So because I've had so much positive reaction to this fic I figured I would post up my update a day earlier than scheduled - I hope you all approve! I would like to say thank you so much for all the reviews, messages and tweets about this fic because I definitely do appreciate them and it means so much to know this fic has support. Sorry for tormenting Sam (you all seem to have picked up on that) and Zoe so much but now it might be Dylan's turn to be put through it a bit more.
This chapter does contain medical information and I make no secret of the fact I am no doctor. All I will say is I have based Dylan's injuries throughout on those of someone I know and therefore I know the outcome is accurate, even if some of the terminology is slightly off or inconsistent. I hope that makes some kind of sense!
So here we go with chapter 9.
For better, for worse
Chapter 9
Saturday 3rd March 2012
Dylan eyed Sam with interest from his position on the hospital bed in the quiet of his own private room. His wife had arrived as expected an hour prior to his earlier surgical procedure and she had remained by his side right up until the anaesthetic took effect, providing a reassurance to him that he had not previously realised he would require. She had been sitting waiting for him on his return from recovery and the two of them had remained in a fairly comfortable silence ever since waiting for an update from the General Surgical team as to the outcome of the operation. It was only now that she had helped him into a more seated position and he now found himself contentedly reclined against the thin NHS pillows he took in her appearance.
"You went through my wardrobe?" he queried pointedly, before seeing her bemused expression. "Those clothes were in my wardrobe," he explained, gesturing at her outfit, which comprised of a simple brown jacket, strappy top and smart jeans, and which he knew was complimented by the long blonde hair she had allowed to trail untied down her back. "Then I guess, what more did I expect from you?" he added sarcastically.
"Yeah, well," Sam started with embarrassment, feeling slightly like she had been caught out rummaging through his private space. "I might have had a look around, you know to familiarise myself with where everything is if I'm going to be staying there for a few days," she continued with a wry smile. "Besides, I don't know what is stranger; the fact that my clothes were hanging up somewhere I've never actually lived or the fact you immediately recognise them. I can't even begin to imagine what Zoe must think, you having your ex-wife's clothes in your wardrobe and all," she elaborated and received a questioningly look from her husband in response. "What?" she added in a mock-innocence. "You think I wouldn't notice the perfume and make-up in the bathroom cabinet? Either she's been staying over or you've got yet another secret part of your life that you failed to mention," she laughed, attempting to disguise the memory of the horror she had felt on seeing the offending items when she was looking for toothpaste in her exhausted state the night before.
"Well she may have spent some time aboard the boat," Dylan began to explain, taking his own turn to feel mortified and feeling his face pinken slightly. "There was this time when," he continued, but was cut off.
"Dylan, it's fine," Sam stated supportively. "I had worked that much out for myself, you don't need to spell it out for me."
The couple shared an intense moment of eye contact as they individually considered the circumstances they now found themselves in, but before either could break the impasse the door flew open and Nick Jordan swept into the room with Dylan's medical charts in his hands.
"Dylan, Sam," he stated, noticing instantly that both parties seemed to be in a better condition than the day before. Dylan was far more alert than he had been when Nick had accompanied the young woman up to see him before the earlier operation and now that said surgery was over, the weight of the world appeared to have lifted from the girl's shoulders and he was able to see that she had obviously heeded his advice the night before to sleep, shower and take some time to relax.
"I've just spoken to your surgeon," Nick began to explain. "I hope you don't mind but after your difficulties with the GS team yesterday I was wondering if you wouldn't rather I be the one to update you on your condition. General surgery has long since been one of my specialisms and they have brought me fully up to speed with your post-operative status."
"That would be preferable," Dylan replied simply and Nick took that as the most positive indication he was likely to get from the normally infuriating Dr Keogh that he was in agreement about this particular course of action.
"I guess that's my cue to leave then," Sam chipped in, looking at her husband for confirmation that she was correct in her thinking, but as she stood up from her chair and made to depart from his side, she was momentarily halted by Dylan unexpectedly and fleetingly grasping at her hand.
"No," the man stated sharply. "I think it would be best if you stayed. You'll only make me repeat it all to you afterwards anyway," he added, making it sound somewhat like he was doing her a favour by giving her permission to be present. Sam recognised the difficulty that Dylan would have had in saying those words aloud, especially in front of his Clinical Lead, and immediately sat back down. She found herself instinctively taking her husband's hand in her own and then turning her attention back to Nick Jordan, who was watching them as intently as she had previously been looking at Dylan.
"Right," said Nick, studying the paperwork in his hands and suddenly remembering why it was never a good idea to give such news to people you knew at all well. "So we were dealing with the injuries caused by a blunt force trauma to your lower abdomen and legs. Therefore a multi-discipline GS and orthopaedics team was convened to conduct your surgery this morning. The orthopods have inserted an internal metal fixator to your tibia and pinned the fibular bone back into its correct positioning. They have completed a minor piece of fusing to the ankle bones to stabilise the joint and as a result your movement on that side may be slightly more restricted than it would have been before, but they doubt there will be any noticeable difference after three to six months. Additionally the damage to your pelvic bones is minimal and they have reset your displaced hip joint without any cause for concern. In fact the damage to your lower body is mainly muscular and therefore you will need to participate fully in a course of physiotherapy to ensure your substantive recovery back to full physical fitness."
Sam and Dylan both continued to stare at Mr Jordan earnestly without looking away from him or commenting in the slightest. In fact his only confirmation that they were both still aware of their surroundings was that he could see Sam was soothingly squeezing her husband's hand.
"As I am sure you already know," Nick continued, "it has been confirmed that there are no spinal breaks, but there is swelling to the muscles and tissue around your L1 to L5 vertebrae which is likely to give you a degree of numbness in your lower body. There is no reason to believe there is any permanency to this, but of course it could trigger bouts of localised temporary paralysis such as that you experienced last night."
"Temporary paralysis?" Sam exclaimed, indignation and annoyance clear from her tone as she turned back towards the man lying in the hospital bed. "Dylan, just on the off chance your condition deteriorates and they call upon me to make a decision about your care, you know the reason I am still here in the first place, do you mind keeping me informed please?"
"There wasn't time to tell you earlier," Dylan responded sharply to a now seething Sam.
"You found the time to comment on my wardrobe. I would have thought temporary paralysis would have counted above that on the things to tell my wife list. Or is that just me?" she retorted, leaving Dylan shaking his head and looking suitably chastised with no snappy reply he could think of seeming appropriate in the circumstances.
"Ok," Nick began again, trying to bring both husband and wife's attention back onto him to prevent any escalation in their argument. "Having seen your scans and x-rays it is my opinion that you are going to be a bit unsteady on your feet for the next few months at minimum, what with the muscle damage and broken leg bones," he continued before pausing. "However, obviously this morning's surgery additionally focused on your abdominal injuries and rectifying as much of the trauma damage as possible, before allowing you time to recover. Your spleen caused most concern, as it was leaking free fluid into your abdominal cavity but that rupture had now been repaired and the surgeons appear confidant that it will not require further intervention. Your kidneys also showed only very minor damage on closer examination and therefore have been deemed clear of injury."
But?" Dylan questioned. "I am aware that there is something more serious than that from the comments I heard in recovery and I would rather you just gave me the full facts than tried to sugar coat things for either of our benefits. It is not as if I am without medical knowledge after all, I am well aware that there are likely to be further complications other than those you have indicated."
"I need to tell you that a small fragment of pelvic bone penetrated your bladder, which was quite distended as a result," Nick began to explain, knowing that what he was about to say may come as a shock to both parties in the room. "The risk of peritonitis if that had been left untreated was too high and it was for that reason you were taken into emergency surgery yesterday. You've been prescribed antibiotics to minimise the likelihood of further infection, however unfortunately there is now localised swelling and partial disruption to your urethra and there is a significant chance that the nerves surrounding your urinary tract have been compromised. The urologist has suggested that due to the distension they were unable to fully establish the extent of the damage, but further surgery will be required and in the interim it is possible that there may be side effects from the injury."
"Such as urinary incontinence?" Sam queried calmly, staring straight ahead and trying not to alarm her husband unnecessarily. "Will he require a catheter?" she added and whilst she did not look at Dylan she instinctively knew exactly the horrified expression that would have settled across his features on hearing that piece of information.
Nick took a deep breath before answering those two questions, knowing that the responses would be difficult for both Dylan and his wife to hear. "Whilst the urologist does need to take you in for further surgery, they will not be able to complete this until the swelling has substantially reduced and therefore, yes, they will need to insert a catheter. It is likely that this will be a urethral catheter in the first instance, but it may need to be replaced with a suprapubic tube if that is not as successful as they hope. At this point in time it is impossible to judge what level of recovery you will make from this particular injury, but the treatment plan they have in place definitely maximises your chances."
"It sounds like I get very little choice in the matter," Dylan replied resentfully. "At what point are they scheduling my next surgery for?" he asked, hoping that it would be reasonably imminent given the implications he was considering of his current state, such as how he would manage the indignation of possible leakage and nurses changing or cleaning his catheter.
"Approximately four weeks," Mr Jordan responded with a degree of certainty. "Dylan, listen to me," he started again, realising how badly his earlier words had impacted on his colleague. "I know that it is a lot to take on, but you have to keep in mind that you are likely to make a full recovery from the majority of your injuries and there is no reason you won't be able to return to work and lead a reasonably normal life in a few months' time. However," he continued before pausing once again. "However, Dylan you do have to realise that you are going to be quite limited in what you can do for a while, regardless of the outcome of your upcoming surgery and you are going to need a lot of support and help with things in the meantime. As an example I doubt very much you will taking your dog for long walks in the country for the foreseeable future."
Nick could see the rage bubbling under Dylan's outwardly emotionless exterior, understanding fully from his own previous experience of illness how difficult and confusing it was to have your life so unexpectedly turned upside down. He also recognised the distress that was evident in Sam's eyes, but like her husband she concealed it well in her external appearance and he couldn't help but wonder whether she had always been that way, or whether it was her connection with Dylan or her army experiences that had drummed an ability to express coherent emotions out of her along the way.
"When am I being discharged?" Dylan asked suddenly, breaking the silence with his own desperation to get out of the hospital suddenly becoming overwhelming. "I need to get home and care for Dervla."
"Don't be silly grumpy," Sam said affectionately towards her husband, trying to reassure him that things would somehow be ok. "I can take care of her for now."
"You are leaving on Friday," Dylan said slowly, as if he was speaking to a small child and then turned his attention back to his fellow consultant.
"They would like you to stay in for a couple of weeks, possibly until your next operation," Nick replied, knowing full well that this wasn't the news Dr Keogh would wish to hear and hoping that he did not react too badly to it.
"What if someone stayed with me to support me?" Dylan asked, his voice becoming louder as he attempted to assert authority over the situation.
"I can talk to them Dylan, but it would depend on who it was and how much care they could offer," Nick responded carefully, not wanting to offer false hope that this may be an immediate answer to the problems Dylan could see in front of him at that moment. "You aren't going to be able to do very much for yourself for a little while, especially until the next operation. So we're looking at someone who could bathe you, change your dressings, assist you in managing your catheter with all that comes with that and generally help you around the place and get about. Plus they are going to need to ferry you back and forth for physio sessions," he continued. "We're not just talking about some temporary agency nurse here; it needs to be someone who is up to the job in hand. It wouldn't be an easy task to offer that level of care to anyone," he added, trying not to imply too forcefully that it would be ten times harder to provide that kind of support to someone as unforgiving and cantankerous as Dr Keogh himself.
"It is still the option I want to pursue," Dylan responded tersely, determined not to be put off by Mr Jordan's lack of backing for the idea.
"Okay, if that is what you want then I will go and talk to the GS team and see what they think, but obviously whatever happens the urologist will need to see you to consult on the catheter insertion before anything can be confirmed" Nick replied, sensing that he would be unlikely to win this particular argument on realising Sam's reluctance to express an opinion on the subject at all. "I'll leave you two to talk," he added and then hastily left the room, finally understanding the comments he had received from his colleagues in other departments about how difficult they found Dr Keogh to be as a patient.
As he went to walk away down the corridor he found himself stopping by the window to the room and watching the husband and wife sitting in a stunned sense of silence thinking through all of the information they had just received. However just before he departed he noticed the very subtle movement from Sam, as she released her husband's hand from her own and instead reached out her fingers into his, allowing them to interlock in a strong and comforting gesture.
Okay, thank you for reading once again. I know the medical elements were not 100% accurate, but I never claimed to be a fully qualified medical professional!
Reviews as always will be very welcome and I will post up the next part before the week is out. Callie x
PS For anyone interested, To Look Out For You will be updated in the next few days also. :)