J: Two for the theatre please!

Today, Thursday, my wife and I are both on our separate ways to the operating theatre. She for a thyroidectomy which is just precautionary and should be a straightforward overnight job. Me for a hip replacement which in itself is routine these days – it’s just all the other cancer issues I have going on which make things more tricky peri and post operatively.

My wife starts her day in the ‘Marshalling Yard’ as we call it,  where pre-op patients get final talks with surgeons and anaesthetists before going to theatre – there can be quite a wait.

I look to be a bit more lucky. I will be taken straight from my current oncology ward to theatre. The surgeon, Michael Bishay, asked when I wanted to go and I said “First, so I can be up and about quicker.” He said I need to see the actual anaesthetist first (the one who passed me the other day is not on duty) so he’s going to do me second, sending the anaesthetist to see me once he’s got going with the first op and is happy for the assistant to monitor. This may of course change as schedules often get hijacked by events.

We should both be out of post recovery wards in the afternoon so I hope our son will be able to post a status update this evening. I don’t expect to get my exit visa until Monday at the earliest though; not having used my right leg for several weeks it will be pretty weak and blood imbalances may return.

A word about drugs
I have had quite a shuffle with my drugs since coming in, thanks to interventions from Dr. Frim, who has been duty consultant, Dr. Mason, who was on duty when I first came in and Dr. Simon Brooks who is the Palliative care doctor and one of my new heroes.

Dr. Mason persuaded me to go on cocodamol which my GP prescribed ages ago but where the codeine content makes it constipatory so I had been avoiding. But it is more powerful than plain paracetamol. Discussing this with Dr. Brooks he moved me back to plain paracetamol plus a weekly patch which works like codeine but without the side effects. I like this combination.

Dr. Mason also put me on gabapentin which is good for nerve pain and seems to be helping.

Some days ago I started to feel very weak again and spoke to Dr. Frim about this. She prescribed steriods and I was amazed by the quick pickup I had from these – which my daughter witnessed with her own eyes over the course of about an hour. I had assumed the weakness was because of high calcium again, but when bloods came back Dr. Frim said I had low phosphate (also cancer related) and I’ve been having tablets for that – a bit like alka seltzer.

All a bit complicated as you can see and it made me realise I could never have had these interventions at home as a lot arise from easy access to these specialists who can quickly deduce stuff from the regular blood samples. So am I very glad to know that Dr. Brooks spends half his time working with Dorothy House, the local hospice which is big on outreach. Once discharged from the hospital I will be assigned a Dorothy House nurse who can be a point of contact for me if I have changes and concerns. That nurse can then go to Dr. Brooks or whoever to get me the right advice, organise bloods etc. That is really good to know as I’ve been concerned about how all that will work out. This gives me much more confidence for going home.

Dr. Walters has also taken out my non-yielding right lung drain so that’s another potential complication removed and the wound has given me no trouble.

We now have the stairlift installed at home thanks to our son’s great research and organisation. It was quite a task for the team as it’s a reconditioned unit (so we could have it quickly – and cheaply!) and they were there till after 8pm two nights running to set it up with the available parts they had and adapt it for our complicated stairs, rather than the one day job they expected.

A stairlift which of course I should not need as I should be ditching the wheelchair and walking out of here on sticks, then discarding those in due turn. So the more of a waste of money it proves the better! But I am glad to have it as judging by events to date and the new tumours identified in my abdomen etc. I’m likely to be up and down, so going up and down at home may still be a challenge from time to time and knowing I can just press the button is another big comfort factor.

The William Budd Ward
I have now been in the William Budd ward for just over two weeks. It’s a specialist oncology ward. I did not like it at first as I had a rather dour team of nurses who spoke Chinese across me and handed me a bowl of food while looking the other way and I was flat on my back with no table in reach. Fortunately I’ve not seen them since and I’ve had a really good series of teams.

They don’t always run it with quite the precision I would like, particularly as to drugs. Most wards dish out the drugs very punctually but here it can vary quite a bit. This can have consequences. For example my lunch time drugs were two hours late which then knocked into my evening drugs. As a result I could not have my night time paracetamol and gabapentin at 9pm and was told I’d get it at 11pm. But at 2am I woke in pain and was told I’d been asleep at 11pm so they did not want to disturb me. If you let the pain get ahead like that it takes longer to get over it.

The ward seems to be the only one operating a 9am shift handover and will next week be switching to an earlier time to match the rest of the hospital so that may help. They are also very prompt at answering bell calls. I’ve never heard a patient bell go unattended for more than a minute whereas in some wards I have known them ring and ring. And I’ve never seen them handle vulnerable patients with anything but kindness and gentleness.

I am lucky to be in a small bay of just four people, all of whom are quiet – i.e. no dementia, not needing a lot of night-time interventions, noisy equipment etc., so although sleep is always difficult due to lights and comings and goings it’s been pretty peaceful.

The food is the same as throughout the hospital though – pretty patchy. I find I can only eat about half of it. Mind you half of it is all you need as you burn so little lying around all day and they want to feed you as though you were a brickie. So that leaves plenty to keep body together. As to soul that can take its refreshment from anywhere, whether it’s a kind smile, the latest nonsense pronouncements of preening politicians on the radio, a glimpse of the sun or a visit from the family. I wake today feeling better than I have for quite a while and am really looking forward to my shiny new hip.