It’s in the bones. Part five

 Day 8 from the bone marrow transplant and no real side effects. The doctor is telling me that my neutrophils are at 2.5 which is unprecedented at this stage and it’s clear that the new cells have already started grafting. Neutraphils are essentially white cells which are our immunity system; they rush to infected sites to fight the good cause. The 2.5 number represents 2,500 white cells. Anything between 2 and 5 is normal; below 2 indicates vulnerability to infection and above 5 indicates that there may be an actual infection. The hospital normally send a patient home once they’ve gone from 0 to 1so that puts my readings into perspective.

Outside my room the doctor meets with the consultant.

“How’s Steve doing?”

“His neutraphils are at 2.5”

“Bloody hell”

The door opens and the consultant grins at me.

“When do you want to go home Steve?”

“Five o’ clock?”

“How about tomorrow?”

The consultant turns to the doctor.

“Arrange for discharge tomorrow and to get the Hickman line removed. His treatment is done” the Hickman line is quite a complex line surgically inserted in the chest and removal is a fairly complex process.

I’m elated. I can’t believe it. I was expecting to be in hospital for at least another two weeks. I told everyone i could think of that I was coming home. Christine, my wife, showing a degree of prescience was concerned. To her it seemed far too early.

Later that day another consultant turned up with the doctor to remove the line. I’m not too happy because I have lousy veins and I know bloods will still need to be taken. Hickman lines are designed to stay in for up to 12 months but despite being coated in silver to prevent infection I’m told it’s being removed because my treatment is over and it’s an infection risk. I reluctantly sign the consent. 

Day nine and the doctor is in again, looking a bit sheepish, and he’s with yet another consultant. They tell me that my neutrophils have fallen back to 0.62 and the 2.5 was what I would normally call rogue data. I’m devastated; not so much about staying in hospital for a few more days but facing painful bloods directly from my sadly insipid veins. My anger grows throughout the day and I eventually confront the doctor. I tell him that I feel I was unduly pressured to have the Hickman line removed, in my uninformed opinion, too early. I’m emotional and the doctor, a rather gentle soul, is contrite.

“I’m sorry it’s not worked out for you at this stage Steve but it’s standard to remove Hickmans when treatment is over. The truth is it’s s resource issue. As you saw removal is a complex procedure and is a nightmare to set up through outpatients. I propose we insert a Picc line in your arm. These can be subsequently removed by a nurse. Does that work for you?”

It works for me and, emotionally I’m back on track and my hissy fit subsides. The reality is that I’ve made decisions in my own career that I’ve regretted because someone delivered rogue data and I wanted to believe it. It’s easily done and I’m impressed with the hospital’s keenness to mitigate the situation. Customer care in the NHS is not a soundbite and they’re working under enormous pressure to deliver a service that puts the patient first. We’re lucky to have it so let’s make sure the patient focus isn’t replaced by the needs of shareholders. We’ve already seen what happens when a hospital trust decides that cod privatised style targets like low caesarean figures which benefit no one result in multiple baby mortalities. 

Anyway. Sermon over. Post done. Bye all.