Sepsis vs Sadler A Week in Hospital

In this Post:
A radiator, drip, a call, then:
Admission to UCLH (University College London Hospital) via their A&E dept.
Two nights reclining on the Haematology ward until a midnight transfer to ICU.
Presenting: Sepsis vs Sadler, a battle fighting sepsis in ICU.
To top it off a dance and a rosie bowl of tom yum soup!

Wow what a ride - the timeline:

|The Radiator:
Saturday morning and I'm trying to rehang the bathroom radiator having been in a state of wonkiness for years. No matter how many times I measured, I couldn't get the brackets in the right place, brain fog! I was taking frustration/exhaustion breaks more and more frequently. I’d also heard an ominous crack from below the floorboards. A pipe joint had cracked and we get the first drip of this story. We now have a large hole in the ceiling of the room below.

Do Not Pass Go:
With perfect irony it wasn't the radiators temperature going up but mine! It was drilled into me at the Macmillan Cancer Centre, 37.5 degrees call the hotline, 38 and straight to A&E. I called and got ‘Go straight to A&E, do not pass Go, do not collect £200’. Off Fliss and go to UCLH A&E. We didn’t wait long because the Emergency Haematology call Line had called ahead to A&E an arranged for us not to hang around in a waiting room full of sick people as I’m immunosuppressed.

Then it’s a blur as I went from A&E to a room in Haematology via miles of underground tunnels. 
UCLH consists of many buildings across several streets, all interconnected with underground corridors, intersected with security doors. Now we’ve all seen T.V. hospital dramas where they burst through double doors, but the reality is quite different. Each security door has a card reader about half a bed length away from the door. The porter (bed driver) has the difficult task of touching his security card, holding both doors open and pulling the bed through before finally letting go of the doors. It’s a three person job and a bumpy ride and I certainly recommend you keep your arms inside the bed’s side gates.

Mr President has Entered the Building!
If this was a hotel room it would be a good sized king double with an ensuite disabled toilet / shower in the style of NHS Novus and double doors to prevent infection.

I was hooked up to a drip of antibiotics (drip two) and every so often a nurse would check my obs. (Observations - get with the lingo!)
I was getting colder and colder, which meant I was actually getting hotter and hotter. Then the shivers set in. This is not a gentle brrrrr, it’s so vigorous that I couldn't talk or hold anything.

On the second night I was moved to a room nearer the nurses station where they could ‘better keep an eye on me’. There was also talk of sending me to ICU (Intensive care unit). I didn't like this idea as I was only in for a quick once over and some strong meds!

Getting Steadily Worse:
I’m naïve, always have been, I see things optimistically, but I was experiencing a growing sense of dread. I’d expected a wait in A&E and a hospital grade prescription. Now it was around midnight and I was being prepped to go to ICU. things were getting steadily worse and there was nothing I could do about it. That’s a scary place to be but either due to the drugs, the fever, or my own internal process I didn’t feel anxiety. I was probably storing it up to be processed later.
ICU (Intensive Care Unit)
One two tree lift! And I’m in, and the bed is way more comfortable than those in Haematology. We’d taken a lift and I believed that I was in a basement. Several days later I would see the back of the room for the first time and see the floor to ceiling windows overlooking Grafton Street.

The Reason:
The reason I was there is because for reasons unknown, my blood pressure kept dropping during the fever. This surprised me because my shivering was like a one man twerking contest and usually blood pressure goes up with activity, but apparently not in my chemoverse!

There are two ways of raising blood pressure: The first is by increasing body fluid. I drank litre after litre which was matched with a saline drip. I entered the hospital at 14st 9 and left at 16st 4! That’s around 10.4kg / 23lb weight gain!

The other way to lower BP is via a certain drug that acts like an accelerator on a car. It needs constant monitoring which can only be done in ICU.

My fevered memory of ICU is disjointed. It jumps from one memory to another.
It seemed at any moment the catering team would pop up and ask for your choice for lunch and dinner. It was just like Monty Python’s Spanish Inquisition sketch. The best food I had was an orange ice lolly, pure nectar. I also managed two half sandwiches, nibbled at two baked potatoes and drank a bowl of soup. That was it for four days. Although I hate wasting food, I rejected everything else when it got to me. ‘Can I take your lunch order for next Wednesday please?’

At this point you may wish to jump to the next post. It contains the most terrifying moment for my in this whole story. A moment that I tried to process through my training as a therapist. As I feel it may be of use to others beyond this memoire, I've made it into a separate post about trauma, particularly the self diagnosis of PTSD.

Everything stops for obs! BP, pulse, temperature etc etc.
You would think the staff would get bored or just go through the motions with obs but not this team. They were on it, obs were their window into my biology. A perfect example was the BP monitoring. It’s done in two ways. Something connected via a cannula reads the BP directly from the blood vessel. There’s also an externally cuff that inflates. This is seen as secondary, but one astute nurse spotted a discrepancy and we switched to cuff only monitoring. My whole BP accelerator medication was dependent on an accurate reading, so who knows what may have gone wrong had the nursing staff not been as professional as they were. Put this into the context of 12 hour shifts, 8am to 8pm or 8pm to 8am. I’m seldom impressed but they impressed me. Definitely worth a few dents in the saucepans! ‘Here's your tuna sandwich and mushroom soup’.

"You're so vein, I bet you think this blog is about you!"
Apart from the pills and a couple of injections in my stomach every day everything else went in or out via cannulas. Once in place a cannula acts like a USB port. The problem is getting them in. I have narrow veins which are hard to hunt down. I think I ended up with six cannulas over the four days in ICU, each one averaging two attempts and three requiring ultrasound guidance from a doctor. Do the math and think pin cushion. ‘Have you finished with your tea?’
Apart from their professionalism, I remember having some wonderful conversations with the nurses about stress, life and what made them who they were, all of which will remain cherished and confidential. Those conversations made me feel valued as a human, safe and secure. I was more than a bunch of obs and a biomechanical puzzle.

I saw any number of consultants as the junior doctors were on strike. They too had a warmth about them that was unexpected. They were also pulling double shifts (16 hrs) making life and death decisions at any moment. ‘There’s no chicken tonight’.

Feeling better
Once the antibiotics kicked things got better very quickly. The last 24 hours in ICU were delightfully boring. I had my first unassisted poo and walked down the corridor. I sat in a chair and thanked my lucky star for the privilege of the NHS.

Hotel California
Admission is easy, discharge isn't. The system's based on the Hotel California as in 'You can check out any time you want, but you can never leave.' Everyone has to sign off on the discharge so there’s a period where you’re desperate to go home and can’t. Fliss and my response to waiting is always to be silly. So we had a Mambalsa dance in ICU. Perhaps not the best dance in our long history but one charged with celebration of life and optimism for the future.

Very few people get discharged to home from the ICU. I’m one of the lucky ones. I can’t take credit for a positive attitude and my general fitness but the support of Fliss and the skills both hard and soft of the NHS are the real heroes. ‘Another cup of tea?’
Ground Control to Major Tom Yum:
Finally I was released right at the peak of rush hour!
I’d had fantasies of a spicy tom yum soup during my fever and by chance I’d asked a Thai nurse where they would recommend locally and they suggested Rosie’s Thai Café. I had the most amazing Tom Yum soup with noodles. Perfect. We also realised that this used to be a pizza restaurant where Fliss and Fabian held their after party for their Bolero concert around a decade earlier. The very concert that prompted my idea to create Mambalsa. I’d never have imagined that years later I’d be dancing Mambalsa in ICU 200m up the road!
And finally  home.

BTW we gat a plumber in who fixed the pipe and radiator in less than an hour! 



Mary Muirhead said…
Glad you can stay so positive.

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