Caffeine and Codeine

Version 3

The following article is my experience of recent major surgery within the modern-day NHS.  Before going into my story, I would like to acknowledge there are some really good people working within the NHS but are heavily constrained or scared to make the necessary changes within.  As a patient, it is easy to see the NHS being systematically destroyed by poor management, and execs who are so far removed from the patient experience/journey their decision making is questionable…

Don’t get me wrong, I love the NHS, but when HCA’s and Nurses are discussing openly about sourcing second jobs just to keep a roof over their heads and feed their family, something’s very wrong here.

What Happened?

Recently I underwent surgery for a Total Knee Replacement, if anyone had explained the amount of pain this type of surgery would create, I would never have believed them…

The pain is incredible even at week four it’s keeping me awake at night!  I’m tired, sleep deprived, lacking concentration and frustrated…  An Occupational Therapists (OT) explained the surgery is the equivalent of being in a car crash and your leg gets smashed up.  However, instead of putting it in plaster for 6 weeks, the repair work has already been done and the knee and bones are structurally sound.

Surgery Day

On the day of surgery, I was wheeled down to theatre and met the team that would be working on me.  They insisted on a Spinal Anaesthetic, I explained I didn’t want to hear, smell or see what they were doing to me and preferred a General… As I sat on the edge of the bed, the anaesthetist was locating the vertebrae to insert the needle (local anaesthetic first) he explained that a Spinal Anaesthetic was different to an epidural (what the difference is I don’t know) …

Thirty minutes of screaming in absolute agony whilst they try and insert the needle into my spine (still trying to get the local in before they could insert the larger spinal needle) I’m crying and calling out for my late wife; the pain was simply intolerable on a level I’d never experienced.  The anaesthetist said “Plan B” to his assistant and they start chatting to me, the next thing I remember was being told to open my eyes.  I’d gone down to theatre at 1:30pm and returned six hours later.

They said the operation was successful, gave me a PCA of Morphine where I proceeded to have one of the most painful nights I remember…

The Next Day

In the morning after surgery, a nurse removed the PCA and it wasn’t long before they tried to get me up on my feet.  With the aid of a Zimmer frame, I move to the edge of the bed and try to stand… Jaysus! The pain was incredible, and wasn’t long before I was back in bed again.  I was given some physio exercises to perform and given a cryo-cuff (an electronic bucket filled with ice water and a cuff that wrapped around the knee to help reduce the swelling.  My leg was twice the size of the other!

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Pain Relief

Given the amount of pain I was on and clearly not working, the consultant referred me to the Acute Pain Relief team who added new meds and advised Oral Morphine to be available every two hours as needed.  In reality receiving pain relief proved problematic, when asking for pain relief, it could take up to five hours before receiving it, in which time the pain intensified.  The consultant asked why I wasn’t using the available pain relief and on explaining the situation, he re-iterated and confirmed the frequency of two hours.

Shortly after the consultant visit, the Ward Sister came to talk to me and asked why I’d complained to the consultant.  I explained I didn’t complain but advised that pain relief was difficult to obtain when required (I didn’t use it every two hours, but when I did ask there were lengthy delays).  The Sister then suggested they change the frequency to 3-4 hours instead!!! I simply said she was part of the problem, if the consultant says one thing and nurses decide something else then that’s an issue… I suggested we get the consultant back and agree between them the correct frequency…  The Ward Sister declined, muttered something and went off…

The next two days again proved problematic obtaining pain relief when required, until the issue was sorted out…

Why is the process so disjointed between professionals, with nurses and sisters ignoring consultants and doing their own thing?

Infection Control?

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I was meant to be in hospital for 2 – 3 days, however my ordeal extended to two weeks, during this time my bed remote control was broken.  I reported it on the first day of being admitted and even though there were 10 empty beds available, I was informed that it was a facilities issue and not theirs…

I asked “can we put some tape around it?” I was informed that wasn’t possible for “Infection Control Purposes”, I asked if they prefer I’m electrocuted instead? The Ward Sister explained they don’t have a procedure or risk assessment for that… so it was fine!  I asked several times about getting the remote taped up or made safe (they could have just swapped a bed over) however on discharge the remote control remained in two pieces throughout my occupancy!  I was tempted to call “Facilities” using my mobile phone… there was no ownership on the ward what so ever… Very much a case of “Not my Job”.

Bullying?

Sadly, there will always be some bad eggs in any hospital…

There were a couple of HCAs (Health Care Assistances) and Nurses that would make snide and aggressive comments such as “You such be gone by now”.  There’s a difference between saying this in a jokey fashion when someone’s been in longer than expected, but these aggressive comments were made when they could get away with it…  I wasn’t blocking a bed there were plenty available on the ward, and their pay is the same whether they are looking after ten patients or nine…

An elderly patient (in his 80s) asks for some bottles for overnight, he’s told no! He protests, they sneer at him and tell him to get up.  Only when he said “right well I’ll just have to wet myself and you can deal with the mess afterwards!” that the arguments started to fly.  There wasn’t a valid reason for not giving him bottles, someone was clearly having a bad day and enjoyed conflict!

A Little Light Relief – The Hospital Experience

The following is a typical experience from Lights up to evening, the events are true but I’ve added a little humour as it’s the only way you can get through the days…

6am: Lights Up, Harsh Sterile white light greets the morning?!? I miss my natural sunrise alarm clock. My body goes into shock like a rabbit in headlights…

An announcement by the Nurses booms around the ward: “Achtung Achtung Patients Vill stand by Zer Beds for inspection Jah…”

The HCA walks into my bay (with only me in it) and powers up the spotlights.  I wait before hobbling up on my Zimmer to the light switch, switch off the harsh lighting and return to the nice mood lighting and Zimmer my way to make room for what will be no doubt a delicious warm breakfast that will be awaiting on my return…

I return from my partial morning ablutions to find that challenging the Gestapo has consequences.  Lights back on, curtains drawn and curtain round my bed protecting me from being exposed from the corridor are pulled back…

Why? Drug round won’t get to me for another hour, so I lay here contemplating my escape plans in bright light when I could have had at least another hour useful sleep instead.

The HCA wanders in and offers two regulation biscuits and a plastic beaker of tepid brown liquid. The regulation biscuits are inedible but then again, I’ve not touched them since admission.

7am: Drug rounds, or breakfast as I call it, the wax cup presented to me resembles a portion of muesli, geez I’m eating more pharmaceuticals than real food…

8am: Breakfast round… What would I like? hmmm… Fresh Croissant, Pain Au Raisin, Bacon Roll, Fresh Orange Juice? yum yum …. Back in the real world I’m proffered two slices of thin frozen cardboard smothered in axel grease shaped like toast?!? that tastes so foul (how can you get toast so wrong?) I once again decline breakfast, a visitor managed to smuggle in a couple of bananas for me (though I shudder to think how they managed to evade the frisking down from the wards checkpoint) …

9am: Time to complete my ablutions. A cardboard bowl of water, a couple of towels and some help passing my regulation approved toiletries and it’s time to get as cleaned up as I can, I’m so desperate for a shower, to feel clean, wash my hair, deodorant the feeling of normality, again denied to me today…

10am: Finally, clean?!? (well less smelly than the day before) just as the consultant takes his rounds and inspects his art work, I’m privileged to have 38 seconds of their time before moving on.  The only acceptable answer is “I’m ok”

11am: The physioterrorists punish me further with the stair test, I sometimes wonder if the army are missing a drill sergeant….

12pm: Dinner! Don’t get excited as I’m served up two type 4 Bristol Stool Scale looking items, diced reconstituted freeze dried caterpillar segments and a scoop of frozen gruel smothered in engine oil and I’m at a loss… Is this meant to be edible? It tastes like someone emptied the entire salt cellar to bulk the ingredients up… So much for nutrition…

1pm: The physioterrorists swoop in unexpectedly in balaclava’s and introduce me to my nemesis “The stairs” again.

2pm: Drug round! and about time too… I’m fed a cocktail of hallucinogenic and truth serum in preparation for the interrogation later…

3pm: I’m informed that the 36 staples holding my knee together are to be removed… It’ll be a doddle I thought, they said I would be numb near the incision until the nerve endings are repaired. The nurse with the friendly smile (one of the good ones) removes the dressing and says this may hurt a little… Jaysus…. I’m screaming in shear pain as each staple is removed one by sodding one… I take a breather, they count down the last 4, I’m in tears, pillow over my head to muffle the screams to not scare the other inmates any more than they are, I’m told my interrogation is over… I take a look to take a photo of the wound and there’s two staples left!!! WTF… and in the most sensitive of sensitive places… I’m in tears… I shake their hand and thank my chief torturer as I explain that if “Nursing” doesn’t work out, a career as an African Warlord is in the making…

4pm: An hour before a tasty snack was to be delivered I’m informed that I have been discharged, however they forgot to add my acute pain meds to the discharge list… And since the doctor has left for the day I’ll have to call in the morning to sort it out!!! An entire hospital brought to its knees (no pun intended) because one doctor is unavailable!?! What about the other 6000+ patients? I worry… more importantly I don’t have the right pain relief to go home with as I’m met by a wave of apathy from staff…

5pm: I wend my way home… to start my rehabilitation…

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To be continued…

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Happy Wedding Anniversary Janice

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Pre-Wedding Photo Shoot

Today would have been our 12th Wedding Anniversary together, every day just seems to get harder without you being here.  There is so much I want to say, stuff I have to say, and yet I still don’t know where to start.  This blog entry may not make sense as I write from the heart so I’ll start somewhere and see where this post takes me.

When I first met you, you were being introduced by our manager as you started a new job in the same department for the same company I was working for.  It was in that moment I just knew…  Don’t ask me how… I just knew.

We became friends for many years, spending a lot of time together when possible, you even took care of me after my near death experience in the late 90’s due to a botched surgical procedure (when my then girlfriend buggered off and left me at risk).  We’d just hang out, enjoy each others company and have a laugh and giggle.  Sunday mornings we’d phone each other and talk whilst watching Hollyoaks, before meeting up for coffee and cake in various places, but mostly shopping.

People assumed we were a married couple long before we started a relationship and would ask how long we’d been married.  You’d giggle and brush it off, until one evening you decided you wanted more than friendship.

Our wedding day could be considered a fairy tale, from proposing that New Years Eve afternoon to getting married, in 9 months you’d found everything a girl needs, the limo, white horse drawn carriage to the castle, string trio, magician, fireworks, music, 300 candles to light the pathway.  It was magical and fun… A day neither of us would forget.

Mind you, I heard later the Castle staff were taking bets on when I would faint as apparently I looked whiter than white (probably from being up until 4am still writing my speech).

We had a magnum of Vintage 196x Moët et Chandon for the top table and I vividly remember you walking around the castle grounds in your gorgeous wedding dress with that oversized bottle in your hand as you didn’t want anyone walking off with it.

In the 11 years, 3 months and 1 day we were married you were always full of life, optimistic, happy and always said it was sunny when you are up with your gran as a kid.  Sadly in retrospect we both focussed (too heavily) on work and should have done more together.  During the times we weren’t working we managed some awesome travel and adventure between us!  Australia, Hong Kong, Singapore, Dallas, Amsterdam, Paris, Prague, St Lucia, Antigua, Dominican Republic, Barbados, most of mainland Europe, to name but a few…  You’ve always loved travel visiting more places before we started dating including Russia (which I wanted to visit).  you’d be up for almost anything whether it was Scuba Diving at the Great Barrier Reef, Rally Driving at Silverstone, Archery, Quad Biking, Learning to fly a Boeing 737 are but a few examples.  You always wanted to sky surf, to jump out of an aeroplane with a snowboard, but we never managed to get that far in our life journey together.

I am so happy to have been part of your life that even today I still feel helpless in not being able to find a treatment or cure for you.  I don’t want this to be a sad post, because you were a positive person who brought balance and happiness to my life.

I think the point is, that our story was never finished, we planned so much together, to travel the world and sharing experiences.  Our story feels incomplete/unfair.

I wanted to spend the rest of my life with you, but I now know you shared the rest of your life with me.  I love you now and always. xxx

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Hello, How are you? Part 1…

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It’s been 16 weeks or 112 days or 2,688 hours since losing my loving, gorgeous, caring, and witty wife.  How have I been during that time?  Total shock, denial, loss, emptiness, sad, grief, apathy towards life and devastation just doesn’t seem enough to describe how I am feeling.

My emotional vocabulary isn’t strong, after all, I read technical documents, papers, books and can count on one hand the number of non technical articles/books I’ve read over the last 30+ years…

There hasn’t been single moment I’ve not thought about last years events and Janice is constantly at the front of my mind.  Unfortunately?!? I have an exceptional memory, especially for details, which at times is a curse…

Everyday my mind replays all the events of last year, my head is stuck in a constant loop of her last 12 days, with particular emphasis on the her last 4 days.  I’m sure you can appreciate this is especially painful and one day maybe I’ll be strong enough to share what happened, but not today.

I’ve played out every “What If?…” scenario, “Bargained” with invisible and non-existanct deities, blame myself for not being able to find the answers/solutions for possible treatment/cure from anywhere around the world, and ask myself is there anything more I could have done?  I feel I failed her, for not being able to save her and for not being able to deliver on my promise to bring her home in time.  Ultimately I wasn’t able to save her though I would happily trade places with her.  Cliché? maybe, but it’s true.

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Merry Christmas and Thank You Friends and Family

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With all my Love xxx

As many know, this year has been both stressful and devastating with the recent passing of my Wife at the start of December this year.  As I sit on my own with a glass of wine and slice of pizza I wanted to say “Merry Christmas, Happy New Year and Thank You for your help and support in 2016” to both friends and family during this season of good cheer.

No I haven’t gone soft, and I’m not celebrating Xmas or the New Year for 2016, but I do want to recognise the help and support from everyone who has been here to help us both.

I do want to say that Janice is a private person and didn’t broadcast her illness, at the same time she didn’t hide it.  Anyone who asked how she was, would learn the terrible truth.

When the news of her cancer broke, people reacted in different ways.

  • Some close friends ran to the hills to never be seen again (Fair weather friends).
  • Others kept in touch and said “Hello” from time to time.
  • Some of you went over and above to provide help and support, especially during the last few weeks of hospital.
    • Two of my friends had suffered their own personal loses and yet with all their added pressure really stepped with support for which I can not thank them enough.
  • There are those that gave us the space needed during the final days.
  • A few I don’t hear from for months/years at a time are behaving angrily.
  • And old friends who learned of this tragic news have shown their regular support.
  • Those who were completely unaware of the seriousness of her illness are shocked and devastated.

For everyone that has been supportive, picked up the phone to say hello, dropped an email, a PM or text, thank you, your words and thoughts are encouraging, even if I am a miserable old git.

To friends old and new, don’t be strangers or feel awkward, sometimes it’s the phone call, the simple hello or text that helps me get through these very dark days and thoughts, but also don’t be surprised or take it to heart if I’m an emotional wreck, grumpy or erratic.  I’ve never been good at either asking for (or accepting) help, just stick with me and good things will happen I’m sure!

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Jason x

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In Loving Memory of my Wife

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In Loving Memory of my Gorgeous Wife

It is with deep sadness my best friend and wife passed away peacefully having bravely fought a ferocious, extremely aggressive and rare form of Cancer.

At the time of her diagnosis, I stupidly asked “Why you?”, she looked at me lovingly and calmly replied “Why not me?”.

We both knew it would be a rough year, as she underwent an extremely tough regime of Chemotherapy, Radiotherapy, Scans, Tests, set backs and more surgery than most can endure, and yet she never complained, got upset or cried.  She took each day as it came and focussed on each days problems in a bid to beat her cancer, a fighter to her very last breath.

In November a new (and fatal) tumour was discovered and grew from nothing to a very large size in less than two weeks.  At this point we were told that there was no surgical, radiotherapy or treatment available.  Thankfully the hospital allowed me to sleep on the floor next to her bed for the next 12 days and nights, never leaving her side taking care of her needs until her passing in December.

This years journey has been extremely tough on friends and family dealing with her cancer, and I will tell my story when I have the strength and energy to do so, please believe me when I say she is an inspiration to everyone who knew her during these difficult times.

I am heart broken, devastated and in pain as I have lost my best friend who is gorgeous, caring, witty and a fantastic wife.

I won’t be celebrating Christmas this year (it’s cancelled) and I won’t be sending any cards or festive cheer.  Instead I will sit on my own on Christmas Day with a pizza and a bottle of Jack Daniels for company as I try and make sense of what has happened.

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Dobré Ráno! Ako sa máš?

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Well it finally happened, took a while to sort out but here I am back in Slovakia and it’s been an absolutely gorgeous week so far with temperatures rising as high as 26 Degrees!

 

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Sadly though, an office looks like an office anywhere you work around the world, and so far no time for any proper site seeing/orientation. I did however manage to say Dobrý večer! to the Danube 🙂

Now which of my friends are making the short hop skip and a jump over the pond to come and visit me and party all night long?

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Amazing Sense of Architectural Humour

IMG_7413.pngWho here has watched the fantastic Cold War Drama  Deutschland ’83?

You can catch up on the  series here :- http://www.channel4.com/programmes/deutschland-83

There’s a scene in Episode 6 where Stamm is on the train and you catch a glimpse of German architecture which was captured above.

Now who says architects don’t have a sense of humour!

 

 

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