UTI

August 2013

I was at home gradually recovering from my surgery, watching the London Olympics and eating grapes. One morning, I ate my Crunchy Nut Cornflakes as normal. As I watched the triathletes embark on the swim around the Serpentine in Hyde Park, very suddenly and without any prior warning, I was sick. Miraculously, my wife managed to get a waste paper bin under my mouth to catch the output.

I didn’t think much of it. I felt perfectly OK. Strangely, my wife (for once) didn’t seem overly concerned either.

The same thing happened the next day – 30 minutes precisely after my breakfast, I was heaving into a plastic bowl. This continued into a fourth day when my wife suggested we called the Marsden to report this exciting development. I was reluctant as I suspected I would be summoned to hospital for a test and not get out. My wife took my temperature. Before the gadget was out of my mouth, she had picked the phone up. This wasn’t a good sign – ‘Hello – my husband is vomiting and has a temperature of 38.7’.

Before I knew it, we had packed a rucksack, turned the Olympics off and departed for the A&E department of Kingston hospital. We registered and sat in the waiting room with a load of people, who, like me, on the outside didn’t look overly poorly.  This was my first ever visit to a casualty department and slightly disappointing – where were the ‘I had an accident with a chainsaw’ type injuries ?

I was triaged by a young, attractive nurse. Which was nice. Her eyes glazed over as I gave her my medical history. She led me to another waiting area and took some blood and urine samples. After a while, inevitably, I was told I had an infection and needed some antibiotics. Not just pills like anyone else but IV antibiotics. Into my arm. Using a canula. That took three attempts to get inserted into a vein,

Eventually, after a couple of hours, I got taken to a ward and shown to a bed. A nurse went to get me a pillow as I was having a sleepover. She came back with a pillow case which looked like it had been stuffed with a blanket. My wife saw this and interjected – ‘Sorry – but is that a pillow case stuffed with a blanket ?’ ‘Err, yes – it’s Sunday you see and we are waiting on laundry services’. My wife (a nurse) nearly exploded with rage (it’s strange what she gets worked up about) and after a lengthy exchange during which I kept quiet, a clean, white pillow was brought to my bed.

I thought about asking for four more as, at that time, I used two pillows for my head, had another between my legs and two more to prop me up and ensure I didn’t roll onto my back. But I thought that might be pushing NHS resources a little too far.

After some drugs, I didn’t feel any better because I didn’t really feel ill in the first place. However, they took my temperature and seemed reassured.

The next morning a doctor came and told me I was progressing well but I being referred back to the Royal Marsden in Fulham Road ‘because of my complex medical history’ and to be seen by the urology team who performed my surgery. That suited me fine as the food was much better and I would have my own TV so I could watch the Olympics and request five pillows with no questions asked.

So I arrived at Fulham Road and saw some familiar faces, the very same nurses who had waved me ‘Goodbye’ in July. They took some more blood and resumed the IV drip. They came and took my lunch and tea menus.

The urologist was concerned about the creatinine levels in my blood tests. They were off the scale apparently which meant my kidneys weren’t functioning very well. He wanted to investigate this as a matter of urgency and proposed squirting a colouring agent back through my waterworks. to check the flow.

The test was duly performed in the X-ray room and the nurse told me ‘Oh – well here’s the problem. Your left kidney is blocked and not passing any fluid at all’.

I thought I could fix this by drinking three gallons of water and gently squeezing my left side but the urologist seized upon this exciting piece of news as an excuse to subject me to another medical procedure – a nephrostomy. So the next day, I found myself in another small medical consulting room with a doctor inserting something into my back to reach the left kidney and take some photographs of what he saw. It was a short procedure and didn’t hurt too much – a slight discomfort.

When it was over I got off the bed and said to the nurse ‘Thanks for the sedative – worked really well. Hardly felt a thing’. She smiled and said ‘I didn’t give you any sedatives. I was watching you closely and you seemed to tolerate it pretty well without any pain relief’.

The urologists looked at the photos and concluded my left kidney ‘showed dilatation at the exit’. Basically, the tube was blocked or narrowed – probably as a result of scarring after the original surgery back in May.

Great – so now what ? As ever, the urologist had an answer – he would simply insert a stent (a very small plastic tube) to widen the tube, keep it open which would hopefully resolve the situation. And the even better news was – they could use the nephrostomy to carefully insert the stent into position.

So the next day, I was back in the same small room, staring at the same nurse who wasn’t going to waste any sedatives on me. Doctors did stuff, looked at ultrasound images and inserted the stent.

Back on the ward, my wife posed one of her pertinent, probing questions to the Professor – ‘Even if the creatinine levels return to normal, how will we know whether the left kidney is, in fact, working again. It could be masked by the right kidney compensating and doing all the work. What if..’

The Professor who was a world renown expert in his field, with over 30 years experience in urology, politely interrupted with the calm, reassuring air of a man who had seen and heard it all before.

‘Mrs. Brightside – you ask a very good question and you raise a perfectly valid concern but there are tests we can run, investigations, non-invasive procedures we can perform…’.

I didn’t like the sound of this – ‘procedures we can perform’. Couldn’t we simply just check the colour of my urine and say ‘Looks OK to me’ ?

Before my wife could reply, the urologist said with a smile that he had given to hundreds of medical students over the years – ‘Yes, we can always squirt the colouring agent the other way, you see’.

And with that, he and his entourage left the room.

Anyway, I completed the course of IV antibiotics, I stopped puking, they removed the nephrostomy, left the stent in and after another week, I was discharged.

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