Kafkaesque NHS

It rained during the night, with a drop in temperature and an increase in humidity enough to wake me up feeling slightly chilled. I put on a warm dressing gown but didn't sleep well thereafter and felt tired all day. A wet overcast day. Each time there's been a torrential downpour lately water has been overshooting the gutter and running down the wall outside the kitchen window. The gutter along the edge of the roof was set too close to the edge of the  bottom tile - possibly a consequence of the re-roofing job done a few years ago. The gutter needed re-aligning in relation to the tiles and set at a different gradient to improve water run-off. It's become more noticeable with the increase of extreme weather events this past year or so. Clare arranged for a visit from a guttering specialist. A morning's work in persistent drizzle for two men - £400. I stayed in with her while the job was being done and missed the Wednesday Eucharist at St Catherine's. We won't know how successful the adjustment made to the guttering will be until there's another torrential downpour.

After lunch I set out on foot for an acupuncture appointment at Parkwood Clinic feeling very lethargic and stiff, so I took the bus from the stop opposite the Half Way pub. The treatment boosted my energy enough for me to walk over the Riverside clinic on my way back home, to check with a wound treatment nurse if my referral for treatment had been received. That was how I learned the district nurses' treatment room is now at St David's hospital. The receptionist gave me the phone number for the district nurse 'hub' which I called when I got home. 

I wasn't able to find out if I'd been referred for treatment, or when I would hear about an appointment. I was advised to call the GP surgery which I did. The receptionist was unable to help as Dr Mullaney, who made the 'urgent' referral, wasn't on duty to ask. All I know from the app is that I'm on a 'Rehabilitation Medicine' waiting list, whatever that is, but no information is communicated about how long the queue is, or what it leads to. It's like being inside a novel by Kafka. It seems the left hand of NHS services doesn't know what the right hand is doing. Just as well the wound seems to be drying out and isn't inflamed at the moment.

The drizzling rain eased off mid afternoon. I walked up and down Llandaff Fields for an hour before supper to clear my head and complete my daily step quota, despite physical tiredness. Without the acupuncture treatment I wouldn't have been able to summon the effort. Bed even earlier tonight.

NHS digtal shambles

A fairly good night's sleep, waking up to a cloudy sky and the prospect of rain again. I waited twenty minutes in the GP surgery telephone queue to get an appointment this afternoon for a wound inspection and referral to the Riverside clinic. I'd like to relieve Clare of the daily pressure of looking after something I can't take care of on my own.

The NHS app sent me a text message notification about messages awaiting me, so I logged in to my phone account and found half a dozen notifications from a six month period informing me that I was being sent a 'letter' about appointments with different specialist consultancies, with with insufficient detail about who I was meant to see in the specified department, be it cardiology or rehab. None of these corresponded with any letter I have received in the mail, although a couple of SMS notifications requesting confirmation of attendance did correspond. The latest notification relates to the appointment requested at Riverside wound clinic earlier this morning, except that I was told when I called the surgery earlier that the GP would have to authorise it. As I had an appointment this afternoon, I assumed it would be dealt with there and then. 

I don't know why, but after lunch the medication made me light headed and drowsy. I felt uncomfortably as if I was sleepwalking my way to the surgery to be examined by Dr Mullaney. She reassured me the buttock wound was behaving and that I wouldn't need more antibiotics. She then proceeded to flag up a visit to the wound clinic as 'urgent'

While waiting to be seen, I asked the receptionist about 'letter' notifications received on the NHS app and was told letters aren't being mailed out but sent electronically. Not that recipients have been informed of what to expect! I tried to log in on my phone to show messages received and the app refused to open in the surgery! I admit that the stroke and the meds I take mess cause my memory to work erratically at times, but the level of confusion generated by chaotic communication from the NHS is enough to make me think I have 'mental health issues'. I said this to Dr Mullaney. She smiled, with a look of resignation. I felt better for getting this off my chest I must admit.

After supper I walked up and down Llandaff Fields just after sunset under an overcast sky as it was getting dark. Then I joined Clare watching David Attenborough reminiscing and reflecting on his pioneering wildlife documentary series 'Life on Earth'. What a remarkable historic contribution to broadcasting he and his colleagues have made over the past half century, spanning the era in which colour television evolved from being a technical experiment to the default medium, making the innovative series even more attractive to watch from the outset.

A thousand people are now confirmed dead after the flash floods in the Nepalese Himalayas and 4,400 are still missing, whole villages wiped off the map. 900 school children were spared thanks to a timely alert from a staff member of a river of mud and debris sweeping down the valley destroying everything in its path. Hundreds of workers are trapped in tunnels belonging to a hydroelectric construction project buried by mud. How many glaciated landscapes around the world are now unstable because of global warming driving inhabitants down to lower safer altitudes? Together with eventual sea level rise, this reduces the area of land which earth's population can occupy with unforeseen economic and social consequences.

Bank holiday nightmare

I was in bed by 11:30 pm, but up again just after midnight with a nose bleed, despite taking precautions to avoid lying awkwardly. It didn't last long and I was able to avoid making a mess, but thereafter dozed the rest of the night sleeping propped up with a bucket by my side, after taking a beta blocker. The wound in my left nostril that caused the previous bleed the day before yesterday was starting to dry out so I thought. Was it a blood pressure surge, or an awkward move that triggered this one? Somehow I slept fairly well. nearly seven hours.

After a lull in the fighting, during which Trump announced heavy economic sanctions against Iran, hostilities have resumed with America targeting Iranian mine laying activities in the Straight of Hormuz and Iran firing missiles at US bases in Jordan and the United Arab Emirates. Iran promises to escalate the conflict further while calling for a return to the agreed terms of the Memorandum of Understanding signed in June.

I realised when I woke up that today is a Bank Holiday. It wasn't clear if the GP surgery was open to have the bum wound checked or get another prescription if needed, and get the nostril wound checked out. I want to ask for a referral to the Riverside wound clinic.  I called the NHS 111 for advice and a robot call handler said I was 87th in the queue. Information googled said the surgery was open. I went there after lunch. A notice on the door said it was open, but the door was locked. When I rattled the door a voice within said the surgery was closed. I went home and packed a bag with all I needed for a visit to A&E at UHW. Not that I wanted to return there after my previous dreadful experience. If I take a turn for the worse, at least I'm ready to go.

I was bothered to find I've almost run out of sterile wound dressing swabs. There's nowhere open to buy them today. To my relief a rummage through the medicine cabinet produced several unopened packs which have been there for the past six years. We can manage now until tomorrow when I will get an opportunity to see a doctor. Without Clare I couldn't manage at all, being unable to see what's happening in my nether region. Come to think of it, I don't remember how I looked after the surgical wound when I was on my own in Ibiza back in 2020, but I know how indebted I was to the Riverside wound clinic nurses during recovery from surgery.

It's getting dark noticeably earlier now. Early bed for both of us tonight

Tax return submitted at last

 A fairly good night's sleep, accompanied by the sound of heavy rainfall in the night and early morning. I went on my own to the Eucharist at St Catherine's, Clare and Owain went for a walk and a coffee avoiding the showers. When I returned from church Owain sat with me while I filled in my tax return, a task and a worry for me that's been outstanding since before I had the stroke. 

Up to that point I'd prepared the various figures and had them all written down in a special book. In the weeks after discharge from A&E I made a mess of logging in to my Government Gateway account and was locked out of it, when I couldn't provide correct details over the phone. Owain found the address and some weeks later I was put in contact with a most helpful man in Newcastle who talked me through reinstating the account. I had lost my nerve at that point regarding digital interactions to do with anything financial, and did nothing until the trauma receded to the point where my confidence and calm returned. 

With Owain at my side I logged into the HMRC web site, and into my bank account too, without needing any prompts. I hadn't forgotten anything. Both sites looked and operated the way I remembered them. The best part was having Owain talk me through the process like a tour guide - insightful and helpful. I don't think he needs to make a self assessment tax declaration as he's on PAYE, using the HMRC's own system, but familiarising himself with the self-assessment tax declaration was a useful exercise for him en passant It was interesting to hear his evaluation of the content and its delivery of information on the opening page of the form. Content design is what he does at work. After submitting the tax return, he added a comment on the feedback page noting a specific issue of user friendliness which he thought could easily be improved.

I was so relieved to have done this at last eleven months after starting on it, and so grateful to benefit from my son's professional expertise and calmness, enabling me to get up to date with my civic obligations. It's a small, less obvious aspect of stroke recovery that makes a difference. Admittedly my head was pretty clear and my focus was sharp while we worked together either side of eating lunch. It didn't prevent me from forgetting to take my lunchtime antibiotic. I'm still prone to distraction.

Owain left by taxi us to visit a friend after lunch. There was a cloudburst just after, and we noticed a large volume of water running down the wall outside of the kitchen window, but we couldn't figure out at what point in the roof guttering it was coming from. The gutter didn't appear to be broken or leaking. A close range inspection is needed.

After the rain stopped, Clare went out for a walk and I followed her twenty minutes later, but didn't walk for long due to drizzling rain. It rained for the rest of the evening so I didn't go out again. We had supper then I watched another episode of 'Ludwig' until it was time to get ready for bed. I finish the antibiotics tonight and need to see a GP tomorrow for an assessment of whether the buttock wound is healing as intended.

Unexpected bleeding

I was in bed by half past eleven last night, and woke up with a light nose bleed at ten past one. Exactly the same time as I woke up with the last bleed that put me in hospital. This time it stopped after taking a beta blocker tablet. My sleep quality was poor thereafter, and I was up at six thirty to the sound of heavy rain, to take my antibiotic. Up at nine for a pancake breakfast, during which my nose started to bleed again. 

A vein in my left nostril that burst before burst again. I sat in my armchair for more than an hour pressing on a vein in the bridge of the nose until it stopped and then fell asleep for half an hour, having taken another beta blocker. I think this works by reducing adrenalin, which in turn inhibits the volatility of blood pressure. The past five days of bum infection and keeping on track with antibiotics, (which thankfully are taking effect) I have been on the alert all the time, taking the meds punctually and with Clare's help keeping the wound safe and clean. It's been stressful to say the least, so no wonder excess adrenalin, and physical exhaustion have given me blood pressure problems and nose bleeds. 

I spent the morning and part of the afternoon resting, unable to do much trying to catch up on as much lost sleep as possible. There was little else I could do. Having rested enough to go to the shops, I got up out of my arm chair and was shocked to find blood dripping down my trouser leg. The boil on my buttock had torn open under pressure while I slept. What a mess to clear up!  Just then Clare returned from a walk, ministered first aid and got the wound stable. Strangely, it's less inflamed and sore now. It was a shocking experience, so unexpected. Eventually I walked to the shops and bought some sterile swabs from Boots and a bunch of carnation buds for Clare from Tesco's.

Owain arrived in the afternoon. He's staying the night and seeing friends tomorrow afternoon. We watched an episode of 'Ludwig' together - a detective drama series featuring an autistic puzzle setting expert whose eccentricities are part of the plot's situation comedy. The logic puzzles at the centre of the story move so fast I can't always follow them. Amusing but also irritating.

Unwanted services

I woke up at six thirty to take an antibiotic, but couldn't get back into deep sleep afterwards and got up at eight to a day of sunshine and showers. So far no torrential rain or flash flooding in Wales. Dry ground is softening and absorbing rainfall. So far, so good. The death toll continues to rise following the landslide and flash floods in Nepal, and there will be more to come as rain falls, adding to the waters dammed up behind the fallen rock and rubble, adding to the danger for rescue workers.

It's Kath's birthday today. She's busy rehearsing Sonrisa's next tour of their show 'Dance in the Dark', so no time for a proper celebration, so Clare and I sang her a Happy Birthday greeting on What'sApp instead.

Clare was already in the GP telephone queue trying to arrange a blood test for herself, and also mentioned that I needed a telephone consultation too. Dr Jordan called me after breakfast, giving me an opportunity to chase up my medication review request, explaining that the combined effect of the platelet lubricant and penicillin medications on my digestive system was making it difficult for me to function and ruining my quality of life. I don't know how this will be followed through. At least I have given the medics feedback on the treatment. The crater left by the erupting boil in my buttock is slowly drying and still tender. Wound dressing after emptying my bowels is tricky, but Clare is making a good job of making it comfortable for me to sit on. 

Yesterday, I received a British Gas Home Care letter exhorting me as a new customer to book service appointments. I had been awaiting a letter confirming the cancellation of this unwanted account, and the service hotline number we called was locked in a loop making it impossible to speak to a live human being. How could I know this wasn't a scam? I wrote a carefully worded letter of complaint to the company, giving an account of what had happened and stating that I intended to cancel the direct debit order. If I owed them a cancellation fee, I wanted them to invoice me for it by email and undertook to pay.

After lunch we went into town by bus to visit Santander Bank and cancel any direct debit in favour of British Gas Home Care. We learned that the amount of the cancellation fee had already been taken out of our account, but nothing more. The first instalment due for payment is scheduled for payment on the first of the month. I cancelled the direct debit order. Hopefully that will be the end of this troublesome affair.

Before going shopping for underpants, we had a cup of tea in Marks and Spencers. I was disappointed to be served tea in a tall cardboard cup. It took ages to cool down, and tasted of waxed paper. We should have made the effort to go to John Lewis' tea room instead and have tea delivered in a pot and drink from proper china cups. Not fine china, but definitely superior to the M&S offering.

After supper, Clare went out to a concert at St John's. My head cleared sufficiently to enable me to go out for a sunset walk. I finished the day watching the rest of 'Nora Sand'. It was so slow moving that it was difficult to retain sufficient concentration to grasp the detail of the plot. Ah well!

Himalayan tragedy

Up at six thirty to take an antibiotic, and manage the buttock wound at the trickiest time of day when my bowels empty. Thankfully Clare is at hand to sanitize it and apply a dressing. I slept fairly well, but not long enough. Tiredness is inescapable as I can't relax and sleep well enough while I'm in this condition. 

I dread to think what it's like for Nepalese people and their tourist trek guests in the wake of flash floods driving mudslides and destroying villages.  It seems a glacier collapse undermined by melt water and triggered a colossal landslide damming the valley below, building up water until it burst through, spilling rock and mud downhill. Essential infrastructure, roads, bridges hydro power generation and water supplies as well as telecommunications have been hit hard. 1,300 are reported missing and 350 dead.

Clare baked bread this morning and I cooked cod and veg for lunch, struggling with the faintness and swimming head that replaces hunger pangs on an empty stomach. I ate a large slice of banana cake before the meal to fend off the feeling while I cooked and took spoonfuls of kefir yogurt in the hope it would make me feel better. Eventually it did, but the 'toxic head' sensation was inescapable. I couldn't sleep, and walked up and down Llandaff Fields for an hour which improved matters a little. I don't know if it's the infection that makes me feel unwell or the impact of the antibiotic on my digestion, already suffering from the clot busting slow release capsules.

I realised that we didn't have suitable wound dressings in the house not long before the pharmacy was due to close. I didn't have the energy to rush out and buy some, my ankle was giving me trouble. Clare spared me the agony, went out and bought some then dressed the wound when she returned. I meant I could sit in comfort during the evening. My head cleared enough for me to watch a Danish crimmie called 'Nora Sand' on Walter Presents. It features a prize winning crime journalist whose team investigates the background of characters involved in a crime. They show up the weaknesses of Police detectives in advancing the case. It's intense in its portrayal of people involved and the relationships between them, and for that reason it's very slow moving - so much so that I started to doze off at one point. My life is beset with too much drowsiness as it. Time for bed.