Thoughts from the frontline - 23

W ell, I'm back at the computer this morning after a few days. Just needed the break. :-) Now where was I? Oh yes, waking up on the Saturday morning in my home from home, the urology ward, after spending Thursday in theatre and Friday in ITU. It was good to be back! But very unreal... As normal I was awake before the day started for most of my fellow patients on the ward so I did a bit of reading and listening to the radio until the ward woke up and breakfast was delivered. But it was nothing for poor old me! "Sorry, not allowed" I tell the hca after the offer to choose breakfast. Now having not been allowed to eat since before 8am last Wednesday this was a difficult call but it was what the doctor ordered. I was allowed a sip of 15ml of protein drink every two hours followed by a sip of just 15ml of water on the alternate hours! Yep, that was all. A total of 15ml of liquid every hour! Now I could understand the logic. They had needed to starve me pre op so that they could do the surgery but this was all about the gradual bringing back of my internal systems into use. When they had taken bits out of me the other internal organs such as the stomach and intestines get "insulted". As in, bugger this we're not working now. In other words they stop their normal processes and the regime of small sips was all about a slow relearn for these vital organs. Whilst I was getting different IV supplements dropped into my central line the idea was a gradual "re-awakening" of my stomach and guts. Tip: If you are ever on this regime yourself, sip the protein drink and water through a straw - and make it last as long as possible across the hour! But the hours did seem to come around quickly and the day was made up of test after test, changing of drips from glucose to saline and back again dependent on BM level and getting to know my new neighbours on the ward. But as the day went on I soon realised that my brain was only just getting back to normal and I was far from being myself again. Putting on my normal smiley face, feeling good most of the time but not all of the time. And I was just so knackered! A day of awake and sleep sessions of varying lengths. I felt good. Pain score: About 1 out of 10 although this peaked if I sneezed or coughed! And it was at some point on this Saturday that the rumbles started. Without warning I'd feel a rumble in my stomach as this ball of air decided to travel through my body. And it hurt. Every millimetre it travelled it hurt and I could track it from the very top of my chest through my stomach, down the whole length of my intestines and through to my... Well you know where it ended up. But... It very rarely exited as a puff of wind. Where was it going? Was my bum filling up with gas that would soon lift me off the bed to be floating up to the ceiling? Now that would add some interest on the ward. But then, not very often, the fart would exit. A gentle puff that needed to be guided. It felt like a triumph. It was a triumph! But then the warned about happened. Luckily it was not during visiting time. And there was a follow through. Nurse, I've had a little accident... And yes, I had to have a pretty nurse wipe my bum for me. Dignity, dignity, where have you gone? :-) But later on, as Saturday night was ending and the night staff were settling us down I felt the need to ask for the commode. I wont go into all the details but I sat there for about 40 mins with the curtains round me, expelling all the wind that had now been stored up in the lower half of my body and a small by significant amount of waste material. Wow, just over 48 hours after surgery and I'd poohed! I was very proud of myself. :-) But it had hurt in a "large amounts of chilli way" My ring of fire. But hey, at least I'd "started"! So Saturday turned into Sunday and my consultant had allowed me to increase from 15ml of drink an hour up to 20ml and finally up to 30ml. I was now such a big eater! And after rounds on Sunday I was told that I could have some soup later on. Nothing else, just some soup. Heaven! Life was looking up! Sunday was becoming a very good day. And I was even in a much better frame of mind for my visitors. Perhaps my brain was getting back to normal. I did feel a bit more like me rather than this slab of meat with wire and tubes and hurty bits! We even had reduced down the epidural during the day to about "level 6" what ever that meant. And I had had the penile drain removed. Things were really looking up. As the visitors left and the night staff started their duties I was, at last, looking forward in a really positive mood. I know that I had had major surgery and we'd have to wait some time for results etc but I was here, I was alive, I was starting to feel better. I'd poohed ( twice by now!) and I had started back onto real food with the sipping of soup. "Shall we turn the epidural off now? says the night nurse "Why not" says I. And it was done and I settled back for an evening of reading and listening to the radio... Then it happened. Bang. No warning. Just bang, the pain burst through. I now could feel every pain across my body and it was nothing I had every experienced before in my life. Pain score: 9.5 out of bloody 10. The night team came to my assistance and gave me some more pain killers. But no respite. The pain just continued and continued and I felt like I'd just had my body cut open by a Victorian barber pre any pain relief. This was not fair. This shouldn't have happened. All we did was to turn off the epidural and that had only been ticking over slightly. Now none of the pain killers were working. On Call doctor called but it took ages as he was dealing with another emergency so I laid in pain for another hour. I then needed to use the commode and quickly. Oh my god, where is all this coming from? Bubbles of trapped wind cascading pain through my body, could this get worse. This opening of the bowels was now really hurting, not just in the sharp pain of the trapped wind moving down my body but also in the "ring of fire" feeling that you are left with. Life tonight was shite. Finally he come and within 1 minute he had written me up for some oral morphine which was delivered just one minute later. Effect.... nothing. Not even a little reduction of pain. This wasn't working and I felt awful. So after another hour or so the doctor allowed me to take another dose of the oral morphine. Now the amount of painkillers in my body should have protected me from just about anything but did it? Did it hell! It still wasn't working and now I felt sick. Very sick indeed. A was not a well boy. Racked in pain I laid there and felt sorry for myself all night until the day staff started to arrive and they all came round to see me and give me as much moral support as they could. Even the big "everyone is scared of her" Sister came to see me and held my hand. But in the end my body did start to get hold of itself and let me have a sleep for an hour. And then after a chat and real time guidance form the stoma nurse for half an hour I fell asleep again for another two hours. And when I woke up... I was now pain free. Wierd. I had been told that I might have some bad days and I had just had my first one. It had lasted about 18 hours and I was glad it was over. Well I hoped it was over... Andrew xx