Opinionista David Gemmell 15 October 2013

Rods in the groin and other joys of modern medicine

A few weeks ago, when consulting one of the country’s top Vascular Surgeons because of pain I was experiencing in my calves, it was diagnosed that the circulation in my arteries was being obstructed. No oxygen was getting through to my extremities and hence the pain. The cure, the eminent surgeon assured me, was just a matter of undergoing a simple procedure called an angioplasty. Sounded fine to me until I discovered what an angioplasty is.

It is a process whereby they, ‘go in’ through your groin with long rod thingys. They push these rods all the way down the arteries in your legs and when they encounter a narrowing; they inflate a balloon to widen it. At which point they can also deposit a metal tube, called a stent, to prevent the artery closing again.

The rod in the artery somehow still seemed acceptable, but I was having a lot of difficulty getting my mind around the ‘going in’ through the groin bit. I’m not sure if I’m different, but my groin seems to have an oversupply of nerves and is an extremely sensitive – and I might add – private area of my body.

However, having been told there was no other way, a week later on a balmy Monday afternoon; I presented myself at the private hospital in Pretoria, which recently served as Mr Mandela’s home from home. After filling in a mountain of forms, I was shown into a ward. There I was given one of those fetching little green gowns, which don’t have a back to them. They seem designed specifically to expose one’s bottom. I never did work out why. It was the beginning of the end of my dignity.

For the next few hours it seemed every passing nurse had a needle they desperately wanted to stick in me. Eventually, I had them hanging off my wrists, my arms and my feet – needles, not nurses. Sadly.

They also attached a million little electrodes to my chest, which hopefully would indicate to the surgeon I was still alive while he was operating.

The remaining item I was provided with was a long wire with a tiny sensor at one end to monitor my temperature. Apparently this sensor had at all times to be precisely positioned between my legs where they join at the top. Because it was loose, it kept displacing itself. But fortunately, it transpired that everyone in the hospital was responsible for this wire being in place. So I constantly found people I had never seen before, lifting my blankets and carefully placing the wire in situ. I could swear at one stage, in the space of an hour, the receptionist, the cleaning lady and a chap delivering bandages, all made sure it was in position.

Eventually, I was wheeled down to the theatre. There I met a whole gang of people wearing masks, who were very friendly; and curiously, also concerned about my temperature.

It is ironic how the one thing I truly dreaded, the operation, was no problem at all. It was a complete doddle because I was asleep throughout. The nightmare really started when I woke up.

I surfaced to discover a thousand tubes, wires and needles emerging from every orifice. The sheer weight of them prevented me from turning anything, but my head. I also felt a constant, painful urge to urinate. When I asked a nurse why that was, and how on earth I was going to manage with all the tubes; she smiled deceptively and said something I never want to hear again. “Don’t worry you have a catheter, so you will urinate automatically when you need to.”

A catheter is akin to a fire hose, which they insert into your bladder through your penis. The fact a penis wasn’t meant to have things inserted through it seemed to be completely lost on them. Never have I been so monstrously, excruciatingly and depressingly, uncomfortable.

At about 3:00 am, a night nurse chap arrived to say he could now pull the plastic out of the artery in my groin, as my blood should have thickened sufficiently to clot. Huh? I hardly knew who I was and he was giving me a lecture on the clotting properties of blood.

Maybe it was fortunate I didn’t understand what he was saying, as I think if I had, I might have topped myself on the spot. Twice, while he pulled, pushed and twisted in my nether regions, I heard my pulse monitor stop beeping. Completely unfazed by my heart almost ceasing to beat, he just calmly waited until it speeded up again. “We can’t lose you at this stage,” he said comfortingly. (So at which stage, I wondered dreamily, would he lose me?) He then proceeded to remove, through a hole the thickness of a drinking straw, a ton of plastic tubing from my groin.

He thereupon triumphantly held up the tangled mass of bloodied tubes and pipes. “It is amazing how they can get all this into an artery…” he said wonderingly. At which point I fainted. After a minute or two, I came around to find a group of nurses studying my now clean-shaven groin, discussing whose turn it was to position the temperature wire.

Fortunately, at that precise moment a sleeping tablet kicked in and I drifted off to sleep.

I awoke a while later to find my night nurse chap looking pleased. “Good news,” he said cheerfully, “the Prof says we can remove your catheter.” I cannot adequately describe what I then experienced, as he pulled a mile of jumbo hosepipe out of my bladder – through my penis. I don’t think any language has the capacity to describe how it is possible to die a thousand deaths, yet survive just long enough to experience every grisly detail of each one. I fainted again.

The next morning, after I had endured a multitude of scenes in ICU that doubtless would have inspired Kafka; the Prof arrived to update me on how it had all gone. Quite frankly, I didn’t care. I was just so bloody grateful it was all over.

“Very good, very good,” he said in his bluff, confident manner. “However, we only managed to do your right leg. It took longer than expected and we were putting too much dye in your system for your kidneys to handle. So we will do your left leg tomorrow afternoon. But don’t worry,” and he patted me on the arm as one would a child, “this time you’ll be fine because you’ll know what you’re in for, which is always better, isn’t it?” And he was gone.

I immediately tried to strangle myself with the temperature wire, but before I could find the tea-lady to tell me where exactly she had placed it, I burst into tears and vomited all over my little green gown. I hope Mr Mandela’s visit was less eventful. DM



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