To the Brink of Death (part 2 – into hospital)
I spent a chunk of last week in hospital, part 1 was about becoming unwell, this is about my experience as a patient going into hospital. As a caveat I was deeply unwell and don’t have total recall. I’m doing this from memory a week out aided by various pictures and messages on my phone. I tried to get my observations (obs) and share them with my wife as we went along.
We went the back route to the hospital, avoiding the roadworks and also giving Tracy a chance to drop me off in front of the Emergency Department before parking. I went in on my own, as I approached the reception a large board informed me that there were three patients waiting to be seen in ED and that the average wait time was 48 minutes. That was OK, I’d brought my phone and Tracy would be back with Lucy when they’d parked the car in the staff car park.
“I’ve got suspected sepsis in my leg” I said to the receptionist.
It didn’t cause any reaction, she asked me the usual series of questions to identify my record and book me in to the system. When it was done she asked me to take a seat.
The display updated. Four patients waiting, expected wait time 50 minutes.
I picked the closest empty seats and walked towards them. Lucy ran towards me, followed by her mum. Lucy and I sat on a chair and Tracy went to get some water for Lucy.
“James Kemp!” A sister from the A&E team was calling me. So I went through to be seen. It was less than two minutes from the fifty the sign had warned me to expect.
Sister Cat took me into a corner of the treatment area and sat me down so that she could take blood and fit a canula. I got some diagnostic questions, and when she was almost done with me a Consultant appeared, Dr King. She was the first doctor I saw in the hospital (all of which were registrars or consultants, I saw the juniors running around, and in one case taking notes on behalf of the consultant, but none of the junior doctors were allowed to practice on me).
Dr King suggested that I be moved up to her unit, Kingsfold, for treatment rather than staying in ED. This might save me being admitted if they could give me some antibiotics to start me off, and then maybe I could go home to finish the course of treatment off.
Made sense to me. I tweeted a picture.
I'm in A&E with cellulitis. The folk here are fab, but it's not something I'd recommend pic.twitter.com/x6WbeChZSM— James Kemp, MBCS (@coldsteelorg) August 15, 2018
I’d expected to walk up to Kingsfold, but a porter arrived with a chair. So I sat in the chair and got pushed round the hospital. One day I hope to go back with a ladder and a spot of white paint to correct the sign over the hospital Ops Centre, which has a superfluous apostrophe…
I arrived in Kingsfold about 0830, less than half an hour after I arrived in the hospital. Lucy and Tracy met me in the waiting room. I spent most of the day there, and when I went in for treatment Tracy took Lucy away for a bit. I couldn’t focus enough to read anything substantive, but I did manage to entertain myself with twitter.
I don’t recall having lunch, I didn’t have much of an appetite at this point. I do know that this was the first day that I didn’t have coffee. I’m fussy about coffee, along with other things, and don’t drink instant coffee. I also decided that while I was on treatment that I’d give coffee a miss to cut down on the number of chemicals affecting my body.
By teatime I’d had several observations, I didn’t record the early ones because Tracy was with me and saw them directly. It was clear that I wasn’t going to go home. My temperature was fluctuating, every time they game me paracetamol I came out in a cold sweat.
A drip with antibiotics in it helped a little, but I spent most of the afternoon and early evening sleepy. Sometime around half seven I went up to Medical Escalation. Kingsfold is a daytime treatment unit, it didn’t have any beds. So they wheeled me round to a place that did.
The unit was a small corner of a larger place I never saw. There were three beds and a nursing station. One of the beds was already occupied, so I picked the one in the opposite corner nearest the toilet.
I was introduced to a staff nurse called Tony who sort of denied that he was there to look after me. He spent the first half hour or so that I was there complaining to the other staff nurse (a black woman whose name I never caught) about how on this ward you never got off on time. However most of my time here I remember two other nurses, a Polish guy called Brian and a critical care specialist that I was too out of it to remember his name.
My recollection is hazy, I think Tracy visited me before I moved up there. Either way I had clean pyjamas, some drinks and snacks and clean underwear for the following day. I managed to get into my PJs and back into bed before falling asleep.
Somewhere around midnight I woke up in a sweat. There was an extra nurse in, the critical care guy was looking after me, helped by Brian. They were worried that my temperature was over forty. I got given liquid paracetamol intravenously. I also got stronger antibiotics intravenously. I sweated so much that my top was sodden, between them they hauled me upright and changed it for a hospital issue one. There was a fan on next to the bed. It blew for the rest of the night. I got put on oxygen, and IV fluids. Apparently my blood pressure had fallen through the floor.
At the time I was largely oblivious. It’s probably just as well. It would have scared the hell out of me if I’d been awake enough to understand the ramifications of two medics working on me exclusively for five and a half hours. Not to mention the observations of extra low blood pressure, sky high pulse and a temperature over 40C.
Those two guys saved my life.
At about 0530 my rescuers decided that I needed to be seen by a doctor as early as possible. So rather than leave me on Medical Escalation they decide to take me down to the AMU. I don’t know what AMU stands for, I wasn’t there quite long enough.
Anyway a porter is summoned and I’m feeling alert enough to sit up and watch another trip through East Surrey Hospital. Brian comes with me and does a last set of observations before personally briefing one of the local nurses and making her give me some drugs. Apparently I’d had too much paracetamol to be allowed any more at this point, and she wasn’t keen on giving me ibuprofen because of my asthma. I swung it for her by telling her that I would self administer ibuprofen when I couldn’t take paracetamol. I got two and some water. Brian’s parting advice was to drink as much water as I could.
This was the point I began to wonder if they might amputate my leg. I don’t think I ever really thought it would come to that. But my head rehearsed the scenario, and everything came out positive. Blades were cool, it’d be like The Last Leg. I’d get disabled parking, and I could tick the Guaranteed Interview Scheme box on my job applications. I was clearly off my head on something. Or probably several things.
I saw a consultant shortly after breakfast. I hadn’t ordered any but there was toast, although I didn’t eat it because it wasn’t hot enough to melt the butter. I can’t stand unmelted butter. I did drink some apple juice, and more water. I still wasn’t really hungry.
This consultant had a junior doctor following him taking notes. He was a Spanish guy, judging by his accent and the name embroidered on his uniform top. He didn’t introduce his sidekick and she just scribbled furiously the whole time. It was a short consultation and the upshot was that I probably needed to spend more time in hospital and have more IV antibiotics. He then disappeared as quickly as he’d arrived. I had another snooze.
I woke to a porter at the foot of my bed.
“Are you ready to move?” He said.
“News to me. When?” I asked. It was clear he’d got instructions, so I helped gather up my shoes and a bag of possessions. We then set of on another tour of East Surrey Hospital. As I lay in the moving hospital bed I observed that it was only a little over 24 hours since I’d been admitted to hospital and I was off to my fourth location.
To be continued…