Thursday, September 21, 2017

Gratitude for the NHS

Saturday and Sunday I still felt somewhat shocked and shaken, by the fall I had on Friday evening, as full sensation and feeling hadn’t yet returned to my right foot and ankle. As I stood up it still felt as though I had a spongy platform sole on that foot.

My beloved rang my GPs surgery first thing on Monday morning and, she explained to them what the paramedics recommended, so the Wednesday appointment offered wasn’t soon enough. About half-an-hour after that, a practice nurse ‘phoned me back and, when I explained the situation, I was soon granted an appointment with Dr Desha at 12.40pm. Although there was a delay before getting in to see the doctor she was extremely thorough in her examination of me, blood pressure, reflex, touch, response to hot & cold in the foot etc. She prescribed 4 dispersible aspirin to be taken immediately, Clopidogrel and Amlodipine, to be taken each morning, to deal with my high blood pressure, and prepared a referral to the TIA clinic at Harrogate District Hospital.

As the time was getting close to that for the House Group / Bible Study chez nous, my beloved left me waiting for my prescription at the local pharmacy whilst she went home for the car to collect one of the attendees at our meeting. Sat in the over-chilled air conditioned pharmacy I suddenly felt quite shaky and weepy. The pharmacist kindly phoned my beloved to see if she would bring the car around to collect me.

The house group had already started in the meantime and I was eager to participate rather than sit on my own, feeling broodingly sorry for myself. Around 3.00pm, mid-way through the meeting, the ‘phone rang and, it was the hospital informing me that I had an appointment at the TIA clinic at 10.00am Tuesday.

Next morning I saw Dr Brotheridge at the clinic and, as the symptoms had not completely cleared within 24 hours it couldn’t be classed as a TIA but was likely some kind of minor stroke. Within an hour I’d had a CT brain scan done and, on returning to the clinic he informed me there was no sign of a bleed and the brain looked normal and healthy. He also said that the medication my GP had prescribed was exactly right and he would expect me to remain on that. Meanwhile an appointment was made for me to have an ultrasound of my Carotid and Aortic arteries at 1.00pm; this left time for ma belle chauffeuse and I to pop home for a cuppa and a snack, but before that we had time to go for some blood tests which my GP had requested.

The attention given, and the efficiency, in each department was really special.

Saturday, September 16, 2017

A Fall becomes a Set Back and a Shaggy Dog Tale

Yesterday’s events brought back a memory from 1962 when I was a student nurse in Exeter. I especially recalled a young man on the orthopaedic ward who had a talent for inappropriately releasing the cot sides from his bed. He was recovering from an above the knee amputation but, to his mind and nervous system, the phantom lower limb was far too tangible. Eventually he became an expert user of crutches as he scooted around the ward and, he was soon performing acrobatics on these supports. This young man later returned, on several occasions, to offer encouragement to children both preparing for and having undergone lower limb amputations.

These days with all my sundry aches, pains and other ailments, I envy that resilience. What brought those memories to the fore last night was my having a fall, in the living room at home. I’d just decided to go for a shower but, after the first step I suddenly felt as if my right ankle and foot had just disappeared. No sooner had the thought occurred than I plummeted to the ground, my head landing on the dog’s snout. The dog was on the sofa near the door and, as I fell I heard a growling bark very close to my ear. That growling bark was the dog’s defensive call as this figure fell directly in his direction.

My beloved’s immediate reaction was a desire to drive me down to A&E at the District Hospital but, as I still had no sensation of there being anything below the calf of the offending limb I was reluctant to venture out. Whereas the young man, referred to in the opening paragraph, fell because of the imagined / phantom lower limb. My fall was because I had an intact limb but had suddenly lost all sense of there being an ankle and/or foot there.

We phoned the out of hours doctors number from which we were referred to the 111 service, (? against using the word service), to whom my wife first spoke about me having a fall due to loss of sensation in my foot and ankle. They then spoke to me and went through their usual script – attempting to detect a stroke or the like – but I became increasingly frustrated as she questioned whether I’d had the numb sensation before I got up to walk, despite my constant reiteration that the loss of sensation and my fall were a simultaneous occurrence, even though the numb sensation was still present. She then asked if there was any bleeding and I mentioned I’d had a little bleed from the base of the ear but, that was probably due to falling onto the shocked dog. There were also the usual questions about whether I was running a temperature, “place your fingers on your chest do you feel as if you’re running a temperature” was their suggestion. I explained that in my case I’ve been diagnosed with an infection by a GP even when there was no sign of me running a temperature. Ever since I succumbed to ME (myalgic encephalomyelitis) some 14 years ago, my body thermostat has proved somewhat erratic).

The person on the switchboard then returned to the stroke detection questions – can you raise your arms above your head, can you smile, is your mouth twisted – to which I replied that I didn’t think it was anything like a stroke, having witnessed my mother when she had a major stroke and several TIA’s but, it wasn’t like what I was experiencing. I was just concerned about the loss of sensation in the right foot and ankle and the consequent fall which had proved most unnerving.

I eventually became rather fed-up with the inane repetition of questions I’d already answered from a person who on their own admission had no medical experience, nursing or otherwise, but she did have a list of questions she had to ask. Eventually in frustration I hung up. A short while after that, they rang back to say that there was an ambulance on its way. The ambulance duly arrived expecting to see a dog-bite victim who’d had a stroke!

The paramedics most conscientiously carried out tests on blood sugar, blood pressure, pulse rate and a couple of ECGs. Blood pressure was rather high and the one carrying out the tests did at first wonder if there was a sign of AF. They suggested that I contact my GP on Monday to arrange for a review.

The setback, referred to in the posts title, is that temporarily at least I’ve had to once again resort to the use of walking sticks, albeit as a precaution against a further fall. The shaggy dog tale / story is I believe even more obvious.

 Even an hour after the fall, as feeling gradually returned to my foot, it felt as though I had a crepe platform shoe on that foot, whilst the evidence of my eyes and the rest of my nervous system reassured me that my foot was actually touching the ground.

There was a time when calling my out of hours doctors number would put me through to the out-of-hours doctors clinic at the hospital. There also used to be a service called NHS Direct which had a far higher proportion of medically trained staff dealing with enquiries than is apparent in the 111 service. After this experience I’m rather pleased that for many of us it is, at present, still possible to have a face to face appointment with a flesh and blood GP even though the waiting time is sometimes a problem. I have never felt much adept at communicating with a telephonically disembodied voice, especially one that is so obviously reciting questions from a script!

Thursday, September 14, 2017

Saturday, September 09, 2017

Falling Prey to my inner wimp

Although most days, of late, have tended to feature a time of sustained pain and discomfort, its manner of onset varies considerably. Sometimes an ache in the palm of the hand and fingers, or more frequently wrist, can be set off by simply holding a newspaper or using a laptop computer for just a  few minutes;  at other times  a throbbing ache in the elbow provides  the warning  sign. Unfortunately, on far too many occasions, the ache soon spreads through the arm as a painful throbbing occurs in the elbow, and a nausea-inducing discomfort in the armpits, apparently emanating from the lymph nodes, spreads through the upper arm.

The application of splints, and various supports to palm, wrist, elbows, and even shoulders, serves to alleviate the pain and discomfort but, otherwise, I have to resort to pain-killers, tramadol proving the most efficacious, alongside these external aids.

Although the donning of a shoulder support can proffer relief, it seems quite strange that many times my body screams out for the removal of even non-constrictive cardigan, shirt or pyjama top. It’s not at all unusual, at these times, for me to lie down with both arms stretched behind my back, upper arms clamped tightly to my sides, to proffer a further degree of alleviation from the nausea sensation.

Discomfort in feet and toes frequently occurs alongside the pains in upper limbs and torso, and it feels as if they scream out to be relieved from any (otherwise un-noticed) constriction of socks and outer footwear. The past twenty-four hours presented me with a monstrous mix of aches and pains, necessitating the donning of additional supports for a considerable portion of both morning and afternoon, yesterday, as the full gamut of excruciating aches and pains in torso and limbs took up residence. The following nocturnal hours presented little opportunity for sleep, or even the slightest hint of relaxation; restless legs and pain skewered toes, alongside sundry discomforts in upper body and limbs, resulted in expletive laden tirades, against the night, emanating from my lips.

Helen, my beloved OH, and our faithful hound Piper, each attempt to console me – frequently to little apparent avail, as I fall prey to my inner, hopeless, wimp!

Sunday, August 13, 2017

Of Conversation and Being Wallopped

Another shattered day, or should that be another day of shattered tiredness; perhaps a tired shattered-ness will suffice. Drained, wrung-out, exhausted; none of these quite hit the mark, although I feel quite walloped out by all of them.

Just working out the cost of spending time arguing, discussing, with an old acquaintance! Today is the 13th August and, the incident to which I refer occurred somewhere in the hours between 11.00 on 1st August and 15.50 the following day.

It was something of a shock to discover how Neanderthal the political thinking / imagining of my old friend had become, since he fell under the spell of the Daily Fail. Once he had a mind but, now, I began to wonder if that was a false memory. Only when the conversation turned to matters philosophical, theological, and even metaphysical, did the verbal exchanges become rewarding.

Once upon a time my mind and spirit revelled in such conversations, with friends and acquaintances, not infrequently running through from late evening to dawn. In those days, the conversation could be accompanied by a bottle or three of vino, and a few mugs of tea to prevent dehydration. Nowadays, a mere few hours of chatter and discussion, even in the absence of alcoholic refreshment, seems to overwhelm my physical and emotional resources. Two days after our late evening chat a painful exhaustion,  from which I’m still recuperating, hit me.

For a couple of weeks before the visitor arrived, I’d been having to resort to wrist, palm, and elbow supports, attempting to alleviate the nauseating discomfort, which frequently seems to emanate from the armpit lymph nodes. At its most discomforting phase, as I curl up, clasping my upper arms tightly to my torso, foul expletives emanate from my vocal organs as if seeking a magical miracle of healing, before the flow of tears erupts. So, perhaps, extended conversation is not the sole cause of my current exhaustion.

Thursday, July 20, 2017

For These Small Mercies

For These Small Mercies (we proffer thanks)

Today, so far at least,
is one of gentle shattered-ness;
welcome relief

from yesterday’s griping
pain and aches.
An ever present undertow,

of generalized discomfort,

still leaves the space
for a richly varied range
of sensory attacks.

Will it be muscles,
joints, gastritis, or other
less easily defined

components of
the neurological kind.
Today at least

I have enjoyed a time
of gentle relaxation,
an ease of body

and a calmer mind.

                                          Malcolm Evison
                               20 July 2017

this post also appears on my poetry blog

Tuesday, July 04, 2017

a REAL Pain in the .... just another day

Why don’t they come and release the clamps … why don’t they come and RELEASE THE CLAMPS? Stupid thing is there aren’t any clamps and, even if there were, there’s no-one around to free me from them. I’m just slowly recovering from one of those all too familiar attacks where throbbing aches and pains in upper arms, wrists, elbows, knees and ankles arrive in an apparently choreographed simultaneity.

It’s not that I’d been doing too much either; I arose from my un-refreshing sleep at around 10.15am, had a small breakfast and browsed a newspaper (online) for about fifteen minutes and then just sat, stroked the dog and made a little fuss of him, before venturing out into the big wide-world. At around 1.15pm I was chauffeured into town, by ma belle Helen, to browse and purchase one or two DVDs for my birthday, utilizing a voucher received (on my birthday) a few weeks ago.

The purchasing venture proved successful and, we were back at home within an hour from stepping out. Judging by the greeting received from Piper, our delightful canine boy, you’d have thought we had been away for days; frantic tail wags, barks of delight and excited bodily contortions were all part of his display menu.

Shortly after our return home I prepared dinner for Helen and myself, one of my own recipes, a Kedgeree cum Byriani. The meal proved most satisfactory, after which I relaxed a while, listening to Bruckner’s 7th Symphony (compliments of Radio 3). After this relaxation interlude, I began to feel uncomfortably exhausted and, hints of the painful bodily niggles were already apparent. I went to recline on the larger sofa, with the intention of watching a DVD but, by now, the niggles were intensifying and a dose of tramadol was in order.

Next thing, I was having to curl up, arms stretched between my legs, legs randomly (and arbitrarily) thrown over the back of the sofa and, of necessity my upper arms clamped tightly to my torso. By this time, the discomfort in my toes, feeling as if my socks were applying an excruciating pressure to the knuckles of these digits, had also kicked in. I think I managed to view the first twenty minutes of the DVD before having to clamp my face tightly against the sofa back.

Elements of these nausea inducing, expletive demanding, symptoms are almost a daily occurrence at present although, I must admit, were of a slightly more disconcerting intensity this afternoon. Spending more than a quite limited time using a laptop, or holding a newspaper or book, regularly induces a squirm inducing discomfort in armpits, elbow and wrists but, although I enjoy playing and wrestling with words, I find it virtually impossible to describe the nature of these swift onset aches pains and nauseating discomforts. These invisible disabilities / infirmities are a real pain in the … (fundament?)!

Friday, June 09, 2017

on the mend and back again

Well, I’ve got to admit that my recovery after the arthroscopy was much quicker than I’d anticipated and, within three weeks I was back to being able to walk the dog on pavement, footpath and fields almost as before the operation. I have to use the assistance of a walking stick at present, but that was the norm until a year ago, but I’ve not had to don my knee supports. Yesterday afternoon, I had a follow-up appointment at the Orthopaedic & Fracture Clinic at the District Hospital and was discharged back to my GP.

During the op they had discovered some degree of arthritis (which hadn’t shown up on the X-Ray), considerable wear and tear of the cartilage and some bare bone into which they drilled two small holes. Incredible what can be achieved through keyhole surgery and, I’m just grateful for our wonderful NHS which the Tories are still intent on destroying.

The only difficulty, if I can call it that, whilst at the hospital was a need to rush to the loo whilst waiting for the appointment; sods law timing of a side-effect from the antibiotics that had been prescribed, the previous morning, for a non-related ailment. It all adds a little (off-)colour to life’s already abundant tapestry.

Now, the back story to the antibiotics: Late on Tuesday afternoon I started to get pains in the upper abdomen, right under and along the rib-cage. At first this felt more like a dull bruise but gradually intensified to a more searing pitch but, I’d had a similar, not quite so acute, sensation a couple of months back which was resolved by a prescribed doubling up of my omeprazole. I’ve long been plagued by digestive and sundry bowel and abdominal problems so, I’ve become accustomed to spasmodic disconcerting abdominal pain and discomfort, alongside other chronic pain symptoms. During the evening this more intense pain seemed to spread into the right-hand side of my back, from just below the shoulder blade into the small of the back. The discomfort & pain reached such a degree, untouched by my usual painkillers, that I had to keep changing chairs, sofas, posture etcetera,  throughout the evening, in an attempt to alleviate each recurring moment of increased intensity.

On Wednesday morning, following a telephonic triage by a practice nurse, I was granted an emergency appointment with a GP. I was amazed, and relieved, that the doctor gave me such a thorough examination of over twenty minutes duration and, judging by my reactions to the examination, he suspected an infection of the gall bladder. The doctor also arranged for a nurse to take some blood samples whilst I was at the surgery and, prescribed a course of Co-amoxiclav. He also asked why I hadn’t gone to A&E the night before, although my beloved OH had suggested that. I explained that I felt A&E were already overburdened and I didn’t want to add to it. The docs response was “but you are really ill!” and, if I experience similar pains again I shouldn’t hesitate in getting down to the hospital.

Early on Thursday morning the GP phoned me to check up how I was feeling and informed me that the blood inflammation flags were rather high and, felt that we were on the right course of treatment. I have to arrange for another blood test in a couple of weeks. Once again, my thanks are due to, and gratefully proffered for, the NHS!

Wednesday, June 07, 2017

the guilt trip of an involuntary social inactivist

As a life-long socialist*, I first joined the Labour Party in 1960 and, involvement in various campaigning groups on the internationalist/ social justice/ socialist spectrum swiftly followed. Unfortunately, health problems have, for more years than I care to remember, prevented me from participating in most party activities such as leafleting, canvassing, phone-bank duties. It has been only on very rare occasions that I’ve felt able to attend local branch meetings.

The reason for my non-participation is that I never know how my stamina reserves will play out on any particular day, part of the day, or even at times hour by hour. Although my general health has recently been better than it was in the first few years after collapsing and succumbing to ME, in 2003, I have to be very careful with my pacing.

I still find it difficult to cope with visits into the town centre, a mere 10 minute car or bus ride, and I have not managed to regain sufficient physical and emotional stamina to cope with the sensory assault of cinema, theatre, church, or concert-going. Indeed, I’ve rarely felt able to visit any art exhibitions, around which, for several decades much of my life seemed to revolve.

What prompted me to write this post is the intense guilt, and even anger, I feel when I receive e-mails enquiring whether I’m able to help out in the run-up to the general election. There are so many organizations whose aims I support but, I’m never able to commit to attending meetings, seminars and sundry proffered events; on a bad day it’s even difficult to respond to online surveys re campaigning on various issues.

The internet has proved a real life-line for me and, I love to know what issues are being campaigned on but, at present I’m contemplating unsubscribing form many of these mailing lists because of my recurring guilt at not being able to proffer my physical presence in support of these causes.

* I’m not kidding myself that the Labour Party is a socialist party, even though there are avowed socialists amongst its membership. I acknowledge that even under Jeremy Corbyn’s leadership it remains essentially a left of centre social democratic party with a modest glimmer of democratic socialism.

Monday, May 15, 2017

Compression Ratios and Ailments

Come Friday night, after all the preceding days anxieties, my only concern as I got into bed was whether I’d be able to get ready on time the following morning; more importantly would my beloved, ma belle chauffeuse be ready to transport me to the hospital for my day surgery. By 4.30 on Saturday morning I still hadn’t managed to grab any sleep but, I then re-awoke by 6.30am in preparation for the days events.

Quite strangely, by this time I was totally calm and relaxed in preparation for undergoing the surgical procedure. I duly arrived at Harrogate District Hospital before 7.30 and made my way to the Day Surgery Unit. The staff were all reallyquite brilliant in making one feel relaxed, and re-assured, about the procedure which one was there for: nurses, physiotherapist, anaesthetists and the consultant all introduced themselves and had a few word about the procedure. When I told the physio that I wasn’t too keen on the prospect of using crutches, owing to sundry aches and pains in elbows and upper arms, but I’d be happy to use walking sticks, she measured the stick I had with me and, a matching stick was cut and ready before I even went to theatre.

I wasn’t first on the list for the knee surgery but, nonetheless, I had undergone the op under general anaesthetic and was back in the bay by shortly after 9.30am. Were it not for a glitch with the computer printer, delaying printing of the discharge letter, they would have called my beloved earlier than was the case, for her to come and collect me. All that having been said. we still arrived back home by 11.40am. The nurse had laughed as she informed ma belle that I insisted on walking out and, wouldn’t take a chair. It really seems that all my anxieties had centred on pre-planning, not the event itself. Mind you, I’ve always preferred spontaneity to planning.

This morning, 48 hours after the op, I removed the bulky dressing from the wound and applied sterile patches in their place. I’ve been doing recommended exercises as and when I felt appropriate and have had little trouble with the technique for ascent and descent of the staircase. The one startling reality that has come to light is just how low the average lavatory pan & seat is; the switch from bladder release to bowel function seems to involve a considerable fall through space. If only we had eyes in our rears the operation would be a little easier. Elevating oneself after action provides considerable exercise of the arm muscles.

Since my return from the hospital I’ve only experienced the minimum of my familiar discomforts in wrist, elbows and armpits. I’ve even started to wonder if having a compression stocking on the non-operated upon leg has somehow applied a kind of lymph(atic) massage, similar to that experienced when an application of a tubular bandage support over the elbow frequently seems to alleviate a nausea-inducing aching tenderness in the armpits. [N.B. this is simply hypothetical – I am neither a medical or mystical practitioner]. Alternatively, it could have even be that my nervous system had diverted all its energies towards healing and soothing any discomfort in the battle of my wounded knee.