A dead SIRT

So this week I am at the cutting edge of medicine in our fine city’s Centre of Excellence. 

When I was in college the swots and go-getters were determined to do their internship in this place. It was where you went if you wanted to Get Ahead. 

I didn’t. I purposefully avoided the place. I chose to work in the calmer cosier environs of the Voluntary Hospitals (anyway, who wants to work somewhere that’s Involuntary?)

The go-getters liked wearing shiny pointy shoes and clicking their way up and down the corridors, studiously not answering their bleeps and talking about their research into peptides or whatever. And that was just the porters. 

So I don’t have very warm feelings for the place. 

I did get a private room though, which is about five billion times better than being in a noisy ward. And a bathroom en suite. Not as clean as you’d like. I won’t elaborate.

There is a fridge and a little mini hi-fi in the room with me. Should have brought my half-empty (I mean half-full! half-full!) bottle of Prosecco from home and a Van Morrison CD. There’s a TV but no one can find the remote. There’s very variable wi-fi. The bed is comfy and the novelty of pressing the buttons to move it up and down still hasn’t worn off. 

In a further addition to the “I Didn’t Think That Through” Chronicles, I have to have a catheter inserted at 5:30am. (I would provide a warning about too much information but I think if you’ve got this far with me that’s a bit late.) No breakfast allowed. I can hear the trolley rattling up and down the corridor outside and can imagine the little steel pots with their scalding thick brown tea in them, and the purple plastic bowls of pale yellow catering cornflakes. Starving.

Eventually I get wheeled down the corridor in my bed, steered by Little and Large porters. I am truly mortified this time, ducking my head in case I see someone I recognise. Even though the bag of wee is hidden under the covers, there’s something about knowing that it’s there that gives you the feeling of standing in the street and realising you forgot to put your trousers on.

Then we reach the xray holding bay and the thought of a panic attack enters my head. Which is really almost as bad as a panic attack itself. I get flashbacks to fifteen years ago (helped by the fact that not a single thing has changed here in that time - I’d swear there’s the same lone Thank You card pinned to the notice board.) We used to have to accompany patients from the Voluntary Hospital to the Centre of Excellence for angiograms, as such technology hadn’t yet reached the southern suburbs, and the intern’s job was to press on the poor individual’s femoral artery after the angio was done to prevent him from bleeding to death. I never once felt in control during that process and spent eight sweaty hours every Tuesday for two months terrified that the fella would exsanguinate and it would be all my fault. It never crossed my mind to ask for help, or to suggest that the burly cardiologist with hands like spades might do a better and more efficient job than the little scrawny girly intern with matchstick fingers. 

I lie back in the same cubicle that we were in when a relatively young man did indeed start spurting arterial blood all over me, while I frantically tried to find the pulsing hole again under the ever-increasing pool of blood. He started to go a little pale, then a bit green, until at last I got the bleeding to stop. In reality it was probably only a 100ml or so that spurted out, but neither he nor I was the better for the experience. 

I really hope they don’t get the interns to do that any more. It is the only question I have when the slightly socially awkward radiologist (is there any other kind?) comes around. I sign a consent form for Mesenteric Angiography +/- embolisation +/- MRA. Yeah me neither.

It takes a while to get everything set up while I am on the hard narrow bed in the angio room. I had walked myself in there, eager to show off how alive I am, and how nonchalantly I can stroll around carrying my bag of wee in my gaping hospital gown. Should have accepted the trolley ride. I get to stand chatting with my two consultants while all three of us try to pretend there isn’t a plastic bag full of urine RIGHT THERE in my hand. 

They can’t find the right tube for the job. They phone a few other hospitals, no luck. They look behind the tube press. There it is, fallen down the back. We can proceed. 

I get the drugs and drift off a bit, but not as much as I hoped. My arm is cold, my back is in bits from lying flat. I politely ask for some more drugs about an hour later. Everyone is very calm and chatting away about things I can’t hear. The music is good. Eventually it is all done. It’s been three hours. I guess the drugs did work, it didn’t feel that long. I have to wiggle from the hard bed onto a softer trolley, then wiggle back on to a different hard bed in the Nuclear Medicine place. A ridiculously ordinary creamy metal box sits over me. No flashing lights, no lenses or apertures or screens, nothing at all to suggest any form of technology at all. Just a creamy box with chips and scratches on it. It moves slowly over me, left and right and down the sides of me. It is almost as unlikely as Reiki therapy to be actually doing anything useful. But, similarly, it seems it does. Gamma rays apparently. Who knew.

Finally I am wheeled back to the ward. I start the tug-of-war with the nurse about when can I eat, when can I get up, when can I have the catheter out. She is erring on the side of caution, I am erring on the side of I’M STARVING AND I WANT TO PEE LIKE A NORMAL HUMAN BEING.  

As has been proven so many times in the past, nurses always win. I did do the shnake and ask the consultant about the catheter while the nurse was in the room, so she was forced to hear his instruction to remove it about ten hours earlier than she wanted to. Hee hee.

I have the ever-wonderful post-fast tea and toast and feel fantastic.

She gets me a dinner later, way outside of normal hospital dining times (7pm? sure who’d be hungry at 7pm?). I horse into it (possibly an indelicate choice of verb, since it was a “beef” lasagne). My meat-free-ness will have to get over itself. I supplement it with a salad snuck down from the staff canteen by my trusty companion, and top it up with some fruit compote and a Mint Crisp. The meal of kings.

A good sleep this time, with no pre-dawn molestation. Have to start drinking contrast for the CT at 06:25 but that feels like a lie-in.  They have put about 300ml of orange cordial into the litre of contrast so my teeth are pinging from the sugar, but hey, it’s not Klean-Prep. 

With unprecedented efficiency the CT is done and all by 9:15. I walk back all by myself from xray, a little act of defiance that cheers me up no end. 

And then we wait. 

Mr Radiologist arrives in a very cheery red tie. He says the scan showed no change since the last one five weeks ago. No better, no worse. In the scheme of things, this is excellent news. So FOXFIRE is go. Or Selective Internal Radiation Therapy, to give it its much more prosaic post-marketing generic name. They are going to do one lobe at a time, so that I don’t get liver failure. How nice. So back in three weeks to have Yttrium-90 microbeads inserted into my hepatic artery, and six weeks after that to have another dose. I’ll be radioactive for a few days afterwards - they even use a Geiger counter to check when I’m safe to touch. Cool.

They have no idea if it will work or not, but hopefully the delightful smell of fried liver tumours will be wafting around me and all will be hunky dory by June. 

That’s grand so! Easy peasy.

P.S. I found the other passports. 

P.P.S The prayers, secular and otherwise, and the pennies in fountains, and punch-bags being punched, and the positive thoughts, and the notes being burned in temples, and all the other good will - it's all working chaps. Keep it up, if you don't mind. Ta.