Not A Smoker In Sight

 Approaching the hospital is unsettling.  We’re on the fringes of one of the city’s 1970s estates, all grass and orange brick, underpasses, men out walking dogs.  Kids on skateboards.  Women in trainers pushing buggies.  The sun is up there, hiding behind cloud.  There’s a car-parked pub that does steak that sizzles.   Houses with washing on twirling lines.  On the main road are trucks and vans  rucking up road dust.  A lone seagull sits on a fence wondering just what it’s doing this far inland.

The entrance, once we find it, is modest, the car park free, the building low-slung and silent.   There’s no one hanging around the entrance, not a smoker in sight.    This could be a council office or a care home.  It could.  But actually it’s Spire private medicine.  A hospital outside the NHS.

In the waiting room there are comfortable chairs, no jabbering TV, no Coke machines,  and a complete lack of misshapen sprawl.  The coffee is free.  There are papers to read.  Admittedly they did take an imprint of my credit card when I arrived but that was, as the receptionist put it, just for identification purposes, best be sure.

Almost all writers in history have suffered illness.  Consumption, gout, bad livers, hearts that fail, the bloody flux, the ague.  They lose their sight, the use of their limbs, are confined to wheelchairs, kept in bed, made to take long holidays on the coasts where the air is clear.  They move slowly.   They are bled.  They leak.   But they all carried on.  They got up at dawn to bash the words out.  Thinking through fog.  Letting the pain wince its way out through their lines.  Bottling it just to get the books done.

Me?  I’m knocked flat by all this sudden vicissitude that’s seeping through me like a river.  Rather than be out there running across the world I’m inside my room worrying.  I must get a grip.  I need to let the ideas circulate again.  Encourage them.  Give them time to foam up and flower.  There’s that book I’m writing.  How the rock and roll changed my life.   How music is always better than poetry.  How sound in the air beats words trapped on the page.  The history, the past and the present.  Where we all fitted.  Where it all then went. 

I start to think about Howlin’ Wolf and how seeing him of stage at the Colston Hall in Bristol in 1964 changed my view of music forever.  Quite a Finch revolution that.  Wolf arriving in the centre of my quiet world like an alien. A 300-pound negro in a bad suit  roaring above Hubert Sumlin’s guitar lead, turning my idea of what music was thrillingly on its head.  I reach for my notebook but don’t get that far.

On the button I get called in for my appointment.  Synovial Cyst.  Ganglion.  Non-cancerous.  But there.  I’m shown the MRI scans, horizontal slices taken along my spine.   There it is at Level  4, nestling in the facet joint and pressing itself softly on the sciatic nerve.  A white oval the size of a peanut.  Would that be KP or Marks & Spencer, I ask.  The consultant laughs.

I get more than 30 minutes of description and discussion.  Prognosis, treatment, outcomes, risk.  Watchful waiting.  Further facet joint injection.  Surgical intervention.  These things ebb and these things flow.  Today there’s little sensation.  Last week my back and right leg were full of electric rage.  Listen to your body, I am advised.  Run if you like.  Exercise is better than no exercise.  Treadmills are not good for the joints but do a bit.  If there’s pain stop.  If there’s not then carry on.

If the whole thing gets worse then ask  for another nerve root block.  Waiting time on the NHS – 3 months at least.  Privately less than a week.  Try high does prednisolone for a day or two.  The stuff will circulate your whole body and some of it will stick.  If all that fails then surgical intervention will sort it. We’ll make an incision, move your muscles to the side a bit and then suck the peanut out.  You’ll feel like you’ve been kicked in the small of the back for six weeks but after that you’ll be fine.

So there’s a future.  Aged Finch sails on.  We shake hands.  Outside they get me to put my pin number  into their credit card machine.  The amount I’m paying  makes me wince but it’s only cash.  Inside I’ve got a new calm flowing. Worth every cent.

Me and the polymyalgia and the bladder stuff and the new companion Mr Peanut Synovial we all clatter out into the car park.   Rattle, smile and hum.  Out there I spot a fat woman leaning on the door of her Citroen C1 sucking on a Bensons.  A man in overalls on a ladder is trying to fix a faulty exterior wall light.  At the pub over the way they are taking delivery of beer in pressurised aluminium barrels.  The sun glints.  The world still works.  I head home, fast, to write it all down.

     

God of the Sea

This is the beach where Ulysses was washed up after his battles with god of the sea Poseidon.  Ulysses, hair in damp straggles, naked and unconscious on the sand, was revived by Naussica, daughter of the King of the Phaeacians.  So wrote Homer.  And as a reminder there’s the Naussica Taverna full of sweating and Homer reading diners staring down at me from the cliff edge.

Naussica – in Greek her name translates as burner of ships.  But out in the bay there are nothing but peddalos and heat. 

The beach itself in the parts that aren’t forever British is entirely Russian. They don’t look like us.  The men have bellies that protrude but don’t flop.  They wear tight and tiny bri-nylon swimming trunks, just like ones I used to have in 1977.   They sprawl across the Thompson Holiday loungers smoking their Russian cigarettes.  They don’t read.  They play cards, they drink. They lunge at the sea and emerge bronzed and dripping.  A woman with a tattooed Venus on the half shell climbing her belly.  A man with a bear growling up his.

I’ve gone to Greece with my prednisolone packed into both my check-in and hand luggage and with an extra packet in my pocket just in case.  The polymyalgia bubbles under.  The treatment is working.  No more proximate muscles like rusted slabs aching like they were trying to jump me to Mars.  Instead I have my new fellow traveller, the sly and slippery synovial cyst.

This one sits somewhere in my lower spine and can only really be subdued by high-strength co-codamol supplemented by Naproxen, a sort of super ibuprofen on speed.  Sounds good on paper but in practise it just makes you numb.  A better cure turns out to be alcohol which relaxes things enough to ease the agony.  We brought gin out bubble-wrapped in Sue’s suitcase and the local beer isn’t that expensive so things should be good.

Out walking I can feel it, Mr Synovial, pressing the sciatic nerve and making my lower leg feel like it’s got a cold chisel in its centre moving up and down.  With PMR you could run a bit and the pain would go.  With this one you have either drink or lie down.  And as the one often leads to the other, I find myself doing both.

In Corfu Town – Kerkyra –  after a long sit in a café opposite the truncated British cricket pitch we visit the Church of Saint Spyridon.  His remains are here in a gilded box, closed today but still touchable.  A line of Greeks take turns to kiss the place where his feet might be.  On high days they take him out and parade him through the streets.  He’s a preserver and a fixer.  Saint of salvation and health.

A women next to me scribbles something in Greek onto a piece of paper and puts it in one of the saint’s waiting bowls.  There’s a whole stack of other slips there.  They tower.  Prayers, pleas for help.  Worth a go I decide.  Help me, I write, Saint Spy, see if you can do something about this spine of mine.  I leave the slip unsigned.  Saint Spyridon will know who put it there.

I follow up this uncharacteristic act by buying a six inch candle from a box near the door.  I’m heading for the spot just outside where similar candles of supplication have been stuffed into a pit of sand and melted wax.  They waver and flame.  They look the Orthodox part.  Behind me an entire extended Greek family are emerging from the Church.  They carry candles too, all nine of them, women in black, children in trainers, men in suits.  The difference is that while my candle is 6” long theirs are five feet and thicker than your leg.   Aflame like Thor rockets they dwarf my miniature squib.  Beijing Olympic fireworks beside my November the fifth. Next to the candle dump is an icon depicting the great man in his golden beatitude.  The family take turns to kiss the image.  At this level of investment they are bound to get whatever it is they want.

Me?  Not a hope.

But then again it’s now a week later and I’m back home in the drizzle again, Saint Spyridon  a sunny memory.   The Cyst is still there but, amazingly, it is quiet.  No flares, no return of the lower leg cold chisel and no repeat of the shaking electric razzle scream of a pain I was getting up and down my right leg just before I went.   And I haven’t taken a naproxen since last month. 

Good boy Spyridon.  I'll be back.

Road Race

In an afternoon when the rain holds off long enough for the sky to go blue the best place to be is not in the city.   So I’m out on the roadside in Wales’ green desert, somewhere north of Builth.    The verge here has to be wider than my home garden, thick green, lush, durable.  The sun is on my back warming through my shirt.   It could be Hawaii but it’s Cefn Coed.  In the near layby a couple towing a caravan with a four by four are sitting on deckchairs drinking tea.  They watch the traffic roll by.  This is how we relax these days.  Roadside get away from it alls.

I’m  here actually to watch the Kate Auchterlonie Memorial Cycle Race.  Women in  lycra with numbers on their backs going past in a great herd on bikes.  As a spectator sport this one isn’t much.  The women do fifteen mile circuits passing me every half an hour.  They go at a hell of lick.  Lead motorbikes with flashing lights clearing the traffic, then a tight cluster of furious peddling followed by a few stragglers spread out down the road.  Blink and they’re gone.  And then it’s back to watching the breeze move the grass beyond the hedgerows and the kestrels hovering overhead until the women come round again.

To fill in time I march up and down the layby trying to free up the pain from my leg.  Is this the polymyalgia returning in a great flare?  I’ve upped the prednisolone from 5 mg to 10 mg.  The GP says it won’t matter in the short term but the head is already filling with fog.  I do a series of leg stretches, squats and knee presses.  I am watched blankly by the couple drinking tea.  I smile back  but they do not react.   

I go behind a tree for a pee and am immediately spotted by a vehicle traversing an otherwise totally abandoned dried up off road track.  The occupants wave.  The countryside’s synchronicity.  I pee on pretending they are not there.

The cyclists come round again.  I give them a cheer and clap a bit to offer encouragement.  For them traversing this circuit must be like watching paint dry.  They disappear into the distance.  I do a few more knee bends to beat the PMR back.

Up at the clinic the following day I get the news.  This isn’t polymyalgia bubbling up from where it’s been sort of slumbering.  Instead it’s my new friend the spinal ganglion cyst.  This is the growth the size of a small grape that’s insinuated itself somewhere in my lower spine disrupting the way the nerves work.  The result is leg pain, foot pain, and thigh pain, often all together,  in long slow burns, in starts and shakes and rushes and aches.  They fade and then they come back. They go and then they stay.   

The consultant puts me in the loop for another MRI scan and a further set of spinal injections.  Might fix it, might not.  You’ll also need to see a neurosurgeon who will discuss with you the risks involved in having the cyst surgically removed.  Risks?   The surgeon will explain it all to you. Doesn’t sound good.

I do the anticipated circuit of bloods, weight, urine sample, and BP measurement ending at the pharmacy where the great team of twenty or so NHS dispensers, heads down hard at work, take an amazing 30 minutes to get my prescription filled.  At the local Co-op the single pharmacist turns my monthly prescription for four different drugs and a tub of chewable calcium round in five minutes.  There’s a lesson here.

On the wall of the UHW Pharmacy next to a sign reading “Antibiotics will not get rid of your cold” is another which says “To ensure patient confidentiality please do not stand or wait against this wall.”  Better not hang about here I say to the old lady on sticks queuing next me.  She frowns.  I don’t have a cold she says, shaking her head.

On my way out under the grey shell of a sky, new tablets in a giant bag under my arm, I go through what the consultant has told me.   Hope for the best but the best is often elusive.  Try.  Live in the moment.  We’ll see what these new tests throw up.  Let’s see how you get on.   I’m really sorry this has happened to you.  She is too.

I’ve asked her if there’s anything I should now not do.  Stretch?  That’s fine.  Exercise?  That’s good but try to avoid running.  The action of all that pounding jars the spine.    Go on the bike instead.  It’s the perfect activity.  Cycling – much better than watching paint dry.  Sure is.

      

Slicing The Air

I’ve barely time to open my book among the waiting queues  at clinic six.  I’ve Nightwoods, Charles Frazier’s dark novel of North Carolina with me.  In this the violent mixes with the lost among the endless trees of the time-stuck Appalachians.  Frazier came to fame a few years back with Cold Mountain.  In the film of this Sacred Harp singers can be seen beating out the rhythm of  the shape-note rouser I’m Going Home, their hands celebrating  glory, slicing the air.  God is with them in their singings.  He is all around.  Down here in the clinic he also hovers, although maybe with not quite the same all-pervasive fire.  Files arrive, delivered in what looks like an ex-Tesco trolley.  Mine is on top.  I’m in. 

I’m also back out.  Five minutes is all it takes.  The prednisolone levels are continuing to fall.  I’m down to 5 mg now, a dose at which most side effects cease to be visible.  Healing, however,  will still be slow and susceptibility to infection from just about anywhere a worry.  The tests all show you as normal, the consultant tells me.  She smiles.   Normality, the aim of us all. 

A day later and I’m up the road in the Department of Oral and Maxilio-facial Surgery being told that the prednisolone will certainly interfere with the healing following my tooth extraction and that the alendronic acid may compromise bone recovery.  Polymyalgia, your tentacles get into everything.  Prednisolone go away.  I took 5 mg this morning.  I’ll have a go at 4.5 mg tomorrow.

The extraction is carried out by a dentist from County Clare wearing a white smock  two sizes too big for her.  Amid the small talk about the loveliness of Ireland and the wetness of Wales it sways about like a duvet cover. I get two mouth-deadening injections of lidocaine with another  six added as the procedure rolls.  My mouth doesn’t like giving up. 

She’s great at the talk, put the patient at ease.  We’ll just loosen it up a bit first.  You may feel some pressure.  Snap.  There, that’s the crown off.  Now let’s see if we can get it out in one piece. Snap.  No.  This is a difficult one.  I’ll have to just move around a bit.  You’ll feel more pressure.  I do.  She’s told me to raise my left hand if I experience pain so I lift it up.  It’s like the northern lights in my head.  More lidocaine. Then more again, just to be sure.

A second dentist who insists on calling me sir arrives.  He is bearing a drill.  We’ll just see if we can cut into this.  No.  We’ll have to slice the socket.    No.  Yes.  Crack.  No.   Have to cut a bit of bone out here, just so I can get a grip.    I Raise my left hand and get another shot of lidocaine.  My mouth is starting to feel as big as the Severn Bridge. 

But eventually it’s done.  My mouth is sewn up and stuffed with gauze.   Fragments of my left lower rear molar lie like pieces of moon rock on a dental tray.  I get a free packet of surgical cloth for use in supressing bleeding and a badly printed instruction sheet.   “For the rest of the day take things quietly” this says.  “Take only cool non-alcoholic drinks.  Eat a soft diet.  You may sit up but do not lie down.”   

Will Marks and Spencer sell things I’ll be able to cope with?  Rice pudding, coddled eggs, luke warm soup.  I’m sure they will. 

Back home sitting up but certainly not lying down and with a glass of 15 seconds in the microwave water beside me I stick on the Cold Mountain soundtrack.  I’m looking for spirit and uplift.  But instead I  get the Reeltime Travellers doing “Like A Songbird That Has Fallen”.  Pretty much it I suppose. 

Fallow

It’s a fallow period.  No consultations, no tests, no health scares.  A quiet time of simply taking the prednisolone each morning and flickering the dose between 6 mg and 7 mgs to keep the pulsing pains at bay.  The target dose is 5 mg.  Decrease should be no more than a single milligram in two weeks.  At this rate I ought to be into freedom territory by high summer.  The body’s own cortisol production is around 5 mg daily.  Since starting on prednisolone my own production has atrophied.  Getting it restarted needs balance and care. 

I look at the line of drugs on the shelf: Omeprazole, Calcichew, Alendronic Acid.  Support dope to counteract the effects of the Prednisolone.  They stop you being sick and keep your bones from thinning.  I guess they’ve worked.  Further along are some hopeful things – Vitamin D, Echinacea, Zinc, Concentrated Cranberry, Saw Palmetto Complex.  This is the snake oil end of my medicine cabinet.  Tablets that work by trust rather than fact.  Mind over matter.  Hope instead of surety.  Belief.

I’ve read the books – how to walk through walls.  How to fly.  How to speak without opening your mouth.  How to lift things by thought.  How to tell the future.  How to walk on water.  None of those things ever worked.   I have great hopes, however, for what it says in my edition of How To Beat Polymyalgia Rheumatica.  People do beat it, it assures me.  It doesn’t go on forever even if it might seem like it does.

Then I hear the mail arrive.  In the days when I was an aspiring poet and sent my efforts out for consideration on a regular basis the thump of paper hitting the doormat was a familiar sound.  I always felt that rejections were like police raids.  They arrived at dawn, unannounced, and were usually upsetting.  Thank you for sending your poetry for consideration but our editorial team felt that despite its high literary values it isn’t for us.  May we wish the best of luck elsewhere.   What they actually meant, of course, was your  verse is rubbish, we suggest you put it in the bin.  But no one ever said that.  The literary world can be overly polite.

Today it’s a padded bag.  Inside is a well-wrapped bottle of something called Gastrografin and a letter summoning me in to Radiology at the Heath for a “CT Thorax and Abdo and Pelvis with Contrast”.   The letter has stern warnings about wearing jewellery and eating beforehand.  Drinking squash is okay, apparently.  Although being over 25 stone isn’t.  There’s a special number to ring if I am.  I commit this to memory just in case.

Fallow period over then.  My letter is signed by someone called Emerctbodywithgastrotemp V2.  If I don’t attend the appointment, writes Ms Emerctbodywithgastrotemp, I’ll be removed from the waiting list and my referring clinician will be informed.  

I send in a message by telepathy.  I’ll be there, don’t worry.  Thank you for your concern.  That should do it.  Then I go out for a walk in the drizzle.  Fits my mood.

Coming Down The Up Stairs

Coming down the up stairs at UHW, just in front of the frightening full-length portrait of Aneurin Bevan in his overcoat, glowing like a warning to boarders, is a mother under full sail.  This one is wearing heavy flowing dark robes, a squalling child spinning at the end of each arm, a hijab wrapped tight around her full moon face.  She’s talking hands free, full pelt, and at maximum volume into a mobile that’s held to her ear by the hijab’s cloth.  Before her patients on sticks scatter.  I lean into the wall to let her pass.  You have to admire her style.

Outside the regularly ignored clutter of Trust notices banning smoking totally anywhere on the site have been supplemented by signboards that direct users to the newly provided smoking sheds.  These are also ignored.  The limp and the lame continue to smoulder and cough just outside the concourse doors, as they always have.  Gorgon guards.  Emissaries of the alternate world.

I’m back at bloods where history is repeating itself.  There are crowds.  Tickets fail to correspond to the numbers shown on the illuminated display.  The bandaged and the unable battle at the entrance, waving their arms, complaining about disorder.  Time flows by.  I does so slowly.  I read the contents of my wallet.  No book, mine left in the car in error.   Old receipts, a blue twenty, credit cards, bits of paper with phone numbers on them, my prednisolone users treatment card.  This contains stern and vital advice.  “If you become ill consult your doctor promptly.”  I’ll do that. 

Then I’m back at Rheumatology where my cascade of symptoms is noted and new tests talked about, done or booked.  Urine sampled.  BP taken.  Temperature written down.  Outside there’s a sun and it’s shining.  But the future is delineated with a mesh of new appointments and hours to be spent in long corridors waiting for my name to be called.

It strikes me then that none of this ever going to fully pass.  Life rolls from one failing to the next.  That’s its essential nature.  It arrives.  It shines.  It renews.  Then it falls apart.  All that’s in question is the speed at which this happens.  Slowing down the rate  is now my prime objective.  I shuffle in my seat, fish about in my pocket.  Come up with a mint.  Sure sign of age that.  Like admiring country and western music,  wearing hats while driving, and standing up when women enter the room.   A nurse does.  So I stand.  I smile.  Then I sit down again. 

How Do You Fill Your Life

According to the private publishers and poet Philip Ward life should be full of books.   For those who don’t know where to start Ward has compiled a list.  His A Lifetime’s Reading lists 500 titles that everyone should be encouraged to  get through.  At the rate of ten a year the quantity is not onerous.  Quite manageable, Ward thinks.  He does, however, allow his suggested texts to increase in complexity as the years roll by.   At my age I should now be consuming Ludwig Wittgenstein,  Giovanni Boccaccio, Nur Ad-Din ‘Abd Ar-Rahman Jami and Abu Bakr Muhamma Bin ‘Abdulmalik Ibn Tufail.  Just a few established mind stretchers that a person of my maturity should be able to manage with ease.

Instead I spend my waking hours navigating the health system.  Dealing with doctors, worrying about what they’ll fine, coping with the NHS.  Ibn Tufail practised medicine, it seems, but back in fifteenth century Cadiz, which is where he came from, they still used leaches and rather than check you by X-Ray they’d pour a mixture of tincture of serma, mercury and wheat germ down your throat and hope for the best.  Prednisolone was unknown.  Their cure for PMR pain was to cut into the muscle and let air into your legs.

I’m heading for X-Ray.  There are muscle pains in my limbs which are at variance with the kind that PMR delivers.  Mine don’t go away when you walk.  Prednisolone won’t touch them.  Instead they hover and pulse. 

The treatment is to be a couple of facet joint injections and a lumbar nerve root block.  The advance information UHW have sent me warns against having this done if I’m taking blood thinning agents (I’m not), tells me that I should avoid driving immediately afterwards and then sternly admonishes me in advance in case I fail to turn up.     

I’ve spent the morning at the gym trying to make myself younger and as it wasn’t raining I’ve also walked to the hospital rather than booked a cab.  I feel fit and awake.  But this isn’t going to last.

I present myself at X-Ray reception and am told by a man who looks a little like David Walliams that today my procedure is being carried out in the children’s department.  Down the corridor, follow the purple octopus.  I do.  And there it is over the door, pointing its tentacles.  You’ll be fine, says the Children’s receptionist.  Must be an NHS word that, fine.  Drummed in at induction.  Everyone uses it. All the time. 

I’m the only patient.  The otherwise abandoned waiting room, stuffed with a disarray of toys, colourful posters and child-friendly furniture feels like something out of JG Ballard novel.  There’s a dark otherness seeping in.  I’m beginning to recognise the signs.

The procedure itself takes around twenty minutes.  Local anaesthetic.  Needles into the lower back. A sensation of ice crawling down my leg.  Lots of encouraging words from the clinician.  The whole deal  is monitored on a sort of video x-ray machine although I don’t see this, lying as I am on my front.

Good, done.  You’ll be fine now.  We’ll just wheel you into the recovery room and let you rest for fifteen minutes.  Back soon. That’s the radiographer.  She is wearing a set of tartan-covered lead panels, a bit like the sort of things newsreaders wear when reporting from Afghanistan.  They are extremely fetching.   I’ll be fine soon.  I try to move my right leg.  Can’t.

And after fifteen minutes I still can’t.  I attempt to point my foot at my shoe and the limb sways and waves.  Misses.  Misses again.  It’s like trying to spear fish underwater.  The tartan clad  radiographer is back and with an assistant this time.  Together they try to get me on my feet.  Legless I sway  and they have to stop me from falling.  You have another fifteen, there’s a love, nothing to worry about.  You’ll be fine.

Fine, fine.    But I’m not.

I fish out my phone and decide to ring for assistance.  It’s obvious that I’m not going to get out of here unaided.  But naturally there’s no signal.  I stop a passing nursing assistant and ask if she can make a call for me.  Can’t.  No outside line here.  You hang on, the radiographers will soon be back.

Time passes.  The recovery room fills and empties.  Patients are brought in and wheeled out again.   Opposite a man who once might have been a miner or a steel worker, ancient tattoos on his arms, rheumy eyes, sits in a wheelchair.  He is having his procedure explained to him by a doctor wearing full operating theatre kit.  Scrubs, head bandana, hairy arms.  Anything else you want to know, Mr Jones?  Mr Jones shakes his head.  It’s all above me, this, he says.  You just carry on.  Right, says the doctor, we’ll be back.

I try to climb down off the recovery trolley, touch ground, and sway precipitously.  Mr Jones opposite looks alarmed.  I grab for the wall.  You stay where you are butt, Mr Jones says.  If you fall I won’t be able to help you.  He waves an arm which is attached to a drip.  His legs are covered with a blanket.

I do another 30 mins on the trolley waiting for the leg I no longer have to make a miraculous reappearance but it doesn’t.  I decide, then,  to make a break for it.  I’ve been here three and a half hours now.  Enough.  I get myself off and balanced against a wall.  Jacket half on half off.  Phone in my trousers.  Tentatively I try walking.  So long as I keep one hand on the wall I can just about manage it.  The missing leg is like a piece of rope trailing.  I haul away and get out into the main corridor.  It’s like joining the M4.  Floods of human traffic rolling in both directions. 

You okay, asks a passing nurse.  I look pained but nod.  Good.  You’ll be fine. Where’s the Concourse? I ask.  She points up a corridor that seems to run on for several miles.  I set off. 

Progress is about as slow as it can be.  I cling to the wall, stumble and half crawl. I’m among the hospital’s surging hordes now.  Uniformed practitioners, suit wearing surgeons, patients on sticks, bandaged, wearing dressing downs, in wheelchairs, on trolleys.  Some stop to help.  Most  look in pain or concerned or both.   

A fat woman in a motorised wheelchair slows.  Can I do anything?  she asks.   She does look concerned.   Doesn’t matter, I say, I’ll be fine.  Hell, even I’m catching it now.

Eventually after two face down falls and one episode of being helped into the lift by a  dressing-gowned man on a stick  I reach the concourse.   Gratefully fall into a seat and check the phone.  Signal at last.   I ring the love of my life for help.  Get me out of here, I say.  I’m overcome with a desire to get seriously down to reading  and have done with all this NHS stuff. 

It takes a good 24 hours for my leg to come back.  Two worried phone calls to the Out of Hours service and one to NHS Direct to check if I’m not going to be like this forever - Wait until tomorrow, they all say.  You’ll be fine -   and then there it is.  A leg that works.  It’s pain free and it holds you up.  Praise be Bin ‘Abdulmalik Ibn Tufail.  I get straight onto Amazon and trying ordering his books.  Any Tuhfat al-Ahrar or Fusus al-Hikam or even the hard to find Haft Awrang, once essential reading everywhere from here to Persia.  Nothing.

They were right, of course.  I am fine.   Bookless I go to the pub instead. 

The Urologists Stay Around

They’ve done a survey, the registrar tells me.  They’ve studied those who like to watch medical procedures and compared them with those who do not.  Do those who watch have a better outturn than those who hide their heads?  Turns out that if you like watching then the prognosis for you and your condition is likely to be pretty much the same as for those who prefer to look the other way.

I prefer to look the other way, I tell him.  Behind me is a video monitor on which the insides of my bladder are appearing in a sort of BBC 405-line colour.  Greys and submarine reds.  Dark and light in a fluid dance.  The internal world of Fantastic Voyage made real. 

What the urologist is looking for are signs of growth return.  My unending problem.  70%-80% recurrence normal.  It won’t go anywhere so long as we catch it.  The malignancy is low with these transitional cell polyps.  The consultant told me that in a bright moment in his room just off the side of Ambulatory Care.  Me in my gown waiting to go in for what’s become known as the procedure.  Flexible cystoscopy.  A camera and a light on the end of the flexible tube inserted  through the male body’s smallest orifice. Up the urethra and through the prostate to reach the bladder.  There’s local anaesthetic to dull the discomfort but the whole idea of the thing still makes me wince. 

This time you are clear, says the urologist.  Hasn’t come back.  There’s no bladder blockage either.  How are you getting on with the prednisolone?  The wonder drug.  The fixer of everything.  He asks this as he withdraws the apparatus.   I try not to look but still manage to see a device that looks as if it has been borrowed from the set of Alien, a snaking tube, dripping slowly as it uncoils through the air.    

I’ve got my dose down to 7 mgs daily, I tell him.  The polymyalgia is staying submerged.  No flares, no return.  The fractured sleep is improving.  The nose bleeds have stopped. The mood swings steadied.  The fatness is controlled.  The self-confidence has returned.   

Good.  See you again in six months.  Wiped dry, hospital record marked, nurse thanked.   I’m sent back to the recovery room.  Sat in a chair, there’s a love, given sweet tea, how many sugars?  Shake my head still get two.  You drink that then try to pass water.  Might hurt a bit, it’ll sting,  don’t worry,   you’ll be alright.  You can get changed then, if all’s okay.  Pants and gown in the bin by the door.   

I manage it, it’s easy.  I’ve done this dozens of times.  But the whole process still takes all your energy from you.   Always does.

Here’s your discharge leaflet and your tablets.  Drink loads of water now and take it easy.   The ward nurse hands me a letter to pass on to the GP.  This explains that Finch has been in and had his flexible cystoscopy at UHW and nothing was found this time.  He’s now not exactly full of beans but relieved.  He’s been given his discharge leaflet and is now heading down the corridor at a slow pace bound for the concourse where he’ll buy the latest issue of Record Collector and a Belgian Bun both of which he’ll leave in the taxi he takes to get him home. 

The letter is my passport to the future.  Nothing further to be done this time.  That is what it says.  It’s in my inside pocket where it glows slightly, nestling, making me warm.

The Return of the Urologists

Periods of public holiday and the NHS’s Accident and Emergency Departments have a fatal attraction for each other. If things are to go wrong then they will do so just as the clock moves the wrong side of five on a Friday, the moment the GP’s surgery closes and the harassed receptionists make a break for home. Down the years I have observed this medical Heisenberg principle many times. It sends hordes of worried citizens through the tobacco-smoke stained doors of UHW’s A&E at the stroke of 6.00 pm, Friday, hauling themselves into line in front of the glassed protected check-in counter, holding their bust arms, their distended stomachs, their aching heads, all waiting to be seen, hoping against hope that the rumours are not true and that somehow today by a fluke, by design, by divine intervention it’ll be quick, or even reasonably so, but it never is.

You hand in your name, tell them the problem, and then you sit. Around you paint dries. The Coke machines are empty. Former Health Minister, Edwina Hart’s healthy option chocolate machines dispense only seeds and nuts. There are no newspapers. And thank the lord there is also no TV.

I thought I was doing well. The prednisolone was working, so it seemed. The Polymyalgia (PMR) was getting squashed. The recent bladder infection was under control, sort of. I’d joined David Lloyd in an effort to get fit.

But then came Easter weekend and the glories of a family Saturday, chocolate eggs down the front of everyone’s shirt and that feeling of being replete you get from pub lunches and hours of conversation about motor racing, gardens, curtains, wardrobes, motorway routes and nice places to stay in Wales. I got home to find my temperature rising and then, in a matter of minutes, falling right back. I began to shiver and couldn’t stop. Middle of the night I was bathed in sweat. 34 degrees then 39 then 34 again. I felt awful. Hangover, flu, migraine and the need to stay sitting down. There’s a twenty pound note at the foot of the bed, said Sue. You have it, I replied. That’s the test apparently. We got in the car and drove for the Heath.

You look terrible, said the triage nurse when I eventually got to see her at Easter Sunday morning’s A&E. Lie down here. It was a hospital trolley. My home from home for the next six hours. I was given co-codamol and entered a sort of pain-riddled doze. Around me heart monitors bleeped and buzzers sounded like this was an eighteen movement composition by Karlheinz Stockhausen. Things clanged. Things thumped. Out at the edge of consciousness I heard what I took to be a doctor’s voice say, well I’ll just check through here to see if anything interesting is going on. Down the line there was moaning. Opposite someone seemed to be giving birth although given where we were they certainly wouldn’t have been. A Rudyard Kipling or an Ifor Thomas would have a made a poem out of it. I hadn’t the strength.

Eventually a young man with a stethoscope round his neck and wearing black scrubs began asking me questions. The duty doctor. According to his badge he was called Sebastian Pompadour. He put a line into my arm and then a chubby nurse with an impenetrable accent fixed a saline drip to it. You have an infection and we need to treat it. We’ll keep you in, he cheerfully told me. I’ll just need my diagnosis confirmed, someone will be round soon. They weren’t.

After several further hours of heart monitor symphony and an increasing hubbub from the cattle yards of A&E admission out there just beyond the curtains a porter in green coveralls appeared. He stuffed my saline bag down the side of the trolley and, without a word, set off with me on it down the corridors of Beirut. The scene, that which I could glimpse as we thundered by, resembled World War One. Bodies of trolleys, people on sticks, groaning persons in heaps, the resolutely ill on drips and with bandages everywhere, people slumped in corners, people leaning against the walls, people lying on the floor. We hurtled round a corner at speed, me grasping the trolley sides and sliding around much as clothes do in an under full suitcase. Crumple, crinkle, slap, thump.

I end up in Assessment. A new, brightly lit ward full nurses and smiles and not a single heart monitor in earshot. Karl Heinz’s intermission, no doubt.

Here I get three nurse, two doctors, a whole raft of intravenous antibiotics delivered by injection and by drip, and a meal. Actually sandwiches and a yoghurt but better than nothing. Am I feeling better? No. But I do know where I’m going. Urology. An Easter admission. They’ve got urologists working, I’m told. Someone will be there this weekend. You’ll be fine.

I spend two nights here. The doctors, and I see so many of these that I lose count, are convinced that it is indeed an infection. What they don’t know is of what.

I come round from my addled doze to hear voices in animated discussion. They don’t understand the stress it brings, says one. They do not, agrees the other. Too many at once, it’s not normal, it takes it right out of you. These are patients, both connected to catheter drains following prostate ops discussing visitors. In hospital you get them. It can be like the Eisteddfod, everyone you know in the world comes by.

In the corner a prostate and pretty knackered-looking man in the seventies, connected to drips and drains without number, is surrounded by his extended family. They all wear track suits apart from the daughter who has on more make-up than they use on Strictly and is wearing tights. She uses visiting time to good effect by playing constantly with her phone. Phones, once banned as devices of the devil that would interfere immediately with hospital electronic equipment, are now welcomed. Everyone in the ward seems to be chatting on theirs, those who are conscious that is.

Even the man in the next bed, a Serbian called Velcro, although that can’t be his real name, bursts into fluent and very loud Serbo-Croatian when his goes off. A quiet man who has hardly spoken the entire time I’ve been here is now shouting into an old Nokia at the top of his voice. Dobar dan rodni vidimo se uskoro da da hopsital yes very good, he yells. On the ward amid the pings of incoming text messages, the discussions about football and the sound of visitors rifling through patient’s supplies of mints nobody takes any notice.

Eventually after a few days of treatment and the taking of endless samples they decide to let me go. I’ve made one foray down to the concourse to buy a newspaper and got lost on the way back. I’m five floors up and in some sort of alternate dimension as far as I can see. The real world and mine rarely touch. But I’m keen to get back.

They are still not sure what’s wrong but the infection’s signs are in retreat. Through the night device in the ear temperature readings followed by the taking of my blood pressure appear normal. I’m given a two week supply of yet another heavy duty antibiotic (no alcohol, take it easy, complete the course) and told that they’ll be sending for me soon to scan those parts of me they haven’t scanned already.

Things read in hospital:

Max Hastings – All Hell Let Loose, The World At War 1939-1945 in which the British come off as not really up to it, the Russians as the world’s saviours, and the French as turncoat devils.

Peter Guralnick – Feel Like Going Home, Portraits in Blues and Rock and Roll in which I discover the unexpected rivalry between Muddy Waters and Howlin Wolf and read about the part played by alcohol in almost every American musician’s career.

Four copies of the Times and one Echo.

Cardiff and the Vale NHS Trust welcome pack, stuffed top of my bed where only the most eagle-eyed will find it. We want your feedback this suggests. I’ll send the CEO a link to this blog, once it’s posted. Maybe.

At home the cat is really pleased to see me and the grass has grown six foot. Grass does this. Unless you are there every day watching it the stuff rockets. Good to be back.

Fit

Fitness is the Catch 22 of this whole Prednisolone adventure. The fit can cope with Polymyalgia (PMR) far more readily than those who are not. The unfit can’t improve their condition because of the PMR. You turn up at the gym and the weight you moved with ease six months ago now feels as if it is stuck to the floor.

I’ve got the Prednisolone dose down to 8 mgs daily. It’s been at that level for more than a week now and so far there are no signs of the muscle throb seeping back. On my favourite piece of reading matter of recent times, the Prednisolone Package Leaflet: Information For The User, there is a warning against “weakness and wasting of the upper arm and leg muscles, brittle bones, thinning or wasting of the bones, bone fractures and tendon rupture.” And as I got out of bed the other day the love of my life backed this up by saying “God, you are starting to look puny. You should do something.” But what?

Street running, which I’d almost given up since the advent of PMR, makes you lean and slim. The weights room at Llanishen Leisure Centre, the Council run operation about three miles north of here, might help. I haven’t attended since last September. The gym itself was okay but the battle to get there, the parking, the jostling entrance queues, the wet crush and screaming kids in the changing rooms, the lockers which don’t lock, the permanent all-pervading smell of the pool, the disco thud from the constantly running women’s aerobics class all mitigate against attendance. I don’t want to go.

Instead I pay some sort of small fortune and join the much nearer private club, the David Lloyd. Here everything is sweetness. The cleanest changing rooms I’ve ever seen. The largest gym. Two heated pools. A comfortable bar and restaurant. And more classes on just about any and every aspect of fitness known to humankind. They do things with weights and pads and tubes and balls and bikes and even things that make you fit by lying on the ground.

There’s a touch of Ryanair about the money regime. There's a set-up fee. Then you’ve got to pay £5 extra for a padlock in order to use the lockers. And because I’m handing over an annual sum up front and have chosen to do this on the 30^th March I get charged £3.34 extra “to cover your half day membership on the 30^th and a full day on the 31^st. All our annual fees run from 1^st April. I’m sure you’ll enjoy it here.” I’ll try my best.

Things are better in the gym. This is a huge and mostly empty place containing more fitness machines than I’ve ever seen. Lift, pull, turn, bend, flex, press. I’m on the treadmill watching the marker on the screen that represents me moving steadily forward around the track. Beyond is the pool. It’s currently full of women of a certain age doing some sort of in-water aerobic dance. There’s music but I can’t hear it. Their instructor demonstrates the moves from the pool side. In the water the fat women turn and churn.

They are game for this, certainly. Some of them have got here on sticks. One of them is wearing socks. But in their polyester one-piece bathing suits they are so big. Like women on seaside comic postcards. How do they get this size? Can’t they see the stuff arriving? But maybe it’s medical and I’m being unfair.

My first session with my puny arms and my puny legs lasts for 30 minutes. I try a few machines set at levels I would have laughed at a year ago. I do five minutes on the stepper set at level one, no resistance. It’s almost like walking downhill. For encouragement I’ve got old rock n roll playing on my iPod. Jerry Lee Lewis, Fats Domino, Charlie Feathers, Dion, Lonnie Donegan. Makes the David Lloyd jump. But not enough to sweat.

The following day I’m a bit tired but nothing much. Have I managed it? I have not. Day two reveals aches in both legs, both arms and round my neck. All of PMR’s favourites, the proximate muscles. They’ll all talking to me. You’d be better off fat and lying down they’re saying. They say it a lot.

Right now, however, two days further on, my proximate friends have shut up. Maybe there is hope out there. What does the Prednisolone Package Leaflet: Information For The User have to say on the subject? Hope. I hunt for the word. There are loads of references to side-effects, abnormalities, being unwell, worsening conditions, depression and feelings of dependency but not a thing about how the world may eventually turn and brighten if you stay the course.

Maybe it’s all an illusion. I’ve taken my daily 8 mgs and it’s back to the David Lloyd now for another go. I’ll beat this thing yet.

Sleep

For once in my life I’m watching a rugby match. This is not a thing I do lightly nor do often. Not that I’m opposed to the sport – rugby was something I once played – but it’s the watching of it, en mass, and the tribal shouting that I find hard. Hysterical commentators. People wearing stove-pipe hats and with their faces painted. Overweight grown men dressed in the tight sporting kit of their teams. Chanting drunks. Middle-aged women in lycra carrying inflatable dragons. Kids dressed as daffodils. The whole deal gets to me. But not today. Wales vs. France, the arch enemy. It’s the 2012 Six Nations Grand Slam which Wales are about to win. And how.

I watch the game on my wide-screen television, polymyalgia subdued for once, a flicker just below the surface. Once the game’s done, an hour and half or so later, and the world has erupted in celebration of Welsh victory, I realise that I’ve been out of the room to the toilet at least 8 times. That’s a lot. Even by my standards.

During the night I shiver, can’t get warm. Then I overheat, can’t get cool. Something isn’t right. Pain in the bladder. Pain passing water. Pain standing up. Pain sitting down. The GP decides the symptoms are those of classic bladder infection. Prednisolone predisposes the taker to infection. The immune system is suppressed. Polymyalgia triumphs again. I spend the week fighting.

Hello toilet my old friend, I’ve come to talk with you again.

The frequency of urination increases. Sleep dissolves into a rapid fire set of getting up. Stumbling through the night’s half-light. Checking the quantity. Pain. Discomfort. Constantly feeling there’s more to come. Then getting back into bed again.

The chemist is five minutes’ walk away. I rush down. There they tell me that all those neat cures offered for sufferers of cystitis won’t work for men. Men have a different structure. Inside, you know, the pharmacist softly says. You could try these. She offers me some sort of branded sodium powders. They stop the stinging. I know it says for women only on the packet but you can ignore that. They won’t do any harm. I try them. Nothing happens. They might even have increased the rate of going, and I’ve got the urge for that. Joni Mitchell once again.

The first anti-biotic used to fight the invader, Trimethoprim, fails. The world closes in. Then Nitrofurantoin, prescribed by the GP after the usual performance of getting an appointment and taken as a sort of second front, starts to work. Turns your pee bright green. Kas, the pharmacist turned tea shop owner at the Waterloo Gardens Tea Shop who I meet in the park on the way back warns me about this. Lloyd Robson sends me an email suggesting that this might be what happened to Rigsby in the film of Rising Damp. Technicolour waterworks.

Passed urine should look like a glass of chardonnay. Mine resembles greengage slush puppy. But like all things, it won’t go on for ever.

By day nine I go out again. Can face the world. Sue reminds me that at the start I was pleading for hospitalisation just to get away from the pain. Now I can walk about in the sun. Prednisolone you two faced whore. You’ve done for me again.

The dose drops. I’m now on 8 mgs / 9 mgs alternating days. The GP thinks it’ll hold the polymyalgia back and it does. So far it has. On a planet which offers two places to go – polymyalgia or bladder infection – which would you choose? At the time of specific suffering the answer is always obvious. But stood back a bit it really is hard to say.

Fear

As a consultation this one has nothing out of the ordinary about it. The clinic is as full as it ever is. People on electric wheelchairs and crutches, the out of shape struggling for breath, the aged lounged in the chairs, the lost, the depressed, the distressed, the misshapen morass of the lumpen majority. Me too. I’m one. Out of shape because the Poly Myalgia (PMR), despite my best efforts, has held me so far back.

We play the expected game of musical chairs. Sit outside for fifteen minutes. Name called. Led into an inner waiting corridor. Name checked. Weighed. Asked how you are today, love. Sat there for a further fifteen. Then called, if you are lucky, in to see the consultant. This little dance is something to do with an Assembly directive on waiting times. If the local NHS can get its patients to queue twice for the same appointment then waiting times will be immediately halved. All delivered with a pataphysical logic of which Alfred Jarry would have been proud.

Only part two, the lounging in the inner waiting corridor, takes one hour fifteen. A bit longer than I might have hoped. But I do manage to read almost all of Jasper Rees’s Bred of Heaven – “one man’s quest to reclaim his Welsh roots.” He does this by learning the language. Been there. He’s a brave man.

When my name is finally called I find myself ushered into a small room manned by a doctor I don’t recognise. The consultant is on holiday, she says. I’m standing in. You don’t mind a few students observing, do you? I look to my left and see a pair of them, young, scruffy-haired, eager faces, minds at the ready.

We proceed. It’s clear the stand-in hasn’t read my file. We go round the houses for at least fifteen minutes with me having to describe my whole medical history and then the onset, diagnosis and treatment of my PMR so far. In fact it’s a little more than round the houses. We go round the whole town. I mention that earlier I’d been diagnosed with what subsequently turned out to be a mild form of bladder cancer. Under treatment now, controlled, and with a good prognosis. Ah yes, says the doctor. Tell me more about that. I do. I tell the whole story: discovery while in America, bleeding into the portaloo at the Cherokee Blue Grass Festival in North Carolina just as Ralph Stanley came on, the fear, the visits to US Emergency Rooms, the rising panic, the American scans and consultations and you’ll be okay, son, and the trip home back to the arms of the loving NHS, carrying my American CT scans under my arm. I leave out the bit about how I turned the whole thing into literature (see Zen Cymru by Peter Finch, Seren Books, 2010). She might get the wrong idea. She might expect the present experience to end up as a poem or be used in a blog somewhere. Perish the thought. The students make notes. The doctor consults my file.

We think, she then says, using the royal pronoun, that the cancer has migrated from the bladder to your spine. Bladder cancer can do that. She looks down at the file while I wobble slightly. My chair has assumed a sort of super real state and feels unmovable, impossibly hard, frozen in time, locked to the ground. It probably hasn’t migrated, she continues. That’s a worst-case scenario. But we need to consider it. I am going to send you for some tests to fid out for sure. We need to look at the bones of your spine.

But I’ve had bone tests, I protest. Bone Density Scans, X-rays of my bones, more bone X-rays and, last Saturday, an MRI Scan. It’s Monday today. The results of that experience and half are not yet through. You’ve had an MRI test, the doctor asks? She’s asking me? She has my file in front of her, doesn’t that tell her? I nod. Okay. The MRI scan will provide a definitive answer. When the results come through I’ll phone you. When will that be, I manage to ask? In the next two or three days, she says. NHS imprecision floats. Now, let’s move on to consider your dose level with prednisolone.

Prednisolone. Do I still care? I’ve got the big C now hanging over me like a dark and evil phantom. Already the sun has vanished. Soon the rest of the world will also shut down. Am I concerned about prednisolone now? I guess I should be. I force myself. I make myself listen.

I want you to reduce the dose more slowly now, she’s saying. Go down from 10 mgs to 9 mgs on alternate days. Do that for two weeks and see how things are. If things are okay you can then try taking 9 mgs daily. At these lower levels we need to make lower incremental changes. I’ll book you in for another consultation in four months’ time. So she thinks I’ll live that long, does she? Better than nothing.

I find myself then in the long UHW corridor among the usual hoards of patients and medical staff all bound for somewhere or nowhere. The purposeful mixing with the lost. I’m clutching a cardboard fragment, torn off the end of a box that once contained latex gloves, with a telephone number biroed on it. This the doctor gave me as I left. It’s the number of the department secretary. I can ring her if something goes wrong.

I sit at home in a state of cold, unmoving silence. There’s a world out there, apparently. But I’m not part of it. I look up bladder cancer, spinal cancer, secondary cancer, cancer migration, cancer treatment and cancer prognosis, all on Google. I then immediately wish I hadn’t. The information uncovered is unclear, contradictory and mostly dark. I make a few phone calls, family, get shocked responses, and then sit staring into the empty distance. My usual habit on returning home is to put on some music. But today I haven’t put on anything at all.

After thirty-six hours of this, including a fitful sleep and much prowling of the house in the deep of shudering night, I find myself at the end of something. The walls seem nearer to me than they once were. The sky is bright white and featureless. The mind churns back through the same furrow once again, the words about migration and it can do that turning and returning.

Suddenly I boil. I can’t take this. Someone out there in the vastness that is UHW knows what my MRI scan showed. They have the answer. And it’s my answer. My spine. My condition. I should know it too. I pick up the phone and dial the department secretary. Manage to press the wrong buttons. Dial again. Engaged.

I take a breath and try once more. The line rings.

The secretary is great. I tell her the tale, my voice as steady as I can make it, and she checks my on screen file. Yes, she says, the MRI result is in. I’ll get a doctor to ring you straight back.

I replace the phone and sit by it. How long will this take? Ten minutes? After five the thing rings. It’s a recorded voice trying to sell me loft insulation. To speak to one of our operators press one. I groan and put the receiver back down.

After sixty minutes and a further nuisance call from someone claiming to be my insurance company who begins by asking me how I am today, a certain sign that they are about to try to sell me something next, I snap. I call the department secretary again.

She hasn’t rung you? Hang on, I’ll do some chasing. There’s a whole bunch of muffled clicking and distant voices and then the secretary tells me that the doctor is in consultation and with her final patient and will call me back immediately that’s over. Won’t be long now.

It’s a further thirty minutes actually. And then I get the voice of the stand in on the line. You’ll be pleased to know that it’s not what we thought, she says. Not cancer? No.

I breathe. I realise that I haven’t been doing this since the phone started to ring. God. Not cancer. I interrupt and ask the doctor to repeat. Tell me again it’s not cancer. You’re certain?

Look, I’ve already told you that, no it’s not, she says. Sternly. Bedside manner not really all that evident. There is a cyst, however, something we call a ganglion. It’s in the lower part of your spine and is pressing on the nerve. That would account for all the non-polymyalgia pains you’ve been experiencing. It can be treated. You might need an operation. I’ll have to talk to the consultant next week and get back to you. Is there anything else? No, I manage to say, thank you. She’ll be going home now. What will I be doing?

I sit for a moment, sort of stunned. Then I get up and I dance. I dance with great big steps up and down and up and down the room.

Running

I’m running. I go past the lake, below the trees and on up the path. It’s a push and it’s a sweat. But then it’s supposed to be that. I’ve done it for decades. It makes you fit. It controls your weight. It makes you young.

I didn’t really begin until I was 40. Went out and found I could do it after all. You ran for half an hour and you didn’t die. Your legs didn’t come off. Felt good the day after too. Ate healthily. Began to get younger. In two months I got myself back to age 35. People I met would say, say you look good. Didn’t you used to be that bloke with the beer belly? Gone. Wonderful. I ran some more. I got back to 34.

After that, though, nature’s natural calendar kicked back in. Age returned. Been like that for twenty-five years now. Run to keep yourself on track. Run to control the weight. Run to think. Run to keep yourself in contact with the physical world.

That was until Polymyalgia (PMR) intervened. Aching legs, aching trunk, aching neck, aching upper limbs. Should I run? I asked the GP. Do what you feel you can was the standard reply.

To be fair my faithful friend Prednisolone has helped. PMR slows you to staggering stop but prednisolone lets you start again. Slowly.

That’s been the trouble. It’s slow. When you cease exercise fitness leaves at a prodigious rate. Getting it back is a mighty task. PMR reduced me from miles to almost feet. Could just about get myself down the lane out back when I felt fit enough to restart. Take 15 mgs Prednisolone, put on the running shoes, clamp the Nano to the ears with Santana on, out for five minutes, then stagger back.

Then the pains began. Leg pains, chest pains. The leg pains could well be skeletomuscular suggested the Rheumatologist. But the chest pains may need checking. Hell, off we go again. Another worry. Something else to get under my skin. I look it up. Furring of the arteries, angina pains. That could be it. Pain which runs across the chest. Is there while you exercise. Yep. Stops when you stop. Yes again. That’s me, that’s what it is.

In cardiology they’ve got me up on their running machine. I’m in day clothes and work shoes and have eight or nine leads attached to me. Just walk, the assistant instructs me. We’ll see how you do. Good, good, she says. Now I’m going to up the incline and see what happens. It’s slightly harder but not much. So the process goes. I walk, she turns up the pressure, I walk some more.

Gradually it gets so I’m running, Heavy shoes not the best for this but she’s so encouraging. You’re doing great, keep on. Many give up at this point but you’re fine. I’m on there for more than twenty minutes. Sort of sweating at the end. You’ve done excellently. I have?

The cardiologist returns and looks the results over. In between a conversational rambles about Ireland, the far reaches of Wales and recent fiction he tells me that I’m totally normal. Not a flicker of heart trouble. Nothing he could detect. Blood pressure brilliant. Cholesterol quite acceptable. Stop worrying about this. The pain is skeletomuscular, my other familiar friend. What do I do about it? Run to get to the other side.

You need to do an hour at a stretch three times a week, that’s the current Cardio vascular advice. I might not manage quite that given my prednisolone disability and the PMR still there deep down below my supressed immune system. But it’s good news. Whoopee.

On the way out I barely notice the smokers. I pass the Council dump on Wedal Road and give the operators a friendly wave. Time for a single malt when I get home. Yes yes.

Mahler, Lieder, Helicopters and Prednisolone

It’s been a hard week trying to reduce the level of prednisolone. I feel a bit like an alcoholic. I deny that the stuff means anything to me and then can’t wait to get the dose down my throat. I’m trying to drop from 15 mgs daily to 10. The advice is to do this as slowly as I can. But every time I manage to reach target the pains start up again. They hover out there in the wilderness waiting to pounce. As soon as my mental barriers are down then in they come. And like police raids they usually operate at dawn.

This morning things were so bad that I considered for a moment not bothering to get out of bed at all. I could hear the drivers in the street outside scraping away at the frost on their windscreens. A couple of them, I know, were using their credit cards. These things have many uses. Portable ruler for drawing straight lines, thing for scratching the side of your nose, opener for recalcitrant front doors when you’ve mislaid your key. Used to be okay for that but I seem to recall snapping my Barclaycard in two the last time I tried it. So maybe Yale has at last got wise.

But I overcome. Rise above it. Get myself up and through the morning’s ritual of tablet taking and healthy porridge. I then through what’s now drizzle to the waiting hospital. Here I am again. I’ve arrived early enough to park on the ground floor and to enter the concourse at the same time as the morning shift. The drifting resident population of blokes with buckets and women in washed-out hospital gowns, men on sticks, relatives staring into space and staff in scrubs looks totally unchanged. We ought to hold a concert or two here, cheer everyone up. Brass band music, bluegrass, a poetry reading. Ifor Thomas with his poetry about the prostate would go down well. I might suggest that.

At the bloods clinic, jammed up the corridor somewhere between eyes and my friend, distant rheumatology, there are at least half a dozen people already waiting. The place doesn’t open for another quarter of an hour. You get there before half eight love and you’ll be first. Hum.

I take a number from the ticket machine rather as if I were at the cheese counter in Tesco. I get 04. Not too bad. Bloods entrance has a large and bold painting of a brown unicorn beside it. The unicorn’s horn is long, thick and severely pointed. I start thinking of needles. I do not get on with needles. Not at all. If I watch I faint. It’s happened before, a grown man helped out of the clinic by tiny nurses. Told to sit and drink some water. Happens to lots of people, love. You have a good rest now. God, there’s just too much of having a rest in life. Live now, rest later. This time I decide that I definitely won’t look.

When the clinic opens there’s a fuss. The electronic number display asks for patient 01 to present themselves but a shouting woman in a wheelchair has managed to draw a ticket numbered 00. I was here before you, she complains to an insistant man holding ticket 01. I’ve been here ages, I have, and I'm not waiting anymore. A nurse intervenes. Patient 01 acquiesces. 00 rolls on in.

Why are they testing my blood again? To measure my CRP and ESR rates. That’s C-reactive Protein and Erythrocyte Sedimentation. These show if inflammation is present in the body and are a good indicator of PMR and how the prednisolone might be going down. Both of these levels were elevated before diagnosis but have come right down to normal since the prednisolone was prescribed. But here I am wobbling on the edge of pain recurrence so I’m expecting something to have changed. Not that I’ll know until I get the see the rheumatologist again next week.

My blood samples will be analysed on the premises and the results put onto the central database. Interested parties can then call details up at will. Well, they should be able to. But the health service seems riddled with slow performing hardware, faulty displays and cranky software systems. This is set against a massive raft of regulatory concern over confidentiality and permission. For me I don’t really care who knows my ESP level. Next week when they tell me I think I’ll post it here.

The test itself is over in under two minutes. I’m secured with cotton wool held in place with what looks like parcel tape. I'm back in the corridor in under five. Could be the day is improving. The walking seems to have lifted the residual PMR discomfort and finding my way back out is a push over now that I’m the next best thing to a resident.

Home and I return to 1967 retreaded. I’m working on a concrete poem sequence in the style of those that once graced Hansjorg Mayer’s poster-poem futura series. Jonathan Williams, Diter Rot, Louis Zukofsky, Augusto de Campos, Ian Hamilton Finlay, Reinhard Dohl. The artist Antonio Claudio Carvalho is reviving the idea for 2012. My piece will somehow mix Mahler, Lieder, helicopters and prednisolone. I’ll let you know how I get on.