What a Drag it is Getting Old, Part 3

There’s a certain kind of camaraderie in a surgical recovery ward. It’s a limited. camaraderie, because everyone is lying there feeling more or less sorry for themselves and no one stays there for very long, unless they’re having proper bad luck. But as the nurses and doctors come and go, they draw those thin blue curtains around your bed, which cut out vision but which really give you only an illusion of privacy, because they leave you audibly naked, so to speak. Every word, every gurgle, squeak and splash is perfectly clear - after all, it might be going on just a meter or two away from your neighbour. No one is exactly eavesdropping - well, I wasn’t anyway - but some overhearing is unavoidable. More than once, when someone new came into the ward and I went to chat and tell them what was going on with me ...

‘I know,’ they said. How could they not?

There were four of us in the ward. There was a chap who had kidney stones or gall stones, I forget which; he was waiting for an infection to go before he could be operated on. He didn’t really belong in our ward, the colorectal ward, but then he didn’t seem belong anywhere, as they he had already been moved once and was shortly moved again to make way for a genuine colorectal patent, much to his ire. Who can blame him? He was ill, in pain, had made himself as much at home as he could, and there he was migrating round the hospital like a some kind of a stateless (wardless) migrant. Poor chap - we all need to belong in so many ways, wherever we are. Another chap, nice man, had had a kidney removed. The forth man, in the opposite bed to me, had had a similar operation to me, but somewhat larger. He had a long scar down his middle, so they’d had to open him up properly rather then the key-hole techniques they used on me.

He was an Indian man. Let’s call him Dev.

Dev was having problems. For one thing, he had violent hiccups. Trust me, when they’ve cut you open like that, you don’t want it. You don’t want to sneeze, you don’t want to cough, and you certainly don’t want the hiccups. It hurts. Poor Dev was hiccupping away, day and night - bravely, I have to say, as he wasn’t complaining about that at all. I think they’d given him on-demand, opium-based pain killers. He was sick once or twice as well, if I remember correctly. I had no idea what was wrong with him at first, but the medical people were spending a lot of time around him; and at some point, they decided he needed a tube up his nose, going down into his stomach.

The thin blue curtains were drawn around him. A cluster of health professionals went in, pulling on their ominous rubber gloves.

It sounded terrible. There was a lot of groaning and gurgling, retching and spitting, poor man. It went on for ages. At the end of it, when they drew the curtains back, he looked neat enough with that tube up his nose, but he was grey in colour. He looked across at me with big, frightened eyes.

Having a tube up your nose was obviously something to avoid at all costs.

The bowel is a wonderful and mysterious organ. They say it has a brain of it’s own - a life of it’s own, almost, living down there tucked away neatly out of sight. Anita was told somewhere along the line that by a doctor that ...

‘We know what it does, but we have no idea how it does it.’

There’s a lot going on down there, more than you’d ever guess. Your gut is a sensitive organ; it can tell when it needs to deal with solids, liquids or gas. As your food passes through you, it works out exactly how much fluid and how many enzymes to let in or out. So it can count, after a fashion. Who knows what wonderful calculations it’s performing down there in your abdomen? All this goes on beneath our notice, and very often, beneath our consciousness. It can tell what you’ve eaten, what you are eating and what you will need to eat, and passes all sorts of messages, conscious and unconscious, to your brain, letting it know what’s going on in terms of nutrition and digestion. It can learn. You can train it to like shit foods as well as good food if you like, but then when it gets ill, that’s your fault, not your gut’s. It wants to be your friend, but like any friend, you have to treat it right. There are foods that some bowels don’t like the taste of or are allergic too. Like many of our other organs, it’s susceptible to stress. We talk about it being irritable, much as if it were a much-loved but rather unpredictable friend. Or perhaps a pet - a farty old dog, in my case. It likes walks. It needs feeding regularly but can’t do it itself. I like to think it loves me, in its own strange way.

So the bowel has it’s likes and dislikes like a being in it’s own right. One thing it really doesn’t like, along with most of the other internal organs, is being man-handled. It really does hate that. As a result, there’s always the danger after a big surgical intervention, that your gut will go into a gigantic great strop, and start to sulk.

You can see why, I’m sure. It’s not really part of the job description, is it? The surgeons hadn’t exactly taken it out and played skipping games with it, but they had cut it up, moved it around, stitched it back up again and re-arranged how it lay inside me. They did a good job on me, I’ve come to realise, but no matter how good a job they’ve done, in the end, the actual business and functions of the bowel - the digestion, the farting, the shitting - all that is up to the bowel itself. You can tach your grandmother to suck eggs, and you can’t teach your bowel how to poop. That’s all their is to it.

So the big question everyone wants to know, after all that interference, the chopping the cutting, the stitching, is - does it still work? Of course, there’s only one way to find out.

Every time a nurse or doctor visited me, they had the same questions.

‘Have you passed wind?’

‘Yes!’

‘Have you opened your bowels?’

‘... No.’

I wasn’t all that worried at first. My bowel was empty, wasn’t it? Those mighty laxatives had done their work all too well - no doubt they wouldn’t have done the operation if there had been anything in there. My appetite was pretty well suppressed, and if nothing goes in, you can pretty sure that nothing was going to come out, either.

... but then I found out that actually, that’s not true. One of the colorectal doctors pointed out that the stomach alone produces a lot of liquid every day - a I forget how much. So the gut is normally never entirely quiescent, even when you fast. In other words, no matter how little you eat, you can always find something to crap out.

This business of the sulking bowel ... what does it mean? Basically, peristalsis stops. That squeezing motion that pushes the food through your insides, even when you’re upside down, comes to a halt. As a result, anything you eat or drink has no where else to go but back up the way it came in. You get hiccups. You vomit. It could get dangerous - you could choke - so if your gut isn’t waking up as it should, they put a tube down your nose into your stomach to pump it out. If it goes on for any length of time, they’ll start to feed you intravenously.

This is why poor Dev had hiccups; this is why he was vomiting. His digestive system was in revolt - from his bowel, which was not just playing the digestion game, to his oesophagus, which was doing its best to reject that tube they’d pushed down his nose. It was very distressing to listen to, let alone to experience.

As the days went by, my desire to have a dump was increasing exponentially.

Inside, I was filling up. There was a sign above all our beds giving each day’s nursing staff instructions for the day. The sign above my bed began by saying that I was on a ‘sloppy diet.’ Hardly surprising - I was surprised I was allowed to eat anything at all on the very first day after my op. The surgeons had explained that could make a good poop-proof seal when they stitched my bowel back together again, but even so, just the smallest leak would release poop into my body cavity, which is sepsis on a stick. Sepsis! - the biggest killer of them all. No one wants sepsis. Still, they wanted me to eat, and I decided long before that there was nothing for it but to do as I was told. For breakfast that first day, I had cornflakes - they get sloppy inside you pretty quickly despite the initial crunch; that was nice, I hadn’t eaten them for years. And stuff like mashed potato, a little stew. No vegetables or anything with skin .. no fruit, for instance. A low fibre diet.

Gradually, it got better. By day three I was told I could eat what I liked. Things began to bulk up inside. The problem was, that was where it was staying.

‘Have you passed wind?’

‘Yes.’

‘Have your bowels opened?’

‘ ... No.’

‘Hmmm.’

It wasn’t my fault. I was doing my bit, keeping the toilet seat warm. But my bowel, although increasingly vocal, was remaining stubbornly unproductive

The days were passing by ... day two, day three, day four ... I was beginning to get worried. Home was beckoning, but so was that tube down the nose. I was even willing to suffer for a poo. On day three I had a lot of pain, and for some reason, despite requests, that day’s nursing staff seemed reluctant to get me any proper pain killers. Maybe they were busy. Maybe that day they were not so good - which would be unfortunate, as by and large they were really excellent. I discovered on day four that I could have more of that lovely liquid morphine that I’d enjoyed so much on request, but I was reluctant to by then because morphine is an opiate, and as we all know, opiates can bung you up. I made an executive decision to forgo opiates, even codeine - even when I was uncomfortable. I would stick to paracetamol. Fortunately, I didn’t get much pain after day three, but still ...

Sometimes, sacrifices have to be made.

Opposite me in his own bed, Dev had been pulling that tube out of his nose by accident and kept getting it re-inserted. He’d learned how to cope with it by now, with a towel around his neck and a bowl held close under his chin. There was no more gurgling and retching, but these were skills I was keen not to learn. Finally, though - he had a breakthrough. Fed up with feeling disgusting, he decided he needed a proper clean up. He left the ward with a small team of nurses wheeling his several drips around him like a flotilla of small boats to have a shower and a shave ... and he came back in triumphant. A shit had been had. He described it in some detail, the rest of us jealously hanging on to his every word.

So there was hope for us all! Each day I was paying a number of visits, trying to encourage the little brown baby to emerge - with no luck. It’s tricky, after such an operation. You don’t want to push too hard, of course - even avoiding a tube down the nose wasn’t worth the risk of a hernia and I was under strict instructions not to strain at anything, stool included.

Anita was getting anxious. She was being a dream, coming in every day, sitting by my bed, holding my hand, letting me sleep and being there when I woke up. But both of us wanted me to go home ...

Day five. I was feeling full. I went to sit on the loo several times ... no luck. Voiding seems to easy when you can do it. When you can’t, it feels like an impossible dream, a heavenly activity reserved for the angels and other lucky souls. Late morning, I had another go ... but nothing again for me. I was reminded of the old graffiti on the walls of public toilets ...

Here I sit, broken hearted.

Spent a penny and only farted.

But - nil desperandum! I’m not one to give up without a final push. And this time, finally ... could it be the turtle’s head? Was it possible after so long ... Yes! The soft sound of a delicate but perfectly formed plop beneath me. Bingo! Bingo in a small way, it’s true, but Bingo never the less. It felt great. I wrapped my gown around myself and strode back to the ward like a King,

‘Gentlemen,’ I announced. ‘I have had a shit!’

I got a round of applause. One of the colorectal doctors came out of Dev’s tent and gave me a grin.

I was on my home.

That was four weeks ago. Since then I’ve been recovering at home, at a luxurious and very comfortable pace. I healed up very quickly, but getting your energy back is a slower business. An hour or two - then someone pulls the plug and the fatigue hits. Then two or three hours, then four or five ... then back to one or two, for some reason. But finally my energy seems (almost but not quite) back to normal. There’s been a lot of pottering around in the garden - we’re lucky to a have a big garden, wildlife and flower centred, so there’s always something not very energetic to do - weeding, sowing seeds and the like. Or just wandering around seeing what’s going on the various areas.

There’s been a lot of butterflies this year.

It’s been like a dream, really. Not quite real life, but a break from it. Relaxing, in it’s own way. It’s left me taking my time a bit more, and now that my strength is returning, I’m not so keen on spending it very quickly.

It’s been something of an adventure too - not quite Peter Pan’s Really Big Adventure, but an adventure never the less. Not as frightening as I thought. Interesting, even.

I felt very loved. Anita has looked after me at home just beautifully, with all her loving attention. That’s been a glorious thing; I could get addicted to it. My daughter Pearl flew from Odessa to see me; my son Oli, who’s kind of stuck in Taiwan rang me much more often with lots of dietary advise on keeping the cancer away in future and building up my strength. My brother has been checking up on me regularly. I’ve had lots of lovely friends been to visit, or sending me messages from half way round the world wishing me luck. People are very kind and generous, which is a good thing to learn. And - yes - typically, I imagine, (I hope!) the roses do actually smell all the sweeter and the colours in our garden do look all the more wonderful. At such a grim time in the world, when we see state-inflicted murder normalised on such a grand scale, when racism is on the rise and politics is getting so aggressive, when the planet is so sick and no one seems willing to make the sacrifices necessary to make it better .... there’s still a lot to live for. We have to remember look to things close to us, as well as the bigger picture, and try to make sure our own lives are good, when we can’t much help others far away. All I have to do is look out of my window to see it, both in the human and the natural world.

All these things. I’d say I’ve come out of it better than I went in. So even cancer has it’s sunny side of the street.

Finally, I want to point out that this is the second time or maybe even the third time the NHS has saved my life. Some years ago I walked into my annual review to discover that my blood pressure had soared to 245/125. I nearly slipped through their fingers then, as the nurse wanted me to wait for a wearable device to measure my blood pressure over time. I don’t why - that reading was dangerously high. Perhaps she didn’t believe it could stay up there for long. But I got hold of a device of my own, and it truly was consistently that high, so I rang 111 the following Saturday. The receptionist there asked me a range of questions, obviously read from a computer screen. When she was done, she said ...

‘We advise you to get to see a health professional within the next half an hour. We can get you an appointment at Halifax in three quarters of an hour. Is that OK?”

Yes, thank you. That’ll do fine.

So I was rescued there, too. That was enough pressure to blow my eyeballs out of my head, let’s face it - and no symptoms at all.

Then I had a thing called atrial fibrillation a year or so ago, which is when your heart starts beating abnormally. That in itself doesn’t seem to be dangerous but you can have the blood pooling in your ventricles and get clots forming, which can lead to a stroke. So that’s twice. And this time, I was picked up by the NHS bowel cancer screening programme. So thanks to the NHS, it’s extra bonus years for me! Falling to bits I may slowly be - and who knows what the next thing will be? Heart attack? Stroke? Ingrowing toe nail? Perhaps it will finally carry me away. But for now, here I still am in a body that’s functioning well and with a mind that’s still entertaining. Well, it’s entertaining me, at least.

Hang on to the NHS, kids. Sooner or later - and it may be sooner than you think - you’re going to need it.