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Showing posts with label Royal Free Hospital. Show all posts
Showing posts with label Royal Free Hospital. Show all posts

Monday, October 20, 2014

A Hard Day's Night

"The sudden disappointment of a hope leaves a scar which the ultimate fulfillment of that hope never entirely removes." ~Thomas Hardy, British writer

   Here we go again, five steps forward and nine steps back. It was with guarded optimism in my bosom that I helped Les pack our bag and get ready for our overnight stay in London last night, prior to checking Les in at the Royal Free Hospital this morning for surgery to remove two cancerous lesions and thirty percent of his liver. 

   (Most folks who follow our blog are well aware of the terrible debacle we both faced this very week last year when Les was undergoing surgery and recovery for bowel cancer. It was my first experience with the NHS and it left me with a bitter taste that hasn't disappeared. Those who wish to do so may read or re-visit those hellish posts here and here.) 
    The Premier Inn is located behind and just across the street from the back of the Royal Free Hospital. I guess I should have recognized Sod's law in action at the check-in desk when we gave the girl the reservation number provided by staff at the RFH, and she brightly chirped, "Michael Biggs?" Correct reservation number--wrong first name. 
   We dropped our bags in the room and headed off for a walk around the neighborhood and up on Hampstead Heath, scoping out restaurants along the way which we might consider for dinner later. After a bracing walk through Autumn leafy lined lanes, and a good stroll across the Heath, we settled on dinner at the hotel restaurant.
   Although it was my birthday, I was too tired to give much thought to celebrations. Not only did I have Les' impending surgery on my mind, but a phone call from the States earlier in the day informed me that a best beloved very close to me has also been diagnosed with cancer. I am back to sleeping only four hours a night and the dark rings under my eyes are testament to that old survival mode which says life is once more a struggle to endure and sleep only comes with exhaustion. 
   After dinner we went back to our room and indulged in deep, hot, sensuous....baths (you thought I was going to say sex didn't you?!!).
   As anyone who lives aboard a narrow boat will tell you, for most of us baths are a pure luxury. Not only is there no room for a tub in a bathroom four foot square, but a tub takes too much water--hot or otherwise. On NB Valerie three minute showers are the norm. So we each had a turn soaking in a steaming hot tub full of water.
   Afterwards we were instructed by an NHS leaflet on preparing the patient for organ surgery, to use one packet of Clinell surgical wipes and wipe the patient's body ALL over, allowing five minutes for skin to air dry before dressing--once after a shower the night before surgery and again in the morning before coming to hospital. Wiping done, I watched as Les ran back and forth in front of the bed flapping his arms like a kid, until we both fell into fits of hysterical laughter. Les did warn me when he proposed in 2010, that he loved to laugh and we would be doing a lot of it; he has kept his sense of humor--or humour--whichever you prefer, as well as his word.
   Soon it was time to drink the Pro Nutria pre-surgery carbohydrate drinks which are a part of "accelerated recovery." We watched Downton Abbey, the BBC news, and then turned out the lights and lay too edgy to sleep, cuddled like spoons in the dark. 
   Our phone alarms went off at five a.m. and it was time for Les to drink his final two pre-surgery drinks before we dressed, gathered our belongings, and headed off in the early morning dark to walk across the street, down a back drive way and into the Royal Free Hospital. 
   Up on the third floor and through a door marked Day Surgery and SAA (Surgical Admissions Area) we were met with a wide hallway lined with chairs full of patients with clipboards in hand, filling our paperwork. We approached the check-in desk where a woman with a face like a slapped ass barked at Les as he gave his name, "wait your turn."
   She then called out "anyone who hasn't finished checking in please approach the desk." After six minutes of studiously ignoring us, she finally turned to Les and demanded to see his letter. Well we didn't have a letter as he was contacted by phone for everything. She sourly turned on her stool, sorted through sets of paperwork and finally found his, sighing, "Well no wonder...you are inpatient aren't you?"
   While we sat down to double check and complete the admissions paperwork she handed us attached to a clipboard, the enclosed area suddenly heaved with a tangle of more than fifty patients and their loved ones, queuing awkwardly at the check-in desk. Les duly queued as well, handed his clipboard and papers back in, and we found a chair down the hall in a quieter section. Eventually his name was called and we entered a small room divided in two by a pleated paper curtain.
   It was here we met two very nice, bright nurses who came to double check Les' admission paperwork, take his blood pressure, swab him for MRSA, and explain the pre-and-post-surgery process, followed by a quick visit from Professor Davidson who looked bright eyed and bushy tailed, the anesthetist and other members of the surgical team.
   We were both highly challenged to hear what was being said to us over the chatter on the other side of the curtain which left us privy to all the personal details of some other patient--a woman whose surgery will include some plastic re-constructive surgery with skin flaps; might as well not bother with paper curtains and pretend privacy...
   A phlebotomist came 'round and Les had his five minutes of terror and severe discomfort (he has a deep phobia of needles) as vials were prepped with labels and the needle inserted, and then moved around a bit after which four vials of blood were drawn. So far, so good we thought despite the rude woman at the main SAA desk, everyone else was cheerful, polite, engaged, and ready to get the surgery started. 
   A lovely enhanced recovery nurse came and had a long chat with us about what to expect after surgery and she took my phone number, promising to call me as soon as she knew anything about Les' condition. We were ushered into a large lounge down the hall with big, overstuffed recliners and asked to wait while they double checked with the floor matron who booked ICU rooms. Sit we did and wait, for two and half hours after which we were called into the previous small room, met with a member of the surgical team and informed Les' surgery was canceled as there were no ICU rooms available! 
   The young surgical tech explained that over the weekend other hospitals who had no room for critically ill patients had delivered them to the RFH and as a consequence there was no room available for Les. The booking matron had to decide who needed the rooms most--someone who had just come through surgery at another hospital--or Les, who was considered "healthy and not in need of a bed." I pointed out that my husband--told he required immediate surgery on his liver to remove metastasized bowel cancer--was not well at all or he wouldn't be there waiting for surgery.
   The technician explained that we would be contacted with another possible surgery date hopefully within a week as Professor Davidson operates Mondays, Wednesdays, and Fridays. I asked if his next surgery date could also be canceled at the last minute for lack of a room and he apologetically said yes. He also informed us that Professor Davidson had fought tooth and nail in an effort to procure ICU lodgings for my husband--to no avail.
   Basically we were told that a full team of surgeons, technicians, nurses and an operating theatre stood by for two and a half hours waiting--for nothing!! Add the cost of the hotel room (£112) and our out-of-pocket costs for train fare to and from the boat, bus fare, dinner, and breakfast for me and it quickly becomes a VERY expensive scenario underscoring once more the inability of the NHS to function efficiently while wasting tax payers' money.
   Meanwhile back in the States my loved one who received a cancer diagnosis last week was operated on Saturday and the tumors were removed. This despite the fact their health insurance isn't the best by a long shot. This person is a member of the working class poor in America and still gets better, more timely health care than Les can receive--and they haven't paid years in advance for it either, while the government gains the benefits on the interest of British citizens' hard earned wages over decades.
   I am tired and I feel fragile. I've spent a year fighting for Les' life against this ugly disease. I've fought my own battle against it twice in the last eight years. I've lost a brother-in-law two weeks previously to liver cancer and been told one of my very best beloveds in this world is facing their own battle with cancer; and I cannot count on the NHS to function efficiently in Les' case...I've been told to "be of good cheer, remain hopeful, don't let it get to me, be patient"...but I am all out of understanding, patience, hope, goodwill, and cheer. My teeth ache from gritty determination and I long for a system I can count on in a time of desperate need. I know this too will pass, but not without leaving me with more scars on my soul.

Wednesday, October 15, 2014

Life in the Fast Lane

"I wanted to be a veterinarian until I saw a video of a vet performing surgery on a dog. Then I decided I wanted to be a pianist." ~Amy Lee

   All righty then! The staff at The Royal Free Hospital are totally on top of things. When we met with Professor D and his assistant on October 7th, we were told that Les needed to come in the following week for a pre-op appointment after which surgery would be scheduled sometime between then and November 2nd.
    Les was called by phone last week and an appointment was booked for pre-op and fitness assessment on Tuesday the 14th of October--yesterday. Off he went on the train down to London. My phone rang an hour and half after Les' scheduled appointment time. It was Dear Sir whose quavery voice informed me that he passed his pre-op and fitness exam with flying colors and his surgery was scheduled for Monday October 20th. That is next Monday!!!
   Since we live on a boat and have to travel from so far away to get down to London, Les was told the RFH would book us a room at the nearby Premier Inn for Sunday the 19th, and someone would follow up with the details. Sure enough my phone rang this afternoon about 1 p.m. and the staff person on the line said the room had been booked and she gave us a reservation number. Job done!!
   The difference between this experience and our previous horror show mis-adventure last year at Watford General Hospital is like the difference between margarine and butter. This folks is the real deal--quick and efficient service such as one could get in the States which places the needs of the patient front and center, which begs the question: if the Royal Free Hospital--which is a part of the NHS--can operate with 21st century efficiency (not one single letter has been mailed; all appointments had been made over the phone or in person--imagine!!!) why can't the rest of the bloody surgeons, doctors, nurses, clinics, tests, hospitals, etc. etc. etc. which are also a part of the NHS bring their daily operations into the 21st century and begin functioning efficiently as well? It seems the true answer is "because we don't want to; we don't like change." 
   While Les was in London I was at home trying not to stew and keeping busy. I washed two loads of clothes, changed the bed linens, defrosted the freezer, cleaned out the cupboards, brought out winter clothes and put away summer duds, prepped an online Tesco order for delivery tomorrow, graded student coursework and answered emails. 
   I also took some time to enjoy nature. Slapton is a lovely quiet place at this time of year. Ours was the only boat moored below the lock. I saw a blond Mink swimming, and three Cormorants fishing together; two adults and a juvenile. 
   Les arrived back home last night in a total tizzy. He's nervous and edgy about this next operation and who could blame him given the debacle that occurred last time? My tizzy concerns being a mountain woman traveling alone in and out of London. We made a dry run of it last week to meet the surgeon. I will purchase a weekly rail pass and my Oyster bus pass is topped up. I'm sure I'll figure it all out and be just fine. It's just a huge jump for someone who was born in the Alaskan Territories and grew up pretty much in the sticks. I'm trying to view it as Jaq's big adventure.
   We have a list of things that need doing before Sunday so we are people on a mission--which is great because it leaves little time for ruminating on the future. 
   Each day has its specific goals which will see us preparing the boat and stove for winter, registering as a temporary patient at Rothschild Surgery in Tring, making a trip to Watford to pick up some packages and mail from our daughter-in-law, getting a Tesco delivery-check, filling up with diesel and coal-check, and moving the boat each day until we reach Berko where we will moor while Les is in hospital. From there the rail station is a five  minute walk with service pretty much all day and night.  It takes about 40 minutes from there to Euston Station and a quick 20 minute trip by bus to hospital.
   The day before Les is released from hospital I will move the boat up to to where we were last year this time, so he comes home to some place quiet, dark, and peaceful where he will begin recovery and we will have easy access to visiting nurses, Tesco deliveries, water and rubbish. 
   In our new food habits, we have made the acquaintance of Quorn vegetarian meat fee products made from mycoprotein. The chicken flavored products are delicious and we are working them into our menu which includes lots of veg, fresh homemade bread and yogurt and a raft of supplements.  I'm adjusting old favorite recipes to meet our new dietary habits which is challenging and fun. As they say over here, "A dog is not just for Christmas--it's for life." Just so with our new eating habits.

Thursday, October 09, 2014

The Royal Free Hospital

"Happiness is a choice. Your circumstances can affect it but ultimately you are the one who decides your happiness." ~Unknown

  We rose early Tuesday and walked up the towpath from NB Val through Leighton Buzzard, across a green park, and strolled into the train station where Les bought our off-peak tickets (travel allowed only during non-high impact times--in other words after the poor rats have made the morning and evening race-commute.)
   I noted in my diary that it was exactly a year ago to the day that Les began Radiotherapy without which Mr. H refused to operate to remove the cancerous rectal mass as he said radiotherapy was required prior to surgery to shrink the tumor. Radiotherapy which--and I quote directly from notes taken at the meeting with Dr. J--the Oncologist at Mount Vernon, who said, "the short course Radiotherapy will not shrink anything but it will assure that the cancer does not return to the bowel or metastasize."
   The train traveled quickly past villages and towns we know well from our travels on our boat until it arrived at London's Euston station which was a first for me. 
   This trip to the Royal Free Hospital to meet the liver specialist was also a dry run for me to suss out the station and the bus for future daily expeditions.
  
Passengers wait for platform numbers to post on reader boards.
The key I think is not to allow one's self to become too overwhelmed by the size of the station and the sheer numbers of people pouring on and off trains and out into the London streets. (Later that evening waiting for the train on our return leg, it was barely controlled chaos as hordes of workers heading out of London packed the main floor of the terminal, scanning the fifteen or so reader boards looking for the train which would take them home; which train line was arriving--London Midland or Virgin--which ones ran straight through, which ones stopped at every town, what time each was due to arrive in Euston Station and which platform from which each would leave. Platforms usually are not announced until the last possible second.


   A canceled train meant the next one would be jammed to the rafters, as happened to us. As soon as a platform number was announced travelers shot off like fish traveling in shoals--first one way then another--as they raced to a platform to find a seat before there weren't any. As night falls every mother's brother's sister's cousin's son and daughter is seeking a way out of London.)
   Les showed me where the cash point (ATM)  and the toilets were and we left via a side exit to Eversholt street where we walked about 500 feet and stood waiting for the 168 bus--which was of course--diverted due to road works that began October 6th and will run until the 17th. This rather large diversion means the 168--which is scheduled to arrive every 6-10 minutes--is running on average thirty minutes late.
   This put paid to Les' brilliant idea of arriving early and walking up to Hampstead Heath to eat our homemade picnic lunch in the quiet of nature.  Instead we sat on the wall of the hospital facing Pond Street, people watching in the brilliant sunlight; specifically we enjoyed two groups of primary school children, walking two-by-two, holding hands as their minders led and followed.
The wall where in front of the RFH where we dined Al Fresco.
   The kids were full of joy about going on a field trip and so cute in their matching gray sweat pants and sweatshirts. They jiggle-jogged along the sidewalk like a large segmented caterpillar, only to pile into one another as the lead minder stopped suddenly every now and then to count heads. Their innocent joy was infectious.
   This was the third time now that we've eaten lunch wherever we could find a spot in a busy town for various reasons. I told Les he was going to have to stop spoiling me with all these romantic Al Fresco dining opportunities for fear they might go to my head!
RFH check-in kiosks.
   In the main lobby of the Royal Free Hospital the automatic check in machines are a world away from the ones at Watford General Hospital; like comparing an Ipad with a 1983 Apple Mac computer--remember the boxy gray units? Les' details came up in a trice and his appointment was confirmed with instructions for us to proceed to the first floor waiting room two.
   Professor D.--a liver specialist, instructor (this is a teaching hospital) and surgeon was right on time. We met with him and his nurse assistant. I took detailed notes as I always do for all Les' appointments. Professor D. took Les' general health history, examined Les (strong heart, good clear lungs, no liver enlargement or tenderness) and proceeded to tell us about Les' scan which showed 2 lesions on the right section of his liver. In his opinion they are doubtless rectal cancer cells which typically travel to the liver, since all the blood in our body sweeps through and is cleansed by our liver every 14 minutes and it travels from the bowels to the liver.  Professor D. said removing thirty percent of Les' liver on the right side (which automatically includes the gall bladder which is hooked into the liver there) offers Les "a very good chance of a cure, although there are no guarantees." Ah yes how well we know...
   "What about chemotherapy?" the Professor asked.
   "I'm not interested in chemo," replied Les. 
   "Have you spoken with an Oncologist?"
   "Yes, Dr. J. at Mount Vernon."
   "Okay."
   We mentioned we live on a narrow boat and continuously cruised and the Professor's face cracked into a lovely smile. 
   "Well then," he said in his Scottish accent, "We'll do the surgery aboard your boat. You've got a dining table, yeah? And some rum?" We laughed and nodded in the affirmative. "All right then we'll call it a day trip."  With that Professor D. left us with his nurse assistant to fill us in on some of the details.
   Les goes in next week for a pre-op and fitness appointment. The surgery will be scheduled sometime between then and November 2nd. It will take place at the RFH in London. Les will be on the operating table for 5-6 hours so with pre-surgery and post-op recovery it means I'll be waiting there all day. After recovery he will spend the first 24 hours in Intensive care and then move to a specialist floor. Recovery in hospital takes 7-10 days if all goes well (no infections) and then he will come home to recover further for another three months.
   So far the services received to date from the RFH have been good. Quick appointments, kept on time, and quick follow-up directly by phone.

    We walked hand-in-hand from the bus stop on Euston and Tottenham Court Road reveling in the beauty of London on a fall afternoon, strolling into the
Les snaps a selfie of our reflection in a window on a busy London street.
British Library for a mooch around the Folio Society Gallery on the floor just up from the main desk at the entry. The exhibits there are always free. This time it is "Enduring War: Grief, Grit and Humour." I was shocked to discover that Britain had been directly bombed in WWI by German zeppelins. This country has been attacked and bombed in two world wars and still it endures.

I could live in the British Library! This view is from our table across the street.
The sunset skyline of St. Pancras station rising behind the British Library.
Dear Sir waits for our vegetarian pizza to arrive as we sit and enjoy the view.
   We stopped outside under one of the large, white umbrellas covering the lunch tables so Les could take the next round of 27 pills he swallows daily now as part of a regimen to keep his weight and health up for surgery and change his blood chemistry so his body is no longer a willing and welcome place for caner to reside, for we know that the word "cure" as used by medical professionals must be translated to say "you may live for five years," five being the magic number chosen by researchers who found they could not realistically follow up on cancer patients past the five year mark.
   Chemo, radiation, and surgery do not cure cancer. Cytotoxic cancer treatments destroy cells--good and bad--with the hope the patient will survive the treatment and the disease will hibernate in remission. Surgery removes the diseased portions of the body. None "cure" cancer.
   We hope this was caught in time for us to reverse Les' body chemistry so that cancer can no longer continue to grow and flourish inside him and his immune system will grow healthy enough to stand guard once more.
   We are so very thankful for everyone's hopeful, positive thoughts and prayers on his and our behalf and the unwavering support we've been offered by our families and our community on the cut.
   We are thankful for each other and this glorious life of freedom and peace lived as continuous cruisers. We really appreciate Canal & River Trust officers working with us during this difficult time. (And I personally am thankful this operation is not taking place at Watford General.)



NB Valerie & Steam Train by Les Biggs

NB Valerie & Steam Train by Les Biggs