Thursday, 25 November 2010

A strange engine and an all-time low

Wednesday, 22 September 2010  was a day of dramas, although it seems to have started ordinarily enough.

Details of the morning are hazy but there certainly would have been a visit from the phlebotomist, the same cheerful Bride of Dracula as on the previous day, followed in due course by a nurse to take readings of my temperature, blood pressure, blood oxygen (this latter by means of an ingenious device with a red flashing light clamped to my fingertip) and my weight.

There would also have been breakfast, always my favourite meal of the day and the easiest of hospital meals to eat since there is little that can be done to inflict serious damage on such basic foods as Weetabix, toast and marmalade.

I would also have hauled myself, now of course not tethered to a drip stand, to the bathroom for basic ablutions. 

I made various efforts during the morning  to chase up my CT scan appointment, including an unsuccessful attempt to speak directly to the clerks (are they still called that?) in charge of the arrangements. Again my frustration grew, although it was largely unvoiced for the moment as I had no audience until my wife arrived after lunch.

Speaking of lunch–and I would rather not–I felt my appetite waning and so ordered what I thought would be the least offensive option on the menu: a tuna salad. I must not blame the humble ingredients of the salad or even the people who prepared it for what was to follow, because I believe that some damage was already working its way through my system by this time. Nevertheless, eating dry, rather bitter-tasting, tinned fish together with undressed salad was truly awful and I had to force it down in the hope of securing nutrition, if not pleasure. As I dictate these words two months after the event, I can still taste this dismal meal.

MY unmade bed.
Tickets to view now on sale...

I wish I could say that I behaved nobly when my wife arrived after lunch but I am afraid that I treated her to a display of temper that should more properly have been directed against “the system”. I should explain why I was so anxious to have the CT scan carried out. When the haematologist examined me during her initial consultation on 3 September she found that my spleen was swollen and that I also had swollen lymph nodes in my left armpit and groin. I was concerned to know the precise extent to which my internal organs were affected by possible tumours, not least because she had advised me that the disease had been working its way through my system probably for the previous five years or so. The scan therefore had prognostic implications that I was concerned to nail down as soon as possible, even though the swellings revealed by examination appeared mild in all the circumstances.

Following my rant however I felt the first real stirrings of nausea and went to the bathroom where I coughed rather inconclusively, but with a taste of acid, into the toilet bowl. Not having any cause to which to attach this latest development, I concluded that I had got too worked up and so agitated a digestive system made delicate by the cocktail of drugs I was taking.

Eventually–and I wish I could remember the precise time–I was told that a porter would shortly arrive to take me to the X-Ray department. It was a great relief when the gentle porter appeared with a wheelchair and I could sit in it for the journey down a few floors for my next encounter with modern medical technology.

The porter left us outside the scanning room and, before it was my turn, I watched two other patients entering for their scans and observed the changing of the illuminated warning signs from white to red when scanning was in progress. I also saw laughing clerks (surely not called that!) emerge from their office and I felt a rise of resentment, justified or not, at what I perceived to be their complacency. Time and again have been disappointed by the failure of people to understand the expectations and anxieties of customers, end-users, clients (whatever) and to take reasonable steps to manage them. In saying this, I am sure that I have let people down in similar ways, but in my personal and professional lives I have always tried to carry in mind the hopes and fears of those who are depending upon me for action, response or information.

I felt another wave of nausea, this time more powerful, and asked my wife with some urgency to find me one of those cardboard bowls that are such a necessary part of hospital life. Bless her heart, she found one very quickly and into it I duly threw up, experiencing the relief that follows such episodes, even if there are to be more to follow, which there were on this particular day.

The respite did however enable me to enter the scanning room in a better frame of mind and I was greeted pleasantly by one of the radiographers and a nurse who now came to attend me. I lay down on the stretcher-like platform that runs through the scanning device and the canula and associated needle were removed from my arm, as they were no longer needed. The strong sticky tape that had held these in place was rather more difficult to remove and not a little painful as it took arm hairs with it.

I was given an injection of iodine-based contrast medium with a warning that this would make me feel warm inside and that this feeling would spread to my nether regions. Indeed it did, although the resulting sensation was not so much pleasant as disconcerting, since the warmth mimicked urinary incontinence. I was then asked to raise my arms above my head so that I would fit through the ring in the scanner when the platform moved through it. Each operation of the scanner was preceded by a pre-recorded request to hold my breath and the moving platform then did its thing, shuttling gently back and forth.

There were some bleeps and flashing lights, but the process was soon over. As I prepared to leave this area of the hospital, I noticed two radiographers looking intently at the images just taken of my insides. Although these images were of my inmost parts, I was not destined to see them until the haematologist reported on them some weeks later. In these small ways the system takes away elements of our control, although we generally perceive this as normal and so give permission for it to happen, because it is for our good, or so we hope.

A typical CT scanner
This requires a man to travel through a donut, rather than what is more usual...

... a donut travelling through a man.

Soon enough I was back in my room and my wife left me to get some refreshment in the cafeteria. While she was away further nausea assailed me and once again I was sick.

I can no longer recall the true sequence of events that followed, other than that my wife went home, to be replaced by my brother and by my son and his girlfriend, who had to witness me becoming increasingly distracted by nausea of growing intensity, climaxing in a final session of vomiting, this time comprehensive and cathartic. Do you really want to know all this, I ask myself? The only justification I can give is that this was how this particular day shaped up.

My brother—the retired, but ever attendant physician—was by my side throughout this last episode and surreptitiously monitored my pulse, which he assured me had held strong. Even though I felt drained by this last episode, in my depths I felt reassured that I was coping.

Shortly afterwards my son and his girlfriend had to leave, while my brother stayed to ensure that I was given the means to make it through the ensuing night. We made a request that I be examined by a doctor on call, who eventually came and, after discussing various options, prescribed a mild sedative. My brother stayed until satisfied that this was taking effect and I was finally granted a peaceful night’s sleep.

All track of time was lost, my stomach was sore, but I sensed that things were now, however tentatively, moving on an upward course and into a sunnier landscape.

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