It all begins to go wrong

Saturday 23rd February

05:30 and this is where it all started to go wrong. I felt like I wanted to go to the toilet quite badly so I called for the nurse, the nurse who had helped me before was on a break so a HCA (Healthcare Assistant) and the Trainee Nurse came. I explained I needed the toilet and the problem I had before so we went straight for the commode. When they came back, and after fighting to get the armrest off the commode so I could transfer across, I asked who was brave enough to take the weight of the stump, the HCA jumped straight in and I started to move across. I got to the point where I had my foot on the floor and was getting ready for the last push, I felt perfectly fine, I heaved my body across and was perched on the commode. I looked up at the trainee and I said I felt really light headed, at this point I started getting really hot and sweating, I then said I felt sick at which point the HCA ran off to get a sick bowl. The next thing I know there are arms everywhere dragging me back on the bed and I felt very little pain. I was saturated in sweat and felt awful, there were 6 people around the bed and I’m being hooked up to have my observations taken. My blood pressure was through the floor and my heart rate was very fast, a nurse said I was very clammy and very pale. I asked the HCA later what had happened, she told me that when she came back with the sick bowl I was slumped on the bed (oh that could have been so much worse if I fell any other way). The trainee (who was exceptionally new) was standing over me but remained composed, she could see I was breathing but knew the two of them couldn’t manage so she pressed the emergency button. About 4 Nurses came running but she did say it was not an arrest (cardiac arrest), They all grabbed a piece of me and dragged me on the bed. After they had done all the observations they tilted the bed so my head was lower than my feet. Everything calmed down, they got me a fan and put some wet wipe things across my forehead to try and cool me down. The HCA was told she made the right decision to call for help and they both dealt with the situation well. The woman in the bed diagonally opposite complained about commotion and thought the use of the alarm was only for something serious. She was told that as I had just had surgery it could have turned into something life threateningly serious. I still wanted to go to the toilet but I was told I had to wait an hour before they would try me on the commode again. A while later a doctor came along to take some blood and see how I was feeling, I explained that I really wanted to go to the toilet and could I be catheterised. She told me that I couldn’t because of the risk of infection but she would get a nurse to do a bladder scan (this is because quite often after surgery you feel like you want to go when actually there is very little in your bladder). Later still I called for the nurse and the HSA came down, when I asked bout the toilet I was told I had about another 15mins to go and they were doing hand over. I couldn’t see the clock from my bed so after what seemed like an eternity, and we must have been near 08:00 by now, I rung the bell again, this time the day shift nurse turned up.

I explained the situation and about the fact that they would not catheterise me but I felt desperate, she told me she would do a bladder scan, which was what the Dr had asked for hours ago. She came back, explained everything and got on with it, her eyes opened wide as she said there was 600ml in my bladder. She checked the other side and said that she didn’t care, she was making the executive decision to catheterise then and there, away she went with the speed of 100 Gazelles to get the bits she needed. I said that I suppose the epidural was also affecting the bladder, she was surprised they didn’t put one in in theatre and couldn’t believe that they hadn’t done it earlier. She had a few attempts at getting it in, she said she was usually really good at getting them in first time. You can only try a number of times with the same catheter so she had to get another one. I was getting a bit sore now but eventually the second one went in, the flow started instantly and she had hands of lightning to get it all fitted together and the bag on. She told me I should start feeling some relief and she had never seen urine come out that fast while fitting a catheter before. She was dead right though after a short amount of time I did feel a lot better and that was one thing off my mind. I also explained to the nurse that my bag with all my medication was still on the other ward. I wasn’t so worried about the bag as apart from the medication there was nothing of value in there, it was the wheelchair I was worried about. Again she saved the day, after trying to arrange for it to be brought up with no success she eventually made the long journey to the ward and collected it herself. That same nurse would be on the ball more than anyone else on the ward and I’m so glad I had her helping me.

I couldn’t eat anything (and I hadn’t eaten the day before) and every time they tried to sit me up I felt light headed and stated sweating. Most of the day consisted of me lying in pain and waiting for the drugs run, the pain team didn’t see me and I assumed they would see me on Monday. Mum and Dad visited me in the afternoon and brought in some art stuff, mobile phone and iPad for me. From the incident in the morning the dressing round the stump was hanging on by a bit of tape, it had rolled up and was digging in the back of the stump, which was exceptionally pain full. The on the ball nurse said that it might accidentally come off and not long after she said that it did. This revealed the wound, which looked amazing already with just tape strips over the top of it.

Early evening my Consultant unexpectedly came in. He said that as he missed me after surgery and he wouldn’t be in the next day or Monday he would come and see me now. He explained that there was a bursa there which they removed, they roughened the end of the bone and did Liposuction, they took away 1,000ml or 1kg which to me seemed a massive amount to me. He told me that it is exceptionally difficult with an above knee amputee as the bone is so thin. He had a look at the wound and I told him the dressing had nearly come off when I passed out in the early hours and fell of a little while ago. He told me that especially as they had done Liposuction he wanted some compression or a bandage on it. They put a dressing over it in the meantime.

All through the day my observations remained the same with low blood pressure and high heart rate, the pain I was in could have caused the high heart rate. The doctor who was on the night before came round again and then I started to feel like a Lab Rat. They took a urine sample as they thought I might have a urine infection. Because of my heart rate they did and ECG, they said they might do some more blood tests in the morning, as my white cell count was high. This can be normal after surgery but it can also be another sign of infection. I had my finger pricked so they could test my blood sugar, as I had had nothing to eat. I have to admit she was being thorough though, which was a bit more reassuring after the night before. The Dr came back a bit later and put another cannula in, as the one used during surgery had been taken out. She made a bit of a cluster doing that by not applying enough pressure as she withdrew the needle. She spilt loads of blood down me and on the sheets, which had to be changed. They had found ketones in the urine sample so put me straight on two bags of fluids through the night. The rest of the night I was spent phone watching, as I couldn’t see the clock to clock watch, I didn’t get any sleep from the pain and called for my pain relief every three hours, it was a long night.

Note:- I have never passed out before and never had any problems with my heart rate or blood pressure following surgery.

 

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