The story
We are
exceptionally fortunate in the UK to have the NHS. After my in-patient stay
last year with cholecystitis, the powers that be decided the time had come to
remove my gallbladder with its thickened walls and undisclosed number of
gallstones. The optimum time for removal is usually three months, allowing time
for the inflammation to die down.
Unfortunately
for me, administrative gremlins struck which resulted in my 6-week follow-up
appointment not happening until 19 weeks after discharge in late February. Then
an appointments clerk rang me the day after my mother died to ask if I was
attending a pre-operative assessment in three days’ time when I'd not received
any notification, let alone agreed to have a procedure which had not yet been
discussed!
The
consultation with the new surgeon (someone completely different from the person
who had reviewed me in hospital, who I had expected to follow me up) took place
in my local hospital the day after my mother’s funeral. Despite being the first
appointment, I was still kept waiting for half an hour while he read my notes.
The conversation about surgery was very brief. It had to be done. He liked all
his patients to go on a diet to shrink their liver and he allowed his patients
to drive four days after surgery. We exchanged a few pleasantries and I
returned home to await the next communication.
I was somewhat
surprised to read his letter to the GP which referred to a “full and frank
discussion”. I wondered if I’d been asleep while it occurred.
At the
beginning of May, as I was packing the caravan for one of our many weekends
away with the kite team, I received a phone call asking if I would like to have
my operation in the local private hospital in the next few weeks as they had
some free time. We’d just booked a week away with our son and his family so I
didn’t want to miss that, so agreed to June 15th. I returned home to
find this date had been cancelled because the surgeon didn’t have enough people
to operate on. An alternative date would have meant cancelling my writing
retreat with a substantial loss of money, so I negotiated to go in a week
later.
I was sent the
pre-admission details including the week-long 800 calorie diet. I had expected
something miraculous if it was going to shrink my liver, instead I was expected
to replace two meals with purchased diet products and, if I were lucky, my
evening meal could be a protein source plus vegetables from a list which was
referred to but not supplied.
I have a moral
objection to spending money (which is limited in my household) on processed
food so I made out a shopping list for lots of low calorie vegetables, fruit
and organ meat. I already had the vitamin tablets to hand and there were
vegetables available in the garden.
The real food 800 calorie diet
On waking: Cup of tea with semi skimmed milk
Breakfast: Small glass of orange juice and half a
red/pink grapefruit plus a cup of tea with milk
Mid-morning: Cup of herb/fruit tea
Lunch: 2 bowls of soup prepared from homemade
chicken stock with a) celery, kale, cabbage, carrot half an onion plus half a
red pepper flavoured with holy basil and mint or b) mushrooms, courgettes, an
onion, carrot, celery flavoured with herbs.
Or a salad comprised of lettuce, celery, spinach, grated
carrot, grated courgette, red pepper, hard-boiled egg dressed with lemon juice plus water to drink
Mid- afternoon: herb/fruit tea
Evening meal: Ratatouille made from 1 tin of tomatoes,
4 courgettes, 1 aubergine, ½ an onion and ½ a red pepper flavoured with holy
basil and mint. Served with steam roasted chicken or liver casserole made with
aubergine, carrots, cabbage, flavoured with rosemary, or steam roasted chicken served with
carrots, broad beans, peas and boiled courgette or stir-fry kidneys with celery, carrot, courgette, onion.
Evening drinks: herb/fruit tea
I wasn’t hungry
and I lost seven pounds during the week. When I finally went for my pre-op
assessment, my operation had been cancelled again because the theatre floors
needed to be re-sealed which meant cancelling the entire weekend operating
lists thus causing a knock-on effect further down the week. I didn’t have a
revised date because my consultant was too busy doing bariatric surgery to fit
me in and a new consultant had to be found. I was not a happy bunny and the
nurse carrying out the assessment was worried about me staying on the diet for
too long.
Other preparations
Meals for the freezer – this meant Chris didn’t have to do
large amounts of cooking during the first week while he was looking after me.
Overnight bag – although I was booked as a day case,
I still needed a nightdress, dressing gown, slippers and something to keep me
occupied whilst waiting for the operation. I took some knitting and a Cadfael
omnibus. The simple dishcloth knitting was wonderful for keeping me calm during
the three and a half hour wait.
Herbal medicine – I put together a bottle of combined
tinctures with the dosage clearly labelled in an accessible place so Chris
would know exactly what to give me and when.
Energetic cleansing of the theatre and
support for the operating team – I
wasn’t in a fit state to do this myself so left it to those who were providing
distant healing support for me, both my healing group and my Druid Grove. This
is the chant I have used in the past when undertaking something similar for
others.
Before an operation
Come
cleansing silver rain
Descend
upon this sterile space
Deposing
fear and sorrow
Anger
and sense of loss
Leaving
all fresh and clean
Then
light the violet flame
Burning
brightly
Burnishing
instruments
Rejuvenating
equipment
Leaving
all in perfect order
For
what is to come.
Come
now, Raphael,
Bring
your hosts
To
guard and watch this space
Spread
your glittering wings
To
comfort all in need
To
heal all that is needful
To
shine the light of peace and hope within
Call
now the healers
Call
them close
To
watch and guide
To
lend assistance to the operating team
That
all may be done to the highest good
Of
all concerned
Then,
in recovery,
Let
there be true care and compassion
Let
the healers remain
To
work on flesh and bone
On
blood and organs too
Until
all is as it should
As
it can be
Let
healing light shine forth
To
hold each moment
To
soothe, to comfort
To
surround with love
Let
all be done for the highest good
Of
body and soul
To
aid in life’s rich journey
And
beyond
The Operation
We arrived at the hospital at
7am. The new surgeon bounced into my room at 7.30am, announced, "It's
going to be horrible in there. If I have to open you up, you'll be here for
five days or more." and bounced out again. He seemed to imply the difficulties
had been caused by the number of antibiotics given to me during my previous
admission but it could have been the length of time (over three years) I had
been suffering with the condition.The operating list started at 8am and I was second on the list. At 11am I was still sitting in my room knitting but luckily the sister/ward manager came in to check I was ok and gave me some more water. Apparently policies have changed and instead of nil by mouth they like you to drink an hour beforehand.
The surgeon did manage to remove eighty per cent of my gallbladder by keyhole surgery. (Chris said he used an old fashioned skeleton key as the major incision was two inches across!) and I came out of the theatre with five holes instead of three including a drain. He had removed three gallstones the size of musket balls. He said it was too dangerous to remove everything as the anterior wall was stuck to other organs. (It was quite sobering to subsequently read his discharge letter to my GP which described the operation as “very difficult”!)
In-patient medication
The anaesthetic cocktail plus liquid morphine and a heavy duty antibiotic (probably Augmentin which necessitated two blood tests the following morning to check liver and kidney function). After the morphine wore off I was given paracetamol and then codeine phosphate at four hourly intervals.
Post-operative issues
Pain – from coughing, movement and internal muscle spasms plus bruising from the anaesthetic venflon in the back of my hand.
Throat – the anaesthetist warned of a sore throat but didn’t mention the post-nasal drip, thick mucus which had to be removed by coughing and “semi-detached” skin flakes on the back of my tongue, plus dehydrated lung tissue arising from the anaesthetic.
Nausea – presumably a reaction to either the anaesthetic, morphine or both. I refused any anti-emetics because they made me feel “spaced out” for several hours when I was given them before.
Internal muscle and other tissue damage from the surgery
The abdominal drain- which prevented me sleeping in any position other than flat on my back and meant I must be aware of the position of the drain bag at all times.
Liver support – necessary because the liver processes all the toxins/medications pumped into me
Bowel regulation – both morphine and codeine derivatives cause acute constipation. Straining to pass “movements” can cause piles and damage newly healed internal organs, so is not advised. I was discharged with senacot tablets but didn’t take any. I had been warned before the operation about possible effects of “bile dumping” by herbalists if I ate fats but this wasn’t mentioned by the surgeon. Only the nurse who cared for me post- surgery and prior to discharge, whose wife had had the same operation, told me I might experience something similar to diarrhoea the day after eating fats.
De-hydration – caused by pre-op nil by mouth, only small amounts of water and two bouts of vomiting over a 36 hour period.
Issue Management Strategies
Although leaving hospital is scary, being in your own, quiet and comfortable home does improve the healing process. The regime of tinctures I’d blended included
Dandelion and burdock for liver support
Plantain – for tissue regeneration, healing dry membranes in lungs and anti-inflammatory
Yarrow – anti-inflammatory and bruising
To this I added
Crampbark - to deal with the internal muscle spasms I’d not anticipated
Fire cider vinegar and honey – I only needed one drink of this to sort out the mucous on the second day when it was becoming intolerable. If I’d thought about it beforehand, I might have made up a respiratory cider vinegar with rosemary, sage and marshmallow but I probably needed the garlic, chillies and other spices as it worked so quickly.
Natural yoghurt and homemade raspberry puree – taken soon after returning home to coat my stomach lining following the bouts of nausea and provide some sustenance after my fast. I had three small amounts at hourly intervals and was then able to face other small meals with no ill effects.
Pain control and bowel regulation - The first few days were not fun; you never realise how many things involve your abdominal muscles until they’ve been damaged! I was also determined to use the minimum of pain killers so I wouldn't have to use a laxative. I managed on three doses of soluble aspirin throughout the day for three days then Chris said those ought to stop, so from day 4 I had one last dose in the morning before travelling to the acute hospital to have the 9" of drain pulled out of my stomach and didn't take any more. It was amazing how much better I felt after this procedure. After half an hour’s rest I was able to walk outside into the garden and stand and pick my St John’s Wort flowers for the next hour!
The first bowel movements on day three were difficult but eased by day four. I tried to drink as much as possible and was eating lots of fruit and vegetables including fats.
Recovery
Every day I improved. For a whole week I did nothing but rest with the minimum of movement. On the Sunday evening I began to feel a little like myself. I was able to teach a few piano pupils in week 2 and a herb workshop at the farm on the Thursday. I had another workshop at the end of the third week, then we went off to Cornwall for two weeks to meet up with friends. I found I was able to drive and go for walks. I still get tired but I'm able to do most things. I have to remember not to carry anything heavy until three months are up at the end of October.
I am now able to eat anything, which isn't a very good thing as I've put back most of the weight I lost prior to the operation and I'd like the scales to go down instead of up! Still, there won't be any more scones, cream and jam for another year! I'm not in any pain apart from the gall bladder area still feeling raw sometimes. My bowels are working well and have had limited problems, for which I am extremely grateful.
I'm sure my quick recovery has a lot to do with the herbs I’ve taken and all the healing energy I've been sent from many different sources. Back in the 1980s, research was carried out which confirmed that people undergoing surgery who were prayed for recovered more quickly than those who weren’t, whether or not the patient knew about the prayers. I’m very grateful to everyone who has taken time to send positive thoughts in my direction.
Although this is a very personal story of abdominal surgery, I hope others will be able to take something away to help with their own circumstances.
