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Wednesday, 16 December 2009

Pre-admission assessment

To be honest I found this a rather unpleasant experience. It wasn't because of the people, they were all doing their jobs, it was because it makes you focus very clearly on what is going to happen and it really brings home the fact that it is going to happen.

The first person we met was a Stoma nurse, who talked us through the mechanical details of a stoma, the procedure and other such details. This made feel faintly sick and actually consisted of information that to be honest I mostly already knew. I could see that is important to have this conversation from a systemic point of view.

There was one slightly strange bt of dialogue when John said

"We are very good at causing pain, and we're very good at taking it away again . . ." which I have to say I found a little unsettleing; reminding me of a scene from the "Marathon Man" - the torture scene between Dustin Hoffman and Laurance Olivier:

Olivier to Hoffman:
(Having just drilled into Hoffman's tooth)

"Simple oil of cloves and how amazing the results. Life can be that simple; relief - discomfort. Now, which of these I next apply, that decision is in your hands, so ... take your time and tell me. . . . is it safe?"

There was also considerable discussion of, and viewing of bags. This made me feel even more odd, although I had seen some before. We discussed how to maintain, empty, replace, pay for these "fashion" items.

"Now I have to site you" he said


"We have to decide the site of your stoma"

I had to pull up my shirt and the position of my waistband, was noted. We had a brief conversation about lifestyle which included things such as my daily swimming, and he drew a black blob on my tummy to the right and below my navel. That done we were off upstairs to another department.

Upstairs I was welcomed and we were shown into another small office where a very professional, intelligent and human nurse went through more details.

I have been put on a fast recovery plan, and I was given some drinks with lots of "good things" in them to drink before the operation. She took my pulse and my blood pressure as well.

Then she brought up the question of MRSA - had I had it at all? and other such questions. Then she said I was going to screened for MRSA and that this would involve a swab up the nose (fair enough) and a swab of the perineum (How do they manage to come up with such elegant forms of humiliation?) I started to feel really nervous about that.

Then another nurse came in to do the MRSA swabbing- the swabber. I was OK with the nose which tickled but all the time I was thinking "Yeah . . . ? And . . .what about the next bit . . . " Luckily I was allowed to retreat behind a (hideous) curtain and do this myself.

Next it was a doctor who came into the room and interviewed me. The stuff you would expect really. Medical history, relevant medical history of relatives, smoking, drinking, allergies, etc. Then there was an examination on the little bed.

On spotting the dark circle made by John she asked

"How long have you had this mole?"

"What mole?" I looked down my body - "Oh! Hah! you got me there- anyway it will be bigger next Wednesday. Ha Ha!"


This time I wasn't sure she was joking, and I reflected that she seemed very young and that many of her questions had seemed a little odd. Not only that I had seen her with an older doctor earlier and he appeared to be briefing her.

It is a teaching hospital, and I of all people believe in learning and teaching, but I have to say I felt a shiver of . . . well actually it was fear.

FEAR for my tiny little fragile self. How pathetic! "Pull yourself together man!"

And here is the thing; I might look like i am 53, 6 foot, hairy, and all that other grown up stuff; but inside we are all vulnerable and emotional children. That includes the doctors.

After that it was just a matter of blood tests and an ECG. A piece of piss you might say - oh no I did that earlier.

I am fit for surgery!

I can't wait. . . .

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