Wednesday 24 July 2002
After saying goodbye to Teresa, Helen and Jay, I went for my X-ray and ECG tests, waited for the results and took them back to the ward. The bed still not being ready, I waited in a small visitors room, simply equipped with a few chairs and a fish tank. One other patient was there. He had already had a bypass operation, but had a problem with his chest wound, and was to be operated on again.
The registrar called to explain the operation and to get me to sign the consent form. Much was made of the fact that, as I was an ‘active smoker’, the risk would be increased and the recovery painful. The anaesthetist and the third member of the surgical team also discussed the operation, and I filled in questionnaires covering medical history, symptoms and life-style. They would be making up to five grafts to the coronary arteries, taking veins to do them from the left leg and possibly left forearm. Later in the day, blood and urine samples were taken.
A former patient detailed at length the recovery procedure, involving complex moves to boil cups of water rather than lift a full kettle. I felt I would never manage such restraint.
Finally, my bed was ready and I went through to the ward. On my left, also due for the same operation the following day, someone else from Cheltenham. On my right, a man from Portishead (but originally from Stourport) who was waiting for the operation: he had been brought in with chest pains and been under observation for four weeks without yet having a date. A fourth bed across the corridor accommodated an Irishman, also living in Cheltenham.
A week or two before going into hospital, Teresa and I had spotted a rather good quality second hand jacket in a charity shop, and I bought it to replace an old jacket which had got steadily shabbier and smaller as the years went by. I wore my latest acquisition to go to Bristol. I felt it had looked quite smart, but wasn’t so sure when I took it off, only to see the label still dangling ‘Sue Ryder £6.50’. (I surreptitiously cut it off.)
I unpacked little. My operation was due the following morning, and the holdall with all my belongings would be taken to the locker room; only my toilet bag would accompany me to the theatre.
Supper came – roast beef - and quite tasty it was. After supper, a nurse told us as a group what would be happening the next day. I don’t think any of us had realised until then quite what we were in for. We all declined to see in advance the intensive care unit (ICU), which would be our first port of call after the operation. Apparently, some patients find it alarming to come round and find themselves attached to the full range of life-support systems, though she emphasised that it was routine procedure for the operation.
Surgical gowns were issued, and, before bed, we were required to shower and wash hair in a pungent red antiseptic soapy solution. There was a late night cup of tea before ‘lights out’ at 11 pm.
I didn’t have much sleep. At one stage, I awoke thinking it had all been a dream, as I seemed to see my own bedroom around me, before the shape of the hospital ward took its place. I began to feel anxious and worried, being more and more doubtful that flesh and blood would survive what was in store.
Thursday 25 July 2002
Early toast and tea at 5.15 am, then fasting until the expected time of the operation, about 1 pm. It was a long morning. I did get a newspaper, and, for the second time, I had to have an antiseptic shower and hair wash, followed by shaving the hair off all body parts which might come under the surgeon’s knife – left leg, chest and left forearm.
At about 11 am I lay down to await the call for theatre. A tense, anxious time. A pre-op tranquilliser was to be administered, but only when the theatre had confirmed they would go ahead. Time passed. I was assured the medication was ‘on-call’, but at 1 pm it seemed unlikely the surgeons would start a 3 – 4 hour operation. At 1.30 pm the senior nurse opened the curtains and confirmed I would not be operated on that day.
I suppose with relief, I put on my normal clothes. Though late, a lunch was produced, with, as a special favour, my own salt and pepper pots, which I kept until my operation. I was told that the reason for the delay was the lack of a bed in ICU and that the operation had been rescheduled for Monday 29 July. My first thought was to go home for the weekend, but the ward clerk said she could not guarantee my bed would still be available. My friend from Portishead, who had contacts in the medical world, told me to stay put at all costs – if I lost the slot now, I could end up at the bottom of the waiting list again. Going home was also, on reflexion, not such an easy option: I had little money with me, and carrying my heavy bag unassisted could be risky. I realised I had no choice: I had to stay put for another three days.
Friday 26 – Sunday 28 July 2002
A strange period: with one exception, all patients in my particular part of the ward were pre-op, ie not actually ill, so we were not being nursed at all, but, on the contrary, quite capable of looking after ourselves. I made a point a walking round the corridor regularly to take exercise. Small events became highlights of the day – breakfast, buying a newspaper, lunch and supper, phoning home. I read through two books Helen had bought me, which I’d only skimmed before, and saved the crossword for the evening. The food continued to taste good and the menu was quite varied – beef in red wine sauce, roast chicken, cod in basil and tomato sauce, roast turkey, tuna salad.
I had a strange but strong sense of déja-vu: the beds, the toilets, the smells, the routine – had I done it all before? I started to sleep a little better.
The adjoining beds regularly changed hands, as new patients arrived, were prepared and went to theatre the following day. One was another man from Cheltenham, whom I had known vaguely at work. My friend from Portishead and I became quite familiar with the pre-op briefing we could hear each receiving. The room, unlike other rooms in the ward, was open plan: a corridor ran through it, there was a bathroom and toilet ‘en-suite’, and a table used by the physiotherapists as their office. The corridor led to the High Dependency Unit (HDU), the second port of call post-op after ICU. From the HDU, patients would emerge a couple of days after their operation to reclaim a bed in the ward: some we recognised from their pre-op day, and we gave them a little cheer.
On Saturday I delved a bit further into my holdall and found a lovely card from Juliet, which she had made and put there for me to find when I unpacked. In the evening, Teresa phoned to say that Nana had passed away. In the circumstances, I could only advise that nursing home should be asked to make the funeral arrangements locally.
On the Sunday evening, doctors and nurses recapped the procedure for the following day and I again went into the antiseptic shower, hair wash and shave routine, this time to be repeated early in the morning as I was due to go early to theatre – about 8 am. I passed on my personal salt and pepper to the man from Portishead.
I was having a peaceful night’s sleep, when, in the middle of the night, sirens sounded throughout the hospital: it was the fire alarm. We all arose to see what was going on. Our ward being at the front of the building, we were able to crane out of the windows to see four fire appliances arrive at the main entrance … and wait … and wait … and wait. It was obviously going to be a false alarm, but how much would it disrupt the hospital routine? Would my op be cancelled for the second time? In our attempts to see out the windows, we inadvertently pushed one of the patient panic buttons, and half-a-dozen nurses arrived at a gallop to find the distressed or incinerated patient. Eventually, the sirens stopped and I resumed my fitful slumber.
Monday 29 July 2002
The operation wasn’t cancelled. I showered early and put on the surgical gown. No breakfast but soon the pre-medication was issued and a porter arrived to wheel me down to theatre. I lay in an ante-room where the anaesthetist took over. I could see the operating theatre through a slightly open door ahead. ‘You may think this isn’t having much effect …’ said a voice, and that’s the last I remembered for 24 hours.
Tuesday 30 July 2002
After the operation, patients usually come round for the first time about 9 hours later, but are encouraged to go straight back to sleep and do not recall it. Certainly my next memory must have been the following morning. Strangely, it occurred on two levels. Part of me knew I was in hospital, recovering from surgery. Indeed, the nurse told me his name and explained that he would be looking after me. My body must have been still numb from anaesthesia, but my mouth was swollen and dry, so dry. I was given a drink of cool water: it was like fine wine. The nurse asked if I would like to sit in my chair: and I struggled into it and drank again the cool draught.
But in my imagination, I was sitting at the back of a large marquee, seeing, in the distance, bright light, as one might looking out to where, for example, a cricket match might be in progress. There was a hubbub of people around, enjoying the event. I seemed to be sitting there with my drink and a snack.
As the day progressed, I became gradually more conscious, and the imagined version of events went away. I didn’t actually see much of my nurse, as he sat behind the bed head, presumably monitoring the life-support systems until they were no longer necessary. It must have been late afternoon or early evening when he said it was time for me to be moved into the other ward.
I arrived in HDU feeling pretty sorry for myself. By now reasonably conscious, I was aware that I was still naked, attached to a catheter and with most uncomfortable bowels. The nurse found a pair of blue pyjama bottoms (not mine), which was all I wore for the next two days. I had a little soup for supper. Then a bed bath with my little red flannel – how I hate wet flannels – after which I asked for the commode, but it brought no relief. I had a fitful night, watching the other recovering patients ranged around, in various states of undress, propped up, or almost suspended, as it seemed, over their beds, like panels from a painting by Hieronymous Bosch.
Wednesday 31 July 2002
Morning brought me closer back to reality. I had breakfast (though not the newspaper) and soon I was being wheeled through to the normal recovery ward. My bed this time was in a conventional part of the ward, a room with four beds, separated from the corridor by a glazed wall. A television in the ward was showing the Commonwealth Games. I was wearing an oxygen mask, smelling unpleasantly of plastic and soon gurgling away constantly as the levels of saliva/condensation built up. A physiotherapist explained how to try and clear my air passages – coughing was enormously painful, but the build-up of mucus was the penalty paid by smokers.
I managed to start walking again, gingerly, and caught up with the man from Cheltenham, whose op had gone ahead on the Thursday when mine was cancelled: he was doing well, and was expecting to be discharged the following day (D + 5 after the op), and the other man from Cheltenham was also fine, expecting to go out a day later. My friend from Portishead was scheduled for an operation on Friday.
Thursday 1 August 2002
I slept little, and rose early, twice for large bowel movements bringing much relief. I had breakfast and bought the newspaper again. At last, my holdall reappeared, and I was able to change into my own pyjamas.
Teresa and Jay visited after lunch, though they had to wait until my leg wound had been re-dressed – it was weeping slightly. Teresa said later that I was still fairly groggy during the visit. I was still finding it quite an effort to talk. They produced a sheaf of get well cards before leaving for the journey back.
Late at night, an attack of diarrhoea.
Friday 2 August 2002
More diarrhoea early morning, then visits to the X-ray and ECG units for tests, which turned out to be satisfactory. Blood tests had also proved satisfactory, so, in principle, if we’d had transport, I might have been discharged on the Saturday (D + 5 after the operation). However, we had opted for hospital transport, and a car was provisionally booked for Monday.
The physiotherapist visited, and brought me a device to blow into to develop my lung functions. I failed miserably to get the little yellow marker to its appointed place, and trying too hard risked a bout of extremely painful coughing.
During the day, I was moved yet again, back to the ‘corridor’ ward I started off in, though to the corner bed next to the one I had vacated five days before and the same bed used by my friend from Portishead, whose operation had obviously gone ahead as planned. He had left the personal salt and pepper, but alas they were now exhausted.
The ward now was a mixture of post-op and pre-op patients. I chatted to a nice old gent from Bradford-on-Avon who was keen on sport, and managed to get the television on for the news, but the nurses soon said it was too loud and off it went.
Saturday 3 August 2002
A slight scare during the doctors’ morning round: as well as keeping an eye on the discharge from the leg wound, the surgeon mentioned my ‘high temperature’ – this would have been bad news, as it usually means an infection – but fortunately one of the junior doctors obviously more familiar with the actual figures whispered as he passed that my temperature was actually OK.
Being the weekend, the morning routine of breakfast, paper and pills ran very late. Eventually, I prepared to take my first shower since the operation: I had to move very slowly and gingerly: all the dressings came off the chest and body wounds, which looked fine. The leg dressing would need replacing later.
A lot of phlegm to bring up first thing, but no more problems with the diarrhoea: I’d mentioned it to the nurses, who said they could only prescribe something if they had a sample. This immediately seemed to have the desired effect. I also had a minor victory with my blowing device, getting it easily beyond the mark I missed so badly the previous day.
In contrast with the period before the operation, I now had little appetite and found the food unappealing: I decided the main reason was the persistent smell of iodine, which had been on my chest and permeated all my clothes. It lingered even after I got back home. To make matters worse, the lunch list had been lost in the kitchens, so everyone received a quite arbitrary choice – chilli con carne in my case, which I never eat.
The sporting gentleman was discharged, to be replaced by a post-op patient I had first met in an earlier ward. He was having some minor problems preventing his discharge, and was pretty grumpy as a result. He called for a fan to cool him down, and I had to draw the curtain to shelter from the draught.
The evening nurse worryingly asked about my ‘fever’: I looked at the figures after he had gone, and could see nothing other than some expected variations around a mean.
Sunday 4 August 2002
Breakfast and the Sunday papers, but no doctors’ rounds, so all hopes for discharge would rest on their morning round the following day. My main concern was the erratic state of my bowels: almost certainly caused by the huge variety and quantity of drugs which were being administered. I asked about a pill for the journey – I didn’t want any accidents on the way home.
During the course of the day, sundry tidying up in preparation for discharge – removal of stitches etc, and of two long thin wires inserted through the chest into the heart as a precaution in case the heart were to need electrical stimulation during the operation or after. Further blood samples and an ECG were taken, but the nurses seemed confident I would be out the following day.
During the evening, phone calls from Teresa reporting that Jay had started her orchestra course at Beauchamp House without any problems. We’d both been concerned that she would be difficult after recent experiences at a master class and her violin exam. She was due to have a wet week under canvas.
Monday 5 August 2002
The registrar’s round: a quick look at my records and the chest wound. ‘And do you think you would make better progress here or at home?’ he asked. ‘At home,’ I said. Then the words I had been waiting for ‘I think so too.’
The car wasn’t booked until 12 noon. I had plenty of time to pack and look at the paper as I waited. Midway through the morning, my friend from Portishead emerged from HDU and back to the recovery ward: welcome news and I was glad to see him and congratulate him. Ironically, during the morning, the library trolley made its rounds: I had been in theatre the previous Monday, so never got see what gems it had to offer.
Bowels were not too good, but I gritted my teeth: I wasn’t going to risk my release now. I never did get my pill for the journey, but fortunately things settled down of their own accord.
The nurse took a final set of BP and temperature readings, put a fresh dressing on the leg, and, shortly after midday, I was wheeled out of the ward and down to the waiting car. It took barely an hour for the journey up the motorway and back to Toddington. Teresa and I stood weeping in the porch together like two big softies … together again.