Conquest Hospital again….. Gallbladder this time!

The NHS may be in crisis, the Conquest Hospital in Hastings is now in ‘Special Measures’, but Battleaxe’s treatment has been just fine, thanks. Am just emerging into the land of the living from an operation to remove my gallbladder, after several months on a low-fat diet. 

      I have had two operations in the Conquest in 11 months, one involving an in-patient stay of over a week as well as umpteen outpatient visits. I therefore think I can safely comment on the effectiveness of the surgical services and suggest some tips to help others.

      My earlier experience, last November, is described in this post – one of the top five most popular Battleaxe posts ever.  People obviously like hospital drama.

     This time, consultant Mr Miller warned me that I might end up with open gallbladder surgery instead of the usual keyhole, because of previous scars on my tummy. That would have meant another stay in the noisy Hades of Gardner Ward – no private room for me this time, I’m sure. If anything was not right about the Conquest at my previous visit, it was the horrendous racket in that ward when you were trying to sleep.

      Back to the gallbladder business. The first good thing was the waiting time – or lack of it. In June an ultrasound revealed positive Hastings Beach of stones in my gallbladder. I agreed with the GP that I’d go through the summer, and my Turkish holiday, on a low fat diet, then see the consultant some time after the end of September.  She said she would refer me to Mr Matthew Miller, who was known to be the best, even though that might mean a longer wait. However, I saw Mr Miller on 9 September, just before I went on holiday. He was a jolly bloke, quite enthusiastic about trying some different keyhole pathways through my tummy. He said he’d do the operation himself, even though that might mean a longer wait. I got a call in Turkey on 16 September asking if I wanted to come in for the operation the following Monday…. I said I’m in Turkey. So when do I want to come in then? I suggest 5 October, and in I went…. Excellent for me, but given that my surgery was elective and non-urgent, I did wonder a bit about the management of the waiting lists. 

      One is constantly seeing appalling waiting time statistics for the NHS, but that has not been my experience here in Hastings.

What is it like having an operation at the Conquest?  

       Everyone on the day’s list rolls up to the Richard Ticehurst Surgical Unit at 7.45am, washed, starved, with their little overnight bags. Frightened-looking patients and their anxious relatives cram into a waiting lounge with not quite enough seats. [Hint – get there before 7.45 to be sure of seat].
      Lucky Battleaxe, each time I’ve been first on the surgeon’s list. Even being first, you wait until operating work starts at 9am. For those with later time slots, it must be long, stressful and arduous. Could anything be done about that? Stagger admissions somehow?

      In earlier times, in Birmingham, I’ve been admitted the night before, but I found that worse – the lonely, anxious night in the ward, and the scary journey to theatre on the trolley with the endless corridor lights flashing past above your head, bombarded with raucous banter from the porter…..

      However, in Hastings, you are eventually called to have your paperwork checked, and to see the anaesthetist and your surgeon.  Philosopher came with me. This time, we both found the anaesthetist a little dour. He would only say rather grumpily that he’d ‘try’ to avoid me being sick, and that he would ‘try’ to preserve my expensive cosmetic dentistry. 
      ‘Nevertheless’, says Battleaxe, ‘Just Do Not Break My Teeth!’

      Mr Miller was as jolly as ever. Rubbing his hands with glee, he said that he had set aside double time to do my op as it would be ‘challenging’. He prodded me happily. 
     ‘Mmn, difficult! Shall I try to put a hole in there? Or maybe there?’ I would not know until I was awake again whether it had been keyhole or an open operation.

      Then, you squash into a little cubicle to undress, put on your gown, haul on your nasty elastic stockings and put on your dressing gown. All your clothes go in one of those plastic baskets you use for gardening. Then you sit and wait, with your companion, outside the doors that lead to the operating theatres. [Hint: if you wear glasses, they let you keep them on in the anaesthetic room. Take a glasses case, labelled with your name, for them to put the glasses in]. 

       We were sitting with a young man and his girlfriend when the double doors crashed open and a large scary woman appeared, shouting ‘One of you lovely people is mine!’ We four collapsed into a theatrical routine of flinching, hand-flapping and gurning, which made us all laugh. She pointed at me. ‘It’s you!’ 

       I said farewell to Philosopher, followed the woman through the doors, down the corridor, clambered up onto the trolley in the anaesthetic room and lay down. In my experience, you do all that in a numb trance of terror. Bit like going on stage in the Albert Hall. Turns out the woman, Sara, was very nice, the dour anaesthetist’s up-beat side-kick, obviously managing the bed-side manner for the two of them.  He was no more cheerful. 
      ‘You’re not very friendly’, I told him while he put the cannula thing in my hand. 
      He said, ‘Why would you want a chummy anaesthetist?’ Then, ‘you’ve had anaesthetics before, so I’m just getting on with it, OK?’ 
        ‘OK…’ Bang, I was asleep.  Maybe not friendly, but very efficient.

        Actually, I’d rather have that than the usual ‘have you been away on holiday’ stuff most of them try. What do they think it is, the hairdressers?

        I woke up on one of the short-stay surgical wards, Cookson Attenborough, a positive tranquil haven of peace and quiet – in fact most of the beds seemed to be empty. I’d had the keyhole job, in fact only three holes instead of the usual four. All teeth in place. The staff were very nice, and Mr Miller came to see how I was.  He said the op had taken 3 hours, and he’d had to crush the stones to get them out…. Ugh. However, I could scarcely enjoy the peaceful surroundings, because two hours later Philosopher took me home. 
       They’d said ‘Are you feeling well enough to go home, love?’ Being me, of course, I said yes, even though I was already feeling sick. Wrong of me, but I also don’t think they should have let me out so quickly. [Hint. If in doubt, just say no. They have provision to keep you in overnight, and it’s no use being home if you are not well enough to manage].

        Now here’s something for the hospital to consider. The information they give you about aftercare is not good enough. It is different depending who is talking, and is rattled off to patients who are too groggy to take much in. You do get bits of paper to take away, mine look tatty and are far too vague. Mr Miller said if I had problems to call the hospital, the ward nurse said to go to the GP.  
        In terms of caring for the wounds, I heard a confused and divergent jumble about showering/not showering, for two days/five days/over a week, keeping dry/soaking the dressings off, going to the Practice Nurse to have the steri-strips off/letting them fall off naturally. Am using past experience and common sense. High Street tattoo parlours have practical things to say about avoiding infection and wound care. [Battleaxe hints from tattoo parlour – to keep wound dry in the shower, wrap the appropriate area in cling film].

Tatty bits of paper – not much use

      They all said about the necessity to take masses of pain killers at home. Fat chance of that, I just threw them straight up, and by the next day poor Philosopher was faced with this vomiting, groaning creature, in loads of pain, with no clarity about who to ask for advice. He went down to Harold Road, and I got anti-sickness pills. All fine, but what if it had been the weekend? Got the sickness under control, and can now eat and drink, but have had no painkillers since arriving home. 
      Actually, the pain from the incisions was not bad, but what was very disagreeable was sharp shoulder pain from the gas they inflate you with when doing a laparoscopic procedure. According to the internet, the gas gets trapped under the diaphragm, and the pain is referred up to the shoulders. If you didn’t know what it was you’d think you were having a heart attack… It is very common, and goes away on its own in a couple of days, but the hospital said nothing about it, nor the fact that nausea after gall-bladder surgery is also quite common. 

       One last thing, the painkillers they give you to take home are paracetamol/codeine. Bad choice there – constipating and nausea inducing. I wouldn’t have touched them anyway, just stuck to paracetamol and Nurofen.

       So, hospital, better after care information, please. Produce clear, practical leaflets relating specifically to common procedures. Get the discharging nurse to sit down with the patient, and/or their carer, go through the leaflet with them, make sure they take it in. Maybe a checklist? Discourage consultants from giving their own, different, versions. Be clearer about possible after-effects and what to do about them. More attention to this would save the NHS money on unnecessary follow-ups. 

       Overall though, as I said at the start, my care has always been very good.  I’ve never had to wait long, either for outpatients appointments or for admission. In outpatients, I’ve never been kept waiting, and I’ve always seen my designated consultant. I’ve been admitted to hospital at times that suited me.  I’ve had the best treatment going from two of the best surgeons, Miss Shah and Mr Miller. During my time as an in-patient, the nursing care was first-class, even though staff were rushed off their feet. I loved the food! 

      I know others sometimes do not get such good experiences, and that I am very fortunate. I just hope the hospital has systems in place to safeguard the less lucky, those who can’t speak up for themselves, the vulnerable and the less strong. 

I don’t see why the Conquest should be in Special Measures. Reading the inspection report, it seems to be mostly about leadership and governance. Duh? Believe me, it’s a nice hospital, and as far as I can see, you will be well taken care of by staff committed to  do their best with limited resources, leadership or no leadership. It can’t improve their motivation to be constantly told they are failing.

      Anyway, finally, here’s my second healthcare worker, Digby, on duty. This worker demonstrated consistent commitment to HHHSK, (heavy, hot, hairy snoozing kitty therapy), plonked on sore abdomen of patient. However, he could supply no evidence that his infection control practices and paw hygiene protocols were in any way compliant with NHS standards.

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