While I’m Away…

I’m off to Nottingham tomorrow for another surgical review.  I last saw the surgeon in June, just 12 days after the 4-hour operation on my head. He was pleased with my progress at that stage and asked me to return again a month later. I never got to that appointment thanks to the development of an unforeseen complication. Before consenting to surgery, I was warned of the dangers of the operation. Osteomyelitis was not on that list but it sure is now! I hope to have more news to share with you when I get back.

I have something for you to ponder on while I’m away. While undergoing prolonged treatment in hospital for the osteomyelitis, it was very noticeable how few Irish nurses were working in the system. It was a large teaching hospital with the usual cohort of trainee nurses on the wards but there were very few fully trained Irish nurses to be seen. The majority of the nurses were recruited from overseas, from the Philippines and India. These nurses were highly trained and  professional except in one regard. While working on the wards, they had a tendency to speak to one another in their native tongue. As a patient, I found this disconcerting as it excluded me from discussions concerning my own care. I wondered if there was a hospital policy requiring staff to speak in English only, while on duty. Do you have any views on this?

Tie a Yellow Ribbon

I’m coming home. I’ve done my time. Now I’ve got to know what is and isn’t mine. It’s been three long years six long days in the UK. I’m ready for home.

I was discharged from the hospital on Saturday and have spent the last few days resting-up at a friend’s house near Birmingham, in preparation for the flight home. It’s been bliss to be able to recuperate in peace and quiet without the constant disruptions of hospital life. My post-operative path has been more rocky than anticipated but the surgeon is now happy for me to fly this evening. Things have already begun to improve following a change in medication so I’m confident all will be well. I return to Notts next Monday for follow-up.

Thanks for all comments and well wishes. I will catch-up with you all once things settle down a bit. So much has happened, its gonna be hard to know where to start. See you on the other side of the pond.

It’s A Beautiful Day

It’s 7am Friday and barely 16 hours since I came out of the operating theatre. I’m still on hourly checks in an observation room with drips attached to my hand and foot, a morphine pump and an oxygen mask. Otherwise, I’m in remarkably good form. Best news of all is that the surgery went really well yesterday, the surgeon is happy with his handiwork and I’ve had no post-op complications. Today marks a new me and there’ll be no stopping me now.

Yesterday’s surgery took longer than expected, four hours to be exact. No cutting this time, just lot of drilling with the removal of diseased bone.  It was all done endoscopically through my nose by image-guided surgery. I spent two hours in the recovery room afterwards before being transferred back to the unit. The pain is well controlled by a morphine pump which I can dispense as needed. My surgeon has been fantastic, totally determined to get the best result and amazingly attentive and caring.

The NHS has scored 1/10 on nursing care (more anon).

Hubby 12/10!

More to follow.

Check ‘N Go

I’ve booked so many flights over the last few days, I really don’t know whether I’m coming or going. I seem to have multiple trips to Nottingham booked and also a return ticket to London for Wimbledon but I’ve a little hurdle to get over between now and the tennis.  I’ve got a date (not THAT sort of date, Grannymar) and I’ve got funding too.

It’s been some week.  Since hearing of the date for my surgery in Nottingham, I’ve been struggling to get funding organised for the operation. When you require treatment outside Ireland, my health insurance company stipulates that you must gain prior approval for funding. There is a long list of criteria to be met and even though I hold comprehensive insurance, funding is automatically refused if surgery proceeds without prior approval. As very short notice was given for my surgery, an urgent application was submitted for approval and we waited with baited breath all week. Thankfully, the green light was given on Friday so now my surgery can proceed.

I travel to Nottingham early tomorrow for admission to a specialist unit at the hospital where I will be prepared for image-guided surgery on my head the following day.  A recent CT scan has revealed further osteomyelitic changes in the bone above and behind my right eye. This diseased bone is in close proximity to the frontal lobe of my brain hence complex surgery is required. Years of severe sinus infections with abscess formation have left the area well-scarred.  All being well, the endoscopic surgery should be completed in 2-3 hours and I hope  to be able to return to Ireland by early next week.  That’s when the fun really starts.

Surgery for chronic osteomyelitis involves detailed follow-up. Long-term antibiotic treatment is required and I will also have a drain exiting near my eye for several weeks post-op. This drain will be used to irrigate the operated area daily with targeted drugs.  I will be taught how to carry out this procedure myself while in hospital so that treatment can be continued at home. I will then return to Nottingham again for review and to have the drain removed.

When I first heard of the date for surgery, my heart fell as I have two tickets for a day at Wimbledon. I entered my name into the public ballot last autumn and hit lucky by getting two tickets for Court No 1.  This was like a dream come true so I didn’t hesitate in purchasing them along with flights to London.  News of my surgery initially dashed these plans but I haven’t quite given up hope yet.

My review in Nottingham happens to be on the day before I was due to travel to London to attend Wimbledon. I will fly to Nottingham for the check-up and overnight there before returning to Dublin.  However, I have a second plan up my sleeve which if it works out, will be a real coup. If I feel well enough after my check-up, I plan to travel on to London by train to overnight with my twin brother who will accompany me to Wimbledon the following day. I’ll then spend a second night in London before returning home on the flight I originally booked many months ago.  This probably all sounds a bit daft right now but it’s where I have my sights set. If I do make it to Wimbledon, it’ll be the best tonic ever.

My long suffering hubby will be with me in Nottingham and so I hope to have occasional access to his laptop while in hospital. I will do my best to update you on my progress and promise not to scare you with any gorey details. I would really welcome comments and while I may not always get to answer them, I would still love to hear from you.  On that note, it’s time for me to Check ‘N Go and get organised for tomorrow. I’ll be back soon!

Got the Call

Our phone has not stopped ringing since last Friday and emails and texts are arriving by the minute. It seems that everyone who ever knew and loved my dear mum-in-law, wants to attend her funeral service next Saturday. As many people will be travelling by air, they are making a weekend of it and so it’s rapidly turning into a 3-day event. It’s gonna be a busy weekend. What was that I heard about getting rest?

It’s a bank holiday here today so the hubby and I set-off on an early morning walk to clear our minds. Our peace and quiet was soon disturbed by the sound of my mobile phone ringing. It was Nottingham letting me know that my operation had been scheduled for Friday. Help! I pleaded exceptional circumstances in light of the funeral on Saturday and managed to get the surgery postponed to the following week. The date has yet to be confirmed.

Frankly, this is one call I could have done without today. As Nancy says, it never rains but it pours around here! You’ve gotta laugh.

You’ll be alright, duck!

Riding through Sherwood Forest on the bus yesterday, I sat in silence. My daughter had kindly accompanied me for the day but as the bus hurtled back towards Nottingham city centre,  I didn’t feel like chatting. My mind was still trying to come to terms with the news I’d just heard. I have to return for more surgery again. The adventures of Robin Hood Steph continue.

My return to see the head and neck specialist in the UK was arranged by my surgeon in Ireland. More expert advice is needed to manage the recurrent infections in my head. I was previously referred to the same specialist two years ago for major surgery to stamp out a chronic osteomyelitis in the frontal bone of my head. This operation was very successful but over the last year, I’ve had intense bouts of pain in the bone around my right eye and repeated infections which antibiotics have failed to control.

When the specialist looked at my CT scan yesterday, the cause of the pain soon became apparent. An abnormal pocket has developed in the bone deep behind my eye and close to the brain. The thickened bone has split causing an abscess to form. Complex surgery is required to take away the infected bone and relieve the pressure behind my eye. Unfortunately, this will require image guided surgery and means a referral to yet another surgeon in the same specialist unit. I will have to return to Nottingham again shortly to meet with the new surgeon and have specialized scans in advance of surgery.

This outcome is not at all what I’d anticipated. I had hoped that the recent scan might offer some welcome reassurance but it was not to be. I’m still reeling today from the news and not helped by a nasty head cold which has left my ears blocked following the flights. The good news is that I’m in fantastic hands so no worries there. The surgeons are the tops, I couldn’t hope for better. The impending surgery while complex, is minor compared to the some of the stuff I’ve been through. As they say in Nottingham, “You’ll be alright, duck!”

Image source: Camera phone en route to appointment.

Still Here

In May 2005, Emma Hannigan found out that she was carrying an inherited gene that predisposed her to cancer. This gene, known as BRCA1, meant that Emma had an 85% chance of developing breast cancer and a 50% chance of developing ovarian cancer.  Emma (32) and with two young children, decided to change her destiny by undergoing extensive preventative surgery. She opted to have a double prophylactic mastectomy (removal of both breasts) and also a bilateral prophylactic oophorectomy (removal of both ovaries) with removal of both fallopian tubes. The surgery reduced Emma’s risk of developing cancer to 5% but it was a gruelling year. There wasn’t just the pain to cope with, there were also the body changes, the loss of fertility and an early menopause. Emma subsequently underwent breast reconstruction but sadly, went on to develop breast cancer under her arm and in her neck. She has recently finished undergoing chemotherapy for a second recurrence. Emma has been through a great deal but as she says herself  “I’m STILL HERE”.

I’ve just finished reading Emma’s debut novel Designer Genes (Poolbeg) which is based on her own life story although the characters in it are fictional. The bookshop Hughes & Hughes made it book of the month for April and are giving €1 for every book sold to St. Vincent’s Cancer Research Trust.

Emma told her story on The Tubridy Show and I was completely bowled over by it. Her battle for survival is remarkable in itself but it was the combination of her humour and resilience in the face of adversity, which really caught my attention. Strange as it may seem, there’s an awful lot of humour in sickness.

You can listen to Emma’s interview with Ryan Tubridy here (fast forward 7 mins).

For information on cancer visit www.cancer.ie or call The Action Breast Cancer Helpline on 1800 30 90 40.

Preparation for Surgery

Here’s another excerpt from my little book of Home Nursing.  It details the preparation of the patient for surgery…

“On the day before the operation the nurse should ask the surgeon how he wishes the patient to be prepared. If no specific instructions are given the patient should if possible be kept quiet the previous day: he should take only light food, have a warm bath and an aperient in the evening. On the day of the operation he may, if the operation is not to be performed too early, and with the surgeon’s permission, have a light breakfast of tea, with toast and butter, and, three hours before the operation, a cup of tea or bovril.

His preparation begins with a simple enema first thing in the morning. Then he may have a warm bath or be well sponged down.  The area of the operation must now be sterilized by shaving and then cleansing thoroughly with either soap or spirit soap, which must be washed off with hot water; the skin must again be washed with hot biniodide of mercury solution, and covered with a compress of lint or gauze wrung out of the same solution: or, after drying, the skin may be painted over with mild tincture of iodine, allowed to dry and covered with a dry sterile towel.

Before the operation artificial teeth, hair-pins, jewellery, etc., must be removed, and if the hair is long in a woman it should be plaited in two plaits tied at the ends. The patient must put on warm flannel clothes which can be removed easily, and long woollen stockings.”

Now that’s what you call pre-operative care. These days, patients are admitted to hospital on the day of surgery and the pre-op preparation is left almost entirely to the patient. I can remember once getting it completely wrong and I paid the price.

I had a young baby at the time and instead of resting the day before my surgery, I rushed around putting preparations in place for during my absence. The following moring I insisted on getting myself to the hospital so that my husband could stay at home to look after our baby. Having fasted from the night before, I travelled by train to the hospital and arrived feeling totally parched and exhausted. I had a particularly difficult post-operative recovery from the anaesthetic on that occasion and it taught me a lesson. In today’s world of conveyor belt medicine, it’s really important to rest the day before surgery so as to optimise your powers of recovery. Allow yourself to be pampered!

UPDATE: I’ve just spotted this letter to the Irish Times from a Consultant in Emergency Medicine, which fits in nicely with the ‘ patient care’ theme of this post.

“And the Minister should focus on the universal need for a familiar smiling face. Let us have carers who have the time to care and the moral support of a loved one in our hour of need. Health economists may have factored these basics out in their many dubious prescriptions, but Mother Nature has not”.

Thank God

A man suffered a heart attack and had open heart surgery. He was awakened from the surgery to find himself in the care of nuns at the hospital.  As he was recovering, a nun asked about how he was going to pay for his care.  He was asked if he had health insurance.

He replied in a raspy voice, “No health insurance”.

Then he was asked if he had money in the bank.

“No money in the bank”.

Finally, “Do you have a relative who could help you?”

He said, “I have only a spinster sister who is a nun”.

The nun got a little perturbed and announced “Nuns are not spinsters! Nuns are married to God”.

The patient replied, “Well then, send the bill to my brother-in-law”.

Life-Saving Surgery

A young woman with purple hair styled into a punk rocker Mohawk and sporting a variety of tattoos, arrived in the A&E department.

It was quickly determined that the patient had acute appendicitis, so she was scheduled for immediate surgery.

When she was on the operating table, the staff noticed that her pubic hair had been dyed green, and above it was a tattoo that read, ‘Keep off the grass’.

Once the surgery was completed, the surgeon wrote a short note on the patient’s dressing, which said, ‘Sorry, had to mow the lawn’.

On a more serious note…

The Brain Doctors is scheduled for tomorrow night. This is a fascinating, no-holds barred glimpse into the world of neurosurgery.

SUPERDOCS  Monday  2 Feb  BBC1 NI @ 9pm