Just home after spending 5 days in the Hospital Universitario Virgen de las Nieves in Granada having a couple of operations replacing my DAI, "Desfibrilador Automatico Implantable" or Pacemaker to be less exact.
I had the old DAI implanted in the left hand side of my chest, below the collar bone) since February 2022. It's job was to synchronise the right and left ventricles of the heart to beat at the same rate, together. It was working really well and my hill walking performance and energy had really improved during the spring and summer. It also provided a backstop which in case of major heart problem would attempt to reset the heart automatically. A reassuring, if expensive (€18000) thing to carry around with you.
Unfortunately a growth, a Pyrogenic Granuloma to be exact, had developed over the site of the old wound. This is when the bodies immune system overreacts to invasion of a foreign body. My mistake was that I didn't go back to the Surgeon as soon as this started showing, I had waited until it got worse, much worse. This meant a simple minor operation became a bigger problem.
I spent pretty much the whole day, Monday the 3rd of October, with my friend Felipe, in and out of the hospital trying to get admitted properly. The surgeon had admitted me verbally and had room for me, but the paperwork all had to be caught up on. A bit of a frustrating day but by the end I was installed in the 3-bed ward 804.
I had been fasting all Monday so was grateful for some food on Monday evening as the fasting would begin on Tuesday ready for the mid-day operation. I was called for the operation just before 2pm on Tuesday afternoon and wheeled down into the lower floor labyrinth of the surgical operating theatres. I was met by a team of at least 6 doctors and nurses. Didn't they look young!
The "team" all knew their jobs and began racing around preparing me for the operation whilst chatting and talking to me, putting me at ease. Very friendly group. I felt in safe hands and at ease. I remember the anaesthetist saying "Great Dreams Richard" ... and then nothing. Blank.
I came round in the ICU (Intensive Care Unit) ward sometime later. Not sure how long I was in the operating theatre but may have been 3-4 hours. I don't like ICUs but I knew what to expect this time. IV fluids, bed baths, constantly measured and evaluated. Fortunately I was out of there the following day, Wednesday, at midday and back into my old ward.
I had had two operations. Firstly, to implant a new DAI in the right hand side of my upper chest. 3 cables connected from this to different sections of the heart. The second operation cut out the old DAI from the left hand side of my upper chest and then cut out the offending Pyrogenic Granuloma. The wound (hole!) was packed with wads and bandages and covered.
My ward consisted of two other "inmates", Rafael and Antonio, both in their 70s. As I glanced around I reflected that I was in considerably better shape than either, fortunately. In Spain on the social health system, the family is supposed to perform menial tasks at the bedside and not take up the time of the nursing staff. Both Mrs R and Mrs A were in attendance. But, where was Mrs H? All of a sudden, like an angelic vision appearing out of the gloom came Mrs H from the corridor outside the ward. Yes, Kiersten had come to the rescue. An emotional moment for both of us.
Later that afternoon I was told a further operation would be necessary on Thursday to close the wound that they had left open. They hadn’t closed it during the original operation as they were wary of infection. Now after courses of antibiotics and medications they decided that it could indeed be closed. Nurse Mercedes came to clean the wound. Now that was a funny experience.
I had thought it would be an open wound, almost like a burn. When the bandages were unpacked it turned out the hole was larger and deeper than I had suspected. 4 wads had been packed into the hole which was 5cm long, 2cm wide and 5cm deep. I peered down into the wound and saw this deep red mass of blood vessels from the inside of my chest. Nearly made me sick. I couldn’t look after that.
Then I had a funny experience. Nurse Mercedes warned me she was going to spray an ice cold liquid into the cavity followed by an alcohol based cleanser. I gritted my teeth expecting the worst. The sprays entered the wound. What did I feel? Absolutely nothing. Nada. I never have thought about this before but I guess the inside of the body doesn’t contain nerve ending so doesn’t have the same sensations as the outer skin. It doesn’t feel cold, heat, pain?
During the night my fellow inmate, R who had just been brought back from his operation, kept trying to escape from his bed and leave the hospital despite prison guard, Mrs R, constantly admonishing him. Honestly, it would have made a good reality TV series.
I was doing a lot of bloody fasting! I had to fast again for the Thursday operation. Due to more urgent tasks they came for me at 3pm and appeared back in the ward at 6pm. Kiersten was waiting. The operation to close the wound had gone well, all that remained was to make sure there was no infection. I was able to finally eat a normal meal schedule again and the recovery process could begin.
Friday morning I had expectations to be let loose after the weekend but a nice surprise came before 2pm when a doctor told me I could leave hospital. We were ecstatic. I could go home! All that was needed was a nurse to take out the catheter, the two IV drips from my arms and, more importantly for me, the very uncomfortable IV drip from my neck. Why the neck? Shortest way to get medications into the heart.
Imagine our frustration then when the following scene occurred all down to a little gadget that was attached to my DAI wound. The gadget (Smith-Nephew Pico 7) extracted air from the wound thus keeping up the pressure of the bandage on the wound. It promoted healing. I asked a question to the nurse about it and she went to check with a doctor. What a big mistake that turned out to be.
5 minutes later a group of paramedics arrived to transfer Mr and Mrs A from Granada to Almeria hospital. Ah well, shouldn’t take long to change beds and get him out of here should it? Unfortunately, Mrs A, who had hard a really tough few weeks looking after Mr A, had 3 travel bags not the 2 allowed. What?
Evidently, the ambulance wasn’t insured for that many bags. A heated discussion broke out between paramedics and patients, everybody talking at once. Phone calls were made to superiors and nursing staff intervened to cool down the situation. Complete chaos reigned. After a further hour and a half of me listening to this a way forward was found (Mrs A would find alternative ways). Mr A departed. I wished him good luck.
At around 5pm the nurse arrived and extracted all the bits and pieces that were sticking out of me and I was free to go. Or was I? There was a couple of final twists to the tale.
The first came after the catheter was removed. I couldn't leave the hospital until I had urinated. Doh, how frustrating! So Kiersten kept filling up bottles with tap water as quick as I was throwing them down my throat. All I wanted was to get home. After another 30 minutes I was able to do a small amount. Right that's it, it's enough, lets go.
Kiersten and I started walking towards the reception area and exit of the cardio wards. That’s when we were informed that I couldn’t leave the hospital without being in a wheelchair. Not on my own two feet. Maybe there had been some prior insurance event that had sparked this ridiculous state of affairs? Ok, no problem, lets find a wheelchair. And, of course, where was a wheelchair when you really, desperately, needed one? We searched around for another 30 minutes to no avail. Sod this!
That was when I made a probably illegal escape from the hospital, Kiersten and I furtively sneaking around between floors and trying to avoid doctors and nurses. Like something out of a James Bond movie. Me, trying not to look like a patient just out of two operations. Eventually we made the exit of the hospital proper.
A thousand thanks to the Doctor's, nurses and porters at the Hospital Universitario Virgen de las Nieves in Granada. You are not only professionals but also warm and friendly carers, enthusiastic in their work. I don't think one could ever say that they enjoyed their stay in hospital, but I came close.
Also thanks for the many messages of support over the past week. Much appreciated. For those who have supported Kiersten with offers of help, lifts etc. I thank you. Special gratitude to Felipe and Sean. I am out of hospital now and my eyes are turning back to the hills I so love. Will take some time and patience so I'm not going to rush.
"The mountains are calling and I must go" (John Muir) #