A Busy Month Part 3: The 'Fun' Continues

Despite the fact that I had felt so good after the kids had visited, the next couple of days were to be fairly miserable. When I had been transferred back into the HDU, I really had felt so bad that I was sure that I wasn't going to get out of the hospital. When I look back on it, I wasn't actually that unwell, the evidence being that a. I didn't need to be re-ventilated at any time, b. At no time was I transferred to the intensive care unit and c. At no time did I require inotropes.

In the early hours of the Monday morning I woke up. I had severe pain in the lower left side and I couldn't get my breath. I was helped out of bed and into a chair, and as I moved, I experienced the most excruciating pain that I have ever experienced in the whole of my left side, and again I couldn't get my breath. Even with the CPAP in-situ, it was some time before I was able to breathe anywhere near normally

This continued for the entire day, with another severe bout of the breathlessness and pain at lunchtime. Fortunately for me, the Cardiac Matron witnessed this episode and got things moving. Before long, I was given a large dose of painkillers and an x-ray was performed that confirmed that I had a pleural effusion. Therefore the decision was taken that ultrasound would be performed and there would be attempts to drain the effusion.

A radiologist performed the ultrasound and marked the 'best' access point for drainage, then one of the surgeons decided he'd have a go at drainage. So, an hour later, and having stuck approximately eight needles into my back, he had managed to drain off 80mls of fluid.

Although it doesn't sound like much, it was a significant enough amount that it improved my breathing and lessened the amount of pain that I was experiencing, which meant that I had a much better night.

The following morning, one of the other surgeons arrived with a portable ultrasound and informed me that he, too, was going to have a go. Having ultrasounded and injected local anaesthetic, he then proceeded to insert one needle and start to drain the effusion. Forty-five minutes and several syringe changes later, he'd drained 450mls of fluid. If I'd thought that the 80mls made a difference, this last lot made a huge amount of difference, and I felt absolutely brilliant. However, the downside to all this was that I had to start on intravenous antibiotics and suffer all of the side effects that go with them.

The other thing that I found rather strange was the number of visitors that I received during the course of the week. Some travelled long distances and some I hadn't seen for a while. Whilst I was extremely grateful to see all of them, I couldn't understand why they were visiting, and also why they were so surprised to find me either sitting out or, in one case, not in the HDU because I was out in the toilet. It was almost as if their expectation was that I was on my last legs.

A little later in the week, I was to find out why. It transpired that my ex-wife had taken it upon herself to telephone all of our old friends, including those in the States, to inform them that I was seriously ill, in imminent danger of dying, and if they wanted to say goodbye, they'd better get in quick whilst I was still around. The payback. Here was I, feeling much better, with all these people visiting and expecting me to die.

In fact, following the drainage, I was feeling much better to the extent that on the Thursday I was fit enough to be transferred out of the HDU and back into the main ward. Yes, I was still a little breathless, and yes, I was still a bit sore, but compared to the week previously, I was 100% better. In fact, I began to think about going home.

The thoughts of home increased overnight on the Thursday night. Unfortunately, the Hobbit was on duty. This meant that I had to be on the ball as it was me that needed to remind him when I was due my medication, including the doses of IV antibiotics. In fact the evening one that was due at 10pm wasn't given until I reminded him at 1am. When I asked him why it hadn't been given at the correct time, I was informed that it was because 'You looked asleep' and he seemed unable to grasp the concept of whether I was asleep or not, the dose should still have been given. I started to realise that if I remained in the general ward, there was a distinct possibility that, through omission, the staff could cause further harm.

The following morning, because I was feeling much better, I informed the doctors that I wished to be discharged. Provisionally, they agreed, the provisions being that I would need another chest x-ray and also prove that I could mobilise without keeling over. So, as soon as I'd had my shower, I headed off to the shop.

The biggest surprise was when I stepped outside. This was on 3rd October, and was the first time that I'd been outside since 17th September, over two weeks previously. The drop in temperature in that period of time came as quite a shock.

Having walked down the stairs to the shop, I cheated and got the lift up the two floors. By the time I got back to the ward I was a little breathless but I had proved that I could mobilise about the hospital (I'd walked to another wing to get my first decent coffee in two weeks) without keeling over and dying. That box was ticked.

Next was the chest x-ray. This showed that there was still a small pleural collection but that it was too small to be drained. Next box ticked.

Some of the junior doctors were a little unhappy that the registrar had agreed to discharge me, and made their feelings plain. However, I was supported by the senior doctors, the cardiac matron and the cardiac rehab manager (the latter two of whom I'd worked with in a 'past life'). However, when my observations were done, they also showed an improvement. Box three ticked.

Lastly, I had to be supervised doing the stairs. Now this was quite amusing as the nurse that accompanied me in a 'supervisory capacity' was both elderly and overweight, so when we actually did the stairs, I had to stop half way to make sure that she was OK, as she was puffing and wheezing more than me! And when we got to the top, she declined to walk back down and insisted that we get the lift back down! Last box ticked.

I was now definitely being discharged, so I telephoned my friend David who'd very kindly agreed to give me a lift home, and he collected me at just before 6pm.

Considering that it was a Friday evening, at rush hour, and we were driving through London, it actually took us less time than I was expecting to get back to Kent and I was home by 7.30, feeling absolutely shattered.

At 10pm, I couldn't stay up any longer, and m'Julie settled me into bed and I went out like a light. Unfortunately, two hours later, I was wide awake, and there was nothing for it but to make my way downstairs, make a coffee, take some paracetamol (I had a temperature) and watch some of the things that I'd Sky+'d before I went into hospital.

A couple of hours later, temperature had come down and I felt tired again, so I went back to bed, but only for another two hours. However, this time when I woke up, I was a lot more breathless and experiencing quite a bit of pain on the left side again. I dosed myself up, but without success, and realised that there was a distinct possibility that another pleural effusion was forming. I settled onto the sofa and watched the remainder of the stuff I'd recorded.

m'Julie woke up at 7, by which stage I really was suffering, in excruciating pain again and really struggling to breathe. I then got the lecture from her for not waking her up earlier. However, I'd felt that it would be unfair to wake her as there was very little that she could have done. Sadly, the only solution was for me to be back in hospital and, for the second time in less than three weeks, an ambulance was called.

First on the scene on this occasion was a single Paramedic, followed minutes later by the ambulance. Unfortunately, I knew all of them, but they were very good and didn't laugh or take the mickey as much as I would have done had the roles been reversed.

Once I was in A&E my main priority was pain killers, as I was in absolute agony. In fact, after 50mg of both oral and IV morphine, 75mg diclophenac, 100mg of tramadol and 1G of IV paracetamol (I'd spiked a temperature) I was still in pain. And it was at this point that the medical SHO came to see me, his opening line being 'I understand you're the resus officer, well I failed the ALS (Advanced Life Support) course two weeks ago and I'm not happy'. Despite my instinct being to say 'I'm sorry, you must have mistaken me for someone who gives a sh*t, and you are clearly an incompetent tw*t, please get me someone who knows what they're doing', I felt so rough that I managed 'Well, it's obviously your own fault as it’s not a difficult course, but can you please concentrate on sorting me out'.

So bloods were taken and an x-ray was performed which showed that I did indeed have another pleural effusion and the decision was taken that I would be admitted. What followed was rather surreal, as various people came to see me to inform me that they were sorry, but if I was admitted I wouldn't be in a side room, but out on the main ward. What they didn't realise was that the way I was feeling, they could have put me in a corridor in full clown make-up, as long as something was done to relieve the pain and breathlessness.

Consequently, I was moved to one of the medical wards and settled in. A little later, the registrar appeared and attempted to drain the effusion. Unfortunately, he only managed to drain 20mls, but even that had quite an effect, relieving both the pain and breathlessness a little. However, the decision was taken that everything would be sorted under radiological supervision, and that there would be no more 'blind' attempts. I also started on a different IV antibiotic to the one that I'd received in London, this one being known as 'Domestos', and its side effects were to be worse than the previous lot.

So, having been home for only 12 hours, I settled down for the night on a medical ward in the hospital where I work, being looked after by a staff nurse whom I'd known since he was a brand new student nurse, which I think freaked him out far more than me.

But this was to be the home straight, more of which in part 4 soon.