My Operation
Wednesday
24 July 2002
After saying goodbye to Teresa, Helen and Jay, I went for
my X-ray and ECG tests, waited for the results and took them back to the
ward. The bed still not being ready, I
waited in a small visitors room, simply equipped with a few chairs and a fish
tank. One other patient was there. He had already had a bypass operation, but
had a problem with his chest wound, and was to be operated on again.
The registrar called to explain the operation and to get
me to sign the consent form. Much was
made of the fact that, as I was an ‘active smoker’, the risk would be increased
and the recovery painful. The
anaesthetist and the third member of the surgical team also discussed the operation,
and I filled in questionnaires covering medical history, symptoms and
life-style. They would be making up to
five grafts to the coronary arteries, taking veins to do them from the left leg
and possibly left forearm. Later in the
day, blood and urine samples were taken.
A former patient detailed at length the recovery
procedure, involving complex moves to boil cups of water rather than lift a
full kettle. I felt I would never
manage such restraint.
Finally, my bed was ready and I went through to the
ward. On my left, also due for the same
operation the following day, someone else from Cheltenham. On my right, a man from Portishead (but
originally from Stourport) who was waiting for the operation: he had been brought in with chest pains and
been under observation for four weeks without yet having a date. A fourth bed across the corridor
accommodated an Irishman, also living in Cheltenham.
A week or two before
going into hospital, Teresa and I had spotted a rather good quality second hand
jacket in a charity shop, and I bought it to replace an old jacket which had
got steadily shabbier and smaller as the years went by. I wore my latest acquisition to go to
Bristol. I felt it had looked quite
smart, but wasn’t so sure when I took it off, only to see the label still
dangling ‘Sue Ryder £6.50’. (I
surreptitiously cut it off.)
I unpacked little.
My operation was due the following morning, and the holdall with all my
belongings would be taken to the locker room; only my toilet bag would accompany
me to the theatre.
Supper came – roast beef - and quite tasty it was. After supper, a nurse told us as a group
what would be happening the next day. I
don’t think any of us had realised until then quite what we were in for. We all declined to see in advance the
intensive care unit (ICU), which would be our first port of call after the
operation. Apparently, some patients
find it alarming to come round and find themselves attached to the full range
of life-support systems, though she emphasised that it was routine procedure
for the operation.
Surgical gowns were issued, and, before bed, we were
required to shower and wash hair in a pungent red antiseptic soapy
solution. There was a late night cup of
tea before ‘lights out’ at 11 pm.
I didn’t have much sleep. At one stage, I awoke thinking it had all been a dream, as I
seemed to see my own bedroom around me, before the shape of the hospital ward
took its place. I began to feel anxious
and worried, being more and more doubtful that flesh and blood would survive
what was in store.
Thursday
25 July 2002
Early toast and tea at 5.15 am, then fasting until the
expected time of the operation, about 1 pm.
It was a long morning. I did get
a newspaper, and, for the second time, I had to have an antiseptic shower and
hair wash, followed by shaving the hair off all body parts which might come
under the surgeon’s knife – left leg, chest and left forearm.
At about 11 am I lay down to await the call for
theatre. A tense, anxious time. A pre-op tranquilliser was to be
administered, but only when the theatre had confirmed they would go ahead. Time passed. I was assured the medication was ‘on-call’, but at 1 pm it seemed
unlikely the surgeons would start a 3 – 4 hour operation. At 1.30 pm the senior nurse opened the
curtains and confirmed I would not be operated on that day.
I suppose with relief, I
put on my normal clothes. Though late,
a lunch was produced, with, as a special favour, my own salt and pepper pots,
which I kept until my operation. I was
told that the reason for the delay was the lack of a bed in ICU and that the
operation had been rescheduled for Monday 29 July. My first thought was to go home for the weekend, but the ward clerk
said she could not guarantee my bed would still be available. My friend from Portishead, who had contacts
in the medical world, told me to stay put at all costs – if I lost the slot
now, I could end up at the bottom of the waiting list again. Going home was also, on reflexion, not such
an easy option: I had little money with
me, and carrying my heavy bag unassisted could be risky. I realised I had no choice: I had to stay put for another three days.
Friday 26 – Sunday 28 July 2002
A strange period: with one exception, all patients in my
particular part of the ward were pre-op, ie not actually ill, so we were not
being nursed at all, but, on the contrary, quite capable of looking after
ourselves. I made a point a walking
round the corridor regularly to take exercise.
Small events became highlights of the day – breakfast, buying a
newspaper, lunch and supper, phoning home.
I read through two books Helen had bought me, which I’d only skimmed
before, and saved the crossword for the evening. The food continued to taste good and the menu was quite varied –
beef in red wine sauce, roast chicken, cod in basil and tomato sauce, roast
turkey, tuna salad.
I had a strange but
strong sense of déja-vu: the beds, the
toilets, the smells, the routine – had I done it all before? I started to sleep a little better.
The adjoining beds
regularly changed hands, as new patients arrived, were prepared and went to
theatre the following day. One was
another man from Cheltenham, whom I had known vaguely at work. My friend from Portishead and I became quite
familiar with the pre-op briefing we could hear each receiving. The room, unlike other rooms in the ward,
was open plan: a corridor ran through
it, there was a bathroom and toilet ‘en-suite’, and a table used by the
physiotherapists as their office. The
corridor led to the High Dependency Unit (HDU), the second port of call post-op
after ICU. From the HDU, patients would
emerge a couple of days after their operation to reclaim a bed in the
ward: some we recognised from their
pre-op day, and we gave them a little cheer.
On Saturday I delved a
bit further into my holdall and found a lovely card from Juliet, which she had
made and put there for me to find when I unpacked. In the evening, Teresa phoned to say that Nana had passed
away. In the circumstances, I could
only advise that nursing home should be asked to make the funeral arrangements
locally.
On the Sunday evening,
doctors and nurses recapped the procedure for the following day and I again went
into the antiseptic shower, hair wash and shave routine, this time to be
repeated early in the morning as I was due to go early to theatre – about 8
am. I passed on my personal salt and
pepper to the man from Portishead.
I was having a peaceful
night’s sleep, when, in the middle of the night, sirens sounded throughout the
hospital: it was the fire alarm. We all arose to see what was going on. Our ward being at the front of the building,
we were able to crane out of the windows to see four fire appliances arrive at
the main entrance … and wait … and wait … and wait. It was obviously going to be a false alarm, but how much would it
disrupt the hospital routine? Would my
op be cancelled for the second time? In
our attempts to see out the windows, we inadvertently pushed one of the patient
panic buttons, and half-a-dozen nurses arrived at a gallop to find the
distressed or incinerated patient.
Eventually, the sirens stopped and I resumed my fitful slumber.
Monday
29 July 2002
The operation wasn’t
cancelled. I showered early and put on
the surgical gown. No breakfast but
soon the pre-medication was issued and a porter arrived to wheel me down to theatre. I lay in an ante-room where the anaesthetist
took over. I could see the operating
theatre through a slightly open door ahead.
‘You may think this isn’t having much effect …’ said a voice, and that’s
the last I remembered for 24 hours.
Tuesday
30 July 2002
After the operation,
patients usually come round for the first time about 9 hours later, but are
encouraged to go straight back to sleep and do not recall it. Certainly my next memory must have been the
following morning. Strangely, it
occurred on two levels. Part of me knew
I was in hospital, recovering from surgery.
Indeed, the nurse told me his name and explained that he would be
looking after me. My body must have
been still numb from anaesthesia, but my mouth was swollen and dry, so
dry. I was given a drink of cool
water: it was like fine wine. The nurse asked if I would like to sit in my
chair: and I struggled into it and
drank again the cool draught.
But in my imagination, I
was sitting at the back of a large marquee, seeing, in the distance, bright
light, as one might looking out to where, for example, a cricket match might be
in progress. There was a hubbub of
people around, enjoying the event. I
seemed to be sitting there with my drink and a snack.
As the day progressed, I
became gradually more conscious, and the imagined version of events went
away. I didn’t actually see much of my
nurse, as he sat behind the bed head, presumably monitoring the life-support
systems until they were no longer necessary.
It must have been late afternoon or early evening when he said it was
time for me to be moved into the other ward.
I arrived in HDU feeling
pretty sorry for myself. By now
reasonably conscious, I was aware that I was still naked, attached to a
catheter and with most uncomfortable bowels.
The nurse found a pair of blue pyjama bottoms (not mine), which was all
I wore for the next two days. I had a
little soup for supper. Then a bed bath
with my little red flannel – how I hate wet flannels – after which I asked for
the commode, but it brought no relief.
I had a fitful night, watching the other recovering patients ranged
around, in various states of undress, propped up, or almost suspended, as it
seemed, over their beds, like panels from a painting by Hieronymous Bosch.
Wednesday
31 July 2002
Morning brought me
closer back to reality. I had breakfast
(though not the newspaper) and soon I was being wheeled through to the normal
recovery ward. My bed this time was in
a conventional part of the ward, a room with four beds, separated from the
corridor by a glazed wall. A television
in the ward was showing the Commonwealth Games. I was wearing an oxygen mask, smelling unpleasantly of plastic
and soon gurgling away constantly as the levels of saliva/condensation built
up. A physiotherapist explained how to
try and clear my air passages – coughing was enormously painful, but the
build-up of mucus was the penalty paid by smokers.
I managed to start
walking again, gingerly, and caught up with the man from Cheltenham, whose op
had gone ahead on the Thursday when mine was cancelled: he was doing well, and was expecting to be
discharged the following day (D + 5 after the op), and the other man from
Cheltenham was also fine, expecting to go out a day later. My friend from Portishead was scheduled for
an operation on Friday.
Thursday
1 August 2002
I slept little, and rose
early, twice for large bowel movements bringing much relief. I had breakfast and bought the newspaper
again. At last, my holdall reappeared,
and I was able to change into my own pyjamas.
Teresa and Jay visited
after lunch, though they had to wait until my leg wound had been re-dressed –
it was weeping slightly. Teresa said
later that I was still fairly groggy during the visit. I was still finding it quite an effort to
talk. They produced a sheaf of get well
cards before leaving for the journey back.
Late at night, an attack of diarrhoea.
Friday
2 August 2002
More diarrhoea early
morning, then visits to the X-ray and ECG units for tests, which turned out to
be satisfactory. Blood tests had also
proved satisfactory, so, in principle, if we’d had transport, I might have been
discharged on the Saturday (D + 5 after the operation). However, we had opted for hospital
transport, and a car was provisionally booked for Monday.
The physiotherapist
visited, and brought me a device to blow into to develop my lung
functions. I failed miserably to get
the little yellow marker to its appointed place, and trying too hard risked a
bout of extremely painful coughing.
During the day, I was
moved yet again, back to the ‘corridor’ ward I started off in, though to the
corner bed next to the one I had vacated five days before and the same bed used
by my friend from Portishead, whose operation had obviously gone ahead as
planned. He had left the personal salt
and pepper, but alas they were now exhausted.
The ward now was a
mixture of post-op and pre-op patients.
I chatted to a nice old gent from Bradford-on-Avon who was keen on
sport, and managed to get the television on for the news, but the nurses soon
said it was too loud and off it went.
Saturday
3 August 2002
A slight scare during
the doctors’ morning round: as well as
keeping an eye on the discharge from the leg wound, the surgeon mentioned my
‘high temperature’ – this would have been bad news, as it usually means an
infection – but fortunately one of the junior doctors obviously more familiar
with the actual figures whispered as he passed that my temperature was actually
OK.
Being the weekend, the
morning routine of breakfast, paper and pills ran very late. Eventually, I prepared to take my first
shower since the operation: I had to
move very slowly and gingerly: all the
dressings came off the chest and body wounds, which looked fine. The leg dressing would need replacing later.
A lot of phlegm to bring
up first thing, but no more problems with the diarrhoea: I’d mentioned it to the nurses, who said
they could only prescribe something if they had a sample. This immediately seemed to have the desired
effect. I also had a minor victory with
my blowing device, getting it easily beyond the mark I missed so badly the
previous day.
In contrast with the
period before the operation, I now had little appetite and found the food
unappealing: I decided the main reason
was the persistent smell of iodine, which had been on my chest and permeated
all my clothes. It lingered even after
I got back home. To make matters worse,
the lunch list had been lost in the kitchens, so everyone received a quite
arbitrary choice – chilli con carne in my case, which I never eat.
The sporting gentleman
was discharged, to be replaced by a post-op patient I had first met in an
earlier ward. He was having some minor
problems preventing his discharge, and was pretty grumpy as a result. He called for a fan to cool him down, and I
had to draw the curtain to shelter from the draught.
The evening nurse
worryingly asked about my ‘fever’: I
looked at the figures after he had gone, and could see nothing other than some
expected variations around a mean.
Sunday
4 August 2002
Breakfast and the Sunday
papers, but no doctors’ rounds, so all hopes for discharge would rest on their
morning round the following day. My
main concern was the erratic state of my bowels: almost certainly caused by the huge variety and quantity of drugs
which were being administered. I asked
about a pill for the journey – I didn’t want any accidents on the way home.
During the course of the
day, sundry tidying up in preparation for discharge – removal of stitches etc,
and of two long thin wires inserted through the chest into the heart as a
precaution in case the heart were to need electrical stimulation during the
operation or after. Further blood
samples and an ECG were taken, but the nurses seemed confident I would be out
the following day.
During the evening,
phone calls from Teresa reporting that Jay had started her orchestra course at
Beauchamp House without any problems.
We’d both been concerned that she would be difficult after recent
experiences at a master class and her violin exam. She was due to have a wet week under canvas.
Monday
5 August 2002
The registrar’s
round: a quick look at my records and
the chest wound. ‘And do you think you
would make better progress here or at home?’ he asked. ‘At home,’ I said. Then the words I had been waiting for ‘I think so too.’
The car wasn’t booked
until 12 noon. I had plenty of time to
pack and look at the paper as I waited.
Midway through the morning, my friend from Portishead emerged from HDU
and back to the recovery ward: welcome news
and I was glad to see him and congratulate him. Ironically, during the morning, the library trolley made its
rounds: I had been in theatre the
previous Monday, so never got see what gems it had to offer.
Bowels were not too
good, but I gritted my teeth: I wasn’t
going to risk my release now. I never
did get my pill for the journey, but fortunately things settled down of their
own accord.
The nurse took a final
set of BP and temperature readings, put a fresh dressing on the leg, and,
shortly after midday, I was wheeled out of the ward and down to the waiting
car. It took barely an hour for the
journey up the motorway and back to Toddington. Teresa and I stood weeping in the porch together like two big
softies … together again.