So on Wednesday I went back into hospital to be added onto the end of my consultants afternoon surgical list. Personally I always used to prefer surgery in the morning, as it gives you less time to hang around worrying on an empty stomach, but I’ve now reached that point where I don’t really worry about surgery any more, and I need to lose a few Kg, so the afternoon worked just fine. I got into hospital around 2pm, and saw my consultant and a new anesthetist, and then waited for my turn to be wheeled down to theatre, which happened around 5pm.
A few minutes to be cannulated (these anesthetists are masters at fitting a cannula), then the usual dance with fentanol and propofol, and apparently only moments later I was in the recovery suite.
The procedure apparently went really well, with my consultant irrigating the wound cavity and using suction to ensure that it was completely empty, prior to installing a corrugated drain. This is (as it sounds) a corrugated piece of plastic that is sewn into the wound tract to ensure that the wound remains open, and directs any discharge down the corrugations in the plastic where it can flow out of the body. Apparently these are extremely effective, but the problem is that there is no way to attach any kind of collection container, so I’ve got to wear disposable pads etc to collect any discharge. Since it’s in the wound where my anus used to be, it makes sitting down somewhat uncomfortable too. All in all, not terribly pleasant from my perspective, but hopefully something that I won’t have to put up with for very long.
I was put back on broad spectrum antibiotics again, though interestingly my pain relief was allowed to continue to reduce, dropping my Ibuprofen from the mix. Fundamentally I’m now on only a maximum dose of paracetamol (1000mg four times a day) only a fortnight after major surgery, though I do have access to some tramadol if I really need it. I find it amazing that the drug you see many people taking for colds and headaches is exactly the same as I’m taking to cope with major surgery.
Because of the timing of the procedure, I was then kept in hospital overnight. This turned out to be convenient, because on Thursday morning I was due to have a (non-voiding) cystogram in the hospital anyway, so I was just wheeled down from my ward, rather than having to trek in from home. In my case the test was essentially a “pressure test” of my bladder, to ensure that there were no leaks where they had re-implanted my left ureter. If there were any signs of a leak then I would need to remain catheterised for another couple of weeks to allow more healing to take place, which would have been a real pain – literally. Those things are not nice long term.
Fortunately, the cystogram showed no signs of any problems (big thanks to my urologist, who obviously did a fine job of sewing the ureter in place) so I was given the go-ahead to have my catheter removed. My consultant also ordered the removal of all my surgical staples (or “clips”) from my major wound tracts too.
Removing the staples sounds horrendous, but is actually almost completely painless. Removing the catheter was not. After 2 weeks in place it was not easy to remove, but there is nothing to be done apart from letting the nurse just pull it out. Breath-taking doesn’t really do the experience justice. Jolly painful is nearer the mark. But having said that, it was getting extremely uncomfortable anyway, so a few minutes pain to be free of thing is a good compromise – especially in retrospect!
And with that, I was considered good to go, subject to being able to pass water normally again. The reason for this is that there are selection of “interesting” problems that can arise after being catheterised, so the hospital are not keen to let anyone out without having demonstrated basic functionality. The trouble with this is that you’re (obviously) starting from nothing, so I had to spend much of the afternoon drinking tea and water just to be able to pass the exit criteria. You’d laugh if it weren’t actually quite serious!
So in the end, I was discharged early on Thursday evening with another bag of medicine and dressings. Home again!