22 February 2014

Royal Prince Alfred Hospital, Club 55 and Broadway Shopping Centre – A Big Journey Home

Prof Christopher Young successfully completed my colorectal surgery at the Royal Prince Alfred Hospital (RPAH) over the middle of the day on Tuesday 18 February.  I awoke at 1pm wondering where I was as I looked around at patients in beds and staff moving noiselessly around attending to their patients’ needs.  The 18-bed recovery ward provides the immediate after care for the 22 operating theatres.

At 2.45 my recovery nurse accompanied me to 9 West 1 Ward where I was placed in the bed 16 position.  I had a lovely view south over Gloucester House (where I had chemotherapy from April 2011 to April 2012), St Andrews College and Newtown.  I was alert and sat in my chair to have dinner while Barbara and our daughter looked on.

Wednesday was harder as I felt bloated.  My abdomen had been filled with gas to make it easier to complete surgery.  It takes more than a day before this dissipates.  I also had gas in my colon.  Best treatment is to walk.  So, I was up and about walking around 9 West 1 and 9 West 2 wards and out into the lift area.  Over the four days there I walked several kilometres.  Things became more comfortable as the gas escaped through my stoma or dissipated in my abdomen.

Lesley, the stoma nurse, taught Barbara and I how to care for the stoma, attach and detach a colostomy bag.  She gave us supplies galore to keep me going for ten days while I am enrolled as a member to the NSW Colostomy Association of NSW (about 1 kilometre from home) and then get my supplies monthly from them.  Over three days I changed the colostomy bag as she watched and made suggestions.  Today, Saturday February 22, April the weekend Stoma nurse came and checked that I successfully manage colostomy bags.  I passed the test and she gave me the all clear to come home!

Meanwhile, Prof Young visited several times and on Friday afternoon said I could go home Saturday if the stoma nurse and doctor in charge on the ward were satisfied.  Each day, other doctors checked on me too.  Nurses were excellent in their care.  In fact, I felt confident to ask questions of all and learned a lot along the way.  The quality of all staff in the ward was excellent including administration, interns and cleaners.  Even the hospital food was reasonable considering how they are trying to feed so many with lots of dietary requirements for as little as possible.

On one of my walking times around the wards one intern said I was healing myself.  A key element in patient recovery is walking, however, most patients languish in bed.  Thankfully, because I like walking and I was determined to progress, I walked.  At first it was painful due to muscle deterioration through the operation and my inability to travel far over the last few weeks due to needing a bathroom.  The pain was from the gas in my bowels and abdomen.  Thursday was much better than Wednesday and by Friday afternoon I felt much more comfortable.  In fact I accompanied Barbara through the hospital to the northern exit on her way home.  I then returned to my ward climbing stairs from the third to the fifth floor and felt good.  Barbara and I even managed to escape 200 metres up Missenden Road to Hoochie Mamma Cafe where I enjoyed a ham and cheese croissant on Thursday.  However, I found the walk painful.  The walk home this morning was fine.

Sadly too many patients lie like beached whales on their beds, slowing their recovery.  The nurses told me I would do better to spend time sitting in my chair rather than lying in my bed during the day.  So, I walked and sat in the chair on Thursday and Friday.  In the chair I watched four movies on Will’s iPod.  The last two nights I had my bed setting so that my body was reclining and my legs were bent.  I listened to music on my iPod (listening to Abba at the moment) to shut out noises, especially the TV of the patient next to me, tuned to the ABC, so the familiarity kept me awake.  One of my parting suggestions to my nurse was that patients be required to watch their TVs using earphones.

Wandering around the two colorectal wards I saw a number of patients in duress.  Some men looked nine months pregnant due to the amount of gas in their abdomen.  A couple of these people slept upright in chairs to have some comfort.  One patient had a nurse assigned to him 24 hours a day.  This means three people, one for each 8 hour shift!  I was told this is done in situations like danger of falling from the bed and mental illness conditions.  Based on the behaviour and age of the patient, I think it was related to mental conditions.  What expensive nursing to comply with high standard protocols.  My time at RPA reinforced my awareness of how as a nation we need to consider how much resources are put into our health system and how it is paid for.  We cannot keep going as it is currently run because it is too costly relative to the proportion of society wide resources it is consuming.

So, with my good recovery, I was able to manage myself to a good degree including adjusting my bed setting using the crank handles, showering, going to the toilet, walking round and finding my nurse when I needed something rather than just pressing the buzzer.

Prof Young said I would feel great relief once I had a colostomy bag.  That is an understatement.  You may find it hard to believe but it is wonderful to be able to move around without feeling a desperate need for a close by toilet.  The cutting of my lower colon and creating a stoma for use with a colostomy bag was essential.  I could not stay as I was.  Now I am comfortably writing my blog entry on my MacBook in comfort.

Leaving hospital at 11.45 am this morning I felt I was starting a new phase in my life.  I felt like I was leaving the womb of the hospital to return to Club 55, my home.  I was leaving the security of the mother ship with all its resources to return to Barbara and my own nest.  I could not walk to the hospital but I comfortably walked home!  It was wonderful when the name identifications were cut from my wrists and we left the ward to the well wishes of the staff.

Once home at Club 55 I unpacked my bag.  We set up my medical box with colostomy, etc products.  But this was not enough.  In my new phase I need to be able to handle the colostomy bag attachment.  So, I needed a man-bag.  Barbara and I drove to Broadway Shopping Centre.  We enjoyed lunch – another ham, tomato and cheese croissant and then went to the bag shop.  Barbara gave great advice on the appropriate man-bag.  So we chose a travel pack kind of one where I can store colostomy bag and other requirements; items I used to keep in my trousers or shorts; a small umbrella; water bottle and other items.  I sling it over my head and shoulder so it sits securely and comfortably on me.

So today I have walked from the RPAH mother ship to the comfort of Club 55 and driven to Broadway Shopping Centre to set me up with a man-bag for my now revised physical body.
My man-bag is beside me as I write this blog update.  Once again, thank you for all your messages of love and encouragement.  Thank you to Barbara, family and friend Chris for your visits.

A thinner me from my weeks of discomfort and two bowel 
preparations in two weeks standing in front of the 
bougainvillea at Club 55 wearing my new man-bag.
My colostomy bag is hanging from my stomach over 
my pants under my shirt on my left hand side (near man-bag).


My abdomen will take about two months to completely heal with most healing take place in the next couple of weeks.  My challenge now is to help that healing, eg by daily walking so that I can start chemotherapy to address the growing cancer in my liver and rectum.  The first stage has been achieved, now to the next stage.  On Monday I am ringing Dr Lisa Horvath, my oncologist to discuss what happens next.  I aim to keep you informed.

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