Trump booed

Taking the beta blocker tablet before bed didn't make any difference to losing half a night's sleep, but I noticed that waking and getting up for a pee felt less stressful and I was quicker falling to sleep again each time. There's no escape from tiredness though, nor from diarrhea. Each of the medications I take has this effect on my bowels. All I can do is rest as much as possible and make sure to drink enough water. 

I woke up early enough to get in the telephone queue for a GP appointment, but my mind wasn't alert enough to work out what I needed to say and why I was calling, so I didn't bother. My nostril wound leaks less blood but stimulates mucus, enough to give me a runny nose. It's unnerving, as the sensation resembles a nose bleed starting which doesn't help me relax and rest. A runny nose cleans, protects and lubricates irritated areas around the wound while it's healing apparently.

Another blue sky day with high cloud, pleasantly warm at 23C. I didn't have much energy to do anything this morning. I arranged for someone else to look after this week's liturgical stand-in duties. I have to admit I'm not well. My head is not clear enough, my concentration is poor. I don't want to make a drama out of a celebration of the Holy Mysteries by making mistakes and losing my way during the service. 

I wrote a letter to the GP surgery asking if there would be follow-up consultation after discharge from A&E. I mentioned the negative impact different medications were having on me, and the difficulty I have waking up in time to book a surgery appointment. Easier to write it down than explain it over the phone.

I cooked rice for lunch with yellow courgettes, onions and mushrooms while Clare fried two chunks of cod. Everything seems to take a long time to do. It's not necessarily that I forget what I'm doing, but that my brain slows to a halt and I need to check what I'm doing.

Ashley phoned this afternoon. He's having trouble with a hernia, and expects to go into the UHW short stay surgical unit to have it repaired. I'm astonished at how long he's having to wait. I shouldn't have any trouble finding him there after my recent experience!

The Americans keep on bombing infrastructure in Iran. Iran retaliates with missiles on US military bases. Ships trying to get through the Straight of Hormuz are being fired upon. Iran's Houthi allies declare they will blockade Bab al Mandab, cutting off an oil transit route between the Arabian Peninsula and the Horn of Africa. This could have further repercussions for the price of oil. It could lead to further escalation by America. The rising number of injuries and deaths of American personnel in the Gulf will add to the unpopularity of this war in the USA. Ironically, Trump was booed by the crowd at a major World Cup football final event, though the war isn't the issue, but rather Trump's intrusion in a refereeing decision during the tournament, considered by some to be 'unfair'. Do football fans realise how unfair Trump's war already is for so many poor countries pushed into recession and famine by the choking of oil supplies?

Gratitude

Warm and cloudy today, 26C. Yet another restless night's sleep, walking early unable to doze. Medication made me feel worse than usual as is often the case. I was meant to take the beta blocker pill, but as it made me feel even sicker yesterday, I didn't take it. 

Last Sunday, I was in hospital, unable to attend Mass and receive the Sacrament. I was determined at all costs, to go to St Catherine's for the Parish Eucharist today, grateful to God for having survived a week which felt life threatening at times. I made sure not to push myself, leaving early before Clare for a change, and not rushing. Fr Rhys celebrated. We had a helpful conversation after the service and he gave me a lift home. Clare cooked pasta and prawns for lunch. 

I slept for more than an hour after we'd eaten, feeling lethargic and drugged. Then I walked up and down Llandaff Fields for an hour, resting at every bench, to make sure I didn't overdo it. I thought my head was a bit clearer so I recorded the next Morning Prayer reflection and office. I wanted to edit the audio there and then, but wasn't able to continue. The stimulus of concentration probably pushed up my blood pressure, and wiped out the positive effect of fresh air and exercise. It made me realise that I'm not well enough to do any duty cover while Sion is away without putting myself at risk so I wrote to him and to Fr Andrew to  explain.

I took the last of the antibiotics this evening, started when my nose was plugged to prevent infection. My stomach and taste buds will benefit from completing the course. The essential clot dispersal medication continues to make life a misery. I'll take the beta blocker as I go to bed to find out what effect this has in reducing the impact of adrenalin generated by concentrating hard, or by being awakened by a full bladder.

Beta Blockers

Another hot night of very poor sleep, disturbed  not only by my bladder but by the need to take sips of water as my mouth dried out and made it hard to swallow. My nostrils aren't as congested now, so it's easier to breathe with my mouth shut - if only my mouth wouldn't fall open when I'm asleep, drying out the saliva in my mouth! The introduction of beta blocking meds curbs the fluctuation in my blood pressure and this helps the nostril wound to stop bleeding and dry out. It leaks blood diluted with saliva which gets paler as the wound slowly dries out. The more I breathe through my nostrils the better. Unfortunately side effects of Beta Blockers are sleepiness dizziness and nausea, leaving me feeling even more unwell than the other drugs that have the same effect. Added to the effect of lost sleep and heat, it was a miserable morning in which I could do very little. I didn't feel well or safe enough on my feet to go out for a walk, but I managed to cook a veggie sugo to to accompany tortellini for lunch,

Thin high cloud today, not quite as hot as yesterday, but still humid. Reports of wildfires coming in from parched uplands in Britain are causing concern over biodiversity loss. Canadian wildfires produce a smoke haze affecting American cities. Trump is using this as an excuse for imposing more trade tariffs on Canada for 'filthy air', ignoring the tangible evidence of global heating due to fossil fuel use. His own 'drill baby drill' political slogan exacerbates the crisis, ignoring the reality facing the world. 

Meanwhile Iran and America exchange military strikes for the seventh night in a row, with Iran attacking US Middle Eastern allies in retaliation, and effectively retaining control of the Straight of Hormuz. Two US servicemen are killed in Iranian strikes on Jordan. Given the unpopularity of this war in the USA this won't go down well with the electorate.

I spent much of the afternoon dozing but went to the Coop for Kefir and bananas at teatime. Examining the change in my pocket the tiny tigers' eye pebble given me by Rachel slipped through my fingers and disappeared into a pile of dried leaves. I felt sad to lose this, symptomatic of drugged state of awareness.

It seems that Beta Blockers suppress the adrenaline response to reduce blood pressure. If only I could have had an acupuncture treatment a few times in hospital instead. Anyway I've been in touch with Peter, and will see him in the coming week.

An interesting programme about Leonardo da Vinci on TV tonight, not that I could share my concentration between watching and writing. I'm just too tired.

Soporific heat

I was horrified when I got into bed last night to see that my ankles were swollen. I felt too ill to go out for a walk yesterday. As it was 30C into the evening, I didn't want to take any risks. The problem with meds I take is they impair my sensory awareness and slow my reactions and heart rate. I might not notice quickly enough that my body is overheating. I instinctively become extra cautious, not wanting to make things worse. My ankles paid the price for languishing all day without exercise. When I woke up in the night no swelling was visible. 

I didn't get enough sleep to recover any of the past week's lost hours, but don't feel as bad as yesterday, but I notice a slow-down in my short term memory. Clare cooked a savoury soy protein dish for lunch with cabbage, sweet potatoes, spuds and butternut squash. By tea time I struggled to recall anything about the meal, until an image of boiled cabbage sprang into my mind's eye. From that I was able to remember the content of the meal. It's disconcerting. Is this pure fatigue or the impact of the new beta blocker meds. 

I slept in snatches after lunch. When I went out for a walk at tea-time, my right ankle was acutely painful to start with. My leg muscles and joints were also painful. I returned home and rested, then went out again. My leg muscles hurt even more, as if I'd pushed too hard when I hadn't. Several days of limited mobility are robbing me of my general fitness at the moment. 

I had a lengthy exchange with my niece Nicky about high blood pressure, and particularly about how ill beta blocking medications make you feel and how upsetting for the stomach many medications can be. She's soon to become a granny for the first time. Time to wish her good health, so she can enjoy it. Rachel called, rehearsing her arrival plans for a fortnight's time. Bob, her ex-father in law, celebrates his 100th birthday the evening she lands and she's been invited.

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.