Day at the Spire

At last my fourth surgical appointment at The Spire private hospital in Pontprennau, courtesy of NHS outsourcing of a small number of day surgery cases to ease demands on Llandough at this critical time. Clare drove me there for an eleven fifteen start, but we were there by eleven. There's a special 'Green Zone' reception area for those who have completed full quarantine requirement and are infection free on other counts as well. In the entrance lobby there was a staff member with a big thermal imaging device which scans incomers at a three metre distance, before they can approach the reception desk. 

Once I'd been checked in, I was escorted to room 211, equipped to look after individual patients, and then went through the familiar routine of giving my name, address and date of birth to each person who came to interrogate me, first the lady who organises post-op refreshments, two nurses, the anaesthetist, and finally Mrs Cornish the surgeon. All were masked and in uniform and came at intervals over a two and a half hour period before surgery started. In between times, I paced around the room for exercise and to relax during a wait which continued until half past three.

I walked, escorted to the operating theatre to be prepared for surgery, then the next thing I knew I was in the recovery room feeling surprisingly awake. Mrs Cornish came and told me about what she'd done. In our pre-op chat I admitted that my expectations of this one being the end of the affair, as I felt certain the bout of infection had caused further problems, and I was right about that. She had identified a small pocket of infection, excised it, removed some of the obstructive over-granulation around the wound and changed the Seton's suture. 

There'll be another op in three months time, and before that a MRI scan to check if there's anything else hiding within. There's no certainty of complete healing in the long term anyway, but rigorous scrutiny before finally removing the suture and closing the wound improves the odds. The next op is planned to be in Llandough again. I imagine the pandemic crisis has required the hospital trust to improve facilities for day patient minor surgery with its own covid-secure zone and staff.

I was wheeled back to my room on the trolley used for the operation and was able to transfer myself to the bed. I was feeling find, with no noticeable pain, but my blood pressure was still sky high, so I had to wait an extra half hour until it reduced to a less worrying figure before the nurse would discharge me. 

I walked out of the front door at ten past seven to be met and driven home by Emma's husband NIck. Once it was clear that I wouldn't be discharged until after dark, Nick was asked to collect me, and kindly agreed. It was great to have a chance to chat with him. Clare had a lovely supper waiting on the table for me, and some hugs and kisses to welcome me home.

Looking forward to being able to walk in the park again tomorrow, hoping that the anaesthetic aftermath doesn't leave me too tired and lethargic to breathe fresh air again. I may not be fully repaired, but I get a physical feeling that the wound is going to be easier to live with while I wait for round five after today's outing to the Spire.

Staycation round two, day fourteen

A text message from the Spire hospital this morning, with a link to questionnaire cum declaration about quarantine compliance, and other preliminaries to admission tomorrow. All straightforward, except for a question which referred to whether or not the respondent was an 'in-patient' or a chemo patient. All the NHS correspondence refers to the recipient as an 'out-patient' or a 'day-patient'. A private hospital is entitled to build its own strict disciplines and develop its own vocabulary, but such a simple thing when dealing with NHS outsourced patients has the ability to sow confusion. I sent a message to the Spire to ask for clarification. 

I didn't receive an email response to my question, but later on the hospital phoned to asked if I could be there an hour earlier. I agreed we could, and then spoke about the web page ambiguity to the person who called, and asked if she could pass the feedback on. Whether it'll get reported or not is anybody's guess.

The weather was overcast, and I completed my day's walk outdoors early afternoon in a spell between showers. Before and after supper I spent on writing that elusive last chapter of my novel, a couple of thousand words, but the time I finished just before be, but still not finished, I'm full of questions about all that I've written. For the most part the story seemed to tell itself, slowly unfolding with all its twists and turns as I wrote. It's the story of an extraordinary person who lives an ordinary life, never becoming famous or rich, but enriching others nevertheless, with their creativity. Writing an end of life scenario is relatively simple compared to that of writing a brief account of the impact of one such life on others. That, I guess, is what I'm finding difficult to imagine. It's not coming naturally.

Good news about vaccine trial success. The media are reacting with great great excitement about the prospect of a return to some kind of normality next spring. It's foolish to be over-optimistic and to under-estimate the complexity of the mass manufacturing, distribution and application of the billions of vaccine doses required to made a substantial difference to the world's population. First there are priority health workers and most vulnerable people, working down to those who least need it. And there's still to be determined, how long the vaccine protects people in different age groups, and whether it will curb the ability of unwitting super-spreader victims to infect others. We've seen a superb breakthrough in getting a useable vaccine made in record time, thanks to international scientific collaboration on a scale hitherto unimagined, but there's still a long way to go yet, perhaps longer than we want to think. 

Staycation round two, day eleven

Glorious sunshine again today, all day. I walked indoors before lunch and outdoors afterwards when it was slightly warmer. Although it looks increasingly certain that Joe Biden has won the US Presidential Election, votes in the remaining key states are still being counted, and Trump, increasingly isolated with his key White House team continues to challenge the likely result by attempting discredit the process. So the wait continues with political pundits and broadcast media working overtime to fill the news vacuum with ephemeral opinions and reactions. It's surreal, like an over the top Netflix drama. 

I decided to email the pre-op assessment team at the Heath to alert them to the slightly bewildering information gap between their team and the Spire's team. It would be good to have some clarification. I got an auto-reply and no follow up phone call. The response said emails were checked daily, but didn't say if that included weekends. I guess I missed today's round. Let's see when I hear, or even if I hear.

Then I had another call from Karen at the Spire hospital to check on when I usually take my medication. From the conversation I got the impression that if it had been a morning op., I'd be asked to omit just the Losartan and take it later. As it's a confirmed afternoon appointment it seems not to be critical. It's something to do with being anaesthetised I think, and not having my blood pressure lowered too much as I go into surgery. It wasn'r an issue on three previous occasions when ops were in the afternoon. The conversation left me with a degree of uncertainty, as I was told it was up to me whether or not I take the Losartan when I get up as usual, or not.

I was expecting a phone call about tomorrow's planned covid-19 test, but none came, I called the surgery at tea time to ask if they had a phone number for the local test centre. When I rang the given number, I got a message stating the office was closed. Will it be open tomorrow or not? No information. How will I know if the mobile testing team has me booked in, as I have no written confirmation. I know better than to trust people promises when they are under pressure. 

More seriously, I have no means of checking tonight. The test has to be done three days before. Not knowing is a worry, What if is on my mind since I learned that the Spire had my home address down incorrectly. Who else has this error replicated in their diaries? I think I'll have to kick up a fuss about this if I don't hear tomorrow by mid-morning, as it would result in my op. being postponed again. 

Staycation round two, day ten

I rose early again before dawn, to a clear bright sky, with just Venus brightly visible in the east before the sun appeared over the rooftops, about half an hour after peeping over the horizon. Mercury should also be there, although I suspect losr from sight unaided in the growing strength of sunlight. A lovely crisp chilly day. I really enjoyed doing part of my daily walk in the garden once it warmed  up a little.

I spent the morning completing the reflections I've written for the Parish web offerings with suitable pictures representing the content. It took a lot longer than expected as finding suitable resources proved difficult. There wasn't much to my taste on-line unfortunately, but they're all done and dispatched to Emma now. I wanted to get it done before going in for my op, just in case recovery turns out to be too much of a distraction. It's so nice to be asked and I don't want to let anybody down.

This afternoon I had a phone call from an administrator at The Spire hospital asking if I had filled in a pre-op questionnaire. Twice I said, when I went for assessment at the Heath hospital. Then she asked if I had filled in their form. I went through the information pack I'd been sent and said I'd not received one from them, whereupon she proceeded to question me briefly over the 'phone. Five minutes later called again with more questions. I think she'd missed the questions on the back of the form. 

Had the surgical team at the Heath not sent the dossier, digitally or otherwise? I wondered, but dared not ask. With such increasing pressure on hospital resources I imagine the admin staff are having a hard job keeping up with immediate demands, let alone work required to out-source a day's surgical patients to another hospital. Still, it wasn't another postponement call.

All eyes are on the U.S.A. as postal ballots continue to be counted in four key states remaining. Trump is whingeing loudly as his presumed early lead is slowly eroded, alleging without evidence that there has been foul play and electoral fraud, causing serious embarrassment to traditional Republicans, outrage in sections of the media and among state civil servants, whose pride in their even handed fairness is being wildly slandered. It comes to something when three main news networks, some of them formerly Trump enthusiasts, cut across live broadcasts of his allegations saying his statements are unfounded or false. 

This has no precedent in American electoral history it seems. Joe Biden has edged closer to electoral victory during the day, but not declared prematurely, speaking with the dignified caution of one who has already served as Vice President. He may be old to take office, but for all that, he's far wiser than the old fool who blustered and lied his way through the past four years as head of state. No electoral threshold was crossed during the day, however. Tomorrow maybe?

It's Guy Fawkes/Bonfire night with the sound of fireworks and the smell of burning in the air, though no big display at the SWALEC stadium this year. I didn't bother to go out into the cold and take a look, idle telly watching in the warm won the evening.

Getting ready to isolate again

Another sunny day, after much rain in the night, despite forecasts of more rain today. I succeeded in getting out of the house to walk for an hour and a half before lunch. As it's half-term as well as lock-down, the parks are busy with parents and children. I saw two women of  a certain age, out with a lively spaniel sit down with their coffees on a park bench with a huge rain puddle next to it. The dog ran up to them, straight through the puddle, soaking them before attempting to climb over them with wet muddy paws in search of attention. They laughed, as much out of exasperation as anything. I don't know which is more trying, let loose in the open air after home confinement, children or dogs.

We took a look at the official self quarantine instructions from The Spire hospital. In effect, the same as those on the standard hospital sheet, a one size fits all prescription. Keep it simple stupid, I suppose. It's complete confinement to the house and complete separation for Clare and I for over next fortnight in spite of living in a bio-secure domestic bubble with no household visitors since Diana and Pete sat in our garden for tea over a month ago. In the end, getting the op requires  testing negative for covid-19 three days before, getting no other infection and keeping fit and well enough to survive the op. An obstacle course by any other name.

We watched another amazing episode of the art detective series 'Fake or Fortune? on Telly, then I did a little work on my novel before turning in. I'm beginning to feel as if I'm on the final stretch at last. Can I complete it before the op, and get it ready for detail and error checking, before the final edit? 

Pastoral policing

Just another routine day yesterday, except that I walked over to Victoria Park for a change, after a circuit of Thompson's Park for a change, and completed my daily mileage walking in the dark around Llandaff Fields before turning in. Covid numbers continue to rise, and now an all-Wales short lock-down is being talked about in coming weeks. The idea is to curb infection rates and avoid overwhelming hospitals with critical care patients, long enough to get the test, track and trace system running more efficiently, as it's still failing to do its job in slowing infection rates and containing the epidemic.

In this morning's post I received a thick envelope with brochures and a letter from The Spire hospital confirming my surgical appointment on 10th November, and informing me that it would take place in the afternoon and not the morning. I'm delighted about this at it eliminates the prospect of a very early morning start to get there by seven. Now it's a twelve fifteen check-in, far less of a worry! Naturally I'm bound to keep hoping this will happen, but realistically, I can foresee another postponement unless there is a significant measure of success in containment. The Spire       

Clare cooked pancakes for breakfast again today after a lie-in, then set about making three Christmas puddings and putting them on to steam. It left us with the logistical challenge of cooking lunch with one ring and one suitable pan to work with, and both of us wanting to cook different things. Somehow we did this without giving each other too much grief or cross words.

After lunch, I finally got around to doing my tax return on-line and submitting it. Having done a little advance preparation, collecting necessary figures together on one sheet of paper, this took just over an hour. The web interface keeps evolving in a good way, clearer and easier to use once you understand all the technical jargon relevant to your own set of income streams. I don't have many fortunately.

Then we walked around the park and down to Blackweir Bridge. For most of the day until after sunset the sky remained overcast. More and more leaves are falling, creating pools of gold, orange or brown colour on the grass, photos, no matter how well tweaked in processing afterwards never quite succeed in capturing what the eye sees.

The second new episode of Inspector Montalbano was on BBC Four tonight. Superb again and several different stories to be told, no major crimes, but several narratives, you might think of as pastoral, all of which would be part of a Chief Inspector's job in a rural fishing community. One involved a Swedish film crew and Salvo's deputy Mimi misbehaving with a film star, another was about bullying the classroom tech geek in a local school, and another was a curious cold case involving mysterious super eight movie clips, leading to the discovery that a past suicide had been a covered up murder, in tragic unusual circumstances. In this latter scenario Salvo ends up listening to a dying man unburdening his conscience, underlining the pastoral role police officers often take when they're not playing cops and robbers, all part of keeping the peace. The perennial stars of this twenty year old series now look more middle aged, but none the worse for that. I'll be sad when there are no more of Andrea Camillieri's stories to tell.

Self isolation - together

Yesterday was a day of intermittent rain and windy dry spells, and still rather mild. In the morning, I had a chest examination at our GP surgery, to confirm my cold is really on its way out. Very little coughing now and the doctor said that I'd be OK to spend the next two weeks waiting in self isolation for operation number four. I was also given a 'flu vaccine injection. Clare also had hers later in the day, having booked one at the pharmacy so we're both covered for the winter now. 

After lunch I had a call from the surgeon's secretary to check that all is as hoped for, and that I know what's happening. She told me I'm listed for a morning operation, That means checking it at the Spire hospital for seven o'clock, leaving at a quarter past six to be sure to arrive in good time. It's like that necessary flight departure time - you may hate the sleep disruption to get there as required, but there's no alternative but to put up with it..

The Taff water level was a little lower than yesterday so much of the island of stones in the middle of the river was visible again, Unusually, there were a pair of cormorants and a heron keeping vigil over the waves, hoping to spy and catch a fish. Owing to the gusty wind, there were scores of gulls and crows grounded on the sodden grass. 

We again spent the evening watching another three episodes of 'The Shtisels' It's entertaining but gives a lot to ponder on, about power and control, love and freedom in an extended family striving to do their best to keep their conservative traditional faith and lifestyle. With nothing in the diary for either of us in the next two weeks of lock-down, we can work our way through our collection of videos we've never got around to watching.

Today was the first day of quarantine, wearing a face mask out in the street on the way to the park and keeping at least five metres from anyone passing. And, not touching anything with hands, i.e. opening gates, or pressing the button at the zebra crossing. No visits to shops etc. It's stricter than usual, but not too far from how I am habitually. I spent many weeks on my own with next to no social contact and no physical contact with others or the environment outside the house and grounds, so I'm used to it.

Walking along the river path this afternoon, I saw a flock of crows grounded and a young heron walking about among them, without conflict or disruption. An older heron was keeping vigil on the island of stones in the river, a hundred metres away. It's rare for me to see two in the same vicinity like that.

This evening we watched two more episodes of 'The Shtisels', and decided that we'd keep the final one in the box set for tomorrow night, both of us being rather tired. Yesterday's 'flu jabs seem to have had more of an impact on us this year than previously. Is it just that we're getting old? 

Different kinds of duties done

Clare came with me to All Saints' Penarth this morning for a Eucharist with a dozen people attending. The last time I was here was for a Lent talk, since I've retired. Puzzlingly, can't track down exactly when that was, although I believe it was just before work began on a major project to re-develop the west end of the church nave for community purposes, as the all new look and feel to the church came as a surprise.

There's a big extended balcony arranged as meeting areas, with offices, kitchen and toilets on the ground floor either side of the entrance. That still leaves room for a congregation of around three hundred. Church here is still well attended and relatively prosperous, with more than enough to do for a priest often having to work on his own, or else be training a Curate, and functioning as Area Dean in addition. I get the impression that he has the support he needs, and his Friday worshippers were welcoming to us.

For Clare, this was the first occasion to come to worship since her brother Eddie died, and it was special for me to share with her mentioning him by name in the Lord's presence. Naming people in the context of time-hallowed repetition of well remembered liturgical sentences is such a simple way of bonding the living and dead with each other across the frontier of eternity, mysteriously blending pain and consolation. I find it such a privilege to have been able to continue doing this over the forty six years of my public ministry. There's no magic to this, just the love that heals.

Afterwards, I took her by car across the city to the Spire clinic in Pentwyn for an ultrasound scan of her repaired shoulder, which has been giving her a lot of pain of late. The delightful young German doctor, who spoke excellent English with just the hint of a Scottish brogue to colour her voice, betraying her career history thus far, was most reassuring. The shoulder repairs were intact, the pain was inflammation, treatable with a cortizone injection that will enable Clare to return to regular re-enforcing physio exercise without too much grief.

Resorting to private medical treatment is far from desirable in our opinion, but NHS services are overburdened. There could be months of waiting, coping with the pain and continued uncertainty about how much re-hab effort she should be making. The scan provided the necessary information when most needed, to enable her to continue to make progress. That's worth the expenditure. After all, the money might have paid for that weekend outing we could have taken if it wasn't for the deterrent shoulder pain. Who wants money more than pain? Why blame state medicine when older people like us are part of the challenge it strives to deal with? Affording this little intervention, one way or another helps make things better.

Having taken Clare home after scan and treatment, I popped back into town on the bus to visit the office, and deal with the half dozen responses so far to the BCRP job advert in the 'Western Mail' and on the JobsWales website. This is a promising start, and shows us the value of a rather costly advertising process immediately. I might regret this, if by the deadline, I have dozens of applications to process for the short-listers to consider. So pleased, however, to have eventually got this far.

I couldn't put it off any longer. After supper this evening, I gathered my wits and made the vital effort to complete my 2014-15 tax return. The HMRC website is as good as it gets, and I believe this is my tenth on-line submission. All the required financial information was in good order. The hard bit was remembering just how I'd navigated my way through the plethora of options and technicalities to make an honest and honourable return, in order to pay my dues. 

I admit I needed to look at the .pdf file of last year's submission to remind me of exactly how I'd categorised earnings relating to locum duties outside the tax administration remit of the Church in Wales Representative Body or the Church Commissioners of the CofE. The result left me owing tax after a run of years when I got a tax rebate, but never mind. I could log off with a clear social conscience, and somehow that matters to me. Perhaps it's gratitude for having enough to live on, not having to scrimp and save to give a family its just desserts.