Tuesday, 25 September 2012
MOAS II-Tuesday 22nd August to date......
In the days that followed I continued to make great progress. Day by day, small step by small I gradually made improvements. Firstly I started on a light diet; jelly and ice cream for starters and then things like omelettes. Initially the central line was kept in as my potassium was low and this was supplemented through my TPN. But as my food intake improved so the TPN was stopped and the central line removed. Interestingly I found out that the central line is not now changed routinely each week as per my first operation. It seems that the thoughts around this are that the ordeal of going to surgery for this to be done under local aesthetic and the risks involved are outweighed by the fact that problems with leaving the line in are few and far between. That said I’m sure there are times and situations when a change is deemed necessary. My central line was finally removed on Wednesday 23rd August after a day or so of eating food without problem and an improvement in my potassium levels.
As my various drains, tubes and attachments were gradually removed then it allowed me to become more mobile. Regular walks were taken throughout the day initially around the ward and then further afield. Robin would often join Tracey and I and we strolled and chatted together.
Another difference that I noted this time around was again regarding the physiotherapy side of my recovery. Having Jade around as the dedicated C2 physio had already shown some improvement as she had put together an exercise plan using resistance bands. This allows the patient (when they are able) to do light exercises either sat down or stood up using the bands. The team are also in the process of fitting out a small gym on the ward and have a flight of three steps with hand rails, a sitting exercise bike as well as other equipment for patients to use as part of their recovery.
I also had a heart ultrasound scan. The technician doing the scan arrived on the ward with a mobile ultrasound machine. The scan was done in my room on my bed and took a while as various measurements were taken. It was all pretty interesting to watch but the all important results were not given to us then as they had to be seen by the doctor. I was a little worried about this as on my last operation as the scan had showed fluid around the heart.
My oxygen levels still proved to be a bit of a pain and took a while to sort themselves out. Gradually I was weaned off; initially the supplementary oxygen was turned down to 30%. Regularly I had spells without the oxygen to see how my system coped but in the early days this would drop away to 92%. 95% to 96% was the target level unsupported. I just needed to be patient.
Again, as per the last operation I was also given an ultrasound scan on my legs to check for deep vein thrombosis. This took around about an hour to do both legs and was done in the x-ray department in newly equipped suits. Thankfully these came back clear.
Gradually my medication was reduced; the drips, drains, central line and PCA were removed until I had no more attachments. I was able to shower daily (with help from Tracey) and started to feel human again. Ward life was becoming easier and Robin and I spent quite a few hours together talking and generally keeping the nurses on their toes with our banter. At the same time we also spent some time on a few occasions having some deep and meaningful conversations about our predicament. On more than one occasion both of us were in tears. I think that some of this was down to the drugs coming out of our system, the relief that we had come through such a big operation and a general outpouring of emotions. I think this is healthy and part of the recovery process be it with a new found friend, family or loved one. To bottle up such emotions is not good and it’s important that you and your supporting team can let off steam once and a while.
I found the nights on the ward quite difficult, even as I improved and was able to move around the bed more freely due to less attachments. The daily routine often started at six am with the night staff doing the rounds taking observations and then giving out medication before handing over to the day team and the arrival of breakfast. Then the doctor’s rounds often started at 8am. Throughout the day there were then various visits from the nurses taking observations, removing drains, changing dressings etc. The doctors again came around about 4pm and dinner was served around 6pm. The evening was then quite a drawn out affair particularly for someone like me who is generally fairly early to bed. Often medication was being handed out at 10pm and observations then done by around 11pm. As you would expect it’s never truly dark on the ward and the green glow of the nightlight illuminates the room. I was lucky that I had my own room so that I was able to shut the door to cut down the background noise and reduce the light coming into the room. All this coupled with day time naps meant that my sleep pattern was completely messed up and most nights I slept for a couple of hours before waking again in the early hours and sitting up in bed wide awake for a period of time before trying to get back off to sleep. I began to dread the nights as they seemed to go on forever.
Finally on Saturday 26th August I was able to come home. I was definitely stronger this time around than last and the journey home was much easier than last time around. I clutched the pillow covering my tummy for protection all the way home. It was great to finally be home and to see the girls again. It was an emotional reunion.
In the following days Tracey and I went for daily walks. Initially to the end of the close, then laps around the close and then this progressed to short walks around the block and then I finally managed a 25 minute walk onto the local common. This was soon cut short however. The Pneumonia returned. Tracey called the doctor and the on call doctor visited and examined me and promptly advised me to go to Frenchay hospital. This was at 4:30pm and I was advised to get there as soon as possible and check into the Acute Admissions Assessment ward as I would need scans and X-rays before the scanner closed. We ended up staying on the ward until around 10:30pm. The doctors there did blood tests and examined me and finally confirmed that the Pneumonia was back. Intravenous antibiotics were administered there and then. There was some initial “umming and ahhing” about whether or not I should stay on the ward overnight as they were concerned that I may have a blood clot. In the end they decided to give me a heperine injection and agreed to let me go home as I felt I could rest better at home than on the ward but only on the proviso that I come back in the morning for more tests and an X-ray. I spent the night in a lot of pain and ended up sleeping on the sofa. We returned the following morning and after more tests and the X-ray they finally confirmed that I did not have any blood clots. A course of high dose oral antibiotics were given to me to take for the next ten days or so. I spent the next few nights in quite a bit of pain and slept on the sofa for the next three to four days. One night I slept sat bolt upright supported by pillows as if sat on the sofa as it was the only comfortable position. Gradually as the antibiotics got to work the pain eased and I felt better. However it had knocked back my exercise regime by at least a week and I had to start my walking around the close all over again.
Luckily I’m now well on the way to recovery. I’m feeling really good now if still tender around the area of my scar. I am feeling stronger with each day and plan some longer walks in the coming days......