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Today has been the last day of my stay in Belfast. I am now back in Coventry due to work - tomorrow I'll be starting a week of nights.
This is the exterior appearance of Ulster Hospital, it looks small. Ulster Hospital is located around 15-20 minutes from Belfast City Centre by bus (buses 4B, 19 and 20 in case you want to get there too) and the bus fare is a mere £2.50, return.
Despite the small size, Ulster Hospital is the centre for plastics surgery in the whole of Northern Ireland. Some of the best (hand, plasctics and maxillo-facial) surgeons operate here. The nurses and doctors all seem friendly and helpful.
Azim was noticeably brighter today. He said that he has had a good sleep, good food and despite morphine and codeine he has finally managed to open his bowels for the first time after 3 days. He felt fresh after the nurse-assisted morning bath and the bandages on both his arms look ed fresh. However, his left arm appeared slightly swollen.
Here is how Azim spends most of his day; writing and answering text messages and phone calls (despite his bandaged hands). If you were wondering how he managed to type those messages I hope the above picture presents a clue.
Noon time, Azim was visited by the Consultant Surgeon and a nurse, who opened his bandages. The Consultant took a quick look at Azim's hands and asked Azim to flex his fingers, which he could to a limited extent, better with his left.
One look at Azim's right hand, and the Consultant instructed the nurse, "Prep him for theatre, nothing to eat and drink starting now. Aim for surgery at 6-10pm. Home tomorrow."
He then explained that they were going to attempt a skin transplant, and that after discharge Azim would be followed up in his clinic after 3-4 weeks, with regular plastics rehabilitation. Azim asked, "I'm a dentist and I really need my fingers to function fully ...". Before Azim could finish the sentence, the surgeon replied, "I'm a hand surgeon, and the skin graft is exactly what I would have in the same situation" ... and soon left.
A quick phonecall to inform everyone the change of events. Preparations were made if Azim was to be discharged tomorrow.
An SHO arrived to explain the procedure, the nurse rebandaged Azim's wounds.
Signing for consent before the procedure.
So from 12 noon, Azim was nil-by-mouth until 630pm, when a group of nurses approached Azim to bring him to theatre. It was then when I left Azim's side & Azim's friends kindly offered to drive me to the airport.
As soon as I arrived to Birmingham, I received a phonecall from Azim saying that the procedure was completed. Unfortunately, they discovered pus and infection inside the wound and instead of doing the skin graft, Azim had further debridement and cleaning of the wound of foreign objects ("grit", as written in the notes) and a drain has been inserted into his arm to drain the pus over the next few days.
Azim has been moved from a normal ward to a posh sideroom, complete with it's own TV, washroom and privacy and comfort. Probably because Azim is a fellow health professional (?). I remember when Puan Mama Sarah and Amar (PMS&A) was giving birth to Amar and she was whisked off to a posh side-room too, without us asking for one. At that time I was still just a humble junior SHO.
It is still up in the air on what's happening to Azim, but I suspect they would want to drain the pus fully and continue with strong intra-venous antibiotics before proceeding to doing the skin flap. Only after then would Azim be discharged.
A good news is that we are planning for Azim's wife and son to come to Belfast in the next 2 days. We feel that with Salamiah around, they would be someone to care for Azim after hospitalisation and also someone to always keep him company. Goodness knows how long he'll still have to remain here.
Above is a picture of Azim's wound right after the accident and before any operations. Azim mentioned how, during the accident and after his car has stopped spinning he got out of the car through a smashed up window (a window that was probably smashed by his own flailing fist, causing his injury) and on remembering his valuables especially his passport, Azim opened his boot and carried his bags to safety with his injured arms.
As usual, larger (and more) pictures on my picasa web album.