risks, surgical risks... and you know that you are going to face a period of acute pain, rather than the chronic pain you have been facing. You are going to be in the hands of others, dependent on their care and skill. Not to mention minor indignities and inconveniences.

I'm supposed to be first on the list tomorrow morning - around 7:00am - and I'm told that it will take 3-4 hours for the procedure, followed by a week or so in hospital and 6 weeks off work. I'll try to keep this blog up-to-date, no doubt for the first couple of days it will be entirely unattended, but as soon as I can I'll give you some details.

That fetish

I'm feeling a little confessional this morning so I thought I'd tell you about one of my fetishes. It's about bags, I can't help myself, I just like bags. I know I'm not alone and I bet a fair number of you also share this fetish in one form or another.

First let me set your mind at rest, it's not a fetish for black garbage bags (go and google that one) nor is it a fetish for handbags. I confine my fetish to functional bags - a bag to carry my stuff to work or to carry around a camera or two. David Alan Harvey, of National Geographic fame, has a serious camera bag fetish. It puts my mild obsession to shame.

Years ago with me it used to be highly functional bags made of all sorts of high tech fibres, designed to stop a speeding bullet at ten paces and protect your camera from anything the world could throw at it. In the mid 1980s I remember buying a Tenba camera bag for, what was in those days, large sum. It was a great bag, not too deep, decent dividers, various pockets and padding. All in all a great bag, including its nondescript grey colour. The problem was it was made, I think, of an early version of Cordura and it wore its way through any fabric it rested against. Your clothes didn't stand a chance. A couple of years ago I dragged this same bag out of its resting place because I had a use for it. Unfortunately the waterproofing in the bag consisted of some sort of coating on the inside of the Cordura. This coating had parted company and disintegrated into a fine dust - the kind that is designed to penetrate - and stick to - every part of a camera or lens. That was sad because it was a good bag, nobody seems to make those shallow, minimalist sorts of bags any more.

More recently my fetish turned to Crumpler bags, first a Fux Deluxe messenger bag, then a variety of computer bags and most recently a computer knapsack. Whilst I really like the look and feel of an elderly, grubby, Crumpler messenger bag, they don't grab me like some other bags. Nor do they quite cut it in the "perfect work bag" stakes.

Now we come to my most recent fetish. Maybe it's something about the ageing process - mine not the bag's - but as I've got older I've come to value the qualities of "old fashioned" materials over the latest high tech carbon nano particle gadget bag. Enter bags by Billingham and others.

The thing about Billingham bags is that they're made of very old fashioned stuff - laminated canvas, cotton webbing and leather. They shouldn't really be effective camera bags...but they are.

Now the next problem with bag fetishes is size - I always seem to think I need a bigger bag than I do. My first Billingham bag was a 555, I can load more kit into that bag than I can lift! In fact I can't work out why I bought that bag. It's so big that nobody in their right mind would try to carry it. I use it as a container to lug stuff around in but I don't try to walk anywhere with it.

My next Billingham bag I decided was going to be a sensible size. I had to be able to carry it when it was full and it had to sit comfortably. "Buy a Hadley" they all said to me at the shop when I told them what I wanted. I tried the Hadley and decided it was too small. I tried the 225 - a great little bag - and decided it was too small. You can see where this is leading can't you?

I ended up with a 335, this is also a great bag, but you can never use the words "small" or "little" in the same sentence. You could take this bag away with you to Outer Mongolia for 6 months and carry enough gear for a professional assignment. A great bag...just not what I intended to buy.

Meanwhile my back's been getting creakier and my bags appear to be getting heavier. So off we go in the search for another bag. I've got to the stage that I don't tell my beloved that I'm bag shopping and I sneak the new purchases into the house hoping they won't be noticed. She's a very tolerant woman but my bag fetish is a bit much for her!

This time I went straight after the good advice bag - a Billingham Hadley Pro. It's a small looking bag but it takes a surprising amount of stuff. I can fit a Leica M, a couple of lenses, notebook, keys, passes, "first aid kit", pens, wallet, MacBook and various other cords, chargers, earphones and stuff. It doesn't weigh too much and it sits comfortably on my shoulder. When I went to buy it, they only had black. I didn't want a black bag, but I wanted a bag. So I bought the black one. It's actually turned out to be an inspired choice. It blends in and it doesn't look like I'm straight out of the British Raj. I just hope that it doesn't overheat in the summer.

Interestingly the bag tags didn't tell me what the material is, however on the Billingham site it says that black bags with nickel plated fittings are made of their new, synthetic, FibreNyte material. If it is, it's a great copy of canvas - it looks and feels just like their canvas.

Oops I realise in this exploration of my fetish I haven't told you about the important sub-branch - Pelican cases...never mind another day.

For those who are interested I'll work up some piccies of various bags to add later.

Ears yet again!

Day 14 is drawing to a close. I've just had my first 24 hours pain free and that is a bit of a revelation. I'm hopeful that it's all plain sailing from here. I was surprised at how painful the procedure was and how long the pain persisted. Since about day 10 the pain has reduced and my reliance on painkillers has also reduced. If there was one thing I hadn't counted on it was the pain - ears are clearly sensitive!

The other unexpected thing was the infection. I suspect that suture removal at the beginning of day 4, may have resulted in the infection. By day 6 I had a substantial infection and that ultimately needed both oral and then IV antibiotics. I finished the course of antibiotics on the morning of day 13 and the infection had certainly cleared up.

Now whilst the ear is tender to the touch it is vastly improved and the outcome looks pretty good as you can judge.

Day 6, two days after the sutures came out

Day 14, well on its way to looking like any other ear

The one outstanding issue is loss of sensation. I've got a large area that runs up the back of my ear and over the top at the centre that has no sensation. As well the area inside the auricle above the graft is also without sensation and of course the graft itself has no sensation. I'm told that this will resolve but it is certainly unexpected and mildly unpleasant.

So really that's the story! The surgeon says I'll get improvement in the look of the graft over then next 2 to 4 months. I'm pretty happy with how it's looking now. When the last bits of serous scab resolve and the surface of the skin renews over the next few days it will look almost indistinguishable from the rest of the ear.