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Saturday, 18 October 2014

A Fractured Existence Part Two: Surgeries, Sandwiches, Pill Popping and Homeward bound

The tale of the trauma, continued...

I think we left off with me awaiting an ambulance, or almost in one. Lovely paramedics Sebastian and Amanda came to transport me, catheter, ripped and (as yet) un-ripped clothing and all, to St George's hospital, Tooting. I will forever be indebted to these two noble professionals, for their kind words, Sebastian's Netflix recommendations, and last, but by no means least, the suggestion that, for the duration of the journey, I should be much more comfortable with unlimited use of gas and air. Recommended for all you pregnant women out there. That stuff is good.

Yeah baby. I talked even more than usual (apparently that is possible!) and as a result of said recommendations have now watched the whole of Whitechapel. (I pass on this recommendation - it's great - history, forensics, heart ache and corruption. Just like Jane Austen ...maybe...without the forensics.)

Even if you don't fancy Rupert Penry-Jones it's still REALLY GOOD.

Now then, a note to ambulance designers and engineers. You are not making fort lift trucks here. The jolt at the top when the ramp stopped was agonising in the extreme, and the one at the bottom was pretty excruciating too, so please - please - consider a gentler approach for spinal patients like me. Just because, well, I suppose, I have this vague notion that the purpose of an ambulance is not to make current injuries worse. But, you know, totally your call.

On arrival at hospital I suddenly had a bird's eye view of the set of Grey's Anatomy ER, Casualty and all those other shows: ten or twelve medics - ER doctors, surgeons, nurses of varying levels of authority. Neck brace, head blocks, More cannulae. More groin interest (oh yeah, they were just as interested in that here too. Freaks). Aside from the heroic and dedicated interest in my wellbeing, though, here's something about this level of activity that happens in the NHS. This is an organisation where everyone is overworked, underpaid, and consistently operating in an environment that's understaffed and unhappy.

Such a sexy look. Why don't I go out like this more often?

This can mean that, unfortunately, where the patient in concerned, things tend to be missed - mis-communicated or not communicated. Here's on: I tried my best to participate in helping with the information about my case. I was sent for an X-ray I didn't need because the CT (another CT because the one from Kingston hadn't been sent over) hadn't shown my elbow adequately. I told them this but was told I was wrong. We went there. The x-ray nurse said, "You don't need this it's on the CT."
"Yes," I said, I know. Back we went.

On the plus side I had a change of ceiling. On the down side, whoever designed hospitals put WAY too many bumps in the floor. And no one could decide whether I was nil by mouth or not. Wet sponges only take you so far.

Mine were pink. I was in too much pain to make feminist statements at the time. Sigh.

The second CT confirmed the nasty fracture in my thoracic (12) vertebra. I needed spinal fusion surgery to my thoracic region to move the vertebra away from my spinal column, to where it was dangerously close, to secure it in place with screws and glue. I hope they don't use Uhu, I thought, that stuff never worked that well. Other options were lying on my back for the next six weeks or wearing a back brace. Since both also carried the same risks as the surgery but with an added dose of extra pain and little mobility, I opted for surgery.

Illustrating where and what I was to have done. Not my x-rays. However an example of my later-in-life tango with piercing fetishism, albeit internal. 

I spent the night in A&E on a stretcher since no beds were available on any wards. I did offer to take a place on the children's ward, but I guess the criminal records bureau check would have taken too long. Ha. I thank Maddie, a brilliant therapist from The Priory (you know - celebrity haunt for rehab - that was where I hung out for my depression hospitalisation, but no celeb sightings sadly) for teaching me deep breathing. At this point my pain was unbearable and I had synchronised breathing with pain-expressing sighs. It really, really hurt.

There's not much to say about the following day. I continued to breathe and sigh with pain, and continued to have morphine that didn't come close to reducing the pain. And finally the operation after another wait in the recovery room, which seemed so ironic - they were still waiting to take me into the anaesthesia room and instead of being there I was with everyone for whom it was all over. Thank you nurses and doctors for your patience where the woman in the bed is actually moaning.

Finally, I had the operation. I managed to tell my wonderful anaesthetist to try not to make me throw up post-op, and that I was really vain so to take care with the scar. And then I was out for the count.

Wires. Lots of them. There were more than this apparently, but I thought I would post this super-attractive selfie to illustrate.

I didn't wake up in recovery, as the anaesthetist really had done a stellar job on putting me out; I jerked awake in the dark, dazed and began to notice all the wires and tubes everywhere, including one down my throat.
"Hello Jessica, you're alright, we've just got a tube down your throat so don't try to breathe yourself."
"..."Am I okay? How did the operation go? [No sound is coming out, why is no sound coming out?]
"Everything's okay, just try to relax, the breathing tube is breathing for you."
"..." Oh right, but can you tell me about the operation? [Why can't I talk? Have I lost my voice forever? What's going on? I want to talk!]
"She's panicking, let's take the tube out."
"..." Get this thing out of me, wait, ow! That hurts. Maybe don't do that. Damn it, I want to talk! "Sorry, I was just panicking because I couldn't talk,"
Yep, never mind the back injury, I just want to be able to gas on endlessly. Plus ├ža change.

I learned I was in intensive care. But it had gone well and Mr. "McDreamy" Laban had obviously listened when I had pleaded vanity.

A pretty neat job. (The other holes were for fluid drains by the way.)

Mat had just gone home, as the operation had taken over five hours and it was nearly midnight. But not after a quick chat with my very own McDreamy, Mr. Laban, They covered the basics: operation was a success - good.

  1. I lost six pints (3/4 of the blood in my body) during the operation so things had been a bit hairy - not so good.
  2. I was nearly paralysed - pretty bloody not good at all.
  3. And then they got on to more important things, and had a conversation about Leibniz. (Update - I spoke to my surgeon last week and while we did discuss my back he also asked after Mat. I promised to try to bring him to my follow up appointment so they could continue their discussion on 17th century philosophers. Bromance made in heaven apparently.)

What? I need spinal fusion surgery? You go right ahead. Swoon.

Life in ICU was made much easier by the fact that I had now had the operation. Despite the gruelling five hour procedure, pain levels were now just about breathable, and I also had a magic button delivering morphine every five minutes as desired. And I did desire it. Oh morphine, how did I love you, let me count the ways...

Button of bliss.

The only downside of morphine is the rather unpleasant side effect. I'm not going to go into too much detail here, as it's not the most pleasant of topics. Suffice to say that suppositories were eventually involved, for all the good they did. The only point of note in relation to this topic is that even ICU staff gets tired and forgetful: I was put on a bed pan at 5 am and told to wait it out. I waited. And then I dozed off. Somewhere in this time I think the shift workers changed and at 11 am I finally woke up and asked for help because by that stage in addition to my scars, cannulae etc. I also had an attractive mottled cardboard imprint on both buttocks. Thanks - NHS - another freebie. I'll be showing it to all my chums. Bedpans. Really, really, not a fan.

I took my first steps in four days in the ICU, using muscles that had clearly been sleeping for most of my life, judging by their virulent objections to my wanting to get out of bed. Once I was 'mobile', though, happily this indicated the true success of the op and I could be moved to a normal ward - when a bed was available.

I was an impatient inpatient, but I did try to keep calm

The next week passed in a blur of pain relief and gradually increased mobility, while I waited for my elbow operation, I waited longer, because, in addition to the nearly dying / blood loss aspects covered above, I also contracted pneumonia during my operation so had to wait longer and take even more drugs. (At this point I'm a walking pharmacy. If you'd listened closely you would have heard me rattling walking down the corridors.) I had a near brush with surgery on a Wednesday afternoon, but the anaesthetist turned me down because of the risk of death from having pneumonia (fair play - death wasn't really the objective of the operation). I was told that I had to wait till Monday because the only surgeon available the next few days specialised in feet and ankles. I thought about it, but then realised that having a foot joint in my elbow might limit my sartorial selections, so I decided to
wait it out.

Pill popping to the max

What else did I learn in hospital?

  1. London hospital food is not that great. I liked the Rice Krispies, but that was about it. Nottingham does it better (or at least they used to).
  2. You can be moved wards with no notice if they need the bed. I was moved 3 times. By the end I basically didn't know (or really care) where I was. 4am,'s moving time Jessica.
  3. Whatever they tell you, having anti-coagulant shots in your stomach is not less painful when you get the terrible bruises that sting for weeks afterwards. I'm an arm-shot woman all the way.
  4. Thanks for the cannulae. At one point I had four. Fun times.
  5. St George's has a Marks and Spencer downstairs and after 4+ days of nil by mouth their sandwiches were really my saving grace
  6. It's not just for home. On my first night on Brodie ward after ICU I demonstrated my unique ability to snore like a brontosaurus and also talk absolute nonsense in my sleep. Luckily this was entertaining for the other patients and we all had a good laugh about it the next day.
  7. You can laugh - you have to laugh. My ward mates had - variously - brain haemorrhages, brain tumours, broken ankles where they'd tried to take their own lives, and more. But we were somehow in this together which made things easier. And we had all left our dignity at the door, all of us. So whatever we did, it really didn't matter. Keep calm and carry on.
  8. Don't use hospital razors. My left leg looked like something from a horror movie after I shaved it using one - just be hairy and go with it.
  9. Some wards do allow flowers; some don't.
  10. Nurses can spill your blood all over your bed when they mess up using your cannula. Don't expect an apology, even though the blood goes all over your own cushion, slippers and cardigan. 
  11. (Some) hospital nurses like to make up rules as they go along:
"I'm just going for a walk."
"You can't go now, we're doing a handover."
"The handover isn't for another 1 and a half hours. I'll be back by then."
"Tsk." [goes back to making up rules for patient she was with at the time].
If you need something, ask for it 45 minutes beforehand to have a chance at getting it: especially for people with incontinence this is vital if you want to avoid having your bedding changed because the nurse didn't get to you with the bed pan in time.

Thanks to everyone who sent me beautiful flowers, enjoyed on the wards that allowed them!

I finally had my arm surgery, by Mr. Trompeter - whom I'm mentioning by name because, well, with a name like that I could hardly not, and he was a super chap and another excellent surgeon. Thank you again, NHS, for laying out the red carpet for me. I had an olecranon fracture at the tip of my elbow, so they numbed my whole arm for this procedure.

McDreamy mark 2 - Trompeter - ortho surgeon extraordinaire. 
(I got this from his public LinkedIn profile. Pretty sure that's allowed, but will take down if not.)

When they do this, you have to have an ultrasound on your arm to ensure that the ENORMOUS needle doesn't nick an artery while going in. I got to watch the whole thing. Probably the closest I'll ever come to watching  a scan like an expectant mother. And I'm happy to report that there was no foetus in my upper arm. I'm sure we're all relieved to hear that. House wasn't available for a diagnosis so good job I kept things relatively simple.

Totally gratuitous shot of House. This is turning into a Dr. Crush blog...

The surgery was also a success. They wrapped my arm up very unattractively, though, like a mummy, as I only have to have the cast on for two weeks. Hard to accessorise. Hard to wear much over it. Ah well. The next day as the feeling gradually came back to my arm (and the not-missed-in-any-way-not-in-the-slightest pain came back) I was finally allowed to go home.

My mum arrived to help and Mat came over to collect me. He did a great job for my return home: he bought pork belly for dinner. Unfortunately he forgot to bring me any shoes, so I shuffled through the car park in white hotel slippers which weren't particularly designed for walking on wet tarmac...but heigh ho. Like I said, he still wins all the "absent-minded" and "clumsy" prizes in my book. Home. The journey through mending my broken body was complete, and the recovery could begin. More on that soon.

Now, please take care! I've tried to have all the accidents possible for this year, but please, please watch out. Particularly on the first two stairs, anywhere.

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