This is a lengthy post without a punchline. It is part of a struggle to control a depressed mood, Thank you for your patience if you manage to read it all.
I had a very large BCC removed in September last year - cut a medium size orange to get an idea of diameter. It went right into the bone, It appeared to be healing well until about three months ago when it all started to look a bit mushy. The new consultant had been at me for some time to go for a forehead flap rotation. Eventually I agreed and the procedure was performed on19 July, a combination of rotation plus a skin graft behind the right ear, the donor site being on the thigh, all under general anaesthetic It wasn't pleasant and having arrived at seven in the morning I was discharged at nine at night having had a single dose of liquid morphine. When I enquired why it took so long to arrange discharge it appeared that they wanted to confirm with consultant. Only problem was as they eventually revealed to me, he had gone home, I was loaded up with ten days of antibiotic. When I enquired about pain management they said I should use paracetamol every four hours -- nothing like strong enough but they were absolutely adamant that if I wanted anything more powerful I should, I’m quoting this because it became a mantra both in surgery and the Plastic Surgery Dressings Unit, "speak to your GP"
The Plastic Surgery Unit duly started dressing it. I won’t go into the whole business -- emergency appointment because the donor site was bleeding, head dressing falling off in the night etc. but cut to the point when he next came into see me. I was having staples removed, 29 July, He turns up to inform me that the material removed to seat the flap more seamlessly into the wound had been routinely biopsied. Guess what -- it was cancerous. So a skin flap of healthy tissue and been placed on top of residual cancer tissue at bone level. Let’s skip over "all I was asked to do etc., and what I perceived to be a narrative drive of "not my fault, not my fault". There was no attempt to engage with my questions if he even heard them, All he would say that he would say was that he would hold a case conference with his WSH colleagues but that he would also involve "Cambridge". I assume he meant Addenbrookes.
Sure enough he turns up the following Monday, 3 August” and tells me that West Suffolk would do a CT scan and thereafter "Cambridge" would take over my care. They, he said had "a range of specialisms” and I should put my questions to them. No information about when "Cambridge" were going to pick up the baton – weeks, months, I don’t know.
As if it was any consolation, the staff at the Plastic Surgery Unit, lovely people by the way, kept cooing over the way the sizeable head wound. I raised the matter of pain relief several times and I was repeatedly knocked back. The pain was initially from the donor site on the thigh which was excruciating but did start to heal but was swiftly taken over by a tingling pain from my right eyeball through to the top of the wound. They were quite open that I had most likely suffered nerve damage. This they said, “usually recovers”. I would have preferred they had omitted “usually”. All discussions about pain relief, and I raised it several times, ended with “speak to your GP”. I tried to explain the chances of getting my GP to prescribe morphine without a consultant requesting same were about the same as me entering the Olympics in the “Freestyle Pain Category”. I doubt that he or they even took in what I was saying.
Let’s move to Friday sixth of August. and another routine dressing as I thought. I go to bed early on Saturday as my right eye was twitching uncontrollably, The pain steadily got worse until it went well beyond what I could bear, the worst I have ever experienced. My wife drove me to West Suffolk A&E at five in the morning. They fed me on a paracetamol intravenouslyand whacked a dose of liquid morphine into me. Within ten minutes I was a sane human being again The doctor said she wasn’t discharging me and I should feel free to come back if needed. I left with a gabapentin, an anti-emetic (opioids make me retch) and a small bottle of liquid morphine which has been a god send.
I’m writing this on Monday ninth of August and I next go to the Plastic Surgery Unit on Thursday 12th of August.
As I said there is no punch line to this post, I am trying to row back a life threatening bout of depression which came on when he told me cancer had been left behind. It has helped to write it down to be read by people who will understand.
