Tag Archives: doctors

John’s UK Coronavirus Diary – No 15 – I suddenly get taken into NHS hospital

… CONTINUED FROM DIARY No 14

The COVID-19 self-administered swab test pack arrived…

SUNDAY 17th MAY

The COVID-19 home test kit with explicit 12-page instructions arrived: I had to do the test around 0700 tomorrow; a courier would collect it between 0800-1600 tomorrow and I would get the result within 72 hours.

Later I had a FaceTime chat with Ariane Sherine’s 9-year-old daughter whose first question was: “Why are you talking so slowly?” I had not known I was.

The UK’s daily increase in coronavirus deaths has dropped to 170 – the lowest since the day after lockdown began.

The announcement comes a week after the first easing of restrictions in England – and, although the numbers are typically lower on Sundays, the figure is almost 100 fewer than the 268 reported a week ago.

The overall UK death toll remains the highest in Europe.

Sticking a swab into your own mouth – Easier said than done

MONDAY 18th MAY

I took the COVID-19 swab test at 0700.

I could stick the swab up both nostrils no problem. Trying to get the swab into my mouth and rubbing it over both tonsils and the back of my throat for 10 seconds was another matter. I couldn’t see the two tonsils nor the wiggly thing – whatever it’s called – at the back of the throat at all, even using a mirror or an iPhone in one hand and the swab in the other. I tried my best and hoped I got it but was gagging/almost puking up so badly I gave up after about 20 or 25 seconds. 

I then waited for the courier to arrive sometime 0800-1600. 

I slept under a duvet on the living room floor, near the door, in case I slept through the courier (They had my mobile phone number anyway.)

Still very tired.

Around 1100, the UK government added loss of smell and taste to the coronavirus symptoms; I’ve never had a problem there, but it always seemed glaringly obvious these were possible symptoms. 

At 1143, the test, duly packaged-up and boxed by me, was collected by a terrified-eyed young man wearing a baseball cap and gloves. He used the gloves to hold out a plastic bag at arm’s length into which I dropped the box containing the test. The tube containing the swab sample was now, together with a soft tissue, inside a plastic bag inside another plastic bag inside the box – and now inside another plastic bag…

In the afternoon, Health Secretary Matt Hancock announced that everyone aged five and over in the UK with symptoms could now (in theory) be tested for coronavirus.

Captain Sir Thomas Moore – a tribute to the power of walking

TUESDAY 19th MAY

Just before fully waking in bed in the morning, I was slightly gasping for air in gulps into my lungs. But only very minor.

The test result came back negative.

Captain Tom Moore is to be knighted for his fundraising efforts after a special nomination from the prime minister. The war veteran raised more than £32 million for NHS charities by completing 100 laps of his daughter’s back patio before his 100th birthday in April. Boris Johnson said the centenarian had provided the country with “a beacon of light through the fog of coronavirus.” Now, under Ministry of Defence protocol, though promoted to honorary colonel, his official title will be Captain Sir Thomas Moore.

The knighthood, which has been approved by the Queen, will be formally announced tomorrow.

WEDNESDAY 20th MAY

The email with the negative test result suggested that, in any case, I should phone either NHS 111 or my GP.

I expected them to ignore me as bureaucratic generality kicks in and I have little trust in GPs – General Practitioners – The clue is in the word General – they know a little about a lot not a lot about a little – let alone non-GPs at NHS 111. At least the GP surgery has my records.

To say the unsayable, I have a very low opinion of basic NHS bureaucracy. Only the hospital and specialist levels work. At the GP/general advice level, it’s one-size-fits-all bureaucracy. 

Obviously, in the hospital Intensive Care Units, it is (one hopes) the creme de la creme of expertise. Mostly.

My GP’s phone was working, which was a surprise as there was a “This phone number is no longer available” message on it last night.

I phoned my GP’s surgery and they told me to phone 111 because I had had the negative result to the COVID test so it was, they said, “not our responsibility”.

I tried NHS 111 online to avoid jamming the system and because I thought it would be quicker. That was a long endless mess because their tick-a-box screens could only deal with single symptoms not multiple symptoms. 

I then phoned the NHS 111 number and, after going through about 6 or so keypad multiple choices, was connected, actually, reasonably quickly.

The phone woman got all the symptoms and dates and then briefly consulted a doctor. They, like I, thought my symptoms – though not coronavirus – were something that I should follow up. They told me to re-contact my surgery and tell them NHS 111 had told me to ask for my GP to contact me within two hours – I think just before any symptoms changed, not cos it was in any way dangerous.

I phoned the surgery at 1246 and, after going through two receptionist people and telling them I had been told by NHS 111 to ask for a doctor to talk to me within 2 hours, got an appointment. I was told he would phone me from his home “within a few hours”. I expected this would be maybe 1700 or 1800 tonight or tomorrow morning.

He phoned back at 1501.

He was/is not really a listener. He was talking on speakerphone in an echoey room in his house so was barely audible. 

He said I might have had a mini-stroke. I didn’t believe this as I didn’t really have stroke symptoms except Ariane’s 9-year-old  saying once: “Why are you speaking so slow?” (Maybe I had just woken up and was sleepy.)

The GP arranged an ambulance to the A&E Dept of a local hospital.

I packed my iPhone and iPad and toothbrush/toothpaste, even though it would just be a check-up.

I was tested in the ambulance. Nothing showed up except some very mild anaemia; but nothing to worry about. They looked at my inner eyelids: fine. They didn’t think I needed to go to hospital. (Neither did I.) They phoned the GP. He insisted. The ambulance lady said my GP was “very rude”. 

I said, “Well, yes, he is always very abrupt.”

“I think just rude,” she said.

I could not really disagree.

The ambulance duo said I would probably sit waiting in A&E  for 4-6 hours, have brief tests, then be sent home.

I had some preliminary tests at the hospital and very quickly (after maybe 5 mins) a long talk with a doctor. He didn’t think I had any truly serious symptoms – certainly not a mini-stroke (zero symptoms). And I am a mildly anaemic, but nothing serious.

Then another wait.

I sat in the waiting area.

A girl in her teens or twenties was brought in to wait with two carers, I think both nurses. She looked like she was on an acid trip or something similar. She changed between staring into the middle distance or staring up very inquisitively at the ceiling or suddenly being startled by something; sometimes moving her two forefingers slowly together and watching them intently, then jiggling like a seated disco dancer, then staring blankly into the mid-distance – all without saying anything.

I had a chest x-ray.

Then another wait and I was elsewhere, having some blood taken out of my hand and some fluid put into my arm. The presumed acid girl was brought in next to me, a curtain dividing us. She was having a blood test.

I gave a urine sample. Awaited another test. Basically, everything was AOK. They were going to repeat the fluid in the arm thing and check it was the same as the last test.

I sat in the waiting area, ready to go home while they repeated the blood test results.

The doctor came back to say I had to have an x-ray. I had slight light kidney damage.

I felt fine. Over the next 45 minutes I had liquid dripped into my arm – 99% water, I think, then another doctor saw me.

They thought the sudden kidney problem was to do with dehydration. 

When I had an X-ray of my back last October (looking at some lower spinal damage I got in 1991 when I was hit by a truck while standing on the pavement) I had a kidney function of 90, which is OK for a man of my age. Now I had a kidney function of 19. So they were confused why I suddenly had kidney damage. They decided dehydration.

They took a bladder scan and decided to keep me in at least overnight for observation.

More blood tests tomorrow. 

No big problem though.

Tomorrow would be a day of tests.

I had maybe 7 or 8 tests and repeat tests end-to-end. Then maybe 5 or 6 more tests and needles and fluids and probing and finally another COVID swab test before they took me up to the ward with another urine test on the way.

Then another COVID swab test before going into the ward and a one-off chat and probe and questioning by the young evening consultant and some younger assistant I guess being trained. The main guy described himself as “a grunt dragged in for the night” and my real personal consultant would start tomorrow. Nice bloke as they all are.

I felt miles more awake since I had been in the hospital. Maybe a result of just being out and about.

They basically didn’t understand why my kidney function was down from 90 to 19. I might be in for more than a day – some possible tests might take longer to come back. They also found my calcium level was suddenly high. I think they said it should be around 2.6 and was 3.3. Might have misremembered by a digit but somewhere in there. Pretty sure that’s right.

Everyone was basically saying I didn’t have any symptoms of anything specific and that night’s consultant said they would never normally have me in on the results but now they had found these inexplicable kidney and calcium weirdnesses…

They put me on another 45-minute drip and would continue dripping liquid (saline solution?) into me through the night.

The COVID test in the ward was a swab test up each nostril and down both sides of the groin(???)

My friend Lynn told me (text messaging is a wonderful thing) that the groin swab was probably the usual one for MRSA. Lynn is the executrix of my will, my designated next-of-kin and has Medical Power of Attorney over me, if I become incapacitated. So it is always best to let her know if I go into a hospital or visit North Korea.

… CONTINUED HERE

2 Comments

Filed under Medical

Dying from cancer in the 21st century

I used to keep an electronic diary.

Thirteen years ago today – on 21st April 2001 – my father was in hospital.

Two days before, he had had a cancer operation.

To set the scene, this first extract from my diary is on…

______________________________________________________

Me (aged 1) with father near home in Campbeltown, Scotland

My father & me (aged 1) near home in Campbeltown, Scotland

Friday 20th April 2001

I stopped in at the hospital to see my father. He had colour in his cheeks, though his hands and lower arms were a bit yellow (possibly because of the tubes and injections he had had in them). He was looking much more awake and bright-eyed than I had thought he would be and his mind was OK, though he had various tubes in his arms, a see-through oxygen mask over his nose and mouth, a grey plastic bulldog clip on one finger (which I think is for blood pressure readings) and he said he felt “exhausted”.

He told me he had slept off-and-on last night. This morning, he was OK but this afternoon he was feeling (and was) sick and had pain in his lower stomach. He said it was odd because, with an oxygen mask on, he was sick along tubes. There were, he said three or four people (he seemed to say doctors) looking after him in the afternoon, giving him painkillers, anti-vomit injections and, he said, two bags of blood because he had a low blood count.

This morning, the surgeon/consultant had come to check on him. The surgeon/consultant said the tumour he removed had been much, much bigger than he had thought it was going to be and – being so big – it had affected either the liver or the kidney (my father was unsure). My father seemed to say the large tumour had rubbed against whichever internal organ it was, though I was not clear if the liver or kidney had been ‘affected’ by the rubbing or if it was a spread of the cancer itself. The surgeon asked my father to tell me he wanted to see me and my mother, if possible, at 10.00am tomorrow morning (on his normal rounds), so he could tell us what he had told my father.

“He said I would need more medical treatment,” my father told me.

“Surgery?” I asked: “He’d need to operate again?”

“No,” insisted my father. “He made sure he emphasised it was medical treatment… though I don’t know what that means.”

Just before I left, my father took his lower, then his upper teeth out and a nurse put the two sets in a glass of water. He was already without his spectacles and his hearing aid. I left him sans teeth, sans eyes, sans everything.

At my parents’ home, I asked my mother if she had slept last night. She said she kept waking up. “I’d be asleep,” she told me, “And I’d stretch my leg across the bed and it wouldn’t touch his leg because he wasn’t lying there next to me.”

My parents in their twenties in the 1940s

My parents when they were in their twenties in the 1940s

Saturday 21st April

My mother and I went in to see my father in hospital this morning and I managed by accident to bump into the consultant on the stairs, without my mother, so I had a chat with him.

The tumour was, as my father had told me, much bigger than the consultant had expected and had affected the pancreas and part of the liver. He had decided not to remove the extra bit but to leave it in because really, he said, it was safer than just chopping away at things. He told me he is not going to operate on it and says the liver is a relatively large thing and there is a small area affected at the moment.

After my father gets out, he has an appointment to see the consultant on Wednesday 16th May – that will be a good week, as my mother is seeing HER Consultant on Monday 14th. My father’s meeting is to decide what to do about what is left. Whether or not to do chemotherapy. The consultant told me he is inclined not to do chemo as, “frankly, sometimes it has an effect and sometimes it has no effect at all” and, in this case, it would probably not make any difference.

Also, I guess, doing it on any 82 year-old man is not a good idea.

So, basically, my father will not be cured of the existing problem. I asked the consultant specifically about life expectancy and he replied – commendably honestly I thought – “We really have no idea how long things like this will take”. He meant doctors are really just plucking a random figure from the sky if they do a guestimate.

His guestimate for a worse-case scenario was that – if the disease suddenly vastly accelerated which he does not think it will – death would be “in a few months”.

I asked what the longest guess might be: “Five or six years?”

He replied: “Oh, not as long as that. He’s an 82 year old man, after all. Eighteen months or so.”

But, as he says, it is really just plucking figures from the ether.

I said I was amazed that my father had never been in any pain at all with the cancer itself (he now has post-operative pain) and asked if things would deteriorate into extreme pain. The consultant’s reply was (I paraphrase):

“Again, one can’t tell. It might or might not happen but there is no particular reason why it should suddenly change its nature.”

I did not quite know what to tell my mother about this, so told her the consultant is happy with my father’s recovery, but that a part of the liver has been infected – I did not mention the pancreas – and that the meeting on 16th May is to talk about possible treatment including chemotherapy.

At 10.00am, the consultant told her the tumour was much bigger than expected and that he had found “a secondary” in the liver.

Basically, she knows what the consultant told me except for my specific question about life expectancy.

______________________________________________________

My parents in Edinburgh, perhaps in the 1970s. Who knows?

My parents in Edinburgh, perhaps in the 1970s. Sometime.

My father died of cancer on 27th June 2001.

My mother died of a heart attack on 13th January 2007.

So it goes.

2 Comments

Filed under Medical