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Tuesday, December 04, 2007

An update - if youv'e got a spare half an hour

For those who didn’t get an update on my knee operation I will try and combine the two but mainly concentrating on part 2.
Part 1 involved the basic knee replacement with various complications not least developing deep vein thrombosis which extended my 7-10 day scheduled stay to 17 days the worst of this being that I had to watch both the Rugby World cup semis and finals on my own on a tiny monitor over my bed, with only 2 cans of Guinness each time but there again not having had a shit for 6 days the guinness did help things along eventually, however after 3 days at home I was starting to walk again with the aid of a frame and even made it to the pub, albeit with a lot of help. The only problem being an incision wound in the side of my knee which had been made to reposition my knee cap wouldn’t heal and was being oozing fluid and being checked daily by our finest district nurse.
I was home for a total of 7 days before part 2 of this journey kicked in. I collapsed on a Sunday morning, fortunately in front of the district nurse who was redressing the wound in the side of my knee which wouldn’t heal. I had felt unwell during the night so she took my temperature just before I passed out. 39 c (102F). She called out a Doc who immediately called an ambulance and I was taken to Swindon A&E.
It soon became apparent that the wound was infected and had then infected the whole of the knee joint. I was admitted and sent up to a Surgical Assessment ward, then straight to theatre, (the play was awful – lol) as I’d had nothing to eat all day and it was then 10:00pm I was able to have a general anesthetic, so they proceeded to get as much poison out as possible then pumped me full of antibiotics.
The next morning they told me I would have to have another procedure which would involve opening my knee and scraping and flushing everything out and this would involve another general anesthetic so nil by mouth. I’d last eaten a slice of toast and drank a cup of tea at midnight after the first op.
I lay there all day waiting for them to come for me to go to theatre, eventually I was taken down at 1:30 am almost 25 hours after the toast but at least I was on a drip so that I didn’t dehydrate. It was a 4 hour op and I came around fairly sharply and although it was 4:30 I asked for something to eat and was rewarded with another slice of toast, Unfortunately I’d fallen asleep before it arrived!
In the morning they explained what I’d had done and that as my consultant surgeon wasn’t on the premises someone else had carried out the procedure and should have replaced a neoprene part of my implant but hadn’t. My consultant wanted to open up again, replace the part and flush out again.
So general anesthetic number 3 and a late afternoon visit to theatre again (same play). The next day I don’t know what planet I’m on, all I can say is thank God for the morphine drip.
After 2 days I feel a good deal better and get moved to a room with 3 other beds where I spend the next 8 days along with a number of different bed fellow who come and go as their stays are much shorter. Many different types of people become my neighbour including a chap who had just served 4 years in Belmarsh prison for attempted murder and was a crack cocaine addict – he had a stroke and was relatively docile but extremely paranoid.
I was told that I would have to have a tube inserted in my neck known as a Central Veneous Catherter, or Hickman tube (we call it my hicky) It’s inserted through a main vein in my neck a leads to the Aorta where it is anchored and a tube then comes out through my chest with a valve on the end. This means that my antibiotics can be administered IV at home. This procedure was done the following Friday under a local anesthetic and was fairly unpleasant and would rather stick my tongue up a Camel’s arse but I would now be free to go home.The only problem was that it was now 5.30pm on a Friday and a district nurse would have to attend on me for the first week when I got home and this would not be possible to arrange until Monday additionally all my medication would need to be ordered and delivered to my home so Tuesday was going to be my release date.
However the chap in the bed opposite had been moved into our room the day after me, he was elderly and not quite with it, on his seventh night he died. I was moved to another ward across the other side of the hospital and later learnt that he had died from MRSA. I had been moved as I was the only one who had surgery.
The new room was exactly the same as the old one, 4 beds, same layout people come and go. The following day, a Sunday a chap in his 60’s arrived on the ward straight up from theatre, he was awake and sitting up, I had a brief chat with him he’d had a minor stomach op and was able to get out of bed a walk to the bathroom with his drip stand. His family visited in the afternoon and I chatted to him in the evening. He fell asleep about 9.00pm and was pronounced dead at 1:38am. I had been awoken by a crash alarm and a lot of people came running into the ward with trolleys etc. They pulled the curtain around his bed but I could hear everything that was going on. Apparently the night nurse had come to me to flush my tube with Heparin – an anti-coalgulant- she had told me earlier in the evening that it would need doing, so I told her to just do it and don’t bother waking me. This she managed to do and after me she checked on the chap opposite only to find him still – no pulse – dead! The crash team didn’t bother to revive him as he’d been gone for an hour or so, apparently heart failure due to the anesthetic, so when they tell you there’s 1 in 100 chance of dying from surgery when signing the consent form believe them!
By now I’m getting paranoid, I really want to get out of there so come Monday morning I get nurses on the case with a view to getting discharged asap. Belinda got on to Hungerford surgery from home and they were brilliant, as soon as the hospital rang them they were already in place for me from Tuesday morning, by the end of Monday the medication I would need at home had been ordered and would be delivered along with a fridge to store them all in would be delivered by 8:30 the next morning and an IV nurse to train us all up.
Tuesday came and I was told I would be discharged late afternoon as all my in hospital medication would have to be administered at the correct time. As I’d been having Tinsaparin injections in my stomach for the last 10 days at 4:00 pm I would have to wait until then. Belinda came at 4.00 and the nurse went off to get my Tinsaparin shot and check my dosage which varies according to my INR blood level. When she came back she aid my INR level was to low and I would need to continue the shots for several days more, however they had not taken this into consideration when ordering my supplies and it was now too late to get pre-loaded syringes from the in-house pharmacy, would I mind staying another night? I was sat on the edge of my bed, packed and ready to go – to right I would mind!
Fortunately Belinda recalled that we had been given 4 syringes for emergencies the last time I came home so once I’d had the jab and we managed to convince them that we had enough at home they let me go – only 17 days!

So I am now home, confined to upstairs (I’m not allowed to use the stairs) so spend all day in the office and go to bed at 6:00pm. The nurse comes every morning but Belinda is getting pretty good at administering the 3 IV syringes and tomorrow she is entirely solo as the nurse wants her to do it without her being here.

Some other facts: The bug I got is called coagulase negative staphylococcus, I lost 3 stone in weight, grew a beard which came out grey and ginger (now shaved off), I still have the infection and will have for a further 6 weeks, they measure the level of infection by a CRP count in the white blood cells. The normal level should 0 – 6, 10 days after starting the antibiotic course my count was 133!, the last count was last Friday when it was 88 so it’s coming down, my next one is Monday so I hope it’s half that but it wont be until it’s in single figures that I will be in the clear.

So that’s it – in a nut shell – I would loose the will to live if I was to tell you the full story.


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