Full of sh*t~GRAPHIC MEDICAL CONTENT

🟨Wednesday 6th March 2024

 That time I was literally full of sh*t.

(Save our NHS)

On four separate occasions, and ambulance 
ferried me to hospital, only to discharge
myself. That idiocy could have cost me 
my life.

  I'm telling this story so that others can learn from my silly mistakes and hopefully avoid an unnecessary trip to the theatre..the operating theatre, that is. People have remarked that it sounds like something from a horror movie and that they were shocked when they checked, only to discover it's completely true. Feel free to share it as you see fit.

A&E where they finally pinned me down with innumerable tubes and wires.

    

   Over a period of about six months, I had become increasingly constipated. But with other things occupying my thoughts and not actually being in pain, it didn't concern me. Upon realising that dealing with this couldn't be avoided and that it wasn't a solo fix, I took the first of four ambulance trips to the hospital. An enema was administered and they pointed towards a door explaining that I should wait as long as possible before availing myself of the amenities. 

Making my way into the single toilet, I locked the door behind me and turned around only to be confronted by the toilet from hell. There was blood and excrement on the walls and floor. The toilet itself was brimming with toilet paper, indicating that it was concealing something unspeakably revolting and that flushing wasn't going to be possible, if it wasn't responsible for s*it volcano in the first place. Fortunately, the enema hadn't worked as expected, so I dressed myself and slipped out unnoticed. 

 The world's worst toilet. 

   On two more occasions, the same events unfolded. By the time I called for the fourth ambulance, I was retching constantly. This time there was no enema and no escaping. I was pinned down and a tube fed up my nose and into my stomach. As unpleasant as that is, the two bags of black bile that it drained from me alleviated the retching. You may or not be aware that expelling red coloured blood from the body is alarming but providing there's not an excessive amount, it's usually not serious. It occurs frequently when small blood vessels and capillaries burst in the body, perhaps from retching, vomiting or straightening. However, nothing black should be emerging from your being.. that is supposed to remain inside you and indicates bleeding from somewhere deep inside and quite probably somewhere critical.

 My surgeon announced that there was no time for a scan and I was prepped for the operating theatre. Instead of wasting time trying to find a willing vein big enough for the anaesthetic drugs, they decided to go straight for a central line (a catheter inserted into the jugular vein at the neck). Concerned about post-surgical pain management, despite my persistent writhing, an epidural was administered which seemed to take an eternity. I've never been very keen on the thought of having those sizeable hypodermic needles stuck into my spine. The final thing I remember saying to the surgical team surrounding me was: "please try not to leave me with a bag". Then I drifted away to my special place where everyday is a Propofol day. Though as I understand it, they gave me a hefty whack of Fentanyl too. I was unduly concerned about the possibility of spending the rest of my days emptying my excreta into the toilet from a colostomy bag. A temporary bag can be fitted until such a time as the highly elastic tissues of the gut can heal and regenerate rendering it redundant.

Eek! They were cutting me in two. Not unlike the magicians trick.

  This  procedure is called a "resection". Some of my intestine/bowel had spontaneously become necrotic (dying/dead). Necrosis spreads rapidly, so it's vital that it's removed as soon as possible. You won't last long when you're literally "dying inside". Had I not discharged myself on those previous visits to the Accident & Emergency department, endoscopic surgery would have been perfectly possible. Recovery times for endoscopic surgery (aka: keyhole surgery) is a fraction of the time and it's obviously way less traumatic so no need for that week in intensive care. Instead, a laparotomy was required. This procedure can last from 3 to 6 hours. Looking back, I feel for the theatre team that day. Given the length of time since I'd defecated, there must have been a veritable "sh*t ton" of doo-doo in there. Rather them than me. 

Following my surgery. 
Grey and swollen from the CO2 gas
they pump! Into your body, making 
space for the surgeon to work.

  Looking at statistics, you could be mistaken for thinking that going under the knife, is more of a risk than it first appears to be. Anaesthetists are the most highly qualified of all health services staff and receive the most pay too. They'll spend the duration of the operation focused entirely on the patient, carefully monitoring your breathing, cardiac activity, oxygen saturation levels, the depth of consciousness, gradually, delivering oxygen as needed and small increments of anaesthetic as required, so you're never too deeply under that you couldn't be quickly resuscitated if necessary. It's a precise state..not too deeply unconscious, yet sufficiently so not to sense any pain or be prematurely roused They'll remain conscientiously attending to your vital signs, making sure you're breathing and haven't slipped away, until they wheel you into recovery. There they can be identified by the paper shower cap they're sporting, staring at you, as you wake in a state of extreme confusion.

  When I was a kid, like many people I wasn't a fan of the dentist. We had "school dentists" who would visit the school regularly and check all the kids. We invariably needed some treatment. Not because we had bad teeth..in fact I had such strong teeth that for a while I had two sets, the baby teeth failing to fall out when the adult teeth broke through. Much of this work was entirely unnecessary but free to our parents who completely trusted this kiddie mouth butcher. He clearly saw little harm in cashing in on this situation. But when he tried to put me under with this utterly revolting tasting gas, I was so terrified that I fought it and by the time that the gas won the battle of Sleepytime, there was no time for him to do anything due to the massive amount of gas he'd given me. I came round with him and his assistant slapping me in the face. Ah, the 1970's! 

  Michael Jackson and Joan Rivers both died after taking Propofol which is a short acting general anaesthetic with the appearance of a thick, white emulsion. Contrary to popular opinion, it doesn't make you sleep-it knocks you unconscious (not quite the same thing!). "The milk of amnesia" as it's known, is useful for patients intubated who are being intubated for ventilation, because of a unique effect of Propofol. It relaxes the muscles in the throat, frequently halting the patient's respiration. Anaesthetists expect and anticipate this - not such an easy task at home, without an anaesthetist or anyone at all. The appeal of Propofol isn't hard to comprehend but it's like playing Russian roulette, especially using it outside of a clinical environment, plus of course, it's also illegal. A drug like Propofol must be correctly administered to be effective and to avoid the patient experiencing the painful, stinging sensation this drug can elicit.

Metoclopramide, Propofol, Midazolam, Succinylcholine, Fentanyl and Lidocaine.

  A laparotomy (open abdominal surgery) is recognised as being one of the surgical procedures presenting the greatest amount of risk and trauma to the patient. But other factors that are massively influential include things like location, socioeconomic status, weight and respiratory health. It's also one of the most costly. Any surgery, especially one under general anaesthetic, is inherently risky. This is why the exact procedure must be explained, while the patient is alert and thus capable of understanding what's been said. This means they are able to make a fully informed decision before signing the "release", confirming that you comprehend the dangers and consent to their plans. This was a little like torture though. I would have consented to impregnating and marrying a plant pot, or anything else if they would just stop the pain.

  It's advisable to lose weight before surgery in order to minimise the dangers. How much anaesthetic is needed and employed can be calculated using an algorithm, in which your bodyweight is the critical variable.

The button quickly became the central focus of my entire world. Those things must take some real abuse

 

  The epidural that was meant to manage my post surgical pain, had successfully numbed one whole leg. I now had even more tubes and wires inserted into/attached to me than before. So even if I hadn't had my abdominal muscles sliced in half, there was no way I was going anywhere tangled in this spaghetti. Of course, that numb leg wasn't exactly conducive to getting up either. One tube was a patient controlled morphine drip. Although the patient can press a button as required to control their pain, a timer restricts the frequency with which it's released. I did my best to destroy that button and an oxygen mask muffled my cries of agony. The nurses mentioned that they thought I was "grumbling" before ensuring that mask was tightly secured over my noisy word hole. Oddly enough, when finally getting around to a closer inspection of what had once been a passable midriff, my belly button was gone! This has elicited allegations that I'm really a clone

  That week - possibly the longest of my life - was spent screaming and howling. I was sweating profusely, forcing the ICU staff to go out pilfering piles of bedsheets everyday, from wherever they could scavenge them. Even on the ICU ward, the number of sheets provided each week was limited. The sweating must have been the worst thing - besides the agonising pain obviously. This was due to the grinding pain, the furnace-like heat you get in in hospitals, which I'm not in the least bit injured to and the fact that even the morphine I managed to get from that miserly drip was insufficient for my immense needs. There was no getting up to get it off me, so I would pay shivering as some poor nurse got to sponge bath my clammy, grey body.

  Sleeping fitfully, minutes felt like hours and hours days. There is no sense of day or night and you take on the identity of your wound as it's poked and prodded. I had a vertical wound for my troubles, roughly twelve inches long and pretty gnarly.

There's nothing quite like a gnarly scar and an
outrageous tale of how it was acquired, to 
Impress children.

   One by one, the tubes and wires were removed. Having done my best to wear out the button, the morphine drip was withdrawn and replaced with oral pain relief. About a week after the surgery, I was moved from the ICU to a general ward where there were no beeping monitors, no alarms and the routine was more akin to that of a normal life, rather than the twenty four hour noise and activity of a high dependency unit. On the morning of the 5th day an epic wrestling match occurred, between a couple of very determined nurses and me. Nobody said so, but we all knew the winner would get ownership of my beloved morphine drip. Who fights someone with a body that's as useful as a plate of blancmange? It's not really cricket now, is it? For being the runner up, they piled all my nonsense on top of me and took me for a ride all around the hospital in bed. Most people feel lucky to get breakfast in bed. It's the only way to travel. 

 Able to sleep every night, I was healing well and twelve days after arriving at the hospital, I was discharged to continue recovering at home. 

Leaving is a joyous occasion and 
one at times, you think (or hope) may
never happen .

  Having sliced through all the abdominal muscles and removed a length of intestine, sitting, standing and just moving was a painful struggle. It was four long months before I really started to regain some degree of normal movement and I still have an impressive scar eight years later. 

   The takeaway from this story is: if your body is telling you that something is wrong, don't ignore it. Had I waited another day or two before going to the hospital that last time, I probably wouldn't be alive to tell the tale. What's more, had I addressed the problem earlier, rectifying it would have been much easier and far less painful with a shorter period of recovery. *If you have red blood in your stool or vomit, it's probably from the throat/rectum and although it's worth getting checked out, it's unlikely to be life threatening. Black stool/vomit is bleeding from deep inside.. blood that belongs inside. Always get help immediately. *Don't be embarrassed because your problem involves some part of the body or bodily function that is "personal". It's highly unlikely that you have something the medical professionals haven't seen many times before. It's much more embarrassing to have it be the thing everyone remembers you for after it kills you, or the epitaph on your tombstone. 

Nothing will embarrass you like losing
your life to ignorance and/or obstinacy.

  Something to bear in mind is that when we're seriously ill or injured, it's far worse for those who care about us and can do nothing but endure the fear, helplessness and concern. For the patient, it's just "happening" to them and it's not really possible to perceived it as others do watching from the bedside. 

   Only this week (maybe 6-8 years ago) did I realise just what a close shave this was. The mortality rate for people who have this kind of survey is as high as 25%. I heard that the cost of this procedure in the US $28,450.00. But remember that doesn't include any of the other things, American people are held to ransom for. There's those four ambulance rides, five days on the ICU, 7 further days on a general ward, A&E (the emergency room), all those morphine drips. They are even charged for each bed sheet, bar of soap and bite of food. I wouldn't last ten minutes in the land of the free. When you have the pre-existing conditions I do, nobody in their right mind is going to insure me. 

  Don't get me wrong. The fact that the cost of my life saving surgery, a week in the ICU, a week in the general ward, medicines, meals, ambulances, A&E, dressings, pain management, oxygen, more drugs, occupational health and aftercare all came to a handsome total of £0.00 is fantastic and something I will forever be thankful for. But people often misunderstand..we DO pay for our healthcare. We all pay national insurance contributions that is calculated as a percentage of income. This is on top of the considerable taxes we pay on virtually everything. It's not a matter of paying or not paying. The difference here is nobody profits from the misery and suffering of people who are unlucky. Going into hospital isn't a luxury. We don't think "oh I've done well this month and have a little extra disposable income. Enough to take the kids and have a picnic at the hospital." Affordable healthcare that nobody profits from isn't a "socialist" policy. It's humane and civilised. Because the taxpayer ultimately foots the bill for the NHS, we get things like preventative medicine, public health, price caps on medicines, supported initiatives for the promotion of health such as legislation promoting good nutrition, exercise, healthy lifestyles, immunisation programmes and social welfare in the health services. All things that minimise the costs for the taxpayer and while all that might sound costly.. it's nothing compared to the expense of not having them.

The elected politicians who sold the heart of 
Britain and of Brits.

  Of course the NHS isn't perfect. You'll be pushed to find someone with a good opinion of our system now. Largely because major underfunding has squeezed provision so waiting times have become impossible. It feels like everyday there's headlines bemoaning the British people dying before they could get an appointment with a doctor. It's nowhere near as bad as all that. If you're seriously ill (like I was) there are no delays. When you're in pain, sick or injured, time slows down and waiting feels like an eternity in limbo. British people love to moan about anything and everything. It's just part of who we are. We've been thoroughly spoiled and on the whole, are clueless as to how good we have it compared to people elsewhere.

  Long waiting times, understaffing, insufficient resources and difficulty getting appointments are not the fault of the NHS. It's entirely the fault of the Conservative government that tricked people into electing Margaret Thatcher more than 40 years ago. The budgetary cuts and privatisation that has brought about these failings are absolutely intentional, aimed at getting people used to coming home from hospital with a big, juicy invoice in their hand. Making them feel that private healthcare is for them (not just the wealthy) and a positive change for this country. What most don't realise is that much of the existing services they are provided courtesy of the NHS, are in fact private concerns. Even within NHS hospitals many departments are now run for profit, just like the corporatocracy over yonder in the "land of the free".

NHS waiting lists~a result of underfunding and 
intended to drive our healthcare services into 
the ground.

  I sit on the public board of our local NHS hospital and have seen this happening. Private healthcare (that term is really incorrect as it doesn't lead to health - rather the opposite - and as for care....!! Contracts were covertly handed to old school pals and "mates" by politicians, many of who have glaring conflicts of interest. If you are living in a place that has no universal healthcare available to all, perhaps you can tell them just what they're missing out on? When it's gone, there will be no getting it back. The NHS cannot be a part of a two tier service. As I mentioned previously, social care is an integral part of the NHS. When you hear about it's creation, it's lumped together with the Welfare state. This is because to work, they must intermesh. Another factor crucial for universal healthcare to work is social solidarity. Instead of feeling resentful that I am paying for the kid down the street to get glasses or have chemotherapy, I know it's for everyone's betterment and my own. I know by endorsing this system that I'd essentially "pay it forward", others will too and if/when I need it, it will be available for me too. The whole point is that it's "universal"..or: free at the point of service everyone.

 Like many British people, I would be prepared to pay even more tax and national insurance contributions, if.. and that "IF" is underlined...we could be certain it would go to the right place and not into the pockets and second homes of greedy politicians who have lied, cheated and thoroughly failed us.

Everyone working together and caring 
about each other~the NHS relies on 
solidarity.

  Most NHS employees don't work in the NHS for the fat salaries, great hours, conditions and the appreciation of moaning Brits. Instead it's about caring and a belief that despite the way we have been treated, we can maintain our humanity as people and as part of a society that won't give in to the cruel and mercenary in seats of power. The NHS doesn't just depend on those people though - like the social care and healthcare, each piece of our society benefits the others. Our nurses, doctors, therapists and technicians need teachers and childcare for their families. They need someone to run the store where they buy provisions, someone to build their homes, fly their planes, drive their taxis, empty their bins and put out fires from time to time. We are one and together we are strong. 

Why we need a people's NHS

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