Operations – The Accident – Part 7

Friday 5th December

Having received a call from the orthepedic doctor the day before, I arrived at the Theatre Admissions Unit at 10am.

Two other guys were already sat in the large waiting area. By the look of them they were either in for a knee or hip operation. On the wall opposite the large reception desk there was a chart from which I worked out that there were two more patients probably already undergoing operations. I deduced this because of the numbering system – each set of two chairs had a number above it and I was number five and the other two guys were sitting in seats three and four.

I was given three pre-med tablets and informed I’d be going into theatre about 2pm, so only four hours to wait. In the meantime I had a nurse come see me to do a questionaire – all the usual questions I was getting so used to by now. But additionally she drew two large arrows in black marker pen: One pointing up the right arm from the wrist and one pointing down from the shoulder and just to be perfectly clear to the surgeons the word “elbow” on the upper arm.

Time was pretty spot-on and I was collected about 2:10pm and wheeled down to theatre number 14. There’s a kind of ante-chamber where they prep you including administering the anesthetic. I chatted to the nurse while she popped in the canula and took my blood pressure and heart rate. It turned out her boyfriend, who also worked at the hospital, as a doctor, was also a keen cyclist and I’ve since “followed” him on Strava. The surgeon came though to explain that he’d be carrying out a washout and debridement of the wound and also confirmed the MRI scan had shown the bone to be infected, so he’d be scraping/removing the infected parts of the bone.

Once I was given the anesthetic I was conscious for  a few seconds before I felt a cold sensation reach my upper arm and then I was out. Next thing I remember is being wheeled back to a ward. I now had a plaster cast. It didn’t completely encircle my arm except at the bottom by the wrist and it stopped just short of my armpit. The reason for the cast was to keep the elbow immobile to ensure the stitches didn’t split as the skin over the elbow is very thin.

All I wanted to do was sleep, so I don’t recall much until next morning.

Saturday 6th December

Woke to find my right wrist was throbbing and it looked swollen as did my hand. Also, the cast around the wrist was pressing into it and causing quite a bit of pain. But as I was under the impression I would be having another operation later in the day I thought I’d be able to put up with it. However it was getting worse so I asked the nurses if they could cut the cast around the wrist to relieve the pressure and pain. Unfortunately, they said they weren’t allowed to do this.

Later on I took a walk down to the hospital shop and on my return met one of the doctors involved in the operation. He asked me how I was and I explained about my wrist. As a result he had a word with the nurses and another doctor came along, cut the cast and relieved the pressure – bliss. The pain had been worse than that caused by the operation. It turns out that I wasn’t scheduled for another washout and debridement until the next day, so I would have had to put up with the wrist pain until Sunday so I’m glad I bumped into that doctor when I did.

Sunday 7th December

In the morning a doctor I’d not seen before came to inform me I’d be having another washout and debridement today and a few hours later I was wheeled into theatre again.

The canula was still in from the previous operation so at least I didn’t need another one inserting (all good, as I’m not a fan of needles) but after my blood pressure and heart rate readings had been taken the anaesthetist explained that 52BPM was too slow a heart rate and he’d give me something to up it a bit.

The surgeon came in and during the discussion I overheard that the first operation had taken an hour and a quarter and he expected to take about half-an-hour. I remember thinking I hope they give me enough general anaesthetic to keep me under long enough, but thinking about it I assume they have ways of keeping patients under for longer if need be. Oh, as an aside, the wound wasn’t sutured after the first operation, so the surgeon doing the second one didn’t have to reopen the wound.

All I had to do now was stay on the ward until Thursday when the head of orthaepedics would pay a visit to assess my progress. In the meantime, I got moved to a single room, which was a lot more comfortable as the room temperature was much lower.

During my stay I had the usual painkillers, Codeine Phosphate, Paracetamol and Ibuprofen although I tended to skip the Codeine as it has a tendency to bung me up. However, they were also giving me a daily injection to prevent thrombosis from laying in bed all day. This was particularly unpleasant as the injection is in the stomach area and as an indication of it’s effect they have to inject either side of the stomach on alternate days to avoid side effects whatever they might be. Although I can say that about half-an-hour after the injection the area became tender and quite sore.

Thursday 11th December

About 11am the head of orthaepedics paid a visit, only the second time since 22nd October, that I’d seen her and after a short discussion with her registrar they decided to put me on Rifamycin, starting that day, as well as Clindamycin which I was already taking, for the next 4-6 weeks. In addition, they were going to use an advanced wound management dressing called a Pico. This works by applying what’s called negative pressure, basically it’s a pump that’s attached to the dressing and sucks out the air, creating a vacuum.

Pico dressing

Pico dressing

I was told the dressing would last about a week and I’d probably need it on for two weeks, although apparently they may only last three/four days, so may be a total of four would be needed. I learnt later they cost £120 each, so not far short of £500, worst case scenario. Also, I’d need to come back on the Monday for the wound to be reviewed, and they’d make an appointment for me.

Unfortunately, it transpired that they didn’t have any in stock that were the right size, so I’d be in for at least another day.

Friday 12th December

About 12 noon I heard the nurses outside my room discussing who would be applying the Pico dressing. Now, bearing in mind I wanted to be sure the dressing would create a successful vacuum otherwise that £120 spent would be a complete waste of time and money, so it was more than a little disconcerting to hear them say that one of them would go down to another ward where someone could explain to them how it should be applied.

Anyway, about half an hour later a nurse came in to apply the dressing whereupon I said, “with no disrespect have you done one of these before, because I heard what was discussed earlier outside my room.” She looked a bit sheepish, but said she’d spoken to someone who’d explained what needed to be done and she’d seen one applied before so she knew what she was doing.

I have to say I was a bit sceptical, but as it turned out she did a very neat job and it worked perfectly.

Now all I was waiting for was the Rifamycin and Clindamycin antibiotics. So I took a walk down to my old ward and had a chat with some of them to pass the time. I remember saying to Tim that my stomach was feeling a bit iffy but it didn’t occur to me that may be it was the new antibiotic.

Eventually, about 4pm a nurse brought my prescription – two carrier bags full of pills! In fairness, one was what I’d call a half-size carrier bag, but still. The nurse apologised for it taking so long but apparently they’d virtually cleared out the pharmacy to give me 35 days supply. Very decent of them because the cost of prescriptions over the weeks had got very expensive, so I didn’t mind the wait. And with that I went off to call a taxi. So looking forward to getting home.

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