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. 

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.