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Postoperative

Standing

The bladder was working. Water as solid and liquid had been consumed. How was I going to get out of this bed and to the toilet? I remember being told to ask for the assistance of a nurse at this all-important juncture.

Using a pillow to place suitable, bracing pressure on the abdomen, I used the mechanical bed to position my body for standing. However tentative, I was vertical. Steps more like shuffles, one at a time.

Trying to urinate without exerting internal pressure on my abdomen was a new challenge. Perhaps I could duo with Weird Al Yankovic for our parody – “Let it Flow“. The gas with which my abdomen had been pumped made an initial escape.

Laying

Flushing and washing, I shuffled back to the bed. Getting up was a level 1 challenge, getting back into bed would be level 2. I was exhausted but thankful for the mechanical bed.

Postoperative pain was certainly mitigated by the anaesthesia that remained in my body. But there was a lingering difficulty when it came to breathing. It felt like there was pressure being applied to my rib cage. Breathing properly, low and slow, was a painful exercise. Thankfully there was some strong pain medication, charted to help relieve postoperative pain, that was relieving the pain in my chest.

I was admitted on the Sunday. I had the surgery on the Monday.

Tuesday

Mobility had improved significantly, necessitated by a regime of self-imposed fluid replacement. Sure, getting up and down, in and out of bed, remained a low-level challenge, nothing my postoperative body couldn’t handle. It seemed there was another reason why getting up to go to the toilet was such an exhausting endeavour. It had to do with the breathing. Between attending nature, I was getting oxygen through a nasal canular, with my spirometry and blood pressure remaining relatively low.

And yet, I was discharged. Initial conversation with the initial consultant seemed optimistic. Surgery went well. I was independent and mobile. Further recovery would be made at home. Low-grade analgesics were prescribed. Pushback One: That wouldn’t be enough pain relief. A new script issued with next level drugs.

There were no further instructions given, at least not straight away. I asked the nurse to take the anchor out and attend my dressings.

Packing my things, I let my ride know to come get me. Packing my things was exhausting. By the time my ride got there, I was in a lot of pain and was apparently looking pale. Heeding her guidance, I began reconsidering the wisdom of the consultant. Further heeding her guidance, I cleared the bed and lay down.

Charles

A man with brown skin in a yellow high-vis knocked, entered, and sat in the corner. His initial assessment was that I was looking pretty white. Upon iteration, he upped his diagnosis to looking pretty under the weather, questioning the discharge order.

I had decided I would stay, that I would put my foot down. The second conversation with a second consultant resulted in a rescinding of the discharge order, on the grounds of my concerns with painful breathing. Off he went to do the necessary paperwork. He soon returned with questions, “Is it the pain that makes you want to stay in?”, “What if we gave you something stronger?”

Even though, at this stage, I would have happily remained an inpatient, the pain was the main concern – now addressed with the offer of something harder. A new script in hand, including the requisit paperwork for a controlled medication, I was discharged – officially.

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Beds

A New Bed

I would be wheeled to Surgery Assessment.  A doctor had seen me and was concerned that my abdominal pain was more than a stomach bug.  How much more, they wouldn’t say.  This was the better of the beds.

There the vomiting continued.  Yellow.  Bright yellow, bile.  Later I would hear what others heard as I reached and wrung the content of an empty stomach into the little white pail.

I was put on a new list, to be seen by a different team of doctors.  This time the doctors I was to be seen by had hard soled shoes.  These were unaccustomed with the halls of General ED.  Nonetheless, it was their job to tend to the specifics of my conditions, to make clearer estimations.

It first came from one of their mouths, “It could be appendicitis…” I was sure an ultrasound would be ordered.  Rather, I was told of two basic ways of determining appendicitis.  The first was a CT scan, which I have come to understand is very seldom ordered.  The second was exploratory surgery.

The First Night

I was kept in overnight to monitor the progress of the pain in my side.  Perhaps aided by pain-relieving drugs, I drifted in an out of sleep.  I took the occasional walk.  I made a cup of tea.  Around me, the sound of sleep apnea contributed to my restlessness.

At least I had stopped with the vomiting.  A nil-by-mouth policy was imposed from 2 am and my name added to the surgery schedule.

I woke with parched lips, seemingly desperate for a drink.  It wasn’t going to happen.  In a moment of cruel mercy, I was allowed to swish but not swallow.  Next came the tight white stockings requisite for those pending surgery.

Suspicions Confirmed

A group of hard soled doctors at varying stages of their training made up the entourage of the Chief Surgeon.  Her proddings, interjected by questions for her students, confirmed a classic case of appendicitis.  Surgery loomed ever closer.

I called my boss to tell him I wouldn’t be into work that day, or for a few days.  It was a quirky conversation.  We’d speak again in the coming days, once I knew what recovery might look like.

“In the next 15 to 30 minutes, we’ll take you up to theatre….” The elevator stopped as the hospital switched over to reserve power.  Reengaged, the elevator completed its journey, doors opening to the clinical white of theatres.

Awake

The mains power was now back in.  A stream of individuals who would be involved in the surgery came to talk to me.  They emerged from the operation theatre to me, in a sort of anti-chamber.  The anesthesiologist was tasked with putting me to sleep, keeping me asleep, and managing the pain.

Theatre was ready and I got to walk in.  The bed, more like a bench, was narrow.

I woke up in recovery, not knowing how I got there or how long I was out.  My concerns turned to quenching a half-day thirst.  I did so with abandon and an ice block.

I was still highly medicated when I was allocated to Ward 34 North.  Initial visitors would bring my toothbrush and I would begin the journey back to normality – without an appendix.

Nurses

Waiting

Room 9.  I had seen it before, but never as a patient.  In fact, I had never been beyond the security doors as a patient at this hospital.  There was the time I hurt my knee, joined the queue and ended up at an after-hours clinic.  The bed was somewhat more comfortable and afforded me opportunity to sleep between bouts of vomiting.

Samples were asked for.  Solid and liquid.  The loud-voiced other patient was right, this toilet space wrecked of urine.  I had to take my socks off.  There was a pool of water in the toilet.  I would tiptoe gingerly around it to procure a sufficient sample.  It would be a while before my bowels willingly offered anything so it would be just the one sample – other than that drawn out by intravenous.

Relief

Time passed slowly and I was surprised to learn how short a time I had actually been at the hospital.  This time the inordinately long wait times didn’t quite apply to me.  Though I was yet to see a doctor, I was being attended to and had even been given a cocktail of variously administered medications to help ease symptoms.  Abdominal pain, now most certainly localising in the right side, was being addressed by analgesics of varying strengths, to my relief.

Looming

Between having my plastic patient ID tag printed and seeing the first actual doctor, there was a small band of nurses attend me.  None of them had ventured to suggest what I feared.  So I asked. “What do you think is actually wrong with me?”  The suggestion of a severe stomach bug seemed to be the go to, but as nurses, they were confident (or perhaps obligated) to say they simply didn’t know.

My fear was that it was as my friend and I had co-diagnosed – that I was under the sway of appendicitis.  I knew what this would mean.  I knew this would result in me having to endure something I had never before experienced: surgery.

Serenity

There were things about this situation that seemed beyond my control.  I had learned how to pray through these situations.  God, grant me the serenity to accept the things I cannot change…