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Surgery 2021 – # 5 of 6: Follow-Ups & Mix-Ups

In the course of recent blogs, I have been recounting my adventures in the Manor Hospital in Oxford, where I had surgery to replace my replacement hip and remove a shattered femur which had failed to heal after an earlier operation.

When I was discharged from the Manor, I was told that I would be given an appointment two weeks after the operation to come back to have my dressings checked.

A couple of days before this appointment was due, I received a voicemail telling me that this would be a telephone consultation and not to come in to the hospital. This seemed a bit odd to me, so I rang them. I was once again told not to come in and that a doctor would call me.

On the appointed day I waited and I waited. No one rang.

The next day, I rang the Manor Hospital to find out what was going on. The person answering my call could find no note on their system to indicate what should have happened with my case the previous day. For that matter, there was no note on the system to indicate that the surgeon had seen my previous message enquiring what was going on.

At around 5 pm, one of the surgeons called. He didn’t know how the mix-up had happened but he assured me that they had definitely been expecting me to come in for a face-to-face consultation the day before.

What’s more, I would have seen a physio.

The surgeon ended our conversation by asking me to contact my GP and get a district nurse to check the dressing. So that’s what I did.

My GP was less than impressed. The hospital hadn’t given them any information about the surgery.

I pointed out that I had got a friend to deliver a letter to my GP that I was given on discharge from hospital. The GP told me, however, that this had turned out simply to be a list of medications.

I then tried to explain as best I could what the operation was that I had had. My GP listened in growing dismay.

I have to say that at this point the Community Health Team suddenly whirred into action. A district nurse came and removed the dressing on my leg which, by that time, had been in place for some time. The nurse assured me the wound was looking good.

Then another positive thing happened. An occupational therapist from the Nuffield Orthopaedic Centre phoned to ask if there was anything I needed. I asked if they could refer me to a physio at my local hospital, the Great Western in Swindon. Such a reference would not only involve crossing the boundary between one Area Health Authority and another, but also between the private health sector and the NHS. I wasn’t at all sure that anything would actually happen!

Despite my misgivings, though, lo and behold, a physio from the Community Health Team duly contacted me.

Wonderful!

At the time of writing, they have already been to visit me twice. This is so much better than after my operation last summer, when I was left to rehabilitate myself. The physio has given me exercises to do and organised for me to receive a perching stool to go in the kitchen, and for my sofa to be raised to a better level. It is so much easier to get in and out of the sofa now that I think I will keep it at this level.

The physio is due to come back next week and I hope he will be able to help me with other practical living and mobility issues.

Surgery 2021 – #4 of 6: Relief Supplies

I have been recounting my experiences in the Manor Hospital in Oxford whilst I waited for and then recovered from surgery. I suppose at this point I should explain what the new surgical procedure involved.

Well, they took out my existing hip replacement and the broken bit of my femur. They then gave me a new hip and put metal in right down to the end of my femur. I am metal now from hip to knee and have a very impressive scar to prove it.

One of the benefits of this approach was that, as they had taken away the broken femur, there was no longer any fracture to heal. One of the surgeons opined that, if they’d left the femur in place, it never would have healed. This was at least in part because my rheumatoid arthritis interferes with the healing process. Medical opinion was that this operation would give me more stability, which it has. I can stand on my two feet without holding onto anything and feel pretty secure, which I didn’t after the first operation. Even better, now, some ten or more weeks or so on from the operation, my leg is nothing like as painful as it was after the first procedure. The pain never did go away after that one.

Mind you, my leg was pretty painful in the weeks following this operation and, while I was in hospital, there were the usual issues over pain control. All was well at first. In the days immediately following surgery, the doctors ensured that I had sufficient pain relief for me to cope. After a few days, though, the nurses started commenting that I had very few of my morphine sulphate tablets lefts. These are the ones I use to control acute “breakthrough” pain. I asked what would happen if I ran out. I was told, “Well, our pharmacy may have them.”

This was vague and not very encouraging.

I discovered when they gave me my medication to bring home that they had simply been relying on the supply that I had brought in when I was first admitted. So much for private healthcare. In the NHS Great Western Hospital in Swindon, when they saw any of my medicines running low, they always made sure that they ordered more from the pharmacy. Fortunately, I was discharged from the Manor Hospital before my supply of medication ran out and I was able to get more from my GP.

It was unnerving, though, and raises questions for me about the contract the NHS has with the Nuffield Orthopaedic Centre.

Surgery 2021 – #3 of 6: Private versus NHS

As related in my previous posts, following an unsuccessful operation last year, I was referred to the private Manor Hospital in Oxford for an NHS operation to replace my hip and repair my broken leg.

I have to say that the nurses and health care assistants at the Manor Hospital were very kind. One took a long time helping me connect to the hospital Wi-Fi. When I discovered I had accidentally only brought the charging cable and not the plug for my phone, one of the night staff kindly lent me a charger for the night.

The only real difference I noticed at first between NHS and private care was that I had a room of my own and everyone knocked and waited for me to say “Come in!” before entering. I also think the curtains might have been made of slightly nicer material.

Then again, I didn’t find the food particularly special. At the Great Western Hospital (GWH) in Swindon, they have a different menu for each day of the week. It’s true that if you are in for more than seven days, the same choices come round again but, in the meantime, each day is different. In contrast, the menu at the Manor Hospital was exactly the same every day except for Sunday, when there were fewer options but one of them was a roast.

Oh yes, I almost forgot: the tea at the Manor Hospital came in a pot, and the milk arrived in a proper jug. All very civilised.

At GWH, I was cared for by nursing staff and they were always very good about anticipating my needs. As I can’t see, they would explain what was on my plate and where the different items (meat, potato, veg etc) were located. They would also offer to cut up my food for me, which was very helpful. The food at the Manor was served by catering staff and, until some of them eventually got to know me, I had to explain to them each time what I needed.

When I first arrived at the Manor, I was told that I would be going down to theatre early the next day, but a problem soon arose. Due to having had a large blood transfusion some years ago, I had antibodies in my blood and, before they could operate, they had to be sure to match the blood I might need very carefully. This meant sending test results to the John Radcliffe, a nearby teaching hospital, and waiting for them to send over the right blood products.

Whilst I waited to go down to theatre, I started to explore my table. I found a remote control. It felt very similar to the remote I have for my Digibox TV receiver at home. I tried pressing buttons. Lo and behold, a TV came on! Even better, it was Freeview, like I’m used to, so the channels were where I expected them to be. Even more wonderful, the audio-description was switched on!

This TV became my lifeline. After surgery I was in a lot of pain and discomfort. I had no visitors so there were an awful lot of hours to while away. I put the TV on a station which ran back-to-back detective shows and watched it from mid-afternoon till 2 o’clock in the morning.

I wouldn’t have been able to do this if I’d been on an NHS ward. Another benefit of being in a room of my own!

Surgery 2021 – #2 of 6: Sent to Oxford

As I explained in my previous blog, I was told in January that the operation to repair my broken leg last summer had failed and I needed urgent surgery.

I was informed that two consultants at the Great Western Hospital (GWH) in Swindon had had to clear their diaries for what could be an all-day operation. They would remove my original hip replacement, install a new one and put a piece of metal down past the fracture in my femur (upper leg bone).

Three days later, one of the consultants phoned me. There was a problem. Because I had arthritis as a child, I have narrow bones, and they didn’t have a prosthesis small enough to fit me. They had decided that better results would be achieved by a different operation and were referring me to the Nuffield Orthopaedic Centre in Oxford.

This is a centre of excellence but I viewed the change in plans with some trepidation. I would have preferred to be in my local hospital, not one an hour’s drive away. However, if it was for the best, then so be it.

I asked about transport but none was available. So, it was going to have to be a DIY job.

It turned out I was actually being sent to the Manor Hospital, a private concern run by Nuffield Health which, nevertheless, does take on some NHS work. While they were happy to accept the ECG and other test results provided by the Great Western Hospital, they insisted on doing their own Covid test before they would admit me. This meant that I had to pay a driver to take my assistant Mary and me to Oxford the week before the proposed admission for a test that had already been carried out by GWH.

Oh well, who am I to question the strange ways of hospital bureaucracy?

Thankfully, the Covid showed that I was free of infection so my niece kindly drove Mary and me to Oxford the day I was admitted. Once again, because of Covid regulations, Mary couldn’t stay with me and, of course, I couldn’t have visitors so, once she had handed me over at reception, I was all on my own.