Friday 1 February 2013

Release


Exactly one year ago I wrote to friends explaining that I had just seen a consultant gastro surgeon who told me that I had a hole in my diaphragm which part of my stomach had gone through. This problem was a residue from the big operation I had in June 2011 (which saved my life). Then they had to cut open my sternum and my diaphragm to get at the heart and vena cava below. When they put me back together again it seems that some of the hundreds of internal stitches hadn’t held.

The bad news was that I needed another operation, using conventional surgery, to fix this hernia. In practice it would mean two and a half hours in theatre, one week in hospital and around three months physical recovery. The consultant also explained that there would be a one in four chance that this repair would not succeed.

My heart sank. I was still trying to get over the terrible ordeal of the 'big op' (my first ever hospitalisation). Having to go back in for more surgery just a few months later was a thing of enormous dread. I told him that I was still recovering (e.g. taking painkillers) and I wouldn't be able to to undertake this at present. The consultant seemed a little disappointed but agreed to defer the surgery in the short term and to review me in six months time. I left the consultation feeling like a condemned man.

At the next review (July 2012) I'd improved. I explained that I felt physically recovered from the 'big op' and my gastric symptoms were stable. But I also told him that the mental side of recovery felt much harder to deal with and seemed to be taking a lot longer. The upshot was that I still didn't feel ready to go back into hospital for further surgery. After some pensive moments, he agreed to defer again and to review me in another six months.

On Tuesday I went for that review with my consultant gastro surgeon. I'd spent a good while preparing myself. I decided to tell him that I was now ready to give myself up to the hospital and have the damned surgery.

He asked me how I was. I told him I felt pretty well and that my symptoms had remained stable. I could eat and drink what I wanted and I was able to do most of the activities I wanted, including some easy hill-walking. I also said I'd joined a choir and found that I could sing, although I didn’t seem to have the same length of breath as others.

He nodded and then smiled. The best course of action, he said, is to put the surgery on hold and to keep you under review. I perked up. As your situation has been stable for well over six months, he said, we'll bring you in and do the surgery when and if the hernia becomes a problem. How would I know that, I asked. Stomach cramps and persistent vomiting, he said. I nodded, thinking of my misspent youth, after many beers and a curry such symptoms were commonplace.

He told me that diaphragmatic hernias are a congenital condition that affects one in two thousand children. The diaphragm begins to form in the sixth week of pregnancy and can grow with a hole in it. When some children are born with this defect it can be very dangerous (depending on how the abdominal organ protrudes) and require immediate surgery, but others can have these hernias for many decades without any problems only realising that they have the condition when something happens in adulthood.

I don’t need to see you again for a year, he said. Call me and come in earlier if you get a problem, he said, but keep on going as you have been and I think you'll be fine. I grinned and shook his hand. A door had opened. I walked out of the hospital with a real spring in my step.

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