Thursday 1st December, 2011

Still in Hospital - Need to be more patient!

A disturbed night. I was woken at 2am for antibiotics. I was connected to a drip which got blocked every 5 minutes. Overall, I was awake for 2 hours. I was woken again at 7:15am. Attracting attention is very difficult. What should be 2 x 30 minute drips are still going almost 2½ hours later. I couldn't move off the bed or get dressed until the drip had been disconnected.

Breakfast was horrible. Yesterday, I ordered breakfast. On the wall was the breakfast menu for people with a compromised immune system, including bacon, sausage, egg, tomato and fried bread. What I got was a small bowl of corn flakes, with skimmed milk, and 1 slice of stale white bread.

It was very frustrating to be wasting so much of my time, when the only problem is in my toe and all the diagnostic tests and examinations have been waiting for 2 days.

A whole posse of doctors came round at about 11:30. After looking at my toe, they decided to refer me to a surgeon and reassured me that the staff on Wessex Ward understood the importance of administering antibiotics on time. I was warned that I would probably have to stay over the weekend.

By 2:30, my next dose of antibiotics was well overdue. One of the problems seemed to be a lack of communication. There may well have been a good reason for the delay, I just didn't know.

At 3:45, I was still waiting for the 1pm antibiotic, the 9am lenograstim, an X-Ray and examination by a surgeon and nobody had spoken to me since the morning ward round. Just before 4pm the antibiotic drip was started and almost immediately someone from radiology came to take me for an X-Ray. The plan was for me to down to the X-Ray department in a wheel chair. I was allowed to walk, which cheered me up considerably.

I had my lenograstim and the results of the morning blood test showed that my neutrophil count is getting much closer to normal. I still have 2 doses of antibiotic to fit in today.

The third antibiotic drip started at 7:45 and did not finish until close to 11pm. There would be one more dose of one of the antibiotics, sometime around midnight, but it was not possible to fit in more fluxocillin that soon, so that dose was omitted.

I must learn to be more patient. There were a number of very ill people on the ward today, one of whom passed away. Getting impatient, and showing it, is not a very Christian attitude. The staff have been working extremely hard, with virtually no break. Nevertheless, there are not enough staff to cope with days like today. The "system" makes it difficult for committed staff to deliver the level of patient care they would like.

When I am teaching TOGAF, I tell a story about prioritization based on Emergency Room triage. If you are dying you get immediate treatment. If you just have a sore toe, you have to wait for quite a while. I am now seeing what priority is rightly given to an infected toe in a ward where people are critically ill and in one case yesterday, dying.
With the antibiotic drip, any possibility of a life threatening infection is under control. All I now have is a sore toe!

In learned a lot about neutropenia this week. Neutrophils are one of the types of blood cell that are destroyed by the chemo-therapy. They are the blood cells that establish the immune system.  Last weekend, I got a really minor infection in my foot. Under normal circumstances, my body would fight off such an infection without my even noticing it. With no neutrophils, it couldn't fight back. Gradually this week, my body has created new neutrophils and has started to fight the infection in my toe, producing puss as a waste product.