Two months ago, I had to make a 999 Emergency Call so the operator could inform Torbay Hospital, my local hospital, to send an ambulance for Nshorna, my daughter. Her emergency began around 7 am on Sunday, 6 September 2021.
She had collapsed on the bedroom floor in immense pain in my home in Totnes, Devon. She had lost all colour in her face and struggled to breathe. The ambulance team arrived rushed upstairs, saw her condition and immediately put her on oxygen.
Before leaving the house, the two medics gave Nshorna morphine plus gas and air. She received more morphine in the ambulance, plus codeine, gas and air in the hospital.
In February this year, Nshorna visited her clinic in Hertfordshire with pain in the lower abdomen area. She returned nine times between February and September reporting ongoing pain despite a high pain threshold.
A misdiagnosis had taken place in Hertfordshire.
A series of comprehensive tests in the Torbay Hospital revealed two large kidney stones, one in the kidney and one in the ureter. A large kidney stone caused blockage in the ureter requiring an urgent operation, but the surgeon could not risk moving the kidney and instead inserted a stent, a temporary measure to allow urine to flow.
After surgery, she received various painkillers including codeine, morphine, fentanyl, and diclofenac.
Often in strong outbursts, the pain continued week after week following the stent operation. She also had to endure a painful infection requiring strong anti-biotics. The senior consultant urologist told Nshorna she would require a second major operation to remove the kidney stones. NHS diarist for operations told the consultant Nshorna would have to wait until the end of November due the urgent needs of many patients.
The consultant told the NHS diarist Nshorna “absolutely had to have the operation within two weeks.” He said if necessary he would also operate on the patient for the cancelled operation at the weekend.
Around six million patients in UK currently wait for an operation or specialised treatment. Between 30,000 to 50,000 people contract Covid per day in England – higher than France, Spain and Germany put together. NHS hospitals and doctors find themselves under immense pressure with citizens needing support and treatment due to the Covid variant, other infections, sicknesses as well as pursuing treatment for long delayed health issues.
The senior urologist at her hospital in Hertfordshire, where Nshorna lives, performed the second operation to remove the stones and replace the stent with a new stent. He said she would require a third operation in the weeks ahead to remove the new stent protecting her from the condition of the kidney.
Soon after the second operation, her blood pressure and heart rate dropped dramatically. At one point, a fading Nshorna heard a nurse repeating to her: ” You have to fight. You have to fight. You have four children.”
The resus (resuscitation) team put Nshorna into an induced coma for a few hours to stabilise her heart rate and blood pressure and stop her falling into a coma or dying.
In the weeks after the second operation, she continued to take pain killers the hospital prescribed at home including codeine and diclofenac. She received the same drugs again plus ketamine totalling about 18 tablets per day. She then had severe spasms from the stent resulting in another drug for the stent. Codeine tablets triggered chronic constipation leading to tablets for constipation. Nshorna then appeared to develop sepsis, an infection of the blood, but the hospital said later it was a false alarm.
Nshorna returned to the A and E (Accident and Emergency) hall five times in the following weeks due to the pain approaching levels similar to the initial outburst. On one visit, she had to wait 23 hours and on another visit 17 hours in the A and E before a nurse could take her to a bed in a ward. NHS target to treat patients in the A and E is four hours.
I had concern that the frequent use of painkillers, week after week, could trigger a severe biological reaction. My Dharma teacher in Thailand, Ajahn Dhammadharo, 87, had major knee surgery. Weeks after the operation, he slipped into a coma for two years before his death. I visited him in the monastery during his time in the coma. One monk told me he suspected the Ajahn’s body could not cope with the painkillers.
A former qualified midwife/nurse with the NHS, Nshorna took great care with the taking of the painkillers, but I had concern about the accumulative effect of so many tablets week in and week out.
While in hospital, Nshorna used her experience as a midwife to ensure steps including the necessity of a CT scan, an in-depth x-ray providing 3D images of a location such as the kidney and surrounding area. At one point, a nurse offered her the same painkillers twice within 90 minutes. The nurse said records did not show Nshorna had taken painkillers a little earlier from another nurse. My daughter told her to check. The previous nurse had forgotten to put on the record the administering of the tablets.
At times in the women’s ward, Nshorna and other patients heard women restless, crying and sometimes screaming with the pain making sleep impossible, except for short periods. Nshorna signed herself out and went home to get rest.
Intense pain continued sometimes day and night including pain when Nshorna went to the toilet.
Her friends gave her immense support with visits to her home, messages, childcare, housework, shopping, being picked up from the hospital and more.
In challenging circumstances, doctors and nurses worked hard often under duress with many patients to take care of 24/7. Mistakes in diagnosis and medication can occur.
This account of her experience reflects countless numbers of others worldwide with similar experiences due to the impact of Covid-19.
Daughter, Diet and Children
Nshorna has never had any vaccinations, never eaten meat or fish, rarely drinks tea or coffee, never taken recreational drugs, barely drank any alcohol and takes a paracetamol tablet perhaps once a year. The doctor said her body resisted the stent since it had little or no experience of foreign matter inside the body. She had no experience of frequent input of powerful opiates.
Slim, fit and with a nutritious diet, she usually recovers from sickness exceptionally quickly. A single mum with four children, a horse, a cat and two small businesses supporting well-being, Nshorna has exceptional energy levels.
My daughter slowly began to recover her energy while remaining for extended periods in bed at home. While in bed, she taught herself how to create a website and fully prepared a new website.
I told Nshorna I could cancel my visit to Germany to teach between 11 October and 28 October. She insisted I travelled to give the retreats and teach the start of the Mindfulness Teacher Training Course. I mentioned I could cancel three or four times but she would not hear of it. Throughout nine weeks of regular drama, I never heard a word of self-pity from her. She dwelt daily with an exceptional depth of equanimity. There were times when she could barely move. We spoke every day. Sometimes, I had the loudspeaker on with the phone pressed to my ear to catch her whispers.
Friends asked me if I was worried or anxious about her. I said I did not experience worry or anxiety. I had confidence in the NHS and her powers of recovery, but I woke up in the night, especially in the time of her hospitalisation. I would have a cuppa, read, write, exercise and abided in the stillness of the night until tiredness returned or the start of the new day.
Joziah, 6, asked Nshorna: “Mummy, if I give you extra hugs, will it make you better?” His grandmother, Gwanwyn, who also lives in Totnes, made the 250-kilometre train journey to Hertfordshire for Joziah to come to stay with her.
Milan, 12, stayed at home as a pillar of support. Nshorna kept D’nae 14, up to date daily. Kye, 20, studying at Sheffield University, always remained available along with supportive messages from Anya, his girlfriend.
The surgeon gave Nshorna a local anaesthetic instead of a general anaesthetic so as not to risk sedation. He then removed the stint telling her she would begin to recover quickly in the absence of the stint. The procedure went smoothly. Nshorna can start to make an emergence from an emergency.
The doctor told Nshorna that her kidney stones consisted of 70% calcium oxalate and about 30% calcium phosphate. He strongly recommended a low oxalate diet.
He listed vegan foods to avoid or eat minimal. Nshorna said the list of prohibitive or minimal food consisted of her daily diet for 40 years. Items to avoid included salt, all soya products, nuts, peanut butter, tofu, yogurt, spinach, leak, parsley, chocolate, figs, rhubarb and more. He advised cooking at home as restaurants often use much salt in their dishes.
Such food can bind to contribute to oxalate calcium to produce kidney stones. Nshorna must drink a minimum of two litres of distilled water per day to wash the kidneys. She would urinate twice as often per day, and urine needed to be clear. If a hot day or through exercise, then to drink an extra litre to avoid even 1-2% dehydration. He told her always to keep a bottle of water within arm’s reach.
The Government needs to fund the NHS to develop a healthy diet suitable for all kinds of patients rather than the current mass-produced food. A healthy and appropriate food supports a healthy body.
Nshorna and I spoke several times yesterday on the phone before and after the surgical procedure in the afternoon.
Yesterday evening, the Totnes Meditation Group had kindly invited me to give a talk, guided meditation etc. I had Nshorna on my mind. If we have something on our mind it blocks out something else. I forgot the evening programme. The organiser kindly sent me a reminder, but I only checked my emails in the morning. The same thing has happened before. It takes a minute to send an apology but yesterday the thought about the evening did not even arise.
Nshorna rang me at home around 7.00 pm last night to give me an update. She sounded bright with a capacity to walk slowly without pain. She rang again this morning after a good night’s sleep, took no medication and made a pain free visit to the toilet. Wonderful signs showing she is on the road to recovery.
My daughter has emerged out of a very gruelling period. I heard a bright energy in her voice this morning.
She said: “Why do we complain about anything? A single drama can put all our life into perspective.”
One relieved group of friends.
One relieved family.
One relieved father.