Looking inside my brain

Cold today but sunny. Awake for two of eight and a quarter hours sleep. A fair night's sleep? It doesn't feel like it. When I got up I didn't take all my meds in one go, but in stages before and after eating and drinking lots of water to see what difference it would make to the usual morning woozy thick headed feeling. Well, maybe. Drinking enough water seems to be most important.

After breakfast Clare went to her study group meeting in Penarth. I wrote a reflection for New Year's Eve Morning Prayer, then cooked lunch in time for her return. With a hospital appointment at four, and being uncertain about the best route to take by bus to UHW, I ended walking there instead - fifty five minutes. So I must have been feeling better, and the weather though cold was pleasant for walking.

I met cardio consultant Dr Hughes. We recognised each other, as he was the medic who took charge of me in  A&E the day after I had the stroke. Thanks to him I saw a screenshot of the MRI brain scan confirming the presence of a clot on my occipital lobe that caused the stroke symptoms. He conducted a physical examination with a class of student medics to start with before revealing the scan findings. Despite my condition, skin to concussion, I noticed and was impressed by his skill as an observer teaching others how to observe. 

During our conversation, he showed me the detailed 3D recording of that MRI scan showing the position of the clot just above the top of the spinal column at the base of my brain. It's only recently that I saw a similar recording of Clare's brain scan - in better condition than mine. We talked about the problems I've been having with different medications making me feel worse. He was willing if necessary to prescribe aspirin plus an additional medication whose side effects wouldn't have such an impact. On further thought he considered that the combination of morning meds may be causing the problem, and proposed spacing them out across the day, as a way of observing which of the meds has a noticeable negative impact. He's going to write to my GP recommending spacing the three things I need to take during the day is written on the prescription.

This session I found most helpful. I felt heard and my concerns understood. I came away feeling lighter and optimistic about a way forward with treatment that doesn't leave me feeling worse. I took a bus into town, then caught another back to Pontcanna after a chilly wait outside the Holiday Inn. On the way home I chatted with Owain, and then separately with Rachel, both relieved to hear my good news. Owain has been recommended taking a food supplement to aid mental clarity and sharpness and taking a test for vitamin D deficiency, as this can be a problem that impacts on metabolism and brain function. I'm willing to try anything that might improve the way I've been feeling this past couple of months. What most affects my brain however, is short nights of interrupted sleep week after week. If only a medication routine could be found that reduced me having to get up for a pee almost hourly, that would change everything.

Rude awakening

I was awakened from deep sleep by a vivid dream with a full bladder at six thirty. After peeing my heart started racing with palpitations. Not the first time, but more intense. Trice the normal rate. No pain, dizzyness or breathlessness. It was very disconcerting. I woke up Clare and Owain, called 111 and this resulted in Kath driving me to UHW A&E half awake. It wasn't very busy, but the change of personnel had yet  to take place. My heartbeat had slowed by then. During the morning I was seen and tested by different medics, blood and urine samples taken. 

I had minor discomfort from a full bowel, which didn't go away until I had dumped my load twice. And then I felt normal again. To my relief the palpitations didn't well up again on either occasion. I was parked in a calm emergency unit in the depths of the hospital to queue for my third check and interview with a medic. It was one place where I could be safely placed near a toilet. Blood tests took time. It  seems l have a low sodium level. A result of the diuretic I take. My Blood pressure is dangerously high. I waited until the evening for a treatment plan to be devised and new medication instructions to be issued. Slowly the clot busting meds take effect - clearer vision and  reduction of visual latency as the speed of my brain function improves.

The aim of the plan is to get people back to  home comfort and peace as soon as possible with phone contact to the UHW emergency care unit. I was given a new medication schedule without a diuretic and with double dose of a booster blood pressure pill to add to the long list. Then I was told I was free to leave. It was pitch dark when I left the hospital and I was left on my own to navigate ye way to a pick-up point where Ann kindly agreed to meet me with her car and take me home. I exited the UHW concourse by the wrong door, because the signage was badly designed for anyone visually impaired. I waited in Concourse Reception until she arrived and returned me to Meadow Street. It must have been gone ten by the time I got home and ate the supper Clare had cooked for me. She had already gone to bed, and Owain welcomed me with a warm meal. Fell sound asleep in my armchair from overstimulation and exhaustion after a cup of tea and went to bed very late. 

Happy ending

At about eleven a porter showed up with a wheeled chair, and took me out of A&E into the vast basement area of the hospital to reach a lift that would take us up two floors to the Ambulatory Day Care unit on the upper ground floor. It's in the same neighbourhood of departments that has the radiology department, with MRI, X-Ray and Ultrasound scanners. I was last here for my gall bladder removal in February. 

There's a suite of seven reclining comfy chairs in separately equipped medical bays all in a row opposite treatment rooms and home bases for specialist medics whose services are most called upon. In another area there are single bed medical units for patients needing to be cared for in isolation, and some small operating theatres for routine procedures that can be done on day patients because they don't need a longer stay under medical care. 

Given the advances in keyhole surgery the number of patients that can be treated has risen. There are complaints about long waiting times for certain kinds of complex surgery especially joint replacement. An averagely ageing population means that the number needing this has grown beyond the capacity to provide it, so inevitably waiting lists are very long. When I look back five years to when I was waiting for my anal abscess to be treated surgically, there was a wait of four months from initial diagnosis to day surgery. This was partly due to the demand of the few diagnostic scanners available, and then there weren't enough of the specialist diagnosticians trained to read the results, inform and interpret to the surgical team how best of target their scalpels. The more precisely a surgeon could operate, the more productive they could be. 

More and better diagnostic tools have been invested in since then, and it will contribute to waiting times dropping. But there must also be sufficient staff, well paid and motivated to make this happen. There's still not enough investment in the entire NHS to bring about change at the desired pace. Let's hope that the use of AI in medical research can make a difference to diagnostics but to helping the institution reform itself by interpreting to NHS leaders what needs doing to ensure what change towards greater efficiency can be implemented without detriment to staff and patients, and without breaking the bank. That's quite a big ask. Thus a patient ponders in the waiting hours, night and day. 

A couple of the other patients who spent last night attached to drips in the upstairs IV lounge moved downstairs with me. They were likely to admitted to other wards once further tests had been done and a suitable treatment plan drawn up for each of them. Mine was simple in comparison. It was a matter of waiting for the next two stages of the medical procedure to take place. But first more checks on vital signs  then soup and sandwiches for lunch. It was gone four when I was summoned into a treatment room near my bed where the ENT team were based.

Dr Emily had inserted the packing balloon and inflated it. Dr Amanda withdrew it, then waited to see what the consequences would be. Nothing happened, so she inspected with a strong light and identified several lesions up my left nostril. Once the mucus and congealed blood had either come out on its own or been chased out with gentle suction, she was able to cauterize the tiny wounds, almost painlessly, and apply an antiseptic dissolving wound dressing that would protect the nostril from infection for several days before I needed to self apply the naseptin cream I've used before, for the next two weeks. All very straightforward. The harder part was getting myself discharged.

Temperature and pulse normal, diastolic pressure a healthy low number, systolic pressure worrryingly high. Again. This happened after my gall bladder operation too. It was hard to persuade the doctors and the nurse in charge that for me this was usual, and inevitable considering the stress of 36 hours in constant artificial light, no exercise, three hours sleep with interruptions for checks on vital signs, as well as the shock element of the procedure, and the direct application of foreign chemicals to nasal skin - one of the most sensitive surfaces of the human body. Enough to make anybody's blood pressure shoot up. In the end they agreed, and off I went, just after six to visit the hospital's cashpoint, to get some money to pay for a taxi home.

When I got into the taxi I quickly realised that I didn't have my 'blood bucket' with me. I'd parked it on top of the ATM while I withdrew money and walked away excited, without it. I leaped out of the car and ran back to the Concourse lounge to retrieve it, while the taxi driver followed me and waited just outside the entrance doors. It gave a little comic relief to the end of the whole affair. With Hallowe'en tomorrow, the discovery of a bloodstained Gower beach bucket might have been deemed a tasteless grisly prank by whoever found it. The only people to know anything different were the ENT team and a few A&E nurses who already knew and were amused by it. Anyway, untoward incident avoided!

Traffic was very heavy all the way home, unusual for a Tuesday evening, except for something which my taxista observed. On Cardiff Road there's a large house decorated for Hallowe'en as a haunted mansion. It is owned by a couple who run a company dedicated to producing special effects for TV and movies, and it is done to raise funds for a children's charity. After it was publicised by local journalists, people have come in droves to see it, parking their cars along the neighbourhood roadside making it too narrow for coaches to pass, adding hugely to traffic congestion nobody wants. Unintended consequences. The journey home was twice as long as usual and cost me more as a result. But it was interesting to see, and I was back just in time for the Archers.

I'm deeply grateful for the experience of the past thirty six hours, not only for emerging well treated from my little bloody catastrophe, but for being able to see A&E staff teams in action, working their hardest in demanding sometimes distressing circumstances. So stressful, but the warmth and good humour expressed in the way they worked together, the sensitivity and tenderness with which they related to patients, and despite being over worked, underpaid, unfairly criticised and vulnerable when anything goes wrong. Here is love in action. Where is God in the midst of all the misery and suffering? In the hands, hearts and minds of those who give their lives right there where it's most needed.`

Such as relief to be back in my own bed again tonight.

 

Scanned again

A mix of sunshine, intermittent showers and drizzle all day, with the wind blowing cold and warm in quite a random way. I woke up at seven and was driving to the UHW Radiology Unit by twenty to eight. The whole place was quiet, with few people around. By five to eight I reached the reception desk and after a short wait was ushered into the MRI scanner area and prepared for the half hour session, enclosed in this huge noisy machine, making an assortment of rhythmic mechanical sounds, which made me think of some kind of techno sound track. I think that's at least the fourth scan I've had. Two or three when I was being treated for the anal abscess, possibly one when a large stone was making its way out from my kidney and now this one. Must check in my blog archive when I get around to it.

With the job done, I was on my way back to the almost empty car park by a quarter to nine. I met Diana from St Catherine's in the corridor, going into work. She's a pharmacist, taking her turn at a Saturday morning duty.

Clare made pancakes for breakfast as it's a Saturday. That's how I know I'm at home again! As a result of a promotion email from the Oxwich Bay Hotel, I booked a three night stay, from tomorrow afternoon until Wednesday. It won't matter if the weather is lousy, just to be in one of our favourite places is what matters.As a matter of urgency, during the day, I got on with recording and editing Morning Prayer and Reflection for next Thursday and uploading to YouTube, so I have no work to think about while we're away.

I cooked sea bass with veggies for lunch. After a siesta we walked together in Thompson's Park. I then went for a longer walk around Llandaff Fields on my own, dodging showers, as I needed more exercise, despite being tired after getting up early. After supper, the last pair of episodes of 'The Sketch Artist'. From the ending, it's clear there'll be a third series. Now a night's sleep without having to think about preaching or taking a service tomorrow.

Scan follow-up

I woke up at seven, posted today's YouTube Morning Prayer link to WhatsApp, then fell asleep sitting up until five to nine. Not the best position unfortunately, as it took an hour for my head to clear, walking to St John's to open up and prepare for the Eucharist as Ruth, who usually does this is unwell at the moment. Fr Andrew celebrated with five of us. 

A couple of times lately, a young woman joined us for the service who asked for a blessing at communion. She said she's a post grad nursing student, working on a dissertation. She mentioned cryptically that she attends church on Sundays, though none of the regular worshippers had seen her though I think I have, arriving at the end of our service with members of the Russian Orthodox congregation to prepare for their Liturgy, which follows ours. When I was celebrating, I noticed she made the sign of the Cross Eastern style - right to left, rather than left to right. Which was a small clue. It's good she feels able do this and is at ease with our concise, much simpler kind of worship.

Clare called to say she was shopping for a new mattress cover for the attic bed which got split during the recent work done on the roof and in the loft. Could I find out the depth of mattress and send it to her as there's more than one size available? As soon as I reached home I measured it and sent her the details. The loft looks great now that the new Velux window blinds have been fitted, and the paintwork touched up by Clare. Instead of dark brown fabric, the new blinds are pale great, which enhances the room when lit up at night with the blinds drawn.

I received a letter from UHW with an appointment for an MRI scan of my liver, a follow up from the gall bladder operation called for the operating surgeon, I wasn't aware would happen. It was booked for 22nd April, when I'm in Spain, so I had to call the Radiology Department and request a postponement, I was offered an appointment on 19th May, when I'm still away. The system doesn't allow for bookings more than two months ahead apparently, so I am obliged to call again a week or so before the date given and ask for another postponement. The lady I spoke to said she would annotate the entry to this effect. It seems that if an appointment is missed or postponed too many times, the patient has to refer themselves back to the consultant and go through the same procedure again. We'll see if this annotation survives on the system until the next time I call.

I cooked prawns with rice and veg for lunch. It was meant to be a risotto, but mistakenly I used paella rice instead of arborio. It could have been either a paella or a risotto. It was ready just as Clare came through the door, brandishing bargain bed linen. I was pleased with the result.

After eating I made a video slideshow of Easter Week Morning Prayer and uploaded it to YouTube, then went for a walk up to the Cathedral and on to Llandaff weir for a change. Though there was a chill wind the sun shone through the clouds and walking was pleasant. I felt less tired than yesterday and walked further. 

It's strange at this time of year to have so much time on my hands, but with no preaching assignments to prepare for Holy Week and Easter, the only thing I have to prepare for is my first Sunday in Nerja. As my flight arrives Saturday afternoon, there'll be quite a lot to familiarise myself with in the chaplaincy house and getting myself to San Miguel on Sunday morning. If using a car is necessary, I need to know how near to the church I'll be able to park. The journey time from house to church may be less than ten minutes, but ten minutes walk across town may be needed as well. I have no answers to these details until I arrive. With time taken up by these matters, I'd rather have a sermon ready rather than writing one last minute. Already I've done a draft, but I still have a fortnight to work on it and print it off.

So, after supper, with nothing better to do, I watched the rest of 'Top Dog' and a few episodes of 'Bones', and then headed for bed, under the Spring Equinox moon.

Long wait over - a day in UHW

Up with the alarm at six o'clock, half a glass of water and my blood pressure pills, then waiting for the taxi to arrive at quarter to seven, on time. My driver was a Sikh. It wasn't long into the trip to UHW before he was quizzing me about why westerners traditionally prefer to bury their dead rather than cremate as Sikh scriptures recommend. I explained that burial was seen as a way to cherish the memory of the dead, and it gave rise to graveside customs and visits with flowers, more about the need of the living than the dead. In Sikhdom and Hinduism bodily remains are of disposable value after the soul has departed. As much as I could manage at seven in the morning!

The concourse at UHW was almost empty, nobody to ask, though the route to the Short Stay Surgical Unit had proper signage. The entrance was locked and unlit, however. There was a pink sheet in a plastic wallet stuck to wall with SSSU and arrows on it. I walked, and came across a porter with a trolley full of half litre bottles of milk. "Hello, aren't you a priest?" Surprised, I confessed. "You did my mum's funeral at St John's four years ago", he told me. He told me to keep following the scant diversion signs and gave me a vague sense of location. I had to ask another staff member when I ran into fencing blocking the way across on open yard to an external door. No notices, no clarity about the destination. But the only way to find out if this was the correct entrance was circumnavigate the security fence, as all the doors leading out into this back alley were locked. SSSU may employ really hi-tech surgery but is evidently of such low status is the hospital pecking order. A five minute walk took fifteen. Just as well I was early.

Then an hour of repeated bureaucracy and identity checks and the inane question "Do you know why you are here?" The anaesthetist noticed that I'd not had a blood test for eight months. Pre-op assessments are, I believe, valid for six months. Clearly I had been fitted into the schedule at ten days rather then two to three weeks notice, for which I'm grateful of course but the admin hadn't caught up. Blood was drawn and taken for testing. This I imagine was a factor leading to my op slipping down the list until last. I waited six hours to go to the operating theatre. The tedium was relieved by conversing with a tall bearded student nurse. We talked about whether there was sense to be made of any religious quest. I steered him towards considering the way of the mystics. Don't start with ritual or belief but with your own curiosity about what's unknown, above and beyond existence. Did he understand me? I'll never know.

It was two thirty when I was taken to theatre. The clock read a quarter to three when I was about to slip into the Unknown, and five fifteen when I emerged. The six year long wait for surgery ended with another  long wait for surgery!

The op was longer than expected as my blood pressure was through the roof. Getting a 430mm stone out through my navel must have been a wrestle, like extracting a tooth. Now the surrounding area is bruised. The four incisions aren't that painful. I thought the recovery room nurse wasn't quite allowing me enough time to come to, then realised it was a quarter past home time. The assistant surgeon already in his outdoor clothes ready to go, gave me a letter for my GP, recommending a hypertension medication review, as the monitoring team had difficulty controlling my blood pressure. Not surprising removing such a big stone.

 The nightmare began when I was back on the ward. I warned that my stomach would be inflated with air during the op and that I should expect to pass lots of wind. Nothing but pure agony. Impossible to move at any angle without pain. It was hard to take anything but a shallow breath despite a nurse exhorting me take deep breaths - like in yoga. Really?

The nursing shift was coming to an end. I was still groggy from anaesthetic, and at the end of 22 hours of fasting, feeling faint. No food was offered, or notification that you should bring your own. A nurse gave me a banana which revived me. No nausea, just pain. Due to the shift change my discharge was delayed an an hour. A young nurse wheeled me down to the concourse. The east wind blowing up the corridor was at minus three. Ruth kindly collected me and took me home by car by 8.30pm.

I was in bed by 9.15pm, dozed for six hours immobilised by stomach muscle pain, then struggling to get out of bed for a pee. Getting in and out of bed was agonising every which way, and had to be careful to avoid stressing the four wounds. My pulse rate was frighteningly high, but calmed down when I took a blood pressure tablet six hours early. I got up and walked around, and slept the rest of the night in the lounge chair.

I haven't felt this bad since I went down with anal infection four years ago,  especially when I was in Ibiza, alone with an infection and struggling to get in and out of bed for a pee. I didn't expect the trauma of that experience to visit me again here. But, I am still alive, the pain reminds me. And I daresay it will subside fairly soon.

Reassured

Another clear cold night, temperature down to minus 4. I woke up at seven thirty, posted today's Morning Prayer link, then sang Happy Birthday to my sister  on WhatsApp. 89 today. I didn't go back to sleep but got up and cooked breakfast porridge. Clare's eye is still inflamed and her vision worsening. Something's not right, so she contacted the eye hospital and was encouraged to visit the Optometry School for a check, as the eye surgeon looking after her isn't available to consult at the moment. 

I went to St John's for the Eucharist. There were the usual five of us with Fr Colin. I skipped coffee after the service to return home and scrape the layer of frost off the car before taking Communion to Sandra in Danescourt. A taxi was reversing into our street as I arrived home. It was collecting Clare to take her to the Optometry School for an emergency consultation. It seems to have taken more than three hours to arrange this. I cooked and ate lunch leaving Clare's share to eat this evening. I walked then to the house where Ray lives the other side of Thompson's Park, to take him Communion. I rang his doorbell for a good while but there was no response. I suspect he may have fallen asleep in the chair. I decided not to phone and disturb him, and went for a walk in the park instead and returned just after sunset. The sharp drop in temperature was noticeable once the sun was below the horizon.

After her eye checkup Clare went into town. We chatted while she was having a cup of tea in John Lewis' top floor restaurant, our usual host. The optometrist gave her a thorough examination and said that the inflammation wasn't yet serious. He gave her a new prescription and arranged to see her again on Monday to check if it's got better or worse. She gave me the taxi service phone number she'd used, to book myself a ride for tomorrow morning. My operation calls for a six forty five departure from home, to allow for any taxi timing error. I could if necessary walk it in forty minutes. I'm more worried about arriving late than I am about the operation itself. My taxi booking was confirmed with a text message giving an estimate of the fare, dependent on drive timing and conditions, plus possible payment means. A neat feature.

Sister-in-law Ann rang to check if whether the operation had been cancelled or not, and gave me a helpful briefing on the procedure and its aftermath. Fascinating. Thanks to low impact surgery, I may not be out of action for long. She said she walked out of hospital after her gall bladder was removed. In any case I have no commitments apart from Sway until a week Sunday, just welcome free time.

After supper, another couple of 'Bones' episodes, then a really early night.

What price justice?

Another wonderful wintry day, cold and sunny. With time to spare while Clare as making lunch, I set to work on next week's Thursday Morning Prayer. It's on the first day of the Week of Prayer for Christian Unity. Nothing much happens locally on the inter-church front these days, although food banks and work with refugees and homeless people does engage people from across the churches. Anyway, I decided to use service material from this year's special Churches Together special leaflet in preparing a text to use.

After lunch I drove Clare to the Heath Hospital for a round of minor eye surgery aimed at reducing the eyeball pressure, which is what causes vision loss. After dropping her off at the entrance, I drove to the University School of Optometry in Cathays to book an eye test, then did some grocery shopping at Lidl's.

I went for a walk in the park, while awaiting a call from Clare to collect her but the operation took a lot more time than expected, and in the end she took a taxi back, to spare me having to drive through rush hour traffic in the dark. She returned home not long after I returned chilled from the park. After a cup of tea, we went out again together for a walk around the block to the Co-op for a few more items which were not on my memorised shopping list in Lidl's. 

When we got back, I recorded the text I'd prepared earlier in the day, and after supper, wrote a Christian Unity Week reflection observing how, even in this time of decline in Christian adherence, there's been a growth in the international diversity of expatriate Christian communities in the area covered by Canton's Parish churches. This year's Unity Week theme is 'And who is my neighbour'. Noticing our world wide church neighbours is indeed something special to be celebrated.

Much to my surprise I had a phone call from the General Surgery Unit at UHW to offer me an operation to remove my gall bladder a week Friday morning. At last, after five years of waiting!

The death toll in Gaza is now around 23,000 and the Israeli assault continues. The military public relations rearguard is showing video of an underground armament producing factory on a small industrial scale, way bigger than any home industry effort. This is offered as justification for their campaign, but even the US Secretary of State, Anthony Blinken is becoming more outspoken about the unreasonable scale of the suffering and death this campaign is causing. 

Such a huge amount of time effort and money has gone into creating this subterranean world, a huge investment. Where does all this funding come from? It's been shown before how material resources such as water piping and fuel have been hijacked and fed into rocket making, but workers and militia personnel can't survive without being fed, trained and rewarded for their efforts. To what extent I wonder has the money supply been investigated, and what efforts have been made to cut it?

The telly drama about story of the 700 postmasters prosecuted for false accounting here at home has stirred up widespread public indignation, years after it was made public through the quashing of some convictions on appeal. The background story of the faulty software introduced over 20 years ago has been aired in tech' journals, and now at last being aired in mainstream media. Far too late. Only in the past week have questions been openly raised in the press about Fujitsu as a key supplier of the financial software  that was unfit for purpose. 

Many people within the post office colluded with the lie that there were no problems with the software, dismissing the anomaly of so many postmasters being prosecuted within the same time span. Statistically speaking 700 prosecutions highlights something might be wrong and need a fuller investigation. That's a high crime rate in an institution which would have checked out the people it was going to hired for safely working with money at the outset. An expert software analyst reported that the software wasn't fit for purpose. He was dismissed and discredited by the company. How many top level executives and lawyers conspired to perpetrate this travesty of justice will be revealed by public enquiry. Will their fate entail as much suffering as has been caused to those 700 victims? I wonder.

Things going right for once

After breakfast this morning, Clare's study group arrived, so I went out for a small amount of shopping, and then went for a walk until the group finished. We had an early lunch so I could drive over the the Heath hospital for a General Surgery appointment. The letter wasn't informative, so I presumed it would be to evaluate my need for gall bladder surgery.

At the reception desk, I found I wasn't on the list of people to be seen. The appointment for today was cancelled on 13th February. That was when Clare rang up to cancel an appointment made for me on a date March which arrived when I was still in Fuengirola. Another appointment letter for today's date arrived while I was away, but instead of adding me anew to their database my case was taken off unintentionally. The new letter revealed the mistake, so I was inserted into today's appointment list and n ot turned away. I only had to wait twenty minutes, and then called in to see one of the Consultant's deputies. While I waited I worked on next week's Morning Prayer text using my phone, and got two thirds of the job done, which I then don't have to do at home.

He asked me if I was in pain, and I explained that my dairy free diet had kept me trouble free since it was discovered that I had one big gallstone, rather than a collection of tiny bits which can leak out painfully one after another. It was the size of the stone that attracted his stone, and he said it was better to get it done sooner rather than later at my age, and take advantage from the fact that I'm still pretty fit and well.

He sent me off with a form in hand to the new pre-op assessment clinic where I filled in my part of the form, marked 'Urgent level 2', then interviewed by a nurse and given a full health 'MOT' as it's known. ECG, blood pressure, blood test etc. I'll need to have a cardiac fitness review to see if my small heart murmur is any better or worse than it was last time, before one of my bum surgery ops. I should hear in the next week or so. Then there'll be a wait time until there's a slot for keyhole surgery. How long that'll be we'll just have to see.

I was delighted at this burst of progress. I didn't expect to get priority treatment, but it's an easy win for the surgical team if I'm healthy and there's no inflammation or infection to deal with, so here's hoping.

I drove home, then took the bus, then took a 61 bus to Pentrebane for a bereavement visit. Fortunately I didn't have to wait long for a bus coming and going, so I was back by half past seven, but before Clare came in from her meditation group. I spent the rest of the evening after supper writing, recording and editing a reflection for next week's Morning Prayer. One way and another, a fruitful day.

Resilient Roy

Another beautiful sunny Sunday morning on which to celebrate Mass at St German's. Just after I arrived Father Roy Doxsey arrived. It was his first outing from UHW's trauma unit since he was admitted to the hospital after being hit by a car. His injuries were serious and life threatening, including head injury. He spent his 80th birthday in hospital, but thanks to superb medical care he making a good recovery, though still with a few gaps n his memory. He's determined not to go into a home for retired clergy, or sheltered accommodation. The adaptation of his flat in the former St Ann's Clergy House to enable supported living where he's lived for the past ten years is under way. He's already planning to throw a party, he says.

By the time I returned from church Clare had lunch on the table, an indication her being able to cope with the back pain, diminished but by no means gone away yet. Afterwards, I sat down to do my daily Due Lingo drill, and no sooner had I finished than I fell asleep for a hour and a half in the chair, sabotaging my effort to do without an afternoon siesta. Then I went out for a walk in the park. There were scores of small groups sitting out on the grass, and down by Blackweir Bridge three pony and trap ensembles belonging to the local Traveller community were parked on the grass and the horses being led to water after their trip across town. I think that's the first visit they've made so far this year. They appear about once a month, a lovely reminder of summers past in another era.

There wasn't much of interest on telly tonight, apart from 'The Antiques Roadshow' so I spent an hour or so reading and revising my novel, and then went to bed early.

Time to say thank you

Mid morning, I drove Clare over to the University Optometry school to get her new set of varifocal specs, her second pair this year, as her eyes have deteriorated further and she needs to make the most of her eyesight while she can, before she is compelled to learn how to use voice recognition technology with the phone and the computer. We called into Lidi's nearby afterwards, where she bought a anti-snore pillow, which turned out to be nothing of the sort - more likely a wrongly packaged standard pillow. Too late to return it once it's been used. 

With a couple of trips to the shops and Post Office, my days exercise was done pounding the streets under a layer of grey cloud - there is visual relief however, from Christmas trees revealed behind open curtains and strings of coloured festive lights, increasingly spread outdoors to front garden trees and fences.

Then I settled down to finish the thank you letter started over the weekend to Mrs Cornish the surgeon. As the wound is now tiny and almost completely closed, I felt it was time. I've been reluctant to write this any earlier, when I might well have done - a bit like tempting Providence. It's now three years almost to the day since I was given an initial date for surgery. I have so much to be thankful for, given the intrusion of the pandemic, and several other delays in between rounds of surgery due to resource shortages. 

I guess if anything has changed in three years it has been not just in staffing, but in improved availability of some equipment, and organisational efficiency. There are still big problems due to lack of functioning wards, shortage of nurses, and lack of home care to enable early patient discharge to avoid bed blocking, but covid has brought a revolution in emergency care and diagnostics, and this makes possible different ways of treating people. 

I heard an industrial scientist on the radio talking about a proposal for a global health monitoring system to spot evolving deadly viruses which could give rise to another pandemic. It would issue a global threat alert early enough to take preemptive action. It would network monitoring technology analysing soil, air, water, especially waste water, relating them to medical and veterinary pathology data. It would require huge investment and political consensus, but save the world from economic ruin and high death tolls in future generations.  

I completed and uploaded to YouTube this Thursday's Morning Prayer video, wrote a biblical reflection for next Thursday's video and recorded the half of the audio. This minimises the amount of preparation I have to do alongside Christmas services and family celebrations. It's going to be a busy week.

Before bed I started watching the movie 'King of Thieves' based on the 2015 Hatton Garden bank vault robbery. It was said to be masterminded and pulled off by a group of retired London East End thieves in their sixties, and starred Michael Caine, Jim Broadbent and Tom Courtenay - a brilliant portrayal of a group of elderly working class males, a non-genteel 'Lunnon' equivalent to 'Days of Wine and Roses

The dialogue was hilarious, mostly comprising old school abusive gangster language, such as you might hear in any rough back street pub or football terrace. Anything but politically correct, so the movie was preceded by a 'health warning'. I had to give up and go to bed before midnight approached as it didn't finish until late, so I'll have to watch the last quarter in iPlayer.

Op date assigned

I was just about to settle down to say morning prayer in honour of St Mark the Evangelist this morning when I received a 'phone call from the hospital. The anaesthetist had already read Saturday's pre-op report and added me to the day surgery schedule for May 28th. Now at last we can plan a week's holiday because we know where we stand. A cottage by the sea, early June in West Wales is what we're hoping to book. 

Another glorious sunny day today, with curried lentils, rice and veg for lunch in the garden. Then I walked into he city centre to take photos on this much awaited day when it became permissible to eat and drink at tables outdoors once more. i can't say that every open establishment was crowded with people queuing for a table, but it was fairly busy, you could say as busy as you might expect on an ordinary Monday. It's nice to have photos that contrast with those take when the centre was deserted for so long due to lock-down.

It's tragic to see the pandemic raging out of control in India, people dying in the streets waiting for treatment at overwhelmed hospitals lacking in oxygen to keep sick people alive. Just as covid deaths are reducing to single figues per day here, they are reaching a couple of thousand a day in India, with a third of a million new infections as day. The country caught unprepared for this huge surge in numbers, and Narendra Modhi's government has a lot to answer for.

I spent the evening watching episodes of NCIS that I haven't seen before from the more recent series. Then there was a full moon to gaze at, brushed lightly with high cirrus cloud. I'm not expecting great things from the photos I took, but it was lovely to look at above the roof tops. It made me remember the three full moons I saw in a crystal a clear pollution free sky last year in the countryside in locked down Ibiza.

Assessment appointment

A lovely sunny day again, starting with a lie-in and pancakes for breakfast, made this week with gluten free buckwheat flour, as an experiment. It was a great success, they were very tasty! 

I walked over to the Heath Hospital for my pre-op assessment. I wasn't given a date, as the assessor's report has to be okayed by an anaesthetist on Monday. Then I'll be sent an operation date. In preparation this time I'll only have to self-isolate for three days and be covid tested before being operated upon. 

I walked back home, after the hour long assessment, arriving just in time for lunch in the sunshine in the garden. We both had a siesta, then walked over to Bute Park to wander through the woods beside the Taff. Wild garlic and bluebells are now out in abundance, replacing the daffodils and varieties of narcissii which thrive in abundance beneath the trees. When we arrived home my Fitbit told me I'd walked over 20,000 paces, just under ten miles. That's a first for me, and I'm neither foot-sore nor exhausted as a result. Slowly my stamina is improving.

Water in the river Taff is very low, revealing lengthy stony reaches along the banks where some of the many hundreds out picnicking in the parks, are enjoying the water and lighting fires. Yesterday kids were jumping and somersaulting off the bridge into the short stretch of water under the bridge which is perhaps five feet deep - a supper ritual for adolescents ever since the bridge was constructed. Today, a police van was out. All but one of the kids had disappeared. Just one was swimming about defiantly upstream, being 'observed' by a masked policeman from the bridge. I couldn't imagine the copper wading in and making an arrest! A man was approaching the bridge from the Bute Park side with his three year old daughter. She eyed the stony stretch below the bridge on the other and exclaimed "Daddy, is that a beach over there?"

Before supper I finished my sermon for St German's tomorrow, then we watched a movie called 'Goodbye Christopher Robin', about the relationship between A A Milne, author of 'Winnie the Pooh' and his son Billy, and how the books came to be written around the various characters of the child's animal soft toys in the 1920. It made Billy aka 'Christopher Robin' into an unwitting child celebrity which has a negative impact on his life as he grew up. The author suffered from PTSD after returning from the World War One, and saw his son join the army, go missing and eventually return home safe and sound, no longer resenting the loss of his childhood, but realising how much his father's books held treasured childhood memories of normality for some of his comrades in arms. A fascinating true story.

Encouraging news

After breakfast this morning I had a phone call from the appointments office in UHW Heath to ask I could take a pre-op assessment this Saturday morning. A delightful surprise and and indication of my surgeon's commitment to resume normal activities as soon as possible. Determination in the face of a nightmare of a backlog of patients needing treatment if news reports are to be relied upon. If all is well on Saturday I may even get an appointment for my final round of surgery.

Recently, in our area many building companies are working on houses. It's consequence of people having to stay at home during lock-down and not spending much, so money saved gets spend sooner or later on jobs needing to be done or major home improvements. A house opposite in our street has been undergoing a substantial loft conversion for several weeks now, taking advantage of the dry weather, and it's nearly complete. The house changed hands a few months ago and couple moved in that until today I haven't seen let alone meet. Pascal is from Nantes and Miriam from Bilbao. She and Clare got to talk in the street because she'd seen me out and about in my Basque beret, bought in Bilbao back to 2009. 

When I got back from my walk of the day, Clare introduced me to Miriam on the street. We chatted in Spanish, occasionally lapsing into English and even French, covering a wide range of subject for over an hour. On my own doorstep, I get to use the Spanish I have learned over the past nine years more than I have done in all my time among expats in Spain. Wonderful! One of God's little surprises, just as I strive to get used to not being able to travel in Spain again.

The new phones we bought last week don't include an answering machine. I needed to get TalkTalk to activate the native answering service. When I visited their website, I discovered that our contract had just expired. I set a phone notification eighteen months ago last time I renewed it, but it hasn't yet arrived. So I did what was necessary, and then tried to find out how to switch on the answering service. I had to resort to usng Twitter's instant messaging service, like I used last time I had a broadband malfunction, and had an exchange with one of their helpline people. The first time I tried, the system wasn't working properly as it was still updating my subscription renewal, but the second time, it did work. That was how I discovered that using TalkTalk's answering service will cost me an extra pound a month. Altogether with my renewed contract, I'll be paying fifty three pounds a month. It works pretty well. Is there better value for money out there? Maybe, but what I have is consistence and continuity where I need it most.

Next up, car insurance renewal at the end of the month. Another tenner on the premium if i pay on-line, but then, I am a year older now, and no matter what my record or how careful I am, the more I am seen as a liability by underwriters. Given how little we use the car these days, using a taxi when we need it would probably be less expansive than have a depreciating asset in need of maintenance parked outside the door.

And now a festal season lockdown

Pancakes again for breakfast today, plus a couple of rashers of bacon from a packet opened a few days ago, an extra treat! There were more outbreaks of heavy rain, plus enough respite time to have a good walk in the park. I've been trying to figure out a setting in which to video the next batch of Morning Prayer videos. It's rather tricky to set anything up that looks good in the favoured portrait display mode, due to the phone camera's field of view at close range. I've cleared Clare's desk to make space for an icon, a big candle in a red vessel and an open bible. but positioning the phone to block avoid home office-like surroundings and having room to show my face as well is really frustrating. I have to record on the phone in one take so distribute via What'sApp. Anything edited on another device or taken with a proper camera doesn't render correctly when transferred back to the phone and I can't figure out why. You have to work with what you've got, however. And I can, with a bit more patience.

At tea time I had my appointment at the Heath Hospital, driving over there in the dark, and parking at the house of Vanessa and Keith, friends from St John's City Parish, to walk into the campus rather than risk not being able to park. I could have chanced it as the hospital turned out to be pretty quiet at that time of day, and during a pandemic. I was twenty minutes early and ushered in straight away. I had to change into a clinical theater gown, before going into the scan room for a briefing, and kitted out with  ear defenders, as the equipment is very noisy. The twenty nine minute sequence of scans, pairs of three, then four five and six minutes at different frequencies is a strange sci-fi like experience. Amazing imaging technology, invented and developed to a high degree of sophistication from scratch over the past sixty years. What a time to be alive.

When I returned to get my my car, I chatted with Vanessa and Keith on the doorstep for five minutes. It had just been announced on the phone that the lifting of meeting and travel restrictions for the Christmas feast has been cancelled nationally, because of the rapid surge of infections caused by the new contagious variant of covid-19. The changes come into effect at midnight tonight. I'm not surprised. Fortunately, church services haven't been cancelled, yet. This could have been foreseen a few days earlier. Such short notice will be create havoc, not just for families planning Christmas gatherings, but also for businesses which are already in an advanced stage of preparation and delivery of Christmas dinners.

Not much of interest to watch on telly this evening, so I worked on my New Year's Eve reflection and Morning Prayer combined video script. Very hard to keep within the optimum eight minutes. I tried a few experimental recordings, but wasn't satisfied with the result, and went to bed, not quite as late as usual.

Op prep

A miserable wet day today, with either light or heavy rain from early morning to late afternoon. Clare drove me to UHW Heath Hospital late morning for my pre-op assessment. The unit has moved from a collection of temporary buildings out in the grounds into the south wing of the first floor of the main hospital, where there's an assortment of other outpatient clinics. The area previously occupied is now a large building site, occupying half the original open green space on the 1960 architectural plan. Spare capacity is much needed as this is one of Wales' main teaching hospitals.

The hospital corridors were busy with staff and support workers moving around but less crowded than it was before the pandemic. Normal services are resuming, but more slowly, as patients must be managed mindful of the need to ensure safe distancing, a more measured workflow without queues, and very few people occupying waiting areas. Everyone is scrupulous about hand hygiene and mask wearing. I guess staff are relieved to be able to resume their normal duties and not have their clinics cancelled and be obliged to cover emergencies with pandemic victims. Covid-19 infected patients are met and managed in a separate zone. A great deal has been learned and put into practice these past six months.

After my examination, and discussion with the consultant anaesthetist I received a provisional go-ahead for the operation. My chest is still noisy with phlegm in the wake of the cold, but there are no signs of bronchitis. I'll need my GP to listen to my chest Monday next, to confirm that I am well on the way to full recovery, to stay on the surgery list for the 20th. There's still another two weeks in which to improve after that, two weeks in which Clare and I must self quarantine. I'll get a covid-19 test three days before to confirm that I am safe to work on in the routine manner. Let's just hope there'll be no more infection set backs in the coming twenty days.

The assessment took nearly two hours. It was still raining when I left the hospital, so I gave up the idea of walking home and took a taxi, just after Clare texted me to say that lunch would be on the table for me as soon as I got back as she'd just finished cooking. Later in the afternoon we went for a walk in the rain, and as we walked the rain got heavier and heavier. I decided to turn back, but Clare under her brolly marched on. I sheltered under a tree before setting off, then the rain slackened to a drizzle, so I resumed walking, and we both got home within minutes of each other from different directions three quarters of an hour later. By sunset, the sky was a clear inky blue, and the almost full Harvest moon was mid horizon. There'll be a second 'blue' moon, as it's called in the coming month. Let's hope it won't be an overcast night.

Unexpected light

By the time I got up, I had a streaming head cold and immediately rang the Pre-op Assessment Unit to inform them and ask for an appointment deferral The person I spoke to thought that a delay of four days would be adequate, assuming it was just a cold - that's nine days from now. 

The worst of Clare's symptoms are receding already, so today she got dressed and tackled a few domestic tasks, taking time out to rest as well. After lunch I received an unexpected phone call from the colorectal surgeon's administrator at the hospital. She was aware of the change in my pre-op assessment date, and it seems this risked causing problems, as the team proposes to perform my surgery #4 on 20th October. I was surprised and amazed, to say the least, having expected another delay of many more months after the pre-op assessment whenever this gets done. Then came the big revelation!

The op will be done at The Spire private hospital in Pontprennau. Mrs Cornish is a specialist surgeon on their list, About a year ago I asked if she'd be willing to operate on me there at my expense, I was feeling so desperate. He response was admirably simple - "Sorry but no. I'm far too busy with NHS patients." In order to clear the waiting list backlog, NHS Wales is hiring the facilities and staff there. This is complex to prepare, as all the surgical records have to be digitized and emailed to The Spire for the benefit of the support team as well as Mrs Cornish. This part takes two weeks. The earlier the pre-op assessment can be done the better, in case there are any further pre-op investigations called for, given my recent ups and downs in health. 

So, I must get through this cold, avoid further infection and look for ways to get my blood pressure closer to normal in the coming weeks. It may not be so straightforward, but knowing that I am on track for treatment soon is a great stress buster. Not seeing an end to being stuck in Ibiza when I was so overdue to return home, then getting sick was traumatic, awakening dark memories of the months of waiting without knowing to get properly diagnosed for surgery in the autumn two years ago. It undermines you saps your resilience. For the second time in 24 hours my pre-op appointment has shifted two days earlier, and I'll get a call Monday morning to confirm I have recovered from the cold.

I've got a few more days of nursing myself, dosing with garlic and honey, making the house smell awful and taking life easy, even to the point of reducing my daily exercise, to recuperate, but at some level I am feeling better already. Shadows are giving way to light at last. Hallelujah!

Unavoidable decisions made

Both Clare and I were awake at five this morning, leaving the house at half past five to drive her to the coach station to start her journey to Phoenix AZ to visit Rachel and Jazz. The Heathrow coach was half an hour late, but got her to Terminal Five with the four hours she needed before her direct flight departed. Fortunately, despite the weather it left on time, and in the evening I was able to find it on a flight tracking website heading south west from Hudson's Bay surprisingly on-time despite strong headwinds causing longer flight times on the direct east-west route. In the past week or so the speed record for the fastest transatlantic subsonic flight west-east has been broken twice due to the power of the jet-stream - 800 miles an hour ground speed.

I went to the surgery this morning for my medication review. I also asked the doctor's opinion about travelling abroad on working in Ibiza, whether under the circumstances it would entail additional risk, and she said that it didn't. If I have the confidence to manage on my own here, as I shall be for the next fortnight, then being on my own in Ibiza is no different. So I can get on with preparations for getting there.

Much to my disappointment, after two weeks, I received an email from the Spanish Ministry of Justice rejecting my application for a police check, on the basis that a UK certificated copy of my passport is unacceptable in their legal processes. The only way I can get a copy 'notarised' as their protocol requires is to obtain an appointment at the Spanish consulate and make a visit in person, or else mail my passport to the office, which I am reluctant to do not knowing how long it would take. It looks as if the only way I can get this done is to find the Ministry of Justice office in Ibiza and go through all the necessary procedures there, to obtain a certificate copy and apply for a police check. So much easier in person.

Still nothing from UHW about an appointment. No response to my letter to Mrs Cornish. Finally I reached the conclusion that further delay is not in my best interests or anyone else's, so if I have to pay for the final round of surgery, I have to pay. So, early evening I called the Nuffield Hospital in the Bay and arranged a consultation with Professor Haray one of their surgical consultants. I have an appointment booked for Thursday morning. Hopefully, I may be able to get an operation within a few weeks. The cost of that is likely to be as much as that river cruise I was hoping to take Clare on. Such a pity.

It seems that the lion's share of NHS resources these days goes into managing any and every kind of medical crisis from A&E to transplants. It's well done and often successful in a way that calls for admiration and respect. Brexit driven staff shortages have hit UK hospitals hard, but the price is paid for this disproportionately by the masses of people suffering from chronic minor complaints needing routine surgery, having to wait twice as long this year as last. If only the hospital admin were more honest and forthcoming to patients about the real position they are in, then at least it'd be possible to make an informed decision about treatment. I'm fortunate to be able to afford to act in my own interests, even though I'd prefer to wait, but enough is enough. Mt family and other people have to endure living with me in the precarious state I've been coping with for so long. It's not fair on them as well.

No lessons learned, history repeats itself

Still no appointment letter from the hospital in the post Monday morning. That's twelve days waiting. So, I rang the surgeon's secretary to enquire. I was disturbed to discover that she didn't have access to Mrs Cornish's surgical appointments diary. She didn't apologise for not acknowledging my message of Friday afternoon last. She told me that Ms Cornish is on study leave this week, and in my opinion this may mean the next appointment lists have not yet been prepared, but who knows? 

She wasn't very forthcoming in response to my concerns but did say that there is now a 36 week waiting list for minor surgery. This disturbed me even further. She promised to email Ms Cornish and enquire on my behalf, as I am so concerned to know when I will be seen. Knowing if I am going to be available for duty or not is a matter of urgency. She said the pre-op assessment handled scheduling and that I could call them, which I did. Their auto-response device intended to deal with waiting list enquiries wasn't working and disconnected me. I was so infuriated by this I decided to re'activate my complaint procedure with the Local Health Board, and wrote an email describing what happened. It's a repeat performance of what happened last June-July.

Today I was called by a hospital trouble shooter and told officially about the 36 week waiting list, but not whether this was from when Mrs Cornish saw me or from the pre-op assessment appointment. I was offered no information about where I might be in that 36 week queue, only that I would receive six weeks notice of such an appointment. It seems that my final operation is regarded now as 'routine' and 'non-urgent', despite reassurances that it would be dealt with sooner or later because of the tissue over-granulation problem I experience. No explanation offered for the reasons behind this. I said that such a lack of definite information was outrageous and unacceptable and that I would be escalating this complaint.

I then set about writing to the Welsh Assembly's First Minister, to whom I wrote back in July to tell him of this repeat performance. Delays are evidently due to lack of resources and that's common knowledge, but it doesn't provide an excuse for keeping patients in the dark about the practical details of their treatment plan. That is just bad management, and needs to be addressed. I walked down to Mark's constituency office and posted the letter through the door, in the hope that ti will be picked up and read tomorrow.

I feel as if I am in limbo at the moment, not knowing where I stand, unable to confirm commitments I want to make until I know when I will be dealt with.

This morning, Laura, one of the Euro-diocesan safeguarding administrators rang to tell me about the need to make a digital CRB check application. After racking my brains, I vaguely remember doing this for the diocese five years ago when the new system was in its infancy. But I still need to prove who I am with supporting documents, posted or emailed to HQ.

This afternoon I popped in to see Emma and Nick and their wee bairns, and got Emma to countersign my old and new passport copies and a copy of a pension document with my address and NHS number on it, all required to support a digital CRB check application. Then I did the on-line application, and sent digitized copies of my proof of i/d to Laura. One more job done. Just in case there's any CRB confusion due to my recent change of passport, I emailed her and the Church in Wales safeguarding office a certified copy of my new passport, as queries will go back to these offices rather than me, as they are the agencies requesting checks. I wonder when the Church in Wales will switch to the same system as the CofE has had for five years already. It seems we're always a bit behind the times.

National isolation day one

Nothing in the post from UHW again today. I would have expected to hear by now. It's distressing. It was also annoying to have my Llandaff Diocesan safeguarding CRB check application form returned to me in the post because when I filled it in and did the identifying document check at Llys Esgob two weeks ago I missed a second form authorising consent to digital data sharing for safeguarding. Earlier this week I found the un-filled form and posted it to Sarah the Bishop's chaplain, but she's not in the office this week, so it won't have been dealt with. It's just as well my Llandaff PTO doesn't run out until the end of April, and I requested my application rather than wait to be notified. Both ways on top of Brexit starting at midnight in Brussels yesterday, a rotten start to the weekend.

I still can't believe brexit has started, let alone come to terms with it. It breaks my heart. Separation and division ferment conflict. Eleven months of negotiations now begin in earnest. Isolation makes us vulnerable. I believe those who have a high opinion of Britain's strength and capacity as a lone global player are profoundly mistaken. It's another propaganda con-trick. Just how vulnerable Britain now becomes may well be revealed in the coming years. All of us will suffer, apart from those who can figure out how to make a profit from the country's plight, then cut and run. 

I walked into town, keeping Clare company while she did some shopping in the afternoon. It was a six nations rugby international afternoon, and while Wales were imposing a humiliating defeat on the Italian ream, the streets and shops were very quiet. We saw a stall set up on Queen Street by a Muslim non-violent anti-extremism group wanting to convey to the world that authentic Islam in no way condones the evils perpetrated in its religious name. Good luck to them. I wonder what impact their campaign will have in a society which habitually stereotypes everyone and feeds on fake news poor quality journalism and 'newspeak', fond of calling good things bad and bad things good in a way which would have George Orwell saying "I told you so." from beyond the grave.

More scanning later in the day, this time a roll of film from a Greek island holiday in 2000 and from the wedding feast of Delbert and Ara in Geneva, on which occasion I played guitar with a Mariachi band of Latin American ex-pats in between courses. The daft things I did in those days!

A re-run of a Montalbano episode seen twice before on BBC Four tonight. Brillant slapstick from the inimitable Catarella, but a sad tale of betrayal, jealous passion and compassion, spanning a thousand miles from Sicily to the eastern Italian Alps.