A Marathon

I left home on Monday morning for a post-op check-up with the surgeon. My appointment was booked for 4.30pm in Nottingham but thanks to a serious delay at the airport, I was only leaving Dublin at that time. By the time we finally took off, I reckoned that I was probably making a wasted trip. However, luck was on my side and I got to see the doc at 7pm that evening. It was 10pm when I reached my hotel for the night. By the time I crawled into bed, I felt like I’d run a marathon.  I’m still waiting for my medal!

My surgeon is a gem and he’s done a fantastic job on my head. He spent at least an hour working on my head endoscopically on Monday evening.  Firstly, he removed the stitches holding the splints in place inside my nose and with a firm yank, out they came one by one.  Not a pleasant sensation but to be honest, I’ve had worse over the years. He then started the process of ‘hoovering’ out the large cavity in the centre of my head. I kept my eyes tightly closed throughout as it was not pleasant. After some time, he asked me to open my eyes and watch the screen behind him. There on the monitor was the inside of my head!  It was incredible, just like the keyhole surgery you see on television. He continued to work on my head, removing a dressing from somewhere deep inside while I watched. It was fascinating stuff. He pointed out large areas of white bone and explained that these are exposed areas of my skull which are healing nicely. At one stage, I told him that I could feel sharp pain on my forehead, up near my hairline.  “That’s exactly where I am”, came the reply.  Gulp! I return in 4 weeks for another session.

One of the side effects of this radical surgery is that I’ve lost all sensation of smell and taste. I was told that it could be a permanent loss. I found this very hard to accept at first but I’m gradually coming to terms with the fact that I can’t smell or taste my beloved coffee and food holds little interest other than filling the stomach. The good news is that since Monday, I’ve had a very slight return of both taste and sense of smell but it comes and goes. It’s early days yet in the healing process so fingers crossed, I get to smell coffee again soon.

The following morning as I sat in the main square in Nottingham eating my hot breakfast roll in the sunshine, it felt good to be alive. I was supposed to be attending Wimbledon that day but I wasn’t bothered. I’d just won my own marathon.

This one is specially for Grannymar…

Don’t Laugh!

Day 2 post-op. Still in a theatre gown and with several drips attached, I decided fresh nightwear and a proper wash was in order. I hobbled off down the corridor to the nearest bathroom, trailing my drip stand behind. My Dad was right, you do learn something new everyday. You have been warned.

I got the theatre gown off without any difficulty and after a good wash, changed into a fresh nightdress. On dropping my Bridget Jones’, I suddenly realised that I had a problem. With two drips still attached to my left foot, there was no way I could get my knickers off! I debated going out to the nurses station to get disconnected but then my determination to succeed took over. I was not going to be defeated by this challenge. Can you work out how I managed?

I tore the original pair and discarded them in the bin. That was the easy part. To get the fresh pair on, I had to thread them over the top of the drip stand, then carefully over both drips, all the way down the stand and finally, I stretched them over each of the four legs, one by one. By that stage, I was totally exhausted from all the exertion. And you’ll never guess what? When they got to my foot, they were upside down and back to front so I had to start all over again!

UPDATE: When my son read this post, he asked (quite logically) why I didn’t unhook the drip bags from the top of the stand, to make the job easier. The answer? One of the drips was led through a pump which was fixed to the drip stand. He’d a good laugh at my expense anyhow!

Tie a Yellow Ribbon

I’m coming home. I’ve done my time. Now I’ve got to know what is and isn’t mine. It’s been three long years six long days in the UK. I’m ready for home.

I was discharged from the hospital on Saturday and have spent the last few days resting-up at a friend’s house near Birmingham, in preparation for the flight home. It’s been bliss to be able to recuperate in peace and quiet without the constant disruptions of hospital life. My post-operative path has been more rocky than anticipated but the surgeon is now happy for me to fly this evening. Things have already begun to improve following a change in medication so I’m confident all will be well. I return to Notts next Monday for follow-up.

Thanks for all comments and well wishes. I will catch-up with you all once things settle down a bit. So much has happened, its gonna be hard to know where to start. See you on the other side of the pond.

It’s A Beautiful Day

It’s 7am Friday and barely 16 hours since I came out of the operating theatre. I’m still on hourly checks in an observation room with drips attached to my hand and foot, a morphine pump and an oxygen mask. Otherwise, I’m in remarkably good form. Best news of all is that the surgery went really well yesterday, the surgeon is happy with his handiwork and I’ve had no post-op complications. Today marks a new me and there’ll be no stopping me now.

Yesterday’s surgery took longer than expected, four hours to be exact. No cutting this time, just lot of drilling with the removal of diseased bone.  It was all done endoscopically through my nose by image-guided surgery. I spent two hours in the recovery room afterwards before being transferred back to the unit. The pain is well controlled by a morphine pump which I can dispense as needed. My surgeon has been fantastic, totally determined to get the best result and amazingly attentive and caring.

The NHS has scored 1/10 on nursing care (more anon).

Hubby 12/10!

More to follow.

Check ‘N Go

I’ve booked so many flights over the last few days, I really don’t know whether I’m coming or going. I seem to have multiple trips to Nottingham booked and also a return ticket to London for Wimbledon but I’ve a little hurdle to get over between now and the tennis.  I’ve got a date (not THAT sort of date, Grannymar) and I’ve got funding too.

It’s been some week.  Since hearing of the date for my surgery in Nottingham, I’ve been struggling to get funding organised for the operation. When you require treatment outside Ireland, my health insurance company stipulates that you must gain prior approval for funding. There is a long list of criteria to be met and even though I hold comprehensive insurance, funding is automatically refused if surgery proceeds without prior approval. As very short notice was given for my surgery, an urgent application was submitted for approval and we waited with baited breath all week. Thankfully, the green light was given on Friday so now my surgery can proceed.

I travel to Nottingham early tomorrow for admission to a specialist unit at the hospital where I will be prepared for image-guided surgery on my head the following day.  A recent CT scan has revealed further osteomyelitic changes in the bone above and behind my right eye. This diseased bone is in close proximity to the frontal lobe of my brain hence complex surgery is required. Years of severe sinus infections with abscess formation have left the area well-scarred.  All being well, the endoscopic surgery should be completed in 2-3 hours and I hope  to be able to return to Ireland by early next week.  That’s when the fun really starts.

Surgery for chronic osteomyelitis involves detailed follow-up. Long-term antibiotic treatment is required and I will also have a drain exiting near my eye for several weeks post-op. This drain will be used to irrigate the operated area daily with targeted drugs.  I will be taught how to carry out this procedure myself while in hospital so that treatment can be continued at home. I will then return to Nottingham again for review and to have the drain removed.

When I first heard of the date for surgery, my heart fell as I have two tickets for a day at Wimbledon. I entered my name into the public ballot last autumn and hit lucky by getting two tickets for Court No 1.  This was like a dream come true so I didn’t hesitate in purchasing them along with flights to London.  News of my surgery initially dashed these plans but I haven’t quite given up hope yet.

My review in Nottingham happens to be on the day before I was due to travel to London to attend Wimbledon. I will fly to Nottingham for the check-up and overnight there before returning to Dublin.  However, I have a second plan up my sleeve which if it works out, will be a real coup. If I feel well enough after my check-up, I plan to travel on to London by train to overnight with my twin brother who will accompany me to Wimbledon the following day. I’ll then spend a second night in London before returning home on the flight I originally booked many months ago.  This probably all sounds a bit daft right now but it’s where I have my sights set. If I do make it to Wimbledon, it’ll be the best tonic ever.

My long suffering hubby will be with me in Nottingham and so I hope to have occasional access to his laptop while in hospital. I will do my best to update you on my progress and promise not to scare you with any gorey details. I would really welcome comments and while I may not always get to answer them, I would still love to hear from you.  On that note, it’s time for me to Check ‘N Go and get organised for tomorrow. I’ll be back soon!

Got the Call

Our phone has not stopped ringing since last Friday and emails and texts are arriving by the minute. It seems that everyone who ever knew and loved my dear mum-in-law, wants to attend her funeral service next Saturday. As many people will be travelling by air, they are making a weekend of it and so it’s rapidly turning into a 3-day event. It’s gonna be a busy weekend. What was that I heard about getting rest?

It’s a bank holiday here today so the hubby and I set-off on an early morning walk to clear our minds. Our peace and quiet was soon disturbed by the sound of my mobile phone ringing. It was Nottingham letting me know that my operation had been scheduled for Friday. Help! I pleaded exceptional circumstances in light of the funeral on Saturday and managed to get the surgery postponed to the following week. The date has yet to be confirmed.

Frankly, this is one call I could have done without today. As Nancy says, it never rains but it pours around here! You’ve gotta laugh.

A Real Supergran

I feel very out of touch with the blog world.  It’s been a roller coaster week here.  It’s got to the stage where when the phone rings, my heart falls.  No news, really is good news.

It all started on the day of the Heineken cup rugby final when my father was rushed to hospital by ambulance with chest pains. After an anxious wait in A&E, news came through that his pain was non-cardiac in origin and so once my dad’s condition had stabilised, he was discharged back to the nursing home.

The following day, my mum-in-law’s health suddenly deteriorated and we were told that her end was nigh. Thus begun a round-the-clock family vigil at her bedside which lasted for five days.  She died peacefully on Friday surrounded by her nearest and dearest. Her funeral will take place next weekend when family and friends will gather from around the world to celebrate a dear life. She was a wonderful mum and a real supergran and will be deeply missed.

In the midst of all this, my son Robin woke last Friday morning with a very swollen foot. He was due to leave at lunchtime on a walking holiday with friends so we had to act fast. His problem was solved by a visit to a VHI SwiftCare Clinic which had him assessed and processed in less than one hour and on his way to Kerry. The following morning Robin phoned to say that the swelling had moved up his leg and a phonecall to SwiftCare confirmed that he should return home.  I collected him off the train several hours later and ferried him back to the clinic for re-assessment. Again, Robin was seen very quickly and thankfully, this time the news was better. He was instructed to rest-up and allow the antibiotics to take effect. SwiftCare is a privatised clinic funded by a health insurance company, to deal with minor injuries and illnesses. I could not fault the care that Robin received there. It would have been a very different story had we attended the A&E department at our local hospital. By lunchtime today, Robin was back on the train to Kerry to re-join his friends.

Thankfully, today has been a rest day.  There’s been no news as yet on a date for my surgery.  Right now the silence from Nottingham, is a welcome reprieve.

A Lost World

Alzheimer’s Disease (AD) is a degenerative condition. It is fatal. The disease can last anywhere from 3-20 years but averages 7-8 years. The first sign is memory loss followed by personality changes. As AD progresses, the afflicted individual becomes disoriented about time and place and tends to exercise poor judgement. People with Alzheimer’s have an increasing  dependence on others and require round-the-clock care. The personality changes, cognitive lapses and eventual demise of a person with AD are extremely difficult on both patient’s and their loved ones. All is not lost however.

My parents both suffer from this progressive form of dementia and are in long-term residential care. Their world has shrunk to tiny proportions and they are oblivious to what goes on outside their own world. Happiness comes down to physical comfort and company. Family visits are a huge source of comfort to them both.

While sitting with my Mum in the Alzheimer unit yesterday, the lady in the bed next to her was very agitated. Doreen* is normally cared for at home but had come into the unit for a short period of respite care to give her family a much-needed break. Despite being very well looked after, there was terror written all over her face. Doreen’s world had fallen apart, she was ‘lost’ and required constant reassurance from the unit staff.  All afternoon she shouted “hello, hello” to anyone who passed and it was hard not to be moved by her anguish. When my Mum fell asleep, I finally got a chance to give Doreen the company she craved. The look of relief in her face will stay with me for a long time. She grasped my hand and tried desperately to find the words to express herself but the words would not come. I chatted to her calmly and told her that I understood why she was upset. Gradually she relaxed and then the tears came.  We hugged and I reassured her that I would come back soon for another chat.  That’s when I got rewarded with a most beautiful smile. Doreen was back on track and even though I knew it wouldn’t last, it made my day.

* Not her real name

You’ll be alright, duck!

Riding through Sherwood Forest on the bus yesterday, I sat in silence. My daughter had kindly accompanied me for the day but as the bus hurtled back towards Nottingham city centre,  I didn’t feel like chatting. My mind was still trying to come to terms with the news I’d just heard. I have to return for more surgery again. The adventures of Robin Hood Steph continue.

My return to see the head and neck specialist in the UK was arranged by my surgeon in Ireland. More expert advice was needed to manage the recurrent infections in my head. I was previously referred to the same specialist two years ago for major surgery to stamp out a chronic osteomyelitis in the frontal bone of my head. This operation was very successful but over the last year, I’ve had intense bouts of pain in the bone around my right eye and repeated infections which antibiotics have failed to control.

When the specialist looked at my CT scan yesterday, the cause of the pain soon became apparent. An abnormal pocket has developed in the bone deep behind my eye and close to the brain. The thickened bone has split causing an abscess to form. Complex surgery is required to take away the infected bone and relieve the pressure behind my eye. Unfortunately, this will require image guided surgery and means a referral to yet another surgeon in the same specialist unit. I will have to return to Nottingham again shortly to meet with the new surgeon and have specialized scans in advance of surgery.

This outcome is not at all what I’d anticipated. I had hoped that the recent scan might offer some welcome reassurance but it was not to be. I’m still reeling today from the news and not helped by a nasty head cold which has left my ears blocked following the flights. The good news is that I’m in fantastic hands so no worries there. The surgeons are the tops, I couldn’t hope for better. The impending surgery while complex, is minor compared to the some of the stuff I’ve been through. As they say in Nottingham, “I’ll be alright, duck!”

Image source: Camera phone en route to appointment.

Finger on the Pulse

Right now this country lacks leadership. George Lee, the well-known economist, has thrown in a well-paid job with RTE to put himself forward for election. There’s no doubt that he has the expertise needed to sort out the financial mess in the country. I’m reassured by his knowledge and feel sure that given half a chance, he’s the right man to iron out the problems in our economy.  Now wouldn’t it be good if some more bright sparks were to declare themselves willing and able to sort out our ailing health service? Harney and Drumm have clearly lost the plot. New blood is desperately needed.

Here’s a viewpoint from someone who does have a finger on the pulse. I’ll be back soon.

Overcrowding in A&E

Madam, – Can anyone explain why the persistent and dangerous overcrowding that afflicts Irish emergency departments remains unsolved and ignored? This Government moved very swiftly to deal with inadequacies in cancer services in the past two years when clinical errors, which had been highlighted in the press, made it obvious that improvements in service organisation and delivery were essential. Key elements in that improvement process were: a political will to sort it out, an analysis of the service as it was, a redirection of funding to key areas, reorganisation of services and, most importantly, co-ordination of all of this by the cancer tzar, Prof Tom Keane.

Emergency departments in the UK were the victims of overcrowding with in-patient boarders for many years, but the public outcry and the media’s persistent reporting on it was enough to stimulate Tony Blair, the then prime minister, to demand an improvement. What followed was a process that was a mirror image of what we have seen with cancer services here and, under the guidance of their emergency services tzar, Prof George Alberti, the problem was largely solved within two years.

What do we do in Ireland? Yes, we recognise that there is a “National Crisis” (Mary Harney 2006) and we set up a taskforce which produced an excellent document on changes required to improve matters (June 2007), but we fail to appoint a credible co-ordinator/implementor and we ignore all of the recommendations of the Taskforce Report.

Such inertia has not just led to a retention of the status quo, but to a gradual and serious deterioration of the care of patients presenting to emergency departments. There is ample evidence internationally that overcrowding of emergency departments with admitted patients puts them at a significant risk of medical complications and death. In that regard they are no different to the plight suffered by cancer victims in the past. Why then do the HSE, Professor Brendan Drumm and the Minister for Health and Children, Mary Harney, continue to obfuscate on this matter? – Yours, etc,

AIDAN GLEESON,

Consultant in Emergency Medicine, Beaumont Hospital, Dublin.

Source: Irish Times online