(Repost) The glory that is the NHS

(This is an old post I’ve moved over from a blog I used to have. I wanted to get rid of the blog but save some of the posts. The original was posted on 02/08/2009.)

Well the update has come quite a lot later than I’d promised, but here it is! I’ve been living with my elbow for 4 months since the operation now and I have to say it seems to have been at least a partial success. Of course I still have problems with it but it was never going to be a full recovery. It simply isn’t possible with arthritis.

In the days leading up to the operation there wasn’t a huge amount to do really. I had told work I’d be off for at least three days afterward (and wow was that optimistic compared to the time off I really had!) and had to attend the hospital the week before to go through all the routine checks. The nurses were, as usual, lovely people who were overworked. I had to go through all the usual questions (any family history of x, do you drink, do you smoke blah blah) to which I always feel like a robot because I just answer ‘no’ to everything. I’m very boring medically, which is something that I’m glad of! Then I was whisked off to have a blood test done. I had to answer all the same questions I’d already answered (again repeating no like some kind of doll with a pull-string) before having my blood taken. As far as I can remember, this is the only time I’ve had this done and I am not a huge fan of needles at all. The nurse talked me through it calmly though (and bless her she was working through her lunch) and Mum kept me looking at her instead of the evil needle. Only thing was I was concentrating a little too much on Mum so when the nurse told me to stop clenching my fist I didn’t for a few seconds and was rewarded with a bruise the following day.

Finally came the night before the operation. My parents were staying with me so they’d brought a blow up mattress for Dad and Mum was to share my bed. We spent the evening watching my DVD of ‘The Gogs’, the most disgusting cavemen you’ll ever see! I was making the most of things as well as after midnight I wasn’t allowed anything to eat so I snacked quite a bit that evening! Luckily it was an early night however as I had to be up for 6am in order to get to the hospital on time so that saved me craving more forbidden food.

We got to the hospital for 6.55am, 20 minutes earlier than we had to. I’d brought my own dressing gown with me and that was about all as it was only a day surgery. I should have known better though. We were the first ones there but soon about another 7 patients also turned up, all for Mr Shah. We’d all turned up that early for pretty much no reason, other than to make sure we were all there by 8.30am when the doctors started their rounds. Great. The nurses had to do their ‘do you smoke?’ round of questions yet again (and once again it was a no to everything) but that took all of 5 minutes with each patient and was not worth being there at 7am for!

When the doctors finally started work, I was within the first couple to go and see them. Mr Shah himself was doing his ward duties so we saw his ‘understudy’ instead; the guy who takes over from him after the first time of seeing an outpatient. We went through exactly the same questions about smoking etc again and then moved onto marking me up which basically consisted of drawing a large black arrow on the top of my right arm near the wrist pointing towards the elbow. He also explained to me the procedure that they would take. They would make a small incision underneath my arm which the camera would be inserted into and then another on the top of my arm just to the side of my scar which they would take the saw/grinder through.

After being shown this came the waiting. In my letter it had specifically said that I was in ‘morning surgery’ which would suggest to me that come afternoon another group of patients would be coming in. So I expected to head down to the surgery no later than noon, perhaps 1pm if running late. The nurses told me I was third in line, which was fantastic news so I settled down to wait patiently. At 10am they started to put people into the surgical gowns, but it seemed to be in a random order as I wasn’t called over until 11.30am, by which time I was getting very hungry. I hadn’t eaten since 10pm the night before and hadn’t been allowed anything to drink since I got up and had a quick glass of water. Still once I was in the gown I expected that it wouldn’t take long.

In actual fact it was 2.30pm before they called for me. My parents were getting very bored by this time; Dad had been to get him and Mum drinks a few times and also to buy a paper but Mum had stayed constantly. We’d chatted to a few of the other patients (and had a good grumble), watched an elderly lady go out for her op and return (just a local anaesthetic on her right hand, and she got a cup of tea and a biscuit after!) and saw the two before me go in along with some random guy as well! When I was finally taken to the theatre it was a good job I didn’t have a current injury as they managed to walk the bed into one of the closed doors which would have jarred a freshly broken bone excrutiatingly.

Once in there the nurse started putting all the monitor pieces on me and was chatting away to me. It turned out she had family up in Yorkshire so we were discussing that for a while until the anaethetist came in, Mr Shah’s understudy. I remember when I was a child and had the anaesthetic they put on a ton of alcohol wipe beforehand which made the area numb and then put in the drip. This time it had only a minute or less before putting the needle in and first time he got it wrong. It wasn’t painful still, though a little uncomfortable, but I hate needles and of course couldn’t look away so I felt rather faint particularly when he had to pull it out and do it again. Second time went smoothly though and before you knew it I was drifting off into blackness.

I woke up around half 4 feeling very groggy and back in the ward. I remember glancing up at the clock and deciding to go back to sleep, which I did for about half an hour. Next time I woke up the nurse was there. She took my blood pressure and gave me a drink and a sandwich. By this time I was very awake and of course absolutely starving. I was surprised with how quickly I came round and also surprised that I felt no slight pains or anything in my arm yet. I easily ate the food and the nurse checked up on my blood pressure a couple more times before finally letting me get up and wait for my parents back in the waiting room. They turned up just after 6pm but we still had to wait for the physiotherapist to check my arm and give me an appointment for when to return.

While we waited the lady from the bed opposite me was wheeled into the waiting room. She’d had an operation on her leg and was having some problems with it. She couldn’t feel a thing and when they’d tried to stand her up she had fallen. When the physio turned up he looked at her first and sent her off to the ward to be kept in overnight. Then it was my turn. He made me aware of why I was unable to feel my elbow; apparently because it was going to be so painful afterwards they used a local anaesthetic on the entirity of my arm as well as of course having me under the general. I couldn’t feel a thing below my shoulder. However I should have been able to move my hand and I couldn’t, which worried him greatly. I was able to twitch the thumb a millimetre or two and that was it. He tried to get me to grip his hand and it just did nothing. I remember nervously laughing a lot but I actually wanted to cry. It was quite a scary thing to happen and of course worries were flashing through my head that they had damaged a nerve or muscle whilst in there. It was particularly weird as due to the fact that I was in a bandage and not a cast, he was able to get me to half-straighten my elbow and then bend it quite a lot too, something I expected to be impossible for a few days at least without terrible pain.

Finally at 8.30pm he told me to go home, keep it propped up and get lots of rest. My parents had informed him that they wanted to take me back to Yorkshire to look after me but he insisted I come down to the ward again for 10am the next day so he could be sure he was happy with my arm before allowing me to go. He told me to keep trying to move my fingers as much as possible. By the time we were home I was absolutely shattered. I’d only eaten a sandwich and a packet of crisps in the past 24 hours and barely drunk any water, not to mention the mental exhaustion from the worry over my hand. It was pretty much straight into bed with me. Of course by ‘straight into bed’ I mean it took me and Mum about half an hour to get me undressed and ready for bed.

I remember waking up quite a lot during that night. It was awkward to sleep on my back with my arm raised and of course the anaesthetics were slowly wearing off meaning that I was starting to get a little aching in the joint. Each time I woke up however I would try to flex my fingers and slowly the movement was coming back to them. By the morning I had almost full finger movement back which I was very pleased with and so was the physio when we got back to the hospital. So we headed back to the flat in order to grab a few items before going up to Yorkshire. I stopped off in GAME to tell Steve I was going and confused everyone as they didn’t know I was going in for an operation and were surprised to see me turn up with a huge bandage on my arm.

As you can see the bandage was a pretty chunky affair. This photo was taken in the car on the way up to Yorkshire. All the pink on my arm seems to be the ‘new’ iodine they use to stop infections getting into the wounds and wouldn’t come off for ages. It was surprising how much I was still able to do with my arm so soon after the operation. I had been given exercises of bending and straightening the elbow, and also trying to improve my grip to keep the hand working as well. It also didn’t hurt too much at all; I was taking painkillers about 3 times a day for a few days but was able to wean myself off those within a week or so and the pain was actually never as bad as the arthritis had been anyway. I was even able to play DS!

Of course getting dressed/ready for bed and showering was a nightmare. I could manage most other stuff, as long as picking up something heavy (a drink counted as heavy!) wasn’t involved but such tasks as twisting my arm to extricate it from clothing were beyond me. At 25 being dressed by your mother is not the best of experiences. I have never been so happy as I was when I was finally able to put my own socks on.

Within three days I was able to take the bandage off. Beneath the bandage was a large piece of guaze and under that it turned out I simply had two smaller pieces of gauze taped over the stitches. There was of course a huge amount of pink dye everywhere still and you could even still see my black arrow from before the operation faintly.

Here is a picture of the ‘top wound’, the one I believed would be just to the side of my existing scar. However it turned out that looking at where the gauze was, it was far closer to the scar than I’d imagined it would be.

And also a picture of the bottom wound. This one was the one which caused me most problems as it was the one I had most weight on constantly. I was still forced to have it raised on a pillow 90% of the time and of course that meant it pressed slightly into the pillow. It wasn’t so much pain as just an irritating ache with the odd slight stab of discomfort occasionally. This one had also managed to bleed a lot. You can barely make out on the picture a small area of dried blood. Well this had gone right through the guaze and that huge bandage just enough to leave a tiny patch on the pillow I was using as an arm rest.

After a week and a half of relaxing at my parents it was time to head back down to the physio again. Here I was to meet my permanent physiotherapist (though I forgot her name now!) and she seemed quite impressed with how my arm was doing. I think she was more used to dealing with people who were recovering from a first time broken bone however as she kept saying how good it was that I didn’t seem to be scared or overprotective of it causing me pain or moving it which was true. I’m used to living with it hurting, or not being able to move it in the ‘normal’ way so I just get on with it and had done since the operation as well. I’d pretty much carried on as normal, the only change being that I was slightly more restricted by the huge bandage and once that was off I was back to my usual cope with the weird movements self. She gave me a few more exercises to do, such as try to get it to the stage where I could lift a full glass of water (something I’d been doing for a week; another example of how I’m just used to coping I guess) and also to eating with my right hand again (yet another thing I’d already been doing for a few days).

She also informed me that I could remove the steri-strips within a few days so the first thing I did when I got back to Yorkshire was to take off the gauze and get a look at the steri-strips. I’d had to change the gauze once or twice but hadn’t really looked at it properly those times.

I was rather annoyed to find that judging from where the blood was, they’d made the incision into my existing scar. Now I can understand a lot of people don’t want more scarring than necessary but I’m also aware that it takes longer for scar tissue to heal than normal tissue and have also been warned by many doctors to try and avoid damage to that scar in any form. Still, the bruise was quite impressive though you can’t really make it out on here in all its glory. The grey/yellow bruise to the left in that picture was far more gruesome in person. I was really quite proud of it! Looking along my arm there was also quite a hefty swelling under the bruise, which is only to be expected. Surprisingly however it wasn’t sore to touch; the only parts that were sore were if I pressed directly onto the entry wounds.

The bottom stitches to me somehow don’t look as bad, despite all the extra blood. Perhaps it’s due to the lack of a huge bruise, plus there was very little swelling on the underside of my elbow. Still, that made me a little wary about taking off the steri-strips.

I came back down to Walsall two weeks after the operation; as much as I love my parents Mum was irritating me with the ‘are you sure you can do…’ routine, particularly when she kept asking about things I’d been doing for days on my own. Of course I had the same thing when I said I wanted to come home. ‘Are you sure you’ll be able to look after yourself?’ If I’m honest it would have done me more good to stay up in Yorkshire a little longer but I was getting bored up there. I found that walking of all things hurt my arm most and other than that I could only read or play DS. Admittedly I got through the entire Twilight series whilst I was up there but I just needed some space.

Just a couple of days after coming home I asked Steve to come and supervise me taking off the steri-strips, just in case there were any nasty surprises. But actually it was a nice surprise. Just 16 days after the operation the wounds were fairly clean.

That tiny mark you can see on the underside of my arm is the bottom entry. This was basically completely healed by the time I took off the strips. It has remained quite an angry red scar as opposed to a white scar like my original one but it is absolutely tiny.

This top wound however still wasn’t healed. It seemed to be healed over with a very, very thin layer of scar tissue but it was actually dented quite a lot into the original scar. Over time it has returned to be flush with my skin but it took at least twice as long as the other wound to heal properly. It has however lightened a little more than the other, though it is still quite an obvious blemish within my original scar. In fact the worst thing on day 16 was the back of my left hand, which was still just one huge bruise from where the first anaesthetic drip had been put in wrong. It took almost another week before that bruise disappeared, after it had gone through a range of colours from grey to blue to green and yellow.

I’ll continue with the physio and healing process in another note as this one is more than long enough for now.

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