Hospitals Shrink Worlds

With this persisting round of hospital visiting (you will be glad to hear that the ageing relative is bucking up), I am sure that I am paying penance for the hell I must have put my own visitors through, this time last year. It is awful; but it is not TAR's fault.

"Tell us about your day" we say, instantly regretting it when he has little more to talk about than the consistency and diameter (dependant on consistency of course) of whatever comes out of his bottom or alternatively the contents of whatever goes in the other end - in great detail. That is what his day consists of, bless him.

My life seems to be going full circle - I started my working life up to my elbows in shit; at least that's how it felt at times. You have already heard how a man shat on my hand and yet that was only the tip of the iceberg. There was the first time I carried out a bowel washout - a procedure to cleanse the lower bowel prior to colonic surgery, and something that now, thanks to skeletal Gillian McKeith, is something of a leisure activity.I managed, due to my poor aim and inattentiveness, to deposit a lump of the brown stuff on my shoe. Only I didn't notice; everyone else did, but I didn't. And they all left it for some considerable time before pointing it out to me.

Or what about the time when, as a staff nurse, I sent a student of to take a stool sample. This was achieved by using a clever little sample container that has a spatula attached to the lid. You unscrew the cap, attack the turd with the spatula and screw the cap back on with the blob inside the container - simple.

I became anxious when the student nurse failed to materialise for some fifteen minutes until she came to me and asked what to do with the rest of the stool because she couldn't fit it all in the container - which she showed me, with some pride, to be brim full.

I remember thinking how apt the expression of a laboratory worker was when we were discussing the woes of pooh one day over a cup of tea in the canteen:

"It might be shit to you lad, but it's bread and butter to me."

So, we shall continue our nightly trips to North Manchester G.H. for a while longer yet and, no doubt, engage in more meaningful conversation on what is reasonable to expect to emerge from ones rectum under a variety of conditions caused by the feeding of the hopper at the other end with NHS cuisine.

Watch this space.

When A Man Shat On My Hand

I promised when I did the post 'Seven Things...' that I would explain how I once allowed a man to shit in the palm of my hand. It seems a good time to write about this sort of thing because it is pretty much the first anniversary of my blog and this sort of subject is pretty much where I started. I started writing my blog when I had time on my hands, having been in hospital for a while. One of my most popular early posts, The Fug and the Time had a particularly faecal theme.

Twenty six years ago I was a callow Student Nurse learning the rudiments of care: bed making with hospital corners, cleanliness, bed bathing and other basics. These were the days of starched sheets and patients who had to look tidy, I remember the protests of patients who liked to lounge in their beds, sheets askew, only to be told by Sister that they could not possibly be comfortable sat like that and made, at her insistence, to sit up straight.

Whilst bed bathing a man who had recently had both of his legs removed, we were in the process of changing his sheets. This was achieved by rolling him over to one side of the bed, changing the sheet on the other, bunching up the remainder of the clean sheet in the middle then rolling him over the lump onto the clean side whilst the other nurse changed the other half. We had just rolled him on to the clean side and I was smoothing the wrinkles out of the clean sheet when the movement must have taken its toll on his insides, "Nurse, I've got to go to the toilet...NOW". Before my colleague had returned at high speed with a commode he added with some urgency, "There's some coming..." and sure enough the evidence presented itself.

Here is where it becomes apparent to what extent the sanctity of clean sheets and orderliness had been impressed into us, because I instinctively grabbed a clean wipe from the trolley and, as if diving for the catch that would save the Ashes, allowed the offending item to land in my hand. Wanting to be sure that there was no more to come before we transferred him to the bedside commode, I asked "Have you done?..."
His reply indicated that he had misinterpreted my question and actually thought I was offering an even higher degree of service than that to which he had become accustomed:
"Ah, thanks lad, there's more where that came from, nnnnnnnhhhhhhhhhhhhhhhh", and with that deposited a load that any man would have been proud of into my waiting hand.

So there you have it, a man shat in my hand. I often wonder whether his misunderstanding caused any future embarrassing moments for him or my colleagues during bed baths as he marvelled at the quality of service that allowed a man to shit without having to leave his pit.

Happy Birthday to my blog!

My left foot: update

The plaster cast is off my foot and my peacock post was every bit as justified as I thought it might be. More of that shortly, but first a musing on my insistence on being right.

Getting around with the plaster cast on my foot was pretty impossible; the process of moving anywhere on one leg using crutches is surprisingly exhausting. When we arrived at hospital V. remembered that an x-ray was necessary before my appointment; she also remembered that we were told to go there first. I remembered differently and because I'm Right, insisted that we book in at Out Patients reception first. We walked the 100 metres along the corridor to Out Patients, passing X-Ray Reception on the way.

I explained to the Out Patient receptionist that I had to have an x-ray before my appointment. She did very well not to say "What are you doing here then?" but couldn't resist one of those sisterly looks with V. that said "Men!" as V. failed to resist the temptation to say "Told you". In total my insistence on being right added an additional 200 unnecessary metres to my walk - I felt every step.

I found the x-rays fascinating, you could clearly see the gap where my heel has been removed and reattached; reassuringly the gap is filling with new bone, though there is a way to go yet. Even more clearly you could see the 6 cm screw up the centre of my foot that is currently holding my heel in place - it looks like any old screw from the tin in my garage! But of course there are non in my tin made of titanium.

The plaster was cut from my foot using one of my favourite hospital tools: the oscillating saw. The blade looks nasty, but, rather than revolving, actually oscillates back and forth, thus it never cuts the flesh. The foot exposed beneath was not mine, but rather the foot of an alien: lizard-like, puffy and showering powdery skin scales. Despite my distaste at its appearance, my surgeon was pleased with it and announced that I could start putting some weight on it.

Having not stepped on my foot for eight weeks, and never having stood on it with the heel in the place it ought to be, I am finding myself reacquainted with an aspect of the surgical process that I had forgotten: pain.

I now have to wear an Aircast for four weeks whenever I am out of bed. This does the same job as a plaster cast but you can remove it; and importantly, you can take it off while submerging the limb in hot soapy water: bliss!

I've noticed on some of the better blogs that it's de rigeur to share favourite products, here are my new faves:





This is my brand new Aircast, the photograph doesn't really do it justice; it is huge: like Frankenstein's boot!








This is one of my crutches, still in use until I am more confident at walking with Frankenstein's boot; and walking with less of a wince.





Boots BPC Aqueous Cream: contains no natural ingredients, (unless you count water), no essential oils, no SPF thingies, no pro-retinol wrinkle removers: but it feels absolutely fabulous smoothed into the reddened scales of my foot; and it's really cheap - £2.25 for this huge tub.

My inner peacock

Peacocks are beautiful but haughty. St Epiphanius knew this when he told his peacock fable. His fables were published in 1588 in Antwerp by Christopher Plantin in the catchily titled Sancti Patris Nostri Epiphanii, Episcopi Constantiae Cypri, ad Physiologum. Eiusdem in die festo Palmarum sermo, or stories about St Epiphanius for short. The fable tells how the Peacock lets out a cry of horror when he catches sight of his appallingly ugly feet.

Tomorrow I go to hospital to have the plaster cast removed from my left leg. I have not seen my foot for six weeks, nor has it been washed, nor has the natural process of skin shedding and regeneration been allowed to take place. I have glanced with trepidation (and a torch) beneath the plaster on my foot - what I have seen is scaly, reptilian even.

I am not known for having a particular pride in my appearance but if, on Thursday, you are driving along Rochdale Rd, Oldham near to the hospital and hear a scream shortly after 14.15h do not be alarmed; it might just be me getting in touch with my inner peacock.

Purple Pain, Purple Pain

It dawned on me today that, during all my talk of surgery, I hadn't mentioned pain. The explanation is that, boringly, pain wasn't much of an issue. That said, pain relief was quite interesting.

I've never really been in to drugs; as a teenager I was too scared to experiment - a justified stance as some of my more adventurous peers fell by the wayside with various chemical accidents - and I was quite happy to follow the Guinness route to enlightenment. Looking back, that failure to be adventurous perhaps explains my lack of imagination; I find it really difficult to imagine things in any detail. This is a typical conversation about the décor in our house:

"Can't you just imagine how cool the burnt aubergine is going to look on that wall?"

"Hmm, yes it'll look great (I hope)"

I've been in communication workshops where exercises have involved imagining things in myriad colours; while colleagues enthuse about their rainbow-worlds, all I can manage is an insipid watercolour version.

Now safely in middle age, I was quite looking forward to some controlled, legitimate use of opiates in hospital. My nurse training taught me that analgesia doesn't really make you high if you are in pain. Sure enough my pain was marvellously well controlled by the morphine syringe-driver ; the only other effect seemed to be drowsiness - until the night time.

I found myself in a cinema - at least that was what it appeared to be - the corridor leading from a cinema foyer down to the screens, with wall to ceiling carpet giving the place that muffled feeling, where anything you say seems to be swallowed up six inches from your mouth - a bit like sound-proofed audiology rooms. I could see a number of doors leading, presumably, to the screens, I could smell a fusty carpet smell, I could feel the plush carpet beneath my feet, hear the lack of echo and everything was vividly coloured purple and green.

At some level of consciousness I understood the significance of my dreaming in colour and decided that if the corridor was so vivid the actual screens must, surely, have even better experiences waiting for me. I tried desperately to get through the doors; but each time I reached for the door handle I woke up; having woken I found I could slip back into this corridor-dream at will, but with the same disappointing failure to progress each time.

Perhaps, at heart, I'm that same reluctant teenager; and my subconscious just won't let me take that extra experiential step through the cinema doors.
Feel free to leave comments with amateur dream interpretation theories.

The fug and the time

Prisons and schools, in fact all institutions, require their inmates to adapt to a certain set of behaviours. This has never been more apparent to me than during my hospitalisation. In an earlier post I mentioned that my two fellow patients Harry and Bert inducted me into the ways of the ward, telling me about the routine, the food and the staff. Other things though more subtly effected my change into 'a patient'. On the first day I wandered around, in my own clothes, chatting amiably with Harry and Bert. Later I changed into pyjamas; that was one significant change, wearing night clothes during the day.

My surgery and subsequent awakening attached to a syringe driver and intravenous infusion deepened the view to anyone passing that I was very much a patient, and in some ways too with Harry and Bert because all three of us now were immobile.

Another thing that bonded us as patients were our shared concerns; in our microcosm different things mattered, the quality of the food, visitors, and doctor's rounds all sparked conversation and concern. All of this was enhanced - and if you have ever been camping you will understand this - by the complete lack of privacy; curtains are not sound-proof. So, Harry and Bert knew to ask me about my pain, Harry and I knew that Bert was having difficulty going (that is the end of that phrase by the way, please don't make me spell it out).
After only 24 hours my pain was pretty much well controlled and I was heartily tucking into hospital fare. After 36 hours, although I mentioned it to no one, Bert and Harry instinctively knew that I too had my own l concerns about going.

Determined that anything that was necessary in the toilet line could wait until I was more mobile, I waited; by day three there was a lurking presence that, sooner or later, had to be dealt with.
On day four physiotherapists taught me to do non-weight bearing walking with crutches, there was only one place that I was heading, Harry and Bert knew it. After manly efforts, I gave up on the grounds that I might break something. "How'd you do lad?" asked Harry anxiously. I shook my head dejectedly and limped back to my bed. Bert was quiet, his own internal drama not yet resolved, and from the conversations we heard, requiring some pretty significant chemical intervention.

I resolved to apply all my food and nutrition knowledge to the problem and gorged on grapes, porridge and hospital curry. The following day I tried again and with considerable effort joyfully exorcised the beast.
Bert's problem though was starting to make him feel ill, he withdrew and only joined in a few of our conversations, dozing on his bed for much of the time. Bert's visitors spent time chatting anxiously with Harry and me about trivia, not knowing how to talk about their concerns about Bert. Later that afternoon from behind drawn curtains snatches of doctors' discussions could be heard:
"Looks like we'll have to...", "Yes, we'll give it him tonight..." Something was afoot.
The following morning Bert remained subdued, feeling unwell, Harry and I chatted about the papers and hoped Bert would be OK. Shortly after lunch the drama came to a head,
"Nuuurrrrsse!" shouted Bert, I reached for my nurse-call button and pressed it, so it seemed did Harry. As two nurses ran to the wrong beds Harry and I pointed in unison across the ward. Curtains were whisked shut and a wheeled seat brought to the bed side. Harry and I glanced at each other, who were they kidding?We knew what that seat with the deep bottom was. For fifteen minutes we listened to groans and strains until finally in response to Bert's call a nurse slipped back through the parted curtains.

We waited anxiously but knew all was well when we heard a happy exclamation from the nurse:
"Good grief Bert I think you've had a baby!"

For two hours a thick faecal fug hung over the ward blurring our vision like a heat haze, but nobody minded.

The title? Fans of the 70s Northumbrian folk/rock band Lindisfarne will understand, click here if you want to know more..

Pull up a sandbag, it wasn't like this in my day

My first night in hospital, I am to have my surgery tomorrow. My only other fellow patients are Bert, aged 82yrs, and Harry, aged 87yrs, they have both been in hospital over four weeks having had new hips and suffered the sorts of complications that come as we get older. They attempt to induct me in the ways of the ward but conversation proves challenging because both are fairly deaf, our conversations frequently punctuated by "You what, lad?", but they do a good job of reassuring me that the nurses and surgeons are of the highest quality.

I am visited by one of the surgical registrars who discusses the procedures to be carried out on my ankle and foot ensuring that I sign, again, a consent form that I had previously signed in an out-patients clinic. It seems that you have to really, really know what it is you are having done. The registrar draws a big black arrow pointing to my left foot. I tell him not to worry because I wouldn't let them do the wrong one, "You'll be unconscious" he reassuringly replies.

During the evening Harry and Bert are asleep early so I settle down to television viewing which is a simple matter with my personal four inch telly. After fifteen fruitless minutes I start to become a grumpy old man, railing pointlessly against the paucity of choice across the Freeview channels, for which I might add, I have paid fifteen pounds. Moodily I settle down for sleep at around eleven o'clock.

Now, when I trained as a nurse night duty involved a very important factor, the need to be quiet in order that the patients could sleep. I'm sure that under the strict regime of that time I drifted noislessly about my tasks like a hospital ghost. Things seem to have deteriorated in my absence and the nurses chat loudly about their colleagues (interesting), the state of the NHS (predictable), the coming Celebrity Big Brother (I am so out of touch with what matters) and the plots of various soaps (see Big Brother) until midnight. Harry and Bert seem to be fast asleep judging from the contended sound of their breathing, perhaps the nurses have forgotten that they have a non-deaf patient, I can't wait to meet Staff Nurse Smith after what I have just heard about her!

I pull the covers over my head and gradually drift into the open waters of the deep night. That is when the real night sounds take over, the nurses tip-toeing about their duties, checking we are all still breathing, and collecting filled urine bottles which are delivered to the sluice room and deposited into the pulping machine. Obviously it would be unhygienic to let the bottles and bedpans fester inside the machine all night so it throbs with a deep rythmic vibration that travels up through my bed frame. Harry and Bert seem unaffected by the throbbing and say so with a chorus of snoring, shouting and farting that seems to last for hours.

Eventually sleep overtakes me and I dream fitfully about a gigantic arrow that resists all attempts to stick to my leg sliding off on to the floor then floating around the ward wafted on the breeze generated by snoring and farting patients; eventually the arrow is wafted back over to my bed where it lands, on the wrong leg and no matter what I do I cannot get it off.

I wake with a start to find a nurse stood at the bottom of my bed with a surgical gown draped over her arm. She invites me for my pre-operative shower, instructing me to wash all over with an anti-bacterial shower gel.

Now I know it's getting serious, it will soon be time.

My left foot, or now I have time and excuse to start blogging

I thought of titling this post 'My Left Foot' on the grounds that it will, hopefully, be a tale of triumph over adversity. On reflection not only has it been done before, but the whole tale was better and more worthy.

I'll be honest, all this business of soul baring by blog is a little alien to me, the idea of a daily diary of life's trivia bores me. Do you really want to know what my day consists of? trust me you don't. But then, as I'm on the precipice of having about 3 months off work maybe now is the time to 'express my 'inner me' or 'find myself'.

Let me explain. Later this month I'm off to hospital for some surgery. Not life threatening, at least it's not planned to be, but significant orthopaedic surgery all the same. For many years I've been robust and healthy; I'm still healthy, in fact very healthy to the point that I feel a bit of a cheat. However - here's where the palms of my hands start to sweat and my insides start to shiver - I do have a lurking suspicion that this surgery is going to surprise me and my body.
Blogging is only one of a long list of things I plan to do whilst not at work, friends tell me howdever that I simply will not have the energy to do it all. Hah! we'll see. If there isn't another post on this blog for some time you'll know who was right.

Despite my bullish confidence in a positive outcome, I have become increasingly anxious for the following reasons:

1. Each time a different doctor looks at my ankle he - they have all been male, orthopaedic surgery seems to be quite a masculine type of surgery - says appreciatively,
"My, that is bad isn't it, tut, tut"

2. Each time a doctor tells me about the surgery they say,
"You know, you must expect some considerable pain..."
Why do they keep saying that?

3. A number of independent witnesses, when told of my procedure have airily volunteered the following information,
"Oh, I've heard tendon grafts are really painful"

4. I have not been in hospital, as a patient, since I was a child.

5. In an earlier career I was often in hospital, I was a nurse.

Do you begin to get the picture?

Watch this space for updates and enjoy reading as we delve deep into the world of pain, hospitals and nurses (sounds like the start of a dark novel, hmm perhaps I'll write that instead of blogging).