Bonkers Part 2

The allotted day had arrived.  Even worse it was Tuesday.  Tuesdays are rubbish for me.  Luckily, we are in exam season.  So, I left my class in the hands of a bemused admin assistant to invigilate yet another mock exam for them.  They took this quite well apart from my manager who still signs off any email I send her about my appointments with, “if you could rearrange this when you are not teaching next time.” Yeah, right.

The ENT department is split into two reception areas.  Normally I am in the second reception area around the corner.  I approached the first reception area, feeling nervous.  The receptionist was on the phone speaking loudly.

“Yes, it’s on the FIFTEENTH.” Pause. “Not SIXTEENTH.  ONE FIVE.” Pause “We’ll send you a letter.  A LETTER.”

She hung up and rolled her eyes.

“Yes?”

I said my name and Dr Q’s name.

“Well it looks like you are here today.” She said sounding quite surprised. “Take a seat.”

I obeyed and got my book out.  After about twenty minutes I noticed something.  Patients were being called out two at a time, going through some double doors and not returning.  Bit worrying that.

After about forty-five minutes mine and another patient’s name were called.  We were escorted by a nurse through the double doors into yet another waiting room.

“I’m sorry but it’s another hour wait from this point on.”

I was on my own but the other patient had his wife with him.  We all sighed in unison.  He reached for his phone and both his wife and I resumed our books.  We were lucky.  After about twenty minutes, the couple were called through.  This took the wife by surprise. She spent a good deal of time faffing about much to the amusement of the nurse and her husband.  I smiled and carrying on reading.

After another twenty minutes, I was called through.  Where had the couple gone?  It was my turn for a bit of awkward faffing.  The nurse led me to a room where sat Mr Q looking immaculate as ever.  I sat opposite him. The nurse took a seat in the corner of the room, facing me.  Mr Q and I exchanged pleasantries.  The nurse looked bored.  I was the last patient in the clinic so it must have been a long morning.

“So, can you remind me why you are here?” asked Mr Q.  I gave him a detailed account of the last six years.  It felt quite strange being encouraged in giving such details.  I have become so used to giving quite a watered-down version of events.  He listened and made notes.  After my history, he asked me to do various facial exercises so he could check out how much movement I had in the left side of my face.

“OK.  What for you is the most important thing to be done?”

I was flummocked by the question.  I’ve never been given a choice before.  I remembered our previous appointment.  He had said the he didn’t want to tread on the toes of the eye people.  So, I said I wanted my mouth sorted and then maybe the eye.

He looked puzzled.

“If you want my opinion, you need to get the eye sorted first.  I’ll refer you to Dr S to advise you on that…”

He outlined a possible procedure that involved cuts to my lower eyelid and weights that could be either gold or platinum, inserted in my upper eyelid to ensure my eye closed properly.  Crikey.  But this was merely the beginning.

Once I had had my eye sorted, then work could start on my mouth.  There were three options:

  1. A hoik up. This was the easiest procedure. He would cut along the smile line on the left side of my face. Hoik it up. Cut behind my ear and use a bit of my thigh to replace any facial tissue he had to get rid of.
  2. The thigh nerve. He could take a muscle from my thigh that had a nerve in it. He would attach this to my face and attach the nerve to the nerve endings near my temple. I then could have a faint smile. I think he ruled this one out as he felt that I didn’t have enough nerve endings in my left temple. Lovely.
  3. The nerve graft. The complicated one. A piece of my right facial nerve would be stretched to the left side of my face. Once it had been grafted over, a piece of muscle could be attached to it and over time, I would be able to smile. This would involve two operations. Although he had done the procedure before, he felt I would be better going to a specialist centre for this op. The centres were in Newcastle, Birmingham and…erm… East Grinstead.

It was a hell of a lot to take in.  I was used to no options.  If there was an option there was only one and I had to have that otherwise I would die.  Part of the reason why our house is in a state in disrepair is because my husband and I are rubbish at making choices.  We are both ditherers.  Now I was being asked what choice I wanted to do with my face.

Mr Q picked up on my anxiety.

“Listen.  There is no rush in any of this.  We can take our time.  Come back and see me in a months’ time and we’ll talk about it further.”

I nodded and looked to the nurse for some reassurance.  She looked blankly at me and escorted me out of the building.

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Confessions of a Junior Doctor

A&E was packed.  Doctors and nurses were running around all over the place.  This must be in London, Birmingham or Manchester.  One of the great cities of the British Isles that are groaning at their seams.  But no.  This hospital was in Northampton.  It was full to bursting and severely understaffed.

None of this is the fault of the staff.  Nor is it the fault of the patients.  The NHS is a victim of its own success by pushing the boundaries of medical care.  We are living longer than ever before.  Something that our politicians are finally recognising. The problem is that the other vital infrastructure needed to support this, hasn’t caught up.

Governments think of everything in the short term.  This way of thinking has slowly dripped down into all aspects of life.  This short term thinking is in direct conflict with the long term planning that the NHS is crying out for.  It operates by using targets to prove efficiency.  A hospital or a school isn’t a machine.  You don’t pump one thing in one end and get a product at the end.  People aren’t commodities.  Yet the management strategies being adopted fail to recognise or question this.

Healthcare, as well as education and to some degree, law enforcement, involves dealing with the whole individual rather than the illness, the exam or the crime.  The only place where this is really done in society is when someone wants you to buy something.  Go to any car dealership and they are trying to find out every aspect about you to find a car suitable to your needs.  The same goes with property and estate agents.  You are even asked for your name when you buy a coffee which puts in perspective one of the junior doctors who had been so busy, she didn’t have time to remember her patients’ names.

This is something the junior doctors in Confessions of a Junior Doctor know all about.  We saw an oncology junior doctor being brave enough to tell her consultant that she wouldn’t be hurrying her rounds.  Her superior was informed that if she didn’t take the time to reassure and listen to one particular patient, he would get extremely anxious and possibly talk of suicide.

On another ward, another junior took the time to find out why a relatively healthy twenty year old man was only weighing four stone.  What he discovered by just listening, was that the patient was using cannabis heavily.  Although cannabis is famous to inducing the munchies, if overused, like alcohol, it can suppress appetite.  I thought the consultant was going to kiss the junior doctor for discovering this.  The man had often been in and out of hospital and he was a bit of a mystery. Yet the junior doctor found out the root cause of the problem just by listening.

Such stories give you hope that all is not lost.  But these are doctors who are going against the system.  They are doing what they think is right, not what some of their superiors want them to do.  Now they can just about get away with it.  Whether they could get away with this in five years’ time, no one knows.

Supervet

Our family have never been big on animals.  Although both my parents had dogs when they were younger, full time jobs and living next door to a main road put a scupper on me and my sister having such luck.  Goldfish and that was the limit we were told.

When the C bomb dropped, I decided to reduce my teaching hours.  Part of this was health related and part because I wanted to do what I wanted to do. After much umm-ing and ahh-ing we decided to get a dog. What dog was the next question. I didn’t want a small yappy terrier type dog.  We had lived next to one when I was a child and it scared the bejesus out of me and my sister.  I didn’t want a puppy either.  I wanted a fully developed, mature hound.  I’m not sure how we chanced upon greyhounds, but we did.

A visit to a retired greyhound sanctuary was booked just to have a look.  Word to the wise.  You never visit an animal shelter for a look.  Sookie was the first and only greyhound we walked.  My husband, who had owned two rescue dogs previously and therefore an expert, decreed that she was the one.

Papers were signed, home visits conducted and in a couple of weeks we had a fully formed greyhound snoozing on our sofa.  They don’t really warn you, but it’s a life changer.  I can’t image what life was like before.  She is so much part of our lives now.  It would feel strange not to open a packet of cheese and not feel a nose by your elbow.

A programme that documents this love so well is Supervet.  The Supervet in question is Mr Neil Fitzpatrick. There is no alter ego or costume change. It is just Neil Fitzpatrick.  But he can do remarkable things.  He can make legs where there are none in a whole range of animals.  He screws, welds and hammers all manner of stuff together. He does all this in the wee small hours, after his surgery closes. It’s clear to see that it’s his passion.  His life is the animals in his care.  He lives and breathes them.  It’s hard to say if he gets this passion from the animals or the owners.  Possibly a mixture of the two.

Before I had Sookie, I never watched Supervet.  I couldn’t see what the fuss was about.  A dog is a dog at the end of the day.  Since getting our hound, I watch now with enthusiasm and awe on what can be done.  It makes you think that if such possibilities are available to our best friend, what wonders are there for all of us.

Melissa had used her organisational skills to the max and had arranged an appointment for me with Dr B and Mr Q, a plastic surgeon.  My eye issue could now be sorted for once and for all.  The allotted day and hour rolled around.  Back in the lovely ENT waiting room and they were running late.  My appointment was at four and we were well into Flog It.  I wasn’t feeling optimistic.

At quarter to five, I was called through.  Dr B and I exchanged niceties, twiddling our thumbs for the man of the moment to make his appearance.  When he did arrive, it was a bit of a let-down.  He snuck in without much fanfare.

What I’ve noticed during my cancer “journey” is that most health care professionals match their job descriptions. GP’s are often quite “general” because they know a little bit about everything.  This means that they can be vague in certain scenarios.  Junior doctors are eager to please.  They don’t want to mess up.  They take detailed histories and agonise over any decision.  Registrars are smug.  They know it all.  What they don’t need are patients cluttering up their day. Consultants are a mixture of junior doctors and registrars, but in a milder form.  Nurses are the glue that hold everything together.  They are the warriors at the frontline implementing the various plans that are devised to make everything OK.  As for surgeons, they are clear and precise.  They are like the surgery that they perform.  They don’t sugar coat anything.  It’s a bit like talking to a scalpel, if that makes sense.

Mr Q was no exception.  He was scanning my face and thinking of all manner of things.  I explained that I wanted the left side of my face hoiking up.

“Oh yes… we can definitely do some hoiking…”

He outlined a whole range of possible procedures.  I wasn’t really listening.  They seemed to involve cuts on my smile line, cuts to the back of my head and at one point thigh muscles were mentioned.  When he finished, he took out his phone.

“OK.  I can see you in my clinic on 2nd May. Is that OK?”

I nodded feeling cock-a-hoop.  Who cared that the 2nd May was the Tuesday after the May Day Bank Holiday when I would have had to rush back from North Wales from celebrating my Auntie Claire’s 80th birthday?  Who cared that I also had a full day of teaching that day which would be a nightmare to cover, especially with exams in the offing? The man had a plan and that was all I cared about.

Doctors

I love Doctors.  It has to be one of my guilty pleasures in the daytime TV schedule.  It’s also something of a dark horse.  It has been on our screens for some 16 years now, yet aside from the terminally ill, the elderly and maternity leave mums, no one seems to have heard of it.  It seems to be taking a break from our TV screens to make way for the Olympics, but I hope it returns soon.

Doctor is a continuous serial drama (oh go on then… soap) that is set at a GP surgery in the fictional Birmingham suburb of Letherbridge.  The stories in Doctors normally follow two strands.  One strand will involve the doctors, nurses and receptionists at the doctors’ surgery.  All sorts has happened to them and compared to some soaps, it does have a very high turn around rate of staff.  Whether this is true of all GP surgeries, I have no idea, but I suspect that the death toll of staff at most GP surgeries may not be quite as high as those in Doctors.

The second strand involves the patients of the surgery.  Sometimes it is a bit like Casualty where they identify someone at the beginning and then they have some kind of medical incident that will then involve them having to visit the doctors’ surgery in Letherbridge in order for it to be resolved.

It’s this reason that I love Doctors.  They are not afraid of taking risks.  I have seen storylines involving child prostitution, domestic abuse, drug abuse, euthanasia, police brutality, anorexia, all at quarter to two in the afternoon.  My mum also loves Doctors and she told me that apparently a lot of new scriptwriters, directors and other TV crew use Doctors as a bit of a training ground.  This sometimes is quite clear to see as some episodes are dramatic masterpieces while others fall flat completely.  However, it’s this boldness that I like.  The two strands means that you have the excitement of a new story but the continuity of the characters from the surgery that somehow, holds it all together.  It can be a bit twee and middle class at times, but then again it is about a load of doctors, so that may not be too much of a surprise.  But the way that they often leave storylines opened ended with no full resolution at the end is often quite realistic, especially where health matters are concerned.

The day of the operation eventually rolled around. So there I was at eight o’clock in the morning on 19th January 2011, sitting on the edge of a bed while a nurse explained to me how a hospital gown operated.  She was mid-way through her preamble when an anaesthetist rushed in carrying a clip board.

“Urm… I’m sorry to interrupt, but we need you in surgery straightaway…”

The nurse looked a little startled and I was told to quickly get undressed and put the gown on immediately.

After I had done this and was sitting up, in the bed, the anaesthetist gingerly approached the bed.    He was quite short and stocky with a mane of dark hair and a beard.

“So Mrs Read, could you confirm your date of birth for me?”

I went through all the normal hospital protocol and he quickly ran through the precautions of the operation.  I signed the consent form and he drew on the left side of my face and neck to show where they were going to operate.  That was a bit reassuring.  Heaven forbid they actually take out my kidney by mistake.

A porter magically appeared and I was rushed, quite quickly, to the operating theatre. I was put to sleep and my last memory was looking at the clock in the anaesthetist’s room and it said a quarter to nine.

When I came round, back in my hospital room it was half past three.  Blimey.  It must have been a pretty big operation.  I generally felt OK if a little sore.  I always became aware of something protrubing from my neck.  I slowly turned my head to the left and saw two transparent tubes coming out of my neck.  I slowly began to sit upright on my bed, to see what the tubes were attached to.  They were attached to two small jars that looked a bit like milk bottles.  These milk bottles were sat in a little cage that looked a bit like a milk bottle carrier that you see milkmen use.  In the bottles, there was blood.  Mmmm.

About five minutes later a nurse came in to check my temperature, blood pressure and the amount of oxygen in my blood.

“Ah… you’re back in the land of the living I see..”

“Just about… what are these?” I said holding up the bottles in the cage.

“They are your drains.  When the blood reaches a certain level, we will remove them for you.”

“When will that be?”

“Well everyone’s a bit different, but probably not for a day or two…”

Great.  That meant no shower, going to the loo being a bit nightmare and not much sleep.  Still I was alive so that was a bonus.

Visiting time rolled around and although my parents, my sister and my husband all said how marvellous I looked, you got the distinct impression that they were a bit shocked.  It wasn’t until I nipped to the loo and saw a reflection of myself that I saw why.  I had a massive scar that started from my left shoulder and arched all the way round to behind my left ear.  However it was the left side of my face that was more shocking.  As the tumour had wrapped itself around one of my facial nerves, Mr C had to remove the nerve during the operation.  The result of this was that now, the left side of my face hung limp.  I tried to smile but it was only a half smile.  When I spoke, only the right side of my face moved so it looked a bit like an Elvis Presley lip curl. Ah huh huh.

I was mortified.  I knew that would be some facial changes but I wasn’t prepared for this.  When I came out of the bathroom, Mr C was there with his registrar laughing and joking with my parents.

“Ah there she is. How are you feeling?”

“What have you done? I can’t believe I look like this…”

The room became silent.

“Well from our perspective, the operation was a success.  It was a long one. You have been through quite a lot for today so it’s understandable that you feel a bit emotional.  I’ll pop in a see you tomorrow to see how you are…”

We chatted a bit more about the drains and then off he went, looking a bit emotional himself.

“Well love, we’ll leave you to it.  You’ve had a long day and we’ll come and see you tomorrow.”

And off my visitors went and I was left with two drains sticking out of my neck, trying to work out how to get some sleep.

A couple of days later I was discharged and ready to go home. I remember on the drive home, feeling completely detached from the world around me.  People were getting on with their lives and as it was a Saturday, that involved shopping.  As we pulled up at some traffic lights I was amazed by these ant like people busying themselves, hustling and bustling and for what?  A new colander from Wilko’s.  Some dog food.  A haircut.  Treats for the kids.  The normality of it all seemed so removed from me.  I was a little bit scared of it. Would I ever get back there?  Would I always be someone who had to be ferried somewhere like some precious cargo that could never be exposed to sunlight? It all seems a bit dramatic now and doubtless medication was clouding my judgement at the time.  But I knew, ever back then, life would never be the same again.