Just over three weeks since my ankle replacement surgery, and the big event of the last week has been my first follow-up visit to RNOH since the surgery.
In preparation, made my first journey down the stairs at home since coming home from surgery - despite the presence of my brother, decided to be ultra-cautious and do it using the inelegant but effective "bum-shuffle" method!
Taxi arrived bang on time, with a driver I know well, and we passed most of the journey talking about cars. Once again (this luck surely can't continue), both the M11 and the M25 we're flowing remarkably smoothly, so as a result (having allowed a "cushion" for traffic), we actually arrived at Stanmore almost three-quarters of an hour before my scheduled OPD appointment.
They really seem to be well organised and patient-focused there; first, a porter appeared within less than a minute and wheeled me to the admissions desk, where I was quickly processed and asked to take a seat. I imagined I would have to wait at least until my scheduled appointment time before I started to get "processed", but to my delight, within five minutes, another porter appeared to take me straight off to my first stop, the plaster theatre.
There, I was wheeled straight in, and helped up onto a table. The plaster nurse then cut away my existing cast (easy, just needing scissors, as I only had a back slab), and then for the first moment of truth as the surgery wound was uncovered.
Whilst the actual incision was somewhat longer than I had anticipated, the really good news was that the wound was healing really well - the nurse did not need to do anything at all to it, and even my untrained eye could see that it looked "healthy", confirmed by the nurse.
A quick wash of the foot, which was probably a bit rank after more than two weeks encased in plaster, and then the staples securing the wound were taken out - mildly uncomfortable only.
They were then ready to do the new plaster, and you could have knocked me over when the nurse produced a colour palette and asked me to select my preferred shade! Just like being in John Lewis' upholstery department! I went for the rather fetching bright red.
This time they put on a full below-knee cast, which I shall be wearing at least until my next follow-up, four weeks away. The finishing flourish was a soft, velcro-fastened "over-shoe" to give a flat walking platform on the bottom of the cast.
As if by clockwork, the (same) porter arrived the moment the new plaster was finished, and took me back to the foot and ankle clinic where, after just a couple of minutes, I was wheeled in to see Mr. Goldberg's SHO, Dr. Amanda Ifie. Deirdre Brooking also joined us, and made some notes on my TARVA trial file. We reviewed my progress since the surgery. I was pleased to get the news that the cysts they had dealt with during the surgery had revealed nothing untoward on a biopsy, and more pleased still to be told that I could move immediately to full-weight-bearing on my operated ankle.
After a routine blood test next door, I gingerly made my way back under my own steam to the waiting room, and was able to tell my driver that I was ready to go home at least two hours earlier than expected - great news!
Well, what a contrast the last few days since have been, now I can put weight on my ankle. Able to move around the house fine by myself so life has become infinitely easier (for my wife also!). I did find one problem - because there is a significant "heel" on the cast, and with the over-shoe, I was quite lop-sided, which caused a few balance problems, but fortunately I dug up a pair of walking boots with a deep, cushioned heel; one of those on the right foot succeeded in evening things out.
The only slight negative since getting back home is that I have been feeling weaker than I had hoped for, but that's my fault for not setting my own expectations appropriately - improving day-by-day, but I do need to rest quite frequently at the moment if I am standing/moving around doing things.
Will be working on building up my strength/stamina over the next few weeks, and looking forward to my next OPD appointment in mid-August, when there is a chance I believe, and depending on X-rays and - obviously - the view of my consultant, that I may finally be able to cast off the cast!
I need to say once again what a great bunch of people they have at RNOH - I couldn't believe how quickly and efficiently I got processed through all my steps there last week, and always with politeness, professionalism and good humour - thank you all.
So, feeling pretty good about things at the moment - hope that continues as I start to actually use my bionic ankle in the future.
See you here again soon.
David
Wednesday 29 July 2015
Tuesday 21 July 2015
ME AND MY NEW ANKLE (S+10)
As promised in my last post, this one is going to
concentrate on my first week home after surgery..
I arrived home a week ago and, after a cup of tea,
faced the first challenge of my non-weight-bearing spell (which is scheduled to
be two weeks, until my first check up).
We are fortunate to have a smallish spare bedroom,
which we decided to allocate to me to sleep in initially after my
operation - I was pretty sure I would sleep fitfully, and didn't want to
unnecessarily disturb my wife's sleep, and it has also meant that we have
been able to arrange it solely focused on the needs of the "patient".
The room in question is upstairs, and so the
challenge was to navigate quite steep stairs. Despite my practice on, and
comfort with crutches, and the presence of my fit and strong brother, I still
decided that the safest way of mounting the stairs would be, inelegantly
and slowly, on my bottom. That's fine until you get to the top and wonder how
you're going to get upright - I could have managed with crutches, but my
brother and the handrail seemed the surer option.
For reasons that will become apparent later,
that one-way trip up the stairs has been the only encounter with
the stairs to date!
In the days before my operation, I installed a
small TV in the designated room, and I also decided to purchase
an overbed table, which has really been an absolute godsend; with the
table, and a "reaching stick", I really do have most things to hand,
saving my wife from running up and down stairs all the time.
In order to help with the essential elevation of my
ankle above heart level for two weeks (to minimise wound swelling), I had
also procured a shaped wedge of soft foam, with a cotton cover, which has
been excellent in helping me ensure the leg remains elevated, especially when
sleeping, and has also been very comfortable.
I actually got a good first night's sleep, despite
the efforts of the dawn chorus outside my open window. After tea and some
juice (I'm back on my juice diet), I manoeuvred myself on my crutches to the
bathroom for a constitutional (unsuccessful), and a shower.
In preparation for showering in relative comfort
and safety, I had bought an adjustable-height shower stool, and a waterproof
cast cover. The latter pulls on from your foot up to mid thigh, where there is
an elasticated collar to provide a seal - this works really well, and ensured
my cast remained totally dry during a lengthy shower.
What didn't work as anticipated was the
(adjustable-height) shower stool - even on its highest setting, it felt too low
to me to safely lower myself on to it from my crutches, especially in a shower,
and I was even more daunted by the prospect of getting up from the stool at the
end of the shower, especially with only my slight wife around to assist.
However, a bit of improvisation sorted
the problem.
I had acquired an adjustable frame and seat to
assist in using the toilet, and fortunately this fit within the shower cubicle.
With a higher seat and arms, this was much easier and safer, so I was able to
have the first real shower and hair wash for three days.
With the aid of my wife, and my crutches, we moved
the toilet frame next to the sink so I was able to shave quite
comfortably, brush my teeth, spray on some deodorant etc., before heading back
to bed on my crutches.
My second night's sleep was not quite as good as
the first at home, mainly because I was finding pressure on the bottom of my
spine and my bottom from essentially being in one position most of the time,
with little opportunity to move around because of my elevated leg. I was also
concerned about ensuring that I had no problems with pressure sores.
Back to good old Amazon, and I found a pump-driven
air mattress, which has about two hundred air pockets, and where the
pressure on each pocket is varied every few minutes. In combination with a
quiet motor/pump, I have found this has almost completely removed the pressure
issue, thank goodness.
I/we settled into this pattern, interspersed with
TV/email/meals, for a couple of more days, and I thought ' "this is going
to be easier than I thought",
WRONG ................ things started to go amiss
last Sunday.
I had felt a twinge in my right
(i.e. non-operated leg) knee on Saturday night; to be fair, I have had
problems with this knee previously (probably also arthritis-related). Well, on
Sunday morning when I got onto my crutches in preparation for a trip to
the bathroom, it was immediately clear to me that my "good" leg would
not support my weight. Dosed up on Paracetamol and tried later, but same result.
So, no way to make even the short journey from
bedroom to bathroom, which also exacerbated another burgeoning problem - the
desire but inability to "take a weight off my mind" (more of this
later).
My wife gave me a bed bath, and I settled back
into bed somewhat frustrated and grumpy to watch more TV.
When I woke the following morning with no
improvement, I decided I needed some physio work on my dicky knee. Spoke to my
local GP surgery, who agreed on the basis of a phone conversation, but
then said it would take at least two weeks to arrange through the NHS.
Contacted a private physio firm, and they agree to make a house visit on
Wednesday. The physio took history, examined the knee, manipulated it and did
some ultrasound, and said she thought that an anti-inflammatory (which had been
discontinued after surgery) would help the process. She undertook to speak to
my GP, who understandably wanted to see me before prescribing more medicine,
but the fact that I could not get to the surgery meant another day's wait for a
home visit. (I'm in no way being critical of my GP partnership here - it's just
the way things are, and they're actually very responsive and helpful within the
limit of their resources).
A GP came to see me on the Thursday and agreed an anti-inflammatory
was appropriate, so finally on Friday I was able to add that to my daily intake
of medicines. Clearly had the desired effect (together with the exercises the
physio had given me) because today, for the first time for almost a week, I have
been able to take myself off to the bathroom, much to my relief (and that
of my wife I suspect, though she said nothing and has been remarkably stoic, as
I'm not exactly a model patient!).
In the interim, we'd had to improvise toilet
arrangements in the bedroom using the toilet stand and a bucket, which
although regularly deployed had not been successfully "initiated"
until a couple of days ago (those of you who are squeamish please skip to the
next paragraph). It's a fact of life that opiate-based medicines tend to result
in constipation (exacerbated by general inactivity), which is why my bag of
medicines included both laxatives and stool softener. Despite these I had
not had any success for more than a week, and started to get concerned about solid
build-up (impaction). I was becoming very uncomfortable, and so I decided
that I had to take matters into my own hands (or fingers rather!) and so
undertook a bit of manual unblocking; not pleasant, but absolutely had the
desired effect, opening the floodgates and, touchwood, no further problems in
that department. I make no apologies for including this last paragraph -
it is these sort of issues that seem to make (the aftermath of) surgery often
more difficult than it should be, and impact on one's sense of dignity, which
then has the potential to make one feel "down", and yet are very
rarely written or even talked about.
So, at the time of writing, I'm feeling
comfortable, the sun is shining in Norwich, and I've been enjoying watching the
Open Golf from St. Andrews. Plus, the ankle itself seems fine, in-so-far
as I can tell - toes get wriggled regularly, are a nice rosy-red colour, and
respond to a daily "touch-test".
Day after tomorrow, I'm back to RNOH for removal of
stitches, new cast (probably, though possibly a boot), and - if all going
according to plan - a big change from non-weight-bearing to
fully-weight-bearing on my operated ankle.
Most likely I will update you on return from that
visit, so talk to you soon!
David
Tuesday 14 July 2015
ME AND MY NEW ANKLE (S+7)
I left you drifting off to sleep the night of my ankle surgery just over a week ago, so this post picks up the following morning,
I had a surprisingly good sleep that first night, what with having to lie on my back (not my favourite), two-hourly BP checks, and one of the loudest snorers I have ever come across two beds away (if you're reading this blog, you know who you are!).
Thankfully, as previously mentioned, no pain, and so I was able to enjoy a light breakfast at about 8 o'clock.
The rest of the morning passed quite quickly, in between watching a couple of episodes of the final series of MadMen on my iPad (fantastic series IMHO); continuing regular BP, pulse and temperature checks; and the general hustle and bustle of the ward, with another group of patients arriving from admissions from about 8 o'clock onwards, and then gradually going off for and subsequently returning from procedures - I "counted them all out, and counted them all back again"!
I had been coping fine with bed bottles during the night and through the morning but, after lunch, decided it was time for a proper sit down, and so I gingerly moved off on my crutches in search of the bathroom. As if on cue, the physiotherapist appeared - their principal task being to ensure that patients can use crutches properly and safely. Despite my having practised with the crutches for several weeks before-hand, I didn't really feel very comfortable now using them for the first time "in anger", and it seemed the physio was not over-impressed either, as she said I would have to demonstrate better use of the crutches before I could be signed off. Despite that hiccough, I am pleased to report a successful bathroom visit as I think that is another of those often unspoken concerns when on one's back after surgery (though this proved to be a bit of a false dawn - see later posts)).
Watching films, supper and calls to family and friends made the rest of the day whizz by and, although I was now off two-hourly observations, the nurses were still regularly with me, both doling out my medicines, and topping me up through my cannula with antibiotics (one particular risk-factor with any implant surgery is (deep) infection) and with a blood-thinner (I should also mention that on return from surgery the previous day I found myself sporting a rather fetching grey/green pressure stocking on my non-operated leg).
With the cessation of the two--hourly checks, and having been disconnected from the morphine drip (though with cannula still in place), I was able to settle down quite comfortably and, despite the renewed efforts of "Mr. Snorer", I had a remarkably good night's sleep.
After breakfast the next morning, the mind started to focus on discharge. I had been advised on admission that, all being well, I would be discharged roughly late morning two days after my op.; to do so, four things had to happen - the physios needed to sign me off on use of crutches; I had to go to the Plaster Theatre to have a new cast installed; I had to have the cannula in my left hand removed; and I had to be prescribed and given the various medications I needed.
My brother had kindly agreed to make the trip down from Norwich to pick me up and, as luck would have it, he was able to combine that with the taking of his very final exam to qualify as a Flying Instructor in nearby Luton, so we anticipated he would arrive at the hospital at around midday.
At around 9.30, the bathroom called again, so it was out on the crutches again and, would you believe it, another member of the physio team chose that moment to come and (re)assess me, prior to sign-off. Whilst I felt steadier on the crutches than the previous day, he was still not especially happy so, after using the bathroom (unsuccessfully on this occasion), we did some practice up and down the ward - with some corrections to my technique I was soon moving along better and more securely. We then practised going up and down stairs, this time to immediate satisfaction. In my view, it is really worth spending time with the physio team making sure you are fine on crutches as this becomes crucial in the weeks ahead.
Literally as e stepped out from the stairs practice, there were two guys with a trolley to take me down to the Plaster Theatre, so off we went.
The team there first removed the existing back-slab plaster cast, and replaced it with an identical back-slab - i.e. the cast surrounds the entire foot and ankle (except the toes), and most of the way up the leg to just below the knee.
As I was to discover, the way to make a half-cast is to make a full-cast and then cut half away! So, the whole leg was duly plastered from toe to knee and then a gentleman with what looked suspiciously like a circular saw approached my leg with clear intent!! He assured me that it was a vibrating blade rather than a rortating blade, and, with a smile, that he had "never even nicked anyone yet". Thus reassured (!) he proceeded to saw off the front half (shin-side) of the cast, and finally the whole thing was over-bandaged.
Back on the trolley for another trip though the (very) undulating corridors of RNOH to arrive back at my bed, where shortly the delightful Normita, our Health Care Assistant, carefully removed my cannula.
Just about then, my brother arrived, so only one remaining hurdle before discharge, which was to complete the prescription and dispensation of all my medicines.
My medicine bag included :
I was asked to demonstrate that I could self-administer the enoxaparin injection, which basically involves stabbing oneself (gently) in the gut with a sharp but relatively short syringe and pressing the plunger - surprisingly UNpainful.
We then completed the final discharge paperwork before me being loaded into a wheelchair for the journey down to the carpark to find my brother's car.
Before rounding off this post, I really must stop for a moment to record my intense admiration and thanks for ALL the staff I encountered at RNOH during my stay - they are a dedicated team, all thorough professionals, who are focused on delivering the best possible medical care to their patients in an efficient yet caring manner. From porter to surgeon, tea lady to pharmacist, they were all cheerful, pleasant and above all communicative in a way which can but be reassuring to the patient.
If I were doing a "TripAdvisor" type review of my stay, and being particularly pernickety, there are two comments I would make.
The first, which I have touched on before, is that the professionals of RNOH achieve what they do DESPITE the RNOH infrastructure, which is in dire need of refurbishment/replacement.
The second was the food. Whilst I am the first to realise that a spell with the NHS is not an invitation to a gourmet event, and although I am sure the food was nutritious, virtually nothing I had even tickled the taste buds and nor (probably back to the infrastructure) was it ever more than lukewarm.
Those two small points aside, my experience as a patient has been excellent, and I would thoroughly recommend the RNOH to anyone.
So, as I close this post, it's back up the M25 and M11 to Norwich courtesy of my brother. In my next post (probably tomorrow), I'll relate my experiences the first few days back home, including my review of the bits and pieces I've bought to assist my recuperation.
All has been far from a bed of roses ..............!
I had a surprisingly good sleep that first night, what with having to lie on my back (not my favourite), two-hourly BP checks, and one of the loudest snorers I have ever come across two beds away (if you're reading this blog, you know who you are!).
Thankfully, as previously mentioned, no pain, and so I was able to enjoy a light breakfast at about 8 o'clock.
The rest of the morning passed quite quickly, in between watching a couple of episodes of the final series of MadMen on my iPad (fantastic series IMHO); continuing regular BP, pulse and temperature checks; and the general hustle and bustle of the ward, with another group of patients arriving from admissions from about 8 o'clock onwards, and then gradually going off for and subsequently returning from procedures - I "counted them all out, and counted them all back again"!
I had been coping fine with bed bottles during the night and through the morning but, after lunch, decided it was time for a proper sit down, and so I gingerly moved off on my crutches in search of the bathroom. As if on cue, the physiotherapist appeared - their principal task being to ensure that patients can use crutches properly and safely. Despite my having practised with the crutches for several weeks before-hand, I didn't really feel very comfortable now using them for the first time "in anger", and it seemed the physio was not over-impressed either, as she said I would have to demonstrate better use of the crutches before I could be signed off. Despite that hiccough, I am pleased to report a successful bathroom visit as I think that is another of those often unspoken concerns when on one's back after surgery (though this proved to be a bit of a false dawn - see later posts)).
Watching films, supper and calls to family and friends made the rest of the day whizz by and, although I was now off two-hourly observations, the nurses were still regularly with me, both doling out my medicines, and topping me up through my cannula with antibiotics (one particular risk-factor with any implant surgery is (deep) infection) and with a blood-thinner (I should also mention that on return from surgery the previous day I found myself sporting a rather fetching grey/green pressure stocking on my non-operated leg).
With the cessation of the two--hourly checks, and having been disconnected from the morphine drip (though with cannula still in place), I was able to settle down quite comfortably and, despite the renewed efforts of "Mr. Snorer", I had a remarkably good night's sleep.
After breakfast the next morning, the mind started to focus on discharge. I had been advised on admission that, all being well, I would be discharged roughly late morning two days after my op.; to do so, four things had to happen - the physios needed to sign me off on use of crutches; I had to go to the Plaster Theatre to have a new cast installed; I had to have the cannula in my left hand removed; and I had to be prescribed and given the various medications I needed.
My brother had kindly agreed to make the trip down from Norwich to pick me up and, as luck would have it, he was able to combine that with the taking of his very final exam to qualify as a Flying Instructor in nearby Luton, so we anticipated he would arrive at the hospital at around midday.
At around 9.30, the bathroom called again, so it was out on the crutches again and, would you believe it, another member of the physio team chose that moment to come and (re)assess me, prior to sign-off. Whilst I felt steadier on the crutches than the previous day, he was still not especially happy so, after using the bathroom (unsuccessfully on this occasion), we did some practice up and down the ward - with some corrections to my technique I was soon moving along better and more securely. We then practised going up and down stairs, this time to immediate satisfaction. In my view, it is really worth spending time with the physio team making sure you are fine on crutches as this becomes crucial in the weeks ahead.
Literally as e stepped out from the stairs practice, there were two guys with a trolley to take me down to the Plaster Theatre, so off we went.
The team there first removed the existing back-slab plaster cast, and replaced it with an identical back-slab - i.e. the cast surrounds the entire foot and ankle (except the toes), and most of the way up the leg to just below the knee.
As I was to discover, the way to make a half-cast is to make a full-cast and then cut half away! So, the whole leg was duly plastered from toe to knee and then a gentleman with what looked suspiciously like a circular saw approached my leg with clear intent!! He assured me that it was a vibrating blade rather than a rortating blade, and, with a smile, that he had "never even nicked anyone yet". Thus reassured (!) he proceeded to saw off the front half (shin-side) of the cast, and finally the whole thing was over-bandaged.
Back on the trolley for another trip though the (very) undulating corridors of RNOH to arrive back at my bed, where shortly the delightful Normita, our Health Care Assistant, carefully removed my cannula.
Just about then, my brother arrived, so only one remaining hurdle before discharge, which was to complete the prescription and dispensation of all my medicines.
My medicine bag included :
- morphine sulphate - a strong pain-reliever (and controlled drug), which I fortunately have not had to use (and must return to my local GP for controlled disposal)
- dihydrocodeine - moderate pain reliever
- paracetamol - pain reliever
- senna - laxative
- docusate - stool softener
- enoxaparin - an anticoagulant (blood-thinner) used to mitigate the risk of DVT; in the form of an injection to be administered subcutaneously
I was asked to demonstrate that I could self-administer the enoxaparin injection, which basically involves stabbing oneself (gently) in the gut with a sharp but relatively short syringe and pressing the plunger - surprisingly UNpainful.
We then completed the final discharge paperwork before me being loaded into a wheelchair for the journey down to the carpark to find my brother's car.
Before rounding off this post, I really must stop for a moment to record my intense admiration and thanks for ALL the staff I encountered at RNOH during my stay - they are a dedicated team, all thorough professionals, who are focused on delivering the best possible medical care to their patients in an efficient yet caring manner. From porter to surgeon, tea lady to pharmacist, they were all cheerful, pleasant and above all communicative in a way which can but be reassuring to the patient.
If I were doing a "TripAdvisor" type review of my stay, and being particularly pernickety, there are two comments I would make.
The first, which I have touched on before, is that the professionals of RNOH achieve what they do DESPITE the RNOH infrastructure, which is in dire need of refurbishment/replacement.
The second was the food. Whilst I am the first to realise that a spell with the NHS is not an invitation to a gourmet event, and although I am sure the food was nutritious, virtually nothing I had even tickled the taste buds and nor (probably back to the infrastructure) was it ever more than lukewarm.
Those two small points aside, my experience as a patient has been excellent, and I would thoroughly recommend the RNOH to anyone.
So, as I close this post, it's back up the M25 and M11 to Norwich courtesy of my brother. In my next post (probably tomorrow), I'll relate my experiences the first few days back home, including my review of the bits and pieces I've bought to assist my recuperation.
All has been far from a bed of roses ..............!
Saturday 11 July 2015
ME AND MY NEW ANKLE - FIVE DAYS AFTER SURGERY (S+5)
Well, here I am again - at last; just looked back to my last post and realise that almost a month has elapsed since my last post.
I guess I just got so tied up in making preparations for my surgery, and especially in making sure that the home was as ready as possible, that time ran out and I was on my way down to the RNOH for my op!
i have a lot of information to pass on about my preparations for the op., the hospital admission and stay, the procedure itself and immediate aftermath, and my experiences since arriving back home, that I think I'll split it into two different posts -
In this one, I'll cover the period I was actually in hospital, from admission to discharge, and in the next will focus on both my preparations for being at home after the op. and the actual experience, particularly in terms of the various gadgets I decided to buy to hopefully aid/facilitate my recuperation,and my actual experience of using those items.
So, first, the spell in the Royal National Orthopaedic Hospital in Stanmore.
I had been asked to check in to Admissions at 7.00 a.m. on Monday, 6 July for an operation that same day. I was subsequently told, in the week before the op., that my procedure would be fourth on the consultant's list, meaning roughly early afternoon. Having to travel from Norwich, I called admissions and asked whether I could be admitted somewhat later than 7.00 a.m., given the likely timing of the procedure, but was told in no uncertain terms that it was 7.00 sharp for everyone! Although this struck me as slightly bureaucratic at the time, I guess - having been through the admissions process - that I can understand the need to process all admissions at the same time, as it fits in with the rhythms of the wards.
So, an early start (4.30 a.m.) from Norwich; thankfully both the M11 and especially the M25 were very well-behaved for a Monday morning, and so we arrived just after 6.30 a.m.
Nonetheless Admissions was open and bustling, but I was processed very quickly and efficiently, gaining the first of two identifying "LaserBands" round my wrist. I was then asked to wait in the main reception area for further processing.
This is when my time in hospital took a departure from the experiences of most other patients waiting for surgery that day.
Partly as a result of my writing this blog, the foot and ankle team, on behalf of the TARVA trial, had asked me whether I would mind doing some filming during my time in hospital, to which I had readily agreed (hence my references to "becoming a movie star" in my previous posts). Well, I was certainly involved in a lot of filming, but it was yours truly who did most of the filming! The production team had decided that it would be more impactful (and more practical) to present the filming from my - the patient's - viewpoint.
So, Jan Letocha, Film Director at RNOH found me in the waiting area and presented with a "go-pro" body-worn camera, which was to be my constant companion for the next 72 hours - I was wearing it all the time I was in hospital (except when sleeping and in surgery), and was filming what I was seeing all the rest of the time (except during bathroom breaks!!). I do believe we may be adding edited highlights of the footage to this blog.
Also, in the same vein, my surgeon, Mr. Andy Goldberg, wore a headcam during the operation, in addition to fixed cameras in the theatre (my understanding is that that footage will be used principally for training, but some bits of it may be included on the material available through this blog).
So, with camera strapped on and running, I was taken through to the surgery reception area, where I then shortly met my anaesthetist - Dr. Nadaraja. He explained to me what the team would be doing in terms of anaesthesia and pain relief (general anaesthetic plus nerve blog in the leg during the procedure, and morphine drip pump immediately afterwards).
i then met Mr. Golberg's registrar, Dr. Ali Najefi (whom I had also met at re-admission), who (re) examined my ankle and, to my great delight and relief, pulled out a black marker pen and drew an unmissable black arrow running down my left shin and pointing squarely at my left ankle. (I have to tell you that, despite my being an absolutely rational being, and having already built up considerable admiration of and faith in the team who were to operate, I had nonetheless considered using a similar marker the previous evening to mark my right ankle
"NOT THIS ONE!"
(In fact I must say that right through my stay in hospital, everyone was meticulous in carefully identifying me (name and DOB) on every occasion when they interacted with me "medically".)
I was also introduced by Dr. Najefi to Dr. Amana Ifie, SHO, a new member of the Foot & Ankle team.
Thus reassured, I was taken off by wheelchair to my ward (Jackson Burrow), and my bed (no. 15)
By this time it was around 9 o'clock and, having had it confirmed to me that I would not be called for surgery until at least 1.00 p.m., I had plenty of time to settle in.
Having read the admission guide, and although I was on an open (male) ward, I was pleasantly surprised at the amount of space around my bed - enough for my two bags (one with clothes and "tech", the other with my (disassembled) crutches).
For those of you like me who have come to rely on tablets and mobiles, make sure you take your recharge cords with you, and either an extension lead or a multi-plug, as you may well find there is only one socket available to you.
My first bed visit was from the two day-shift nurses looking after me that, and when they introduced themselves I guessed from the name (Marcelle). that one of them might be French. She actually turned out to be from Brussels, and so I was able to resurrect my rusty language skills for a few exchanges then and subsequently in French, somewhat to the amusement of other staff on the ward. Marcelle turned out to be the life and soul of the ward, always smiling and joshing with her patients, so it's sad in a way to learn that she will be retiring at the end of this year.
I then met the pharmacist, and went through my existing and likely future medication, which was then locked away in my nightstand. I was also pleased to renew contact with Deirdre Brooking, the Trial Coordinator, who has been my main point of contact from the start.
It was now just about that time of day for a much anticipated cup of coffee, but with the dreaded NIL-BY-MOUTH writ large on my board, no chance of that (though I was allowed to drink water until a couple of hours before my scheduled time).
I then whiled away the time before my op. catching up on The Times on my iPad, and a couple of old comedy episodes of Yes, Minister and Only Fools and Horses. Just managed to get in my order for supper, and change into my hospital gown, before the men in blue arrived to transport me down to the operating suite.
As I said right at the beginning of this blog, I'm not particularly one for wearing my heart on my sleeve, and nor am I particularly introspective, but I must confess that - on what is quite a lengthy trip down to surgery - I did have one big moment of doubt, such that for a brief moment I thought of aborting the whole thing, but that quickly passed.
Once down there I saw the anaesthetic team, and then Mr. Goldberg came to see me to show me the operating plan (I researched this later and discovered just how technically sophisticated it is), and also covered a small issue that had been previously mentioned - some cysts which had showed up on the MRI scan and which he explained would be filled to hopefully avoid any subsequent problems.
Then the anaesthetists started to ply their trade and .....................
woke up about four hours later (I think) in the ward (I think) feeling quite "woosy". I guess one fear most of us have in relation to surgery is pain, but with the anaesthetic and the nerve block, I felt nothing then and, mercifully, for the rest of my time in hospital (and nor, touch-wood, up until the date of writing this piece).
Managed some water and a cup of tea, only to find I had quite a sore throat (I believe I had had a tube down my throat during surgery). Nonetheless, and feeling quite hungry, did manage to demolish my pork sausage and mash, and subsequently a cup of coffee, before "lights out".
During this time, I am having my BP, pulse and temperature taken every two hours, and being given regular feeds of medication. I was given a morphine pump on a drip to use for pain if I needed it, but thankfully I didn't.
I think this has become quite a long post already, and there is a lot more to tell of my time in hospital, so I'll post this one now, and do part two of my hospital stay in the next day or two.
As a final point, I had been a little puzzled - despite the number of views of my blog - at the total absence of any comment. Well, mystery solved. I did finally have a comment from another individual awaiting a TAR, and she told me that comments are apparently restricted to those having a Google/Wordpress account, which I guess most don't have - I'm going to see if I can resolve/correct that tomorrow.
So I'll leave you at the point I was drifting off to sleep the night of my surgery.
Hope to see you here again soon!
I guess I just got so tied up in making preparations for my surgery, and especially in making sure that the home was as ready as possible, that time ran out and I was on my way down to the RNOH for my op!
i have a lot of information to pass on about my preparations for the op., the hospital admission and stay, the procedure itself and immediate aftermath, and my experiences since arriving back home, that I think I'll split it into two different posts -
In this one, I'll cover the period I was actually in hospital, from admission to discharge, and in the next will focus on both my preparations for being at home after the op. and the actual experience, particularly in terms of the various gadgets I decided to buy to hopefully aid/facilitate my recuperation,and my actual experience of using those items.
So, first, the spell in the Royal National Orthopaedic Hospital in Stanmore.
I had been asked to check in to Admissions at 7.00 a.m. on Monday, 6 July for an operation that same day. I was subsequently told, in the week before the op., that my procedure would be fourth on the consultant's list, meaning roughly early afternoon. Having to travel from Norwich, I called admissions and asked whether I could be admitted somewhat later than 7.00 a.m., given the likely timing of the procedure, but was told in no uncertain terms that it was 7.00 sharp for everyone! Although this struck me as slightly bureaucratic at the time, I guess - having been through the admissions process - that I can understand the need to process all admissions at the same time, as it fits in with the rhythms of the wards.
So, an early start (4.30 a.m.) from Norwich; thankfully both the M11 and especially the M25 were very well-behaved for a Monday morning, and so we arrived just after 6.30 a.m.
Nonetheless Admissions was open and bustling, but I was processed very quickly and efficiently, gaining the first of two identifying "LaserBands" round my wrist. I was then asked to wait in the main reception area for further processing.
This is when my time in hospital took a departure from the experiences of most other patients waiting for surgery that day.
Partly as a result of my writing this blog, the foot and ankle team, on behalf of the TARVA trial, had asked me whether I would mind doing some filming during my time in hospital, to which I had readily agreed (hence my references to "becoming a movie star" in my previous posts). Well, I was certainly involved in a lot of filming, but it was yours truly who did most of the filming! The production team had decided that it would be more impactful (and more practical) to present the filming from my - the patient's - viewpoint.
So, Jan Letocha, Film Director at RNOH found me in the waiting area and presented with a "go-pro" body-worn camera, which was to be my constant companion for the next 72 hours - I was wearing it all the time I was in hospital (except when sleeping and in surgery), and was filming what I was seeing all the rest of the time (except during bathroom breaks!!). I do believe we may be adding edited highlights of the footage to this blog.
Also, in the same vein, my surgeon, Mr. Andy Goldberg, wore a headcam during the operation, in addition to fixed cameras in the theatre (my understanding is that that footage will be used principally for training, but some bits of it may be included on the material available through this blog).
So, with camera strapped on and running, I was taken through to the surgery reception area, where I then shortly met my anaesthetist - Dr. Nadaraja. He explained to me what the team would be doing in terms of anaesthesia and pain relief (general anaesthetic plus nerve blog in the leg during the procedure, and morphine drip pump immediately afterwards).
i then met Mr. Golberg's registrar, Dr. Ali Najefi (whom I had also met at re-admission), who (re) examined my ankle and, to my great delight and relief, pulled out a black marker pen and drew an unmissable black arrow running down my left shin and pointing squarely at my left ankle. (I have to tell you that, despite my being an absolutely rational being, and having already built up considerable admiration of and faith in the team who were to operate, I had nonetheless considered using a similar marker the previous evening to mark my right ankle
"NOT THIS ONE!"
(In fact I must say that right through my stay in hospital, everyone was meticulous in carefully identifying me (name and DOB) on every occasion when they interacted with me "medically".)
I was also introduced by Dr. Najefi to Dr. Amana Ifie, SHO, a new member of the Foot & Ankle team.
Thus reassured, I was taken off by wheelchair to my ward (Jackson Burrow), and my bed (no. 15)
By this time it was around 9 o'clock and, having had it confirmed to me that I would not be called for surgery until at least 1.00 p.m., I had plenty of time to settle in.
Having read the admission guide, and although I was on an open (male) ward, I was pleasantly surprised at the amount of space around my bed - enough for my two bags (one with clothes and "tech", the other with my (disassembled) crutches).
For those of you like me who have come to rely on tablets and mobiles, make sure you take your recharge cords with you, and either an extension lead or a multi-plug, as you may well find there is only one socket available to you.
My first bed visit was from the two day-shift nurses looking after me that, and when they introduced themselves I guessed from the name (Marcelle). that one of them might be French. She actually turned out to be from Brussels, and so I was able to resurrect my rusty language skills for a few exchanges then and subsequently in French, somewhat to the amusement of other staff on the ward. Marcelle turned out to be the life and soul of the ward, always smiling and joshing with her patients, so it's sad in a way to learn that she will be retiring at the end of this year.
I then met the pharmacist, and went through my existing and likely future medication, which was then locked away in my nightstand. I was also pleased to renew contact with Deirdre Brooking, the Trial Coordinator, who has been my main point of contact from the start.
It was now just about that time of day for a much anticipated cup of coffee, but with the dreaded NIL-BY-MOUTH writ large on my board, no chance of that (though I was allowed to drink water until a couple of hours before my scheduled time).
I then whiled away the time before my op. catching up on The Times on my iPad, and a couple of old comedy episodes of Yes, Minister and Only Fools and Horses. Just managed to get in my order for supper, and change into my hospital gown, before the men in blue arrived to transport me down to the operating suite.
As I said right at the beginning of this blog, I'm not particularly one for wearing my heart on my sleeve, and nor am I particularly introspective, but I must confess that - on what is quite a lengthy trip down to surgery - I did have one big moment of doubt, such that for a brief moment I thought of aborting the whole thing, but that quickly passed.
Once down there I saw the anaesthetic team, and then Mr. Goldberg came to see me to show me the operating plan (I researched this later and discovered just how technically sophisticated it is), and also covered a small issue that had been previously mentioned - some cysts which had showed up on the MRI scan and which he explained would be filled to hopefully avoid any subsequent problems.
Then the anaesthetists started to ply their trade and .....................
woke up about four hours later (I think) in the ward (I think) feeling quite "woosy". I guess one fear most of us have in relation to surgery is pain, but with the anaesthetic and the nerve block, I felt nothing then and, mercifully, for the rest of my time in hospital (and nor, touch-wood, up until the date of writing this piece).
Managed some water and a cup of tea, only to find I had quite a sore throat (I believe I had had a tube down my throat during surgery). Nonetheless, and feeling quite hungry, did manage to demolish my pork sausage and mash, and subsequently a cup of coffee, before "lights out".
During this time, I am having my BP, pulse and temperature taken every two hours, and being given regular feeds of medication. I was given a morphine pump on a drip to use for pain if I needed it, but thankfully I didn't.
I think this has become quite a long post already, and there is a lot more to tell of my time in hospital, so I'll post this one now, and do part two of my hospital stay in the next day or two.
As a final point, I had been a little puzzled - despite the number of views of my blog - at the total absence of any comment. Well, mystery solved. I did finally have a comment from another individual awaiting a TAR, and she told me that comments are apparently restricted to those having a Google/Wordpress account, which I guess most don't have - I'm going to see if I can resolve/correct that tomorrow.
So I'll leave you at the point I was drifting off to sleep the night of my surgery.
Hope to see you here again soon!
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