Chapter 27 - The Yoyo

I made a hasty readmission on Saturday night once I realised that I was obviously becoming unwell and it was nothing to do with watching Broadchurch. But despite initial optimism, I didn't make it back home on Sunday, or even Monday and to be honest I would have been kidding myself to think that going home again then could possibly be the right thing to do. Before Sally and I left home on Saturday evening my temperature began yoyo-ing between 35.5 and 38.4 and I was perhaps ill-advised to take paracetamol at home since it obviously masked the underlying problem. I was shaking violently and despite having a high temperature felt cold; at least until re-entering the hot-house that is Southampton General.

My temperature, once admitted on C3 AOS ward, was clocked at nearly 40! In fact it took the nurse five devices and several attempts to get a sensible reading; I was seriously dehydrated and couldn't stand bright lights; even the old fluorescent tubes on the ward and the screen on my iPhone dazzled me. An hour later with an i/v antibiotic on board, I was back down to 37-something and feeling a whole lot cooler, and they wheeled me from the relative peace and quiet of C3 AOS to the noisy clatter and bustle of C4. I hadn't been back on this open bay for some time and it doesn't seem to have improved in my absence. Nothing you can put your finger on as the staff are great and everything is there (you even get a hot cup of tea at 7.30am) but it lacks the camaraderie and 'family' atmosphere of D3. It's all a little impersonal.

Neutrophils following a similar pattern to my platelets; slow later recovery

Topping Up
So the next things to tackle were my blood counts which were seriously low:

Neutrophils: 0.0
Platelets: 20
Haemoglobin: 62

Nothing much to be done about the first one but they gave me a pool of platelets, followed by no less than three bags of whole blood to tackle the rest. Whole red blood has the effect of thinning down the platelets, hence the extra platelets first.

Investigations
Blood cultures were taken to see if anything nasty was growing, a urine sample for the same reason and sputum sample to cover all the angles. A midnight X-Ray topped it all off. Try doing all that at home, whilst continuing with 8-hourly i/v antibiotics.

By Tuesday, and the smiling Prof Johnson's rounds (at least he resisted the temptation to say "I told you so", bless him), it became obvious that I am going nowhere until (a) my temperature stops yoyo-ing (which it had by then for 24 hours) and (b) my blood count has recovered to a point where they can stop the antibiotics, or at least revert to tablet form, and send me home without risk of further spikes and infection; that means many more neutrophils than the 0.0 of several days and even the heady 0.1 (!) of Tuesday. A glance at the chart above (thanks, Nanda Basker, for this and the previous post's chart of platelets) shows the sorry story rather well and reinforces just how vulnerable you are without an immune system! So I go nowhere in the hospital without a face mask and badger the lovely Spanish Nurse Eli for as much information as possible about my blood counts. The cultures and urine test have all come back as 'negative to date', which is good news; nothing evil lurking in the system, then.

No less than three bags of blood required

Only 24 hours later and - hey presto! - I trebled my neutrophils to 0.3, platelets positively skyrocketing at 34 and haemoglobin 92, so all looking much more positive for going home on Friday or Saturday.

24 hours later again and although platelets have dropped to 22 my neutrophils are well on course, at 0.5.

An Eventful Morning
Open wards are not the quietest of places at the best of times but this morning (Thursday) I was more than a little put out when at 4.45am my next door bed neighbour, who obviously couldn't sleep, struck up a loud conversation with another insomniac, covering a broad spectrum of topics from the price of tractors ("ridiculous") to the trouble with trying to sleep on open wards. I did make a few protestations along the lines of "sshhhh" but was greeted with a jovial 'oh, you're awake too, isn't it awful, still as you're awake join in the fun' sort of chuckle. After an hour of incessant and loud chatter, during which I did my best to jam my head between two pillows (to no effect whatsoever) they eventually gave up and all went quiet. I got my own back on one of the miscreants later when I walked past his dozing form and shouted "wakey wakey!" as loud as I dare. He jumped. Revenge is sweet.

More line learning. This is going to be a good 'un

Having had so much excitement for one morning I was a little surprised to get more in the form of Yet Another Move. Apparently ward C4 has a bed crisis and a broken window, necessitating me to be moved up one floor to D2, opposite my old familiar ward D3. I was not upset by this at all - far from it, it's a nice airy ward and the open bay I am on contains only four beds. Furthermore it is staffed mostly by many of the same people as D3 so I know most of them.

When the porter arrived he checked my name and asked if I was to be taken up on my bed with my belongings. I replied no, I was very happy to walk. Much sucking of air through teeth and the porter commented "well I'll have to check on that with my colleague, it's a bit irregular". I did make a half hearted attempt to explain that putting one foot in front of the other was not only within my capability but actually quite good for me but I giggling too much to reply at all.

But walk I did - the result of which meant that the bed stayed put and the porters trudged along behind me like a couple of sherpas to our destination one floor up. I think they had a job to keep up.

Life on D2

Horace, you have been surpassed by a newer, prettier, lighter version

To be honest life is not much different but there is a view, a constant parade of familiar faces - Theresa, Grace, Debbie, Edit - and the whole place has a light, airy feel to it quite opposite from the oppressive darkness of C4. The only downside is that one of the two nocturnal miscreants from C4 has been sent up too and is in the next bed. If he tries it again tonight he's so much hospital fodder.

One thing - they've got a dead posh new type of Horace on this ward.

But it looks very feminine, doesn't it, so can hardly be called Horace. Suggestions for appropriate names on a postcard, please, or in the comments box below.