The sequel...part two of 'Responsible Adults and a Big Knife'

Responsible adults and a big knife – Part 2

Everyone has gone and there is a new nurse present. The recovery nurse. She asks me how I am feeling. Good, I think except my throat is a bit sore? She removes the air-way; a plastic tube that keeps your actual airway open during GA surgery. She props up the bed a bit and gives me a glass of water. ‘Your throat will be fine soon’.

Coming round from general anaesthetic is quite a pleasant experience. It really is like waking up from a deep sleep, which I guess is what it is?

She wheels me on the bed back to the bay. It is 5pm, one hour in surgery. The ACl patient is still in surgery, plainly a more complicated procedure than mine. One of the unit nurses appears and brings me water and asks if I would like tea and toast or biscuits.

Two top tips.

1. The coffee is likely to be instant. Avoid. My experience of post-procedure NHS tea is that it is really good. Maybe it’s all the drugs sloshing around inside me?
2. Tea or biscuits? OR? Ask for both. I had jam on the toast. I could have had marmite and the nurse apologised that there was no marmalade – Thatcher has a lot to answer for. And I have biscuits. And a while later, I have more biscuits and another tea. It is 10 hours since breakfast and I realise that I am properly hungry and thirsty.

I contact the responsible adult and let her know that I am now in recovery. Unbeknown to me, ‘my’ nurse has gone out to the waiting room for a chat with her. My responsible adult used to work with her partner; it really is a small World.

The ACL patient is wheeled back in. We have a bit of a chat. He damaged his leg playing football and will miss much of the new season. I share my experience of knee surgery and encourage him to follow his physio programme; he’s only 19 and if I can get back to riding 100-mile events following knee surgery, I reassure him that he can get back to playing.

Having a general anaesthetic is quite a big thing and the medics do like to keep an eye on you for a while before they let you go. And you have to promise to have your responsible adult nearby for the next 24 hours and not lock the bathroom door or drive or operate machinery; and this includes the kettle!

After about an hour, a person in scrubs appears and introduces themselves as one of the surgeons. So, 3 anaesthetists, at least two surgeons and several nurses; quite a big team, we really are lucky to have this level of care. He asks me how I am feeling; I say OK and ask.

‘Was the procedure successful?’

‘What do you mean by successful?’

‘Well, did you get enough material for a biopsy?’

He smiled; a genuine smile, a reassuring smile and a kind smile.

‘Oh yes, he used the big knife’.

THE BIG KNIFE! I have already described the location of my primary cancer. Access to this area is via my bottom. So, a big knife and a camera have been…, there is some involuntary clenching.

 At this point the actual knife wielder appears. He really is a very kind and gently spoken person, I feel reassured that the big knife was in caring hands. He says that the procedure went well; they got plenty of material (I envisage a bucket full) and it has been ‘blue stickered’ for priority analysis. He drops in a caveat, that sometimes biopsies are inconclusive.

Time ticks by. I am allowed to get dressed and sit in a chair. The discharge process starts. I am given a copy of the 2-page discharge summary and an advice sheet – ‘Advice following Anal or Perianal Surgery’.

I now have a file of NHS paperwork. And I expect this to get bigger. I learn from the discharge summary that this was an ‘uncomplicated procedure’ and that my main diagnosis is an ‘Anorectal tumour’. I do have a seriously unglamorous cancer, managing to combine anus and rectum in one hit. No mention is made of the ‘big knife’, is this an actual proper medical term? The advice note tells me that for the first 24 hours I may have leakage from my ‘back passage’, lovely, and that after 24 hours I can drive when I feel comfortable.

I am driven home by the responsible adult.

Recovery from this procedure is steady. I do as the advice says. I stay off my bike for a few days and potter around the house and garden.

I am aware though of the work of the big knife. Pooping is an uncomfortable experience for the next week, and I consume quite a lot of paracetamol and ibuprofen.

Just over a week later I get a phone call from the colorectal nursing team. The biopsy did get enough material. The big-knife wielding surgeon is one of the senior surgeons and a top person to have. She uses the term ‘mis-match repair’ or MMR to describe the tumour and I quickly forget what this means! A treatment plan can be made, and I will see an oncologist next week. She also tells me that the prostate MRI scan I had on 28^th August looks OK (although a detailed report is awaited), which is good news, we think.

She advises me to make a list of questions for the oncologist. ‘Write every question down as soon as you think of it’.