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Thursday, December 20, 2007

Requests for the full story

Since my last post I have had a number of requests for the full story so here then is part 1 in more detail:

Tues 9thth October admission to Aldbourne ward in the new Brunel building at Swindon’s GWR. Check in very uneventful nice room though as it seems I managed to blag a private room with on suite bathroom, not dissimilar to a travel lodge but without the trouser press and mini bar. A fairly comfortable night although apprehensive about the op scheduled for 2 pm the next day.

Interesting experience down in the anesthetic prep room. I was having a spinal bock and epidural instead of a general anesthetic, this involved an injection directly into the spinal sheath along with a catheter placed outside the sheath (for the epidural pain relief – this stays in for 5 days) I was lying on my side whilst the injections where put into the base of my spine and IV canulas (cannuli ?) were inserted in my left arm.
The anesthetic took immediate effect in my left leg which I commented on to the anesthetist saying that it was rather clever. He explained that the dope solution worked on gravity and when I turn over I should go numb from the waist down which was rather handy as his next job was to insert a catheter up through the end of my willy and into my bladder, I then informed him that as I was now numb from the waist down would he refrain from volunteering any further details on what he was about to do.
My surgeon then came in along with his registrar when we exchanged the usual pre-op jokes like me asking if I will ever be able to play the Piano again. ‘Of course’ he replied, ‘strange’ I said ‘I couldn’t before’ Boom Boom!
He of course said ‘You won’t feel a thing’ with a maniacal grin, I waited for him to add ‘ever again’ but he didn’t
I then complained that every one had a face mask except me, was I becoming paranoid? So they gave me one just to shut me up. It was at this point I saw the strangest thing; the surgeon who was standing adjacent to my waist had a shaved orange leg hanging over his shoulder in the way a butcher would carry a lump of meat, oddly this made me laugh until I realized the leg was mine coated in Iodine.
It had been explained to me that I would be awake for the whole procedure but I would not feel anything and as it was scheduled for 2 hours I would probably drift off with the help of a mild sedation I would be given. So into theatre we went and the surgeon plunged into me with his scalpel, I couldn’t see or feel anything and so fell in and out of consciousness; however I could see a clock on the wall which currently read 2:45. suddenly the surgeon exclaim ‘Oh shit!’ at which point everyone gathers round, it appears that after having cut out and sawn off my existing knee and inserted the uper rod into my femur the lower rod would not pass an old fracture preventing the insertion of the lower shaft. I know no more until I come round in recovery at 5:00 pm and then taken back to my room.

My Implant

As I fully come round I feel fine, I do a quick assessment of my status, check that I still have both legs, I have a saline drip, a blood drip, a drain tube from my knee and a catheter from my willy (don’t even think about a morning involuntary erection) and the best bit an epidural drip into my spine delivering a measured dosage of Morphine and heroine so no wonder I feel no pain and have a smile on my face. I’m reminded of the Pink Floyd song ‘Comfortably Numb’
I’m offered food and drink at this stage which I gratefully devour at which point Belinda arrives and is pleased to see me sitting up and so bright.
I finished my meal and chatting non stop telling B all that I can remember about the op when she says that I am looking a little pale and getting paler by the second. I then pass out and she runs out shouting for a nurse who arrives very promptly and proceeds to try and rouse me (B, explained all this later) by gently shaking me and calling ‘Phil, Phil can you hear me’ she repeated this a couple of times then asked B if I responded to Phil or Philip, ‘Neither’ she explained ‘his name is Martyn’ at which point I came too.
Apparently my blood pressure had dropped rapidly causing me to faint, but back on the oxygen it soon returned to normal. The drawback of this meant that I had to have my BP taken every 30 mins throughout the night for the next 4 nights, this is not conducive for getting good nights sleep, but you soon get used to sleeping with your arm hanging out of bed.

A couple of days later a physio comes to see me, fortunately along with the staff nurse who was looking after me. At the time of my admission it had been explained to the staff that due to my Neuro condition that I could go into spasm any time my legs received a sudden jolt or pain shock and that IV Diazapam be kept on the ward in case. Unfortunately there was some part of this that the physio didn’t grasp because he just grabbed my foot and jerked it toward me. Immediately I felt my quads tighten then the whole of both legs, I shouted ‘spasm!’ just before the full effect hit me, fortunately the nurse was ahead of the game, she got out of the door, unlocked a drugs cabinet, filled a syringe with 20ml Diazapam and shot it into a canula in my left arm all in about 15 seconds. Unfortunately she didn’t have time to flush the canula first so had to force the drug through which hurt like hell and I didn’t know which was making me scream most. The spasm relaxed immediately, it was some time before the physio came back.

On the Saturday I watched England beat France in the semi of the RWC, somehow not as satisfying on your own with only a couple of cans of Guinness, watched on a 14” lcd screen 2ft away from your face, all alone. No one to discuss the match with, not quite the same somehow.

Ok now it’s time to get lavatorial, I haven’t ‘opened my bowels’ as they put it for 6 days now and so there is some mention of suppositories which I really do not take on board so I do a deal. I have now had all my tubes removed and so I am sort of mobile so if they can get me on the commode, which is basically a toilet seat on a wheelchair that slides over the toilet, put me in position, I can be left to get on with it. Well there’s a lot of wind but little lese so I pull the bell cord to get some one to let me out and half an hour later I am still sat there. I attempt calling but to no avail.
I am basically nude but decide that if I can at least get to the door I can probably get out and get some attention. To cut a long story short I managed to wheel myself by grabbing wall etc, into the main corridor with balls akimbo only to find everyone had gone for a tea break.
So day 7 and still no shit so will have to have 3 bum pills tonight. The duty nurse that evening was a delightfully funny, large Jamaican woman who explained that she would administer the suppositories for me and make sure that I ‘hung on to them’ so that they would be absorbed properly and to do this she would use a short piece of plastic tubing.
I immediately had an image of her using a blow pipe and said no way. I explained that, should I find it suddenly necessary, it would be difficult to get to the toilet unaided in the middle of the night I would have to use a bed pan – would this be a good idea after 7 days? She saw my point and decided to leave it until the morning.
The first thing next morning I got a nurse to get me into the bathroom and with the image of the nurse with a blow pipe I suddenly passed the equivalent combined weight of the England front row, it felt so good I let out a large cheer, cleaned up and pulled the nurse called.
‘Are you alright?’ she asked.
‘Yes, but you may need to put in a call to Dyna Rod’

I had an incision wound at the side of my knee which wouldn’t heal up and continuously leaked fluid and it seemed whatever dressing they put on it still leaked through, however I was due to go home as I could now fully weight bear on the knee and inspite of leaving a trail of blood from my wound along the corridor after having convinced the physio’s that I could manage stairs, they pronounced me fit and able to be discharged. This would mean that I would be home for the Rugby World Cup Final! However I did mention to the Doc that morning that I had a pain in the calf muscle to which to suggested that they get it scanned before I go ‘just in case’
Getting a scan took another 2 days, Friday, and the result was …. 3 blood clots in 3 veins so if you would care to stay with us for another 7 days we’d be pleased to have you, oh and enjoy all the facilities, sorry about the trouser press. I actually cried
Didn’t enjoy Rugby final started on Warfarin and high dose Tinzaparin injections in stomach.
Sunday was fun, I had my staples out, this made my side wound bleed even more heavly, never mind they just used thicker dressings.
A week later Thurs 25th Doc says I can go as long as my INR is near 2, but only way to stop wound bleeding will be to stitch up. Mr Cool (the registrar, real name Ahmed somethingorother) comes up from theatre to confer and agrees, as skin at that point is so tough it takes 2 of them to get 8 stitches in but it does the job and finally the wound is sealed. Physio tries the steps again and we are successful so he signed me off. INR result comes back at 1.9 which is good enough with a final shot and off I go!


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