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Date: 22/07/16

Four-Wards

Part 4 - Out-Wards And After-Wards

(Our Hero is still in hospital...)

That the period after my 'procedure' was likely to be a frustrating one was a given. Despite the initial projection by Dr. Dua that I would be out of hospital by the following Monday, this was always going to be a bit of a long shot given the concern still being shown with regard to the fluid around my heart (something which, it seems, is called an 'effusion', which is one of those words which you associate more with medical tracts from the eighteenth century than the twenty-first, but why let go of a good piece of jargon?). So I remained on the intravenous diuretics twice a day through one of the cannulae with which I now seemed to be festooned. 'Output' had to be measured as a result, which meant always having to piss in one of those bottles which seem to be made out of recycled egg carton material so that said 'output' could be weighed in the balance, hopefully to ensure that it exceeded my 'input' (which was supposed in theory to be tightly restricted, but which in practice was often not).

That things were otherwise progressing satisfactorily could be judged by the fact that the young chappie who had given me at one of the two echo-cardiograms prior to the operation turned up to do another one on the second day after the 'procedure' and - at the end of a thorough scanning - including, of course, yet more of that vile jelly - pronounced himself very pleased at the new state of my pulmonic valve ("It's got a good score", he cooed, before leaving me with an encouraging smile and wink).

(Even I with my lack of expertise - after all, I'm merely giving house-room to the organ in question - could tell things were better. At various points in the scan, the radiographer - if, again, that is the correct designation for him - turns the sound on so the heart can tell its tale audibly. Whereas, prior to the 'procedure', this had sounded like the introduction to a trance mix of Blue Monday, now it sounded comfortingly clear and regular).

My brother and sister-in-law had visited me the day after the operation and a card from a couple of colleagues had turned up on the ward while I was actually under the anaesthetic. These, plus the encouraging texts passing between me and family and colleagues, went a long way to enabling me to take the strain of a longer stay than I would have wished. The need to monitor the fluid situation plus the fact that the team dealing with me wouldn't be discussing my case until the following Tuesday at least gave me a timetable of sorts. This didn't stop me from sending whingeing texts to all and sundry, which led to a rather sharp rebuke from my niece.

The main problem I had now was my blood glucose level. This hadn't been brilliant to start with, but had now decided to play one of its occasional tricks of rocketing sky-high and then resisting all attempts to bring it down again. Specialist nurses were flown in from another part of the hospital to advise, one of whom told me not to become anxious about it because anxiety would make it worse. In which case, I reasoned, if it stopped doing it I wouldn't be anxious about it and it would stop doing it. There seemed to be a small flaw in the logic here.

Beyond that, it was just a question of sitting out another weekend and a bit pending a decision. I finally had the last cannula taken out on Monday afternoon, and was looking forward to being able to relax in bed that night without fearing that I would pull the damn thing out...except that that evening, when they measured my blood pressure, the nurse thought that my heart rate was very low. It may have been for those few moments, but after that it came back OK; however, because she had already noted it down, I had to be strapped in to a portable monitor for the night (just as I had been for the twenty-four hours prior to the operation), so there went the prospects of comfy sleeping for another night.

But the case conference on the Tuesday came and went without any definite decision other than to keep monitoring the fluid, although it did mean that I got to meet Dr Jenkins for the first time (she being the consultant who had originally admitted me). Very nice, up-front and positive person, too. But no decision to discharge me was forthcoming from that quarter either.

I did manage to get off the ward under my own steam two or three times. This was partly out of curiosity, but also due in no small measure to being bored with drinking coffee or water all the time. I knew that there was a vending machine on the ground floor near the lifts, and so availed myself of the chance of the odd can of a product which - ethical consumerism being such a difficult thing to achieve - I would otherwise have avoided. The first journey, I took the lift both ways; the second, I took the stairs. Taken at a gentle pace I managed them, much to my satisfaction.

It was Dr. Jenkins' next visit to me on the Thursday morning which finally brought a result. She asked me how I would feel if she told me that I could go home on Friday. Naturally, my first response was to genuflect to her in a most pathetic act of gratitude, and then to try to stop myself from bursting into tears because the homesickness had got that bad and I had practically begged the doctor doing the ward round the previous day to do whatever was necessary to get me out. Dr. Jenkins said that - unless the latest blood tests showed any problems - I would be discharged the next morning, and that she was very pleased with the results of the 'procedure', although they had only been able to open up the pulmonic valve so far because any further and there would have been the risk of leakage as the flaps (for want of a better word) of the valve would not have seated properly, and that would have made matters worse. Free at last! Free at last! I went around the rest of the day grinning annoyingly at everyone.

Thus it came to Friday morning. No need to be connected to a cannula, no need to pee in bottles! For the first time since I had been admitted two weeks (bating a few hours) before, I tried on my shoes (having shuffled about in slippers without socks for the intervening period). From struggling to get them on previously (and having to unthread the laces one row back to do even that), I now found that I was going to have difficulty keeping them on, even with the addition of quite a thick pair of socks. Further evidence of the success of the 'procedure', to add to the fact that I had lost over two and a half stone in weight during my stay; all to be accounted for by the elimination of the oedema.

I knew that my brother and sister-in-law would not be able to come and pick me up until late afternoon so, having packed, I just mooched around the ward and thereabouts waiting for my discharge papers. By this time, all of the other people who had been on Ward 4 on my arrival had either gone home or had been moved to other wards for further attention, so I availed myself of the entertainment facilities for the last time, and found that - serendipitously and synchronistically - Radio 3 were playing my very favourite orchestral piece, Grieg's piano concerto. So I settled back and wallowed for a bit, before enjoying my last full meal (at least for the time being) at Manchester Royal; their very nice shepherd's pie.

The afternoon dragged with the ward now half-empty, and it wasn't until just after five - when the soup (not red) turned up - that anything of any interest happened. I knew that my lift would be arriving shortly, so offered the main course that I had ordered the day before as a precaution to an elderly gentleman who'd just been transported down from Blackpool. My brother and sister-in-law turned up, we thanked the nurses for all they had done for me, and it was off back home at the end of a long, strange trip which seemed to have had the optimum outcome, i.e., I'm still here, and supposedly getting better.

I got home around 7pm on a sunny evening and was greeted by the spiffy new paths that the Council's contractors had put in during my absence (Helo, hogia' Gelli! Diolch yn fawr - mae'n nhw'n edrych yn grand rŵan!) and to a far tidier front garden (thanks to the efforts of family members). I tried to take a nap but couldn't settle, so got up again and pottered around until about 2245, when I went to bed. I slept long and well for the first time in ages.

Since then? Well, I'm having better days and worse days. On the better days, I can go as far as the front gate without my grandmother's old walking stick (she was, 'ow-you-say, a shortarse, so if I have to lean on it I list at a perilously Lusitanian angle); on the worse days, I need the stick just to get to the kitchen with any confidence. The fatigue seems to be taking a long time to wear off, and still manifests itself in bright white objects (such as the concrete of the paths) glaring in my eyes as if illuminated by magnesium, or by an aching weakness in my neck and shoulders.

The problem is that I don't know whether I should still be feeling like this now, a week after getting home and over a fortnight after the operation. Dr. Dua did warn me - when I asked him over the pea soup about the time-scale for recovery - that it would likely be months before I felt anything like again, so I may simply have to be a patient patient and adjust my expectations accordingly. But it's very frustrating to be supposedly improving (and if Dr. Jenkins was happy enough with it to send me home, then that's good enough for me) yet be incapable even of some things I was able to do prior to the 'procedure'.

There will, of course, be a veritable carnival of GP and hospital appointments to attend (at Wrexham, I'm glad to say) to monitor and adjust accordingly, and goodness only knows when I'm going to be in any position to go back to work. But, as I said, I'm still here, and hoping.

Some thoughts to close on:

The people who work in the National Health Service form part of the bedrock of what is left of those progressive values which have not yet been throttled out of us by the unrelenting corporate takeover of our land in recent decades. They therefore deserve our unconditional support whenever they seek to defend the services that they provide for us.

The whole concept of a socialised medical system is surely the sign of a civilised society, and those who would seek to take it away from us for ideological reasons - using such weaseloid formulations as 'modernisation' and 'reform' - must be fought all the way. Oh, and Americans? For all your self-boosting rah-rah - be it Hillarious or Trumpery - why then do you allow yourselves to be scared into rejecting socialised medicine by the voodoo lobbyists for the insurance industry? Don't you know that the single largest cause of individual bankruptcy in your country is healthcare costs? Wouldn't you prefer to live in a land where people like yourselves are not reduced to the gutter because they have the misfortune to fall ill?

"People who need people...". And finally, on a personal note: perhaps the most important thing I have to take away from the events of the last few weeks is how the people in my life matter. I have guarded my independence for a long time, but it has been brought home to me that without others, I am largely helpless. I will try from now on to be here for them as they have been steadfastly here for me.

With all of that in mind, this piece and the three preceding it are therefore dedicated: