Thursday, 12 August 2010

Accident and "emergency"

This is a follow-up from the Sense of Humour blog which ended with my awful Sunday night of stomach pain.

Woke up on the Monday feeling much better, which is when I wrote that blog and still had some sense of humour. From lunchtime on Monday 26th July, I started vomiting every time I tried to eat something. This went on all afternoon and the final straw was not being able to keep down a cup of rooibos tea and two tiny pieces of dried toast. I felt absolutely awful. I could not keep any of my painkillers down so not only did I have the terrible stomach cramps, I also had back pain that was getting worse by the minute. Reduced to tears, I rang Alex and asked if he and Rob would drive me to A & E as soon as possible. They were having dinner with Lin-Pan but came over straight away and we left for Kings College Hospital, myself armed with a bucket just in case. In retrospect, we should have headed for UCH which is where all my documents reside.

Well, as expected, A & E was full of (dare I be so prejudiced) chavs who’d been smacking each other or OD-ing on various substances. The receptionist took my details and promised that I would be processed quickly. I was in a lot of pain and felt as if I would throw up any minute but nothing was coming out every time I went to the bathroom. I finally saw the pre-admission nurse who was a South African and who promised to get things moving quickly. We were sent through to the next waiting section where there was a woman in a wheel chair, doubled over, holding her guts and groaning and moaning. Eventually, a nurse told her to follow him to a cubicle and she hobbled out of her wheelchair, still bent over and followed him. Perhaps they’ve seen this woman before and know her story but for us, sitting there watching it for the first time, it was not very reassuring.

After what seemed like ages, I was finally placed in the “minors” section as there were no more beds in the "majors" section. Of course, this drops your rating in terms of urgency. A nurse (yet another South African) set up a drip but that was all he could do while I waited for a doctor. I do not exaggerate when I say that the pain was driving me insane. I could not lie, sit or stand as each was as uncomfortable as the next. Alex kept rubbing my back and Rob tried to calm me down and get things moving but it was a long wait before a doctor finally appeared to examine me. She was good, said that she was going to get me some morphine for pain relief and that was the last we saw of her! Eventually, another nurse appeared with some morphine I had to restrain myself from snatching it out of her hand and drinking it straight down. She seemed surprised at the amount I wanted (needed) and I cannot describe the sense of relief when suddenly, the agonising pain started to disappear. I was then sent for an x-ray which was done efficiently and with the least amount of discomfort until the porter wheeled me back to my cubicle. Not long after the x-ray, the pain returned as apparently, the morphine had a short life-cycle. I started pacing again, groaning, lying down, standing and sitting up, waiting to see what would happen next. My previous doctor was replaced by another one who seemed a lot more experienced and he re-examined me and mentioned that my stomach was extremely distended and that the stomach pain was due to a combination of accumulated constipation and over use of ibuprofen. He said that the blood tests and x-rays did not show anything alarming but that he would keep me in overnight and administer another and longer lasting pain killer. This took a while to arrive but once it did arrive and was administered, I relaxed and was taken to a private room where surprise: another South African nurse took care of me. It was about 2am by this time. Rob had gone home post x-ray and Alex took a taxi home. Poor guys, having to spend an entire evening with me in agony and knowing that they had work the next legends they are! Once they’d got my drip working properly and turned the light out, I fell asleep almost immediately.

I woke up early in the morning with some back pain and rang for the nurse who first told me that I would have to wait until 8am to see the doctor but then she changed her mind and gave me a painkiller. Saw two excellent doctors, the first saying that I was too unwell to go home and she would have to admit me but wasn’t sure whether to admit me under oncology or not, but when the consultant came around 2 hours later, he examined me thoroughly and said that he thought I could go home but if I wanted, I could stay. I opted for home and left around noon armed with yet another huge bag of medicines. The whole ordeal took a lot out of me and to be honest, really frightened me as I began to wonder if this was how it was all going to end.

Little did I know that the same scenario would repeat itself last week Friday. Once again, I could not keep anything down. This time, I decided to take a train to UCH once I felt that I was safe to travel without throwing up all over the place. Unfortunately, the chaos was worse there than at Kings. I was in agony waiting to see the nurse first and after several people being called in before me despite me arriving there early, I demanded to be seen by a nurse. Tony arrived shortly after that. It was not long before I was seen by a doctor whom although beautiful , decided to be very thorough as she hadn’t been on the job for too long. She made me follow her butterflying fingers with my eyes among other strange tests. At one point, I started vomiting again and she rubbed my back while Tony got me some tissues. How anyone can watch someone else vomit is beyond me. She finally organised a shot of morphine and I was taken through for an x-ray. While in the x-ray room, I started shivering and shaking uncontrollably, my teeth literally knocking together. I thought that I was entering into a grand mal epileptic seizure. I felt so cold but the radiographers seemed unperturbed. By the time they let me out, I was shaking even more. It subsided and then started again; unfortunately, my doctor was not there to witness it. Tony (a medical doctor) thought it might have been my reaction to the high dose of morphine or that I went into shock. The pain returned shortly after that and my one of my oncologists arrived at that moment. Bloods were taken and the doctor agreed that I should be admitted into hospital until Monday. As you can imagine, I was not the world’s happiest chap around but if it meant getting the pain under control then I was prepared to do it.

I was wheeled into the Acute Admissions Unit ward around 7pm. Tony got me a TV card and sat with me until approximately 9pm. During this stage I had to have more bloods taken as apparently the previous ones had coagulated (?). A junior doctor fresh off the graduation podium made a determined attempt but finally gave up and looked for a friend, equally fresh, to have a go. He finally succeeded. A line was put in and I was put on a drip and told I was a “nil by mouth” patient. All drugs thereafter were administered either IV or IM.

I will admit to being a total wimp and allowing myself to get into a right state about the pain and being in hospital. I had no idea that it would be so noisy, making sleep impossible. The poor night nurses had their work cut out for them with me ringing the bell each time I felt uncomfortable or in pain. I didn’t realise, though, that they had reduced the amount of painkillers they were giving me which then explained why I was still in so much pain. However, this was a good thing because I now realise that my back pain can be controlled with less tramadol than had been prescribed. The only two remaining pain issues were the stomach and the left buttock where the pain was still intense. The butterfly doctor came upstairs and re-examined me assuring me that I would see her or one of my oncologists first thing Monday morning so that I could be released. Unfortunately, she missed the “nil by mouth” instruction so her prescription had to be changed which of course, meant that I had longer to wait for pain control. More hospital news to follow shortly.

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