the experience continues

It is 2am. I am lying on my back in the anaesthetics room, wearing my operative gown. There are five or six people in the room including two anesthetists and a few nurses. They say they are going to put an arterial line into my arm. I'm fairly relaxed - the mild sedation is keeping me so - but I remember the many arterial blood gas tests I've had over the last few years and know I am in for some pain. It is much harder to access an artery than a vein - when the artery is stabbed it collapses, then gradually relaxes, so the needle has to be held in place for a while until it opens up and the line can be inserted. Also, the artery is deeper in the arm than the veins, so there is some digging to be done...

Ann is still with me, and asking me questions about family and where people are. While we chat the anesthetist who came to see me in the ward has a go at the arterial line, near my left wrist. It is painful and unsuccessful, after quite a while prodding around inside my arm to try and find the artery. He has another go, a bit higher up my arm - again he can't get the line in. It's a bit of a mess now. "Having a bit of trouble?" I say, cheerily. I realise this is probably not helpful. He calls over his colleague, who I feel is probably his superior, and he finally gets the line in about half way between my left wrist and elbow on the inside of my arm.

The last thing I remember is telling Ann that Vicky's dad is in South Africa on holiday, and then everything is gone...

...I am conscious. I hear words: "you've had a transplant".
"oh, ok. I must be alive. I must have made it. This is going to be unpleasant...I guess I am intubated..." and as my senses begin to kick in, I search around for the sensation "yep, there it is, tube in my mouth. Just breathe"...

...I fight the ventilator. I try and breathe at my own rhythm. I'm choking. "Breathe with the machine" says a voice. I try to relax, to breathe in when it pushes in the air. I get the hang of it...

...There are people in the room. I can hear Vicky and Ellie. I try to open my eyes and there they all are standing at the foot of my bed. My eyelids are leaden, and I can't hold them open for long - against my best effort they close again...

...I open my eyes again. Mum and Dad are there too. As I open my eyes people react - they smile, they point, they go "ooo!". I find this hilarious, and try it a few more times to get the same response...

...I am still finding it hard to breathe with the ventilator. They say they will take the tube out. They pull it out and replace it with oxygen through a mask - it is loud and high flow. "breathe, breathe" I think. I struggle. "Relax"...

...I am awake. I can take stock of my surroundings, in the weird half light of intensive care. There are no windows, except one on the opposite wall of the single room to me, but it only looks out onto the rest of the ward. As I gradually become more and more aware I notice all the tubes, all the machines around me, I notice the catheter for urine. I notice the chest drains - four fat tubes coming out of my chest wall, draining light red fluid into pots on the floor. I notice the nurses, who change every eight hours or so. One in particular is very kind. They take blood out of one of my tubes every hour and instantly run off results of levels, then tweak various infusion pumps to keep me stable.

I start to notice pain. The nurses need to clean me, and this means moving onto my side so they can scrub my back and bottom. The effort required to do this and the pain are extraordinary.

Time passes in a blur. I start to drink fluids. The oxygen is changed to a nose peg. I get some sleep.

A doctor comes in and advises about chest drains and when they might come out. People come with a portable X-ray machine - I have to sit up, which is agony.

After a couple of days Jas arrives and does a bronchoscopy to have a look around and hoover out some sputum. I am encouraged to cough and bring up the sputum - they give me a rolled-up towel and tell me to squeeze it to my chest as I cough - it feels like my sternum is tearing open with each cough, it brings me to tears.

I get out of bed and into a chair. I have so much pain it is close to unbearable. I want to get back into the bed but the nurse can not move me on her own, and can not get help. It is the worst day so far. Eventually I get back into bed and an epidural is arranged. Having the epidural I sit on the edge of the bed and lean forward, the nice nurse comforting me as the anaesthetist takes three attempts to get the epidural in the right place. Eventually it is done and the pain is relieved. They check the numbness by rubbing ice on my chest and asking me if I can feel it.

A bed comes free in the ward and, a day later than originally planned, I am wheeled through with all my tubes and machines. On the ward the noises of all the other machines filter into my dreams and my mind creates hugely complex compositions around the rhythms of the ward. I think that I wish I could somehow record the music, write it down - I had no idea my brain could come up with this stuff. I have gory dreams of tubes, gristle and blood, I see ants and cockroaches crawling around a scene of viscera. I have trouble sleeping.

Gradually life becomes more normal and less dreamlike. My drains are taken out, two at first, and then the other two. The catheter is taken out, which hurts like hell. All of these are done with gas and air, and I get to quite like the old nitrous. I make my first blog post, at 19:26 on Monday 26th October 2009, three days after the operation. The rest is history

Postscript: Sorry about the delay to part 2 of the transplant experience. We have been away on a lovely holiday on Exmoor, with some good walks up and down hills and along cliff paths, plus plenty of cream teas!