“…I thought it might have been something serious, like cancer,” I say, sheepishly, relief flooding through me.
“Huh? Oh no! Nothing like that!” she laughs and tells me to get dressed. I remind her about the lump. After feeling it and asking me to cough, she pronounces it a ‘small hernia’. I’m amazed. How long has it been there? Had it been caused by hauling the heavy horse-trailer around in the yard recently? Why hadn’t I felt it happen? Driving home, I can’t help wondering why she had not done an internal rectal examination…’
‘…After carrying out a rectal examination, the consultant says he doesn’t think it’s anything to worry about, but they will take a look under general anaesthetic ‘just to make sure’. I guess they are just taking every precaution. When he notices the lump in my groin, I tell him my GP said it’s a hernia.
“Yes, I think she’s probably right,” he confirms and arranges for me to be admitted in two days time.
I wake from the general anaesthetic expecting to be told whether or not I’ll need an operation for haemorrhoids, but all I get is smiles. Everything must be fine, or the nurse wouldn’t look so cheerful and they’d be discussing operations – wouldn’t they? It’s going to be a two-day wait until the next appointment. Why don’t they tell me now? Anyway, I console myself, the lack of urgency confirms the absence of malignancy. I have a lot to learn about hospitals and the way they function.
My experience of unnecessary pain begins next day when I try to have my bowels open. It’s so acute I have to tighten my bottom muscles to prevent passing anything. They’d said they would ‘just take a look’, but I realise they must have taken a biopsy. Nobody had asked my permission, or even informed me afterwards. They must have known the general anaesthetic would slow things down and cause constipation, but nobody thought about giving me anything to counteract it. Nobody thought about my pain. Nobody thought. It’s a hard lesson, one I am to recall several times in the near future.
How did you feel when you realised they had taken a biopsy?
Duped, vulnerable and frightened by their disregard for my pain. I knew nothing about giving consent for procedures.
Why do you think the surgeon confirmed the hernia diagnosis?
He probably thought the GP had been ‘protecting’ me by calling it a hernia, although this was not the case. By going along with this, taking the easy road, he did not have to deal with my emotions.
What needed to change?
Honesty, rather than false reassurance, would allow patients to understand their situation and make informed choices….
Patients need to know in advance
- why tests or investigations of any kind need to be carried out,
- how long they will have to wait for test results
- what results might mean
Consent should be obtained before biopsies are taken.The need for pain relief during and after investigative procedures should be considered routinely and discussed with patients beforehand. The hospital pharmacy could have provided Lactulose syrup on the ward to take home
CH 2, p12-13