It’s now Sunday, and I suspect a lot of people are wondering what has happened to me, and how I’m getting on.
The answer is that the operation went ahead as planned, though as usual I spent a lot longer in the operating theatre than expected; that started with the anaesthetist having a 30 minute battle to position the epidural in my spine, and my surgeon still reckons I then spent about 12 hours under anaesthetic after that. The good news is that everything went to plan, with my surgeon able to remove very little of my colon, giving me the best possible chance of a “good” colostomy outcome, and the flexibility to provide me with what we hope will be quite an unobtrusive siting of the actual stoma.
My urologist apparently spent a lot of time dissecting the remains of my left ureter, which was completely encased in scar tissue, and kinked at the point where it entered the bladder, causing the blockage problems. That kink has now been removed, and the ureter re-implanted into my bladder again.
The difficulties that dragged out the length of the operation seem to all revolve around the various tissues within my body cavity adhering to themselves after all my previous surgeries. This meant the surgeons had to dissect most of my innards before they could repair them all, adding greatly to the length of the operation.
At the end of the operation on Wednesday night I was moved straight to ITU, and don’t really remember very much of that experience; I do remember it being hot and noisy, and people coming and going, but that’s all. However, I was apparently still able to hold a perfectly lucid conversation on the telephone with my wife that I don’t remember taking place. Go figure.
Through the night I became more aware of the people around me, and the care that I was getting; the block from my epidural kept moving, so the nurses were constantly adjusting me and my medication to keep the block over my wounds, and monitoring my health. It turns out that this isn’t normal, and in the end on Thursday morning my epidural failed completely, which was not fun, as I went from total pain block to none fairly quickly. My anesthetist tried to restore the epidural, but that didn’t work, at which point it was then a case of getting the relevant replacement drugs (Tramadol and Paracetamol IV lines and a Morphine PCA) written up on my prescription and administered to me.
Because of the problems with stabilising my pain relief I was then kept over in ITU for an extra night, before finally being released to my room up in the private patients unit late on Friday afternoon. The shock for me was having to transfer from the ITU bed to a normal ward bed; they were only 6 feet apart, but it felt like a mile, and took me literally minutes to do.
Friday night I didn’t get much sleep – a combination of headache and sickness from the new cocktail of drugs I was receiving – so I wasn’t feeling on top form during Saturday. But visits from family helped with my spirits, and according to my consultant, apart from the problems with my pain relief, I was making very good progress indeed. Unfortunately that was countered when the first of my cannulas stopped working and had to be removed. This increased the strain on the other, which was nearing the end of its 3 day life anyway, so one of the specialist nurses installed a replacement cannula for the one that had to be removed. Unfortunately, this new cannula really didn’t seem to flow very well.
However, I still managed to get a really good night’s sleep on Saturday night, and for the first time managed to get out of bed on my own (well, perhaps with just a little help!) and into a chair where I could get washed, which felt like a small victory.
Unfortunately my other original cannula then also failed, closely followed by the poorly performing replacement cannula, so they both had to be removed, along with the now unused arterial line. This left me remarkably free of tubes, which was very liberating, but also problematic, as the nursing staff are not allowed to insert cannulas unless they have undertaken specialist training which most of them are still undertaking. Fortunately my consultant called in to see me at just the right moment and was able to oblige us by re-cannulating me!
Overall I am still making good progress, but need to start to ween myself off my IV lines, and in particular off the saline fluids that are maintaining my hydration, and start eating and drinking for myself. Getting off the IV drugs and onto oral equivalents will also help in terms of reduced side effects and a simpler drug regime (my veins flow so slowly that it takes an eternity to administer the drugs by IV).