River of calm and kindness

A warm night and a poor night's sleep, although that may be from wearing my Fitbit too loosely to record any data that makes sense. Awake in time for Thought for the Day and a more complex routine of medication at breakfast time. The beta blockers add to the existing lethargic foggy head sensation, and slow my pulse. The leak from my nose wound continues to dry slowly and reassuringly, so the systolic pressure reduction remedy has worked.

Despite being more hard of hearing than I, Clare noticed the high pitched alarm sounding from the fridge freezer, which lost temperature overnight. Initially I didn't hear it due to my tinnitus being louder. Clare called British Gas services to arrange an emergency call out. Two hours after noticing it the alarm stopped. One tub of posh ice cream lost. It seems a bag of something in our over-packed freezer caught in the door seal, allowing the heat leak, and it was a hot night, 30C this morning. Fortunately the refrigeration unit worked. It wasn't broken, but took its time getting back down to 18C. Thankfully the pump  kept working and didn't overheat. Clare was able to call off a diagnostic visit, but we ended by signing up for a household maintenance package for emergency cover.

Half a morning, half asleep while Clare went shopping. I cooked Paella for lunch with the half defrosted pack of fish pie mix and used up the remains of a bag of Valencian rice from Mercadona from our trip to stay with Veronica a year ago. Another hot afternoon, languishing indoors, sleeping uncomfortably in my armchair, too lethargic to go upstairs to bed. 

Updating my cousin Dianne on course of events gave me an opportunity to reflect on the oft-commented emergency medical crisis - having been on the receiving end. A&E seems to surf on the edge of chaos, brilliantly fielding the new intake of suffering patients, facing logistic challenges, shifting them asap, which can be an excruciatingly long wait in noisy places. I was admitted at two in the morning parked in a kids' treatment room, missed by the half awake breakfast team. I got NHS cheese and ham sandwich packs instead at lunchtime. 

Shifted to a transfusion 'lounge' for a few hours, with several quite poorly people, then decanted to a surgical couch waiting room overnight - my first visit to this place was when I had my gall bladder out, six months before the stroke and a previous nose bleed. Then, up a few floors to the same day emergency surgery unit. That was where we had to evacuate a few hours later, due to a MRI scanner electrical fire in 32C heat. Once re-instated, getting back to recover any kind of sleep was continued torture - England v Norway football made staff and patients hyper and loud. But staff continued keeping an eye on patients anyway, enjoying the mildly festive moment. That was where I was for a couple of days until further surgery was avoided by introducing beta blockers to curb my high blood pressure reaction to a stressful environment, driving the nose bleed. 

Yes it was slow and unpleasant, losing so much sleep, yes there were times when the staff seemed a bit chaotic or communicating poorly, but the whole process worked, inevitably in fits and starts. Including random and planned moves. Hard to be on the receiving end when you can't attract attention, then get woken up from recovery sleep every four hours for a BP check. Time seems to stand still as you wait, but it resembles a river or a flood, lots of movement simultaneously, not always in the same direction.

A man of my age with verbal diarrhea, talked unstoppably with a teacher's voice for 18 hours. He was losing his home as he couldn't look after himself. The conversation with his night nurse was moving. She showed him such good humoured kindness and respect, even though he was irritating half a dozen others in the same ward. There was no other place to park his bed and keep an eye on him. A sacred moment, overhearing such a conversation.

Once I'd been stabilised and the nose pack removed, I was issued with a take home bag of medications and allowed to call for a taxi to take me home. Clare came for me. As I left the ward, the team on duty bade me farewell with smiles and looks of achievement on their faces, some of them I'd seen several times in the previous days. I wish I could have said more than a mere 'thank you' as I left. Patients arriving in A&E are likely to be in a mess physically if not emotionally due to accident, injury or illness. The treatment process carries them, finds them a safe place and starts them on the way to recovery with calm respectful words, maybe even a touch of humour. A river of calm and kindness flows through the hospital at every level. I wonder if we fully appreciate it?

A day spent inactive, inert, dozing, coming out of crisis mode, getting used to a new medication regimen. Maybe after more sleep my head fog will go away.

Discharged

My blood pressure lowered overnight and isn't as volatile now. After breakfast, I was relocated in a ward up on the sixth floor. It was possible to look down from that height on a helicopter landing on the A&E helipad. I don't think there's air-conditioning here as windows were kept open overnight. A bit noisy and polluting high above the A48, but the breeze was definitely cooling in the small hours.

One of the ENT medics deflated the nose pack and removed it briskly without too much pain, confident the blood flow from the wound would reduce to a trickle. washed out by mucus in the coming days. I'll be kept an eye on for 24 hours to ensure all is going to plan, then discharged. 

A nurse with pharmacy duties delivered me a big bag of medications old and new. I took time organising them and their dosage on a phone spreadsheet. 

There were several elderly sick men with organ or mobility issues on this ward whose treatment plans and discharge plans are more complex to arrange than mine. One of them, with a teacher's voice talks audibly and constantly. I'm not sure if he speaks into his 'phone or if it's a stream of consciousness conversation with a person remembered. In much of the discourse he tells stories. He was treated for constipation, but it released more energy to give him verbal diarrhea. Non-stop, all night. The real life conversation he had with a night nurse was movingly kind on her part. It could have been from a script for a Radio Four play. Needless to say, I slept badly. Some of the talk is about his home being sold without his consent. Voicing his loss of control due to infirmity. I experienced that sense of loss of control after the stroke. It's a struggle if cognition is impaired, Medication can have the same effect.

Mid-morning, the cannula was removed from my left wrist and the discharge bag of medication checked. I called Clare, who came by taxi to collect me. The punishing routine throughput of emergency doctors and nurses must be tiring. I'm amazed and very grateful when I see them wave farewell to departing patients with smiles of satisfied pleasure on their faces. From the moment of admission onwards after a medical crisis there are so many possibilities of chaos to be coped with in complex and difficult cases. Focus on the moment and the eventual outcome is essential. If the backlog of patients drops by even a small number it's a job well done.

Good to return home, more or less stable now, despite the chemical fog in my head and metallic taste of antibiotics on my tongue. Fish pie for lunch, in hospital and at home. Clare's was better.  At 30C It was too hot to go for a walk in my present condition feeling fragile exhausted and drugged up. I slept a little, occasionally, and made an effort to stick to my medication timetable. My hand-eye co-ordination is chaotic leading to time consuming typos. The nostril bleed is slowly drying, and will need extra care to avoid a repeat. "It's like living on the edge of a crumbling precipice." as I said to niece Veronica. Bed now

No peace in hospital during the World Cup

It was impossible to settle down to sleep last night. My head felt as if it was aching, about to explode. The systolic lowering meds took time to act. The real problem was the excited chatter of medics and patients responding to the England v Norway World Cup match. Not just that noise but the careless banging shut of pedal bins and automatic doors banging open late at night No wonder my blood pressure doesn't drop and my nose still drips blood, but it's less painful now. Dealing with echoes of trauma from the experience being violated by emergency treatment last time this happened made things painfully worse last year has to be faced, like it or not.

I push back and complain if I'm disturbed from a snatch of relaxed sleep. I insist on retaining control of habitual self medication to impose structure on the day, otherwise it becomes an incoherent blur. I had a good chat with the medicators, necessary for them to understand that I haven't lost my grip on the process.

 I still can't pray more than a few remembered words and phrases at a time. Concentration is often foggy, drug impaired. Eyes water making reading difficult on times. Such a relief when the lights were finally dimmed after supper and some degree of peace and quiet descended. 

Fire emergency at UHW

Only a few hour's dozing. The noise on the ward of staff conversations through the night and automatic doors next to my bed crashing open violently at random times overnight was enough to ensure my blood pressure remained dangerously high. I can't recall feeling as ill as this before. Being disturbed from semi consciousness every four hours and having the monitor cuff over-inflated on my strained upper right arm was painful and contributed to a doubtful reading of my state when not being violated by this device. Stupid compliance to routine, not patient care. My muted cries of pain ignored.

I was overtaken by diharrea on my way to the toilet, abd had to borrow hospital pants a bit too small for me.

Clare brought in spares after lunch plus chargers and mail.

It's Sunday. I asked Rhys to arrange a Communion visit. No result. I could hardly do anything apart from doze. I couldn't read the office or liturgy of the Word. All I could do was entrust myself to being held in the moment and carried, with few if any words of prayer. No expectations, or consolations, just gratitude for each moment of need met by strangers in hospital uniform. A dark night for the mortal coil if not the soul. I was reminded of my covid exile in Ibiza when my surgical wound got infected.

End of the morning the ENT resident doctor visited, and engaging attractive woman with whom I had a good clear conversation about my hypersensitivity to a stressful environment boosting my blood pressure. She prescribed a pill that would reduce my systolic reading. The diastolic reading is OK-ish it seems. Within an hour of taking the first pill, and having supper omelette and chips, the fire alarm went off. I was half asleep by then, It was agonisingly loud. I took off instinctively fleeing the noise out of the first floor ward and walking down to the upper ground floor entrance bare footed, the acrid fumes of an electrical fire in the air. One of the scanners in medical physics had overheated due to the 30C heat. 

My phone wasset to 'do not disturb'.  It was an hour later Matthew, a ward orderly tracked me down standing near a staircase entrance and exit with fresh air blowing in. Hospital radio chuntered on, with nothing useful to say that could ease the situation with advice to patients and staff to keep phones on and go on foot as lifts were out of action. 

I watched the fire brigade arrive, all six machines and their amazingly fit teams in heavy gear despite the heat. The alarms stayed active for another hour although it was by then safe for Matthew to escort me via the back stairs to return to the ward. It was providential the systolic lowering drug was already taking effect. It was nearly sunset already. It was still noisy on the ward. Without ear plugs and a blindfold it would have been unbearable.

Bloody hell again

I went to bed at eleven and was awakened by a nose bleed at one.The carotid artery in my left jaw was trapped by a firm pillow when I fell asleep. I accidentally switched off the power extension for my bedside lamp and had to grope around in the dark to find the nain light switch holding a bucket in my hand to catch the blood. Amazingly There were no blood drops on the floor. It  was unstoppable and Clare called a taxi to go to UHW at three. My worst fear repeating itself. 

The A&E doctor who treated me was gentle, thorough and considerate. The nostril needed an inflatable plug - my horror from last time, but use of a suitable snalgaesic made the pain bearable. 

I spent the night in a kids' treatment room. All that was available. Clare returned home once she kniw I had been stabilised. I slept very little and missed the breakfast trolley. A patient sleeping iin the kids's room wasn't flagged up. Breakfast caught up with me two hours later - cheese and ham sandwiches. Then I could take my meds without distress to my stomach. I dozed on snd off until moved into a room to wait for arrangements to be made to relocate me to the short stay surgical unit to assess the outcome of the nose plug. It was teatime before this happened. Clare had visited with clean clothes and other things on my emergency hospital list texted to her. 

I'm tired stressed out with interrogation by nurses, and my blood pressure is so high they are worried.

Who knows what tomorrow will bring?

Dangerous heat

A good night's sleep, waking up in glorious sunshine with a cloudless sky, 30C rising to 35C. Medication leaves me feeling light headed and drowsy. It affects my hand-eye coordination too, judging by the typos I have to correct. I stayed indoors and gave my feet some attention - hard skin on the ball of my foot and toe nails in need of trimming. I can still bend down to do this, though some muscle groups threaten to go into spasm unless I take plenty of time and care when twisting and bending down. It saves me the hassle of making a podiatrist appointment. Advice about side effect of using Dipyridamole indicates it may reduce blood pressure, accounting for disconcerting symptoms I have to put up with daily. High blood pressure and nose bleeds were the bane of my life for decades. I used to be at risk from nose bleeds while bending down to cut my toe nails, but so far so good.

Amnesty International has denounced Israeli military actions in Lebanon as war crimes, given the number of unarmed civilians, women and children, murdered in the IDF's war against Hezbollah. Equally disturbing are the attacks on Palestinian West Bank villages by Israeli settler gangs protected by the IDF. Ethnic cleansing by any other name. 

Wildfires in Almería Province have killed at least a dozen people with double that number missing. A couple of people were found in a burned out right hand drive car at Los Galliardos, 10km from Mojácar. It's an area I remember from locum duty stays ten years ago, with a sizeable resident community of ex-pats as well as holidaymakers. 

Clare fell asleep when she returned from shopping. I had been writing while she was out and didn't notice the passage of time until I started to feel extra light headed rather than hungry. I hastened to make a lunch of couscous with frozen veg and prawns, almost dizzy with slow reactions. Luckily I didn't make a mess of cooking and it turned out as intended. It bothers me that the medication has such a drastic impact on my ability to cope. So glad I don't have to drive any more.

I walked in the heat for half an hour before supper and walked again for three quarters of an hour after supper when the air was cooling at sunset in an attempt to clear my head, which has been dull and foggy for much of the day. I can't tell if this is due to the heat alone or the effect of medication and heat. I drink plenty of water and tea, but tired legs seem inescapable. I drop off to sleep a couple of times during the day if I sit down and relax for a while after a period of activity. My heart rate isn't noticeably high or low during exercise, but at the end of the day I feel like I've run a marathon and don't stay awake for long once I get into bed. I wish I could make sense of all this.

Defiant in grief

Another hot sunny day with a clear sky. I  slept fairly well despite being woken up several times by gut pains, possibly from eating too much acidic sauerkraut. Shoulder pain is not so strong now. I remembered to use anti inflammatory gel before getting into bed. The clot busting meds continue to make me feel unwell, drowsy, slow reacting and stiff. I don't think the heat improves matters. I make an effort to stay active mentally and try not to push myself too hard physically.

After breakfast, I started recording audio for next week's Morning Prayer while Clare was out shopping. It's rarely quiet by day in our neighbourhood as the background sound of power tools or hammering from building or maintenance projects plus vehicle noises is annoyingly pervasive. it would be better to record at night, but I'm too tired late in the day. Anyway I was able to record and edit out most background sound while Clare cooked lunch, and then made the video slideshow for uploading to YouTube after we'd eaten.

I went out for a long slow walk in the shade of the trees in Llandaff Fields The temperature was 31C and there was almost no breeze. After an early supper I went to St Catherine's, as choir practice was taking place at seven, giving me an opportunity to go into church and hunt for my missing spec's. A thorough search of the chancel, choir and side aisle where I may have dropped them yielded nothing. So where else might I have dropped them? I retraced my steps home, feeling drained by the heat, no sight of the spec's anywhere. Then when I stepped through the door I thought - what if they fell out of my pocket when I put the jacket on when I left for church? And that led me to find them, lodged out of sight in one of Clare's ankle boots in the shoe rack! What a relief!

Millions attended the burial of Ayatollah Khamenei at the shrine of Imam Reza in Mashhad in Iran. Meanwhile Iranian missiles have hit Jordan, Bahrain, Qatar and Oman in retaliation for American strikes on Iranian targets following Iran's assertion of control over the Straight of Hormuz. Determined defiance regardless of the cost.

The air cooled a little as the sun neared the horizon, so I went out and walked around the block to get a breath of fresh air before getting ready for bed.