Hospital Tips

So, I am back after a week in hospital. 

My first ever hospital stay. I’ve been an outpatient and had day surgery as a child but this was the first time I had ever been in hospital for longer than a day.

And it was a deeply confusing experience.

So some tips and reflections. 

I went in for scheduled surgery as part of a clinical pathway https://en.wikipedia.org/wiki/_pathway

In the run up I had a dedicated surgical nursing team who told me what my condition was, what the treatment would consist of and what the risks were.

They were supportive, in regular contact (including on New Year’s Day) and consistent.

The week I was scheduled to be admitted I had a pre-op check at the hospital where they checked my health, my understanding of the procedure and that I had a support network in place for both operation and eventual release. 

Take someone with you to the pre-op check. They can take notes and laugh with you when the doctor says “I’ve put all your details into the computer and this screen says you have a less than 2% chance of dying in surgery.”

Sadly I could not find a bookies to take that bet.

Make sure that you have clearly told them who your next of kin is. Even better set up a Lasting Power of Attorney. Do not wait until things get emotional and urgent. It takes a long time for a Lasting Power of Attorney to be processed to start today!

On the day of admission I was told to bring a bag and again someone to wait with me.

The most important things to pack in the bag were pyjamas, slippers, razors and toiletries, books, phone, chargers, and headphones. 

I was the last act of the day and spent the morning having bloods taken, swabs er swabbed, blood pressure read, so it passed quickly with little time to worry. 

You do have to change into one of those gowns and hospital pants. 

There is a logical reason why hospital gowns do up at the back but that does not make wearing them any better! 

You get to put your bag and clothes in a plastic crate which you will eventually see again.

I was then taken into anaesthetics and sat on a trolley.

(An aside, the NHS most closely resembles the Armed Forces culturally with anaesthetists being akin to RAF pilots.)

I was given an epidural. This involves sitting to one side, leaning forward while someone sprays local anaesthetic on your back, you then do an “angry cat” yowl as they stick a needle in your lower back.

I was then laid flat on my back on the trolley and given an oxygen mask. No sooner had I thought, “This mask is too small to knock out a bear” than I was waking up after the operation in a recovery bay.

The lead surgeon came to see me to tell me that the operation had been a success but they had had not been able to do the whole thing via keyhole so I had three cuts in my abdomen. I think Count von Count is in charge of surgery so they insist on telling you this. 

When I woke up I had had a cannula inserted into the back of each hand and a catheter inserted, er, where catheters go.

There was a drip running into one of the cannulas providing glucose to feed me and paracetamol to manage the pain.

The epidural remained connected to me as well as it delivers pain relief directly to the site of the wound.

Essentially you are connected to drips, tubes and wires so you will not be going anywhere.

This only becomes an issue after they remove the catheter.

The drips dump a lot of liquid into the body and that has to go somewhere…

You will become familiar with the “bottle” as you will be filling one every 90 minutes!

The alternative is to walk to the lavatory but you will be so wired up that this is an exercise in logistics akin to walking to the North Pole.

You will be frequently checked by nurses and doctors who will want to take your blood pressure, your temperature and blood samples. 

Sometimes they take the blood samples through a cannula, other times they use a syringe. I have no idea why, possibly it has something to do with Appelation Controlee.

Eventually they will switch the pain control method from surgery to recovery.

This means that you might be given a button to press to self administer pain relief. https://en.wikipedia.org/wiki/Patient-controlled_analgesia

This gives you temporary pain relief when you need it. After surgery for example you may have gunk to cough up yet coughing strains the diaphragm and causes pain. So press the button first before coughing. 

Do not “be brave”. Surgery is immensely disruptive to the human body and it will hurt as you recover. Recovery is the key thing, not impressing some imaginary idol with your stoicism.

Some people experience mild euphoria when using morphine based pain relief. I am not one of them alas so I cannot tell you what that is like. All I can say is that the button was worth pressing when I needed to manage pain.

Eventually I was disconnected from the drips and moved to a normal ward with 6 beds on it.

And this was when headphones and books became essential. Hospital is deliberately low energy. You need to focus on recovery. 

And it is very alien. Everyone who goes into hospital goes a bit mad.

So books and podcasts were a great way for me to maintain my sense of self. 

I slept very badly in hospital as I normally sleep on my side so books and radio drama were vital in those long long hours. Just make sure you have a charger! I use this one https://www.anker.com/uk/products/a2045

Pain relief switched to tablets, in my case standard paracetamol with the very occasional OxyContin tablet in the morning.

Again, I did not experience any euphoria as a result nor did I feel the need to join McKinsey https://www.nytimes.com/2021/02/03/business/mckinsey-opioids-settlement.html

I spent 3 days on the ward getting more and more desperate to be released. 

Visitors were lovely but they got to go home. I remained. 

If you are given exercises by the physios then do them! Not only do they break up the day but they will get you home sooner.

The discharge process is odd. After the highly structured admissions process discharge was, understandably, much more adhoc. I found myself looking at it as a service design challenge.

Anyway be patient! That’s the key message. 

On discharge I was given a recovery timeline. I would be cautious. Yes I could put the bins out 2 days after release but I then had to spend the day in bed.

I had major bowel surgery and it will be a fortnight before the clips from the operation are removed and I suspect another fortnight after that before I am strolling in the park once more. 

If in doubt, ask the nurses. They will have seen everything before. 

I cannot fault the excellent care I received from doctors, nurses and all clinical staff at Croydon University Hospital. Thank you all.