Wednesday, November 27, 2019

Not the End


I entered Alexandrovsko University Hospital at 17:00 on Friday 20th and was sent to the emergency room where there was much discussion about me being on the system. I was put on a saline drip for rehydration and 5 hours later I was moved to ward 2, bed 2, floor 3, this time just 2 beds in the ward, brightly painted yellow and blue and apparently well equipped.

As we entered the room there was an unmistakable odour of tobacco smoke, 'This feel homely, thinks I'. My roommate Ivan, who looked like Richard Dreyfuss, was quickly moving away from the open window and greeted us with a smile and friendly dobur vecher. We exchanged some pleasantries whilst I unpacked, I liked the cut of his jib.
In the morning there was the usual to-ing and fro-ing of medical staff at 6am, after they had finished Ivan asked me if I minded him smoking out of the window, I replied if he didn’t mind me doing the same, then all is good. I later found out the staff room for that floor has an ashtray on the table.
During the day Ivan invited me down to the local cafe for coffee and smokes, often a bite to eat as the hospital food, although the best I’d eaten so far, was still not so tasty. As we made our way through our life stories, Ivan an international coach driver of many years, it emerged that his kidney condition was found out, like mine, with a CAT scan, 2 months previously and the total degree of cancer wasn’t known. I could see he was scared, he didn’t know if the kidney was all that was affected nor how long or intensive the operation would be, I felt his anguish. We made the best of times though, as the hospital policy on patients freedom to travel seems to be very laisse-faire and you need tell no one you’ve left the building nor returned. On the Sunday we went for a long walk into Sofia to locate a tobacconists.
Ivan’s son visited on Monday he spoke English well so I was able to fully explain the pre-op embolisation I’d had to Ivan. In hindsight I’m not sure this was such a good idea as he had passed that point, although it did mean he was in surgery sooner than me and had to endure just one lot of pain where as I had to endure 2 lots.

Tuesday was supposed to be operation day for me, it started with a visit to the anaesthetist where I would discuss my medical history and allergies. This took about 15 minutes, then a walk back to my room to await results. Both Ivan and myself were on nil by mouth and as the day progressed the tension rose. We were unpacking our lockers and labelling our bags and possessions, issued with a theatre gown each and were now in some kind of limbo neither one place nor another. At some point before now you have been to apteka for wetwipes, water, thermometer, nappies etc. During the day Ivan had a surprise, an orderly came into the room with a wicked almost toothless smile and held up a vinyl hose whilst looking at Ivan. He followed her instructions and went into the adjoining toilet, his squeak and sharp intake of breath indicated what was happening. I was almost expecting a cackle from the orderly, she did seem to enjoy this part way more than she should. Ivan called me, I knew he was in there with no toilet roll so I quickly gave him my spare roll. He emerged a short while later with his eyes like saucers and the look on his face could only say "well I wasn't expecting that!" It was quite a funny experience, from the sidelines, to see and hear it described with sound effects and I'm sure when translated he said "without a by your leave"
The orderly left, which left Ivan with a bemused look, I roughly translated his comment as "why aren't you being subjected to this abuse?" "Ne znyam" says I, (I don't know) with equal bemusement and relief. Apparently he was 'nil by mouth' at 09:30 I was 'nil by mouth' at 17:30, so my time was coming, just a while later.
I then got the call, an experience I won't forget is how I would describe it.
So the dirty deed was done, bags packed, almost in the theatre gown when I was given the news that I wasn’t going to surgery, the reason being allergies and pulmonary test results were giving concern. So back on food and water and visiting the allergy and pulmonary departments.
The hospital site is so big they have ambulances to transport people about. I was given the nod and off I went with an orderly carrying my ever growing medical file, via ambulance, to the allergy and tropical diseases building, it looked very old and forbidding like an old sanatorium. The lab technician, who had obviously been in this job forever, ushered me in after a small wait and had me put my arm through a plexiglass screen where he scraped my arm and put a variety of fluids on to see my reactions to them, after 30 mins my reactions were recorded. I was then told to go to Room 13, this sounded more ominous than it was. It was just to be interviewed by a well spoken nurse in English about my medical history with regard to allergies. Back to the ambulance and off to pulmonary department. This building looked even older and more forbidding, it had the most dangerous looking lift I'd ever seen as it was an open cage with access/egress from front and rear. I was given a lung capacity test, the results led the doctor to tell me they are worried about my lung capacity, but gave me no recommendations nor did any further tests to find out why. I believe it’s because of an infection I caught whilst in cardiology the previous week, which I’d asked, and been given, treatment for from my GP Neli.
Back in the ward I was given a prescription for anti-histamines which I had to buy from the pharmacy across the road, these were to be taken for the next 3 days to bring my histamine levels down. The 3 days turned into a week, I made good use of the time by improving my Bulgarian in written and spoken form, helped along by a new roommate Penko he was in for a kidney operation too. As we exchanged life stories I learnt he was the ex Deputy of Transport for Bulgaria and responsible for the 2nd Danube crossing bridge in the west of the country, as well as being in charge of finance for the Sofia metro project. His English was good and we got on very well. After his examination he informed me he would be having an embolisation like I had, so I was able to give him the lowdown on what it entailed and how conditions were across at Cardiology and what he would feel like afterwards. I hoped I was a force for good. He left on Saturday I think to be admitted into Cardiology.
The day after my surgery was postponed I was ambulanced to the cat scan dept, I presumed for an update for Dr Georgiev on my embolisation to see how it was faring. Also that day as I was getting dressed I felt a pinprick on my arm which had swollen up, I showed it to the duty nurse who contacted Immunology. So off I went with my friendly porter to have this thing looked at, she initially looked at it, ummed and ahhd, took my file and asked me to wait outside, a few minutes later she reappeared and declared it was an external injury and I should go to Dermatology dept. This declaration was in Bulgarian so I kind of got the gist of it but had no idea of where it was, my porter had gone walkabout (ironic as she did look aboriginal) I had my file so back to the ward I went.
After 10 minutes of relaxing in my bed the ward sister, phone to her ear came rushing in saying "yes he’s here" with a big smile on her face. Another 10 mins later we were at Dermatology who were quick to determine it was an insect sting and would require an anti-biotic and compress. I had an anti-biotic injection, the compress however was never forthcoming, regardless the wound disappeared in a few days.


During my waiting time my thoughts were drawn to Ivan’s bags still in the wardrobe, I was thinking they have been there too long, I asked the nurse if Ivan was in this area, and eventually, Thursday or possibly Friday,  she replied in the affirmative with a big smile, he was in the room I would later be in. He greeted me with a huge smile and feeble handshake, he looked ruined but in fairness his kidney condition prior to surgery was far worse than mine. He had given me his wifes phone number in case he didn’t come out of surgery. He was expecting to have bad news after surgery, however it wasn’t and we both cried with happiness when he told me the news


This brings us to the 2nd Monday all signs of the operation happening are good so far, morning visit from Dr Georgiev, as he arrives he is followed by at least 20 students and doctors who all try and fit into our small 2 bed ward, what they expect to learn is a mystery as not only does Georgiev not say much but most wouldn’t hear it anyway. As for me he asked how I was feeling and maybe told me surgery, was still looking good for that day. He is treated like the Grand Poobah, I’m expecting excellence no less.
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Surgery day Monday 30th, a visit from Ivan to wish me luck set me up with good feelings soon to be dashed by, woohoo another anal irrigation, by the orderly who seems to enjoy that part of her job far too much. My gear was never unpacked so just don the theatre coat and I’m on my way to Alexandrovsko University hospital nerve centre. I remember leaving my shoes on the rack by the door, sitting with 4 others, this was looking like a production line. The room was massive and filled with what seemed like every single medical apparatus recently invented, nothing old here. I remember getting on the table and having yet another canula fitted then the mask and I was out cold.
A weird thing happens after surgery, you're taken from Alexandrovsko hospital to St Ekaterinas hospital for recovery in their intensive care ward, which is in fact just a gurney ride across the hallway. Here I was to experience my darkest hours.
As I came around I became aware of all the tubes I had attached to me, I had 2 tubes draining my abdominal cavity, 3 or 4 drips in my arms, an oxygen mask, I was wired to a heart monitor and had a catheter.
My immediate concern was I couldn’t speak, I had a tube down my nose into my stomach I couldn’t clear my throat which was full of gunk, I felt nauseous and in pain. I did feel blessed though that the bed was brand new electronic and multi functional so I could adjust my position for some comfort. It was the nasal intubation that was tickling my throat and triggering my cough reflex which caused my abdominal muscles to tighten and caused me pain. It was like drowning while being punched in the solar plexus, I was on my back and I couldn’t move onto my side due to all the tubes.
I’ve never felt so imprisoned, helpless and claustrophobic in my life, I had to change this, the oxygen mask was first to go. I was able to get some sleep but it was disturbed by this tube down my nose, I tried to adjust it to a more comfortable position to no avail, it had to come out, in truth I thought it was a short tube but what the heck it was coming out. I pulled and pulled the diameter increased in the middle which was a surprise but it was like a clear gel coating the tube causing this, it came out without pain. I had no idea what this tube was for exactly but figured if it was looking for food, I’d had 2 arse vacuums I was empty. At last I could feel my voice box though it felt like it was coated in pepper flavoured silicon, I could now swallow to a degree. I removed the tube late at night and it took a while for staff to notice and as it set off no beepers I figured it wasn’t that important, proven out by the ward sister when she did find out saying with a smile "I hope you won’t be any more trouble tonight" and left the tube out.
I was now at some sort of peace and slept to the morning in spite of staff shouting across the ward like Grimsby fish wives, along with other patients choking and setting off alarms. The time seemed to stand still days and nights merged, the noise and pain were merciless, I had no voice to complain with.
After 2 nights I really was ready to scream and shout but with damaged vocals this was impossible the best I could manage was an angry whisper, knowing that this morning I would be back amongst familiar staff and friendly faces gave me a focal point. Not a moment too soon I found myself in bed 3 ward 3 able to move a little more independently albeit with massive pain across my upper abdomen just below the diaphragm. I have no idea how they stitch abdomen muscles together but they did a splendid job. My new roommate was Hristo, in for a prostate operation a very well read man with a great command of English, he is an importer/exporter of goods, of German extraction who shares my view on the 'green' mafia and global green stupidity, I was with the right roommate.
My doctor was Nikolov a prodigy of Dr Georgiev, he looked after my dressings, every day for 3 days and then 3 days later, my morning of discharge, it was changed for the last time here in Sofia.
Before that happened though I was having my 8am chat with my Doctor about my chest complaint which I picked up in cardiology, I got treatment for it from my GP but there was little time for it to be fully fixed before I had my operation, so Dr Nikolov had me go for another chest xray which showed up nothing unexpected, this condition I had now was usual after this type of surgery and to be honest most patients seemed to have it.
At this point I have to mention the heroic efforts of Tracey my beloved, her ability to pretend to cope with organising some of my children, train, accommodation, clothes, food, livestock and her own health and well being. Whilst keeping my mother, siblings and children informed of progress. Tracey you are a legend, I thank you from the heart of my bottom.    Special thanks go to our friend Tracy (without an 'e') for blood donation and moral support.   Thanks also to the others who donated and those who were willing but not needed.   Eternal gratitude to Pete & Anne whose care of the livestock removed some of Tracey's stress.

Current status external wound 90% healed, interior wound feels like 70%.  Have gained a new thrombosis in my left leg, in good spirits and looking forward to getting back to work.