Teva UK is celebrating the 70th anniversary of the NHS this year. Everyone has a story of how this vital service has touched their lives.
Yvette Spencer (Production Artwork Manager) had to undergo the trauma of a double mastectomy in 2015 and her life was made worse by a persistent infection after breast reconstruction. It was the very personal service she received from the National Health Service that helped her get through what was a very difficult two-and-a-half-year journey that included 11 surgeries.
"I wouldn't have got through this, physically and emotionally, without the support I had from the NHS staff. This journey really began in the early hours of Christmas morning. I was at the Royal Free Hospital in Hampstead, in their A&E department, because of pains in one of my reconstructed breasts. The doctors decided I needed surgery that very day and one of my breast implants had to be removed.
I'm quite small, only five-foot tall and a rock climber, so there wasn’t enough of my body, like my stomach for example, to use to reconstruct my breasts, so I had to have implants. Six weeks after they were implanted I was back in surgery having one removed. An infection that had set in on one side of my chest after the reconstruction, and was being treated with oral antibiotics, wasn’t going away.
The hope was that, once the implant was removed, the infection could be fought, and in a few months a new implant put back in, but the situation did not improve. In January, we realised the infection was still there and it was decided more surgery was needed and specifically a procedure called debridement. This is where, under a general anaesthetic, they scrub the soft tissue of the infected area to clean it and remove any infected tissue. Sadly, this surgical procedure was not the end of it.
After the debridement they left a small opening which had to be packed with an antibiotic wadding which normally means I would have to go back to the hospital every three days, but my fantastic breast care nurse, Rebecca Canny, taught me how to pack the wound myself. It's quite difficult trying to pack a hole in your chest when it's hurting.
So, I was packing the wound and I had to go back every week to have it checked and swabbed to see if there was still any infection – and unfortunately there was. About four weeks after the first debridement, the surgeons decided another debridement procedure was needed. So, this second time, the surgeons really, really scrubbed it, scraping all the tissue from the inside, anything that they thought could still be holding this infection. The staff on the day surgery unit were getting to know me well. They’d speak to me by name, “Hi, Yvette, how are you doing?” Everybody's so nice.
The surgeons were so determined, but unfortunately, that didn’t work either. Three weeks later we realised the infection was still there. At that point, I burst into tears and I said, "I can't keep doing this, can we try something different?" because I was in a lot of pain and getting so fed up. So, they came up with a different plan and a multi-department team was put together. The infectious diseases department, led by Dr Alex Lake, got involved and I had a magnetic resonance imaging scan and an ultrasound. They discovered the infection was in one of my ribs.
The infection had got into the cartilage of my fourth rib, where it attaches to your sternum. They found that the rib there had disintegrated, it had dissolved by about two inches which was why I had been in so much pain. We now knew why the infection had not gone away too as it’s very difficult to treat infections in the bone (osteomyelitis). They operated on me and removed the dissolved section of the rib and put me on Veraflow Vac Therapy for two weeks. This involves a sponge being inserted into the infected area and antibiotic fluid pumped into the sponge and then drawn out at one hour cycles.
I then had a 36cm PICC line (Peripherally Inserted Central Catheter) inserted from the inside of my arm into a large vein that leads to the heart to give intravenous access as I needed IV antibiotic therapy for 9 weeks.
After the two weeks the sponge was removed and I was given a smaller machine to help the body close up the wound. During all this time I had weekly visits to the hospital to collect my antibiotics which were made weekly for me as they only had a 10 day shelf life. In total, I had seven months of antibiotics including nine weeks of them being given intravenously via my PICC line and a Baxter pump.
I got to see the pharmacy team making my drugs in the Hospital Labs and met regularly with the department head Hannah who would stop me in the hospital and ask how was I doing? At the end of the day, we managed to get rid of this infection because of the NHS staff’s determination to do it. Everybody, the ward, the people on the ward, every person, I felt was there for me. I'd be in the canteen or at the coffee shop and one of my anaesthetist would come up to me and ask me how I was doing.
After the infection had been beaten my reconstruction could start again and I’ve just had my eleventh surgery. Everybody along the way, every single person in the NHS I've come across has been brilliant. My plastic surgeon, Stephen Hamilton, and his team have presented my case to doctors from around the world as they hadn’t used the Vac Therapy in this way before. I've been to the clinic since all this happened and Stephen said “Yvette, can I just introduce you to my colleagues, they're from India and they’ve got a lady with a similar problem.”
My NHS consultant and team have changed the way they deal with infection after reconstruction. It’s a fact of life that improvements and advancements happen after things go wrong. I feel proud to have been part of that change even if it meant I needed to go through it all. I learnt a lot about myself along this journey – you can deal with more than you can imagine, and despite everything I went through, so much good has come from it.