Patient Choice

prostate_logo After what had seemed like an interminable wait, December 1st, Admission Day, had finally arrived. I’d d run the two week gauntlet attempting to avoid catching a cold and was still “go for admission”, as Houston might say. Even the meteorological fortunes smiled on me; while the eastern and south-eastern counties were suffering serious snow disruption, High Wycombe remained in a pocket that was strangely clear. It seems very odd to be actively looking forward to a major surgical operation but looking forward to it I was and I seemed to be home and dry.

Or was I? My admission time was ostensibly 4:00 PM for a date with the operating theatre on the following morning. My instructions told me to call a number between midday and 2:00 PM to confirm admission. I called.

The ward’s closed at the moment and you can’t be admitted until it re-opens. Wait at home until I call you back. It may be best to wait ‘til after tea-time.

Tea-time! What do you mean by tea-time? I don’t “do” tea-time. I have lunch at about 1:00 PM and dinner at about 7:00 PM. When’s tea-time?

More blasted waiting to wait and for a time I didn’t understand. I’m not good at this waiting stuff; I was twiddling my thumbs and pacing up and down like a pregnant father. Having avoided both a cold and a cold front, I felt as though I was now getting the cold-shoulder. An unforeseen ward closure was threatening to stick out its leg to trip me up.

I called back. Apparently the ward was “being cleaned”; all would be well, just later than planned. OK but how much later? Waiting would give the snow a chance to reach us. It would also increase the darkness and, though she’s perfectly capable, anything that might make Carol drive back in the dark and snow was less than appealing. There was a day room I could wait in. I might as well twiddle my thumbs and pace at the hospital instead of at home.

Carol dropped me off at 3:30 and returned home in as much daylight as possible. After a bit of a struggle – the hospital maps are rubbish – I found the day room and began my wait.

At about 5:00 PM a nice lady found me and began talking to me. I deciphered her accent rather more readily than the hospital maps and realized she was to be my anaesthetist, responsible for my “pain management” both during and after the operation. Pain; good thing to manage; excellent. Explaining both, she presented me with two options: an epidural or a PCA (Patient Controlled Analgesia – a manual pump that I would drive myself). As usual. each option came complete with a list of pros and cons. Which option did I want?

Now, look, patient choice may have its place but here wasn’t it. How was I supposed to make that decision? I’d never before had any kind of major operation, far less a radical prostastectomy, so where was my decision point? I don’t have a yardstick by which to measure. My anaesthetist kept referring to epidurals for pregnant ladies – I’d already cast myself in the role of pregnant father, now I was being cast in the role of pregnant lady – who have this approach at childbirth by default these days but I was still a virgin. Having never once fretted about my impending operation, here I was being caused to fret about my pain management choice. I’d much rather just be told by the professionals which is likely to be better for me and have them get on with it. “Think about it and let me know in the morning”, she said. Gulp! “OK”.

6:00 PM came and went; I was beginning to think I’d been forgotten and that a night on the floor of the day room might become reality. The floor looked as cold as the weather forecast. The following day’s operating theatre trolley might be my first chance for a lie down but, what the hell, at least I’d be there for my operation.

6:30 PM brought a consent form in the capable hands of my very approachable surgeon. He assured me the ward did know I was there as I signed the form. He looked a little quizzical when I told him, just by way of conversation, that I was looking forward to the operation so I explained that I just was keen to be on the other side of it to start mending.

8:00 PM arrived along with a bubbly nurse who collected me and shepherded me, along with a few others waifs that she’d rounded up en route, up to the now open and sparklingly clean ward. I was offered and grabbed the window seat and began settling down into my very first NHS bed.

The adventure was under way.

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