The Accident at Tashi Lapsa Pass – Part 11: Meeting the Mad Hatter

With the assessment on her injuries complete and her family close by, Louise is at long last on her way to the operating theatre. 

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After this I also had visits from the assistant orthopaedic surgeon who would be there during the operation and the anaesthetist who told me I would have a spinal tap this afternoon rather than a general anaesthetic. I had mixed feelings about this – you recover quicker from the former but I wasn’t sure whether I really wanted to be awake throughout. I also had a repeat ECG and a heart ultrasound. I was told that the result from last night indicated some irregularities and they just wanted to check the results again. A senior cardiologist came in, asked me a series of questions about whether I had suffered any breathlessness during the trek (which you invariably do while walking uphill at altitude), and then said my heart was okay and I was ‘cleared’ for surgery.

I was told the surgery was going to start at least 30 minutes late, however, I was still taken down to the operating theatre about 12:30pm as per the original schedule. Bijay came down as far as the door.

I ended up waiting in the operating theatre for almost 20 minutes with nothing much happening. It’s so different from operating theatres in Australia, where you may only wait a couple of minutes for the surgeon to arrive then things get going very quickly.

The anaesthetist arrived then and I was given a spinal injection to eliminate all sensation in my legs. In Australia, when I had my C-section, I had two nurses holding me still while they inserted the spinal injection. Here they just told me to sit still but left me sitting unsupported. Eventually the spinal injection started to work, the surgeons arrived and things got underway. There seemed to be a huge number of people in the operating theatre and for some reason, the scene reminded me more of a panel beaters rather than an operating theatre. People were wheeling around bits of equipment, doctors inserting rods and nails, and I also heard the sound of drilling. The surgeons were good, updating me regularly about what they were doing. The anaesthetist was my main support person, checking on how I was going every 10 minutes or so.

But it all took so much longer than planned as problems were encountered while inserting the plate in my fibula (small bone).

Apparently they tried out one for size but it wasn’t the right fit which meant sterilizing and then trying another. At around the three-hour mark, the assistant surgeon was trying to use a small hammer to insert some small nails into the main pin in my tibia bone and I actually felt some pain.

At this stage, I’d had about enough. I demanded to know what was going on; why was it taking so long? I found I couldn’t lie there passively anymore and I was actually starting to think they had stuffed things up. I had an uncomfortable pain in my back and I was finding the whole thing a distressing ordeal.

At this stage, the anaesthetist said, ‘I can give you a general anaesthetic if you like and then you can sleep through the rest of the surgery.’ I agreed. After the anaesthetic was given, I had a strange Alice in Wonderland experience for a few minutes, where I swear I met the Mad Hatter, and then drifted off.

I ended up drifting awake some hours later. Obviously I wasn’t in the operating theatre anymore but in what Australian hospitals refer to as the Recovery Unit. Here in this Nepali hospital they refer to the Recovery unit as the ‘Intensive Care Unit’. And unlike in Australia where you remain in Recovery for an hour or two, depending on the nature of your surgery, they ended up keeping me in this ‘ICU’ for 24 hours. And it was not as if the surgery had gone badly – apart from the fact that it had taken four hours in the end – nor that I was in any way critically ill. It was standard practice to keep post-operative patients there for a long time.