Two minor operations and one long recovery

scalpel

#1 The eye-watering operation

On Tuesday 2 April I drove north with Jane to Stracathro Hospital (52 miles north of Anstruther, on the A90, 38 miles south of Aberdeen) for what would be the first of two minor operations within a week.

This first procedure, which would see me admitted to hospital for the first time since I emerged into one on a very cold and dark morning on Remembrance Day, November 1971, was for a ‘gentlemanly operation’ to ensure that no more little Saunders’s would be making an appearance in the years to come—at least not from this branch of my family tree; a procedure, under local anaesthetic, which would sever the vas deferens but make a vast difference.

With Jane having suffered from post-natal depression since 2008 it was the least that I could do to remove at least some of her anxiety about what lies in the future. Still, I have a further three months and two samples to go until I’m given the all-clear…

Oh, and there is the small matter of two nasty post-op, NHS-sponsored, iatrogenic infections that have laid me low for most of April.

On the day

I was remarkably calm the day of the procedure. I had half expected to be very anxious on the morning of the operation but I really rather enjoyed our drive up to Dundee, crossing the Tay road bridge in the warm morning sunshine and then skirting our way around Dundee to the east to meet up with the A90 towards Aberdeen. It was a pleasant change to have Jane to myself in the car, no children interrupting every few moments, although they are usually very polite in doing so, “Mum! Mum! Mum! … excuse me?” I was also surprised to see so much snow still piled at the sides of the road, when we had had so little this winter and what we received had always melted within hours of falling.

Stracathro hospital was surprisingly far away. (Are we nearly there yet?) It was built in 1939 as an emergency hospital for WWII military casualties. It reminded me very much of Peel hospital, at Caddonfoot situated outside Galashiels between Selkirk and Peebles, built around the same time for the same purpose.

Seemingly the first patients at Stracathro were victims of an air raid on Montrose in 1940, followed by civilian casualties from London, Birmingham, Coventry and other English cities, and later by soldiers from all theatres of the war, all delivered by train to the nearby station at Brechin.

We parked the car and navigated our way to the day surgery ward in time for my 08:30 admission. The waiting room wasn’t much more than a large abandoned ward with a handful of chairs pushed to the edges at the far end.

The operation

“Ah! Hello!” came the cheery greeting from the nurse in charge. “You’re first here, so you’re first on the list that’s how it works here.”

Seemingly Stracathro carries out a number of minor operations for three health authorities: Fife, Tayside and Angus, and on Tuesday mornings they alternate week-about chopping off the bits of men from Fife and Tayside, four men every 90 minutes. That week it was Fife’s turn. And as it turned out I was not just the first to arrive, I was the only one to arrive. Two had phoned to cancel, one just didn’t turn up. Cowards!

In theatre, besides the surgeon there were two nurses. One was assisting the surgeon, the other it would appear was simply there to sit in the corner and talk incessantly about the weather, and the snow, and how she had spent an entire afternoon digging out her cul-de-sac, where all the old folks in the street had stood watching from the comfort of their living room windows and where none of them had made her a mug of hot chocolate.

During the operation the surgeon asked me if everything was all right.

“This is very odd,” I said, grimacing.

The surgeon looked at me.

“Certainly… unusual.”

“I’ll accept unusual,” he replied.

There was a slightly awkward silence.

“I mean… I’ve not had this done to me before.”

The surgeon burst out laughing, stopped what he was doing, looked at me and said, “No. No you wouldn’t have.” He smiled then returned to chopping up my bits and melting the severed ends with a soldering iron.

The nurse in the corner took that as her cue to continue with her epic tale of shifting snow.

And I can tell you another thing. After all these infections, I’m certainly not having another one!

Next!

After a returning to the ward, and once my stats had returned to normal (my usually-high blood pressure was refreshingly low after the procedure) I was allowed to dress and leave. No tea and toast for me. Not even the whisper of a biscuit. Or nuts! NHS cut backs, eh!

I emerged into the waiting room just as the next batch of men were arriving. Well, two of them, anyway. One rather brow-beaten looking man was accompanied by a heavily-pregnant wife and—very obviously—his mother-in-law.

“She’s expecting her fourth!” the mother-in-law exclaimed to anyone who was listening. “So A’ve come tae make share he gets it cut oaf!”

And so the long road to recovery, and back to Anstruther, despite the information sheet accompanying my admissions papers assuring me I’d be well enough to return to work the following day.

#2 The eye operation

My second minor procedure was simply to remove a cyst that had developed next to my left eye this year. I noticed it in mid-January and by the time it was removed it had doubled in size.

This minor op. was done at Ninewells Hospital in Dundee, where all three of my boys were born, during the Monday afternoon ophthalmic clinic and by the Charge Nurse. She was brilliant—by which I mean she was very good at her job, not that she was particularly shiny.

And guess what?! No infection. Mind you, I’ve had so many antibiotics this month I’d probably live through another plague. Or even survive a Big Mac meal from McDonalds.

Recovery

Neither procedure, the vasectomy nor the cyst-removal, was particularly traumatic although I did feel rather sore and wobbly for quite a few days afterwards—certainly more than the one day that the information leaflet suggested; but then I guess that everyone is different.

The post-op infections, however, really did knock me for six: everything from pain to fever, shaking and confusion. A skin infection to begin with, followed by a particularly nasty UTI for which I am now on my third course of antibiotics, which will last another three weeks.

Thankfully, though, I am now on the mend and greatly looking forward to getting back to work tomorrow morning.

A retrospective on 2012

My bedside table
A view that I saw far too much of in 2012.

I’ve never been a massive fan of new year, even after my dad died shortly after 1998 began. I’ve always preferred Christmas Day. It’s the reason for the season, so they say. At least, it’s one of the reasons. I never really enjoyed sitting around while my mates got drunk, I never really got into the whole new year resolutions thing, and for me it was really just another day (albeit it one where the shops were closed, and we always ate steak pie).

Health

But twelve months ago, as 2011 rolled into 2012 I decided that this was going to be good year. I was determined that it would be a good year. “This is the year that I get fit,” I decided.

However, 2012 wasn’t the year that I got fit, and not for want of trying. In between periods of intense back pain in February/March and trapping two nerves (C6 and C7) when my twin boys, Reuben and Joshua, jumped onto my neck on the sofa in June, I managed to get out on my bike as much as I could and even lifted my dumbell weights a few times.

But I slowly realised that I was actually becoming afraid of doing any exercise. Whenever I did any kind of moderate exercise I would shortly after come down with a cold, or pull a muscle, or injure my back. It was incredibly frustrating. I even asked my renal consultant about it (I have polycystic kidney disease) but she wasn’t interested and told me quite clearly that that shouldn’t happen. “But it does,” I said. “But it shouldn’t…!” But it does, and it has continued to do so.

During 2012 I spent £420 on private physiotherapy. Having been diagnosed with trapped nerves by a stand-in GP who told me to take some time off work, see if things get better, and if they don’t improve within six weeks come back, I phoned the physio the following day, shortly after both my arms went completely numb.

I felt desperate. I didn’t want to have to wait the three months or so I had to when my lower back went in September 2011. I phoned, explained what was going on and the receptionist kindly said, “I’m really sorry, but I won’t be able to squeeze you in until tomorrow.”

“Tomorrow?! That’s brilliant.”

I saw a chap called Clayton Hardisty in St Andrews. He was excellent. I told him what I thought were the vaguest of symptoms and within minutes he had both diagnosed and confirmed what the problem was. And it all stemmed from my bad posture. I’m 6’4″ and for years I’ve apologised for my height. No longer. I now sit and stand tall, and what a difference it has made. I’ve not thought about my posture so much since I sang in the National Youth Choir of Great Britain.

I was signed off work for 60 work days in all, to give my body the chance to rest and recover. I returned to work on a phased return programme: two weeks half-time, two weeks three-quarters time, then back full-time.

Then the week after I was discharged by occupational health, I came down with the ‘flu. Like, proper ‘flu with all the symptoms, and a temperature of 39.8°C. And then a chest infection. And then a tummy bug. Rubbish!

Family

Clockwise from top: Joshua, Isaac and Reuben.
Clockwise from top: Joshua, Isaac and Reuben.

What has got me through this past year of one health frustration after another is my faith and my family.

Reuben and Joshua turned four in November, Isaac turns two later this month (late-January). While we have had our fair share of ups and downs with them (I imagine no more than the next family), particularly as they fight one another and jostle for attention, they remain my little delights. I have enjoyed nothing better this Christmas and new year holiday than cuddling up on the sofa with all three of them and watching films and silly children’s programmes.

And Jane has been amazing this year; I love her very much, and more so each year. As well as living with and trying to manage depression, she’s had to put up with me recovering at home, as well as refereeing children and escorting them from one engagement to the next; they have a far better social life than we do. She’s amazing.

So… 2013. Two-thousand and thirteen, that’s the year I get fit. Oh yes. And the year that I continue to try to be better at putting my family first. Here’s to a much better year.

What would also make it better, or at least neater, would be to always write the year as 0123.

Pain in the neck

Man clutching neck
C6… C7… You’ve sunk my spinal disc!

Well, I think I can safely say that 2012 hasn’t been the greatest year for my health.

After a recurrence in May of the same lower back pain that disabled me for nearly a month last autumn, I managed to trap a couple of nerves in my neck (cervical vertebrae C6 and C7, I am told) about a month ago.

It started as a really sore right shoulder and neck; to the point that I couldn’t move it. I now realise that this was swelling, to allow my body to protect the nerves. This lasted about 1-2 weeks… after which my right arm started to go numb.

I phoned NHS 24. “That sounds like a nerve problem, see your doctor tomorrow.”

I got an appointment with a GP the next morning. “That sounds like a trapped nerve, take painkillers and anti-inflammatory medication and it should settle down in about 6 weeks or more.”

The next day my left arm started to go numb too.

A friend of mine, Andrew, at the University of St Andrews, recommended that I see Clayton Hardisty at the St Andrews Physiotherapy Practice.

He has been excellent. The numbness/pain has now been reduced to just my right thumb now, and occasionally my arm starts to go numb again but dropping my arms to my sides seems to help. Which makes it feel awkward to type but otherwise I’m getting by.

This week I even managed to get back to cycling, and set a personal best on the Home – Kilrenny – B9131 – Home circuit. And that was me taking it easy! But it may have had something to do with my posture.

I’ve never thought about my posture so much since I sang in the National Youth Choir of Great Britain and we were introduced to elements of the Alexander Technique. At the time I foolishly dismissed it as being irrelevant to me because I wasn’t going into professional singing or drama.

I’ve noticed how often I slouch. I’ve noticed how often I sit (or cycle) with my shoulders pushed up and my head pulled down into it like a tortoise.

And occasionally, ever so occasionally, I get a glimpse of life before this, with no odd sensations. That’s what I’m aiming for…

Cycling in the fat lane

A mountain bike leaning against a milestone
My Giant mountain bike, this morning, leaning against a milestone two miles outside Crail.

A couple of weeks ago I was re-reading Leo Babauta’s excellent book Focus: A simplicity manifesto in the Age of Distraction in which he encourages people to slow down, reduce the number of things you are doing and focus on just one.

That was something I needed to hear again.

My mind had been spinning for weeks with the number of small projects that I was running at the same time; some web projects, some writing projects. I’d reached a point of stalemate, a mental impasse, where I couldn’t decide which one I should prioritise, which I should work on next. They all excited me. I wanted to do them all. And in the end I was doing none of them.

So I took Leo’s advice to heart and began to simplify and reduce, and in my deliberations I realised the one thing that I really needed to focus on to the exclusion of everything else: get fit. My health had to be my number one priority.

Children

Before Reuben and Joshua were born in November 2008 I spent a lot of time on my bike, and with my dumb bell weights, and I lost a lot of weight. I dropped about 5-6″ off my waist. I wanted to get fit so that I could play with my children. I wanted to get fit so that I have every chance of improving my own quality of life so that I wouldn’t die young of heart disease or kidney failure or whatever.

And then Reuben and Joshua arrived, and a few years later Isaac joined them, and I’ve pretty much not slept for the best part of three and a half years (averaging probably around 3-5 hours of broken sleep a night for most of that time). And my weight gradually crept up again as I ate at odd hours, or ate high calorie foods just to keep myself awake.

Summer 2011

Last summer I made the decision to get fit again. We were having issues with who needed the car (we went down to one car after the boys were born) and so I decided to cycle to work. My office in St Andrews is almost exactly 10 miles from our house in Anstruther.

That was going well until…

Back

In September 2011 I was cutting the grass and taking a break I sat on a travelling rug with a ten-month old Isaac… and I couldn’t get back up. My back had gone. I went to bed and fell asleep only to be woken a couple of hours’ later with the most excruciating muscle spasms I’ve ever had.

I was screaming in pain. It took me 30 minutes to crawl the 18 feet or so from my bedside to the toilet. The second time I tried it I could get only as far as the chair beside my bed.

Jane phoned NHS 24 just after tea time, around 6pm.

A doctor from the out-of-hours service arrived seven hours’ later, sometime around 1am. He returned four hours after that to give me a shot of morphine and I finally fell asleep, too doped up to care about the pain. It took another week or so to be given diazepam, which finally helped the muscles to relax, and another four months to see a physiotherapist.

I was off work for about a month, and even when I returned I struggled to walk without pain. It took me until about early May to start feeling better enough to even consider exercising again. I was desperate to get out again.

Back on the bike… twice

Nervously I got back on my bike in early May and rode a short and familiar circuit around a few of the local back roads.

About a week later my back went again. More diazepam, more diclofenac, more 30/500 co-codamol and within a week I was actually feeling better than I had been the previous month. The pains in my legs had gone. I could walk again without feeling that my hips had been replaced with knives.

Last Sunday I went out for a cycle. I made a conscious decision to go easily, to pace myself. Something that I’m not good at, but where has that got me in the past?

I cycled for an hour and covered about 15 miles. It felt good.

Two days later, on Tuesday, I went out again for a slightly shorter run. And I went out again this morning: 14.75 miles in 57 minutes. I was pleased with that.

I’m determined to get fit. I need to lose weight to help bring my blood pressure down, for a start. I’m determined not to overdo it, as I usually do. I’m determined to pace myself. That’s been the big lesson from my back injury: pace myself.

So for the next 4-6 weeks I’m going stretch every day (my physio gave me a bunch of back stretches to do twice a day), and start doing some daily stomach crunches to help strengthen my core, and go out cycling twice a week. I’ll see where I go from there.

But this time I’m hopeful. By this time next year I should have cycled my way out of the fat lane.

Lower back pain–an update

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On Saturday 24 September, over two weeks ago, I did something to my back that left me barely able to stand let alone walk. I am still on the mend.

Folks who follow me on Twitter and Facebook will know a little of what I’ve been going through for the last couple of weeks but this is a longer post with more details.

What happened

I suspect that a number of factors contributed to the intense back spasms that left me immobile that day, including sleeping badly in the spare room bed while on Isaac-watch, carrying both toddlers at the same time, an increase in the amount of cycling I’ve been doing and cutting the grass at the back of the house, that fateful Saturday afternoon, was probably the erm… straw that broke the camel’s back, so to speak.

With the grass cut Isaac came out to sit on on a rug in the middle of the lawn at watch me while I pottered around finishing off tidying up the edges and trimming a couple of bushes; Reuben and Joshua both insisted on ‘helping’ me with the secateurs. Those were a nervous few minutes while I encouraged them to not accidentally chop their own fingers off.

Within a couple of minutes the boys had ran off to help Jane round the front of the house where she was now cutting the grass. I sat down on the rug and chatted with Isaac for a moment.

When I got up: I couldn’t.

Stubbornly, I put the garden tools away in the shed using the Dutch hoe as a support. I ate dinner and then, encouraged by Jane, went to lie down in bed to rest my back.

I’ve had back twinges before which have gradually eased over the course of the week with applications of a heat rub ointment, a little massage, a hot-water bottle over the stiff area and painkillers. So at that point I wasn’t overly concerned.

NHS 24

After a short sleep I got up to go to the loo. Only I couldn’t move; at all. My lower back went into the most excruciating spasms, whenever I tried, that felt like my back was trying to snap me in two.

It then took me the next 25-30 minutes to literally crawl to the en suite bathroom. A distance of about six metres.

Jane phoned NHS 24 (0845 4 24 24 24), Scotland’s health information and self-care advice line, for advice. Their advisers were busy but would phone us back within three hours; it was about 19:45 at this point.

At 11:15 they phoned back, and said that they would send out a doctor to my bedside straight away.

The doctor arrived at 01:15. Five-and-a-half hours after we’d phoned; that’s quite a long time to be lying, immobile in pain. The doctor apologised saying that the message had only been passed on from NHS 24 to the St Andrews Community Hospital shortly after midnight.

Voltarol and morphine

I have to say that the doctor was lovely. I’d seen him before at the out of hours service, that time for what turned out to be a chronic prostate infection. He listened, was gentle, sympathetic and gave me a whacking great injection of Voltarol in my bottom to address both the pain and inflammation.

When he left I drifted off into a drug- and exhaustion-induced sleep.

Only to wake about two hours later; I was desperately needing another wee. This time though I only managed to get as far as standing next to my bed. I couldn’t move any further without inducing the most horrific pain. I ended up weeing into a bucket that Jane kindly balanced on my bedside chair!

With me back in bed she called NHS 24 again, around 03:15. The same on-call GP, Dr Bird, turned up around 05:15 and this time gave me a shot of morphine into my bottom.

It didn’t really touch the pain but it did allow me to relax enough to fall into a longer sleep. I came to around 10:00 on Sunday morning. Thankfully I wasn’t scheduled to conduct any services.

Sunday, Monday, Tuesday, Wednesday

On Sunday afternoon, one of Jane’s friends who is an osteopath visited and spent around two hours with my back, gently converting me from a plank of wood into an old man.

Over the next few days I rested, alternately applied ice packs and hot-water bottles to my lower back, stumbled around and generally tried to follow the advice I’d been given by the doctor and osteopath.

I obviously over did it on Wednesday because by 17:00 I was lying on my bed once again screaming in pain as my back went into spasms.

I was screaming so loudly that Jane had to close our bedroom window in case passers-by or neighbours thought that I was being murdered! I was also aware that I was frightening Reuben and Joshua who, bless them, despite their fear wanted to stay around and “help daddy”.

Jane phoned NHS 24—with me screaming in the background! They said that they would call back within three hours.

I couldn’t wait that long.

“Help me!” I pleaded with Jane. Knowing, actually, that there was little she could do to instantly relieve me of this pain.

Jane grabbed an ice pack from the freezer, and that coupled with an electric, ‘buzzy’ back massager that Jane had bought for my Christmas years before brought the spasms under control.

Jane called NHS 24 back, nearly two hours after calling them, to cancel the request to phone us back.

Thursday

I got an emergency appointment on Thursday (29 September) morning with one of the practice GPs; I rarely get to see my own these days.

He offered me Tramadol. I gently declined as it gives me hallucinations; and not the happy kind.

I walked away with a prescription for Co-codamol 30 mg/500 mg (that’s codeine and paracetamol) and Diazepam 2 mg (1 or 2 to be taken three times a day), and the advice that. despite my kidney condition, I could also take Ibuprofen for a short period if I needed it.

They’re not called patients for nothing…

And so I wait.

No lifting, no bending, no stretching, no sitting for extended periods of time. I just need to find a balance between rest and activity and gently allow my back to heal.

Jane’s osteopath friend returned on Thursday (6 October) and spent about an hour with me, which again really helped.

I do feel my back getting slightly stronger each day but the slow progress is frustrating.

I want to get back to work but I’m still feeling quite spaced out from the Diazepam and when I tried to do a full day yesterday, Sunday, getting up around 07:30 and not returning to bed for a rest until after 18:00 I was absolutely exhausted. I fell asleep on the sofa around 19:00!

I just need to be a patient patient.