Tuesday 28 August 2018

The Thing in TJ's Brain Part 8: The End?

The Great Ham Sandwich Fiasco ebbed into the past. Eventually I started to feel less ill. They noticed that I was dehydrated and put me on a drip for a day or so, and as I began to feel less unwell, I started being able to eat and drink more. It took several days for the results of the cisternogram to come through, but they did and the surgeon decided to operate to replug the hole. Not only would this require a new fat-graft, but he decided to install a lumbar shunt as well. This is essentially a pipe that runs from my lower spine into my abdomen to help drain off CSF while my leak was healing.

The appointed day of the operation came round, and I was once again decked out in the subtle but stylish surgical stockings, gown and paper pants. I was loaded onto a trolley and trundled off. Events proceeded much as before, but this time, the injections into my arm hurt less. I’d mentioned the pain the first time round to the anaesthetist, and she went rather more slowly. Again they fitted the mask, and again I began to feel rather woozy. I lay back, closed my eyes and tried to relax.

After my first operation, I remember being woken up after the surgery, but this time I have no such memory. I lay back and let the anaesthetic do its work, then I was awake and back in the High Dependency Unit, but have no recollection of actually being awakened.

Happily, this time round the operation had been much shorter, since they neither needed to remove any brainlumps or collect nasal stem cells for the advancement of Science. As a result, they’d not felt it necessary to fit me with a catheter, a decision of which I was extremely glad. On the other hand, the nurses in the HDU seemed oddly obsessed with my ability or otherwise to pass urine.

They presented me with a bottle and demanded that I provide some. I explained that I didn’t really need to go at the moment, but agreed to do my best. However, nothing was forthcoming, and the nurses exchanged concerned looks that threatened the insertion of pipes where no pipes ought to be inserted.

Later on, they returned with another bottle and more demands. I felt more of a need by now, and I was able to oblige, at least a little bit. They seemed dissatisfied with my performance, but at least a little mollified. This was repeated a couple more times, eventually persuading them that everything was operating as it ought.

I had new wounds. One on my stomach where they’d taken a new and larger piece of fat to plug my head, one on my spine where they’d inserted the shunt, and another on my side, where I assume they pulled it through and positioned it. I was informed that there had been a slight problem with the installation of the shunt. Apparently my liver is not where it’s supposed to be, or perhaps more accurately is where it isn’t supposed to be. As a result, in feeding the pipe through my innards, they managed to stab my liver, producing a small amount of internal bleeding, which they were able to quickly remedy.

Again I had the wadding up my nose, and again for the first day or two I felt incredibly thirsty. I was returned to my ward where I stayed for another week. They decided to pull the wadding out of my nose again, and a pair of nurses came and spooled it out. Once more it was deeply uncomfortable, but not as bad as before. The wadding seemed to have been coated in some sort of slightly oily substance, possibly Vaseline or something of that ilk, before being inserted, and this obviously stopped it from adhering to the insides of my head as it was tugged out.

I continued to recover, but I was still expected to urinate into a bottle and present it to the nurses. This was a process I found not only embarrassing but extremely inconvenient, especially if there wasn’t a nurse immediately around once one had finished. You’d end up standing rather self-consciously, clutching a cardboard bottle and peering around trying to catch the eye of any wandering nurse who happened to move into the vicinity.

A week after my surgery, I was feeling a little better and the Powers decided I could be paroled again. However, based on my experiences of the journey home during my previous imprisonment, I tried to persuade the hospital to transport me home. This wasn’t out of laziness or a desire to drain the NHS’s already scarce resources. I’d not had a pleasant stay, and I wanted to do everything I could to ensure that it wasn’t repeated.

Initially a helpful and sympathetic nurse went to enquire and came back to say that it wouldn’t be a problem, and that the hospital would be able to transport me home. Closer to the date of my release back into the wild, I asked again, and a different nurse came back to say that this would not be possible. I explained my situation and circumstances, and how awful my journey home had been before.

Their suggestion was that I should get a taxi from Central London to Bedfordshire. I expressed my opinion of this particular scheme, and suggested that they find an alternative. The fact that I’d been brought to them in an ambulance apparently held some weight. Eventually they conceded that perhaps they could arrange to transport me home.

The day arrived, and a chap came with a wheelchair to collect me. After my illness and operation, I was feeling sufficiently feeble that this seemed wise, and I didn’t feel too self-conscious as I was wheeled away. I found that this time, it actually was one of those mini-bus ambulances, which made me feel slightly better about my decision. However, it turned out that I was the only passenger, which made me feel worse. Then, during the journey, the driver told me that he frequently had to go and collect, and later drop off, a woman from Grimsby, and this made me feel better again.

The journey home was relatively good. The driver was friendly, albeit wholly obsessed with sports of varying kinds, so I didn’t feel able to contribute much to the conversation beyond fencing. On the way, we passed London Zoo, where I caught a glimpse of the giraffes, and later on passed through a small village which consisted of nothing but a handful of houses, a tree nursery and a lap dancing club.

Eventually, we arrived home, and I was able to bid the driver goodbye and gratefully collapse into bed. I spent the next several weeks slowly recovering my strength.

One minor hiccup occurred recently. I’d been given an appointment from a follow-up MRI to check that everything is still present and correct. I travelled down to London and presented myself. I filled in the usual form promising that I didn’t have cybernetic limbs or a metal plate. On the other hand, I did have a shunt, so I mentioned this. I handed the form to the radiographer, who glanced at it.

“What kind of shunt do you have?”

“Um, I’m not sure. I was definitely told that it’s one that doesn’t interfere with MRIs though.”

“Ok, I’ll just check.” Off he went.

A little while later, he came back. “We can’t find anything in your notes about the type of shunt, sorry. We can’t proceed with the scan.”

“They definitely said it was ok for MRIs.”

“Yes, but there are some that are only alright for low magnetic fields, and we need to know before the scan. If it’s the wrong type, it might shift inside you, and you’ll have to have surgery to put it back again.”

I immediately had images of my shunt slithering up my insides and trying to strangle my brain, which didn’t sound like a Good Thing.

“We do have a note in your file,” he continued, “but it’s hand-written and none of us can figure out what it says.” Jokes about doctors’ handwriting immediately surfaced in my mind. Ultimately though, they couldn’t risk going ahead with the scan, and all because the left hand can’t read the right hand’s handwriting.

Some time later, I finally had the scan. Beforehand, I had to have an x-ray to help the radiographers figure out what kind of shunt they’d stuck inside me. I’m sure that I remember x-rays being a long and complicated procedure when I broke my arm back in the olden days, but nowadays they’re over before you realise it’s happening. The photographer puts you in a suitably artistic posture, disappears into an adjacent room, and you barely have time to say ‘Cheese!’ before they’re back in again and telling you to leave.

On the basis of this, they discovered that my ‘shunt’ is little more than a rubber tube, and that therefore they could safely load me into the torpedo tube. Once more I donned the earplugs and headphones, once again my head was wedged and caged, and once more I was loaded and ready to be launched. My first MRI was an experience full of interest and curiosity. Having had so many though, the novelty has worn off, and I very nearly fell asleep in there. Eventually I was released and sent home.

A curious thing happened on my way back to the station however. A homeless man asked me for some change. Instead, I offered to buy him something to eat, and we repaired to a nearby cafĂ©. Here, we got chatting, and when I told him I was a copywriter, he immediately asked me if I’d be willing to proofread and edit his five-volume work entitled ‘The Chronicles of Doom’. I initially assumed that this was a fantasy series, but it turned out to be a collection of prophecies. The titles included ‘The Cosmic Clock’, ‘2121AD’, ‘The Chronicles of Doom’, and a couple of others to do with aliens and doomsday. He offered to send me a synopsis. Intrigued, I gave him my email address. I will be interested to see if he ever sends me anything, and if so, what.

I’m now waiting for the results of the scan, and generally my recovery is going fairly well. My initial feebleness has passed, and even my headaches are only fairly mild. I’m now back at work, albeit only part-time to start with. The vision in my left eye doesn’t seem to have recovered much, if at all, but apparently this could take months, if it even happens. However, The Thing in My Brain has been defeated, so at least it won’t get any worse. It’s been a mostly interesting process, but not one that I think I would either recommend to others or wish to repeat myself.

I will end however by singing the praises of the NHS. Early on in the process I tried to work out how much everything would have cost in the US, and was already into the tens of thousands of dollars even before the first operation. The NHS is by no means perfect. There’s an awful lot that it could do better and more effectively. It can be rather slow and inefficient. Often the right hand doesn’t even know where the left hand is, let alone know what it’s doing. However, it is still a wonderful service filled with hard-working, compassionate professionals, and it strikes me as being a good deal better than the alternative.

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