Man falls from 12 metre pole, gets ground-breaking operation

By Jimmy Ellingham and Phil Pennington of RNZ

Still nursing horrific injuries after falling 12 metres at work, a follow-up call from a surgeon may have saved a Palmerston North man’s mobility.

Myles Dieming’s recovery from the late-October fall was hampered by severe blood clots that were not responding to treatment. He could barely walk.

But almost straight after a ground-breaking operation to remove the clots, he was back on his feet.

The 60-year-old’s ordeal began when he was at work the day of the Rugby World Cup final.

“I’m a telecommunications technician. I was working on a 12-metre monopole.,” he told RNZ.

“I really have no memory of what happened. Basically, I have a blank from there completely, until I woke up in the ICU.

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“Something went wrong. The subsequent investigations found one of the pole steps rotated but, obviously, I made a mistake as well.”

Dieming fell from the top of the pole onto a strip of grass, narrowly avoiding hard concrete.

He was choppered to Whanganui Hospital, then flown to Wellington on a life flight.

His flight from Whanganui took off just moments before the city’s airport closed for the evening.

This avoided a trip by road to Palmerston North, which Dieming may not have survived. Even on the flight it was touch and go.

“The injuries I sustained from the fall were 10 broken vertebrae, split liver, penetrated lung, broken sternum, and I had detached the main vein that goes from the lower part of the body up into the heart and tore that.

It was not certain Myles Dieming would survive after suffering horrific injuries in a fall.

“That bled out on the flight into the pericardium, which is the sack surrounding the heart.

“It compressed my heart and stopped it,” he said.

“I actually died on the flight. The flying doctor there did cardiac compressions and ruptured the pericardium, and the heart started again and they topped the blood up and I made it to Wellington.”

He was rushed to theatre, where a top cardiac surgeon repaired the vein into Dieming’s heart.

His heart stopped beating at one point during surgery, but he was kept alive by CPR.

For six days he was in a coma, and it wasn’t looking good - he was not responding when his reactions were tested.

“They thought I might have brain damage,” he said.

“I remember waking up and [seeing] ceiling tiles, and people talking to me.

“Fully [waking] was quite a humbling experience, meeting the specialists. Because I wasn’t supposed to survive they were all coming to see if it was actually true, I think.”

Transferred to Palmerston North, he spent six weeks in hospital before being sent home, but he remained in a spinal brace.

Dr Shueh Lim, lead interventional radiologist at Wellington Hospital. Photo / RNZ / Angus Dreaver

The usually active man, into running and tramping, was barely mobile.

He was diagnosed with blood clots, something Dieming thought were associated with inactivity or long-haul flights rather than trauma, and given blood-thinning and pain-relief medication.

But the clots weren’t going away.

Fortunately, Dieming told his cardiac surgeon about this in a routine follow-up phone call, and the surgeon consulted Shueh Lim, an interventional radiologist at Wellington Hospital.

Lim suggested Dieming get to Wellington right away for surgery - which, after considering the risks, he did.

“He explained outright where I would be in five to seven years had I not had this operation.

“I would probably lose my mobility entirely and I’d end up, later in life, getting bits chopped off that were getting gangrenous because of lack of blood flow.”

Dieming’s legs were swelling hugely, and scans showed he had clots from his kidneys to his knee.

Despite surgery usually happening a couple of weeks after the clots form, Lim was prepared to operate even though Dieming’s were more than six weeks old. That meant they’d hardened, increasing the risk in removing them.

Using an advanced medical device Lim delicately extracted them during a six-hour operation on December 23.

“The device has to expand so it can capture all the clots. I said to Myles when we do that there is potential risk that we could disrupt the recent repair and if that happens, although you’re in a hospital [and] we can salvage your situation, the chances of dying are pretty high,” Lim said.

“He is a pretty active person and he said he’d rather die than live with these symptoms.”

The operation showed how clots could now be treated successfully, Lim said.

“There is a misconception out there that clots should just be treated with oral anti-coagulants, which is a pill, and that pill will dissolve the clots.

“However, that’s not the case. It’s trying to raise the awareness, especially to GPs, that we can do more.”

Dieming was home on Christmas Eve, and he went on a 7km walk the next day.

That recovery has continued. Dieming is back at work at KiwiRail on full duties, thankful for the care he’s received through his ordeal, and especially from Lim.

“My procedure, being a first in New Zealand, has pushed the limits, but it’s proving what’s possible. It will help other people that are in a similar situation.”

Dieming’s back running now, too, but can only go for about 1km at a time.

To fully fix this would require another risky operation, one he was thinking about.

At the back of his mind was the goal to one day do a marathon with his daughters - unthinkable when he couldn’t walk down the road a few months ago.