If you confuse your TWOC and your TURP are you a twurp? When I wrote about my first ever stay in hospital (for a TURP) I was expecting to return a couple of weeks later for another TWOC. Things didn’t quite work out like that. It has become time to introduce you to some new words – acute pyelonephritis, hydroureter, hydronephrosis and pseudomonas – and I might even tell you what they mean.
I was due to go back for a TWOC a fortnight after my TURP but a few days before that I had severe “right flank pains” (on my right side just below my rib cage) during the night and threw up un the middle of the night. So Liz booked an appointment at the surgery with the first available doctor. A lady who she had been talking to when she was booking the appointment very kindly gave us a lift to the surgery. I was given an examination and blood and urine samples were taken. The GP then spoke to the urology duty doctor who said that I should go to A&E at Stoke Mandeville for a CT scan and then to the Urology Ward in Wycombe. (We have various specialisms split between two hospitals twenty miles apart!).
A&E was its usual mixture of genuine accidents and emergencies along with minor injuries who couldn’t get to the Minor Injuries Unit twenty miles away, people who couldn’t get an appointment with their GP and so on. We had been given the blood and urine samples to hand in (so as to get them to the lab as quickly as possible) along with a note from the GP but when we checked in we were told to hang on to them, and again when we saw the triage nurse. Eventually we saw a doctor and were able to get them off for analysis. I was examined again and ‘tapped’ on the side and back – I nearly leapt out of my seat when he tapped my kidney. Then another wait.
After a while I was told that my blood tests showed that my kidney function was fine so I could go home. Hang on a cotton picking minute – I am still in agony, still throwing up and where is my CT scan. A more senior doctor appeared and a CT scan was organised. I was wheeled round and given water to drink to fill my bladder (my catheter had to be clipped shut) and had a scan of my kidney, ureter and bladder. It was all over in a couple of minutes and there was no obvious reason why it couldn’t have happened a couple of hours earlier.
Now I was being taken more seriously – the scan showed a blockage in one ureter (not a kidney stone) and fluid build up in the kidney. (I have learnt that there are two ureters, one for each kidney, which take urine from the kidney to the bladder where it is stored until it is time to have a pee through the urethra.) So now I could be sent to the Urology ward twenty miles away.
A chariot was summoned – well actually two paramedics turned up to wheel me to a waiting ambulance where I laid down and was strapped in. It was my first ride in a civilian ambulance – long ago in my working life I was involved in manufacturing Land Rover based ambulances for various armies. We used to joke that if you weren’t ill when you got in you were by the time you got out. This was marginally better but it isn’t a particularly comfortable ride. Various notes were taken by the paramedic sitting with me and finally I was wheeled in to the Urology ward.
I was checked in and given oromorph (oral morphine) which unlike paracetamol and codeine actually did something about the pain. I was actually able to get a nights sleep but was not allowed anything to eat until the doctors did their rounds (in case I needed to go for surgery – which would probably have been twenty miles away in Oxford since it was now the weekend and there was no-one else available to fit a stent to drain the kidney if it was needed). I was no longer in pain so the plan was now to wait until Monday and have an ultrasound scan and then decide a course of action in the light of that. However if things got worse again in the meantime it would be off to Oxford.