COLOSTOMY OPERATION

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It’s April 2009. I’m in St Patrick’s, a spinal surgical ward in Stoke Mandeville Hospital. I have just come back from theatre having undergone a colostomy operation via laparoscopic surgery, performed by Mr Huang. I decided to have a colostomy around three months ago. Fed up with years of painful and bloody manual evacuations, it seemed the only option. Maureen Coggrave helped me make the decision. Spinal patients know her as the ‘Bowel Nurse’. She is really a doctor. I like and respect her a lot. She is the person to see if you have a problem with your bowel.

Laparoscopy is a cinch. I’m left with just a few stitches, three plasters and a bag on my side. The bag does not horrify me. As far as I’m concerned it’s a blessing. The benefits? No more arse raking. Can’t get better than that. I can now relax in the mornings, knowing that never again will a nurse or an orderly poke their gloved fingers up my rectum and scoop out the contents.

I’m leaning up in bed, propped on my elbows and looking around the ward, relieved that the operation is over. I feel ridiculously well. It’s like I’ve been given a gift, a new lease of life. Didn’t even have to be bowel prepped prior to the operation. No gunk to empty my guts. Yes, laparoscopy is a cinch.

So what now? I’m told I can’t eat anything until my gut starts moving again. Could be a week before that happens. I’m prepared. Eating doesn’t bother me. I can easily go without food, just so long as I can drink. Told I can drink as much as I want. That suits me fine. Can’t understand why I feel so good. Absurdly good, in fact. Still leaning on my elbows and looking around, wondering why I’m not in pain. Strange that, considering surgical instruments have been poked through my stomach. Thought I’d feel much worse than this. I’m not even hung over by the anaesthetic. All very weird.

I watch the other patients eat their evening meal. It doesn’t bother me. Not even hungry. I know their arses will have to be raked out in the morning. Mine won’t. Wry smile. I’ll just lay here behind my curtains and let the orderlies pass with their trolleys and wipes. What bliss! No more 5 o’clock wakings for me, suppositories inserted into my bum, incontinence sheets tucked under my hip. No more embarrassment. No more pain. From now on I crap into my own personal, little bag. All neatly packaged and easily disposed of. What could be simpler? Such small mercies to be grateful for. Unimaginable that I would ever be grateful for a colostomy. But I am. Eternally grateful, sincerely grateful, ecstatically grateful. Yes, I’m grateful alright.

It’s 8 o’clock in the evening. The day staff are preparing to go off duty and the night staff have arrived. They all gather round the nurses’ desk. I’m relieved to see that Jooles is on duty. I like him. All the patients like him. We feel safe when he’s on the ward. Jooles is the most experienced night nurse in the spinal unit. Yes, we all feel safe at night when he is on the ward.

It’s time for my final turn before sleeping. I take my tablets, then Jooles and Dexter flip me onto my right side. A bolt of white hot pain shoots through my side and abdomen. I’ve never experienced anything like it. I let out a yell. “Turn me back, Jooles,” I scream. Jooles and Dexter quickly flip me over. The pain subsides. I feel more comfortable. “Let me try going on my other side,” I say hoping that I’ll have no problems. They gently lift my legs, bent at the knees, and allow them to flop to the side, then tuck their hands under my hips and pull my backside across the bed towards them. Relief. “I’m okay,” I say. Jooles is concerned. He asks if I need any painkillers. I say no. He moves on to the next bed, leaving Dexter to tuck the blankets up around my shoulders.

I am turned onto my back in the night. No pain. In the morning I try turning on my right hand side again but it is impossible. Too much pain. It’s like I’m being blasted with a shotgun.

It’s around 7:30 in the morning. The day staff have arrived. They’ve taken off their coats and jackets and are now gathered around the nurses desk, listening to Jooles as he gives his report. Reading from notes he has made, I hear my name mentioned. Sister Nicholls looks my way. I have given her the nickname ‘Popeye’ on account of the way she holds her arms, bent at the elbow and hands facing inwards. A couple of tattoos and she would really look the part. Me and Sister Nicholls don’t see eye to eye. I have never forgotten the way Paul was treated. She knows it too. Some things don’t have to be spoken to be realised. They kind of hang in the ether, quantum ripples of knowledge shared by those involved.

After everybody has had their breakfast, which I don’t have and don’t miss, I’m given a bed bath by a young nurse. I hate lying naked and being washed in bed. It’s undignified and reminds me of how dependent on others I am. She pulls the bed covers back. I’m horrified — as she is — to see a huge bruise on my abdomen. It’s a hideous shade of purple and green, and is around nine inches in diameter. “I’d better get the doctor, Michael,” she says, and disappears through the curtains that surround my bed. I don’t like lying there cut off from the rest of the ward. Two or three horrifying scenarios run through my mind. What the hell is going on here? What’s happened to my abdomen? Will it cause an enormous dysreflexia attack? Has the operation been botched? It doesn’t do to be isolated. Too many anxious thoughts. Moments later the curtains part and the doctor steps in. He prods and pokes around the bruised area. I squeal with pain. “You may need a scan, Michael.”

Half an hour after the doctor leaves, my abdomen rages with pain. It’s so bad I can’t help verbally crying out. I’m beyond embarrassment. My cries can be heard the length of the ward. I’m not bothered whether patients here think I’m a wimp or an attention seeker. I look towards the nurses desk. The doctor is on the telephone and he’s looking my way. He puts the phone down and walks towards me. “I’ve just spoken to Mr Huang,” he says. “The surgical team are on their way. Meanwhile, he wants me to hook you up to a morphine pump …” A nurse wheels the pump to my bedside and connects it to my cannula. She presses a few buttons which control the dose. Passing me a length of tube, she says: “Suck on it when you need the morphine.”

I’m still in agony when the surgical team arrive. They position themselves either side of my bed. Rick, the senior doctor, scratches his chin. There is something about his mannerisms that gives me confidence. I feel safe in his hands. He tells me I need a CT scan. “We need to see if you are bleeding internally,” he says. “If you are you’ll have to go back to theatre…”

That evening Mr Huang and his surgical team discuss my options. Half an hour later I am in the scanning department. A PAT slide is placed on my bed. The staff slide me onto the surface of the CT scanner. Soon my body is passing through the doughnut-shaped scanning head. After I’m scanned, Mr Huang tells me I’m okay. I’m not bleeding internally. “There is no need to go back to theatre,” he adds. I’m relieved. They slide me back onto the bed and push me to the ward. Still can’t lay on my right hand side. Confined to my back and left side. Can’t eat but I can drink. Eating is no problem.

Three days go by. The agonising pain calms down. It’s now just a dull ache in my side. I am taken off the morphine pump. Caroline, one of the nurses, asks if I’d like a boiled sweet. I gratefully accept. She takes a packet from her pocket, selects one and passes it to me. I thank her. It is an act of kindness that I never expected. As I roll it around in my mouth, savouring the flavour, I mentally vow to buy her a box of chocolates when I’m up.

A further two days pass and I have my first meal — jelly and ice cream. I’m actually hungry by now, wolf it down.

I have my first result. Through a small cellophane window in the colostomy pouch I observe the stoma. It is amazing to see. The stools squiggle out like soft sausages. The stoma itself is wrinkled, the edges smooth and rounded. It seems to have a life force of its own, spontaneously opening up like a flower and expelling its offending load — a series of six to eight centimetre long stools as thick as a man’s finger. With a squelching fizzle they ooze into the bag. I’m fascinated by the whole process. When all the stools are discharged the stoma relaxes, the creases and folds come together and the hole closes up.

The next day, Robin, the stoma nurse, shows me how to change the bag. It’s a simple process. He peels the flange away from my skin, cleans round the stoma and then presses the new self-adhesive bag on. Takes about ten minutes. Robin is brilliant. Doesn’t mind getting his hands dirty. He says my stoma is looking good. There is no infection. The stitches that hold it in place will dissolve by themselves.

The bruise now covers the whole of my left side, from my naval to my pubis and around my waist to my buttock. Nobody has ever seen anything like it.

Another week passes.   I can now lay on my right hand side. Such sweet bliss. Such small luxuries but so welcomed. Seems like I’m healing nicely. Mr Huang tells me I’ll be discharged in a couple of days.

I lay in bed contemplating the future, think about the colostomy operation and how it will change my life. From now on it’s all roses. No fingers up my arse anymore. Goodbye manual evacuations. Hello bliss.

It’s 5:30. Time for patients arses to be raked out. The orderlies pass my bay on their morning rounds. I daresay they hate the procedure as much as we do. Some of them must find it repugnant. It’s not the sort of job you boast about in the pub.

I hear farts and squidgy gurgles from the arses of other patients who are being manually evacuated, then I smell the stench of human excrement. It wafts around the ward like a toxic gas. I thank god it is not mine. That now comes neatly packaged in a bag. How beautiful, how discreet, and how hygienic. Oh yes, this colostomy is a life changing event — a life life-enhancing event. Good old Mr Huang.

At last I am well enough to get up. My wife lifts me from the bed to my chair. The ward goes round and round. My blood pressure is so low I nearly pass out. Holding my body upright, she quickly swings me from the chair back onto the bed. I lay there for a few minutes waiting for my blood pressure to recover. We repeat this procedure but each time I’m lifted my blood pressure drops and my head spins. She is incredibly fit, has no trouble lifting me from the bed to the chair and back again. It’s a knack more than a feat of strength. Finally I am able to sit up-right without fainting.

I wheel down the ward to the shower room. My hair hasn’t been washed in weeks. It is matted and greasy. My skin is oily. After washing my hair, my wife cleans my ears out with cotton buds. It feels good, very good.

On the morning of my discharge I speak to Jooles and thank him for the help he has given me. With a warm smile he tells me there is no charge. This might be the last time I ever see him. I know he is retiring soon. He has worked nights for many years. Good old Jooles. You are one of the best, mate. One of the best. People like him are what is good about this place. He is a true humanitarian. I shall miss him. The hospital will not be the same without Jooles.

Nights on St Patrick’s ward are no longer comfortable. Some staff can barely speak English. Others are not very caring. I overheard two nurses talking at the desk after the light had been switched off. They were discussing the good and bad points of working nights. One of the nurses said, and I quote: “What is there not to like? You spend most of the night sitting around.” That said it all.

 

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