Chapter 43 – The Aftermath of Surgery

“Being deeply loved by someone gives you strength, while loving someone deeply gives you courage.” – Lao Tzu

Austin had just gone into surgery and I was looking for anything that would help occupy my thoughts until it was all over.

Amy and Austin Stevens in the Namib Desert. Photo by Austin J Stevens

Amy and Austin Stevens in the Namib Desert sand dunes.
Photo by Austin J Stevens

I took the lift to the admissions floor, sat at a table in the hospital cafeteria and tried to read a book. My thoughts kept wandering to Austin and what he must be going through at any given moment, and I could not sit still. I put the book back into my bag and walked out through the entrance to the hospital’s garden, checking my mobile phone constantly to make sure I was within signal range if Dr Katelaris phoned. I sat in the sun watching the birds and thinking about everything Austin and I had been through since we met. This definitely ranked as one of the more difficult days. After only a short while, I decided to make my way up to the Urology ward. I wanted to be sure I was there when Austin came out of surgery.

Ninety minutes after Austin was taken into theatre, Dr Katelaris phoned my mobile number.

‘Hello?’ I answered.

‘Amy, it’s Dr Katelaris here. Austin is out of surgery and everything went very well. He’s in the recovery room at the moment but he’ll be taken to Urology shortly.’

‘I’m already there,’ I answered. ‘So everything went as you expected?’

‘I think I was able to reach both cysts and drain them. The prostate contained some solid material that we have sent to pathology for identification. We should have the results in a day or two. We drained the haematoma and there were no complications. Everything went very well.’

‘Thank you so much,’ I said. ‘That’s a relief.’

‘We gave Austin a spinal anaesthetic and sedated him for the procedure, which is safer than giving a general anaesthetic, but it will be several hours before he can move his legs again.’

‘Okay,’ I said. ‘I’ll be here when he arrives.’

For half an hour I paced up and down the waiting room. All I wanted was to have my man back in my arms. Every minute felt like an hour. When other visitors joined me in the waiting room, I resumed my pacing in the foyer outside the ward so as not to disturb anyone. After what seemed like an eternity, I saw two nurses wheeling Austin into a room just ahead of me.

‘Hi my love!’ I said.

‘Hi gorgeous,’ Austin said softly with a slow wave. For a man who’d just undergone major surgery, he looked pale but remarkably rested.

‘Give us two minutes, and then you can come in and see him,’ one of the nurses told me. As soon as the nurses reappeared, I made a dash for Austin’s hospital bed and hugged him gently.

‘How are you feeling my love?’

‘Much better now I’ve got you,’ Austin smiled. A brief look of discomfort flashed across his face. ‘My legs won’t move. It’s the strangest feeling, being paralysed. The nurses put these compression stockings on my legs and I could see them doing it, but it was like my legs weren’t attached to me.’ Austin struggled against the anaesthetic to move his legs, getting more and more frustrated when his body failed to respond.

‘Don’t,’ I said. ‘I know the lack of sensation must be horrible but it will wear off soon.’

‘They said it could take a few hours to wear off,’ Austin replied glumly.

‘I’ll stay here until it does,’ I said. I walked around to the other side of Austin’s bed where the urinary catheter tube emptied into a bag near the floor. The contents of the bag were bright red, a mixture of blood and urine.

‘What does it look like?’ Austin asked, straining to see over the end of the bed.

‘It’s quite bloody but we were warned to expect that,’ I said. I pulled up a nearby chair to sit beside Austin’s bed, where I held his hand. ‘It’s nice that you’ve got the room all to yourself.’

‘You know,’ Austin said, ‘it all seemed to go so fast. I remember at one point seeing an image on a screen that must have been what Dr Katelaris was seeing on his surgical camera and then they must have upped my sedative because I think I fell asleep again.’

‘Dr Katelaris phone me when you were finished and said everything went really well. He said he didn’t expect you’d have any further problems in future. We’re just waiting for a response on the samples he sent to pathology.’

Austin seemed to consider this for a moment, and then to put it out of his mind. We began talking about other things besides the surgery for the first time in two weeks. After approximately four hours, Austin regained the sensation in his legs but quickly found that the catheter prevented him from lying on his side. He would have to sleep on his back throughout his hospital stay, as the catheter would not be removed until the day he was discharged. Around 8pm the staff brought dinner for us both and we watched television together, clinging to each other’s hands the entire time. Soon after dinner, a nurse informed us with a kindly smile that visiting hours were over, but I sensed that she had little inclination to separate us. Sure enough, the nurse conveniently ignored my presence when conducting her rounds and it was not until near midnight, when I feared I would soon be too tired to drive, that Austin encouraged me to leave. I kissed him goodnight and promised I would return first thing in the morning. When I arrived home, I phoned Austin’s brother, Martin, in South Africa to let him know that Austin was all right and I also typed an email to Tigress Productions telling them what little we knew so far.

The next day I parked as close to the hospital entrance as possible and raced up three flights of stairs to the admissions floor. From there I took the lift to the urology ward where Austin was having a late breakfast after showering. He required assistance to move about due to the catheter, but he seemed in much better spirits and informed me that there was only a moderate amount of pain. Early in the afternoon we had a short visit from Dr Katelaris, who informed us that the pathology results had come back negative for cancer. He gave us some information outlining what we could expect in the coming months as Austin healed from the surgery and he advised us that Austin would need to refrain from his regular work-outs for approximately six weeks. I could see that Austin was not terribly impressed by that requirement!

I spent another night at my mother’s house, phoning Austin to say goodnight before going to bed. The next morning, I called him before beginning the drive to the hospital to see how he was doing, and he informed me that barring any unforeseen occurrences, he was going to be discharged that afternoon. I arrived at the urology ward around 10.30am and the nurses came in shortly after and removed the catheter. They told us that once Austin had passed urine without the aid of the catheter, we were free to go. They brought water, orange juice and tea for Austin, and once he felt ready I walked with him to the bathroom and stood close behind him, helping him to stand. Within seconds Austin groaned and collapsed in agony and I caught him under his arms before he hit the floor. I immediately pressed the red emergency assistance button on the wall beside me.

‘Oh God, the pain…’ Austin said breathlessly, doubled over and clutching his lower abdomen. He was struggling to draw breath and looked as white as a ghost. Just then, a nurse responded to my call for assistance.

‘Can you help us?’ I said. ‘He just tried to urinate and then collapsed in pain.’

‘We see this often after this type of surgery,’ the nurse said. ‘His bladder has gone into spasm and it can be excruciating.’ The nurse helped me take Austin back to his bed, where we laid him on his back. The nurse proceeded to administer analgesics.

‘Oh, that was terrible,’ Austin breathed. He had broken out in a cold sweat and looked absolutely awful.

‘Give the bladder a few minutes to relax, and then try again,’ said the nurse. ‘We can’t let you go home until you’re able to pass.’

I sat beside Austin and gently stroked his head. ‘My poor man, I’m so sorry you have to go through this,’ I said.

‘That was among the worst pain I’ve ever felt in my life,’ Austin told me.

‘And you’ve had plenty to choose from,’ I muttered.

Amy and Austin Stevens in Etosha National Park, Namibia. Photo by Austin J Stevens

Amy and Austin Stevens in Etosha National Park, Namibia.
Photo by Austin J Stevens

Over the next hour Austin summoned the courage to make multiple attempts to empty his bladder but each was met with similar results. A bedside ultrasound showed that his bladder was filling rapidly, but he simply could not pass anything. When he was too uncomfortable to continue, the nurses made the decision to re-catheterise. This meant that I would have to take Austin home with the catheter in place, and he would have to rely on it to empty his bladder for the next seven days, until his follow-up consultation with Dr Katelaris. I held Austin’s hand as the nurses struggled to pass a catheter tube through the wounded prostate gland and into the bladder, but they were unable to bring about the flow of urine. Eventually, the nurse educator was summoned to make another attempt, and she selected a smaller tube. After a couple of minutes of experimental positioning, a small stream of urine, dark red with blood, began to drain out of the tube and the nurses then affixed the tube to a small bag that they strapped to Austin’s leg. As they explained to me how to care for the catheter bag, we both felt that Austin was not yet ready to leave the hospital and expressed as much to the nurses.

‘You’ll be fine,’ the nurse educator said. ‘It’s very common for patients not to be able to pass urine after surgery and many of them go home with the leg bag. Here is the larger version that you can exchange for the small one overnight, which will give you more time before it needs to be emptied and cleaned. If you find that the bag is not filling with urine, it’s possible that blood clots or scabs from the healing tissue have blocked the drainage holes in the top of the catheter tube. If that happens, come back to the hospital so we can flush it for you. Try to drink as much water as possible to decrease the chances of that happening.’

Austin and I blanched simultaneously as we imagined hurried trips to the hospital from our faraway cabin, and we made the decision on the spot that we would remain closer to the hospital at my mother’s house until we felt more confident.

The nurse proceeded to show me which valves to depress in order to empty the bags and how to replace the tubing after exchanging bags, and I committed the information to memory while fighting the feeling that we were being hurried to leave before Austin was ready.

Austin remained in bed for another half an hour until he felt strong enough to attempt the walk to the car. He managed to keep control of his claustrophobia as we took the lift down to the admissions floor rather than the stairs, and I helped him step by step to the car.

‘This doesn’t feel right,’ he said gesturing to the catheter now hidden under his pants.

‘I’m not surprised,’ I said as we reached the car. I had come prepared with pillows and I lowered the front passenger seat so Austin could lie back.

‘No, it’s more than that. It almost feels like the tube isn’t in the right place or something, like it’s slipping out.’

‘The nurses assured us it couldn’t,’ I reminded him. ‘It has a small balloon at the top which they inflated with air from a syringe once it was in place, so that it can’t come out of the bladder,’ I reminded him. When he did not respond, I asked, ‘Do you want to go back and ask them to check it?’

‘No, they wouldn’t have let me go if they thought there was anything wrong with it,’ Austin said. I immediately saw the logic of his statement.

‘Okay, then we’ll go to Mum’s house and see how we go. We’ll only be half an hour away then if anything happens.’

I helped Austin into the car and he sat back, looking awkward and uncomfortable. ‘Are you okay, my love?’ I asked.

‘Not really,’ Austin said. ‘I just don’t feel right about this.’

‘What do you want me to do?’ I asked, running through all the possible scenarios in my mind.

‘Let’s try this drive,’ Austin said. I climbed into the seat beside him, started the engine, and pulled out of the hospital car park. All seemed well until we were halfway to my mother’s house.

‘Ohhhh, it feels awful,’ Austin said, clutching his abdomen. ‘I need to go but it just seems to be building up and not flowing…’

I was immediately concerned and took my eyes off the road for a moment to glance at him. What I saw filled me dread. Austin’s pants were wet and stained bright red with blood, which was spreading down his leg at an alarming rate!

To be continued in Chapter 44, in which we discover that Austin’s recovery would not be as simple as we hoped…

Have you or a loved one ever been through a major operation? Did everything go as planned, or did you encounter complications you had not expected?

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