Wednesday 15th August- MOAS II +1day High Dependency Ward

I was moved to the High Dependency Ward (C1) at 4am on Wednesday morning. It’s a brand new ward and has only been open a matter of a couple of months. This phase of my recovery I have no memory of whatsoever other than odd snippets usually prompted by Tracey telling me about them.

 I also started on the first of the post operation Chemotherapy treatments where the abdominal cavity is filled with the solution for 23hrs and in the last hour the solution drained and then replaced.

Tracey and Mum came to visit me apparently I was still very sleepy but said I could remember conversations from the day before in ICU. I had a visit from Sue Alves (specialist nurse) and Tom Cecil (consultant) who said that I was doing very well and that they planned to move me back to C2 later that day. My bowel was already showing signs of recovery with bowel sounds clearly audible! This was a good sign and Sue advised that they would also start me on the intravenous food TPN.

 I later fell asleep again and after a while awoke with some pain in my left lung. Whilst I was asleep obviously I was not using the morphine pump (PCA). This is a manually operated pump that when pressed delivers a dose of morphine to help pain relief. There is a timer built into the pump to control how much morphine is administered and stops overdoses!

Tracey returned around 13:30hrs and shortly after Sue returned to tell us how the operation had gone. She advised that the entire macroscopic (visible) tumour had been removed. They had found two area’s of PMP two on the duodenum and pylorus and a nodule on the stomach. HIPEC had then been administered and the whole area washed with the heated chemotherapy bath.
 The official line is that " We opened the abdomen through a long midline incision and had to spend several hours untangling dense small bowel adhesions. We eventually mobilised the bowel completely including the stomach, duodenum, the small bowel and the colon. There were two area's of tumour recurance,one just below the pylorus and the second one just below the third part of the duodenum. We removed these two areas. There were a few serosal tears.
 Having completed the macroscopic tumour removal we perfused the abdomen with Mytomycin C heated to 42 degrees for one hour"

The physiotherapy team had also started on me early and had got me out of bed and into the chair. This was quite a job as there were a number of pipes tubes, drips and drains that had to be untangled just to get me into the chair. I spent an hour sat out of bed in all. I was also given a bed bath and cleaned my teeth.

I also started using the spirometer to try and exercise my lungs. When I tried it the day before the operation I again maxed it out at 4000ml. This time however I could only manage 1500ml but it was a start.

My progress at this point was still considered to be good and I was moved to C2 ward. I ended up in the same twin room that I was in last time around but in the bed opposite. In the other bed was an elderly man who had been involved in a car accident and had been hit on the head and was somewhat confused. Apparently I was still very sleepy and was repeating conversations quite a bit. Tracey and mum left me to sleep.....