As I promised in the last post (no, not the bugle call) there are going to be several days rolled into one here as not a lot happened so it is just for the sake of completeness. Appropriately it encompasses three days so I have dated it to the latest date.
The 24th of September had no World Cup Rugby so that was one option ruled out and it was tipping down with rain so any sort of walking was right out. The image shows you how unpleasant it was weatherwise. Yes, I still wanted to do a bit of walking, partially to aid my recovery and build up my strength and also because it is one of my favourite pastimes, at least it was until I started feeling unwell. What was I to do?
My newly rediscovered appetite made breakfast a must and I really fancied a pancake breakfast which meant Wetherspoons at Margate. I much prefer their outlet in Ramsgate but they have some odd ways of working there. I do eat breakfast quite a bit in JDW and my two favourite breakfasts there are the pancake breakfast or else Eggs Royale but neither are offered in Ramsgate. My preferred tipple, even under this current abstemious regime is Strongbow, one of the most popular ciders in UK and again not available in the Pavilion although it is in every other ‘Spoons that I know. I am fobbed off with Thatchers instead which is not a bad drop but not my first choice.
I am very partial to “bangers and mash” for lunch or dinner and again it is available in every other Wetherspoons I know but not Ramsgate. I believe they have exceeded it now with another outlet but when the Pavilion opened it was reputed to be the largest pub in Europe and certainly in the UK. It was very much their flagship with a customer area of a staggering 11,000 sq. ft. not to mention kitchen, staff, storage areas etc. so you would think they would offer their full range of food and drink but apparently not. It completely baffles me.
Off to Margate then on the Loop bus, into the Mechanical Elephant which I have mentioned here before is not my favourite of what is an excellent chain. You would think that pancakes, maple syrup substitute, bacon and blueberries is not too difficult to get out but they could not even do that right and the non-maple syrup was fridge cold. Apaprently they could not even manage a few seconds in the microwave where they cook most of their food. When I received the obligatory “Is everything OK Sir” which was as mechanical as the elephant of the pub name, I did point this out and she offered to have it sent back to the kitchen. Not a chance, I have known enough chefs to know what happens to returned food.
As usual, the internet was not working in the Elephant so there was nothing else for it but to head back to Broadstairs as the weather didn’t look like livening up any time soon as you can see below. I won’t bore you with my evening in the pub tapping up this stuff on my computer and nursing a pint or two of cider spritzer so we shall pass quickly on to the next day.
A quiet day, wired in the evening and a bit of seagull wrangling thrown in.
The 25th was not a lot better than the previous day weatherwise, it really was getting autumnal. I have mentioned before that Thanet has an odd weather system and I have known T-shirt days in October but here it was wet, blowy and none too warm.
After the slight debacle of the Wetherspoons the day before I decided to play a bit safe and return to the Pavilion for breakfast. OK, there would be no pancakes nor Eggs Royale but I had half an idea to try something I had seen on the menu which was a relatively recent innovation known as Miners Benedict which I am quite sure is something the chain had invented themselves as I had never heard of it before. It substitutes black pudding for the ham in the traditional Eggs Benedict. I was not sure how it would work as the Benedict family is served with Hollandaise sauce whereas I would normally associate brown sauce or preferably English mustard as the condiments of choice for black pudding but I am game to try anything once and so that was the order.
No doubt Wetherspoons have very well qualified executive chefs, all sorts of focus groups and whatnot and had probably trialled the new dish before putting it on general release so I really should not have had too many misgivings about my Miners Benedict. Let’s be honest, as a man who makes tuna, banana and garlic pizza nothing should seem too odd and, against all expectation, it worked very well and provided a good start to the day.
Seagull wrangling in Ramsgate.
As I was sitting allowing my breakfast to settle and doing a bit of leisurely blogging I became aware of a bit of a commotion which was a couple of members of staff making a fairly half-hearted attempt to direct a juvenile seagull, which had somehow found it’s way in, back the way it had come. The creature was obviously confused by the concept of glass and was persistently trying to get through the window to the outside world it could so clearly see. Incidentally, I apologise for the quality of the images but the beast just would not keep still, probably understandably. Lest anyone is concerned, it was eventually returned to the great outdoors, apparently none the worse for it’s visit to the Pavilion. With the excitement over, I settled down to another quiet day of blogging and attempting to keep my alcohol consumption down. I must say I was becoming increasingly good at that although I will never like it.
What an amazing history the harbour has.
As I was walking back the short distance to get the Loop bus back to Broadstairs I stopped to capture the two images above. I had seen them many times before and knew the whole history but I thought I would capture them to share with you. I have told you before how much I love Ramsgate Harbour not to mention boring you with interminable images of it but in addition to it’s obvious aesthetic qualities it is packed to the gunwales (note the nautical reference there) with history and these plaques represent only a fraction of it.
I was heading home for the afternoon dozette that is becoming increasingly a part of my daily routine the older I get. I wanted to be fresh for the evening as it was “Wired” in the Wrotham so I suppose I should explain what that is.
“Wired” is a long-running open jam session which has had several venues rond the town and has now settled in the Wrotham which seems to be the centre for so much good live music. It is held on the last Wednesday of the month and is an open jam session tending towards electric music, predominantly blues and rock. It is not to be confused with “Griff’s Open Mic night” which I shall explain in a future post, nor the “Woodshed” (ditto re: explanation), both of which are also held in the Wrotham.
Totally wired all of them!
I know a lot of musos on the scene round Thanet and have played with most of the guys you see pictured here but I did not know the guy who provided me with a great treat that night in the shape of the Hammond organ you can see being expertly played in one of the images above. I love Hammond organs and whilst Lee (apparently that is his name) did not have the Leslie speakers (are there many originals still around?) but it still sounded great especially as he was such a good keysman. It was a great night and I thoroughly enjoyed it. A very short trip up the stairs (no, I did not literally trip up the stairs) and straight into bed for another great night’s sleep.
Two breakfasts, one rugby match, one hospital appointment and little else.
Thursday 26th rolled around and the only item in my rather full social diary (I am only semi-joking about that) was yet another hospital appointment at the QEQM in the late afternoon. I knew Dave would not be opening the George for the early rugby match of Italy vs. Canada as it was of little interest locally but England were due on at 1145 and whilst it was a foregone conclusion I fancied watching it as I love my rugby.
Breakfasts in Thanet.
Breakfasts in Thanet.
I awoke early and hungry which thankfully seems to be my default position now and so I took off over to Ramsgate for a quick breakfast. I only ordered the small version as I knew damn rightly that Dave would be putting food on in the bar and he does not take no for an answer when it comes to eating, at least not with me. As I told you before that the man is on a very well-intentioned and much appreciated mission to bulk me up again. My supposition proved correct on both counts and the two feeds are shown above.
The match was pretty much as expected with England running not only riot against USA but also running out 45 -7 victors. Then it was back to the QEQM hospital again for my appointment before back to the bar where it was quiz night and despite being asked I declined the offer to join a team and make a complete fool of myself.
As always, a gentle stroll home and off to bed content with another day on the road to recovery. Certainly I was not going to be entering any Ironman events in the near future but my wound was healing nicely and I was able to walk increasing distances with no ill effects. As I have described I was eating with a vengeance and an appetite I had not had for a very long time. The only downside were those annoying jabs but they were an inconvenience rather than a major problem although they were becoming gradually more uncomfortable as I was forced to revisit the same injection sites but I suppose it is preferable to a blood clot roaming around inside me.
In the next post I get to visit a fascinating place I have wanted to see for a very long time and there is inevitably yet another breakfast so stay tuned and spread the word.
On the 17th September, I awoke after another excellent night’s sleep in my comfy bed in my quiet cosy room and I felt good. I knew I wanted to stay round Broadstairs and Thanet for a while as a) even getting a cab to and from the train stations at either end I was not sure if I was physically strong enough to hump all that luggage back to London and b) it is so much better an environment to aid recuperation. I was still a bit surprised as to how weak I felt but I suppose it is natural. Jackie was happy for me to stay more or less as long as I wanted so everything was set fair.
Unfortunately, there was still the problem of getting registered with a Doctor locally and getting repeat prescriptions etc. If you have not read the previous post here, I had been turned away from the local health centre despite several hospital Doctors telling me they were legally obliged to take me on. The simple fact of the matter was that I needed medication and my only option was to go back to A&E (ER) at the hospital albeit that I knew it was a ridiculous waste of the time of a Doctor already busy in an already over-stretched department. I queued up again, checked in and then sat down for the long wait with another large, good book. I was not too bothered by that as there were other people there obviously in need of much more urgent attention than me.
I was finally shown through to a small room to speak with the lovely Dr. de Giorgio who quizzed me about my current condition and wrote the script out in the matter of a few minutes. She also checked across the corridor where the door to the opposite consulting room was open and asked me if I could just say hello to her colleague, the Doctor who had initially admitted me what seemed like half a lifetime ago. Sure that was no problem until the Doctor explained that her colleague (whose name I still do not know) had spoken of me when I was admitted and said that it was a long time since she had seen anyone looking as ill as I had. I have a mirror in my room and I didn’t think I looked that bad but obviously so.
The Doctor also told me that her colleague had checked with my ward later the next day to check that the surgery had gone OK, just to be sure. I wonder if she does that for every patient she admits. Somehow I doubt it and it was a bit worrying albeit I only found after everything was sorted. Naturally I went to see the other Doctor and cracked a joke about rumours of my demise being greatly exaggerated. She said I was looking a lot better than I had been before and wished me well. Nice lady.
I know of a couple of pharmacists in Broadstairs but my friend had been telling me before how poor even the largest one was when she was trying to fill prescriptions and so I jumped on the Loop bus as I had topped up my weekly card. I reckoned that as Ramsgate was a larger place than Broadstairs I might have had a better chance of success. As it turned out that was a false hope and it was the Enaxoparin sodium syringes that were causing the problem. The first pharmacy did not have them and the second one which was the biggest in the town could only give me 20 of the 30 prescribed which would have meant a return trip so I did not bother as I had enough for the night and thought I might go to Margate the following day.
I never tire of looking at this view.
I have lost track of how many images I have of this harbour
I was in Ramsgate and waiting for a bus back to Broadstairs and took a couple of images of the harbour although I do not really know why as I already have dozens from every angle and in every weather condition you can imagine. I just love the place and, as is my way, I am going to share a little factoid with you about it. It is the only Royal Harbour in the UK and received the designation in 1821 from King George IV, a German who used to embark here en route to Hanover. He was so pleased with the rapturous welcome he got from the townspeople that he granted the title and allowed his Royal Standard to be flown three times a year, a tradition that continues to this day.
I also took a quick image of the lovely Rover you can see above. I do not know if it is my imagination but there seem to be an awful lot of wonderful old cars around Thanet, I seem to see them everywhere. From the number plate I reckon this was registered in 1970.
I got the bus back to Broadstairs and, more in hope than in expectation, went into the local chemist clutching my prescription. A quick check and the young lady told me I was in luck and that they had everything I needed. Happy days.
I could not resist taking the image above which is my personal “medicine cabinet” on the mantlepiece in my room. Terrifying, isn’t it?
The evening was taken up in the Wrotham where the excellent Cinelli Brothers Band were playing. The brothers are the drummer and the frontman with the hat who are London based Italians and the other two guys are British. They play really good basic blues and do it very well. You can have a look here to get an idea. They are also very friendly guys and I had a chat with a couple of them. Definitely recommended if you get chance to see them. I d not know how she does it but Jackie punches well above her weight with the quality of the music she puts on in what is a pretty small pub.
Having jabbed myself, filled up on various medications and dressed wounds I turned in for a few chapters of my book and another nights sleep.
I am still in Broadstairs writing this in October so if you want to know what I got up to whilst recovering please stay tuned and spread the word.
There I was, awake on a pleasant autumnal morning at a time of my own choosing and not having my blood pressure, pulse and everything else recorded and it was delightful. If this makes no sense at all to you then I suggest you read the previous few entries where I have spent almost a month in the QEQM hospital in Margate being not terribly well frankly.
It was a Monday morning so it was a new week and in many ways a new beginning, an enforced new lifestyle which was certainly not of my choosing as I was quite happy with the one I had before but I had little choice now. I should say at the outset of this post that I managed to take a grand total of one pretty uninteresting image the whole day which I have posted above for two reasons. One, it is the only one I have, as I say, and two, it is indicative of my new regime as this little box of tricks is more or less the first thing I do in the morning and the last thing I do at night. It is not a major problem but it is just something you would rather not have to do. I do feel sorry for diabetics who have to do this every day. I have some sort of light at the end of the tunnel as it will be for a finite period. I am writing this on the first day of October and I probably have another six weeks of this although they are currently discussing changing me to oral medication but I am not holding my breath.
Whilst I did not take many images on this day, I was far from idle. The very first thing was to sort out the smoking. I mentioned in previous posts about my enforced abstinence from tobacco whilst I had been laid up, assisted by prescribed nicotine patches and I was surprised at how few physical cravings I had actually had compared to long-haul flights of perhaps 12 or 14 hours when I am literally climbing the walls at the airport at the far end. I had thought that my hospital experience was psychological in that my brain knew there was no chance of smoking and so just dismissed the idea. I didn’t think the patches would have that much effect but something seemed to be doing the trick.
Whilst it was not contributory to my illness, obviously smoking isn’t a brilliant thing to be doing although I have to say that I enjoy smoking, always did. I did think, however that having made this start I could maybe manage to cut down and my plan was to start vaping rather than the patches or gum or whatever else. I had been thinking about vaping for quite a while and some of my friends had reported very good results with it. Obviously the vape shop was not open on the Sunday I was discharged so I bought a packet of cigarettes to replace the one I had given another patient in the QEQM hospital. He was ambulatory but could not get cigarettes in there obviously, although he could get out into the garden for a smoke. I knew I would be in for a while and so I gave him mine. I have to say that I was pretty good though and only had two or three all night.
First thing then I was off to the vape shop and there is certainly plenty of choice. As far as I know there are at least six in this little town of approximately 25,000 people. I am a great believer in utilising local knowledge and the general consensus was that Pure Perfection in York Street was very good which was handy as it is literally about three minutes walk from my front door. In I went and told the two guys there that I was completely new to the whole vaping concept and I was not interested in passion fruit bubblegum flavour or whatever else nonsense ideas they have come up with but rather I just wanted something that tasted as close to a Marlboro Light as they could get.
I have to say that the blokes were very good and obviously knowledgeable. They could have tried to foist a very expensive machine on me but they didn’t and offered me a starter kit (pictured) which included two “burners” or “coils” or whatever they are called and a bottle of Gold and Silver which I have not used a quarter of in two weeks and all for £35. For non-smokers, to put this in perspective a packet of 20 Marlboro Lights are getting on for £11 now due to the obscene taxes on them and I was smoking 20 – 30 a day. Since I started the vaping there have been a couple of days when I have smoked four but most days it is three and I am very pleased with myself. In truth I have little reason for self-congratulation as it has been relatively easy and I have not had the serious cravings I thought I would. I have been smoking for the best part of half a century now and fairly heavily for a large portion of that. Yes, I know that none would be better than three but the fact is that, as I mentioned, I enjoy smoking. I always did and probably always will so it is now a matter of keeping it to manageable proportions and I am happy with the current status quo.
Incidentally, I am not lying to you, the image of the vape here was taken at a much later date, I really did only take the one image that day.
If I am happy with the smoking situation in response to Doctor’s orders then I am very far from happy with the NHS in that respect of their further orders. I had experienced the very best of the NHS during my time in the QEQM hospital, and believe me that is very good as I hope I have conveyed but now I was to be faced with the pathetic bureaucracy that dogs it so often and the “left hand not knowing what the right hand is doing” way of doing things.
In hospital when I had told the medical staff that I had not been registered with a doctor for over 20 years they freaked out and asked me why. I told them it was because I did not get sick which is generally speaking true and if I get an odd sniffle or whatever I just drink plenty of fluids and take to my bed until it passes. The problem apparently is that whenever I get ill I get spectacularly ill but I was never one for doing things by halves.
The Doctors (several different ones so it is not merely one of them being in error) stated categorically that although I was not resident locally I could register on a temporary basis. Wrong. I am writing this to backdate over two weeks later, the situation is still not resolved, I still do not have a GP and some of my medication runs out this weekend!
I went to the Health Centre in Broadstairs (the only Doctors I know of in town) and explained the situation to the young receptionist who seemed unsure of the procedure and called her superior. The superior was very sure of the procedure and told me that under no circumstances could they register me even on a temporary basis unless I produced photographic ID AND a utility bill or similar to prove a local address. I repeated that I had just told her and her colleague I was not resident here but merely visiting and repeated, yet again, what the hospital Doctors had told me. Also, as I do not have a driving licence my only photographic ID is my passport and I am not in the habit of carrying that round unless I am going overseas. I shall let this story unfold in it’s proper sequence over the next few posts and, believe me, it does not make for happy reading.
I know some of you have been good enough to follow me down some rather unusual roads in my days of travel writing so if any of you, old friends or new, wish to accompany me down the as yet untrodden road to recovery then stay tuned and spread the word.
Hello again there folks and welcome to what is certainly the most unusual post I have yet published on this site and promises to be one of most unusual I shall ever post if I manage to keep my blogging going for a very long time. There are a number of reasons for this and so I am going to begin with an even longer than usual preamble to try and keep you abreast of what is going on.
Firstly, you will notice that this piece is dated almost a month after the last entry relating to the day of my operation and this in itself is not unusual as I am often appallingly behind in trying to keep my entries current. In truth, I am composing this on the 24th – 30th September (yes, it took that long) to backdate as I usually do.
Rather than posting individual days from now on I am going to report this entire month in one piece as it will make more sense so please bear with me on this and hopefully all will become clear. It will be a very long post and there will be little to break it up in the way of images, the reasons for which will also become apparent. You might want to grab yourself a drink of your choice at this juncture if you intend to read it all.
I should mention that some people of a delicate disposition may find one or two of the images I do post a little distressing but they are not for a long while in the post and I shall issue another warning in good time so you can stop scrolling if you fall into that category. It is certainly not my intention to upset anyone.
I also realise that some of the things I write here may not particularly please family and friends but I have thought long and hard and have decided to be honest as I have always tried to be in my blogging and to offer explanation of the reasoning behind my various actions. There will also be various views of mine which may not accord with everyones but, again, I am determined upon a policy of honesty and I hope this is appreciated. As always, please feel free to contact me with any comments, observations or anything else.
Right, this has all been cryptic enough so let’s get back to what happened in the days and weeks after my operation.
Whilst I had been under anaesthetic the had inserted two drains, one in each side of my abdomen to remove all the nasties that were apparently in there. Without wishing to be too indelicate the hole in my duodenum had been gradually leaking all sorts of semi-digested food or whatever into my abdominal cavity for an unknown period of time and whilst it was trying hard my body just could not get rid of it all. The left hand drain was not too bad and seemed to be getting rid of what looked to me like diluted blood but the right hand one was removing alarming quantities of a fluid which I will not even begin to describe here lest you be eating as you read this but suffice to say it did not look like it had any place in there and I was much happier to have it out of me than in me.
Of course the drains presented yet a further impediment to sleeping as I always sleep on my side, nearly always my left. With a drain in either side I was forced to lie on my back all the time and I just cannot sleep in that position. I used to spend the whole night reading my book which I was husbanding and supplementing it with the newspaper from the trolley that came round from Monday to Thursday but sadly not on Friday or at weekends when all the good big papers with the supplements come and which keep me going for days under normal circumstances.
I was slightly panicking as to what to do when I finished the book and asked one of the staff if there was a hospital library trolley which was something I remember from visiting people in my younger days. The Healthcare Assistant (HCA) who is basically an unqualified nurse and who do many of the non medically specific tasks like medications looked at me in complete bemusement and asked what I was talking about. I explained and was told that there was nothing like that. I suppose in this modern day and age that Kindles and the like as well as the free internet gave people access to all the reading material they needed. I had not bothered lugging my laptop with me when I attended nor even my daysack as I genuinely expected to be there for a couple of hours and leave clutching a prescription for some industrial strength antacid. How wrong I was but the worry about reading material never developed into a problem as I shall explain.
I had deliberately not told anyone except my landlady about my position as she obviously needed to know I had not done a runner from my room and also my mate Paul (who I had played the sessions with) in Newcastle as he was wondering if I had played the local Folk Club in the Tartar Frigate pub. Needless to say the Broadstairs bush telegraph went into overdrive and I started getting messages on my ‘phone with people saying they would visit and enquiring if I needed anything. The only thing I needed was a book or two and, with the wonderful network of friends I have round the area, I ended up with a library in a few days.
One afternoon I was away for one of my numerous scans which I shall come to presently and returned to find a few books on my bedside table alongside the tissue box which I noticed had the message on it which you can see in the image. Thanks Rita, sorry I missed you but we have caught up since. My friend Pauline, the lady I normally stay with, appeared with more books and a newspaper and then Krista, my musician friend from the band Phoenix, the Bubbleband, the Ramshackle Band and various incarnations of my bands over the years turned up. She too came bearing gifts of books and went one better by driving over to my digs and picking up my daypack which she filled with my sponge bag, a few spare clothes although I could not actually wear them due to all the tubes and best of all my computer which meant that I was able to occupy myself and did. I could even listen to my music at night and drown out the screaming of the old guy opposite.
There are a couple of issues raised here, firstly the very dear friends I am fortunate enough to have in these parts and secondly the reasoning behind my trying to keep a low profile albeit unsuccessfully. I know that the first my family will know about all this will be reading about it here and may feel annoyed by that but I promised to explain my reasoning and I shall.
What would have been the point of informing my family, all of whom are in Northern Ireland? What did I expect my brother to do, jump on a ‘plane and trek all the way to Margate to visit me? What would have been the sense in that? What was the sense in worrying them unnecessarily? By the time I had actually realised how serious things had been they were more or less dealt with and anyway I was working on the same principle as I did when I was in the Forces that if anything bad did happen they would find out soon enough. I do hope my logic makes sense here and I promise you that everything was done with the best intent. To quote a Judeo-Christian concept, they were sins of commission rather than omission and I did consider the consequences of my actions.
A myth dispelled by technology.
I mentioned scans above and it seemed like I had bought a season ticket for the radiography department as I do not believe they have a piece of equipment there that I was not hooked up to at one point or another. As far as I recall I had CT, MRI, contrast, Doppler and ultrasound, all in the plural. The problem with scans is that the more they looked at me, the more they found wrong with me which was a bit worrying but probably best they did.
During all my time in the QEQM I must have driven the staff mad by asking endless questions and this started the evening I was admitted and had a CT scan as I have described. Despite my pretty poor state, I was chatting to the young radiologist as best I was able and had to ask her a question that I had often wondered about but never actually wondered enough about to look up online. Here was the perfect opportunity to enquire what CT stood for which is apparently Computer Tomography. Dare I say yet again that every day is a schoolday when blogging? If you re wondering where the word tomography comes from as I was, it derives from the Greek tomos meaning slice or section and graphy which is just, well, graphy!
During all this scanning, I did have the rather interesting experience of seeing inside myself from various angles which I found absolutely fascinating. If there was a secondary screen the radiologist would offer the option of turning it off or tell you to look away if you did not wish to see their screen but if you showed any sort of interest they all seemed more than happy to explain what you were looking at. It was so much better than a TV documentary and also disproved a popularly held myth about me. Contrary to what many people have said over the years, I do have a heart and I have actually watched it beating!
One day, when I had been there about a week I was going for an MRI scan and as I was waiting I was chatting to Megan, a lovely nurse who was escorting me. I had been wheeled down there by a porter called Kevin who I was joking with as he had moved me a couple of days previously. On the way I exchanged greetings with another porter who had shifted me somewhere at one time and then when we got to the radiography unit I spoke to Sal and Roz, two of the staff there who I had chatted with during previous procedures.
We were waiting in the corridor when I heard a quite loud and totally unmistakable voice behind me say, “I saw the list and thought it must be you”. It was my mate Big Rob who I have known for over 30 years since he was training at the London Hospital as it was in the days before it got it’s Royal prefix in 1990. We both used to drink in the “Good Sams” pub, a haunt for staff at the hospital in Turner Street and indeed used to chase some of the same nurses as I recall! We had a brief chat and then he had to dash off to work at which point Megan said to me, “Is there anyone in this hospital you don’t know”? or words to that effect. I just like talking to people, what is the point in not talking to them? As luck would have it Rob ended up doing my scan which was slightly odd but we both went at it professionally and there was no messing about. Jokers we may both be but we are old enough now to know when to act like grown ups albeit that that was not always the case.
I might as well get all my scan stories out of the way here so they are all lumped in one place. After my op, one of my many scans revealed what looked like fluid sitting above my liver and which they ascribed to being a by-product of the procedure. They naturally wanted to drain it and the only way to do this was to insert the drain whilst I was wired up to the ultrasound as it was quite delicate negotiating the vital organs. Nature and evolution have certainly done a fine job of optimising the space within the human torso as there is not an inch of space unused and with my disordered little brain working overtime as I looked at my own insides I thought it would be wonderful if Nature was able to design campervans, caravans and canal boats where again space is at a premium. Yes, I know, it is a bloody odd thing to think when someone is about to stick a needle into the side of your ribcage but that is the way it happened.
The man doing the “needle sticking in” had introduced himself as Dr. Boersma and, unusually, he was even taller and slimmer than me. I surmised that he was possibly either Dutch or of Afrikaans extraction due to his surname and he confirmed that he was indeed Dutch although he spoke English with only the very slightest trace of an accent. As usual he offered me the option of turning off the screen facing me and I told him not to dare as I wanted to watch. Well, that was that and he proceeded to explain to me what everything was using the cursor on the screen to illustrate it as he went. It was slightly odd to watch the foreign object of the drain going into me although I did not feel a thing. He showed me my liver and lungs which, given my lifestyle were all still in existence never mind looking surprisingly healthy, and the “collection” which is a rather nice name for the not very nice pus / poison / gunge or whatever else you want to call it that had no business being there.
I am sure the radiologist was wishing he would quit the “anatomy for beginners” lesson as it was late in the afternoon and I think I must have been the last patient. No doubt she wanted to get off home.
I should report that the good Doctor did a fine job and the nasty stuff was gone in a few days but despite all the rambling in the foregoing paragraphs that is not the major reason for relating this tale. It was a simple little thing that happened right at the end when he was taking his leave. I said, “Dank u wel”, which is one of the three Dutch phrases I know and means, “Thank you very much”. He actually laughed, undoubtedly at the mangling of Dutch with my Northern Ireland accent, and replied, “Alstublieft” which actually means “Please” but is a standard response to a thanks. We parted with a smile on both our faces and a look of mild bewilderment on that of the poor radiologist. Strange as it seems to say such a thing under the circumstances, I spent quite a bit of time smiling in the QEQM and that is a subject I shall return to.
Let me explain the food chain.
Life settled down into a bit of a daily routine of observations, internet on what was a surprisingly good connection, reading the newspaper and wading my way through my extensive library, what seemed like at least one scan and two blood-lettings (OK, taking a small amount of blood for testing), trying to sleep when the old guy opposite was not having the horrors and so on but there was still one major problem to be addressed and that was food, or more properly nutrition as food in the accepted sense was still a long way off. Libby, the delightful dietitian, came round and chatted to me and she told me I was to be put on TPN whatever that might be. What it might be was a very large green bag attached via a drip through a PICC line (peripherally inserted central catheter if you are interested) which would provide all my nutritional needs. I suppose I had better explain the PICC line first as you are unlikely to have heard of it if you are not a health professional or have known someone who had one.
When I had been told the TPN was intravenous I assumed that it would go in through one of the various cannulas (or should the plural be cannulae?) I already had but that was way wide of the mark. One morning a guy called Matt came round with a trolley full of all sorts of equipment and wearing a polo shirt with some fancy job description embroidered on it. What it effectively meant was that he stuck tubes a long way into veins rather than the slight intrusion of the cannula. With the calibre of the staff in QEQM it seems almost superfluous to say that he was charming and hugely professional. After having laid out all his kit and got togged up like he was going into a live nuclear reactor he inserted a needle into my right upper arm followed by a tube. He explained in detail what every stage of the procedure involved and what I could expect to feel which amounted to a slight sensation as the needle went into my arm (“sharp scratch” in nursespeak) and similar as it entered the vein.
Like so many of his colleagues from various disciplines, Matt was more than happy to explain all about his specialism and told me that he was not being boastful but he had been doing it for many years and was regarded as one of the top practitioners in the world to the extent that he went overseas to speak at conferences. I believe him when he said he was not being boastful as he didn’t strike me that way and his status was confirmed to me later by other members of staff who said that he was indeed “top banana” at his particular rather tricky line of work. Basically he guided the tube along my vein, through my armpit and across my chest to terminate not far from my heart. I would have given a lot to have been hooked up to Dr. Boersma’s ultrasound machine at that point as it would have been fascinating. Matt’s fascinating lecture leads me neatly onto
Things you didn’t know and probably didn’t want to #1.
Human veins have nerve endings on the outside but not the inside which is why I could feel the needle going into the vein but nothing thereafter. I really did learn a lot in that place.
OK, so that is the PICC line explained and all it needed now was something to pump into me through it which came in the form of a rather large and heavy dark green polythene bag full of TPN which stands for Total Parenteral Nutrition and means that it is all you get to keep you alive. At the start I was on 2000 calories a day and was tethered to the damned thing 24 hours a day, not to mention all the other antibiotics, vitamins, pain relief (which I started declining after about three days) and various other bits and bobs and between them all they must have been doing me some good because the strangest thing happened. After about three weeks or so in hospital where I had not had so much as a peanut to eat they decided to weigh me again and I was utterly astounded to find out I had gained a touch over two kilos in weight however that happened. I joked with the nurse that if I stayed there for a year I’d be 18 stone and ripped like a bodybuilder. She just gave me a “look” and said something like, “Trust you to come out with something like that, Fergus”. By that point I was joking non-stop with the staff as it passed the days, and the nights come to that. Sleep was still not an option for reasons as explained.
Speaking of vitamins, I am now going to bore you with
Things you didn’t know and probably didn’t want to #2.
Vitamin B stinks.
I was being pumped full of various vitamins, notably B and K which I had never even heard of. I thought it went up to about E and stopped. As everything else the Vit. B was in a bag and administered intravenously. You could always tell it from the other meds as it was a bright psychedelic yellow colour for reasons never adequately explained. The first couple of times I was hooked up to it I was sure I smelt something odd and none too pleasant. Please don’t ask me what it smelt like as it is totally unlike anything I have ever smelt or tasted before.
Wait a minute, I hear you say, tasted when it was going into a vein? Yes. When I was on it and for a while after I could taste it if I ran my tongue over my lips and indeed vaguely in my mouth. Not pleasant especially when I was on Nil by Mouth and could not even wash the taste away with water. When I eventually went onto oral medication the yellow bag was replaced with a very small brown pill which I am still taking three times a day in late September and which still smells vile and tastes even worse if you do not get it swallowed quickly enough so there is another factoid you can bore your friends with and the next thing I want to tell you about is
The NHS food chain.
Being in hospital and more or less bedridden gives you a lot of time to think and I certainly did. As you can tell from some of the ramblings here, I came up with some pretty off the wall thoughts and I do not even have the excuse of strong medication as a lot of the guys were on (oral morphine) as the strongest painkiller I was on was paracetamol and, as I said above, I gave that up after a few days. One such thought that kept scampering about in my hindbrain was the concept of small victories. I know I have read about it somewhere although in what context I cannot say for sure but I have a feeling it was something to do with POWs and how to get through that incarceration. The concept is not to worry about the big picture but to concentrate on small victories, little things achieved like getting one over on the guards or whatever. The concept was very much on my mind in relation to my diet with a series of small victories and one crushing defeat. Allow me to explain but first
A WORD OF WARNING.
I mentioned earlier that there would be a possibly distressing image later and it is coming in a few paragraphs so if you do not want to see it then stop scrolling now.
At the very bottom of the food chain is the pretty ghastly Nil by Mouth which I have explained. It was the title of a critically acclaimed film directed by Gary Oldman with Ray Winstone and Kathy Burke starring and the soundtrack by no less than Eric Clapton. As a film it was no doubt excellent but as a dietary regime it leaves a lot to be desired.
The next step is sips which is fairly self-explanatory but after the awful parched feeling of nothing it is pleasant enough and the first small victory. If sips doesn’t do you any harm you move on up to Clear Fluids (CF) which allows you black tea or coffee, herbal infusions, fruit juice and, somewhat oddly, jelly. Another small victory and I spent a few days happily downing as much green tea with mango (really tasty and I shall be buying it at home), jelly, apple juice and water as I could get down me. I know it does not sound like much but it was so good just to have the taste of something in my mouth. The catering ladies were super and gave me as much as I wanted, which was allowed, as they had been looking at me apologetically for days when I was NBM and they knew they couldn’t give me anything.
After CF we take a really major step and get onto Full Fluids (FF) and now we are really in the big league as we get up to milk in the coffee which was great as I do not like black coffee, ice cream which went beautifully with the jelly, yoghurt which I love and, joy of all joys, soup. There is tomato soup with lunch which is the main meal of the day and then tomato and another soup for supper (served with sandwiches, cake, biscuits etc. for those that are allowed) but the soup was fine by me and I must say that they make damned fine soup in that hospital. I found out that it is actually made onsite and not brought in and reheated as the main meals are and the tomato is exceptional so well done chef. Maybe my judgement was a little clouded after so much starvation but it really was at least gastropub quality of not actually Michelin starred and had loads of herbs in there. The carrot and coriander was damned tasty as well but sadly I did not get to sample the curried parsnip which is a favourite recipe of mine. It would have been interesting to compare them.
I think it was somewhere between CF and FF that I managed to take the image below which is the one I warned you about above when the nurse went off to get a different dressing. I didn’t want to waste their time earlier by taking images so I seized the moment here. It was a rather impressive would and I am now going to have to think up a suitably ridiculous story to explain it next time I am swimming and someone asks about it. I reckon there were 22 staples in it but I might be one or two out either way. Incidentally, the dressings you can see on either side of my abdomen are two of the three drains I had in.
Thinking about it now I should probably have warned you about the image of my ugly mug with the tube inserted and wearing a hospital gown as that is arguably more distressing than a fairly neat surgical incision!
Back to my eating habits and the halcyon days of tomato soup and jelly and ice cream were soon to end, I knew it was too good to be true but before I get to that sorry event I should tell you about the rest of the food chain. As far as I was aware the next step up from FF and positively winning the game was D&F or Drink and Food, which meant that anything goes. You had breakfast, chose what you wanted from the menu for lunch, had the soup, sandwiches and so on for supper, snacks three times a day and more rounds of the drinks trolley than you could count. I never actually reached that state of grace and the best I managed was “light diet” which I had never seen or heard of before and nobody on the nursing or catering staff was able to precisely define for me. I suspect the Doctor may have just made it up, but more of that in due course.
After one of my numerous scans (contrast X-ray if you must know) my friend Dr. Wong and the more senior Doctor, whose name I can shamefully never remember, came into my bedspace, pulled the curtains and I knew by the look on their faces that “something was rotten in the state of Denmark” or in Cheerful Sparrows ward anyway. I had been told earlier by the junior ward Doctor that the scan had been fine but apparently this was not the case and they thought they had detected either a secondary leak or a continuation of the one they had supposedly fixed but this had only come to light when the scan had been examined by a second medico after the first had given the all clear.
I am not sure what annoyed me the most, the fact that they could not even make up their bloody minds if I still had something wrong or the inevitable reversal to NBM which was to last for many more days. I had climbed a couple of small ladders and then found the biggest snake on the board. Of course, my greatest fear was that if there was a problem that would have meant another operation, re-opening the wound etc. etc. and I obviously did not fancy that at all although that scenario was never actually discussed with me. I suppose the medical staff did not want me fretting over something that may not happen but it was the only time I felt despondent throughout my stay. The catering ladies went back to their “I’m really sorry to be handing out all this food in front of you” looks and the staff did their very best to keep my spirits up but it was a bit of a blow to the spirits and I was a distinctly uncheerful (if that is a real word) sparrow for a day or two. I know some of the staff have the URL of this site and if any of them are reading and I was grumpy with them, I do apologise but I was feeling pretty down.
About this time they had changed my TPN to an 1800 calorie one for whatever reason and that meant that I was only tethered for 20 out of every 24 hours which let me loose for four whole hours and I got a routine worked out. After a day or two to synchronise things, I had it arranged that the night staff who came on at 2000 could take it down at about 2030 when it ran out and that gave me until about 0030. What was the significance of all this? Well, firstly, it meant that I could get a proper wash and wear real pyjamas instead of the theatre gown I had been in previously. You cannot remove a pyjama top with a PICC line wired up unless you cut it off and the pyjamas are so much better as the gowns are “one size fit all” but not a man of 6’5″. Shall we say it leaves little to the imagination and it lies open at the back to the extent that once or twice one of the nursing staff would tell me to cover my backside up if I was dragging my IV stand to the bathroom. I dread to think what any onlooker made of my tattoo!
With the pyjamas and free of the IV I could go into the bathroom and have a good strip wash and take as long as I liked as most of the guys were asleep or not wanting to use the facilities. Small victories, and it felt so good as I had not had a shower for weeks now. Thankfully my hair is not greasy as it was not washed for nearly a month.
The other great advantage to being “free” was that I could go for a walk as the medical staff had told me to do to keep me mobile and keep my strength up. Yes, I could walk a short distance with the IV stand but it was just so cumbersome it was a real pain. Now, I could go for a walk round the corridors, again when it was quiet at night and that led to some amusing incidents. I know it must just have been me and possibly my lack of eating but I always felt cold although I know hospitals are notoriously warm. I had four blankets on my bed when other guys were lying in shorts and T shorts on top of their bedding. Even when I was sitting up during warm summer days (we had record breaking August Bank Holiday temperatures when I was in there) I would sit with my combat jacket draped over my shoulders to keep warm. At night I could put it on properly as I went for my nocturnal rambles.
I said it is strange the way your mind works at times although mine seems to do it all the time but during my periods of being unhooked from the IV, the song from the Disney film Pinocchio kept coming unbidden into my head. You know the one,
“I’ve got no strings
To hold me down,
To make me fret
Or make me frown.
I had strings
But now I’m free,
There are no strings on me”.
Utterly bizarre I know as I have never even seen the film but that is what happened.
I was shocked the first night I went for a walk as to how weak I had become in such a short period of time. After less than 100 yards I had to sit down for a rest but it gradually got better and better and I explored further every night, working up to trying stairs both up and down, going all the way to the Discharge Lounge, then North Foreland reception etc. etc. but what was really funny was when I met people, especially if they were head down over a mobile ‘phone as the whole world seems to be these days. They suddenly walk round a corner or look up to be confronted by a very tall bloke who looks like some sort of hirsute mountain man wearing a combat jacket and moving completely silently on hospital issue “house socks”. I scared the living daylights out of one or two of them and a few others asked if I was lost, was I OK etc. obviously thinking I was confused and had escaped from some ward somewhere. I was really pleased the night I got to the St. Peter’s Road entrance which was as far as I could go without going outside. Small victories.
All these things are going on more or less at the same time and I realise this account is not properly chronological but as time went on everything was hanging on the result of yet another scan to determine whether indeed I was fixed up or still at square one on the snakes and ladders board.
Thankfully, after a couple of days of being a “great big grumpy old Hector” if any of you remember that children’s TV programme, I got a grip and stopped feeling sorry for myself. The wonderful staff undoubtedly helped and would have a chat with me whenever they could spare a moment, I cannot speak highly enough of them. I came to the realisation that being a miserable sod wasn’t fair on them and it was not going to change anything anyway and so I made a conscious effort to get back to normal. Certainly, I won’t deny that I was very worried about potential outcomes but another thought crawled out of my hindbrain and I do actually know where I heard this one originally. My Father quoted it to me many years ago when I was so young I did not really understand it and he attributed it to a teacher he had in Belfast Royal Academy back in the 1940’s. He said to me, “Sufficient unto the day is the evil thereof” which I now know to be a Bibilical quotation. It seemed appropriate somehow but I was still on bloody NBM and that was more than enough present evil for me.
View from a room.
I am sure I asked for a sea view.
It is amazing how quickly you can get institutionalised and I literally lost track of what day of the week it was as the routine continues in exactly the same manner every day. A weekday is the same as a weekend and, as I mentioned, a Bank Holiday weekend passed unnoted except in the newspaper headlines about the weather which I could look at out the window but that was it. Speaking of the window I have included a couple of images here of the view from the window beside my bed and another of the view from the window at the end of the ward. We were in Margate and I am sure I asked for a sea view. One of the nurses told me there was nowhere in the hospital where you could see the sea as there was no point high enough even if they do have a sea bathing unit (honestly).
Another odd thing was that we were supposedly on the ground floor and yet a look out the window showed us to be a good twelve feet from the ground below. On my frequent visits to the radiography department and on some of my night time rambles, I went down in a lift from the ground floor to the lower ground floor. It was explained to me that the original hospital was on the level that we were on and then it was extended downwards hence the odd naming system.
The tale of the Cheerful Sparrows.
I might as well take a moment here to explain another matter that I alluded to much earlier and is connected to the lower ground floor and my nocturnal rambles and that is the strange name of the ward which was rapidly beginning to feel like home to me, to wit Cheerful Sparrows. When I had enquired, someone had muttered something about a charity but didn’t really seem very sure and I never really thought much about researching it until one evening when I had expanded my ambulatory horizons and made it all the way down to the St. Peter’s Road end where there were a lot of old photos, portraits of distinguished people and several wooden boards listing past Chief Surgeons and the like. Also on large boards were lists of people or groups who had donated £500 or more towards the building of the “new” Margate Hospital back in the 1920’s. I do not know how much exactly but it must be worth quite a bit now. One such group was the Brotherhood of Cheerful Sparrows who donated the requisite sum in 1927. That was it and so, when I had glided on stockinged feet back to the ward that bore their name without terrifying anyone, I got to work on the internet and again every day was a schoolday.
The Brotherhood of Cheerful Sparrows was founded during the Boer War in the late 19th century and was named for a Mr. Sparrow, a railway employee from Honor Oak Station in S.E. London who had volunteered to fight. In those days there was no provision fo the welfare of dependants and so the charity was founded after commuters at the station held impromptu whiprounds. Soon there were branches nationwide and the Thanet Branch was formed in 1925 and is believed to be the only Branch still in existence today. It was not confined to assisting the families of servicemen and by 1939 the Thanet Sparrows had not only raised the £500 required for a mention on the wooden board but a staggering £20,000 towards the new hospital and hence the ward name which I still think is a bit odd but I will never scoff at again as I know now where it comes from.
D-Day (Decision Day at last).
The Doctors wanted to give my stomach the best possible chance of recovery and so it was a week on that awful NBM and with increasing anxiety that I was counting down to yet another scan which would determine just about everything. On the given morning, I was wheeled downstairs yet again, clutching my TPN back to my chest as they had taken it off the pump but not detached it (risk of infection) and it was back to the contrast room. I knew the score well enough by now and required the minimum of direction to get the job done before getting back on the bed, back up the stairs and what seemed like an interminable wait for the result.
Eventually Dr. Wong came round, all smiles so she didn’t really have to say anything but she confirmed that the scan had been looked at by all the top people and it was conclusive and all clear, there was no leak and no problem. She also said that the senior Doctor had let her come round to tell me herself as he knew that for some inexplicable reason she was quite fond of me. I hasten to add that there was nothing at all improper in this but she took great delight in my “small victories” and tried to help me through my occasional reversals so I think it is time I told you about
The lovely Dr. Wong.
When I was initially admitted to the ward, I had a brief visit from the on-call night doctor but the first medico that spent any time with me the next morning was Dr. Wong who was a Foundation Doctor which I should explain. Whilst the actual name of the hospital is the QEQM it is administered, along with several other sites, by a Hospital Trust, which is the way a previous government parcelled up what had hitherto been a genuinely national health service and there are various arguments about whether this was a good or a bad move which I do not intend to go into here as I really do not know enough about it. The QEQM comes under the auspices of the rather cumbersomely named East Kent Hospitals University NHS Foundation Trust (EKHUFT for short, well shortish) which basically means it is a teaching hospital for various disciplines including Doctors.
When someone qualifies as a Doctor they then come to a hospital like this to learn how to be a “proper” hospital Doctor, being supervised by more senior staff. Dr. Wong, Charlotte as her name tag identified her, was in her first year of training and was obviously very diligent as she was regularly still on the ward long after her official finishing time. She would often pop in to see me before she did go off which I thought was nice of her although I did not quite understand why she seemed to be taking a particular interest in me. It was the more remarkable considering the events of that first meeting where, to use her own phrase later, “we did not get off on the right foot”.
I had decided to be totally honest with the staff there even if it made me look bad as I knew I had an pretty unhealthy lifestyle specifically in regard to smoking and drinking. I told her honestly how many I smoked, which was far, far too many and enquired about nicotine patches or gum or whatever as I reckoned I would be climbing the walls after a few hours without a cigarette as I know that is what happens on a long-haul flight. She told me that nicotine patches were available but would have to be ordered from the pharmacy. No problem, I was not feeling great and I could do without a smoke for a while. She made some comment about me obviously giving up smoking when I was eventually discharged and I replied, again in all honestly, that I would be doing nothing of the sort and the patches were merely a temporary substitute as on the ‘plane journeys I mentioned. This was obviously the wrong answer and she appeared to be most unhappy. She said she would be speaking to the pharmacist about the matter in a manner which suggested she was going to recommend that I was not prescribed patches. I do not know if she did or didn’t but the patches eventually turned up.
I must tell you about the utterly ludicrous situation regarding the nicotine patches, bearing in mind that in the UK I can walk into any pharmacist and buy as many as I want without prescription. In hospital the patches have to be locked away in a cupboard for which the nurse holds the key and must be put on and taken off by a qualified nurse (not even an HCA) when (s)he is doing the drug rounds morning and evening. What utter nonsense. I’ll talk more about my smoking habits later on but back now to Dr. Wong.
Next time we spoke she had calmed down about the smoking business and by unspoken mutual consent it was not spoken about for some time and we started to get on quite well. She seemed impressed that I knew that Changi airport in Singapore was in the area where the POW camp had been during the Second World War (Dr. Wong is Singaporean). The only reason I know that is that my uncle Tommy died there due to maltreatment by the Japanese. The good Doctor is petite and I mean extremely petite and there was quite an amusing incident one day when I was up and about and she walked past me. I swear she could not have reached to my elbow! We did get on remarkably well and, whilst she is already a very conscientious Doctor with a great “bedside manner” I have no doubt that when she is fully trained she will be an outstanding physician.
With my all clear, I was fairly quickly moved back up the food chain but still by stages as they were not going to rush anything and I was also moved into Bay three which is the place you go when you are not quite as sick as you were and they do not have to watch you quite so closely. All good and more small victories. In bay three I was reunited with my old mate Nobby who had been admitted the same day as me and had also been moved from bay two a couple of days previously. Nobby was a great old guy in his 80’s who had managed to fall out of his bath at home , luckily just avoided smashing his head on the wash hand basin but still managed to fracture no less than wight ribs, the poor old sod. Despite his age he was as sharp as a tack and we used to chat all the time. Other patients came and went after a few days but Nobby and I were very much the “old hands” in the Sparrows. We had been there so long we knew the drill inside out and that led to a couple of interesting little things.
Whilst I was on the TPN, I was treated as being diabetic for some reason as the red triangle on my board denotes and this entailed regular blood sugar tests which involve pricking the pad of a finger with a single use very small needle and then analysing the blood with a hand held machine. It got to the point where I would draw the blood myself and I should say that one of the good things that came out of my hospitalisation was that I now know categorically that I am not diabetic so there is one item off the “to do” list.
Similarly, when I saw the obs trolley coming round I would put my own blood pressure cuff on, get the nurse / HCA to hand me the tube and the sensor and I’d do it myself but the best laugh was the handover.
There are basically two twelve hour shifts in QEQM and they change at about 1930- 2000 and 0730 -0800 with a handover procedure I have described in the previous post. I used to always make a point of saying hello to the oncoming shift and cracking some sort of a joke if I could. One night I had made some crack about a change in my dietary regime or something which led on naturally to something else that had happened as a consequence and when I had finished that bit the day sister smiled at me and said, “Go on then”. By this point I knew exactly what was covered in the handover, I knew the names and dosages of all my drugs and what procedures I was due for in the future and just about everything else so I rattled it all out and at the end I asked the Sister if I had missed anything and she said no. Everyone had a bit of a smile and it became a bit of a regular occurrence after that – one of the highlights of my day really! I should say that the handing over staff member was always ticking things off so there was no danger of anything getting missed! Later on I heard one of the nurses showing an agency nurse round for a “short day” introduce me as, “This is Fergus, he does his own handovers” which amused me.
After a couple more days, I was taken off the TPN to my great relief and as I was now in a position to take oral medication I was completely free of any attachments which was a great relief. Pinocchio got another few mental run throughs as I wandered at will about the hospital, “I’ve got no strings……….”.
Looks tasty enough.
Not a bad selection.
Not a bad selection.
With no ill effects from my progression back up the food chain and with no nutrition going into my arm it was time to get me back onto real food and I was eventually moved onto “light diet” as explained above although never explained to me. I had been tempting fate a bit by reading the menu which I have reproduced above and whilst a curry looked very appetising for my first meal after nearly a month, I decided to play safe and stay away from spicy food and plumped for the savoury mince with mash, carrots and peas as that was fairly “baby food”, almost pureed, fairly bland and with nothing difficult to digest.
When the lovely lunchtime catering lady took my order and later served it to me I’ll swear she was almost as happy as I was that I could finally eat as she too had been doing her bit to try to keep my spirits up.
I am going to provide another pearl of homespun wisdom from my very basically educated late maternal grandmother which is, “hunger is the best sauce” and, as always, she was perfectly correct. It was getting on for a month (27 days to be precise) since I had eaten a bite of solid food and I had been literally in discomfort with hunger pains for some days and a simple meal, cooked miles away in a “base kitchen” miles away and re-heated in an oven on the ward tasted like Michelin starred food to me. Joel Robuchon would have struggled to better it. Follow it with an old school dinners classic of syrup sponge with custard where the custard was not even lumpy and follow it off with a nice cup of coffee and Fergy was one very happy man who was smiling like some sort of simpleton all afternoon.
It is quite coincidental that I should be talking about food in the NHS here as, during my time in QEQM there were two running stories about the NHS that were taking up a lot of column inches in the daily newspapers. Well, the NHS is always a good subject to liven up a slow news day in summer and they could not fill the entire editions with Brexit, hard as they tried. The first topic was health tourism which is a national disgrace and which currently stands the NHS £150 million in unpaid fees including over £500,000 from a single patient. I am not going to go into it or I shall just make myself very angry again.
The second major area of discussion was the state of food in NHS hospitals in the wake of a scandal a few weeks previously when at least six people had died in various hospitals after eating sandwiches which had been prepared in a central kitchen and were contaminated by listeria . The pot was kept boiling, if you’ll pardon the pun, by the appointment of the celebrity chef Prue Leith to improve the standards of hospital food despite the failure of her celebrity predecessors who include James Martin and Jamie Oliver. Still, it cannot be easy when some hospitals attempt to feed ill people nutritious food on a budget of £2:61 a day. It just cannot be done, even by a chef of Prue’s obvious talents.
In a very interesting sidebar to this story it was revealed a few days later that Prue Leith’s son Danny Kruger is a top aide to the Prime Minister, Boris Johnson. Coincidence? I’ll let you decide.
A nicely spiced lamb curry.
Sticky toffee pudding and custard, how tasty is that?
Of the long time I was being a mostly cheerful little sparrow, I only got to eat three lunches which slightly disappointed me as those I did have were pretty good. Having got past the savoury mince OK, I decided on the chicken curry which was described as mild (it was actually nicely spiced if not lunatically hot) and then the next day the lamb rogan ghosh which was equally tasty. I never even got to sample the fish pie, the sweet and sour chicken or the chilli con carne!
If you are paying attention, you are probably a bit ahead of me now and know that I was fairly close to being discharged. I had been given the all clear from my final scan on the Wednesday evening and on the Thursday my Doctor changed my food regime and told me they would think about discharging me in the early part of the next week. Great stuff and all sorts of things began to happen then. I was interviewed about where I would be staying and how I would get home and when I told them I would be getting a bus home to stay in a room above a pub, I do not think that it was perhaps their preferred option and something was muttered about patient transport and so on with further questions about who would look after me etc. It took me a while to explain that I probably had a better support network in Broadstairs than I have in London where I can go for long enough without seeing another soul I know and where I do not know a single one of my neighbours, the building I live in is just not like that.
There were other considerations as well. For some time I had been on twice daily subcutaneous injections into my stomach region for blood anti-coagulants (enoxaparin sodium) and there was also my “midline” (i.e. the wound through my belly button as pictured above) dressing to be considered. The wound was still not completely healed. There was talk of District Nurses twice a day and I quickly kicked that idea into touch. Apart from the fact it was a total waste of the time of staff who are already overworked, it would have meant me having to sit about all the time in my digs waiting for them. Not a chance. I told them to give me the pre-filled syringes and some dressings and I’d look after myself.
My offer of self-care obviously required some sort of conference with someone higher up the medical heirarchy but later on the nurse came round for the evening drug round and gave me a crash course on self-injecting which is a doddle as I had watched it dozens of times and so, in a classic role reversal, she watched me as I did one. I managed to make her smile as I had the hypo poised above my abdomen and said in a slightly falsetto voice, “Sharp scratch, Mr. Campbell” and then replied in my own voice, “Yes, nurse”. Still, the nurse in question was not difficult to coax into a smile, she was an absolute darling as they all were.
I obviously passed the test as I am still self-injecting with no problem. As for the dressings, I went back for an outpatients appointment to examine the wound and asked the sister if the dressing was OK whereupon she pronounced it “a very tidy job” which pleased me and now I have another couple of life skills to add to my CV in the unlikely event I ever go for another job.
Having got myself mentally attuned to being discharged in the early or middle part of the next week it was something of a shock to me when the Doctor who examined me on the Saturday morning told me I could go home the next day. Things really had moved quickly, from sips of water to discharge in four days, that was something I had not expected.
I just kept on with my routine on the Saturday when the only event of note was that dear old Nobby was discharged. I was rather sad to see him go as we had become pretty friendly but I was happy for him obviously. As well as him I would also miss his family who always made a point of having a word with me when they were visiting. One thing I did find a bit odd was that the nurses kept insisting on injecting me when I was supposedly “trained” and going to be doing it for myself as of the next evening. Probably some ludicrous health and safety regulation or another.
I didn’t sleep much on the Saturday night but I did not read too much into that as I rarely slept a lot in there or indeed when I am at home. The nurses were quite used to it and passed no remarks when I would be up typing or reading at all hours or wandering off, complete with combat jacket, for another nocturnal ramble. I knew every inch of that hospital and I never have to ask for directions to one of my many out-patient appointments!
In the next post I finally taste fresh air (and a pint) after about four weeks, I see a great gig, catch up with friends and get to sleep in a bed in total silence with all the lights off so stay tuned and spread the word.
For all the reasons outlined in the previous post I only managed a catnap or two and the morning eventually arrived to a further round of obs, being ignored totally by the catering lady with the breakfast tray (remember the hated NBM?) and then I was visited by a Doctor in scrubs so obviously kitted out for theatre. He had a clipboard with him which turned out to be my consent form for the operation. The first few questions were fairly straightforward and then it started to get a little bit worrying. After explaining the procedure and confirming I understood what was to be done it came to the slightly worrying part when he showed me the list of potential problems that might occur although he was at pains to point out that they were extremely unlikely and this was merely a legal requirement. As the list included stroke, stoma (colostomy bag) and death, I was glad he seemed so sure they were unlikely but it did focus the mind somewhat.
I had no option but to sign as it was clear I could not continue as I was and he told me I would be in theatre about 1200. No sooner had he departed than another young man in scrubs appeared and I briefly considered employing one of the nurses as my social secretary as it seemed I was the most popular man in the hospital that morning. He got me to confirm my name which I did fairly monosyllabically, not out of rudeness but because he immediately launched into his spiel about being my anaesthetist for the procedure and what was involved. About half a sentence in and it was obvious that he was from Northern Ireland and my mischevious nature quickly kicked in again, I just cannot help myself.
If anything the young man said required an answer I continued with the monosyllabic ploy and lots of what I was once taught is called “gurgling” i.e. non-verbal communication. Years ago I attended an interview course and I am apparently quite good at it. After a while of this I cranked my already thick Belfast accent up a notch or two to almost caricature levels and said, “Tell me this fella, what part of the home country are you from”? The look on his face was priceless and even under the circumstances made me smile. He told me he was from Fermanagh and we had the quick “old home week” so beloved of my countrymen before he finished up what he had to tell me, reassured me all would be fine and told me he would see me in the theatre shortly. For no logical reason I felt marginally more comfortable that he was from my homeplace although it would have made no professional difference had he been from Belcoo, Belgium or Belarus. Strange how the mind works.
Next to appear was a porter with a wonderful bit of kit I had never seen before which lifts one end of a hospital bed a couple of inches and is motorised so it allows one person to do the work of two when it comes to shifting beds and patients. I really fancied having a go on one but it never came to pass. Accompanied by one of the nurses we took off the relatively short distance to theatre where I was again greeted by my “new best friend” from Fermanagh who introduced me to a rather large group of people in scrubs all bustling about so I just smiled a generic hello to all of them and let them get on with what they were doing. Then he got on with what he was there for and in no time flat I was way off in the arms of Morpheus (fast asleep if you are not into the classics). I was expecting the “count down from 10 to one” routine I had gone through 30 years before during my previous op but no such nonsense here, one minute I was awake and the next I most definitely was not.
I do not know exactly how long surgery was and how long for recovery but I know that it was about 1230 last time I looked at the clock in the theatre and it was after 1630 by the time I was “compos mentis” back on the ward. What happened in the interim was quite amusing even under such relatively serious circumstances.
I started to come round in what was presumably the recovery room and through one half-open eye I had a brief look round although I quickly learned not to move anything more than my head as it hurt! I could see a lot of bright lights above and all around what looked like slabs. Do not panic, I do not mean slabs as in a morgue (I wasn’t that morbid) but slabs in a fish market or fishmongers and my still befuddled brain came to the conclusion that somebody had put me to sleep in Billingsgate Market or somewhere similar although I could not for the life of me imagine why. One of the staff must have noticed signs of life and said to me, “Hello Mister Campbell, do you know where you are”? I replied confidently (I hoped) and obviously intelligibly, “In the fish market”, what a ludicrous thing to say. The reason I know I was able to be understood was that I heard a female voice say, presumably to a junior member of staff, “It’s OK they are often like this, he will be fine in a little while”. After that it was lights out again in the Fergy household until I awoke in the land of the Cheerful Sparrows with a member of the nursing staff fussing round me and taking the inevitable obs etc.
I was going to write here I felt like I had been kicked in the stomach by a horse and then I considered just how common such terms are in writing and how ludicrous they are albeit hugely descriptive and valuable in a literary sense. Thankfully I have never been kicked in the stomach by a horse so how would I know? As a child I was butted in the backside by an ill-tempered goat but it is hardly the same. In the interests of satisfying my undoubted pedantry here shall we just say that I felt like I imagine I would have felt had I been kicked in the stomach by a horse. I do sometimes worry about the tangents my mind takes off on when I write.
I was certainly in no mood to eat which was probably just as well as I was still not allowed anything orally which made sense as they had just cut a large hole in my abdomen and been messing around in there so best to leave it well alone for a while. Because of this I was not able to take tablets and so my pain relief was paracetamol through the drip. They did tell me that if I required it that I could have oral morphine although I did not quite understand how this squared with the nil by mouth concept but it was certainly on offer. They must have thought I was in a lot of pain and whilst it was undeniably uncomfortable it was not unbearably so and I do not like taking medication of any sort at the best of times. In my own home I do not even have a packet of aspirin.
I did feel fairly drowsy which I suppose was a combination of the anaesthetic wearing off and the physical trauma of the day so I dozed on and off until the ritual of the handover at about 1930. Somehow I had missed the morning one at 0730. The ward basically works on 12 hour day and night shifts although sometimes staff work a “short” day of eight hours. During handover all the incoming staff are escorted round the ward by a senior member of the outgoing and the notes of each patient are gone over, including what has happened to them on that shift, changes of medication, proposed procedures and just about anything else of note. I’ll bore you with a story about handover later on if you do not lose the will to live before the end of this saga.
I am sure you will appreciate why there are no images taken on this day and the one which is at the top of this entry is of my bedspace taken much later (you can tell as there are no IV stands evident!). I just thought I had better put something to liven the page up a bit.
Plenty more medical musings to come so stay tuned and spread the word.
Another fairly uncomfortable night and up in the morning for a shower and get dressed. I still felt lousy and getting ready took a while but fortunately the bus stop is literally across the road and I got the bus to the Queen Elizabeth the Queen Mother hospital (known locally as the QEQM) where I was dumped near enough the door of the A&E (ER for my American readers) and queued up to sign in. The receptionist obviously did not have English as a first language and after four attempts of very slow and distinct spelling I thought she must have it but subsequent events were to show that she had rendered Fergus as Fergess which is what I am now known as on the NHS computer and who knows what hassle that will lead to eventually?
Always bring a good book.
I know that A&E Departments are notoriously slow and so I had made sure to bring a very thick book with me. Had I known at the time that the whole hospital has free wifi I could have brought the laptop and got a bit of blogging done. In fact, I could have got a lot of blogging done as I did an awful lot of sitting about that day.
I am very aware that there are very few things as boring as listening to someone else’s medical stories and so I am going to precis this as much as possible and merely add any little anecdotes which may be of interest. I know it will still be massive and if you want to skip directly to the next post then please feel free, this one will be a slog and if you do want to read it you may wish to get a drink of your choice before you begin.
I had walked into A&E at about 1130 and in the next 12 hours I was seen by three different Doctors, poked and prodded in the same places, asked the same questions and then sent for a CT scan all between long periods of sitting about and I was so glad I had the book!
By now I had come to the conclusion that maybe there was something a bit more than trapped wind involved and this was confirmed by the fourth Doctor who took me into yet another consulting room and told me that I would be staying the night and they would be operating on me in the morning. Whoa, hold on, operating? What for? “Mr. Campbell, you have a perforated duodenal ulcer”. “Is that serious, Doc”? “Extremely, now if you just wait there a minute or two we’ll get you moved to the ward”. I am sure I knew it was serious but it was just an instinctive thing to ask and I suspect I was in a little bit of shock. I genuinely had no idea I even had a duodenal ulcer never mind that it had decided to open itself in such a dramatic fashion. Thinking back later it must have been there for at least four years if the symptoms from the canal trip are to be believed.
Once they had decided to admit me, things picked up pace considerably and a bed quickly appeared which I was told to get on so naturally I bent down to take off my shoes, well you don’t get on a bed with your shoes on, do you? Apparently in hospital you do as I was told not to worry about them, get on the bed. There I was, fully clothed on a bed with a porter and a nurse fore and aft and feeling like a complete fraud. I had walked into the place and I was sure I could get to the ward unaided but no chance of even trying.
As I was wheeled into the ward I caught sight of the name of the place and I wondered had they given me some drugs I had forgotten about and which were making my hallucinate. Cheerful Sparrows, I kid you not. Cheerful bloody Sparrows, what deranged mind thought that one up? Like so much else, it all actually makes perfect sense once you look into it a bit and I shall explain it all to you when it comes up in the narrative later on.
I was put into bedspace 28 in bay two (of three) which meant nothing to me at the time but I was later to find out the significance of. Bay two is directly behind the nurse’s station and there is a window so they can keep a constant eye even when they are not wandering about doing the many things they have to do. This is where they put the most serious cases, usually on admission, and my bedspace was right opposite the window. Later on when I got friendly with a lot of the nurses, they told me that they were keeping me under very, very close observation that first night. Certainly I did not feel great but I did not know how just how seriously the medical staff were taking my condition.
I was given a not very flattering hospital gown, as you can see in the image above, and told to get into it which I did. I was weighed and the result was displayed in kilogrammes which meant nothing to me as I still work in proper Imperial measurements as I was taught at school. I asked the nurse what it was in “real money” and she had to resort to her mobile (cell) ‘phone to find out! I do not possess a set of scales and it had been a very long time since I weighed myself but I was a lot lighter than I had been in “my prime” if indeed I ever had such a thing. I suppose it is hardly surprising as I had not been eating properly for a very long time. Things were really starting to mount up against me.
I was asked another load of questions, most of which I had already answered three or four times, and all of which were duly recorded and then it was time to get down to the real work.
Next up was the “obs” i.e. blood pressure and temperature and it had really changed a bit since I was last in a British hospital almost 30 years before. Long gone are the days of the thermometer under the tongue which is replaced by some electronic device that they stick in your ear and it comes up with a digital reading. In fact, they don’t even need to do that as they can just point it at your forehead from a range of about an inch for a reading.
For the BP there is still the same inflatable cuff but instead of a Doctor or nurse pumping a little rubber ball and listening with a stethoscope the mighty wheelaround machine does it all. A sensor on your finger gives your pulse rate and even manages to provide a reading on how efficient your blood is at supplying oxygen to the body. I still do not know how it does that without access to the bloodstream but it does. Surprisingly, given the amount I smoked and over the period I did, my readings were consistently 98 or 99% and even topped a perfect 100% several times. Incredible. They told me that my BP was slightly low but I have always had low blood pressure and so it was to prove throughout my stay. If medical science has advanced so much in 30 years I can only wonder where it will be in 30 years hence. Presumably a nurse will stand at the end of your bed and say, “Alexa, obs” and some machine will do it all without even touching you. Or perhaps not.
Probably the worst part of all.
I was wondering what else they could find to do to me and did not have long to wait. The next little procedure was not at all high tech and I suspect has changed little for decades if not longer. The night sister told me I was going to have a tube stuck up my nose and down my throat which did not sound overly pleasant and so it was to prove although at least she did not lie to me and told me it might be a “bit uncomfortable”. I was later to learn “nursespeak” and “a bit uncomfortable” means anything from very uncomfortable to bloody painful whilst “just a sharp scratch” means “I am about to stick a needle in you somewhere”! As time progressed I used to joke with the nurses and say “sharp scratch, Fergus” before they did which, whilst not much of a joke, invariably seemed to raise a smile. I can honestly say that the insertion of this tube, which involved much gagging, dry retching and, I am ashamed to say, a little fruity language on my part for which I hastily apologised, was the most detestable thing that happened to me during my entire confinement in QEQM. Calling it a “bit uncomfortable” was like calling Chernobyl a “bit of a mishap”.
Surely they were finished by now but that would have been too much to hope for and I had to be cannulated which I think is a lovely word for a not particularly lovely operation whereby, with another euphemistic “sharp scratch”, they stuck a needle in my left wrist with a couple of tubes attached to fill me full of various fluids. Whilst I was cannulated numerous times in there it was only this morning in September whilst researching this piece that I discovered the word cannula derives from the Latin for “little reed” and I can only re-iterate that every day is a school day when I do my blogging.
How green is this really?
I was then given a cardboard “bottle” with a circular extended aperture at one end and which I recognised from caring for my elderly grandfather many years ago as being for the purposes of urinating in if you are bedridden. I assured the nurse that I was perfectly capable of getting myself to the bathroom, which was adjacent to my bedspace, but I was told that they wanted to measure “input” and “output”. Out put I can understand but input was very simple to calculate as the figure was nil, zero, nada, zilch, rien, call it what you will. If you look again at the image above which I apologise for the quality of (if I do not use flash in a restaurant for fear of upsetting other diners, I will certainly not use it in a hospital ward in the middle of the night), you will see on the board behind me the dreaded letters NBM or Nil by Mouth. I was to come to hate this phrase with a passion as it literally means what it says, you are not even allowed a sip or two of water and your mouth gets totally parched, relieved only by a totally ineffectual mini sponge on the end of a lollipop stick which you wet and moisten your lips with. An utterly awful way to exist.
Later on in my stay I did enquire why they were now using single use cardboard “bottles” instead of the plastic ones I had known before. I was told it was part of the hospital’s “green” campaign to cut down on plastic use but whilst that is laudable I am unconvinced by the argument in this case. The plastic bottle can be sterilised and re-used hundreds of times whereas the cardboard one has to be disposed of for recycling and a new one produced. I wonder what the energy usage is for the respective processes.
“To sleep, perchance to dream” – not in this place.
Eventually the nurses seemed to have done with me and they told me to get some sleep which was much easier said than done. My natural nocturnal / insomniac nature was always going to be a factor as was a little anxiety about what was to happen in a few hours time. I can honestly say that I was not fearful and my only terms of reference for such a situation were the absolutely successful spinal operation I had undergone all those years ago with no ill effects. I am also a fairly fatalistic sort of person and I knew from what the Doctors had said that I really did not have a choice and so I reasoned that “que sera sera” and there was little I could do to alter the outcome. Just to top things off, the night lights were on for very good and obvious reasons and I prefer to sleep in the dark.
Whilst all the issues I have mentioned above were certainly a factor in my poor sleep that night, it was a far more physical reason that was primarily to blame. In the bed diagonally opposite mine was an elderly male (as were most of the ward, I reckon I was the youngest in there) who, in addition to being very ill and on some seriously strong medication, was also obviously victim of one of the many conditions of the mind that can affect the elderly. This man screamed at the top of his lungs at regular intervals at all hours of the day and night. I used to watch him sometimes when he started at night (I might as well as none of the rest of us had a hope of sleeping) and he appeared to be calling out whilst asleep, or at least his eyes were shut. He continued through his waking hours and it really did become unbearable.
There were eight of us in total in the bay and I did ask one of the nurses days later if it would not be possible to move him into one of the side rooms on the ward and I was told that they were strictly for infectious patients only. In other words the recovery of seven patients was being hampered by this poor man’s condition and it seemed there was nothing that could be done about it. The worst part of his problem was when his elderly wife and middle aged son came to visit as they did faithfully every day and he would scream and shout utter nonsense, apparently not recognising either of them even when they tried to reason with him. This obviously caused great distress and I really did feel sorry for them.
I think I managed to doze off less than an hour before they woke me again for a further round of obs and a look at the passing breakfast trolley.
There is much, much more to come so stay tuned and spread the word.