26 January 2016

For the want of a nail

Do you remember that old poem "For the want of a nail, the shoe was lost"? For those, who don't know it, you can look it up here. Basically it reminds us that sometimes seemingly insignificant things can have enormous consequences and how one thing can lead to another.  My life seem a bit like that at the moment. A seemingly small thing has has become enormous and taken over my life.

About eight months ago I started to have slight indigestion. Nothing that I couldn't cope with, but I noticed I'd get the occasional excruciating pain in my lower abdomen. I didn't go to the doctor  it hardly seemed worth the bother and in any case they'd probably prescribe indigestion tablets which I could get myself. A few months on, I noticed it was getting more frequent, so I decided to keep a food diary to see what exacerbated it. Things like beans and peas seemed the main culprits, but also onions, cheese and fizzy drinks (not that I drink these hardly at all, I swear, but I had had a few on ice while we were in baking-hot Rome). The list started to get longer. I started to think maybe I should go to the doctor, but always made excuses not to go - too much to do and it wasn't after all that serious. However, in late October I managed to pass some black blood over the space of three days and that made me sit up and  take notice. So I finally went off to the doctor imagining they'd say it was something simple like an irritated bowel or something minor.

Instead, the doctor said black blood indicated I had been bleeding from my stomach (only red blood comes from the bowels, apparently) and instantly referred me to a private hospital to see a consultant  gastro-enterologist. Now, I do not have private insurance, but I am told that these days in order to help the National Health Service get their waiting lists down, private hospitals have been helping the NHS by taking on NHS patients. Along I trotted in mid November and got seen in luxurious 5-star circumstances by the private consultant. His view was that, as I had obviously had  a gastric bleed, he needed to send a camera down into my stomach (gastroscopy) to see what was going on in there.

The gastroscopy  was on 16 December and revealed I had a tumour, a grand-sounding Gastro-Intestinal Stromal Tumour or GIST, in my stomach. Biopsies revealed it was benign but it would still need to be removed as they can turn malignant and it had already obviously bled. However, the case was becoming more complicated than the private hospital could deal with, so I was referred back to the NHS for further treatment.  Because of the nature of the beast, I was to be fast-tracked, so I saw an NHS gastro-enterologist a few days later on Christmas Eve. He decided I needed to have a full-body CT scan and a colonoscopy to make sure there was nothing else lurking within. Those tests were done in early January. 

The colonoscopy revealed nothing at all, despite that being the area where the original pain was, but the CT scan revealed some questionable deposits in my lung, so now I have to see a respiratory consultant next week. Meanwhile, because the stomach tumour is rare and not all hospitals can deal with it, the operation has to be done at a Central London teaching hospital and they have first asked for another gastroscopy with ultrasound, in which an ultrasound probe is put down into the stomach together with a camera, so that the ultrasound can be done from within and get a clearer picture than it would on the skin surface. That will happen this week. I am so not looking forward to that.

See what I mean....... what turned out to be something simple is now becoming a hospital fest. My 2016 diary is full of hospital appointments and we're only in January. Add into the mix the fact that my 92-year-old mum, for whom I am sole carer, is having a knee replacement operation in 5 weeks' time and you can see life is getting a tad complicated.

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13 January 2016

Five minutes of fame

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Kay had her five minutes of fame yesterday - her photo was on a lot of the media websites as she protested about junior doctors' working conditions. I do hope the paparazzi don't camp on my doorstep wanting an interview. Joking aside, it has been clear talking to a lot of people that they don't understand the real issue of the strike. They see junior doctors as money-grabbing, not devoted to their calling and not caring about their patients.The reality is so different.

First the term "junior doctor" suggests someone straight out of university like Kay, but "junior doctor" can mean anyone who is not yet a consultant or a GP. Therefore a lot of those on strike are thirty-somethings (even older) with spouses, families and a mortgage to support.

The strike has never been about pay, in fact at no point in this current debate have the doctors made any request for more pay. The strike has been all about the safety of patients, but seeing as I've mentioned pay, the starting salary for a junior doctor fresh out of university is £22,600. Bear in mind they have studied for 5 or 6 years to get to that point and have a lot of student loan to pay back, they are at least aged about 24 or25 when they start work. In some cases they can be considerably older as not all would-be medical students get into medicine first time round and have to do another degree first to demonstrate they can cope with medicine. To start in your mid-twenties at £22,000 when other graduates are being offered a considerable lot more is disappointing. Even shop assistants earn more than that without any training at all. But, as I say, the strike has never been about pay. Doctors know what the pay is going to be , when they start, and they accept that, because they are doing the job they want to do. If they work on-call and at weekends they get paid extra, but on-call varies according to where you are and what you do, so that is not a given salary booster for most of them. Kay for example regularly had to work weekends (as well as the weekdays either side) resulting in 12 days in one run without a break. For the Government to say they are offering an 11% pay rise is misleading. The 11% would be based on the £22,000 and abolish the extra for working weekends, so 11% to work 12 days without a break every so often would actually work out as a pay-cut.

So if not about pay, what is the strike about? Surely doctors are doing what they do as a calling and not to endanger patients? Exactly. Doctors love their job and want to do their best to help every patient. The reality is that they work such long hours that they are tired and make mistakes. They recognise that this is not safe for patients. In Kay's case, she has had  to work 13 or 14-hour days, starting at 7am and finishing around 9pm, sometimes longer. You get up, go to work and come home in time to grab a snack and fall into bed. Social life or even an evening slouched in front of the TV is non-existent. For those who are married or have children, it means they hardly see their loved ones. Kay is often so busy she doesn't have more than 5 minutes for lunch.  After 12 days of 14-hour shifts, she says it is like thinking through mud. Even a simple mathematical calculation, such as working out the correct dose of drug per kilogram body weight of patient, can cause her problems, because she is so tired. Fortunately so far she has not killed anyone or done anything dangerous but she has narrowly escaped overlooking something vital , because she was too numb from tiredness. This is the hub of the problem every junior doctor can see. There are not enough of them to bring the hours down to more manageable shift hours. If someone wants to take a day's leave, it falls on the few left to cover. 

The argument has been made that there are other jobs which involve unsociable hours. In the retail trade, for example, people are required to work late into the evening and at weekends. That is true. But they probably get a decent break for lunch and, if they make a mistake, the worst that can happen is that they undercharge someone or tell them it is not in stock, when it actually is. A doctor does not get a sufficient break during their hectic day and, if they make a mistake, the consequences can be dire. I don't need to spell it out.

Much keeps being said about a 24/7 service, but that already exists, so far as doctors are concerned. If you are ill out of hours or at weekend, there are on-call doctors to treat you. If you are already in hospital, there is  (pardon the pun) a skeleton staff of on-call doctors working over the weekend to treat you.  But it is no good treating patients, if there are no x-ray staff or physiotherapists or cleaners or whatever to support the doctors. This is where the 24/7 service needs bolstering, as well as extra doctors to cope with a fully operational 24/7 service rather than overloading existing staff with even more hours.

So next time you see the doctors striking, please do not think they are selfish, money-grabbing and uncaring. It is because they care for their patients' safety that they are striking at all.They do not want to strike, but nobody is listening to their cries for help and before long it could be too late to avoid a tragedy.

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12 January 2016

Home Sweet Home

Today I got quite a big shock. The 12th January is the date Greg and I moved into our house.................in 1988. When I worked it out I've been here 28 years. Twenty-eight! That's more than a third of the average lifetime and more than a quarter of the longest lifetime. I'm a creature of habit, love the familiar and hate surprises, but even I was shocked at how part of me this house has become. If ever I should decide to move from here, (not that I have any plans to at present), it will be like tearing a limb off. I can still recall  in detail the very first day we moved in. This and so many happy memories of Greg and I as young-marrieds, of getting pregnant, planting the garden and gradually putting our stamp on the house. Some bad memories too of when Greg took to the amber liquid and  threw his life on the scrapheap. But thankfully the good more than outweigh the bad. There have been some fantastic neighbours over the years (and there are still). Twenty-eight years, eh? It just doesn't seem possible.

02 January 2016

A rather belated Happy New Year

Christmas always comes and goes in a flash in our house. I spend weeks, if not months preparing for it, making lists, ticking things off lists, buying, sorting, wrapping, organising and, come the day, it is over so fast before you can blink an eyelid. Presents unwrapped, food gobbled and too much to nibble or drink.

New Year is usually different.  Kay is usually off somewhere with her friends and I sit up until midnight, some years with my mother, at other times on my own. It tends to be a non-event. Sometimes I even go to bed rather than wait up for something to happen at midnight (turn into a frog maybe). 

This year was different. Kay was working both on New Year's Eve and New Year's Day, so did not have time to come home to celebrate with her old schoolfriends, as she usually does. One of my close friends, who lives in Brighton, had invited me and another close friend of mine down for an overnight stay at New Year, so I jumped at the chance to catch up with them. I was also animal-free for the first New Year in decades ages, so was free to just up and off without having to make arrangements for cat- or dog-sitting.

It was a very magical different sort of New Year for me, celebrating with my two closest friends. We ate a lovely meal, sipped fine wine, chatted and played a hilarious card game into the wee small hours. The wind howled and the rain lashed outside, but we were all warm and cosy by a real fire. Happy New Year to you all.