12 hours Post TMJ prosthesis operation

A blur of images, sounds and sensations. Someone, a male, is telling me the operation went really well. A Covid swap is being given to me and I'm being told to take a test. Nausea. Confusion. Relief. I'm alive... what next?

It is twilight when I come round enough to form coherent thoughts. I can't see a clock but it feels around 8 or 9pm based on light and people's behaviour. My nose feels funny. I try to move to explore why but realise I am surrounded by tubes. A slight movement of my head immediately tells me not to do that again as the pain and nausea is intense. Slowly and carefully I raise my hands, one at a time so they are just in my eye sight. They both have cannula but one is split into 2 tubes. Painfully I touch my nose only to realise I have an oxygen tube attached. My hands slowly flop down and I sink back into blackness.

The next time I awake it is darker. Possibly nearing midnight but virtually impossible to know as I can neither see a clock or dare open my mouth to ask the nurse whose arrival seems to have woken me from my stupor. She efficiently takes my readings then vanishes, once again leaving me to drift off.

I have no idea how much time has passed when I next wake up, although it is still dark. My bed looks out of a large window giving a view of another section of the vast whiteness which is the QE hospital and I see shadows and artificial dim lights. A different nurse is approaching me with a syringe. `It's time for your meds. I'm just going to pop them in here' she gently says, pointing to the tubes protruding from a vein on my right hand. A strong memory of the overwhelming nausea which had engulfed me following meds given intravenously after my last operation swiftly forces me to try out my new jaw and ask for sickness relief. The nurse gives the dose then swiftly goes to get the anti sickness formula, yet when she returns it is first to flush my veins; a feeling of fire enters my veins and rapidly burns all the way up my arm, across my chest and to the back of my throat in seconds. Before I have time to protest she is inserting the anti nausea injection and once again flushing through. I lay in pain and apprehension wondering whether it was really worth it after all; the anti sickness medication, the operation, life... Thankfully, these thoughts dissipate after 20 minutes along with the evil sensations which had washed violently through my body.

Each visit from a nurse had included sips of the drink given via a straw at my bedside. As the peace settles the awareness of a tingling in my bladder pulls me back from the edges of sleep. The last nurse had placed the call button in my hand so I press it, knowing full well I would be unable to get across the room to the toilet myself in my current state. Time passes strangely in a hospital; sometimes jumping or leaping ahead during dozes and others dragging painfully while you await doctors, procedures, results. I guess it is around 10 minutes when I decide that my need to go to the toilet is outweighing my ability to wait for help. I try to sit up using a complicated system of adjusting the drip coming down from my head (I had expected this as I had one last time) and tiny movements to the bed yet am hindered unexpectedly not just by my oxygen tube but another one which appears to go off from my left side and over the bed, only to vanish - it's start and end points completely unfathomable to me.

My bladder is becoming very uncomfortable so I reluctantly press for the nurse again. After a short while a friendly faced nurse - yet another one I had not seen, or at least not in my conscious state - arrives asking what is wrong. I explain and she disappears for 10 minutes, ascertaining whether she can remove the oxygen briefly. It's only after she has removed the tubes and I am painfully and dizzily trying to sit up that I remember the other tube. I see that while I had been fighting the waves of pain she had found the end and was holding a large red square of plastic (approximately 10cm by 10cm). My medicated mind could only fleetingly query why she had red Tupperware and why it was attached to me, let alone where before focussing every ounce of energy and determination on standing upright, moving one leg at a time to cross the distance to the toilet. I had been carrying the small drip attached to my left temple as we walked so it was with confusion that she asked me whether I would be able to hold the other drip too while I went to the toilet. It was with shock that I realised that the red tub was in fact attached somewhere on my head. Deliberately refusing to look at it I took it and began the complicated manoeuvre involved in going to the toilet in a hospital gown, holding 2 drips, while feeling in pain and dizzy.

Relieved, I did my best to wash my hands - whilst trying not to get the cannula on each hand wet - discovered the nurse had vanished, and returned to my bed where I gratefully sank back into oblivion. I'm not sure how long I was asleep but my next realisation was that the old lady opposite me was calling for help. I couldn't explain to her about the button so pressed my own and watched anxiously as she became more hysterical, heaving and gasping. Perhaps it was my concern which made it feel so long but it seemed like 10 or so minutes before relief came and I was able to point the nurse to the lady in need.

As morning dawned my bladder once again made itself felt. I remember at the time being annoyed yet also feeling so grateful that I had requested the anti sickness medication as my experience this time had so far been so much better in that regards. My last stay had been a storm of waves of pain and nausea, of stumbling to the toilet and virtually collapsing, of heaving over a sick bowl. Feeling confident following my earlier success, I gradually prepared myself to go to the toilet, raising my bed to upright, removing the oxygen and lifting (but not looking at) my drips, however, once I sat on the toilet I made the fatal mistake. I looked. My blood pressure dropped suddenly as it always does when I panic as I realise that it is not a red tub. It is a clear tub full of my. Red. Blood. Resisting the urge to faint I once again wash my hands and return to bed, collapsing into sleep.

I mentioned in an earlier post how I think the NHS are amazing. Even before COVID I had known that they were something special. The stories my Mum had told me of her time working in a hospital as well as my own experiences over my lifetime had cemented this admiration, so when the old lady opposite was bruskly told off for having accidentally knocked, thus unhooking her drips whilst trying to get out of bed to go to the toilet (she had given up waiting for a nurse to come despite calling) I wasn't angry at the nurse. I was livid at society for making our nurses so tired, so rushed off of their feet that they had begun to loose their focus. I got the definite feeling like all hospital staff around the country this team was working long hours and long weeks on what is well known to be little thanks and pathetic pay considering the incredible job that they do.

But back to the TMJ replacement recovery...

I always find it amusing that the morning after TMJ surgery you are asked what you would like for breakfast. Surely it's obvious? Pain medication and vast quantities of cool water! So I always find myself doing a strange chuckle-groan when I am asked `would I like toast or cereal?' You try to explain that you can barely open your mouth let alone have a hope in hell of chewing. They just don't seem able to accept it. It's hilarious really. I know after the last operation I was told that I needed to eat something really soft just to prove that I was able to move my jaw, but the fact that I had repeatedly been told that I would be living on liquids and mush for at least a few weeks after my replacement should surely have gotton through to the nursing team? Once again the overpacked, overworked problem rears it's head.

So, following a breakfast of orange juice (it was all I could think about from the moment I fully came to) I began to have a proper look at my surroundings and evaluate my self.

What I knew so far:

• My neck and head hurt but not unmanageably.

• My nausea was only slight

• I had a small drip coming out of my left temple and a big one out of lower down my head/neck somewhere

• I had been allowed to remove my oxygen permanently following the readings at breakfast.

• The needles in my hands made it unpleasant to move.

• I was the youngest person on my ward by about 30 years.

• DVT socks don't look good on anyone.

By 10am one of the team I had met in the operation theatre visited me and repeated that they were happy with my operation and that I would be going home by lunchtime so long as the drips were removed. He said lots of other stuff and gave me bits of paper, but I had no idea what he said. I had just heard the magic words `going home'.

As soon as he had gone I began the mammoth task of getting out of bed, locating my bag, getting the security removed and texting my Mum telling her to make her way to Birmingham (she had a 2.5 hour journey). I then, rather smugly, used my charger as my mobile was running low. So pleased I remembered it! It's the little things in life. It was around this time that I realised that the 10 tonne weight was no longer pushing down heavily on my shoulders. Tentatively I probed my thoughts, trying to work out what was different. It was with a slightly manic bubble of internal laughter that I realised that I was happy that I hadn't died and could see my family once more; their development into teen and adults, their weddings, their children... I was frankly astounded that I had once again cheated death, and not only cheated death but done so with less pain and nausea than following the last operation. It wasn't until later that I learned that the enormity and intensity of the pain and the length of time I had suffered since summer 2018 had built up an incredibly high pain threshold and it was this, combined with the foreknowledge to ask for anti sickness medication which had made the difference.

By 12 o'clock I had managed to get myself dressed and packed. At 12.30 I had the drips removed and 1 o'clock the cannula removed. The nurse also gave me my discharge form and told me that following a visit from the pharmacist, I could leave whenever I was ready so long as someone was outside waiting to drive me home. So, once the pharmacist had given me my prescription (about 1.15) I made the very long, slow and wobbly journey by myself shuffling along the endless corridor and down to the foyer all the while holding my sick bucket just in case, briefly stopping for medicine then outside to fresh air and home!