The document describes a patient's experience undergoing and recovering from a nephrectomy (kidney removal surgery) over the course of several weeks in March. Key details include significant delays in being transported to the hospital for admission, a cancerous lesion being discovered in the removed kidney requiring additional scans, and a very painful recovery process complicated by issues like paralytic ileus that required the patient to slowly advance their diet.

1. Nephrectomy Timeline
March 11th
Today is admission day, according to my letter admission time will be 1pm. This
being so, there's time to prepare and eat lunch, nor time for a midmorning snack,
firstly because lunchtime would be while I am on transport, and between 8am and
11am no food is allowed because of taking my immunosuppressants at 10am.
It's gone 1pm, a call to the hospital assured me that transport was on its way, to sit
tight and I'd be picked up soon. 2pm now still no sign of transport, another call illicited
the same response. 3pm, same nonsense all over again. Really annoyed now, I
explain that I hadn't had lunch and was very hungry, adding because I live on my own
(which they've known for ages) I'd be in no position to get something to eat and just
leave it if the transport was to turn up in the middle of everything.
Time still dragging, I'm still frustrated, because now it's 4:30pm and there's still no
transport. Another call to the hospital and I'm assured my driver is just dropping of
the last one on his current run and is on his way to pick me up as he's in my area. No
surprise that transport has yet to turn up, it's gone 5pm. If he'd been in my area, it
should've taken no more than 15 minutes to arrive.
At last! Transport has arrived it's about 6:20pm, I'm finally on my way. Got to the ward
at 7:40pm barely time for half a sandwich before 8pm arrived, no food allowed now
until 11pm, all due to my having to have my immunosuppressants at 10pm. But who
wants to eat at that time of night? Paperwork followed, met surgeon, more
paperwork, next bloods and an ECG. Because of the operation being due tomorrow
morning, I'm not allowed to eat after midnight.
March 12th
I've only been allowed sips of water since 4am and enough water to take my tablets.
I've been told to take my immunosuppressants at 8am instead of 10am, this is
because I'm going to the theatre very soon. I've also been advised that I may have to
spend the rest of today in ICU and possibly tomorrow as well. That comes as no
surprise being as my nephrectomy is a major operation, more so than the transplant.
I woke up in the recovery area and not ICU as they thought may be necessary, I'm
really glad about that, very glad indeed. 3:30pm, I'm back on the regular renal ward
attached to a catheter (yuck), drain, NG tube (more yuck), and two IVs. I'm very
aware that under the rather long dressing is the incision through which they removed
my left kidney (aka Leftie, aka Brutus).

2. March 13th
I've woken up this morning still feeling weak, very uncomfortable and very, very sore
indeed. I've been told the catheter and the NG tube will be coming out today. That's
great news from where I'm standing (laying down).
They've removed those items and one IV as well, it's nearly lunchtime and I intend to
try and start eating as soon as possible.
Lunch is sausage, mash and peas with a good onion gravy, I'm looking forward to it.
My dear sweet #1 angel bought it to me herself, and cut up my sausages exactly how
I would've cut them up myself, she really knows me so well despite the very brief and
too infrequent times we share.
Lunchtime is over, I managed one delicious sausage, a few forks worth of peas and
mashed potato. This worried #1 angel, so I gently told her it would be a while yet
before I could do justice to her cooking.
It's a curious thing really, when she cooks the food, although it's very plain fare, it
tastes fantastic, but when she's off and someone else cooks the same food in the
same way, it's lifeless, tasteless and just plain awful. She puts her heart and soul into
her cooking, the others don't seem to do that, and there's the difference.
March 14th
Received an email from my surgeon this morning with eight photographs of my
kidney attached. The left side of my abdomen is still incredibly painful and tender
despite my regular pain medications. Dear, sweet #1 angel is very worried about my
continuing lack of appetite, especially as she's going home for a two week holiday.
March 15th
Today is the first day of twice daily subcutaneous heparin injections, oh joy, not! It's
bizarre how the vast majority of subcutaneous injections only present a mild to
moderate pain in myself, yet heparin injections are moderate to very painful, I often
wonder why that's the case?
Immediately after taking my early morning medications I threw up, over a litre of
gruesome, greenish fluid. Still very little appetite, in fact I don't relish eating at all
because of this morning's incident.

3. March 16th
There isn't very much to tell about today. Early hours were dreadful, numerous hot
flushes and bouts of nausea and then before medication time another massive throw
up. I still have very little appetite for food, I had no breakfast. I managed a little lunch
and dinner, later on in the evening I threw up again.
March 17th
In the very early hours of this morning I had been booked for a CT scan, the doctor
attempted to put an NG tube in to administer the contrast fluid, I couldn't cope with
that so I have to drink the contrast instead.
Went to the CT scan room, and they injected a different contrast substance via my
cannula. I have a metallic taste in the back of my throat and a rather strange fluid-like
hot sensation around mon derrière. After the scan we finally got the smallest NG tube
in me, not pleasant at all. Later on I heard that the initial findings suggested trapped
air, constipation and possibly a sharp kink in the bowels, somewhere.
It's been confirmed I've got paralytic ileus, which may have been caused by the
trauma of the sit very or the general anesthetic.
Much later that evening it started getting windy for the first time since before the
nephrectomy. Also I began burping quite a lot, but each uto was accompanied by
very painful churnings as if my stomach was a nest of vipers, and I don't mean paper
handkerchiefs. lol
Footnote: I even got out of bed today walking from my bed to the bay door and back
again. It was like climbing Mount Everest while doing a marathon at the same time.
March 18th
First bowel movement in a week, lots of wind throughout the day, I'm now on soft
foods (yogurt, mousse and jelly) plus two bottles of Fortisip Compact Protein.
Exciting eh?
Today I met with the senior physiotherapist, I told her all about my mobility issues as
well as how I was feeling post-operatively. She assessed my mobility with all that in
mind and provided a number of exercises for working my left leg. She also gave me
one for my abdomen that is incredibly hard to do, I've got to lay down flat on my
back, I really don't know if I can do this one.
I've been knocked back somewhat by one thing, while the removed kidney was being
examined in the laboratory they discovered a cancerous lesion in it, just over an inch

4. long. Talk about falling into the Slough of Despond.
Then about an hour or so later an experienced consultant who I've known for over a
decade and who is familiar with my case from its very beginning turned up with a
bundle of student doctors. He looked at me with his hand on my shoulder and
concern all over his face, he asked me to say what I'd been told.
I slowly recounted the news I'd been given, and my reaction to it, as I was also
nearing the end of my account of the news I began to struggle with it and I felt him
give my hand a reassuring squeeze. That helped me carry on, and as they walked
away, he squeezed my hand again.
March 19th
More wind throughout the night and early hours. There's going to be a multi-
disciplinary meeting today of nephrologists, urologists and oncologists to discuss my
kidney and the measures that need to be carried out.
I told the doctors later yesterday evening that I need to see the renal psychologist as
I needed to talk about what had happened. I was surprised and pleased when she
came today to start discussing how to move forward. This was very helpful as I
effectively was using her as a sounding board for the turmoil in my head.
The physiotherapist came again today to review my progress and to check I was
doing the exercises properly.
The outcome of the meeting I mentioned was there'd be three annual scans, if the
third is clear the next scan will be two years later and the one after that will be two
years later as well. If the final one of those scans is clear, then I'll be classified as
completely clear.
The was a single bowel movement today as well.
March 20th
There's a distinct possibility the drain and the NG tube will come out today, I'm
hoping this happens. Still only on soft foods in order to allow the intestines to recover
gradually. Too many false alarms sent me lurching towards the commode, I seem to
have fallen into a general malaise and lethargy, I wasn't even up to walking for the
physiotherapist today. I feel hungry, but don't feel like eating, I feel thirsty, but don't
feel like drinking. But I know I must do these things as they are part of getting better.
The NG tube has come out, this will enable me to eat more easily, but must be
cautious in how much and how fast I eat. I'm having meatballs and pasta for dinner

5. this evening. The drain didn't come out today, but is certainly coming out tomorrow,
it's being replaced by something called a stoma bag.
March 21st
Very windy throughout the night and early hours, bowels are still sluggish but are
moving in the right direction. Had an unprompted bowel movement before breakfast
and another after breakfast, hopefully this will mean no more subpoenas .. I mean
suppositions ... oh heck, suppositories.
The exit site of the drain is leaking, I've been told that because of this the drain will
definitely come out today and that they'll place a bag over the exit site. Initially the
drain will just be clamped to start with. The exit site is inflamed and very sore despite
my regular pain medications, so I was given an oral solution of Oxynom, a morphine
derivative that is safer for kidney patients than regular morphine.
Because they heavily taped the drain tube to my stomach and thigh to reduce
movement of the tube, moving about has become ververy difficult. Even the simple
act of walking for the physiotherapist was hellishly difficult. Another very productive
talk with the psychologist today, I'm sure she realises as I do that I'm using her as a
sounding board for all the stuff churning around in my head.
The surgeon and another doctor turned up just after I'd eaten my evening meal. I
declined explaining that having just eaten I wasn't very keen on the idea. So it's been
agreed the removal will occur around 10am tomorrow.
March 22nd
A very windy night again, two false alarms then a very small movement after a great
deal of effort, then an inordinate amount of paperwork. After a dry night, the drain exit
site is leaking again. It leaked even more while I was sitting up before, during and
after breakfast, had to wait until after handover before I could talk to anyone about
this.
Today's meals were prepared by a diminutive lady of Asian appearance, it turns out
that she was trained up by dear, sweet #1 angel, and she considers #1 angel an
excellent rôle model to respect and emulate. I didn't think I could've been made any
more proud of my love, but this raised my pride in her even higher.
I had another dose of oxynom before the drain can be removed, less than an hour
after the drain is out and the bag is on. It feels rather weird. Sitting in the chair I'm
feeling wobbly and light-headed, after an hour of this I went back to bed, these side-
effects soon disappeared.

6. I tried to be rather adventurous today, my deodorant had fallen on the floor, so I
carefully walked around the bed, put one hand on the table and one on the bedside
cabinet. I lowered myself down slowly onto one knee keeping my back straight,
retrieved the deodorant then tried to stand back up. I just couldn't manage it, so two
nurses had to help me get back on my feet.
I made my concerns known about the serious weakness in my left knee, which
somehow occurred during my visit to ICU back in October 2013 but hadn't been
addressed despite the physiotherapy department knowing about it.
Now the drain is out and the stoma bag's in place some of the nurses and doctors
are getting rather pushy, so I've told them I'll make better progress in my own time as
long as I don't feel harassed. That's made them back off, at least for a while.
March 23rd
Not so windy last night, but this morning I've had several false alarms that were just
wind. I hope I can move my bowels before lunchtime. Half my staples are coming out
today, that's good news, they did it without the help of the oxynom, that's bad news.
Five massive efforts produced four very small jobs, and one wet and windy one, all
requiring large amounts of paperwork which is very annoying. Then effort number six
arrived an actual decent sized movement. That was actually followed by a windy
false alarm. They decided that I'd have to have another dose of Lactulose before
bedtime.
March 24th
Two small jobs in the early hours, one good sized job at 6am, two more small jobs at
8am and 9am, medium at 10:30am. Big job just before noon, and around 2pm.
I'm scheduled for a CT scan of my chest this afternoon, this means another flipping
cannula has to be inserted. Cannulated after lunch, expecting to go for the scan
anytime now. Then I'm informed that it may be this evening, that isn't a problem. But
then I'm told it won't be happening until tomorrow morning.
One doctor told me they could leave the cannula in and bandage my arm to keep it
secured, or I could have it removed and another inserted again in the morning. Then
another doctor out-and-out told me it would have to stay in, he disregarded the fact
that this would prevent me from being comfortable overnight, and I strongly objected
to this, demanding to see the other doctor again. That doctor didn't come back, but a
little later a nurse came along and told me she would be taking my cannula out.
There is an interesting conflict of views between the doctors and the physiotherapist,

7. the doctors have told me that they will be happy for me to be discharged if the
physiotherapist is happy with the idea. And the physiotherapist has told me that she
will be happy for me to be discharged if the doctors are happy with the idea. There's
a puzzlement indeed.
March 25th
Overnight was only slightly windy, cannulated and bloods taken before breakfast. I
discovered today that the physiotherapist had asked to see me way back on the 17th
of March and was told that I was too ill to see her. As I said to her, even if we didn't
work on any exercises she could have got the necessary things going that much
earlier.
The bag collected less than half it's capacity over the last few days, the bulk being in
the first twenty-four hours. It's been removed and a pressure dressing has been put
in place over the hole that remains which will heal as all wounds do from the inside
out. I'm now all packed and ready to leave. Read in the next part what happened to
prevent my departure.
March 26th
It's about 5:20am, I'm still in hospital. Yesterday I should've been discharged, the last
of the staples were out, the stoma bag replaced by a dressing, and the last cannula
removed. But then while talking with the renal psychologist all hell let loose inside. In
fact I've a better idea of the feeling of that Shakespearean line "Cry havoc! And let
slip the dogs of war!" Why? Well now, imagine your worst pain emerging like this.
It starts soft, and focused in a single spot, slowly it becomes a little harder, and
harder, harderstill love, all the while becoming sharper too. It becomes as hard and
as sharp as a diamond tipped drill. Just when you think it can't get any worse, it
destroys you like a depleated uranium tipped shell vapourizing a box of man-sized
paper tissues. That's what hit me yesterday, starting at a small point between the
lower lumbar region and the high blade of the pelvis on the left of my back, pushing
through me and fanning out as it arrives between the midline incision site and the
drain's exit site.
Add now to that a churning nest of massive boa constrictors writhing about like
there's no tomorrow. And such a constant urge to have a bowel movement that you
visit the bathroom three times in under two hours. Each time ridding yourself of so
much that it shouldn't be possible to have anymore waiting in the wings, but then as
much as before departs your body.
That was yesterday afternoon between 3pm and 6pm, with just the pain alone
continuing throughout the rest of the evening. Ouch just doesn't cover it.

8. Thinking about the whole event, the drain while removing fluid from the abdominal
cavity was inhibiting the peritoneal membrane from doing that small, but significant
part of its duties. I had been told that removing the drain would trigger this, it did after
a fashion. But the brown stuff didn't hit the whirly thing until the bag was replaced by
the dressing. That's when it all kicked off, it would explain the churning of my guts,
the strong and almost constant urge to empty my bowels, and the pain as well. Why?
Because after so many days of not doing that part of its job, it must have swung too
far the other way. That's only my educated guess, and I could in fact be completely
wrong about that.
March 27th
It's great to be home, slept better last night than all those nights in hospital. Big
problem I'm seriously short on certain medications, so I'm going to do something that
is considered unacceptable in my doctor's surgery, I'm going to put through a
telephone request for these medications. It's incredible, the receptionist accepted my
request, the prescription will be prepared and signed by the doctor sometime this
morning. She said she'd do it because I've never made a habit of doing that sort of
thing, I replied that I thought it may be the very first time I had done so. I've been with
that surgery since later 2006 and I've always done my best to comply with their rules
and guidelines.
Emboldened by this I called my pharmacy, which is just across the road from my
surgery, advised them that the prescription will be prepared sometime this morning
and could one of them pop across the road later and pick it up. They confirmed that
they will do so, and I asked if the medications could be delivered tomorrow, and they
have agreed to that as well. I just can't believe how incredibly fortunate I am to have
such good support in my community.
Someone came from the local Intermediate Care Team this morning, to see if there
was any support or advice they could provide. The silly person talked loudly and
simply as if I was deaf and daft. So I just answered calmly, quietly and intelligently in
response to her initial parroting. She soon realized that I was neither deaf or daft, and
continued in a normal manner. They couldn't offer me anything, because over
yesterday evening and this morning I'd figured it all out for myself.
Well that's the whole of the tale as best as I can put it down in plain English. I hope it
has been informative and given you an insight as to the things that went on with
respect to my nephrectomy. I'm not saying all such operations will go the same way,
every operation will always have a different outcome.
Thank you for taking time to read this account of my days in hospital.