A Senior Moment

That nice Mr Automatic called me the other evening. It was the first time I'd heard from him since around last February, and it was good to hear his dulcet tones enquiring after my health and temper in this wintry weather. Are your symptoms worse than usual? No. Do you have enough medication to last two weeks? Yes. And so on. I'm not sure quite what happens if you answer 'Yes' and 'No' respectively, mind - a couple of years ago, when Mr Automatic was still experimental and not so well trained, my symptoms really were a lot worse than usual and I was having problems talking at all. After several repetitions of questions with a polite 'I'm sorry, I can't understand you' he finally just gave up, hung up and said he'd call again! I'm sure, though, that the new, better trained Mr Automatic would not behave in such a cavalier fashion but would send round knights in shining armour (or green scrubs) to make sure I was OK.

Anyway, some considerable time later I was mulling over my good fortune in having someone checking up on me so nicely when I realised that I had no recent memory of acquiring any medication. One particular item on which I depend lasts exactly four weeks, and I usually re-order as soon as I start on a new supply, so that I don't have to panic about getting down to Fore Street to collect it until I feel like it. But I was about half way through, and - had I ordered it? There was no new supply on the shelf. I had ordered and collected medication for Ron last week, but where was mine? I had to call the surgery and ask them - had I ordered it and forgotten to collect it? Had I collected it and forgotten to put it on the shelf? No, I hadn't ordered it at all. So now I have, and all will be well.

Mr Automatic, I thank you. On your very first day of operation this winter you have already saved, if not a life, at least considerable discomfort and embarrassment. According to the BBC, Mr Automatic costs the taxpayer £21 per patient per year, and he is worth every penny. Taxpayers, I thank you too.

Good News and even more Good News!

Good News #1:

I went to Derriford yesterday to the fracture clinic, and they signed me off. I don't have to go there again, only to St Barnabas over the road for physiotherapy. They sent me home with a leaflet of impossible wrist and finger exercises an that was that. I don't even have to wear the splint any more unless I want to, and should try (carefully) to use the fingers at least, if not the wrist, a little more each day. All quite liberating and satisfactory.

I can actually myself notice small bits of progress - typing is now more or less normal, although I do not appear to be using my thumb (still the most swollen and painful digit) for the space bar. Unless I actually force myself to do it with the thumb, the natural space bar presser seems to be the middle finger of the right hand. Truth is, I can't remember what I used to use, before...

Good News #2:

Even better, this. The bone scan results say that my bones are perfectly healthy, not even borderline osteoporosis, and the wrist fracture was a genuine accident, not a trend! This is such a relief that even the weather seems to have improved. I haven't quite come back down to earth yet, and still have a silly grin on my face!

Can you hear me now?

Yesterday morning, only a matter of seven weeks since I first asked our GP to refer him to the hospital and two weeks since his hearing test, Ron was fitted with his hearing aids.

The programming took an hour and looked quite complicated - but was all done on a computer screen, without even having to ask him how sounds felt/sounded. Against the audiologist's advice (he said get used to them gradually) Ron insisted on wearing them home on the bus, and was fascinated that he could hear the engine accelerating and the gears engaging. By the time we got home, though, he had had enough and had to have them out and go for a lie down.

I am very impressed with the speed and efficiency of this service. All that remains now is for him to actually use them; I know several of his contemporaries who either don't wear them at all or only in selected circumstances. I know he's going to find it difficult to get used to them, but for my sake as well as his I hope he perseveres.

Bone Scan

Back to Derriford again this afternoon to the medical physics department, located down in the dungeon, for a bone density scan. Actually it was quite a pleasant experience - on time, nice people, good explanations, no pain. No results either, at least not for a couple of weeks.

They were very thorough. The information I'd seen on the internet said that it would be on a wrist, but in fact there were four scans, on the spine, left hip, right hip and wrist. The biggest problem was the questionnaire they gave me to fill in first - I did it, but I wasn't convinced they would be able to read it. I think my lefthanded writing would be much better if I could do it from right to left across the page. I understand now why lefthanded people have so many problems; I can't even hold the paper down properly.

Unplastered

Today was my first visit to the fracture clinic since the operation. It started none too well, as I had decided to go by bus, which meant that I arrived five minutes late for my 2.55 pm appointment. When I apologised, the receptionist was all smiles. 'Not to worry, we've started late today anyway.' Not really kidding, she wasn't - it was ten past four when I was called in to the plaster room. All went well from then, though. The plaster and bandage dressing was removed, the wound and repair declared satisfactory, and I was sent home in a small splint the same as the one Judith wears for aquacise.

There's not just a plate across the wrist, that's just the top of a T shape which goes quite a long way down the front of my arm. It looks quite impressive on the x-ray. It feels much better, much more comfortable, although I've been given exercises to do which aren't altogether pain free at the moment. And if all goes well I don't have to go back for four weeks. I'm to be sensible, of course - no lifting, no doing too much, no driving. I've just checked, and typing's out, too, except for middle finger, which will peck a bit. Still, I'm sure it will come in time.

I saw my friend from the bed opposite, too. She was in having her cast removed and replaced with a lighter one, and looked very well, although she's still not able to put her foot on the ground.

I jumped on a bus into the city centre, as I was so close. Not that the bus went straight there, of course. It wandered all over the place, in and out of Asda, in and out of Marsh Mills retail park, and finally crunched into the back of a green car, luckily for me right outside the back door of Primark, my chosen destination. I left the drivers arguing and got Ron's new trackies, then on to my third bus of the day and home in time for tea. Wonderful, these new bus passes. Before, I could have done Derriford and back, or the city centre and back, but not the round trip.

Deaf as a Post - but not for long

It has long been Ron's contention that I mumble - and long been mine that he's deaf. Many years ago in Spain he had his hearing checked, with the conclusion that although he was missing the top and bottom tones he had enough left in the middle to get by on. And so he has struggled on; with what he calls 'tin-ear', blighting the TV screen with subtitles, switching off on social occasions. One of his reasons for not getting anything done about it was a belief that hearing aids were either very expensive if purchased privately or involved a very long wait if pursued through the NHS.

Long wait or not, I decided something must be done and asked our GP about a hearing test. This was exactly five weeks ago. Today we had a trip to Derriford's Audiology Department and after a fascinating hi-tech test session he has had moulds taken of both ears and aids will be forthcoming in the very near future. Not a long wait at all - and it was quite a pleasant experience.

There is one slight worry; the Doctor was unhappy with his right ear as there appears to be another problem. He showed us on the graph that it was very different from the left, and two points which should have been close together were almost a page away. A 35 decibel difference, he said, which was very comprehensible! Anyway, he is passing this on to his colleagues in ENT so they can investigate further. In the meantime, I shall be much more laid back about subtitles and overloud music, knowing that it may not last too long.

Do You Need an Appointment?

My Ron's hearing has been deteriorating for years, and I have finally managed to persuade him to have it looked at. Last time it was checked, back about 15 years ago, he had lost all the high and low tones. but could just about get by on what was left.

The system for a hearing test is simple; see the GP, ask for a referral, get an appointment at the audiology department. The system for getting an appointment is a little more complicated, however. First we had a letter asking him to phone for an appointment. I did that, fixed a date, put it in the diary. Job sorted. Ha! Since then we have had confirmation letter. This confirmed his appointment and gave him some instructions on seeing the practice nurse and getting his ears cleared of wax before visiting the audiology dept. Fair enough, although I would have done that as an insert with the 'call for an appointment' letter. Job done? Apparently not. We had an automatic phone call this evening, requiring him (if he WAS him) to press 1 to confirm his identity, enter his DOB in six digits to prove it, press 1 again to confirm that he was going to be there next week. Job done? Let's hope so, this time...

Tales from the NHS

On Sunday (yesterday) morning at 7.30 am I went to get my smashed wrist fixed at Derriford. I got home this afternoon at 6pm with it neatly rebuilt and wrapped in plasters and slings and things. Some of it is a bit of blur, to be honest, but on this day when the media is full of NHS 60th anniversary stories there are some clear snapshots worth remembering.



Arriving on the appointed ward at the appointed time and finding I was first on the list for surgery (good) but my allocated bed was unmade, and what's more never got the promised pillows... Nobody had time or inclination to explain to Ron what was happening or how he could get in touch later. Still, the bed was sufficiently prepared for me to go down to theatre only about 30 minutes behind schedule, someone stuck a venflon in the back of my hand and the next thing I knew it was all over. I was in recovery in extreme pain, with a button to push for pain relief.



I pushed it a couple of times until the pain went away and was returned, somewhat woozy but OK to the ward, where I was instructed to keep my arm elevated in a pillowcase pinned to a stand beside the bed, but I got into a row for not having it high enough, or was it too high, or was it that the bed was being moved up and down? Yes, and the under elbow pillow never arrived, either. And moving the bed kept pulling my oxygen out of the wall, but a kind girl in green got a longer tube. I was OK, however, until told I could get out of bed for the toilet, sat up and felt, but wasn't actually, sick. I was still feeling a bit queasy when Ron arrived; while he was there dinner was also delivered but one mouthful of rice from the sweet and sour something made me very sick indeed - all the several pints of water I had drunk. After that I dozed and started to feel better about nine - by 10.30 I was starving! "There's cheese & biscuits, yogurt or banana in the fridge." "Yes, please!" "Which?" "All of it!". And I ate all of it, later, plus Jaffa cakes Ron had brought me.

At 3am I was due a dose of antibiotics which involved putting in a new venflon as the first one had dislodged. From about 4 am the lady in the next bed was awake but confused, calling for her daughter and trying to get out of bed. Nurses occasionally came and went (usually when I summoned them to her because she was about to fall and hurt herself), but basically I spent the rest of the night listening to her if not talking to her.

By 9 am I had been issued with a fancy navy blue sling and been told that the only thing keeping me in was paperwork. After about 2.30 pm, when I discovered that the cut off point for getting out depended on whether the pharmacy was still open for painkillers to go home with (5pm) I started mentioning my predicament loudly to every passing NHS employee, in the hope that one of them would do something. I finally got my marching papers at 4.30pm, but was not just made to feel but actually told that I was being 'difficult' - and indeed keeping the doctor who had to sign the release from two very sick patients elsewhere!

Well, all I can say is that this is the only way that works. Opposite me was a small, quiet, polite lady, slightly older than me. Very reserved, very well mannered, accustomed to accepting authority, broken ankle. She had been there since Friday night and had never been free from pain, had not been visited by a consultant or a physiotherapist (or her husband, but he was not allowed because he had the flu). She was not aware that she could make phone calls. She was not a happy lady, but not the complaining type, and I learned most of this while we were up in the night with the 'confused' lady. So I did a little complaining on her behalf, and some asking for stuff and pointing out deficiencies. The first thing was some proper pain relief (she was written up for liquid morphine, she had been getting paracetamol), so she got some strength and some sleep, and by the time I left she had also been seen by physios etc and an ambulance had been ordered to take her home with a zimmer frame.

By contrast, on Monday afternoon a lady was wheeled in, complete with husband holding her hand, after some elective surgery. Confident, outgoing, greeted with a smile, people running round fetching her things, two physios walking her up and down the ward within ten minutes of arrival, etc.

And the 'confused' lady, who was being treated like a naughty, forgetful child but seemed to me to be mostly dehydrated, had apparently been fine apart from having fallen and hurt her leg some 10 days earlier. But was getting worse each day.

I have nothing but praise for the clinical part of my treatment, but life on the ward was completely and utterly shambolic and disorganised. It was a big, rambling, mixed sex trauma ward, although within the individual bays it was mostly all male or all female. There was no one in overall charge at any time, and although there were a lot of staff about it was impossible to know who to talk to. 'Uniform' in any meaningful sense, is totally absent. They all wear cotton tunics except the ones with nylon coats, of course. All conceivable styles and colours. Uniforms should identify roles clearly. Doctors are like sixth formers at the end of term; dressing up because they can, with absolutely no regard for hygiene or practicality. There were at least two competing regimes in the 8 beds Icould observe from my own, with two different drug rounds, observation and tidying lists. My bed was never properly made in the first place and not once did anyone attempt to tidy me up, but then once I was awake I was on it rather than in it anyway, more comfortable sitting crosslegged than trying to lie down. I had my temperature taken twice in ten minutes once, by two different nurses. I had the little clip put on my finger and the BP machine started with the cuff wrapped round the stand, not my arm. Because there was no control, no continuity, non assertive patients were ignored. Lies were told to shut people up (particularly the 'confused' lady) because that was easier than dealing with the situation. I heard a (presumably senior) member of the nursing staff tell my consultant that I hadn't been sick at all (because Ron had held the vomit bowl, emptied it and replaced it for me). She also said I was imagining the lack of oxygen supply, because a junior, greener, altogether nicer member of staff had gone and got a longer piece of tubing (possibly also because it was the senior nurse's constant fiddling with the height of the bed that caused it to come out the second time). I said never a word - what's the point?

I could go on, but I won't. Sadly, my experience is far from unique. I can see ways to improve the service, but the basic premise is now, sadly, flawed. And about to become a constant factor in my life, it would seem - Ron and I now have GP and an outpatients appointment each in the next week...