Day: November 27, 2013

Template Biopsy !

Monday was one of the longest days of my life. I was scheduled for a “Template Biopsy” which for the un-initiated is described thus …..

The template biopsy is carried out using an ultrasound probe which is passed into your back passage and samples of the prostate gland are obtained through the area of the skin between your scrotum and back passage called the perineum. The procedure is similar to a trans rectal biopsy which you will usually have had.

Let me tell you, from the recipients perspective, it is nothing like the TRUS (Trans rectal biopsy).

To start with my TRUS was carried out fully conscious by a specialist nurse, the lovely Vanessa. The main difference though is that I was in and out of the hospital within an hour or so. But that was 18 months ago or more.

Mondays procedure was to be carried out under general anesthetic, for which I am truly grateful. But lets scroll back the clock a little.

Early Monday morning, Very early

I was awake, some time in the wee small hours. Either I am worrying about the procedure, or this is the residuals of jet-lag acquired on our return from Oz just over a week ago. Perhaps a combination of both.  I checked the clock at 04:00 and thereafter approximately on the hour until I got up just after 07:00. I was not allowed to have anything to eat but was allowed clear liquids to drink and had a black tea around 08:00. The taxi was due to pick me up at 11:30 so I was pottering around in the house killing time. It’s amazing how often I found myself by the bread bin thinking “I’ll just have some toast” or over by the cupboard staring at a packet of peanuts. My last eats had been around 21:00 the previous evening. Going without food for that length of time is not natural for me.

Eventually the taxi turned up, although not at my house but three doors away. Luckily I saw him out there. It could have been worse, the dispatcher at the taxi office misheard my address as Sistine and, had I not corrected him, the taxi would probably have been well on his way to Rome and the Vatican. Still, having ascertained that he was there for me I boarded and we set off. Twice I had to correct his directions back to the main road before I was sure we were going to the hospital.  Mentally I was crossing my fingers, hoping that the surgeon had a better sense of direction than my erstwhile pilot.

Tedium Begins

And so, at 11:50, I checked in at the QA Day Surgery Admissions Reception. And thus began the long wait.  It’s a bit like being on a long haul flight, hours of tedium broken up by announcements from the flight crew. In this case there was no food or drink.

After thirty minutes or so I was taken along to a small room. Here I was visited by the anaesthetist  who interrogated, sorry, checked my details and gave me a brief summary of what to expect. He also arranged for some initial meds.

Shortly thereafter, around 13:00, a nurse arrived with my lunch. A cup of water and four tabs, 2 x paracetamol / 1 antacid and 1 stop you feeling sicky pill.

While I was downing this feast another nurse arrived, interrogated me again and checked my blood pressure and heart rate. My heart rate was right down at about 55 which I queried but is apparently normal for “someone of our age”. She later demonstrated her own readings which were similar, so that was alright then.

I was then left alone to my own devices. I read for a while, played hangman on my phone, read some more, got up and walked around my room, looked out the window , read some more. Well you get the picture. I believe I even had a nap for a few minutes. The window looked down on the back dock but there was nothing happening down there.

Around 16:00 a yet another nurse informed  me that I was Mr. Hodgsons last patient and that I would be seeing him soon. Well I saw his registrar who introduced himself but I have no idea what his name was. His accent, he was English I think, was as indecipherable as his signature on the forms that he got me to sign. He went through the now familiar interrogation, during which Mr. Hodgson popped in, shook my hand and disappeared again.

Oh The Indignity

Twenty minutes later I was invited to go and get changed, by yet another nurse, who led me down to a room full of changing cubicles. This is where all dignity ends.

I am not a small guy at just over six feet tall and way over twenty stones (280lb / 127kg). The nurse threw me a smock and left the room. Needless to say the smock, of the tie at the back variety, did not fit well and I struggled to secure it. Although there was no mirror available I could tell by the cool air that most of my back and all of my bum was pretty much fully exposed. The nurse popped her head in and asked how I was getting on. When I explained that the smock didn’t fit and I was having trouble tying it she assumed a sympathetic air and replied “I shouldn’t worry, the first thing they’ll do is undo it”. I then settled down to fight with the compression stockings which when battle was over were rolled up to just below my knees. Wonderful!!

So there I am with my pale blue smock reaching from just below my chin, down to about two inches above the knee. Struggling to meet my sage green stockings, some two inches below my knees. All with my bum exposed to the rear.

The epitomy of sartorial elegance ? Nope, not a pretty picture.

Not to worry, I thought, I have my dressing gown which should bridge the gap. No such luck. To make sure that I was all bright and shiny for the hospital, my wife had washed and tumble dried it. I hadn’t worn it until now and yes, you’ve guessed, it had shrunk. At least it still closed at the front but the length was a sadly lacking being just a tad longer than the hospital smock. At least my back & bum were covered and therefore a little warmer.

I gathered my stuff and found the nurse, who then gathered up another guy (John) and led us through the hospital. Imagine my feelings as we passed through the first doorway into a public waiting area. I’m dressed like a freak and as we entered the waiting area all heads turned to see who had arrived. I thought later that it must have looked like me and John got dressed in the dark and swapped dressing gowns. His gown reached from neck to ankles and wrapped around him properly while mine was way too small. So, we made it through the waiting area without the gales of laughter I was expecting. Next we traversed the hospital to a stairwell where we descended to the floor below and were left in a new waiting room with one other guy and a TV. Here we waited for what seemed like ages but must have been about thirty to forty minutes. John and the  other guy got the call and then eventually so did I.

Kim, not sure if she was a nurse or a doctor, arrived to lead me to the Operating Theatre suite. Once again I had to traverse the hospital through the public corridors and climb to the upper floors via the stairwell. At this point a cold draught, not Guiness, reminded me about the negative aspects of my attire as I climbed the stairs. The stairs with the open railings to the centre, the railings that gave a not so glorious view of my nether regions to the several people descending these same flights of stairs. One glance up by any of them and they would be scarred for life.

Nearly There

On arrival I am sat in another waiting area, just for few minutes, but my apprehension levels are rising. This is not how I imagined the process would work. All this walking and waiting followed by more walking and waiting. And then an assistant anaesthetist comes and interrogates me one more time and I am on my way. One more surprise was that I had to walk into the theatre and get on the table myself. A green bag is held out for me to dump my shoes and dressing gown into. As I take off the gown a nurse rushes across the room to shut the doors to the outside, to prevent my blushes or those of any outsiders I’m not so sure. Then I am on the table.

And They’re Off

When I entered the theatre there was a group of folks gathered in the corner. Presumably they were in a pre-scrum huddle discussing my procedure. Or maybe they were just discussing Pompeys abysmal record. As I hop on the table I suddenly become the centre of a hive of activity as the anaesthetist and his assistant close in to prepare me. Cannula in the back of the hand, heart monitors etc. then the anaesthetist is telling me that I will feel a coldness in my hand as he injects the first of two concoctions. I felt nothing  and then he informs me that I may feel a little dizzy. I’m staring at the ceiling and the light panels suddenly seem to displace and the next thing I know is a voice over my shoulder is speaking and inviting me to cough.

Job Done

I open my eyes and I am in a different room, apparently job done. This is like taking a shot with an SLR. You look through the lens, focus, shutter release, view goes blank as the mirror lifts, then the view is clear again when the mirror drops. All in the blink of an eye. I’m not feeling dopey or dizzy, just wide awake. Once the nurse is happy that I am OK I am wheeled through to a recovery area.

As I enter the new waiting area I pass John and the other guy from the pre-op waiting area. They are sitting up in their respective beds eating toast which they both wave at me.

After a short time and a cup of water I was invited to get dressed and was led outside to a seating area. The nurse asked if I had eaten anything or had a drink to which I responded “No”. I was offered coffee or tea and I was expecting toast but was in fact offered eggy or corned beef butties. John was already out there so I sat alongside and we compared notes as he had the same procedure. When my coffee and butties arrived he was rather envious since he was only offered toast and like me he loves corned beef. My wife was brought in and she eyed my butties hungrily too. She had been waiting outside since just after five and, as it was now gone seven,  was very hungry.

The purpose of this little tea party is to ensure that you are OK, that you can keep down food and drink and most importantly that you can have a pee. If you can’t keep your food down or you don’t make water they won’t let you go home. Worst still an  inability to pee can mean catheterisation and / or an overnight stay. Luckily I was able after a short while to produce a dribble. Oh but it burned. I’m guessing that I was catheterised during the procedure although nobody said.

Freedom

Anyway, based on my meager performance I was allowed to go and  my daughter came and drove us home. Once home it was more tea and everyone seemed amazed, not the least of which me, at how alert I was. Also that I was in no pain. Well apart from when I had a pee which I was having to do with ever-increasing regularity.

Today, Wednesday Morning

Well the good news is that I have not had any pain. Two nights sleep, although still not sleeping all the way through so blaming the jet lag.

It is now nearly forty-one hours since the procedure.  Any residual pain blocking by the anaesthetic must have worn off by now. The burning sensation has all but disappeared and I have a slight soreness in the perineum, like when you have a bruise, which only makes itself known when I sit on something hard.

Now I have to wait for approximately four weeks to hear the results. That brings us to Christmas week I think, so it is likely that my appointment will be after the holidays. We shall see.