Tag: anaesthetist

Bobs Bowel 4 – NHS Healthcare


After years of paying National Insurance there is no doubt I am getting my moneys worth from the NHS. After playing the poo sticks game I have had a Colonoscopy, CT Colonography, a session with a colo-rectal consultant and have been booked in to Surgery School.

My home phone seems like it is a hot line to the QA (Queen Alexandra Hospital).

Following the consult I received a text message informing me that a call had been booked by the Care Coordinator !!! No explanation of why. Obviously I could make a pretty goood guess. But I still had to confirm back to them that a call before midday on the 31st was acceptible. I also took the opportunity to ask what the call was about. The response was almost instantaneous. Lisa, the Care Coordinator from my GP Surgery, having seen various letters between the hospital and my GP, was making a courtesy call to see how I was doing with the ongoing investigations.

So Friday 31st arrived and it turns out that Lisa had very little information. I have since seen the letters that my GP was sent. Not very enlightening. So I brought Lisa up to speed, giving my history so far, up to and including my consult on Tuesday.

She in turn told me about the services that were available to me leading up to the surgery and what support they can provide after I return home. This includes councelling, assistance with obtaining benefits etc. After a very pleasant chat we agreed that she would call me on 28th February to see how I was going. Hopefully I will be home recuperating after the operation.

As I said my phone has been very busy. On Friday morning I missed a call from Julie, one of the colo-rectal nurses. She left a message inviting me to call her back. I returned her call and retaliated by leaving her a message in her voicemail. After one round of answer phone tennis she called me.

She asked if I had heard from the anaesthetist, which I had not. She told me that they had spotted that I was borderline anaemic and that I needed to be scheduled in for an iron infusion/transfusion!

Two weeks ago, the doctor that did my colonoscopy had told me about this. I had forgotten but I am glad that the anaesthetist is on the ball. Julie told me that I should probably expect to be contacted early next week, and that if I didn’t hear from them by Wednesday, to call her.

Later that day I received one of those neutral NHS appointment invitations. Informing me that an appointment has been made for 10:00 on Thursday 13th of February. What is this for? Is it for my iron infusion, or just a face to face with the anaesthetist? There is no information about what if anything I need to take with me. Nurse Julie told me I should arrange a lift for when I have the infusion just in case I’m not fit to drive after. There is nothing in this invite to clarify so I will have to call them on Monday.

One thing I will say for the NHS, once you are in the system they do look after you. So far, I have nothing but praise for the staff that I have been involved with. With the one exception, the CT Colonography, they have ensured that my experience thus far has been reasonably pleasant.

Bobs Bowel 3 – The Consultant & More


Tuesday 28th January, and my first meeting with the consultant. It was quite intense and a bit of a good news, bad news scenario.

First up the bad news, the results of the biopsies taken during the colonoscopy  confirm that the tumour is cancerous. I guess I was expecting that and was already resigned to the fact that surgery was required. Confirming the cancer was just detail.

On to the good news. The results of the CTC show that the cancer seems to be contained within the colon and hasn’t spread elsewhere. Apparently, there are a couple of polyps but nothing to be concerned about at this time. Some time after the surgery, I will likely have a colonoscopy, and the polyps will be dealt with then.

I was told that I should get a surgery date within the next three weeks. The surgery itself will be of the keyhole variety. The consultant ran through some of the issues / risks. Obviously, all surgery comes with risks. It is invasive, and the body wasn’t designed for easy access. In my case, proximity to the spleen was of concern.

Given that my tumour is causing a partial blockage, surgery is the only option. It is what it is.

Prior to that, it seems they have a lot of fun activities planned for me, so I will be visiting the Queen Alexandra Hospital …. a lot.

I have already been booked into surgery school.  This two hour classroom session is on Monday, 3rd January, to be held at the Oasis Centre. The purpose of the class is to prepare the patient, me, for the surgery and after. To tell about the process, the time on the high dependency ward, and preparation for going home and what to expect in the time following the procedure.

Another treat will be a session with the stoma nurse. Although it isn’t planned, the surgeons won’t know until they go in and may decide that a stoma is necessary. This may be temporary to allow my bowel to heal or, worst case scenario, permanent if they can’t repair the bowel. Apparently, all bowel surgery patients are taken through this possibility and the ramifications.

Finally, there will be a consultation with the anaesthetist. If they can glean enough information from my notes, then it should be just a telephone consult. Otherwise, a further trip to the QA will be required.

Once I have had the operation, I can expect to be in the hospital for about a week or so. Escape will be dependent on my how fast my bowel starts to function. I was told that some patients have gone home after three days, but typically, it is a five day stay.

The things I’m prepared to do to get out of cooking and housework.

And then it’s on to recovery, i.e. back to normality. Again, everyone’s different, but they were talking three to six months.

I’m coming to realise that this is a big operation. Nobody has actually vocalised this fact, but I’m picking up on the odd words that were dropped by the consultant and one of the colo-rectal nurses.

I have no idea if there will be any after treatment, i.e., chemo or radio therapy. This was not mentioned, and I forgot to ask, but perhaps that is a discussion for after the operation, when they know what they are dealing with.

In the meantime, I have been having a lot of discussions with Gerry about preparing for my time in the hospital and immediately after. These are non medical in nature.

Gerrys mobility is OK around the house, but she can’t stand for long. So preparing meals for herself could be problematic. There are a number of companies that make and deliver ready meals so we are considering getting some to put in the freezer. Gerry should be able to manage those.

Of course, after I return home, my capabilities are a bit of an unknown quantity at this time. There are likely to be restrictions on lifting and carrying. Simple things like lifting a kettle to make a cuppa may not be allowed.

I won’t be allowed to drive for a while, and although Gerry still has her licence, she hasn’t driven for a couple of years. So we are going to have to rely on family to provide taxi services for any appointments etc..

Sadly, this bloody tumour is causing a lot of disruption, impacting others’ lives too.

At the back end of February we have tickets for two concerts. The first is for Uriah Heep, a band that I started following in the 70’s. This concert is part of a 50th Anniversary and farewell tour. Missing that will be a bit of a blow.

The other concert is for Brit Floyd, a Pink Floyd tribute band. We got tickets to this show as a Christmas present for Summer,  our great-granddaughter. She is always saying how she likes Pink Floyd, so we thought a tribute band was the nearest she would get to the real thing.

We are already trying to arrange for others to take the tickets

Two further events are possibly in jeopardy.  The Goodwood Members Meeting in April, which usually entails a whole day on my feet. And then there is an Andre Rieu concert at Wembley in May. We will just have to see how my recovery goes.

That’s it for now.

My Prostate and Me – Part 3


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.