Twenty Four Hours

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 Game of Death – New Players

Warning: If you want to avoid the topic of death and dark humour read no further.

Covid 19 has made people think and talk about how people should die, with emphasis on not being alone, preferably with family. Covid patients in isolation have been unable to see loved ones.

In reality most of us cannot choose where to die or plan the scenario; victims of murder or major disasters certainly don’t have the luxury of dying in their own beds comforted by family. Awful circumstances such as terrorist attacks find total strangers holding the hand of a dying person, giving their death some dignity. As no one comes back to tell us, we cannot know if the surroundings and company or lack of it make any difference to their own unique internal solo journey. Celebrities often seem to have died ‘peacefully at home with their family present’ but folk lore and family tales seem to indicate that dying people often wait till the very moment loved ones pop out of the room.

Most terminally ill people will probably get the chance to opt for palliative care at home, though it can’t be guaranteed; they may need to go to hospital or a hospice eventually, but Covid has made it even more desirable to stay at home and leave hospital beds free for others. Unless everyone in your family is a medical person, carers will need help along the way or near the end; team work and various bits of equipment are required to make life easy for patient and carers. There is nothing to stop you ordering wheelchairs and all sorts on Amazon and getting next day delivery, but the National Health Service is geared up to lend what you need and the various teams helping you will be busy arranging equipment. The largest item is the hospital bed; you might die in your own home, but probably not in your own bed, however romantic that looks in films. The beds have to be plugged in and do all sorts of things. The bed and other items come with wheels and stiff pedal brakes impossible to put on or off if you are only wearing your slippers!

In the first few months of the lockdown I coped fine by myself with Cyberspouse. District nurses were trying to avoid going in any homes, but they phoned regularly with advice and to arrange some of the medications. They were ready to come out with their protective gear if necessary. Cyberspouse was happy not to have any visits, medical or otherwise, relaxing at home in the exceptionally sunny weather we had.

Later on, family help was more vital than keeping isolated and they took turns to come and stay; it was only in the last ten days that the district nurses came and arranged for Marie Curie nurses to parachute in with four visits a day. A helpful bright yellow book arrived promptly in the post. We were also glad a few times to ring the emergency numbers that had been sitting by the phone for months; night duty district nurses and 111 doctors. Marie Curie were excellent, compassionate and caring ladies and one chap. Visits rapidly increased and they made sure I had a night nurse for what turned out to be the last night, one of the few nights I was going to be by myself. They told me I was going to have wonderful Linda who had been doing the overnighter ‘forever’.

Linda arrived with a huge bag, rather like a mature Mary Poppins. I explained yet again that none of the family lived nearby, but they had all been to visit and my daughter was coming back the next day. It was a busy week in real life with two grandchildren just back in the UK and starting a new school and my daughter’s son starting school! Younger son had just got engaged. Linda was there to make sure Cyberspouse was comfortable, to organise the practicalities and make sure I didn’t miss the moment…

I later got a nice card from Marie Curie and they have rung me a few times to see how I am getting on. They are a charity well worth supporting.

Handy Home Hints

You might think your loved one is past the point of seeing the GP, but it is the GP who has to prescribe the drugs and you will have to go and sign for the ‘just in case’ controlled drugs as well as collecting various ongoing prescriptions.

It is helpful if someone in the family works for the NHS or has a friend in palliative care nursing … my daughter is a physiotherapist and had that very friend to ask for advice. She always made lists of questions and sounded professional on the phone, so we were well prepared.

After the death a doctor has to come and certify the death, either the GP or the on call ( 111 ) doctor at night. After that you must call the funeral director, but you can decide if you want them to come as soon as possible or wait a while.

Afterwards you will have to return all the drugs to a pharmacy, especially the controlled drugs, but unused needles have to be returned to the doctors’ surgery.

Darkly Funny Moments.  

The next day, Thursday, the funeral directors phoned to say they had not had the notification from our GP of the death. The on call night duty doctor had sat at the kitchen table typing into his lap top, saying ‘everything is going straight through to your doctor’s surgery’ but my writer’s mind thought ‘I have no proof he’s even been here, no piece of paper, was he actually a doctor?’ I was slightly reassured that nurse Linda knew him. When my daughter tried phoning our surgery she couldn’t get through and in the end resorted to using her internal NHS email. Luckily the information did end up in the right place.

One thing the district nurses requested unsuccessfully was a hospital bed extension, we had been expecting it for weeks. When a chap with a truck arrived at the door on Thursday morning I thought he was very quick to collect the hospital bed until he said cheerfully ‘I’ve brought the bed extension’. Poor bloke was embarrassed when I apologised that it was too late.

We had not seen much of the palliative care team from the local hospital who originally got us organised. One of the nurses had phoned the previous week saying ‘I’ll touch base with you on Friday.’ Sure enough on Friday the phone rang and she said brightly ‘Just calling to touch base’… so I had to tell her the news.  

Because of  Covid we were saved a trip to the registry office; instead I had a nice phone chat to Polly the registrar including Cyberspouse’s no funeral request. After taking most of the details she asked me my occupation. Oh oh, was I going to fail this part? I replied that I had done all sorts of things and she said ‘How would you like to be known in a hundred years?’ Well who in a hundred years would know I didn’t earn a living at it, so of course I replied  ‘A writer!’

https://www.mariecurie.org.uk/help/support/terminal-illness/preparing/what-to-expect