My first surgery. Why did it have to be...there?

No surprises here, but I imagine most of us aim to finish the week without a stay in hospital. I managed to get 33 years without one, and then it lasted for 22 days. I'll be blogging later about the realities of life in hospital and some tips in the hopes it's of some use to someone facing their own stay, long or short, but for now I wanted to talk specifically about my surgery. It took me by surprise, it frightened me, it was invasive, and it hurt - but there were things that would've helped me had I known going into it. So here goes...

If you've read my intro post you'll see that my original admission into hospital was unexpected and intense - I'd been awake for 22 hours, not eaten in 19 (eternal gratitude to the McDonald's in Aldershot), sat in A&E for 9, waiting on CT scan results for 5, and I imagine it had been about 6-8 hours since my poorly-judged takeaway had arrived and shortly after left the military base at which I live and work. Needless to say, I wasn't in a good place when the on-call doctor shook me out of a dazed stupor and proceeded to tell me in very quick fashion that 1) a "large mass" had been found within my pelvis, 2) it was visibly obstructing the ureter connecting my right kidney and bladder, 3) my blood results confirmed that something was seriously impeding the function of this kidney, 4) there was no available specialist to say now whether or not this obstruction was benign or malignant, and 5) I would need to be admitted immediately for an urgent surgery later that day. He took time to sketch a quick doodle of what this surgery would look like, and how the urology team would be accessing me; a stent would be inserted inside my ureter, anchored at the kidney and bladder, finally allowing my kidney to drain as intended rather than poison my own bloodstream. There was an option to access the kidney by creating a small hole in my back but this was somewhat more complicated as well as requiring more dedicated care and infection control than the obvious alternative - going in through my urethra. I feel this addition could've waited till I'd had time to absorb some of the earlier info.

Passage of information

So, I didn't take the news particularly well. I was alone, tired, hungry, scared, and most of all, just wanted to get back to my room. Even if only for an hour or two to pack a change of clothes and have a shower. I was told that with the information the CT scan had uncovered, the hospital could not release me. I would be admitted, given a bed in a pre-surgery ward, operated on, and hopefully discharged that same day (reassuring, if untrue). I was told that I would be seen by a urologist and possibly a vascular surgeon between 0800-1200 at morning rounds - not ideal, but I figured I'd at least get a couple hours' sleep. Sadly, as is often the case with our over-stretched and under-staffed NHS, the passage of information wasn't smooth; it was a couple of hours before anyone realised I was to be moved to a ward. It was then 1600 before I was seen by anyone, which felt a long time to go with no update when I was expecting to be operated on that day. Thankfully, for my nerves if nothing else, it became apparent that a surgery slot wouldn't be available that day, so the wonderful urologist arranged for me to have a stay of starvation until 0200 - that chicken mayo sandwich will likely be up there amongst my top three meals of 2023.

Slice and dice!

The next day was similar, a lot of waiting around with not much happening, though I did change wards. One thing I cannot underplay in how a patient deals with hospitalisation is those who surround them. My first ward was calm and quiet, but every bed was curtained off, and there was virtually no chatting or discussion (probably natural considering most of us were expecting to shortly be under the knife). My second ward though, now that place was noisy and bright, but I was in a bay of 6 beds, and always had at least 3-4 people I could chat to. People so far removed from my world, job, hometown etc. but whom I was able to forge an almost instant connection with. Geoff, Stan, Henry, Pradeep, Med - you all helped me through those weeks, and I owe you. And Geoff especially, up and on his feet days after a bin lorry literally parked on him; RESPECT.

So, I digress. The day waned on, and we began to settle in for another delay. The nurses told me to distract myself with a shower or a phone call whilst they confirmed yet again whether I could be allowed to eat again (I'm pretty bad for getting hangry...) . As I walked back to the ward, having just been on the phone with a friend discussing whether I could leave things another day before telling my parents I was in hospital, I bumped into a doctor in scrubs looking around with purpose. As we entered the ward together I jokingly asked him if he had any slots going for a patient needing a stent. You can guess whose name was on his clipboard. Norman, who it transpires was my anaesthetist, did his pre-surgery checks and talked me through the surgery procedure (4th time's a charm). Half an hour later in was in my gown and being wheeled up to theatre. As we entered the pre-theatre room where the anaesthetic is administered, I was in bits. Not quite crying, but not managing to get a word out as intended either. I'm not good with needles, and certainly wasn't happy about the procedure I was about to undergo. Especially as no one seemed to be able to tell me with any certainty how much pain I would be in when I woke, and whether I should look down and expect to see a catheter - it seemed to be very much a "we play the course we're on" situation. Well let me tell you, when that course is your penis, you tend to want some firm details.

So Norman and his team got underway with knocking me out, after of course giving me the healthy dose of painkillers they assured me I would need when I cam round - another win for bedside manner. As they asked me to count back from 10 all I could think about was what was about to happen. No huge surprise then that not even a couple of hours later, as a breathing tube was pulled from my gullet I sat bolt upright, screamed "My cock!" and threw up over the arm of the nurse looking after me. I couldn't stop apologising, she couldn't stop laughing. Probably would've been a decent meet-cute had I not been off my face on opioids. Thankfully, I came round pretty quickly and just after midnight was graciously wheeled back down to the ward for some long-awaited food. Also, quick check on the downstairs - no catheter - result.

Now for the pain

Look, I love the NHS, and I cannot say enough about the care I received, but the bureaucracy and under-staffing is beyond laughable. I had to wait 4.5 hours for a sandwich because it could only be fetched and delivered by a porter. I'd have limped to the kitchen, trailing my drip stand and IV line with me had they told me where it was. I didn't even specify a particular sandwich. Alas no, get woken up at 0430 for a sandwich I probably would've foregone to be left to sleep another couple hours. Ah well, I took the sandwich gratefully and enjoyed it nonetheless.

Now a few hours had passed, and a sense of unwarranted confidence was beginning to build within me. Had I just got through a pretty invasive procedure, free of any scars to the naked eye and with no noticeable pain? Well, probably about time for a stroke of luck after the surprise tumour, right? WRONG! When I went for my first piss, it was pain like I wasn't expecting. I'm not going to go into vivid detail, and I certainly don't want to create more trepidation in anyone else with a similar procedure on the cards. Instead, allow me to give three little bits of advice that will make things pass more quickly and have you back to normal in about a day and a half. Firstly, despite knowing that it is going to hurt and wanting to do nothing more than hold it in, accept that you can't. The longer you hold, the worse it gets. The pressure creates more contact, at more angles, and we're after a slow-flowing river that barely touches the banks! Secondly, don't restrict your water in the hopes you'll need to pee less. I did, and it doesn't work. Peeing more really does help to get through the worst of it quickly, and your kidneys will be grateful. Moreover, the nurses will get angry and put you onto a drip anyway. Thirdly, get proactive with the pain relief. The nurses have access to some excellent medication that you'll no doubt have a prescription for. Just bear in mind that even the immediate release drugs aren't instantaneous, particularly if you're not hooked up to an IV. They'll take about 10-15 mins to kick in, so if you have the opportunity, get ahead of the game where you can!

So there we have it. A fairly honest appraisal of an experience I have no desire to relive, but unfortunately one I must, because whilst the stent may go in, it must eventually come back out, and mine has about 3 months left. Let's just hope it's a removal and not a swap for a new one, because I really don't know how I feel about a third procedure.