Saturday, 15 August 2009

Operation: Colon

Arriving back at my beloved Chelsea and Westminster A&E (ER for American readers - it's strange, but I can only really associate 'ER' with the show ER - which just seems too glamorous for the real-life thing), I was whisked straight through to get some IV fluids and paracetamol, then taken up to the impressively-named 'Acute Medical Unit' where various doctors came and went. While being wheeled up, I ran into my charming Old Etonian consultant, who looked concerned while I did my slightly pathetic lying-down act. One thing I found after three weeks in hospital - it's difficult to look dignified and, well, 'well' while you're being wheeled from one place to another on a hospital bed.

After this they parked me in a ward with a number of ancient and leaky-looking men, including a chap who threw things when he felt he wasn't being paid enough attention. This was a bit of a shock, as I still wasn't really feeling that bad, and among these incredibly ill and depressed-looking old men wasn't really where I'd have classified myself.

Anyway, doctors came and went. I was on IV hydrocortisone at this stage, with fluids/potassium and various other bits and pieces being popped down my throat or in my arm at regular intervals. I settled down to becoming slowly institutionalised. I was still running to the toilet up to 15 times a day, I suppose. But again, I wasn't feeling that bad, apart from not really eating anything.

There was something a bit worrying, though - I wasn't really feeling significantly better, either. And the doctors who made their rounds every day weren't looking that positive. I had 'levels' of things that 'weren't going the right way'. This was my CRPs (C-reactive proteins - I don't really know what this is, but it wasn't good) and, most importantly, it turns out, my Albumin, which is the protein in your blood.

So I lay there for three or four days, when the surgeons started to appear. This was, as you'd imagine, a little disquieting. The most disquieting thing was how they would creep up, and reassure you so heavily that there was probably no need for them to see you, that everything would be fine, but it was just a precaution. Then they'd flick through your notes and fire some questions at the junior doctors, and look concerned. This disjuncture between their pseudo-sunny disposition on their first arrival, and their barely concealed pity/concern as they left was pretty alarming.

A quirk of Chelsea and Westminster (which, by the way, is a great hospital) is that all the medical doctors seem to be incredibly posh English people, and all the surgeons are Greek. Now I've written that, I sound like there's an interesting anecdote behind it - but sorry, there isn't. These are the kind of things you notice when you're lying in bed for so long.

Mr Tekkis, the head honcho surgeon, came in once a day to explain how he thought I was. Bad news - the albumin was going down and down, which essentially meant I was getting weaker and weaker, and my body less and less able to heal. This was because of the steroids, the colitis, and a lovely new drug I'd been on for a few days - Cyclosporin, an immunosuppressant. He started off by saying it was '50/50' whether I'd be going under the knife. Then it became '50/50, but slightly more on the surgery side' - which I guess didn't really mean 50/50. Then, suddenly, on Friday evening, one of the junior surgeons came up and got my signature on a nasty little bit of paper saying that I was quite happy to go in for a subtotal colectomy. I suppose Mr Tekkis was away playing tennis or whatever it is that surgeons do on weekends.

It all happened a bit quicker than I thought. I didn't get much chance to think about it - which was probably all for the best, if I think about it. On Saturday, a charming German anaesthetist came and half-explained what happened. I was quite excited about having anaesthetic - I mean, come on, there's not much else to look forward to. Then I was wheeled up to the mysterious fifth floor, where the surgery happens.

Oddly, the ceilings were painted with jolly murals depicting little flying birds, blue skies and pseudo-Mediterranean tiled roofs. The nice German whispered things in my ear while I got painkillers and other bits and pieces inserted, and then said 'In a moment, you'll go to sleep'. I was at least expecting a 'count down from ten' moment, but it was quite nice, at least. Zzzzz.

Some time later, I woke up in 'recovery' - a giant room that I imagine on ordinary weekdays was filled with people slowly coming round from major surgery. On this particular Saturday, there was little old me and a wailing child, who may or may not have been French - I'm not quite sure how much I was hallucinating, because I also thought I was in Le Meridien hotel - just for a split second, mind.

The nurses in recovery, as you might forgive them for being at 4.30pm on Saturday, were chatting over my prostrate body about their plans for the weekend. All I really wanted was a big hug. Instead, I got a kind of big hot lilo over me that kept me warm - this is at least called a Bair Hugger, which I only found out afterwards, but made me feel a bit better. I had vague recollections of being lifted and hauled about a bit. And feeling cold, then hot, then cold.

It's strange, because one of my main concerns when I went into theatre was that I would wet myself. No-one really explains that they've got this all figured out. You wake up to find a tube right up there - hooray! And there was obviously no issue with the rear end, given this was now non-functional.

But the weirdest part was that I couldn't really feel any of this. I didn't realise why at the time - but along with the urinary catheter and ileostomy, they'd popped in an epidural. This is a local anaesthetic in your spine - I only really knew anything about it in terms of women in labour. Still, as far as I'm concerned it was just another little box on a stand that went around with me.

Back to the ward after recovery was pretty traumatic. I had a naso-gastric tube which went up my nose and into my stomach (as you'd imagine), and gave me a voice a bit like Marge Simpson's sisters. I was obviously also basically unable to move, given the epidural kept me numb from diaphragm to toes. BBC Radio 4 kept me sane for the first 24 hours, as I listened my way through all manner of crap. Thank God for all these crazy British socialist inventions like the NHS and the BBC. So I just lay there, listening to Jenni Murray's soothing voice, depositing involuntarily into various bags, while other bags pumped the good stuff back into me.

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