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.

Scan

Despite the PMR flare which had me sitting on the stairs with my head in my hands yesterday I decide to walk. It’s a fine day in between winter blasts, low sun streaming down the street in a great headlamp dazzle. I go past the Roath Laundry on the corner of Marlborough and Blenheim, its red brick outer walls still in place but its innards almost entirely demolished. There’s a man in a long ragged coat and knitted hat picking his way across the top of one of the rubble piles like this was a pit village in the 40s. A mechanical digger lifts a rusted RSJ and bends it as if it were rope.

I’m wearing loose clothing as advised. Track suit bottoms, t-shirt, sweat top, trainers. I shouldn’t feel out of place. I’m dressed as much of Kentucky Fried Chicken Britain usually is. But you lose authority weraing clothes like this, don’t you. Could you sell insurance door to door wearing Nike? Or if you read the news on TV dressed as a bag lady would anyone believe what you said? Probably not.

Beyond the parks, full of cyclists now we are suddenly allowed to ride on their paths, the tennis courts and the Lake end roundabout, lies Wedal Road. Before the coming of hard-topped roadways the Wedal was a stream. A tributary of the Roath Brook. It’s piped now, a lost Cardiff river, running below the road’s tarmacked surface. The Wedal Road dump, officially a council Household Waste Recycling Centre, has eighteen notices across its gates. These warn against climbing, arriving by truck, walking, being commercial and driving too fast. The latest, a splendid bilingual banner with a drawing of a pick-up truck at its centre, reminds dumpers that if they intend arriving in too big a vehicle then they will have to book.

Around the corner, beyond what was once the Allansbank but is now the Grape and Olive, is the hospital. UHW. The Heath. I’m heading for my first of four tests this week. Each will be performed on a different day, the relevant departments being unable to speak to each other and patient consideration being pretty far down the list. Today it is bone density. Prednisolone has a detrimental effect on bone thickness. The steroid thins. Osteoporosis sets in. A counter measure is to also take Alendronic Acid and up your intake of calcium. I’m on two Calichew daily and Alendronic (stand up, drink loads of water, then swallow) each week. The bone density test will put a measure on all this. Set a reference point to which in the future I can return. Are my bones now more susceptible to breaking? I’ve asked the GP that. Her answer was yes.

Outside the hospital entrance is the usual clash of signs banning smoking with the smokers themselves. White haired ancients in dressing gowns with bandages on their limbs resolutely puffing. Thin faced young men in wheel chairs with drips on wheels beside them pulling hard on roll ups. Well-dressed doctors and file carrying administrators going by without saying a word.

Bone Density measurement takes place in the Department of Medical Physics and Clinical Engineering, a place I’ve never heard of let alone been to before. It’s situated way up the main drag beyond X ray, Pharmacy and the Surgical Day Unit. The procedure itself is done in no time flat. I’m given hospital trousers as my loose fitting track suit bottoms, worn as instructed, turn out to have metal zips on the pockets. I lie on a machine that vaguely resembles the laser table in Goldfinger but lacks the straps with which to tie me down. This is a Bone Density Scanner but we call it a Dexa the nurse tells me. Put your feet here, stay still, breath, don’t breath, breath, there we are, done. Let’s just check. Okay. Get up slowly so you don’t fall over. Fine. You can go now. Put the pants in the dumper. Results will go to Rheumatology. Take two weeks.

I’m done, gone back down the long corridor to the exit, filled now with slow moving patients in robes and on sticks, theatre staff in blue scrubs, blokes in anoraks from Matalan, a man his head totally bandaged with only a small gap for his eyes, a woman carrying a ladder, a porter pushing a chair, a business man in an expensive suit.

Tomorrow I’ll be back. Bloods again. I can feel the polymyalgia there in my legs, a dull throb. Outside the sun’s still shining. But it’s lost its edge.