metastases

Is what I have got a new one of, in my biliary arrangements somewhere. I know it is blue because I asked the nurses to show me, whilst sitting perched up on the table in gown and slippers, mouth and throat numb and tasting vile, not able to assume the position because I had not yet signed the consent form and they had temporarily mislaid their surgeon.

I had a couple of goes of biliary colic, first time for ages; opinion is divided about whether that might have been caused by the stent blocking, but anyway it turned out to be “pretty grubby”. I came out of hospital feeling quite skippy, for me, and with a list of things I wanted to do in my week off chemo, especially since the Oxford trip had to be canned. The skippiness went on until Friday, at which point I started feeling decidedly un-skippy. Yesterday I was feverish and wobbly and slept almost all day. Today I am better, but still have various aches and pains. Haven’t yet sought medical advice because (a) Colin has several of the same aches and pains and general feebleness (b) the pains didn’t seem quite right for anything to do with gallbladders, pancreases or bile ducts (c) I am on antibiotics anyhow and (d) I am getting bloods done tomorrow anyhow. An adventitious virus, possibly.

I have now been an NHS inpatient of my local DGH three times and an outpatient for six months. My conclusion is that the overall experience is just as good as being a private patient of the super-duper world famous tertiary centre whence I came (which was very good). I am not going to speculate about how much this is to do with the DGH being a well-run hospital and how much to do with the NHS in Scotland not being in such strife as the one in England (they are different organisations; perhaps the Scottish pollies have not embraced central top-down management with such fervour as the English ones have over the life of the Blair government).

Nurses – all unfailingly kind, caring and energetic, which was actually not (quite) the case in London. And having been on 5 different wards now, plus the chemo clinic, I have a reasonable sample size.

Admin – slightly muddle-headed sometimes, just the same as London and I was impressed to be rung by Admissions late on Friday to check that the secretary who was meant to have told me about my Monday admission had in fact done so (she had). Not quite so impressed to have to wait for a bed for 5 hours by which time, having had chemo a few days before, I was pretty tired…but I was looked after kindly whilst waiting, and it was a short-notice admission.

Cleanliness – just as good, certainly; I got lots of chances to watch the cleaners (one of whom told me that she had been cleaning that hospital for 30 years, and when she started she didn’t know what to do and was told firmly “if it can be moved, move it!”), and also the nurses, who, before making up the bed for a new patient, got a bowl of something with bubbles and wiped the mattress and the pillows and the bed-head and the side-rails.

Medical – of course I am not technically qualified to judge, but I don’t have any reason to believe that anything different would have happened in London. My new consultant is very straightforward about (occasionally) saying she just isn’t certain and wants to speak to someone else, and is also very happy to communicate by email, which suits me. And of the consultants I have met (quite a few given all the stenting) I would say that the same proportion as in London aren’t very good at communicating….and the same proportion of F1s are good and bad at cannulating….

The food is fairly horrible, but it wasn’t anything to write home about in London. The only benefit so far to being a private patient is getting a private room. I don’t mind being on the ward (a 6-bed bay) in general, indeed it is more sociable, but a sociability out of which you can opt if feeling too ill, and also better for getting the assistance of a nurse for relatively minor things (“please can you help me open this window”) for which the call-bell seems excessive.

Having a private lavatory is definitely an upside, though, especially when several of your ward-mates are required to use a bed-pan so that all their outputs may be counted. And the REAL benefit is that, in a private room, you can SLEEP, because you can switch the lights off when you want rather than after the drugs round at nearly midnight and you have no ward-mates to have loud visitors or snore or have crises in the night.

There is an easy solution to this last problem though, in the form of ear-plugs and an airline eyeshade. The first time I was an in-patient, I didn’t sleep until after 3am (despite being really quite ill), and was a wreck next day. I got Colin to bring me the kit next day, and every other night I have slept fine (occasionally being woken by nurses to ask if there was anything I wanted, duh, but at least one can fall asleep again quickly). Surely it is important for ill people to be able to sleep? Surely they get better more slowly if they are prevented from doing so? Surely it would therefore be cost-effective to provide ear-plugs and eye-shades for all who wanted them? Surely, indeed, it would be costless to allow someone to install vending machines where for a trivial sum one could purchase same?

Perhaps it might even help reduce the incidence of ITU psychosis?

Is there any medical reason not to offer ear-plugs and eye-shades? (apart from the obvious exceptions of people with things wrong with their ears or eyes)?

Perhaps I should start a campaign. Better, perhaps I should persuade someone with more energy than I to start a campaign.

I have been meaning to report that my hair was growing back in, much greyer. But now it is falling out again. Presumably the temporary recovery was because of the longish break over Christmas. Oh well. Back to Buffs. I might even need them to prevent sunburn this time; the sun has just reappeared on our house after the winter, hurray. The crocuses are out and the daffs are well on the way. The woodpecker has come back (wonder where she went). It would be really nice to be well for the spring.