The Longest Night…


(How I felt on the first night after surgery…)

Stabbing, pulsating pain.
I open my eyes.
It takes me a moment to remember where I am and why. I press the PCA button in my hand and release the morphine. It feels cold as it travels through my wrist vein and up my arm. I retch a couple of times as it makes me feel woozy. Then it settles.
It’s the middle of the night. I must have only been asleep for an hour or so. 
My mouth is so intensely dry. I need to drink water. I adjust the bed, pull my table round with my right arm and pour myself some water. My whole arm shakes as I tip the jug. I become aware as I drink, of a huge mouth ulcer on the inside of my top lip. I must have bitten it under the anaesthetic. 
I can hear the young girl in the bed next to me whimpering and intermittently retching. She seems to have pressed the call button as the night nurse comes in and goes to her. 
‘I’m sorry I can’t give you anymore pain relief. Just keep pressing your PCA.’
She sounds genuinely sympathetic, but the young girl is now sobbing and crying out with pain.
‘Let me see if I can adjust your position. Perhaps that might help…’
I’m so dehydrated. I drink the whole jug of water and as the nurse walks past I ask her for some more.
She returns with a fresh jug and also a plastic cup containing a white fizzy drink.
‘It’s potassium. Your levels are a bit low. It’s not very nice but it’s important that you drink it all.’
She hands me the cup and I gulp the fizzy, salty liquid. It’s not as bad as I expect but I quickly drink a glass of water afterwards to take the bitterness away. 
‘Do you need the toilet?’
I shake my head.
‘Ok. Well, we’ll just keep an eye on that side of things. If you haven’t passed urine by about 5am we’ll need to think about a catheter. We’ve got to support your kidneys…’
Panic comes over me. I do not want a catheter. I immediately drink more water in the hope that it will wake my bladder up. 
My side is throbbing again. I can feel so many different kinds of pain in so many different places. There is the throbbing pain inside my chest which is deep and pulsating. The sharp pain round my top incision which is stinging and fiery. By far the worst though is the pain from the new chest drain wound. It’s both dull and achy and sharp and stabbing at the same time. It also spasms intermittently and feels, I imagine, like a kitchen knife in the chest.
I try to press my PCA again but realise I’m thirty seconds too early. I can only press it once every five minutes. 
It’s incredible how long five minutes can last.
The faceless man from behind the curtain has woken up now too. He starts shouting for the nurse. 
The same nurse who has been looking after me and the young girl rushes in with another male nurse. There is some kind of commotion and I hear the male nurse say he’s going to fetch the doctor. 
The faceless man is crying now and wailing incoherently. 
I feel afraid. 
I’m attached to so many bleeping machines. I have tubes travelling into my side, my left arm and wrist. There are suckers all over my chest. Drugs are coursing through my veins. I have two new swollen, bloody surgical wounds in my side and one has a chest drain sewn into it.
I am so utterly dependent on the medical staff for everything. I’m as helpless as a new born baby. 
Around me these two others are in a similar or possibly worse state than me. 
We are three grown up new born babies relying on the night nurse to care for us.
I’m so relived when the doctor comes in to attend to the faceless man.
Presently he stops screaming. Somehow between the three of them the doctor and two nurses have managed to calm him and ease his suffering.
I feel very emotional. Perhaps it’s all the drugs in my system and the intense pain or maybe it’s just the whole experience… The whole two and a half week nightmare. 
I start to well up.
I wonder how long I will feel this bad for? How long will everything hurt like this? Will I ever feel like my old self again?
It seems so surreal that as little as three weeks ago I was happily going about my daily life with no idea of what was about to happen inside my body.
There is a packet of wet wipes on my table. I take one from the packet and rub it roughly over my face. The coldness is soothing and I try to calm down. Crying hurts so much. I tell myself I must stop it.
I close my eyes for a while, but don’t sleep. 
This night seems to be lasting forever. Time has never moved so slowly. Each five minute gap in between morphine shots feels like an eternity…
‘Can I try you on the commode?’
I open my eyes. The nurse has wheeled a commode in next to my bed.
‘We really need to get those kidneys going…’
I try to lift myself up and realise I can’t. My arms and thighs begin to shake violently when I try to bear weight on them. I can’t manoeuvre my body up at all.
‘Here, let me help you…’
The nurse adjusts my bed to it’s lowest position, then helps me swing my legs round to the side. The commode is as close as it can possibly be next to the bed and somehow with the nurse’s help I manage to clamber onto it.
‘Ok I’ll leave you. Just do your best…’
The nurse pulls my curtain round then leaves me sitting on the commode.
I almost feel like laughing. The loss of dignity has reached new depths…
I try to urinate and encounter the most bizarre feeling. I feel my bladder is full. I feel I need to go but I cannot engage the right muscles. I cannot find the right command in my brain. It’s as though I’m numb from the waist down. It’s so strange. I suppose I’ve always assumed if a person lost control of their bladder muscles then they would immediately wet themselves but I seem to be having the opposite problem…
‘Any joy?’
I say unfortunately no…
‘Ok I’ll give you another five mins or so. If not we’ll need to go down the catheter route..’
The threat of the impending catheter makes me determined to urinate on my own no matter how long I have to sit on this commode.
Eventually after another few minutes or so, I feel a warm trickle of urine come out of my body. I’m so relived. I actually call out to the nurse to tell her….
I smile wryly to myself. I never knew urinating could feel like such a massive achievement…
The nurse takes the commode away and helps me back into bed. 
‘Make sure you drink plenty of water. Your urine was very dark. You need to cleanse your kidneys. They’re trying to rid your body of the anaesthetic…’
About half an hour later after drinking another jug of water I need to use the commode again and this time it comes slightly easier.
‘Well done. Much clearer. Those kidneys are doing a great job…’
The night nurse has been fantastic. What a job she has. She’s genuinely been one of the best members of staff I’ve met in my whole two and a half week stay so far…
It’s light now and the night nurse gives me and the young girl our bed baths, before helping us to sit in our chairs, ready for the doctors to come and assess us on their morning rounds.
The staff change over and a new nurse brings me a cup of tea and some Vaseline for my lips which have started to peel in the night.
For the first time I get a proper look at the girl next to me. She’s so thin and very small. She looks about eighteen. I ask her what’s she’s in for?
‘Lung resection and pleurectomy. I’ve had pneumonia twice and my lung has collapsed five times…’
I find out that the surgeon had tried to perform minimally invasive surgery on her but had been forced to convert to open surgery during the procedure. She’s been in hospital more than ten times with her lungs and she’s only twenty years old…
The morning doctors assess the faceless man first and decide he needs to stay in HDU for now. The young girl is also told she is not ready to be returned to the ward. I am expecting the same.
I feel horrendous. The worst I’ve ever felt in my life…
‘Vitals are good. No air leak at all. Oxygen levels are spot on…
I am amazed. 
‘All looking good. I think you’re ready to go back to the ward…’
I can’t quite believe it. 
Almost immediately after the doctors leave a porter arrives to transfer me back upstairs. 
‘That was quick dear!’ Gloria says as I’m wheeled back to my old bed.
‘We didn’t expect you until at least tomorrow…’
A nursing assistant who I’ve not met before comes in to attach my chest drain to the suction machine.
Unlike the Royal London, the suction machines at St Barts are not portable. They are attached to the wall and the one next to my bed is on the right hand side. The vacant bed opposite has one on the left. The same side as my drain. I ask politely if I could swap beds so I could be connected to the machine on the same side as the drain to give me a little more freedom of movement.
‘Look. We know what we are doing. This is the bed you’ve been allocated. I’ll just cross the tubes over your chest…’
I try to protest. I say surely it makes more sense to put me in the bed with the suction machine on the correct side. If the tubes are crossed over my chest that will really restrict my movement…
The nursing assistant is very terse with me…
‘Don’t argue. It will have been done like this for a reason…’
She proceeds to literally cross the two tubes over each other on my chest. I feel tearful as she marches of.
‘Well..’ says Edna. ‘Sorry to be blunt, but what a bitch!’
I laugh. Edna is normally so polite…
‘Call the nurse, they can’t have you like that for the next few days…’
The Sister comes to my rescue. She may be authoritative and cold but she is professional. 
‘No, no. This is not how they should be… Let me sort this…’
The Sister doesn’t move me to the other bed, but somehow manages to rearrange all the tubing so instead of it being crossed over my chest it’s all behind the bed and not interfering with my upper body. There is enough slack that I can comfortable sit in my chair and walk to the end of the bed.
Just as the Sister is leaving a sporty looking young female physiotherapist arrives to talk to me. 
‘I’m just here to help you with your shoulder and left arm… Can I see what movement you actually have…?’
The physio asks me to raise my arm above my head which I find I can do quite easily. Then she asks me to extend it out to the side.
This proves much more difficult…
‘So I want you to keep trying to extend it to the side like this as much as possible… What we don’t want to happen is that your arms freezes… Try to do this ten times in the morning and ten times at night… You can start now…’
I extend my arm to the side as far as I can ten times after she leaves, as instructed. Each time the chest drain wound spasms and throbs…
I’m exhausted. 
It’s only mid morning but I am so unbelievable tired. It’s not officially ‘rest’ period until one o’clock, but I climb back onto my bed and close my eyes anyway.
Every bit of me hurts. My muscles ache, my wounds throb and I still feel nauseous from the morphine. I’m just going to rest my eyes for a bit I think to myself. I’ll just close them for a minute….
Soon I am sleeping more deeply than I have for days. On top of my bed sheets in the middle of the morning….


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