Wednesday, 18 April 2012

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.

Wednesday, 4 April 2012


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 30th March I get charged £3.34 extra “to cover your half day membership on the 30th and a full day on the 31st. All our annual fees run from 1st 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.