15) Infection

  Before I went for surgery, I did quite a bit of research into what I should expect. I like to know what’s coming and be prepared. I knew I would wake up in the recovery room with an intravenous drip and a catheter, I was ready for pain and sickness and I was well aware it would be a long road to get back to normal. I remember seeing two diagrams illustrating the process of recovery. One was how it was imagined, a graph with an X axis of time and a Y axis for improvement. A perfect straight diagonal line was the imaginary recovery, each new day along the X axis meant a little further up the Y axis of feeling better. This was juxtaposed with a diagram of actual recovery. The perfect diagonal was replaced with a meandering line, a squiggly up and down just like a snakes and ladders board, a few steps forward followed by a drop back down. But as I approached the four week mark after my surgery I was feeling quite confident that now I was on the perfect diagonal, so when I landed on a snake it caught me a little by surprise.
  My long scar was healing as expected, I was following instructions and not lifting anything that weighed more than a small piece of tissue paper so everything seemed to be going to plan. The non dissolving dissolvable stitch had been removed from the sight of where the drain had been so even though it looked a little red, I was not at first unduly concerned.  I felt a little niggling pain, but expected that to pass. Perhaps there was still a suture there that was hiding away under a little scab, irritating like a splinter that lies beyond the reach of tweezers or maybe it was just taking a little bit longer than expected to heal. I could feel something causing an annoyance, the sensation was similar to the last left over, non dissolving stitch, but nothing was obvious to see. It was a Saturday night when it began to get steadily more and more uncomfortable. It is Sod’s law that it would happen on a Saturday night, as no doctors are available and our nearest casualty department shuts at ten in the evening until the following morning. Unfortunately there are insufficient staff available to keep it open. The pain got worse and radiated away from the wound  across my abdomen and even around to my back. Sharon thinks we need to get it checked out, it’s not an emergency so we will need to telephone the NHS out of hours service on 111.  I’m sure it was a human and not a computer I was talking to but the questions I was asked at times seemed a little bizarre, as if generated by an artificial, not very, intelligence. I was eventually told that a doctor would phone within six hours and advised to take both paracetamol and ibuprofen for the pain. I pointed out to the call handler that as I was still giving myself a daily post operative injection of an anti-coagulant, I would avoid the risk of an unwanted bleed and stick to the paracetamol only.  It’s just gone eleven, very late for us, so the phone is left next to the bed and we both try to sleep.
  I actually slept quite well, the pain was lessening, and I was very tired. The phone rang at around ten past seven in the morning which woke us up. I’m quite glad it wasn’t within the promised six hours as I had managed a restorative rest and now feel a lot better. The doctor would still like to see me though, so an out of hours appointment is made for later that Sunday morning.
  He is looking very closely with a bright light at the wound and it actually looks quite good, at lot less red and inflamed than yesterday. He has a little prod around with his fingers and Sharon, ever my advocate, asks him if his hands are clean. “Well, it’s not an open wound” he retorts and begins typing on his computer, hands still unwashed. “It doesn’t look infected and I can’t see a left over stitch so there isn’t anything that I can do” he says and then continues “but you should make an appointment with your own surgery tomorrow.” It is a good job that I do as the next afternoon as the nurse practitioner takes the dressing off she is confronted by a weeping, oozing infected wound. So now I am on a weeks course of antibiotics and hoping that they don’t cause me diarrhoea as my bowels were just beginning to get back to a degree of normality.
  The nurse has made me an appointment to see the doctor later in the week to check the progress of the wound. When four days later I see the GP, she prescribes a different antibiotic for a further seven days. It is just as infected but she agrees with me that there may a stitch hiding away.  “I can’t see anything for sure but I think you should come back in a few days and I’ll have another look.” So I go on applying a new dressing each day and taking the pills which are so huge I think she may have prescribed suppositories by mistake.  On the next visit she is armed with tweezers, a stitch cutter and a determined look on her face. There is far less oozing pus and she believes she can see the top of a suture. Lying down, the action is outside my field of vision but I can feel the probing, pulling and sharp stabbing pain and then eureka, there it is, the offending centimetre length of surgical nylon held aloft like a hard won trophy. I could give her a grateful hug but decide against it and re-fasten my trousers instead.
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