A Fleeting Relief

Sometime mid-afternoon, we watched a trolley with a multitude of equipment being wheeled past the door of the ITU waiting room. Marc was being brought back from surgery, having been down there for between three and four hours. I felt a huge sense of relief: the possibility that he would not come back from the operation alive had never been far from my mind.

I seem to remember the waiting room being much busier by then. Certainly, the visiting hours of 1.30-4.30 were in full swing, and whilst on Intensive Care this does not imply the mad rush of visitors caused by the single-hour window in other wards, there were certainly more people around. I expected to be ushered in to see him straight away (how foolishly ignorant I was of the needs of Intensive Care patients at that point) but was instead simply told by one of the nurses that Marc had survived the operation and, once he was settled back into ITU and reattached to all the relevant machines, someone would come and speak to me. This process took over an hour. Necessary, but none the less agony for those of us sitting outside with no idea what the operation might have revealed to the consultant.

To this day, I marvel at what the medical profession are capable of. Marc was in a medically induced coma, with machines breathing for him, IVs with various antibiotics, anaesthetics and fluids attached to him. The staff had managed to make all of this mobile, transported him to an operating theatre somewhere else in the hospital, kept him attached to all the relevant drips throughout his abdomen being cut open and completed the journey in reverse, hooking him back up to all the relevant equipment once he returned to ITU. All whilst keeping a dangerously ill man alive. It's no wonder that it took a while for them to settle him back into ITU.

An Update

Once they were ready, they asked us to come into the Relatives Room. This was another space, slightly smaller than the waiting room, on the other side of the hallway leading into ITU. I can't exactly remember who was there at this point, probably just myself, Linda and my mum. I know my dad was taking care of the children and don't think that my sister had arrived at that point. We were joined by Laura, the female doctor who had been so nice earlier on, and the current ward sister on duty in ITU, Rebecca.

They told us that the operation had revealed that part of Marc's bowel was ischaemic. When the consultant had examined it, some of it was the wrong colour and did not look healthy. Basically, it was dying. The operation had not revealed the cause of the ischaemia, but the consultant had acted rapidly to remove the part of the bowel which was damaged to prevent it from spreading. We were told that Marc now had a stoma. (This is basically when the end of the intestine which has been cut is directed outside of the body and an external bag is attached to collect the waste product.) Looking back, this seems like a pretty shocking fact to have learned without warning. At the time, it hardly registered. All that mattered to the three women sitting in that room was that he had survived.

No closer to a solution

The fact remained though, that the removal of part of the bowel had not solved the problem of what was wrong with Marc. He was still very ill and the medical staff were no closer to working out how best to treat him. At first I had taken comfort in the fact that Marc had got through the operation, but the faces of the doctor and sister across from us told a different story. They told us that he was now back in Intensive Care, still very much in the same state he had been the previous night, if not a little worse due to the added trauma of the operation. They were continuing to monitor him and would see how he went on through the rest of the day and night.

The point at which I realised his chances of survival were still extremely low was when I asked if I could go home for a while, to get a little sleep and see the children. Their faces told me they still had no expectations of a positive outcome from the situation, and they both immediately said no, I should not go home. I instinctively knew from this that they didn't want me to be away from Marc, as his condition could very easily worsen.

Stress and exhaustion

We were left in the Relatives Room for a little while to gather ourselves. Someone must have contacted my dad. I think my mum probably did. He had collected the children and all was well at home at least, but the stress and exhaustion was getting to me and all I wanted to do was leave. That sounds selfish to me now, writing it down. I should have wanted nothing but to stay with Marc and be there for him, but I honestly just wanted to get out of the hospital at that moment.

I went in to see Marc again. He looked much the same, except for the addition of a strange, thick blanket which seemed to be made of some kind of soft plastic tubes and a large new machine at the back of Marc's bed. Laura had told me that Marc was now on dialysis, which was removing the blood from his body and cleaning it before placing it back inside. Dialysis was something I associated with people without kidneys, and I was concerned that his kidneys were damaged: another thing to be frightened about. At this point there was no telling what kind of state Marc would be in even if he did survive.

Shutting down

Laura explained that when a patient suffers from sepsis, as Marc was doing, their body begins to shut down, one organ at a time. The heart would be the last organ to give up, should the patient not survive. Marc's lungs were being supported by the ventilator and his kidneys also now needed some help to keep on functioning properly. The staff had no way of knowing whether or not Marc's kidneys would recover, and I began to wonder whether or not Marc would need constant dialysis for the rest of his life, should he ever make it out of the hospital.

Anyway the dialysis machine seemed huge, and Marc had tubes coming from either side of his neck (I suppose a little 'Frankenstein' in style, if I can look back with a touch of gallows humour). These tubes were literally carrying the blood out of one side of his neck, across to the machine, through it (while it did its magic) and then allowing it to flow back into his body via the tube at the other side. The dialysis machine is a truly amazing piece of machinery, and I firmly believe that this process, which helped to purify Marc's blood and rid it of the poisoning caused by the sepsis, allowed Marc's organs the time and space they needed to begin to recover.

Distant

The only thing I hated about the process was the blanket. It was called a 'Bair Hugger'. (Though I prefer to spell it 'bear hugger'.) Patients undergoing dialysis can get very cold, and the blanket helps to retain the body's temperature whilst the process is going on. I found the name of the blanket comforting, and it clearly helped to keep Marc warm and alive, but what it did was reinforce to me how distant my husband was from me. I was told I could hold his hand whilst he was under the blanket, but it was difficult to find, what with all the thickness of the blanket and the multitude of tubes and cables running in and out of Marc's body and around the bed. Also, I was terrified that if I moved him at all, I might dislodge one of the tubes and potentially kill him.

This sounds extremely melodramatic, but at the time he was in such a poor state that I believed it would not take much to send him over the edge, so when I did hold his hand during those first few days it was extremely gingerly and with great trepidation. I met the two nurses who had taken over Marc's care that morning, and who I had met during the briefing with the consultant that morning. I remember one of them was called Amy, as she has the same name as our daughter. The fact that Marc had two nurses assigned to him was significant. It was yet another demonstration of how sick he was.

Asking questions

I must have driven them mad asking constant questions. As I have previously said, I didn't cry much during those first few days (although I know I did sit by his bedside and cry at least a little that day) but I think I distracted myself by asking every question I could possibly think of about Marc's care. I wanted to know about every tube, every machine, every IV solution that was being pumped into his body. The nurses were brilliant, and clearly understood that I needed to know, in order to be able to cope with what was happening. They patiently answered all my questions and allayed my fears about the constant noises made by all the different machines.

But they refused to say that Marc's condition was stable and avoided any of my attempts to get reassurance that it was looking like he was going to be ok. It would not have been responsible for them to do so, as he was still so very ill. And so I sat, for most of the afternoon, not able to go home and see the children or sleep, waiting again to see what would happen next.