“Hitting the marathon wall” is a much-feared and much-discussed phenomenon in marathoning. Runners speak ominously about a sudden wave of fatigue that sets in at about 20 miles into a marathon. At this point, they say, the race is half over.” https://runnersconnect.net/marathon-hitting-the-wall/
I have never run a marathon (I have eaten a few and now they are called Snickers so that joke doesn’t work so well), I’ve never run a half marathon or 10k but I did complete the 5k race for life in June 2019 – I walked briskly. Having DIEP surgery is I imagine like running a marathon. There is all the nervous anticipation about moving on from breast cancer, the preparation – the CT angiogram, pre op, eating well, following the Rainbow Diet, keeping fit, staying busy and handing over work. Then there is the start of the race – handing yourself over to the health professionals who are going to remove a chunk of your tummy and plumb it into your chest. This is then followed by the slog of recovery. To begin with the drugs keep you in an artificial pain free high and the one to one nursing makes you feel secure. As the drugs wear off and the nursing staff make you more independent, combined with not eating much and sleeping less – it is hitting the wall.
I hit the wall first thing on Saturday morning. 5 days in to the marathon. I had had another very restless night – you have to sleep on your back, pillows are put under your knees and the bed is a zig zag to keep your head high and hips at a 20 degree angle so you don’t strain the tummy incision. The drugs round on Friday evening consisted of two paracetamol and a strong version of ibuprofen called Naproxen which were repeated again in the morning drugs round. Added to the mix was some blood thinners which were injected into the tummy or thigh area (every day) and some antibiotics added via the cannula. I’m not complaining as all this care was keeping me on the right track. However, I felt as if I’d been awake all night, I had been awake for most of it as with every observation I had a conversation with Sister D or one of the HCAs. I did not want to play Rounds on Saturday morning. I felt groggy and sick, wretched and was retching. It was a new team this morning led my a tall Indian locum consultant who was wearing scrubs. He and the team looked at the toob and tummy, there was a discussion about the accuracy of the output into the drains and then he asked me why I wasn’t sitting up or even out of bed this morning. I just said I don’t feel well today and I’ve had enough. He was quite robust and said that a wash, breakfast and getting up would have me on the mend. I wasn’t going to be allowed to loaf about. Sister D was kinder, she said that when on duty that night she’d make sure I had a sleeping tablet – but I still had to get up as the HCAs were not going to bring me the commode anymore and if I needed to go then I would have to walk along the corridor to the toilets.
Bosom Pals, which is a breast cancer support group, had provided me with a couple of drain bags and I duly but the drains into them, hooked them to the portable saline drip and holding onto my gownie, gamgee and what dignity I could muster started to shuffle to the loos. Past the nurses station where they were all quite cheery and gave me some encouragement and down to the loo with the sliding door. I managed to get in, lock it and put the cardboard potty in the loo (as the output was still being measured) when sorted and rearranged I attempted to unlock the door and slide it open… it opened a crack and I didn’t have the energy or strength to slide it further to had to pull on the emergency string and then I was rescued… apologising profusely, I then shuffled back to the sanctuary of my side room and sat in the chair. This wasn’t the usual me. So I gave myself a bit of a talking too, made myself walk to the basin to clean my teeth, sort out my belongings and wait for Nick. All was well once he arrived with smoked salmon, avocado, brown seeded bread, orange juice and a flask of decaf coffee with koko milk. It wasn’t so difficult after all. Washed, clean gown, bed made the day lay ahead.
Visitors – a blessing and a curse. Your own visitors are a blessing – others should be cursed, especially when they don’t leave until 10pm! I had had a few visitors during my Costa del Derriford staycation. Nick every day, my daughter, a couple of friends, the brother of a good friend who was visiting his mum and my parents. It is lovely that they come and see you and I’m usually always up for a blether but it was hard work. I didn’t have much to say and found it a real effort to concentrate. If they made me laugh then I had to hold onto my tummy. I couldn’t even blame the Anastrozole as I’d taken an executive decision not to take that tablet as it was hard enough without the side effects of this A.I. I didn’t have many visitors though and I think the nursing staff were aware of this so were always chatty. On Saturday during the day Sister C was in charge – I think she must have run about 26 miles that day with one thing and another including the male patient who escaped. She was very upbeat as she checked the dressings and toob and I told her about my experiences 18 months ago and she explained that the entire set up of the ward had changed. The most critical patients were in the bays closest to the nurses station as they required the most frequent observations and interventions, those less ill were fanned out at the end bays. It was the most efficient use of staff and those patients who were the most ill had the most attention.
My saving grace was BBC I player and wifi. I had invested in a tablet and was very glad I had. I could get onto Facebook, twitter, check school emails (a bit naughty but then I do like my job), personal email account and watch box sets. I choose Bleak House – there are 15 episodes and I enjoyed each one. I watched a couple of movies on Netflix, read a few articles on line and kept up with the news. I was becoming institutionalised! Saturday’s day crew handed over to the night staff and Sister D returned. She explained to me that the staff nurse I’d be anxious about would be on duty that night, that she was going to speak to her and that it would be a good idea if we would then all meet.
I’m not afraid of a difficult conversation. Sometimes in school we have to have difficult conversations with colleagues when a lesson observation hasn’t gone well or there has been a complaint from parent or outside agency. I try to be solution focussed, 99% of the time try and find a positive and then outline the expectations to move on. One of my NQTs had been rather problematic and I’d had to have several difficult conversations with this person. It was difficult as this person did not appear to understand that there were consequences to the actions they’d undertaken or when they hadn’t followed instructions. Youth and inexperience, tinged with a high degree of arrogance were not a great combination. I’d had difficult conversations with parents, with senior colleagues and whilst I didn’t relish them I didn’t shy away from them. However, this was going to be a different difficult conversation as I was still quite vulnerable, still attached to the saline drip, in bed wearing the hospital issue gownie and not wearing my school suit complete with lanyards.
Sister D, always practical and sensible, had spoken to the other nurse who didn’t remember the incidents, but was mortified that she’d upset a patient. At about 10pm they arrived in my room for the conversation. To be quite frank the nurse was more nervous than I was. We were re-introduced and I said that 18 months ago x, y and z had happened and I’d been distressed having just had a mastectomy. She explained that 18 months ago her personal life was very difficult and apologised for any distress. She said she did recognise me. It was all a bit awkward, she had been having a very tough time (as was I) and whilst it is easy to say “leave your baggage at the door” I’m sure we’ve all had times when we haven’t behaved in an entirely professional and productive way. The “boil” was lanced. We’d both said our piece. She wouldn’t be looking after me but was perfectly friendly when I saw her on my shuffle from the room to the bathroom.
Sister D gave me a sleeping tablet – I could look forward to a better night.