Tomorrow is my next scheduled sponge change. This will be the fourth change of sponge, and the surgeon is keen to take the opportunity to try a few things out.
For starters, he’s going to try the change with me awake but sedated, rather than under a general anaesthetic. He is however going to make sure that there is also an anaesthetist standing over me too, just in case it’s too painful to bear. So I’ll need to be nil by mouth for a while too. Currently it’s looking as though I’ll be going down to theatre sometime after lunch, so I’ll at least be able to have an early breakfast and some black coffee, but nothing at all after about 10am.
Of course, this means that we’ll play the usual game of “find the vein” in the operating theatre, as by the time I get down there I’ll be thoroughly dehydrated, but it’s the price we pay to have me in the safest possible state for the (possible use of) anaesthetics.
I have a feeling that being awake while they do this is going to (literally) expose me to a whole new level of dignity management issues. I’m always somewhat amused by how hard the NHS works to try to maintain people’s dignity while we are undergoing treatments that generally don’t leave you many options other than to cast your inhibitions aside. Of course, this is a really good thing, and I’m not for one moment deriding them for it. But from what I can imagine of tomorrows procedure I suspect it’s going to present some real challenges to anyone trying to “preserve my dignity”. It will be fascinating to see what they feel obliged try – I’ll let you know!
The other change is that the surgeon wants to start to reduce the size of the cavity, and feels that with the formation of granulation tissue, now might be the time to reduce the volume of sponges. Whether this is done by cutting the sponges down more, or considering a move from 2 sponges to only 1 again will depend very much on how I am currently healing.
He also wants to investigate how the cavity is closing up, and is trying to figure out a way to run a gastrografin test on me. That’s problematic because it can’t be run with the sponges in situ, so we need to either take the sponges out, move me to imaging for the test, and then put new ones in (difficult with the needs for sedation/anaesthetics) or do the gastrografin test in the theatre as part of the sponge change. Which is perfectly possible, but isn’t going to help with any dignity issues, and is going to add to the time that I potentially have to cope with only sedation to help me.
So, all in all, some interesting challenges ahead. I must admit to some serious misgivings about the sedation vs anaesthetics issue, but I have to assume the surgeon knows best and do what he recommends. However, I suspect I’ll be a lot happier when I’m looking at tomorrow from the other side of it 🙂
Edit: Corrected spelling of “gastrografin”.