Wednesday 8 January 2020

Surgical intervention

Before I begin, I want to make it clear that I am well aware how fortunate I am to be living in a place and at a time where (a) surgery is a viable option for so many medical conditions and (b) it is unlikely to involve buckets of boiling tar.

At no point in my story do I have to bite down in a piece of wood, leather or bone, or quaff home-made moonshine in an attempt to reduce the agonising pain.

There is no sawdust.

As I mentioned in a previous post I was on the waiting list for surgery - gall bladder removal - and was sent to Salisbury Hospital for my pre-op back in September (2018.)  According to their website, there's an 18-week waiting time for surgery, so I assumed that I was due to be called up fairly soon. When they do the pre-op they take MRSA swabs, for one thing, which have to be re-done after a few weeks, so it seemed likely that my operation was scheduled within the next few weeks. 

I asked the surgeon whether I was likely to be seen before Christmas, and she said oh gosh no. I was pleased, as work gets very busy around Christmas, so taking time off then would have been inconvenient.

Christmas came and went.

January (2019) came and went.

At the end of January I worked out that the 18-week waiting period was almost over, so I rang the hospital to find out when I was going to be called in.

The helpful receptionist checked and told me that there's an 8-MONTH wait for this surgery, placing my operation slap bang in the middle of May.  Which is when Mr WithaY and I were planning on being on holiday in Uzbekistan, celebrating our 25th wedding anniversary.

Well, bollocks.

The holiday was booked and paid for over the Christmas holiday, as we had (foolishly) assumed that the 18-week hospital wait was realistic, and that I'd have been operated on and fully recovered in plenty of time by May.

To add a delightful frisson of pressure, we were booked on the last possible trip for that year, as it gets too hot to travel after then.  No opportunity to reschedule except to 2020.

I rang the doctor to ask if there was any way to speed things up, given that I had been waiting for months, and she advised that we start the whole process again, but selecting a different hospital to Salisbury "as it has a really long waiting list for elective surgery." 

Given that originally I was told that I could pick either Bath RUH or Salisbury, it came as a revelation to learn that in fact there are multiple available hospitals, some with much shorter waiting times.  Live and learn.

I also contacted the Circle Hospital in Bath to find out how it might work as a private patient.  Several friends and neighbours have been there for surgery and had very positive things to say about it, and I thought there was no harm finding out what all the options were.  The answer came that it was going to cost almost five grand, BUT that the waiting time was in weeks not months.

And the reason for this unseemly haste, other than the increasing frequency and severity of my gallstone attacks (biliary colic, look it up, it's fucking excruciating) was that there must be a window of minimum elapsed time after surgery otherwise your travel insurance is not valid.

That window for me closed at the end of February.

After a lot of checking available options, calculating timescales and considering worst case scenarios, we decided to bite the bullet, opt for the private hospital, and pay for surgery. It was the only way to ensure the operation took place outside of the insurance-invalidation window, thus allowing our booked and paid-for holiday to go ahead.

I met the surgeon - charming and reassuring - and was told my operation should be "very low-risk" and would take place within a couple of weeks. He commented that the only possible risk was linked to the fact that I am overweight ("but you are very tall as well.")  All my stats were normal, so there really shouldn't be anything to worry about. Hurrah.

I went back a few days later for my pre-op appointment, having already filled in and posted back all the forms they sent me - height, weight, next of kin, allergies etc etc etc.

The nurse who carried out the pre-op checks hadn't received my paperwork but she said there would be no problem, I could just quickly re-do the form - height, weight, next of kin, allergies etc etc etc - which I did while she sorted out the blood tests and MRSA swabs.

As I sat there waiting to be told I could leave, she announced "The only issue is that the anaesthetist might refuse - the hospital doesn't operate on anyone who has a BMI of over 45."

Say WHAT?

"Are you telling me that they might refuse to operate one me? But the surgeon said I was really low risk!"

"Ah but it isn't up to the surgeon. If the anaesthetist thinks it's too dangerous they can prevent the operation."

I was, not to put too fine a point on it, fucking mortified.  The surgeon had specifically commented on my weight, and then assured me that there wouldn't be a problem because my general health was very good.

The nurse finished her paperwork and cheerfully said "We'll let you know on Friday." And I was out into the cold, cold snow, appalled that after all that, I STILL  might not get my operation.

Friday came, I rang the hospital, spoke to one of the senior nursing staff and was told that yes, everything was ok, I would be operated on the following Wednesday.  No, no problems at all, see you then, bring the five grand with you.

Hurrah!  Finally we could relax, and start thinking about the holiday in a more positive way.

BUT.  WAIT. On Tuesday evening Mr WithaY and I were preparing to go out for dinner with some friends when the phone rang.

It was the senior ward sister from the Bath hospital, calling to apologise "but the anaesthetist is not prepared to go ahead with your operation tomorrow, as you are too high risk."

What the actual fuck?

She explained that the hospital lacked the appropriate "hoists and lifting equipment" should there be a problem, and that the nursing staff were not able to cope with a giant freaky killer-whale sized person like me.  I was DISTRAUGHT.

She said there was the possibility of moving the operation to a different location in Bath on the same day, she would check and call me back.  Mr WithaY rang our friends to let them know we'd be a bit late, and I sobbed uncontrollably for 20 minutes.

Then I had a bit of a think.  I know I am overweight - I have been since I was about 22 - but I have NEVER been told that my BMI is so incredibly, dangerously high.  The BMI calculator I found online said that my BMI was high (in the fat bastard category, for sure) but not anywhere near 45, as stated by the pre-op check nurse.

So how did she arrive at that figure?  Why, dear reader, by calculating my BMI for my weight, but for a height of 5'1" rather than the statuesque 5'11" which I actually am.

Fuck's SAKE.

The senior ward sister rang back.  No, sorry, the other hospital wasn't scheduling surgery tomorrow.  I'd have to speak to the admin team and get a new date for my operation.

"Do you have my paperwork there?" I asked her, still a bit sniffly.

Yes she did.

"And how tall does it say I am?"

She checked.  "154cm, so 5'1"."

"Well I'm actually 180cm tall - 5'11".  My BMI is significantly less than 45."

There was a long, very pregnant, pause, after which she apologised profusely, absolutely furious that:
(a) she'd been messed about
(b) I'd been messed about and
(c) she was going to have to go back to the anaesthetist and explain that they'd been messed about because one of the nursing team couldn't convert inches to centimeters.

We went out for dinner - our hosts politely declined to notice my swollen eyes and shiny red nose - and I was off to Bath the following morning for surgery.

All went well, I was released back into the wild the following day, made a full recovery, went to Uzbekistan in May as planned.  The only minor side-effect is that I have to eat meals at regular intervals or I get a hellish upset stomach. No skipping breakfast for me any more.

I'll talk about Uzbekistan another time.

And all this happened last year, but who's counting?

1 comment:

Z said...

I'm somewhat speechless. That's awful and incredible.

Apart from your particular last minute cock-up, I think that waiting times have become a lot worse over the last couple of years. I went to see my consultant in the autumn of 2017 about my hip and he told me waiting time for hip replacement was about 6 weeks but, because of Christmas, it would be an extra month. Fair enough - but in fact I was lucky and filled a cancellation in early December. Recently, the hospital ran out of money and all non-essential operations have been cancelled or put on a really long waiting list.

Congratulations on your 25 and I look forward to your return to blogging.