Lucy (Feltham) Leonelli

The reason I have to go through the God-awful colostomy training is because today the doctors have finally decided on a plan for the next phase of my recovery: In less than a week, I will be sent home.

The news stuns us all.

Given that I am now stable, the doctors explain that there is no need for me to stay in hospital for another four weeks as we wait for the bones in my pelvis to fuse so that the external fixator holding my hips in place can be removed, and until this point there will be no more surgeries. So my options are either to go into a ‘skilled nursing facility’ (affectionately known as a ‘SNIF’), or to go home and be looked after by Mum, Mat, and a collection of visiting nurses.

At first, the idea of going home like this scares the crap out of all of me. How will Mum and Mat cope? And what will we do if something goes wrong? Will I be safe? And do I really want Mat and mum to be changing my colostomy, giving me bed baths, injecting me and emptying my catheter every day?

We talk to various nurses about the options, and learn that SNIF’s are typically inhabited by the elderly and those who don’t have the mental capacity to take care of themselves. In other words, they are full of people who shit themselves and call out in the night. Sadly, in my current state I am not a million miles from fitting this description, but I think back to the fractious yelling that kept me up all night when I first arrived at this hospital and remember the misery of it all – can I really bear that for a whole month?

But, on the other hand, I feel awful about not wanting to go. These places exist, I know that now, so is it immoral of me to just write them off and pick the easy option? Do I feel somehow better than the people in a SNIF, even though I am pretty much one of them now? Why do I deserve the luxury of my home when they don’t get to have that? I wrestle with my conscience and struggle to make a decision.

After two days of deliberation, and much lobbying from my doctors and nurses, I accept that my presence won’t make a difference to the welfare of those already in a SNIF, so I stop being an idiot and agree that being a burden on the people who love me is probably better than being shipped off to a nursing home at the age of 32.

And so it is that, over the course of the next five days my small team of carers learn how to manage my every need. Mum learns how to take care of the wounds on my back, clean the holes around my external fixator, bathe me, and empty my catheter.

“Fiancés shouldn’t have to change colostomy bags”, she insists, and volunteers to join me and Michelle for another training class.

Mat learns how to take over my twice-daily blood thinning injections, pretending he isn’t a bit fazed by this when the nurse teaches him how to practice his skills on a small rubber cushion.

A Social Worker comes in to talk to us while he is attempting his second ‘quick and confident’ stab. She leans against the door, chews gum loudly and fiddles with her hair.

“I’m sorry, but you don’t have medical equipment included on your policy” she says, looking down at the list of equipment the doctors have recommended we will need in the house. “Yeah, none of this is included I’m afraid, so you’ll have to rent a hospital bed, a hoyer lift, and a recliner wheel chair out of pocket”.

She looks back up at us, “and you should also buy a commode, a walking frame and a hoyer sling because none of them are included either”.

She hands us a brochure with a number to call and promptly leaves the room.

I didn’t think to read the small print when setting up our company healthcare policy, and foolishly presumed that a relatively top-end coverage would include things like wheelchair rental and walking frames.

This is the first time the reality of money really hits me. Mat explains that he got his first taste of this when he was followed around the ICU with a card machine while I was in emergency surgery and he didn’t know what was going to happen to me; whether I would survive, whether I would be paralysed.

“How would you like to pay your first $3000 deductible, cash or card?”

Even with ‘platinum’ level insurance, this accident will leave us hugely out of pocket – around $15k in deductibles so far – excluding future surgeries (six more of them and counting), medical supplies, multiple ambulance transfers ($250 each way) co-pays for physical therapy, psycho-therapy, hand therapy, pelvic floor therapy (don’t ask), drugs, leg braces, out-patient visits, loss of earnings, the immeasurable costs of emotional and physical trauma, dental surgeries and scars.

Luckily, for Mat and I, this isn’t an insurmountable burden. It won’t leave us bankrupt. But what if we weren’t so privileged? What if we had to live pay-check-to-pay-check, like so many do? It would have ruined us.

To be the victim of an accident in the US is made so much worse by the fact that you are expected to pay enormous medical bills. The minute you are of no use to the system anymore, the system chews you up and spits you out; there is no safety net. Even the innocent victims of mass shootings have to create their own Go Fund Me pages, so they can afford to survive. God bless the NHS.

Rant over, and the wonderful Mat is ready for his debut. Smiling and joking, he grabs a pinch of the flesh at my tummy, stabs the needle into me and squeezes down the plunger with a shaking hand.

I gasp, grit my teeth and smile, “I didn’t feel a thing poppet”.