Patience, a necessity

Sunshine and clouds again to start the week. I was surprised to find that Mother Francis posted the link to my video of last night's service on the Parish Prayer WhatsApp group, and a few people who weren't able to attend expressed their appreciation for this.

It wasn't such a cheerful start for me however, as the suture has been digging into the wound again, after a spell without trouble. Sometimes the preventative measures I take stop become ineffective. Remedying the problem is never without painful debilitating consequences, as the suture presses on the vagus nerve. It's not just the dull pain, but the way this drains me of energy that makes it so frustrating. It interferes with daily activity. Walking can ease the pressure, though not entirely. It slows my page noticeably - not the pain, but energy drain that accompanies it.

I walked for an hour before cooking lunch and for another hour after a post-lunch siesta. To take my mind off it, I took thirty odd photos of buds and blossoms with my Olympus OMD10 to add to an album from which I propose to make a video slide show, and possibly a photo book. I've asked Mark if he'd like to accompany this with suitable solo violin. It's something he could use to promote his music making and I could use to present the photo book, if I decide to go into production.

I had a good conversation this afternoon with Mark and Fran about the icon video presentation we're to make tomorrow. They sent me a script which we discussed, along with ideas about shots we hope to get, once we've settled on a background setting within the church. I'm excited about working with others on a creative project. I can't remember when the last time I did anything collaboratively.

In Wales from today, supermarkets are allowed to sell non-essential items again, and garden centres can re-open. I suspect they are going to be very busy for the next week or so. Clare is keen to visit, a garden centre, but neither of us are keen to brave the crowds at the moment. She has a hairdressing appointment with Chris for this coming Friday, right at the end of the day. He's so busy that's the best he could do to fit her in.

After supper, I decided to lie on the bed for comfort and watch NCIS episodes on my Chromebook, but it wasn't that comfortable. Sleep seems to be the best remedy for limiting the distress the wandering suture causes. I'm supposed to be having a phone consultation with Mrs Cornish the surgeon on Wednesday morning. Just as well this has happened now, as I won't forget to tell her. Clare says I'm prone to forget to mention bad days when I have a run of good ones. 

I've come to accept setbacks and stay mindful of the slow but overall persistent progress I have made. And that calls for qualified optimism. Set-backs happen, they mess me about, but I've had some experiences of seeking medical help that were a waste of time as the problem called for surgical expertise, and that's simply not there on call when you need it. Unless it's critical - life threatening or psychosis inducing - you have to wait in turn. It's what being a patient means,

Works in progress

Another day at zero degrees centigrade. I tracked down my long johns and wore them for possibly the first time in the ten years since we visited Rachel when she was living in Canada. It's also cold enough to wear the balaclava hood my sister bought for me last year. It fits nicely under the hood of my ski jacket, which now shows signs of its antiquity, bought in the early nineties. I think the padding has compacted, reducing its ability to insulate. It's a long time since we lived anywhere with a cold enough winter to call for an outdoor clothing upgrade.

When Clare returned from her early walk she said that a team of people were about to start work on Blackweir Bridge. When I walked down to the Taff later in the morning, work was in progress. The deck of the bridge was being taken up and each panel of stout mesh steel, two metres long, was being secured to the handrail above. Since last week's break-in through the barriers closing off the bridge to the public during the pandemic, a decision has been made to make a short-cut impossible by removing the deck. It's a sensible move under the circumstances, although, like thousands of others, I resent having to walk around instead of crossing over. A second temporary bridge with a one way system would have been preferable and not impossible. In other situations where bridges have been washed away by floods, Army engineers have erected temporary crossings. Why not here?

The Wales and West Utilities team replacing the street's gas main hit a problem this morning which meant the gas supply had to switched off for three hours while it was fixed. The house was quite warm and only slowly cooled to the point that the temperature difference was noticeable. Before reconnecting the supply an engineer came in and tested the gas flow to the meter with a special device before rebooting the boiler. He used a smartphone app linked (I think) to the house smart meter to check the supply. Unfortunately, he couldn't initially access the app and had to get the help of a colleague outside to make it work. It all works perfectly, except when it doesn't!

In daily pandemic news reports, it was disturbing to learn that six out of ten covid victims were disabled, very much a reflection of the unjust social and economic disadvantages they endured, and reflected in their general health condition. The UK's high covid related death rate, one of the world's highest, is also an indication of economic and environmental disparities that contribute to poor health. It's not just a matter of decades of NHS  under-funding, but people being made more vulnerable by their living conditions. Is this going to change any time soon I wonder? 

A month ago I was very annoyed by the criticism levelled at the Welsh government and NHS at what was perceived by BBC news and other media to be a slower roll-out of the covid vaccination programme. It now turned out that Wales has reached the target of vaccinating for the first time 20% of the population most at risk a few days ahead of the date set. The logistics of distribution and inoculation were thoughtfully worked out at the outset, even surviving a few days of setback due to snow closing some of the vaccination centres. Tonight's news now reports a planned reduction in first time injections to allow for re-stocking so that second injections and first timers can be continued in March. But will the newshounds apologise for unwarranted criticism of First Minister Mark Drakeford? He's done us proud.

State of Alarm - day Forty Five

It's Mayday here, and normally a day of grand fiesta on the island. In the religious calendar it's the feat of San Josep el Trabajador. In fact, the titular feast of the Parish in which I'm residing. In the UK tradition makes this the Feast of St Philip and St James the Apostles, with St Joseph the Worker kept on 19th March, except that in the secular calendar for more than a century Mayday has been Labour Day. I love this cultural messyness, the tension between the local and the universal!

The Spanish government has today published its relaxation of lack-down plan. Church services may resume in the last week of May, just after I am due to leave. People over seventy may walk for an hour between ten and noon, then again between six and seven. Kids and those training for sports get time slots of their own. Nothing is scheduled for between 11.00pm and six in the morning, begging the question - is sleep or staying at home obligatory? Are there sanctions against walking in the dark? I've not seen answers to these questions anywhere. 

It's not clear how any of this will be monitored. It's designed with urban lock-down in mind where CCTV is common, but what about inhabitants of rural areas? Am I meant to walk within a 1km radius of home for one hour a day only? Who is going to check? How will anyone know? Do the authorities have that many surveillance drones en el campo. As ever, the devil is in the detail. At least I can walk out in daylight tomorrow. And if it's safe enough to do that, I can also go to the bank, which is permitted, though it doesn't specify how I should get there, foot, car taxi or bus. It'll all become clear as everyone muddles through, no doubt. 

The farmer opposite came out with his four by four and a trailer today and parked by the pump house. While I was out walking the sound of his chainsaw filled the air, and slowly the trailed filled with logs he'd cut from trees in the arroyo next to the house. I daresay there's some tidying up to be done down there, to reduce the amount of flammable material as a precaution against forest fire, A man with a petrol driven strimmer like the one in the garage downstairs was also out working on the roadside verges for the same reason.

I examined the strimmer downstairs a few days ago and decided it wouldn't be safe for me to try and figure out how to use it and get it working as I'm here on my own. I've done a little manual clearing of vicious spiky growths choking up garden beds but that's painful hard work, to be tackled slowly, with recovery days in between! Accepting one's limitations is part of getting old, I guess.

I prepared most of the material for this weekend's on-line audio service in between usual domestic tasks of the day. The final components will come in tomorrow. I had a two lovely emails, one from Yong locked down in Singapore and another from Fr Rhys, our GP NSM in Canton Benefice. Most of his daily work is now done by phone. Any time he needs to see a patient he has to be kitted out in full PPE gear. And for him it's all so remote from the needs of so many of his patients with chronic health conditions needing to be dealt with. 

While the NHS is coping heroically with the impact of the pandemic, it's a major setback for the objectives of health care as a whole, from which the UK like many other countries will take years to recover. He talked about the shrine created in the closed off porch of St Luke's Parish Church, featuring a votive candle stand in front of a large icon of the Evangelist, emblazoned with an NHS logo. Brilliant cultural adaptation. He was especially pleased that Mother Frances asked him to bless its inauguration. What a super parish I go home to - hopefully!

Adverse conditions

After very heavy rain Thursday night, I walked down to Blackweir Bridge to inspect the river level and found that it was a few inches short of overflowing on to the path and still rising. There was more rain during Friday and I got very wet, with soaked shoes, despite wearing my new rain jacket and rain trousers. It was a struggle to make my daily mileage target.

I received a letter from First Minister Mark Drakeford AM in response to mine sent to him on 4th February. His response merely re-iterated information I have already received from the Patient Care Co-ordinator, nothing more. My really essential question to the Welsh government about the way patients are kept waiting for treatment is why it's impossible to get any more than a minimum of general information. I will write to him again.

In any other public service with a waiting list, clients are given a ticket and there's an information display which indicates where they are in a queue. If managing the queue is halted for any reason, an explanation my be offered. Keeping people in the dark causes anxiety and doesn't generate good-will. Coronavirus experts are saying how it's the the public's benefit to give as much information as possible and treat people as if they can handle this responsibly as it's in everyone's best interests. Too much power is being exercise with too little accountability by everyone in public service, and it's set to get worse, given the appalling behaviour of Boris Johnson's government.

We had supper at Stefano's Restaurant this evening. It's always a pleasant and sociable experience. We were saddened to learn that its' closing down at the beginning of May. The property, owned by the family has been given planning permission to be turned into a couple of flats. It will, in the long term provide them with a steady stable income for less effort. The family has done business in the property and catering sectors of the market for half a century with considerable success. I guess retirement must be on the cards for someone.

Project milestone reached

Apart from taking a funeral at St Catherine's at lunchtime yesterday, I spent most of the day writing, with an afternoon break for an interrupted five mile walk, to re-charge my brain. The exercise, both of transcribing and adding in explanatory detail is quite demanding, as in places my journal is  thin on detail, as it was written at the end of each day's activity while I was in Sarajevo.

When I'd had enough, I stopped watched the previous and current episodes of 'New Amsterdam' on More Four. It continues to sustain interest with its complex medical procedures, some difficult ethical decisions, and the evolving personal relationships between dramatis personae. 

Much the same was true of today, with another uninterrupted five mile walk and watching a couple of episodes of Series Two of 'The Team' On More Four to punctuate the day. By late afternoon I finished the transcription job, and felt a great deal of relief. It's not finished. There are vital corrections, and probably additions as well, as I'm finding memories of the time surfacing, which didn't get noticed and noted then even though they were and still are important aspects of the story to be told.

'The Team' is most enjoyable. It's a crimmie about an international group of detectives working on the same frontier crossing case. The cast is different from Series One. Team members are from Belgium, Denmark and Germany. It's about a mass murder in Jutland with Islamist terrorism, antiquities theft and people trafficking all in the mixture. What I appreciate is the way different languages are brought in - Danish, Flemish, German, English, Arabic and French.

It's well subtitled and not confusing, but it lends a special quality to the drama. The detectives often use suitably accented English between them and sometimes with subjects being interrogated. Arabic conversations between people caught up in the crisis also occur, but the speakers use either English or French to relate to the police, since they are Syrian refugees or settlers. Both ex-colonial languages are still used in Syria. It's very well done.

Thankfully, no sermon to write this evening, as I have no assignments for tomorrow. I'm quite glad of a respite, I've done a lot of extra jobs this past year with little time off. Our Oxwich Bay holiday told me that I'm in need of refreshment. If only I could take a few quiet weeks seaside retreat in Malaga. It's impossible to plan anything until I hear about my next surgical appointment. I don't know when that will be. It could be several months before I get treated. This is really beginning to bother me. I increasingly feel like a hostage awaiting release pending negotiations out of their control.

Enough light in the tunnel

I celebrated the Eucharist with just four others at St Catherine's Most of the church regulars are away at the moment. A young mother with a ten month old baby joined us however, giving much pleasure to the rest of us, who are all old enough to be grandparents.

Just after I returned home I received a phone call from Jacquie, Patient Care Coordinator at UHW, apparently being pursued by the LHB Concerns team to find out what was happening about my case. It turned out this was the same person I spoke to a couple of weeks ago when I last had to call in the Concerns team. At that time, it wasn't at all clear who she was or what her role is in relation to the surgical scene, but she explained what was happening and it satisfied me all was proceeding in order.

She was upset with me for reaching out in several directions at the same time instead of contacting her. She didn't initially understand that I didn't know who she was or have her contact details. When things fell apart last Friday, and previous pattern of dis-junction in relationships between hospital and patients repeated itself, as several others have said to me; "It's time to make a big fuss. It's the only way to get listened to."

Anyway, after several minutes of heated cross talk, to break the ice, where I made my position clear about the hospital's communications dysfuction, Jacquie admitted there had been an error. I had been assigned an outpatient appointment with Mrs Cornish when she was on annual leave. When this was realised it was re-scheduled without regard for the measure of urgency which Mrs Cornish conveyed through Jacquie in setting this appointment. So I told Jacquie that this is exactly what has happened to me previously, and the reason for me getting militant about it.

Anyway, the outcome is an appointment to see Mrs Cornish on a ward in UHW, in exactly the same way as I saw her back at the end of March, before the second op. This was set for Monday morning next. Fine, OK, that's all I need for now. Booking a surgery date will follow from the examination, though I don't imagine it'll happen until after the holiday now. I'll find out.

Within a couple of hours, Jacquie was back on the phone to me apologetically, asking if I'd agree to being re-scheduled to Tuesday morning. It seems that Monday was 'window of opportunity' due to the cancellation of an operation as no anaesthetist had been booked, but in the time elapsed between calls an anaesthetist had been found and the operation was back on, so I was rescheduled again! Well I don't mind this change, just as long as I get seen, and get to know what the next step is.

I guess this scenario is indicative of the hospital's state of health, overburdened with a huge case load resources over-stretched, constantly juggling to achieve desired aims. No wonder there can be chaos, and it's terrible to be on the receiving end. Communications and the technologies employed by the NHS hospitals are notoriously poor in many quarters, outdated, insecure and difficult to implement universal change because some departments insist on absolute control of their assets and don't give priority to ensuring communications are working for everyone as intended.

By way of contrast our GP surgery has brought its patient communications system up to date, using emails texts, and even a smartphone app for booking appointments and arranging prescriptions. It works, although I don't make use of it, as it's easy to pop into the surgery when I'm passing and say hello. So often I see a couple of admin staff huddled around a screen, studying and cross-checking general arrangements and bookings. Their attention to detail in the face of high demand in a busy practice is impressive.

Well, for the moment the cloud of anxiety has lifted, my stress level is much reduced and blood pressure back to normal. I even had a spring in my step when I did my five mile afternoon walk, but perhaps that's the hot hot weather leaving my leg muscles more flexible than usual, so that it doesn't take so long to get into stride.

News but no news really

I rose early enough to walk to the surgery at eight to arrange an appointment later in the morning and returned later to see my GP, who had two very young looking medical students in attendance. She was able to tell me that my MRI scan had been registered on my medical record database, signed off by the consultant radiologist, a whole month after it had been done. A week later than stated by the scan operator, six weeks ago. 

I expressed my concern that I had heard nothing from the surgeon, about when I would next be seen or operated upon, and asked (partly for the benefit of the students present) how so much time could have elapsed between the scan and its interpretation as during that time the wound condition would have changed again, for better or for worse, as happened in my case last time. Fortunately it has changed for the better, though the internal healing process is still incomplete. I could tell as much six weeks ago, but since the time of scanning, there's been even more improvement, as evidenced by the ease with which the wound can now be managed, as opposed to six weeks ago. 

The District Nurse team could corroborate that, but they are not consulted either by surgeons or GPs, and neither surgeon nor GP has checked it out since then. I declared that in my view it's bad science, not much better than magic to rely on an abstract body map without the evidence of the examining eye so many weeks later. I hope the young girls in attendance will hear what I was saying about the inadequacy of this process. 

Meanwhile, my GP promised to write to the surgeon and ask her to get in touch with me. I also learned there's still an appointment letter on the system for a September date. I received this at home around the time I went for the second operation, and was told to ignore it, as I could expect there to be more follow-up appointments before then. It's still on the system, however, and how do I know that this isn't contributing to delay on the part of some minor administrator who is unfamiliar with the case load. 

Sure, the NHS is overloaded, but so often there are alarming gaps in the accuracy of some record keeping, not to mention the patient mail-out regime, with differing information systems in place that don't automatically connect with one another, some using out of date software too.

I went into town in the afternoon, via the clinic to pick up some supplies, to visit the Co-op bank and close a Super Saver account I've had for years. It was used to deposit the content of an ISA which I cashed in, I emptied it, as it only gave minimal interest. Six months later, the last sum of minimal interest, just twenty pence, boosted the balance from zero, and I received a statement telling me so. I've intended to get around to dealing with it for goodness knows how long, four five years maybe? 

I just wanted to put the change into a charity box and put an end to this tiny waste of paper. But to do so I had to identify myself as the account holder, without an accompanying account card. Fortunately Coop bank makes this easy with a secret PIN code and memorable date, of which I'd kept a record. Mission accomplished, there was nothing else I could think of that I needed to do in town, so I returned home by bus. I had intended to walk but it started to drizzle

After supper I watched the first half hour of Cardiff's Singer of the World competition, and rather than sit for so long that I got really uncomfortable, I went to bed and read several chapters of Pablo Poveda's 'El Aprendiz', so I'm now half way through it, and pleased to find that it retains my interest, even when I have to look up or guess so many words which aren't quite in the dictionary. His trilogy is about a Spaniard but is set in today's Eastern Europe, and is bang up to date in the way it speaks of the information age and the surveillance state, in which countries East and West aren't that different from each other in the way they strive to control their citizens lives and behaviour.  

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.
   

Most holy nights

On my way back from the Cathedral last night, I caught sight of the Passover moon just as it rose above the city's roofscape across Llandaff Fields. I dashed the last stretch home and took my Sony  HX300 to the attic, and got a fairly good picture of it as it emerged above the houses beyond. Not quite my best and sharpest moon pic, as holding the camera on the edge of an open Velux window was all I could manage - no time set up a tripod to capture such a huge low lying night time image with pale orangey brown hue.

Due to the routine disruption of the bank holiday weekend, I mis-calculated what medical supplies would be needed to see us through, and was obliged shamefacedly to call the out of hours nursing service and ask for a home delivery. This happened at tea time, with a cheerful nurse, at the end of what she described as the day's 'insulin run' - treating, I imagine, diabetic patients who cannot inject themselves. There so much with home nursing services that goes on quietly 24/7 which one never hears about normally.

After a quiet restful Holy Saturday, I returned to the Cathedral as the sun was setting for the Paschal Vigil, which had the virtue of being at eight, just at sunset instead of eight thirty. I was last there for the Vigil four years ago, Archbishop Barry's penultimate. Again, it was lovely to be on the receiving end, even if Bishop June's sermon around the harrowing of hell seemed a bit off the point after the proclamation of the Gospel of the empty tomb. It was good just to pray, enjoy the music and sing a few favourite Easter hymns loudly with gusto. There were about a hundred present, half of them congregation, half choir and servers. I can't think of a better place to come and renew my baptismal vows, if I'm not on duty officiating somewhere. 

I value this occasion more than I do the Maundy Thursday Chrism Mass, with renewal of ordination vows introduced only in the 1970s by Pope Paul VI. Anglicans for the most part followed suit with this innovation. To my mind it's unnecessary, as baptism is the one thing that unites all Christians. Ordination sets people apart to serve others, but is it really so helpful to emphasise the distinction and status it confers, for bettor and for worse? It's something about which I always had misgivings.

I got back just after ten, and having missed the first of this week's double episode of 'Follow the Money', decided not to  bother the catching up, but to saviour without diversion the joy and peace of a calm warm Paschal night-time "... when heaven is wedded to earth". He is risen indeed! 

Welcome home Rhys

This morning at St Catherine's Fr Rhys Jenkins presided and baptised at the Parish Eucharist. It's his first Sunday as NSM Associate Priest in the Benefice, a welcome addition to the team, as he lives in the community and is already well known and loved. Although this was a Sunday off for Emma, she took part in the celebration, welcoming Rhys at the start and administering Communion with him.

After an early lunch, I went to the wound clinic in St David's. Only on my way back did I realise that I had no appointment booked for tomorrow. I called the nursing helpline, but they were unable to fix one for me, as this team doesn't have access to the clinic's booking diary. I found St David's hospital reception number on-line, however, and was able to contact the clinic and obtain a date. It seems to me that the NHS suffers greatly from not having an computer data management system handling all the information of every department in an integrated way. It's not an impossible thing to achieve. 

The problem is, that the use of computer systems in hospital medicine evolved at different rates in different departments over decades. And each is a law unto itself. Many existing systems are out of date. Also they are not as secure as they need to be against malicious hackers. In other countries it seems, integrated information systems have been the norm for decades. Attempts to do the same in the UK have so far been expensive failures. To what extent, I wonder, does this reflect lack of shared vision about the future of the service offered? A bit like the failure of the brexit process to declare unequivocally what kind of future the UK wants, as opposed to what brexiteers are clear they don't want in future. 'Without a vision people perish' as the saying goes, as we spiral into chaos.

We didn't go out together in the afternoon. It rained. After a siesta, Clare had a school meeting from four until six with her eurythmy colleague Jacquie, so Russell came over with her, to drink coffee and chat for the duration. It was good to welcome him here for a change. 

After supper I watched the last episode of ITV's Inspector Morse prequel 'Endeavour', and very good it was too, telling a story of police corruption in the seventies. Before and after I watched on iPlayer the two episodes of the Icelandic crimmie 'Trapped', missed last night. It continues to develop interestingly, touching on current themes of multinational industry colonialism, environmental pollution, homophobia and political corruption, xenophobia and nationalist extremism. So many themes, tightly played out in a constricted social setting with awesome landscapes. Very much a modern Icelandic saga.

Repeat performance

I still haven't had a response from the hospital's surgical administrators to the query I raised ten days ago about the strange date for my interim outpatient appointment, ten weeks instead of four weeks after my operation. Neither has our GP surgery practice manager. So, yesterday, on her advice I rang the number of an office of the Cardiff and Vale Community Health Council, which offers support to patients in sorting out appointment concerns.

I spoke to a sympathetic lady called Donna who made notes on the story I told her and promised to get in touch with those responsible, and find out what is meant to be happening. 

There was no further contact from her at the end of the afternoon - typical Friday afternoon I guess, and there was nothing in the mail and no phone call today. We'll see what Monday brings. The same office helps people to make official complaints to the Local Health Board, and if this isn't sorted out in the coming week, in time for the outpatient appointment I was promised, this is the path I will take. It seems that however excellent the medical, surgical or nursing service that's offered, the managing of it all is chaotic, inefficient and error prone. And to think of the money spent on paying the elite few to oversee and support the front line teams!

Anyway, this evening, we went to the Millennium Centre for the WNO's performance of the third of Donizetti's Tudor cycle of operas 'Roberto Devereux'. It was the same production was we last saw on 6th October 2013, with a different cast of excellent singers, but still with Carlo Rizzi conducting. He's a great favourite with audience. It was only as the opera progressed that I realised that I had seen it before. The music and its performance were wonderful, but there are no memorable popular arias to establish it in the long term memory. I appreciate the sheer virtuosity in 'bel canto' operas, but this doesn't imprint itself upon me emotionally. The drab production was forgettable too. Looking back at what I wrote after last seeing this, my opinion hasn't changed.

The best part about the evening was bumping into Fr Hywel Davies in the foyer beforehand. He had been given four free tickets for the performance, and had invited Diana, Pete and Val, all of who we know. We had time for a snack supper together and a natter before the performance. Diana offered us a lift home by text, but as our phones were off, we didn't pick up the message until we were on the bus heading to the city centre. If fact, we were lucky to get a bus which left just minutes after we arrived at the stop, saving us a half hour wait. LIkewise in Westgate Street, where we took a 17 to Canton Cross and walked. We were back home, forty minutes after the performance. I wonder how long it took to retrieve cars and drive the same distance? I must remember to ask.

Appointment kept, appointment deferred

I was up and breakfasting at seven this morning, ready for an early taxi ride to the Heath Hospital for an ultrasound cardiogram appointment at twenty to nine. The taxi dropped me off at the Gabalfa interchange and I walked the last half mile into the hospital, and arrived in good time for the scan. Unlike three years ago, it wasn't a cardiologist who did the job but a trained nurse, who would then send the report to the consultant. She didn't have much to say, and didn't comment on her findings. I will have to wait and see if there's a follow up to this procedure.

I walked back home via the big Tescos, where I stopped for a look around and bought a bargain SD card again. I've done this before, and now have three empty 16gb cards in stock, plus a couple of 8gb once that I try to recycle and keep in my wallet. I found on checking that when last I'd been able to sit comfortably to organise my SD archived storage, I'd stopped mid-job. It took me quite a while to figure out what my intentions had been at the time. Now that the Sony HX50 is dead, I decided to decant remaining photo files from a couple of 8gb cards to one 16gb card. When I get around to buying that replacement camera, I'll have a choice of empty new faster cards to use, just right for shooting video. Not that I've done that much, apart from music events. Thinking about that, I still have work to do on sound editing videos from the last Fountain Choir concert in St Catherine's - if I can figure out how to do it!

At lunchtime, we had our annual service visit from Matt, our gas heating engineer. The new system which we had installed last summer works well, and has been busier than usual these past months, as I've been feeling the cold more than usual, perhaps a consequence of losing weight since returning and fending off serious illness for so long. The operation should have been today. The new promised date is a month from today, if the surgical team keeps its promise. All I can do is be philosophical about it, recognise the huge competing demands on NHS time and resources, and live each with as much gratitude as I can muster.  

During my visit to Riverside Surgery for a wound dressing this afternoon, the regular District Nurse was accompanied by a student nursing assistant 'on observation'. It's the second time this week. On Monday it was a woman in her early twenties who'd recently returned from a year's internship in the Scilly Isles. Today it was a bearded young man from Wyoming in his early thirties, who'd come to Europe to work in Disneyland Paris a long time ago, and then decided to train as a nurse in the UK. I am getting to meet some interesting people in the course of treatment.

When things fall apart

Today is six days since my pre-op assessment visit to UHW Heath hospital. Still no news of an ultrasound heart scan, so I thought I would ring the colorectal surgeon's secretary and enquire about progress, as this was said to be a precondition of the operation taking place, and I had been advised to enquire in this way.

The person answering the phone wasn't the one whose name I had been given. I was told she had only started work on Monday as the previous secretary had changed jobs, and as a newbie was not yet familiar with all the details of the work in progress. Nothing on my case file referred to the required scan, I was told, also my name was not on the schedule for operation on 17th January. She said she would have to enquire further and get back to me. Somehow the account of my pre op assessment seemed to have vanished without trace and my case unexpectedly cast into limbo.

My heart sank, and it's just as well that wound pain and discomfort was minimal. The impact of this brief conversation caused me to feel as if I had been physically assaulted. Clare was shocked and equally bewildered, but what do do?

Well, I went to the midweek Eucharist at St Catherine's, needy for the normality of routine prayer and worship, and traditional memorised words. I wasn't expecting God to magic a way through this bureaucratic nightmare, I wanted consciously to let myself be carried to wherever this situation is meant to take me.

From there, I walked to the wound clinic for a dressing and inspection appointment. Nurse Emma was there, the first to see my sorry state on Boxing Day, and on two subsequent days. She expressed satisfaction at the way it had improved under the right care. At least the deterioration has reduced in the past fortnight. The wound condition, although undesirable and unhealed, is stable for now. One less thing to fret about. I think the two nurses present were also shocked at the news, but I suspect not that surprised. It's all part of the NHS running battle to juggle resources against demand.

On the way back, I called in to our GP surgery in the hope of having a brief word with a doctor at the end of morning appointments, to flag up the problem. Instead of a doctor, after a half hour wait, Debbie the practice manager came and spoke with me in a by now, empty waiting room. I think she recognised that I wasn't my usual self, and asked what was the matter. She was astonished when I told her what I'd learned. Having gathered relevant detail and checking this against the hospital's  intranet, she promised to get on the case and report back as soon as possible.

After an unsettled evening in front of the telly, I had a nosebleed as I was getting ready for bed, the first since September. What a crazy unsettling day!

  

Not with a bang, but a groan of pain a sigh of hope

Despite waking in the small hours for a second time in a row, with bedclothes and duvet drenched in sweat, with almost no pain, pulse and temperature normal, I had a fair night's sleep and felt better. Clare went out early and secured a necessary GP appointment, as promised to the doctors of the 'out of hours' service yesterday. The appointment was in good time for me attend the appointment booked at Riverside Health Surgery clinic. After examining the wound, my GP acknowledged my reasons for resisting a long wait in UHW A and E at the busiest time of year, and was happy for me to continue with the antibiotics, monitoring any change of condition, calling for an ambulance in the event of any further deterioration. She is resolved to write again to the surgeon and express concern over my condition, and ask if reassignment to another team or NHS hospital is possible. Hope against hope, maybe, but such a relief to know our local medics and nurses are on the case!

At the Riverside wound clinic I then met another of the District Nurse team, who treated me with the same expert confidence and good humour as the others. She observed that the swellings seemed to be draining well the new type of wound dressing as hope for. The GP practice nurse had observed that I was walking better too. Those with a trained eye notice things. I too think I've been walking a little easier since both the recent mini crises - but for how long?. A modest gain with all that pain, I suppose is something to be grateful for.

Clare and Owain were playing Monopoly with Jaz when I got back, and just after we'd had a big dish of soup for lunch made from carrot, swede, parsnip and beetroot, which I helped prepare with a lot of veg dicing, Jaz' step-brother Pete arrived with his wife Jodie and two year old Sam, to collect her and take her to Newbury where she'll stay over New Year until her dad and step-mother arrive back from Venice to take her back too Arizona. People visiting from the States get to see lots of people and experience lots of  parties and treats, it's such an intense time, so exhausting. Hopefully a few twelve hour nights of sleep chez nous will stand her in good stead for the days to come.

The rest of the day was spent reorganising ourselves to resume life as a two person household. Being quite tired, we gave up on the idea of seeing the New Year in and went to bed early. Later that's been a change in pattern for both of us, driven by just about coping until operation day.

Apart from the horror of British political incompetence and the continued rise of far right wing politics in a world which seems to have failed to learn  the bitter lessons of 20th century history, there were lots of good things about 2018. Time well spent in Malaga and Montreux in the first half of the year. Seeing Owain get a permanent job again and find a place of his own to rent and move into, days from now. Seeing Kath flourish with the continued success of Wriggledance Theatre. Having Rachel perform live in our own locality, for the first time in over a decade. Seeing our lovely grandchildren gently crossing the threshold from girlhood to womanhood. In the second half of the year, things my illness has overshadowed everything and narrowed our world, but introduced us to a world of wonderful caring people whose daily job is getting others well again.

NHS workers I salute you! Not quite so sure about the managing classes and medical elites, however. And in three months, the curse of brexit falls due. Or not if the whim of Parliament or even the electorate think otherwise. I hope and pray for a change of heart, mind and will on all sides.

  

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.
       

NHS ransomed and not by politicians

Another surgery visit this morning for a further attempt to take blood samples for testing, this time with success. I was asked to take my blood pressure measuring device in for calibration, which I did. I was surprised to find that 'calibration' meant taking a couple of readings from the surgery's device and mine in turn and comparing them. Rather a misuse of such a technical term. As I'm sure I've said before, both at home and in the surgery, my first 3-4 readings start high, then drop down to a fairly consistent level. It is rare for any medic to take more than a couple of readings, so I've come to the conclusion that their practical observation is of a more general that specific kind, i.e. 'high' or 'low', and accurate data is of concern mostly for those compiling epidemiological statistics. Well, what else have they time for?

After an early lunch, I was collected to go to St German's to take a funeral. It was my third in a row for someone who'd died in their early sixties, and once again the church was full with mourners belonging to a large extended family. It was an unusual occasion, using a hearse of antique appearance drawn by two young purple plumed black stallions to take the coffin of the deceased from home to church and then to the crematorium - during the 'school run' phase of the evening rush hour. Even so, it arrived only five minutes late at Thornhill, after an hour's journey. I was taken ahead by car and had time to spare before the committal.

I was home again just after four, and was pleased to receive another call from my GP, with whom I had a reassuring discussion. I'll see her again after the blood test results have been returned, and find out if any further intervention is needed. Meanwhile I continue with well established medication, and keep an eye on my blood pressure in case it suddenly escalates.

Then my sister June rang to tell me worriedly about breaking news of cyber attacks on the NHS. I asked her if this was about ransomware lockdowns and she confirmed it. I said this was old news, as there's been a spate of this worldwide this past year, but that it may have come into focus if there's been some attacks on London hospitals, which she confirmed. News mostly seems to happen in London according to the mass media. What surprised me, when I checked on the web, was the scale of the outbreak. 

Given these have been happening sporadically over the past year around the globe, the serious news behind the news is that not enough precautionary training has been given to NHS staff at all levels to avoid such attacks, which generally occur because malware infected files are unwittingly opened. The situation is exacerbated because too many NHS computers are running on out of date Windows systems and equipment, and Windows systems across the board contain vulnerabilities due to their basic design, which attackers can readily exploit. If only more use was made of Linux systems which are less susceptible to attacks of this kind. Interestingly enough, I read news earlier today of a version of Ubuntu Linux running medical information management software called NHSbuntu. There used to be a version called Medibuntu with a similar aim, but that closed down four years ago. 

After phone calls, I still had enough time to go shopping before preparing supper. Clare had earlier decided to cook some fava beans using the pressure cooker, and I prepared a dish that could make use of them. Without warning, the valve of the pressure cooker discharged explosively, spraying a fine mist of liquidised beans over the stove and working surfaces. Fava beans cook quickly and when overcooked, dissolve into the liquid used to cook them in, creating a puree. The valve had stuck and the puree overheated until it finally blew. What a mess! It took us ages to clean up. The puree, however wasn't burned and added a pleasant flavour to the vegetables I'd prepared. 

Question of treatment

As it was bitterly cold and there was fog in the air, I drove to this morning's dental appointment rather than walk. There was only one lost filling to replace, otherwise my teeth are in good shape. I paid just over forty pounds for a check-up and a replacement filling. A notice displayed in the reception area say that patients must pay in advance for any planned scheme of repair work arising from a check-up. 

This can be very expensive indeed, more than some patients can lay their hands on there and then, so they need to go away and think about how they can afford it. But, the proposed costed plan itself only lasts six weeks, and they must return and pay up front within that time frame, or be obliged to go through and pay for another checkup for the same or a revised estimate to be applicable.

Modern dentistry is high tech, effective and expensive. Registered NHS patients only get to pay a proportion of treatment costs. Those on benefits get completely free treatment. The economics of modern health care are complex and difficult, and it seems well nigh impossible for health authorities not to run out of money to achieve their aims. We pay for dentistry through taxation, and most of us have to pay also through the charges levied on treatment. 

The same could also happen in future for medical treatment. Recently we've been hearing in the news about JAMs (=people Just About Managing.) Those in this category not on benefits may find themselves unable to afford treatment and having to forego necessary repairs, maybe medical treatment generally. Such progress has been made in health care and medicine over the past century, but at an increasingly great price. Where will it all end?

After the dentists, I went into town and met Fr Rufus for lunch at Cafe Zest, and heard about the way his ministry has been developing in the most positive way, since we last met, the best part of a year ago. It was great to hear someone so enthusiastic and delighted with the response to his work, in a broader context where ministers' moral is low as a result of catastrophic decline in church membership. Monmouth diocese has reduced its clergy numbers from 130 to 46 in recent years, and coping with the demands of radical change is proving hard for many.

Then I returned to Pontcanna to meet with Fr Chris Lee at Cafe Castan on Llandaff FIelds, to discuss the funeral of his sister who died last weekend. It's going to be held at St German's. I've already been asked to conduct it, and as there are several other clergy who also wish to be involved, some advance planning will be needed to enable everyone who wants to can take part.

After an early supper, Clare and I went to Chapter Arts Centre, where mulled wine and mince pies had been laid on for subscribers of Chapter Friends. It was strange to realise when we were there that there that out of hundreds of people there for various evening activities, there was only one person I knew and nobody else I even I recognised from the neighbourhood or the churches. Perhaps that's because I haven't really been around that much over recent years, or simply an indication of the size of the area served and the eclectic constituency of Chapter Friends. It's typical of urban living, I guess, but not really the most congenial experiences to start this so-called season of good-will.

   

On line government admin

Monday was a quiet uneventful day, spent doing CBS office work at home. I also went on-line to renew my European Health Insurance Card (aka EHIC), and while the NHS website was accessible enough, I ran into trouble straight away. Using the email address EHIC staff used to notify me that me card was on the way five years ago, I put in a lost password request, and found that my email address wasn't recognised. I tried registering from scratch, again the email wasn't recognised, and the error message thrown up stated categorically that it wasn't a valid email address format.

Just as I was starting to get really grumpy out loud, one of fortnightly home cleaners said "I had that trouble too renewing my Dad's EHIC recently, but they did it over the phone for me, automatically." Finding the number on the website was no trouble. I was put through to a robotic answering device, the kind that normally makes me even grumpier, but this was quite exceptional! The clarity of the procedures and the accuracy of the voice recognition software astonished me, and within minutes I was promised delivery of a new card within seven days. If only the website promoted this as the only sensible and efficient alternative, instead of leaving a less than functional registration page in place.

My day was otherwise notable for finally getting around to emailing golden wedding anniversary invites with 'how to get there' maps for a couple of dozen people, near and far, that we know are coming. There should be around forty of us on August 6th.

Today I had to go into the CBS office, and register a new internet banking facility to manage the BCRP Board finances, since a bank card and a new security device had arrived and needed to be registered for account use. There were charges to pay in relation to the Crime Manager's salary, tax and National Insurance. I was dreading it, but delighted as I discovered how user friendly the HMRC web payment facilities are, and the job was quickly done.

I also needed to do some leaflet design using an ancient copy of MS Publisher, which I don't have installed conveniently at home at the moment. As we're now using some additional types of radio handset equipment, user guides need re-writing to accompany them. It is far less rare that I have recourse to this kind of work nowadays, and it takes longer than usual to remember how to make use of some of the available features. As a result I left the office for my double Chi Gung / Tai Chi class later than intended and was twenty minutes late entering the session, annoyed with myself for not baling out earlier and leaving the job unfinished.