Operation - too much information for some

Tuesday, 23 April 2013 – St George’s Day and operation day

Elodie from the Taxi firm arrived at 10.30am prompt and we set off for St Brieuc.   A grey day but not actually raining.   We talked about weight and my gastric bypass etc. for most of the journey.  She weighs 114 kilos and isn’t very tall so is thinking about a bypass.  She was very pleasant and made a welcome change from the boss who, although very nice, talks in a non-stop piercing way.  She waited with me in Admissions at Clinique du Littoral and carried my main holdall to Room

which is to be my home for the next two days.   I carried my laptop case with extra goodies.   I hope it will be her who comes to take me back home on Thursday.  I gave Matthew a quick ring to let him know my room number, but I don’t think he knows the ‘phone number here so it won’t help much.

A nurse came in, confirmed my details and asked for a urine sample.  I’d just finished unpacking when another nurse arrived with a computerised weighing machine.  She checked that I had showered in the Betadine preparation, not eaten or drunk since 07.30hrs, had no false teeth, that I wasn’t sporting any make up or jewellery and told me that I would go down to the operating block at 13.30hrs.  I have to change into my gown, fetching paper hat and knickers and my black support stockings, these latter items from my last visit here in November last year, in time for the porters to take me down.   

I’ve brought in a tarte amandine to have as a treat tomorrow and a bar of Lindt chocolate with salty caramel. 

A bottle of Lucozade is also stashed in my bedside cabinet.  This is what my mother used to give me when I was poorly as a child.   I loved the foil caps they had on the bottles in those days and I’d while away time carefully rubbing out with the tips of my fingers the heavily creased circle of golden foil until it was almost completely smooth.  They make an orange flavoured Lucozade now but I like the original version.

As I woke up early this morning without the aid of the alarm, I did manage to have two scrambled eggs on buttered toast and a cup of coffee before 07.30hrs and I’m glad I did as I am already feeling hungry again.   

I was surprised by the porters arriving at 12.55hrs expecting me to be ready.  I had to change quickly and struggle into the tight black stockings supposed to prevent blood clots.  They wheeled me along the corridors and down in the lifts to the operating block, where I waited for forty-five minutes before being taken into the operating theatre.   They hadn’t received urine results which worried them and I hadn’t thought of using my Ventolin inhaler as my asthma is so good nowadays.  It was cold in the theatre and one of the nurses fetched a light plastic inflatable heated sheet which she draped over me. For a while I worried that I might be put on hold while a urine test was done and while they fetched my Ventolin, but they carried on inserting the drip into my left wrist and giving me the anaesthetic while I breathed into an oxygen mask.  At the interview with the anaesthetist last week he had explained that they didn’t always completely sedate patients.  I left him in no doubt that I wanted to be completely out of it and to remember nothing.  He agreed and obviously did his job as I am oblivious to what went on in that room from 14.15hrs onwards.  What they actually did was to install a TVT - tension free vaginal tape to cure my stress incontinence resulting from three difficult births.

The TVT operation works by supporting the middle of the urethra with a tape. The tape is made of Prolene and has a long needle at either end. A 3cm incision is made in the vagina underneath the urethra and two 1cm incisions are made at the bottom of the abdomen beneath the pubic hair line. The needles are passed upwards from the vagina so that the tape comes to lie underneath the urethra.

A telescope is inserted through the urethra into the bladder to make sure that there is no bladder injury. The tape is then placed in the correct position and the needles are removed. Dissolving stitches are placed in the incisions. If an overnight stay is planned, then a catheter is often put in the bladder.

Diagram showing the tape in position.

Unusually, I can’t remember any time spent in Recovery at all, just being wheeled back to my room again, where a nurse came in and set up my saline and antibiotic drips.  She also set up morphine and an anti emetic as morphine makes me nauseous.   I remember briefly ‘phoning Matthew to let him know I had survived the operation and I contacted Flick too.  Later, during the night, paracetamol replaced the morphine  on the dripstand.   Dr Braguet, my surgeon, came in to see me during the early evening, examined my abdomen and reported that everything had gone well.

Sleeping did not seem to be an option.  It’s a very noisy hospital, no sound absorbing materials, so the slightest noise echoes and becomes magnified.  I thought often of my friend, Sheila, who was also in hospital today have a reconstruction after breast cancer surgery last year.  I used my earplugs which are usually efficient but they didn’t give me the quiet I wanted and I couldn’t do more than doze a few minutes at a time.  It seemed that whenever I did nod off that the night nurse would arrive to take my blood pressure and examine my dressings.   Movement was difficult as each time I moved a muscle I could feel pulling in my lower abdomen which was painful enough to gasp.  It appears that the operation was not able to be done entirely vaginally, but that two incisions were also made externally to aid the insertion of the hammock.  My vagina has been packed with gauze which will be removed today at the same time as my catheter is taken away – not something I am looking forward to.  Apparently I am peeing well and they are happy with the quantity and quality of my urine. 

Wednesday, 24 April 2013

I was put into a semi-seated position in my bed for breakfast - hot chocolate, a 20cm piece of baguette, butter and peach jam.  The nurse reminded me to take my normal medication which I had completely overlooked.   Funny how here they trust you with your own medicines whereas in the hospital, Yves le Foll, you have to hand over responsibility to the nurses.  The drugs must be in the packets in which they came from the Pharmacy, which is always annoying as I decant them into pill taking boxes as soon as I get them home.   During my breakfast a different nurse came in to remove my drip, so I am now less restricted in my movements.

My room must face west as I came back from theatre to blazing sunshine late yesterday afternoon and the staff opened the bottom section of the window as it was so hot in here.  The bed has a pale yellow pillowcase and sheet with a rainbow striped type of duvet/bedspread all in one.

I ‘phoned Libby to tell her I was alive – I guess she was on her way to work as she was walking and sounded breathless. 

While I was watching a DVD on my laptop, My Left Foot, a white cat came across the flat roof I look over and peered in through the window – wherever I am it seems I will always be with cats.  If I can get a nurse to find my camera in my laptop case I’ll take a photo as it’s now another metres above my room in the sun on what I assume is a ventilation system.   

Look how far its back leg is from the front legs - you can just see it in the bottom left of the photo. It’s a really large white/grey cat – really large. 

At 10.20hrs two new nurses came in to remove my vaginal packing and catheter.  It was not a pleasant experience.  The length of the packing seemed to be equivalent to the Bayeux tapestry, or like the endless silk squares a magician pulls out of a closed fist but not as smooth.   While cleaning me up they craftily removed the catheter without prior warning – probably just as well.  That done, one washed my back and the other fetched my own nightie to put on once I had negotiated my way to the bathroom and washed the remaining bits of me.  I emerged to a newly made clean sheeted bed and my next visitors were two cleaners who did a thorough job of cleaning my room and bathroom.  Amazingly they were French and not immigrants.  One of them brought me the camera from my bag and I took several photos of the huge white cat.  Truly I have never seen such a huge cat – it’s as if he – for it must be tomcat – has taken some body altering drug.  The tips of his feet while he is lying down are so far away from his head and his head is enormous.   He has now moved out of view and I have lost my feline entertainment.  I suppose I will now spend a good part of my day scanning the rooftops for him in vain.

It’s a lovely sunny day without the wind of yesterday – doux the cleaner called it – soft or sweet – a good description.  It’s the sort of day when I could be digging, weeding, planting and sowing.  From the discomfort I’m in I can’t imagine doing any of those things for a good few days – so frustrating when the weather is finally improving.  Just a few, very few, small white fluffy clouds against the blue, moving it seems from the south west very slowly in the light breeze.

I finished watching My Left Foot just as I could hear the lunch trolley advancing down the corridor to my room.  It was a good film and I enjoyed it while I ate my almandine tart which I bought in Bourbriac and brought to the Clinique with me.  I enjoyed the tart too – there’s something about the succulence of almonds in a mixture which is mouthwatering.

Lunch arrived just after midday and consisted of a tomato salad with mustardy vinaigrette and a little mozzarella followed by ham (very salty and inedible) in a sauce Madère  with creamy mashed potato.  I ate the sauce and potato. 

There was also a mild cheese with a bright orange rind, St Paulin, a slice of baguette and a pat of butter.  Then to finish off, a banana and a small cup of black coffee.  I ate everything but the ham and some of the potato – I was surprisingly hungry.

I have been reading a very lightweight book by Jack Sheffield, Mister Teacher, his second book after Teacher Teacher, a little along the lines of Gervaise Phinn who wrote about his experiences as an

 inspector of schools but not quite so amusing.   It’s quite suitably undemanding for my current circumstances.

I ‘phoned Paul before lunch to ask about Sheila.  She had her operation quite late in the day in the end and was too drowsy still to go home last night so she spent the night at St Michael’s.  Paul will fetch her home later this afternoon and he said he’d pass my love onto her.

It’s 14.00hrs and feels like 23.00hrs – a very long day.  Blood pressure taken again and it’s fine.  Nurse told me I had to have a pee and drink at least three jugs of water each day.  I said that I did drink a lot at home as the water was fresh, cold and iced, whereas in hospital it was warm.  She shrugged and repeated – three jugs a day and left me a bedpan on the loo seat so that they can monitor my output.

17.30hrs and it’s been such a sunny day that I’m really fed up I’ve had to be here in the Clinique.  I opened the windows fully and sat in the reclining chair with my feet on a stool letting the sun get to me, but it’s no substitute for lying on a sunbed in the garden wearing a sarong or swimmer with an iced drink on the little table beside me.  I can’t believe that the weather’s so beautiful and I’m stuck in here.  I filled the bedpan and the nurse was happy and asked me to continue doing that until tomorrow.  I finished my book and read the first few pages of my next Book Club book, The Seamstress by Maria Duenas, which unbelievably has 612 pages! 

It seems to be a very history based novel and that’s not usually my cup of tea, so we shall see.  I may resort to my Kindle store of novels if I get too fed up with it.

The weather changed towards 18.00hrs and it became grey and misty.  The woman who brought in my supper tray kindly closed the windows for me.  Supper was awful.  Dishwater soup, the menu just said potage so no way of knowing what it was supposed to be.  This was followed by something called Cordon Bleu.  It did have the melted cheese and ham but what they were wrapped in under the soggy breadcrumbs it was impossible to tell.  The slice of baguette and wrapped portion of butter were fine and the rice pudding was edible and tasted strongly of vanilla.

While I was trying to get the soup down, Dr Braguet came in to enquire how I was.  She looked at my external wounds and pressed on my lower abdomen, enquired about my peeing ability and said that if all was well tomorrow I could go home at around 11.00am.  She said that an appointment would be made for me to see her in two months and that I wasn’t to bath for three weeks because of the possibility of prematurely dissolving the stitches – showers are fine.  The soreness will disappear gradually but I am not to do anything strenuous for a few weeks and no heavy lifting or straining  for six weeks or more.   The nurse will be in later to scan my bladder with ultrasound to check that it is emptying satisfactorily.

Matthew ‘phoned me on my mobile – I hadn’t realised I’d left it on – good to hear from him.

No more sightings of the cat and strangely, being at rooftop level, very few birds.  I seem to remember seeing a few flying about in the sunshine but very few and I certainly didn’t hear any singing.

I spoke briefly to Libby and said I’d ‘phone when I got home tomorrow.  Then I tried ‘phoning Flick and Andy to see if there was any baby news yet but didn’t get a reply. 

A new night nurse came in at 21.10hrs and said if I peed now then she’d fetch the machine to do the ultrasound to see if my bladder was emptying completely.  I complied and she did the scan.  Absolutely empty was the verdict – so that’s really good news.  There seems to be no reason why I shouldn’t leave the hospital around 11.00hrs tomorrow.  I passed the time until I decided to turn off the light listening to the first of three disks of Nick Hornby’s A Long Way Down.

Thursday, 25 April 2013 

Well it was a better night than last night but still appalling.  I wonder how many times I looked at my watch – far too many that’s for sure.  At 06.00hrs someone checked on my overnight peeing, then another nurse with to take my temperature – 36.5°C as normal – how is my temperature always slightly below the norm when I am always so warm?  Then blood pressure taken but I can’t remember hearing the result.  I reminded them that I am leaving at 11.00am today and need the taxi company to be booked and that their card is stapled to the front of my file. 

Another cat came to visit me this morning, sitting for several minutes outside my window looking in.  It was also large, partly due to being long-haired, but not as big as yesterday’s white one. 

 Hazy outside at the moment, 08.00hrs but the sun is already licking another part of the hospital to the side of my window and I think it will be a hot day - it reminds me of holidays abroad when during breakfast the warmth of the sun makes itself felt and you just know it will be gorgeously sunny all day.

The new day shift nurse popped in to say Bonjour and asked if I was in pain.  I said only a little bit when I moved.  She said she’d get some painkillers and I said that it wasn’t necessary.  She insisted saying that if I didn’t take them the pain would be worse so I gave in.   I forgot to ask for soluble medication – I can’t take the plastic capsules because of poor absorption since my bypass – she had to return with the right ones.   They are vile tasting and don’t dissolve completely, even being stirred so there are unpleasant bits floating in the solution.

I packed a few things into my holdall and brushed the breakfast crumbs from my baguette off my sheets before settling down onto the bed again to listen to the second disk of Nick Hornby’s A Long Way Down.  When this disk finished I cleaned my teeth, washed, dressed, brushed my hair and put it up into a slide.  Then I packed almost everything away into my holdall and laptop bag.  The nurse came back in and gave me a follow up appointment for 27 June with Dr Braguet and returned my blood group card and a paper detailing the implant they’ve put in which I have to keep safe.  She didn’t know whether my exterior stitches had to be removed or whether they would dissolve so went off to telephone Dr Braguet. 

At 11.10hrs she came back saying the stitches didn’t have to be removed but that Dr Braguet had asked that she do another bladder scan.  I went to pee again and lay on the bed waiting for her to arrive with the scanner.  The scanning gel wouldn’t squeeze out of the wide container so the nurse removed the top and shook it.  A whole load suddenly plopped out onto my abdomen – we both laughed.  She scanned my bladder and announced “zero” – no urine remained in my bladder – good news.  She packed up her trolley and went off to ‘phone for the taxi.  I settled down to listen to the last three tracks of the third and last disk of A Long Way Down.   The taxi arrived later than hoped as the message hadn’t been listened to when it arrived.  We were still in time though to stop at the Gourmet Wok Chinese restaurant just off the roundabout in St Brieuc to get a takeaway for lunch.

It’s good to be home – there’s no place like it!

Three things I like:

1.       Walking back through my own front door.

2.       Feeling the cats rub against my legs.

3.       Sleeping in my own bed.