Oral Morphine

 In the big bottom drawer by my bed at home are the boxes.  These are my stacked supply of prednisolone in 5 mgs and 1 mgs tabs, dozens, enough to de-polymyalgia a whole street.  The boxes are dated and aging.  I haven’t touched them since my dose rate dropped to zero.  They are the reserve, held against the pains returning.  I should take them back to the pharmacy but they are my psychological prop. 

In the drawer by my bed where I am now there is no prednisolone.  In fact there is not even a drawer, just a mobile cabinet containing my clothes  with a box of Kimberly-Clark Professional Tissue sitting on its top.  In style these  are hygienic  regulation NHS.  In reality they are little different from the serviettes offered to me last week at Lobster & Burger in Hills Street.  No printed menu, three items only served, same price for each, all of them containing lobster. 

I’m in an otherwise empty side ward at the back of the being rebuilt Short Stay Surgical Unit.  The corridor outside is sealed with plastic sheeting  held in place with gaffer tape.  This is the University Hospital of Wales, built in 1971 and now showing signs of wear.  I’ve taken oral morphine, given to me in a self-dosing syringe.  It’s put a great bank of soft glory between me and the pain.  The catheter with its bloody bag recedes into the clouds.  The ceiling glows.

I’ve been under having samples taken from inside my bladder and several tumours  removed.  I’ve no idea how long I was in there.  One minute I’m talking to the anaesthetist who is administering dope into the cannula inserted in my wrist  and next I’m seeing two versions of everything in post op.   Now I’m languishing in that half world between crisp reality and the safe haven of fog. 

The night rolls.  I drift  through it.  At 3.00 am in the near distance an alarm sounds and the winking equipment around me flickers off before coming back on.  Fire alarm.   I realise in the total dark that there’s not much I can do about this, secured as I am to the bed by tubes and drips and full  with somnambulant drugs.  I call but no one hears.  I reach for my phone and try to check current UHW status on the UHW web site.  Nothing.  There’s an emergency phone number.  I ring that, at least I think I do.  No one answers.  I search for things like “what to do in hospital when there’s a fire” and “large building evacuation procedures” and finally “how to get down a corridor with a catheter inserted into your old man”.  The results I pull up all suggest that help will come.  It doesn’t.

I’m worried, I suppose I am but the dope takes off the edge.  The alarm which has rung for at least half an hour suddenly  silences.  They’ve put the fire out.  The alarm system itself has been consumed in a conflagration.  I’m in heaven on the other side.  One of those.  Eventually a nurse carrying a torch turns up to check on me.  “You alright love? ”  I nod.

The following day, which is not long in arriving, the staff nurse reviews my case.  The catheter is removed.  “There’ll be a bit of sensation as this comes out.” Jeez and a half.  The deal is that so long as there is someone with me and so long as I can lie down and be looked after for a few days I can go.  That and the fact that I am able to pee again.  Sounds so easy doesn’t it? 

Down at the SSSU latrines, one working, two out of commission, one with a sign up showing that it is currently being cleaned, I get into the queue.  There are two blokes in front of me both aged beyond, using the walls for support and generally looking terrible.  Once it’s my turn I stare at myself in the mirror.  I look pretty much the same.

Pee is beyond me.  I return to my bed dispirited and depressed.  The nurse advises drinking more.   “That’s the answer.” I’ve already done two jugs of water and four polystyrene cups of  hospital tea.  “Why don’t you go down to the concourse and have one of their giant coffees?  The walk will help.”

In the real world of the concourse, such as it is, everyone seems so business-like and aware.  I’m still full of fog.  I do a Grande something, hot brown liquid sold for an exorbitant price and then walk myself slowly back to the ward.  I join the latrine queue and manage a miserable eighth of a cup.  Nurse says no.  Not enough.  Drink more.  Keep trying.  She hands me another tea.  I can feel it, this flood of liquid, swilling around inside me.  I’m filling up like a tanker.

Eventually  after a few more failures there’s relief, of sorts, a trickle that the medical staff declare to be just about sufficient.   They need the bed, after all.  I’m clogging the system slowing   the flow of patients.  So long as I can just about cope I should go.

It takes a good two days before proper flow returns and a whole two weeks before the pain subsides.   It’ll happen again, I’m told.  These things, benign mostly, have an 80% likelihood of regrowth.  What causes them?  Exposure to certain chemicals, being Caucasian, getting older.  Two out three then.  Rock on.

SSSU: Short Stay Surgical Unit

Approaching Zero

The dark wonder drug lies in the drawer.  In there, behind the socks, are the massed heaps of green and white boxes containing my collection of as yet untaken prednisolone.  Open the drawer a crack and they sort of shimmer.  5mg tabs.   Full of fatness, sleeplessness, reflux and fear.  Taking these back at the beginning  the world was a desperately dark place. 

Up at the clinic, once the diagnosis had been confirmed, and the pain had magically lifted, they told me I might be on these things for a time.  There’ll be side effects, some worse than others.  You might get a moon face, a fat neck and a humped back.  Weight could hang onto you like sliding lard.  I looked up photographs of sufferers and saw them.  There was something defective and old about the way they represented themselves.  They didn’t want themselves photographed.  They smiled painfully from somewhere deep in their disability.  They were how the world was back in the 1950s only this was now.

I gave up eating, almost, and went to the gym as often as I could.  This weight won’t get me I told myself  and neither did it, miraculously.  Instead I was overtaken by a sort of paranoia, a fear of company, a dislike for being anywhere crowds were.  Didn’t do readings, didn’t go out much,  I stayed at home.

Tapering was the buzz word.  The dose would slide down the scale in a sloping line.  I began on 40 mg daily with a whole armful of additional drugs to counteract the side effects of the first.  Stuff to fix the calcium drain from my  bones, to stop the stomach acids roaring up my throat, to fix my blood.  Might take 18 months, advised the GP, to get down to zero.  In the background was the vague suggestions that for some people zero never actually came.  I read about it.  Patients who’d become sufferers in middle age and were still full of prednisolone fear when they were 80. 

But as the taper sloped, ever so gradually, the fear began to dissipate.  The nose bleeds stopped.  The sleepless nights slowed down.  The pain which had taken over all my major muscles never returned.   I got down to 10 and then 5 and then 1.  I stopped carrying boxes of the drug around with me as a bulwark against missing a dose.   Now I’m in new territory, facing days where prednisolone does not feature.  I’m through the sound barrier in a place where anything can happen.   Yesterday I took nothing.  Today a single tablet.  Tomorrow I’ll take nothing again.

Out there are prednisolone free skies.  Ones where there is no polymyalgia and no paranoia.  It’s taken three years.  What will I write about now?  How shall I continue to observe medical practise and report on the NHS?  But, given my age, I’m sure something will shortly be along.

Facet

So it goes like this.  I’m in the car driving back from the builders merchants with a boot full of home improvement requisites (batteries, screws, rubber gloves, a new saw with which to tackle the dead tree, a bucket, escutcheons, door knobs, glue) when the phone goes.  Being ultimately lawful I negotiate the bend and get myself stopped on the kerb before I take it.  With a voice sounding like something direct from Stella it’s the hospital.  Ringing me. Gosh.

It’s  UHW X-Ray here.  We want to get you in for your facet joint injection.

What?

Your facet joint injection I’ve got you down here for one. Mr Finch.  Yes?

Yes, but that request was made months ago when was in real pain.

Oh there’s a three month waiting list see love sorry can we do you Friday?

No.  I mean I was in pain, enough to boil eggs on my back at the time,  but in the nature of this cursed condition that’s passed now and I’m pain free again.  Well, relatively.   I don’t see the point.  Can I defer it?

I’ll put you down as a cancelation then.

No, don’t do that.  I needed that injection when it was the only thing available to me that could alleviate the pain and then it wasn’t available.  I had to wait.  When I rang up your department said they’d get back to me soon.  And it’s been 90 whole long days.  If I’d turned up at A&E after falling down drunk you’d have got me round to X Ray and checked my bones for breaks almost immediately.  But because I suffer from a condition (as opposed to getting pissed which I guess is just part of daily life) I’m slung on an NHS waiting list.  That’s not equitable.  I want the thing deferred so that next time condition strikes I can call down my already done waiting time and have the thing straight away.  Can I do that?

I listen but she’s gone.  It was my use of the word “equitable” I’m sure.  The line is dead.

I check the private medicine website.  Facet Joint Injections.  Available within the week.  £500.  Nye, your great vision has become terribly muddied.  I decide to go to the pub instead.

   

Alarm

Outside the hospital the smokers gather again below the Please Refrain From Smoking notices. They look the part, their faces lined and drawn. They are outside, at least, in the wind. Their hospital issue dressing gowns sop up the pervading drizzle. Inside the usual melee prevails. People on sticks, doctors in suits and gowns, nurses, ancillary staff, mothers with push chairs, a man in a turban pulling a suitcase, folk queuing for sandwiches and papers. Smith’s pushing their huge bars of chocolate, a pound a go today with any purchase, no one buying. This is the NHS shopping mall: St David’s Two without the luxury, Bluewater less the desirability. You are here because you have to be. Unless you are a record collector, that is. The Christian bookshop, stashed over there in the far corner beyond Boots, is selling off a lot of its record collection. I got Rod Stewart and the Steampacket for £2.00. I saw that band, in the mid-sixties when Rod was nowhere yet and Long John Baldry was taking the lead. The Steampacket live at Klooks Kleek. Back here in suburban Cardiff where little ever happened I lived out on that experience for months.

I’m heading for Clinic Six again, Rheumatology, home of prednisolone my friend, and hope for the future. Half way there, wending my way along the patient strewn corridors, the fire bells starts. It’s a loud, piecing scream. It throbs, it pulses. It’s incredibly loud. It enters your ear and it stays there. Your head swims in accompaniment. You begin to wonder if there’s any way you can still get your brain to carry on thinking now this sound has arrived right in its middle. I expect to see fire wardens rushing to the aid of us staggering patients or, at very least, some instruction coming from the NHS’s uniformed staff. But there’s nothing. The alarm is ignored. Staff continue to go about their business as if all this wasn’t happening. Can they not hear it? Why are they not flinching like I am? I shake my head. The sound is entering my bones and making them rattle.

Eventually I reach Rheumatology reception where the woman behind the counter tells me over the racket that because the alarm is intermittent we can safely ignore it. You mean it’s a test, I ask? Someone upstairs has burned the toast I expect, she says. She smiles. And then it stops. The air fills with silence like cool cool water. Glorious.

I’m still in pain, right leg, from the heel to the top. The pain arrives and stays for days. Does it get worse when you exercise it, the rheumatologist asks? Sometimes. Just the sort of answer I am sure she wants. I’m sent out for more tests. We have to get to the bottom of this. X-Rays, trunk and upper leg, put on the list for an MRI scan, sent to bloods to let them have just a little bit more. I feel like Tony Hancock. I’ve given them at least an armful now. Back in two weeks. There’s something happening here but we don’t know what it is, do we, Mr Jones?