30. PEG Tube Insertion

Monday 20th February 2:00 PM

Fear and Loathing...

I'm being fitted with a PEG Tube, that's a gastric feeding tube. The whole idea of which fills me with dread & foreboding. It's sold to me on the understanding that it will make recovery from the RT easier and quicker. If I can live for 3 months or so with the PICC Line in my arm then I guess I can learn to live for 2 or so with the PEG tube in my tummy. But still the idea creeps me out and I'm having 'extreme' difficulty maintaining the facade of being 'brave & strong'.

I'm due to be admitted into the Blundell ward of Guy's hospital at 2:00 PM, I'm there 20 minutes early, so I have plenty of time to feel sorry for myself and have a little cry. At 2:30 past I'm collected and taken across the corridor to the Esther Ward ( Blundell are full ) and I have my own room.

No jumping on the beds ?

There's a pay for view TV supplied by www.hospedia.co.uk its "pants". The screen is of such poor quality and such low resolution that with the contrast bright enough to see what's going on in the dark areas, the light areas are totally over exposed ( and vice-versa ) and there's continuous horizontal banding on the image. The sound is so bad that even with professional quality headphones there's a constant buzzing noise. And, the processor is so old and slow that loading "Facebook" or "Hotmail" involved staring for so long a blank screen that half a dozen times I was sure that the thing had crashed. And with the screen resolution being so poor that it made deciphering "Facebook's" security measures nigh on impossible, I gave up after the first 16 attempts, locking me out of FB on my phone too, an hour later it took another 10 tries to finally get the security words right. And, the OS was so old and clunky that FB couldn't even be displayed properly, and "Hotmail" crashed every time I tried to read a message.

4:30 PM a nurse comes to get me, a couple of the doctors needed to give me a quick examination... a camera ( endoscope ?) up the nose and down the back on my throat. I've had my stomach drained via a tube up the nose, I remember it to this day, vividly, it was FUCKING HORRIBLE. This actually turned out to be not nearly as bad as I had imagined, the endoscope is 'steerable', and the Doctor that performed the examination was so adept at her job that I barely felt a thing throughout the whole procedure.

At 6:30 AM Tuesday, I'm woken to get washed and dressed in gown and stockings ready for surgery. The nurse puts a hospital name tag on my ankle. I already have on on my wrist. I wonder what the hell can go wrong with this operation that they might need to be able to identify two separate halves of my body, what do they do... insert the PEG Tube using an explosive tipped harpoon ?

At 9:00 AM the nurse takes me to the surgical suite. A doctor comes and explains the procedure to me, The PEG tube is "pulled" through the incision in the belly with a wire instrument put down the throat and into the stomach, it's guided to the best location with the aid of an endoscope. I want to go home and hide. He leaves me to wait for my turn...

I'm waiting at one end of the recovery room. This is a surgical production line, there are six, maybe eight operating rooms radiating around the reception area, down one wide long corridor there are probably a dozen recovery beds on wheels lined up. The recovery room is long enough to accommodate well over a dozen beds separated by curtains, along the opposite wall there are eight or so specialty operation tables. Each one with a large heavy looking gray wheeled plinth festooned with foot pedals and levers and topped with deep black vinyl articulated beds.

I'm left to wait, on my own, at one end of this big empty room, alone and cold. I cry to myself some more. I really want to go home.

9:30 a nurse comes to get me, she leads me to the operating room. I stand there, hands trembling, bottom lip quivering, teary eyed. I really-really want to go home now.

Three are 4 'operating' staff and they take turns reassuring me, it 'kind' of works. I hop up onto the table. Thankfully all the drugs & medication will be via the PICC Line, so no needles. A quick squirt of an antibiotic and "pop" a little plastic 'gag' between my teeth. The whole procedure start to finish should only take 15-20 minutes and will be performed while being "heavily" sedated and local anesthetic. In goes the sedative, and I'm lying there thinking this better start working soon because I'm feeling no effects what so ever, I'm starting to think that unless I start to feel drowsy soon I'll have to say something, because I don't think this is working. That it I'm going to have to say something...

I come-to an hour and an half later in the recovery suite. Someone is saying may name, I'm wide a wake and as lucid as I ever am. The procedure was a success with no complications and they would take me back to the ward in half an hour or so. I check, I'm not in two halves.

Over the next 36 hours of recovery I have 4 or 5 episodes of excruciating pain, groaning out loud, fever, cold sweats, crippling stomach cramps, gasping for breath... The pain medication helps, but I keep asking for it during and after the attacks, and not at their first onslaught. They only last 5 to 10 minutes but their aftermath lasts well over an hour. I'll get the hang of it.

During Wednesday 22nd I have a stream of visitors, a dietition, nurses, a couple of doctors, a nurse to show me how to clean and flush "Tubie", a nurse to discuss pain management, nurses just popping in to see how I'm doing and not last and by no means least my very good dear friend John Behetts, who I haven't seen for years and who had read something that Jo had posted on FB and who I was delighted to see again. One of the doctors tells me that during the operation the team noticed that my oesophagus was looking a little inflamed, raw & tender, a classic symptom of either stomach ulcers or acid indigestion, and that they could see no evidence of ulcers. I would be placed on a six week course of medication to take care of it. I explained that one of my side effects from Chemo was indigestion and we agreed that that was almost certainly the cause.

Everyone on the Esther ward has been so very lovely, not just for taking care of me, but in the way in which they all took care of me. I have had two nurses specifically assigned to my care, I'm embarrassed to say I can't remember their names but well over half a dozen other that were regularly attending to me. 

One of my visitors that afternoon was a member of the surgical team, doing a follow up. He inspected the "wound' and was happy with what he saw, clean pink healthy no sign of any soreness or infection. As a parting measure he would just "release" the tube slightly, and give it a little "turn". It really fucking hurt, and off he went. The subsequent pain was so bad that I had to be given, in addition to the pain killers that I was already on, morphine. 

An hour or two later I was discharged from the Esther ward, and off for a consultation downstairs in the Oncology Outpatients Clinic.