I left you drifting off to sleep the night of my ankle surgery just over a week ago, so this post picks up the following morning,
I had a surprisingly good sleep that first night, what with having to lie on my back (not my favourite), two-hourly BP checks, and one of the loudest snorers I have ever come across two beds away (if you're reading this blog, you know who you are!).
Thankfully, as previously mentioned, no pain, and so I was able to enjoy a light breakfast at about 8 o'clock.
The rest of the morning passed quite quickly, in between watching a couple of episodes of the final series of MadMen on my iPad (fantastic series IMHO); continuing regular BP, pulse and temperature checks; and the general hustle and bustle of the ward, with another group of patients arriving from admissions from about 8 o'clock onwards, and then gradually going off for and subsequently returning from procedures - I "counted them all out, and counted them all back again"!
I had been coping fine with bed bottles during the night and through the morning but, after lunch, decided it was time for a proper sit down, and so I gingerly moved off on my crutches in search of the bathroom. As if on cue, the physiotherapist appeared - their principal task being to ensure that patients can use crutches properly and safely. Despite my having practised with the crutches for several weeks before-hand, I didn't really feel very comfortable now using them for the first time "in anger", and it seemed the physio was not over-impressed either, as she said I would have to demonstrate better use of the crutches before I could be signed off. Despite that hiccough, I am pleased to report a successful bathroom visit as I think that is another of those often unspoken concerns when on one's back after surgery (though this proved to be a bit of a false dawn - see later posts)).
Watching films, supper and calls to family and friends made the rest of the day whizz by and, although I was now off two-hourly observations, the nurses were still regularly with me, both doling out my medicines, and topping me up through my cannula with antibiotics (one particular risk-factor with any implant surgery is (deep) infection) and with a blood-thinner (I should also mention that on return from surgery the previous day I found myself sporting a rather fetching grey/green pressure stocking on my non-operated leg).
With the cessation of the two--hourly checks, and having been disconnected from the morphine drip (though with cannula still in place), I was able to settle down quite comfortably and, despite the renewed efforts of "Mr. Snorer", I had a remarkably good night's sleep.
After breakfast the next morning, the mind started to focus on discharge. I had been advised on admission that, all being well, I would be discharged roughly late morning two days after my op.; to do so, four things had to happen - the physios needed to sign me off on use of crutches; I had to go to the Plaster Theatre to have a new cast installed; I had to have the cannula in my left hand removed; and I had to be prescribed and given the various medications I needed.
My brother had kindly agreed to make the trip down from Norwich to pick me up and, as luck would have it, he was able to combine that with the taking of his very final exam to qualify as a Flying Instructor in nearby Luton, so we anticipated he would arrive at the hospital at around midday.
At around 9.30, the bathroom called again, so it was out on the crutches again and, would you believe it, another member of the physio team chose that moment to come and (re)assess me, prior to sign-off. Whilst I felt steadier on the crutches than the previous day, he was still not especially happy so, after using the bathroom (unsuccessfully on this occasion), we did some practice up and down the ward - with some corrections to my technique I was soon moving along better and more securely. We then practised going up and down stairs, this time to immediate satisfaction. In my view, it is really worth spending time with the physio team making sure you are fine on crutches as this becomes crucial in the weeks ahead.
Literally as e stepped out from the stairs practice, there were two guys with a trolley to take me down to the Plaster Theatre, so off we went.
The team there first removed the existing back-slab plaster cast, and replaced it with an identical back-slab - i.e. the cast surrounds the entire foot and ankle (except the toes), and most of the way up the leg to just below the knee.
As I was to discover, the way to make a half-cast is to make a full-cast and then cut half away! So, the whole leg was duly plastered from toe to knee and then a gentleman with what looked suspiciously like a circular saw approached my leg with clear intent!! He assured me that it was a vibrating blade rather than a rortating blade, and, with a smile, that he had "never even nicked anyone yet". Thus reassured (!) he proceeded to saw off the front half (shin-side) of the cast, and finally the whole thing was over-bandaged.
Back on the trolley for another trip though the (very) undulating corridors of RNOH to arrive back at my bed, where shortly the delightful Normita, our Health Care Assistant, carefully removed my cannula.
Just about then, my brother arrived, so only one remaining hurdle before discharge, which was to complete the prescription and dispensation of all my medicines.
My medicine bag included :
- morphine sulphate - a strong pain-reliever (and controlled drug), which I fortunately have not had to use (and must return to my local GP for controlled disposal)
- dihydrocodeine - moderate pain reliever
- paracetamol - pain reliever
- senna - laxative
- docusate - stool softener
- enoxaparin - an anticoagulant (blood-thinner) used to mitigate the risk of DVT; in the form of an injection to be administered subcutaneously
I was asked to demonstrate that I could self-administer the enoxaparin injection, which basically involves stabbing oneself (gently) in the gut with a sharp but relatively short syringe and pressing the plunger - surprisingly UNpainful.
We then completed the final discharge paperwork before me being loaded into a wheelchair for the journey down to the carpark to find my brother's car.
Before rounding off this post, I really must stop for a moment to record my intense admiration and thanks for ALL the staff I encountered at RNOH during my stay - they are a dedicated team, all thorough professionals, who are focused on delivering the best possible medical care to their patients in an efficient yet caring manner. From porter to surgeon, tea lady to pharmacist, they were all cheerful, pleasant and above all communicative in a way which can but be reassuring to the patient.
If I were doing a "TripAdvisor" type review of my stay, and being particularly pernickety, there are two comments I would make.
The first, which I have touched on before, is that the professionals of RNOH achieve what they do DESPITE the RNOH infrastructure, which is in dire need of refurbishment/replacement.
The second was the food. Whilst I am the first to realise that a spell with the NHS is not an invitation to a gourmet event, and although I am sure the food was nutritious, virtually nothing I had even tickled the taste buds and nor (probably back to the infrastructure) was it ever more than lukewarm.
Those two small points aside, my experience as a patient has been excellent, and I would thoroughly recommend the RNOH to anyone.
So, as I close this post, it's back up the M25 and M11 to Norwich courtesy of my brother. In my next post (probably tomorrow), I'll relate my experiences the first few days back home, including my review of the bits and pieces I've bought to assist my recuperation.
All has been far from a bed of roses ..............!