Showing posts with label Queens Medical Centre. Show all posts
Showing posts with label Queens Medical Centre. Show all posts

Saturday, 21 August 2010

Stroke Diary (9): On the Mend

7th. August: Getting up takes forever. Our solution to my balance problems is to bring one of the garden chairs into the shower. It takes up most of the space but works. I manage to wash and dry my hair (a hairdryer at last!). The garden chair is replaced the next day by a picnic box. We are nothing if not resourceful. Each step of the getting up process seems to require long intervals of staring out of the window. Is this what is meant by loss of motivation? I'll have to work on my 'bustle' if I'm going to get back to work any time soon
I pretend to be Virginia Wolf and 'sort the flowers' which have been rammed somewhat haphazardly into various vases. I salvage what I can and create two displays. Flower arranging was the only badge I got at Brownies although I may, on reflection, have also managed to pass parcel wrapping. Both skills have stood me in good stead and I wonder what other key life skills I might have acquired had I not wasted my energy annoying Brown Owl.
My daughter and partner arrive for the weekend and on Sunday we try 'going out' and visit the Botanic Garden for lunch. I manage a short walk with the support of an elbow and my stick. It's a beautiful day and the garden is busy with visitors looking at the sculptures but I don't take much in because I'm concentrating on managing. My walking is improving but I really want to know when my head will return to normal.
My first task on Monday morning (9th. August) is to look at my e-mails. I delete 30/36, most of them links to Facebook. I must have ticked a box which notifies me by e-mail when a friend has posted on Facebook but I find it annoying. I'll see those messages when I choose to look on Facebook.
My second task is to do some research on cerebellar haemorrhage. I have left hospital with no information on steps to aid recovery, what is normal and how to get help if I need it. The Stroke Association website is helpful but I learn that only 1/10 strokes are haemorrhagic and a small number of those occur in the cerebellum. What I read on other sites isn't encouraging. I get the impression I'm lucky to have survived. Perhaps there's not much information on recovery because not many people need it.
I telephone the secretary of the consultant who discharged me to see if there's any news from QMC. I'm still hanging on to the belief that something of importance might have been discovered on that last scan, the one that went in the post. She doesn't work on Mondays.
A friend comes for lunch and we walk to the shops. I feel vulnerable around traffic because it's hard to focus on too many things at once. If a car is doing anything unexpected, like parking on the pavement just ahead, I have to stop and wait until they've finished. The rest of the time I sleep.

Sunday, 15 August 2010

Stroke Diary (4): Yet More Waiting for QMC

Now it's Wednesday 28th. July. I am left out of the ward round and no one makes eye contact. I'm an embarrassment, a shadow sitting by the window. I start to cry. I am truly miserable but also deeply frustrated. I'm a person who makes things happen. I'm good at 'kicking ass' on behalf of others. I can't believe the inaction, the poor co-ordination, the lack of energy that is the hallmark of my treatment so far. I ask a nurse if anyone is chasing up my scan? I want the telephone number of the person at QMC who is managing my case. 'I'll ring him myself', I threaten between sobs. They're desperately busy with some very sick old women who've arrived in a bad state but my distress brings some action.
A doctor appears, previously met on A&E. He's surprised I remember his name but I point out, a little sharply, that there's nothing wrong with my cognitive functions. He's clearly embarrassed that I'm still on Ward 16 and tells me he'll chase up the scan. He also says that 'nothing magic' will happen at the Stroke Unit but I'll at least get some Pysiotherapy and should get a better night's sleep. I wonder what he's getting at. Is it a warning about the Stroke Unit (don't expect much) or is he trying to make me feel better about the time I've languished on an acute ward.
I tell him about the headache at night and the nausea and he finds me some pillows. These are like gold dust. When I've asked the nurses, I've been told there are none.
I feel hopeful that I might now see some co-ordination but in the afternoon, an ambulance arrives to take me to the Stroke Unit at Leicester General. I should have allowed them to take me but I argued that I couldn't possibly go now, I was waiting for a CT Angiogram. The ambulance driver finds a nurse who explained to me, as if I was indeed cognitively impaired, that I'd had all the tests I needed, I could go. I insisted that a doctor (always pull rank) had told me that the warlords in Nottingham had requested another scan. She checked. It seems there had been a problem with my notes.
By late afternoon, I'd been wheeled back through the corridors and lifts to Radiography. I waited outside the scan room with a couple of teenage girls, the one on the trolley had taken an odd turn when they were out shopping, the other was her friend. We all sit and text. No one speaks. I noticed some pillows tucked onto a shelf and make a note to tell them back on the ward.
There is uncertainty that my canula, the awful plastic device they put into the back of your hand before any operation, will work since it was fitted in A&E several days ago and has been roughly treated by me, in my fumbled attempts to wash and dress. Thankfully, it works. I felt the dye swoosh around my veins and a prickle in my groin and my brain as it reached its target.
Later, the same doctor appears to explain that a CD of the scan has been sent to 'Nottingham' and we could expect the results tomorrow. And tomorrow, I would definitely move to the Stroke Unit.
On Thursday 29th. July, a week after the stroke, I arrive at last on the Stroke Unit after midnight. But I spend the entire day on Ward 16. An orderly teases me, because I read the Times every day. She thinks I'm pretending. I'm now a fixture, an institution.
A doctor finds me and says that 'Nottingham' can't read the CD. It's a software problem. I despair of this link with QMC. It hasn't worked for me and has prevented appropriate action. Looking at the problem from a management perspective, it's obvious that the consultation model has failed because I'm no one's responsiblity. If I was actually a patient at QMC, they would have made decisions quickly because I would have been blocking up one of their beds. In Leicester, the doctors felt no responsibility for me because I wasn't their patient.
I have not been able to organise visitors apart from my husband for a couple of days as I couldn't be sure where I would be, so I spend my time sleeping, reading and staring out the window. People say to me it would 'drive them mad' but when you're very ill, many hours can pass doing very little. Think of when you have had a bad flu and take to your bed with only Radio 4 for company. The day passes in a fog of half-remembered programmes.
That night, a Stroke consultant appears. He's the first I've met and his presence is due to a chance encounter downstairs with another doctor. He assesses me, doing the now familiar neurological tests and takes a brief history. He says he'll move me that night. The nurses say it could be any time, so I go to bed as usual. About 12.30 a.m the ambulance arrives. I'm wrapped in blankets and wheeled through the deserted hospital, past the shuttered WRVS shop and cafe, to the outside. Outside smells so raw. On the drive to the Stroke Unit, the paramedic asks me what I do 'in the real world' and tells me about his child who has seen a county educational psychologist. She's done a good job, he says. I'm pleased to be spoken to like a person rather than a patient and to hear this good report about my new team. I try to adjust my features into 'professional mode' but actually I'm exhausted.

Stroke Diary (3): Still Waiting for QMC

There is no news from Queens Medical Centre. Yesterday was Sunday, the doctors re-assure me on their ward round. Everyone will be back at work today, so we should hear something. What is the social etiquette of a ward round or nurse changeover? Should you, as patient, make eye contact, smile and nod as you are discussed? Or even chip in? Or is it more polite to stare out of the window, pretending not to hear, until you are spoken to?
Now I'm no longer on a drip, I manage a shower. It requires military planning and feels chaotic and painstakingly slow. When I drop something, the world spins when I bend to pick it up. But it's also blissful to sit down under a stream of warm water, to feel my skin prickle and relax, to smell my own, chosen bathroom lotions. It feels like an achievement. I also start going to the toilet independently, planning my route down the ward, staking out the hand holds before I set off. I crave fruit and think about mango and avocado salad with prawns. I wonder what Jamie Oliver would do with hospital food. Is there really a need for a three-course hot meal twice a day? Does anyone still eat like that?
I sit in my chair by the window, staring at the Connect Four tower that I can see from my office but from the other side. I ring work and tell them what's happened, I speak to my secretary and cancel appointments. It doesn't seem real. My mobile phone is heavy with texts. It's a struggle to answer them all. I sleep and sleep. At the end of the day, there is no word from QMC. The other patients come and go, the very elderly returned to their half-lives, the suicides restored to the life they don't want, the chronic alcoholics wasting the lives they have, the mentally unstable unwittingly destroying the lives of those who care for them.
I'm visited by Hospital Radio. I choose Ruby Tuesday by Melanie for the request show that night. Listening to Hospital Radio is free and I hear my request, 'for Morag, on Ward 16'. My TV money has run out and I'm reluctant to buy more because I'm moving on aren't I?
On Tuesday morning I hear from QMC. The doctors tell me there's nothing urgent to be done (which I guess means it's not an aneurism) but they want another scan done, this time a CT Angiogram. I can't move to the Stroke Unit until the scan has been taken. I have to wait. This is actually nonsense. I could have moved to the Stroke Unit and the scan could have been done there but I don't know this yet.
Another big step forward today; I manage to wash my hair. It's hard to believe but there's no hairdryer on the ward. I'm not allowed to use my own (brought with all my possessions in the suitcase) because patients 'musn't use their own electrical equipment'. I understand this, I know about PAT testing, but it's hard to understand that no one has thought that women patients will need a hairdryer. Here's a tip, if you're having a stroke, go to the hairdressers the day before (and get your legs waxed- those hairy legs matter to you, if not to anyone else). The matron at boarding school talked a lot of sense when she explained that clean pants were necessary every day because if we were run over by a bus, she wouldn't be shamed at the hospital.
Another patient was told off for charging her mobile phone so after dark, when the night shift starts, I secretly charge mine, hiding the charger behind the curtains. I also start to sabotage the persistent fans. Such minor rule-breaking brings a certain satisfaction.
In the event, my hair dried like a bush but the friends that visited in the afternoon were too polite to comment. They brought fruit and magazines and I let them see me walk. We talked about the nurses. Revenge is sweet.
I telephoned my potential new employer and relayed what I'd been told; the bleed is small, it might never happen again, I should make a full recovery. Since I haven't yet seen a specialist, this is only somebody's guesswork but I don't know enough to question. It's what I want to hear. She is kind, re-assuring and we agree to speak again.
By 'lights out' (optimistic since whenever a new patient appears they go back on again) I still haven't had my CT scan. That night I start to feel nauseous and the headache starts. I worry that the bleed has started again.

Stroke Diary (2): Waiting for QMC

Ward 16 was an acute ward, not somewhere patients were expected to linger. Day and night, patients arrived, were assessed and were moved on, which meant that the traffic was continuous and sleep was impossible but the interest level for an observer like me was high. Sick people arrived with their distraught families and I could listen in to what had happened and the talk of the nurses and doctors. Curtains provide only an illusion of privacy. I had no idea how sick I was. In fact, my condition was poor. I'd managed a wash by the bed but I needed help to get to the toilet. If I tried to walk alone, I swayed like a drunk and was at risk of toppling over. My head felt tight and heavy, like I'd suffered the worst flu. But I texted friends, pleased I could still do so, I slept a great deal and when awake, I eavesdropped. It was shocking but funny to hear confused, elderly Asian ladies, who otherwise needed an interpreter, telling the nurses to 'fuck off'. I also overheard a spectacular row between a teenage girl and her mother. The girl had rung one family member in the morning, to let them know she was being discharged. The message had got confused and poor mum arrived late in the afternoon, without a car, carrying a bag of things her daughter might need overnight. The air was blue.
My stay had started energetically, with an MRI scan first thing on Sunday morning 25th. July. I was impressed, recalling Gerry Robinson's television series on the NHS and how critical he had been that facilities stood idle in the evenings and at weekends. The porter was a young man who told me how he had to be busy, how he hated standing around waiting for patients. He helped me complete a questionnaire outside the scan room and I noticed that his reading skills weren't that great. On the way back to the ward, he and another porter complained above me and around me about their working conditions. I wanted to say to the lad that maybe he was lucky to have a job. He should hold onto it, see where it might lead.
Being wheeled around the hospital made me think of the many times I had energetically patrolled these corridors and drummed my toes impatiently outside the lifts, when I was the educational psychologist for the hospital school. I was glad it was the holidays. I wouldn't bump into any teachers. I didn't want to explain; not yet.
The MRI scan was less frightening than I'd expected. I was very aware of the radiographer's breath, perhaps because my sense of smell had been affected but once inside the tunnel, I found that there was a re-assuring periscope arrangement where I could see him (but not smell him). I had headphones, which played music and an alarm button if I panicked. It was noisy, exactly like a washing machine and the music didn't mask the sound but I found it helped to try and match the length of the tracks to the noise. So if the radiographer said 'here's another scan. It's very noisy and will last for four and a half minutes', I thought of it as one and a half tracks. When I came out, I suggested to the radiographer that he try to pair the length of the tracks to the scans but I don't think he got it.
Back on the ward I'd been joined by a woman I vaguely recognised. I thought she might have been on some training I'd given a few weeks before. Her husband sat with her for a while then left. The rest of the patients were elderly women or very sick Asian ladies, who all seemed to have sons who might have been models. The absence of affection struck me. No one kissed or hugged their women when they left.
It was the end of Nil By Mouth and I over-optimistically ordered lunch which I couldn't eat. But a cup of tea was wonderful. At visiting time my daughter and husband arrived and our talk was cheerful, as it so often is in hospital. I explained that I was on my way either to Queens Medical Centre (QMC) or the Stroke Unit at Leicester General. I wouldn't be on Ward 16 long. We were just 'waiting' on word from QMC.
My daughter had rushed from her home in north London as soon as she'd heard and I think it was a relief to her to see that I looked the same and could talk normally. My husband had had the task of telephoning family and friends and amidst the widespread shock, everyone wanted answers, 'how could this happen?' I had my own worries. I was between two jobs. I had resigned from one and had not yet signed a contract for the other. I was expected to deliver three days of training in early September. I had left so much work undone, including a half finished chapter of my novel. The holiday would have to be cancelled; we wouldn't be able to see our youngest son in Sri Lanka. The ordinary turn of life had been interrupted. I'd been brought to a full stop.
Later that night my husband brought the entire contents of the shower and my dressing table in a suitcase in the hope that 'some of it would do'. The senior nurse on duty sat with me for a while and told me about his family, his working hours, his staffing problems. I switched on my professional 'listening face'. I worked out how to put money into my personal T.V and watched the first episode of the new Sherlock Holmes. Later, that would seem like a heroic level of concentration. My brain was still swelling.
Meanwhile, the fans roared and open windows spilled cold night air across me as I shivered in my hard, pillowless bed. The other patients came and went. The friendly lady opposite disappeared in the middle of the night and I woke to a whole new set of companions.

Saturday, 14 August 2010

Stroke Diary (1)

On Thursday 22nd. July I had a stroke. In the morning I'd had some vaccinations for our holiday in Sri Lanka on August 12th. but otherwise it was a normal day. Although it was the school holidays, I had seen a small child at home, as a statutory report was required. The visit had been stressful as the child ran around the room,snatched my glasses, threw things. The parents had seemed reluctant to intervene, perhaps intimidated by having a professional in their home. The father sat on the floor watching me and I was aware that every time I leaned forward, either to pick up something the child had thrown or to arrange some toys on the coffee table, he was getting an eyeful of cleavage. As it was a muslim household, I felt concerned that there might be a complaint about my dress. I also managed to fit in a visit to my hairdresser at lunchtime, to have my fringe trimmed. So it was busy, but not unusually so. By early evening I felt tired and a litle unwell but thought it was a reaction to the vaccinations.
At around 7 pm, I had a severe headache. It was sudden and felt like a vice. With hindsight, I think I felt a hot rush at the base of my skull. The headache was not unusual, I'd had a few as severe in the past. I waited for it to settle and then I started to feel sick. I tried to get to the bathroom but couldn't make my legs work properly. The world spun and I couldn't stay upright. I was sick for 12 hours, unable to move from the bed. In the morning, we rang the G.P and over the telephone, I was precribed some anti-sickness medication. At this point, the vaccinations were still in the frame.
By Saturday morning, although the sickness had stopped, I was no better and we called the out of hours doctor. We were told we were number 25 on the list for a home visit. They rang back and asked to speak to me and I gave a detailed account of what had happened. An appointment was made for me at the Urgent Cases Centre (a G.P. practice) at the Leicester Royal Infirmary. I was reluctant to go as I had to get up, shower and dress but I managed this and was driven in the back of the car to the hospital. I needed a wheelchair to get to the Urgent Cases Centre and found the wait to be seen intolerable. A television on the wall droned with the sound of motor racing and the hot waiting room seemed full of well, lively people. But the doctor was thorough. He took a full history and did some neurological tests. He looked at me and said, 'forget the vaccinations, I think you've had a stroke.'
After that it was A&E, where a CT scan confirmed his diagnosis. I remember the doctor breaking the news. I'd had a bleed in the brain, in the cerebellum. I'd like to say that I was aware of the implications but I think I must have been too ill to care. It seemed more important, right then, to find somewhere warm and sleep. Left alone, we talked about the other patients; middle-aged women who'd had a 'funny turn', the breaks and fractures and those comatose from alcohol.Within a couple of hours I was on a holding ward, freezing cold, asking for blankets. Although the weather had been hot, it was evening and all the windows were open and the air conditioning roared above me. My husband went home to get my night things and my companions were an Asian lady, her husband and a tall, handsome son who spent his time texting. Late at night, clutching my blankets, I was transferred to a wheelchair and moved to Ward 16, my home for the next 5 days. My journey through the quiet hospital, was accompanied by the relentless banter between the nurse and the porter that both excluded me, yet required me to be an amused audience. This model of interaction was the standard fare of life on the wards.
On Ward 16, quickly taking in the open windows, the fans whirring, the patients lying under a single sheet, I clung onto my blankets. My boarding school training clicked in; hoard, hoard, hoard. For the first time I heard the magic letters 'QMC'. They want you to lie flat, a nurse told me, snatching away my pillow. No one explained and I didn't ask but QMC (Queens Medical Centre) were clearly in charge. I am Nil By Mouth. I don't care. I would never eat again.