What now!

One definition of ‘hardship’ is having to use the outdoor community pool rather than my rather more congenial local swimming centre.  I realize that this definition is not one that will be enthusiastically shared by those, for example in the UK, where the number of outdoor community pools for private citizens is somewhat restricted.  And even if they were in greater supply than they are, when would an ‘outdoor’ pool ever be used?

And that brings me to the serial untruthfulness of my friends in Britain.  It is a ‘given’ that any telephone conversation between Catalonia and the UK will touch on the weather.  Even though we have had an indifferent early and late spring with weather that all of us grumbled about, I refuse to believe that the weather in my country of birth is markedly better.  Yet, in every telephone conversation I have to listen to my British friends say (yet again) that “Today” (or more tellingly “yesterday”) has/had been glorious!”  [I know that the quotation marks in that sentence are not exactly correct, but merely thinking about them brings back memories of fiendishly difficult exercises on punctuation in Form 4 or 5 that took sick minds to devise - and certainly created nausea in the stomachs of hapless pupils who were called on to ‘solve’ them]  At first we took such statements on trust, but then the suspicious nature of the consistency of response encouraged us to be a little more circumspect and we started to check up on these statements of nationalistic climate one-upmanship.  And behold! the facts would invariably cast (at the very least) doubt on the assertions of flawless skies and tropical temperatures.

It was refreshingly direct, when my cousin Margaret came to Castelldefels, she sent a selfie by the pool or on the beach to the folk back in Maesteg and, at the same time she checked the weather.  Rain, rain, and more rain.  Or, as one of her correspondents put it, “It’s pissing down here!”

It’s odd, isn’t it - the weather is a topic of national conversation, whose awfulness is bewailed at every opportunity.  We hark back to the ‘Great Summer of 1976’ and somehow seem to ignore the fact that it is a warm experience of over forty years ago!  But let foreign weather attempt to better our (for want of a better word) climate and suddenly we become all protective and start rationalizing ‘light rain’ as something that can be ignored, or ‘a patch of blue’ as a sunny day.  Trump’s alternative facts have a lot to answer for.

I have a simple way of showing the difference between the weather in Cardiff and Catalonia.  Every day I use my bike (admittedly an electric one, but I still have to pedal) to go on an epic journey to my local swimming pool.  I do not use my bike if it is raining.  So far this year, I have had to use the car on four occasions.  I ask you, members of the jury, how many days would the bike have been kept at home in Britain?

Of course, you could say that my continuing concern with the weather is a form of displacement activity to encourage my thinking of something other than my health.

Six months ago I was diagnosed with thrombosis, embolism and strained heart.  Eight days in hospital; two weeks total rest; weeks of gradual exercise; hospital appointments; blood tests; health centre visits, a doctor’s visit to the house (!) {sic.}; twice daily injections etc etc etc.  The six-month period is a time for more evaluative tests to see exactly how I am doing.

The last visit to the hospital doctor (as opposed to my local doctor) was generally positive: blood, pee and heart all passed muster.  Now on to leg and lungs!  And it’s the lungs that are the worry as the damage that the embolisms did might well be permanent and if that is so, Other Things Will Need to be Done.  What these things are, I know not of.  But they will be the thorough irritation of my world.  There are Dark Mutterings about some sort of ‘mask’ that might have to be worn during the nights, but I was told not to worry because the newer ones are almost silent.  If that was meant to comfort me, it did not.  My ever-active imagination has already sketched out some form of modern/medieval form of nocturnal torture instrument!

So, while I get browner, as an actual and real sign that our weather is really quite good, and stride about looking the soul of health, I still have nagging worries that I will have to take my local doctor’s injunction that I will have to “remake my world” and live with the consequences of what happened six months ago.

The visible signs of this remade life are that I now walk with a stick (when I remember to take it) and I wear a pressure stocking (when I am shamed into putting it on) and my pathological hatred of the act of walking is now a sort of medical imperative.  I do not look ill.  I do not feel ill.  My swimming times are the same or better than those before January.  But it is difficult to feel totally at ease when you consider that my basic medication is rat poison.  Admittedly it is packaged in little white tablets that can be easily broken into quarters to match the ever-changing daily dose, but the fact remains that I am ingesting rat poison.  On a daily basis.  You might be interested to know that Warfarin killed the rats by causing internal bleeding, and it is that ability to thin the blood that is supposed to help those with thrombosis etc.  And I hope that it is.  This month will demonstrate exactly how effective the drug has been.

I have also had to change my diet.  I am on a low fat and no salt regime and I haven’t had a drink of alcohol since January.  Admittedly I was told that I could have an occasional small glass of red wine - but I would rather do without than be so glaringly abstemious!  No salt is just about impossible unless you cook all your own food and I have less than no intention of doing that, so I tell the waiters that I need to have a ‘no salt’ dish and believe in their veracity.  Well, don’t knock it, I’m not dead yet!

It is ironic that in the The Guardian today (the on-line version that I read) there is a report that suggests that the NHS could save billions by encouraging doctors not to over prescribe and not to encourage patients to have series of tests and examinations that may not be strictly necessary.  I think that the succession of tests that I have had in Catalonia and the level of medical care that I have received are in marked contrast to the service that I would have had if I had still been living in Cardiff.

As a Baby Boomer (Leading Edge) I am of the generation that is now entering into the age when the availability of medical services are going to be called on with greater regularity.  On the 70^th Anniversary of the NHS now is the time to start funding the service as it should be funded and, incidentally, to be taken out of the hands of a Conservative Party (“lower than vermin”) that did everything in its power to try and halt its foundation.

You see the way my mind works.  I start talking about the weather and end up with the NHS.  But thinking about it, they are both linked, and the more I think about it, the more one appears to be a metaphor for the other!  But such literary niceties are for another post!

The Doctor Calls

My daily cup of Earl Grey and my morning injection over, I have the rest of the day to consider and plan.

I have found that, much like my time in hospital, meals now occupy much of my thought and structure my day.  Toni is discovering new skills as he produces the low fat and salt-free meals that I am supposed to eat, and I have to say that he is showing surprising aptitude in producing tasty food that I wolf down with alacrity.

Although I am eating healthily, my enforced lack of exercise does not allow my body to take full advantage of the calorie denial that it is going through.  I am hoping that, after another week, my ability to go for short walks will add at least some exercise to my sedentary existence at the moment and encourage my weight loss.

Perhaps the most significant event today will be A Visit By The Doctor.  The capitalisation is essential in this day and age when such a thing is not exactly the norm.  I seem to remember when a child and going through the usual round of illnesses that a doctor’s visit was a sort of physical affirmation of the medical rites of passage as measles and mumps and the like were ticked off the list!

I have made a list of questions for the doctor.  This approach is a direct result of my mother’s experience when she was ill.  She found that the Bedside Manner that some doctors had precluded significant questions and at the end of her time with them, she was able to recollect later that important points had not been covered.  Not one to suffer fools gladly (especially when she had been hoodwinked by technique) my mother wrote out what she wanted to know before hand and doggedly stuck to her points (rather than the doctor’s waffle) and sometimes cut through pleasantries to ask the next question!

One head teacher in my experience had the ‘deflection through mutual intellectual conversation’ down to a T, and I recall leaving his office with a smile of satisfaction on my face, but no extra money in the Faculty.  It’s a good trick if you can master it.

Anyway, thrombosis, embolism and dickey heart are not elements that are made better by ‘a smile of satisfaction’ but rather by concrete changes in attitude and life style.  I need to know exactly what I need to do to get back to where I was.  And indeed if it is possible to get there.  I need hard facts or clear details about what has happened to me and how I can change or work with what is going on with my body.

It is easy to feel positive because mine is a no obvious pain condition, but that in itself, is something that can be a false positive.  After the horror stories related to me by the doctor in the hospital of the fatal results of not following the guidelines for recuperation, I am satisfactorily unsettled.  I now need to know how to put that unease to good use so that I can progress to . . . to wherever I am reasonably able to go!  With Toni’s eagle eye watching for any tea-related backsliding, I have the incentive to extend this period of abstinence from my usual caffeine and fat related diet and make a steady improvement.  We shall see.

My poetry progresses slowly and haltingly.  Perhaps one of the reason for this is that, since I have returned from hospital, I have not been writing in my notebook each day.  My notebook is for ‘ideas’ that can be worked on later.  Usually I write in this after my swim and while I am having my cup of tea in the leisure centre café.  The ‘notes’ that I make are usually of a truly banal nature concerning the weather or some trivial details of my daily life, but the point of always keeping a notebook is that sometimes these quotidian remarks develop into something more significant, or, almost in spite of myself, I find a phrase or a sentence that prompts some other writing.

Another element, just at important as the creative, in my notebook is as a jolt or reminder of action that needs to be taken.  Sometimes I have gone as far as to write a signed and dated note to myself, agreeing (with myself) to get something done by a particular date!  Having written it down in a book, it is a constant reminder of those things that, in my case I have not done (and there is no health in me!) – ah, the cadences of the Book of Common Prayer are never too far from my way of expression!  And generally speaking they work, my little aide memoires.  Because when you really want to do what you have not done, all it takes is the slightest hint to actually get it started!

The doctor has called and my conversation with him was both better and worse than I expected.

He said that I can re-join the normal life of my fellow humans at the end of this week, when short walks and drives will be acceptable and I will be able to get out of the house for the first time.  Well, that’s not strictly true as the doctor arrived when Toni was scouring pharmacies to find more of the Clexana injections that I take.  Apparently these are in short supply, though god knows why as they seem to be the bog standard treatment for thinning the blood to treat thrombosis and embolism.

Anyway, the doctor said that they don’t really know why the thrombosis in my right leg formed and they were still studying the blood tests to see if there is anything that might give a clue.  They will also be checking my heart after the extra work that it had to do to cope with the thrombosis as that might be damaged as well.  The course of injections I am taking will last for six or twelve months, maybe longer.  Although there is a chance that I will fully recover, that chance is qualified by what may be found out further.  It may be that the damage to heart and lungs is permanent, but that is taking the most pessimistic view.  Which I, resoundingly, refuse to accept.  At least until further evidence to the contrary is shown.

I also asked about tea.  When I asked the doctor looked at me quizzically and said that I could drink tea.  I then pressed him by asking how many cups of tea I could drink.  To which his response was, “What sort of question is that?” to which I replied, “Yours is one only a foreigner would ask!”  At least he laughed and said, “I’m not going to worry about a cup of dirty water!”  Dirty water!  Only a lesser breed without the law would refer to Earl Grey as dirty water!

So, although I am going to be able to do the simple things in life a little earlier than I expected, the long-term problems are still to be discovered.  For example, when I asked about my present low far/no salt diet and how long it would last, the reply was, “For ever!”  Ah well!

My next doctor’s appointment is in three weeks time and then in March I have two tests back in the hospital to see what progress, if any, has been made.

At least I will be able to drive myself there!  I hope!

Four Days Later

It has now been four days since I returned from hospital to a more domestic setting.  And four days in which I have had to supress all my natural impulses, and try and learn to relax and rest and take it easy.

You might think that would be easy.  Just think of it as a ‘holiday at home’ with ‘butler’ service provided by my partner, I told myself.  Sit down in a comfortable (reclining) armchair, write, eat, watch television and allow the sun to warm the back of one's neck through the closed window.

It has been much, much harder than I thought it would be.  The basic problem is that my medical problem (thrombosis, pulmonic embolism etc.) while serious has no outward indication and, apart from a slight tightness across the chest, I actually feel fine.  But I’m not.  And I have to keep telling myself the same.

Walking up stairs is a problem.  Not because I can’t, but rather because I can too easily!  I have to tell myself to climb three steps and pause and the next three and pause and so on.  When I need something, it is an automatic response to get up and get it.  And if I do get up quickly, there is no stabbing pain or twinge to remind me I’m ill.  Presumably the only indication that I will get is when I drop dead!  However, let us not dramatize this too much.  I am feeling well, indeed very well, when you take the ‘waiting on’ that Toni is doing into account!

I keep telling myself that this enforced, unnatural tranquillity is only for a fortnight and then I can start taking little walks.  And I’m already 4/14ths of the way through!

Given what has happened to me over the past week or two, my view of life has (in the short term) changed somewhat – priorities change when a doctor explains the significance of my condition with horror stories in which some foolish patient ignored medical advice and went for a walk smoking a cigarette AND DIED!  Well, I don’t and have never smoked, but the import of the story is not lost on me!  Therefore, in the reworked version of my ‘way of life’ the two ‘luxury’ basic needs that I have are to drive the car and go for a swim.

I have been told that driving a car may be possible in ‘a couple of months’ – and there is nothing which defines captivity for a driver than lack of access to wheels.  The going for a swim is even more tenuous.  My usual daily total for my swim is 1,500m. crawl.  I have been told that in a month or so I might be able to complete four lengths in a slow breaststroke!  Now that is going to be difficult, the temptation to do more will be almost overwhelming – but the possible outcome of ignoring advice is, after all, terminal!  So I may well stay in line!

Although the last two weeks have been somewhat focussed on me and what is happening to me (at least to me and mine) the outside world has, allegedly been carrying on as if there were nothing wrong with me!

The travails of the Conservative (“Lower than vermin”) Party in Britain over Brexit would be laughable if it were not so important.  May is a disaster, but I am not sure what sort of leader would be able to take the terminally divided party forward.  And certainly looking at the dearth of talent on the ‘government’ side there is no one who immediately springs to mind as intellectually, politically or morally eminent enough to take the party out of the morass into which it has sunk.  I suppose that we, the people, are looking for a politician of the calibre of Sir Robert Peel who was prepared to split the Conservative (“Lower than vermin”) Party in the repeal of the Corn Laws because it was the right thing to do for the country above the needs of the party.

I think that even Peel (1788-1850) would be uncomfortable with the grotesque anachronism of Rees-Mogg, and the fact that this reactionary throwback is the most favoured candidate for the leadership of the Conservative (“Lower than vermin”) Party in the eyes of activists, is a crushing condemnation of the present positioning of a right-wing minority government that doesn’t seem to have any idea about what specifically it wants from one of the most significant episodes in the history of our country since the Second World War!

Meanwhile in Spain there seems to be a descent into the world of the comic, given the news that fills our television screens.  This infantile approach to government is not helped by the fact that the minister who is mostly in the news at the moment has both the name and the look of a cartoon character himself.  Señor Zoido (sic.) is the Minister for the Interior and is responsible for the present hysteria in Spain as the investiture of the next President of Catalonia approaches.

So far, in their frantic response to the independence issue in Catalonia, the Spanish government has dismissed the Catalan government; instituted direct rule from Madrid and imprisoned Catalan political leaders. 

The past President of Catalonia, Puigdemont went into exile in Belgium and in an embarrassing series of inept actions by the minority right-wing Spanish government they attempted to use Interpol and an International Arrest Warrant to get him extradited to Spain where he would have been arrested.  It was clear that the Belgian authorities regarded the warrant as baseless and the Spanish withdrew it before it was ignominiously rejected.  They are now paranoid that Puigdemont (the only candidate for the presidency) will somehow or other make it back to Barcelona for the investiture.

Zoido (sic.) has been poncing his rotund, porcine way across our TV screens preening himself on the risible (but expensive) and futile ways in which he has ordered the security of the frontiers.  To illustrate the security of our borders, on TV this morning one reporter drove from Spain to France and back again with no police or security at the border, illustrating the expensive waste this political propaganda continues to be.

Our glorious walking joke of a national president keeps himself out of the limelight – as he always does when anything difficult raises its head, pushing others into the firing line in order to save his own non-existent prestige.

To some extent, it is necessary for the minority right-wing national government to concentrate on Catalonia because, otherwise, it would have to focus on the number of PP corruption cases that are coming to judgement.  Bear in mind that literally hundreds of PP officials, ex ministers, workers, etc. are involved in billions of euros of corruption presently in the courts and you can see that any distraction from the systemic corruption of the party is a positive for them. 

I also fail to see why they worry.  No member of the government ever resigns, no matter how overwhelming the evidence of wrongdoing is.  Documents, film, tape recordings – no matter the evidence they ignore it all and hope that it all goes away.  And with the politicization of the judicial system in their favour, they have little really to worry about.  At the moment, however, some of the accused in the most notorious of the corruption cases are ‘singing’ and implicating all of our favourite villains in government.  

Even so, I do not hold out much hope for those thieving criminals to be behind bars any time soon.  After all, look at the thief that is the husband of the sister of the King.  He has been tried and found guilty; he has been given a seven-year prison sentence.  Is he in prison?  No, of course not, he is living in Switzerland and recently went on holiday to Rome.  As his philandering father-in-law once remarked on a television broadcast, “Justice is the same for everyone!”  Except of course for when it isn’t!

So, in spite of the fact that I am stuck in the house, my irritation and disgust reach out through this country and the United Kingdom.  It keeps me occupied!

Tomorrow is the Catalan investiture, so I expect Spanish hysteria to reach a point of melodramatic queenliness unparalleled in recent political history.  Each action they take against Catalonia merely serves to make them appear more ludicrous and less democratic.  

Bring it on!

Reason to be grateful!

I went out to lunch a week last and didn’t come back home for eight days!

It wasn’t the food, you understand – my lunch was excellent (and slimming) with special excellence reserved for the Tast home made tiramisu, oh, and the excellent sangria.  But basically within the limits of my regimen.  Sort of.  The real problems with the day started, or perhaps continued, when we walked from the meal to the post office to get the latest instalment in the series of archaeological books from National Geographic that was waiting for me there.

I took a few paces and had to ask for Toni to stop while I got my breath back.  This was not normal and we headed for our local medical centre.  There, because of the suggestion that my condition might be connected to the heart we were seen in super quick time and were talked to by a very personable doctor who went through the usual tests.  At the end of the series, we waited for a new prescription to be offered, but instead we were told in a matter-of-fact sort of way that I should go to hospital and that an ambulance had been called and I was placed in a waiting wheelchair.  Protocol.

There is nothing that concentrates the mind more than an immanent ride in an ambulance.  Looking out at the passing motorway and the cars and lorries on it through the semi-frosted panes of glass in the ambulance windows I had the semi-detached feeling of someone who has been suddenly placed in an oddly disorientating position of a person whose very physical stability had been called into question.

I was processed efficiently and I was soon wearing one of those terminally unflattering white cotton smocks, lying on an unnecessarily uncomfortable wheeled bed with a chest full of stuck-on electrodes.

Although I spent an uneasy night, it was as nothing compared to Toni’s night of absolute torture on a stock issue metal hospital chair!

For anyone who has been in hospital the contents of the next days will be familiar: blood tests, blood pressure readings, temperature readings, radiological tests, and on and on, day after day.  At least I progressed to a more comfortable bed!

Rather than give a daily account of my time there, I will choose a few instances of what happened and leave it at that.

“Your chest is too hairy!” remarked one radiologist who was ripping off electrodes as she spoke, and removing clumps of said hair at the same time.  Indeed, in hindsight, I would shave my chest were I to go into hospital again.  Not only is removal of the electrodes somewhat painful, but also if you have to sleep with electrodes attached (and if you are a restless sleeper as I am) then each toss and turn will dislodge a lead and fumbling to replace them is a hit and miss matter and lord alone knows what my erratic reconstruction actually did to the readings!

If your diet stipulates that it is very low fat and salt free, then most commercial eateries are going to struggle to give you something appetizing.  The soups that I was offered were generally insipid and one or two were impossible to define in terms of what they might have been made of!

The first meal that I was (eventually) given was of a series of small yellow sausages that looked, frankly odd.  I cut one of them open and I was unable to identify what the interior of those cylinders might be composed of.  I ate them.  All.  I was hungry.  But I was no nearer to identifying what I might have eaten.  They remain imprinted on my memory, though not on my taste buds.

My next evening meal was of some unidentifiable and completely tasteless white fish fillet garnished with a slice of lemon.  The lemon tasted like the smell of cheap toilet cleaner, but again, I ate it all.

I don’t want to be unfair to the hospital, these were two stand-out awful meals, the others that I had during my week’s stay (given the restrictions of my diet) were more than acceptable and they certainly made the most of the limitations that they had to work with to ensure that we had something half-way tasty to eat.  Though, I have to say, it was never more than halfway!

Meals were one way of ordering the day.  Whatever else was going on, the times of our meals was the one certainty in our ward lives.  Once one meal was finished we could start thinking about the next.  Given the tests, scans, blood taking, pressure measuring, injecting, pill popping, temperature taking and consultations, it is hardly surprising that any form of stability is more than welcome when intrusive but essential things are being done to you!

I didn’t manage to sleep for any real length of time for the first five days in hospital.  The bed that I was first put on was extraordinarily uncomfortable.  I sleep on my side and that was not a possibility on that bed of pain.  It is also very difficult to get any rest when you are linked via stick-on electrodes to a machine that bleeps, buzzes, flashes various colours and periodically inflates a blood pressure cuff.  To say nothing, of course, of the abnormally normal sounds of an emergency unit at work 24 hours a day and therefore through the night.

When I was eventually taken from the emergency unit to a four bed ward, it was quieter outside the ward but there were different noises to cope with inside.  

All of the members of our ward needed oxygen and all the ways of delivering it to individuals come with their own sound signatures.  The quietest one is the nasal feed where a tube is looped over the ears and under the nose where two small tubes jut out and into the nasal orifices.  This type just adds a low level hiss to the sound landscape.  The nose and mouth mask is louder and makes a variety of noises depending on the intensity of the oxygen flow and whether a medicinal filter had been added.  The worst form of delivery was a small portable machine with a larger diameter tube which, when turned on sounded like a jackhammer!

Then there were the noises of the men.  I know that I snore, but I didn’t have an opportunity to add my orchestral part to the nocturnal symphony of groans, shouts, wheezes and coughs that was a normal night.

The day started at some time after 6 in the morning as each patient was attended to.  One man had to be changed; another had to have his blood sugar level checked.  The lights would come on and go off again and again as the day got under way.

After a breakfast (for me) of a couple of small French toast rounds with some sort of fruit slime, together with something I have not had for over 25 years: a cup of milky instant coffee!

The most interesting test that I had was in radiography where, lying on my side with the operator’s over me so that my side was firmly lodged under her arm, I heard the actual sounds of my pumping heart and the different sounds that different parts of it made.  

And that is one of the things about being in a hospital and undergoing the probes that the doctors have to make: all that it inside is brought to the outside.  You can see the beats of your heart, you can hear the sounds it makes, you can see the force of your breath, and you can count the oxygen level of your blood.  Your internal organs become photographic images.  No part of your inside or outside is away from prying eyes!

The end of the investigation was that I had a thrombosis in my right leg, that thrombosis had probably been the cause of pulmonic embolisms that effected both my lungs and had some slight effect on my heart.  I had had, in effect, the equivalent of a heart attack but in my lungs.  I was told that it was serious and that I was lucky that it had been discovered before it was too late.

For the next six months or so I will have to alter my way of life and take things easy.  For the next two weeks I am confined to the house and I have been told to do the minimum of moving about and if I have to, to do it slowly.  

After two weeks I might be able to go for a very short walk and gradually build up my distance bit by bit.  My swimming (1,500m every day) has been terminated.  Perhaps in a couple of months I might be able to do four slow lengths of breaststroke.  I cannot use my bike.  I cannot drive the car for a couple of months.  And so it goes on.

And I don’t really feel ill!  If I take a deep breath I can tell that there is still some sort of tension, but, basically, I feel fine.  But I’m not, and I have to keep remembering that simple fact if I want to get better.  And believe me, I do!

I am very grateful for the care and attention that I received in Viladecans Hospital from doctors, nurses, orderlies, cleaners and caterers: it was exemplary and there is no doubt that their ministrations have saved my life.  

I will never forget that.