Walking on water

As I said, its not all doom and gloom. Being run over by a truck means you get a personal trainer for £2.80 an hour. With a qualification in sports rehab and remediation. And a nice Scottish name. Today it was my first real session down at the gym. And after the session, I finally got into the pool.

First challenge. Getting undressed and changed and then hauling my gear into an overhead locker - a few steps away from the disabled changing area. Had to take each item individually. Had a look at myself in the full length mirror. Mmm. Bit odd. My graft is bulky and strange. My right buttock has migrated down my leg and I still have massive bruising on my right thigh. Have to expose this lot to the public.

Hopped into the pool area. Waved at the life guard. He gave me some weird green tube that acts as a flotation device. And then I was in. Was easy to slip into the pool. Left my crutches by the ladder. And then I walked. Actually I walked in the water, not on it, but it felt pretty miraculous. Walking without crutches. And the deeper the water, the easier it became. I walked two lengths, and then tried a swim. Extraordinary.

Managed a couple of lengths breaststroke with almost no pain at all. OK - I was a lot slower than I used to be. And two lengths is fairly minimal. But I was swimming... A few more exercises and then it was time to get out. No point in overdoing it. And its cold when you aren't racing up and down.

Getting out was a breeze. This was unexpected. I had been offered the hoist.... And then the last challenge. Getting everything back out of the locker and into the changing room - item by item - while wet and cold. There's a design fault here somewhere.... I'm booked in with the personal trainer next Tuesday at 3pm. And I'm actually looking forward to it...

Operation No. 4

Back to the consultant. A lift there by a kind friend. Patient transport was full. X-ray first. (I asked the technician to colour in any hole he noticed in the x-rays). Then a short wait and in to see the miracle maker.

But it was too much to hope for. The hole was still there. And the technician hadnt't helped me out (no Photoshop in the RIE it seems). My tibia is 'lazy'. And, as it hasn't healed, it will have to be 'encouraged'. This will be done by replacing the current nail (from my ankle to my knee) with a slightly bigger one. When the new nail is pushed through, it results in a kind of bone graft - by pushing tiny fragments of bone through to the hole which then activates healing. In essence the operation aggravates the site and gives it a boot up the proverbial.... We hope.

It may not be successful, in which case we try again, with another nail replacement three months later.

The operation will take two hours and I should only be in hospital overnight, assuming everything goes well. I should take around a week to 'recover' and so I won't be knocked back to the beginning. I have to keep on with the physio and the moon boot stays. I asked not to go back to the orthopedic trauma ward. But there are no guarantees - it all depends where a bed can be found...

The operation is slightly complicated by my free flap (skin graft). My flap is fed by an artery, which may be very close to the screws holding the nail in. To undo the screws near the artery means care is required. If the artery is damaged, my skin graft is at risk. (although it now has other blood supplies). So a letter is being fired off to my plastics consultant to find out where the artery is.

God, I hope he can remember. I hope he wrote it down! The artery can be traced with a doppler if all else fails. And my consultant is a modest genius - he will not get it wrong.

So now its a waiting game for the appointment letter. My case is marked urgent. This means I should only have to wait 4 - 6 weeks. Given that this is operation No. 4. my consultant has said he wont bother with a preoperative clinic appointment. I've been in so many times I practically run the place. And it would only mean more hassles with patient transport.

So to the big question. How do I feel? Strange really. Not as I expected. Not hysterical. Not furious. Not desperate. Not anxious.

Just flat. And tired. Tired of the pain which continues to get worse although at least I know the root cause... Tired of telling the same story. Tired of being upbeat. Tired of thinking I should do valuable things with my time and not doing them. Tired of relying on other people. Tired of being tired....

But its not all doom and gloom. Today my ambulance crew included the fabulous Ali. Ali is a fairly recent recruit - around 18 months into the job. And she's wanted to do this work for years. And she starts with the emergency crews in May. She bounced up the stairs, met me with a cheery smile, told me how much she enjoyed her job and beamed all the way to the hospital and back. So much smiling. So much happiness! I can't remember the last time I met someone so genuinely upbeat. I might have a hole in my tibia, but I get to meet people like Ali.. And not many people get that happy opportunity...

Stan and his wife

Stan carries a picture of his wife in his wallet. He has always done so. For as long as he can remember. The picture was taken in 1944. Stan's wife is beautiful in the photo. The photo is protected in a clear plastic bag. Its the second one. The first was lost in Spain when Stan's wallet was stolen. They go abroad twice a year on holiday. They were evacuated from Croatia during the Bosnian crisis. Stan and his wife have been married for over 60 years. They met in the war at a RAF base in England. They are devoted to each other.

Stan and his wife have lived in the same house for over 40 years. It was new when they moved in. Until his wife's fall, they went out every day in the car: to Portobello or Arthurs Seat for a walk. They took tea in a flask. Stan's wife suffers from anxiety. This is caused, she thinks, by her experience of the war. Bombed night after night. After a while her mother didn't wait for the sound of the air raid sirens. She just took the children to the shelter in the evening. And there they slept. Terrified. Around 70 years later Stan's wife was nervous of her hospital appointment because of those air raids.

Stan's wife was the last patient on the ambulance list. The ambulance crew were in the house for quite some time. Stan's wife wasn't ready and she was nervous about travelling without Stan. So Stan came too. He was told he would have to find his own way back if the ambulance was full later. Stan's wife was wearing a nightie over her trousers, and a navy blue coat buttoned up tight. She had a soft neck brace and one arm in a sling. She was awfully pale. However, she survived her appointment and wasn't kept in. Come back in another three weeks they said.

I guess I wont see them again. 800 patients are collected each day in Edinburgh for their appointments. So the chances are slim. But I was very struck by Stan and his photo. Over 60 years. How beautiful is that?

Four Months

Four months on. time for an update.
I have just started my exercise referral. In essence this means I get to use the local gym/pool for £2.80 a time. The referral comes from my physiotherapist. Once again, though, I stumbled onto the opportunity by accident. Nobody told me about it. I just wandered into the gym and asked what was available. So this morning I had my first session. With a Fitness Instructor. Was more difficult than the physio as the minimum weights in most of the machines are 5kgs - rather than the 2kgs I'm used to. This means I have to be careful not to overdo it or injure myself inadvertently.

And next week I will use the pool. Getting in will be alright. Getting out will be a great deal trickier. There is a hoist. but I'm damned if I'm being lifted out of the pool - at least not with the lights on! My visits to physio will reduce to twice a week from early April - supplemented by the these gym and pool sessions. This must be progress.

I am still on my crutches and still not fully weight bearing. My ankle movement is still limited although my knee is almost 100%. 'Walking' round the block is exhausting. The local shop, though, is manageable. I am still eligible for patient transport and still haven't managed to use a bus. I think, though, I can now walk to my GP's surgery - just... My wheelchair can probably be returned to the Red Cross - perhaps after I have seen my consultant next week.

I have had a letter from my employer informing me about half pay. This is frightening - and very complicated. Three conversations with patient HR staff and I still only vaguely understand it. Sick pay is worked out on a calender year - but also over four years. (This means that as well as my injury leaving a physical and perhaps mental legacy, my time off work now will continue to have an impact over several years.) And weekends and public holidays count as sick days on continuous sick leave.

I have to start sorting out my finances. As I will go back to work on a 'phased return' I will almost certainly run out of full sick pay. This means that future sick days will be paid at half rate. A future operation (or two) for example. A stomach upset or the flu. Stress. Or a setback with my injury. A drop in income is guaranteed. So now I am investigating my finances, reducing my mortgage (thank god for the ridiculously low interest rates), raiding my savings to pay off my loan, and binning my credit card. Reduced mobility tends to cut down spending on some things - but it increases on others - particularly transport. Taxis do not come cheap.

I am as skinny as ever. 50kgs at last count. This is largely to do with lost muscle tone. But cooking also remains a drag. Eating in the kitchen isn't much fun - although the radio helps. I am practically a local down at Ambridge... I have less assistance now that I'm four months on. More independence is required. I can eat at the pub next door. But its expensive and often full.

My mood still swings and I have almost no tolerance for what I perceive as bullshit. I have been badly behaved in a local community group meeting and stupidly upset by a canceled lunch appointment. I am visibly shaken when I see a policeman on the street, and passing trucks are too big, too close and too loud. Listening to a House of Lords debate on cycle safety the other night was odd. Reading about Hillsborough (20 years ago in May) also very unsettling. I assume this will dissipate over time - but its worrying nonetheless. However, my concentration has improved. I am ploughing through books and spending less time on the Internet.

Here in Edinburgh spring has arrived. Its hard to be miserable when the sparrows are singing on the skylight and my flat is filled with sunshine. Healing requires a focus on the present - not the future or the past. One breath at a time. One step at a time. Its so easy to write...

Lost in transit

Its Monday. Its physio. My appointment is at 10am. This means I have to be ready at 8.30am just in case (last week the ambulance came dead on 8.30 for a 9.30 appointment). I have breakfast and wait. And wait. And wait. at 10 I try to phone Patient Transport. Cant get through. At 10.15 I phone the physio department to say I will be late. I try Patient Transport again. And again. And again.

In the meantime I try to call St Johns. I have an appointment in April and I need to arrange patient transport. But the secretary's number doesn't work. I try switchboard. Seems the secretary's phone has been put on the wrong setting. There is no way of contacting her. I call someone in the outpatient department. Not their responsibility apparently. They tell me to call Patient Transport direct.

At 11 I get a call from Physio. The person is extremely apologetic. Seems someone forgot to book my transport. My appointment is lost and I have wasted two and a half hours waiting. And money on all the phone calls.

I ring Patient Transport again. Astonishing. Get through. Try to book the trip to St Johns. No. Its the rule. The hospital has to make the booking if its less than six months since I saw them the last time. Outrageous. But I cant get through to the correct person in the hospital. I plead. Pleading doesn't work. I ring the switchboard. Ask if there is any way of contacting the secretary. No. What about email? I am given an address. I have no idea if hospital staff read their emails. Most of the systems still appear to be on paper. I send her an email anyway.

I don't like complaining about the NHS. People work hard. And they care. Resources are stretched. But I am a good patient. I turn up on time. I do my physio. I am always ready when the ambulance comes. I fulfill my side of the contract. But today's antics are more akin to a 19th century French farce than a state of the art health system. Of course it is probably just coincidence that the booking wasn't made and the phone was on the wrong setting. The systems are set up tp produce efficient positive outcomes. But I made around 15 phone calls this morning. With nothing to show for it but disappointment and frustration.

I did, though, get a nice letter about my prescription payments - warning me that my pre paid prescription card was about to expire. It remains to be seen how easy it is to renew it! Going on my experience with community pharmacies to date, it should be a piece of cake...

A legacy for Ward 18

Most of us want a legacy of some sort. Something positive to be remembered by. Its not necessarily altruistic. We want to be seen to be doing good for others. It makes us feel warm inside. Some people leave their bodies to medical science (cheaper than a funeral too...). Others pay for a park bench (sometimes situated in the oddest of places...). Still others leave money to charities. Cat and dog homes are popular. Cancer research and hospices too. Conservation charities do well. Church roofs used to be the in thing. And often the people who have the least to give donate the highest proportion of their wealth.

There's been a lot of mention of this in the media recently. Millionaire and billionaire 'philanthropists' who donate large sums to charity with plenty of media coverage but don't pay tax in this country. There's a wonderful irony in this. For their tax bills would probably be considerably higher than their donations. And with more tax coming in, would there be less need for the charitable donations...?

So where do I fit into this? I pay direct debits to three well known charities. I have a charity credit card. Every time I buy something, a little brown bird benefits. I make one off contributions to disaster funds: earthquakes, tsunamis, illegal wars. And then suffer the interminable phone calls for weeks afterwards asking for more. I could off course make more and higher contributions. But sometimes it feels strange to be funding things - where the perpetrator of the loss or suffering should really pick up the costs. Gaza being a prime example. However, I digress.

Back in November I was in Ward 18 in St Johns Hospital, Livingstone. The standard of medical, nursing and 'hotel' services was outstanding. Staff coming in on their days off to decorate a Christmas tree. Time taken for patient hair washing. Fresh hot delicious food. A comforting chat in the dead of night. I genuinely didn't want to leave. I noticed, though, that the ward could have done with another commode. An extra one would save nurses time and effort, and increase the comfort of patients. So at Christmas I sent a card, offering to purchase one for the ward. It was a daft idea, but appealed somehow. What a legacy!

Yesterday I finally received a call from the Ward. Was I still interested in buying the commode? The nurse was a little embarrassed about the price. Someone is making a healthy profit out there. But the cost of the commode is less than a weekend trip to Barcelona, less than dinner for four at a Michelin star restaurant, less than a designer handbag. OK, perhaps the NHS should be picking up the tab. But it isn't. So I, with a generous contribution from my mother, will buy the commode. Its not clear yet whether there will be a plaque, but if so, we will need something appropriate with just the right amount of cheek. Entries on a postcard please...

The great escape

It was bound to happen sooner or later. Getting into my flat is always a bit tricky. Holding the door open and trying to hop in without jamming my fingers, or slipping on the rug. And every time there are two furry spectators, sitting just far enough away to be safe from my sticks. Waiting for a opportunity to head out themselves. Last night they finally made a bid for freedom.

It was around midnight. I'd been at the movies with a friend. I opened the door and the two furry creatures looked up, and then cool as cool things, strode out the door into the stairwell. Shit! I fumbled around, trying to screw up a bit of paper to entice them back in. (usually works a treat when getting them out of the living room). But I couldn't manage without letting go of the door. I propped the door open with my coat, hopped through to the kitchen, grabbed the cat food and scattered some cat biscuits in the hall. Betty, the little furry one, couldn't resist and strolled back in. But Gordito was sniffing the plants. Its a jungle out there. I shut the door and chased Betty into the kitchen. Then, armed with more biscuits I struggled back into the stairwell. Looked down. Gordito was two floors down scrutinising the neighbours' doormat. I called him. He ignored me.

Overheating and stressed I hopped downstairs with my crutches. Gordito started to pad upstairs. He passed me half way and found the biscuits I'd laid as bait outside the door. He's a greedy thing so he stopped to munch. I hopped back up and caught him. But I was unable to hold onto him, open the door, keep Betty in and hold my crutches at the same time. I sat down on the floor. Furious. But laughing. Thank goodness no one could see. Gordito ate more biscuits. Betty cried on the other side of the door. Sitting was easier though. I opened the door, threw some biscuits inside for Betty, shoved the fat one through and shut the door. Now they were inside and I was out - on the floor. It took me a few minutes of planning and a lot of manoeuvring to get back in safely. Once in I collapsed on the couch. They looked at my in puzzlement. And then Betty asked for more biscuits.

The next day, revenge was had. I didn't wake up until 11am (despite the incessant and increasingly desperate furry wrestling on my bed). The creatures had their breakfast three hours late. That'll learn them...