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Blog - Nick Lewis

Hospitalisation

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Watercolour painting of a sea front from the sands looking back at a promenade of beach huts and houses

Southwold 1996. Image © Nick Lewis

We booked late for our annual holiday in Southwold, in September, and so we missed our usual house above the beach. The new one wasn’t bad, but it brought the rain and broke the spell that the town seemed to cast over our July breaks. Mother went home early, possibly because we had our new baby Lewis and couldn’t give her as much attention as usual.

It was raining as we left; one of my sticks slipped on the wet concrete drive as we were packing our car; I fell, broke my leg, and almost sunk my teeth into the car tyre to ease the excruciating pain.Someone called the doctor and an ambulance. Both were very welcome, and necessary. The doctor gave me a shot of analgesic; the ambulance paramedics scooped me up and kept the pain-killers going.Ipswich Hospital orthopedics immediately operated, fixing my fractured femur with a steel pin stretching from hip to knee. Meanwhile they transfused me with several leg-fulls of blood. A helpful nurse told me later that in wartime many soldiers with broken femurs used to die from loss of blood.

I got acquainted with the other inhabitants of the ward. The first question was: why were they there? One elderly man had left his alarm pendant in the bathroom. He fell over and fractured his arm when he was getting out of his armchair to go and get it before he made a cup of tea. It took him hours to inch over to the other side of the room, where the alarm system was based, and then reach up from the floor and press the button. By the time help came, he said, he was really desperate for that cup of tea!One man had fallen off a ladder while trying to replace a tile on his roof and one young man had been playing an informal game of football in the lunch break at work and had kicked a curb instead of the ball. Ouch!

The composition of the ward kept changing in about even numbers between genial local people who have come to grief, and very ill elderly men confused by tubes inserted into their wrists to provide them with life-giving nourishment or catheters to drain away the liquid byproducts. It is a real problem for a nurse to explain to a bewildered old man exactly why he has something protruding from his penis, and tell him off for clutching at it.

While I was hospitalised, I was encouraged to drink as much as possible; they fitted me with a catheter to drain away the contents of my bladder. This seemed to me an admirable situation. MS makes you lose control of the muscles regulating the bladder and so you are forever wanting to have a piss, sometimes very urgently.

Doctors had prescribed me tablets to solve the problem, but they were never very effective. And so it was a relief to be comfortable, at least in this department, while I was in hospital. On discharge, it was wonderful to be back home with my little family. My sister Kate and my friend Liz, who had helped Tio come to see me more or less every day, were also there. I was overwhelmed to have them all around me.

Convalescing was nice too. Until that is, I was knocked over again by my bladder. I felt as if it had been taken over by one of those mediaeval fools, inflated, and swung around to belt me in the belly. “Aha!”, said the clown, “You thought you’d got that sorted. That was just a trick. Let’s get real.” Try as I could, I could not wee. The pain became excruciating, and so there was nothing for it but to call the ambulance to take me to Casualty, where to my great relief they inserted a catheter once more.

Unfortunately, the doctors decided to keep me in King’s College Hospital, in one of those massive old general wards the size of a football pitch, where the nurses, at full stretch in those Thatcherite days, busily strode up and down with their eyes glazed and firmly fixed on the horizon, determined not to meet a patient’s eye and be coaxed away from the set curriculum.

The regime in that general medical ward was primitive. Meals, washes, bottles, bedpans, commodes and a medicine trolley once or twice a day. I was surprised that this kind of place still existed. Very soon they shifted me; just, I think, in case I made a fuss in the outside world.

The new ward was pleasant enough, and I soon got to know the patients in my bay. Opposite me was a terminally ill cancer patient, John, whom I liked a lot. He and his wife were concerned that in many wards where he had been treated, weak and elderly patients tended to be neglected.

At mealtimes, their food was often put down out of their reach and then carted away if they hadn’t eaten it. One day John fell while he was getting out of bed to use his wheelchair. I couldn’t move, and there were no nurses about, so I pressed my alarm button.

After several minutes, during which John, clearly distressed, sank further onto the floor, a nurse arrived. She hauled him into a sitting position, threw a blanket over his shoulders and hurried off, apologising that they were in their “clocking on” meeting.

This is command economy “Stalinist” behaviour, in which people do what is expected of them by some bureaucracy rather than treating people with humanity. I have met it and, I am ashamed to say, done it myself. John survived. For a time.

Sue, the Continence Nurse
Another nurse breezed in, this time to see me. She announced herself as Sue, the Continence Nurse. “I have come to teach you how to use a catheter,” she said. I had been briefed by a doctor the day before that somebody would come to talk to me about my urinary problems, but this plump, well endowed woman surprised me.

In a reassuringly capable way, she asked me to pull my pyjamas down below my waist and proffer my penis to her. She donned rubber gloves, produced a package about twice the length of a classroom ruler, and ripped the paper cover off the catheter. Then she squeezed some kind of lubricating jell over it and inserted it into the opening at the end of my penis.

I had always thought this hole to be rather small, but having now become better acquainted with it, I realise that it’s quite big enough to accommodate a 14mm plastic tube. I helped her to thread it, right down through my penis and urethra and then, with a slight push, through a valve into my bladder. Magic! Just as if I was having a piss, the urine came peeing out into a jug. The nurse left me some catheters to try out, which I did the next time I wanted a pee. My immediate thought was what a wonderful woman Sue was. She probably has a following all over South London.

Since then, intermittent self-catheterization (ISC) has been the way I have a piss. Initially, I interspersed it with the traditional method, but it was not long before urgency, combined with lack of mobility dictated exclusive use of the catheter. I have given up nostalgia for the ability to have a pee whenever you need one for the certainty of not pissing myself or alternatively living in the toilet. Courtesy of the NHS, we ISCers simply siphon our bladders three or four times a day. I am technically incontinent of course, but I no longer feel it.

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