Let's hear it for the SSSU!

It stands for Short Stay Surgical Unit, and it is where I spent 24 hours earlier this week following my corneal transplant. The SSSU is a big operation: 30 beds with pretty much 100% occupancy, catering for all manner of things surgical, either booked or emergencies transferred form A and E. The nurses there take on all comers with equal efficiency and equanimity.

Par example, let me list the cases sharing the ward with me last Monday night. On my right was an elderly man whose catheter had blocked with blood following surgery the week before. Down from him was a man who, while protecting his sister from her crazed, knife wielding boyfriend, had punched him in the mouth. He was able to recover the knife, but sustained injuries to his hand from the man's teeth, which had then become horribly infected. He needed surgery to release the huge bag of pus that had accumulated in his hand.

Across from me was a man who had chastised his husky dog  (with a stick) for peeing in the house but was then paid back by being badly bitten on his arm. This too had become infected to the point where he too required surgery. Next to him was a young man who had been out on the lash with his best friend, who then unaccountably (according to his story) kicked him, twice, in the face, shattering his nasal bones which required re-setting. As I left the unit on Tuesday morning, a new batch of patients was already being processed, doubtless with a new set of highly diverse issues.

But back to me, obviously my favourite subject. As I have stated above, I was in for a corneal transplant to address my worsening Fuch's syndrome. Followers of this blog may recall my mentioning this hereditary problem, which affects both my eyes, but the left more severely. The defect lies in the back layer of the cornea, the endothelium, a delicate membrane only one cell thick, but which carries out the vital role of removing fluid from the cornea as a whole. When it fails, the cornea becomes waterlogged leading to a fogging of the vision and if untreated, leads to a bursting of the whole cornea which, as we might imagine, results in permanent blindness. By sheer coincidence, my NHS allocated surgeon, Vinod Kumar, just happens to be one of the world leaders in partial thickness corneal grafts, specifically a procedure called a DSEK (Desemet's Stripping Endothelial Keratoplasty, no less).

Corneal transplants have been around for a long time. The first, remarkably, was performed as long ago as 1905, though in the early days, most were full-thickness grafts, performed for scarring as a result of trauma or infection. Only by 1998 were partial thickness grafts attempted, and Kumar's procedure only in the last seven years. At the end of the operation, a small bubble of air is introduced into the front of the eye to press the graft up against the rest of the cornea. It must stay in place for 48 hours until the air is absorbed, because if the bubble should move it can engender acute glaucoma and threaten the eyesight and even sometimes life itself. So I was ordered to lie on my back for 24 hours, staring at the ceiling with just five minutes per hour allowed to get up and go to the loo, though the head must be held back at all times. Have you tried peeing with your head back? I assure you it is a tricky, and rather messy procedure. When I was released back into the wild at 24 hours I had to keep the practice up for a further day, though obviously these things are always easier at home.

Upon my release my vision in the left eye was zero, not total blackness as you might expect, but an all enveloping, milky whiteness. I am delighted to announce, however, that each day has brought a small improvement. What stays with me from the whole experience is the strange torture of being confined to a supine position for two days, meticulously obeying orders for fear of the dire consequences of failing to do so. That and the awed respect I feel for all the professionals who cared for me, from the bloke who made the tea and toast, to the nurses who were so kind and thoughtful, to the doctors who did their job with such a lightness of touch but such a high level of skill. Thanks NHS! You done me proud!