This Is Not A
BLOG!
Date: 22/08/24
Ab-later
I feel that an explanation is warranted at this point for what - even by my recent standards - has been a long silence.
Back in mid-June, I got a letter from Broad Green calling me in for an appointment with one of the specialist nurses on August 6. The letter gave no details as to the specific subject matter, so I assumed that it was just a routine review, given that that would be six months since I saw Dr Narayanan.
In mid-July, I got another letter, this one specifiying that it was for the pre-op assessment for the ablation. This was to be on...August 9. Somewhat taken aback by a seeming lack of co-ordination which expected me to make the journey twice in four days, I phoned them up to query this. I was told that the first appointment was the pre-op for the valve implant, but they would combine the two assessments on the 6th to save me from the duplicated effort. For which relief, much thanks.
A few days later, I was hit by the worst spell of depression I have experienced since the glory, gory days of 2010-11. Nothing seemed worth doing (Volume Two is still in progress, if 'progress' is the word I'm looking for, which it isn't) even if I had the energy to do it. This state of affairs continued into August and, amongst other things - led to my having to give a miss to all bar the ceremony of my great-nephew's wedding (you should always try to sample new experiences in life, which led in this case to my going to a family wedding via an Arriva bus). The reporting of the court cases following from the Southport killings also re-engaged my 'prisoner complex' from that earlier period, which was an additional twist I could have done without (this is a subject I may return to shortly).
On the following Tuesday, it was up to Liverpool. The journey would have been quite uneventful but for the fact that when I got to Lime Street station, I found that they had closed the excalator from the Mersyrail subterranean platforms to the ground-level bit. I got lost trying to find the way up, and had to ask for directions. It turned out that I had to go out of the station building altogether and come back in via a different entrance. In a sense of rising panic, I reached the Scouse Overground at Platform 9 when I needed Platform 4 (which was - of course and inevitably - at the opposite end to my entry point). I made the Wigan train with about a minute to spare.
I arrived at the Willow Suite at the hospital in good time for my 1100 appointment, and was called through for the standard tests and questioning not long after, before being returned to the waiting room. Where I waited (I don't believe in needlessly breaking old traditions). About forty-five minutes later, I went through to see Julie the specialist nurse. We had a thorough discussion about both my upcoming 'procedures'. After a long chat, she asked to see my feet...
...this is not, I hasten to add, some sort of fetish on her part; swollen feet and legs are a symptom of the valve problem...
...Now, my feet and ankles have sn inner sense which means they are at their worst whenever they know that a medical professional is going to want to see them. Such was the case here, and Julie was sufficiently concerned to go off in search of one of the doctors. This left me lying there for about fifteen minutes, starting to get the awful feeling that perhaps the appendages in question were so bad that they weren't going to let me go home that day. The doctor - a consultant, no less, and a very cheerful and upbeat woman to boot - came and had a shufti, and decreed that I should increase the dosage of one of my piss pills.
And that was that. With all of this, it was 1335 before I got out. I had hoped to catch the 1354 train back into Lime Street, but I hadn't eaten since about 0630 and my belly was thinking that my throat had been cut. I went and ate my lunch in the main hospital reception area and then shuffled my way back to Broad Green station to catch the 1440. The trouble was that the underpass linking the two platforms there was still shut (despite what I had been led to believe) and - just like last time - I had to go all around the outside to get to the Liverpool-bound platform.
Getting to Lime Street, I had to navigate the diversion in the opposite direction, but arrived on Platform A in good time. The way the timetables meshed meant that I would be going back home via Bidston rather than Chester (which I was fine about, because I wasn't up against a deadline and I was fed up of seeing Rock Ferry anyway). Then a change at Bidston for Wrexham, waiting twenty-odd minutes for the bus home and done.
And 'done' I most emphatically was. I got home at about 1730, took off my shoes and coat and crashed out on the sofa. That evening, I felt at my lowest ebb since time was, my mood not helped by the fact that I had a phone call from Julie at about 1845 to tell me that my blood sample had showed a very high reading for potassium. She recommended that I drop my other piss pill entirely, since that could have been causing too much Kalium to be retained.
As August 16 neared, I found myself making a list of things I would need to take with me. Py-jams, of course, plus a pair of slacks (sorry, I mean 'lounge trousers', because that's what the label calls them) because I didn't fancy trying to wear standard lower garments bearing in mind where the wound would be; all my meds (which took up three of those sealable plastic bags you get from hospital pharmacies); my phone charger; my .mp3 player and its charging cable, because I didn't want to be stuck with someone else's choice of sounds as I had been in Manchester; two short books which I had been meaning to get around to reading since late last year. There were also one or two little administrative jobs I needed to get done which I should have sorted out long before but hadn't due to the cantbearseditude I described above.
In the end, I was as sorted as I was ever likely to be by the time my niece called to pick me up shortly before 0930 on Friday, and off we went.
The journey was uneventful, and we arrived at Birch Ward at about 1045. After a wait of about ten minutes, I was shown to my bed and Andrea headed back home.
Unlike 2016 - when I had to be put into some sort of viable condition before anything of any substance could be done to me - things moved much faster this time. What this also meant is that I didn't have much time to take things in as they were happening, so my memory of the next sequence of events is pretty scrappy. I was asked the usual questions (many of which I had answered at least once before), given much the same tests as previously (oh, hello Mr. Canula!) and finally given the standard gown and disposable drawers, which I put on once I had wrestled with the curtain around my bed to enable full coverage.
Finally, sometime around 1330, I was put in a wheelchair and trundled through the corridors to one of the catheterisation suites (known here, it seems, as the Cath Labs, if only to stop people having to spell 'catheterisation', which it has just taken me four attempts to get right). There, stood by a nurse with an unfeasibly large monitor in front of her, I gave the same responses to much the same questions as before, and was invited to clamber aboard a narrow bed. Above me was something which turned out to be an x-ray machine (and the use of it in the procedure meant that I had had to discard my blood-glucose monitor and test myself - and be tested by the hospital staff - in the old-fashioned way by the pricking of my fingers), and to my left and forward a bit was another large screen.
I don't recall if I had been introduced to Dr Ashrafi the surgeon by this point, but there was to be a thin polythene screen between me and him which meant that I saw him as if through a bathroom window. My brand bew disposable knickers were then cut on the right-hand side to enable the local anaesthetic to be administered to the entry point, and the canula was loaded with what I presume was the sedative...
...And this is what had caused me the only real degree of anxiety I had felt about all this. I was not to be knocked out, but would be conscious (in as much as I ever am) during the procedure. I wasn't at all sure about this, not wanting to be able to hear what was going on just in case there was a mutter of "Oh, oh!" from the surgeon at some point. But apparently this is the standard practice now, so all I could do was endure.
The first thing I 'endured' was the catheter being inserted. I'm sorry, but there is no amount of local anaesthetic which will blank out the sharp sensation of a plastic wire being shoved into you in the close vicinity of your home entertainment hub. Over the next few minutes or so, I found myself apologising to Dr Ashrafi for tensing up all the time. Beyond that, however, it must be said that I felt nothing further untoward. Instead, I concentrated on, for example, examining the screw-holes in the underside of the x-ray machine (which was placed either directly over me or swiveled over to my left-hand side) and staring at the blurred image on the monitor placed front left ('blurred' because I didn't have my glasses on; not that what I would have seen otherwise would have meant anything to me).
It's difficult to calibrate the passage of time in such circumstances, so I don't really know how long I had been there before I heard Dr Ashrafi exclaim, "CTI in one burn! That must be a record!". Now this could have meant anything; I've looked up that abbreviation since and can't imagine that in my case it stood for 'Computer Telephony Interface', 'Combined Taxable Income', or even 'Ceramic Tile Installer'. I think, on the whole, that 'CavoTricuspid Isthmus' is the most likely usage here. The tone of his voice suggested comfortingly that he saw this outcome as a positive one.
After a further undefined period of time, the catheter was withdrawn - a sensation which, whilst not as painful as its insertion, was nonetheless unpleasant. The polythene screen was removed and I could see - albeit fuzzily for reasons already stated - the rest of the room. Heavy gauze was then pressed very firmly into the entry point for some minutes, then the site dressed and I was ready to be manoeuvred onto a bed which had been itself wheeled into place beside me. Under strict instructions to lie still and perfectly flat thereupon, I was wheeled back through the corridors to the ward, being occasionally scolded gently for raising my head to see where we were going.
It was about 1515. A procedure which can often take over two hours had taken little more than half that time.
Back on the ward, the rule was the same, and one which applies very well to many other aspects of life: keep your head down. Luckily, I had had the foresight/craftiness to place my phone and .mp3 player on the shelf of my bedside table within easy reach even of my recumbent position. So I grabbed my phone and texted family and friends to tell them that they hadn't managed to get rid of me that easily, and to do a bit of browsing to catch up on the world (using the hospital's wi-fi, naturally). I then tried to listen to some comforting music, but was regularly interrupted by members of the medical profession seeking bodily fluids. Dr Ashrafi was kind enough to pay me a visit (which is always was a nice touch), and in the course of our conversation said that the ablation had gone so well that he would be happy for the valve implantation to go ahead any time after I had fully recuperated from this operation, although that won't be a matter for him, of course.
So I lay there in my gown and still wearing the ripped knickers. For over three hours. I had been nil-by-mouth all day. There would be no point in asking for food while I was compulsorily horizontal, but I did ask for water, which a nurse brought me in a sealed cup with a straw, which I then proceded to mis-handle and spill down my front. Any interaction with my ward-mates was out of the question, as was simply dozing off. A long, dull afternoon and early evening was the consequence. I was finally fed at about 1935, and in fairness the fish in parsley sauce with mashed potatoes and carrots would have been delicious even without the enforced fasting beforehand.
Freed from the need to avoid being perpendicular, I could now cast my eyes around the ward. When I had arrived late that morning, there were four of the other five beds occupied, all of them by men of my own age or greater. The one immediately to my right and the one opposite him had left during the afternoon, and the hitherto empty bed to my left was brought into use shortly afterwards. So there were four of us.
I Idon't clearly remember now whether I engaged in much conversation during the rest of the evening, but it was soon time for beddy-byes. In my case, this was always going to be a doomed enterprise: a strange bed, the typical background noises of a hospital, my semi-shredded shreddies and the fact that that bloody canula was still sticking into the back of my left hand even though there was nothing connected to it (I had asked - almost begged - for it to be removed, but was met with a gentle refusal); all of these combined to make even the possibility of sleep remote. At about 2300, I grabbed the .mp3 player again and listened to the latest RSA which I had uploaded to it before leaving home. Midnight, one a.m., two a.m., nothing.
Eventually it was Satuday morning, and breakfast came around shortly after 0900. Two rounds of toast and a yoghurt in my case. Then it was simply a case of either lying there or wandering around the room engaging in more conversation. We were a well-balanced ward, with two Cymry and two Scousers, and some gently joshing banter was the inevitable result. I found out that Ged - who was in the bed in the far corner - was a freelance writer, and so was able to find some common ground for our chat.
As to when I was going to be released, that was still up in the air. Julie the nurse (remember her?) had told me that it was unlikely they would hold on to me much after Saturday lunchtime, but I had started to wonder. Lunchtime arrived, and I was treated to two rounds of cheese-and-pickle sandwiches and another yoghurt. I finally had the canula removed, and was now waiting for the pharmacy to approve my medications (which had not been changed in any case). Finally at about 1300, I was able to tell Andrea to start making her way over, with specific instructions not to break her neck doing so, seeing as I wasn't going to be going anywhere in the meantime. She arrived a little over an hour later and - having of course thanked the nurse (and via her, all of her colleagues) for making my stay an easy experience, and having wished the best to Ged and to Graham the new arrival (John, my fellow Cymro, had been discharged an hour or so previously), I left Broad Green. The journey home was equally uneventful, and I got home shortly after 1540.
And now?
Well, my discharge notes tell me that I have "sinus rhythm with 1st degree AV block". So I had to go and read what that meant, didn't I? Basically, it means that there is still an arrhythmia there, but it's so minor as to be of little consequence.
That apart, there was some discomfort from the wound, although the degree of bruising around it has to be seen to be believed (thank you, warfarin!). I had muscle pains across my chest for a few days every time I coughed or sneezed, I still have to take my time a bit going up the stairs, and I can't do any heavy lifting for a couple of weeks (which is why I did a double-trip of shopping last week). Beyond that, I'm feeling quite chipper and looking forward (in a manner of speaking) to getting The Big One done before too long. Then I can have what passes for my life back.
********
I'll finish this piece with a repeat of the statement and warning which I gave in 2016:
"The people who work in the National Health Service form part of the bedrock of what is left of those progressive values which have not yet been throttled out of us by the unrelenting corporate takeover of our land in recent decades. They therefore deserve our unconditional support whenever they seek to defend the services that they provide for us.
"The whole concept of a socialised medical system is surely the sign of a civilised society, and those who would seek to take it away from us for ideological reasons - using such weaseloid formulations as 'modernisation' and 'reform' - must be fought all the way."
Given that the despoilers and looters now include not just the hard-right Faragistas and self-labelled 'libertarians' but also Streeting, the odious little student pol who's in charge of the service in England now, our watchfulness is needed more than ever.
