My Xmas holiday in Belfast didn’t quite work out as planned.
Like many journeys the beginning seemed to go as expected. After a light
breakfast at 7.30am I had come in to Belfast City Hospital on Tuesday Dec 15th and was registered at the Day of Surgery Unit. Mine was
to be the final procedure in theatre that day. I got into the gown and lay on
the bed, holding hands with T. After an
anxious age the porters were there and I was being wheeled along the corridor
on the bed, fluorescent lights blinking past my eyes. T followed me to the theatre door. We blew
kisses. Then she was gone.
The consent form had a long list of possible problems, but I
signed it. Then I was moved onto a narrow surgical bed with ankle rests, banks
of bright lights overhead and a group of people in theatre scrubs talking
jocularly in the corner. The anaesthetist introduced himself, put an injection
into my spine and then settled me back with a mask over my face. ‘It’s now
3.20’, was the last thing I heard him say. Then I was in the Recovery Room,
mask still over my face.
‘Hello Paul, are you in pain?’ Yesssss: fire burning in the
centre of my guts. She gave me a shot of morphine. Do you need more? Yes, oh yes! She gave me another. The fire
continued to burn. I pleaded for more. ‘I can’t’ she said, ‘you’ve had the
maximum dose’ and went to get the anaesthetist. He asked me about the pain and
then gave me some ketamine, saying ‘this might make you feel a bit
disorientated.’ The room spun but the fire receded. They told me it was 5.30pm.
A couple of hours later I was wheeled into Ward 3 South. I
asked a nurse to get my phone. I rang T. Soon she was beside me and we
embraced. I asked a nurse for a drink of water, she brought me a glass filled
with small ice cubes to suck on. This was all I was allowed. A foot-long wound
sliced down my belly, looping around my belly button. And a catheter had been
fitted. I was very sore front and back and extremely bloated. A saline drip was
hooked up above, with paracetamol and antibiotics pumped in through the cannula
on my arm. After T left I tried to sleep, but I felt so disorientated that all
I could do was doze and even this was interrupted by checks of blood pressure,
pulse and temperature (‘the obs’) every hour. I woke up to the recognition that
I was installed in the same bed-space that I had been placed in during my last
incarceration in the ward. No wonder I had been so afraid of T leaving me last
night.
At the ward round on the first day (Weds) I was told by my
surgeon that they had a problem with the incision into my abdomen. My small
intestine was very compacted with adhesions from my major surgery in 2011 and
when removing these they had caused a small tear in the bowel which had to be
stitched. The good news was that the tumour appeared to be fully encapsulated
in healthy cells (its disguise), was only attached to the abdominal wall and
was easy to remove. He thought I was likely to be in hospital for up to a week.
I remained in bed all day on drips and munching on little
ice-cubes. In the evening I was helped by T to get out of the bed and sit in
the chair. It was a painful struggle to get one step from the bed. And just
trying to sit still for half an hour took all of my strength as staying upright
seemed to use all my very sore abdominal muscles.
I soon got used to the regular patterns of ward life
(wake-up, bed-making, obs, breakfast, ward round, drug trolley, obs, dinner,
drug trolley, obs, visitors, tea, obs, visitors, drug trolley, bedtime) that I
remembered from my previous time in the ward in 2011. As the days went on I
found I remembered many of the nurses from before; indeed, several recognised
me as a returning customer.
On the Thursday I managed an unsteady little walk, aided by
T who kept tight hold of my arm. I still felt very sore and bloated. I was allowed
fluids and drank water and Ribena but suffered also from belching, hiccups and
waves of nausea. I still felt very disorientated and found it hard to
concentrate or read. Friday was similar, but I managed to get out of bed by
myself and walk down the corridor on my own.
I began to cough up some phlegm and did so regularly thereafter.
On the Saturday the catheter was removed and I was told I
was allowed to try solid foods. I tried an inch of vegetable soup in the bottom
of a bowl. My guts felt compacted and completely bloated. It was hard to get
even a tiny bit of soup down. Afterwards my belching and hiccups increased then
I vomited. Despite being given anti-sickness medication, I vomited five times
during the rest of the day, my temperature spiking up too. They sent me for an
X Ray, the report said that there was no obvious obstruction to the bowel.
On the Sunday I was put back on fluids only but there was
more vomiting with fever spikes, followed by dry retching. Exacerbated by my
abdominal wound, this was very painful and distressing. But the worst was still
to come. Overnight I had four hours of hiccupping. Once or twice might be
amusing, but when it goes on and on and on without any break the experience is
deeply purgatorial. The nursing staff could give me no relief. I rang T at 2am
howling with anguish.
On the Monday, despite my protestations, the team decided to
continue with the same treatment as the day before. My fever increased, as did
my nausea and distress. I spent much of the day lying on my bed in a sort of
hallucinatory dozing. Strange faces appeared to me, looming in front of my
eyes, along with the routine sounds from the room. The nurses seemed to be
avoiding me. The consultant said he would come back to see me but didn’t arrive.
I spent the evening dry retching and then the hiccups started again. This time
they went on for seven hours. I moaned and groaned throughout in complete
despair. I pleaded for help from doctors and nurses but they said there was
nothing they could do for me. At 4am in complete desperation I called out to
God for help. Within a minute the hiccups had stopped.
I lay panting with exhaustion. The nurse checked my
temperature, it was nearly 39 degrees. She brought me a fan to try and cool me
down and began to administer intravenous antibiotics. I dozed for a couple of
hours and woke on Tuesday morning feeling lucid for the first time since the
operation. At the ward round they decided to send me for an urgent CT scan,
suspecting some infection in my abdomen. As usual I was asked to drink a litre
of heavy water beforehand. I thought I would be unable to manage it without
vomiting, but strangely enough I managed to drink about half of it and keep it
down.
I was taken down in a wheelchair by a porter for the scan.
As I was wheeled back into the ward a doctor was waiting for me. She pulled the
curtain around and told me to get up onto the bed. You have a collapsed left
lung and a chest infection she said, caused by the bloating of your stomach. I
need to put this NG tube down into your stomach to relieve the pressure. She
produced a long coil of plastic tubing with a valve at the one end and began to
spread anaesthetic gel on the other end. Then she got me to sit up and put my
head back. She threaded the end of the tube up my nose and down the back of my
throat. I began to gag and retch but, with some words of encouragement, she
kept pushing the tube right down until I could feel the end almost under my
ribs. She then got a large syringe and attached it to the other end of the tube
and began to pull out the contents of my stomach. At first little appeared,
then, with a gurgle, a flush of greenish fluid appeared in the tube. I gasped.
Bile, she said, the liver produces it at a constant rate, so we need to drain
it. She finished up by taping the tube going into my nose and around the back
of my ear. Now you’re Nil by Mouth again she said. I sat on the bed confused, I told
her that I had been much worse overnight and the day before.
I also need to take some arterial blood, she said, producing
a small hypodermic. It’s an accurate measure of blood oxygen levels, but it can
hurt a little. She grasped my wrist and felt for my pulse. Then she dug the
needle in deep. At first nothing came, so she hoked around until blood spurted
up into the barrel of the syringe. Finally, a nurse came in and fitted a small
clear bag to the end of the stomach pipe. She put up a drip again and left me
with a cup of ice with a plastic teaspoon in it.
In the next couple of hours I was visited by three concerned
specialists. First, the head of the Intensive Care Unit came, who was assessing
me for being transferred there. I told her I would gladly have gone to the ICU
yesterday but I felt I was improving today. She agreed. Second, two general
surgeons came who were assessing me as to whether I needed emergency surgery to
save a major organ from failure, they were worried about my collapsed lung and
the possibility that my constricted stomach might lose some blood supply. After
some discussion between them they turned to me and said, well we’re not going
to operate tonight. I gasped with relief. They seemed a little disappointed and
strode away saying they would be monitoring my bloods carefully.
I felt exhausted and rested for much of the day on the bed,
taking some small walks with T up and down the corridor. I noticed that people
seemed to avoid eye contact. Then I caught sight of myself. I looked like an
alien: a tube emerging from one nostril, looping across one side of my face,
behind one ear and then down my neck into a clear bag with greenish liquid at
the bottom. I was glad that my problem was now being taken seriously. My
condition had been much much worse and the ward staff had not acted on it soon
enough.
On the Wednesday morning I was visited by a specialist from
Respiratory Medicine. He told me that he had looked at my scans from before and
after surgery and concluded that my diaphragmatic hernia had not got worse. He
thought that the collapse of the lung was caused by surgical gas distending the
stomach into the lung cavity like a balloon. This meant that the problem would
go away as the gas dissipated and would also improve as my bowels moved. I had
been bunged up now for eight solid days. This was normal after abdominal
surgery and was called ileus, bowel movements usually began again naturally. He
encouraged me to walk more and do more breathing exercises, which would be good
for both my lung and bowels. He told me that my blood oxygen levels were now
normal.
I went out of the ward and down in the lift to the ground
floor, I walked to the front entrance around the foyer and up the steps to the
Cancer Centre, and then returned to the ward. The alien carrying a bag with
green stuff in it got plenty of strange looks from strangers who rapidly
glanced away as soon as my baleful eye was upon them. During the rest of the
day, I did this three times. Each time I got farts but nothing more. There
seemed to be a log stuck in my back passage that would not move.
On the Thursday morning I was given an enema. I walked up
and down the corridor but did not stray far from the toilet. A wise move as I
was soon in there straining away at the log, which put up strong resistance but
eventually emerged. Next the bag was
taken off the end of my nose tube and sealed. This made walking around much
easier. I was also told I could sip fluids and try some light food. After nine
days without eating this was great news. At first I had felt so rough that I wasn’t
hungry, and then I felt very nauseous so food smelt unpleasant. So not eating
anything had become normal. And now I was very weak.
I first tried a strawberry yoghourt. It tasted good. I ate
half of the small pot then stopped, it was a lot to get down. After about five
minutes I ate the rest. It was a strange feeling to have food in my gut again.
I decided to wait and see how it went before I tried some more.
A porter took me for a chest X-ray and when I got back I had
tea and toast. I went on my regular walkabout a few times. Later I tried some
chocolate. T arrived with a big bag of Xmas decorations. My bed soon becomes
Santa’s Grotto: red lights across the back, tinsel across the top and sides,
flickering candles, and a large red stocking. He certainly shouldn’t be able to
miss me this year.
For tea I had scrambled egg on toast, then another yoghurt.
It was Christmas Eve, a nursing auxiliary came in wearing a Darth Vader cape
and a Rudolph the Red-Nosed Reindeer headdress. T and I went to the small
hospital church three floors down for a candlelit service. The alien was one of
only four patients in the packed room. We sang carols and took communion.
I never expected to
be spending Xmas Day in hospital. But you never know how things can turn out. I
woke up in the morning in Santa’s Grotto. The normal routines were happening
around me. For the hospital it was just another day. My chest felt clear for
the first time. I put my hand into my red stocking and pulled out sweets and
lovely card from T. She’s been so very loving and thoughtful every day. I don’t
know what I would have done without her. And thankfully I don’t need to find
out.
My second Xmas present was the NG tube out. It was great not
to have it irritating your nose and the back of your throat. My third Xmas
present was to be told that the X-ray showed that my lung had reinflated. Then
a porter dressed as Santa walked the ward ringing a bell and shouting: Merry
Christmas.
The first meal I ate was the hospital Xmas dinner. We pulled
crackers and I placed the party hat on my head. I managed some white meat,
mashed spud and carrots, but felt pretty full after. I went for my normal
walkabout and was very pleased to then have a natural bowel movement (my fourth
Xmas present). T arrived and stayed the afternoon and evening. We spend it
eating treats, watching TV in the ward day room and going walkabout in the
empty hospital.
But my best present of all was being told on Boxing Day that
I could go home. All in-patient treatment had been completed. All my bodily
systems were fully functioning. And what I needed most of all was to
recuperate. Hospital was not the right place to undertake that. It was an
environment that was bright and noisy by day and by night, a place where your
rest would always be interrupted.
I was given a bag with five days of oral antibiotics and
three weeks of blood thinning injections to administer myself. Then T came and
helped to dismantle Santa’s Grotto. We decided we would postpone our Xmas to
New Year. I couldn’t wait to get back home. I’d spent my twelve days of Xmas in
hospital, nine without any food and three of these nil by mouth. It was certainly
an Xmas experience to remember.
