A record of Matt’s operations and recovery

Its been a long time since my last blog and a lot has happened to say the least…..

The single biggest events was Matt’s botched appendix operation.  The following details day by day what happened, just for the record…..

Wed 2 Sept – Matt complains of stomach pains.  We phone up NHS hot-line.  Told to wait and take paracetamol.
Thur 3 Sept – 1:30 am Matt’s pain is worse.  We phone again and decide to go to Redhill.
Arrive at 3:00am go through A&E process.  Get bed in Surgical Assessment Unit at 5:00 ish.  Moved to Tandridge ward early afternoon.  Pain gets worse.  Treated well but I insist on knowing if the Op will happen that afternoon or not.  Nurse calls surgeon and told not today.
Fri 4 Sept. Arrive mid-morning and see Matt briefly to give him books and magazines.  Not visiting time so we leave for coffee and to read the papers.  Ask to be called when Matt’s turn comes up.  We don’t get the call.  At around 3:00 we go to ward for visiting time to be told that he was taken to surgery at 12:00 ish.  (Later told it was 12:30).  We go for walk outside, pleased that there would not be any more waiting.
Come back at 5:00 ish and told to sit down in the ward office – wave of panic.  Told that he is OK but that there have been complications.  Nurse didn’t know details.  Junior doctor comes out at 6:00 ish and tells us of a nick in a blood vessel and that a consultant from London was called “half an hour ago”.  No further communication until Redhill consultant NS comes to talk to us at 8:00 and explains that it is quite serious and that the London consultant arrived at 6:30 and is to patch a hole in an artery that takes blood to the right leg.  At 9:30 we meet Mr S and J and they explain that the patching has been successful but that they need to do other things with the right leg to relieve pressure.  They tell us his abdomen will remain “open” and he will be transferred to St Georges in Tooting.
We see Matt (unconscious) in recovery room at about 11:00 as they prepare him for the transfer by ambulance.  Very sad.  Breathing through oxygen tube and lots of drips and monitors attached.
Sat 5 Sept
I phone intensive care at about 3:00 a.m to confirm that he has arrived safely and is stable.  I call again at 8:00 and am told that his blood pressure was low and he started to wake up.  Both things corrected by drugs.
Got in to St Georges mid morning and went in to ICU to see Matt.  As expected he was heavily wired up but looked OK.  We couldn’t sit there long as we both kept welling up.  We waited in the relatives room.  Early afternoon a very tall young doctor came to see us to explain what they were going to do to close him up.  He returned a little later with his boss, the consultant.  The operation happened at around 3:00 and went on for an hour and a half.  The doctors returned and said all had gone well and that blood flow to Matt’s right leg looked good.  The anesthetist came in to explain that they would wake him up tomorrow morning.   We waited while they settled him back into ICU and then went in to see him.  He still looked very sorry for himself but, just before we left for the night, his eyes flickered open when we called his name and spoke to him.
Sun 6 Sept
Early morning call to ICU revealed that they had failed to remove the breathing tube.  We don’t know if this is a problem or not.
Just before leaving this morning we got a call from Grace, the nurse at ICU, to say that Matt’s tube was now out and he was asking us to bring his glasses!
When we got to the hospital we found Matt with a oxygen mask on and the multiple tubes as before.  He was able to whisper a few things to us.  The tall doctor came and felt his feet and measured the strength of the pulse in his right foot.  He was very happy with what he found.  After a while we went to lunch.  On our return Matt was without face mask (just a nasal tube) and was looking a little better.  They had fixed him up with a self administered morphine machine – he pressed a button and it gave him apre-limited shot of pain killer.
They were able to remove his nasal oxygen tube as his levels were good.  Matt really wants to get rid of the tube into his stomach from his nose (bile bag) and the line from his neck into the area near his heart (direct line).  Those are the two that are bothering him the most.  When we described what went wrong with the operation he very dryly quipped “well they did say there could be some bleeding”.  He has trouble focusing his eyes and, when he reaches out to hold our hands, he struggles to co-ordinate.
Mon 7 Sept
Got into St Georges at 10:00 and we were asked to wait while Matt was being sat-up for the first time.  When we got in they had moved him to the other side of ICU where it was a bit quieter.  We met his new nurse Garry.  Matt was also being seen to by a new physiotherapist.  He was being made to breathe deeply and cough up more phlegm.  Matt looked very uncomfortable sitting there.  He was holding his head a little bit sideways probably because of the “direct line” still in his neck.  They had removed the “bile bag” from his nose and one arm is now free from tubes.  He is in a lot of pain and is pressing the morphine button regularly.  He is also on a paracetamol drip.  We left while the nurse re-dressed his leg wounds.  Matthew later told us they looked disgusting.  A little later the physiotherapist came back and made Matt pull his right leg closer in.  This is so that, as the muscles slowly contract, they are slightly stretched.  If they contract with his toes pointed then this could cause problems later on.  For the same reason they are fitting a splint for wearing in bed to make sure the foot is held at 90 degree rather than being pointed while he lies down.  The morphine makes Matt say some strange things like the floor is glowing!  Another nurse said that the next few days will be the hardest work Matt has ever done to get himself fit as soon as possible.  Matt told us that his gut is starting to show signed of life.  This means that Matt could soon be eating again.  Matt became increasingly uncomfortable in a sitting position but the nurse made him sit, for his own good, until after lunch.  Matt wanted us to stay with him until he was allowed to lie down again.  When he was finally allowed back to bed at about 1:30 he looked very relieved.  A doctor said that the central line could be taken from his neck that afternoon.
Tuesday 8 Sept
Went into ICU at about 10:20 and Lou, the physiotherapist, was still working on Matt.  Lou told us that there was good progress with his leg and that it was a lot more mobile than yesterday.  They had made Matt stand up holding a frame.  Matt was sitting in his chair (his least favorite position) and complaining of feeling sick and having pain in his stomach.  He was allowed a cup of tea but, unfortunately, brought it up later, along with a load of bile.  His eyes were more alive today and they would flick around more than yesterday (when they were more of a fixed gaze).  He had not used the morphine much all morning but, as the pain got worse he pressed the button a couple of times.  The line in his neck is out which means that he is more comfortable and holds his head straighter.  His digestive system is still not working yet, hence the vomiting.  Apparently this is not yet a concern and is par for the course for major abdominal surgery.  He is still on an antibiotic drip but this may be discontinued soon.  We were told that he would be transferred out of ICU later today.  Since returning home we had a call to say that Matt had been transferred to the Chesterton Ward.  Despite the improvements progress seemed disappointing today.
Wednesday 9 Sept
We saw Matt in his new ward.  He is lucky enough to have his own room and now has TV.  We saw the physiotherapist before we went in and he was all enthusiastic about Matt’s progress.  Unfortunately our joy was dashed by the lack of progress elsewhere.  Matt is now off morphine.  Whilst this is good news it has cleared his head and has made him, understandably depressed.  He seemed to be blinking back tears (something Sarah and I have been doing regularly over the last few days).  His digestive system is still not working.  This means that he can’t eat and he has his nose tube and bile bag back again.  He had to have the line into his arm redone (not a pleasant process) and when he went from the chair to the bed it was a comedy of errors.  The nurse couldn’t cope and we ended up helping.  Unfortunately all his tubes got tangled up and he ended up perched half-on half-off the bed unable to move and in a great deal of pain.  I helped lift his right foot and realised just how much the open wounds are weeping.  Just to cap it all we spoke to the doctor (PaulMoxel ?) who explained about the risk of infection from the remaining pools of blood left in his abdomen.  Matt’s temperature is being monitored, along with his blood, for signs of infection.  An x-ray the evening before had shown good progress with his lungs but had shown a swollen stomach.  Altogether a very depressing, disappointing day.  The next milestone is getting his guts working – lets hope it is tomorrow.
Thursday 10 September
The “nil by mouth” sign still hung on Matt’s door.  The physiotherapist had Matt standing up and going for a walk.  Initially unsteady (and walking like a cowboy), he soon sped up and became more confident.  When theZimmer frame got in the way he was able to discard it.  “Quicker than grandma” was his accurate observation.  Almost as soon as he sat down he paused and said “I feel a rumble”.  His bowels had started to move and I had never felt so happy!.  The physio took credit, justifiably, for the awakening of the gut!  The day got even better.  Once the awakening bowel was confirmed the doctor allowed the removal of the bile bag from Matt’s nose and the removal of the catheter tube.  Suddenly Matt was free from tubes and wires!  He was allowed a sweet cup of tea.  Matt commented that he had a teddy bear tummy and when he showed us I understood what he meant – slightly swollen and with a vertical line of metal staples that looked like a zip.  I helped Matt to the bathroom for the first time.  He managed a very awkward looking return to bed and scared himself that he had pulled too violently at his stitches.
Friday 11 September
Our real hope today was that Matt would eat solids.  The “nil by mouth” was back on the door and Matt was not in his room as he was having his gut scanned.  Slight additional concern crept over us until he returned being pushed on his bed.  His scan involved the extraction of some fluid from his abdomen that, according to the doctors, appeared not to have pus in it.  Matt found the scan interesting as he could see his own internal organs.  Matt was thirsty and downed a bottle of Oasis.  I helped him walk with his frame to the toilet which he managed far more smoothly than yesterday.  He then ate some bangers and mash and apple pie and custard washed down with more Oasis.  We were so chuffed that he was able to eat. We left Matt when Rob the physiotherapist showed up for his daily session.  Matt phoned us up later with some bad news – he had thrown up!  Our delight at the progress disappeared.  Some consolation was that Matt’s physiotherapy session was good as he walked down the corridor without his frame.  Oh well – one small step backwards must be expected I suppose.  Matt’s friends visited him in the evening.
Saturday 12 September
We phoned the ward in the morning and spoke to a doctor.  He told us that he was pleased with progress.  The scan looked fine and the lack of life in Matt’s gut was to be expected and wouldn’t be a problem unless it went on for two weeks.  His comments cheered me up.  We took Simon and Harry to see Matt.  When we arrived Matt’s leg was being re-dressed behind the curtain.  Matt was keen for us to come in and take a look which we did (apart from Harry).  His leg had a long pink bulge down its length.  We still don’t know what will be done to the leg yet.  Matt, still with his nose tube in, is getting more chatty but he is obviously weak and gets tired very easily.  I took Matt for a walk down the corridor – he didn’t need the frame.  He went to the toilet but no life in the bowels unfortunately.  Getting his guts working is now number one priority.
Sunday 13 September
This recovery is excruciatingly slow!  No real progress to speak of except better and further walking and a low temperature.  Matt is starting to talk about wanting food – that has to be an encouraging sign.  He is able to manoeuvre more easily now and can move between bed and chair relatively easily.  He is looking a bit scrawny now especially with all the scabs and bruises on his arms from the multiple injections and drips.  We left him in his chair, with his feet up, a remote control in one hand and a pile of magazines and novels to read. C’mon guts, you can do it!
Monday 14 September
Matt spent a long time waiting with his leg exposed for a doctor to examine it.  When he did come he said that it looked good and explained that the plastic surgeon would take a look later in the week to determine whether skin grafts are needed.  They also decided to put a vacuum dressing on the wounds which consisted of a pad over each wound with tubes from them that are connected to a mini “vacuum cleaner”.  This negative pressure apparently helps the wounds to heal quicker.  Matt’s nose tube is no longer connected to a bag (they are leaving the tube in because it is difficult to insert).  He sipped two cups of sweet tea in the afternoon.  We are really hoping he kept them down!
Tuesday 15 September
This morning they removed the tube from Matt’s nose – lets hope for the final time.  This must show they have confidence that his guts are returning to normal functioning.  He was drinking tea when we arrived and then, following a specific request, moved on to energy sports drinks.  He also had the staples removed from his torso.  63 in total, 43 from the main wound.  His guts were making extremely loud noises while we were with him.  Things are definitely moving!
Wednesday 16 September
We went up by train today – trying the route so that Sarah can visit by herself when I return to work.  When we arrived Matt had some good news and some bad news.  The good news was that he kept down all the fluids he had drunk the previous day and had eaten ricekrispies for breakfast.  At last it looks like his stomach is working properly.  He went on to have soup for lunch (that we had to buy from M&S because the hospital had no soup for lunch!) followed by a yogurt and, later, afternoon tea with a slice of cake!  The bad news was that Matt’s wound down his torso has started to ooze. Apparently this is not uncommon and the doctor encouraged the liquid to come out.  The nurses taped a small bag to the wound to collect it.  It was a cloudy salmon-pink colour and looked disgusting.  Apart from the vacuum tubes, Matt is no longer connected to anything.  If he keeps his food down, then all we need to worry about are the wounds…..

Thursday 17 September

Visited Matt in the evening after work.  He had eaten lunch and dinner and kept everything down so it looks as if that particular problem is behind him.  He still doesn’t have the capacity to eat huge volumes.  He had a CT scan earlier in the day and the results cam back whilst I was there.  There are a couple of “pools” of liquid that they want to drain.  They will then test them to see if they are infected or not.  The doctor said that all the markers of infection were coming down (temperature and white blood cells), but that platelets were blipping up.  This means that the blood is getting thicker so they have prescribed aspirin.  Matt’s right leg was more puffy than usual.  I had to point that out to the vascular doctor on the round – he didn’t even glance at it until I pointed it out.  He said that it was DVT and that he should put his foot up on the stool.  I asked if he should sleep with a pillow under his foot and the doctor replied that that would be a good idea.  Why are they not more proactive!  That particular doctor has gone way down in my estimation!
Friday 18 September
Another evening visit found Matt just having polished off corned beef pie followed by a donut.  He had been kept hungry all day waiting for a scan and aspiration of the fluid in his abdomen.  It turned out they were unable to draw the fluid off because it was so thick.  The doctor said they were quite happy with the situation provided Matt stayed well.  So far his white blood count is low and so is his temperature – so fingers crossed.  His tummy wound is looking pretty horrible with a couple of gaping holes.  The doctors seem happy with it.  They also said there is no DVT.  Still waiting for the plastic surgeon to visit.  Matt’s guts are working explosively which, I guess, is good!  Matt needs to build his strength up and eat as many calories as he can!
Saturday 19 September
Afternoon visit with Harry.  Plastic Surgeon had visited and was happy with the wounds.  The vacuum dressing is now off ready for surgery tomorrow.  Matt is now eating well.  He does not have the capacity to eat large amounts but can eat frequently so is increasing calorie intake – he still looks painfully thin.  This is the first time I can see that things are starting to return to normal.  Matt gets extremely tired very quickly still and just needs to spend time building his energy back up.  His temperature is still nice and low.
Sunday 20 September
We waited all day for matt to have his leg wounds closed.  Matt was unable to eat while he was waiting – torture considering his malnourished state.  Finally they canceled and Matt stuffed his face as fast as he could!
Monday 21 September
Sarah texted me at 1:00 to tell me that Matt had been taken to theater.  I went to the hospital to keep Sarah company during the wait.  The wait seemed to take forever but I managed to get the sister to check that he was in the recovery room.  Still the wait went on for another hour while they found a nurse and a porter to wheel him back.  Matt looked surprisingly well as they wheeled him into his room.  He immediately demanded food and got through a good sized dinner and had a pile of snacks waiting by his bedside.  The doctors came around and said that the wounds must be left still until they are checked on Friday, and the “doner” patches will take a couple of weeks to heal.  The latest estimates for a release date range from one to two weeks.
Tuesday 22 September
Matt’s is not allowed to move and this is making going to the toilet a bit difficult.  Balancing on a bedpan was not conducive to success so he is holding on!  He has very sharp pains from the area of the thigh where they took the skin for the graft.  It is only painful when he moves so he is good at holding his leg still.  He is eating really well now.
Wednesday 23 September
more waiting and slow healing
Thursday 24 September
Yet more waiting and slow healing.  A doctor mentions that if the skin graft is good Matt could be out soon!
Friday 25 September
The news we have been waiting for!  The skin graft has worked and Matt can come home.  Apparently he reminds the doctors that he can’t walk yet.  They decide that it is indeed better that he can walk before they let him go.  Monday is now the release date – time for a bit of walking practice….
Saturday 26 September
Recovery continues.  Matt is moving more easily into and out of bed.  He put shorts and t-shirt on and we went for a walk.  However, having walked to the end of the corridor, Matt had beads of sweat on his nose and wanted to rest.  As an alternative we got a wheelchair and went for a ride down the the garden and pond.  After a few days with difficulty moving to the toilet Matt seems to be taking the opportunity frequently!
Sunday 27 September
We watched the Singapore Grand Prix before going for a wheelchair ride down to the cafe.  Matt is munching his way through lots of snacks now.  I think his body wants to pile on the calories.  Both main wounds are now dressed in smaller bandages that seems to make them look closer to healing somehow!
Monday 28th September
Yeah – We collected Matt from hospital and bought him home.  He didn’t like the bumps in the road.
1st Week at home – to Sunday 4 October
Matt is eating very well which is great news.  He is hobbling around slowly using two crutches and goes up and down stairs with great care and with a lot of effort.  I took Matt to St. Georges on Thursday to see the Plastics clinic.  The nurse spent ages peeling the blood encrusted padding from the donor site on his thigh.  With the exposed iodine-stained open wounds on his calf and the dried bloody patch on his thigh, he was lying on the bed looking like a victim from a battlefield.  The skin graft has taken well on the wound on the outside of the leg, but, on the inside wound, the take up is only 80%.  This means that their are a couple of bloody patches that will take longer to heal.  The nurse took a swab to have the wound checked for infection.  The lower leg is still very puffed-up so Matt spends a lot of time with it elevated.

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