Dressed

Jul. 12th, 2016 03:33 pm
davidgillon: A foot, mine, in a camwalker brace (Boot)
I finally had the dressing changed on ex-nail today - it was supposed to happen at the 48 hour stage, but they forgot to give me the number for the wound therapy clinic (conveniently based at my GP's, but booked via a central number) and I didn't get hold of that until 48 hours gone, at which point today was the first available appointment, a full week on from surgery.

2:45PM appointment, home by 3PM, which is a bizarre contrast to last week's surgery and refusal to release me.

The wound itself is a lot tidier than I expected, while the weal from the spilled phenol looks like a burn that just failed to blister. The verdict is both are okay, so no more appointments, just keep covering both with plasters for another week to protect them. That is - fingers crossed - a lot better than last year's experience, when it took about two months for the cholesystectomy wounds to heal.

So I was home by three and the sun was gorgeous, so I pencilled in book, beer, sun for the rest of the afternoon. Which of course meant the skies immediately clouded over, the wind whipped up and the heavens opened.

British summers, sigh!

davidgillon: A pair of crutches, hanging from coat hooks, reflected in a mirror (Default)

Back in December I somehow rammed my left big toenail back into my toe - physically shunted it backwards at least 3mm, which got tediously infected. I finally had a hospital appointment to look at it a couple of months ago and the decision was the nail needed to come off. Ironically within a couple of weeks of seeing the surgeon the infection dried up, but it was clear the nail was slowly being ejected, so no change in the plan. After a couple of changes of date yesterday was the day for surgery.

Admitting time for the Pre-Operative Care Unit (POCU) was 7AM, and no sooner had 7AM come around than they called for me, which given I'd been warned at the pre-op assessment I might be there all day was a bit of a relief. So I was escorted through to a little room of my own (armchair, chair, sink and not a lot else) and left, for an hour. Then I fairly rapidly had visits from admissions nurse, surgeon (not the one I'd previously spoken to, a humongous, jovial Indian guy), and anaesthetist (not quite sure of her origins, but likely somewhere speaking a Latin language), and was eventually taken through to the pre-op room. This was when things got a little weird.

The anaesthetist noted I was down for a local and said "are you really sure about the local, we usually do light general for this?" and explained the op could be done fine under local, but putting the injection into the two nerves of the toe was extremely painful. I said I was willing to be guided, but the surgeon had said local. At which everyone in the room got a rather you than me look on their face. They did check and the surgeon bounced into the room, said 'oh, definitely local', and bounced out again.

So local it was, and by god was the anaesthetist right; forget extremely painful, try excruciating! I didn't quite turn the air blue, but I was swallowing the words to do it. Despite the pain the local was instantly effective, I could feel vague pressure on the toe, but not a great deal more. And the rest of the forefoot was slightly numb. I was through into the operating theatre about ten to nine, and the op started pretty much on the dot. Some vague clipping noises and I was told the nail was off, and then it was time for the 'phenyl ablation', intended to stop the nail growing back as a problem. I did get a burning sensation as they put that on, oddly over my middle toes rather than the big toe. And seven minutes after starting we were done. At which point I was wheeled through to Recovery.

The Recovery Ward had a dozen beds, and I was about the tenth patient to arrive, being hooked up to a blood pressure monitor on my left arm and a blood oxygenation clip on my right index finger. So I was pretty much pinned in place, but they did fetch me a cup of tea, Despite the nurses randomly breaking into snatches of Give Me Joy in My Heart (clearly one of them had earwormed all the others - I suspect the little West Indian nurse, probably not the Hungarian one*) they were ever so slightly in crisis mode; not only did they only have two senior nurses rather than three (one had rung in sick), but they were also dealing with having had three patients overnight in what is supposedly a day-only short-stay ward (which presumably meant every other bed in the hospital was jammed - this is what happens when you have one acute hospital for a city of 270,000+). So the two senior nurses were run off their feet trying to cover 6 patients each rather than 4, the junior nurses were having to cover where the seniors couldn't be and surgical nurses were being forced to hang around until they could corral one of the seniors to do a handover (one of the surgical nurses was someone I knew, we did eventually have a chance to have a catch-up when she was stuck watching a semi-comatose patient in the bed opposite).

Initially this wasn't a problem for me, I was enjoying watching the comings and goings and noting them down in author-brain, but then my foot started to hurt. And not just this is a bit sore, but fuck, this is burning! I finally kicked the blanket off it as unbearable, and there was a bright red weal from the second joint of my middle toe running about an inch onto the top of my foot and then trailing off towards the outer edge. It was pretty clear what had happened - they had spilt some of the phenyl onto me, that burning sensation during the op had been right where the problem was, but the local had been enough to obscure the fact it was still doing damage until it started to wear off. So I needed to flag down a nurse, but of course 'my' nurse had vanished, the beds on either side had curtains drawn, cutting off my view of the rest of the ward,  and every nurse I could see was handling something urgent. On a normal ward I'd have had a call button, and I could have pressed it so someone would come as soon as they were free, but the Recovery ward beds/trolleys don't have one (this strikes me as dangerous, so I'll probably write a letter). In the end it probably took over half an hour to flag someone down.

The nurse wasn't exactly dismissive, but it was fairly obvious that she thought the scenario I sketched in was unlikely. OTOH she did agree to contact my surgeon. He popped up eventually (I couldn't expect instant response if he was in surgery), I explained and he too said he thought it was unlikely, but he'd clean my foot off to be certain. He was back fairly quickly with saline and a scrubbing brush, but as soon as he started he said "You're right, I can smell the phenyl. I don't know how it happened, we put it on with a cotton-bud to stop this". Of course being right doesn't makes someone scrubbing a chemical burn any less unpleasant, but it did at least deal with it. It ended up as a dull weal rather than blistered, which they covered with some gauze to protect it. I haven't checked under the gauze yet, but I've not had any more pain from it.

Time started to tick by, and by Noon even patients who had been brought in after me and unconscious from a general were being released to the discharge ward. Someone eventually mentioned the hold-up was one of the nurses in POCU was worried about releasing me given I'd driven myself in and live alone. And then about 1PM  one of the senior nurses was on the phone to that same nurse, about me, and came over to my bed to check my notes. "Looks like you're here overnight' she commented to me as she discussed it, "there's no way you can drive home with only one leg usable." That was when I stuck my oar in, pointing out I don't use my left leg to drive, and that being a wheelchair user doesn't make it more of a problem, it makes it a non-issue. Which got a collective 'Oh!' and 'We'll go sort out your discharge papers then'. There was a short delay while we waited for my chair and clothes to turn up, but by 1:30 I was on my way to the discharge lounge. (Which incidentally explained why 'my' nurse kept disappearing. Every time she had someone to discharge she had to walk over to the discharge lounge, which is at the opposite end of the hospital, at least five minutes walk away. Add 10 minutes to do the handover and she's out of the ward for 20 minutes a patient). Once she'd handed me over I just needed them to print my discharge letter and I was home by 2pm, asleep in the sun in the garden by 2:30pm.

*Once again, the people caring for me emphasised just how much the NHS depends on immigrants to keep it running.
davidgillon: A pair of crutches, hanging from coat hooks, reflected in a mirror (Default)
"Ah, yes, Mr Gillon!"

It's always worrying when you ring a faceless bureaucracy and they recognise your name.

But in this case it was because ortho-guy's secretary was in the middle of juggling surgery dates and my name was in the pile.

The irony here being that I was ringing to confirm the revised date she just sent out last Friday.

But seeing as she's talking about bringing me forward to next Tuesday instead of three weeks from now, and hopefully that'll let me escape the 7AM check-in of the current date, I'm not too upset. She claims she'll ring tomorrow to confirm, we'll see.
davidgillon: A pair of crutches, hanging from coat hooks, reflected in a mirror (Default)
Hospital appointment went much as expected - 25 minutes late, "Yes, your toe is infected, normal treatment is to remove the nail, sign here'.

In and out in 5 minutes. I'd have to label his manner as brusque, not interested in any details. I flagged up hypermobility as a complicating factor for locals and he noted there would be an anaesthesiologist there on the day, but that was about the extent of his interest.

Embarrassingly I couldn't find my sock to put back on afterwards, I turned out to be sitting on it.

So now I just wait for the appointment date, no idea how long that's going to be.

But after never having had surgery, that's now twice in two years. Clearly it's all downhill from 50!
davidgillon: A pair of legs (mine) sitting in a wheelchair (GPV)
I've just been looking at the mail that piled up while I was away. If you exclude magazines, about 30% of it is for hospital appointments.

Admittedly two of the three are for the same appointment, just one of those was for the date I had to reschedule through not being at the same end of the country. And the final version of that one, tomorrow's appointment to look at my infected toe, is quite likely to lead to further appointments if they don't sort it out on the spot, which I suspect they won't when I point out I had problems with wounds reopening after last year's gall bladder surgery and that hypermobility complicates local anaesthetics. If they do it on the spot, great, but I suspect they won't, and then there's potential follow-ups.

The other is the second wheelchair assessment appointment, and I know that I'm due at least one more after that. The good news is I didn't expect it so quickly, it's for the 26th, and they knew I was unavailable until the 14th, so given I was warned it wouldn't be fast, but it was then upgraded to 'high priority', that suggests that their high priority actually is pretty fast. Of course then they have to build the thing....

It's good these things are getting done, but they are complicating life. I had to shift my fortnight in Durham because of the first wheelchair appointment, which combined with my sister's already booked holiday meant she and I couldn't see a solicitor together while I was there to start the power of attorney process for Dad (which is likely to turn into the Court of Protection process, hence solicitor from the outset rather than doing it ourselves) before the school holidays ended and she's back to being unavailable during the business week. That's the second time it's happened, and I've had to tell her to do it herself when she next has an opportunity, because I just can't guarantee to be available.

Fingers crossed for no more unexpected ones, but my neck and shoulder do show potential signs of being a problem again - the orthopod I'm seeing tomorrow may well be the one I saw about last year's shoulder issue, and he did say it was only a matter of time until I'd be back....
davidgillon: A pair of crutches, hanging from coat hooks, reflected in a mirror (Default)
Apparently my immune system has managed to turn the infection in my toe into a granuloma - iow it's body-tackled it with immune cells and firewalled it away. This is not ideal, so GP is referring me to podiatry, don't yet know where or when, as she couldn't get their IT system to book it. She says they'll sort it out on Monday and ring me. I have a nasty feeling this means someone will be reaching for their scalpels....

This is a pain, fortunately not as much a pain as it would be if I wasn't already on high grade painkillers or was still a walker rather than a wheelie.

 {Sigh}  a whole seven weeks into the year before the first hospital referral.....

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davidgillon: A pair of crutches, hanging from coat hooks, reflected in a mirror (Default)
David Gillon

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