Wednesday 16 May 2012

DAY 1 HOSPITAL NIL BY MOUTH

I was asked to arrive at the ward at 7am and advised 'no solids for 6 hours before op and no drinks 2 hours before op'.  We unpacked my stuff and we decided that N should leave, as I was quite happy to chat to the lady opposite and really was not feeling at all nervous or in need of support!  On the table was a hospital tie-at-the-back gown and a black wedge which I knew would be placed between my calves after the operation to keep my legs in the right position.  The lady across the way had had two knees done, and was waiting the all clear to go home.  She offered me her TV payment card which still had a day's viewing left on it.  I then thought that I should have bought my debit card with me for purchases that might occur of that sort.  Various hospital staff began to arrive to deal with me:

The first was a student nurse checking through paperwork, and asking health history questions.  During that time my surgeon arrived, had a brief chat about what was happening and drew a large black arrow on my right thigh 'to avoid any confusion'!! The nurse then noticed my nails, and as the surgeon was leaving she asked him if they were ok (they were pale and pearly deliberately in the hope I could keep them!) and he said 'yes'!  (At least 3 other staff commented on them and suggested they should be removed between that time and the operation, so in retrospect, I think it is probably better to not have them.) 

Then a nurse and a student nurse arrived and asked me to put on the hospital gown.  I got on the bed and they painted me with iodine from waist to ankle and wrapped me up in green paper and tape and then in blankets.  They then noticed the toenails and got a bottle of acetone to take that off.  I asked if they could just take off the left foot and leave the right as the left I can reach and re-do, but they said 'no', so that was that!  They opened a packet of support knee highs (white with little flaps that can let your toes come out to breathe; my brother in his hospital in Dorset had olive green, so maybe men get darker colours!) and put one on the non surgery leg and tied the other on the end of my bed for later.

At 9.30 the anaesthetic doctor arrived and discussed the two options with me:

General Anaesthetic where you are totally unconscious the whole time.  Downside you take longer to return to feeling ok, can feel nauseous etc.

Spinal block which is injection into your spinal column and anaesthetises the sciatic nerve and numbs everything from the waist down.  From the waist up you then have a choice whether you want to feel happy and away with the fairies but conscious and chilled, or knocked out.  A catheter is put in with this option so that there are no peeing issues.  I asked her which she would choose and she said the spinal.

So I decided that the second option sounded more interesting and because 30 years ago I had a bad response to GA I felt it was the right choice for me.

At 10.30 a very jolly girl arrived who turned out to be the bed pusher and she wheeled the whole thing with me lying in it out of the ward, into the lift and up to the theatre.  There in the anaesthetic room I had a connection for the drip put in the back of my hand.  This is also used to give you anything else you need during the next 24 hours or even longer if necessary.  The anaesthetist administered the spinal block and put in the catheter and then I was turned on my side and blue paper was taped all over me and created a screen from shoulder downwards.  I asked when I was going to feel happy and chilled out ............... and the next thing I woke up, saw the clock and it was at 12.30 and it had all been done!  I never had a chance to ask why I was completely knocked out, maybe to stop me talking all the way through the op! 

My anaesthetist brought me my hip to look at, or rather the ball at the top and the 2 or 3 inches of femur (?) they had cut off.  It looked just like the leg bit in a leg of lamb, obviously bloody, but you could see all the wear on the ball, I asked if I could have it; in my woozey state I thought vaguely I could preserve it somehow, freeze? No. Boil up and then dry and keep? - this sounds gruesome, but it was rather strange seeing something from inside one's own body and as it was mine I rather wanted to have it.  Anyway, she said 'No'!

I was wheeled into a recovery room where my blood pressure and temperature were constantly checked, and the dressing to make sure there was no bleeding, and eventually I was wheeled back to the ward. I was attached to a drip which was hydrating me and putting back electrolytes to replace those lost.  Anti biotics were also delivered this way.

My waist down was totally numb I could not move a toe, but my waist up felt fantastic, I was so cosy and comfortable and pain free and hungry!  So they bought a lunch pack of sandwiches, Kitkat, banana and orange juice and I had all of it!  I do not think I would have felt so perky had I had the GA.  I heard other patients discussing their anaesthetic and they all had a GA because they seemed to think they would hear sawing and grinding and feel tugging, I was the only one who had opted for the spinal block.

I sat up and gradually noticed a slight clamping on my legs - this was compression pads which were filling up to press my calves automatically and help prevent the forming of blood clots - this also meant the medication was starting to wear off and a began to get a little movement in my toes.  I called all those who I thought might want to hear from me and two of my daughters arrived late afternoon bearing gifts of wine, chocolate, grapes and flowers!  Only the grapes got to stay as flowers not allowed on wards anymore and I couldnt face the wine or the chocolate, uncharacteristically!

Nurses were doing the observations (blood pressure and temperature) very regularly, and plenty of cups of tea were provided.  My ward, which was ladies only, contained 6 beds, all either hip or knee/knees.  The knee people seemed to have more pain than the hip people.  There was plenty of staff and a lot of different coloured tunics - there was a bedside book to interpret who was wearing what, but I lost track after the fourth option - there must have been about ten of them.  Anyway every single person I met was kind, cheerful, patient, professional, brilliant.  There were two elderly ladies in my ward, one of 80 who had had the same (RH) hip as me, and one 90 who had had her knees done, and they both did a lot of groaning and found it very difficult to get going out of bed at all, but the staff were so patient and caring and thoughtful and and respectful.  Nothing like the horror stories one has recently come across in the press.

The drug trolley came round every four hours and as the anaesthetic wore off we had paracetamol and codeine, and a couple of senokots to help with constipation caused by codeine, and an anti blood clot medication taken in the evening.  I didn't sleep at all the first night and wished I had bought my blindfold with me and probably ear plugs so I would hear the groans of others!  Surprisingly given that we were all sleeping on our backs, there was no snoring!!

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