The surgery I had to remove an, as it turns out single germ cell tumour, involved being cut from solar plexus to just above pubis and then, in my Oncologists words ‘taking everything that was in, out and laying them out around you’. My surgeon took out 46 lymph nodes in the two lymph plates that descend from my kidney’s downwards and I’m still struggling to come to terms with the fact that my stomach, intestines and god knows what else were outside of my body and now they are back in. They still aren’t working in the same way they were but they’re back in.
I’ve had big surgeries before but nothing like this. The recovery has been the most gruelling experience; riddled with pain, aches I don’t recognise and permanent discomfort on an ongoing basis. I still can’t stand up straight too quickly I have to ease myself into it. I can’t sit for too long as my stomach starts to cramp and what used to be a more than healthy appetite now sees me picking at food like a pre Paris super model. But please don’t think for one second that I am complaining, it beats the hell out of having a tumour inside me.
When I started writing this blog I was going to write about the joys of having a catheter detach, leaving you in a bed soaked in your own urine or a blood drain swinging from your stomach or any one of the many other small ignominious events that can happen on a daily basis to a patient in hospital. However this forum is my own small way of raising issues that I would dearly love to see changed, it is important to note that this is in no way a sleight on the medical team that looked after me.
The medical professionals themselves were and are the embodiment of effective treatment and patient care, however the bureaucracy that surrounds them is shameful – for instance how can it be right or appropriate to be told you’re being discharged at 11am but not get out until 5pm because they can’t find a doctor to sign the discharge notes or they can’t fill your prescription because the pharmacy is closed for lunch and then when it does open doesn’t have enough of the drug you need to take home with you.
I would love to believe that this was an isolated occurrence but four weeks later in a different hospital following Cancer surgery a good friend of mine had to wait for 8 hours from being told they were being discharged to actually leaving.
When all you want to be is home, in your own bed surrounded by your own things this to me has been the embodiment of frustration, forget Tantalus trying to get a drink, try getting out of a hospital with your sanity intact when you’ve been discharged.
My second issue with the management of a hospital is something that anybody that works in a customer service environment knows and that is consistency is king. When your pee is coming out of you into a bag, there’s blood dripping out of you and a central line amongst the myriad of other tubes in you I would like to build a relationship with one or two nurses perhaps. But with the vagaries of rota’s and shifts in the 5 days I was in hospital I was attended to by over 14 different nurses. All of them great in their own way but no rapport with any of them as there had been no time to build any.
When did the NHS forget that the patient is the customer and as such there should be an expectation of a level of customer service? I’m not referring to Disneyesque smiles or a mandatory greeting but a consistent approach to patient care starting with a consistent service delivery. Patients would benefit from it in recovery terms so why not?
However my greatest disappointment and concern is the quality of the food that is offered in hospital. For those of you that know me you will know that food is one of the most important things in my life. I understood that this surgery and the drugs that I would be taking would affect my taste buds and appetite but that is no excuse for the execrable slop that was served up three times a day at times convenient for the kitchen not the patient. I’m not even prepared to say that the kitchens do well with what they have. They don’t. The pre-made, heated ready meals that are served are lacking in any nutritional benefit, taste or sense of care at all. Even the tea is like dishwater. I honestly was grateful to have no appetite rather than eating any more of the “food” that was served in the hospital.
What should concern even more is that I was a private patient, my insurance company paid for the privilege for me to not eat the food; I am mortified and dread to think what would be served if you were a patient of the NHS only.
A cursory search of the internet looking for facts about hospital food will alarm and disgust anybody who understands the benefits of nutrition to recovery and health.
In the UK 82,192 meals are thrown away uneaten in Hospitals daily
67% of hospital staff would be unhappy to eat the food they serve
There are no food standards for hospitals yet there are for prisons and schools
Since 1992 there have been 21 voluntary initiatives to review and improve the quality of hospital food. All have failed at an estimated cost of £54 million to the tax payer.
The reasons as to why nutrition is so important to recovery from surgery are seemingly quite obvious however I have taken the liberty of paraphrasing the post of Dr Wilson MD the full article is available here http://drlwilson.com/Articles/SURGERY.htm to add a little scientific validity to my point.
1. All surgery is an attack or wound on the body, even if it saves your life.
Recovering from wounds always requires extra nutrients. However, for the most part, the surgical community still ignores this research. This is unfortunate. In my extensive experience with surgical cases, those people who are well-nourished heal far more rapidly and thoroughly than the average person.
2. All surgery exposes a person to many infections.
This is another major problem with all surgery, especially major surgery with the body cavity wide open to the air for hours. It is a very common occurrence that can take one’s life. The proper nutritional balancing support can help strengthen the body and significantly reduce the risk of infection due to surgery.
3. Surgery exposes the body to numerous drugs in most cases.
These usually include very toxic anaesthesia drugs, antibiotics, toxic soaps and cleaning solutions, muscle and nerve relaxants, and, at times, others. Proper nutritional balancing support can significantly help the liver and kidneys remove these drugs faster and more effectively.
4. Another risk of all surgery is venous stasis and blood clots.
The proper nutritional balancing support can help reduce this risk of all surgery to some degree. It can help prevent improper blood clotting, enhance circulation, enhance the ability to form collateral circulation with substances such as vitamin E, and balance the autonomic nervous system so that if a cardiovascular accident occurs, the body is less liable to go into a fight-flight response that often is the immediate cause of death.
5. The risk of uncontrolled bleeding or haemorrhaging.
Once again, the proper nutritional support such as a little extra vitamin C, zinc, copper, manganese and others can help prevent excessive bleeding and reduce this risk to some degree. If a person undertakes a nutritional balancing program for a few months, at least, before surgery, this risk, and the others above, will be reduced even further
6. Scarring or adhesions after surgery is another important risk factor.
Scarring is common and perhaps inevitable to a degree. However, if the body is balanced, particularly the metabolism of zinc and copper, and when toxic metal levels are low, it happens much less. In fact, a nutritional balancing program often prevents keloid scarring and can dissolve some scars and adhesions in time.
7. Stress and shock from blood loss or just surgery itself.
This is another important risk of major surgery, in particular. A properly designed nutritional regimen can reduce instability and chaos in the body, balance the nervous system and thus minimize the possibility of a shock reaction due to any number of factors such as blood loss, fevers, infection or just due to trauma to the tissues and the organs.
8. Slow healing after surgery.
Here nutritional balancing is quite amazing, in my experience. Even just a significant improvement in the diet, drinking water and lifestyle can have a significant impact on the rate and quality of tissue healing and regeneration after surgery.
For these reasons and the fact that it might be you or a loved one I urge you to raise awareness of this criminal inaction with the UK Health Minister Jeremy Hunt firstname.lastname@example.org or @Jeremy_Hunt for those of you on Twitter
I would also urge the charities and patient bodies to become involved, pressure and lobbying is the only way to achieve mandatory improvement rather than a soffit to those people that shout loudly. The reality of this situation is that one hospital trust spends hospital spends just £2.19 a day on feeding its patients dozens spend less than £5 and some spend more than £15. Voluntary action clearly doesn’t work at a cost far greater than a couple of pounds when there are lives at stake. Indeed now is the time to move beyond voluntary initiatives to create a standard of nutrition that will enhance the well being of patients in the care of the medical community.
If you want to get involved then www.sustainweb.org/hospitalfood is a good place to start.