Tuesday, 19 February 2013

Beyond The Day Care Unit

Physiotherapy sits in a wasteland way up beyond most of the clinics I already know.  It’s deeper into the hospital than X-Ray or Pharmacy, both places where I’ve spent more hours on hold than I have with BT.  It’s beyond  Short Stay Surgical where I’ve sat in fear and trepidation waiting for catheters to be inserted and cameras on long flexible sticks to be turned on.  It’s out there, further than the cubby hole occupied by Radio Glamorgan, UHW’s own station.  Here Vince Savile, hospital porter and brother to the late ungreat and now late himself other Savile once deejayed.  Does anyone now listen to these enterprises?  There are nineteen presenters all beaming in the staff photo and twenty-three thousand visitors recorded as having visited the station’s new web site.  Local radio clearly rocks on.   Then there it is.  Physiotherapy announces the sign.  I’ve arrived.  The waiting room is dense with seats,  buff,  serried, uninviting.  There’s a rack next to reception where you can leave your crutches.  The art of the recycle. The places is like Lourdes.

I’m here to learn how manage.  What can't be fixed can certainly be accommodated.  So I'm told.

Rich, his name is on his badge, the man who will sort me out, is fitter looking that I was at his age.  In fact he’s fitter looking than I’ve ever been at any age.  With his huge healthy hands he takes notes, asks questions, learns about my case.  He checks my records, my graphs, my MRI scans on the hospital system.  He tells me that it’s the cyst that’s the issue and the way it bulges, flows, ebbs, and presses.  I had an idea it was. We can’t solve it here, he says.   But we can help manage.  Yep.  Manage.  Word of the age. 

I get a demonstration of lower-back specific exercises – stretches and flexes – things to help with the discomfort, when it flares.   He hands me a sheet showing the routine being done by a stick man.  Round head, smiling face, no hair, thin body.  Me.  To a tee.

Back home I do the stick man thing while staring out of the window.  Point hands at feet and hold for thirty seconds.  Sit up.  Bend back.  Breathe.  Repeat. 

Beyond are men here to build a new extension.  They have their hoods up against the cold and wear knee-high leather boots like they might have done  at the battle of Omdurman or when riding through the brush in the cowboy west.  Now it has stopped endlessly raining  they are digging up the patio.  They uproot plants and crack slabs into slivers ready for the arrival of the mechanical digger.  This wonder machine on tracks will excavate the footings.
By now, like me, this house had almost all of its innards explored and tested.  It’s old, it’s been around, it needs some tlc.  Rods have been inserted into cavities, coverings have been lifted to check the sub-structure.  Cracks have been discovered, stitched and sealed.  Roofs have been waterproofed.  Steps mended.  The framework has been stabilised.  Damp ingress excised.  Blood counted.  Temperature taken.  Wiring renewed.  Body declared to be about as okay as it’ll ever be “for a build of this age”.  It’ll all be okay for the medium term. 

Quite how long that medium term will be is no one is actually prepared to say.

The sky is cold, winter blue.  Uprooted plants and fragments of slab begin to appear stacked in the skip.  The dross we no longer need.  When they are done I’ll get the guy on the roof with the scraper and the claw hammer to have a go at Mr Synovial down there in my lower spine.   Hit it a couple of times, squeeze it out and then stick the incision back together with two screws, some hi-flo instant set grout and a metal strip.  Plaster over.  Allow to dry then paint.  You’d never know there’d been anything there.  Okay for the medium term.  That’s all I need.

I have a cup of tea and two naproxen.  Next week I see the neurosurgeon.  He does scraping out and re-grouting, so I’ve been told.  Does it with micro precision  and has an 80% success rate.  He doesn’t wear a hood and comes to work by BMW and wearing  patent leather shoes.   He probably doesn’t listen to a radio which has a large battery stuck to its outside with masking tape.  That’s my guess.  But how do I know?

Monday, 4 February 2013

The Blues

In the waiting room I have my head deep in my book.  It’s in so deep that when they call my name I fail to hear .  It takes the receptionist tapping her feet in front of me, files in hand, to get me to stir.  This is the Welsh National Health and I’m being called in more than fifteen minutes ahead of schedule.   Aneurin Bevan, your dream is coming true at last.

The trick is, of course, that after checking your weight and your blood pressure (what do you want me to do? I’ll need an arm) and your name and address, mother’s maiden name, medical number, GP details, birthdate and secret password (mine is arse, apparently there’s a move on to popularise these once discredited words) I get to sit in waiting room number  two.  Empty apart from me and my book.  Medical students come and go.  A trolley of files rolls by.  The leaflets on the notice board advertising the rheumatic hip self-help group  and what to do when you fall over flutter in its breeze.

I’m reading the late Robert Palmer’s Deep Blues, an excellent history of blues music.  Palmer was a music journalist and fanatical record collector with a personal library of blues albums that ran to thousands.  He’s explaining how it was that jazz improvisation came from negro string bands and early jump-up  groups having to extend the length of their numbers.  They had to do this to satisfy the demand of dancers who didn’t ever want to sit down.  Middle of this my name again gets called.  This time I hear. I pad my way to today’s target - the consultants room.

It’s all centred on this.  Me sitting there before the doctor, a pair of silent students arrayed left, my file in all its fat and paper-stuffed glory in the centre of the desk.  The pred levels we’ll leave as they are, 3 / 4  mgs on alternative days, the consultant tells me.  Get that down to 3 mgs each day by the end of the month.  The synovial cyst is the real issue.  Your MRI scans show that it might not be growing but  it’s certainly there.  They are so unpredictable these things.  It will take just a small shift  for the pain to start for you again.  She frowns sympathetically.  You are not in pain now?  I was last week but today, no.

There are drugs we could put you on, gabapentin for example, but it does have side effects.  I get read a list.  There’s everything I've heard before on the prednisolone danger directory and then more.  Fat face, night frights, pain everywhere, bleeding stomach, head spins, fear of the outdoors, suicidal tendencies, hiccups.  Get all those and you’d never leave your bed.  Not everyone will suffer from these side effects, she tells me, reassuringly.  Up to you.  For now I’ll pass.

We’ll see what we can do with your visit to the neurologist, she continues.  You’ve already been on the waiting list for 3 months, can’t be long now.  I’ll give him a call.

Then I’m back on the street.  Nothing actually prescribed and nothing new to do.  There are a few specialist consultations out there somewhere in the future, maybe a spinal injection if that department gets its act together and another visit to Rheumatology in six months’ time.

What would Charley Patton or Robert Johnson have done?  Sung about it a bit accompanied by their slide guitars, Pain Down My Leg Blues,  Hollerin’ ‘Bout Gabapentin, Shake That Synovial Thing  Mama, and then retreated to the bar.  Alcohol, the great cure all. If in doubt put half a bottle of Wild Turkey down your neck. 

Patton died at 48, Johnson at 27.  Doesn’t really give you hope.