Out of PACU and Home from surgery

Discharge from PACU came suddenly - after being delayed a day it was time to move on in the evening of 16 June.

The hospital was quiet, I was still  pretty drugged up and the journey, by silent hospital bed, expertly steered by porters through an unknown hospital geography and lift infrastructure into the dim night time ward was yet another slightly surreal experience.

6th floor - great views

And another temporary family of people to get to know, staff, students, patients.

Again, there were aspects of recovery that were just astounding but which make that bit in A Fistful of Dollars more believable - the beaten-up Clint Eastwood gets better and more accurate   before going out to gun down the baddies. When I arrived, I couldn't walk to the loo in the corner of the ward bay - maybe 10 metres away. Then I could creep on a nurse's arm, stooped over and trailing my drips and catheter bag. Then I could creep on Christopher's arm. But, attentive reader, I hear you cry, 'Why do you  need to go to the loo at all if you still have a urinary catheter?' Because dear reader, by this time, having gone through a period when I would have paid not to have wanted a poo, I had definitely arrived at the point where I would have paid to have one. Prune juice, plums and cherries had been brought in, litres of water were being drunk, to no avail. The world after opiate pain relief shrinks to one where bowels are all.

And on the afternoon of my first full day on the ward, my catheter was taken out anyway. While it isn't a pleasant thing to have, I had got used to it and was nervous about the process, entertaining unreal ideas about how it stayed in. They are actually retained by a balloon inflated around the tube inside the bladder, so all that's needed is to deflate the balloon after which the catheter (no other word I'm afraid) slithers out. Ikk. A rather more high tech business then followed - they want to make sure that you are able to empty your bladder. So the first time I  needed a wee after the removal,  I crept on the nurses's arm to the loo to wee in one of those cardboard bowls that looks like a hat and left it for her to measure the volume. In this case, the very competent and emotionally intelligent student nurse, then brought over a bladder ultrasound machine and did an ultrasound which did its own volume calculation to check there wasn't an unacceptable amount of wee left behind. All well, and I managed to creep on my own to the loo for a wee before sleeping that night.

Hospital nights are inimical to sleep - too many observations being taken, drugs being given, soft soled susurrations, quiet moans and  the farting that seems inevitable after abdominal surgery. I had my little digital radio and earplugs and listened to some odd stuff the first night. My first morning was a Sunday and relatively quiet with no ward rounds and no  London bustle or crane movements outside. I had a sentimental morning, doing some overdue crying for mum and feeling very glad that Maddy would be coming back to London for a while. Radio 4 gave me Auguries of Innocence and Sometimes I feel like a Motherless Child which just heaped it up.*

While very emotionally therapeutic, this couldn't go on,; I rather arbitrarily landed on  UK Gold while trying to do my leg and breathing exercises and found myself in the thrall of supine silent disco. Once started, there was no stopping - I did the exercises supine, sitting, standing by the window and eventually walking around the ward, increasing my distances and jigging about as I went, radio in dressing gown pocket.

On the second morning on the ward, I was standing at the window, silent discoing and watching the anty people at the top of Tottenham Court Road come and go about their business. In the  middle of Steve Harley doing 'Come up and see me make me smile' (which always creates a surge of my happy chemicals for some reason - this one too) someone drily commented that I looked ready to go home. This turned out to be the ward round consultant accompanied by his acolytes who had crept up behind me. 'Today?' I asked thinking this would be pushing it but worth trying on - 'Why not?' The principle established, there were still some hurdles that would take the rest of the day. 

The first one was for him to examine the surgery wound under its sticky dressing, sternum to pubic bone. (I have a picture of this but decline to publish.) My surgeon had said this dressing could come off on the day after the surgery, but there was no way I was going to do this until someone insisted - for a raft of reasons: what it might look like, that it would hurt like hell and might all fall apart, that I wanted as much as  possible holding my insides in , never mind the access it might create for all those hospital germs. But on that morning off it came, it did hurt but nothing fell out and it did all look quite neat, if you ignored all the crusty glued bits and the purple and yellow bruises. The consultant thought it was great, ordered a physiotherapy stairs test, a bundle of drugs to go home with and moved on. I did first ask him why I had found that I could  lie on my back in bed and stretch full length with my arms above my head but could hardly walk upright - he said this was how you gave yourself a hernia and to desist. Close shave.  

I passed the physio stairs test, had my remaining cannulas taken out and dressed, learnt how to inject myself with Fragmin anti-clotting agent (28 days of that to follow), ate some more hospital food with increasing appetite, took possession of more compression stockings, sticky socks, a sharps box and a discharge summary and finally got the real go-ahead to leave. This seemed like the moment to be really brave and have a shower, on my own, before getting dressed. But somehow, any urgency to leave had faded away during the afternoon. Friends had visited in the  morning, and by 4pm Luke was settled in by the bed watching a football game on his phone and exchanging commentary with the husband of the lady in the bed opposite who was watching it on his. 

This meant my shower was a fairly relaxed affair - despite only just managing to be upright and unable to move much or rub in any cleansing agent it was fantastic just to be in a stream of clean water - I didn't fall over but finally managed to have a poo!!!! Yay!!!! Going  home on a high!!!!

Coming out, I almost had to persuade the others to leave. Despite my great achievements in walking, showering and bowel movements, I had to be wheelchaired out by a porter - such a comfy wheelchair with red upholstery. Outside was balmy and breezy and the transport waiting area on that Monday afternoon in NW1 was almost paradisiacal. 

Thanks to UK Gold and silent disco I had made up the day lost due to lack of progress on the PACU and got out on 18 June. Home and back in the bosom of my family just in time to sink into the sofa for the England - Tunisia game.

The early days post surgery are a bit of a blur. I shaved the remaining wisps of hair off my head - it took three goes over three days before all the last hairs were spotted and scythed. I wore floaty dresses to avoid anything touching the scar, I submitted to Chris and Luke and friends putting my socks and compression stockings on for  me, I mostly didn't lift things that were heavier than a bag of sugar (and got told off if I did), when I coughed or laughed uncontrollably I ended up in excruciating red-faced tears, I used the long-arm grabber (a welcome present) to pick things up, I lay around a lot but also started on some forays out, making it to the allotment on 24 June where the sweet peas were magnificent, I considered the wisdom of being an old woman and wearing purple, I got my paint box out again, I practiced annotating the pictures on my phone, I soaked up the heat and prepared for the fourth chemo cycle.

*Input from a friend who's had a lot of surgery later suggested that all this was actually post-anaesthetic blues. It was still therapeutic.