"A Transverse Arteritis Biopsy"

I spent from some time late last year in Ward 2E of Sydney Eye Hospital, during that time the ward nurses took great care of me in a difficult environment.

I was a Lucky Man.

Unfortunately they couldn’t control everything. The hospital is trying to keep many balls in the air and is staffed with excellent people, but sometimes things don’t go the way they were supposed to go. So one day last month I was a very Unlucky Man.

I was being checked for Arteritic Ischemic Optic Neuropathy, a malady that takes your sight. To fight it takes a sustained effort covering years. In order to prove whether it was present I needed a transverse arteritis biopsy (over my left ear). Professor Raymond described it as a 20 minute procedure with a snip. I had gone through 20 operations in the past 40 years, so how hard could it be?

The answer was very! The procedure had an anaesthetist, assisting nurses, and two surgeons. What I didn’t know, but picked up on really quickly, is that it was apparently a training exercise, as well as my procedure. The active surgeon was doing everything, but the other surgeon was telling them what to do. Really quickly the anaesthesia was overwhelmed, and I was in the greatest pain I have ever felt. I could not make a sound as it hurt so much. At one point I felt something being ripped out of my head.

It went on for over an hour, I wasn’t sure if I could stand it. Originally they had said they might need to do both sides. I don’t think I could have taken a second go. Finally I was wheeled into recovery. Then something didn’t happen that I had become used to. After every operation I have had (knee replacements, shoulder replacement, back vertebrate decompressions, etc) the surgeon has stopped by to make sure everything was all right. In this case, no one appeared, and eventually I was wheeled back to the ward.

In the middle of the night the wound bled, the nurses fixed it, but said I should have it checked in the morning. I was planning on a 9AM train to get half way home (5.5 hours south), and knew that shift change happened at 8AM and my chances for making that train were slim. At 5AM my nurse came in with a doctor, who fixed me up and cleared me to be discharged.

Days later my GP noticed that my left eyebrow was (and still is) very droopy and said he thought they cut a critical nerve (since then Prof Raymond has said it should recover).

I am not angry at anyone, but rather the process. To do no harm is primary, despite whatever surgical limitations exist. I think if too many exist, get another surgeon, or postpone surgery. I had spent 3 days fasting waiting to get to the theater each day, and I wondered if it was so close to Christmas there was a rush, just to get it done.

I finally got the results of the biopsy on last week. So I spent a month not knowing what my status was. It's a hard way to have a Merry Christmas and Happy New Year.

I finally had the absence of Arteritic Ischemic Optic Neuropathy confirmed that day by Prof Claire. And when I told Prof Raymond about the biopsy I felt he looked visibly hurt, and said he had expected a senior surgeon to do the procedure. I did also.

I don’t think it was good enough, I believe the process was faulty, and steps should be taken that no one else suffers the way I did.

An Unlucky Man