Tim and I were admitted to St George’s Hospital, Tooting on Oct 15th at 10.00am. This timing, with a promise that we would be let out for a meal at 7.00pm on condition that we were back by 9.30pm, seemed slightly generous to me as I couldn’t see how we could spend an entire day doing admission. However, we had a very busy day of interviews, form-filling, tests and a few injections, all of which would never have allowed me to read a book for more than a few minutes. Even Kathy (his wife) and Jane (my wife) did not really have time to be bored, and they were included in the drinks provided. For the day there were no beds available (and they would have been pointless anyway) and we were given sole use of a day room (with TV) reserved, it seems, for precisely that purpose. Tim had a small issue to be resolved so although we went for a quick meal at 6.05pm, he had to be back by 7.00pm. Soon after we returned, Tim was allocated a bed but I had to wait for one (in a different bay, deliberately) until after Jane had left with Kathy, and so I did not sort myself out until almost 10pm (after watching England beat whoever it was in the last World Cup qualifier).
My schedule for the 16th was to have a shower and
shave as soon as I woke at about 6am, and then get dressed in surgical gown and
surgical stockings. These stockings were
knee-length and have a hole at the toes; this hole is really annoying as it
gets wrapped around your toes in uncomfortable ways, and needs constant
adjustment later – I got very good at asking anyone who came (regardless of their position) to sort them out for me. I was told
later that the hole has a purpose in the operation so that they can see your
toe-nails which are a useful indicator of your condition.
Thus before 7am I was sat there ready and waiting for something to
happen. Slowly people wandered past and did or said things. One was the nurse in charge of the night
shift who said that she was expecting the anaesthetist as he hadn’t done his
form (which she was clutching), and then she looked worried when I said that he
came yesterday and definitely filled in a long yellow form; later she returned and
said that she had found the completed form filed in the notes in the wrong
place! Tim and I had a nurse assigned to (just) us for our time in hospital,
and he arrived at 7.30 to check my preparations. Then he accompanied me as we walked to the
operating theatres at 8am after I had a quick goodbye with Tim, who would
follow later. St George’s overlap the two operations as much as they can in
order to minimise the time that the kidney is uninstalled, so his would not
start until they were almost ready to remove the kidney.
The same friendly anaesthetist met me in his room which is
between the two theatres. His West Indian assistant reminded me of a friend in
Bermondsey and called me “darling” in the same way that she does sometimes.
Then he put something into the cannula and the next thing I remember was waking
up in “Recovery” (which I keep on calling “Resuscitation” by mistake!), being
told to “wake up, it’s all fine” or similar. It turned out that it was about
2.15 and I had been there for about an hour; given that they spent a while
sorting me out (intubation, positioning, covering etc) in the theatre, I had
actually been operated on for 4 hours, which was longer than I expected. Within
30 minutes I was fairly conscious, in time to see Tim wheeled in beside me and
be told that it had all gone fine for him as well. Looking across I could see
two large bags of fluid – one was largely blood and the other was definitely
urine, so I thought to myself “well, it’s working, so that’s all right”. I
think Tim actually came round enough for me to catch his attention before I was
away down to the Renal Ward at around 4pm (after a delay getting a porter). Once
installed in Bed 5, before I could take stock of my surroundings, there was a
relieved Jane, having ignored instructions and been hanging around the hospital
since 1030am!
Now, I knew it was inevitable that there would be a number
of things attached to me: there was a catheter, a wound drain, an oxygen pipe
under my nose and the supply from the “Patient Controlled Analgesia”
(PCA). I also wanted to have available
to me the call button on its lead, the control to use the PCA and the control
to do things with the clever bed. I now had two cannulas (“cannulae”?) on my
left hand, both of which tended to catch on the bedclothes. This adds up to a large number of things
draped on and around me, so it is hardly surprising that I felt uncomfortable,
especially remembering the stockings which were now making their presence known.
The PCA is a device which gives me a regulated amount of morphine and also
allows me to administer extra doses through the system at my command, but it is
set up so that you cannot overdose. I
was encouraged to use it generously before pain hit me, but truth be told the
side effects were probably worse than the pain that I was suffering.
Apart from some abdominal gas pain (mostly indigestion, I
think) and the same gases pressing on the main wound, I felt pretty good. I was also feeling hungry and so the sweet
young woman doing the meals found me a yoghurt but this was a mistake as eating
less than half of it gave me additional indigestion!
Jane left at about 8.30pm and I thought about getting some
sleep. However, there was sudden
activity and the occupants of the other beds in the bay were on the move; the
nurse in charge explained that they needed a ladies bay and that I would be moved
to Bed 1 which is a single room! Great excitement – I might be able to get some
darkness, peace and quiet. So my bed (with me), my table and cabinet, were
wheeled off, accompanied by other assorted items such as the PCA. Shortly after that, the surgeon looked in; she was on her way to do a transplant - somewhere a family was grieving, but someone on the transplant list had received "the call". She also popped in when she finished after midnight, which was sweet of her.
It is not really surprising that I had a poor night’s sleep, with regular interruptions for “OBS” (observations – blood pressure, temperature etc) and “MEDS” (medications, of which I have no real memory but I know that some were to counteract the side effects (e.g. nausea and constipation) caused by other things). It also did not help that once I was propped up, my bedside cabinet was now behind me and I could not stretch or reach, and then, once or twice, my jug of water was left out of my reach. I developed a tactic of asking whoever came in to do anything I needed regardless of their responsibility, so once it was a doctor who closed the blind and adjusted the stockings. Once, when I wanted to know the time, my watch fell off the table and I managed to lower my bed so that I could see it then shine the light on it. Somehow I forgot about the call button for this purpose!
It is not really surprising that I had a poor night’s sleep, with regular interruptions for “OBS” (observations – blood pressure, temperature etc) and “MEDS” (medications, of which I have no real memory but I know that some were to counteract the side effects (e.g. nausea and constipation) caused by other things). It also did not help that once I was propped up, my bedside cabinet was now behind me and I could not stretch or reach, and then, once or twice, my jug of water was left out of my reach. I developed a tactic of asking whoever came in to do anything I needed regardless of their responsibility, so once it was a doctor who closed the blind and adjusted the stockings. Once, when I wanted to know the time, my watch fell off the table and I managed to lower my bed so that I could see it then shine the light on it. Somehow I forgot about the call button for this purpose!
Following an operation, the night is there to be endured
rather than enjoyed, so the arrival of the Thursday morning activity was a real
joy. Unfortunately that started with a
visit by the duty registrar at 5.05am (I’m not kidding!); twenty minutes after
she left there were more OBS and twenty minutes later there were more MEDS, so
I had no sleep between 5 and 6 and that was really when I felt I might actually
have got to sleep. Drat.
Eventually there was the ward round. This is a semi-formal
visit by the entire team plus a number of hangers-on, so it was interesting to see
the surgeon plus at least three other doctors, plus three nurses and about four
students all try and fit in this small room.
The form is that one doctor (the 5 o’clock registrar above) introduces
me and my case, everything is considered (OBS, fluid input/output) and after
questions then they decide what to do with me. One question is always whether
you have had a bowel movement (Eh? I’ve eaten nothing since Tuesday evening and
my bowels are in shock – what do you think?). The decision was to release me
from all the connections except for the drain and changes were made to my MEDS –
from now on I was only on paracetamol for pain relief. The really impressive thing was that the doctors in turn rapidly say what they want and the nurse in
charge does not seem to write a thing down, but it all seemed to happen.
So, soon after, I was almost free (just that wretched drain
with the plastic bottle on the end). The
removal of the catheter means that you have to record your own fluid in/out (and
there is a lot going out, frequently!). Come lunchtime,
although I tried I could only face a steamed pudding dessert – no main
course. It was the same at dinner time.
Just after lunch someone arrived and announced, without
warning, that they were going to weigh me.
They didn’t seem to realise that I had not got out of bed since the
operation, so it was with some trepidation that I attempted this slowly. After
being weighed in a sort of special chair, I sat back on the edge of the bed
feeling none too good – that had all happened far too quickly for my liking.
However, I resumed my position on the bed and slowly things got better. A few minutes later the surgeon appeared and
asked if I had seen Tim yet? No, I had in mind that I should be waiting for the
physiotherapist. Forget that, get up and see him was the surgeon's instruction so, with the help of Jane
and the surgeon, I got to my feet and put on my dressing gown (and the drain bottle fitted in a pocket). This time it all felt much better and it was
good to go down the corridor and see Tim.
At the nurses’ station was the physiotherapist...
Tim was looking good and I only stayed a short while as some
of his family had arrived. Back in my own bed, some of my family arrived as
well. Then the surgeon, consultant and a couple of other doctors came to see me
(not doing a ward round, just a visit) - again, lots of people in the small room.
One of my visitors was another brother, Duncan, who is a GP and with whom I was to stay
when I left hospital; Jane cleverly introduced him to the surgeon and
consultant and I am sure that this had no small part to play in my early discharge. So it was already quite a hectic afternoon
when three of Tim’s young adult family came to see me – all beaming and smiling, so
happy to have seen their father looking so well, and I felt quite humbled as
they each, in their own way, thanked me for what I had done. Words were
actually unnecessary as their thanks were visible in their eyes and faces.
Later on, everyone left, including Jane, and then I was disturbed by another of
Tim’s sons who was not to be left out.
Fortunately his mother took him away fairly soon, as I just crumpled
with the emotion of it all. This was an aspect that I had not previously
considered at all – the gift was almost as much to these loving kids as it was
to their dad.
After all that it would be good to say that I had a
contented good night’s sleep, but I didn’t. I was all settled down comfortably when
the nurse came in with an “I’ve got bad news” look on her face. “I’m really sorry, Matthew,
you’ve got to be moved - we need this room for an infection control case.” “OK,
when?” “Well, right now actually.” There was a bed for me in a 4 man bay but
she reckoned I would have more chance of a good sleep in the dialysis room which
was empty, so there I went, on foot this time. I lay on my
bed with my earplugs in, thinking that I was free of pain, quite comfortable considering
and very tired – so apart from the gurgling machines, why couldn’t I get to sleep? The answer soon came, although I didn't realise it at the time. At about 10pm someone came to
do my meds and my temperature was up and my O2 level down; the next OBS were
done by the nurse (temperature 38.8!) and then, at midnight, the duty registrar took some blood.
They thought I might have a slight chest infection and needed an X-Ray, so at 2am I was wheeled
by a burly porter through an eerily deserted (and chilly) hospital to A&E where a bored duty radiographer
sat huddling under a blanket - at least she could now feel useful! Back to my
bed and at about 4am I was given a huge dose of antibiotic through the cannula.
By 7am my temperature was back to normal and I was back in
the proper bed in the bay, ready to face the ward round with confidence. The
surgeon popped her head in when she arrived - she had gone into the single room
and found that I had been moved, and said that she would be back soon on the
ward round. In fact it was quite some time before they came but I need not have
worried – the consultant said quite clearly that he thought that my recovery
would be faster in my (doctor) brother’s home than in the hospital and so it was agreed. All that was needed
was the removal of the cannula, the drain and my dressings, provision of a
large bag of medication and some instructions; these were all duly carried out
and, by 1pm, I was shuffling out of the entrance to the car park to be driven to Duncan's by Jane, a mere 48 hours
after the operation.
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