Category: An Appreciation of the UK's National Health Service (2)

Eyeball to eyeball (with tooth-sucking….)

 

Eyeball to eyeball - with politics!
Eyeball to eyeball - with politics!

Tooth-sucking – ie slow inhalation of air through lower teeth (or, even worse, dentures) – is a very bad sign.

Plumbers do it. Electricians do it. Computer geeks do it. Builders are especially prone to it. When accompanied by head-shaking and eyebrow knitting, it is a particularly bad sign, usually meaning you are going to pay – lots – in money, time, inconvenience and often all three.

Here I am, sitting in a stout black steel chair fronted by all sorts of high-tech equipment, a range of which has just been addressing itself in great detail to my eyes for the last half hour or so. The kind and painstaking ophthalmologist is now consulting with the tall, grey-bearded, grave consultant.They are talking ophthalmo-speak to one another. I begin to feel very tense, apprehensive. It sounds like tooth-sucking. Oh dear.

“Yes, I’m afraid you have glaucoma in your left eye. If we start treating it now, you will probably retain your sight well into old age.”

“Oh well,” I think, “at least my right eye is ok.”

As if reading my mind, the consultant goes on: “But this condition is bilateral. It is likely to affect your right eye too, eventually.” “How long is eventually?” I wonder, feeling like a small rodent trapped in a corner by a big man wielding a broom with his back to the exit door.

On to discussion of treatment options. Drops, for starters, to reduce the pressure in my left eye, at present higher than it is in the right.

[questions I forgot to ask, (i) : how does this relate to my overall blood pressure, on the low side of normal?]

One type of drop, a form of beta-blocker, will “lower your heart rate, limiting your exercise capacity….” No thanks to that one, unless I get desperate and nothing else works. Rushing about everywhere on foot is my main transport mode, and I rely on that with a little light hill-walking from time to time to keep me fit.

Option two, which I decide to try for starters, has a distinctly surreal dimension. Apparently it will turn my affected eye pink [questions I forgot to ask, (ii) : for how long? For ever?] and cause my eyelashes on the bad eye to grow longer and thicker.

“So I’ll go around looking like a cross between Dracula and an aging fashion model?”
“No,” says the grave but quietly smiling one, patiently, already realising he has a drama queen on his hands from now until his well-earned retirement.“ When we have stabilised the left eye, you can even up the eyelash balance by rubbing a little of the drops on to the right eye’s lashes.”

At this point I am visualising going around in a large brown paper bag with eyehole slits.

Shortly after my arrival at the brown bag interim solution, the session is over. Having asked various questions, I have not been my usual forensic self in eliciting answers. Being told you are slowly advancing towards blindness, sooner or later depending on treatment, does not sharpen the mental faculties.

[questions I forgot to ask, (iii): Just exactly how bad is this, NOW?]

I sit for some time with my husband, waiting for some photographs to be taken of the back of my eyeballs – partly for research purposes.  I come from a family psychological matrix where one’s default position in any crisis is the worst option, always. Guide dogs and white sticks feature prominently in our conversation – or rather, my monologue.

Then we walk home, having had three hours of NHS Scotland’s time, state of the art expertise, professionalism and kindness. All for free. It is a beautiful, mild autumn day, the streets rusty with fallen leaves. The verb “to see” and the noun “vision” have just taken on a new significance.

It would be totally dishonest to pretend that behind the – I hope! – lightly ironic, witty tone of this article I am not rather upset both in the short and the prospective long-term, by the implications of being diagnosed with glaucoma.

Insouciance would not be normal. But writers are not ‘normal’. All of us to a greater or lesser degree have a streak of psychopathy which makes every vicissitude of human experience – including our own – potential writing fodder. In the midst of my entirely appropriate angst is arising a tingle of anticipation: a new seam to be mined – and shared – has just been opened. Should I set up a new blog? What could I call it? “To the White Stick”, perhaps? Or – this is a bit more dignified, don’t you think? – “The Glaucoma Diaries.” I could have a sub-theme called “More bits fall off” for my popular column “Just let me get old, ok?”…….mmmm…….

Watch this space!

( ps one of my friends, when told the news, shrugged his shoulders, remarking: “Oh, well, c’est la fucking vie, innit?” I don’t think there’s an answer to that, yet….but give me time, give me time!)

850 words copyright Anne Whitaker 2009
Licensed under Creative Commons – for conditions see Home Page

Where’s that wasp? Fetch me my AK-47!

– and by the way – a big thanks to NHS Scotland !….

….in this turbulent time of controversy re major changes proposed to the USA’s healthcare system, and the often bad press which the UK’s NHS tends to receive, I thought I’d add my own contribution – an account of how I still have my left arm, thanks to the NHS in Scotland….

10.30 pm: Thursday 13th August 2009: Western Infirmary, Glasgow, Scotland, UK.

A young woman has just been wheeled in to the next bed. She is crying with pain. Nurses and a doctor are in attendance. The woman opposite, snoring loudly, is only a year older than me. Epileptic, registered blind, she has had six strokes. Swollen, painful legs have caused this admission. She has cut her smoking to fifteen cigarettes a day.

I have not slept for twenty-one hours. My left hand looks like a kilo of sausages, forearm beginning to resemble a marrow. My right arm is attached, via a cannula inside the elbow, to an antibiotic drip. “Domestos, basically!” a male nurse remarked cheerfully earlier that day. “ Kills just about everything. You’ll be fine!” I did not feel fine.

How quickly life can pitch us from order to chaos….

Noon, Tuesday 11th August 2009. We were relaxing in sunshine outside Exeter airport, drinking coffe, waiting for the Flybe plane to take us home from a happy family visit in Devon. Clasping my hands expansively to the back of my neck, I did not see the wasp. “Ouch! That hurt!” My first ever sting. By 4 pm it was almost forgotten – only just red by then, and barely tingly.

It was good to be home. Off I went to do a week’s shopping – our cupboards were bare. Whilst carrying bags up the three flights of stairs to our house, I noticed my hand was redder, and a little swollen. It was 5 pm. By 6.30 pm, I was having slightly tingly feelings round my lips and throat as well. Anaphylactic reaction? Off we went to the local Accident and Emergency department.

It was fairly quiet – “Thank goodness it’s not a Friday night!” I remarked to my husband. Within half an hour, I had been assessed for degree of urgency, seen by a doctor who confirmed a very mild but not serious anaphylactic reaction, then a GP, and sent home having been given an antihistamine tablet. “Go and see your own GP tomorrow if it’s any worse,” the hospital GP said. “It should settle overnight, though.”

It didn’t. It was worse, and I was worried. The surgery already had the notes from last night’s consultation. They fitted in an appointment that morning, Wednesday 12th August. My GP tailored the antibiotics prescription to one aimed at skin bacteria, which apparently can be very noxious indeed. Some time ago, a friend had licked a tiny scratch on his hand made by a staple, and found himself in the Western Infirmary with necrosing fasciitis. They only just managed to save his hand….   “If it hasn’t started to improve in twenty-four hours, come back”, he said.

“Are your patients worried about swine flu?” I asked, ever curious. Apparently not. It seems they are far more affected – especially with mental health problems – by the recession….

During Wednesday, things did not improve. My hands and wrists are small and thin. The swelling, moving slowly upward, had obscured the wrist bones by nightfall. We went to sleep at 11 pm.

At 1.50 am on Thursday 13th August I woke up: my hand and arm were swollen almost to the elbow. Around my knuckles between which the wasp had stung, the skin, turning a purply-yellow, was starting to ooze.

That was it. We returned to the A and E Department at 2.30 am.

Assessed at 3 am, I waited till 4 am to be seen. Through the wall of the small brightly-lit consulting room, we could hear sounds of someone who was obviously mentally ill. The first doctor thought I’d probably be admitted for intravenous antibiotics. At this point, I sent my husband home. He had a difficult day ahead, and one of us might as well get some sleep! A kind nurse with thirty-two years’ experience sat and chatted, commenting that good nursing care wasn’t just about hooking people up to machinery. I agreed; at this point it was good not to be alone.

Another doctor, a young orthopedic surgeon with a delightful celtic voice and the charm to go with it, eventually managed to get a cannula in my arm for the antibiotic drip. The kind nurse continued to chat in an effort to distract me, my having warned them that physical courage was not my forte. “You have awkward veins!” he said. “Just like the rest of me!” I replied. We all laughed.

6.15 am. At last, a bed was found – in a surgical ward on Level 10. The very brisk, cheery porter conveying me there on a trolley informed me that wasps had to sting before they died. He expressed great surprise at my ignorance of this fact – especially at my mature age. Though not convinced of the veracity of this statement,  I felt too feeble by this time to argue. How unlike me….

Even butterflies get attacked!
Even butterflies get attacked!

10.30 pm: Thursday 13th August 2009: Western Infirmary, Glasgow, Scotland, UK.

Surrounded by very ill people – some in great pain, I finally ‘hit the wall’.

After 21 hours without proper sleep, having being told I would have to lie for an hour getting my sixth lot of antibiotics for that day, the shock of the day at last hit me. Tears welled up. The duty nurse until that point having been quite brusque, immediately became kind. “I’d feel the same, if it was me,” she said, going off to make me a cup of sweet tea – quite outwith the official tea or meal times. A slender young female doctor who, truly, looked about twelve years old, came and sat on my bed whilst I drank the tea, solemnly asking me if there was anything else troubling me. “Don’t worry,” she said. “You’ll soon be fine, and out of here.” She was right.

3.00 pm  Friday 14th August 2009 : discharged! Armed with some more antibiotics and an appointment five days later with the very thorough consultant who had overseen my case, I was soon fine again.

However, as a consequence of this experience, I will for some time be reflecting on what we all know at some level, but do not like to contemplate often: how poised our lives always are on the edge of chaos of one kind or another. Tossed from a quiet, reclusive life into the midst of human suffering much worse than my own, I was humbled by the way we were all cared for – by the staff in our National Health Service who are perpetually undervalued and overworked.

Memory of the unobtrusive acts of kindness and humanity I overheard and witnessed during those two long days, and largely sleepless nights, will stay with me for a long time.

I am only too aware that there are times when our UK National Health Service grievously lets down, for one reason or another, those who are entrusted to its care. No institution can be perfect. The gap between the ideal and the real can never be bridged in any situation involving human beings. Even at our best, we are all only too fallible – there is always lots of room for improvement. But I will remain forever grateful for the care provided by all concerned in those few fraught August days. Thanks to the NHS, I still have my left arm – not to mention, perhaps, my life….

1200 words copyright Anne Whitaker 2009
Licensed under Creative Commons – for conditions see Home Page