The Operation

It was the 10th of April 2013 around lunchtime and I was getting admitted to hospital "B". I was shitting bricks, almost enough for a mansion. I was shown to my single room, the nurse call bell and TV remote were explained to me. Eventually a nurse came in to ask a couple of questions that she could not work out from all the info I take with me to hospital. She handed me a tube of chlorhexidine and told me to use half tonight when I shower and half tomorrow morning when I shower.

I was given a few sachets of picoprep  this is not as violent as Colon golytely but it still cleans you out. I had a visit from a friend and a nice long talk to a pastoral care person. we talked on many varied topics and she reassured me about the surgery. I had a shower and went to bed to sleep,I did not really sleep that night.

D Day.........

I was up and in the shower not really thinkinking that this would be the last shower I take in a fair while standing. I got dressed into a clean hospital gown, not sure if it is green with white stripes or white with green stripes. I got in bed which the nurse had made while I was showering and having a shave. I was wishing I have remember where I put my two hair lackeys :(.

Another pastoral care person came over and talked to me for a while, then Dr "X" came to let me know that after lunch (it was that time of day already) I would go down and he would set to work. Shortly after Dr "U" came and looked me over, checked my wrists and pulses (he needed to get an Arterial line in for blood pressure monitoring) he got me to lean my head all the way back as far as I could, then listened to my lungs, he was happy with everything and said he would see me down stairs. Shortly the theater orderly arrived to take me down, as they were getting everything ready the nurse realised that the TEDS (a brand of stockings worn to prevent Deep Vein Thrombosis) and the calf pumps, so she quickly (as quick as you can apply thigh high TEDS) put the TEDS on and left the calf pumps for someone else.

I was wheeled down to the theater holding bays. Here they checked my two name bands, what surgery I was due to have and that it was indeed my signature on the surgical consent form. A short time later, I was wheeled into theater. I was asked to hop off the ward bed and hop on the operating table. Once the calf pumps were fitted, Dr "U" inserted a temporary cannula and gave me something so I was relaxed. I was asked to sit up and dangle my legs over the side. they put a stool to support my feet, then gave me a pillow to bend over on.Dr "U" now inserted a epidural which was to be used post op to control the pain. I was then asked to swing around and lay down. a few more minutes went by and Dr "U" put me off to sleep.

The next I remember is being wheeled into ICU, where I was to stay for two days. The nurses were nice and I drifted in and out full consciousness, this was due to all the pain killers.Moving was very painful, I was being fed by a nasogastric tube, this is due to the fact that Dr "X" thinks we heal faster with food from day 1. I asked the nurse what had been done: the bladder was removed, the testes were removed, prostate was removed. I was thinking that is all of it great, but there was more: adhesions were removed, in removing the SPC wound tract they had to lipo the pubic mound to flatten it, remove 2.5Kg from the lower abdominal apron.. I was shocked, so much extra surgery.

I was eventually moved back to the ward, where I slowly progressed. around the 16th I started to get high fevers, they were not sure where they were coming from and CT'd my abdomen looking for leaks from the intestines, as I am allergic to contrast they could not really see much of a collection. they were treating the infections with just about every IV antibiotic that is not penicillin also an antifungal was used. as by thursday the 18th I had not had a decent bowel motion, they gave me a sachet of movicol. I have never had such a violent reaction as I had this night, I managed not to mess the bed, got to the loo and sat for probably 30 minutes till both legs fell asleep, then I moved to a big comfy chair with the help of my nurses. I rang for them to come back but it is night time and there are only three nurses and 32 patients. I messed the chair :(

I went to the loo but it was all over by now. the nurses showered me and cleaed the chair, I sat up till 8am. then I went back to bed. ready for a dressing change.

Friday the 19th of April 2013

 Dr "X"'s reg came and looked me over, he thought I was not looking the best but my vital signs were OK. The dressings were changed and I was sent down to radiology for a PIC line as my CVC line was blocking up. The Reg came down and thought I looked worse, but when radiology did my obs they were ok. The PIC was sited and another set of obs done still ok. I was wheeled back up to my room, where a nurse said I looked like death warmed up. The reg took as set of obs and I was crashing the Reg told the nurse to get GELO which is a fluid they use to boost blood pressure. It had not much effect. another 2 L was pushed in fast and then I was moved to ICU.

I was soon placed into theater for unexpected surgery. I awoke the morning still intubated, they then extubated me. a couple of nights later they did a vac dressing, this is dressing that has special foam in the wound (In this case my open midline,I had no idea they did not close up, this dressing and the moving of all the others was so painful that I was given entonox (nitrous oxide premixed with air) sometimes I was not breathing deeply enough and the nurse could see the pain I was in, so she would say " Imagine there is a brat coming out of your nether region" it worked, made me breathe more deeply. I was after 4 days transferred back to the ward.

On the Ward Dr "V" who had helped Dr "X" with the surgery on the 19th suggested I be moved to Hospital "C" as they have a ward for Intestinal Failure. He said in his opinion I would be there for 6 month. I was just kept stable at hospital "B" while we waited for a bed at hospital "C" One Finally came up on the 27th of April.

Due to the amount of pumps I had, they had to use the bariatric ambulance, it has a larger stretcher and more space inside.the stretched was winched into the ambulance and while it was a sounder was going off to let people know that the winch was in operation :( everyone in the main entrance was looking and all the rooms over looking the entrance were looking . :(

I finally arrived at hospital "C"............

The History of the Saga up toThe Day before Surgery:)

First off a warning or two ;).

#1 Something's may be graphic in the text, I am trying what happens, this is as much a tool to let others know how I am going as a means to help me cope with this.

#2 I am an Electronics Engineer, Not an ENGLISH TEACHER, so there will be wrongly used words, spelling mistakes and incorrect grammar. I am trying my best, which is hard with all the drugs I am on.

 

The Background:

So in 1994 I had an accident which resulted in me falling in a safety harness. In ~2001 I was in hospital with Kidney pain. they found out at that as I had lost feeling in my bladder the Kidneys were suffering from reflux (the urine was not flowing into the bladder as it was already FULL and I did not realise. This causes damage to the Kidneys. So to stop this damage they put a urethral catheter in.

After a couple of years of Urethral catheter changes, some doctors ram catheters in which in me created a false passage ( a false passage is a second pathway for the catheter to travel down which does not lead to the bladder) in my case the false passage was as long from the point it split from the urethra as it was to the neck of the bladder. So with the problem it took the continence nurses at hospital "A" up to an hour to change each catheter, with a fair amount of pain. So the nurses managed to convince the Urology Dr's to swap to a Supra Pubic Catheter, this is a catheter that goes into the bladder via the abdomen right above the pubic bone.

The Supra Pubic Catheter (SPC) worked well for just under 9 years, then it started to irritate the bladder, I would keep wetting myself (I was wearing matrices between my legs just to keep dry), have massive spasms, sometimes my urine would turn very red (indicating blood) and the poor nurses in the community who were  changing it were having problems, either my bladder would spasm so much they had trouble getting the catheter back in and staying in while they filled the balloon, or I was in so much pain as they tried to remove the old one that they were near the point in their protocol that they had to stop and send me to hospital.

So in March 2012 when the pain during the day be came so strong that I had to stop working I asked my GP to refer me to a Dr "Z" who visits Hospital "D" thinking that anything that needs to be done can be done there and it will all be close for friends and family.

Dr "Z" Recommended to remove my bladder and make an Iliac Conduit for a Urostomy. When he said this I wanted time to consider this surgery, research etc. One or Two of my good friends discussed things with me over Facebook and in real life, It turned out a good friend on Facebook has had this procedure done overseas where they live about 30 years ago and say it was the best thing they had ever had done.

So I went back to Dr "Z" and said with zeal lets do it :). He informed me it could not be done at hospital "D" as they do not have big enough operating theatre rooms, if I need ICU there are none there, it would have to be done privately at a cost of $35K or It could be done at hospital "A", so Dr "Z" sent off a referral for an urgent appointment.

I attended hospital "A" and met with Dr "Y". I explained the situation, he laughed it off and said I needed to intermittent self catheterise, although this would not work if I produced over 7 L of urine in a day (which some days I do) but he still wanted me to do this...... I was after lowering the risk of UTI's not increase them. As I work on construction sites, some of the workers cab bit hit the toilet bowel, some when wiping the back side get a small bit of faecal matter on their fingers and smear it on the wall, the partitions in the portable toilet blocks are not full height.... This was not a good idea.

I went back to Dr "Z" who referred me on to Dr "X". Dr "X" listened to my concerns, and came to the same conclusion as Dr "Z". So Dr "X" referred me back to Hospital "A" but this time to Dr  "W" who apparently has done a few of these procedures in the past. He looked at the test results that Dr "X" had ordered, and said that he did not believe them and that he wanted to repeat them again. I informed Dr "W" that I was nearly out of savings, if things did not happen soon I would have no money, which would mean I would be bankrupt, which would then make me unable to hold a Security Agents, Installers and Consultants license. When I said this he replied that it was not his problem. I told him that this work was my life and that without it I would have not life no happiness so I would kill myself, he replied "That would be unfortunate!!!" I ran from the room back to my van, I punched my seat hard for a few minutes to try and calm down, all I really did was bruise my fists.

I went back to Dr "X" who was more than happy to do the Surgery on a date after my medical insurance would cover it. My Medical insurance said it was a pre existing condition as I had a catheter when I joined on the 23 March 2012. I asked them If I broke an arm while in the pre existing lockout period if they would cover it as I had two arms when I joined ;) they could not answer. We agreed that the surgery would involve the removal of the bladder, prostate and testis, the creation of a Iliac Conduit to drain the urine from the ureters to the outside world (where a pouch would cover it to hold the urine till I empty the bag.

Some months later a date was set for the 10th of April 2013. This would be a day for cleaning out my intestines ready for surgery on the 11th.