By Sunday morning my eyes had started to go a bit yellow, and my skin, under the Christmas tan, was turning a bit Trump orange. You didn't need to be a trained clinician to know this wasn't good. I called the helpline and described all that had gone on, and I was advised there was nothing that could be done today, but to get bloods taken at my GP on Monday. Fair enough. So, come Monday I went down and got needle-sticked once more, and the samples wound their way to the hospital. Come Tuesday I got a call from the hospital: "could I pack an overnight bag and get in there ASAP?". Now, getting asked to immediately head to a hospital is generally not a good thing, save for cases where your partner is already in labour.
So, the MIL and I drove into hospital and reported to the Surgical Assessment Unit to be, presumably, assessed surgically. Now, as previously noted, this past year or so has instilled in me a hitherto unknown level of patience. That said, today was going to test it. So, I filled out the forms, got taken to a comfy chair, and first off was blood pressure/pulse/oxygen, all fine, bang-on average if anything. The nurse asked if I had had blood taken, and since no, said someone would be along. A Healthcare Assistant then asked if I had had blood taken, and since no, said someone would be along. The another nurse asked if I had had blood taken, and since no, said someone would be along. And so it went. Even so, I couldn't get stressed or irate: the people are stars and are working their nads off in a testing environment. They all treated me with care and compassion, and as always, I'll defend them to my last breath. Where we were sat did offer a good spec for people watching and overhearing various conversation, the best one being the response by a nurse to a colleague about a another staff member they had been dealing with "oh, her name is Mimi? I've been calling her Angie for the past year."
I didn't immediately realise, but my visit to the hospital appeared to have coincided with a work-experience program, or a "bring your son to work day", since there was no way the 14 year old in scrubs who came to check on me could have been a qualified doctor. Still, he had a lovely manner and had remembered a fine collection of long medical words. After examining me, and finding nothing particularly of note, save my lovely collection of abdominal scars, he asked if I had had blood taken, and since no, said someone would be along. No shit Sherlock. The young boy then wandered off, probably looking for his dad.
Eventually blood was drawn, and after a few goes in the past days, my the veins in my arms are taking a bit of a battering, not quite looking like Christiane F's just yet, but they certainly could do with a break. Generally on morning visits to the oncology unit, bloodwork comes back in under an hour. It became obvious that as the day moves on, and samples back up, it gets longer, so yes, more waiting. At this point, the would-be doctor had found a grown up, so he came to speak to me. The senior clinician advised that absent adverse movement on the blood markers, he wasn't going to keep me in overnight, and would not be expediting either the CT scan or ultrasound (both scheduled for tomorrow). Thankfully at this point he didn't ask if I had had blood taken, so didn't advise someone would be along. I also made a huge mistake at this point, by admitting that I wasn't phased by waiting. As such, he ultimately advised that I could come back tomorrow for 4 more hours sitting in the unit before my scans. That will teach me to be honest and open.
So, at this point I was waiting on bloodwork result and also a couple of prescriptions to deal certain of the symptom. 2 pills. How hard can that be? We're in a hospital for crying out loud. One of the 2 drugs was Vitamin K. It took almost 2 hours of searching, but ultimately they came up empty handed. The only doses at this time were on the paediatric ward, and they prepacked to such a size, that the required dose or me would have cleaned out the entire stock and put all the sick kids at risk. I am glad to say that the medical team concluded that I could skip that one. So, in the end, I was sat for 2 hours waiting to take 1 pill that was sat in the ward all that time. And with that, we went home, some 7 hours after arriving at the ward.
So on to Wednesday, I got dropped off at the assessment ward, checked in, said hello to the various now familiar faces and started the waiting game. First off, as always, was blood pressure etc, and then they wanted some more blood. I offered up my right arm initially, on the basis it looked less battered. The nurse had to put in a cannula for the scan later, as opposed to a routine needle in an out. First stab didn't go well, she fiddled about a bit, much to my discomfort, and ultimately pulled out. So, back to the left arm. It took a tight tourniquet and a lot of slapping to bring up a vein, and then she went for it again. After deciding we had a bull's eye, she then opened the line and it sprayed like Old Faithful at Yellowstone, hitting my jeans, my jacket and the chair. Note that all of this was taking place in a waiting room chair, with a fellow patient sat next to me (to be fair, she did try to not watch and didn't appear overly alarmed.) After that, I only had 3 hours to kill before the scan, with nil by mouth other than copious amounts of water. I watched a lot of YouTube clips in this period.
So, time passed, and I wandered over to X Ray for the scan. 2 lovely Filipino staff took care of me and aside from the normal effect of the contrast agent, this was all run of the mill. As I think I have mentioned before, the contrast agent used by the hospital has a very disturbing side-effect, which is to make you convinced you have just peed yourself. Having just consumed several litres of water to aid the liver for the scan, having a reasonably full bladder provides no positive benefit to this effect. Still I hadn't peed, so a win. Plus, it is better than the rectally delivered marker I had to suffer way back when.
After the CT scan, I made my way over to the ultrasound department, and after a very short wait, a technician came out to speak to me. They had taken the decision that because I had just had a CT scan, there was no added benefit to having an ultrasound, so thank you and good night. It's a tough one to know what is the appropriate response in such situations: do you argue that other medical staff have requested it and surely it isn't for some technician to unilaterally kibosh the plan, or do you simply accept that someone more qualified than you has made a balanced decision. In hospitals I generally take the latter approach: I wouldn't expect doctors, nurses, and other staff to 2nd guess my job, so it seems a bit rich to take a different approach with them. As such, I wandered back to the assessment ward.
I then sat with the senior doctor on duty to go through what happens next. I did tell him what had happened at ultrasound, and he looked a tad bemused, but otherwise was "ok, move on". He advised that he, and the endoscopic consultant needed to review the scan results to ascertain whether their diagnosis of a blockage was confirmed, and if so, then I was needed back the next day to do more bloodwork (my veins didn't leap for joy) and sign the consent for the procedure (which should be Friday). He did suggest I could stay in overnight, and get it all done in the morning. My reply was whether there was a point in taking up a hospital bed that might be needed by a rather more urgent and deserving case. His comment was interesting given the general bed shortages across the NHS that are commonly reported: "if we need a bed, we'll find a bed." Reassuring stuff, even if part of me visualised this as spending the night on a gurney next to the 24 hour laundry department. So, we concluded that I would get a more restful night's sleep back in my own bed, and I pencilled in a 3 straight day in the assessment unit. And I went home.
And so to Thursday. I was told the evening before that any urgent issues from the scan might require an early visit to the hospital. So, in the absence of that, my wife and I made it in for 6pm for what we presumed would be a brief visit.
First off, we met with staff from endoscopy, which indicated I was set up for the procedure the next day. The lead person went through various checklists and asked one question that, in other circumstances, would have elicited a different reply. When she asked "do you have a hearing aid?", my response of "no" set my wife into fits of laughter. After 30 years with me, hearing pretty much the same 4 gags on repeat, I was proud she knew the correct answer was "pardon?". Explaining this to the endoscopy pair resulted in a pair of blank faces.
Back to the ward and next up was blood. Always blood. This time it took 2 nurses and 1 HCA 4 attempts of sticking my arms before they found a viable vein, and this ended up being just up from my left wrist. Junkie arms strike again. Then I had another list of questions from the ward sister, one of which queried the state of my stools. The laughter that followed my offer of photos could be construed as nervous or appreciative. She also asked if I had any other issues, and rolled her eyes at the reply of "no, just the cancer".
After that we waited for the bloodwork to come back. And waited some more. I was at a midnight nil by mouth cut-off, and had tea waiting for me at home. As such, we agreed with the doctor that I would go home, eat, pack a bag, and come back and stay overnight. Fast forward to my return to the ward, it become apparent why my bloodwork had not come back: somehow they had lost the sample. As such, they wanted another go. After a long search for anything resembling a vein they plumped for my right hand and, thankfully, stuck a cannula in, so at least it could be reused.
And with that I was left for the night in my bed. This was a first for me: spending time in a shared ward. I didn't get much sleep, lots of wailing and moaning around me, which is to be expected in a hospital I guess.
And to Friday, surgery day. I was Nil By Mouth from waking up, so it was great to watch all the other patients get breakfast delivered. The cleaner came sweeping by, and I chatted to her for a bit. She was originally from Thailand, but had lived in England for 14 years. We swapped stories on the relative beauty of the beaches on Koh Samui and Minehead. No contest really, I don't recall a Butlins on Samui. The surgical consultant did his rounds with his swarming horde of junior doctors. He stopped to speak to me, seemed a really nice guy, explained what was going to happen, and said I'll see him soon. After that I waited some more, before I spotted someone from Endoscopy pushing a wheelchair down the ward, clearly looking for a patient. Batter up, here we go. The staff member pushing me back to Endoscopy was a lovely Polish woman. Once arrived, I was put into the prep room to await the call down. I was handed over to another lovely nurse, I didn't catch her nationality, but again she was not native British. I only mention these interactions to reinforce again the amazing breadth of nationalities that support the NHS, and I defy anyone to argue that immigrants do not contribute to our society.
After an hour or so I was taken downstairs for the procedure. I was scheduled to have an Endoscopic Retrograde Cholangio-Pancreatography (ERCP) to address a bile duct stricture. Basically, put a stent in the bile duct to, hopefully, unblock whatever was blocking. All a bit of a mouthful, but basically sending a camera down my throat, through the stomach, and to the bile duct, then using a smaller wire to do the leg work. I had previously signed the consent, and like all these documents, the myriad complications and risks were documented, ranging from slight stomach pain to death.
I was taken into the room, and assumed the position: face down on the table, face off to one side. The consultant explained again what was going to happen, and describing what it was going to be link getting the camera in, pretty much said "it's going to hurt, it's not pleasant, and you will not like it". First off, a mouth spreader was inserted and taped to my head. Not the same thing, but this was my first thought. I had the painkillers and sedation, and then the camera. The consultant had not lied, it was God-awful trying to swallow and gag to get it down my throat, but once over that hump, it got better. The whole thing lasted about 30 or 40 minutes, but with the sedation, I wasn't all that aware anyway. Before I knew it, I was back in recovery, and had to spend 2 hours there under observation before I was sent back to the ward.
I was barely back there before I was told I was being moved to the surgical ward: which was good, since it was a private room, not an open ward. I was taken over there, and soon my wife and MIL came in to see me. Not long after they left, the doctor came in to tell me I was cleared to go home if I felt OK, since the consultant had already signed off my discharge order. I voted to get back, since I assumed it would be more restful, and after a few hours of kicking my heels, my wife came back to get me, and after the most crappy of weeks, I got to have tea at home, relax, and sleep in my own bed. Hopefully this holds.