Fire

I did end up in hosptial yesterday, in the end.

I phoned 111 at about four, and there was an ambulance at my house by half past, with two cheerful paramedics who helped me into some real clothes, fed the dog and sent him to Downhill Neighbour’s house, shared a plate of cinnamon rolls with me, and joined me in my despair when the doctor they called for was completely unhelpful (He decided that the appropriate response to “I’ve taken as much morphine as is safe, and am still in pain” was “Take more morphine then.”)

So, the only solution was to load me into an ambulance at take me to St J. On the way in I was given gas and air, so by the time I was at the hospital I was both no longer in pain, and feeling kind of strange. So when the second of the two paramedics said “Oh, you’ve been playing noughts and crosses on your arm, eesh, you shouldn’t do that” I had no too-much-information filter and replied with “Given the choice between taking enough morphine to competely shoot my liver, and having chequerboard arms, I will always pick the latter” and she winced and looked utterly scandalised, then refused to talk to me for the rest of the transfer. In retrospect – Anyone who pokes the privacy ulcer should expect it to perforate and spray them with unpleasant truth.

I got into the A+E waiting area, was tagged in, then told that there was no cubicle available, so I’d have to wait on the metal chairs. I picked up a book (Harry Potter and the Order of the Phoenix, a good-sized brick to last me through since I’d forgotten to bring a book of my own) and settled in across five empy seats to try to sleep.

It took three hours, of intermittent sleep, reading, and losing the ability to move independently, including some of the most frightening back pain I’ve ever felt, before I was helped into a cubicle where I could lie in a more normal position and take yet more morphine.

More hours passed. I managed to completely panic a nurse by getting her to help me reset a spontaneous shoulder dislocation. I took more morphine, and dreamt about trains.

I was eventually woken up at about 11 by a doctor who, I swear to god, looked like Stuart Broad. Not just “Vaguely tall and blond” but “Looked exactly like the noted England bowling all-rounder.” I immediately developed a speech impediment and tried to look less like a complete mess that was only wearing pyjamas.

He introduced himself, apologised profusely for the wait and the pain, then said;

“Aw no, you’re not going to be wearing underwear are you?”

I went a terrible, pomegranate colour. He offered me a gown.

“You may as well just tie it on like a skirt, to protect your modesty a bit, but I’m going to have to examine your legs and your anal sphincter, that’s done by-”

My sensation of wishing for a less attractive doctor got about a thousand times worse.

“I know. Knees up, glove on.”

He checked the sensation in the legs first, apologising profusely every time he had to set off a twitch in the right leg since it made me fly across the bench and make sad dugong noises, and reported them as “Basically fine”, as well as the usual doctor-that-is-paying-attention response of being fascinated with how zebra legs work (“Your knees go backwards. If I press here, will your leg just keep moving upwards? They rotate a lot further than you’d expect”) Then it was the turn for the spine (“Nice tattoo, what the hell happened to your back muscles, I am so sorry that looks so painful”) He then went and got gloves and a chaperone, got me to assume the position, and tried the DRE. First attempt, I flinched (just through cold and surprise), and the chaperone, instead of being an impartial observer, decided that it was appropriate to grab both of my knees and try to hoick them up further to my chest whilst telling me off for flinching. This resulted in an actual scream of pain, further flinching, and a stream of four-letter abuse towards the cack-handed twat that saw a patient presenting with severe pain and lack of mobility in the hips, and tried to drag their legs around with no medical rationale and no asking for consent.

The second attempt got a “Yep, your sphincter is fine, but your lower back is a mess, which I suspect isn’t news to you.” and he sent the chaperone away to get me a porter to take me for x-rays on my pelvis and hip joint, and also to bring up my last spinal MRI for him to have a look at.

The second after she had gone, he said, in a very calm, measured tone “I’d have kicked her. you could have kicked her, and I wouldn’t have said a word. You don’t touch a patient like that.”

I thanked him, and continued trying to squeeze some life back into my now-dead leg, and he went on his way.

Not long later, I was portered through to x-ray, where the incredibly youthful radiologist immediately struck up conversation, asking how things were going and once again apologising for the long wait.

“It’s not been that bad, but a couple of minutes ago a complete stranger did put his finger up my bottom, so it’s been a bit surprising.”

And without missing a beat she replied with;

“Oh no – the really good looking one? God, I can barely talk to him, never mind… Oh god. You poor thing, it wouldn’t be so bad if he wasn’t just so nice as well…” and then started collapsing with the giggles. I had to join in the giggling, mostly due to be being glad that someone else also saw the ridiculous depth of embarrassment at the situation.

She got the images neded – with the obligatory “Do you have a piercing? It looks like a little planet with rings! And it’s right in the way of the pubic arch…” then retreated to the prep room to apparently die of a giggling fit (It ECHOED) before coming back and taking me back to the waiting bay, where a porter took me back to the main ward.

Not long after, Dr. Broad returned, with good news and bad news – The good news being that it was definitely sciatica, the bad news being that A+E can’t prescribe painkillers for neuropathic pain, and that it has to go back to the GP. He mentioned amytriptalin and pregabalin, and I gave the obligatory groan; Mention neuropathic pain once, and a GP will assume that all of your pain is neuropathic, even if you present with a broken finger.

I told him this, and he agreed, and confided that he’d had sciatica once, which took a while and gabapentin to heal, and then every other injury he ever picked up, doctors had assumed was neuropathic. He promised not to use the word “neuropathic” in the letter, and to also point out that he’d seen me reset a stubborn dislocated shoulder without even thinking about it whilst we were talking.

Once again, the takeaway was basically that I needed to get back to rheumatology, sharpish. And, thankfully, that I wasn’t going to suddenly lose function in the leg and cause havoc on my CBT, as long as I could deal with the pain during it (And, adding the CBT to the four-times-a-week swims, getting a bit of a laugh and a “You really aren’t letting it slow you down”)

Then he offered to admit me into hospital, since it didn’t look likely that I could cope safely at home, with how much pain I was in and how badly I was moving. Admittance would have got me into rheumatology more quickly, would have got me fitted for a better mobility device (probably a walking frame or a wheelchair) and would have, obviously, relieved me from the pressure of having to prepare my own food or do my own paperwork for a few days.

I had to weigh it up really, really carefully. From where I was, there was no downside to it. Apart from the obvious – Having to do more paperwork with the DWP, and possibly having my benefits cut whilst in-hospital. So I didn’t take it. But the offer is, apparently, there. I suspect that when someone turns up in this much pain and with this much loss of function, but still alone, there’s probably cause for concern.

Overall, a bit of a mixed bag. I’m back home, still in as much pain as when I started, but I know what the problem is, and that it’s not going to get noticeably worse. I’ve slept most of today (It’s taken me about eleven hours to write this) and I’ve missed both yesterday’s and today’s swim. This is probably about par, really. One good paramedic, one bad paramedic, one good nurse, one bad nurse, one good doctor, one giddy radiologist. Letter sent to GP yesterday, phone message left with rheumatology today.

I’ll be fine, I always am.

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6 thoughts on “Fire

  1. Goodness Percy even by your standards of grim…this is ghastly.

    I do like the Stuart Broad incident/joke – same thing happened to me with the Registrar who diagnosed my over-active thyroid. My pulse went sky high because of his electrifying presence, which he reported to the graying consultant, who came over and found it completely normal, and then told off the Registrar. Oh dear.

    But I really do wish NHS staff would be taught NOT to comment on evidence of self-harm if it it’s not immediately relevant to the matter at hand. It’s just so very wrong. And as for the grabbing without consent – bloody hell!

    Warmest wishes, C xxxx

    • Doctors should be taught this in advance – That if they’re unusually stunning, and the patient is in an unusually suggestible mood, they might add about 20bpm to the heart rate just by being nice and having very, very pretty hands.

      I’d thoroughly support a campaign pitched to NHS staff along the lines of “If it’s obviously self harm, the patient already knows that it’s there. You’re not the first person to point it out.”

  2. When good looking blokes put fingers up my arse I give them my phone number.
    Hope you are OK. Word to the wise…pregabalin is a treatment for anxiety. Licenced. You sound really anxious about your pain.

  3. One of the (many) things which shoved me in the direction of overdose assessment and working with those who self-harmed was the attitudes of junior doctors and A&E staff: as a student in the ’80s I recall a bumptious pillock of a GP registrar on his MH module gleefully describing the offensive and insensitive things he had said the previous night to someone in A&E. This person remains on my list of doctors never to be treated by.

    I did hope that attitudes in A&E were changing: for several years in the ’90s I taught the post-qualification A&E nursing course in The Toon about self-harm and set out to demolish mythology and preconceptions. However, my subsequent dealings with A&E staff in Smoggyland, then running courses about self-harm in Northumberland suggested very strongly that old ideas and bad habits keep coming back, if they ever went away.

    But getting A&E nurses to listen to a MH nurse was sometimes like banging your head off a wall, because I wasn’t a real nurse, was I? Male, over-educated and MH…

    Bitter? Me? Sometimes…

    • I’d take a mental health nurse that knew what they were doing and wasn’t squeamish about reducing a dislocation, over a nurse-nurse that might be technically better at the physical bits (But, usually, still won’t look at a disloation…) and can’t help but whang on over stuff which is obviously either not recent, not severe, or not the reason for being in A+E.

      It seems like far too many clinicians think that being rude, invasive, or trying to shame people is the best way to stop them from self-harming. As opposed to recognising that they’re not naturopaths, they’re not here to treat something holistic, sometimes their job is just to provide tractive effort when a suitable carthorse or doorframe isn’t available.

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