Wednesday, November 01, 2006

The First Operation – or Before I had the opportunity to write Scar Wars Episode I

I had forgotten to let anyone know - probably because I was quite knocked out by this first Operation.

So, slightly out of sequence with the rest of the blog here is a view of the first operation I had. This is a bit long but I suppose the whole thing is therapeutic for me to tell it as it was. Whilst a bit on the indulgent side, I hope that if you ever have to go through this you may take some small comfort in the following things:

  • Everyone is really scared of Operations - it isn't just you
  • You are allowed to be really frightened and to cry and to be cross with people who don't understand you
  • It is your body - only YOU know what you are feeling and what they are doing to you. Only you can tell the Doctors if you are in pain or if you don't understand something. You are not "in control" but you can ask questions and I believe you should demand answers (within reason)
  • Lose sleep - I did - but make it up when you get home
  • The Doctors tell you to do lots of things you don't understand but do follow their advice - the bit about drinking lots of fluids - do it - it really does help
  • This is not a "Punishment from God" or anything like it. The Doctors and Nurses actually want you to get well and you should do everything in your power to make yourself well, to recover quickly and get better
  • Don't overdo it. You cannot have major work like this done and think you are going to run a Marathon in 6 months IT WILL NOT HAPPEN.

Having given you the bullet points of the day. Here is the remaining missive. Not as long as War and Peace, not as interesting as Lord of the Rings but a little story of an ordinary bloke caught up in something that 4 weeks previously had not even been thought of. I had a new job - the job I had dreamt about for most of my working life. I had just got my feet under the table and this happened.......

Now read on.

Four (two working) days after the Flexible Cystoscopy I arrived on one of the hottest days of the year at the Admissions Lounge of the Hospital. I had not had any pre assessment and no X-Ray because of the preparation time that would have taken.

I had nothing to eat or drink after 5:30 a.m. and as I’d been awake all night it meant that I could easily ensure that I had my last food and drink for that day. Grapefruit segments and a coffee were my meagre breakfast in the early light of the 25th July 2006.

To say I was nervous was an understatement. There were lots of people in there, the on duty nurse could have done with a brain transplant as she was as much use as a a chocolate teapot. she didn't know who was up next and didn't know a lot at all really. People were nattering nervously (I tend to go very very quiet in my nervousness) those around me were chattering incessantly about nothing at all and the TV was busy playing daytime re runs of some cash in the attic crap or some such stuff - very annoying. My wife (bless her) came with me and I put on my CD player and listened to lots of classical music to try and calm down. One by one everyone left and I was still there 4 hours later. They let me have a mouth wash which was great and at 4 ½ hours after first arriving I was finally admitted.

The flurry of activity when I got on the ward was amazing. They had to take a blood sample (probably the one thing I hate most in all the world is needles). Having got that out of the way then it was on to weighing, measuring height and all that, getting into the Operating Gown and answering about 20 pages of questions. Then the Anaesthetist came we went over the questions and then an assistant Doctor who ran me through the procedure and what to expect.

Things had changed in the 30 years since I had last been in a Hospital and probably for the better. To calm down I kept trying to listen to music but would be interrupted quite a bit. They measured me up for DVT Stockings – I put those on and I was down to Theatre I suppose 1 ½ hours after getting onto the ward. As I said it was a very hot day, probably the hottest of the Summer and it was a relief to get into the air conditioned Theatre complex – the Wards being naturally ventilated (yea right!).

Theatre is probably the most frightening bit of the whole event. You are there on a trolley, you’d love to run away but you are surrounded by porters and Doctors. You get wheeled around watching the lights on the ceiling like some sort of ER movie. Then you go into the Prep room and you think stupid thoughts – the one I think is “Will I ever wake up or is this it” – I find that it isn’t a particularly reassuring thought but sort of reflects my thinking at that particular moment. I think you get to settling stuff with yourself and then, just as you do, you realise that actually, you don't have enough time to resolve all the things you'd like to correct in your life, to right the wrongs, to change the world and all that. Perhaps we are not meant to. Mmm - this appears to be going off at some deep and meaningful tangent so I'll stop that thought direction for now and get on with the story.

I met with the anaesthetist and the Theatre helper and then my Surgeon. They then put on some heart monitoring sticky pads and blood pressure sleeve (which ended up leaving a trail of scratches down my arm). Then it was time for inserting the cannula or canula into your wrist. Now this is the bit where you are allowed to swear but this one was better than the second or x-ray ones. It stings I suppose. I’m sure they inserted a blunt one on the second Op. So swear away and really put some venom into it - they expect it and they know far more swear words than you do so let rip!

Then there are some drugs that go in and then a cold sensation and that is it “good night Vienna”. They say you have really pleasant dreams. I don't remember anything at all certainly nothing nice. Perhaps you have to be receptive to that sort of thing?

You wake in Recovery and I was absolutely desperate on waking to go to the toilet. The Nurse told me I had a catheter in. I wasn’t convinced I HAD to go; so a shot of some sort of pain killer and the sensation passed – thank goodness it felt like I was going to burst.

At this point always ask for something to drink. You get the best tasting water in the world. Your throat may hurt as you have had a device in there during your operation. Also you haven’t had a drink for hours. Sip it slowly though - it is nectar.

After a while and I couldn’t tell you how long, you get transferred back to the ward. You then notice you have all sorts of bags hanging from your bed on poles. I had a saline drip to keep me hydrated I believe and two thumping great big saline bags which were washing out my bladder. I couldn’t see what arrangement was there but the catheter had feeds from these two bags and another collection bag attached to the bedside.

Now all was well, I felt wide awake, was chatting to my wife who had been working locally. That was fine – they had saved a sandwich for me and they made me a coffee. I was just starting to eat my sandwich and had a few bites out when they started messing around with my catheter as it wasn’t draining so they do a little trick with a sort of backwash to clear it. I said that I felt dizzy and then I said I feel feint.

When I came too – yes I passed out! I had managed to knock the coffee over the nurse who was messing about with the catheter (serves her right – fancy just diving in there and doing that whilst I was trying to eat – you get no privacy or dignity sometimes). I was jiggling around on the bed and it felt like I had cramped my legs but apparently that was because I had gone quite stiff on coming out of the feint.

The nurse reckoned that this feint was something to do with eating on an empty stomach or some such stuff. Anyway, it gave everyone in the room a shake up and wake up call. After that, I didn’t have too much to worry about but they did transfer me to another ward which was a specialist Urology one.

I’m going to say that I didn’t get any sleep that night but I think I probably did. However the 5 am blood pressure and temperature taking was a bit of a shock. Later that morning they took away the saline drip. During the night I had probably gone through 4 more large saline bags that were washing out my bladder. So they stopped all of those and removed the bags. I was transferred to a leg bag from a bedside one and moved out of bed to a nearby chair. The evening before my wife had brought in an electric fan as it was so hot and I set myself up with a fan, my music and a book.

I had a wash and changed into some hospital pyjamas. I felt a lot more comfortable. At this time, unbeknown to me, the heat, the chair and possibly the linen were about to give me a heat rash (or what I thought to be a heat rash).

The day passed very slowly and they checked the amount you drank against the amount you passed out with repetitive regularity and I didn’t feel much like doing anything. TV was an option but having to shell out money to watch TV when I would be going home the next day didn’t appeal. I managed to read half of the first Harry Potter book. In fact by the time I went back to work I had read all of the Harry Potter books and started on some history books too.

The Consultant’s do their round very early in the morning. They told me all had gone well, what they had seen and what they took away and I was to see them in a number of weeks after the X-Ray as they would have done the Pathology tests as well by then. If I behaved myself the catheter would come out in the morning and I could, if all things were functioning normally, go home. I was to rest, not bend, not lift and a whole list of things of do’s and don’ts were provided to me.

Again, I felt that that night I didn’t have much if any sleep. I had no idea what having a catheter out was going to be like (patience – I’m coming to that bit). So morning arrived and joy of joys, an injection – they gave a small shot of antibiotic to ensure there was no infection. The catheter is a complicated looking thing and I tried not too look but was sort of not in a position to do much to start with. They take a sample of urine to be checked. They then let the water out of the catheter – this has been pumped in to hold the thing in place. After that the damn thing is drawn slowly out and you have to cough a few times as it passes the sphincters but after that there is a slight pulling sensation like a vacuum I suppose and what can only be called a tear inducing feeling but not painful, just a weird sensation I suppose. The relief of having the damn thing out and being “free” of it are greater feelings than having the thing come out of your body so you feel a lot better immediately. At this point, I was also allowed to get rid of the DVT Stockings and to go for a shower.

Best shower in the world? Possibly. I remember standing in the shower for ages just letting the water run over me. It had been a really hot and sticky night. In fact I now remember having a thunderstorm that lit up the ward from about 3 in the morning – most impressive. Things are a little sore I remember and real care needed to be taken to wash all the crud and bits off. However you do feel so much better.

After I had had my shower I had to urinate into a jug so that the nurses can keep an eye on what has been drunk and what has been passed – this is to ensure that you are not retaining water. Anyway, thank goodness for Hospital pyjamas as there was some blood oozing out and I am afraid that you leak a little bit too.

A tip is to ensure you hold on a while before going as that way you don’t strain yourself trying to urinate. Second time I held back a while and found that helped and I got to go home earlier. This first time, I took ages to sort this out and they had to keep checking me with an ultrasound machine. After I calmed down a bit they finally released me in the mid afternoon. My wife came and got me. It was strange to walk all the way to the car park from the ward. John Wayne would have been proud of my walk! It took a while but we got there. I used the lifts instead of the stairs. We don’t live far from the Hospital and I was home in 5 or 10 minutes.

I remember looking at my wife and saying that I was feeling very tired and very weepy. I went in to the living room and bawled my eyes out for a few minutes and let out all the anxiety, shock, worry and everything else out. That was probably the release that was needed as I felt a lot better for that. I’ll write up the story of the recovery process in another blog entry.