Checking-In

My bum hadn’t even touched the seat when I heard my name being called out. It seems not everyone was prepared to brave the elements today as there was no queue and I was in and out of the hospital in double quick time. If only the health service worked like this all the time!

I struggled through the slush and biting easterly winds this morning to get to my hospital appointment. Having examined my head endoscopically, my surgeon was pleased to report his findings. While the three-times-daily sinus wash-outs are not a lot of fun, they seem to be doing the trick. There is no evidence of infection in my sinuses at the moment.

We then discussed the recent swab result and it’s consequences for me. As I’m clinically well right now, I do not require antibiotic treatment despite my positive MRSA status. However, should I develop an acute infection, I’ve been instructed to report to A&E as I’m now resistant to so many antibiotics, I can only be treated with hospital-prescribed antibiotics.

I left the hospital with a prescription for an antibiotic nasal ointment which is an effective topical treatment for methicillin-resistant Staphyloccus aureus (MRSA) and also instructions to continue doing the wash-outs.

I’m now officially on holiday from the hospital until after Christmas. Fingers crossed please, this holiday doesn’t get cut short.

Reasons to be cheerful

I don’t need to be admitted to hospital…Having consulted my GP about the latest infection in my head, he advised that I should be admitted to hospital for IV treatment. With my extensive resistance to antibiotics, treatment is limited to antibiotics which can only be given under hospital supervision. With a heavy heart, I presented myself for admission through A&E yesterday morning. After a long day of tests and assessment, the doctors concluded that I did not need to be admitted to hospital.

The infection is not systemic… While the recent swab analysis showed resistance to the antibiotic which saved my bacon last year, as well as resistance to methicillin (MRSA), yesterday’s tests confirmed that I am not systemically unwell with the present infection and therefore there is no need for intensive antibiotic treatment.

I was assessed by a new doctor… My own consultant was unavailable and so my care was overseen by his senior registrar whom I’d not met before. This worked to my benefit as it meant that my head was fully assessed from a new standpoint. Following a thorough endoscopic examination (the surgically altered internal anatomy of my head earned some interesting comments as he’d not seen anything like it before), I was sent for a CT scan.

The scan ruled out any serious complications… Reassured by the scan result, the doctors decided to opt for conservative treatment. I’ve been commenced on a rigorous regime of daily sinus wash-outs with a hypertonic saline solution. It’s not pleasant but if it manages to flush out the infection without recourse to systemic antibiotics, I’m happy.

It was heaven to come home to my own bed last night… When you are admitted to hospital with a positive MRSA status (colonization or infection), you have to be nursed in isolation to prevent cross-infection. In the hospital which I attend, all MRSA cases are put into a large isolation unit as they do not have en-suite single rooms. I had been dreading going back into this particular isolation unit.

I awoke this morning secure in the knowledge that the right decision has been reached… Conservative treatment is the right decision for now. It makes no sense to bombard my system with potent antibiotics just because I’ve tested positive for MRSA. While pus is discharging down the back of my throat, I’m not having severe headaches and I feel reasonably well. I’ve been instructed to return to the hospital if my symptoms worsen but otherwise I will be reviewed in a few weeks time. I told you I was in good hands!

I’m enormously grateful for the messages of support received over the last few days. It’s a real pleasure to bring you this good news.

You win some, you…

The good news is… I’m on the mend.  The bad news is… I missed a weekend away with good friends. You can’t win ’em all, I suppose?

I was a bit “under the weather” last week. The back of my throat felt congested and my chest was a bit wheezy but as I’d no cough or cold, I concluded that the symptoms were probably viral in origin and not a cause for concern. I was wrong.

On Thursday evening, the congestion in my upper throat gradually turned sore… very sore… and I began to feel distinctly unwell. I tossed and turned all night in discomfort and while my throat had eased by the following morning, I’d developed severe pain in my head. I now had all the signs and symptoms of a bacterial infection which had homed in overnight on the vulnerable area of my head and I knew treatment was urgently required.

My GP took one look at me and sat down to write a letter to the admitting doctor at the hospital where I’ve been treated on many occasions for the severe infections in my head. However, luck was on my side on this occasion.

Being a Bank Holiday Friday, my GP agreed to let me go home to my own bed armed with oral antibiotics and a concoction of opioid pain relievers, with the promise that I would report to A&E if my condition worsened.

To be honest, the rest of the weekend is a bit of a blur… thanks to whatever was in that prescription. All I can tell you is that the pain in my head has now eased and the worst is over. While I missed out on the holiday with friends, I’m very happy to have avoided being admitted to hospital. Not only is the battle won, I feel like I’ve won my own lottery.

Memories

When I got out of bed this morning, I knew there was something significant about today’s date but I couldn’t think what? Having escorted my husband to the private hospital where he’s undergoing a minor operation today, I drove home deep in thought. It was another few hours before the penny dropped and then the memories came flooding back.

This day last year, I was re-admitted to a large, public hospital via the emergency department having been at home for only 6 days following a week of IV treatment in the hospital. I’d developed a nasty infection in my head following an operation some weeks earlier. At home, the pain in my head had gradually increased to a point where I could no longer bear it and I knew I needed help. As I sat in A&E going through the process of admission, the swelling around my eyes began to visibly worsen so I was rapidly hooked up to several drips and put in the queue for transfer to a ward. As luck would have it, a bed was found within hours and this was to become my home for the next twelve long days.

On arrival in the ward, my first reaction was the gloominess of my surroundings. I was transferred to a bed in a dark, cramped corner of the ward where I lay exhausted but grateful to have escaped A&E so quickly. On looking around the room, it soon became obvious that I was the youngest by far, by at least 25 years and I’m no spring chicken myself! Two of the patients were bed bound, a third was a psychiatric patient and the fourth lady (in the bed next to me, luckily) was a sprightly 90 year old who became a great buddy over the following days. We were soon doing the crossword together everyday but sadly, she was discharged home all too soon only to be replaced by a seriously ill, incontinent patient.

I’ll never forget the days spent in that ward. The two old dears in the beds nearest the windows complained whenever the windows were opened so they remained closed most of the time despite having two incontinent patients in the room. I used to take myself and my drip to sit by a window in the corridor, to escape the awful conditions in that room. I was also trying to escape the attention of the psychiatric patient who was very restless and needed 24 hour care with her own special nurse.

Every morning, a new agency nurse would arrive on our ward to care for the daily needs of our confused room mate. Each day, I would watch the same situation evolve where the mood of the psychiatric patient would gradually deteriorate to a point where her young nurse could no longer calm her and we would then be exposed to many hours of disturbed behaviour. After a few days of observing this situation, I could clearly see where these inexperienced nurses were going wrong so in order to save my own sanity, I decided to intervene. Every time a new nurse arrived, I would quietly warn them of the pitfalls that lay ahead and give them tips on how best to manage the situation. This worked a treat and our days became slightly less chaotic as a result.

The nights were another story. The agency tended to supply ‘carers’ rather than nurses for night time duty. Many of them were college students with little or no nursing experience who had simply enrolled with the agency as a summer job. Having put my eldest son through college and with my daughter still in college, I understood these ‘kids’ and often chatted with them quietly for hours while their charge slept soundly thanks to heavy duty nightime sedation. As my bed was nearest to the door, these carers tended to sit all night on a chair at the end of my bed, using the light from the corridor as a reading light. I would often settle down to sleep for the night with a hunk of a male student sitting just inches away from my feet!

Until this morning, I hadn’t given another thought to the time spent in that room. I was eventually transferred to another ward where I spent a much happier fortnight being nursed back to health in a lovely bright, airy room and where my companions were delightful. Sitting here a whole year later writing about my memories from that time, it feels like it was only yesterday. Today, it’s my husband’s turn to experience hospital life from a horizontal position. When I collect him from the day unit shortly, I know I’m going to find it very hard not to smirk at his tales of woe!

What a week!

It all started last Sunday. We had some visitors staying and I wrongly assumed that my constantly recurring headache was as a result of the extra workload. I’m well-accustomed to popping pain relievers in order to function normally and I make no apology for it. As anyone who suffers from a chronic condition will know, it’s the only way to get things done. The secret however, is knowing when to shout for help.

When I dragged myself out of bed last Monday morning I knew I was in trouble. I’d barely slept a wink overnight as my headache was no longer responding to pain killers. As luck would have it, I’d a hospital appointment already booked with the surgeon for the following morning so expert help was at hand.

By the time the surgeon got to examine my head on Tuesday morning, I was in so much pain I could barely talk. A few hours later, I was lying inside an MRI scanner having a brain scan to rule out a possible brain abscess. Thankfully, nothing of this nature was diagnosed although a nasty infection was visible at the site of my recent surgery.

The same evening, my daughter arrived home from her work placement in a hospital, looking like death. She was suffering a flu-like reaction to travel vaccinations received the day before. Despite running a very high temperature overnight and still looking very pale the next morning, she insisted on going back to work. By lunchtime, she was in A&E of the hospital having developed a severe nose bleed while on the wards. Her nose had to be cauterised to stem the flow of blood and she limped home to bed for the second evening in a row.

The next day, I woke with horrible nausea and the return of colitis as a result of the antibiotics prescribed to treat my head. I had no choice but to lie very low that day.

On Friday morning, my husband was admitted to hospital for a cataract operation. Having collected him from the hospital at lunchtime and brought him home to recover, I was looking forward to a quiet afternoon but no such luck. One of our cats appeared with his tail bent double and I knew immediately that an urgent trip to the vet was in store. Last year, this same cat became very unwell having developed an abscess in his tail (most likely from a bite from another cat) and the tell-tale sign was a drooping tail. So, Friday afternoon was spent getting the cat sorted with an antibiotic.

As if the week hadn’t been testing enough, Saturday morning started with an early morning trip to bring the eye patient back to the hospital for a routine check. Having delivered the patient safely home again, I then attended a funeral before spending the afternoon at the nursing home where both of my parents are in rapid decline at the moment.

Today, apart from frequent trips to the loo, I’ve done nothing but loll around in the garden enjoying the sunshine. The pain in my head has eased but I’m not out of the woods yet. If I go quiet again next week, please don’t worry. Wimbledon fortnight starts tomorrow. Bring it on!

Stranded

Dying to get home. It’s no fun getting stranded especially when you’re on your own. Just imagine it…

You’ve spent an exhausting day anxiously waiting for news. It seems no-one can tell you how long the wait will be. You try to pass the time by reading but the constant level of activity around you, makes it impossible to concentrate. Each time you visit the toilet, you risk losing the cramped space you’ve made your own.

Night time comes but there’s no prospect of getting any rest. Sleep is impossible in the noisy, brightly lit environment. You lie there exhausted hoping that tomorrow will be a better day.

Yes, I did feel sorry for all those people stranded in airports last week but not half as sorry as I feel for the many patients stranded every day in our overcrowded emergency departments while awaiting a hospital bed.

Four years have passed since our Health Minister, Mary Harney declared A&E overcrowding a national emergency yet still the number of patients on hospital trolleys continues to reach record highs.

Old Age is a Bugger

My parents were born in the 1920’s and are now old and frail. Thanks to improvements in medical care, they have outlived their own parents’ lives by several decades. In the last few weeks, my mother and father have each endured an emergency admission to hospital having been rushed by ambulance to A&E. They are now both safely installed back in the care of the nursing home.

A report published this week by the Centre for Ageing Research and Development in Ireland (CARDI), has shown that while life expectancy in Ireland has increased significantly during the 20th century, our later years are likely to be spent in poor health. The report emphasises the need for further research to ensure that sufficient planning is undertaken so that adequate policies and services are in place for older people.

The CARDI report revealed that since the 1920s, Irish men have increased their life expectancy by around 20 years, while women have extended their average life span by 24-25 years. A man can now expect to live to 76.8 years while a woman  can look forward to making it to 81.6 years.

Our expectations have certainly changed. Not so long ago, 64 was considered old. Remember this song?

By 2041, it’s estimated that the number of people aged 75 and over, will reach almost one million. That’s three times the number living now. And the number of people who make it to 85 and beyond, could increase five-fold.

The number of years a man can expect to live in poor health, has risen from 9.5 in 1999 to 14.7 in 2007. And for women, the projected years of bad health have increased from 11.3 years to 16.8 years.

In other words, these figures show that while we’re successful at keeping people alive for longer, we’ve not managed to extend healthy life spans to the same extent. Do you have an opinion on this?

If all this talk of old age is getting you down, let me remind you of the famous quote by Maurice Chevalier (New York Times, 9 October 1960)…

“Old age isn’t so bad when you consider the alternative.”

Held To Ransom

Having spent the best part of the last month undergoing treatment in a semi-private ward of a large public hospital, I’ve seen first-hand how our health service operates. It’s the same old story. Once you get through A&E and into the system, the care is excellent. But it’s not all a bed of roses.

In Ireland, we have a 2-tier public health service with a unique mix of public/private patients and public/private consultants. Approximately one third of hospital consultants work in public-only practice. That leaves 70% of consultants allowed to practice publicly and privately. These consultants enjoy the best of both worlds. They do not have a boss, their hours are not monitored and many enjoy extraordinary salaries. Granted, our Minister for Health, Mary Harney has tried to exert control over hospital consultants by introducing new contracts (terms and conditions with the State) and new posts of clinical directors (about 100) to manage and monitor hours. However, having watched the consultants do their ward rounds over the last month, I’ve come to the firm conclusion that we’re all being held to ransom. It’s time someone blew the whistle.

I witnessed consultants reassuring elderly patients that there was no hurry for them to go home. I’m talking here about patients who had very obviously recovered from the acute illness that brought them into hospital. These patients had homes to go to with family in support, they were not waiting to be allocated a nursing home bed. We hear so much about the shortage of beds in our acute hospitals. Why are the consultants not working hard to free-up beds?

I saw the look of disbelief on the faces of the junior doctors (NCHDs) as a consultant announced further tests on a young girl who’d been in hospital for many weeks and whose tests had all come back normal. This girl appeared very well to me so why was she occupying a hospital bed? Why were her investigations continuing as an in-patient?

Could it be that hospital consultants choose to have a proportion of beds occupied by patients who require minimal input of care/time? Patients whose health insurance will continue to reimburse both the hospital and private consultant as long as they occupy a bed? Is this the realistic truth? I presume that the NCHDs remain silent on this issue because their jobs depend on pleasing the consultant?

I don’t know about you but my conscience finds it very difficult to accept that ‘well’ patients are occupying hospital beds when I know that acutely ill patients are lying on trolleys in A&E?

We have some fantastic consultant doctors in this country who are totally dedicated to their profession and I’ve no wish to tarnish their reputation. However, as a patient, I feel a need to protect our health service. The fact is, I depend on it.

No White Flag

This is my nurse (thanks Grannymar).

I’m back! Well, sort of… if you know what I mean. I got home from hospital on July 10th on oral antibiotics but it turned out to be a shortlived escape.

Six days later, I was back in A&E with all the old symptoms again. The osteomyelitis has returned in the bones of my skull and the colitis has flared up again too.

There will be no white flag above my bed. I won’t put my hands up and surrender. I’ll let it pass (more anon).

Full credit to Dido (I love this song).

Do Not Enter

I had a great bit of fun last week on my last night in the A&E department. If there’s one thing I’ve learnt over the years of being admitted to hospital, it’s to use humour to get through difficult situations. This time, it really helped me through a potential emotional meltdown. I won out in the end too!

Those of you who’ve read this blog before, will know that I have a past history of MRSA infection and although I am clear of this horribly resistant bacteria, I’m still regularly stigmatised by it when in hospital. On this occasion, on admission to A&E, I was carefully questioned about my MRSA status and swabs were taken for analysis. A very kind ward manager found me a bed rather than a trolley and it was pushed into a little side room to ‘protect’ the other patients in case the swabs came back MRSA positive.

The side room had four walls, a bed, one chair and a door. No television, nothing. No en suite either which means that potentially infective patients use the same facilities as everyone else. As I was only a ‘suspected’ carrier of MRSA, no restrictions were placed on my movements around a very busy A&E department. On the third night, I came out of the side room to find a new sign on the door… “Do not enter, please contact staff desk first”. My immediate reaction to this was “Help! My swabs must have come back positive”. I went back into the room and lay down on the bed in despair. That’s when the fury hit. “How dare they put up this sign without first informing me of a change in status!”. I was tired and in danger of losing my cool. Humour was called for. I sat up and carefully made a sign which proclaimed “Enter at own risk, I bite!” and using a sticking plaster from my handbag, I stuck it to outside of the door below the other sign. About 30 mins later, a night nurse stormed into the room and asked if I was responsible for the sign. I smiled back at her cheekily and replied,  “two can play at your game you know. Nobody consulted me about the restrictions placed so I didn’t consult you”.  I demanded to know if my MRSA status had changed. She replied that it hadn’t and admitted that they were playing safe. She then left the room clearly annoyed. I chuckled to myself in victory.

Shortly afterwards, she returned with a smile.  “You win”, she said.  We’ve taken both signs down now”.

The following morning, I left the room briefly and on my return, my bed and all my belongings had disappeared. Nobody could tell me what was going on but I was hopeful it might be a sign I was about to be transferred to a ward. Another patient was wheeled into the side room and my bed was eventually found in the middle of the department, lined up with trolleys all groaning with patients. Later that day, I was informed that I was to be moved to a ward and as you can imagine, this news came as a huge relief.

The swab reports came back negative on my fourth day in the hospital. Phew! If I’d tested positive, it would’ve compromised my treatment and also meant that I’d been infective to others in the hospital, for a full four days. Countries like Holland, which has brought MRSA contamination under control in the hospitals, must laugh so hard at the Irish interpretation of  infection control.