anaesthetics

Twenty Four Hours

~ tidalscribe.com ~ 27 Comments

When I woke up there was a strange man in blue standing by my bed, then I remembered I was not at home. He spoke.

‘The operation went well.’

I felt a sensation of total relaxation, the sort of calm people spend hours doing yoga or meditation to achieve. I looked at the clock, it was 5.45pm. I had not woken up during the operation and it was all over, a quick feel revealed that the right side had been operated on. Now I need do nothing except lie there and relax.

It’s only now that my writer’s mind brings forth alternative scenarios, what might be said to you when you wake up…

‘I’m very sorry, the operation went wrong…’

‘You’re in hospital, you had a massive stroke when you were in the operating theatre six months ago…’

‘Do you understand, you have dreamt the past thirty years, you are not a writer, you are in a high security mental institution…’

Fortunately it was still Friday evening and I was soon down/along/up? on the surgical ward. The four bed bay was devoid of other patients, I was not by the dusty window, but sitting up had a view of the harbour. Dinner was not an option. I had been amused when my friend told me she managed to eat quarter of an egg sandwich over three hours after her operation and the walk to the bathroom made her sick.  A cup of tea and a nibble of ham sandwich was welcome. Getting out of bed is encouraged, a relief not to be involved with bed pans, but the walk to the bathroom did make me sick.

In the lead up to the hospital visit there had been much discussion on what I would take in with me. There were numerous leaflets written pre and post Covid and pre and post our three local hospitals suddenly deciding to call themselves University Hospitals Dorset NHS Foundation Trust and changing the phone numbers.

The main message seemed to be Don’t bring too much stuff, Don’t bring valuables. I was certainly not going to bring my brand new iPhone, which according to my younger son who looked it up after my older son bought it for me is very expensive! And I had managed to lose WiFi on it. I had brought my old phone which still had its sim card, but I couldn’t log in to NHS Wi-Fi in the pre op waiting room, because you had to confirm when they sent you an email and I didn’t get the email as I didn’t have any Wi-Fi… Nor was I going to bring any bank cards to log in to the bedside television, wifi etc which I was sure I would not be able to work; the leaflet said just bring small change. My Kindle would be enough entertainment, though it would be a shame to miss Gardener’s World...

I couldn’t imagine they expected every patient, however old or unconscious, to leap out of bed and rummage around in the locker for their smart phone to contact their family as soon as they arrived on the ward. Patient notes have next of kin and a phone number and you only want two messages sent to someone responsible ‘still alive after operation’ and ‘come and fetch me.’

It turned out they did try and ring the hospital but there was confusion over phone numbers and they weren’t to know how late I had gone down to the operating theatre…

A closer view of Poole Harbour

The nurse did ring my daughter so I sat back and relaxed for an evening of blood pressure and pain tablets, each time asked my date of birth, presumably to check I was still alive or still the same patient. One more patient arrived in the opposite bed. The nurse said she would be back at 11.30pm with the anti blood clotting injection so I didn’t bother turning off the light or tying to sleep. At 12.30am she still had not arrived and I wondered at what time my blood would start clotting.

At 1am I had the injection and presumably went to sleep because a cheery voice said ‘Good Morning’ and checked my blood pressure. I was looking forward to breakfast, but it looked very dark for a summer morning. When I asked the time the nurse said quarter to four! After a wander to the bathroom I asked the nursing assistant what time breakfast was – 8am. Then asked if I would like a cup of tea and a biscuit. YES

Custard creams, yuk, bourbon, no..  or  digestives. Yes please. When the mug of tea arrived there was a packet of three Crawfords digestives, I refrained from saying ‘Haven’t you got Macvities? and it turned out to be the best tea and biscuits ever.

Breakfast was a nice bowl of porridge and toast, all I could imagine facing when I ordered it the evening before. The elderly lady opposite was bed bound and mouthed something, I realised she was whispering I’ve had half my bowel removed. I got out of bed and searched for her lost pen unsuccessfully, then lent her mine so she could fill in her menu. Also I had a good look through the dusty window at the views and took photos, my old phone had come in handy for something.

Another view of the outside world

A doctor came round and said I could go home after lunch, so I went and had a wash, dispensed with the hospital gown and put on my new nightie. Any moving around involved lugging the wound drain bottle and the long length of tube I would be attached to for the next week or so.

I had just got back into bed and a different doctor came by and said I could go home right now. The nurse asked if I wanted to ring home. I tried to explain the phone situation and asked if she could ring. A sensible request as she knew the system and I didn’t. Getting from a ward to the ground floor and then endless corridors to the multi storey car park had seemed a logistical nightmare, but my daughter was told to park in one of the few bays near the main entrance and ring the moment she arrived and the nurse would wheel me down. A better exit than my arrival in my son’s builder’s van. On the way from the ward we passed the machine for purchasing access to the television which had remained perched up by the ceiling above my bed. I hadn’t even needed the small change as in Covid times no one comes round with trolleys and newspapers etc

My departure was exactly 24 hours since we had arrived thirty minutes early the day before and about 21 hours since I had gone to the theatre. Sunday would bring the district nurse on the first of the daily visits...

The Long Corridor

~ tidalscribe.com ~ 46 Comments

If you are purposely going into hospital for an operation, perhaps purposefully, elective, not elected… you will probably be filtered through the system with all the operations for that morning, afternoon or day; so make sure you get the right operation and don’t assume the time on your letter has anything to do with the actual time you meet your doom go to the theatre.

The basic procedures are much the same for all of us and after our many lockdowns and isolations at least we get to talk to lots of people and answer lots of questions, again, from nurses, anaesthetists and surgeons. This is your opportunity to remind the surgeon which side they are doing. You can also mention to the anaesthetist that documentary you saw thirty years ago about patients who wake up during their operation, but can’t alert anyone because their eyes are taped over and they are paralysed. Point out this is in the notes on general anaesthetic under Rare Risks AWARENESS, just above Very Rare Risks – DEATH. Anaesthetist reassures you that there is only a very slight possibility of waking up, just wave your arm if you do. You have more chance of being involved in a road accident on the way home… reminding you of something else to worry about. Of course, there is also a very good chance of waking up at the right time in the recovery room.

In this long corridor of waiting rooms and little consulting rooms and long waits, at some stage you will have to change into a hospital gown, tight black stockings which are hard to pull on ( ladies, you needn’t have worried about shaving your legs after all ) and your dressing gown and slippers, which hopefully you haven’t forgotten to bring. Then you realise the overnight bag you brought isn’t big enough for all your street clothes.

When I went for my interview with the breast care nurse the week before, she produced the consent form for me to sign and it said mastectomy left hand side ‘NOoo, it’s the Right side’

‘That’s funny, only the second time that’s happened to me in twenty years, I’ll do a new form.’

Because I was slotted in at an earlier date I hadn’t met the surgeon who was going to do my operation. He asked if I was happy for him to examine me or did I want a nurse present. I thought hmm, not worried about being molested at my age, but I just said ‘No, that’s fine.’ I was tempted to add ‘well you will certainly be the last chap to play with that breast… ‘ I did add ‘…as long as you know which is the right side, which is the right side…’ He did some drawing with his felt tip pen, saying don’t worry, it will come off.

The worst part was being back in the waiting room in the middle of the afternoon with no food since 7.30am and no water since 11am and more waiting; there were not many patients, but they all seemed to go before me...

Then at last yet another nurse comes to collect me, my bags are confiscated secured and tagged. Now the long walk to the theatre, the walk down long corridors, this is why you bring your slippers. It was a relief to get moving and stretch my legs and interesting seeing all the secret parts of the hospital. Everything is blue; corridors, doors, uniforms, scrubs…

These days patients wear masks as well as the medical staff, so naturally I was wearing my favourite mask to get Brownie points. My last general anaesthetic was in 1978 and most of those involved tonsils or teeth. I had all my caesareans with epidurals and some hand surgery under local anaesthetic, so I didn’t miss out on what was going on…

Destination anaesthetic room, next door to Theatre Number One; the nurse let me peer through the porthole where people in blue scrubs were getting everything ready; all that just for me! My elderly neighbour who had the same operation a year ago had reassured me that being an anaesthetist is an actual job, an important job and my friend who watches all the hospital programmes said they look after you all the way through the operation!

Everyone who has an operation will tell you that they put the canula in, put an oxygen mask on and tell you to take some deep breaths, next thing you know you wake up in the recovery room. I kept taking the deep breaths and I was still wide awake, it wasn’t working! Then the anaesthetist said ‘Okay, I’m going to start putting the drugs in now, first the pain killer, tell me when you feel funny.’

It was a lovely warm glowing feeling and then…

Going To The Dentist.

~ tidalscribe.com ~ 19 Comments

It is a truth universally acknowledged that most people don’t want to go to the dentist. It is also true there is nothing worse than toothache, so there are occasions when you may be glad to visit. Another mystery is why anyone would want to BE a dentist, but that’s for another blog (perhaps a blogging dentist.)

Dental tales abound among three groups of people; those who never go to the dentist, those who will travel miles to visit the one and only dentist they trust in the whole world and those who change dentists as often as their clothes. The last group doesn’t always reflect on the dentist; how many of us put off going for a check up, then are too embarrassed to face our dentist; you can’t fake it for he will look up his records…

‘Sorry I missed my last check up.’

‘It’s actually eight years since you were last here…’

So we seek out a new dentist who must go through the whole procedure – dictating to his assistant in a strange language.

4 upper missing, 6 right lower decay, front left 7 amalgam, back lower 15 gold crown…

Just put this sharp piece of plastic in your mouth so we can take an XRay…  and the other side, open even wider for this extra large piece of plastic. Okay, that’s all for today

Sigh of relief.

Make an appointment for next week for three fillings and a three hour appointment in a fortnight to remove those four teeth…

I knew someone who would ring round dentists asking ‘Do you knock people out?’

The answer is usually No as dentists do not want to be responsible for a patient dying under general anaesthetic.

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My frequent attendance at dentists as a child was through no fault of my parents, except genetically. I was not allowed to have ice lollies, only ice cream, sweets carefully rationed. It was the orthodontist I had to visit at nine years old. At the time it was thought it was necessary to act quickly before it was too late, but nowadays plenty of adults have their teeth straightened and braces are an accessory.

I had teeth too large and too many to fit in my mouth; nearly a dozen first and second teeth had to be removed to give the remaining teeth room to grow straight. In those days cocaine was something injected into your gum at the dentist, the local anaesthetic. There was also gas, general anaesthetic. I sampled both, how it was decided I don’t know; I recall gas required the dentist to have a doctor present. The first time I was to have gas I walked into the room and was horrified to see a huge tank with a large skull and cross bones on. My first sensation on waking up was feeling the dentist was trying to yank my mouth open.

In between all this I wore a single wire on my teeth, a removable plate. Visits to the orthodontist were to tighten the wire, a cause for aching mouth during the night, but probably not as sore as after tooth extraction.

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Why do we have such fear of dentists?  People unlucky with ill health or accident have surely endured much worse suffering. Perhaps it is because it is our head, an intrusion into the part of our body we need for speaking and more vitally, breathing. We can’t talk or protest. I’ve had three caesareans and two carpal tunnel operations awake; lying helpless in the dentist’s chair is definitely more daunting.

But don’t be scared, it’s not really that bad. A handy hint; the older the building, the narrower the wooden staircase, the higher up the winding stairs you go, the better the dentist.  My current dentist is in an edgy part of town, a nice young man at the very top of the building, unlike my previous dentist he discusses everything with you first. I had a tooth out on Monday, it’s not fun having the first needle go in, but better than the alternative! Luckily he asked if I could still feel anything – YES – so he gave me a third shot.

Tell us your best – or worst dental story.

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