Post Op - the hospital saga

BEFORE

Doctors give you instructions for a reason and mostly you find, if you follow them, you will benefit from the best outcome possible for your situation. My doctor calls it team work.

Right from the pre-op prep, the cleaning out of your digestive system, following a strict diet down to your last drink, rough as it may be at the time, ensured that I was able to go into surgery with no delays.

Keeping yourself busy during the lead up helps - I did it by having the hall carpet pulled up and laminate flooring installed - a few days of negotiation with a couple of companies followed by a couple of days of physically moving furniture around. In hindsight, I probably would recommend a less taxing form of keeping yourself busy but my sense of achievement and ease of rest the night before my operation spoke volumes.

The morning of the operation, I had to give myself an antiseptic scrub with a special sponge, including my hair, excluding my eyes, ears and face. This is harder than it seems but I managed. It was a little eerie waiting before sunrise for the car to arrive (I had to be in the admissions centre by 6.30 am) but at the same time, as it was out of the ordinary, it felt like more of an occasion.

I had been to a pre-op clinic the week before, when they had taken blood for testing and been counselled for pre-op procedures so all I had to do was turn up and hand over my slip of paper. (I actually remembered this just after being seated in the waiting area so went back to the front desk - no harm done!)

After a little while, my name was called and I went over to one of the booths. This is where they check your details and tag you with the first of your patient bracelets. Having been through surgery twice before, I was familiar with the constant asking of my name and birth date and what procedure I was in for. Laborious as this may sound to the uninitiated, it is a comforting thing to have confirmed when you're the one being sliced open. At this point, they checked that my account was paid (which it was) and sent me back to the waiting room. I have to compliment the hospital on their efficiency - I have heard of patients being called in the morning then waiting around for hours (starved of food and liquid) until their operation in the afternoon, allowing their natural anxiety to build to quite unbearable levels. To the contrary, I was called again within half an hour of the last process.

With the good fortune to be a private patient, I was led into a single room and asked to remove all clothing and put on a rear fastening gown. I was also given a robe in case I needed the lavatory and a sample bottle to fill if I could.

Shortly after lying down in the bed, a nice young lady with a clipboard came and checked all my details, measured me for and applied embolism stockings and mentioned that James would take me up to pre-op. There was no appearance of urgency, in fact, we spent quite a bit of time talking to each other and she had to rush a few things towards the end as they were calling for me in theatre.

I was wheeled by James into an open ward where a variety of patients waited. Here a nurse checked my details and applied a red cap to cover my hair. By just after 8 am she had parked me in a medical bay outside the doors of the theatre. When asked if I was comfortable, I mentioned that I was feeling a little cold and was rewarded with a heated blanket which was heaven.

In quick succession, I met my anaesthetist (with whom I discussed various intolerances and my concern over nausea and to whom I mentioned that I always felt very cold on waking from anaesthesia. This provided me with the benefit of waking up with about 5 blankets instead of the normal single one and a high degree of comfort in comparison to previous experiences.) and my surgeon.

By 8.30 am I was being wheeled into the theatre and felt the prick of the needle providing a sedative. I'd been told that they would put me out to install the canula as my veins were small (nice touch guys!). The last thing I remember was being asked what I did for work. I don't remember finishing the sentence.

AFTER

The next thing I remember is waking up in a very dark room although it most likely only felt dark because I could hardly get my eyes open. A nurse was making me comfortable and I could hear family asking after me but all I wanted to do was sleep.

I remember being told about my personal pain medicator and how my bed worked. I don't remember being woken for the 2 hourly blood pressure, temperature and oxygen level checks but assume they must have happened. Next thing I knew, it was 6.00 am and time for the first post-op day to get under way.

I was "woken" for breakfast - an apple juice, jelly and clear broth combo that was designed to be digestible and to gently re-introduce food to my digestive system. (More on food later)

Breakfast was followed by a bed bath, hot damp towels laid against my naked body and wiped by two nurses. Although I was still in a bit of a fog, I remember hearing one of them say "Dr C just loves bethadine, doesn't she?". I can just imagine that I must have looked like I'd been dunked in a vat of it. I still find it amazing that they manage to change my bed sheets and my gown by having me only roll from my left to my right side and back the other way.

Once this was out of the way, my doctor came to see me. She advised me that everything went well, that she had not had to remove anything other than the minimum. She also looked at the morphine I had been prescribed for the evening of my operation and mentioned that they were going to remove it by lunchtime so I should use it as much as I could! In truth I hadn't needed it. I either seem to have a really high pain threshhold or perhaps other people are a little more restless than I am post-op requiring continuous medication to cushion the effect. I certainly wasn't in agony at any time and anticipated the discomfort I was feeling. That said, I couldn't help but give myself a booster every hour or so until they finally took it away from me!

In the days which followed, I came to the conclusion that as well as the general, a fair amount of local anaesthesia may also have been employed as the area immediately adjacent to the incision began to "thaw", in the same way that a shot at the dentist does, the feeling gradually came back. Unfortuntely by then I was no longer connected to the instant pump - fortunately, in spite of this, I didn't really need it - the pain was no worse than being nipped on the skin.

The only time I was glad to have it was when they removed the catheter. While not excrutiating, it was a bit of a shock to the system and not something I would choose to repeat.

After my various attachments had all been removed, it was time to get out of bed. I don't remember feeling overly anxious as I'd been mentally well-prepared for it by others' invaluable experiences. Once I'd done it the first time, with a little help, I was hauling myself out of bed every time I needed a bathroom visit. I understood that getting my system working normally was the first step to getting better.


FOOD

When one thinks of fine dining experiences, no one puts a hospital at the top of their list. An institution like this has to minimise risk and ensure nutrition to enable their infirm inmates to heal.

I do get this but after 2 days of breakfast, lunch and dinners, I was reminded of Jamie Oliver's Food Revolution programme where he documents his attempts at improving nutrition in the US town of Huntington. We meet the administrator of the school programme who tells him that his menu doesn't include enough vegetables so (unhealthy) french fries have to go back on that day's meal offering, an argument which illustrates the idiocy bureaucracy can result in.

My own example of this came down to my advising certain food intolerances which meant that entire food groups were eliminated from my choices - an intolerance of heated milk had me taken off all dairy products; an intolerance of fermented soy products had me taken off all gluten products, I was unable to eat eggs or nuts so that left me with ... very little.

After the first two tri-liquid meals, I was surprised to find when my dinner arrived at the end of the day that it was reduced to just two - jelly and apple juice, even less than I had been ingesting the rest of the day. A nurse took pity on me and offered me some toast which I readily accepted.

Once I was peeing as much as I was drinking (one of the measures for establishing your return to normalcy) I was happily given the freedom to choose what I wanted to eat but even this didn't go as smoothly as you might have thought. I duly ticked away at the menus but nothing that I ticked eventuated. Day 2 post op, for example, I ordered chicken and was delivered beef. I ordered the chicken again on the morning of Day 3 and was delivered fish. I began to wonder if someone in the kitchen thought they knew better than I what I should be eating. This is fair enough as my health is in their hands but then why give me the option?

The only reprieve I had was a surprise visit from a family friend who happened to work in catering at the hospital. I explained my dilemma and she offered to cook me a special meal (of which she is in charge for a select number of patients) which she did and it was terrific. This connection itself was not without its quirks however.

As I do not see her on a daily basis, I am still obediently filling in and having my menus collected just in case she is not in that day and my lack of menu leaves me without food altogether. My hope is that she will recognise my room number and amend my diet accordingly. On one occasion, having partaken of each of the protein options and finding it overcooked to my liking and unappetising, I decide to nominate only vegetables - a combination of steamed potato, broccoli and sweet corn with gravy. Part of me assumes rather smugly that they couldn't get this wrong, surely.

When I removed the cloche, I had to laugh (as much as this hurt me at the time) as they had presented me with just the steamed potatoes and the broccoli; of the corn and gravy there was no sign. For the life of me I could not figure it out but I ate the meal which turned out to be one of the best I had. Before my meal tray was cleared away, an officious woman (whom I discover afterwards is the hospital's dietician) brought another meal tray into my room and apologised that a portion of my meal was missing. She has brought me an entire other serving of the whole meal. I protest that I have eaten and am quite full but she insisted on leaving the tray anyway.

Before I can lift the cloche, I hear a short confrontation outside my room after which my friend arrives with a third meal tray! Quite simply, my friend, in the interests of looking after my health, had removed the corn and gravy from my original meal because she thought (incorrectly of the corn, correctly of the gravy) that it contained gluten and that I was coeliac. What she had brought me, apart from the steamed potato, broccoli, corn & gravy also contained a crepe which I had to gently advise that I couldn't eat because of my egg allergy. Although I didn't need it, I felt guilty about having been the reason for the wasted food so I ate at least one portion of corn and some gravy. In hindsight, given a hospital's penchant for plain and really really well cooked food, I probably could have eaten everything from the general menu with the exception of eggs and nuts. Lesson for next time.

1 STEP FORWARD, 2 STEPS BACK

My only real set-back was my lack of bowel motion by Day 3. I was starting to feel the symptoms of toxic waste. My body felt sluggish and I woke feeling groggy. Throughout the day, my stomach bloated to vast proportions and I passed enough gas to power a motor vehicle for a week but nothing came of it.

The doctor ordered a double dose of coloxal senna (a laxative) and a suppository (which I elected to apply myself. The nurse wass pleasantly surprised as she had two others she had to administer.) When it finally happens, it was like water gushing back through a pipe that has been temporarily shut down - but what a relief!

With everything getting back to normal, I am regularly getting out of bed for a 5-10 minute walk around my room, I can look forward to going home.