Londoners’ experiences of life-changing injuries

Hospital and medical treatment for an injury

People we interviewed were treated in hospital for a variety of problems with different levels of severity; back, neck and spinal cord injury, head and brain injury, broken or crushed bones, punctured lungs, blood loss, burns, eye damage and hearing loss. The length of time spent in hospital ranged from just a few days to several months or, in some cases, over a year. Different hospitals offering specialist services could be involved.  Some people, injured abroad, were flown home once their condition was stable and admitted to hospitals in the UK for further treatment. Mostly people were admitted to hospital from the scene of their injury and Marina is convinced the proximity of trauma centres in London, with neurosurgeons on site, saved her son’s life. One man said his spinal injury occurred during an operation.
To understand the extent of the damage caused, people had various tests, including MRI and CT scans, x-rays and nerve conduction tests.
Initially, some family members were warned that their relative might die or may remain in a vegetative state (where they are fully awake but have no awareness of their surroundings).
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Some people were comatose, or sedated to reduce the likelihood of further damage, for just a few days or for months. People reported having weird or unusual dreams and experiences (including hallucinations) whilst they were comatose and thought these may have been related to the strong drugs they were prescribed.  Barrie thought that the coma was “the mind’s way of shutting the body down” so it could survive.  Raymond explained that coming round from a coma is not the way it is portrayed in the movies. He described the difficulty he had speaking and could only say “yes” or “no” when he regained consciousness, and felt very sensitive because “this was completely new territory for me”.
Some people spent time in intensive care or high dependency units where they were kept away from other patients and visitors.  This could be an isolating and lonely experience for those who were conscious, although Louise, who was in an isolation unit for weeks, described how she felt very emotional and cried a lot with relief during this time.

Depending on the type and severity of their injuries people needed different treatments or interventions. Some injuries were left untreated because they would heal better on their own. Instead of surgery Simon B’s treatment for a spinal cord injury was ‘conservative management’, which involved stretching his vertebrae. Some people had several life-saving operations and procedures, including limb reconstruction or amputation, muscle, nerve or skin grafts, head and brain surgery (to remove fluid and clots), and orthopaedic operations (to insert titanium rods or plates to rejoin breaks and encourage bones to mesh together).
People also had operations to implant aids and prostheses, including hearing aids, contact lenses and catheters.
The treatment decisions people faced could be distressing. For example, those who sustained significant damage to their legs in road traffic collisions were asked whether they wanted to have reconstructive surgery (in which their legs would be rebuilt) or have their damaged limb amputated. While initially wanting reconstructive surgery, they either eventually opted for amputation or it later became necessary after the reconstruction failed. When they were comatose or sedated, treatment decisions were made on people’s behalf by hospital staff or family members.
Medication was prescribed depending on the severity and type of their injury and the problems resulting from it. Drugs were used to treat pain, infections, depression, seizures and psychiatric problems.  Different types of anti-depressant medication were commonly taken. A man with a brain injury (Interview 7) said he felt he took so many pills he “rattled” when he walked. Finding the right medication involved some trial and error, and people said it was important to be guided by specialists. Medication changed over time as people’s needs changed and they decided which side effects they could not tolerate.
The potential side effects of medication (antidepressants, anti-seizure medications and medication to treat spasms) put people off taking them. They reported experiencing a range of physical and psychological side effects from the medication, including feeling “drowzy”, “zombified” or “hungover” (John and Jack). They said it clouded their thought processes, made them forgetful and caused them to feel like they “couldn’t be bothered” (Louise). Other side effects included upset stomachs, heartburn, diarrhoea or constipation, weight gain, sweating, hallucinations, dry mouths, feeling tired, lightheaded, and unsteady. People did not always like taking medication, but understood it was necessary to ease their symptoms or aid their recovery.  Aiden refused pain medication because he was concerned about long term side effects. Sometimes people turned to alternative therapies or changed their lifestyle, but some questioned whether any improvement it made was just a placebo effect. It could also be difficult to disentangle side effects of medication from symptoms of injury, or simply getting older.
There was some concern among staff, patients and families about infections developing whilst they were in hospital. Nick Z had operations not typically related to spinal cord injury, such as having his oesophagus rebuilt after getting an ulcer in his windpipe. Sometimes family members were involved in caring for them.
Many people had little recollection of the early part of their time in hospital because they were unconscious, medicated or experienced amnesia.  People could be in a lot of pain at this time; even having dressings changed on wounds was described as very painful. Some spent the time in hospital coming to terms with what happened. They wondered how their injury would affect them practically and physically. Dave felt the news that he was paralysed was given to him in a “blasé” way and he would have liked the consultant to be a little less certain to allow him some optimism about the future. In other cases, consultants were not able to give much information about potential recovery and this could be unsettling for the person and their family. One man, who was concerned about whether he would be able to have sex after his spinal injury, said, “I had sex in hospital. As soon as I realised that I could still get it up, it was one of the first things I was doing.”
After hospital, people went home or to rehabilitation, but often had to return to hospital for specialist treatments or regular health checks; Louise goes to hospital for steroid injections to help heal her burns and treat the itching she experiences. Others required further operations. For example, Bill and Jack had their amputations revised, which involved removing part of their stumps. Marina said the hospital staff describe her son Daniel as “their star patient…and everyone comes running to see him” when he goes back there. For some people, the extent of the injury was not immediately apparent and it was several months before they were fully diagnosed and received hospital treatment.  

​Last reviewed October 2015.

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