Friday, 20 February 2015

An op to the head of the Head of Ops

A misleading excuse for a punning headline. This will be extraction of two lower wisdom teeth under general anaesthetic.  Completely routine day surgery. Home in time for lunch. Spoiler alert: I survived.

0745. A bright, beautiful winter's morning. I'm not nervous, yet. The outpatients building looks dilapidated but the staff are welcoming and perky. Wifey is directed to a waiting area, while I sit alone in Room 8. It's bare and tired, but clean. There is trolley with a surgical gown and blanket folded neatly on it; a cabinet; a couple of plastic chairs; a sink; a shelf with magazines from 2010; and a floral curtain concealing the back half of the room, stamped with the words "Do not enter - privacy and decency". I wonder if there's someone sleeping on the other side.

I contemplate reading my book. I've brought with me a bag containing just that and a few coins. The latter is in case I find myself groggily wandering around the car park after my op. Wifey assumes that I'll have had the clarity to remember to pick up my bag before absconding.

0815. The staff nurse comes in to do paperwork, talk about drug options ("I'm rubbish at swallowing pills," I tell her, apologetically, trying not to sound like a two-year-old) and take my blood pressure and weight. She attaches an identification wristband. Then she wants to see my ankles. "It's so I know what size surgical stockings you need. You look ... medium."

Wifey is allowed to join me now. There's not much to do or say, but I'm glad she's here. A nurse wanders up and down the hall, singing. She's very good. We join in a bit. We're not very good.

The consultant comes in. More paperwork. "Did we talk about the risks?" Yes, a small risk that you'll accidentally paralyse my face. "It's not a small risk. Your alveolar nerve runs right next to the roots. What would you like to do?"

What I would like is to have more than five seconds in which to digest this information and make a decision based on quantifiable risks. One in a thousand chance of paralysis? One in ten? Evens?

I tell the consultant that I'll accept her best recommendation. She thinks for a moment and decides to hedge her bets: extract one tooth and perform coronectomy on the other. She gets out a permanent marker and draws a large figue 8, with a line over it, on one side of my face; and 8C, with a line over it, on the other side.

This is so you don't cut off my leg by mistake? I ask.

"Or something else," she says, gravely.

Wifey and I are left alone. I find an open packet of sweets in the bedside cabinet and contrive to spill them all over the floor. Wifey ventures past the "Do not enter" curtain and discovers a birthing pool - a relic of this building's past as the maternity ward.

The staff nurse returns with a soluble paracetemol. "How bad are you at swallowing pills, really? I could get you an antibiotic solution and soluble painkillers, but I'd have to go all the way over to the pharmacy ..."

Do you know those tiny anti-malarials? I ask. I can't swallow them. Sorry.

She does a fairly good job at pretending that she's not annoyed.

A man in a quilted jacket wanders in and announces that he's the anaesthetist.  He looks at the paperwork and asks a couple of questions about allergies and when I last ate.

We are left alone again.

But then it's all go: a nurse tells me to get into the surgical gown and stockings. She returns ninety seconds later to check that I've done so - to find Wifey laughing hysterically and taking photos while I try, with low levels of success, to don the stockings.

Then I'm on the trolley, paperwork in my lap, and being wheeled out of the room by a porter and anaesthetic nurse. I'm wheeled into an unfamiliar corridor and we joke that I'm going to be dumped in the car park. Unfortunately, I've forgotten my bag full of change.

It's disconcerting being fully in control of my faculties, yet being pushed around the place. However, I remember that, in just a few minutes, I will be completely helpless and in the hands of a group of experts. A trolley ride now is nothing.

I'm taken into the tiny anteroom of the theatre and the anaesthetist from earlier appears. He and the nurse check my signature on the paperwork and the ID band on my wrist. There's a clock above the inner door: it's just about 0955.

A cannula is inserted into the back of my left hand. "Are you allergic to penicillin?" the anaesthetist asks. I've never had it, I tell him. He looks genuinely taken-aback. "Not even as a child? Never had tonsilitis?" A long pause as he weighs the risk. "Welcome to being a human," he mutters, which seems unnecessarily dismissive of my previous years on this planet.

My trolley is moved into the fully-reclined position. On the ceiling, there's a large poster of a tropical beach. A mask appears from behind me. "Are you OK with masks?" asks the nurse, clamping it to my face. "It's just oxygen. There might be a slight smell of gas." What gas? Natural gas? Something sulphurous? Chlorine?

"Have you been anywhere nice on holiday recently?" she asks, and I recognise this as the precursor to being knocked out. I gesture towards the poster on the ceiling. Caribbean for Christmas, I mumble through the mask. "What islands?" Barbados, St Lucia ... "Smell of gas now - breathe deeply," interjects the anaethetist. One deep breath. "I hear St Lucia is nice," says the nurse. "Breathe deeply," commands the anaethetist. A second deep breath. It's beautiful, I agree. A third breath.

Suddenly, I'm at work. Everyone is happy and relaxed. This might be a dream.

Then I'm in a yellow room, and very cold. Someone asks if I'd like another blanket. Not sure whether I can speak, I nod. One is brought.

Now I'm awake, definitely, and in the yellow room for real. The clock on the wall opposite - there seems always to be a conveniently-placed clock - reads 1120. There's a desk in the corner of the room and a nurse working behind it.

I surreptitiously check that I haven't wet myself during the surgery. All good.

I close my eyes a few times. When I open them again, and keep them open, two people come to wheel me back to my own room. I'm told to rest for a while.

I sleep. At one point, I think I hear a nurse phoning Wifey to let her know I'm out.

After forty-five minutes, a nurse comes in to check on me. I'm awake and more alert this time. She asks me to move from the trolley to the chair. She waits a few minutes to make sure I'm OK. "If you're still feeling OK in ten minutes, you can get dressed," she says. In ten minutes, I am and I do.

1300. Wifey returns to fetch me and the staff nurse brings my soluble medicines and tells me to go home. It feels a bit of an anticlimax. I thank her, and the reception staff, and go home to spend a week sleeping in front of daytime TV.