Monthly Archives: September 2016

Wednesday.

Having been here for almost a month, changes have materialised in me, amongst them being clarity of thought.

Well either that, or I’ve gone stark raving mad and everyone, except myself, realises it. After all, all mad people are convinced that they’re sane, aren’t they – it’s the mark of true insanity.

I know I’m gonna get texts saying ‘ you’ve always been f****** crazy, it’s just now that you’ve noticed ‘ but that’s not what I’m talking about.

Whilst a student, I was banned from :

The whole Cardiff Student Union,

the student halls bars

both halls campus’s,

Pierro’s wine bar/ club, where I met my future wife,

the Cardiff student night club, the ‘ Hanging Gardens’,

the Woodville Pub where ALL students went,

the Sports Union.

And the rugby club…

At the end of my first year, they threatened to ban me from the 3 year course I was doing – rare for something as dull as Ophthalmic Optics

I don’t think ANYONE else came even close to that, in the history of Cardiff University.

They were all lifetime bans, so still apply.
I ended up banned from pretty much everywhere that I went, and I’m sure had I gone to more places, I’d have been banned from those too.

Personally, I think I was a victim of circumstance, and they just misjudged me..

In retrospect, I deserved everything I got ( OBVIOUSLY!!! )

Hindsight is a wonderful thing.

Anyway, I’ve digressed.

Having been here for a month, I’ve now realised that the people that come to see me, are coming because they WANT to see me ( because they like me )
That’s a big, massive, huge difference from people coming to see me because they feel obliged to/ought to / think they should be ‘seen’ to.

I really only want visitors from the first category, and I can tell which category people fit into, straight away.

As a consequence, I’m having a positive time in this hospital.

Isn’t life full of surprises ?

Russ
Aka Mad Russ

Ok, so I am in LONDON BRIDGE HOSPITAL

It’s not part of another hospital, and I have a private room, with a Tv, and an bathroom ( visited twice )

There are no visiting hours, but I’m get ally asleep by 2.30 am and awake by 10.30 ( but possibly earlier, and possibly I doubt sleep at all. )
This evening I’m really yawning.

Wednesday.

Few good things :

I’ve signed up as a ‘ living kidney donator’

They managed to unblock my colon… The ‘ creature’ lurking there was like something from The Deep.
Stomach now flat’ ish.

They took me out for a haircut.
Now I don’t look like Ken Dodd.

Nicola H came to visit and brought red wine.
From now on, I don’t want chocolate ( please ) if red wine is an option.
But really, no ‘ gifts’ necessary, other than kindness.

Thank you so much to Samantha and Helen Brooke for your visits ( and exotic fruit from Helen )
Exotic to me, includes things like pineapples. I thought until recently that those rings grew in the tins?

Thank you to the staff here for their kindness, their company, and for saying that they’ve never had a patient like me, ever before… whatever that means.

They won’t let me out of here until they are sure I can survive outside, more or less by myself. Since that’s a far taller order than before, I think I could be here for a while.
As I’ve become used to it, that now seems to be a sensible, non emotional, strategy.
I really, really have no interest in being a burden to anybody. I know people hate the thought of that word being applied to another human, but the reality is factually true.

For the morbidly obsessed wannabe doctors out there.

Procedure:​
Surgery was covered with intravenous Cefuroxime, intravenous Gentamicin, Flowtron Boots, pre-preparation of skin with alcoholic chlorhexidine.

Position: Supine with left-sided raised 20° on beanbag.

Incision Approach:

Approached Mr Agu. Left oblique incision. Two window approach. L4-L5 L4-3 rector sheath opened obliquely with external and internal oblique split in line of fibre. Transversus abdominis split and retroperitoneal space entered. Peritoneum pulled to the right hand psoas exposed with the vessels retracted to the right hand side. Excellent exposure of the L4-L5 disc. Segmental vessel over the L4 body ligated with Liga-clip. Good exposure of the L3-L4 disc space and the proximal one half to two thirds of the body of L3. Two separate window for the L5-S1 space with opening of the rectus sheath with a retroperitoneal approach. Iliac vessels identified and the bifurcation identified. The bifurcation retracted both to the right into the left to give exposure of the L5-S1 space. Median sacral artery divided.

Procedure Findings: L5-S1 anterior lumbar interbody fusion undertaken. L5-S1 discectomy with elevation of the end plates with good exposure with the end plate. Good removal of the disc material. Disc was normal. A size 18x38x28 12° cage was placed. Excellent hold. Position checked on imaging intensifier. Two screws placed in L5 and S1 27.5mm. Excellent fix and screw satisfactory on AP and lateral imaging intensifier. Exposure facilitated with the SIN frame. Two L4 corpectomy. Good exposure of the L4 and L3 bodies with the SIN frame. L4 and L5 discectomy. L3 L4 discectomy. The L3 L4 disc was very degenerate and destroyed. No overt parcel evidence of sepsis but a very abnormal disc. L4 corpectomy was undertaken with a combination of rongeurs and Burr. Complete removal of the L4-5 disc and the L3-4 disc with one third removal of the body of L3 down to normal bleeding bone. Burr used to get posterior wall of L4 removed to approximately 3-4mm of the back of the spine. Thorough washout of the space with approximately 1.5L of normal saline over the procedure. Combination of curette used to remove all the disc material which was sent for histology and microbiology. A VLIFT cage was placed. 22×32 with endplates of 3° and 8°. Expanded satisfactory. Excellent hold. Rock solid within the L3 L5 space. The cage was packed with allograft and DBX. Good haemostasis at the end of this procedure]

Closure: Closure Mr Agu. Closure was in layers for transversus abdominus internal oblique and external oblique with one Vicryl. A one PDS loop to the rectus sheath. 2-0 Vicryl to the subcutaneous fat and 3-0 Monocryl to the skin.

Post-Operatively: The surgery is covered with 48 hours of IV Cefuroxime and Gentamicin. Clexane to be started at 1800hr on 17.09.2016. Postoperatively there was good perfusion of both feet but dorsalis pedis and posterior tibial pulses present with both femoral pulses present too. Both feet were warm and well perfused. He can sit up and mobilise into his wheelchair as his symptoms allow.

Many thanks.

Yours sincerely

Dictated but not signed to avoid delay

Monday, I think.

Massively blocked up and bloating, all over again.

I did get transferred onto a table, strapped firmly on, and then tilted slowly to upright.
I ‘ stood’ for about 20 mins, before I got too light headed.
It’s been many months since I’ve been upright, it causing crazy spasms.

Today no spasms though, and it will ‘ aid my constipation ‘ – though not yet..

12 hours sleep in 4 days.
The General anaesthetic messes your sleep up – I am tired, for sure, but I don’t sleep.
It’s not something that bothers me, as I have far worse problems, but it makes the days long, tho shorter today through having 3 people visit – Toby, then Cherie, then Mary.

I did watch that film, Inglorious Bastards, last night, and wondered how I’d managed to not see it before.

If you like Tarantino, then you’ll like this.

But you’ve probably already seen it!

It helps if you’re not a fan of the Nazi regime.

I find myself sliding and dreading my future.

Euthanasia is now available in Belgium.
A lady that just won a medal in the Paralympics was talking about it last night. Living with a disability that still allows you to win a medal, does not mean that happiness accompanies it. It’s what she intends to do before long.

As I’ll now need a carer, I can’t see contentment being an outcome, so I’m back to other options.

I’ve had a thoughtful 24 hours.

Fresh challenges.

Difficult times for me.
And all so unexpected.
I am going to find everything so much harder now.
Dressing will be severely compromised as I can’t reach down further than the top of my thigh, when lying down,and neither can I roll myself over in bed. Once up, reaching anything to either side will require me to turn my chair first. Performing what I have to do in the loo looks physically and anatomically impossible so I might need a carer to do that. That obviously affects all travel possibilities.

I’ve no reason to feel very satisfied, when I look at it, but haven’t broken just yet.

I think I’ve paid a big price for being upright, although my surgeon is sticking with the ‘ you had no choice ‘ line, and I do trust him.

Oh, and my spasms are back.