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The jockey and the pressure sore

27 November, 2018

SO many of us grow up hoping to say it, and so few get to say it: “The highlight of my life has been my marriage.”

Former jockey Ian Duckling wed one-time Miss Australia contestant Shirley Dean on 7 August 1965. He was 28, and had lived for five years with a complete T3 spinal cord injury. She was 29, and had shared some stern words with her parents.

“It’s been a great union,” Ian says simply.

“I said, ‘I’m going to marry him and that’s all there is to it’,” Shirley recalls. “The only thing wrong was that he barracked for Collingwood.”

Ian has had other big days. His winning rides. His representing Victoria in four diverse sports. His raising of two children with Shirley. The children’s presenting the pair with four grandchildren.

The low point of Ian’s life since he married? That began just this year, in June, a few months after he celebrated with Shirley his 80th birthday. He was admitted to the Austin Hospital with a dangerous pressure sore. He received surgery to clean up and then fill the cavity that had opened under his skin, and spent the next four months in bed – watching TV while he lay on one side.

Ian had known for nearly 18 months that he had a weeping wound, in a particularly vulnerable place on his bottom. And he had known how, in an ideal world, he could have allowed it to heal.

He should have kept off it, he recognises. He should have kept off it “twenty-four seven”. He should have spent at least a few consecutive weeks confined to bed, with all of his needs met by others.

Ian greets apprentices with Shirley in his role as Ambassador for the National Jockeys Trust in 2017.

Ian has had other big days. His winning rides. His representing Victoria in four diverse sports. His raising of two children with Shirley.

It had seemed to Ian, however, that others who could sustain him were few. The couple had lived independently in Melbourne’s south for 52 years. Their son and daughter, now in their 40s, lived nearby, but each had a family, and Ian had always resisted making his problems their problems. Disability support workers looked expensive, intrusive, constraining, and novel. The only obvious person to whom he could turn, as he saw things, was Shirley.

Shirley was awaiting eye surgery, and had been encouraged to refrain from driving. If necessary, she had been told, she could make short trips near home. Ian had stepped in as chauffeur.

He was not going to have Shirley do all their driving, shopping, banking, cleaning and cooking, while she waited on him, disposed of his urine bags and helped manage his bowel care. All for a tiny little sore. Similar spots had appeared in the past, and with just a little care they had always cleared up.

A racing life

Ian grew up in the southern Melbourne suburb of Mordialloc, near the bay and not far from the former Epsom racecourse. Racing had fascinated him, and he had gained an apprenticeship and become a professional jockey.

“I was going okay,” he told an interviewer last year, “especially over the jumps. I was a pretty good rider. You could say the money till was open for me but as soon as I got my hand in, somebody slammed the door shut."

He was 22 when a horse he was exercising at Caulfield, Uproar, declined to lift for a steeple. “I gave him a kick in the guts and gave him his head to take off,” Ian recalls. “But he didn’t take off.”

The two tumbled together over the fence. Uproar got to his feet. Ian found he could not. At the Austin Spinal Unit he was told early that he would never walk again: his spinal cord had been severed.

With Shirley at the Australian Paraplegic Games in Brisbane in 1966.

'I said, "I’m going to marry him and that’s all there is to it". The only thing wrong was that he barracked for Collingwood.'

Six months later he was back at Epsom racecourse, repairing racing equipment for a saddler.

“I was discharged on a Friday and started work on the Monday,” he says, adding with evident pride that he had never spent a day unemployed.

A credit squeeze trimmed demand at the track, and so he accepted an offer of work from a printer.

Ian graduated to running a press, producing the Victorian, South Australian and Tasmanian telephone directories for Telstra predecessor Telecom Australia. He was head of quality control for that work when he accepted redundancy in 2001, retiring at the age of 63 after 33 years.

He had met Shirley casually before he was injured.

'Everything clicked'

“I knew Shirl,” he remembers. “I’d been talking to her at the races. But I’d never taken her out or anything.”

“We’d known each other well,” Shirley corroborates. “But at that stage he wasn’t interested in that sort of thing, and I was only interested in horses.”

Ian’s life-changing fall had not ended his own interest in racing. Sometime afterwards, he travelled with a neighbour to attend the Mornington Cup.

“We were having a beer, and we started talking to Shirley,” Ian recalls.

“When we came home, [the neighbour] came in and saw my mum, and he said: ‘I can tell you now, you’ve lost your son’.”

“That was very quick, wasn’t it,” Shirley responds with a grin. “Very quick. Everything clicked.”

Ian remained an active sportsman, keeping fit with basketball, table tennis, archery, and swimming, all pursued competitively and at national championship level. He looks young for his years, wastes few words, and has refined a supple grasp on life’s ironies.

“There is a life after paraplegia,” he says. “I think people deal with it in their own skin. It depends on their outlook in life: whether it’s half full or half empty.

“But I reckon you’re alive, so you may as well bloody live it.”

Ian negotiates the famous fallen log at at Oakbank in South Australia on his way to winning the Von Doosa Steeple with Felpura in 1960.

'I was going okay, especially over the jumps. I was a pretty good rider. You could say the money till was open for me, but somebody slammed the door shut.'

Among his pastimes with Shirley has been the cultivating of orchids – at one time the couple had 90 of the spectacular plants under their care.

Both say that they are happy mainly to potter about at home, watch the racing and the football on TV (Shirley follows Essendon), and make a weekly excursion to share lunch out and have a spin on the pokies.

Last year they got to more race meetings than they had for a while, Ian having been named 2017 Ambassador for the National Jockeys Trust – a fund that helps injured riders.

One small slip

Ian traces his pressure sore to an uncomfortable transfer into his chair, which at the time had new tyres.

“I sort of got half over, and the new tyre gripped,” he remembers. “It wasn’t a good transfer, and I straddled it.”

About a week later, he noticed a tell-tale spot on his clothing. With Shirley’s help, he kept the wound clean and dressed.

At a visit to the Austin 12 months later for his two-yearly check-up, the sore was examined: “They just had a look at it and said it’s pretty clean, and keep off it as much as you can.”

A nurse from the Spinal Outreach Service followed up monthly with home visits, taking a photo each time and reiterating the message that Ian needed to rest the injury – an enjoinder that he believes he did his best to heed, in his circumstances.

“I’d get up and have my breakfast and do what running around had to be done,” he explains. “Take Shirl and do the shopping, or to an appointment, or in to the bank. And I’d get off it for about an hour before lunch. I’d get up then and have lunch. And then go straight back to bed. So I’d be off it about four to five hours through the day.”

As it turned out, the distressed tissue needed much more down time.

“Over about a four-week period, it went from a pretty runny sore to - Bang! It was this great hole in my bum,” Ian remembers. “It was a hole that just about went straight down to the bone.”

Shirley adds, the memory vivid: “Out of the blue, after all these dressings and all, it just blew up. That was it. He went to bed one night and the next morning: whoosh! Everywhere. It just burst open.”

'A pain in the bum'

At the Austin, Ian was given general anaesthesia so that surgeons could debride his wound, removing damaged tissue, and then fill and cover it, cutting and stitching into place a flap of muscle and skin.

Of his convalescence, he says, fully alive to the joke: “It was a pain in the bum.”

For 10 days after the operation, he was constipated. A “super-dooper” enema resolved that problem, triggering diarrhoea that persisted for 12 days. Nurses cleaned up his sheets periodically.

Over these first three weeks, Ian lay exclusively on his left side. That side developed red spots. And so for the next 10 weeks he lay exclusively on his right.

After that, he could try out his back, initially for only 10 minutes. And his bottom, 10 minutes at a time. Extending his use of the damaged areas took a further month.

'There is a life after paraplegia. I think people deal with it in their own skin. It depends on their outlook in life: whether it’s half full or half empty.'

At work in 1965, repairing racing equipment.

'Over about a four-week period, it went from a pretty runny sore to - Bang! It was this great hole in my bum.'

Ian was in hospital and rehab for 17 weeks: 13 June to 10 October. Shirley survived on her own, also surviving short trips in her car. On Sundays, her children drove her across town to visit Ian. She cancelled her cataract surgery.

“He was very down, very down actually,” Shirley reports of Ian’s first weeks in hospital. “In the first month he was there, they weren’t sure what was going to happen. Yes, I was worried.”

Ian knew that an untreated injury could be deadly. And that delaying treatment could have dire consequences short of death. Naz Erdem, Team Leader with AQA Spire, and a frequent visitor to the Austin and Royal Talbot, says he has met two people recently whose pressure injuries led to leg amputations.

“For a long time, these injuries don’t look that serious on the surface,” says Naz, who has a C6 spinal cord injury. “And of course you can’t feel them. But the serious damage is going on underneath.

“You think you’re managing it, but it can get really out of hand. The words ‘It’ll be right’ don’t apply here.

“No one likes spending weeks in bed, and putting pressure on loved ones, but the alternative may be months in bed.

“It is probably easier for me than for most people to keep that in mind. As part of my role I see so many people readmitted to hospital with pressure sores, and I also see how bad they can get.”

Home, sweet home

Ian is delighted to be back at his modest suburban house, with all his limbs. Receiving welcome-home visits from his children and grandchildren. Watching the racing with Shirl. It feels, he says, “Bloody fantastic!”

Have his two years of anxiety, risk and disruption brought him insight that others might learn from?

“Just take care of your body as best you can, basically,” he recommends, keenly aware of how compelling in human affairs are the needs of the moment.

“You know in your own mind what you should do. But then the reality is what you’ve got to do.

“I didn’t keep off it as much as I should have. That’s where I buggered it up.”

No one likes spending weeks in bed, and putting pressure on loved ones, but the alternative may be months in bed.

Early days. Ian began his career as an apprentice.

Author Ian Baker is a content writer for AQA. Spire is grateful to Ian and Shirley Duckling for their assistance in the preparation of this story, and for permission to use the accompanying images from their personal archive. Spire is grateful also for helpful comment on this article from Andrew Nunn, Medical Director, Victorian Spinal Cord Service, Austin Health.

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