Op-day, liberation at last.

I went to bed early but didn't get off to sleep until eleven. I woke from a very short dream in which I bit on a juicy tomato which was tasty and slaked my thirst. It's the first time I can ever recall tasting something in a dream. I'm no stranger to hearing identifiable music, voices and physical sensation while dreaming, but identifiable taste, not just the word associated with a taste is different. And curious.

I was out of bed and having a shower by six fifteen, stepping int a taxi at ten to seven. The driver told his sorry take of being scammed over a smartphone purchase, Somehow a crook intercepted communication between him and him phone company, or else he got diverted to a malware look-alike site. He lost both his new phone and some money, although his bank reimburse some of his losses. I hate on-line purchases and shopping as you have to be so much more vigilant than you do when you the goods and vendor in a real life store.

I arrived at ten past seven, but couldn't get into the building until the surgical staff arrived at seven thirty, so I did a complete 2km circuit of the hospital ring road, and  stopped at a place where there was a view to say Morning Prayer. Later, while I was waiting for surgery, third in Mrs Cornish's list, I overheard the nurses debating the length of the building. One of them googled and learned that Llandough has the longest hospital corridor in Europe, at 1km. 

Mrs Cornish came by for a briefing beforehand, but afterwards a nurse discharged me. For the first time in five operations, I was allowed to walk to the operating theatre now relocated next door to the pre-op ward. The out-patient surgical suite has been reorganised since my last visit for op number three. You no longer have to be taken on on a bed in the service lift to get to theatre. It was one by the time I returned on a bed, more than an hour under anaesethetic, and then another hour before I was discharged by a nurse, once my blood pressure was low enough to be deemed safe. At last I'm rid of the Seton's suture, as planned. I'm on antibiotics for the next five days. Initially, the pain was more than I was expected, but the more I walked about, the more relief from pain I felt.

Jacquie drove me home, accompanied by Clare, who'd gone over to her house mid morning. There was a lovely and much welcome fish soup for lunch. The hospital offered post-op cheese sandwiches only, so I had to make do with a cup of coffee until we got home at three. The hospital wound dressing detached after I arrived. It was a relief, as it was thick and pressuring the wound repair. I wasn't bleeding so I used a much slimmer clean dressing instead, with a couple of ibuprofen tablets to curb the inflammation. This made such a difference that I went out for a walk in the park. 

This helped curb the pain, but drew rebukes from sister in law Ann who thought I should lie down, take it easy and rest, as I was taking too much of a risk by exercising so soon. Well, I felt better for movement, rather than struggling with discomfort unable to sit or lie comfortably without pain. The risk paid off. The concern is something to do with the use of adrenalin in anaesthesia to curb blood flow. When I came round after the op, I felt bright and clear, as if I'd awakened from a long refreshing sleep. This is regarded as an adrenalin 'high'. When it ends it may do so suddenly and cause you to faint. No sign of me fainting! 

I felt relaxed and well enough to watch tonight's episode of 'Rocco Schiavone' live, and felt naturally tired towards bed time, and pain no worse than what I've been used to after too much or too little bowel movement. Tonight I'm feeling quite relaxed, having turned a decisive corner in my two year open wound ordeal. I may pay the price for my 'hyperactivity' tomorrow, who knows? It was worth it just to express the sense of freedom I feel as I turn in for the night

Quarantine day three

How cheering to wake up to a day of brilliant sunshine, mild weather and no wind! As I was closing the bedroom curtains last night , the moon shone brightly in between clouds, ascending just above the terrace rooftop south of our back garden.

I went to bed half an hour earlier than usual, and benefited from this, strangely, with a night of relaxed sleep with just two disruptions. I published the YouTube link to my upload of Morning Prayer and biblical reflection on WhatsApp for the first time before Radio Four's 'Thought for the Day'. Tonight, early bed and up at six to be sure I reach Llandough Outpatients for the op by seven thirty. I do so hope that this will enable me to return to complete physical normality.

Over the past couple of years, I've remained active and fairly fit despite infection, but having a wound at the base of my central nervous system, often irritatingly uncomfortable, thought never painful enough to require analgesics, has been a strange experience. I compare it to grit in the eye or a stone in the shoe, something that incessantly undermines bodily harmony ans hinders focus. I've not been able to sit and relax comfortably without consequence. If I've taken photographs obsessively these part two years, it must be because this is a head and upper body activity for which I need to stand.

I've stopped playing guitar which I've done for the past sixty three years. A guitar is, after so long, like an extension of my body. Sitting to concentrate on playing has proved as hard an effort as coping with rheumatic fingers and wrists. Fighting against the reaction of the nervous system to make the effort to play has felt counter productive. Better to rest, avoid any negative over-stimulation and wait to survive the affliction, in the hope of one day returning to enjoy playing. It's been much harder since Clare has started to learn jazz piano, as I'd relish the pleasure of playing with her. 

Most of my walking today was outdoors, enjoying the sun. I begin to feel normal, relaxed, and not feeling confined by the restriction of a few days self-isolation. My sister June has had a plague of flying ants and ordinary ones on her Wandsworth Common balcony. She was worrying about how to get rid of them, and then the local bird population turned up, crows, magpies, then blue tits and coal tits. It's been a while since we've seen tits in our garden. Or ant plagues for that matter.

In the local news today, a further closure of Blackweir Bridge while work is done dredging out hundreds of tons of stones from the river bed, presumably to improve flash flood drainage and let broken trees that fall in the water float downstream and not block the channel. I hope this doesn't have too much impact on the ecosystems of the riverbed that help sustain fish, and insects on which the birds feed. This past week or so I've seen swallows and swifts feeding on the wing over the river, a lovely sight as summer arrives.   

Thanks to another delivery of fresh salmon, sea bass for the freezer, plus laver bread, supper tonight was my favourite Welsh sea food. Then a couple of hours writing, and off to early bed.

Creative spurt

Thanks to a gentle flow of ideas, I spent much of the day writing my next round of reflections for the Parish WhatsApp prayer group. A letter confirming my surgery appointment arrived in the lunchtime mail. Unlike previous ones it's an morning rendezvous, 7.30am. I'll have to take a taxi to Llandough, as Clare may not be cleared to drive me there, if her field of vision test turns out unfavourably. I had to ring up and confirm acceptance, as the procedure now includes a covid test before three days self isolation. 

Jackie came over for lunch in the garden. She moves house to Stroud in a couple of week's time, and is currently waiting somewhat nervously for the sale formalities to be completed. At 78 she's uprooting for the first time in twenty years, moving away from friends to be nearer family. Quite a challenge.

Later on I walked, first around Thompson's Park and Llandaff Fields before tea, then continued writing reflections, before and after supper. To clear my head before bed, I went for a short walk around the block and realised that tomorrow is rubbish collection day, so I put out the recycling and organic waste bags, a job Clare usually remembers before I do, but tonight she was in the lounge absorbed in listening to an album of Art Tatum playing piano. It's what she needs to do as she gets to grips with playing by ear and improvising jazz. It's great that she does this.

Yesterday she planted some beans in a seed tray and by this evening a couple were poking their heads out of the compost, so I took close up photos with three different  cameras for comparison. It wasn't as easy as I imagined with different lenses. Hand held close ups can be as difficult to get sharp pictures of as distant telephoto subjects. Working at both ends of the lens range may well be more effective with the camera on a tripod using the timer. Lesson learned.

Surgeon's inspection day

As Clare was working in kindergarten this morning, I chose to go by bus to Llandough Hospital for my long awaited surgical inspection. It poured down cruelly, on the fifteen minute walk to the nearest bus stop to get the 94 and 95 services which call there. I had to wait half an hour at a stop without a shelter, and it continued to rain throughout. Apparently the weather was causing schedule delays, and giving me the panics. I arrived soaking wet, rain penetrating through to my jacket beneath, half an hour early, and was pleased to discover that appointments for outpatient consultations are at the new reception area close to the entrance, so I didn't have to walk an extra third of a mile to the zone where the outpatient surgery theatres are sited.

Three others were being seen by Mrs Cornish, and I was second. She asked how I was feeling and I told her that I sensed though couldn't see the improvement, but for me the measurable sign of this is a huge reduction in medical dressing waste needing to be bagged and go out with the rubbish, at which she laughed. She inspected my wound and said she was very pleased with it. There needs to be a final operation to remove the Seton's suture, clean up and then plug the remaining holes. This again has but a fifty percent chance of success in preventing recurrence. 

Is this because the damage done by the long wait to get treatment in the first place was rather serious? But let's not go there. If this doesn't work, and a wound re-opens and leaks, there are two other plugging surgical techniques to be tried. It's not a matter of an ageing body it seems. The same can happen to someone half my age, if their condition isn't dealt with promptly.

The less than good news is that there'll be a three month wait for the final surgery. Mrs Cornish has had four operating theatre bookings cancelled for coming months due to a shortage of anaesthetists, and on top of that there's the impact of the run up to the Christmas and New Year holidays disrupting schedules as well. As they did last year, delaying the start of my treatment. It's the way things are, with inadequate NHS investment in people and services, plus poor management in some quarters. What a mess the country's in, and unfortunately us oldies living longer and failing to stay healthy add to the burden, so we must beware of complaining too loudly.

At least I know where I am now, and that makes waiting patiently less burdensome. For the most part I can cope with the residual pain and discomfort, although I still won't be able to offer to start locum duties once more, until I know when the next surgery date will be. I may be a few weeks before I am given a date. An earlier date might be possible if there was a cancellation and I was prepared to enter the lottery of a qualified duty surgeon assigned to the task, but Mrs Cornish has seen me through thus far, and that element of trust and confidence is important enough for me to be prepared to wait.

  

Op day number three

I walked to St John's for the Eucharist this morning, my rucksack packed with stuff I'd need during my afternoon stay in hospital. When I got to church, I realised that I'd forgotten to pick up my phone, left on charge in the kitchen. Emma took the service, I sat in the congregation and didn't receive the sacrament, but Emma gave me a blessing after Communion instead. Thankfully Ruth's husband John offered to run me home to collect the phone afterwards and I was soon back to chat with worshippers before Emma drove me out to Llandough.

We arrived at 11.30am, and although early, my appointment was processed quickly and I was on the day surgery ward ahead of time. After the usual three interrogations (nurse, anaesthetist and surgeon's registrar), Mrs Cornish the surgeon arrived, and briefed me about the procedure. Given the MRI data, she was prepared for a worst case scenario. I pointed out how much improvement I'd seen in the three months since the scan, it was clear she would take that into account. It was then a matter of settling down and waiting.

The ward was busy, with a half dozen or so patients having minor surgery for carpal tunnel syndrome or Depuytren's contracture. It was marvellous to hear the nurses and doctors dealing with each one with consistent kindness and clarity. Each patient was different, from an extrovert septuagenarian, uninhibitedly chatting about her Catholic churchgoing, to a taciturn lady dressed in a colourful, probably North Africa burka and several other women, all but one of retirement age. 

There were a couple of quiet men too. One of them found he couldn't get his wedding ring off, a prerequisite for the work to be done on his left hand. The traditional recourse to silken thread (such as was tried on me two years back in a clinic in Rincon de la Victoria), failed on him as it did on me. His operation was postponed to allow him to get a jeweller to remove it. The metal shears available on the ward, he was told, weren't good enough to ensure an easily repairable cut. As Mrs Cornish said to me two weeks ago, when mine was cancelled - sometimes it's just bad luck.

I was last on the surgeon's list of the day. During the long wait I read a chapter of the Poveda novel, dozed, occasionally paced up and down, feeling anxious given the uncertainty of the outcome. I don't know where the clouds of pessimism come from. I'm in good hands, well cared for, but dread another disaster, and having to cope yet again with a new open wound on top of the existing one. I realised how hard I was finding it to focus on God, or to pray. I made an effort to stay facing the experience of desolation as I waited, and telling God that's all I can manage for now. Only when I was being taken to the operating theatre did my anxieties finally calm. After so much waiting for treatment, and waiting upon the healing process, I then realised that any further wait of any kind would summon the clouds of anxiety. Am I naturally impatient? Or is this a low level stress disorder? No matter what, it is survivable, and that's all that counts.

It was ten to five when I went down to theatre and ten to six when I returned. The surgeon's registrar came in to tell me what she'd done. I still have the original seton's suture in place, but the excess tissue has been removed which will enable normal healing to take place. I get reviewed in six weeks time, then a final op will follow to remove the suture and plug the remaining abscess site hole in my anal muscle with a collagen compound. I forgot to ask if this would be a permanent feature, or one which muscle tissue would grow over. Finished in time for Christmas hopefully. As for travel, quite possibly, if the wound is now going to be more manageable, less risky to live with, as it has been for so long.

After getting dressed to leave, I stooped to put on my sandals, and was quite surprised that despite the hefty dressing pad, I was able to bend right down and reach my toes without uncomfortable pressure or tugging at the wound, sometimes painful. This was how it had been for the past four months, since the over-granulated tissue attracted attention from surgeon and nurse, and started to obstruct wound closure. It was a question of having to put up with it until it could be dealt with, and today was finally the day! I felt like cheering, and left the ward with a spring in my step, to meet Clare, who had just arrived at quarter to seven. 

It was such a delight to return home to a most welcome cooked meal, and be able to sit comfortably to eat it, without fidgeting in the face of constant discomfort. I feel like I've turned a corner, just the way I did when the District Nurses took charge of my case for the first time last Boxing Day. There was much emailing to be done and WhatsApp messages to exchange as I settled down for the evening, and time for another 'Walter Presents' crimmie before bed.

On inadvertantly moving the goalposts

I was up and breakfasting at six thirty this morning, then preparing a hospital bag for my surgery  appointment this afternoon. Then at ten fifteen I walked to St John's to celebrate the Eucharist with half a dozen regulars. Clare arrived early while I was drinking tea afterwards, nervous about traffic congestion on the drive to Llandough hospital by midday. We set out early enough to visit Penarth Tesco filling station en route, as the car announced it was running low on fuel. Even then, I checked in a quarter of an hour early, and began the wait.

After getting undressed, I went through the routine interrogations with two nurses and then a houseman, who asked what I had last had to drink. I mentioned the cuppa I had at St John's and he frowned, and disappeared to check with something. He returned with bad news. The op had been vetoed by the anaesthetist as there was not enough time before the end of the afternoon's procedures for the tiny amount of skimmed milk I'd ingested to be digested.

Being in no position either to question or understand the clinical science behind this decision and knowing how risk averse they have to be, it was a matter of accepting that in one thoughtless moment I'd screwed up.

I was upset with myself and feeling desperate, but a few moments later, Mrs Cornish the surgeon came on to the ward, and spoke with me before I left. She agreed it was bad luck, especially as I've been dairy free for a year. She graciously undertook to book me in for her next surgical session on the 19th, two weeks today, the 50th anniversary of my diaconal ordination as it happens.

I took the bus back and walked home from the stop near Ninian Park station. Clare had just started lunch when I arrived, and she'd cooked for me, thanks to my message from the hospital. And now I have to endure the humiliation of telling everyone who is likely to ask how the op went what an old fool I've been. At least the sun shone when I went out for a walk along the Taff late afternoon.

  

Waiting time again

It was good to return to celebrating the midweek Eucharist with seven regulars this morning. I've not done much over the past couple of days, apart from routine shopping and my daily walk, but have slipped into waiting mode.

It's been good to see some Parliamentarians expressing their concerns about the hard right Boris Johnson government's behaviour. Some have put their career on the line, voting against their own party line.

Deep divisions of opinion about involvement with Europe are passionately held, and there are many more and different motives among people on each side for holding their position.

A binary referendum of the kind held with its carelessly devised options, revealed a deep fault line covered up by pragmatic compromises for 40 years. It has worked for the most part to the benefit of most people iin idfferent ways they may not always have been aware of. But didn't work well enough to benefit everyone, which I attribute to pre-existing social division and concentration of wealth and power in the London and the South of England.

Parliament is divided between dreaming nostalgic opportunists who think we'd be better off out, and those who realistically consider that we might lose more than we'd ever gain, even if they admit that EU governance needs a big overhaul. Three years have been wasted on power struggle and confrontation between these blocs.

Thank God in a way it's been deadlock and stasis, as desperation may lead from confrontation to dialogue, not only among Parliamentarians, but in the country as a whole, about what we need and hope for in future. Not just those who made the effort to vote, but also those who failed to vote for whatever reason at the time, plus those expats excluded from voting. From genuine dialogue it may be possible to reach a constructive compromise. If not there will be civil strife.

How to get people out of social media echo chambers to engage without nastiness and bullying is the big challenge, the other side of this present stalemated game of chess. But first, the liars bullies and blackmailers holding the country to ransom have to be discredited. An election may not the the answer. Political realignment of MPs, and / or reversing the hard right governmental coup needs to happen before resorting to the polls.

Tomorrow is my third round of surgery at Llandough. I'm a lot better now than I was five months ago, but the mild pain and discomfort coped with most of the time, and caring for an open wound have taken their toll on me.

I dread the thought of having the Seton's suture and/or a new wound for much longer and with no certainty of outcome. It plays on my mind, a bit like being a hostage in the dark chained to a radiator, not knowing what's going to happen, if or when freedom will be restored.

How to say this to Mrs Cornish the surgeon? I don't need sympathy, I need closure, both physical and psychological, to resume a full life before ageing sets in with a vengeance.

  

Another appointment shock

First this morning a clinic appointment for Annie, one of the nurses who has seen me numerous times over the past six months, to check the wound, as had been recommended by my GP earlier in the week. Whilst in good condition, nearly closed and infection free, her opinion was that the over granulation problem was related to the continuing presence of the Seton's suture, not that its purpose in draining the wound has been fulfilled. All the more reason for the surgeon to be asked to remove it soon and complete the job.

Then I went into town for a meeting with Ashley and the Director or our radio equipment supplier about concluding our business with him. This is indeed a complex affair and it's hard to see how it can be achieved within the time frame remaining to us before winding up. Nothing is simple in this fast changing world of advanced technology, where things can lose their value and utility very quickly indeed.

I returned home at lunchtime to find a letter from Llandough outpatients department informing me that the appointment recently re-scheuled from 19th September to 8th August has been re-scheduled again for 8th January 2020. I was told after asking the LHB Concerns team to trouble shoot my appointment problem only fifteen days ago, that I was to be seen by Mrs Cornish the surgeon on 8th August prior to booking a third operation. This came as such a shock that I was overwhelmed with distress and thought I would collapse. If my blood pressure was still as high as it was last autumn, I could have had a stroke or a heart attack following inexplicable news like this.  

The increased pain from the wound this past week has been bad enough, and now this. No personal communication and no explanation, exactly the same as occurred last December when my first scheduled operation was cancelled, and this performance repeated in March before the second operation. Three times running is inexcusable. 

I straightaway called the Cardiff and Vale Local Health Board Concerns team hotline, explained what had happened, and stated that this time I am launching a formal complaint procedure against the hospital administration, on account of the extreme anxiety and distress such incompetent case handling is repeatedly causing.

Just after I made the call, in which I received a promise that it would be dealt with after the weekend,  Roy Thomas called, to re-organise our catch up tea time session this afternoon. We haven's actually seen each other since he was appointed a bio-ethics Professor of Swansea University a couple of years ago.

When I told him what had just happened, he laughed and said he was currently with the family of a kidney patient whose case was being mismanaged in exactly the same way as mine. He spends significant amounts of time wrangling with the health authorities over obtaining examinations and treatment for patients who are chronically ill. It's easier in third world South Africa to get to see a specialist than it is here he said. 

Health service administration in Wales is running in a state of competitive chaos. Having to campaign to obtain the medical services the NHS is there to provide for all citizens is an indication of a sickness endemic in the system itself. It can be brilliant in managing crisis care, and innovative treatments for cancer or heart surgery, but ends up neglectful, de-priotitising minor routine systematic surgical treatments, extending the suffering of many more patients with non prestigious ailments. No account is made of the waste of resources on extended nursing care and support for those waiting for or recovering from treatment, due to endless delays due to mis-management.

Anyway, it was good to see Roy again at home, late in the afternoon. He's been out of the country a lot in recent years, and now that his time as CEO of Kidney Wales is ended, he's looking to a future in which his pastoral and advocacy skills on behalf of seriously ill people can be put to use in a new context. It's marvellous to know that a high standing medico legal professional has his heart set on caring for those in such dire need.

Making the most of the sun

Clare drove me out to Llandough hospital for my pre-op assessment check mid-morning. Same routine as before, except that I am fitter and feel better for being able to exercise more. I see the surgeon in another four weeks from now, and some time after that will get a date for the third round of surgery.

I returned home on the bus, and then did some necessary weekend shopping. Making the most of the weather, Clare took our large double duvet to the dry cleaners on her way to the gym. I collected it at the end of the afternoon and hung it out in the sunshine for a couple of hours to give it an extra airing, and make it smell extra fresh, naturally.

I went for a walk after supper, spent an hour editing my Caldey photos, then went to bed early to read some more of the Pablo Poveda novel I have been neglecting lately as I've not found time to settle and read. I've not watched much telly lately either. When the sun shines,  and it's not fiercely hot, being outdoors is what matters most. As a result, I look as sun-tanned as when I  spend time in Spain, and the same happens in deep mid-winter.

When I did teaching practice in the mid eighties, some kids in an all white class asked if I was a Pakistani, because my Welsh accent was unfamiliar to them, and I was dark skinned compared to them. Was it a wind up, or sheer adolescent ignorance of anyone outside their cohort? I'll never know.

A church on top form

Yesterday, I was pleased to receive an email from one of the Europe diocesan administrators Emma Biaggi, enquiring if I would be free to  take on locum duties in Ankara Turkey any time soon, as the Embassy chaplaincy is going to be without a priest. Archdeacon Adele had suggested my name, in the hope that I might now be fit enough for locum duty again. But alas not yet, I had to reply. But, it's so nice to be asked!

I received an appointment letter from Llandough hospital out-patients admin this morning to telling me that the one issued on April 1st for 19th September had been cancelled, to br replaced by one on 8th August. This year. No mention of what I was told on Wednesday last by the surgeon's secretary that I was soon to be examined as a day patient 'under anaesthetic'. Immediately, I wrote a letter to the surgeon reporting this, and asking what I can expect to happen next. She told me last time we met to ignore the 19th September booking - although not to cancel yet, just in case it was needed. 

My letter won't arrive before Tuesday next. Who knows? I may hear something different by Monday. Meanwhile, the wound continues to improve and is slowly closing. That doesn't make it any less comfortable, so I have to be vigilant whenever I go to sit down, or stay seated for any length of time. I've noticed that things are more difficult Thursdays to Sundays, for the simple reason that on these evenings, I am more likely to spend time sitting and watching telly. Having Cardiff Singer of the World on all week for many hours meant that I had either to lie down and listen from afar, or else be sure to get up and move around, or stand to listen instead. But, it's been worth it. Such a wonderful week of music! And all of it from Cardiff city centre. Very proud I am.

Clare cooked one of her delicious bara brith loaves to offer for the refreshments stall at St Catherine's summer fair. It was a marvellous community social event, attracting hundreds of people out on a sunny summer afternoon, with a full range of stalls selling toys, drinks, bric-a-brac raffle tickets, with a throwing wall in a safe corner for those wanting to smash plates or win a coconut. There was a full Punch and Judy show for the kids, with scores of little ones and their parents for an audience. I reckon that most of the regular congregation members were running a stall or helping with one. The church grounds were comfortably full the entire time, and early reports indicated that a large sum of money was raised for church funds. It was a real good news event in my opinion.

When I popped into in Tesco's later, I saw a man wearing a tee-shirt declaring 'Christianity is Stupid'. I thought of St Paul's saying: "The foolishness of God is wiser than human wisdom." and was tempted to accost him and ask him what he made of Paul's statement. But then I thought, would he be able to make sense of this?

If his tee-shirt had read 'Brexit is stupid' he might have been attacked for this out on the street. If he wore one saying 'Islam is stupid', he might be liable to prosecution for hate crime. The fact is, Christianity is broad shouldered and tolerant in the face of its detractors, because it bears Good News about freedom, even freedom to reject and not believe when searching for meaning and truth in life. It has to be resilient, even in the face of hostility and persecution, or it ceases to be Good News for all humankind. Such an amazing mystery.

The Cardiff Singer of the World title final was broadcast in the evening, and I watched some of it. The very worthy winner was Ukrainian baritone Andrey Kimach. who distinguished himself in his performances earlier in the week, in a strong field of finalists, all worth listening to. The length of the programme meant that Inspector Montalbano was shown an hour later than usual. It was a rerun from an earlier series, with a convoluted plot, about Mafia corrupt monopolies in the construction industry. It benefited from a second viewing, even though I was quite tired by then.
  

Good offer

Before lunch today I went to the wound clinic for my second appointment of the week. The nurse remarked on the progress made since she last saw me two weeks ago, and we agreed it would be OK to go without a dressing, just a light protective covering to ensure it gets an airing, as long as this is convenient and manageable. This is good news although there won't be any major change until the remaining Seton's suture is removed, to make complete closure possible. 

It's now four weeks since the MRI scan, which was promised to be 'available' three weeks after processing. I have no idea when I will be summoned for my next meeting with the surgeon, and the hospital appointments system has not improved since the utter chaos of the last round. However, it was a lot more distressing when I was getting worse last autumn and not getting better, like now.

Clare and I went into town together shopping for shoes in the late afternoon. She got she wanted in one store, then we went looking for the Ecco shoe shop, relocated recently in the St David's Grand Arcade. It was only when I took my sandals off to try on a new pair that I discovered a huge crack in the left heel, and a piece threatening to break off. Just in time! It's three years and two weeks since I last bought sandals, and I have worn that pair fairly continuously for eight months each year, without becoming uncomfortable. This is indeed impressive durability in consumer footware. The shop had a special offer on two pairs for forty percent off, so Clare took advantage of this, and we both returned home pleased after our little expedition.
   

St Fagans May Pole Fiesta

After my clinic visit yesterday morning, I went straight into town to meet briefly with Laura again, before she returns to Romania tomorrow. I was pleased to learn that she had been able to visit the Chapel of Rest where her friend Sheila's body is awaiting her funeral, and pay her last respects. We didn't have long, as I had to go home and get ready to go to Llandough Hospital for my MRI scan, but it was good to have an opportunity to talk once more. 

Clare drove me there and dropped me off. In just over an hour I was finished and waiting for a bus to take me back to Canton on the main road outside the hospital. I learned that I can expect to hear about the scan results in three weeks. I wonder if the surgeon will hear earlier than this?

This morning we drove out to St Fagan's Museum, our first visit for two years. Last year saw the 70th anniversary of its opening. Already a major re-development of the main building was under way, and now it's open, and being touted for a national award, shortlisted with several other museums for their innovative educational work. There's a new entrance hall, large and spacious like an airport departure check-in area, and exhibits upstairs in new and renovated galleries. Whole groups of historic artefacts have been re-located here from the museum in the town centre. It's very impressive and today, on a bank holiday weekend, car parks were almost full and the place was full of families out for the day.

First, we visited an open air arts and crafts fair where I was very much attracted to the work of an unconventional wood turner, Bernard Dite, a one time East Moors steel worker, who uses a lathe and other hand tools to sculpt irregular chunks of wood into a variety of dishes, bowls, vases and flasks, taking advantage of existing flaws, different grains and colours to reveal beautiful patterns which would otherwise never be seen. His artistic creations are refined and some of them extraordinarily lightweight. On impulse, I bought two pieces, one to be a fruit bowl, another for a salad bowl. We might have spent that amount of money on a weekend meal for two, but now we have a feast for the eyes that'll be with us at table every day instead.

On the lawn outside a team of folk dancers and a small band were performing. Later these moved to Gwalia Green, the open area around which many of the historic village shop buildings stand. At two, a May Pole was ceremonially brought in by the men among the dancers, dressed by the women, then erected and danced around for half an hour, drawing many of the younger spectators into the dance. It was such a delight, and the weather was just perfect for it. My photos are here

All of this was an unexpected pleasure. It more than compensated for the bout of stomach cramp that came upon me as we were walking around. Clare had cooked pancakes for breakfast, using a couple of eggs. I didn't think about this when I ate them, and they weren't indigestible, but slowed normal digestive process right down, as my bile duct no longer works with normal efficiency. After half an hour of unpleasant pain and nausea, and drinking a fair amount of water, the sensation passed, and we were able to resume our tour of the grounds, and glimpse some of the new features.

In the evening we went to Chapter Arts to see the movie 'Red Joan', a thought provoking piece about a young scientist who leaked secret atomic research material to the Russians in her twenties, and was finally unmasked in her eighties, based apparently on a true story. Brilliant acting from Judy Dench as the old lady and Sophie Cookson as her younger self. Well with deferring the final double episode of 'Follow the Money' until tomorrow.
    

Op day number two

After a somewhat restless night's sleep, I was up cooking breakfast porridge by 6.45am this morning, under instruction from the hospital to eat before 7.30 in preparation for afternoon surgery. I walked to St John's in the drizzle to celebrate the ten thirty Eucharist with seven others, and Clare was waiting for me in the car outside afterwards to take me to Llandough hospital. I arrived at day surgery Reception half an hour early and waited even longer than last time to settle on a ward as it was pretty full with the morning's intake.

I was shown into a waiting room and my registration details checked, a little later. I was interviewed by Magda the anaesthetist, who checked my medical history and reviewed last time'snuse of anaesthetic. Then we fell to chatting. As I was wearing my cross, he felt free to tell me he was an Egyptian Coptic Christian and treasurer of the South Wales Coptic church community with its base in an old church building in Risca. What a delightful conversation!

It was nearly one by the time a bed was free on the surgical ward. More interrogation, changing into theatre gown and pants, then a conversation about the operation plan with  Mrs Cornish the surgeon, followed by two hour's relaxed siesta, against the background sound of nurses coming and going and talking with patients before and after surgery. Several of them had come in for carpal tunnel surgery it seems. It was gone four by the time I was wheeled to the lift and taken up to theatre, sedated and worked on. By ten to five I was back on the ward again, given a cup of black coffee and a round of chicken sandwiches and allowed to recover.

Clare arrived to collect at half past, but I wasn't ready for discharge until ten to six. She'd cooked a delicious chicken soup for supper, and despite the coffee and sandwiches in hospital I felt hungry and ate with relish. No post anaesthetic nausea or hangover. An inspection revealed I'd been dressed with a large loose absorbent pad. It wasn't uncomfortable and I wasn't in pain. How very fortunate! A wound inspection revealed that the Seton's sutures had been exchanged for a single, much finer one serving the same purpose. I was delighted at how comfortable sitting became, despite having a new vertical incision intended, I think, to drain remaining fluid trapped in the area around the first fateful puncture wound from August 31st.

Once again tonight feeling mildly elated, extra glad to be alive and no longer inwardly tensed up, awaiting the return of discomfort and pain from the pressure of sitting for more than half an hour. No analgesics were given me to take, and if I had received intravenously any during the op, they would have worn off by now, I'm used to being careful and avoiding undue pressure on an open wound site. I guess the elation could be an aftermath of anaesthetic, but I'm not sure that would lead me to add the Te Deum to the recitation of Evening Prayer!

Another milestone reached on this tentative trip into the world of modern surgery with all its delightful dedicated inhabitants, and so thankful to all who looked after me.

A cutting edge saints day to remember

The world many just think of this as St Valentine's day, but in the church calendar it's the feast of Saints Cyril and Methodius, apostles to the Slavs, brothers gifted Roman civil servants, sent by the Pope in the ninth century to evangelise on the eastern frontiers of the Roman empire. Cyril learned to speak the  language of the Slav tribes and invented what is still known as Cyrillic alphabet, based on Greek and Latin scripts to turn speech into writing. They translated scripture and liturgy into the written texts known as Old Church Slavonic. Methodius was a bishop. Cyril remains a founding hero throughout the slavic cultural world, yet both were laid to rest in Rome's San Clemente basilica, which I well remember visiting over forty years ago.

So, all in all, a memorable day for an afternoon surgery appointment as far as I'm concerned, though any days would have been just as good after a six month wait. Clare delivered me to Llandough at noon. I was taken to a ward and interrogated by nurses and the duty anaesthetist before meeting the surgeon. The charge nurse told me that she's a Sunday School teacher at Llandaff Cathedral when she home for the weekend. A nice co-incidence.

The head of the surgical team excused himself from attending to me on account of 'other duties' and much to my surprise and delight, Ms Julie Cornish introduced herself to me. She was fully briefed, having read all the notes and my two letters to the boss man, and explained what was going to be done to me. Today's procedure starts sorting out the internal damage, draining the wound tracks. There'll be a further procedure in two months time to complete the repair work. She was honest with me in stating that there's only a 50% change of a fully successful outcome, and that further measures using other techniques might be required if not.

I was taken down to the operating theatre around three and returned to the ward three quarters of an hour later, having calmly drifted off into unconsciousness, and waking up later as if coming around from an afternoon nap. No nausea or dizziness, vital signs stable, no pain, nothing to worry about. Before Clare collected me at five, I was treated to a cup of black coffee and a turkey sandwich, and walked out feeling steady on my feet and reasonably comfortable.

Clare cooked us huge tuna steaks for supper, eaten with relish, as my last proper meal had been a seven o'clock breakfast. The new wounds leaked a fair amount of blood, as the dressing applied was loose and needed an absorbent back up pad. All a bit messy, but never mind, I found I didn't need any pain killer to see me through the evening. In as much as I can sense a change in my condition at this stage, I'd say that it's easier to sit without stressing my perinaeum. There's a peculiar kind of pain associated with pressure on the core of the nervous system. This is a great relief. I think I will sleep well tonight.

So much for me thinking this would be a straightforward repair job! It's been a positive beginning however, and fortunately my body is still good at healing itself and I have the benefit of acupuncture to help maintain the equilibrium of my immune system and energy levels. I don't need to believe in it or know how it works, I have the evidence now. Four courses of antibiotics needed in the last four months of 2018. Seven acupuncture treatments this year, and no new threat of infection.

Thank God for the surgical team, the nurses and my acupuncturist, all doing what they do best to get me back to health.

MRI dismay

On the way to her morning study group, Clare dropped me off at Llandough Hospital at a quarter to ten this morning for a MRI pelvic scan. At half ten I was escorted to a mobile scanner unit located in the yard outside the Orthopaedic Unit, and subjected to five scans over the period of an hour. The last time I had this procedure was when I was about to shed a kidney stone, at New Year in 2009. Then I had to undress completely and leave outside any metallic objects. This time I wasn't required to undress, just uncover my pelvis to make room for a device which fitted over the area to be scanned, possibly to focus the magnetic field that generates the resonance images. 

The scanner made five passes. Three with the machine making one frequency noise, then two more in a slightly different position at another. I think the second two were directed at my liver and right kidney to probe the anomalous signals registered by last week's ultrasound. I asked the scanner operator how long it would take for the report to reach the surgical team who had commissioned the scan and was disappointed to hear him say four or five weeks. Not much urgency there, I thought. I must ask my GP to chase it up. A long wait isn't improving things and may be taking its toll on me.

I walked out of the hospital an hour later and within a few minutes boarded a 95 bus. This dropped me at the end of Lansdown Road in Canton, a fifteen minute walk home. It conveniently offered an opportunity to do some shopping and then cook lunch in time for Clare's arrival. The inflammation today was worse than usual and I had to rest and recover after lunch. Then I wrote to my GP and took the letter around to the surgery, to get some exercise. Then, another evening in front of the telly with unseen episodes of NCIS and Bull. Rather too much of Michael Weatherly for one evening to be honest.

Llandough on time

This afternoon we took Rachel to the coach station to start her journey to Kenilworth, where she'll not only be staying with big sister Kath this week, but making some song recordings with brother in law Anto in the attic studio where he composes his own sound track music for AKM Music and has recorded their own Sonrisa band albums. Getting quality recordings done in the USA would be not only more costly but maybe also a more chancy process, where you can't be sure that the people you're dealing with want to help you or take advantage of the fact that you're a foreigner. Working on home ground has its advantages! Unfortunately, her coach suffered a door closure malfunction, leading to a departure delay of over two hours.

Clare and I went to Llandough Hospital after dropping Rachel at Sophia Gardens, as I had a first examination and briefing about having an endoscopy inspection. I'm impressed by the improved way the hospital appointment system now works, checking and rechecking by text message, that you still want and can keep the appointment. This strategy aim to cut down on time wasted by those who fail to notify of their need to cancel or postpone. 

For good or ill, there are always reasons why a scheduled booking has to be changed, or cannot be taken up. While there's little excuse for not letting the hospital know in good time, I guess with a range of older, less capable patients, some of whom may be supported by busy careers, additional effort to communicate and obtain a response is worthwhile. I was also impressed by how everything ran to time. We were on our way home again within three quarters of an hour of arrival.

I was interested to find the specialist I saw wasn't entitled Dr or Mr but Lt Col, a military surgeon, not in the reserves, but on active service. As a ranking officer, leading or managing a team he spends time in a civilian hospital alongside military duties to maintain his level of professional competence when not on operations. That's a comforting thought now.

Over the weekend, I started watching a series of French crimmies called 'Dead Beautiful' on More Four Walter Presents. They feature Thierry Godard, who plays the Parisien flic who co-stars in the brilliant long running 'Spiral' series. Instead of being a team member, he's Le Commissaire in this series with the usual complex personal and family life which seems to be built in feature of the narrative in so many police dramas, representing the exacting demands on the individuals who serve in law and order roles.

As the generic title suggests, this is a series of stories about women who are victims or perpetrators of violent crimes. Wealth and privilege also part of the scenario, and the power politics surrounding the judiciary aren't really a feature. Each is a two hour watch, quite tough going, and each has a few surprise twists in the past ten minutes. Best of all, my comprehension of movie mode French seems to have improved, perhaps because I have been using the Duo Lingo app to revise French this year, in addition to maintaining my Spanish. Half to three quarters of an hour's language drills daily is a quite a routine to maintain, but I'd rather that than doing Sudoku or crosswords. It seems a bit more useful, while I'm still able to travel and live abroad for decent periods.
       

Lucky x-ray date

I rose at eight this morning to phone the GP surgery for a 'book on the day' appointment, to tell the story about my need for a knee x-ray to Dr Benjamin. I walked to the surgery, and after a brief conversation and inspection, came away with an appointment request, and a telephone number to call. Within minutes of phoning the appointments booking desk, I was given an appointment in Llandough mid-afternoon, fortunately free due to a cancellation. 

I was in and out of the hospital just three quarters of an hour, and this meant I could return home for a cup of tea before walking across the parish to make a bereavement visit, to prepare for a funeral next Monday. It'll be a week before the x-ray results reach my GP. Whatever the outcome, my knee joint has improved noticeably since yesterday. 

Walking through the parish today I picked up eighteen pieces of litter. It's only a fraction of what's there to pick up. Paper, cigarette cartons and paper cup get trodden flat and sodden in gutters. That sort of mess call for gloves and tongs, it's messy business, so I focus on removing things people could stumble over, and hope it won't be too long before the street sweeping machines do the rounds again.

  

Not so good news, followed by good news

This afternoon, my long awaited cardiology test appointment at Llandough hospital was scheduled to take place after a two month, ten day wait. As I drove from the street the engine temperature warning light came on. Fortunately I'd left in good time, so I returned home and discovered the engine coolant had lost two litres, since it returned from servicing over the weekend. I replenished the fluid and drove to the hospital without any further trouble, but by then was in danger of running late in the 'school run' time traffic. 

Although I found a parking place easily, I parked almost as far away as I could from the Outpatients department, as I hadn't registered where it was located from signage on the way in. I power walked the five hundred yards along hospital corridors, stopping to ask my way twice, and arrived just on time. When my blood pressure was taken ten minutes later, I was met with the usual frowns, as it had gone through the roof. I didn't bother to explain, just said I always reacted badly the first few times I was tested. The nurse didn't take it again.

The ultrasound and EEG tests followed one another in quick succession it seemed, after brief waits. Little was said by way of explanation. Maybe it was assumed I'd been through this before. I was quite fascinated to hear the different kinds of sound feedback issuing from a system monitor during the ultrasound test. The EEG chart I was given to pass on showed no irregular spikes this time, but then I have stopped overdosing on dark roast Americanos since the first time I had one.

The consultant  discussed the results with me in detail, and smiled when I recounted him the tale of my arrival mishaps. No wonder my blood pressure skyrocketed. He said the tests show my heart is healthy and normal for my age, allowing for the wear and tear to be expected for three score years and ten. As ever, keep an eye on hypertension, and come back for another check in two years time. No tests ad interim, no treatment needed. And for me no more worries about travelling abroad and getting insurance cover. I can once more let others know that I'm available for locum duty. A joyful return home, with an extra spring in my step. The uncertainty of waiting has finally been lifted. And I am utterly grateful, to be able to continue normally, at least for the time being. I keep on reminding myself, nothing lasts forever. Especially not the car.

  

Surgical success so far

After I'd finished writing last night, I scanned my Twitter account before turning in, and found the first chilling report of the German Wings Airbus 320 black box voice record, indicating that one of the pilots had been locked out of the cockpit as the descent of the aircraft began. So unless the pilot locked in way unconscious or incapacitated, the crash was due to malicious intent. But what sort of malice? I fretted as I tried to sleep, thinking about the ramifications of discovering that the pilot was a secret jihadi, much more far reaching than if he was a loner, minded to do evil. What would morning bring? 

Well, morning meant another early rise and a trip to Llandough Hospital with Clare by seven for her shoulder repair job. I learned from the seven o'clock TV news as we arrived at the surgical unit reception area, that the pilot who locked himself in the cockpit  and caused the death of 149 others as well as his own, was a young German. It was a terrible kind of relief. It could have been even worse than it already is, if he'd been a non European or had an Arabic name. There'll be a lot more to come out regarding his motives in due course, and much breast beating. How could no-one have noticed his state of mind? etc etc.

For Clare it was third time lucky. Infection free, and no urgent jobs to push her back down the list, so we parted company just after eight. I recognised her surgeon Alex Roberts entering as I was leaving. I doubt if he recognised me, but I was pleased to know he'd arrived to get on with the job that his team were preparing for him to do and I wished him a good day in my heart. I killed time, going home, having lunch, returning to the hospital to check when I couldn't get through on the phone. By one she was out of theater and in the recovery ward, so I went for a drive to kill time until she was ready to go home, and by five I was cooking her a post-op meal.

Learning to cope with many routine everyday tasks with one shoulder bound up and an arm bound in a protective sling is all going to take her a good deal of time to get used to. There are all sorts of tasks I can do, but many essential ones which she must master left handed to be able to support herself and her recovery as best as possible.  By bed time she was already commenting critically on the clarity of the instruction leaflet provided by the surgical time. She's good at making better sense of things, so I imagine a re-write will be offered to them in appreciation of their excellent care.

The surgeon declared that her shoulder internally was 'a right mess', but that he'd been able to effect all the repairs he'd intended to carry out. She and he agreed that in the end it was a very good thing she'd persisted with the operation, even at a later stage than desirable for best effect. As Clare is pretty fit, recovery and rehabilitation, although demanding on her should be fairly straightforward. Altogether, well worth the risk. 

Before keyhole surgical technology, an operation like this would have had far more impact, and involved a week if not longer stay in hospital. To be in an out in half a day, able to recover in the comfort and security of one's own home is an amazing kind of progress. Yesterday I was listening to a radio programme about health service statistics, attempting to explain how the NHS got so much more done with fewer beds, and despite complaints about empty and closed wards which seem to beset the service in some places, the fact that in some areas beds are averagely occupied more than 100% a day. It's not damned lies type statistics, but an abstraction of the reality into numbers. There will be surgery days, when two patients will have keyhole procedures and recover using the same bed within the 24 hour defined period, so efficient is the use of resources. 

You only realise how impressive it is when you have the direct experience for yourself.

   

Silver lining

We were out of the house be eight fifteen this morning to drive to Llandough Hospital, where Clare had an appointment with an orthopaedic specialist about her shoulder injury at nine, After an initial x-ray had been taken, we were ushered into a consulting room where Clare was given a scrupulous examination by a physiotherapist skilled in diagnosis, to confirm what the x-ray and previous scans of the injury had revealed. Then the surgeon appeared and very quickly pronounced his willingness to perform keyhole surgery to fix a ripped tendon. 

This came as a complete surprise, as others involved had suggested the injury might not be treatable due to her age and she might have to live with some painful limitations for the rest of her life.. The physiotherapist, however, observed how fit Clare is and unusually mobile and flexible because she's a eurythmist, dedicated to the art of movement, and thus more likely to respond well to treatment, as well as needing it to continue her vocation. With a wait time of two to three months, this could be an unexpected Christmas gift. The treatment will leave her arm immobile for a month, so she'll need a lot of looking after. It'll be a while before we have a date, and hopefully it'll be around the time I return from Costa Azahar. Just in case there's an overlap, Rachel has expressed her keenness to arrive early from Arizona for Christmas to be number one nurse. Every cloud has a silver lining.

At half past ten we were on our way to Dyffryn House and gardens for a walk around, to inspect their historic dahlia collection, 35 varieties, 6000 in various flower beds, now somewhat past their glorious best, yet still a riot of colour against the trees tinged with autumnal gold. Several new rooms, partly renovated, have now been opened to visitors -one has been made into a library, another furnished with a history on the Cory family who owned and developed Dyffryn House as the family residence. They were very rich, both from ownership of coal mines, but also from shipping coal to ports up and down both sides of the Atlantic seaboard. They were also philanthropically minded, and as a result house and grounds were much used and enjoyed. Indeed, they were eventually given to Glamorgan County Council and used as an education centre, before finally being taken on three years ago by the National Trust for a major restoration project, with lots of volunteer engaged in looking after house and gardens. A visit is a must-do thing for us now, all the year round.

We had a pleasant lunch there, and then I went into town to do some more money moving, and spent an hour in the office, to fit in a couple of urgent tasks while I could. Things aren't easy just now, as Julie our administrator is off sick, but we muddle through. Afterwards, Clare joined me and we spent an hour at John Lewis' having tea and indifferent chocolate cake and then looking at their selection of curtains for our front room makeover. News came through today of the delivery of our new sofas,  next week, ordered back in August on our way home from East Anglia. I'll have to content myself with viewing them on Skype.

All too soon, it seems, I was hunting down all my bits and pieces, spread around the house, packing the rucksack ready to travel, and off to bed early, for an eight o'clock airport bus trip, wondering how soon it'll be before Clare hears about her surgical appointment.