Dorell Ward

Dorell ward was an exercise in contrasts with CDU. It was quiet, peaceful and cool. Initially I was the only one in the six person bay my bed was wheeled into. After the flurry of activity over being moved and sign-in had finished, the on-shift ward sister came to see me, equipped with a set of gowns for me to change into. She took her time to talk quietly to me and apologised "I'm sorry. We sent you home too soon." I started crying. She sat with me for some time before encouraging me to lie down and to try to get some sleep.

I did not know it then but I was to spend a total of twelve days in hospital. The time spend in Dorell ward was a cycle of sleeping, eating and walking. It was a real pleasure to have access to proper washing facilities too. The showers on this ward were cavernous and I felt much safer using them than I had the one on the spinal unit - no dragging equipment out of the way and more grab rails.

I tried to read the magazines that previous patients had left but found I kept reading the same few lines over and over and over again. I had no concentration whatsoever. I'd had the same experience wirth previous surgeries but it had always worn off after two to three days. It was not until day eleven after surgery that I was finally able to read an entire article and not until day twelve that I even wanted to watch TV. When I think back, I realise that these two things really underline just how disconnected I'd been mentally. It probably took about the same length of time to regain confidence in being able to do even the simplest tasks without feeling like I could do myself some serious damage.

Toward the end of my time in Dorell I finally had a couple of visitors both of whom I've always found calming and peaceful to be around; the sort of people you just know you can rely upon.

I think my re-engagement with interests such as reading and watching TV led the ward sister to deciding I was now really in a position to go home.

Discharge this second time was a completely different experience. For one, I was not totally physically exhausted.

The ward sister took the trouble to re-fill my blood pressure medication as well as the pain relief that the hospital had prescribed so that I would have one less thing to concern myself over. She had arranged for the first of several appointments with my GP practise nurse for wound care. She had also provided me with pads to prevent me getting blood all over anything I lay or sat upon and a pack of spare dressings. Yes, my right incision was still bleeding! I can't help thinking that had these things had been done the first time, I may have not had to have been re-admitted. Another difference was that my lift home was pre-arranged and trouble free as my friend Jimmy was off-shift.

I had been very lucky that my friends Gary had been able to stay at my home this entire time to look after my cats and that he'd done so willingly and without making me feel like I was imposing.

Critical Dependency Unit (CDU)

The two days I eventually spent in CDU were horrendous. I had been told I could stay there so long as I didn't move around. This instruction was in direct contradiction with what I'd been told to do by my spinal consultant. The light levels were kept very dim and the beds were packed closely together. I was told that a member of the spinal team would be down to see me. At this pount I didn't know why as I's already been seen by someone from the team whilst in A&E. I had also overhead them saying that the spinal team were dealing with someone with three breaks in their spine so knew that they would not be down "in a while between patients" but would be in theatre for at least nine hours. In short, I knew I was being lied to.

Some of the other people in CDU were very ill. I was under the erroneous impression that my incisions had not been re-dressed after being examined in A&E (did I mention I was a complete fruit loop at the time?) so was in a panic about being infected. I also felt disgisting as I hadn't had a wash for two days. I eventually decided to ignore instructions to stay put and locked myself into one of the bathrooms to take a quick wash with the emergency hygiene kit I'd been provided with because, of course, I hadn't expected to be re-admitted so didn't have my own stuff with me. Though I felt better for being clean, I was still very sore and emotionally volatile.

I think it may have been the evening of day one in CDU, my surgeon's registrar came down to see me. It's difficult to be sure of the time as the lack of daylight and having no watch meant I had no sense of time. We talked for a whole but I think he just thought I was mental. To be fair, in hindsight, I do think I'd lost it a bit and was quite paranoid by then.

On the second day of being in CDU, the patient opposite me started talking to me as she was feeling a bit better after being admitted as a result of a bad asthma attack. She did more to calm me down that any of the staff... I'd had to disobey instructions a second time just to get them to notice me long enough to get a jug of water earlier. Given how hot CDU was and that I'd been told by the spinal care team how important it was to drink a lot, this had also had me bouncing with anxiety.

As day two wore on with no further information on what was happening I got to the point where I was a hair's breadth from walking out, without my meds, and in blood soaked clothing (yes, not even provided with a gown after two days). It would have been an evens bet as to whether I would have made it home or been found jumping off one of the bridges over the Thames at this point. I mean this sincerely. I was a mess mentally.

I asked for some paper and a pen and started writing. No, scribbling, at high speed, using the counter at the nurses' station. I tend to write to vent anxiety anyway but I also wanted to capture what I was going through for future reference. It seemed to have the side effect I was hoping for as I think the staff assumed I was writing a complaint. Indeed, I may well have eventually but knew I was in no fit state to make a reasoned decision at the time. From this point on, things finally seemed to get moving.

Two, maybe three hours later, I was surrounded by staff and told I was being moved to Dorell ward. I think it may have been in the early hours of day three. I was later to find out that this ward is part of the Ear, Nose and Throat (ENT) suite.

Re-Admission

I was third in the queue when I arrived at the hospital. I was also sobbing hysterically. I was dressed in blood stained shorts and T-shirt with no toiletries, just a bag with my pills and discharge letter in it. The lady second in the queue waved me ahead of her. Hunter ward had called A&E to let them know I would be arriving. I gave them the pager number Hunter ward had provided and was then ushered through to the cubicles.

It did not take long for an A&E nurse to fetch me despite the hour. She got me to lie down on the most uncomfortable bed ever. She examined the dressing and then ran off. A doctor (I assume from A&E) came in whilst she was gone and got me to explain what had happened. He told me that someone from the spinal team would be down to see me shortly. The nurse came back part way though and took off the dressing and cleaned the wound so that the doctor could take a look. They then left me alone.

I'm not sure how long it took, but a lovely lady from Orthopaedics arrived and took a look at my back. She was also the first person to ask me about my mental state in detail and agreed that it was most probably the codeine that I'd had an adverse reaction to. She explained that she wanted a more senior member of the spinal team to take a look at my incision. I didn't really get why at the time.

A few minutes after the Orthopaedic surgeon left, the head of A&E came to speak to me. He was unaware I had already been seen so I had to explain what I'd been told. He had a very gentle, reassuring manner about him.

I can't remember who told me but some time later I found out that they were re-admitting me. I was told that I would be admitted to the Critical Dependency Unit (CDU) until they found me a bed on the ward. I was not to move around whilst I was there. I started crying again as I was scared and alone. It was hours before porters arrived and wheeled me into CDU.

Hunter Ward (Part Three)

I was to spend a total of seven days in Hunter Ward. The reaction to codeine was awful and really messed with my head, even after the nausea and other physical symptoms had gone. I was in a cleft stick regarding my bleeding right incision. The nurses wanted it to close as they were concerned about the risk of infection. The surgical team were happier that it was leaking as it was better for the blood trapped during surgery to evacuate rather than staying in (a haematoma) providing a route for infection and, possibly, leading to further surgery. I was subject to endless blood taking. I think the lab technicians must have been heartily sick of checking for signs of infection by the time I was released.

Washing was restricted as I needed to keep the dressing on the open right incision dry. This meant I could not wash my hair as I was not allowed in the shower. I can not tell you how revolting it felt. I'm normally prone to the dry frizzies but by day seven, it looked like I'd tipped a vat of oil over my head and encouraged my hair into clumps that stood out at all angles!

The nursing staff were avoiding getting trapped into the 'what does it look like' conversation. My friend Jimmy popped by after visiting a relative and kindly took a look at my wounds for me. Apparently they did not look 'too bad' but were about six inches long instead of half inch. He also counted my staples for me. I had seven in the left side and fourteen in the right. I am glad that the staples did not give me too much discomfort as the wounds shrunk widthways as they closed.

I  had several false starts regarding discharge. My right incision would dry up for just long enough to convince the staff I could go now go home, only for it to suddenly flood again. It was to be day six before they made a firm decision I could go.

Day seven was a complete muddle. I was not the only one scheduled for discharge, nor was I the only one due to take their first shower. There must have been three of us in my bay alone who were to take a first shower and get discharged. It was just after lunch by the time I got my turn. I was left alone in the ladies' wet room. This made the whole thing so much more hard work. I am very short sighted. I was still unable to 'read' my body properly. There was nowhere to put down my wash bag that would have been accessible whilst standing so I had to perch on a shower stool that was set a little too high for me. To say I was a nervous as a long-tailed cat in a room full of rocking chairs was an understatement! I was so exhausted by the time I'd washed that I had to ring for a nurse to help me finish drying. I'd more or less drip-dried by the time she got there. I just could not reach my feet.

I collapsed on the bed until a nurse came to ask me if I'd been signed off my everybody at about 2pm. How should I know? I didn't know who had to sign me off! Eventually they were happy for me to go. I was issued with pain killers, including the wretched codeine, and a slip of paper with the ward phone number on it. No spare dressings, no post-surgery booklet, and no tips on how to care for incisions I couldn't see let alone re-dress.

A pal eventually drove me home after I was let down my my planned designated driver. She could not stay too long so she cleaned up after my cat sitter and then I was on my own. The first problem arose when I realised I could not eat because all the meals I had prepared before going into hospital were at ankle height in the freezer. Fortunately my hose and cat sitter Gary had left enough in the 'fridge for me to fix a sandwich. I had to eat it off the breadboard however as, of course, the plates were also at ankle height in the cupboard!

I pottered about a little, trying to see what I felt okay about doing for myself and trying to work out what I would need help with.

The sofa and TV beckoned about 9pm. My ability to concentrate was still quite limited so I turned off the TV called a neighbour who'd had knee surgery a few weeks before I went into hospital. Best thing I could have done as he echoed that admission and surgery was good but that the discharge was a complete shambles. He also fixed for his wife to come over once she got home as I needed the cat pan changed before I could go to bed. I then realised that I was sitting in a pool of my own blood. I went into complete meltdown.

The doorbell rung. Perfect timing. I rang Hunter ward and rambled at the nurse until my friend took over. She confirmed that the right dressing was totally flooded. The next ten minutes were frantic as I contacted Gary to tell him he had to continue cat sitting, and got into another neighbour's car as I'd been told to go to A&E.

Hunter Ward (Part Two)

The other ladies had warned me that day three would be shit. Day three is when the last of the general anaesthetic and other drugs given during surgery completely leave your system. It is also the day that the drugs given orally reach their effective level in your blood. It tends to make your emotions tank and not one of the patients in my bay had gone through day three without having a least one crying jag. In my case it also saw the arrival of the most appalling nausea and a bad tempered physiotherapist. I'd just been injected with anti-nausea medication when she started in on wanting me to walk up and down some stairs. I tried to tell her I would, just not right now, but she still went on and on. The physiotherapy assistant with her gave me a sympathetic look. In hindsight I wish I'd given in to the urge to projectile vomit over her.

My right incision was still bleeding so I stayed in hospital scrubs. The morning was a bit of a blur as I felt really sick. I seemed to be outside of myself, the world a bit distant. I still went for walks and ate but it all became more disorienting as the day wore on.

I eventually did do the stair walking and was able to explain to the physiotherapist's assistant that I'd been trying to avoid puking over them earlier rather than being uncooperative. She understood but the physio herself still had a face like she'd been chewing wasps when she met us in the test room. I was to find out a couple of days later that she'd had several run-ins with other patients on the same day. I felt like I floated up and down the steps rather than walk on them. I also managed not to swear at the physio when she snapped at me that I was only to use the one handrail (rather than both) as I only had one at home.

I'm not sure but I think day three was when one of my former colleagues and friends popped in to see me on her way from visiting her mother in the same hospital. Jane patiently let me ramble on and on. It was whilst I was talking to her that I realised I seemed to be gabbling and a bit off my tits to be frank. I'm also not sure if it was day three or day four when I saw Mr Muir again. He appeared to be about the size of a leprechaun and floating in a seated position just about the end of my bed. I remember telling him I felt chemically toxic. In fact, I felt like I'd been poisoned! The psychedelic effect was only added to be the fact he seemed to take this completely in his stride and told me that what I was experiencing was completely normal.

Two porters took me down to Main X-ray in the afternoon. I was so glad to be wheeled out of the ward on my bed as the corridors were so much cooler. The accompanying stand-up routine was a welcome distraction. The younger of the x-ray technicians was a bit startled when I pointed out that my consultant wanted my x-rays to be done 'under loading', i.e. with me standing up. Even so, she still wheeled my bed too  close to the machine. It had various bits sticking out all over the place. I was still very nauseous so I really did not want to have to look down or move my head at all really. The technician went to check with her older colleague that the 'under loading' bit was correct. Having checked the sheet, the older lady said, yes, it was. So the younger one added "who's her consultant?"."Oh, it's Mr Mckenna". "Ooh" was the reaction, said with a tone that suggested that this explained everything. I surmise his post-surgery method rather startles some of his colleagues!

Days three and four I had the most appalling craving for a chicken mayonnaise sandwich. So much so that I nearly kissed my friend Mary's feet when she brought me one in. The hospital food was great. I just had this awful craving. She sat and chatted to be for quite a while then pointed out the window and told me she was not surprised I felt weird. Mary eventually had to explain that it was the night of the full moon and commented that of course a white witch like me was bound to feel strange.

It was something more than that though. I was on high dosage of paracetamol and of codeine. I'm not sure at what point the nursing staff figured it out, but it would appear I shouldn't be allowed anywhere near codeine. It had been causing the nausea, the hallucinations and the sensations of non-existent constipation and period cramps (yes, that good!). Once my mental fog cleared a bit, they explained that it's not uncommon for people to find that they can't take a given pain killer in large amounts. I was told that I would seem to be at the extreme end of the codeine sensitivity however and to make sure to check anything I took in future for codeine as an ingredient (e.g, cough and cold remedies).

I refused all further offers of pain killers for the next twenty-four hours and only resumed the paracetamol as a precaution.

Hunter Ward (Part One)

I woke early on the first day after surgery. I felt very hot and thirsty and a bit cramped up at the foot of my wrinkly bed. The oxygen enabled me to breath very well though; my perennial sinusitis dried right out. The 'obs' nurse took my stats and got me to breath deeply for a few breaths. Then came the first of numerous pain killer pills. I took them even though I was pain free as I'd been warned not to wait to be in pain before requesting medication.

My neighbouring lady asked me how I felt. We chatted for a bit then a nurse asked me if I felt able to get up. I was delighted to be allowed to give it a go as I needed the bathroom again. I was very cautious at first as I couldn't really tell what my back was experiencing so it was difficult to assess how much of any movement was too much. I'd had concerns prior to surgery that 'wiping' might be an issue if I wasn't allowed to bend. As it turns out it wasn't but it did require a bit of trial and error as the arms on the over-toilet commode limited knee spread!

Breakfast was a joy as I was ravenous by this stage. I took care to have the healthy options of porridge and fruit juice with some brown toast to follow. I was keen to avoid to gloop issued to other patients to aid 'going'. Strong pain killers have a tendency to 'back one up', hence the gloop.

I was visited by a couple of members of the spinal team later in the morning. They got me to roll over onto my side to check my wounds. I was told that they could see the incisions through the dressings. When I saw a pack of these later, I saw that they were composed of a bi-layer of transparent plastic with a blue honeycomb sponge sandwiched between. I was then asked to roll back onto my back so that they could check my reflexes. I flexed toes, then ankle, and then rotated my feet. Yes, I could feel being tickled by the plastic stick, there, there, and there. The senior surgeon commented that he was surprised at the amount of motion I had and that it normally took most people several days to regain full sensation in their lower limbs.

That afternoon, I stood chatting to a fellow patient for longer than I've been able to stand in the last five years. Standing still had been the most painful posture prior to surgery. I'd considered it a good day if I'd managed three minutes without wanting to kill someone for keeping me waiting. That afternoon I managed twenty minutes before even feeling tired. I was delighted once I realised and reflected on the fact that I'd also been able to walk further than in the last five years and that my posture felt NORMAL!

I was grateful later that I'd obeyed my surgeon and got walking as soon as possible as it let me know that surgery had been the right option. I'd been able to judge my corrected posture, my mobility, and had eliminated worries over one of the possible complications, that of permanent urinary incontinence.

...ooOoo...

The heat of the ward, the constant need to drink and the endless trips to the loo, and the general noise in the unit meant I go no sleep on day one. Day two was hailed by the arrival of the dreaded butt and lower back swelling. This was not painful per se but did result in some very weird sensations. I was both numb yet fizzy and any movement carried the risk of intermittent sensations like having your butt pinched. It also revealed that my right incision had been bleeding. Bleeding enough to cause my previously sterile dressing to lift off my skin. It was re-dressed and a blood sample was taken to check my blood count and to look for signs of infection. One of my consultant's registrars, Mr Muir, was called to take a look. I only realised much later that he was trying to assess whether I was losing spinal fluid. If I had been, it would have meant another trip to the operating theatre for a procedure akin to applying a puncture repair patch to a tyre. Thankfully this was not required.

I was allowed to sit in a chair for a while and brought a cardboard washbowl and cloth so that I could rinse myself down. The nursing assistant helped me to wash my back as I had to make sure my dressings stayed dry. My surgical gown and bed linen were changed. One of the nurses checked my dressings again and told me she wasn't going to tell me what it looked like. I found this rather perplexing as I hadn't asked! I rested for most of the afternoon. I didn't manage to sleep but did sort of hover on the edge of sleep whilst listening to the hiss of my 'boots'.

My rest was interrupted by a brief visit from that day's physiotherapist. She gave me a sheet that basically covered the same sort of leg and foot exercises you're given on planes to prevent DVT. I took one look and understood why my surgeon had said he didn't want me bothering with them too much as the walking was far more important to my recovery in his opinion.

I was still very hungry so ate like a horse at each mealtime. I made sure to ask for fruit as snacks, knowing that I'd probably be very grateful for having it in the small hours. The pattern of ops, drugs, dressing changes, blood tests, and endless loo trips was set. I got to know the other ladies in my bay a bit. No one else was in for spinal surgery. It was all hips and knees. I also met to the night sister for the first time. She was Albanian and had a wonderfully gentle, kind yet naughty personality.

Surgery Day

It was a wintry 23rd January 2012 that saw me being transported to the Royal Berkshire Hospital in Reading to have fusion surgery. I had to report before 7am and I don't *do* mornings. A lovely pal drove me there in her other half's 4x4 which felt safer than a 'normal' car on the icy, slightly snowy streets.

Once there I found out that I'd been bumped out of second place on the wickedly adorable Mr Patrick McKenna's surgical list to later in the day; like nearer 4pm. Fortunately they were happy for me to pop off to my mother's for a few hours and I was given leave to drink water or very weak squash until 2am.

I was signed in once I got back to the Orthopaedics admission list and given a shot of gloop. The gloop was a mixture of pain killer and a drug designed to stop me from fitting on the table. The latter being a distinct possibility due to the surgery being so close to my spinal cord.

Previous surgeries had led me to expect to be taken to a bed for surgical preparation but the Royal's Orthopaedics suite does not work like that. I was led through to a small room with a changing cubicle. I sat down on a bench outside the cubicle and asked the usual questions to confirm ID and procedure. I had two labels attached to my right wrist, one with my identity and one detailing drug sensitivities. I then entered the cubicle, stripped down and get into a cotton surgical gown. The fastenings were down the side but I couldn't reach so had to hold it around myself as I peered around the door looking for the nurse. He had me place my possessions into a locker and then did me up. I went back into the cubicle to wait for a member of the surgical team.

The surgeon again confirmed my details and then got me to turn around so that he could draw on my lower back with a thick black marker pen. He got me to confirm which level of my spine was to be fused and the details of the work to replace the right hand side of my L5/S1 facet joint. I was then led through into an anteroom to the operating suite itself.

Shedding my flip-flops, I was helped onto a surgical trolley bed and released my gown from underneath myself. The anaesthesiologist did most of the talking but it was the surgical nurse who again confirmed my ID and so forth. I noted that the oxygen mask had been massively re-designed since the last time I'd had a general anaesthetic. It was much, much smaller and made of a transparent, clear, rubbery material. It was held just above my nose in recognition of my claustrophobia. The anaesthesiologist talked away my nerves as he placed a cannula with tap into the back of my left hand, taking care to avoid the ganglionic cyst I have near the centre of my wrist.

It seemed to take ages but was probably only a few minutes before I was injected with the anaesthetic which seemed to take me over much more quickly and gently than in previous surgeries.

...ooOoo...

I woke in the recovery room, unaware of having been wheeled out of theatre (I had been on previous occasions). It was the first and last time that I got to meet Mr McKenna himself. I was tearful on waking. I had expected this as modern generals seem to have the same effect on me that gin does on some women. I had warned Patrick beforehand so he was grinning at me. He squeezed my hand and briefly explained that he'd had to cut bigger incisions due to access issues and that he'd only been able to fuse up the back of my spine, leaving the front of my disc in place. I had been warned of both possible complications ahead of time so was not surprised. He squeezed by hand again and left me. A few minutes later my attending nurse came up and told me it was all okay as I was still crying.

I do not remember much about the next few minutes, just the trip up to Hunter Ward and the transfer to a six-bed sub-unit. The turn into the unit was tight and I was a bit uncomfortable due to the bed being bumped against the wall. Several of the other women in the bay introduced themselves as I was wheeled through to a bed adjacent to the window. I came to appreciate this 'easing of relations' so much over the next few days.

The bed I was transferred into was far more comfortable than the surgical trolley bed but felt extremely wrinkly. My lower back itself was cushioned by the specialised dressings placed in theatre. There seemed to be a lot of hazy fussing around me but I was finally arranged on my back in a reclined position with my lower legs enveloped in softly hissing, hydraulic, foot-less 'boots', and a soft rubber oxygen tube poking up each nostril. I had no pain, just a sensation of sitting on a lop-sided cushion (my butt).

I drifted between the frequent monitoring checks (blood pressure, temperature, blood oxygen saturation) until the demands of my bladder became too much to ignore. By this time the unit's lighting had been dimmed so I guess it must have been around ten in the evening. I called a nurse who proceeded to get me to try to use a cardboard bed pan. The 'log-roll' needed to get on to the pan presented few issues but I simply could not get started. It felt like I was trying to pee out of my ears. Very weird! We decided to leave it a while before trying again. I was told that the anaesthetic stops smooth muscle from working well due to blocking the innervating nerves. This meant that one's urethra does not dilate easily. It also explains why one is asked to cough at many of the monitoring checks as it impacts lung function too.

A second attempt with the bed pan was equally fruitless. The nurse warned me that I might need to be catheterised however she offered to let me try to use a commode placed adjacent to the bed first if I felt able to try standing. I knew Patrick wanted me to stand and to walk as soon as possible after surgery and not fancying having a tube inserted, I agreed.

I had practised the 'log roll' method of getting out of bed before coming into hospital and I'm glad that I did as it gave me a lot more confidence that I would be able to get up and sit on the edge of the bed safely. I was surprised that sitting gave me absolutely no discomfort and that I was slowly able to stand without pain, wobble or other alarms. Lowering myself onto the commode took time as I was terrified I might cock up and end up butt first on the floor.

I could not go at first but using a simple mini body scan meditation and utilising my pelvic floor muscles as a pump brought relief in more ways than one. I was comfortable and knew the surgery had not let me with urinary incontinence.

Once back in bed, I started the first of the pints and pints and pints of water I was to down over the next few days. The nurse plugged my 'boots' back in and told me to try to sleep. I think I must have managed a little eventually but the heat and hissing of hydraulics throughout the unit made that difficult.