“Death is not the greatest loss in life. The greatest loss is what dies inside us while we live.” – Norman Cousins
Austin had just been discharged from hospital after undergoing surgery for the treatment of prostatic cysts, but things were already going wrong…
‘There’s something wrong, I can feel it,’ Austin groaned.
‘Surely it’s not meant to do that!’ I exclaimed, staring at the rapidly spreading stain of bloody urine running down his leg. ‘Hold on, we’re nearly there.’ After what seemed like an eternity, I pulled into the driveway of my mother’s house, got out and opened Austin’s door. I lifted the hem of his pants up to his knee to check on the urinary catheter leg bag. It was half filled with blood-red urine. I helped Austin to the front door of the house and unlocked it. Supporting him with my arms around his waist, I helped him into the bathroom and shut the door.
‘Check the tubing,’ Austin said. I did as he asked and discovered that the tube leading to the leg bag was longer than before.
‘It looks like it slipped out somewhat,’ I said. Just then, Austin groaned and doubled over in pain and the blood stain on his pants doubled in size as the urine leaked out around the catheter tube. ‘This can’t be normal,’ I said. ‘I’m going to call the hospital.’ I dialled the number for the urology ward and waited anxiously for an answer. I can’t believe they sent him home like this! I thought desperately. We knew he wasn’t ready!
‘Hello, Urology,’ a nurse answered.
‘Hi, my name is Amy Stevens. My husband Austin was just discharged from your ward after a trans-urethral prostatectomy for the treatment of prostatic cysts. He was sent home with a catheter and a leg bag and we’re having a lot of trouble with it. The urine is flowing past the tube and isn’t making it to the bag at all! The tube has lengthened, almost like it’s slipping out,’ I hurriedly explained.
‘That’s impossible,’ the nurse assured me. ‘What you’re experiencing is quite normal.’
‘How can that be normal?’ I asked, feeling as though my concerns were not being taken seriously.
‘It’s not possible for the catheter to slip out of the bladder because a little inflated balloon holds it in place inside the bladder. Tell your husband to try to relax and take it easy.’
‘Okay, okay,’ I said. ‘Thank you.’ The nurse said goodbye and I relayed the conversation to Austin. I then helped him upstairs to my old bedroom and packed towels under him to catch what the catheter missed. He lay with his left leg hanging off the side of the bed so that the leg bag could use the force of gravity to drain the catheter tube. I brought Austin plenty of water to drink, as we feared the formation of a blood clot that could block the tube entirely, but each time Austin needed to empty his bladder it was accompanied by extreme discomfort and a further lengthening of the tube outside his body. I made another two worried phone calls to the urology ward, but the evening shift had started and the nurses who were now on duty were not familiar with Austin’s case. Both calls were met with the same advice and reassurance I’d experienced before.
Soon after I made the second phone call, my mother, Carolyn, came home and knocked on our door. I explained as best I could the problems we’d been having, but there was little she could do to help besides assisting me to make Austin more comfortable. She left us to make dinner for the rest of the family, and not five minutes later Austin experienced the same painful build-up to relieving his bladder and a stream of dark red bloody fluid ran out past the catheter tube, which I tried to catch with a towel. Upon checking the tube’s positioning, we found it had lengthened an alarming amount, and we were now absolutely sure that the catheter was coming out, regardless of how many times I had been told it was impossible. I helped Austin downstairs and into the car, hurriedly calling out to my mother that we were going to the emergency room. The drive to the hospital was very difficult for Austin. Every bump in the road intensified his pain and discomfort and I was torn between getting to emergency as fast as possible and driving slowly for him. I simply couldn’t believe this was happening, and my anger and frustration deepened by the minute. We had told the nurses we didn’t feel Austin was ready to be discharged, especially since his bladder was unable to function without the aid of a now malfunctioning piece of equipment! Now here we were, not four hours later, going back to the hospital! I was absolutely furious as I struggled to support Austin’s weight while he limped into the emergency room. I gave the nurse on duty a run-down of the situation, and just as I was finishing my explanation, Austin bent forward in pain. I held tight to Austin’s arm as the nurse showed us to a room with a bed and left me to help Austin into his hospital gown. As I helped him to undress, his bladder went into spasm, and with another stream of bloody fluid the catheter tube slipped out completely and fell to the floor at our feet. I washed Austin as best I could with water from the nearby sink and helped him back into bed. Then I collected the various components of the catheter from the floor and examined them. The plastic balloon at the top of the tube that should have been keeping the tube inside the bladder was completely deflated, and since it had begun to dislodge soon after Austin was discharged, I formed the conclusion that it was never inflated from the very beginning, either due to human error or defective manufacturing. I dumped the hated catheter and leg bag into the bin and returned to Austin’s side.
‘How are you feeling my love?’ I asked as I covered him with an extra blanket.
‘I feel much better now that thing’s gone,’ he said. ‘I just hope they don’t have to put it back in again.’
There was a soft knock on the open door and a young man entered with a bladder scanner machine. He identified himself as one of the nurses on duty, and I explained everything all over again. The nurse checked Austin’s blood pressure and then proceeded to use the scanner on Austin’s abdomen, which determined that there was now only a little fluid in his bladder. The nurse gave me a tapered plastic container with measurement levels on the side and asked us to use it when Austin felt his bladder needed to empty, and he said that a doctor would be along shortly. Once we were alone again, I took out a pen and paper and made notes for the next hour of exactly how much fluid Austin passed. Each attempt was painful and I supported Austin in a standing position as the shock made him shake uncontrollably, but at least he was able to pass urine and to my mind, would therefore not require re-catheterisation. Around 10pm the doctor came to see us, and confirmed my thoughts. He told us we were welcome to stay as long as we wished until we felt confident enough to leave, and we took full advantage of his offer. It was not until after midnight that we were satisfied Austin would not need further medical attention. I bundled him into the car, propped pillows behind him and under him to help shield him from bumps in the road, and covered him with blankets. By 1am I was tucking Austin into my bed at my mother’s house, smiling as I noticed her preparations for us. She had managed to locate pyjamas for both of us, and she had also put warm blankets on the bed, brought a kettle and coffee and tea supplies up from the kitchen and left a bucket for Austin to use so he would not have to make the trek to the bathroom during the night. It was just as well, because Austin passed more bloody fluid approximately every half hour during the night, shaking with pain and discomfort for a full five minutes afterwards each time. By morning we were completely exhausted. I stumbled downstairs to get us some breakfast only to find my mother already preparing a full bacon and egg breakfast complete with toast, tomato and mushrooms. She helped me serve Austin breakfast in bed and we told her everything that had happened since the previous evening. She was unfailingly supportive and made sure we had everything we could possibly need before she left for work.
Austin spent the next several days in bed, during which time his symptoms barely improved. The shaking stopped but he had decreased bladder control, which woke us at least every hour during the night when he needed to go again. Each morning when Austin felt ready to sit up, I propped pillows behind his head and then drew the blinds back and opened the door leading to my bedroom balcony. Being on the second floor of the house put us level with the tops of nearby trees, which were visited daily by some of Australia’s most spectacular birds – rainbow lorikeets, crimson rosellas and sulphur crested cockatoos. Each afternoon, I spread a handful of sunflower seeds on the balcony outside our door, and it was not long before I was hand feeding a flock of eighteen cockatoos. Seeing Austin smile for the first time in ages, I began to spread the sunflower seeds in a trail leading through the door and onto the floor beside the bed. In no time at all the cockatoos were inside the room and their antics made us laugh as we watched them from the bed. A couple of them would land on the balcony railing before the rest of the flock and shriek loudly to let us know they had arrived. On mornings when I was up and about before they were, I would walk out onto the balcony and wait until I saw a cockatoo flying past. I would then raise my hand and wave, and the bird would turn in mid-flight and come to land beside me. Austin and I were reminded of what we had both always known; that the presence of animals can make even the heaviest of burdens seem somehow lighter.
It was just over a week before we felt that Austin no longer needed to remain near the hospital, but we had put off his follow-up appointment with his surgeon as he simply couldn’t face more medical appointments at that stage. We decided to attempt the drive back to the cabin in Rouse Hill where our luggage and supplies had been left. Austin managed the journey with difficulty, lying down on pillows with his seatbelt awkwardly strapped around him. Once we reached the cabin, I made a bed on the lounge chair in front of the TV for him. Over the next several days I made a couple of short and infrequent dashes to the local shopping centre for food and spent the rest of my time watching films with Austin. When he felt up to it, I took him to his follow-up appointment in Dr Katelaris’s offices, where we were assured that the continuing pain and bleeding were normal for this stage of recovery. Although they were to be expected, these symptoms were disheartening to Austin and stressful to me as I could do little to make him feel better. A few weeks later, little had changed. Austin still lacked control of his injured urinary system and was passing scabs from inside the prostate frequently, and this made it impossible for us to be away from a bathroom. He began to tell me he felt as though he would never get better, and I realised that such a major surgery would demand as much of a psychological adjustment as a physical one. Austin was feeling useless and helplessly out of control of his body, both extremely difficult sentiments to deal with for someone who had always been physically fit and determined to live life to the fullest. Being such an active person, it was very hard for Austin to accept his inability to ‘fix’ himself and being stuck indoors all day was causing him considerable depression. Slowly, as he regained some control, we began to take short drives and eventually we were able to visit my mother. Such visits were always short as Austin was easily exhausted, but I was beginning to see positive changes in him.
By Christmas, some six weeks after the operation, Austin’s doctors declared it safe for him to make the long flight back to Africa. We left Australia and returned to Namibia, unsure when Austin would make any more films, but deeming it increasingly necessary to consider eventually making a move to Australia as there seemed little chance that I would ever be granted permanent residence in Namibia. There was only one crack in our resolve – our love of African wildlife. There was simply nothing to compare to it or replace it anywhere in the world, and we lived with an ever-present anxiety about how we would manage without it if we were ever based in Australia permanently. We simply had to hope that we would find something almost as enjoyable to take the place of the African wilderness.
To be continued in Chapter 45, when Austin and I return to the wilderness of Etosha National Park…
I would love to hear from any readers who would care to comment on the direction the story of ‘African Adventures’ has taken. What do you think of the content of the blog? What would you like to see more of? Your responses help me decide what to focus on in the future.
Previous chapters can found on the Blog page.