Blog: Adventures in the NHS
It's been a long time since I used this journal as an actual journal, and I kind of wanted you to know what has been going on in my life the last few weeks.
I've had a problem with my back since I was a teenager. Normally I ignore it, but sometimes it can cause me bigger issues, such as sitting being painful. It last caused its big issue nearly three years ago now, just before I started my teacher training, and earned me a four-week sick note and my parents' help when I moved to Aberystwyth because I couldn't carry anything heavy.
Just before the Easter holidays, I secured myself a job in what you might call a challenging school. They have behavioural issues coming out of their ears. I have never issued so many detentions in my life. And in that same week, my back decided that was the time to start playing up. It wasn't too severe for the first few days, and because the holidays were upon me, I could relax and take it easy - rest up and get back to normal. Hah.
Tuesday before Easter, I had a hospital appointment in Burnley, which went well except that I could barely stand to put my bum on a chair, and even standing was getting painful. Walking was a joke. So after my appointment, one of the nurses helpfully pointed me towards their A&E. They dosed me up on some nice painkillers and directed me to walk-in physiotherapy.
Dutifully, I attended the nearest clinic on Wednesday (opting to drive for 15 minutes rather than spend 30+ minutes on the bus), and was made to wait 90 minutes to be seen, despite the fact I was actually shaking with the pain by this point, and couldn't stop the occasional fits of tears. And they were categorically useless: they did exactly the same assessment as the very nice F2 doctor at A&E, got exactly the same results, asked me what exercises I was already doing then prescribed the same ones and nothing else. Nothing. Despite the fact I was clearly in agony.
I was lucky that on the Thursday I already had an appointment with my GP for something else. I usurped it for this infinitely more important issue, and got a referral to a musculoskeletal (MSK) specialist. Hurrah! To be fair, I had almost passed out on my way into his surgery, so maybe that had something to do with it. He also gave me some very nice painkillers that work on nerve pain since I clearly had some sciatica going on too (since he did all the same tests as the other two).
The Friday - Good Friday - found me in my local A&E (not the same one as Tuesday; Blackburn this time) because I was in so much pain. As you might imagine, being a bank holiday, the place was rammed. And I still couldn't sit - I was kneeling on the floor, clinging on to my chair for dear life and begging myself not to cry (I failed, by the way). A very nice lady who I think had been there for a lot of time already told my mum straight up to go and get someone, because it was obvious I wasn't messing about and I was seconds away from just lying down. I was only stopping myself because there was literally nowhere that would not be in the way of someone else. A couple of minutes later, a nurse was escorting me to a cubicle with a MSK guy, ready and waiting for me! He gave me some morphine then did the same battery of tests as everyone else and said I would have to wait for the official MSK referral as I wasn't hitting any of their red flags for immediate admission. With lumbar back problems, especially where they suspect a slipped disc, they are looking for something called cauda equina syndrome, which is basically damage to the nerves in the lower back and causes loss of toilet control and/or paralysis and/or loss of sensation in the thighs and genital area. That's a very simplistic overview, but I wasn't showing the danger signs, so there wasn't much he could do beyond pain management. And boy oh boy did the morphine work. I don't really remember what my mum and I talked about on our way back from the hospital, but I do remember her laughing at me quite a lot. I also remember her taking advantage of the fact I wasn't in pain to get me into the shower before I crashed because it made me sleepy as well as high. It also made my skin crawl really unpleasantly and (I now know) gave me a migraine the next day.
A week later, I went back to the GP for some more painkillers since term was starting and I needed to be able to function. Saw the same GP, who was pleased with my progress - I was walking without the stick I had taken the first time, and smiling at him.
I spent a whole four days back at school, in agony, with a camping mat so that I could lie down to mark in my free periods, before they said they were too worried about how much I was deteriorating and they were getting someone in to replace me. I was devistated - I had given so much and, to be honest, if I hadn't been going back to the same job (that was promised until the end of the year), I wouldn't have gone back to work after Easter at all. But they were right - I couldn't even drive by that point; my mum was driving me to work every day and picking me up, and by the end of each day I was so glad to get home and not worry about any kids wandering in.
On the Friday, I ended up back at the doctor because four days at school had done me in completely. I was back on the stick (I hadn't used it at school because I had too much pride), and refused to sit at any point during the consultation. This time, it was a doctor who had been at the practice for donkeys years, and he was a bit worried because I was starting to lose the sensation in my right leg (not something I had noticed myself until he started going through all the same tests again). He told me to go straight to the MSK clinic and ask about my referral, since they were upstairs in the same building!
Up the lift I (and my mum, bless her soul) staggered. The MSK receptionist was very, very nice and tried her best, but could not find my referral at all. So back downstairs my mum trotted (abandoning me with the MSK receptionist, who kept asking me if I wanted a chair), only to find after much discussion that GP #1 was actually a trainee and the referral letter had been passed on to his trainer because it 'lacked content'. And nothing had been done. For two weeks. Bless them, though, they got it sorted, and the MSK lady promised she would get me seen that day. So I lay down on the floor in their waiting room, much to her horror and my relief.
Dr MSK was great: he went through all the same tests as everyone else, determined without much difficulty that it was a prolapsed (slipped) disc (just as my GP had done about an hour earlier) and referred me for an MRI. He also upped my painkillers, and told me that surgery for disc problems was rare (despite my dad having had it), so I was probably in for a long, gruelling trial by physio once they worked out exactly what was going on in there.
In the meantime, I opted for some private physiotherapy. She was marvellous - she sussed me out the moment I stepped over the threshold and spent the next hour finding my problem spots and manoeuvring the vertebrae to create some relief for me. And boy did she. For the next few days, my spine felt freer than it had for quite some time. It wasn't a miracle, it didn't cure me, and I was still left with the sciatica that was starting to cripple me, but at least my back felt better, as long as I didn't lie on the bruises! (she's vicious, but wonderful).
The MRI was fun - Royal Blackburn Hospital is such a poor design really, from the point of the poor schmuck who is barely ambulatory but doesn't get referred straight from A&E. Getting referred from A&E would be easy, since you go out through a back door with a porter/nurse and straight in. Should you not have that luxury, you have to make the trek along a 'U' shape. And I mentioned barely ambulatory, right? I was in so much pain by the time I got there that I was doing a repeat of my trip to their A&E department (read: kneeling on the floor, bent over a chair, with tears in my eyes). Add to that the metal parts I didn't know were in my shoes and claustrophobia, and the MRI was just awesome. That said, I got the chance to look at the results for myself nine days later, and that was really cool, but that's another story.
So, eight days after the MRI (a week past Friday), I get a phone call from my MSK guy saying that there is definitely a prolapsed disc (L4/5, if you're interested), along with a degenerating disc underneath it (L5/S1), and that surgery was probably the best option after all. By this point, I had already been starting to worry as I was having some trouble with the toilet, so he said he would contact the surgeons and they would probably want to see me on Monday. But not ten minutes later (a ten minutes in which my mum/chauffeur had nipped out to run some errands), I was on the phone to the surgical assessment team at Royal Preston Hospital, who wanted to see me that morning, and I should probably bring a bag because they might well do it there and then. So I should also not eat or drink anything else. This was half past ten in the morning. So all hell broke loose, finding my overnight bag and hauling stuff out that I wouldn't possibly need; replacing the pyjamas that had mysteriously disappeared from it at some point; topping up my shampoo bottle. Simple things like that. By this point, I was on crutches, really struggling to walk, and anyone who has ever been to RPH will tell you that it has the WORST car parking of any hospital. We were actually lucky enough to get a space in the front car park, nearest the main entrance, but it was still a long walk, and I felt no qualms about lying on the floor in their waiting room. It had a carpet and Loose Women was on. Not something I would normally watch, but it's better than Jeremy Kyle. Turns out, though, lying on the floor in a hospital, even if you look comfy and are chatting to your mum, really alarms nurses because they think you've fainted. Who knew? So they moved me to a room with a bed, which I really wasn't going to complain about.
When I finally got seen, at about two o'clock, the physio did all the tests again, added some new and very personal ones into the mix, and said that yes, they were going to admit me but no, they weren't going to do the surgery itself until Sunday. This meant I suddenly didn't have enough stuff with me. But she let me see the MRI for myself, and was impressed that I could pick out the two problem dics without any help. It wasn't hard - even they said the prolapse was massive, and it was pressing on my spinal cord, causing this cauda equina syndrome that they needed to sort before it became permanent. So, while they were waiting to admit me (which takes a shocking level of coordination from a shocking number of people) I was allowed something to eat. Finally. It was, by now, about half past three, and by the time I actually got up to the ward, it was nearly five. And I was the youngest on the ward by a good thirty years.
This was my first experience of being admitted to hospital, and the first night was pretty horrific. One of the ladies in my room was... the technical term used by the nurses was 'barking'. She was very confused, very ill, and had a broken hip. She alternated between praying very loudly and blaming her granddaughters for her current predicament. And she found a way out of the bed by slithering her legs into the space between the end of the bars and the foot of the bed. She nearly got out of bed twice in the space of a couple of hours. Eventually, she was moved to a ward where she could be watched constantly, and I finally managed to grab a few hours of sleep. I tried morphine to make me sleep, but they only gave me a quarter dose, and all it did was make my skin crawl - none of the nice sleepiness I had gotten the week previously. And I woke up with another migraine, so I'm not trying that again.
Day two (Saturday) was actually kind of nice after the migraine: I got to know my neighbour a little better - she was the room's next-youngest resident at sixty-six, a retired nurse and a survivor of the op I was about to have. And she told me off for doing little things around the ward to help out, like picking up things that the other ladies had dropped. Yes, it took me a while, but I was making the most of it and it was a waste of the nurses' time when I could still do it. One of the surgeons came to see me, to make sure I understood exactly what they were going to do the next day, and promised that I would be the first patient operated on the next morning. I would have a chance of actually enjoying some of the roast dinner or, if not, at least the rhubarb crumble that was on the menu for lunch. And tea was nice too for the next day.
After another restless night, this time caused by a combination of one of the nurses sharing her concerns about a member of her family who had gotten themselves into a pickle just before their GCSE exams (I got asked my 'expert' opinion as to what they should focus on rather than trying to do them all and failing everything) which tied my brain up trying to think of things I could do to help, and my three roomies all coughing (I don't sleep well with others. It's a tragic but true fact), I didn't get the greatest night. And in the morning, when the anaesthatist came to see me, his reaction to my op (ON MY SPINE. WITH MY SPINAL CORD IN THE WAY) was "Is that it? We'll do the other one first then." So I got pushed back at the whim of an anaesthatist. And by 'pushed back', I mean by about five hours! I was supposed to go down to theatre about 8am. I actually went after 1pm. That meant after the roast dinner I was so looking forward to and got to watch everyone else enjoy instead. After the rhubarb crumble and custard that is my absolute favourite. So late, in fact, that by the time I was back on the ward, still really whacked-out, it was five; tea time, and I just about managed someone else's ice cream (my throat was and still is sore from the tube).
Then when I started to come round properly I realised that my right leg wasn't working properly. By which I mean I could feel it but couldn't move it. Which sucked big style. And even discounting the indignity of having to have the nurses manoeuvre around my leg, I was in so much pain when they tried to put a bed pan under me, I couldn't go anyway! So just before nine, they ended up putting a catheter in. Now, ladies, you think your smear is undignified? It really, really isn't. Having never given birth or had a proper gynie exam, I can't say whether they are more undignified (probably, yes) but I have never experienced indignity like having a catheter inserted while awake. Especially since I couldn't move one of my legs out of the way. But I grew to love my catheter: as long as I can remember, I have always gotten up to go to the loo in the middle of the night, and with the catheter, I didn't have to. Two nights I had it in, and boy do I miss it.
But during that night (also pretty sleepless due to pain and my next-door neighbour's increasingly painful coughing, which she was really conscious of), my leg came back to me in fits and starts, often without me even realising it. It's like it never went away in the first place! Except for my knee's tendency to be a bit too knee-ish on occasions - i.e. the occasions I want it to be nice and straight and not at all bendy - you would never know I had a period where I had no movement whatsoever in it. This was a good thing, because I was once again banned from eating and drinking. Fortunately, I had an IV to stop me getting too dehydrated this time, which they took away as it became apparent they weren't going to have to operate again after all. So Monday was all about making sure they hadn't broken me after all and I could do stuff like stand and sit, no matter how much it hurt my surgery site, because that would go away with time.
Tuesday, there was this sudden flurry of visitors, all of whom seemed confused that I still had the catheter in. It quickly became apparent it was because I was due to be discharged despite no-one telling me or my parents. So, out came the rubber tubing and the physiotherapists were allowed to torture me all they liked. And the pharmacists took forever to come up with the drugs; some of which they were supposed to have provided for first thing Monday morning (only my steroid inhaler which isn't supposed to be stopped under any circumstances - bloody typical). And I've suddenly got a plethora of things like migraine tablets, just because I took one while I was there. Weird.
So, here I am, home and recuperating from spinal surgery. Yesterday was easier than today, mostly because if feels like all the muscles in my back have suddenly realised something fairly traumatic happened to them and they really should get in on that action. I am unimpressed. But it is only a small step back, and one that actually would respond to heat treatment, unlike the nerve trouble that plagued me for six weeks before the surgery. The sciatica is gone completely and all I am left with is seven staples, an irrepressible itch in the middle of my lower back and a numb left foot that I can live with. Although the DVLA might not be too happy about it when I come to try driving again...