Well, stone me! #gallstones

2018-06-29 18.36.36Three months and not a little confusion, falling-through-the-cracks and communication hiccups later, I finally had my gallbladder and its impressive payload of gallstones removed, in the latter days of June, courtesy of the NHS – just a week or so shy of its 70th birthday milestone.

Things went more-or-less as they should, save for the fact that a bigger than usual gallbladder meant a bigger than usual keyhole incision in my bigger than it should be abdomen. Then – as far as I can tell – this was followed by a bigger than usual amount of surgical rummaging about to sew me up. (In the words of my surgeon, it was a bit tricky … and that, I think, is as much detail as I choose to cope with.)  Mea culpa though, at least in part, because for the first time in my life, obesity was cited as a co-morbidity.  That’s a fairly brutal word to see, even though it doesn’t mean quite what you imagine it does. Ironic it was, all things on my healthy lifestyle journey considered, but I have to suck that one up.

But that wasn’t the end of things. A couple of weeks after my operation, with things generally going just fine, I found myself doubled-up in agony and back in hospital again, as some kind of surgery-related kink or blockage knotted my insides. That kind of pain, you really don’t want. It took several days to resolve, as I attempted to rest my protesting intestines, my arms perforated by cannulae, dragging a drip-stand wherever I went, and not get too stressed about it all; all in an overstretched, overheated ward, during one of the most suffocatingly steamy weeks of the decade.

But as the cliché goes, every cloud has a silver lining, and my silver lining has been that with the surgery, followed by the imposed starvation necessary to relax my twisted gut, I have waved farewell to a further 10 pounds.  That leaves just 10 more to go until I’m back where I was at my lowest, in May 2017.  That’s properly within reach now – so I’ll take that win.

Then, at last, I will be able to put the psychological, emotional and physical disruptions of the last 18 months behind me, and continue the onward/downward weight management drive. Hopefully by the next time I need hospital care (ummmm…. hopefully never?) they won’t feel the need to note obesity anywhere on my records.

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Well now, that was interesting… #NHS

Getting carted off to hospital in an ambulance at 4am, doubled-over with acute abdominal cramps that just won’t go away; not the best start to the week.

I’ve had a stressful year, upturned – the untimely death of a parent does that. So when stomach problems started to surface a few months ago, that’s what I put it down to – stress. I’ve had several instances of crampy discomfort, one or two much worse episodes more recently. And then there was Sunday. Sunday was off-the-scale. I’ll spare you the details, but the upshot, after several increasingly painful and vile hours, was this: A call to NHS111 when I could stand the pain no more and was thinking I might be having an actual heart attack; the despatch of an ambulance; a day in a chaotic and overwhelmed A&E; nil-by-mouth; the extraction of blood – lots of it; X-rays and ultrasound; people prodding and poking (I hope they were doctors); a further day on a ward operating beyond its remit; industrial quantities of antibiotic and painkillers on drip; thence to be packed off home with instructions to avoid overly fatty meals and attend a clinic next Monday to see what comes next.

Unbeknown to me, over recent weeks, I’d developed an inflamed gallbladder and a ‘deranged’ liver, courtesy of some errant gallstones, one of which kicked off the latest, greatest episode of vileness and agony. It wasn’t pretty. It wasn’t pretty at all.

That’s more detail than anyone would want, so I’ll leave the rest of this miserable experience to your imagination. Save to say a word or two about the extraordinary situation in my local hospital (that’s Hillingdon Hospital in West London, but it could just as well have been any hospital, anywhere in the country), and the equally extraordinary professionals who are doing their very, very best in utterly over-stretched conditions.

I have a lot of time for the NHS – it has served my family well over the years and is a good and positive thing,  whatever Donald Trump might think. The UK is a much, much better place for the NHS. But this venerable institution is in trouble, thanks to a decade of austerity (from the financial crisis, which was kicked off by the USA’s sub-prime loans catastrophe).  A decade of under-funding has left the armies of dedicated and committed professionals across the NHS fire-fighting, horse-trading, and doing everything in their power to deliver care in totally and utterly strained circumstances, day after day, night after night.  And do you know what? All except for one sullen nurse, every single person I met in the last few days at Hillingdon Hospital, was doing it with a smile and good cheer. And I imagine it’s much the same in every hospital and clinic across the country – because that’s the kind of people they are.

They raced around, chasing down scarce equipment. They juggled cubicles, tended to people on beds in corridors and chairs all over the place. When they needed more beds they ‘flexed’ a day ward into service, forcing them to cancel who knows how many minor operations in the process. If the odd minor thing fell through the cracks, they stayed on top of what mattered.  And they kept going, through twelve hour shifts and acres of… carnage.

It’s a crime that the NHS has been expected to operate under such conditions.  And now that we’re getting the small hints that ‘austerity’ might be coming to an end, the very, very first priority of the Government must be to pump money into its veins and jump-start its exhausted heart before it expires altogether. The country deserves it, but more than that, those hundreds of thousands of extraordinary professionals – nurses, doctors, consultants, radiologists, anaesthetists, orderlies, porters, paramedics and everyone else, yes, even the administrators and managers – deserve it.

One of the Healthy Ones

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I visited my GP last week for the first time in well over a year. During a miserable menopause, I was in and out of her surgery every few weeks, with one distressing or uncomfortable symptom after another, overwhelmed by what they used to call hypochondria, but now label ‘health anxiety’. I spent the better part of six years stressing about a host of discomforting symptoms. The worst of these, by some considerable margin, was prolonged bouts of lurching, pounding heart palpitations, lasting hours at a time. Every time my hormonally induced palps kicked off, which they did frequently, I could not suppress the fear that I was in some sort of cardiac crisis; worse still, that I had brought it on myself, through my failure to take control of my eating and unhealthy lifestyle habits.  But it turned out I was fine – once the hormonal havoc settled, so did my blippy, ectopic heartbeat.

The last time I saw my GP in connection with one of those bewildering menopausal symptoms that there wasn’t anything to be done about, as I left her surgery, she said to me, “You don’t need to be here.  You’re one of the healthy ones.”  Her words stuck with me.  She was of course politely – very politely – telling me to pull myself together and stop taking up appointment times. On one level she had a point, but that time-of-life thing is a prickly period for some women, physically and psychologically.

Anyway, cut to last week and as I sat by her desk, she noted she hadn’t seen me in a while. She could see I’d lost weight, and I wondered if she was wondering whether this was intentional or not – as in, has this woman finally got herself under some control, or is she really, really ill?  But I don’t look ill. I’m actually looking remarkably… healthy.

She asked me how I was, normally the precursor to explaining whatever problem one is experiencing.  I said I was great, absolutely great, thank you. Not the usual response when one occupies an appointment slot at the surgery. (Worth saying, I did have something else to see her about, so I wasn’t there under a purely indulgent pretext.)

I told her what I’d lost over the past eight months, and that it was through adopting healthy eating and exercise habits, including walking regularly and giving up added sugar. She was plainly delighted. I was her first appointment that morning and she said I’d made her day. That was lovely. After our all-too-frequent interactions of recent years, it re-set the clock between us, I feel.

I asked her if I could have an NHS Healthcheck. I had one just over a year ago, and you’re not supposed to have them more than once every three years or so. But I was hoping to get a check on the various important numbers as I reached my weight-loss half-way point.  She readily agreed and I went off for my Healthcheck blood test.

An NHS Healthcheck is a fairly straightforward thing, not particularly detailed, but it does give you some useful data on things like blood pressure and heart health, as well as liver function and a few other things they can assess from your blood – like whether you’re heading for diabetes.

A few days ago, just as I was about to leave to walk down to the surgery for my Healthcheck (I walk everywhere I can these days, especially on lovely, sunny mornings), I got a phone call. It was the surgery receptionist, advising me that the nurse who conducts the Healthchecks ‘didn’t need to see me’. My blood test was ‘normal’ end-to-end and, well, that was that. I explained my situation, and that my GP had happily agreed to my having an interim Healthcheck, but nurse knew better – and seemingly had better things to do than monitor the healthy weight-loss of someone who is nonetheless still in the BMI obese category.

There are many, many good things about the NHS, the most notable one (for benefit of Stateside readers in particular) is that it is completely, totally free of charge at the point of need. Beyond what’s collected in our taxes, nobody pays.  But that means too, that if the NHS doesn’t think I need one of its many services, facilities or drugs, I don’t get it. Fair enough, I have to say, though I was momentarily miffed – well, I’m human, and petulance is my middle name. So I walked down to the surgery anyway (still a good excuse for a walk on a sunny day) and collected a copy of my blood test results.

So it turns out, several of those important blood-related numbers have come down nicely. There wasn’t anything really wrong last time; one or two were a bit borderline (I’ve said before that I knew I was getting away with things) – but even those were now comfortably in the ‘normal’ range. A couple were considerably improved.

I know these numbers aren’t the be-all-and-end-all, but it’s great to have such tangible evidence of the good that my new habits are doing to my insides. There wasn’t much else I needed from the Healthcheck anyway – I can work out my own BMI and I didn’t need the healthy lifestyle lecture.   It would have been nice (I’m a completer, remember?) to have had the full set of Healthcheck tests. But I can’t really object when the reason behind it is that I’m doing so well, I’ve already become medically unremarkable. I’ve still got quite a way to go, but what better way than that, to put my health anxiety to bed once and for all?

I hope you like today’s picture. Thanks to an infusion of nutritious compost and a proper prune, my rhododendron bush too, is healthier than it’s been for several years.