I’m not easily distrac … ooh, SHINY thing …

The Unexpected Exorcism of St Bagnes the Bilious: Part 3

Image of an MRI scanner

Warning: This is the third and final part of a long story. If you want to start at the beginning, you can find Part 1 here. The whole saga also contains some medical stuff that the squeamish might find a bit…icky?

A scan…and a bit of a shock!

When you’re not allowed to eat or drink but find yourself sitting in a hospital restaurant for an hour or so, it can be a bit of a chore. However, needs must and it was still more comfortable than hanging around in a remote corner of a busy surgical ward.

Soon enough the time came to head over to the medical imaging department to get myself thoroughly magnetised in an MRI machine. I was actually scheduled for what they call an MRCP scan. That’s Magnetic Resonance Cholangiopancreatography to give it its Sunday name. Basically, it just means a type of MRI scan that looks at the gallbladder, bile ducts, pancreas and other assorted wibbly bits that live in that part of your abdomen.

It takes around a quarter of an hour or so, during which time you lie in the machine listening to the dunga-dunga-dunga-wheeeeee-bzzzzzzzz-dunga-dunga noises from the machine itself while a nice voice in some headphones tells you to take a deep breath in, let it out, hold your breath or breathe normally depending on what the radiologist is trying to see. Some people find MRI machines quite claustrophobic and a bit scary but I’m very lucky and actually find it all a bit restful. Although I did almost get a fit of the giggles when listening to that voice very politely and calmly say “Please resume breathing”. I couldn’t help but think that it must be the only time in a hospital that that particular phrase is used so politely and without the least hint of panic or desperate hope.

Once the scan was over with and I was allowed to put my trousers back on (metal zips etc. don’t get on with MRI scanners) we headed back upstairs to the Surgical Assessment Unit (SAU) to await the results.

And we waited…

Then we waited some more…

I’d actually come out of the scanner at around 3:15. Around 4:15 we checked with the doctors and nurses, only to be told that the MRCP report still hadn’t come up from the MRI department and one of the surgeons would need to check it out before they could decide what to do next. So, with the nurses saying that they’d give us a call once things were happening again, we went back to the restaurant for a cuppa and to wait even more.

Tea time and a bit of a surprise

By 5:15, we were still sitting waiting and the phone hadn’t uttered so much as a beep. Much of the day had been pretty tedious. All the walking around and the initial wait in A&E had been a bit frustrating. Now it all began to get a bit frustrating again. With the prospect of a couple of hours driving to get back home, possibly in the dark and with continuing bad weather, I took a walk back up to the SAU to ask what might be happening. Where I was told that the MRCP report had now come through and the surgeon would be looking at it but he was currently busy resuscitating someone. That’s fair enough – whoever they were, their needs were obviously a lot greater than mine at that point and I hope they were OK.

The nurse did, however, then tell me a couple of other interesting things. First of all, that all of my blood tests had come back and were normal so the doctors were happy about that. Second, that the surgeon and various other doctors, including one of the surgical registrars on duty and my consultant, had been discussing my case and were thinking that they would just take the drain out altogether. It was clear from the MRI images that only the tip of the drain remained in place in the gallbladder and the surgeon just wanted to double check the report before making the call. If we could just wait a little longer, hopefully things will get sorted.


No…more…St Bagnes the Bilious…

Feeling more than a bit stunned and with this completely unexpected idea rattling around in my head, I made my way back down to the restaurant to tell Glenda. We decided to use the additional time to get something to eat and waited a little longer. The phone finally rang sometime around 6:30 I think. The surgeon had reviewed the MRCP report and the decision was made – the drain was coming out. I had to report back to the SAU and head for room 12.

Breathe in and hold your breath…

Clsoe-up of a Merit biliary drainage catheter

Remember this guy? That curly little piggy-tail was the bit that was still inside my gallbladder. Well, more or less anyway.

When they fit one of these, they do it under a local anaesthetic and use ultrasound to guide the procedure. They then stab you with a bloody big needle and use that to put the tube in place. Owing to the infection and inflammation I was suffering while in hospital back in June, I had been a difficult case and it took the doctor four or five attempts to fit the damned thing. And it was screaming agony the whole time he did it. But at least it did its job and helped to save my skin once it was in place.

Now, it was coming out. We headed on up to the SAU and settled into the room. We hadn’t been there long before a nurse arrived and confirmed that the surgeons had given the go-ahead to remove the drain and, if I was OK with that, she could do it now. Once she’d done it, she’d need to put a dressing over the hole and we’d have to wait a while just to make sure that I was alright but I could then go home.

I’ll admit, I was bit nervous. I’d had a different type of scan back in August that showed that my gallbladder was still blocked up. At the time, the various doctors had decided that it would be safest to leave the drain in place until such time as I could have the surgery to remove the gallbladder altogether. Otherwise there was a risk that I could have another attack of the same problem that had put me in hospital in the first place.

I mentioned all this to the nurse and she was lovely. She said that she was just reporting back to me what the surgeon had told her but if I wanted to wait to have it all confirmed that was fine. Although the surgeon was currently busy in A&E so I’d have to wait until he could come up to see me.

Under the circumstances and with the clock ticking around towards 6:45, I decided that it was fine and she could go ahead and remove St Bagnes from my person.

How do they remove one of these things? Simple. They take off the dressing, get a little scalpel to cut the stitch that holds the tube in place and remove all the stitches. Then they tell you to take a deep breath and hold it, while they press a dressing pad over the hole where the tube comes out of your body. As soon as you’ve done that, they take hold of the end of tube and just haul it out. All the way. With no anaesthetic.

What you do at this point is scream, while most of the muscles in your body tense right up and make you kick your legs about a bit. With the tube out, the nurse keeps firm (and I mean FIRM) pressure on the wound while your body adjusts to the new state of affairs and stops leaking. It continues to hurt all the time she’s doing that – maybe five minutes or a bit more – but once she’s happy that the hole is behaving itself and she releases the pressure, it all rapidly calms down. A nice soft dressing is applied and you settle down to wait for a while. Within another ten or fifteen minutes, the trauma is more or less over and you already feel more comfortable than you did when the drain was in place.

While we were waiting to be given the all-clear to head home, the nurse brought me my hospital discharge letter and the surgeon arrived from A&E. He was very nice and answered all my questions. He explained that they had looked at the MRCP report and were happy that the drain could be removed without too much risk. Obviously, there’s never no risk at all so if I found myself feeling unwell again I should head straight for A&E. In the meantime though, the MRCP images had shown them a clearer picture of the situation and they had all agreed that the drain wouldn’t need to remain. Particularly since it had already been in so long and was starting to become problematic and an increasing risk in its own right. The fact that I would be likely to be having my surgery soon (within the next month or two) also helped.

So, a mere five or ten minutes later, I checked with the various doctors and nurses at the desk and they were happy for me to head home. We were back on the road by 8:00 p.m. and finally got home around 9:30 p.m. The final scores for the day were:

  • Miles driven: 160
  • Miles walked around hospital: probably between 1 and 2
  • Time out of house: thirteen and a half hours
  • Time in hospital: just under ten hours
  • Drains attached when entering building: one
  • Drains attached when leaving the building: zero
  • Emotional rollercoasters ridden: one monumentally bloody big one.

Today, I’m not feeling too bad. There’s obviously still a dressing over the wound and it will need to be changed fairly regularly over the next few days. The one that the nurse put on on Tuesday night was rapidly soaked as the wound continued to leak a bit so I popped in to see the district nurses the following day and they re-dressed it again. I’m seeing them again on Monday for another check up but things are already improving and the wound has already stopped leaking.

All in all, it’s been quite an adventure.

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