[Ed: Good grief, how’s that for alliteration?]

It is said that writing about something can be cathartic. Let’s hope so.

Whatever comments I have previously made about hospitals, two other things must be said. Firstly, the staff that I met were universally terrific people doing a great job. Secondly, in my case hospital seemed to work; it must have because, having been given some reasonably major laparoscopic surgery on Thursday 2nd December, my systems had rebooted sufficiently well for me to be booted out just three days later on Sunday 5th December.

As a result of the surgery, I had five holes in my abdomen: four smaller holes for various surgical implements to be inserted and one larger hole where the subject of the operation had been extracted. For 36 hours or so following the operation I was treated to a very effective dose of epidural analgesia. After that was stopped, I was on simple, standard paracetamol. Throughout, the nurses regularly asked me to assess my pain threshold on a scale of 0-10. I started off saying 1 and later zero, though I think any difference was hardly noticeable. Honestly, at no time did I experience anything that I would call post-operative pain.

To get me mobile, my catheter, which I have to keep for two weeks following the operation, had been attached to a leg bag rather than the large capacity container on my bedside. On Sunday morning I excitedly discarded my hospital issue, fetching pink nightshirt and dressed in street clothes once again. This simple act taught me an immediate lesson. However loose or baggy one may have thought one’s trousers were, when it comes to making room for the catheter pipe work and leg bag, they are nowhere near baggy enough. It’s enough to make you become claim Scottish heritage and wear a kilt though great care would be needed tucking the skene dhu into one’s kilt hose lest the catheter leg bag get punctured. 😯 Nonetheless, dressed I eventually was and Carol gave me a very comfortable ride home despite our appalling road surfaces.

I’ve now been at home for seven days and I’m no longer taking any paracetamol. At no time did I get anywhere near the big guns, the tramadol. I have still not experienced anything I’d call pain as a result of my operation. Excellent!

I wish I could say the same for the catheter. Once dressed in truly baggy trousers, preferably with soft seams, sitting still can be relatively (though definitely not absolutely) comfortable. Moving around the house tends to make the catheter wobble which, in turns, tends to rattle various tender bits of the male anatomy about. It is a strange sensation that fairly quickly becomes decidedly uncomfortable. A feeling similar to having been bruised seems to result. I’ve never been good at sitting still but, quite suddenly, I find it strangely appealing. The discomfort can be worsened by wearing less appropriate clothing and by rerouting the pipe work but it seems it can never be got rid of. At least, I’ve yet to find a combination that gets rid of it. Which would I prefer, wearing a catheter or giving myself repeated taps on the end of my dick with a ball-pein hammer? Hmmm – difficult choice!

The catheter also seems to produce an almost constant burning sensation which ebbs and flows but, again, never seems to go away. Most bizarre considering the function of a catheter, is the relatively frequent sensation of bursting for a pee. Given the overall discomfort and particularly the burning sensations (which can be associated with cystitis), I decided to call the specialist nurse at Wycombe hospital. I explained that the catheter was far worse than anything resulting directly from the operation itself and asked, “is what I’m describing particularly unusual?” “No”, she replied, “I’m afraid not – all catheterized men coming back to us say, ‘get this bloody thing out’”.

I can only conclude that catheters were developed in the same Nazi torture chamber that came up with the Alpine ski boot.

I have an appointment back at Wycombe hospital on Thursday 16th Dec for “a trial without catheter”. Whilst I may not be looking forward to the actual withdrawal of it, I am certainly looking forward to getting rid of it. My fingers are firmly crossed that they don’t find it necessary to put it back in.

Though never before having been an inpatient, I’d played the unenviable rôle of hospital visitor in the past, so I was prepared for the ward to be a hive of activity during the day.

The day seems to be kicked off by the drugs trolley. It reminded me of those wonderful ice cream trays round peoples’ necks in a cinema. “ A choc ice, please”. “Sorry, paracetamol, tramadol … oh, or this gannet on a stick.” “Stuff the gannet, I’ll have the paracetamol.”

The drug issue was a source of fascination to me. The nurses ask what medications one is regularly taking, prior to this visit, that is. One guy next to me was a clear winner taking a dozen tablets a day. A dozen, for Darwin’s sake! Popping three or four pills seemed about normal. When I said, “none”, the nurses looked at me in disbelief. “None?” “Nothing, nada, nichts.” I can see why drug companies make unreasonable amounts of money.

The day shift of nurses start drifting in and greeting their soon-to-be-outgoing friends who’ve been on the night shift. Once everyone is assembled, a handover meeting ensues. The nurses gather around the nurses station and discuss the states of their various patients. There doesn’t seem to be any private office area nor does there seem to be any attenuation applied. I frequently heard my name drift across, “John Curd – perfectly fine.” Phew, that’s a relief! Listening to the occasional less than satisfied remarks concerning doctors or the pharmacy staff was quite entertaining, too. The NHS doesn’t appear to be familiar with the old management adage that one shouldn’t do ones dirty laundry in public.

Following the morning staff change came the breakfast trolley, the only meal not kicked off by soup (stick it on the list), which is, in turn, followed by the hot drinks trolley (on the list).

Then we’re into the morning doctor’s round, two doctors pushing another cart full of nothing more palatable than patient’s’ notes. Here the main question seems to revolve around bowel activity or the lack thereof. It appears that the bowel is generally the last bodily system to reboot following one’s system crash induced major surgery. Forget your God if you have one, the bowel is omnipotent; it is the system that decides when one will be released. Curiously, given its importance, unlike the fluid accountancy that is carried out for the liquid system, there seem to be no checks and balances on bowel activity. Rather, it is an honour system where the patient is left to report their own success or failure. It seemed to me that one could tell porkies [Ed: for non-natives, porkies = porky pies = lies, Cockney rhyming slang] though the wisdom of so doing is very questionable. For the most part, these clever folks do actually know what they are talking about.

A brief lack of medical activity enables a personal hygiene session, following which lunch, including soup (on the list), is not far away. Then, of course, another visit by the hot drinks trolley provides a little something (list!) to wash that solid stuff down.

Visiting time kicks off at 3:00 PM following which there are usually conversations going on around one or more of the 5 beds that were in my bay.

In between all these activities, if there is any in between, the general monitoring of blood pressure, blood O₂ levels and temperature is done at varying intervals. The nurses speak of a “protocol” whereby, following surgery, these standard health indicators are checked firstly every 30 minutes, then every hour, then every two hours, finally reducing to every four hours as progress is made.

Here’s where I’m going. Prior to admission to hospital one receives helpful suggestions as to what to bring: pyjamas, sponge bag, reading material. I took in three books but, with the almost constant hubbub it’s almost impossible to read and books are almost entirely superfluous. After the first night my pyjamas, specially purchased ‘cos I don’t use them at home 😯 were superfluous too because I was in either a theatre gown or a regular hospital gown.

Night time isn’t much better. Lights are dimmed but not, of course, right out. Without some light, the nurses would be unable to wander round every 30 minutes or every hour following their blood pressure, blood O₂; and temperature protocol. I’m not one for sleeping on my back but, given all the pipe-work I was porting, sleeping on my back was the only option. Just as I’d dropped off a cold blood pressure cuff was Velcroed to my arm and I was awake again.

The hospital night is much like the African night. Many years ago we were wise enough to go on a tented safari to Kenya. Sleeping in tents just outside the Masai Mara you can’t help but listen to the sounds of the African night: the bass rumble of elephants, lions roaring. You should listen – it’s all a captivating part of the experience. A hospital has night sounds, too: saline drips click and whirr their way through the hours of darkness; pings resembling submarine sonar invade any brief silence; somewhere I would swear that the ghost of Jacques Cousteau was testing one of his earlier aqualungs, judging by the gurgling I could hear.

I mentioned all this entertainment to one of the almost universally delightful nurses who sagely remarked:

I don’t know how anyone ever gets better in hospital. You need three things to get well: fresh air, rest and good food; you don’t get any of those in hospital.

Lie back and concentrate on getting your systems rebooted. 😉

Though not my first brush with general anaesthetics, I am fortunate that this was my first stay in an NHS hotel hospital. Now I was being nursed back to health from a major operation and having no idea of what to expect, everything about it was a novel and occasionally interesting experience.

Having been returned to my ward at ~4:00PM on The Shortest Day of my operation, I felt OK – quite good. actually, and certainly much better than I had expected – but I fancied only liquids, not food. So, I sipped from the ever-present jug of water frequently. Good sign: drinking often with no resultant nausea. Hot drinks are offered quite regularly, too. Most of these are of the powdered variety with tea being the exception. For some reason, I didn’t even like the sound of milk in a hot drink. However, since instant coffee is against my religion and they weren’t able to offer me a Starbucks, I thought I’d try some black tea to break the monotony of the water. It proved to be far too strenuous. I never did like even subtle black tea, far less black builders’ tea, so I can’t say I was surprised. I reverted to water.

My largest surprise here was that the nursing staff slipped into the role of fluid accountant. When you have a cup of tea or coffee, it’s entered on a form. Likewise the water; half a jug in the afternoon, stick it on the form. Soup with your sandwich? On the form! The medical equivalent of double-entry bookkeeping comes in when someone arrives to empty the bag into which one’s catheter drains – assessed and on the form.

The following day, Friday, I did fancy some solid food. Good sign: appetite returning. Ah, now, food. I would class myself as an epicure; food doesn’t have to be complex or ornate but it does have to be pleasurable. This will come as no surprise to my friends. Nor did it to my mother whose greatest concern with my going into hospital seemed to be that I’d never be able to eat the substandard offerings. In preparation, Carol very kindly procured for me a hospital survival kit: Marmite, Branston pickle, mustard mayonnaise. These were stashed in my bedside cupboard on the right.

The breakfast trolley offered lots of those childish cereals that I tend to avoid but could also manage porridge (best left to the Scots) and toast. Marmite; be still, my beating heart.

“I’ll have some wholemeal toast, please”.

Picture this: I had a catheter strapped to my left leg and running to a collection bag hanging on the side of the bed; one of the two cannulas in my left hand is played host to a saline drip suspended on the left side of my bed; taped up my back and to my right shoulder, thence running back through my pillows to a control device behind my bed, was a very fine tube feeding me with a measured dose of epidural happy-juice; additionally, running up to my neck, over my ears and under my nose, I had the standard hospital-issue oxygen tube; just for good measure, there was also a pipe from my operation wound running to a drain bag lurking in the left of my bed like a punctured hot-water bottle. I was comprehensively tethered where I sat. Due to some of the plumbing devices standing behind my bed, it was positioned further forward than it would normally have been. The bedside cabinet was well behind me and to the right. Could I reach the Marmite tantalising me from the second drawer down? No, of course I couldn’t. Exit stage right: hospital survival kit.

“Do you mind if I have some marmalade as well, please?”

I must say that our combined fears were largely unfounded. Once I was on milk, the tea may not have been Assam but it was drinkable. Clearly the food is run on a tight budget and the chicken starring in my grilled chicken salad was never going to be free-range but it was OK and the salad was very reasonable in that the green leaves were fresh and crisp and the tomatoes were cherry and red. On my second day I went for the shepherd’s pie which, though far from being a Gary Rhodes New British Classic, was perfectly edible. My third sample of the hospital gastronomy was to be pork meatballs but Carol sprung me before they could be delivered. 🙂

All the main meals could be rounded off with some (pre-packaged) cheese and crackers, which would have loved for me to be able to reach my Branston, and could be kicked off by a cup of passable soup.

Stick it on the form!

P-Day dawned after my first experience of a night in hospital. [Ed: more of that another time.] The condemned man was given a theatre gown, those intriguing garments that fasten (almost) down the back with short ties that no human without dislocated joints can possibly reach, and was pointed at the shower. I freshened up and changed into my elegant theatre clothes with my butt hanging out.

I couldn’t help but feel that I should have been getting nervous by now but I felt no jitters at all; I was still perfectly calm and raring to go. In my youth, my mother had needed to administer drugs to settle my stomach prior to every school exam, such were my nerves. Where were my P-Day nerves now? I was about to mount an assault on the theatre of operations, storming the assembled might of the NHS on the beaches of HIgh Wycombe, and I felt good. No sense, no feeling, I guess – either that or I had no qualms whatsoever and really did want my troublesome prostate excised. I was also given an anti-sickness pill and another whose function I forget. Maybe it was the cyanide pill lest I fell into enema hands. 😀 Speaking of which, having read about perhaps being given an enema, I wasn’t. No complaints.

A nurse came to help me on with some particularly fetching surgical support stockings and very soon our presence was requested in operating theatre 3. Forget the TV; forget Hollywood. Was I loaded up onto a trolley and wheeled into theatre? No, not a bit of it. My M&S dressing gown went over the revealing split up the back of my theatre gown, my chic M&S slippers went over my seamless surgical support stockings and, at about 8:30 AM I was led down to theatre 3 à pied, self-propelled, on foot. Great stuff! well, why not, I suppose, I wasn’t an invalid yet – it just wasn’t what I expected.

First stop, the preparation room staffed by two calmingly chatty nurses and my anaesthetist lady. Decision time again. We’d “phoned a friend” to discuss my analgesia options. I went with the epidural. If it didn’t work for me, there was always the morphine PCA (Patient-Controlled Analgesia) pump. This felt like waiting in the wings of the theatre waiting for one’s cue and stage entrance. With two delightful nurses making supportive noises whilst sticking two cannulas into the backs of my hands, the anaesthetist set about sticking the epidural into my spine. The cannulas were a doddle; getting the hardware between my vertebrae seemed to take for ever. I was asked to hunch my shoulders and curve my spine. Make like a rag doll. This position is designed to open up the inter-vertebral spaces on the outside of the curve thus making the probe easier to insert. My layman’s brain says that this same curve also closes down the spaces on the inside edge making the passage through that second side more difficult. What do I know? Eventually ‘t was done and time for me to lie down on the trolley ready for my grand entrance. Cue patient. The anaesthetist held a gas mask, well, hovering just above my nose, actually.

Anaesthetist: “I’m just going to drift you off, now … “

Me: “Oh, hello, who are you?”

My new companion was a softly spoken male. He was soon joined by a captivating, diminutive lady with Asian features and an utterly irresistible smile. Thinks: “An angel; I’ve died and gone to heaven”. In reality I was fine and this was what a recovery room looked like – hard to improve on, really. A split second ago it had been about 9:00 AM and now, after a spot of Douglas Adams time-travel, it was about 3:00 PM. In no time flat I’d lost one prostate, two seminal vesicles and six hours. On the other side of the balance sheet, I’d gained five holes in my abdomen. Result!

If there had been one part of this process about which I harboured concerns, it was coming around after the general anaesthetic. I’d had two generals for day procedures way back in my youth and had felt nauseous coming round on both occasions. Here I was feeling fine and I was soon having a lengthy and relaxing chat with my new male companion. I’d got to cram a 24-hour day into 18 hours, after all. He was the trainee recovery nurse, an ex-forces chap, and was frequently joined by the angel who turned out to be from the Philippines and was the qualified member of my duo.

How was my pain? What pain? Excellent! Actually, I felt very slightly sore on my left side but completely comfortable on my right side. My friends rolled me a little to try and distribute the happy-juice from the epidural more evenly. I was blown away by how well I felt. How things have advanced.

Eventually it was time to leave. At least I didn’t have to take Shanks’s pony back to the ward. This time I got the expected, TV-style ride on the bed accompanied by my recovery team.

I was sorry to see them go.

I’ve arrived at the last day of Movember. Tomorrow, all those “real men” who’ve been growing ‘taches (sorry, I still call it a mo’) in support of the Movember prostate awareness campaign can have, in the words of Sweeney Todd, “a nice shave”. Also tomorrow, being 1st December and having been waiting throughout Movember, I am due to present myself to the very pleasant medical staff at High Wycombe hospital for my seemingly long-awaited radical prostatectomy. I know I keep repeating that phrase but it’s not only good for search engine indexing, I like writing it – I’ve become quite attached to it over the preceding few months.

In our pedestrian but free NHS, the process through which I’ve been has taken four months – that’s from the consultant seeing a PSA level that he didn’t like, through my delightful transrectal prostate biopsy (there’s another one I enjoy writing), to my imminent surgical solution [Ed: I’m damned if I’m going to miss out on the solution fad just ‘cos I’m retired]. These  four months have very definitely felt like waiting to wait. By far the worst time, however, the most psychologically stressful, has been the last two weeks – the two weeks between my pre-op assessment, a.k.a. health check to make sure I was fit for surgery and less likely to become one of the 1 in 300 that apparently doesn’t make it off the chopping board still breathing, and the surgery itself. Having arrived at this stage, the last thing I want is a delay but there’s two weeks where fate can conspire to confound the process. “Many a slip twixt cup and lip” is the phrase that springs to mind. A lot can happen in two weeks.

Catching the common cold is one of the potential problems. One of the questions at the pre-op assessment is, “have you had a cold during the last three weeks?”. (I can’t remember the exact time span but you get the idea.) No. Great! What’s the implication if I had, though? I’m not sure but my not having had a cold sounded important. “Try and remain healthy between now and the actual operation.” Right.

The common cold is well named, especially at this time of year – there’s a lot of it about. For a retired person, the biggest problem is shopping which brings one into contact with the snuffling, sneezing, coughing masses gamely struggling their around the same relatively confined spaces. I couldn’t help remember hearing, many years ago, that the contagious range of the cold virus is 32 feet indoors. This may have been revised these days, like many other things – cramming full fat milk down kids’ necks use to be recommended – but I found myself spotting a cougher or a sneezer from 30 paces and giving them as wide a berth as possible whilst walking on the streets. Inside shops space is more restricted and avoidance is a little more difficult. Two weeks waiting for what is considered a vital operation can turn you into a paranoid recluse.

Despite my best efforts, last Monday morning I awoke with a strange feeling in my throat. Sure enough, a few sniffles duly developed. Unbelievable! It really didn’t feel as if it had developed into  a full blown cold – no overnight congestion, no tightness across the chest, no constantly steaming nose – but something was certainly there. Fearing the worst and in respect for everyone else involved, on Thursday morning I phoned the hospital and ‘fessed up; I think I have a cold. How did I feel? Fine, actually, but I’m sniffling. “I’ll speak to the doctors but, if you hear nothing, come in as planned.” I heard nothing – phew!

There’s another type of cold that I really didn’t expect to be a potential problem, not at this early stage of our winter anyway. That’s the kind of cold that blows down off the Russian Steppes, sweeps across Scandinavia and the North Sea and slams into our north-east coast, bringing with it unwelcome amounts of slippery, traffic-disrupting snow. High Wycombe is inappropriately named; HIgh Wycombe itself is low, it is the land that surrounds it that is high. Consequently pretty much every road into and out of High Wycombe is a hill. Any amount of snow is a potential cause of transport problems. Regrettably, we cannot yet control the weather so avoiding this kind of cold is down to the last and rather ineffective resorts of hoping and, if one is that way inclined, praying.

This morning I’ve awoken to a world thinly blanketed in the unwelcome white stuff. Scotland and the north-east of England have already had very disruptive snow falls but the weather forecasters suggest that the weather is moving south and west towards us. Since I am not a believer (no omnipotent being would have designed/engineered the human body the way it is), I am left with but one choice – hoping that the roads on Wednesday will be free enough to enable our 30-mile journey to the theatre of operations.

Assuming fortune smiles on me, I suspect that parts of me are also going to get shaved at the end of Movember, too. Probably not my ‘tache, though.