I have just enjoyed a large bowl of crunchy nut cornflakes though I guess it is lunch rather than breakfast. This time yesterday I was sitting in a side room on a hospital ward sipping cola then regurgitating it into a cardboard bowler hat (as I like to think of them) now combined with my saliva. A friend commented via text that it didn’t sound very pleasant but it was quite nice to have the taste of cold cola in my mouth since it had been twenty hours since I could eat or drink anything. I just wished the nurse had given me diet cola because then I wouldn’t have felt the sticky fuzziness covering my teeth.
The adventure started with a hedge trimmer that had been borrowed from friends. My wife wanted to pay them back for its use, so she planned to give them a meal and a couple of bottles of wine. I didn’t think any payment was necessary but life is about compromises. When my wife cooks for friends it usually involves lots of recipe books and a hunt for unusual ingredients (for where we live). Her current favourite is Persiana by Sabrina Ghayour and so the usual search went on in several shops, puy lentils and rosewater where among the challenges this time. Whilst my wife was busy creating in the kitchen, I was out trimming the hedge with secateurs.
I think I need to explain that latter sentence. You see, I had already cut the hedge with the trimmer over a month ago so now the hedge was looking a bit spikey with new growth. I had debated for the last few days about using the trimmer again, or doing the hedge by hand. Unfortunately our shears were broken so it was petrol driven hedge trimmer against hand secateurs which reminded me of the piece I wrote about progress recently. It was a lovely sunny day and I decided to go the meditative way and cut each twig by hand (though I was aware that a passer-by would think I was rather mad). It didn’t take too long actually.
So five o’clock rolled on and our guests turned up. It was all rather hectic in the kitchen so my wife asked my opinion on whether the chicken was cooked. Since it was chicken breast cut roughly into inch cubes I suspected it would be fine and an investigation with a fork suggest that was correct. However I decided to do the ultimate taste test; the chicken was really tender and tasted superb, without thinking I chewed a bit and swallowed. Pretty much immediately I could tell the chicken was stuck in my throat, not in a choking way, but lodged in my oesophagus. So much for having a nice meal shared with friends.
Food getting stuck in this way is not unusual for me, it pretty much can happen with every meal but normally I can feel the blockage forming and stop eating until the bolus passes further down. This happened when I ate the cornflakes this morning for example. When a complete blockage happens I take myself off to the toilet because I know that I will need to regurgitate my saliva and looking like I am being sick every few minutes is not a nice thing to share with people. Eventually I am able to free some of the food up and after some rather uncomfortable time, the bolus shifts and life continues (I don’t usually feel like eating much afterwards though). Very occasionally, it can take hours for the food to shift but twice now I have had to resort to seeking hospital help to move the food on. I gave myself twelve hours before deciding to walk down to the A&E at the end of the road. It isn’t just about the discomfort and not eating that drive me, it is about the loss of fluid that goes on when I don’t swallow my saliva.
It was approaching six a.m. as I set off from the house and down the hill. It was a very still peaceful morning as I walked, occasionally a car would drive pass, an early morning jogger overtook me. I looked at people’s gardens noting any bee activity and watched for suitable places to dump my saliva. I have trodden this path many times to the hospital but not usually to admit myself in with the possible outcome of undergoing another nightmare of a gastroscopy. It is only a personal nightmare of mine, though I don’t know anybody that likes having them done, in past times I have woken up having burned through the sedative during the procedure and found myself in a blind panic fighting to get away, fighting not to choke and suffocate, knowing that I was haemorrhaging. It is hard even to acknowledge those times now.
I guess this is courage then, taking myself into hospital because it is the right thing to do in the long term even though I know the consequences in the short term are going to be unpleasant, even more unpleasant than what I am going through at that moment. At A&E I am quickly triaged then left sitting for a couple of hours waiting to see a doctor. I have learnt patience a long time ago when in hospitals, I know I am not an emergency, nothing life threatening is happening to me, and I also know that a shift change is taking place soon. Morning television keeps replaying the same news stories mostly about the record number of medals Team GB won at the Rio Olympics and the closing ceremony (I didn’t think the Japanese PM looked much like Mario – it takes more than a red cap!). The TV noise combined with the refrigerated drinks machines and my general fatigue, and I find myself getting impatient and restless. I try to concentrate on reading a book.
By the time I see the A&E doctor, my saliva is finding a way past the blockage and I feel a bit foolish for bothering her. She reassures me it is okay and suggest I try drinking some water. I sit one cup and it stays down though I can feel some of it sitting in my oesophagus. I try and cup but this time it is too much and I have to splurt it out into the sink, I ask the doctor for a sick bowl and make use of it. The A&E consultant thinks I should be admitted for a gastro-intestinal consult and I agree, following the expected course. A porter arrives and I am taken in a wheel chair to the admitting ward where I have the privilege of a side room complete with ensuite shower and toilet, perhaps it is because I might be “sick” so much. The procession of people begins: first the nurse to fill out the admitting form; then blood pressure, temperature, and pulse are taken (my b.p. is a bit high but she doesn’t say anything); then the fourth year medical students come to practise taking a case history; the junior doctors return to put a cannula in my arm to take bloods, they both fail; a friend who works in the hospital drops by for a chat and leaves a newspaper; next the registrar comes so we are finally getting down to business, she suggest another fizzy drink whilst she talks to the endoscopy unit; the pharmacist asks about my tacrolimus dosage and says they are trying to source some IV version from Dundee but there is a question mark over dosage; a nurse brings the fizzy drink, it is cold cola.
I lose track of the sequence after this. The registrar returns to put a cannula in my arm and take bloods, she succeeds on the second try. I am hooked up to IV saline mixed with glucose. At some point a nurse appears with a gown saying that I will be going down for a gastroscopy within the next hour, this is news to me. The registrar reappears and tells me that they have convinced the endoscopy unit to take me that afternoon so I will be going down soon; she notes my failure at keeping the cola down. I suspect the complexity with the tacrolimus might be the driver for getting me done today. My wife pops in. The nurse reappears to take my vitals again and I ask her to remove the IV for a moment so I can put the gown on, she helps do the ties up at the back. The registrar appears again to talk about the procedure and what could go wrong, I sign the consent form. Then the consultant appears and has a short chat. I think he just wanted to see me because not only have I had Wilson’s disease but also I have survived fifteen years post-transplant; I am a medical rarity.
The porter turns up to take me down. I gather my things together and ask where to put them, but it turns out I will be returned to the room and so leave my stuff there. I stare at the ceiling as I am wheeled through the corridors, it feels a bit like I am in a film, I try to keep the panic at bay. The sister in the unit is very friendly and understanding, we have a bit of a laugh but I tell her that I am a fighter and need sedation, she appreciates my candour. A patient is wheeled into the bay beside me and proceeds to tell the nurse that he really struggled to stay calm during the procedure this time, and the nurse points out that I don’t need to hear that; he underwent the gastroscopy without sedation.
After fifteen minutes or so I am wheeled into the theatre. I look dispassionately at the equipment around me and notice that the endoscope used is made by Olympus whose cameras I have a fondness for. The consultant introduces himself and explains what is going to happen. He sprays some supposedly tropical tasting stuff to numb the back of my throat; there is a hint of bananas about it. I lie on my side and the nurse pops the plastic mouth guard thing in and secures it around my head; next is the oxygen line into my nostril and the pulse detector on my finger. The consultant puts some sedative in my through the cannula and I wait for it to take effect; it seems to take a while to me. I guess I have drifted off but I become aware that I am gagging and struggling, the procedure is underway and I try to concentrate on my breathing as advised by the nurse somewhere.
I am on the trolley outside my room on the ward once more, and I get off and climb into bed I think, I have a vague memory of comments suggesting and giving me help. I sleep. When I awake my wife is there, and we chat a bit. A nurse tells me to take my time and rest, jokes that I have been given the date-rape drug so my wife can say anything to me, I find that a bit disturbing somehow. I eat a rather tasty meal (perhaps my standards are rather low at that moment). My wife leaves for book group and I go back to sleep. At 9.45pm the registrar appears again and says that she will write my discharge note so I should be good to go in half an hour. I text my wife the update and she says she will pick me up on the way home.
My wife has arrived but I can’t find anyone to ask about leaving. The registrar turns up again and apologises for not writing the letter yet and says she is doing it now. I notice one of the students that earlier took my case history walking down the corridor obviously heading home in his coat and carrying his bag, it is gone ten o’clock and I mention to my wife that he must have had a long day. The registrar appears with my gastroscopy results; I was right about the blockage and there appears to be no change in my oesophagus from the last time they looked. It is good to know the constriction isn’t getting worse. She reappears with my letter, and hopes it doesn’t happen again; I hope so too.
When I look back on this adventure the main thing that strikes me is the sheer number of people involved in dealing with a piece of chicken stuck in my throat. I haven’t mentioned all the ones I met let alone the ones in the background dealing with tests and supplies. Each and every one of the people I met appeared to be happy, positive, patient and chatty. Perhaps Mondays are a good day to be in hospital but I am struck by level of care and attention I received which far outweighs the nightmare of the procedure I went through. Thank you the UK for the National Health Service.