Tuesday, 24 September 2013

The Hospital Drama - Part Three

A cancelled scan is not ordinarily a big deal. I'm sure there are many of you reading this who have, from time to time, suffered the inconvenience of having scans, maybe even operations cancelled. But the thing was this. My scan was going to reveal the extent of my kidney damage over the last six years. It would determine whether or not I would be allowed to continue to urinate through the conventional body part. And it was cancelled because of a mix-up with a couple of porters.

What I perhaps should have known but did not was that porters have absolutely no authority to decide what time a patient can be taken for a scan. That's not that surprising. They are porters, not medical people and so to have them scheduling scans seems a stretch. What is surprising is that they don't seem to know this. They have no business offering anyone any more time to 'settle in' to a ward they have just arrived on. No matter how distressed and possibly terrorised the patient might be. And I was.

And so it was not long before the arguments began to rage. I was rather pointlessly (or so it seemed) trying to explain to the nurse that I did not refuse to go for my scan and that rather I was twice offered more time by the porters. There were more phone calls back and forth. The initial upshot was that since I had not gone at the agreed time, for whatever reason, my slot in the running order had been taken and the best they could do was fit me in first thing the next morning. It's understandable that they want to work to a strict schedule. They have lots of patients to see and very probably cannot afford to waste time waiting for me to decide when I am sufficiently calm to turn up. The first signs of a weakening in their stance comes when the nurse who had been making the calls offers me a CT scan. This will involve the tedious, painful ballache that is having more injections in my already Incredible Disappearing Veins but at least it would be done today.

No it wouldn't. Another bogus offer had been made. While they had room on their schedule to conduct a CT scan, they then informed me that actually this method of scanning was not recommended for patients who had damaged kidneys. Something to do with the dye they use when they are pricking holes in you. A part of me was relieved at not having to go through the whole human pin cushion thing but a significantly more sizeable part of me was further distressed at this news. It was around 3.00pm at this point. Under the terms of their offer I now had to wait another 18 and a half hours to find out my fate.

Another phone call was made to the lab. If the 10 minutes or so that it took was any barometer, the next 18 and a half hours were going to feel like several lifetimes. Yet finally it was worth the wait. The nurse came back and informed me that, miraculously, unfathomably given their previously adamant refusals, I would be able to go for my ultra-sound scan at 4.35 that afternoon. The chances of pissing through a hole carved into my person had not reduced any, but it was some comfort to know that I would not have to wait so long to get the news.

Shortly after the relative high (I was taking any encouragement on offer at that point) of getting my scan appointment back, there came the setback of another encounter with our friend the lady doctor from earlier. Mercifully she had not come to discuss my future toilet arrangements but instead to interfere with my genitals. And not in a good way. Quite matter-of-factly, almost cheerfully, she informed me that she needed to place a permanent catheter into my you-know-what. Why? Was this a rehearsal for what life might be about to be like, post-scan? The explanation was actually that they needed to monitor the flow of my water for a sustained period, maybe a day or two. So from the original prognosis of being in overnight until they could control the potassium, I was now resigned to at least the next 24 hours and probably 48 in the hospital. Not only that, but I would have to suffer the great indignity of having my knob grabbed by a twenty-something, smart-arsed female doctor who I had already decided I did not like. And it wasn't just the knob-grabbing I objected to, but also the insertion of a catheter which seemed roughly the size of a garden hosepipe. That had to hurt. It did.

There followed a pointless argument between myself and the doctor about my level of discomfort (both embarrassment and pain) as opposed to the level of necessity of the permanent catheter according to the urologist. I hadn't even got to speak to the urologist yet, but I was being assured by this doctor that the permanent catheter was the only real way to monitor my condition. It seemed odd to me that of all the many doctors who insisted on prodding me and asking me personal questions on my arrival, the one person they had not sent to investigate me personally was the urologist. Before I could think of an alternative the female doctor had me in her grasp and began inserting the hosepipe. She suggested I might feel a pinch, which was rather like telling Joan of Arc that she might start to get a bit warm.

When the porter arrived I did not hesitate this time. Interestingly they did not send either of the two who had contributed to my predicament. A third porter was tasked with the job. In truth, they could have sent Hannibal Lector to trundle me down to the scanning lab and I would have taken my chances of not being devoured with a nice chianti somewhere along the way. Getting on to the chair which was to transport me was not at all straightforward. With a permanent catheter inserted it was actually very complex. Wherever you go, it goes. Eventually I managed to clamber on to the chair and, carrying the most unsightly and humongous bag of what can only be described as my own piss on my knee, was wheeled off to have my long-awaited ultra sound. By the way, not only do porters not have the authority to schedule scans, they also don't see it as part of their job description to help you complete your journey to the lab. I was left in a corridor for a good five minutes before a member of staff came out to wheel me in to the scanning lab. Another dance with the piss bag ensued until finally I was on the table getting smothered in gel. I was relieved to note that it was not cold. Last time I had an ultra-sound the gel had been freezing cold, just adding to your anxiety and the feeling of wanting to be anywhere else but on that stretcher.

I was taken outside into the corridor a few minutes later, scan complete. Again I was made to wait for a porter to pick me up so we could make the undignified return journey of the wee carriers. An hour later something incredible happened. A man I seemed to recognise approached my bed and began to pull the curtain around it. Not a man I had seen since I was admitted, but someone from a hospital visit in the past. My old urologist. He walked nearer to address me and explained that he had seen the results of my scan. I winced inwardly and awaited all manner of possible calamities about to unfold. Except they never did. He told me that there had been very little damage to my kidneys since my last scan. He also said that a permanent catheter (for longer than the day or two that he also informed me that he had in fact ordered the female doctor to initiate) would be no good for me and that I should continue to use intermittent catheters. A permanent catheter would only increase the risk of infection in my case, he said. A wave of relief shot through me but I just felt drained, physically and emotionally after everything that had unfolded in the last 24 hours or so. What he could not tell me was how to stop the palpitations which I was still experiencing, although they had become something of a side issue. For that I would need to consult with the other doctors, including my new girlfriend.

I was not out of the woods just yet.

Wednesday, 4 September 2013

The Hospital Drama - Part Two

So we left me on my way to bed after an evening spent in the not so splendid surroundings of A & E at Whiston Hospital. The next morning, after a pretty uneventful night I woke up early and watched the Saints game. It was a triumph which I will not bore you with here, but I was still not feeling as I should. I passed the rest of the day watching all manner of shit television programmes which I inexplicably insist on recording despite the fact that, unless I'm off sick, I have no hope of finding the time to watch. The White Queen? Come on. I am vehemently against the monarchy so why do I give two shites about the antics of Richard III? And besides, isn't that just rhyming slang for taking a dump? I followed this rubbish with a quite awful film called Battleship in which Taylor 'Friday Night Lights' Kitsch goes out to sea to fight seemingly indestructible alien vessels. I can't recall exactly how it ended because I was becoming ever more focused on my deteriorating condition. I'm guessing Rihanna whailed the aliens into submission.

It is difficult to describe how I felt. I had the anxiety of wondering what acidosis might be, and of wondering whether I had done the right thing in discharging myself the previous evening. Despite my not very big or clever Facebook status announcing that I had, I was starting to get the feeling that I almost certainly had not. That feeling was only added to by the fact that I was still experiencing waves of palpitations. By the time some intellectually challenged woman had contrived to trap herself in her bedroom with a psychotic killer in an episode of Luther I was really struggling to achieve any peace. So I went to bed. Not for long.

At about 1.00am I woke up suddenly with some serious palpitations. These were much stronger than anything I had experienced up to this point. My heart was pounding at 1000 miles per hour and I was panicking wildly. I felt like I might have a heart attack, which might sound fanciful but if you are experiencing something like this for the first time your mind wanders to all sorts of dark places. That it was during the dead of night in the pitch dark only added to my hysteria. After a couple of attempts to get back to sleep I gave up and got up. Every time I would get close to dropping off to sleep the palps would ramp up again to the point where breathing became something I had to think about. Added to this was the chilling tingle down my arms which is closely associated with heart trouble. I didn't get any more sleep on the couch but at least I had stopped disturbing Emma.

On Wednesday I remember (aswell as more shit television) a long telephone conversation with my mum. She was concerned about what I told her about the kind of night I'd had, and about what acidosis might be also. Somehow, even though normally I am the kind of person who would jab myself in both eyes with a pitch fork before I'd agree to go into hospital, I had agreed by the end of our conversation that if I had a repeat of the palps that night then I would go straight into the hospital. By the time Emma and I went to bed I hadn't talked myself out of it. It seemed like I had no choice at that point. It was the only sensible course of action. The palps were not just going to stop of their own accord. And they didn't. Within 10 minutes of going to bed, and again just at the point where I was about to drift into sleep I jolted up as the palps swept through me again. Heart pounding, arms tingling, I woke Emma and we got straight up and prepared for the hospital. We were expecting a somewhat longer stay this time so we actually packed a bag of overnight essentials. It was a grim thing to have to do, given my rising phobia. Yet at this point all I wanted was for someone to do something to stop my heart pounding so violently. I didn't really think about how many nights in hospital that might entail. At the back of my mind was the fact that I knew I was heading face first into that scary kidney scan also, but again there seemed little alternative.

We can probably skip the A & E part. It was almost identical to the events of two nights earlier. Blood tests, blood pressure, ECG, waiting. And waiting, and waiting. We spent what remained of Wednesday night in the observation ward. I was zonked out on a bed trying to slow down the palps but suffering from sleep deprivation. Emma was in a chair next to me suffering similarly. As morning arrived we were visited by at least three, maybe four doctors who each wanted to carry out an examination and ask the same questions. Have you got any pain? Are you on any medication? Are you allergic to anything? The final doctor who examined me was accompanied by a young female doctor. The doctor count was rising faster than my phobia at this point. What they said plunged me into a world of terror and, with a mind like mine, no small amount of depression and anxiety. Having been told by another doctor that I should only be in one more night, just until they could reduce the potassium which had risen again, this new pair had other ideas. They began talking to me about my kidney scan from six years earlier, this despite the fact that I had always been adamant that I did not want to know if there was nothing they could do to improve the situation. They were not deterred as they went on to describe how I might be treated to the delights of a permanent catheter, or another surgical procedure which basically entails bypassing the normal method of urinating and having your water escape from an altogether different, artificially created, orifice.

The deadly duo left me with that thought for a few very dark hours indeed, until I was finally, at about 1.00 Thursday afternoon, moved up to an actual, real ward. As the nurse pushed my bed around the different corridors en route to the ward I remember catching a glimpse of the doctor who had wanted me to stay in on Monday night. She made eye contact but didn't say anything to indicate that she recognised me, but I couldn't help but think that she would be thinking 'I told you so'. So now not only was I depressed and feeling hopeless, I was fairly humiliated also. Finally I arrived at Ward 1C where two nurses immediately greeted me. Nurses are great, don't get me wrong, but I was not at that point ready for the way they went about their business as if I hadn't just been told that I might need life changing surgery. To them I was just another patient, just another day in the life and they couldn't see what all the fuss was about. I was so edgy that I was very reluctant to even allow them to take a simple swab of my throat, something which I was informed is mandatory for anyone who is a guest in these dubious surroundings.

Just at the point where they were helping me to transfer from my observation ward bed to the 1C bed a porter came in and announced that he was here to take me for my kidney scan. I let out an expletive and wondered aloud how it could have taken them nine hours to get me on to a ward but only a matter of seconds to disturb me again to take me for my scan. I'd already had one scan which I thought would be enough, but I was now being advised that I would need an ultra-sound. The porter seemed to empathise with my plight and offered to come back in 10 minutes. To give me time to 'settle in'. I was glad of the respite so I agreed, but within two minutes another porter arrived to take me for the scan. I explained that another porter had agreed to give me 10 minutes only moments before and he, like his colleague, was unfazed by this and agreed to let the other man come back for me at the agreed time. Only nobody came back. Half an hour passed. Then an hour. Soon after that I could hear one of the nurses arguing my case. She was telling whoever she was speaking to that I had been told by not one, but two porters that I could have a little more time to adjust following my arrival. This debate carried on for a few more minutes before the nurse came into the ward to explain the outcome of the discussion.

The scan would not be happening today. So the possibility of life changing surgery would continue to hang over me for at least another 24 hours. I was booked in for another scan at 9.30 on Friday morning. But for today my scan was cancelled.