Neuro recovery

IMG_2809

Lynne, Lynne, open your eyes…

Blurred voices, fragments of images, something metal going around.  A pull in my throat, raw. I want to cough, but it’s too sore.

 Have I had it done? Have I? Hoarse.

Yes, Lynne it’s all done, you’re in recovery.

Crying I feel like crying. I feel sick. There’s a pain in my head, sore, aching, in the place of Hunt but not the Hunt pain, a more intense but less palpable pain.

Lynn, the nurse. Kind, soft voice, smiling.

Do you have any pain?

Yes, in my head. I’m going to be sick.

The PCA button is orange, glowing, I press and hear an odd noise. It’s working, and the pain throb in my head eases. I ask for ondansetron because I’m fixated on it now, my trusty anti-emetic. I’m given a tiny sip of water from a plastic cup, through a black straw. Black is a bit S&M for a straw. The water eases my throat, the raw feeling cooled, but then I feel it pooling in the pit of my stomach.

Lynne, I’m going to ask you some questions. Who’s the prime minister?

David fucking Cameron!

There are titters.

What’s the day today?

Um, Wednesday.

What’s the date?

Something of March.

And the year?

2015, 16…

Lynn still laughing, shines a torch into each of my eyes.

The man next to me is agitated, upset, trying to get up. I see Lorenzo the anaesthetist’s hat bobbing as he sorts him out; they try to calm him, to talk him down and explain, but he’s uncontrollable so eventually they administer a sedative.

I’m really fixated on vomiting, sure it’s going to happen as it has after the original wide local excision for breast cancer, and after the bilateral mastectomies, and then after the partial thyroidectomy in October 2014 when I spent the night being given anti-emetics and pain relief orally, and vomited it all up each time. That night hangs over me like the shadow of death.

The BP cuff inflates, hard on my arm, and Lynn looks at me. I’m desperate for a pee, feel the pressure mounting.

Let’s try the bed pan, do you think you can do that?

Yes. I don’t feel I can do anything, but I need to pee so badly.

She sits me up a little more; post neurosurgery I’m supposed to be semi recumbent at a minimum incline of 35 degrees, so I’m sat up now to about 50. I feel the pressure in my bladder increase if that’s even possible, while the pressure in my stomach rises in sympathy as the vomit threatens to well. I lift my bum, feel the sharp edge, I’m sure I’m going to vomit.

Someone gives me an anti emetic, I think it’s swallowed but it’s a blur.

Lynn has already closed the curtains, and she tells me she’s going to leave me now; the whoosh and tinkle of water as she turns the tap on outside does nothing but increase the urgency. The wee is right on the edge, pressing out, almost relief but…it won’t come. I try to breathe, relax, feel the nausea switch in. I try to push, then relax, but it won’t come.

I can’t do it Lynn. The bedpan is hard under my bum, another annoying pain. Nausea hangs, spreads, drops back to the pit of my stomach. Clamminess breaks on my forehead, and I feel the ache from my skull. I press the PCA, the drug flows in and I try again, but that’s somehow made it farther away. The pain in my head has gone.

It’s ok, let me speak to Lorenzo… She turns away. I stare across the way, there’s a footballer over there and they’re talking about the good old days of Argyle.

Yes we can do an in and out catheter, how’s that? Lynn’s smiling again.

Yes, please. All I can think about is peeing, and nausea.

Lynn asks for help, gels the catherter, rearranges the bedpan, pulls out the catheter from its bag. I flop my legs to either side.

Is that it? she asks the other nurse…yes, I think so.

I feel it push in, relax, relax, and then blessed relief. It takes longer than I’d thought, but then it’s all gone, the pressure and the angst.

1000 mls, a litre. The bedpan is full, and Lynn giggles as she carries it carefully away, retuning to wipe and settle me back down.

The nausea remains, I ask again.

You’re not going to be sick, we can manage it. You’re okay. A small sip of water again?

I feel so much better with the urine bomb gone.

There are conversations, I kind of hear but don’t. I see Lorenzo, he talks to me about the tumour, he thinks it looks like a metastasis. He tells me there are things to be done if I do have lung mets, I think I must have asked him but it’s a bit of a blur.

Lynn phones my parents for me, let me tell them you’re okay she says. I’m supposed to stay here till 7, think I got here about 5, but the ward won’t let me come up till after 9. There are people all around, each with various staff.

Have a little sleep Lynne, do you think you can?

Later we talk, about Hunt the tumour, and about her husband, and good pubs on the moor with walks, and my swimming. She tells me Lorenzo has horses.

That kindness, that exchange of confidences, that willingness to accept my crankiness and fear channelled through the vomiting phobia it’s become, have bonded us. I know what’s happening in my head, but I can’t seem to control it at all. Lynn understands. Fear of not being able to wee adds to my list of foibles now, and I remember taking ages and going into a full shake on the commode the last time, then fainting on the loo. I’d kind of forgotten. Displacement.

Lynn arranges with Lorenzo that I can be catheterised later if necessary, and that’s written down so I won’t get into the situation where there’s a problem. She tells me another nurse remembers me from last time, when we talked about wild swimming. I’m becoming a Derriford recovery regular…

Finally at about 9.30 I’m wheeled up to Moorgate Ward. There I meet Binu, a nurse I’d seen a while ago when visiting my friend Linda on the ward. Binu can’t do enough for me. I get ondansetron IV, feeding my rather prosaic anti-emetic habit, and more water. She’s one of those people who’s self-contained, but she has a quietly cracking sense of humour and we hit it off at once. How kind she is, how tolerant of my fretting. Two gems in a row, must be a pattern forming here.

But I know I’m in for a long night.

 

 

 

 

 

 

Advertisements

Sick

One of the more subtle symptoms of my brain tumour is a vague, intermittent nausea. It’s one of those feelings I’ve been able to ignore perhaps because it’s not that troubling, and I’m used to GI symptoms.

The nausea worsened with steroids which are pretty irritating to the gut and my GP Dr H prescribed domperidone to help alleviate it a couple of days after the diagnosis. That helped, and enabled me to eat more which in turn made me feel better, certainly later in the day once the steroid doses were done.

But in the past two or three days the nausea has worsened considerably, from a slight annoyance to something more; for most of the day I’ve grown an acid gremlin that sits in the pit of my stomach and threatens to shoot. It’s not reflux, and eating doesn’t help. This afternoon I thought I might actually vomit if I laid down.

The duty GP at my surgery is Dr E, a man I know and like very much, partly because I’ve seen him a few times in recent months with my various troubles during which he has been excellent; he also works for the out of hours GP service locally. On the occasions when I’ve called him regarding a patient – one of which was especially complex and and involved an extremely upsetting mental health crisis where as ever we had no access to specialist resources – he has been unfailing in his willingness and ability to sort the most intractable situations.

Dr E had called me within 20 minutes, at 4.45 on a Friday, which was the point where I realised the domperidone was no longer working and that I have another weekend to get through. We discussed the options. His solution is to hit it with the big guns, because as he says, the point is to alleviate the symptoms for this period until I undergo surgery. So, within an hour my brother Dave has collected Ondansetron from the pharmacy.

It’s the first truly effective, multi-purpose anti-emetic that paramedics here were authorised to administer, and I have used it in a number of situations to great effect. I’m to take it prophylactically – with the aim of preventing nausea rather than treating it – starting with 4mg twice a day, with the option to double either or both doses.

Another  big up for our NHS.