Pain Control

As I said in my previous posting, I chose an epidural as my preferred method of pain control. It worked very well. I was completely pain free from the moment I came round after the operation until the epidural was removed on the following Sunday lunchtime.

Every few hours the nurses would check the area in which the pain was being control. This was done using a spray of very cold water. To begin with they would spray it on my hand so I could feel what it was really like then they would spray different parts of my body from my thigh up to my rib cage on both the right and left hand side of my body. I had to tell them how it felt. Where the anaesthetic was at its strongest I could feel absolutely nothing but where it was weak I could feel the spray. in some places it felt cool in other places where there was no pain control it felt very cold indeed.
The epidural can stay in place for five days so on the Sunday after my operation it had to be removed. I had been told that if I was still in pain after this withdrawal I could have pain control using a patient control morphine pump. To begin with there was no pain but after about an hour it increased and I asked for the patient controlled morphine pump. This was at about midday. It was then that things started to go wrong.

On Sundays the NHS seems to work on emergencies only basis. Doctors are thin on the ground and if they are required they take some time to turn up. The first thing that went wrong was that the line into my vein that would be used for the morphine collapsed and had to be replaced. It took ages for a pleasant but very young doctor to turn up to do it and he made a total pig's ear. When a little later a nurse came along to test it was faulty and he had to come back and do it again. Even when that was ready for the morphine that device itself was not available. It was now early evening and the only people with keys to the storeroom were three security guards and the duty manager. All these four people seem to be in the accident and emergency department involved in some sort of crisis and were inaccessible to my nurses. In addition two other nurses from the ward had been called away so they were short staffed. As the evening wore on the pain was getting worse and worse and I was getting quite desperate as to how it was to be control. Eventually they got the key to the storeroom and brought a pump to the ward but there was some incompatibility with the equipment on the ward so it was useless. Eventually they had to beg borrow or steal one from the emergency department. It was finally set up about midnight. I think there were lots of other little steps along the way but as the pain got worse they all sort of merged into one terrible experience. The trouble is, as one nurse explain ,that once the pain really gets a whole whatever they do is likely to be fairly ineffective as they are playing catch up.

Once the device was setup and I could administer a small dose of morphine myself every five minutes I could begin to get in control. It took about an hour before the pain became bearable again. After that I had very few problems. During the day on Monday I rarely press the little button to give me a shot of morphine and overnight on the Monday I used it only once. I was very happy for them to take it away on the Tuesday as I was quite convinced I didn't need it.

From then on pain control was limited to oral over the counter medicines such as paracetamol. And that was quite sufficient. Even now: I'll take the occasional tablet of pain killer when I ache a little bit.

The moral of this story is, I suppose, that nobody undergoing this operation should worry about the pain. However make sure that when the epidural is withdrawn the morphine pump is already available in case you need it. And of course don't let them do that on a Sunday.