Is there life after day surgery?
As hospitals are pressured to carry out ever more day surgery, Cherrill Hicks describes her own swift return to family and work, and Annabel Ferriman asks if the NHS gives adequate support
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Your support makes all the difference.One horrendously early Thursday morning last May I checked into the day surgery unit of a London teaching hospital for an operation on my varicose veins. I was apprehensive, but grateful to have been squeezed in as a day case: the veins, in both legs, had been getting steadily worse, constantly ached and were so ugly (like bunches of grapes, someone said), that I'd taken to wearing trousers all the time.
I'd been told what "stripping" entailed: a general anaesthetic and an incision (about 2in) into each groin, through which the major defective veins would be pulled out using a special wire. A dozen or so tiny nicks in each leg would also be needed to remove surface varicosities. Home by early afternoon. With two small children, would I be able to cope? "You'll need paracetamol,'" said the consultant. "Get your husband to look after the kids this weekend."
At 9am I was wheeled into theatre. About two hours later I woke up, in some pain, with both legs swathed in bandages. I was given a shot of morphine, a cup of tea and a biscuit and told to rest for as long as I wanted.
At lunch time my partner arrived to collect me. I hobbled unsteadily to the car, armed with a packet of strong painkillers, a wad of dressings in case of bleeding, a pair of thick support stockings to replace the bandages and a leaflet which said I might experience "some discomfort". By this time I was so high on morphine, I felt ready to step into a microskirt there and then.
A miracle of modern day surgery? I'm not sure. The day unit was wonderfully swish, the nurse who looked after me was kindness itself, the anaesthetist reassuring and my consultant surgeon, I'm sure, top-notch. But no one warned me just how long it would take to recover or just how severe the pain would be.
I confess I quite enjoyed the first two or three days. While I reclined on the sofa, and took, as advised, the occasional gentle exercise, friends came to cook meals, my partner took time off work and other mothers helped out with the children. As long as I didn't try to do too much, or stand for too long, the pain was manageable.
But after that time the help faded away: friends had their own lives, and my partner a business to maintain. However, I was still far from mobile.
It's not easy holding down a job and looking after two children when what you need to do most in the world is put your feet up.
The worst memories: hobbling to the stove to get supper with a crotchety - and heavy - toddler on my arm; sitting in front of the computer screen at work, unable to think clearly and trying not to cry - even the walk to the coffee machine seemed too much effort; the house reaching chaos levels, with the children living off baked beans and wearing crumpled clothes; standing on the green outside our house trying to push the two- year-old round on his trike, desperate to put my feet up and weeping with self-pity.
Anxiety exacerbates pain. Within a day of the operation a purple-black bruise had appeared on each tender and swollen thigh; as the days passed it gradually spread to the knee. Was this normal? Or did I have a deep- vein thrombosis, a clot, as can happen after surgery? My leaflet advised calling the GP: he did his best to be reassuring.
Ten days came and went; while my right leg was definitely on the mend, I still couldn't put any weight on the left or even stretch it straight. I wondered why it was taking so long to heal; in my worst moments, usually late at night, I began to doubt if I would ever walk properly again.
Finally I telephoned the consultant. Why did it take so long to do so? Articulate and middle-class as I am, I share with many patients the desire not to be a nuisance, not to be thought neurotic or over-anxious. He was impeccably polite. Sorry to hear it was taking so long. If the "tracking" - the path left by the wire - became bruised it could become painful.
Finally, after what seemed like an age, I began to feel more myself, became more mobile. A check-up six weeks later found everything to be normal, although even now the scars ache when I get tired. My condition had not been life-threatening but I had felt vulnerable, as though I needed looking after; as though for a while I should have been cocooned away from the world, rather than being thrown back into it so brutally.
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