Friday, 19 December 2014

8 days in hospital - what to expect

It's now just under 4 weeks to my surgery and after last weeks talk of lists, I felt that it may be useful to write about what I can expect during my 8 day stay in Brighton. The Nuffield provide you with a well written "itinerary" for your stay and I'll borrow from that alongside experiences I have listened to from others that have had this surgery.

Monday - Admission

I have to arrive during the afternoon between 14.00 and 16.30, a nice comfortable window but rest assured we will be travelling early to avoid traffic issues. Once admitted, I am started on a low residue diet which in basic terms is one which makes less matter exit the body from the other end. Standard observations (weight, height, pulse etc) are taken along with a urine analysis and possibly a blood test.

Tuesday - Operation day

I have been told I am the first operation of the day although I am of the mind that this could change. Assuming it doesn't, I will be nil-by-mouth from the start of the morning. The following will then happen although I am not sure which order:
  • I will be given a phosphate enema to clear my bowels. These are a particularly aggressive type of enema and will be an interesting experience.
  • Observations will be taken.
  • I have to have a shower with a special sponge.
  • I put on special TED stockings that help prevent clots forming in my legs
  • I will be visited by the surgeon, discuss any questions I have and then sign a consent form in front of him.
  • I will speak to the anaesthetist who will discuss my medical history with me.
Following all of that, I am then taken down to theatre and have my surgery. Something I have been told is that I will possibly be asked more than once whether I am sure about whether I want this surgery including at the theatre doors. I am 100% certain I will still want it!

The surgery and recovery will take about three hours and when everything is normal, I will be returned to my room. I will be on my back in bed for most of the next 5 days and between my legs will be a pack. This pack consists of a dressing around the external surgical site which will also hold in an internal pack that was inserted into my new vagina during surgery. This will hold my new vagina against the walls and encourage it to heal into place. There will be a catheter in place because I will be physically unable to urinate whilst everything is healing. Also the new urethra will be too swollen so catheterising helps to reduce this swelling.

I will have two drains within the surgical site to help reduce swelling. I will also be on intravenous (I.V.) fluids to keep me hydrated as well as being administered I.V. antibiotics. 

Finally, I will be wearing special boots around my lower legs. These will inflate and deflate and their purpose is to keep blood flowing around the calf muscle and reduce the risk of clots forming.

Wednesday - Day 1 Post op

My bloods will be taken in the morning. This day, I also start on a clear fluid diet which consists of jelly, sorbet, black tea or coffee and the infamous Brighton Consommé (speak to anyone that has had this surgery here and they will remember this!). I am still on I.V. fluids to start with although they are stopped at some point this day. I also have an injection (Clexane) into my abdomen to help prevent blood clots. Medication will be offered to help with pain relief and I will have regular observations. I will be lying mostly flat this day.

Thursday - Day 2 Post op

(The next few days follow a similar pattern to Wednesday so I will just note anything that is different from now on)

I am still on a clear fluid diet but in the evening I restart on a low residue diet which will consist of some toast. I will also have my last I.V. antibiotics today as well as the drains being removed. Everything else is the same.

Friday - Day 3 Post op

This day is a low residue diet, but I am unsure what this consists of! I also have an assisted wash and can sit a little higher in the bed.

Saturday - Day 4 Post op

Saturday, I should have the luxury of being able to get out of the bed and sitting in the chair for 30 minutes morning and evening. I will resume a light normal diet as well as being given laxatives to keep me moving!

Sunday - Day 5 Post op

To say this is a big day is an understatement. This day my pack is removed and I get to see my vagina for the first time. I am not even going to think about what this is going to be like at the time of writing, but I am certain this is going to be a very special moment. 

Following on from that, I am dilated by a nurse for the first time. I am then going to be taught my new anatomy and this includes being shown how to dilate. An assisted bath follows and then I will be taught how to douche. 

I am also on a normal diet as well as being given more laxatives. I have also heard some talk that there may be another enema involved somewhere although this is not mentioned in the notes I have now. If this is the case, it is certainly not of the same violent nature as a phosphate one!

In the evening, my catheter is removed along with antibiotics given. If things go well, I may well have my first pee in the night!

Monday - Day 6 Post op

The list for this day in my notes goes as follows and :
  • Patient to dilate three times today
  • Breakfast, dilate, bath and douche.
  • Lunch, dilate, bath and douche.
  • Supper, dilate, bath and douche.
This is a routine I will have to follow for at least 6 weeks before I can reduce the amount of dilations. 

A nurse also has to check if I have passed urine at least six times and measures each one! A nurse is also on hand if I need any help at all.

Monday - Day 7 Post op

It's breakfast, bath, dilate and douche again but then I get everything checked prior to being discharged by 10.00 am. The journey home could be interesting and I have taken on board some advice for this. It is not an easy journey, the roads are awful when fit, so it will be something I will have to get through.

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