I think I was actually stressing more about the taxi turning up on time yesterday than I was about the op, and I didn't even try to sleep, spending the night drafting my piece for BADD tomorrow. The taxi was actually early, and by 7;15 I was sitting in the 'Sunderland Day Case Centre' ('Sunderland' as Rochester is where Shorts built the iconic flying boat - I spent 22 years working for Evil Aerospace in the old Shorts Factory), sittiing facing a lovely print of a Sunderland over Southampton Water really helped also helped with the relaxation. They actually opened at 7:30 and I was fairly quickly called through into the ward area, which was more extensive than I expected, at least 4, probably 5 bays, for between 6 to 8 patients each and a whole load of treatment rooms etc.. Quick run-through of pre-admission details with the nurse - as soon as she heard I live alone it was 'right, you'll definitely be staying overnight', another with my surgeon 'I can't guarantee it will solve the pain, but I can guarantee you'll never have gall-stones again', then a third one with the anaethestist, who really impressed me as knowing his stuff. Being hypermobile means a reasonably high likelihood of unusual reactions to anaesthetics, such as them not working, and various bendy friends had emphasised I needed to make sure he was up on this, which he was, and he was equally quick in understanding the implications for moving me onto the table when I've subluxed hips and shoulders in the past (in fact within the last month for my hip). He told me that on the off-chance the local I'd be getting on top of the general didn't work then he'd be quite happy to prescribe Patient Controlled Anaesthesia (which delivers IV Morphine on demand), which is the one thing I wish I'd had during the December admission. He'd also caught something I'd completely missed, which was that the fact I've had (and may still have) a C5/6 disc prolapse meant there were concerns for arching back my head to insert the ventilator tube. The only negative is that their records again said I have ankylosing spondylitis, which must still be in my GP notes even though we discarded it as a possible diagnosis 20 years ago. And now is presumably in my hospital file as well - which is comfortably 5cm thick.
Then it was sit down and wait - turns out I was second on my consultant's list, and it's a 60 to 90 minute op. They had the sense to tell me I didn't need to change into a gown as yet, though unfortunately the seat in my bay was a plastic bucket type, which I really don't get on well with and I started getting uncomfortable fairly quickly. There was a surprising mix of patients in the bay - another guy in for his gall-bladder (number 1 on the list, bah!), an amputee between me and him who'd been in for several days and was waiting for a transfer up to a rehab centre (OTOH I'm not 100% certain he was actually in for the amputation itself), a woman on the other side of me with potential appendicitis, a guy having existing pins removed from an old leg injury, and a young woman directly opposite who'd been admitted overnight when her existing lumbar disc prolapse worsened, I spent some time comparing back notes with her, she was particularly pissed because she'd only just been discharged last week.
Round about 10:30 I spotted my surgeon wandering past , so clearly number 1 was finished, and the nurse popped up relatively soon after that to tell me it was time to change into the gowns - one worn front to back, the other back to front rather than a dressing grown, and the so-glamorous thigh high compression stockings which are my constant companion for the next fortnight. They decided they couldn't really ask me to walk down to the operating theatre given crutches, so around about 11AM I was wheeled down on a trolley to the pre-op prep bay, where I met up with the anaesthetist again and his rather gorgeous nurse (a statuesque black woman in scrubs, I think my brain may have been focussing on her rather than the impending op). They checked my ID and wrist band for about the dozenth time that morning, the anaesthist said it was time to go to sleep, and the last thing I remember was him saying 'the injection might feel.... ' and that was it.
I woke up in recovery, very woozy, and with a couple of nurses hovering and trying to get my attention and telling me everything had gone fine, I clearly wasn't completely out of the anaesthetic at that point as there was a very weird fish-eye effect on my vision. And then I went back to sleep again and woke up back in my bay at about 2PM. At that point I discovered my stomach was rigid to the point you could have played it like a drum - they inflate the abdominal cavity with CO2 to give them space to work through the keyholes, which has the unfortunate side-effect of meaning one of the post-op issues is a really bad case of trapped wind (gas, for our US readers). Closer inspection revealed that I had four dressings on different incisions, the main one in the belly-button and three smaller ones in an arc just below my right ribs. I also realised (eventually) that someone had completely shaved my abdominal hair - I'd expected some to go, but they went for a clean sweep - in which case couldn't they have done the chest hair as well? I don't think 'the crop top' look is quite as fetching as 'the brazilian'! I'd also acquired a pair of pressure leggings over the stockings which were alternatively compressing each calf from bottom to top.
Initially I was okay painwise, but then I went into a cycle of going from practically nothing up to an 8 out of 10 over the space of about twenty minutes and then back down again. I think at that point they would have kept me in even if I'd had people to look after me at home. The initial response was oramorph, which helped, but IV morphine might have been closer to the mark, I also felt like I needed to pee, but couldn't. Given I was clearly still in pain they got the anaesthetist in, a different one this time, a pleasant young woman, but equally on top of her game and ready to offer PCA if the initial solution didn't work. But first she wanted to try an anti-spasmodic, and that was when things went slightly wrong. I got the oramorph she prescribed, but simultaneously another set of nurses turned up wanting to move me out of the bay I was in as they were making that one all female for the night, plus the shifts were about to do handover, and I fell asleep. It wasn't until I woke up about 9PM, still with pain going on, and asked if 'd had the anti-spasmodic (buscopan - I had it when I was in just before Christmas and it was pretty effective) that they realised they'd completely forgotten it - and lost my drug notes, which it took them an hour to find, clearly that wasn't ideal, but we got there in the end. PCA was mentioned again if that didn't work, but there was a hint that would mean a longer stay, which I didn't want and by that time I think I'd sorted the pain problem on my own by dragging myself up into a sitting position on the edge of the bed, which clearly shifted me around enough to let me a) belch away some of the CO2 that had been diffusing into my stomach, and b) pee! (I'd thought the semi-reclined position they had the bed set in was part of the issue, but I wasn't really up to articulating that to the nursing staff before then).
I finally managed to eat something about that point, they'd given me a cheese sandwich earlier, which I managed about a bite of - I'd have been better going with one of the other sandwich options, cheese on its own was too dry, but after 4 months with no cheese in my life I was really looking forward to some; second time around I went for cheese and tomato, which was just right (I think I must have slept through dinner, and been under the knife during lunch). Things got better after that and I managed to sleep comfortably, though it's a hospital, so there's noise all through the night as patients arrive and so on (plus I turned into the amazing pee monster, I didn't think I'd had nearly that much to drink). I think I probably managed 8 hours of sleep in total between the op and this morning, but in sessions of 2 hours at a time. I was wide awake come 6AM, so took the opportunity to get out of bed, even if still hooked up by the six air hoses linking the little compressor to the pressure sleeves. I didn't get very far, but I managed to do enough stretches to work out a few patches of stiffness from being in bed too long and once one of the nurses came to check on me got the pressure sleeves off and was able to walk to the loo.
And that was pretty much that, they fed me breakfast, checked I wasn't in any significant pain, changed my dressings, loaded me down with paracetamol and ibuprofen, and sent me on my way with instructions to make an appointment at my local wound clinic to have my dressings changed tomorrow - which handily is in my own GP's surgery, though given the bank holiday weekend the only slot was 8:30 in the morning :( The one unexpected development was one of the theatre nurses coming by just before I was discharged, she'd managed to jag herself with a needle while clearing up afterwards, which meant both of us needing to have blood tests. Given how much fun (not) I'd had with bloodtests last week I wasn't looking forward to that, but when I warned the phlebologist she went for a slightly different option, a vein around the side of the elbow, which she says almost always flows better than the ones in the crook, even if it is a bit more difficult to find.
I'd been warned one of the characteristics of the abdomen full of C02 was radiating pain in your shoulder, and thought I'd gotten away without experiencing it. 50m of walking with my crutches changed that, and by the time I'd walked the 300m or so to the front entrance I was seriously shaking. But I popped into the hospital shop to get myself something to eat, and by the time I'd texted a friend to come pick me up, and eaten a packet of hula-hoops, I was feeling much better, and 20 minutes standing in the sun waiting for him completely fixed that. The ride home was slightly unpleasant, being rocked from side to side by bends and bumps in the road was setting stuff off, I hadn't realised how much noise I was making until my friend asked 'do I need to pull over?'; but it was more me whinging than there being any serious problem. I was home by about 10AM, and after sitting down with a ham sandwich and a cup of coffee I was fine again.
The sun's out now, and hopefully it's warmed up from earlier, so now I'm going to go and see if I can't doze in the sun and catch up on some more sleep.