Category Archives: health

The Final Countdown

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It’s 9.40 am. I’ve already had my first hospital trip of the week and my time is now my own until 7.30 am on Thursday. At that point (fingers crossed) I should enter the final phase of the operation that has now lasted six weeks. Based on previous experience and the scanty information I was given at the beginning I was expecting it to be over in 3 days. Yes, what an idiot I was.

It is now three days until the operation and seven more before the catheter comes out. I am counting…

Although I’ve tended to concentrate on the urological side of things, as there are ready made elements of pathos and low comedy in that, I’m also been investigated for a range of other problems, all identified on my visit in December.

Take the Great Warfarin Farce as an example. I asked for the tests to be left until I’d finished with the operations but the doctor insisted. It involves visiting a hospital on the other side of town twice a week and eating rat poison. They may call it Warfarin and pretend not to know it has another use but I’ve fed bucketfuls of the stuff to rats over the years. It was first sold as a rat poison in 1948 and as a medicine in 1954. I leave you to draw your own conclusions

I went for my first appointment and I got off to a bad start with the nurse by enquiring why I had to give the same information every time I visited and why they couldn’t store it from visit to visit. She didn’t like that.  To be fair, she probably hears it a lot.

Things worsened when I told her I couldn’t make the next date for testing as I would be in hospital. Basically she called me a liar, and supported this by calling up a copy of my discharge letter to prove it said nothing about part two of the operation.

I suppose she thought I just wore the urinary catheter for fun.

“That,” I said, “is the discharge letter from the emergency admission last week. You need the one from 10th April.”

“Ah!,” she said, “I see.”

However, the operation didn’t happen and I had to stop the Warfarin five days before the next operation. That meant I was on Warfarin for five days.

I’ll cut to the chase – on my last test the nurse, a more practical and cheery individual than the first one – said: “I don’t even know why they started you on Warfarin until after the operation.”

So, I’m off Warfarin at the moment, though Julia has intimated she’s at a point where, if I don’t stop whining about the NHS, she’ll be happy to feed it to me, whatever the nurse may say.

Mad as a Hatter

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Sorry, this should have been part of yesterday’s post.

I’ve always known that “mad as a hatter” was something to do with hatters, madness and chemicals but I wasn’t quite clear on the details. I’m currently reading The Elements of Murder (slowly, I admit, but it isn’t light reading) and the book has some interesting details.

I was going to stick a paragraph in about it, as it seemed appropriate and I had a suitably mad photograph. However, having the information and the need to write a post I thought I’d better find more information to fill it out.

This proved to be a mistake. “Mad as a Hatter”, according to some sources, has little to do with madness, and nothing at all to do with hatters.

This is a nuisance, to say the least. According to Wikipedia there are several possible sources for the expression, including the Anglo-Saxons who used the expression to mean venomous as a viper. There are other explanations too. I’m not happy with any of them, nor am I impressed by the references to early usage, without exact dates. However, this is a blog, I’m citing Wikipedia and I’m never going to be mistaken for an academic.  Can we just say “other explanations are available”, and I’ll talk about the one I want?

The Mad Hatter is supposed to be based on Theophilus Carter, an eccentric Oxford furniture dealer and reputed builder of an alarm clock bed exhibited at the Great Exhibition of 1851. When it was time to get up a clockwork motor engaged and tipped the sleeper into a tank of water. This seems a bit brutal even for stern Victorian early risers.

Unfortunately, though there were two alarm clock beds exhibited in 1851, neither of them was attributed to Carter in the catalogue. Nor, despite Carroll’s extensive diaries, is there any real evidence  that the Mad Hatter is based on Carter. It’s a shame, because it’s a good story.

There is, however, plenty of evidence for hatters exhibiting signs of madness.

The main material used in making hats was felt, which was made from the hair of rabbits and beavers, mixed with mercuric nitrate and repeatedly shaped, boiled and washed until it formed smooth cones of felt. This process released mercury vapour which, went inhaled, caused symptoms such as delirium, hallucinations, irritability, excitability, tremors and depression.

In many countries, including the UK, measures were taken to protect workers from exposure and by the end of the 20th century hatters were no longer suffering the effects of mercury poisoning. In the USA it persisted until 1941, being known as the “Danbury Shakes”, after the hat-making centre in Connecticut. Eventually the need for mercury in the war effort meant the use of alternative chemicals and the end of the Danbury Shakes.

Be that as it may, in the 1860s, when Carroll wrote about the Mad Hatter, mercury poisoning, was a major factor in the behaviour of hatters.

The Good News

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Thanks for the comments everyone, working on the basis that a trouble shared is a trouble halved I feel much better already.

I had a call from the hospital this morning. They have fixed me up with a new pre-operative assessment next week, my third (fourth if you count the extra one with the anaesthetist I had to have so they could tell me I was fat) in six weeks. I’m pretty sure this is due to a need to tick a box somewhere rather than the fact I need to be seen. After all, the proof of the pudding is not in the pre-op but in the fact that I didn’t die under anaesthetic during the first operation.

Regarding my weight, I’m fairly sure that could be left to a volunteer, as I don’t think you need five years at university to spot that I’ve let myself go a bit. I may suggest this efficiency measure to them, as doctors clearly have better things to do.

They have also fixed me up with a new operation date in two weeks, though I’m not sure how much faith to put in this. Fourteen days isn’t a massive delay, I suppose, though if I give any of the staff involved in the delay the chance to wear a urinary catheter for fourteen days I don’t suppose anyone will volunteer.

I was lucky they didn’t cancel me the day before the operation. By cancelling on the day for non-clinical reasons they are committed to giving me a new date within 28 days. If they had cancelled the day before there is no such obligation. In the last quarter of 2016 there were 21,249 cancelled operations, which is 233 a day.

There are various reasons for cancellation including lack of beds, lack of staff, running out of time, equipment breakdown and administrative error. Looking at it that way, 233 isn’t a lot of cancellations, though last week the man on my ward who was cancelled twice in two days may have had a different view.

I hope the new appointment is right because it’s for 7.30, which means there is no delay and though I miss breakfast I will be on the ward for lunch.

Institutionalised? Me?

The picture has nothing to do with the text, I just wanted to add something cheery to the post. It’s from the Cloud Bar at Anderby Creek. 

Fish, Chips and Disappointment

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Well, I’m back home already. No overnight stay, no pain, no blood.

On the downside, there was no operation.

I rose at 6.00 and, like Paddington Bear, breakfasted on marmalade sandwiches. Five and a half hours later I was washed, packed and provisioned. I was also starving and slightly nervous, as medical staff kept drifting through, asking to see my appointment letter. In the end one of them, having drawn the short straw, sidled up and asked me to step through, obviously trying to separate me from the herd.

“I’m sorry, but you’re not on our list.” she said, and like a modern nightclub the NHS operates on the policy of “if you aren’t on the list, you aren’t coming in”.

So, despite having a letter telling me when to report, despite having rung to confirm and despite having had my pre-op done while I was on the ward last week, I was sent home.

That’s the summary anyway. In real life it took longer, with more muttered excuses and a lot of waiting.

I’m now waiting for a new date.

On the positive side, this gave us the time to enjoy the sunshine and go for haddock and chips at The Big Fish  and Julia allowed me to have syrup sponge and custard to get over my disappointment.

I’m now engaging in one of my favourite activities – mentally composing a letter of complaint about my cancelled appointment. I always seem so much more intelligent at this point – the draft always seems so much better than the final written version.

I’m currently debating whether I should offer to fit catheters to the staff concerned as this might concentrate their minds on the delay in removing mine.

 

Part 3 – Free at Last!

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After the drainage procedure the pain immediately subsided, and I suspect that what remained was due to the drainage rather than the abscess.

We will now deal with the bed. It finally arrived from a secret off-site location (after a second call was placed), at 9.30. That’s about 8 hours. I presume it was either stored a long way away, or that it was close and they pushed it all the way by hand. To suggest a third choice, that it took eight hours because they couldn’t organise a party in a brewery, would be a cheap shot.

It was a monster, requiring furniture to be moved round, and had a pump which operated constantly, and noisily, to keep the special mattress inflated (this strikes me as a bad thing in a piece of furniture designed to facilitate sleep).

There were other faults – the main one being that it was so high I couldn’t get into it unassisted. For some reason The Great Bed of Ware comes to mind. City Hospital is currently running a campaign (End PJ Paralysis) to encourage patients to get dressed properly and get active. Strange really, considering they seemed to go out of their way to render me immobile.

I won’t mention the the list of other faults, as several of them have already come back to me as bad dreams. It’s difficult to imagine anyone being traumatised by a bed, but I promise you, on top of everything else, that bed came close to breaking my spirit.

Once I had been assisted into bed, and we had addressed various problems with adjustments things took a turn for the worse when a junior doctor arrived with a cannula. I had hoped to avoid having one but it seemed that they couldn’t get enough antibiotics into me by mouth alone. When you think of the alternatives I suppose intravenous isn’t so bad.

As usual, it didn’t go in at the first attempt and the doctor decided to try my right hand. I try to avoid the right hand as I often catch it whilst doing things. In this case, I started by bleeding on the book I was reading; this wouldn’t have happened if the cannula had been in the left hand. Second, I caught it on the cuff of my nightshirt whilst preparing to wash next morning, This resulted in a cannula that stuck out at a strange angle. I got it roughly back in position and replaced the dressing as well as I could, but it wasn’t quite right.

The rest of the day passed in a haze of boredom punctuated by random bottom inspections. Dark forces are obviously afoot in the NHS, striking back at the rising trend of patient dignity.  Under the guise of skin inspections to prevent bed sores, random members of staff wander along at irregular intervals and demand to see my heels and bottom.

I may refuse to show them next time, on the grounds I am a man, not a baboon.

Finally, Julia arrived to visit and help with my liberation. The first thing she did was point to a spot by my side and say “What’s that?”

It was the cannula. I must have plucked it straight out, which couldn’t have taken much effort as I didn’t even notice.

We asked a passing nurse to dispose of it instead of leaving it lying about.  She didn’t seem grateful for our help in keeping the place tidy, but maybe she was just sad at the idea of losing me.

 

 

 

 

 

 

 

 

 

 

Part 2 – The Pain Continues

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Quick note – the antibiotics are working and I’m near enough free of pain, but as I’m writing about Wednesday night and Thursday I thought I’d go for sympathy via a heart-rending title. 

My reward for demonstrating fortitude was a letter to Harvey 2 ward at the City Hospital. That was where, a month previously, my tale had started. It was also, give or take, quarter of a mile away from where I had started my journey that morning.

I got there before my notes did, and was shunted off to the Day Room of Despond. That’s not its official title, it’s just my description. I’ve been thinking of John Bunyan since reading Mr Standfast, and this seemed as good a time as any to get a reference in.

It’s also a chance to roll out my new literary project. I’m thinking of an historical crime series set in late 17th century England and written in a hard-boiled American style under the pen name Damon Bunyan. Yes, first the temperature comes down, then the puns return…

By the time I was finally called through to the ward I was quite comfortable in my recliner in the day room. The chair in the ward was quite painful to sit as the…er…swelling got in the way. It was also bad for my swollen and infected foot because I couldn’t put it up. Still, no matter, as I would be lying down soon. Apart from one thing…

Either a rule has changed in the last month, or I have put weight on, as I am now officially too fat to lie on an ordinary hospital bed.

It did, at least, allow me to hear this classic gem of English recalcitrance when I asked if I could just lie on the bed for a while.

“It’s more than my job’s worth to let you lie on that bed.”

I’ve never actually heard that in real life before, just in comedy scripts.

Fortunately an enterprising junior doctor, anxious for some hands on experience , found that the bed in the triage room was strong enough for me. He and his senior colleague explained that the abscesses needed draining and that it was probably better to avoid anaesthetic (as in general or spinal), the subtext being that it’s not good for fat people. Local anaesthetic, it appears, does not work well on abscesses.  This left one choice, involving just a stiff upper lip and a large measure of macho insouciance.

“The procedure,” said the senior doctor, “is not without discomfort.”

He was correct. It was, I can confirm, an experience that had moments of discomfort.

 

Part 3 will cover the rest of the stay, the arrival of the bed and the unfortunate occurrence with the cannula. 

The Day That Dignity Died

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Well, it looks like I owe you all a number of apologies.

First, I missed a day, which means you had to survive for 24 hours without my daily ray of sunshine. I think it was 111 days, but even if  I miscounted it 111 is a good number to remember.

I also misled you by claiming things were under control and getting netter.  This turned out to be inaccurate. Looking on the bright side, the further developments turned out to be more interesting (and cringeworthy).

And finally, after leading you into the apologies in a flippant manner, I’m going to apologise in advance for some of the words and details I’m about to use. If you dislike posts with unsavoury details of the interior of my trousers you may wish to pass on this one. I will be as refined as possible, but remember the “as possible”; that’s a long way from the sort of anecdote I’d tell my mother.

Cast your mind back to Wednesday morning. It is bright and clear with the gentle hum of traffic and the muted twitter of urban bird life. All is well in the world and I am getting ready for my pre-operative check. The only fly in the ointment is a slight feeling that I should be feeling better as I am positively crammed with antibiotics.

I was not fated to make that appointment, and half an hour later I was at the A&E department at QMC shouting at the receptionist. It wasn’t that I was annoyed with her, just that they have put up glass security screens and you now need to broadcast embarrassing personal details at high volume to make yourself heard. So much for patient dignity.

They sent me straight to the Urgent Treatment Centre. It’s a two minute stroll for an able-bodied, or a crippling lifetime of toil for a man with a bad foot. Not only that, but it’s not all that urgent.

When I was finally seen (which wasn’t really that long compared to a wait in A&E) the doctor asked me to describe my symptoms. Part way through, she seemed to be looking bemused.

“Is there anything wrong?” I asked.

“Well,” she said, “they seem to have booked you in with joint pain.”

“I do have joint pain,” I said, “but that’s not what  I told them at reception.”

I distinctly recall what I had told them at reception.You remember such things.

So, once again, I took down my trousers. It’s getting to be automatic and really doesn’t bother me any more.  In the last three months I’ve exposed myself to more strangers than the average flasher.

“Yes, you’re right.” said the doctor, “that’s definitely an abcess, in fact it looks like there’s one here too.

She squeezed.

“Eeeek,” I said, trying not to cry,

 

(To Be Continued…)

More Medical Details

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Well, life never loses its capacity for surprise, does it?

As I mentioned yesterday, I have a swollen foot and difficulty in walking. What I didn’t mention was that when I went to bed last night it involved a major effort and a lot of pain. Even after a night spent with the leg elevated, things were not much improved by morning.

In the end I rang the doctor for advice early this afternoon, as I really was feeling quite rough. It’s not a pleasant feeling to think your body is breaking down to the extent that even sitting down upsets your capacity to function normally.

The doctor’s advice was that I should go down to the surgery quite quickly so they could prod me about. I was feeling so weak that I didn’t even argue.

It seems that my self-diagnosis was incorrect. I don’t have a swollen foot due to poor circulation, I have a swollen foot because I have an infection.  It seems that as the previous antibiotics sorted out the other infection (in a laudably selective manner) another infection was gathering in my foot. That is the cause of the swelling and the pain. It’s also the reason that it isn’t going down despite me doing all the right things.

I had an interesting temperature when the doctor checked. It was nearly 39 degrees, against a desirable level of 37 – 37.5. He’s quite keen me getting it down, as at 40 it’s officially “life-threatening”, which is, apparently, a bad thing. He couldn’t believe that I hadn’t noticed, but as signs of having mild fever include feeling hungry and thirsty I don’t really know how I’m expected to separate this from my normal state of feeling hungry and thirsty.

We are currently monitoring my temperature with a thermometer that’s left over from my time as an antique dealer. It;s old, but it still works, and my temperature is falling.

I’m happy now.

With any luck I might start to become interesting again.

You never know…

Light at the End of the Tunnel

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As the day progressed I started becoming more agitated. It’s hard to settle when you have a 4 pm hospital appointment. At least, by scheduling two health appointments on one day, I wasn’t going to waste two days.

It was cardiology this time and I haven’t been looking forward to it. It proved to be one problem after another. First I had trouble folding myself into the taxi as all this sitting round is making my knees seize up, then I got lost in the outpatients department. I say “lost”, but some proper signs would have helped. By the time I got to the right place I was three minutes late, annoyed with myself for poor punctuality and irritated by the signage.

At that point I discovered I’d left my glasses at home and my arms aren’t quite long enough to allow me to read.

It got worse when I was sent off to another department for my third ECG in six weeks. Why not do one and use it three times?

Things improved after that. The ECG technician apologised for asking me to remove my upper body clothing and I replied it was no problem, and a real bonus to keep my trousers on for once.

That led to an amusing story about her morning. She asked a patient to remove his upper clothing so she could attach the sticky tabs and turned round just in time to stop him removing his trousers. It seems he thought he was in for a haemorrhoid examination. I’m not sure where sticky pads and wires fitted into his view of things…

Anyway, much cheered, I made my way back to the clinic to be weighed (again), measured (again) and have my blood pressure taken (again). I seem to have shrunk by two inches since my last measurement. Sadly I haven’t grown any lighter.

After examining all the evidence the doctor told me she’ll write a letter to my doctor,  and said I was free to go. She didn’t need to tell me twice.

That’s one to cross off the list.

Now that I have a date for Male Urology I also feel I’m close to crossing that off.

I’m tempted to say I can see the light at the end of the tunnel, but that just reminds me of a flexible cystoscopy.

Eeeek!

 

 

An Awkward Moment and Some Good News

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I went to the dentist this morning, which proved to be a prelude to an embarrassing episode. As I was leaving, I noticed a couple of small pools of liquid on the floor.Oh dear.

A quick inspection revealed that the tap on my leg bag was open. Whether this was due to me not closing it properly, or whether I caught it at some point, I don’t know. Fortunately it didn’t leak on me, just the floor.

This left me embarrassed, and the dentist with the impression that he must have frightened me.

Ah well, I suppose it had to happen some time. If you store urine in a bag attached to your leg you must expect accidents. After my time in Male Urology I know that worse things happen…

The good news is that my teeth passed muster, though the gums need attention. As a result I’ve been trawling the internet to check on ways to enhance my gum health.

It seems it’s all down to eating the right things, and not eating the wrong things. In other words, it’s just like other sorts of health.  As you would expect, some foods appear on both lists.

I may start writing lists for the blog. How about a list comprising chips, chocolate, cheese and cake?

One week it could be Four Foods to Avoid, the week after Four Favourite Foods and the week after that Food Alphabet – Letter C. That’s before the sound of barrel scraping and the inevitable What I’m Having for Tea Tonight.

Finally, some good news. I’ve just had a letter from the hospital. They want me to present myself with an overnight bag in two week’s time. I’m not getting too excited after what happened last time, but it does seem that there might be reason for hope.