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2007 - June 19th - Tuesday

OPERATION DAY

JH slept.  A Nurse came and spoke quietly to JH at 7.00am - or was it 7.30am – anyway, by the time JH went to the toilet at about 7.45am, the toilets were spotless. 


 

JH cleaned her teeth, and washed the ‘usual’ spots (anatomical not infective) using soap and water, or Andrex moistened toilet tissue (which she had spotted on the co-operative supermarket shelves, and purchased just for this occasion); there was ‘no go’, and no call to stool, with regards to the bowels (as to be expected having not experienced the normal gastro-colic reflex after eating breakfast). 


 

When the lady Registrar arrived, she remembered all the details of JH’s conversation about JH’s bowels: having ascertained that JH had not been given any suppositories - as JH did not ‘feel like’ having her bowels open so early (but perhaps JH should have thought of asking for them sooner, prior to going to Theatre at 8.30am, or more likely was too frightened to remember to do so) - the Registrar went to fetch a couple as there was still 20min to go; however she then returned without said suppositories, saying that the porters had arrived with a wheelchair in which to convey JH to the Theatre (so it was too late after all!) but that she would review JH’s bowel regime postoperatively.  JH was not given any premedication – as would have been customary prior to a major operation in her day – and so was quite capable of walking to the Theatre, but JH did have a very unflattering operation gown on, and somewhat posher TED stockings {compression stockings to help prevent deep venous thrombosis), and so sat regally in the wheelchair as instructed, and with her arms resting on a pillow on her lap.  As JH passed by on her regal way, Kathy met JH in the corridor and said that she would be following JH in about an hour or so: it was tacitly understood that we were both relieved that we had, at last, come to this!

In the Anaesthetic Room, JH climbed onto the operation table!  JH was spoken to by two Anaesthetists who gave succinct, patient-friendly explanations (most of which JH had already been told, or realised herself) of what JH should expect: at the outset, anaesthesia would be induced by injection (through JH’s venflon); during the operation, drugs would be given (intravenously, as a bolus injection and/or continuously infused, JH assumed) which would continue to subdue pain in the immediate postoperative period; a patient controlled analgesic drip, and a drip for fluid administration would be set up; a urinary catheter would be inserted; furthermore, JH would wake up with an oxygen mask on her face.  The Anaesthetist noted that JH had virtually no teeth at the top (JH having, of course, removed her denture); the Anaesthetist asked if any of JH’s remaining teeth were loose – to which the answer was ‘no’ but that it would not be a disaster if he knocked a tooth out; however, said Anaesthetist dryly intimated that knocking teeth out was not quite within his scheme of things!  The Nursing Staff – who would be looking after JH in Theatre - also introduced themselves to JH.  As the ‘knock-out’ shot was given, all these friendly faces disappeared from view, and JH ‘disappeared’ from her own view!

JH awoke Euphoric: the left side felt ‘number’ (ie more numb); whilst all limbs felt as if they were devoid of tone and didn’t belong to anybody – let alone JH; the mask was lifted up by a person who was speaking to JH; JH was taken back to the Ward in her own bed which was placed in ‘spot 22’.   The time was 12.15pm.  In the bright sunshine outside the window, where the leafy branches of a tree could be seen, were also the shadows cast by the open windows of the adjacent wing: these shadows - on the wall by each window - were shaped like the business-ends of scalpels.  

The Surgeon and the Registrar came: they continued the discourse on ‘expectations’;  at some point in the conversation, JH used the word ‘miracle’, but then wished she could think of a better word than that – because a ‘miracle’ could be construed as really being an accident which had just happened to have gone right!  Did Ralph call before? - having briefly popped in on Operation Day, which was really not allowed: – anyway, some-one - or two - said that Kathy had come back to the Ward at 1.30pm, and that the kidney, ie, Kathy’s Kidney had kicked-in immediately – as is the way with live(ly)-donated kidneys!  During the afternoon, JH was visited – not in any particular order,  and as far as she can recollect – by nurses recording observations; nurses emptying the urinary-drainage bag; nurses putting up another bag of saline for the drip; and the Pain Relief Gentleman whom JH regaled with her personal tales, such as ‘in my day there were no such things as patient-controlled analgesic drips (PCA)’; but no visitors of course on operation day!  JH was just explaining, to the P-RG, about her indecision as to what to have for supper, ie, expressing her apprehensions about eating anything at all, when she was offered an omelette and mash by the Supper Lady; Sister just happened to be passing, and suggested a soft diet.  Sister also undertook to pin a note on the tap of the sink by the side of JH’s bed, requesting that it be TURNED OFF tightly to preclude JH hearing a steady drip, drip . . ..

But – on sitting up to eat her supper - JH could have done without the pain . . . however, the Anaesthetist arrived – to endorse all the advice JH had already been given:- the pump attached to the PCA would only ‘allow’ infusion of a bolus at 5-minute intervals, so JH should ‘administrate’ some PCA in anticipation of needing to move about, rather than waiting until she experienced pain when moving.  JH noted that the pump bleeped a receipt of the knob - on a lead clutched in JH’s right hand - being pressed; after delivering the bolus intravenously, the pump played a rather musical dove-like note after which no doubt it went into roosting mode – until the next time.  JH had a yoghurt for sweet, and then retched up a load of wind, and some supper, which she had been determined to eat, even though the Anaesthetist had suggested giving the mound of mash ‘a miss’. And some of Kathy’s marshmallows, which JH had scrounged from a Nurse running between the two of us, were ‘wasted’ as well.  As an aside to the Anaesthetist, JH remarked that she was guilty of eating an omelette which had, apparently been ordered by a ‘rampant’ (as rather unkindly written by JH in her Diary at the time) lady – whom JH subsequently learned is called Grace - who berated the Supper Lady for no longer having an omelette on her trolley: this scenario ‘unfolded before everyone’s eyes’.  Oh dear!

At about 6.45pm, JH was visited by the Hospital Radio Man – asking JH if she would like a request to be played on the Hospital Radio before 8.00pm: JH explained that she had not paid for the use of the Patientline console but, apparently, Hospital Radio could be received free via the Patientline headphones; JH also said she was a bit ‘toffee-nosed’ about her choice of the music she listened to, but the HRM told JH that he played ‘allsorts’.  JH suggested ‘The Hippopotamus Song’ by Flanders and Swann, which the HRM had never heard of, so JH’s second suggestion was ‘When I’m 64’ by the Beatles!  However, when the HRM attempted to get JH ‘registered’ to listen to Hospital Radio, he was unable to do so, and said he would need to consult a colleague to overcome this fault.  [In any event, JH was by now 66; furthermore, JH had already decided that she would NOT be using Patientline Services – free or otherwise!]  JH did observe, and the HRM did remark about his tiredness: he had missed most of his sleep the previous night due to some family commitment, and then he got up at the crack of dawn - in order to get back to work today from the far reaches of Essex.  JH listened to The Archers on her walkman, to allay her withdrawal symptoms [due to missing The Archers].  Connection was not made with Hospital Radio.

The Registrar did her Round: she said to the Nurses that – as they knew that she wished donors to get up and sit in a chair on the evening of operation – that she was rather concerned that JH had not been out of bed: the Nurses explained that the Physiotherapists had not visited the Ward to assist JH.  JH observes that she is aware that Physiotherapists are in such short supply in the NHS that all patients – whether in- or out-patients – are not able to receive all the Physiotherapist’s help and treatment they require.  In any event, JH wore her anti-embolic TED stockings all the time she was reclining in bed as they were so comfortable, as was her modern electrically-controlled bed.  JH continued to gaze out of the window, and marvel - at her own presence watching the lengthening shadows and waving tree branches.  JH had intended to ask the German SHO to speak to Ann - in the latter’s now more familiar language - but a window of opportunity (as the saying goes) did not arise.  JH was of course told that Ann had phoned, and Su and Sharon (her attorneys with regards to her Living Will),; Ray Trevitt visited and said that he had phoned Sarah Stacey in Derriford Hospital.  Another Bedlam Night began: a lady who wished to go home seemed to be gripped in Tourette’s-type paroxysms of expletives and distresses, but she was obviously a ‘regular’ and settled down following kindliness being offered by the Nurses.  Kathy subsequently told JH that the lady was well known to her as well: we all have to have our own coping strategies.  At about midnight, during this warm June night, JH lowered her bed head, and slept well . . ..


 
 
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