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Wednesday, November 19, 2014

Un stapled but not un hinged

Well yesterday was an ordeal having to make the trip down to London and have the remaining 42 staples removed from the wound. Luckily the lovely Angela drove me down and back. Even the very small amount of effort it took for me to walk from the car up to the first floor completely whacked me out and by the time we got back I was wiped out completely and just slept till morning. This is for sure worst than the bowel cancer op.

The surgeon was not amused that the visiting nurses were not dressing the wound correctly. It seems the wound has to be kept open slightly by packing a small amount of gauze into the open wound to enable it to keep draining and not seal up yet. 
Anyway he showed me what to do so I could make sure the visiting nurses understood, all is now well with a nurse having visited today.
All the questions I asked the one I forgot was how does the wound heal if kept open to drain. I guess once it stops draining it can be left un packed. Any previous patients/medics out there any idea?

I will E mail the surgeons clinical assistant in the next few days for an answer but any thoughts from you would be interesting.

Another CT scan is to be done soon as a final check all is well within.

Anyway many many thanks to you all out there it is so appreciated be it just your thoughts via comments or your actions, a big thank you.
We are in Cow Roast marina and any body passing by is most welcome, just don`t ask me to dance....yet.......i`m working on it you can bet on that.

By the time this all comes to an end and we once again cruise the canals we will have had two years decent boating taken from us. Please remember none of us is immortal so if you never use the boat in winter or perhaps always fancied that particular canal do it now, who knows what is around the corner.
I will get fit and will continue doing what I love but I do realise it could have been so different. I have been lucky.

Happy boating everyone.

Sunday, November 16, 2014

Moored up for the foreseeable future

We had the intention of getting back to the mooring outside Cow Roast marina that we occupied when I had the bowel cancer surgery last year. Jaq did walk up to check the mooring and perhaps find out if the boats would be vacating soon but had no luck finding any one on board.

The pound we were in had a leakage problem bad enough that CRT had banned the locks being used 4pm through till 8am the following day. It had no affect as a cruiser went through about 7pm and ended up with it`s bow fender stuck on the gate. This came to light when a woman banged on the boat some hour or so into the saga asking for a little bit of muscle to help shift the boat. Just lifting my top soon sent her away apologising. They did eventually get moving.

So Jaq was back and forth closing gates to the rear of us and letting water in ahead otherwise we were at a terrific angle as the boat settled on the bottom. As soon as a boat had passed us we knew within 30 minuets that they had left the gate open allowing the water to leak through the top gates coupled with the mysterious leak in the canal itself soon bottomed the boat.
So the decision was made to go into Cow Roast Marina for at the moment an undetermined period of time. We have all services needed, steady water level, good access for nurses to visit and Mr. Tesco can deliver to the back door of the boat.

We have had already several visitors from the great bunch we made friends with last year. Robert popped in, Angela is due tomorrow and Mike turned up this morning with the Sunday paper.

I have an appointment for Tuesday at the Royal Free hospital to have the remaining 42 staples out and to see what happens about the open wound that still has a small amount draining from it.

As for me, well I have felt better each day since coming out of hospital and have NO pain just overwhelming tiredness that is soon solved by closing my eyes on the world.

I have just read through all the comments again having only glanced via the phone over the last week or so.
My one answer to you all is Thank you all so much.

Wednesday, November 12, 2014

Back home

Ok "Sir" is back, a little lighter in the Liver dept but having to remove only 10% rather than the expected 30% is in itself a bonus. Hopefully now Mr. C has been finally sent on his way but best not to take anything for granted. All we can do is cut out some of the crap food millions of us put in our mouths and hope my immune system can be strengthened to help keep evil at bay. At least I still have one. The chap in the bed opposite had 40% of his liver removed and was put in a comatose state for 9 days in intensive care after his surgery because the chemo had wiped out his immune system.


The surgeon tells me the 50 metal clips along the wound have nothing to do with the Stars and Stripes.
Neat, clean and dry it all looked good. The pictures I took about 3 days post surgery when they were taking the drain out. Four days later I awoke to a high temperature and the wound near B red and hot. Just to make clear my belly button is just under the A.
My gripes are; Why did it take 3 days before a different doctor opened the curtain and from the bottom of the bed told me I had a wound infection. Secondly after putting me on anti biotics and opening the wound (8 clips removed) did they send me home the same day. They could at least have let me stay even only for the first dressing change and to check the effect the antibiotics were having.
Anyway the district nurse came by the boat and changed the dressing and repacked the open wound with alginate based on sea weed. I was pleased to observe that very little other than that absorbed by the dressing came out of what is a very deep incision. When the wound was opened to drain at the hospital I would seriously estimate the liquid sludge to be of about a half pint. No wonder it was Red and painful with the body working overtime to get it all out.
Although as I say I would rather  not be here today at least with the drain working and an adjustment here and there with the pain meds Jaq and I can between us muddle on. Jaq has bad knee joint problems and needs to take it easy but of course she is toddling around after me. I do love her for that.

Monday, November 10, 2014

The Universe Tries My Patience!!!

"Patience is the ability to idle your motor when you feel like stripping your gears." ~Barbara Johnson, American literary critic
Thank you Robert!!
   I woke to a glorious morning with blue skies and golden sunshine. Jules and Richard on Jules Fuel were moored up behind us, on their way down the cut. They filled NB Valerie up with diesel and hoiked a couple bags of coal on the roof while I was gone to London yesterday to visit Les. I settled our bill, and waited for our friend and fellow boater Robert Rogers of WB Wind in the Willows to come along. We were going cruising together, me steering and Robert locking so I could move the boat up near Cow Roast for Les' imminent home coming. 
Our bow, left, the water point, and the offending boat.

   I needed to top up our tank with water but there was a boat moored on the water point--all night and it showed no signs of moving! Robert steered NB Valerie across the canal since I could not jump off with a rope--the other boat took up the space needed and the bollard as well.
   While waiting for the tank to fill I took a closer look at the boat moored up on the service point and found a handwritten note taped to the inside of the cratch cover of NB Annie Too, which said:
Dear Boaters, We apologize to our proximity to the water hole. It's too difficult to navigate back up the cut without bothering the fishermen. We will be gone when they're headed here also. Sorry again, Matt, Tiphaine & Basil
The note from Matt, Tiphaine & Basil
    God forbid you should inconvenience some fishermen who will spend mere hours camped out on the cut, but please do make it bloody difficult for boaters to get into the service point for an essential like water--while you are gone for days??? Weeks??? Go back to whatever marina you came out of and stay there until you know the regulations about mooring on water points and you learn to have some consideration for boaters--of which you are obviously not (considerate or a boater).
   While I fumed, my phone rang. It was Les, calling to say he was greeted by a nurse who told him he was going home today. "I don't think so," he said as he attempted to explain that home was a boat and not some house he could pull up to in a Taxi. A short time later a doctor came in to take a look at  him and finally realized what Les and I have been saying for the past three days is in fact true...Les has an infection in his incision. 
   There is a reason why he has been running a fever for the past 72 hours. I thought the incision looked swollen with a red margin that seemed to be reaching outward. We were assured by a nurse two days ago that this was normal. Les has had the same junior doctor looking at his incision on rounds for the past three days who told Les all is fine and it's time to go home. 
   A different junior doctor this morning didn't like the look of Les' incision. It is hot to the touch and dimpling under the staples. Junior Doc prescribed a broad spectrum antibiotic and said it may be necessary to pop a couple of staples to let the incision breathe...but still Les can come home tomorrow! Here's your hat what's your hurry...it took a month to get Les a bed in the RFH and they have been giving him the bum's rush since last Wednesday--unbelievable!!
  Meanwhile Robert and I cruised off up the cut, headed for Cow Roast. Coming out of Gas lock 2 we noticed the pound was low. Ahead at Gas Lock 1 a boat was waiting to come down. The lock was in my favor so I took NB Valerie in and as we rose the bloke on the other boat struggled to keep his boat in the center of the canal, the muddy bottom sucking him towards the towpath while he pushed off the bank with a boat pole. He said the pound above was really low and warned me to stay in the middle. 
   Robert walked up to Bushes lock to let some water down. I figured if I stayed in the middle of the canal I would be fine, however there was so little water in the pound that I was basically cruising through mud! I could not get up any speed as the tiller pushed through thick glop and coming around a curve I found myself quickly aground.
When I say low--I mean low!!
   Thanks to Les' fine teaching skills, I remembered to slow down and reverse gently which did the trick. A short while later a slogged up to the lock and the boat sluggishly slid in the open gate. I was truly thankful for Robert's company. I had considered single handing it up to Cow Roast which I could have done--slowly--in good circumstances but not with the pounds so low. 
   Robert follows a web page called All Things Berko and he showed me a picture posted two hours previously of the pound between The Rising Sun and the Boat pubs in Berkhamsted. The text suggested "someone pulled the canal plug," possibly due to a need to dredge the canal for evidence regarding a murder which took place there last June. 
   As we cruised up to Dudswell Lock 47 a notice by Canal & River Trust said it all. Usually there is a sign from CRT on this lock asking folks to shut the gates but leave a lower gate paddle up to facilitate the flow of water. Not today!
   Apparently there is leak somewhere and the cut is losing water between Tring Summit and the locks lower down through Northchurch and Berkhamsted. Navigation through Dudswell locks is restricted now and no traffic is allowed from 4 p.m. to 8 a.m. in order to save water. 
  We moored up by the donkeys (boaters who know the area know exactly where we are), and after a much needed cup of tea and some Angel Bars Robert headed off back home.
   I finished washing several loads of curtains, dinette cushion covers, throw pillow covers, and got down to some basic wall scrubbing and cleaning to prepare for Les' home coming, all the while fretting about it.
   Yes, I want him to come home, but I don't want a repeat of last year, with district nurses visiting every day, cleansing his incision with sterile water, covering it with Dermateg waterproof sealed surgical pads, and reassuring me that the wet, gooey look of Les' incision was "normal"--just exudate--an apparent new trend in British nursing--according to a research paper on the difference between British and American Nursing by one of my nursing students.
   I was always taught a cut, sore, scrape, or incision should be kept clean and dry. To leave it wet invites infection; covering it over and restricting air flow also invites infection by anaerobic bacteria. As someone with eight major surgeries under my belt I know a thing or two about what to look for and I knew what I was seeing wasn't right. Nonetheless the nurses were happy and they completely missed what was right in front of their noses--his wound was infected and he developed Sepsis and nearly died. 
   I don't want a repeat of this situation and I don't want the responsibility--because it's not mine to bear. Les developed this in hospital and he should remain there through the end of this week until the medical professionals are clear the antibiotics are working and the infection is healing. I am not a nurse. I am a herbalist and a healer but I know my limits. 
   I remembered in late afternoon that I was given the phone number of Professor Davidson's nurse assistant. I called and shared my concerns, to be told that if indeed Les had contracted an infection (she hadn't been up to see Les today), then the best place for him is at home because hospitals breed too many bacteria and a lot of resistant strains. It would be best for Les to come home and have a district nurse come in every day and check his wound. 
   I explained what happened last time and replied, "So Les would be sent home to the care of the nurses who failed to recognize an infection in his last surgical incision and also failed to spot the signs of Sepsis." The nurse assistant said she would go up and see Les right away and call me back. 
   Les called about thirty minutes later to say she had been up to visit, and agreed there was an infection (how many medical staff does it take??). She touched it and the incision is hot. Apparently she agreed Les should stay in hospital one more night and be reappraised for release in the morning. 
  I received a call from her several hours later in which I was basically told the same thing but in which she reiterated that the best place for Les to recover is at home and he should be able to leave tomorrow.
  I reiterated that I was not comfortable with that and I wanted Les to stay in hospital until we knew for sure that the antibiotics were working. She told me I could call her any time with my concerns. I asked if she had received my email from last Friday. She replied, "No." So I've sent it again. 
It just never ends....

Sunday, November 09, 2014

Patient and Caregiver Update

   Les continues to feel a little bit better each day although his ribs on the right side hurt considerably. Why is that you might ask? Liver resection requires the ribs be lifted or spread out of the way.
   The torture device surgical instrument used is called a Finochietto Retractor--stainless steel with rack and pinion steering thumb screws to hold it in place. Needless to say Les' ribs are bruised and sore.
   When I arrived on Wednesday he was clutching his side in agony--face pinched and pale, lips trembling. Dear Sir had fallen asleep while waiting for me to arrive with his lunch and a ball of phlegm in his chest decided to cough itself up while he slept. It was an autonomic response for which Les was not prepared which woke him with searing pain. Usually when he is going to cough he tucks a rolled up blanket or a pillow over his surgical site and clutches it to ease the pain. A few minutes later a nurse arrived with extra liquid pain medicine which sorted Les out after about five minutes.
   The care provided by the staff of the Royal Free Hospital has been above and beyond reproach. The service provided there is first class--first world and it is the standard in my opinion which every British citizen should receive at any and all NHS facilities. 
   Les said on Wednesday that the surgical staff who visited him on rounds were pleased with his recovery and talking about sending him home by the weekend. I told Les No!! Not a good idea. It took us a month to get him a bed in the RFH and he needs to take as much time as is necessary and comfortable to be sure he is well enough to come home to the boat. To that end, On Friday afternoon I emailed Professor Davidson's assistant the following: 

I am writing to express some concerns I have regarding my husband Les Biggs who is on Ward 9 West recovering from a liver resection completed Monday last (November 3, 2014). I would appreciate it if you would kindly pass my concerns on to Professor Davidson and his team.

I've been in to visit my husband every day for 4 hours at a time. I've been bringing him homemade chicken noodle soup, fresh homemade yogurt with strawberries, and banana-blackberry smoothies with cross flow micro-nutrient whey powder blended in, which stops muscle wasting.

On Wednesday Les told me when I arrived at 2 p.m. that Professor Davidson mentioned Les possibly coming home on the weekend as he was progressing quite well. I have concerns about this time-line for discharge from hospital. Wednesday when I arrived, I found Les pale, lips trembling, and in a great deal of pain. He had fallen asleep waiting for my arrival and in his sleep a ball of phlegm irritated his chest and he automatically had a very deep cough--for which he was not prepared at all. The intensity of the pain knocked Les for six and exhausted him. (The nurses have been terrific about helping Les manage his pain--when he remember to ask for pain meds, and Sheila--the Enhanced Recovery nurse--has been absolutely wonderful and attentive to my husband's needs).

After some good food, and an afternoon of light rest I asked him if he felt like taking a small walk. Les said yes and I helped him to walk from his bed and out the corridor about halfway between his ward room and the one next door. We turned around and walked back to his bed and he was spent. I suggested that perhaps he might want to take shorter walks more often--say walking from the bed to the doorway of his ward room and back three times a day to start. Les knows that the sooner he walks, the sooner he walks out of the hospital and he is committed to doing everything he can to get on his feet and get better. I believe though that he may be overdoing it and pushing himself too hard in the hopes of coming home right away. Yesterday when I arrived Les said that he had gone for a walk with Sheila, up the corridor almost to the nurses station and then could not muster the strength to walk back. Quick thinking by Sheila kept Les from falling and together they finally did manage to get him back to bed.

Doctors do their patient visitation rounds in the early morning when most patients have had a night's rest and their energy levels are the highest. By the time I arrive at 2 p.m. each day I see a patient whose energy has peaked and is on the downturn which offers a very realistic idea of what my husband is capable of coping with at present.

I do not believe it is in Les' best interest to be discharged before Tuesday at the earliest. There is also one other issue which I ask Professor Davidson to take into consideration when looking ahead to a discharge date for my husband: we live on a boat not in a house. This means we will not be pulling into the driveway, helping Les to take 6-8 steps from the car to the house and settling him in.

Les will have to walk from the car out to the towpath and down the muddy, slippery, uneven towpath for a distance of 75-500 feet depending on where we are moored, in order to reach our boat; it is then a step off the towpath and over the bow of 20 inches width and a drop from the towpath to the bow deck of nearly three feet on a boat that is at present in high winds, moving about, rocking and not stock still.

We are currently moored up in Berkhamsted which provides me with easy access to the train in order to visit Les daily, however I need to move our 18 ton narrow boat up eight locks to Cow roast (Tring) in order to moor for any length of time over 14 days and to provide Les with a quiet, dark, and peaceful atmosphere surrounded by other boaters who will assist us in the months ahead. I also need to take in consideration the best location for me to access water, rubbish and other facilities (the boat must be moved twice a week to get water and empty the trash).

We heat our floating home with a solid fuel stove. In order to keep the boat and Les warm and comfortable this means the stove must be attended to constantly throughout the day--the ashes must be swept out, bags of wood must be brought in and a bucket of coal--every day. A bag of coal lasts about four days and then a new 50 pound bag must be hoisted off the roof and into the well deck on the bow. Les usually does this but I will be doing it for the next three months. I will in short be doing all my activities of daily living aboard the boat and his too, as well as taking care of him so he doesn't over due things, managing his exercise so he continues to regain his strength and preparing wholesome food etc. etc. ..as we live on a boat with only 110 feet of actual living space it is key that I am as organized as possible and our home is ready for Les as well as Les being ready to come home.

To this end I respectfully ask that Les not be discharged before Tuesday November 11th and that I am given 48 hours notice of his discharge date so I can move the boat and ensure things are prepared for Les' arrival. Please let me know if you have any questions or concerns about my request. I wish to offer my humble thanks to everyone who has provided superlative care for my best beloved.
   This morning Les phoned at 7:30 a.m. to say he has a temperature and some pain in his side.  He phoned again at 9 a.m to tell me staff were at his bedside with vials testing his blood. He asked them if they were looking for Sepsis. The woman said, "Yes. How do you know about Sepsis?"
   "I had it after my last operation and my wife recognized the symptoms."
   "Is your wife a doctor?"
   "No, she works for a university and is trained to do research. She researched the symptoms and knew what to look for." As it turns out Les does have a temperature but he does not have Sepsis--thank The Goddess. The best place for Les to be right now is right where he is--receiving excellent care and being watched carefully and resting until he is actually well enough to return home to my care. 
  And what about moi? Instead of beginning this post with a quote I've chosen to include this 1984 U.S. Dunkin Donut commercial because it encapsulates exactly how I feel about this past week and the one to come. My daughters know the phrase "Is it time to make the donuts? It's time to make the donuts," has a special resonance in our family!
   I feel like I've met myself coming and going on the train in to Euston. Everything else is a flash in between until I get to the RFH and Les' bedside and then back again to collapse in my reclining chair on the boat every evening.
   Life has been complicated by my putting my S-I (Sacro-Iliac) out on my right side last Tuesday afternoon. The odd thing about this injury is that one does not automatically feel it in the lower back/hop area--it is felt first in the knees, as one leg is longer than the other by about a quarter of an inch. All the muscles and ligaments at the knees torque out of place to accommodate walking and it feels like thirty inch splinters are being driven through my knees and calves. Searing pains shot down my legs as nerves are pinched.
   By Wednesday every step was agony and by Friday I could barely walk and I was completely exhausted from the pain and an inability to sleep as my S-I joint popped in and out of place while I rolled around in bed all night. 
   Fortunately a blog reader and dear friend Anonymous A. (Angela) came to my aid. Angela lives in Berko and happily picked up a few groceries for me as well as a brochure for a chiropractor a stone's throw from the canal.
   My deep thanks to Dr. Gary Kirwin of Naturality Chiropractic for seeing me on such short notice and sorting me out. He adjusted me with firm, gentle care while talking with great enthusiasm about narrow boats!  His practice is located In Berko on New Road--in between the Cook! gourmet food shop and the Waitrose parking lot entrance. I can see the building's chimney from our mooring on the cut. It will take a few days for my knees to stop aching.
© Peter and Susan, NB Dreamer
   In the meantime I am making tidbits to take into Les each day to supplement the nasty hospital food which has had all the nutrients and taste steamed out of it.
   I am also quite proud of myself for moving the boat yesterday to fill up with water. I forgot to put the TV antenna down but still I managed to just slot the boat in at the water point without becoming entangled in the Whomping Willow tree branches just waiting to ensnare anything on a boat roof. 
   After filling up with water and dumping the rubbish I reversed back across the canal to our mooring spot, deftly missing all other moored boats and a dutch barge which cruised into sight suddenly from behind the aforementioned mass of will branches much to our mutual surprise! I didn't reverse as deftly as Les does but no children, animals, or boats were harmed in the process so it's all good!
   Finally many thanks to Ken and Sue Deveson for visiting Les in hospital and for their moral support, offers of help, and ongoing friendship; to Maffi who stopped one evening on his Autumn Progression to say hello and have dinner with me; to Angela for running errands and practical support. Many kind thanks as well to everyone else who has called, texted, emailed and commented on this blog to offer support, encouragement and assistance. 

Wednesday, November 05, 2014

Sit by your beds

Taken Wednesday morning. Out of bed 3 days running.

Tuesday, November 04, 2014

In Sunshine and in Shadow: Post-op Update

"One cannot enjoy sunshine and light without also accepting and embracing shadows. There cannot be the one without the other--they are equal halves of a whole." ~Anon

   We arrived at the Royal Free Hospital yesterday morning at seven a.m., and reported to the same place as last time: Day Surgery and Surgical Admittance, to the same hostile, unprofessional woman as before, staffing the desk, and Les proceeded to check in again. The same pandelerium reigned with a sloppy queue of day surgery patients mixed in with folks like Les waiting to be admitted to hospital.
   About ten minutes later a nurse with a very heavy foreign accent called what could have been "Mr. Biggs" or any of twenty variants on a theme. No one responded so Les stepped up and said, "I am Mr. Biggs?" Yes, yes, of course, come this way... and off we went to an exam room for a Deja Vu ride into the uncertainties of the British NHS. 
  There was still no guarantee of a bed in the ITU (Intensive Therapy Unit) for Les! We were told however that we would know one way or the other by eight a.m. The anesthetist was a lovely young Eastern Indian woman with impeccable English pronunciation--thank The Goddess. She went into great detail on what Les could expect which was very helpful. 
   One of the surgeons on Professor Davidson's team came in and introduced himself. He explained that the scans had indicated two lesions on Les' liver but during the ensuing weeks since the scan was taken things could have changed. While they were planning to take 30% of Les' liver, they might need to take more and there was a possibility--although he thought it slight-- that they could go in and find "there is nothing we can do for you, in which case we will stitch you back up without removing anything." Chilling words indeed for me to consider as I pondered in helpless anger, the weeks we've lost to the progress of this disease in the face of the NHS' inability to cope with a level of efficient care in our case.
   Meanwhile a shy young woman with a strong Polish accent who we also found difficult to understand, came to take five vials of blood. Les has a deep phobia of needles. He is fine once it is in but the process almost undoes him every time. 
   This time the technician could not seem to find a vein and she poked him three times, digging around with the needle, until finally she managed to draw blood.
   We sure wished Sparky had been with us. My youngest daughter is a trained and experienced Certified Nursing Assistant/Phlebotomist and she can tell you--some technicians have the touch and some don't. Sparkala has the touch and can seamlessly insert a needle and draw blood from a turnip. This young woman working on Les was too timid and she didn't have the touch--at all. I thought we were going to have to hold Les down at one point. All the color leached out of his face and he went pasty white. I was worried he might faint.
   We were told to go back out in the hallway and sit until someone called us. Back we went  to watch the scene of hyper manic medical business unfolding and within five minutes the nurse came and got us. There was a bed and Les needed to strip down, put on a gown, paper panties that resemble nothing so much as one of those paper food service worker's caps, and a pair of navy Ted hose to prevent blood clots. 
   We were unceremoniously shown to a locker room where the items were shoved into my hands and the nurse turned and left. As I was tying up the back of his gown, she returned and stepped in front of me to take over the gown tying, then she urged him to get into his stockings.
   Now anyone who has ever worn Ted Hose knows they are super tight and harder to put on than women's pantyhose--something akin to attempting to slip a membrane thin finger protector over an engorged erection. This process is made more difficult yet for Les, whose stoma bag is in his way when he bends down. We tried to explain this to the nurse while he struggled to get a leg up and work one sock on. The nurse urged Les to get a move on it in a staccato burst of words completely lacking in any meaning for us (although I am sure she was confident she was speaking English) until she could see Les actually struggling and realized he needed help.  
   Stockings on, we were herded back out in the hallway where medical staff were calling out patients names for day surgery, family members trailing along behind their loved ones as traffic bottle necked in the narrow hallway near the nurse's station. Our nurse grabbed me by the arm and led me off to the end of the hallway to select a large locker for Les' belongings. Items secured, she took the locker key, marched off to the nurse's station and put it in an envelope with Les' name on it, then hurried off to attend to other things. Meanwhile Les was still standing in the drafty hallway as a milling throng of sick people and their families swirled past him accompanied by their medical staff. 
  We wanted to know how I was supposed to collect Les' things after his surgery. Les asked another nurse at the station. She replied in broken English with a heavy Polish accent which we had to hunker down and attend to every syllable in order to understand. She hadn't grasped Les' initial questions either and she assumed he was a Day surgery patient so her instructions were meaningless. 
   Our nurse returned to say it was time for Les to come along and follow her. We wound down the hallway and stood across from the per-op doors. The frenzy and seeming disorganization coupled with a round of foreign accents that were hard to follow, and the fact that my husband had been standing in the hallway in his flapping nightgown for fifteen minutes did not inspire confidence in me at all.
   Finally a pre-op nurse came out to collect Les. I took his face in my hands and kissed him, saying, "Remember--I am waiting here for you, so you come back to me do you hear me--you come back to me." I kissed him again with tears in my eyes and they walked through the pre-op doors at 8:45 a.m.
   I was told someone would call me to offer an update on his status near the end of surgery. Both the nurse and the anesthetist had written down my phone number. I was left at loose ends as the morning passed, sitting first in the hallway amongst the throngs of day surgery patients and their loved ones. 
   I took a brief walk at ten a.m. to the Belsize Park Underground station five minutes away, to redeem an extra Oyster card and get our money back. I stopped in the hospital canteen run by Marks & Spencer for a breakfast sandwich and coffee which were terrible and totally unappealing. The latte was weak as rainwater despite my having asked--yet another person with a thick foreign accent who I found as hard to follow as she found mine--for a triple shot latte with double caramel flavoring. It took two other employees to explain to her what I had actually asked for and she had to cancel my order which she had interpreted incorrectly and run it again.
   Finally my latte arrived with a breakfast sandwich that had been nuked to death. One half was hard as concrete and the cheese had become molten lava, flowing out all over everything. I took two sips and one bite and threw it all in the garbage.
   Back up on the Day Surgery floor I sought out a quiet place to rest--four hours of sleep and a rising time of five a.m. meant I was exhausted. I discovered the Day surgery patient lounge we had waited in on October 8th. It had large, overstuffed recliner chairs on wheels all around the walls with a bank of windows opening up to Hampstead Heath in the distance. I settled in and closed my eyes, listening to the sweep of voices in the room. 
   I have always been good a identifying accents. It comes from having had a HAM radio operator for a father. I used to sit on his lap as a little girl back in the early 1960's and talk with other HAM operators all over the world. I also had a Norwegian grandfather and a Welsh grandmother so I grew up in a world peopled by the music of foreign accents.
   Around me now, I heard Albanian, Italian, Spanish, Chinese, and Farsi. Each language was spoken by a day surgery patient accompanied by a family member who acted as an interpreter and signed medical paperwork to this effect. I am a foreigner in a foreign land and although is it England I cannot count on the national language being spoken clearly enough for me--whose ears have always been sensitive to the nuances of a foreign accent--to understand or indeed for my flat American accent to be understood in return.
  I stood and looked for the time. I had become a clock watcher now as the hours crawled by. The surgeon had said Les might be in the theatre for as little as two hours or as many as six depending on what they found. By 1:45 I could sit no longer. For me, the passing hours did not bode well. I went to the Day Surgery nurse's station and asked if someone could update me on my husband's status--was he still in surgery? The nurse called around and discovered that Les' surgery was just finishing up and I should go up to the 4th floor and ask for bed nineteen. 
   Imagine my surprise when I arrived to the ITU floor to discover a beautiful--and empty--waiting room with over 40 chairs and two vending machines. I could have waited up there in quiet and comfort if only someone had directed me hours ago. There was no one at the reception desk but the notes taped to the glass indicated that bed 19 was in the south wing. After ten minutes search I found it and then stood and read the lengthy directions on how to use the phone to call the bed number. Calling bed 19 a nurse picked up and I explained who I was. She asked me to hold please, and came back a few minutes later to tell me my husband was still in surgery which was just finishing up and he would be in bed 33 when he came in to the ITU. I should wait and someone would find me. 
   Back out in the ITU waiting room I sat with eyes closed for thirty minutes until a door swished open and one of Les' surgical team came over to me with his hand outstretched. He shook my hand, and said, "Your husband is in ITU now. Everything went very well. We found the two small lesions and removed them with about 10% of his liver. Everything we took had very clear margins so that's good. We found a third very small lesion which we also took. We don't know if it is cancer--it looked to be a calcification--but we took it and it has been sent off to pathology."
   I asked about Les' gall bladder and he told me they didn't need to take it. I started to say, "Thank you Mr. Kumar--" he clutched my hand warmly and said with a smile, "Call me Satch--everyone does. Wait about another twenty minutes and you can go in to your husband. He's doing really well."
   It was clear this young surgeon was feeling very happy at the outcome of Les' surgery--"Satch" was relaxed, happy and had a spring in his step. His demeanor would have been quite different if there had been a less than desirable outcome. 
   I spent the time texting friends and relatives with a brief update. I offer my heartfelt thanks to everyone who kept in touch with me and who kept Les and I in thoughts, prayers and meditation throughout the day. 
  I reported to the South wing and rang bed 33. The nurse answered and I explained I was Les' Bigg's wife and asked to be admitted. The door clicked softly and in I went. 
   Just around the corner and there he was--my Best Beloved!! One nurse was assigned to him and she was all business, ordering me to put on a plastic apron. I washed up to my elbows and stumbled through unfolding the plastic bag apron and getting it on.
   Still groggy and barely out of surgery, Les felt me lay my hand on his arm. He opened bleary eyes in slits and stared intently at me as though I were an alien with three heads, then slipped back into sleep again. I stood by his bedside while his nurse checked and re-checked his paperwork, the surgeon's instructions, and keenly monitored the eight or so machines which were clicking and beeping, following Les' blood pressure, oxygen level, breathing, heart rate and medicine dosages.
   Slowly, slowly Les came back to me, as his anesthesia began to wear off.  He had IV cannula's in both hands, a urinary catheter, and a large tube sticking out of his neck on the left side, to which were attached a snaking half dozen thin plastic tubes carrying medicine and other life sustaining things directly into Les' carotid artery.  A large oxygen mask was strapped to his face.
   As the hours passed I got to know his brilliant nurse Cynthia, who speaks with excellent English diction and has been an ITU nurse for fifteen years. She was right on top of everything and stayed there, watching and listening intently as Les came 'round and began to use sign language to indicate his pain level was a nine and his mouth was too dry. 
  Cynthia gave Les some pain medication by IV and squirted drops of water into his mouth. She got his medicine on demand box set up so all he had to do was push a button every five minutes. He struggled to sit up and could not find a comfortable position. Cynthia rearranged him a half dozen times at Les' request, in a gentle, efficient manner. I warned her Les has a very low pain threshold and as he comes 'round he will begin asking a thousand questions--which he did. She told me he thrashed around a lot when he first arrived from the operating theatre.
   I knew he was fine when he began to negotiate for release from the oxygen mask. He hated it and it made him very uncomfortable. Cynthia told Les he needed to keep it on for 24 hours. Les bargained for an oxygen cannula in his nose instead and won. As she slipped the plastic cannula hose around his ears to hold it in place, I said, "Darling its a very good thing you've got the ears to support this hose." Les came straight back with, "It's mean to take the piss out of a new surgery patient!"
   We laughed and Cynthia relaxed as she watched Les and I banter with one another.
   "I can tell you to have fun with each other don't you?" 
   "Yes, we carry on like this every day, laughing and having a good time together."
   Within three hours of coming back from surgery Les was alert, happy and raring to go. He too was over the moon at the surgeon's pronouncement about his surgery outcome. Cynthia took me aside and said, "It's such a pleasure to have a patient who is alert, happy and ready to get well. Most of our patients in ITU are very ill and not very happy."
By the time I left at six p.m. Les had eaten a pot of yogurt, drank some water and was attempting to cajole Cynthia into letting him get out of bed!! I told her to be careful or he would have her out in the garden doing Pancake races in a few minutes. Emotionally threadbare and exhausted, I left for home, knowing Dear Sir was in competent, caring, professional hands.
   I managed to catch the correct bus to Euston Station, eat a bite of dinner, spot the train I needed, get on the correct train despite the thronging hoard of travelers heading out of London, and I was met at the other end by Robert from WB Wind in the Willows, who took my bags and walked me home though the dark. Thank you Robert!!
   I am off to visit Les now and I should not be at all surprised to find him leading Step-dancing classes for the ITU staff!