HUGE APOLOGIES! I thought I'd published this but it was still in my drafts. Sorry! I think I was going to add some pictures, but instead I'll just get this posted and do pictures for you another time. I do have videos I've been doing but I have so much trouble getting them uploaded to YouTube I may give up on them. Anyway, hope this is still useful/interesting and I'll get writing more I promise.
*should have been published a month ago, whoops*
It's been three weeks since my last update, and I'm now 21 weeks post-surgery.
Last week I picked up my new, custom, orthotics from the hospital. That marked the end of my hospital appointments at the Royal Berks, apart from when I need the orthotics replacing in about two years' time.
The orthotics are as slim as they can make them. You can see from the picture that they are really thin, but the curve of them where they support my arch and heel means that they push my foot up, which means I need to be careful what kind of shoes I wear.
I am working on a post looking at shoes, but basically my orthotist would like me to wear big, clunky shoes with very rounded toes, either completely closed or with a wide strap, and generally pretty ugly.
So far I've found I can wear my orthotics in my flat ballerinas, which have a rounded toe, because although they have no strap they grip the back of my heel and my heel doesn't slip out of shoe when I walk, which is often a problem with very open shoes.
I also wear a pair of sporty styled shoes with two velcro straps over the foot.
As the weather warms up, I probably won't wear the orthotics as often as I should, because you cannot wear them in sandals, but I do make sure that I am conscious of my foot positioning and pronation, and I hope that will be enough to make up for it. I'll definitely wear them all winter.
Right now, I can't wear them the whole time anyway. The orthotist told me I had to build it up by wearing them for half an hour the first day, then an hour the next day, and two hours the next, and so on.
I find they do make my feet and legs ache, because the muscles are adjusting to the new positioning, so I'm still working on increasing the time. I can't wear them in the house unless I wear shoes inside, and I usually wear slippers, so it's taking me longer to build the time up, but I think that's OK.
I also saw my physiotherapist again. I know Ed has been reading the blog, so "Hello Ed!" *waves*
I had to admit I've not been doing my exercises as much as I should have been, because they make me hurt, so I have promised that over the next month I will do them regularly, and wear my orthotics, and hopefully when I go again he will discharge me.
I did go back to yoga and have done two sessions now. Surprisingly, it wasn't as hard as I expected.
During my recovery I have been making sure I did foot exercises, and calf stretches, and I found I was no where near as stiff as I thought I'd be. My teacher, Minna (who also reads this so "Hi Minna!" *waves again*) does try to tell me to take it easy but I like to push myself and I never do anything that is painful.
As expected, it was a challenge to roll over my toes to go from all fours into downward dog, for example, but I either do it one foot at a time, or I do both together but put a lot of my weight onto my hands and arms.
Over time, it will definitely get back to normal, I'm sure.
I am actually really pleased with my recovery; with my range of motion and with my lack of pain. I know I've worked hard on my recovery but I also feel very lucky and blessed.
I do still have the problem with my toenail on my left foot, but I can now see that there is a new nail growing under the old one, and the old one is growing out, so in six months that is going to be back to normal. It's irritating, but a temporary annoyance.
So there we are! I'm still doing my exercises, building up my general stamina for walking and standing, and sometimes overdoing it a bit! Some days I'm fine, some days my legs and feet really ache, but the progress is in the right direction and soon, in terms of medical appointments, I'll be flying solo!
As usual, please ask any questions or make any comments below.
Showing posts with label NHS. Show all posts
Showing posts with label NHS. Show all posts
Monday, 27 May 2013
Saturday, 16 February 2013
Two hospitals, one day, and three orthotics.
Thursday was a busy day, and not just because it was Valentine's Day and I was sorting through my large pile of cards from admirers for the best part of the morning.
Lol.
Actually, I did end up with three cards - one from the hubby and two from the Little Lady, bless her - but I was busy because I had two hospital visits.
The first was at the Royal Berks to the orthotics department. You may remember I'd asked to be referred when I had my casts off, and the appointment came through very fast.
It turns out that it came through too fast, and I have to go back in a month, but I did have a full appointment anyway.
I saw someone called Emma. I'm not sure what her title was because I didn't catch it (does anyone ever? They just rush their name and title at you as soon as you walk in and I'm lucky if I remember their name) and she isn't listed on the department's web page so I can't look her up.
What can I say about her? She was young, probably mid to late 20s, she was Scottish...oh yes, she nearly crippled me.
Obviously she needed to examine my feet, but she took hold of my left big toe, grabbed it and then YANKED it up towards the ceiling!
I nearly hit her!
It was so painful, but she didn't feel the need to apologise. She just carried on.
I did ask her to be more gentle, and we managed the rest of the examination without incident, although afterwards she said "I thought you were going to assault me". If I had, I'd only have been returning the favour!
I wasn't very impressed with Scottish Emma, which is a shame as we share both a name and a heritage, but she told me all about how bunions are not caused by anything at all, and are not only purely genetic (that bit's true) but "just happen". Hmmm. Not what almost every other medical professional will say, but she certainly seemed to believe it.
Another medic to add to my "do not believe" list I guess.
I came away with some insoles for my shoes, with added-on bits supposedly making them a bit more tailored to my feet.
When I go back they will see whether I need custom-made ones, which was what they were going to make for me this time but can't. The ones I was given cost £50 while the custom ones cost £150, so I imagine they'll try to avoid making some for me if possible.
This is what they look like.
The coloured bits are the added-on sections.
And this is the box, in case you're interested. Emma told me that it is cheaper to buy them direct from Talar so if you want to get some then this is the box to look for. I had a look on their website and am not sure which ones are mine exactly, but they definitely are cheaper direct.
Emma told me to wear them for short periods and build up to a full day because the foot has to get used to a new position. I figured that I am a) not walking much and b) getting used to new foot function anyway, so I'd just wear them whenever I wear my trainers.
That appointment done with, and a new one booked for next month (at which I hope I get someone else), I went to my local hospital in the afternoon for a physio assessment.
Townlands Hospital is a cute community hospital which has been saved from closure numerous times, although much of it has been shut down, including the maternity unit. These days if you want your child to be born in the town then you have to have a home birth (which is exactly what I did, although not for that reason).
We still have one building left, which houses the minor injuries unit (like a mini A&E, very useful) and the physio department, plus X-ray facilities, and other things such as clinics. My first appointment with Mr Nugent was at Townlands; it's an excellent facility to have.
Enough eulogising!
My appointment was with Ed. Unlike the RBH physio bit I went to while on Hunter ward, which was like a storecupboard, Townlands has a large room filled with equipment, although there was only Ed and me there.
We chatted about my history and operation, and Ed had a look and tested my mobility.
Sadly, because nobody measured my mobility before my op, we don't really know how much I have lost. Ed says there's no 'normal' so it's impossible to say, which is a shame really.
But what I do have is the ability to bend my toe 35 degrees, which is about two-thirds of what Ed can achieve, so I'm not doing too badly. I am pretty hypermobile, so I probably had much more than that, but average will suit me fine.
Apparently my toes are weak and stiff, but that's only to be expected really. Thankfully, Ed approves of all my exercises (see here and here) and just added in one more, which uses an elastic band (very high-tech!) as a resistance band for my big toes.
Basically I have to use the band to pull my toe in one direction, like towards me, then use my toe to push against that the other way, then swap and do it in the other direction. This will build up my strength in my toes.
Ed also had a look at my orthotics, and devised me a different one, for my most painful foot. It's a short-term fix for my pain when walking. The idea is that my other toes are lifted up so that when I propel off from my toes the big toe doesn't have so far to travel.
In the short-term this will help me learn a new gait or way of walking that is correct, as at the moment I'm tending to either walk stiffly, or to propel off the side of my foot.
This orthotic looks like this:
It's basically made from thin foam board (probably not the proper name for it) like the stuff you can get for crafts, and some cut up pieces of that padded sticky stuff (also not the proper name) that you can get from Boots, like this.
All very Blue Peter, but it does work.
One thing you might notice is that it has been cut to my actual foot shape. Yes, that is my actual foot shape! Amazing. I'm so pleased.
I see Ed again in a couple of weeks. Our goals are to maximise mobility and minimise pain, so we shall see if we can manage it.
Ed did say he might read the blog, so if you are reading Ed, then hello!
Lol.
Actually, I did end up with three cards - one from the hubby and two from the Little Lady, bless her - but I was busy because I had two hospital visits.
The first was at the Royal Berks to the orthotics department. You may remember I'd asked to be referred when I had my casts off, and the appointment came through very fast.
It turns out that it came through too fast, and I have to go back in a month, but I did have a full appointment anyway.
I saw someone called Emma. I'm not sure what her title was because I didn't catch it (does anyone ever? They just rush their name and title at you as soon as you walk in and I'm lucky if I remember their name) and she isn't listed on the department's web page so I can't look her up.
What can I say about her? She was young, probably mid to late 20s, she was Scottish...oh yes, she nearly crippled me.
Obviously she needed to examine my feet, but she took hold of my left big toe, grabbed it and then YANKED it up towards the ceiling!
I nearly hit her!
It was so painful, but she didn't feel the need to apologise. She just carried on.
I did ask her to be more gentle, and we managed the rest of the examination without incident, although afterwards she said "I thought you were going to assault me". If I had, I'd only have been returning the favour!
I wasn't very impressed with Scottish Emma, which is a shame as we share both a name and a heritage, but she told me all about how bunions are not caused by anything at all, and are not only purely genetic (that bit's true) but "just happen". Hmmm. Not what almost every other medical professional will say, but she certainly seemed to believe it.
Another medic to add to my "do not believe" list I guess.
I came away with some insoles for my shoes, with added-on bits supposedly making them a bit more tailored to my feet.
When I go back they will see whether I need custom-made ones, which was what they were going to make for me this time but can't. The ones I was given cost £50 while the custom ones cost £150, so I imagine they'll try to avoid making some for me if possible.
This is what they look like.
The coloured bits are the added-on sections.
And this is the box, in case you're interested. Emma told me that it is cheaper to buy them direct from Talar so if you want to get some then this is the box to look for. I had a look on their website and am not sure which ones are mine exactly, but they definitely are cheaper direct.
Emma told me to wear them for short periods and build up to a full day because the foot has to get used to a new position. I figured that I am a) not walking much and b) getting used to new foot function anyway, so I'd just wear them whenever I wear my trainers.
That appointment done with, and a new one booked for next month (at which I hope I get someone else), I went to my local hospital in the afternoon for a physio assessment.
Townlands Hospital is a cute community hospital which has been saved from closure numerous times, although much of it has been shut down, including the maternity unit. These days if you want your child to be born in the town then you have to have a home birth (which is exactly what I did, although not for that reason).
We still have one building left, which houses the minor injuries unit (like a mini A&E, very useful) and the physio department, plus X-ray facilities, and other things such as clinics. My first appointment with Mr Nugent was at Townlands; it's an excellent facility to have.
Enough eulogising!
My appointment was with Ed. Unlike the RBH physio bit I went to while on Hunter ward, which was like a storecupboard, Townlands has a large room filled with equipment, although there was only Ed and me there.
We chatted about my history and operation, and Ed had a look and tested my mobility.
Sadly, because nobody measured my mobility before my op, we don't really know how much I have lost. Ed says there's no 'normal' so it's impossible to say, which is a shame really.
But what I do have is the ability to bend my toe 35 degrees, which is about two-thirds of what Ed can achieve, so I'm not doing too badly. I am pretty hypermobile, so I probably had much more than that, but average will suit me fine.
Apparently my toes are weak and stiff, but that's only to be expected really. Thankfully, Ed approves of all my exercises (see here and here) and just added in one more, which uses an elastic band (very high-tech!) as a resistance band for my big toes.
Basically I have to use the band to pull my toe in one direction, like towards me, then use my toe to push against that the other way, then swap and do it in the other direction. This will build up my strength in my toes.
Ed also had a look at my orthotics, and devised me a different one, for my most painful foot. It's a short-term fix for my pain when walking. The idea is that my other toes are lifted up so that when I propel off from my toes the big toe doesn't have so far to travel.
In the short-term this will help me learn a new gait or way of walking that is correct, as at the moment I'm tending to either walk stiffly, or to propel off the side of my foot.
This orthotic looks like this:
It's basically made from thin foam board (probably not the proper name for it) like the stuff you can get for crafts, and some cut up pieces of that padded sticky stuff (also not the proper name) that you can get from Boots, like this.
All very Blue Peter, but it does work.
One thing you might notice is that it has been cut to my actual foot shape. Yes, that is my actual foot shape! Amazing. I'm so pleased.
I see Ed again in a couple of weeks. Our goals are to maximise mobility and minimise pain, so we shall see if we can manage it.
Ed did say he might read the blog, so if you are reading Ed, then hello!
Sunday, 10 February 2013
A letter from my surgeon
You may remember the rather unsatisfactory dicsussion I had with a doctor the last time I went to hospital, to have my casts removed.
If you don't, then you can read about it here, but basically he told me I could wear any shoes I wanted from that point on, I could drive within a few days, and didn't need to do any exercises or have physiotherapy.
I was deeply unhappy with that advice because I felt that it was, not to put too fine a point on it, wrong.
So I called my surgeon's secretary, who was lovely and agreed to print out an email from me and give it to Mr Nugent.
So I did that on the Wednesday after my Tuesday appointment. On Friday afternoon I realised I'd had a bounceback to my spam folder (doh!) so I resent it. And then I waited.
It took a long time, due mainly I think to the actual time it took for the letter to be posted, but last week I received a letter with some responses to my questions.
I had asked:
So many questions! But in my opinion they should all have been answered at the appointment, without me having to ask. I'd say they are fairly basic.
Mr Nugent was comprehensive in his reply, which I've photographed removing my identifying information. I hope you can read it. I think that if you click on each picture it will open up an enlarged version for you.
He has said everything I expected to hear, really.
Yes, I need to wear trainers.
Yes, I need physiotherapy.
No, I can't drive immediately.
Yes, I can trim the spacers. Although I didn't expect to be told I could stop wearing them at nine weeks. I'm choosing to continue to wear them.
Yes I need to exercise although walking should be sufficient. I'm choosing to do some specific exercises as detailed in these posts, though, because I think they are useful.
So that's good to know. But I think that such basic information should be in a printed sheet and handed out at follow-up appointments so people don't have to ask, be misinformed, and chase.
Imagine if I'd followed the other doctor's advice? I could easily have ruined my feet. That's not good for anyone; me, or the NHS. I really do think it's time the follow-up care matched the quality of the surgery.
If you don't, then you can read about it here, but basically he told me I could wear any shoes I wanted from that point on, I could drive within a few days, and didn't need to do any exercises or have physiotherapy.
I was deeply unhappy with that advice because I felt that it was, not to put too fine a point on it, wrong.
So I called my surgeon's secretary, who was lovely and agreed to print out an email from me and give it to Mr Nugent.
So I did that on the Wednesday after my Tuesday appointment. On Friday afternoon I realised I'd had a bounceback to my spam folder (doh!) so I resent it. And then I waited.
It took a long time, due mainly I think to the actual time it took for the letter to be posted, but last week I received a letter with some responses to my questions.
I had asked:
Should I be wearing trainers?
Can I walk barefoot in the house? Or should I wear the velcro shoes?
Should I be doing some exercises? The doctor yesterday said no but I have heard of just gently moving the toe up and down, and raising the foot on the toes, to increase the range of motion, and if appropriate I would like to do that - is it OK?
The doctor also said I could drive next week but I don't feel I'll be ready. When is normal to go back to driving?
My middle left toe is very red, swollen and feels bruised, and kept me awake with agonising pain last night despite me taking two codeine tablets. I think the cast has been pressing on it and has bruised it. Is this likely and should I be doing anything?
The doctor told me I could rub Bio Oil on my incisions to help the scars, so I am doing that. Is there anything else I should be doing for scar management?
How much walking should I try to do? I feel very unstable and sore, and not sure how much would be too much?
Also, the skin on my foot where the cast was is very tender, feels gritty and is a speckled red, is that OK? I rubbed all the dead skin off by hand in the bath last night so maybe I was bit enthusiastic?
Can I take the spacers out when I have a bath or do they need to be in 24/7?
My right spacer is very uncomfortable under the adjacent toe when I walk - can I cut it to make it less lumpy or is it possible to get a new one made?
So many questions! But in my opinion they should all have been answered at the appointment, without me having to ask. I'd say they are fairly basic.
Mr Nugent was comprehensive in his reply, which I've photographed removing my identifying information. I hope you can read it. I think that if you click on each picture it will open up an enlarged version for you.
He has said everything I expected to hear, really.
Yes, I need to wear trainers.
Yes, I need physiotherapy.
No, I can't drive immediately.
Yes, I can trim the spacers. Although I didn't expect to be told I could stop wearing them at nine weeks. I'm choosing to continue to wear them.
Yes I need to exercise although walking should be sufficient. I'm choosing to do some specific exercises as detailed in these posts, though, because I think they are useful.
So that's good to know. But I think that such basic information should be in a printed sheet and handed out at follow-up appointments so people don't have to ask, be misinformed, and chase.
Imagine if I'd followed the other doctor's advice? I could easily have ruined my feet. That's not good for anyone; me, or the NHS. I really do think it's time the follow-up care matched the quality of the surgery.
Frustrated and achy at 9 weeks 6 days
Sorry for being a bit AWOL recently. I usually aim to write something every four days max, but I've been a bit busy and a bit miserable and so after posting my videos over a week ago I've been MIA.
I'm feeling quite down about my feet right now. Some of it is not really to do with my feet. Partly it's because it's winter and I get a bit of Seasonal Affective Disorder (SAD) which you can read about here. I have had depression on and off since I was 13, and although I've been free of its worst ravages for a few years now, I do find winter a VERY hard time.
It's also partly because had I not lost my last pregnancy, I would have been a new mum with a two-week-old right now, and that is obviously a really difficult milestone to face. Especially as I have lost five babies in pregnancy, to first-trimester miscarriages caused by my Factor V Leiden, which you can read about in older posts here.
So it's been a tough time.
Add to that the fact that my feet ache all the time, and I often get some sharp throbbing along the incision sites, and you can see why posting hasn't been my top priority.
But I have promised this would be a no-holds-barred account, and so it's only right that I explain my absence.
Over the last week and a bit, my feet have definitely entered a new phase of recovery. Sadly, it's a really difficult and frustrating stage that brings with it new aches and pains.
I've gone from my feet being mostly OK, to them hurting pretty much all the time. In the main it's a dull ache in the big toes, and under the foot in the arch, as well as generally in the soles.
If you have a read of what makes up the arches of the feet, it's easy to see why this is happening.
My feet have been totally reshaped by the bunion removal. Bone has been cut, shaved and moved, tendons have been moved and adjusted, and now my entire leg needs to work in a new way, which puts strains on pretty much all the muscles in the legs and feet.
So my hips ache, my knees ache and click (because they always have clicked at times, it probably wont happen to you!), and my feet hurt as well.
Seriously, I'm trying to be upbeat but I am struggling because I feel so miserable!
I have managed to see my osteopath. Last weekend I had my first appointment with her since the surgery, and it was great!
She was amazed at the new shape of my feet, and also at how tight my entire body is! Clearly, all this inactivity and new ways of using my body have taken their toll - my back was so tight she couldn't finish it off in the session, and my head and jaw muscles (the reason I go to her in the first place) were so bad I need another session really soon.
But she was quite keen to get her hands on my feet! I said no because the thought of it made me go cold, but since then I've been thinking how nice a good massage that properly remvoes the tension in my feet would be, so next time I think I'll let her.
I definitely wouldn't let someone without her level of knowledge do it though - no massage therapists for sure. My osteopath is Jane Kaushal (see her website here) and she has good knowledge of anatomy and is highly skilled.
The main frustration is that I expected to be much more mobile by now. I thought I'd be able to walk about almost normally, so that a short trip into town or on the preschool run would be feasible, and while I thought I'd need to rest still I didn't expect a short baking session with the Little Lady to completely wipe me out.
But I'm nothing if not adaptable. So I've arranged for my lovely mum to come and stay next week (half-term!) to help out with the Little Lady, maybe do a little bit of cleaning for us, and generally ensure I'm not trying to do too much, which I definitely have been this last week and I'm suffering as a result.
And I'll probably be leaning a bit more on my fabulous friends again, to do school runs and help me entertain the Little Lady. I know I owe so many favours right now, but I'll happily pay them back because everyone has been so amazing.
This week I have a hospital appointment to get fitted for some orthotics, which are shaped insoles for my shoes. I had asked about those at my last appointment and the date came through really quickly, so hopefully they'll be made in the next few weeks.
My plan for the future is to wear orthotics and spacers as much as possible, to help maintain my foot shape and hold off recurral of the bunions.
So that's me at the moment. Little Miss Miserable! Let's hope I'm Little Miss Sunshine again soon.
I'm feeling quite down about my feet right now. Some of it is not really to do with my feet. Partly it's because it's winter and I get a bit of Seasonal Affective Disorder (SAD) which you can read about here. I have had depression on and off since I was 13, and although I've been free of its worst ravages for a few years now, I do find winter a VERY hard time.
It's also partly because had I not lost my last pregnancy, I would have been a new mum with a two-week-old right now, and that is obviously a really difficult milestone to face. Especially as I have lost five babies in pregnancy, to first-trimester miscarriages caused by my Factor V Leiden, which you can read about in older posts here.
So it's been a tough time.
Add to that the fact that my feet ache all the time, and I often get some sharp throbbing along the incision sites, and you can see why posting hasn't been my top priority.
But I have promised this would be a no-holds-barred account, and so it's only right that I explain my absence.
Over the last week and a bit, my feet have definitely entered a new phase of recovery. Sadly, it's a really difficult and frustrating stage that brings with it new aches and pains.
I've gone from my feet being mostly OK, to them hurting pretty much all the time. In the main it's a dull ache in the big toes, and under the foot in the arch, as well as generally in the soles.
If you have a read of what makes up the arches of the feet, it's easy to see why this is happening.
My feet have been totally reshaped by the bunion removal. Bone has been cut, shaved and moved, tendons have been moved and adjusted, and now my entire leg needs to work in a new way, which puts strains on pretty much all the muscles in the legs and feet.
So my hips ache, my knees ache and click (because they always have clicked at times, it probably wont happen to you!), and my feet hurt as well.
Seriously, I'm trying to be upbeat but I am struggling because I feel so miserable!
I have managed to see my osteopath. Last weekend I had my first appointment with her since the surgery, and it was great!
She was amazed at the new shape of my feet, and also at how tight my entire body is! Clearly, all this inactivity and new ways of using my body have taken their toll - my back was so tight she couldn't finish it off in the session, and my head and jaw muscles (the reason I go to her in the first place) were so bad I need another session really soon.
But she was quite keen to get her hands on my feet! I said no because the thought of it made me go cold, but since then I've been thinking how nice a good massage that properly remvoes the tension in my feet would be, so next time I think I'll let her.
I definitely wouldn't let someone without her level of knowledge do it though - no massage therapists for sure. My osteopath is Jane Kaushal (see her website here) and she has good knowledge of anatomy and is highly skilled.
The main frustration is that I expected to be much more mobile by now. I thought I'd be able to walk about almost normally, so that a short trip into town or on the preschool run would be feasible, and while I thought I'd need to rest still I didn't expect a short baking session with the Little Lady to completely wipe me out.
But I'm nothing if not adaptable. So I've arranged for my lovely mum to come and stay next week (half-term!) to help out with the Little Lady, maybe do a little bit of cleaning for us, and generally ensure I'm not trying to do too much, which I definitely have been this last week and I'm suffering as a result.
And I'll probably be leaning a bit more on my fabulous friends again, to do school runs and help me entertain the Little Lady. I know I owe so many favours right now, but I'll happily pay them back because everyone has been so amazing.
This week I have a hospital appointment to get fitted for some orthotics, which are shaped insoles for my shoes. I had asked about those at my last appointment and the date came through really quickly, so hopefully they'll be made in the next few weeks.
My plan for the future is to wear orthotics and spacers as much as possible, to help maintain my foot shape and hold off recurral of the bunions.
So that's me at the moment. Little Miss Miserable! Let's hope I'm Little Miss Sunshine again soon.
Thursday, 24 January 2013
The big reveal part 2. Doctor's verdict.
OK, I teased you a bit in that last post, but what's a little anticipation between friends?
Back at the orthopaedics department, we were called straight in and then waited for quite a while in a side room.
There were big signs everywhere saying "do not take pictures in here" I think mainly to stop you photographing your own X-rays, but laughably claiming it was to "protect your information". Right, not to encourage me to pay a fee to access my own information from you later, then. Of course not. Ahem.
So I took off the velcro shoes, and waited on the bed.
This was my view.
You can see how much of the steri strips I let the plaster lady pull off before I wimped out. My skin is still yellow from the stuff they paint on before surgery, and if you look closely you can see how dry and flaky my skin is.
At this point, I thought the worst dryness was on the top of my foot, near my ankle, and on the balls of my feet, where I could see it cracking.
After quite a while waiting a doctor came in to see me, but it wasn't Mr Nugent.
I have to say I wasn't happy about that. I had wanted to see my surgeon, and my dissatisfaction was exacerbated when this doctor - I didn't catch his name - said "Right, we'll get new casts on you then".
What?!
"Er," I said. "I've had them on for seven weeks, I thought they came off today."
"Oh yes," he said. "That's right, I thought you were at two weeks."
Really NOT confidence inspiring!
I was not happy. I asked him my questions about driving, exercises, shoes, and he told me "You can wear any shoes. You can drive on Monday. You don't need to do toe exercises. But don't exercise till you come back at 12 weeks."
Right.
So Mr Nugent told me to bring trainers, which I bought especially with money I don't really have, and now I'm told I can wear anything? And I don't need to do any exercises to improve my range of motion? And I can drive in six days' time?
I call BS on that, frankly.
I was, and am, really unhappy with that appointment. I feel that the doctor was not fully informed and I really wish I could have seen Mr Nugent.
Before I left, he got me to walk a little but I was SO SCARED that I couldn't really do it, and just put my weight on my heels. I was terrified of being in pain.
So I hobbled over to the computer and he showed me my X-rays. To be honest, I wouldn't know how good it was. I could see where the bone had been cut and moved, but without the old ones next to them, it was hard to tell anything really.
I want to know if Mr Nugent is happy with them, as he is my surgeon, but more of that later.
So, unsure about the shoes thing I put the velcro shoes on to go home and once we'd got the Little Lady to bed I ran myself a lovely warm bath so I could start de-flaking my feet.
If you want to see lots of pictures of that (my feet, not me nekkid in the bath) then look out for part 3 which is coming soon.
Back at the orthopaedics department, we were called straight in and then waited for quite a while in a side room.
There were big signs everywhere saying "do not take pictures in here" I think mainly to stop you photographing your own X-rays, but laughably claiming it was to "protect your information". Right, not to encourage me to pay a fee to access my own information from you later, then. Of course not. Ahem.
So I took off the velcro shoes, and waited on the bed.
This was my view.
You can see how much of the steri strips I let the plaster lady pull off before I wimped out. My skin is still yellow from the stuff they paint on before surgery, and if you look closely you can see how dry and flaky my skin is.
At this point, I thought the worst dryness was on the top of my foot, near my ankle, and on the balls of my feet, where I could see it cracking.
After quite a while waiting a doctor came in to see me, but it wasn't Mr Nugent.
I have to say I wasn't happy about that. I had wanted to see my surgeon, and my dissatisfaction was exacerbated when this doctor - I didn't catch his name - said "Right, we'll get new casts on you then".
What?!
"Er," I said. "I've had them on for seven weeks, I thought they came off today."
"Oh yes," he said. "That's right, I thought you were at two weeks."
Really NOT confidence inspiring!
I was not happy. I asked him my questions about driving, exercises, shoes, and he told me "You can wear any shoes. You can drive on Monday. You don't need to do toe exercises. But don't exercise till you come back at 12 weeks."
Right.
So Mr Nugent told me to bring trainers, which I bought especially with money I don't really have, and now I'm told I can wear anything? And I don't need to do any exercises to improve my range of motion? And I can drive in six days' time?
I call BS on that, frankly.
I was, and am, really unhappy with that appointment. I feel that the doctor was not fully informed and I really wish I could have seen Mr Nugent.
Before I left, he got me to walk a little but I was SO SCARED that I couldn't really do it, and just put my weight on my heels. I was terrified of being in pain.
So I hobbled over to the computer and he showed me my X-rays. To be honest, I wouldn't know how good it was. I could see where the bone had been cut and moved, but without the old ones next to them, it was hard to tell anything really.
I want to know if Mr Nugent is happy with them, as he is my surgeon, but more of that later.
So, unsure about the shoes thing I put the velcro shoes on to go home and once we'd got the Little Lady to bed I ran myself a lovely warm bath so I could start de-flaking my feet.
If you want to see lots of pictures of that (my feet, not me nekkid in the bath) then look out for part 3 which is coming soon.
The big reveal part 1. Plaster room and X-ray.
Sorry everyone. There you are, waiting on tenterhooks to hear about the casts coming off, to see the final result, and I go AWOL.
Apologies.
The excuses are that my appointment on Tuesday was right at the end of the day, and by the time we got home and put the Little Lady to bed and had something to eat it was bedtime. Plus, I haven't worked out how to take good shots in artifical light and the flash on my camera bleaches everything out close-up, so I needed to wait.
And yesterday was my birthday, and I decided that instead of blogging and taking pictures that I would see friends, go out to lunch, and generally have a nice day.
So, sorry, but this is the first chance I've had to write.
Regular readers will know that I had my casts changed after two weeks, then had the new ones on for another five weeks, so a total of seven weeks.
We went to the hospital and this time I had to have the casts removed before having the X-rays.
I was sent to the plaster room (last time my surgeon removed the casts) and they did the same thing - cut the bandages round my ankles and then wiggled the casts off.
The lady did start to pull my steri strips off but it made me so squeamish I almost cried so I begged her to stop and told her I'd soak them off at home.
Another nurse dealing with the lady next to me (no privacy here, this is the NHS) told me she had had one bunion done, and I got the usual "you were brave" comment about having them both done at once.
I have to say, I don't feel brave. I mean, I know the recovery has been more onerous as I've not been able to walk at all, but at least I don't have to go through this again!
After the casts were off I felt very vulnerable, so I put my velcro shoes back on and wow! They wrapped so far round my feet I had to fold one of the flaps under! Amazing just how big those casts were.
See how thin my feet look there!
In X-ray, I had the same girl again who had one of her bunions done. She was impressed with my feet, which was reassuring, and we talked about shoes. She said she rarely wears heels now and makes sure her shoes are soft and supportive. I guess I really am going to have to rethink my shoes for a while!
Once she'd taken two shots of each foot, I went back to wait to be seen by Mr Nugent.
Head on over to part 2 for the next installment.
Apologies.
The excuses are that my appointment on Tuesday was right at the end of the day, and by the time we got home and put the Little Lady to bed and had something to eat it was bedtime. Plus, I haven't worked out how to take good shots in artifical light and the flash on my camera bleaches everything out close-up, so I needed to wait.
And yesterday was my birthday, and I decided that instead of blogging and taking pictures that I would see friends, go out to lunch, and generally have a nice day.
So, sorry, but this is the first chance I've had to write.
Regular readers will know that I had my casts changed after two weeks, then had the new ones on for another five weeks, so a total of seven weeks.
We went to the hospital and this time I had to have the casts removed before having the X-rays.
I was sent to the plaster room (last time my surgeon removed the casts) and they did the same thing - cut the bandages round my ankles and then wiggled the casts off.
The lady did start to pull my steri strips off but it made me so squeamish I almost cried so I begged her to stop and told her I'd soak them off at home.
Another nurse dealing with the lady next to me (no privacy here, this is the NHS) told me she had had one bunion done, and I got the usual "you were brave" comment about having them both done at once.
I have to say, I don't feel brave. I mean, I know the recovery has been more onerous as I've not been able to walk at all, but at least I don't have to go through this again!
After the casts were off I felt very vulnerable, so I put my velcro shoes back on and wow! They wrapped so far round my feet I had to fold one of the flaps under! Amazing just how big those casts were.
See how thin my feet look there!
In X-ray, I had the same girl again who had one of her bunions done. She was impressed with my feet, which was reassuring, and we talked about shoes. She said she rarely wears heels now and makes sure her shoes are soft and supportive. I guess I really am going to have to rethink my shoes for a while!
Once she'd taken two shots of each foot, I went back to wait to be seen by Mr Nugent.
Head on over to part 2 for the next installment.
Sunday, 13 January 2013
Classified?
The thing I've noticed about the NHS, apart from the unreliable quality of care and general shabbiness of its buildings, is that it operates on its own version of the need-to-know basis.
Usually that means you get to know only that which you need to know, at the time you need to know it.
My experience of the NHS is that they operate more by telling you only some of what you need to know at the time you need to know it.
Which I guess is why I have no idea whether, at the moment, I am allowed to walk around lots on crutches, or if I'm supposed to walk only a bit, and whether it's OK to walk without my crutches (which I have been doing because I'm very stable now).
Today I was at a first birthday party (doing an entertainment slot of action songs, I love doing kids' parties!) and one of the guests was an orthopaedic theatre nurse. The last party I went to I met someone who works in healthcare as well. I seem to be attracting these people right now!
Anyway, this lady told me I should be "completely non-weight-bearing for six weeks".
Really?
"Oh yes," she said. "The bones in the foot are very small and they need to heal."
So now I'm totally confused.
Am I supposed to be resting still? My surgeon just told me to elevate my feet when I'm sitting but he didn't say how much sitting I should be doing.
I thought I was erring on the side of caution by mostly not walking anywhere, but now I wonder if I shouldn't be doing that?
The orthopaedic theatre nurse lady did say it was OK to be using crutches, so I'm thinking maybe I should just be keeping my weight off the front of my feet, and if so, I'm probably OK as I have been mostly doing that. (Apart from a few exploratory times when I've put my weight down through my whole foot. And to be honest, it's felt fine.)
Hopefully that hasn't done me any damage.
But how much easier would this process be if I'd been given some actual information, and comprehensive information at that?
Usually that means you get to know only that which you need to know, at the time you need to know it.
My experience of the NHS is that they operate more by telling you only some of what you need to know at the time you need to know it.
Which I guess is why I have no idea whether, at the moment, I am allowed to walk around lots on crutches, or if I'm supposed to walk only a bit, and whether it's OK to walk without my crutches (which I have been doing because I'm very stable now).
Today I was at a first birthday party (doing an entertainment slot of action songs, I love doing kids' parties!) and one of the guests was an orthopaedic theatre nurse. The last party I went to I met someone who works in healthcare as well. I seem to be attracting these people right now!
Anyway, this lady told me I should be "completely non-weight-bearing for six weeks".
Really?
"Oh yes," she said. "The bones in the foot are very small and they need to heal."
So now I'm totally confused.
Am I supposed to be resting still? My surgeon just told me to elevate my feet when I'm sitting but he didn't say how much sitting I should be doing.
I thought I was erring on the side of caution by mostly not walking anywhere, but now I wonder if I shouldn't be doing that?
The orthopaedic theatre nurse lady did say it was OK to be using crutches, so I'm thinking maybe I should just be keeping my weight off the front of my feet, and if so, I'm probably OK as I have been mostly doing that. (Apart from a few exploratory times when I've put my weight down through my whole foot. And to be honest, it's felt fine.)
Hopefully that hasn't done me any damage.
But how much easier would this process be if I'd been given some actual information, and comprehensive information at that?
Monday, 24 December 2012
Pssst! Want the goss?
I hate to direct you to read the Daily Fail Mail, I really do. But if I'm going to share the gossip, you have to share the pain.
You may have noticed my surgeon is called Ian Nugent.
This is him:
I, erm, borrowed that picture from this website. Credit where credit is (legally) due, and all that.
So, that's Mr Nugent. Now, before I had my surgery, I had a little Google of him. I wanted to find out if anyone had written about having him operate on their bunions, but it seems I'm blazing a trail on that one.
In my searching, though, I found this article.
To save you reading it all (unless you want to) it's about a woman who had her flat feet operated on using a new procedure that took only 15 minutes and involved inserting a "bullet" of silicone into the ankle to prevent the foot rolling over (known as overpronation).
So far so totally not anything to do with bunions.
Underneath, the article has two comments.
The first is this:
Thank you for an excellent article. We love to hear stories like that of Ms. McDonnell and how so many patients like her have eliminated their foot pain with HyProCure. If you are suffering from foot pain, please the HyProCure site to learn more about the underlying causes and solutions. -Fran V, GraMedica
Fran V , Macomb, MI, USA, 26/4/2011 15:43
Which is obviously from the people who make the implant, touting their wares to any unsuspecting readers.
Why unsuspecting?
Because of the story behind the next comment. Which is:
I am a consultant orthopaedic foot and ankle surgeon practicing in the NHS and private practice. I was concerned about this article written by a podiatrist whose views are not supported by the evidence of the medical and surgical profession worldwide. This article infers that this procedure of arthroereisis with the Hyprocure prosthesis is an accepted proven treatment for "flatfoot". The evidence for the results of treatment is lacking and the rationale for the principle of the procedure is flawed. This operation is not recommended as appropriate by NICE for treatment within the NHS and I am concerned that your article infers it is an accepted practice in the orthopaedic foot and ankle world. There is probably an incentive in certain areas of "private practice" for a quick and simple yet unproven procedure to be advertised in the national press, especially as it is considered inappropriate and is unavailable on the NHS.
Ian Nugent , Reading, UK, 26/4/2011 15:03
Ian Nugent? MY Ian Nugent?
Well, yes. If you'll excuse the rather proprietorial tone.
When I had my casts changed, I mentioned this article to Mr Nugent, and that I saw he had commented on it. You probably don't want all the details but it was because I told him I used to be a journalist, and he said there is never 'used to be' when it comes to journalists, ho, ho.
Anyway, then we got to the gossip.
Mr Nugent told me that lady had come to see him prior to having that 'bullet' procedure, I think at his private practice, and that he had told her it wasn't suitable for her. But off she went and had it done anyway
And apparently, three months later, she was back to see Mr Nugent because it had failed!
So there we are. If you fancied it, it may be a good idea to wait until HyProCure have done it on a few more people!
(I was going to say something stronger, but they are American, and Americans tend to be litigious, and I could use the defence of fair comment but I don't want the hassle. I'm sure you can draw your own conclusions.)
You may have noticed my surgeon is called Ian Nugent.
This is him:
I, erm, borrowed that picture from this website. Credit where credit is (legally) due, and all that.
So, that's Mr Nugent. Now, before I had my surgery, I had a little Google of him. I wanted to find out if anyone had written about having him operate on their bunions, but it seems I'm blazing a trail on that one.
In my searching, though, I found this article.
To save you reading it all (unless you want to) it's about a woman who had her flat feet operated on using a new procedure that took only 15 minutes and involved inserting a "bullet" of silicone into the ankle to prevent the foot rolling over (known as overpronation).
So far so totally not anything to do with bunions.
Underneath, the article has two comments.
The first is this:
Thank you for an excellent article. We love to hear stories like that of Ms. McDonnell and how so many patients like her have eliminated their foot pain with HyProCure. If you are suffering from foot pain, please the HyProCure site to learn more about the underlying causes and solutions. -Fran V, GraMedica
Fran V , Macomb, MI, USA, 26/4/2011 15:43
Which is obviously from the people who make the implant, touting their wares to any unsuspecting readers.
Why unsuspecting?
Because of the story behind the next comment. Which is:
I am a consultant orthopaedic foot and ankle surgeon practicing in the NHS and private practice. I was concerned about this article written by a podiatrist whose views are not supported by the evidence of the medical and surgical profession worldwide. This article infers that this procedure of arthroereisis with the Hyprocure prosthesis is an accepted proven treatment for "flatfoot". The evidence for the results of treatment is lacking and the rationale for the principle of the procedure is flawed. This operation is not recommended as appropriate by NICE for treatment within the NHS and I am concerned that your article infers it is an accepted practice in the orthopaedic foot and ankle world. There is probably an incentive in certain areas of "private practice" for a quick and simple yet unproven procedure to be advertised in the national press, especially as it is considered inappropriate and is unavailable on the NHS.
Ian Nugent , Reading, UK, 26/4/2011 15:03
Ian Nugent? MY Ian Nugent?
Well, yes. If you'll excuse the rather proprietorial tone.
When I had my casts changed, I mentioned this article to Mr Nugent, and that I saw he had commented on it. You probably don't want all the details but it was because I told him I used to be a journalist, and he said there is never 'used to be' when it comes to journalists, ho, ho.
Anyway, then we got to the gossip.
Mr Nugent told me that lady had come to see him prior to having that 'bullet' procedure, I think at his private practice, and that he had told her it wasn't suitable for her. But off she went and had it done anyway
And apparently, three months later, she was back to see Mr Nugent because it had failed!
So there we are. If you fancied it, it may be a good idea to wait until HyProCure have done it on a few more people!
(I was going to say something stronger, but they are American, and Americans tend to be litigious, and I could use the defence of fair comment but I don't want the hassle. I'm sure you can draw your own conclusions.)
Wednesday, 19 December 2012
Freedom is a new cast.
Ah! The sweet, sweet joy of being freed! The deep blue of the living room carpet! The brighter daylight through the front room windows! The smooth exapnse of the kitchen floor!
Yes, dear readers. I have been downstairs. T'was a momentous occasion.
Obviously, I had to go down the stairs in order to go to hospital yesterday. I didn't abseil out of the Little Lady's bedroom window.
But when I got home from hospital, I scuttled straight back upstairs again, to my cosypit nest where I've been very happy hibernating from the cold this last fortnight.
See? It's all set up for me. Who wouldn't want to be there?
But today I had a friend come round for a cuppa and I thought 'why not entertain downstairs?'.
Why not indeed, verily and forsooth? (Sorry, I'm in a funny mood today. Must be all this freedom.)
Employing the 'puppet crab' method, I edged sideways down the stairs, clinging onto the bannister. Classy and graceful, as always.
I ditched the crutches because I have found that I can walk around as long as take weird high steps (because I can't bend my feet). It's a bit like powerwalking only it is very very slow. And hilarious to watch. Kudos to the hubby for not laughing.
My friend and I sat in the living room, my feet perched on a borrowed pouffe (thanks Hannah!) and it was nice to be out of the bedroom.
So nice that I had lunch at the kitchen table. I know! Living dangerously is my second hobby.
But sadly, after a couple of hours my feet were objecting. Despite the surgeon telling me to continue to elevate them, I forgot while I had lunch, and that short period - around half an hour - of them being down was enough for them to swell.
I could feel the casts getting tight, the incisions throbbing.
So I scuttled back upstairs to my lovely pit and took some paracetamol and ibuprofen. I also remembered to do my heparin injection and damn that stuff stings when you're not on codeine!
So freedom is great, for sure, but I think too much of a good thing can be dangerous. Maybe I'll ease myself back into the world slowly.
Yes, dear readers. I have been downstairs. T'was a momentous occasion.
Obviously, I had to go down the stairs in order to go to hospital yesterday. I didn't abseil out of the Little Lady's bedroom window.
But when I got home from hospital, I scuttled straight back upstairs again, to my cosy
See? It's all set up for me. Who wouldn't want to be there?
But today I had a friend come round for a cuppa and I thought 'why not entertain downstairs?'.
Why not indeed, verily and forsooth? (Sorry, I'm in a funny mood today. Must be all this freedom.)
Employing the 'puppet crab' method, I edged sideways down the stairs, clinging onto the bannister. Classy and graceful, as always.
I ditched the crutches because I have found that I can walk around as long as take weird high steps (because I can't bend my feet). It's a bit like powerwalking only it is very very slow. And hilarious to watch. Kudos to the hubby for not laughing.
My friend and I sat in the living room, my feet perched on a borrowed pouffe (thanks Hannah!) and it was nice to be out of the bedroom.
So nice that I had lunch at the kitchen table. I know! Living dangerously is my second hobby.
But sadly, after a couple of hours my feet were objecting. Despite the surgeon telling me to continue to elevate them, I forgot while I had lunch, and that short period - around half an hour - of them being down was enough for them to swell.
I could feel the casts getting tight, the incisions throbbing.
So I scuttled back upstairs to my lovely pit and took some paracetamol and ibuprofen. I also remembered to do my heparin injection and damn that stuff stings when you're not on codeine!
So freedom is great, for sure, but I think too much of a good thing can be dangerous. Maybe I'll ease myself back into the world slowly.
Thursday, 6 December 2012
Tales from hospital part the fourth: day 3. Homebound.
My extra night in hospital was marginally better than the first one. The nurses were quiet but I still found it very hard to sleep. I had even kept myself awake all day after my fainting episode so that I'd be exhausted enough to get off, but there was something about being in hospital that made it impossible.
I forgot to mention I'd had loads of visitors the night before: two colleagues from the Breastfeeding Network popped in around their wards shifts, my mate George and of course Andy, my husband.
We were woken in the morning and the nurse said: "Do you want to have your breakfast sitting in the chair?"
"Do I take it that means you think I ought to?" I asked (Bet those nurses just loved me!)
"Yes," she said, so I agreed I'd eat breakfast sitting in the chair, but first I needed the loo.
I got her to wheel me there,and when I came back my bed had been stripped! Seriously. I know I'd said I'd eat in the chair but I'd been planning to get back into bed for a nap afterwards.
"We need the bed," I was told. "We've got people backing up in recovery. You need to go home."
Charming. Way to go with the bedside manner.
So I had my toast, then sat around waiting to have some X-rays, get my drugs, that kind of thing. I also had a little practice at stairs under the guidance of the physios, and tried out using crutches.
We also got to have a wash! I assume we should have had that opportunity the day before, but it didn't happen, but we were brought cardboard bowls of hot water with disposable cloths, plus a washbag with soap, toothpaste, etc.
So I had a nice strip wash and felt so much better afterwards.
Here's my bowl:
In the end, a nice nurse let me stay on the ward till Andy picked me up at 2pm.
This post is quite dull, really, as all I did then was come home and get myself into bed.
So here are some pictures of my bandages to liven it up:
You can see that the bandages are like cocoons, rounded underneath. This is to stop me from putting any weight on the front part of my foot. I also have to wear some super-sexy velcro shoes whenever I get upright.
I forgot to mention I'd had loads of visitors the night before: two colleagues from the Breastfeeding Network popped in around their wards shifts, my mate George and of course Andy, my husband.
We were woken in the morning and the nurse said: "Do you want to have your breakfast sitting in the chair?"
"Do I take it that means you think I ought to?" I asked (Bet those nurses just loved me!)
"Yes," she said, so I agreed I'd eat breakfast sitting in the chair, but first I needed the loo.
I got her to wheel me there,and when I came back my bed had been stripped! Seriously. I know I'd said I'd eat in the chair but I'd been planning to get back into bed for a nap afterwards.
"We need the bed," I was told. "We've got people backing up in recovery. You need to go home."
Charming. Way to go with the bedside manner.
So I had my toast, then sat around waiting to have some X-rays, get my drugs, that kind of thing. I also had a little practice at stairs under the guidance of the physios, and tried out using crutches.
We also got to have a wash! I assume we should have had that opportunity the day before, but it didn't happen, but we were brought cardboard bowls of hot water with disposable cloths, plus a washbag with soap, toothpaste, etc.
So I had a nice strip wash and felt so much better afterwards.
Here's my bowl:
In the end, a nice nurse let me stay on the ward till Andy picked me up at 2pm.
This post is quite dull, really, as all I did then was come home and get myself into bed.
So here are some pictures of my bandages to liven it up:
You can see that the bandages are like cocoons, rounded underneath. This is to stop me from putting any weight on the front part of my foot. I also have to wear some super-sexy velcro shoes whenever I get upright.
Tales from hospital part the third: day 2
So, I knew it was all going too well, despite the utter lack of sleep.
The day after surgery the physio came round to see me. Up to this point I'd been on bed rest, not allowed to get up at all, even to go to the toilet. I'll gloss over the details but suffice to say I'm glad I have good core body and upper arm strength. How elderly people manage to use bedpans without spillage is beyond me.
Anyway, I'd been lying down for hours, my feet raised above my hips, maybe sitting up a bit assisted by the rather whizzy electric bed.
And then the physio gets me up, out and walking around.
Does anyone sense disaster?
Using a walker frame, I edged gingerly and painfully around the corner of my bed, and then thought: "While I'm up, I might as well use the toilet instead of the bedpan."
In a demonstration of complete lack of judgment by both the physio and me (although she's the professional so I'd have thought she might have said no) I got her to wheel me on a chair to the toilet.
And there she left me.
I managed the business part fine. Washed my hands, then realised the world was going a bit grey, my stomach was feeling rather nauseous, my limbs were going heavy...
I pulled the help cord and heard the alarm go off.
After a while (probably not that long but it felt it) I was unable to support myself any more and getting panicky. The nausea was so bad I felt I was going to throw up all over the floor, I couldn't keep my eyes open, my head was swimming, my body was just. so. heavy.
Somehow, I managed to open the tricky bi-fold toilet door a bit.
"Please help me! Someone help me!" I called out. I felt like I was shouting but it might have been just a whisper. I recall the frightened face of a woman lying in bed in my sightline as I began to collapse.
Suddenly a nurse appeared with a wheelchair.
"Get in the chair!" she barked at me.
"I can't," I gasped. "I feel so ill. I need to lie down."
"You can't lie there! Get up! Get in the chair!"
"I can't..."
The next thing I knew I was slumped in a chair next to my bed, with another nurse slapping my face.
"Emma, Emma, focus, open your eyes. We need you to get on the bed."
Like a sullen teen, I replied: "I can't."
"But if you won't, then we will have to get the hoist."
"Get the hoist."
The world went black again.
Slap, slap.
"Emma! We're getting the hoist. Focus! You need oxygen."
An oxygen mask was put on my face, blasting air into my nose and mouth at hurricane speeds, suffocating me.
I pulled it off. "Don't like it!" (there's that sulky teenager again).
They turned it down and put it back then hoisted me onto the bed.
I passed out again.
...
Later, I gradually came round and lay for a while breathing the oxygen before I felt well enough to pull the mask off.
"Welcome back," my fellow patients chorused.
"You were grey! You were the colour of the sheets! We thought you were dying! It was so scary!"
Yeah, me too. In fact, I ended up crying while a lovely nurse gave me a hug.
It wasn't so much the faint; I've been there before. It was the fact that I was left in a toilet, with no-one answering the alarm call, and then being almost shouted at as though I were an inconvenience.
The physio came back later and apologised, which I appreciated. For while I shouldn't have suggested going to the loo, it was up to her to say that it was too much too soon. She's the professional after all.
Later, I indulged my time obsession by asking my neighbour how long I'd been out for. I was expecting her to say about 15 minutes. She looked at the clock, calculating. "Oh, about an hour and a quarter," she said. Crikey. no wonder everyone was so worried.
The rest of the day was uneventful. I was supposed to go home but it was decided I had to stay in another night after that episode, and there was much checking of my obs because my blood pressure is naturally low and they were worried.
The only other excitement was learning to inject my heparin that evening. I'm such a wuss I actually cried while Queen of Hunter called over: "I do it every night! It's easy! Just do it! Stop working yourself up!"
And actually she was right. The needle didn't hurt going in at all. The heparin stings afterwards but by then it's all over. I can do this!
The day after surgery the physio came round to see me. Up to this point I'd been on bed rest, not allowed to get up at all, even to go to the toilet. I'll gloss over the details but suffice to say I'm glad I have good core body and upper arm strength. How elderly people manage to use bedpans without spillage is beyond me.
Anyway, I'd been lying down for hours, my feet raised above my hips, maybe sitting up a bit assisted by the rather whizzy electric bed.
And then the physio gets me up, out and walking around.
Does anyone sense disaster?
Using a walker frame, I edged gingerly and painfully around the corner of my bed, and then thought: "While I'm up, I might as well use the toilet instead of the bedpan."
In a demonstration of complete lack of judgment by both the physio and me (although she's the professional so I'd have thought she might have said no) I got her to wheel me on a chair to the toilet.
And there she left me.
I managed the business part fine. Washed my hands, then realised the world was going a bit grey, my stomach was feeling rather nauseous, my limbs were going heavy...
I pulled the help cord and heard the alarm go off.
After a while (probably not that long but it felt it) I was unable to support myself any more and getting panicky. The nausea was so bad I felt I was going to throw up all over the floor, I couldn't keep my eyes open, my head was swimming, my body was just. so. heavy.
Somehow, I managed to open the tricky bi-fold toilet door a bit.
"Please help me! Someone help me!" I called out. I felt like I was shouting but it might have been just a whisper. I recall the frightened face of a woman lying in bed in my sightline as I began to collapse.
Suddenly a nurse appeared with a wheelchair.
"Get in the chair!" she barked at me.
"I can't," I gasped. "I feel so ill. I need to lie down."
"You can't lie there! Get up! Get in the chair!"
"I can't..."
The next thing I knew I was slumped in a chair next to my bed, with another nurse slapping my face.
"Emma, Emma, focus, open your eyes. We need you to get on the bed."
Like a sullen teen, I replied: "I can't."
"But if you won't, then we will have to get the hoist."
"Get the hoist."
The world went black again.
Slap, slap.
"Emma! We're getting the hoist. Focus! You need oxygen."
An oxygen mask was put on my face, blasting air into my nose and mouth at hurricane speeds, suffocating me.
I pulled it off. "Don't like it!" (there's that sulky teenager again).
They turned it down and put it back then hoisted me onto the bed.
I passed out again.
...
Later, I gradually came round and lay for a while breathing the oxygen before I felt well enough to pull the mask off.
"Welcome back," my fellow patients chorused.
"You were grey! You were the colour of the sheets! We thought you were dying! It was so scary!"
Yeah, me too. In fact, I ended up crying while a lovely nurse gave me a hug.
It wasn't so much the faint; I've been there before. It was the fact that I was left in a toilet, with no-one answering the alarm call, and then being almost shouted at as though I were an inconvenience.
The physio came back later and apologised, which I appreciated. For while I shouldn't have suggested going to the loo, it was up to her to say that it was too much too soon. She's the professional after all.
Later, I indulged my time obsession by asking my neighbour how long I'd been out for. I was expecting her to say about 15 minutes. She looked at the clock, calculating. "Oh, about an hour and a quarter," she said. Crikey. no wonder everyone was so worried.
The rest of the day was uneventful. I was supposed to go home but it was decided I had to stay in another night after that episode, and there was much checking of my obs because my blood pressure is naturally low and they were worried.
The only other excitement was learning to inject my heparin that evening. I'm such a wuss I actually cried while Queen of Hunter called over: "I do it every night! It's easy! Just do it! Stop working yourself up!"
And actually she was right. The needle didn't hurt going in at all. The heparin stings afterwards but by then it's all over. I can do this!
Tales from hospital part the first
So here we are, it is done.
I did mean to blog before I went into hospital, but time ran away with me and I was still packing my hospital bag at bedtime the night before. If I had posted, it would have been full of fear, because all of a sudden I got really scared and nervous about having it done. Even on the morning of the surgery I briefly considered not going through with it, and had to give myself a stern talking-to.
So on Monday morning I was up at Unacceptable O'clock and ready to get in my taxi at 6.30am. It was still pitch dark and felt like the middle of the night. The driver did attempt some conversation but soon gathered from my incoherent grunts that I was attempting to pretend I was still asleep in bed, and that this taxi ride was just a bad dream, so he gave me up as a bad job and instead silently delivered me to the door of the Royal Berkshire Hospital.
I dragged myself through the hospital, pausing briefly to to breathe deeply the tantalising smell off coffee from the AMT kiosk, before hauling myself through the corridors to the far end of the hospital, past the plush bit and into the section that looks like it belongs in Calcutta.
After wandering about wondering exactly how much it would cost to put some signs up so people would actually know where to go, I found the Chesterman Suite, where people go to wait to be cut up.
I had been too keen. Almost no-one else was there, but it did mean I could bag myself a comfy seat on the burnt orange sofa near the television, and opposite the fish tank.
I filled in a form, and a menu for what I'd like to eat on the ward when I came round. I remembered the advice I'd been given by people who have experienced the gastro-offerings of the RBH, and chose the simplest thing on the menu, which turned out to be fishcakes, mash and baked beans, with orange jelly to follow. More of that later.
After a while, the room had filled up and I got chatting to a couple of other ladies. One was having her shoulder replaced, the other surgery on her cruciate ligament in her knee.
Then Mr Nugent started having chats with us. He drew two fetching arrows on my legs - "So I remember to operate on both" - and told me what he'd be doing. I was surprised to hear that I was going to have not metal pins but some made of something dissolvable, so that ultimately I won't have foreign bodies in me, which I hadn't thought much about but still felt pleased on hearing.
After Mr Nugent, a lovely anaesthetist came round. I didn't catch her name, but as Paul the Doctor had advised, I mentioned wanting a Des and Remi, and ankle blocks.
"I always do ankle blocks," she said. "And I can do you a Des, but I'm not sure about the Remi. I always use Des though, the hospital would like me to use something cheaper but I only use something that I'd want used on myself if I were having surgery."
Reassuring! I warmed to her and was glad that if anyone were in charge of me not dying or feeling any pain on the operating table, it was her. She had fab hair too, all pre-Raphaelite.
Then we waited.
The anaesthetist came back after a while, and let me know that she'd worked out her list and I would have surgery probably about 12.45.
"So have a cup of tea now," she said. "You must be gasping. And then only water till 10.45 after which nothing."
A cup of tea! Fantastic.
Sadly, I was too lazy to walk to the cafe and instead went to the League of Friends kiosk nearby which, while friendly and helpful, made possibly the worst cup of tea I've ever had. Still, it was wet.
I did get so bored waiting that in the end I lay down on the sofa and went to sleep. At which point, naturally, they called me in.
I had to walk to the operating theatre, and then the lovely anaesthetist chatted to me while she put me out. Next stop, Recovery.
I did mean to blog before I went into hospital, but time ran away with me and I was still packing my hospital bag at bedtime the night before. If I had posted, it would have been full of fear, because all of a sudden I got really scared and nervous about having it done. Even on the morning of the surgery I briefly considered not going through with it, and had to give myself a stern talking-to.
So on Monday morning I was up at Unacceptable O'clock and ready to get in my taxi at 6.30am. It was still pitch dark and felt like the middle of the night. The driver did attempt some conversation but soon gathered from my incoherent grunts that I was attempting to pretend I was still asleep in bed, and that this taxi ride was just a bad dream, so he gave me up as a bad job and instead silently delivered me to the door of the Royal Berkshire Hospital.
I dragged myself through the hospital, pausing briefly to to breathe deeply the tantalising smell off coffee from the AMT kiosk, before hauling myself through the corridors to the far end of the hospital, past the plush bit and into the section that looks like it belongs in Calcutta.
After wandering about wondering exactly how much it would cost to put some signs up so people would actually know where to go, I found the Chesterman Suite, where people go to wait to be cut up.
I had been too keen. Almost no-one else was there, but it did mean I could bag myself a comfy seat on the burnt orange sofa near the television, and opposite the fish tank.
I filled in a form, and a menu for what I'd like to eat on the ward when I came round. I remembered the advice I'd been given by people who have experienced the gastro-offerings of the RBH, and chose the simplest thing on the menu, which turned out to be fishcakes, mash and baked beans, with orange jelly to follow. More of that later.
After a while, the room had filled up and I got chatting to a couple of other ladies. One was having her shoulder replaced, the other surgery on her cruciate ligament in her knee.
Then Mr Nugent started having chats with us. He drew two fetching arrows on my legs - "So I remember to operate on both" - and told me what he'd be doing. I was surprised to hear that I was going to have not metal pins but some made of something dissolvable, so that ultimately I won't have foreign bodies in me, which I hadn't thought much about but still felt pleased on hearing.
After Mr Nugent, a lovely anaesthetist came round. I didn't catch her name, but as Paul the Doctor had advised, I mentioned wanting a Des and Remi, and ankle blocks.
"I always do ankle blocks," she said. "And I can do you a Des, but I'm not sure about the Remi. I always use Des though, the hospital would like me to use something cheaper but I only use something that I'd want used on myself if I were having surgery."
Reassuring! I warmed to her and was glad that if anyone were in charge of me not dying or feeling any pain on the operating table, it was her. She had fab hair too, all pre-Raphaelite.
Then we waited.
The anaesthetist came back after a while, and let me know that she'd worked out her list and I would have surgery probably about 12.45.
"So have a cup of tea now," she said. "You must be gasping. And then only water till 10.45 after which nothing."
A cup of tea! Fantastic.
Sadly, I was too lazy to walk to the cafe and instead went to the League of Friends kiosk nearby which, while friendly and helpful, made possibly the worst cup of tea I've ever had. Still, it was wet.
I did get so bored waiting that in the end I lay down on the sofa and went to sleep. At which point, naturally, they called me in.
I had to walk to the operating theatre, and then the lovely anaesthetist chatted to me while she put me out. Next stop, Recovery.
Saturday, 1 December 2012
Another call from the hospital
The other day I got an unexpected call from the hospital.
A young-sounding girl called Cassandra told me it was a courtesy call to make sure I was OK about my forthcoming operation.
Which sounded positive.
Until she started asking me for my name and address, and whether I'd been to a post-op assessment, and when was my operation, and what time, and when was I nil by mouth from.
Don't they already know this stuff? Why phone me up to ask me?
She then asked me if I had any questions. Why yes, I do. I asked about anticoagulants, and where I am on the list, but sadly Cassandra was unable to help me.
"She probably just expected you to ask if you could take your slippers," said my Mum. "And to check you're going to turn up."
Ah, well, if that's the case, why not just ask that? I get that missed appointments cost the NHS hundreds of thousands of pounds each year, but calling me up and asking me basic questions they know the answers to is a waste of everyone's time and an insult.
I'm sorry to sound so down on a system that was once the envy of the world, but I do think the NHS needs to sort out its processes and stop wasting money with this kind of nonsense.
I really do hope they are more efficient at the actual surgery and care end of this!
A young-sounding girl called Cassandra told me it was a courtesy call to make sure I was OK about my forthcoming operation.
Which sounded positive.
Until she started asking me for my name and address, and whether I'd been to a post-op assessment, and when was my operation, and what time, and when was I nil by mouth from.
Don't they already know this stuff? Why phone me up to ask me?
She then asked me if I had any questions. Why yes, I do. I asked about anticoagulants, and where I am on the list, but sadly Cassandra was unable to help me.
"She probably just expected you to ask if you could take your slippers," said my Mum. "And to check you're going to turn up."
Ah, well, if that's the case, why not just ask that? I get that missed appointments cost the NHS hundreds of thousands of pounds each year, but calling me up and asking me basic questions they know the answers to is a waste of everyone's time and an insult.
I'm sorry to sound so down on a system that was once the envy of the world, but I do think the NHS needs to sort out its processes and stop wasting money with this kind of nonsense.
I really do hope they are more efficient at the actual surgery and care end of this!
Friday, 23 November 2012
A chat with the anaesthetist
I had a call this week from the anaesthetist at the hospital. I'm not sure if it is the one I'll have next Monday, or just one of the team, but she called because of what I'd told them at the pre-op assessment, about how I always end up passed out on oxygen after a general. (OK, 'always' sounds a bit OTT, I know. It's true but it has only been twice.)
At first, she was threatening not to anaesthetise me at all! Eek! So I explained what usually happens - I come round OK, then I suddenly go tingly, see flashing lights, I feel incredibly heavy, then I come round with an oxygen mask on my face. It's pretty dramatic and the nurses always look worried.
The anaesthetist was unimpressed.
"Oh," she said. "That's just a faint."
Just a faint? I dine out on this story!
She explained that as I have low blood pressure, and a GA lowers it even more, I'm fine when horizontal but put me upright and pow! Blood 'rushes out of my head' (her phrase) and into my feet, and I pass out.
Suddenly it's not such a great story, but the plus side is that I can still have my surgery, and all I have to do is make sure I'm kept horizontal for longer when I'm on the recovery ward.
So Thunderbirds are still go.
I did decide not to talk to her about wanting, as my anaesthetist friend told me, a Des and Remi. I'm saving that for the day itself. I want to see their faces when I ask.
At first, she was threatening not to anaesthetise me at all! Eek! So I explained what usually happens - I come round OK, then I suddenly go tingly, see flashing lights, I feel incredibly heavy, then I come round with an oxygen mask on my face. It's pretty dramatic and the nurses always look worried.
The anaesthetist was unimpressed.
"Oh," she said. "That's just a faint."
Just a faint? I dine out on this story!
She explained that as I have low blood pressure, and a GA lowers it even more, I'm fine when horizontal but put me upright and pow! Blood 'rushes out of my head' (her phrase) and into my feet, and I pass out.
Suddenly it's not such a great story, but the plus side is that I can still have my surgery, and all I have to do is make sure I'm kept horizontal for longer when I'm on the recovery ward.
So Thunderbirds are still go.
I did decide not to talk to her about wanting, as my anaesthetist friend told me, a Des and Remi. I'm saving that for the day itself. I want to see their faces when I ask.
Sunday, 18 November 2012
Pre-op down, two weeks to go!
This is the first chance I've had to update since I had my pre-op assessment on Friday. Sadly, since it was the NHS, I didn't get to ask my questions as it was clear that the person I was seeing had absolutely no knowledge of my procedure at all.
The assessment block at the Royal Berkshire Hospital (RBH) is actually a Portacabin in one of its car parks. So far so very NHS. To be fair, once the staff had stopped arranging their Christmas night out and actually paid me some attention, I did only have to wait 20 minutes to be seen, which is surely some kind of NHS record.
And the people I saw were very nice. And obtained the information from me that THEY need. It's just that I didn't get the information that I need. Which was more than disappointing.
I did manage to get a leaflet out of them once I'd a) asked for one and b) insisted that they really ought to find one as telling me 'we don't have one, sorry' wasn't cutting it.
But I have learned far more on the internet than I did from the hospital and that's a poor state of affairs.
I was hoping to get a lot more detail about my expected recovery and to discuss the anticoagulants I will need post-op because of my Factor V Leiden inherited clotting disorder.
But the nurse simply assured me that I will be walking within days (er, really? Not according to the many blogs I've read from people who have actually had this done. Not to mention that for nearly two weeks I'm supposed to keep both feet elevated above my pelvis level for 90 per cent of the time. If you know a way of walking around like that, let me know.) And assured me that, I quote, "If you need drugs then they will give them to you."
Yes, I would hope that would be the case, but actually, I KNOW I will need them, my consultant at St Mary's tells me so, my common sense tells me so, and so, ya know, I'd really like to discuss them with someone BEFORE the day of surgery. Not least because as a breastfeeding mama I need to make sure anything I take is not going to adversely affect the Little Lady. Although a quick look at the excellent resource that is the Breastfeeding Network tells me it should be OK. See here.
Sigh. It's obvious the nurse had NO knowledge of a bilateral scarf osteotomy which is really annoying although not surprising, sadly.
So now I'll have to try and contact my surgeon and get a chat with him before the operation, which I can't imagine is going to be easy.
But I don't want to leave these conversations until the day itself, especially if I need heparin afterwards and will have to inject myself as I will need to learn how to do that when I am not groggy from anaesthetic and in pain from major surgery!
I do sometimes wonder when the NHS is going to finally implode from its arrogance and incompetence combined, but I guess there are just enough decent staff to keep its head above water at the moment. Let's hope I encounter lots of them over the next few weeks.
The assessment block at the Royal Berkshire Hospital (RBH) is actually a Portacabin in one of its car parks. So far so very NHS. To be fair, once the staff had stopped arranging their Christmas night out and actually paid me some attention, I did only have to wait 20 minutes to be seen, which is surely some kind of NHS record.
And the people I saw were very nice. And obtained the information from me that THEY need. It's just that I didn't get the information that I need. Which was more than disappointing.
I did manage to get a leaflet out of them once I'd a) asked for one and b) insisted that they really ought to find one as telling me 'we don't have one, sorry' wasn't cutting it.
But I have learned far more on the internet than I did from the hospital and that's a poor state of affairs.
I was hoping to get a lot more detail about my expected recovery and to discuss the anticoagulants I will need post-op because of my Factor V Leiden inherited clotting disorder.
But the nurse simply assured me that I will be walking within days (er, really? Not according to the many blogs I've read from people who have actually had this done. Not to mention that for nearly two weeks I'm supposed to keep both feet elevated above my pelvis level for 90 per cent of the time. If you know a way of walking around like that, let me know.) And assured me that, I quote, "If you need drugs then they will give them to you."
Yes, I would hope that would be the case, but actually, I KNOW I will need them, my consultant at St Mary's tells me so, my common sense tells me so, and so, ya know, I'd really like to discuss them with someone BEFORE the day of surgery. Not least because as a breastfeeding mama I need to make sure anything I take is not going to adversely affect the Little Lady. Although a quick look at the excellent resource that is the Breastfeeding Network tells me it should be OK. See here.
Sigh. It's obvious the nurse had NO knowledge of a bilateral scarf osteotomy which is really annoying although not surprising, sadly.
So now I'll have to try and contact my surgeon and get a chat with him before the operation, which I can't imagine is going to be easy.
But I don't want to leave these conversations until the day itself, especially if I need heparin afterwards and will have to inject myself as I will need to learn how to do that when I am not groggy from anaesthetic and in pain from major surgery!
I do sometimes wonder when the NHS is going to finally implode from its arrogance and incompetence combined, but I guess there are just enough decent staff to keep its head above water at the moment. Let's hope I encounter lots of them over the next few weeks.
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