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2007 - June 23rd - Saturday

POSTOPERATIVE DAY FOUR

This was a much calmer night: JH slept well in between getting up at +/-1.15am and 5.00am – after which she dozed calmly.  At 6.30am the opposite lady’s console switched on and quite pleasant music was heard; however, when JH drew back her curtains, the screen was in her view – facing outwards towards the ward – in other words the patient was not watching the screen but still tucked up in bed.  JH managed to obstruct her view of the unwatched screen by drawing her left-sided curtain more effectively.  JH ate her other currant bun (provided by either Lorraine or Ralph), and also some bran-flakes and had two cups of tea when the breakfast trolley came round.  JH was just putting anti-MRSA cream up her nose when the lady who was cleaning the bedside tables came round; JH picked up her empty vomit bowl, with one cup of tea balanced therein; the lady picked up the other cup; JH asked if she had drunk all its contents: the answer being ‘yes’ about a third of a cup of tea got thrown in the sink!  I suppose that this would be the average amount of tea left in the bottom of patients’ cups, as it is still a general habit to do so – even though practically everyone now uses teabags, and so there are no loose tea-leaves to dispose of.  Unfortunately, the top of the tube of cream got swept onto the floor, but JH managed to get up, bend down, and retrieve it.  Grace regaled everyone, from behind the curtains round her bed, with some personal information – although she was perhaps just ‘discussing’ details to do with her possible discharge with a member of the staff: Grace loudly declared that, on one occasion, she had been housed in residential accommodation where ‘they’ had ‘stolen her granny knickers’: she really could not understand why ‘they’ would want them?  Grace also apparently shared her reading material with Gertrude ‘next door’ to JH, (Grace was apparently well-known to Gertrude!) which sharing necessitated a loud appraisal of said reading material.


 

The day-duty-weekend Registrar did his round and JH ‘arrested’ him in his tracks: there was further discussion about JH’s pain, and bowel, management; further discussion took place about JH taking OxyNorm but, at that moment, JH’s pain was ‘manageable’ – she was of course already wearing a Fentanyl patch, and she refused paracetamol.  By the time the Nurse came round with ‘whatever’ might be required, lactulose and paracetamol had been ‘struck off’ JH’s prescription sheet.  JH went for a wash fairly early (by her standards) and felt distinctly woozy, so lay on her bed for a spell – during which time her blood pressure was taken; this must have been high, as JH was requested to stand up for the reading to be repeated and her B/P was then within the expected range of normal.  JH went to make phone calls from the Solitaire phone in the day room – into which a young man came to have bloods taken following receiving a cadaver kidney transplant last week (occupying No 11 bed presumably in a side room) from a 51-year old lady: when he was still a teenager, this gentleman had had a kidney transplant – the kidney having been donated by a relative which had lasted 21 years.

JH only had her ‘emergency’ £2 coin and so asked Lilian for change – as the Solitaire phone did not take £2 coins: JH phoned Sally Thomas and left a message on Sally’s CM; on phoning the Oxfam Shop in Tavistock the first time, JH got cut off, but a second try elicited the fact that Mary was not there, although JH had referred to the list which Mary had provided with regards to her whereabouts.  JH then phoned Jane Moss (who had not had time to read the note JH had left for her) in Derriford’s A&E Tea Bar.  Jane took JH’s news very ‘calmly’ – in other words she did not fall about in amazement and become all gushy other than to say that JH was ‘a very brave lady’ (several times).  Jane is the definitive volunteer for wheedling out gossip and expounding her opinions about said gossip, and so JH had ‘hedged round’ Jane’s questions beforehand with regards to where JH was ‘going away’ to!  So JH quite believed that Jane had not read the note, and was really just being her usual friendly self; and of course, Jane was the very person to ask to pass on the information to the WRVS Officers, and to Tony (Parking Man) that JH was fine (as ‘fine’ is such a bland word, no qualifications are needed here).  Jane then excused herself to attend to her queue of customers.  JH phoned Elizabeth Pearce, in Maidenhead, and had a long chat: Ann had already phoned Elizabeth – which lead to JH expressing her sadness about JH’s relationship with her elder sister; Elizabeth simply said ‘. . . we are so different . . .’. 

JH went to the wash room (ie the hand basins outside the toilets) and washed as ‘much as possible’ – bending, stretching, hovering (on one leg with one or other hand on edge of sink), etc, etc.  When the short black lady wearing her bath-hat {which seemed to be a permanent fixture} met JH in the washroom, this lady ‘blessed’ JH for giving Kathy a kidney: it was quite apparent that all the ‘evangelical’ ladies joined in the Ward’s ‘Neighbourhood Support Scheme’ which necessitated thanking all the donors of kidneys with unabashed friendliness – it would have been churlish of JH to be irritated by this open-hearted disinterested blessing.  Just then, Kathy came into the washroom, and endorsed this lady’s blessing!  Out of the toilet windows (through the statutory 4” gap) was to be seen a building which looked more like a plant room than anything else – but the walls were covered in paintings of sea creatures, so no hippos of course!  A nurse called JH back to her bed, and her dressing was changed again.  Grace was at the front of the queue by the lunch trolley and – on hearing the Dinner Lady (a different lady during the WE but still almost shouting in her irritation) having a heated discussion with Grace, who could not remember what she had ordered - JH recollected that menus had not been handed out, (+/-48 hours ago, ie two days before Saturday), for the patients to fill in.  Grace had a cheese omelette {which JH noted was the usual vegetarian option on the menus, and about which JH fell to wondering whether the cheese was made with non-animal rennet}.  JH said she would wait at the end of the queue and see what was left after the irritated dinner lady had served two or three other patients: then JH had shepherds’ pie, and broccoli, and carrots, and gravy – the latter making all the difference!  For afters JH ate some dried fruit with marshmallows, and also ate the packet of biscuits which she had been given by the morning tea lady who had not missed out JH who was chatting on the phone at the time: overall JH found the food more palatable {possibly because JH had been aware that things had ‘shifted through’ her gut after breakfast – albeit more wind than motion}. 

In the afternoon JH rang Mary Andrews – who had got her ‘wires crossed’ (on her location list) about her sessions at Oxfam; M had not ‘raised’ JH’s neighbours by phoning their landline, so she had decided to leave one large case at her friends, the Stacciolis’, for Reme to subsequently deliver to Hippo Haven; therefore JH could not ask M to find JH’s ticket (in a drawer in Hippo Haven) - to give to a Zimbabwean member of staff - to attend Karen Paolillo’s lecture, about the Zimbabwean Hippo Haven, to take place at the Royal Geographical Society In London on 12 July 2007 {which JH would undoubtedly be unable to get to}.  Mary suggested an earlier departure from the RLH – at 1.30pm on Monday – assuming that JH would have had some lunch by then, M said she would bring some sandwiches with her for us to eat on the train journey to Plymouth; M had had discussions with enquiries at British Rail and the lady she spoke to had said that JH could convert her ordinary return ticket to a first class ticket, which was required by persons wishing to use BR’s assisted travel scheme but, as Mary did not have JH’s ordinary return ticket to do the swap, much the simplest thing to do was to buy another single first class ticket for JH for £40!

Incoming phone calls enabled communications to be continued during the afternoon and evening - as JH was kindly sought out by the Nurse who answered the Nurses-Station phone.  Lyn phoned from Derriford Hospital and gave JH everyone’s best wishes, and briefly mentioned that the Trustees at PRCRC had been most ‘tolerant’ of her minute-taking (and JH suspects - ‘entertained!’).  Ann phoned from Germany: Big Sister was obviously being ‘eves-dropped’ by her children, Stefanie and Johannes - so they all heard JH say with a lump in her throat, ‘. . . both of us are euphoric’; furthermore JH regaled Ann with the story of ‘the stolen granny knickers’ (which snippet of information the Staff nearby probably did not hear because they were far too busy, and also were hoping that JH would relinquish the use of their phone ASAP); JH mentioned her impending discharge on Monday. 

As JH was sitting near K when the tea lady came round, at K’s request JH and K received a large cup of tea: Kathy - the seasoned patient - knew she could ask for tea in the large polystyrene mugs!  The stout black lady, whom JH had seen being manoeuvred onto a ripple mattress the previous evening, had been moved into the 4-bedded bay, ie, opposite Kathy.  Kathy was now feeling better herself and so, now, was feeling very sad for her opposite companion, whom Kathy could completely forgive for constantly weeping, and crying-out, all night; Kathy explained that this lady - who had previously had both legs amputated – hand now undergone bilateral above-knee amputations, and was in dreadful pain and distress.  Whether or not Kathy knew this lady from previous meetings at the Hospital whilst receiving treatment, or from conversations with the lady and/or with her relatives, JH does not know, but JH recognised the two disconsolate young men standing quietly either side of mum’s bed. 

At evening mealtime, Grace rushed up to the trolley, but the Supper Lady told Grace in no uncertain terms to ‘wait her turn’ – as otherwise everyone else would ‘rush up’ and form a queue (which queue the lady presumably considered to be unnecessary); the lady progressed down by bed No’s 19, 20, and 21 and {a bit like a punter at an auctioneer) nodded her head at the Nurses, who were round and about, when she was ready to serve the next patient.  JH did not dare to have a look at what was on offer, as she had done previously, but then JH was asked by the Nurse if JH would like to do just that – she did - and ate a wholemeal chicken tikka sandwich also containing sweetcorn(!) with some tinned pineapple to follow, for supper.  At some point Grace was heard to be loudly declaiming that ‘. . . you always lost weight when in hospital!’!  JH was weighed pre operatively and postoperatively and recorded her weights of 93, 97, and 98 kilos, which, in view of her lack of ingestion, and adequate fluid output (if not of anything else) would have suggested to her that she should have weighed less postoperatively – but she supposed that several litres of intravenous-fluid receipt would preclude a loss.

Communications continued: a card was received from another of K and R’s friends.  Ralph did not visit until rather late because he had been at Myles’s Birthday Party that afternoon; furthermore Ralph got ticked-off by Kathy for getting all ‘hot and bothered’ and had his B/P checked by one of the Nurses – at his wife’s request; afterwards K remarked (to whoever was there to hear, and after ticking off her husband) that JH and K had not had a row – yet.  JH joined the Skinners for her post-prandial drink - although she had hot water, milk, and sugar in the evening instead of caffeine- and tannin-laced tea.  Kathy had a large tea, and asked the tea lady for a cup of tea for Ralph: the rather stern Tea Lady said ‘No’ but with a twinkle in her eye directed towards Ralph added ‘I’ll give you one this time!’

Kathy introduced JH to the patient now occupying the next bed, Ruby, who had had kidney failure for 2 years but had been told that – at the age of 69 – she was too old to have a transplant: JH observed a ‘degree’ of obesity in this patient, and Kathy observed (quietly to JH) that so many patients do not stick to their strict fluid ‘rationing’ – let alone their strict dietary advice.  JH decided that she would watch Coast on the television, and this programme started at 8.30pm just as the Day Staff finished their hand-over report to the Night Staff, (in the day room): however, JH  realised that she had seen this episode after all, and so went back to scribbling in her diary.  At about 10.30pm, smiling, buxom Lily came round with the evening medicines: after discussion, JH opted not to have the OxyNorm although it had been prescribed for her; JH did take a dose of senakot.  JH had already been advised to continue using the anti MRSA cream up her nose: the path reports on her nasal swabs had not come back from the Lab (and were unlikely to do so before JH’s discharge).  JH chatted on about being a typical Nurse – and not abiding to the rule of maintaining her fluid-balance chart; Lily picked up these charts off the end of JH’s bed and requested that JH should PU in a jug to be found in the sluice; furthermore, if JH found it difficult to read off the millimetre-level, she could ask Lily to do so for her.  JH was a bit miffed about being asked to do this (having been PUing in the toilet for 2 days) now – but it was herself who started the conversation; furthermore JH was asked to try and remember her fluid intake over the last daytime hours at least – ah well, just get on with it! 

At 10.30pm, Grace was talking, again, constantly for half-an-hour to a sympathetic ear she was ‘loaned’ from behind some curtains.  Then the next disturbance (although Grace can be forgiven for creating her ‘disturbances’ which are just really survival techniques) was, yet again, the tinkling sound emanating from unworn earphones: so JH sallied forth and found the offending earphones hanging off the console above the lady to whom Grace had just been speaking.  This ‘new’ lady patient was a seasoned inpatient, and knew Grace well: she remarked (as Gertrude had done) that she (Grace) does like to talk but ‘meant well’.  JH asked the new lady if she minded having her unused earphones switch off, to which she replied that she would be pleased for JH to do so, as she could not see to switch of the console herself.   This lady was virtually blind: however, it was apparent that she was so familiar with the layout of the Ward that she could negotiate to the toilet using her minimal remaining view of her immediate environment - and her inbuilt personal positioning system, which JH assumed had developed over the long period of deterioration in her vision.  JH had just got into bed, after already having got up twice to adjust her curtains (to be sure an unwatched console screen facing outwards did not switch on to disturb her in the early hours) when the I/V pump ‘belonging’ to the patient in bed No 18 bleeped, and kept on and on – so JH got out of bed again to let one of the nurses know.  About half-past midnight the phone by the work station on a table at the other end of the ward rang, and rang again and again: JH had noted that, during the daytime hours, the Staff used the computer thereby to read off investigation results, and make out-going phone calls, but she had never been aware of this extension ringing in the night, so she assumed that there was some hiccough in telephonic communications over the weekend.  So JH went and spoke to the Members of Staff at the Nurses Station with a request that they somehow prevent this aberrant telephonist from persisting: and then there was comparative peace.



 
 
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