Chapter 4

Friday 28/2 : The Day of The Operation (Under The Wires)

On waking up: sounds. For some reason (could it have been another song from the album? maybe it was the obvious choice), All I Ever Am was the song in my head so I decided to play it again (possibly one of the first times I didn’t listen to the album in its entirety, not that I would have had the time there), and it turned into that intense emotional moment when I couldn’t stop the tears. And I remembered maybe, sometimes, it is good to cry. I wasn’t fearful of the operation, my world didn’t collapse (the immediate world collapse was on Tuesday), just, I don’t know, some of the good luck messages and love I received and yes, despite no huge apprehension, the appreciation that I would necessarily be facing a period of uncertainty. A Fragile Thing was next, but somehow less affecting this time. Time for the last Betadine scrub (no brekkie obviously, not even water), dressing up (Hope of the States T-shirt, Paul Smith Zebra sweatshirt, Arsenal winter tracksuit bottom (bought for last year’s training and very handy as they were basically the only thing I could wear over my leg with the unzippable bottom part of the leg) and one running shoe (I might have mentioned above, choice to privilege cushioning and try to protect the left achilles).

The pharmacy opened at 8.30am so I called a few minutes later, explained the situation (glad I got another person again) and was told that oddly the order for the plasters seemed to not have been made – another black mark for that one pharmacist then- so they could only get them the next morning. Which was fine.

The taxi was booked for 10am, Ben planning to be around for 9.45. I was initially planning to kind of ‘brief’ him and ask him about a couple of things I needed done, but I realised that it was me panicking a bit about whatever state I’d be in after the operation. As I was able to prepare my own stuff (backpack for the boot, front bag for all the paperwork, jacket with zippable pocket for ID, keys and phone – I decided to take only one phone for practical reasons – the personal one), I realised I didn’t even need him to come up. As the clock was ticking and he was slightly delayed, I figured I’d get ready by the interphone to optimise timings and movements. Just as he rang the bell, I got notification that my taxi was here already, seven minutes early, so I told Ben he probably didn’t even need to come up, and I just met him inside the lobby, still very helpful to open that heavy door and the outside one too.

The taxi driver, as ever with G7, was friendly and helpful, and we got dropped outside the hospital with plenty of time to spare.

I registered into the machine (which was weirdly set to one hour early, so UK time rather than summer time, or maybe it is just meant to be UTC?), which asked me to confirm I had an appointment with Dr Sigonney at 12.26. So I guessed it was the actual operation schedule time, which made sense as I had roughly inferred the night before, with me being asked not to eat six hours before the operation in generic notes, but also from 6.30am in the secretary’s e-mail. It leaves two hours for registration and preparation, which is ample time. We then sat down, waiting to be called. At 10.21 (somehow I checked), I got called (well the number appeared on the screen), and the formalities were quickly done. A couple of forms to sign and a piece of paper confirming the individual room and that it had been paid for. I think I might have forgotten to write it above, but during pre-admission, I was asked if I wanted an individual room, to my surprise as I wasn’t staying over (my previous two hospital operations were not in ambulatoire), and the lady had said ‘yeah, but your mutuelle allows it’, so I was happy to take it. I was also given a sheet with labels.

Next stop, fourth floor, handling over the labels and waiting to be called. I told Ben he could then go and do his stuff and I’d call back once I know about release time, probably about 2 or 3pm at the earliest. Wrong pronunciation again next, I think (a few got it right so I might not remember all the occurences accurately, but honestly I have never heard my name pronounced wrong so many times in a short period of time during these days), the nurse had to fetch the badge from another one in the waiting room to re-open the door as I couldn’t get there quick enough, and I was greeted by the first standard observational hospital ‘joke’ about left and right as we entered the patients-only area. I was led to my room (weirdly I didn’t memorise the number). I was given the instructions there about the lockable cupboard, how to put on dress, scrub cap, foot sock on the non-operated foot and just rest until I got collected.

As I lay waiting, many thoughts occurred but I can’t really recall now.

A brancardier (stretcher bearer?) eventually arrived and that’s when he folded the arms of the ‘bed’ and unlocked the brake that I realised that what I thought was an oddly very narrow bed was in fact a brancard a stretcher with wheels (brancard). Down in the lift to the operation floor (first floor I think?) until he handed me over to the next one (‘Jacques’) and he said ‘goodbye see you later’. I was surprised thinking that wow, they’d use the same guy to get me back in, but I am now guessing it is a standard hospital formula, not personal. Perhaps designed to make people feel safe and confident that after the operation they would be wheeled back by an already familiar face? After all, I think the nurse who left me in the room might have said the same (though I was less surprised then, thinking it was likely I’d see her again), but I never saw her again either.

I was put in a ‘parking spot’ next to a younger guy, with a TV showing something like The Young and The Restless [as you can imagine, I had to look up the original name, I only knew this series as ‘Les Feux de l’Amour’, and certainly wouldn’t have recognised it if not told by the anaesthesist when he wheeled me back there] which I found slightly annoying but after a bit managed to abstract myself from. A bit of waiting and overhearing hospital banter/conversations (with some bloke seeming to resent not being greeted by a kiss from the orthopedic department head nurse anymore) before I got taken care of again.

I forgot most of the names unfortunately, but the next nurse who appeared was working for the anaesthesist, and prepared my left hand for the catheter (after the hospitalisation it took me a couple of days to realise that my left hand looking bruised for a while was because of it), and gave me some more helpful details before carting me to the anaesthesist’s room. The first thing I saw was two big circled 23 numbers in front of me, at the same time making me think of Sol Campbell, and reminding me that earlier this week had been arseblog’s 23rd birthday. I was only going next door though, at number 22 (all that was probably less than ten metres from my ‘parking’ spot anyway), to be greeted by the anaesthesist with the ‘oh it’s your right one, is it?‘ joke again but augmented by ‘I have a good sense of observation, don’t I? Luckily for you I am good at other things too’ (cant remember the exact words), and his intern I think (younger guy he had to show the ropes to). There was good human contact there, so I was at ease. The nurse finished setting up the IV while the anaesthesist was getting ready. Whatever was injected there I don’t know, maybe I was told and didn’t remember, all I can say is that if it was a sedative, it was very mild. Having to untie the top of my hospital robe to set it all up, the much amused nurse remarked I had made some sort of double knot (she called it triple), the truth being I didn’t quite know how it should be tied. Anyway, her job done she left, with thanks and goodbye, another friendly and helpful person. I got explained how the loco-regional anaesthesy worked in some details while it was happening, and found it fascinating, what with viewing everything on the screen. The anaesthesist showed me where nerves where (while explaining all the tricks to his intern), where he was aiming, and it was like an exploratory journey where he probed and injected there and then. Obviously, while I could see what he was telling me and nerves moving etc, I was not truly able to distinguish nerves/muscles/etc. but I could tell I was in good and safe hands. Sometimes there was a minor but expected pain as a membrane was pierced through, but the only possible painful thing he asked me to signal if it happened, a clear electric discharge, never occurred. To be fair, he seemed pretty confident it wouldn’t so I wasn’t worried. This was apparently helped, as he said, by me having ‘beautiful nerves’ (adding ‘I bet no-one ever made you that compliment, did they?’ for good effect. ‘Indeed, it’s a first’). Then once done he announced there was a second injection to make, possibly slightly trickier (as illustrated by the happenings on the screen), on the front of the thigh, not in direct connection with the operation but to avoid other side-pain/reactions to some physical movements (or something like that, I am sure details of the procedure could be found online). This was fine too, and when he asked if all went well, I told him that not only it did but I found it captivating. He asked me what domain I worked in, and sort of acknowledged it made sense for me to find it interesting then. Anyway he got me back to the parking, asking if that series had still be on, and telling me there was an old lady in the morning who seemed to really enjoy the teleshopping programme. Heh. Guess the TV is still on maybe to distract patients, though I am still not sure who decides on the programme. Maybe they do requests. The programme had changed when I came back anyway, to some game show, if I remember well. I am not sure in which part of the trip I saw a clock on a screen indicating 11.28 am, maybe it was before the anaesthesist in fact because timing would make more sense.

Only minor hiccup when he parked me is my foot hit a little piece of metal from something on the wall, he aplogised, but thankfully it was a mild connection so no hurt. Timing was explained about how long the anaesthesy would take to fully work, and then the surgeon came, introduced himself (even if I had seen him two days before, but I guess patients are mostly impersonal to surgeons (you’re just another achilles operation) unlike the other way around), asked how I was, checked that I had brought the boot and achilles wedges (small panic as they were not immediately found, but they were in the envelope with my ‘dossier’), gave a few more basic details and left.

Next visit was the head orthopedist nurse (Béa), a few more words on timing (‘it is a short procedure’ – no idea then what ‘short’ entailed though) and I was on my way to the operating room not long after.

Small adjustment of brancard height before I could roll to the table to lie on my belly (‘it’s like sunning yourself at the beach’ I was told, with a few caveats added that you might actually also want to tan your front side and occasionally turn when at the beach).

Little rest for the head, arms rest in position too (in the end I adopted a possibly unusual position as my left arm was more across me, so I didn’t lay in a cross as seems expexted, which briefly made the addition of the left arm pad slightly inconvenient but I decided not to move and got used to it being only under the elbow). Some electrodes put in, a tourniquet on the right thigh, I was asked if I was cold (I wasn’t), then the very small curtain was put on for me not to see the operation and we were on.

Obviously, one wonders whether the anaesthesia is working. I wasn’t sure how my body was meant to react. I thought I was meant to feel/sense nothing at all. The anaesthesist reassured me first that it was normal and that the surgeon would test it before operating, which I acknowledged made sense. The funny thing? You are not always sure what happens with which timing whereas I suspect they know it cannot not work. So it’s quite possible the operation was started before I knew it. Either way, there was a moment when the surgeon smeared something on the sole of my foot, I was asked if I felt it and I did, and if I felt it was cold and no I didn’t. The anaesthesist then explained that was the sign that the anaesthesia was taking effect.

Shortly after, when I said I felt something but didn’t feel any pain, he said ‘you’d certainly feel it if now if it wasn’t working’, which the surgeon verbally confirmed with added laughter (expression of a perverse pleasure or a simple classic chuckle?).

Either way, I was intrigued, because I felt a lot of small tugs and pulls on the skin (and that my right leg was elevated, but near the end of the operation, when I could feel a mat under my left, I figured – though didn’t ask this time – that this mat had probably been going across both legs all the time, it is just that I couldn’t feel it at all on the right). Anyway, the anaesthesist explained that, because how nerves were, and the brain, while you couldn’t sense what happened on the operation site, messages about some movements were still carried to part of the bodies not under anaesthesia that they are connected to. And then the brain interprets it the way it is used to (probably with a little imagination about someone fiddling with your skin I’d say as you know there is an operation happening there?). Again, interesting and educational.

During the operation I mostly tried to keep my eyes open, sometimes closed them, but there was definitely no pain, no cold, and my mind felt quite alert so it was easy to communicate. I don’t feel I had been drugged at all, whatever was in the IV drip. There was a box with two LED counters, one was sort of fixed I think, at two hundred something, another was changing but as I had no idea what it was I didn’t quite notice that it was just in fact increasing slowly between my few peeks. I could feel the blood pressure being taken regularly, and no bad sound. Just heard a few technical details I had no idea about when the surgeon was asking for this or that (tools or threads I guess, some were 0), got a little more information about it nearly being over and the surgeon now stitching me back together, and I think it is just at that point that the operation was declared over and one of the assistants called the time at 27 minutes. Looking at the box and seeing it display 27, I realised that LED counter was just timing it. The conversation got more ‘mundane’ between surgeon and assistants while he had to fit me with the boot, so I just heard about him not being on call this weekend, eventually remembering who was, and lots of talk about this or that surgeon(he was my intern/this one I worked under/that one is rather slow but is so nice it kind of makes up for it/oh she has no filter, quite a mouth on her, but she’s calmed down a bit/she’s had to, etc.) before the brancard was brought back and adjusted and I could roll back onto it on my back. My (left I think, it would make sense and justify that the recommended position was not the one I had adopted) shoulder was a little painful so the manoeuvre was slightly less easy than it should have been, but I don’t think it showed.

I was given a last few words and good wishes, finally seeing most of the faces who had helped with the operation but without being really able to take them in, and I thanked them before being lead to salle de réanimation (ICU? Ressuscitation room?For once the French word truly works better, or rather, I can’t find the appropriate English term). I saw a clock (a Windows lockscreen on the same screen as earlier in fact) displaying 13.02. There another guy took care of me, just measuring the usual vital signs. I was initially put next to a young girl recovering from general anaesthetic I think. Until they quickly figured that putting me one or two metres further might be safer in case she had a bad reaction or needed serious help on waking up. The guy asked about operation time and figured he’d have to keep me for about 15 minutes, though given the type of anaesthesy it seemed like a formality rather than a necessity.

The anaesthesist came back to give me instructions on painkiller timings (just Doliprane really) relative to the awakening from the foot anaesthesia (up to 48 hours) and notified me that the sum mentioned on the inital invoice from Tuesday was wrong and in fact it was a little less and a round sum (‘we don’t put such complicated numbers’), so I dont know if that one robotic secretary was the reason or a software issue, or if even possibly I had been an easy patient so he offered a discount, heh. The guy from réanimation touched the skin under my big toe and asked if I felt anything. I didn’t think so but I wasn’t even sure. Think it was an unrelated sensation maybe due to the arthritis/memory, as in any case I wasn’t meant to feel anything for about 24 hours.

Another brancardier came and picked me, older, nice guy, asked who operated on me, said he was a nice and friendly guy (I am to be fully convinced, due to past stuff, even if some of my instinct tells me he is not the most genuinely greatest human being, or at least that the ‘humane’ touch is not what it is about, but as long as he was great at his job and had good bedside manner, that worked for me), and got me back into my room.

A new, fairly young, nurse brings me my ‘collation’ (apple juice, coffee, apple compote, a yoghurt and a piece of bread, with butter and strawberry jam to put on) and final instructions, then asks me if I have someone to collect me (yes) but also to stay overnight (er, no, not sure but I could ask – yes, do, it would be sad if we have to keep you overnight when it doesn’t seem necessary – I am still going to mark you as out at 3pm so you have a bit of time to eat and get ready). She fetches my phone so I can be sort of set. I eat and send messages or reply to a lot of people (feels like a lot anyway, initially I thought I should just focus and eat first and everyone else can wait, but I feel Ok enough in my mind to combine or compromise, it is slighly (a lot) different from 2014, I don’t particularly need to only prioritise myself to save myself there). I tell Ben about the mooted time of release, and that if asked he just has to say he is staying over with me though I don’t think it is necessary. I think I manage to essentially notify the family first this time. I think I have one or two actual phone conversations, I remember to call the nurse to arrange the first visit for Sunday, and once having eaten and finished all interactions, I feel a little confused about what comes next. During all that, my initial thoughts are that I am glad I only took one phone, as I am already struggling to juggle the conversations. But with time passing and as I leave good news on social media (or arsenal blog comments) for people I couldn’t yet reach otherwise, even though I had planned to only do that once home, three o’clock slowly nears, I get bored and nearly start to think I should have brought the other phone too! I lie down and relax for a bit, notice I still have the scrub cap on, the catheter of course, but also the name tag around my wrist. In the paperwork, they had mentioned that during the course of my stay I would be asked for my name and date of birth a lot. I think they said it is for patient ID, making sure you have the right patient. I suppose it makes sense, though while I was waiting pre-op when the head nurse asked again, I was thinking more about people taking someone else’s place and was confused about the asking procedure as I could read the info on my wrist if I intended to fool someone. So could they, mind you. Anyway, here waiting to go out was a different realisation seeing this tag, as it also had the age, and on seeing ‘51 ans’, I thought ‘fucking hell, am I really 51? I really don’t feel this old right now’.

Back to reality, Ben notifies me he’s arrived back to the fourth floor waiting area. A time to reflect on the many important Smiths in my life. Ben Smith. Nicole Smith. Robert Smith. Paul Smith to some external extent perhaps. The Smiths? Maybe not so much overall. Is it really so strange? Given it is the most common surname in the English speaking world, maybe not then. Although, I am French, and only lived in England for about 13 months. So yeah, maybe not so contextually strange in the way my life has been since the end of 1996, but probably a little odd for a random Frenchman who has pretty much only lived in France. Anyway, just the kind of thought I had in that moment.

As 3pm turns into 3.30, I am starting to wonder if I actually have to wait for someone to clear the tray and help me dress. It seems odd that nobody’s turned up. Quick chat with Ben who also thinks that someone should come, so I think I only have to be patient and wait. I am trying to get clues, like my ID tag still being attached to my wrist, the nurse not even having told me to remove my cap [something obvious that doesn’t need telling, fair enough], and, what could be a release form not facing me ready for pick-up but the other way around, surely that is a very good visual clue? Turned out people are not all that subtle or thoughtful. Sure I might not have been super clued up on getting back to my room, but I pretty much understood instructions clearly when being told ‘how to’, and apart from a mooted release time that still seemed to require full confirmation in particular with doubts about overnight company, I am pretty sure I wasn’t told all the practical timings by the bossy-looking nurse. It may have seemed obvious to her on her nth shift, but not to me on my first operation in over 20 years, and in fact the first not requiring an overnight stay.

I tried to look around to see if there was a way to call the nurse, but all I saw was a red button slightly out of reach (I wasn’t ready for acrobatics), just designed to be used when in a bed. Sure I COULD move out, but there was no sign that I should yet, not to mention the fact I could not get into the tracksuit bottoms with the boot on so would ad minimum need to have it carefully temporarily removed. Something a more clued up or experimented nurse could have worked out (or enquired about at least, not knowing what clothes I had with me) for sure. Anyway, 4pm went, me joking with Ben that like the welcome machine their clocks may be one hour back, until a different person (maybe not a nurse in fact) comes in to fetch the tray, asks if anything is wrong, so I say all is physically and mentally fine but explain I can’t currently get dressed and leave. She fetches the nurse who had brought me the collation, who appears a little flustered and kind of complains she had told me I could get up and leave when ready (which would have also entailed getting to the nurses’ secretariat first, pretty sure I hadn’t been clearly told that either) before I explain it was technically impossible and I would need boot removal first. I haste to mention that the whole how do I dress with the boot issue is something I had envisaged while in the room before the operation already. Still seeming to behave as if all patients are children, she explains that no the boot has to stay permanently for a few days in the first phase (‘wasn’t I told?’ ‘Er, no, not really’, thinking of it) but still has a look, unfastening refastening the scratches (maybe why one went loose at night), until she sees the problem with my clothes. In the meantime, while she goes get another pair of hospital trousers, I am asked who will collect me, ‘Ben Smith’ (I didn’t think of saying Benjamin) so he gets called in to see me in the room.

Once the fetching blue XXL trousers are there (with a big slit cut down the right leg so the boot can fit in), I am being helped to put them on, I think of asking for my belt again to hold it as at A&E until I am shown the bits to tie it with, realising my stupidity at not thinking these had to exist and there was never the need for an external belt.

Anyway, now I can pack my bag with Ben’s help, get to the secrétariat as clearly notified this time. Some paper seems to be missing but I ask Ben to check back in the room and indeed, in the confusion we hadn’t put them in my front neck bag and Ben hadn’t picked them either (he couldn’t know, though again, it means the qualified personnel, also in the confusion, didn’t pay attention, the nurse probably considering that leaving that paper on the table, the wrong way round had been enough to declare it given to the patient).

I get the catheter removed(from the bossy nurse or another, at this point, the little commotion caused by the misunderstanding has left me slightly upset and confused), and the only bright memory is a young bouncing nurse calling me oddly by my first name and asking if I have everything and had been told I could leave, which I confirm

Well I think that was the second time, she definitely called me twice, maybe the first was at the secrétariat before the catheter removal, but either way, it felt unusual, she was like a funny little imp or fairy that was placed here to brighten the story).

And then out of the ward, no button to push, you had to pass your hand before the sensor to trigger the opening of the door. As Ben was carrying my backpack in his hand and I was nearer the door, I figured I could try and put the crutch across the sensor to see if it worked and it did! Cue a nurse saying ‘you are the patient and he lets you do everything’ in an amused voice. More hospital humour, though with the recent annoyance just clearing but not totally out of my system it took me a couple of seconds to take it in so I immediately defended Ben before acknowledging the humour.

The anaesthesists could be paid downstairs or by mail, but I figured that despite that secrétariat not being miles away, the effort, formalities and potential extra wait weren’t worth the bother. So a little sit down, cab back ordered.

Another one who arrives early-ish so a little panic, as, again, there is no official pick-up point, just the entrance to the hospital. As we get to the entrance, rain starts pouring down (I had checked the possibility but it seemed low so had decided not to wear a hood), we don’t see the taxi (I assumed he would have to drive around as there is no other way), find a little shelter that is pre-steps, and I can call the driver (thankfully the second, more chatty driver on Wednesday, the one who recommended the balneo, was full of tips so told me this was possible from the app) and let him now we are just at the entrance to the hospital. As we spot him on the opposite kerb about twenty metres away when he shows up, I am able to wave one of my crutches (another interesting use for these!) so that he can spot us, and he kindly does a U-turn to get to us rather than let us move to him. Comfortable drive, another one who is helpful and sympathetic. I am sure Uber drivers are OK too, but G7 certainly convinced me to stick with them through these four rides! The music in the cab is pleasantly relaxing too, and even with some Bowie tune playing at some stage (which brings me back to arseblog again).

Home, I settle down briefly. Discuss a few things I need Ben’s help for, like fetching the now meaningless energy gels and shinpads from the letterbox to free the space, posting the sick leave, explaining about the pharmacy trip I will need him to do the next day to fetch the plasters, and also a small initial shopping list of things I would need from Carrefour (knowing I have plenty of food left and will mostly place a huge order from Picard soon).

Of course, the second phone is now on and with it more people to inform or reply to.

I get a call from one of my sisters, then another one from another, but when I check the list of people to inform post-op that I had made before leaving, it seems like I hadn’t missed anyone. Once all is done and Ben goes home, I think I might go to bed early, maybe 8ish, but with the kind of buzz from a successful operation and hyperactivity (again I wonder if the IV drip had anything druggy in it, but my head feels pretty ‘clear’ or as much as it can be, I only had the one Doliprane once home, so if I am ‘high’ it is quite a natural one). I am ultra positive, while remaining aware that I will come down and that the tougher reality will hit back in the next few days. I just have to be careful not to crash down. But yeah, I am kind of chatty right there, and I post this message on the arses (arseblog commentary system) as a reply to being asked if I was on morphine (following quite a few positive/upbeat/humourous not related to my situation interactions) which reflects how I feel:

“Heh, no, paracetamol (effects of local anaesthetics wore off a while ago I think[wrong, but not completely relevant anyway]). I have Tramadol in reserve in case of acute pain (though it is slightly tempting to try it anyway) but I am mostly high on a ‘successful’ day where about everything went well and being happy that the long road to mending can start.

I think I put some decent hard work over the last three days to make my life a little easier now.

I know there will be a lot of harder and boring and perhaps even depressing days next, especially if I don’t succeed in making myself busy enough, but tonight, I am just feeling happy, will probably try to sleep soon.

I’m not going to go all Blanche Dubois as I don’t think I actually ‘depend’ on the kindness of strangers, but somehow I feel I have benefited from it a lot, and, even more from that of friends.

23 years of arseblog, a few less for me (can’t remember when I started reading though, maybe earlier than I remember), and quite frankly, I know that’s made my life incredibly richer and better and full of friends.”

This is the last I post there for the day, as I like it to be my final public word for today before I try to get away from that. But whatever I do (more private messages I guess on top of trying to listen to a bit of music and possibly read), this was still more than two hours before I decide I really should try to sleep.

I think I go to ‘sleep’ not long before 11pm, and quite naturally, rather than sleep well from exhaustion, I have a terrible night due to all the brain overdrive. But I am kind of used to it, I expected it, so no panic as long as the following night will be OK. I resolve that tomorrow at least from the afternoon, I shall definitely be less social, take time for myself, listen to music and breathe.