Shake me and I'll rattle

In my last post, I mentioned the amount of painkillers I'm on. Some of you might be wondering why I'm on so many different drugs, and why I'm taking them all at once.

The short answer is: the nurses told me to.

But anyone who knows me, knows I don't take anything the medical profession says to me at face value, and I always ask questions.

So yes, I did ask why I was taking three painkillers.

Specifically, I asked why everyone on the ward was being given paracetamol, as in my experience, paracetamol does absolutely nothing to manage pain at all, not even the slightest headache.

I almost think of it as a placebo, so useless have I found it.

But the nurse explained that it works WITH the other tablets, increasing their effectiveness.

I did try to find some kind of study or article explaining this but was defeated by not really knowing the best keywords to Google. I ended up reading a slightly shocking chatroom discussion on how best to get from various legal drugs, and a few illegal ones, which was illuminating in a number of ways but shed no light on the drugs synergy issue.

Anyway.

I already knew that ibuprofen is an anti-inflammatory, and so it helps to prevent and bring down swelling.

And of course, codeine is a strong painkiller. As well as being, for some people, a bit of a high. Sadly, I'm not opne of those people. There's no buzz for me when I take it, more's the pity, although if I were constantly high at the moment my Christmas cards wouldn't be getting written, so I guess I should be grateful.

And on a serious note, codeine is known to be highly addictive, which I'm assuming is because of that high so many people get from it, so I'm glad that I will be spared the possibility of becoming hooked on it, especially as I have 100 - count 'em! - tablets of it in my bedside table drawer right now.

Apart from the painkillers, I'm also taking heparin, which I inject daily, to thin my blood and prevent DVT, which I am more prone to anyway because of my Factor V Leiden, but which anyone who is bedridden and immobile is at risk of.

In hospital, we injected it around 10pm, but at home I've been finding that a really bad time of day for finding the mental strength to stab myself in the tummy and inject a liquid that stings, so on Saturday I skipped my evening pincushion session and instead injected the next morning, about 45 minutes after taking my meds.

That worked much better. I felt mentally more prepared, and I also seemed to feel the pain a bit less because I wasn't tired like I am at the end of the day.

I don't think I put myself at too much risk by postponing the dose 13 hours, but if they had set the injections at a decent time when I was in hospital, by giving it to me in recovery as I expected rather than late at night when I finally demanded I have it, then I wouldn't have had to do it anyway.

In addition, I'm also taking Pregnacare, which is a vitamin supplement designed to get your body ready for, and keep you healthy during, prenancy, as well as supplement your diet during breastfeeding.

I'm taking it because the Hubby and I plan to TTC (Try To Conceive) soon, and it's recommended that you take it for three months before conception. With our history of miscarriages, even though they are caused by the Factor V Leiden, I'm not taking any chances, so I'm popping a Pregnacare pill each evening to ensure my body is as healthy as possible.

The other medicine I'm taking - I think drug is too strong a word - I began taking yesterday, but if you are going to have this or any other surgery that will mean you having a general anaesthetic, and/or you are going to be on codeine for more than a couple of days, it is one you should get ready in your medicine cupboard.

It is Lactulose.

Look away now if you are squeamish or don't have any desire to know about my bowel habits, because here's the thing - Lactulose is great for constipation.

General anaesthetics give you constipation, and so does codeine.

If you're going to have this surgery, or even any surgery requiring painkillers afterwards, you need to know about this stuff. The hospital weren't very bothered about my constipation because it's not like people die of it, but when it's you, it is very uncomfortable and makes you feel yuck, so my recommendation is to get some Lactulose in.

I recommend Lactulose rather than senna, because Lactulose is much more gentle in the way it acts on the body, and yet is very effective. Considering how much medication I'm putting into my system, I want to try and be as gentle as possible.

This link explains what's different about them and how they each work.

I'll be doing a post soon on what I think you need to get ready in advance of having your bunions done, which will include medicines but also will cover lots of other things you might not have thought of and which your hospital is unlikely to tell you about.


*Your Mileage May Vary, or, your experience may be different to mine.

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!

Tales from hospital part the second

"What time is it?"

For some reason, that is always the first thing I ask when I come round from surgery. I seem to be obsessed with how long I've been in theatre.

For this surgery, I'd gone in at 1.45pm and woke up at 3.20pm, which was pretty quick as I'd read it was around an hour each foot for bunions. Either Mr Nugent is a genius or a total butcher. I'm hoping it's the former.

Forewarned as they were about my fainting episodes, the staff on Recovery kept me lying down, checked my obs almost obsessively, and only moved me towards being upright very slowly over a long period.

For once, I felt fine. No fainting, no passing out or feeling sick, just chatting away and wondering why the room looked ever so slightly like a morgue.

Just before 5pm, they decided I was fully recovered, and I was wheeled away into Hunter Ward, where I ended up in Bay B, bed 4, next to the cruciate ligament lady and opposite a lovely girl who was in having her second hip replacement despite being under 40.

I dubbed her Queen of Hunter, because she knew all the staff, and how everything worked, and wasn't afraid to ask for what she wanted: "Get me some oral morph please!"

Luckily I was out of theatre and onto the ward in time for tea, so I did get my fishcakes, mash and beans after all. They tasted like school dinners, which I've always liked, and while Michel Roux Junior won't be asking the hospital cooks onto Masterchef anytime it was perfectly OK and I'd even go so far as to say I liked it.

Here it is:

That first evening was uneventful. I got given drugs, injected (quite roughly) with my first dose of heparin and then spent the night wide awake listening to people snoring and the doctors and nurses apparently having a small rave in the corridor. I can't get no sleep..do,do,do,do,da,do,do...

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.

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.