Wednesday, 15 July 2015

Surgery #2 - Day 1

Piece of piss

I rocked up at the hospital at 7am on Monday last week, and checked in to Ward 23a. This ward is closed on weekends, except for clinic on Saturday mornings, so every Monday morning is a fresh new start with a brand new batch of patients. (If I worked on this ward, that would please me very much.) I was shown to my bed, my home for the next few days, which was in the middle of the section of the ward in front of the nurses station. It had 6 beds - 3 along one wall and 3 along another. I spent 5 days on this ward in January so I felt right at home, and set about unpacking my bag, laying my things out - basically playing house in my little bay.

The surgeons, registrars and anaesthetists started to arrive and do their rounds. The first one I spotted was Dr Death - the Anaesthetist of Doom, my nemesis. I took a deep breath. I practised my lines in my head. "Aint no talk about morbidity gonna scare me this time, pal. I am a bad ass, hard as nails, fearless cancer surviving warrior. So take your scaremongering about the risk of death from general anaesthetic elsewhere, mister!" But Dr Death actually came nowhere near me. Instead I got a lovely anaesthetist who had no apparent obsession with morbidity. "You've had anaesthetic before. A long operation in January. No problems. Good! When did you last eat and drink? Do you get acid reflux? Any questions? No - great. See you later!" I don't remember his real name so his new nickname is Dr Cool, Anaesthetist of No Fear.

Once I'd been visited by the nurse to do my observations, the registrar to go through the consent and other forms, and my surgeon to draw all over me with a marker pen, I sat back in my chair and did some people watching.

I was genuinely not in the slightest bit anxious. But I was clearly the only calm one. The girl next to me ended up crying her eyes out behind her curtains. The woman opposite was nervously babbling away to anyone who walked by, telling them her life story. And the old woman in the corner was clenching her fists, snapping at her husband on the phone, and complaining about the crying girl every time a nurse came over. The crying girl could hear this, and it made her cry even more. I knew I was last on my surgeon's list for the day, which meant maybe 7 hours of waiting (with NIL by mouth!) so I got my gown on, climbed in to bed, and easily went to sleep. As I'd told my friends: this surgery was going to be a piece of piss.

A glass of wine on the beach

I think it was around 3pm when I was woken up and told it was time to go down to theatre. In the little room where you are given the general anaesthetic there was a bit of debate about where to shove the cannula in. It couldn't go in my right arm because that was the surgery side. I thought it couldn't go in my left arm because I've previously had lymph node clearance and there's a risk of lymphedema (aka Fat Swollen Arm or Hand For The Rest Of Your Life). But the anaesthetist didn't want to put it in my leg because of the risk of a DVT. My surgeon came in and had the deciding vote - left arm. He was confident it wouldn't lead to lymphedema. So in went the cannula and MY VEIN DID NOT COLLAPSE! Big up to my body for recovering so well from chemo over the last 6 months. That arm didn't even have locatable veins in January, let alone ones that would withstand a cannula. I lay back and did Dr Cool's counting down game. Imagine you're on a beach with a large glass of white wine, and count down ten things that are great about where you are. I managed to count down from ten to four, and then wondered aloud why I was not yet asleep, and that's the last thing I remember.

The final violation in the Recovery Room

First of all, for context, I just want to recap my recovery room experience after surgery in January. That was an 8 hour surgery where my surgeon removed all my breast tissue including nipple and areola, removed all of my lymph nodes, took muscle from my back, moved it round to the front, and along with an expander implant, used it to create a fake boob, then replaced the skin lost with a skin graft from my back, attaching that to blood vessels and stuff under my arm.  In January when I came round in the recovery room I felt fine. It was a bit sore, but I honestly felt fine. The nurses, and my surgeon, kept telling me to press the morphine button. "Don't try and be brave about pain." I wasn't. I just didn't need it.

This one was 3 hours surgery, tissue removed, expander implant put in, stitched back up. No node removal, no messing with my back, no skin grafts etc. Simple! Easy! It's why I was so calm and had been telling my friends it would be a piece of piss.

I was wrong.

This time, as I came round, the first thing I realised was how much horrendous pain I was in. Oh. My. God. I think I might have screamed. I know my body was writhing around all over the place, legs thrashing about. It hurt more than anything has ever hurt me before in my life. And then some. Now when I'm in hospital and asked how painful something is on a scale on 1-10 - that is my reference point for 10. It was excruciating. They gave me morphine, and more morphine. They gave me codeine, and tramadol. And more morphine. And despite the fact that this was the one part of my body which had remained unviolated throughout cancer treatment, I didn't hesitate for a second when they offered to shove some diclofenac up my arse.

The nurse that didn't belong on Ward 23a

The cocktail of painkillers started working and the pain subsided a lot, and after a while I was taken back to the Ward. The nurse who had been with me in recovery and who wheeled me back to my bay was so lovely and kind. Another one of those guardian angel nurses. She said goodbye and a nurse on the ward who I'd never seen before started doing my observations. Blood pressure, temperature, oxygen levels. She said she needed to find my paperwork and left. And then she didn't come back.

After I while I started to stress. Where had she gone? Where were the other nurses? I couldn't reach anything. I couldn't sit up. I heard that nurse's voice at the nurses station. Some of my friends were calling in to ask if I was back yet. I heard her tell them yes, and that she would pass the messages on (she never did). I realised the other nurses must be away doing the switching over from day shift to night shift. I tried to reach my phone but I couldn't. I looked for my buzzer. I didn't have one. I looked for the bed controls. They were out of my reach. I looked at my table - that too was out of reach, and there wasn't even any water on it anyway. I started to cry. I was weak, in pain, and stranded in the bed, unable to move or reach anything. The other patients around me were all fast asleep. The crying turned to sobbing, and the stupid nurse finally noticed and came to ask me what was wrong. I asked for her to pass me my phone which she did, and if I could have some water. She  said yes but again, didn't come back. I sent a few text messages to friends telling them I was alive but what was going on, and then couldn't help but start crying again. I assumed she must be one of the night nurses and that this was the way things were going to be. I cried myself to sleep!

I was woken up (probably very soon after) by a different nurse who needed to do my observations again. She asked me if I would like a cup of tea. Yes! I said, "I think I'm meant to have a buzzer". She showed me the buzzer that she'd put next to me. I looked around and realised she had made everything right. The bed sides were down, the buzzer and bed controller were next to my hand, the table was moved closer and a glass and jug of water within reach. She brought me tea, and was kind to me, and was lovely, and I fell back to sleep feeling safe and ok again. I never saw the horrible nurse again. Apparently when one of my friends called she had said she was a bank nurse so I assume she was just covering the time the others were switching shifts.

Toilet trauma

Each time she woke me to do observations, the lovely nurse offered me a cup of tea. Never say no to an offer of a cup of tea! So in the middle of the night, I needed a wee. I had no catheter this time round, dammit! I pressed my buzzer and the other lovely night nurse came over. Would I like her to bring me a bed pan? NO! As if having a diclofenac shoved up my bum wasn't enough embarrassment for one day! I said I wanted to try and walk to the toilet (the sooner you are up and moving after surgery the better, especially for reducing risk of blood clots). So she helped me to sit up, got bags for my drains, helped me get my slippers on, and helped me to stand up. I stood for a moment on the spot, then told her nope, not ready, I need to lie down again.

Ten minutes later I tried again and she walked me to the toilet, and told me to pull the orange cord when I was done so she could help me walk bad to bed. I sat for about 5 minutes, unable to wee, then started to go dizzy again. I pulled the orange cord, started to flop, and the nurse managed to get me sat on a commode, holding me up, while I dry heaved and retched in to a bowl. I was passing out but somehow she wheeled me back and got me into bed, where I fell asleep, still needing a wee, wondering what the fuck Dr Cool had spiked that anaesthetic with.

After another sleep I tried again, made it to and from the toilet without fainting but still couldn't actually pee! Stupid, messed up, lazy, shy bladder!


Finally, daylight arrived. It was Tuesday, and I was woken up by Helen, Chief Guardian Angel Nurse of Ward 23a from January, with the trolley of painkillers, and another of my favourite nurses Sian, Supplier of Snacks and Drinks, with a cup of tea.

And all was well again  in Bay 12 of Ward 23a!

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