post-op question

[pineapple]

Just to update- I had my op on Thursday and got home from hospital today (sunday). I ended up staying 3 nights in the end, which was not what I expected. Basically the drain wasn't ready to come out until today and I chose not to come home with the drain. The main reason is that getting to and from hospital is not that easy for me, we don't have a car and have the stairs to contend with.

Things have been quite smooth so far in general. I haven't really had much pain, just a bit of discomfort. Even the drain coming out today was fine. I'm taking paracetamol and diclofenac regularly. I had my op around 10:30, was back on the ward by 1pm and managed a short walk to the loo by 5pm. I felt nauseous on the hot ward but that settled eventually.

The worst thing about it has actually been the back and hip pain I'm getting from lying on ym side so much! I've also been bored and frustrated with extra time in hospital, but my lovely boyfriend has been visiting diligently every day. I guess what has really shocked me has been how shoddy the NHS care has been at times. There were some genuinely skilled nurses on the ward, but also some downright shocking things. I don't know if it was due to it being weekend, or staff shortages (there were a lot of agency staff)

One nursing assistant (agency) kept insisting that I turn onto my back for my blood pressure measurement. I kept refusing as i wasn't inclined to lie on my wound and fortunately I was assertive enough to say no. Another nurse last night (also agency) came to empty my drain but said she didn't know how to do it. She came back hours later after my boyfriend went to see if anyone was actually going to do it. I had to explain to her how it worked and she ended up unclamping it too early and blowing air UP the drain into the wound (which did not feel nice!!!)

I ended up in floods of tears, mostly freaking out because I was convinced the air was going to damage it and turn it into an open wound. It took 2 different experienced nurses to convince me it would be ok. It was ok and I later realised i had felt the air rush back out fairly soon, it just felt so wrong! It just seemed to me that an experienced nurse should have been changing the drain or at least showing the new nurse how to do it! would've saved times anyway.

I think I've been quite negative about it all so I'm working hard to stay positive from now on. The boyfriend pointed out that I've tended to latch on to anything bad like it's inevitable things will go wrong. So i've managed to blow things way out of proportion at times (although some of the NHS care is truly shocking!!!)

Anyway, all is well with the wound so far, going to be doing daily dressings and back to clinic in a week for a check up. Fingers crossed, will keep you posted.

[stopit]

awww hun, i'm glad it the op went well but i totally sympathise with you on the aftercare. it's pretty shocking.

it's like the nurses didn't even know what i had done or why i had a drain. every time one came over i begged to see a doc but never saw one until i was discharged. one stupid nurse made me get up to answer a call, not even 3hrs after i was bought upto the ward. i was like 'i really don't think i can get up yet' and she was all 'nonsense, just get up'. i made it to the phone area, finished speaking to my mum and passed out in front of them all, followed by being sick all over the reception area floor. well, she did get told off from all angles for having got me up so soon.

one of the nursers who started later was a star though. but it's very disturbing that a lot of them just go 'eh? pilonidal sinus?' when they look at your chart, wonder what your drain is for and generally have no idea how to provide the appropriate aftercare.

but the worst is over, i hope the rest of your recovery goes smoothly. just a tip, try to keep a dressing on as long you can, even if it's not completely covering. for me, it protected the area from rubbing against clothing etc. my GP nurse agreed with that and i went back for quite a while for dressing changes until i could do it myself.

[pilonidalslaughter]

I'm glad everything is fine for you now, but I do agree the NHS system (at least the post-operation part) can be truly shocking. I had experience with some continental national health systems and compared to the NHS sometimes it looks like third world country. I mean, there is a lot of money going on, good equipment and buildings but nurses and docs sometimes look like they are out of the world. They don't know what to do, they don't have experience, sometimes they just repeat the same movement infinite times like machines without thinking!!

[pineapple]

Pilonidalslaughter, IAgree it seems third world and since the royal london is a listed building parts of it do look third world too!

My main concern now is when do these stitches come out? I have 3 different answers: ward nurse said 7 days (which will be weds/ thurs, so to see practice nurse), registrar said in clinic a week on mon (10 days) and my discharge letter says 14 days by practice nurse... just left me confused!

7 days seems soon to me. But I may see if I can hobble down to the GP on thursday and have the nurse take a look. The hospital only gave us 3 days of dressings which my boyfriend has been doing for me (although not very confidently after not really being properly shown how!)

Stopit, thanks for the advice about the dressings, will keep doing daily dressings for now at least. Fongers crossed for no problems!

[pilonidalslaughter]

Originally Posted by pineapple

Pilonidalslaughter, IAgree it seems third world and since the royal london is a listed building parts of it do look third world too!

My main concern now is when do these stitches come out? I have 3 different answers: ward nurse said 7 days (which will be weds/ thurs, so to see practice nurse), registrar said in clinic a week on mon (10 days) and my discharge letter says 14 days by practice nurse... just left me confused!

7 days seems soon to me. But I may see if I can hobble down to the GP on thursday and have the nurse take a look. The hospital only gave us 3 days of dressings which my boyfriend has been doing for me (although not very confidently after not really being properly shown how!)

Stopit, thanks for the advice about the dressings, will keep doing daily dressings for now at least. Fongers crossed for no problems!

I don't know for your case but 2 weeks seems ok for me (for me was like this). Seven days is too early!
This is another big problem of the british NHS: to split tasks between different buildings, teams and people. And so, each one has a different opinion on the matter. Informations are not sent to other people as well. In other countries if you have a surgery in the hospital, these post-surgery tasks are done by the nurses of that hospital and it's the same doctor the operated you that check your conditions afterwards. Here in UK one surgeon operates you, than some stupid nurses take care of you for one day; then you are sent to another center to take care of the wound; and then to a center to take out your stitches. It's a nightmare!!

[stopit]

hey pineapple, do you know what kind of stitches you have?

i had dissolvable with steri strips laid across the wound. in the first week to two, i had those waterproof dressings that I kept on for three days, then would have them changed by my practice nurse. it would also give her an opportunity to assess the wound. in addition, i think in the early days, it's not a good idea to change it everyday if you can avoid it - it should be clean even when it comes off and it's best not to disturb the wound.

after about week 2, the nurse said it could come off but beacuase i was going back to work with a long train commute, i said i'd rather keep a dressing. so i got a prescription for a bunch and would put on one every morning myself (it didn't cover the lowest part) and would let it breathe at night.

i would still see the nurse once or twice a week. she only took off the steri strips when they were starting to peel a bit themselves.

i think a lot of this is down to waiting and seeing how you're healing.

i would advise building a relationship with your practice nurse/s. mine were great after the first time i went in with my drain. if i needed an appointment at short notice or anything they were very accommodating. the receptionists were aware that i had surgery and needed aftercare too.

[pineapple]

I'm not sure the exact type of stitches I have, just that they have to be cut off.

I wasn't planning on daily dressings but today the wound was oozing quite a lot and needed a change. I was a bit freaked out but my bf and flatmate said it doesnt look infected, just oozing. It is also much more painful since last night but I think that might be the local wearing off???

I'm seeing the practice nurse on thurs afternoon so unless things get worse I'll try to hold on unti then... bit scared though, but hopefully just pilo pananoia?

[pineapple]

Turns out I have an infection. Yesterday the oozing continued and by the evening I felt feverish. I took a taxi to A&E where they cut a couple of stitches from the bottom of the wound to allow the infection to drain properly.

They took swabs and bloods and sent me home with lots of gauze and tape. I'm waiting to hear from the team to see if I need to go in for IV antibiotics. Not keen to go back in but gotta do what needs to be done!

I'm a bit scared now but feeling better, I knew something wasnt quite right. It seems beter today, I'm just worried about the open bit and longer healing.

[stopit]

So sorry to hear that pineapple

I hope the infection clears up soon so you can heal.

[pineapple]

Thanks Stopit. I saw the practice nurse today because I've given up on hearing from my team. She is optimistic that the infection will clear over the weekend so we will see. I'm going back daily for dressing changes. She was surprised that we were doing the dressing ourselves and after reading posts on here I've started to feel that the aftercare advice I have received is very bad.

I want to complain but I'm not sure if it will make any difference or get anywhere. It may make me feel better. I'm seeing my surgeon in clinic on monday so I'll mention it to him...