Friday, January 27, 2012

A Patient's Minor Contribution to Medicine

I am rather proud of my two contributions to medicine – although I may be the only person to have benefited from them.
Recovering from prostate cancer, I had a catheter fitted that ran from my bladder to a bag strapped to my leg. This bag had to be emptied when it became too heavy for comfort. Then a convenience (often an inconvenience) had to be located, trousers lowered, and urine released.
I had a zip fastener put into the side seam of my trousers from which to extract the drainage tap. Then, even when in public, I could find a drain or flower bed for the purpose. I dubbed it
“The P-R Zip”.

On another occasion, when being released from hospital with a pacemaker, instructions were not to raise my left arm, the side in which the device had been inserted. A reminder was necessary for the following month or so.
I installed a cord (string) loop that rounded and fell from my trouser belt.
With the arm dangling through this loop, there was a restraining reminder whenever I started to raise it. The doctors had not seen one before.
This could be the cheapest medical aid ever invented.
I dubbed it “The P-R Loop”.
The “Loop” can be threaded through a strong safety pin attached to waist-high nightwear.

My other contribution to medicine was only an observation.
In a shaft of sunlight I was using an electric shaver with an oscillating head, and was astounded to see so many small pieces of hair flying about. These, I thought, must be an irritant when breathed in to my ex-TB lung.
I changed quickly to a rotating headed shaver that retains the cut hair.

Sunday, January 22, 2012

Background music and nature films

Being laid low by a virus infection gave me more time to watch television. Two matters from this have been food for thought.
Years ago I saw a film that had, as one of its scenes, a man crawling through desert sand about to die of thirst. He was accompanied by orchestral music. So I didn’t see why he couldn’t have turned right, crossed a sand dune, and asked a musician for a glass of water.
Much the same situation has been very apparent in a nature series that I saw on the box.
It is true that long-lens photography of animals making a noise is difficult to record. So, somewhere, a sound person might well have been extracting a cork from a bottle each time a penguin rocketed from the water to land on an ice floe.
When making appropriate sounds to fit the action becomes difficult, a full orchestra is brought into play. Natural sounds are then thought by these portrayers of nature to be unnecessary.
But the accompanying orchestras can be so intrusive that the music detracts from the action.
One feels that all might well be reversed. Why not show the orchestra, with a showman of a conductor encouraging his musicians - with a few nature bits superimposed on a backdrop behind him.
Because we, as viewers, especially of nature programmes, have now seen the intimate lives of nearly every bird, insect and beast on this planet, it has become essential with repeat images to announce every so often that: “This is the first time that anyone has seen…”
The makers of these films have not been watching television. Most of us have seen the lot already.
So that is now the new quest when repeating the subject. It is to find something new.
The great fall-back is to film lions chasing wildebeests toward crocodile-infested water.
Now, if one of these wildebeests should reach the water, see a crocodile, take fright, turn back, and fall into the jaws of a lion, that might be new. But do we care any more?

Wednesday, January 11, 2012

Sirens and red lights

Travelling by rail to and from Amsterdam, with a change of trains in Brussels, would seem to be the best method to choose for a winter’s visit. But there was, at Christmastime, a great deal of heavy luggage to lug about at stations.
And then, in Amsterdam, where space is at a premium, and where stairs are unproductive areas of a house with treads narrow and assents steep, heavy suitcases meant that extra muscle power was required.
Probably because of these additional manual matters, my heart acted strangely on our return to London.
When walking along a street I was suddenly short of breath and struggling. Something was not right.
So, for a few days before the New Year, I took my pulse rate at various times of the day and night. It seemed to be extremely low.
Margreet wanted me to see a doctor. An appointment was to be made at the counter of our local health centre, where we learned that no one could see me for several days. At Margreet’s cajoling, the receptionist then found that, due to a cancellation, I could be seen by my own doctor right away.
After the briefest of examinations, she ordered an ambulance and booked me into the cardiac clinic of Hammersmith Hospital.
So, with me in a wheelchair, ambulance paramedics and Margreet, we set off with sirens screaming and red traffic lights ignored.
Wheeled into the hospital for another brief but thorough examination (symptomatic complete heart block), I was put into a bed and connected up to a mass of cables that led to monitors of lights, flashing numbers and noisy alarms.
I was to have a heart pacemaker installed in my chest. These are inserted beneath the collarbone and connected to the heart by two wires. In place, it would result in my heartbeat being under control at a satisfactory level for life. Fine.
Speed was necessary, but I had to be fitted into the pre-arranged surgery programme. It was not until mid-day the following day that the operation took place. Antibiotic pills aplenty were administered.
The surgical procedure was to be conducted with local anaesthetic.
This obviously involved delicacy and, unexpectedly, some brutal force from a surgeon who was discussing his future in medicine with a colleague. The procedure appeared to be a success.
Margreet was much relieved when I appeared from the surgical quarters looking much the same as before.
With some aches and pains and soreness the following day, I dressed to go home. But a final and more comprehensive extra scan revealed that one wire from the pacemaker to the heart had become detached (atrial lead malpositioned).
So off came my street clothes and, once again, on went that surgical garment – one that surely needs some re-design and logical thought directed at it.
But, once again, with a surgical schedule full, could I be fitted in?
I was (possibly to make up for the previous failure).
Now, a glamorously dressed lady surgeon from another hospital appeared. She read my notes, and retired to change into her surgeon’s kit.
I was not really looking forward to another session of pain and brutality. So I asked for the more liberal use of anaesthetic.
She started the procedure after the accompanying sterilisation of about everyone and everything. I expected a repeat blood-letting and brute force – except that it was not that at all.
The surgeon operated so gently and skilfully that, compared with the previous day’s attempt, it was almost painless. She re-attached the atrial wire to the heart.
The female touch in surgery is to be recommended.
Poor Margreet was the one who suffered throughout this medical saga, imagining the worst – the very worst – when the risks were actually quite small.
So, with almost a new heart, I was returned to my hospital room and to Margreet with the prospect of, once again, returning home the following day.
Final (satisfactory) tests were taken, and doctors released me. I was ready to start life again – with the restricted movement of one arm for several weeks.
To remind me not to raise my left arm, I devised a simple cord (string) loop, tied around my belt and hanging down into which to thread my lower arm. With the arm dangling through this loop, there was a restraining reminder whenever I started to raise it. This was a simple idea and, apparently, one not thought of before. And it must be the cheapest medical appliance ever to be used.
Never throughout the saga having felt ill, at times I felt a bit of a fraud. But doctors and nurses knew otherwise, and had saved me with their expertise.
One must admire hugely the Hammersmith Hospital’s staff, the National Health Service – and Margreet, whose supportive hand needed holding much more than mine.

Tuesday, January 03, 2012

Holland 2011

To travel abroad is to suffer. However easy inspections and controls at airports and railway stations are, there will be queues, noisy children, neighbours with streaming colds and general mayhem. So the relief at having accomplished any international journey is considerable.
One of the many advantages of age is that one generally has an excuse for avoiding it.
After all, the pleasures of enjoying one’s own home environment without hassle are great. Foreign beds, foreign pillows, foreign coinage, foreign manners and foreign languages do not always add up to happiness.
However, I write on this trip to Holland in a positive mood.
Our train journey took us by Eurostar to Brussels (via the Channel Tunnel), and then on by train again to Amsterdam.
We passed through the wet and cold English countryside, while inside the carriage there was warmth and the sounds of pleasurable anticipation.
Space for luggage aboard Eurostar was at a premium as passengers had arrived with Christmas presents for those close to them abroad. So, although Margreet and I normally travel light on this occasion we had two suitcases and a haversack crammed full of beautifully-wrapped presents for the Dutch relations, who we seldom meet and who multiply quite quickly.
We emerged from the Tunnel to find that the weather was better in France – well, it was not raining, anyway. The open spaces were larger, and bleaker. I looked for signs of wildlife – any wildlife. I could not see even a pigeon – or any creature in the sky or on the ground. The French are very keen on “la Chasse”, so by Christmas time, most wild creatures in the countryside would have been eaten – with some sauce or other – and washed down in that part of France with, possibly, cider – certainly beer.
The large fields were either green with winter-sown grain, brown plough furrow or smooth seedbed. The furrow lines often contained unabsorbed rainwater and there were shallow ponds of water lying in fields.
Neither was there any sign of human life. The arable season was in obeisance. Humans were inside and warm – with warm insides – contrived by calvados, probably.
A small bonfire in the grey countryside lit up its small area of monotonous landscape.
Cleverly, concrete “ponds” had been, or were being constructed wherever water could be garnered -such as beside the lowest point of roads. The French and Belgians are wisely preparing for future water shortages.
Trees did not really fit the landscape, and looked a little unnatural, having been planted in regimented rows or in blocks.
Because of the delay in leaving London St Pancras, due to Christmas luggage blocking the carriage exits, we were to be late in reaching Brussels. As we had not booked train seats onward, missing our proposed connection did not affect us too much.
The lateness of our train enabled us to have a beer and a baguette in Brussels’ Midi Station before taking a rather seedy stopping train (called Inter City) through poor industrial suburbs, then to Antwerp. It was noticeable, in Belgium especially, that many house roofs had either water heating or electricity-making panels installed. They were ahead of the English.
So on to Holland and Amsterdam in particular.
How can a country that once almost ruled the seas and been about the most commercially prosperous nation in the western world, and one that produces some of the most delightful architecture anywhere, almost totally neglect the culinary arts?
Ask anyone to recommend an eating place and the answer will be a restaurant that is Indonesian, Thai, Italian, Spanish, Argentinean, Vietnamese, or any non-Dutch – but seldom Dutch. Possibly because of it, these “foreign” foods will have been given a strong Dutch (heavy and mixed up) slant.
But there are charming bars in Holland where one can drink wine or beer in congenial company. And there are “coffee Shops” where, I suppose, if you stood outside for a few minutes you would experience a “high” – at no cost.
Our hotel, the Wiechmann, on the Prinsengracht (No. 328), was all an Amsterdam hotel should be (described by Margreet as being like an old aunt’s well-appointed spare room), overlooking a complex junction of two canals, four roads and two bridges. Its breakfast room must have been one of the most interesting hotel dining rooms in Amsterdam. One sat inside, so close to pedestrians, cyclists, and cars, that it seemed almost possible to touch them. And the vistas were a delight to the eye.
There was a fine bar (a Brown Café) near to our hotel (the Eland Bar, where the Elandsgracht joins Prinsengracht), and a supermarket, wine merchant and cheese emporium. But where might we eat?
We went to a recommended Vietnamese restaurant across from the bar, in the Jordaan. But the food there was disappointing and expensive. So next we tried another recommended place – Italian (La Festa). It was bleak and almost empty when we looked through its window. But we took a chance. They offered carafe wine, and by the time we had started on our excellent mixed hors d’oeuvre, the place filled to bursting point. We ate very well there. Our last “restaurant” was our hotel room, where we dined well on bread, sausage, white goats’ cheese and excellent red wine. Picnic meals like that are hard to beat.
In between our evening meals we were entertained by Margreet’s family. The first was by one brother and his wife (Bert and Henny) who arranged for their part of the family to meet in a splendid, Edwardian 1st class waiting/dining room beside a Centraal Station platform (2b), then to cross the IJ River to a pleasant café (de Pont).
There were 15 of us guests who took the free ferry (destination Buiksloterweg) across the IJ, giving way to a long fuel barge as we did so. Café de Pont, where the ferry docked, was spacious, clean, and ideal for a family meeting. We drank wine, amid much fun noise and friendship, and ate steamed mackerel flesh on bread with salad. The children were charming, enjoyed opening their Christmas presents, and were well behaved.
On the next day we took a 20-minute train journey to Hilversum to meet Margreet’s other brother and family. It being Christmas Day made no difference to the railway schedules in Holland. At Dick and Reina’s modern house, that was full of art (including some of mine), we sat down firstly to individual plates of 8 cheeses with wine. Then, several hours later, we sat at another table for an imaginative repast that included venison with a sweet raspberry/strawberry sauce. The wine was excellent. Here, other children opened presents, behaved well, and were a delight.
Margreet’s brother, Dick Klees, was an original pirate broadcaster on a ship (Radio Veronica) outside territorial Dutch waters in the 1960s. So, being still a broadcaster, he is very much au fait with electronics. So we enjoyed his very professionally produced films on wide-screen television. In the past one was shown still photographs, then slides, then primitive film, now an exemplary presentation such as this one.
Another treat in Hilversum is to see Dudoc’s 1930s Town Hall. This magnificent example of Art Deco architecture is surely one of the greatest anywhere. Its enormous and simple block shapes of pale yellow bricks with deep-cut pointing are designed to form light and shadow to huge advantage in almost all weather conditions.
I notice that when I travel away from England I write about plumbing and its related matters.
This time it is about the bath and a person’s ability to get out of it.
The bath in our hotel was large and the hot water almost at boiling point. All seemed well.
But there were no handholds to help one get out. I had to have help, and then Margreet had to have help as well.
At least, many foreign baths have a handle to help – even though this handle is usually badly placed for comfort and success. This one had no handle at all.
But if one stood upright to have a shower, a handle was supplied – when it was not necessary.
I chose to have a bath and call for help when wanted.
Then I noticed that our bath towels were fairly long. So I asked Margreet to thread my bath towel through the shower handle.
With it doubled up I was able to reach it, to pull myself up, and then get out of the bath. Margreet was then able to do the same.
Do foreign plumbers ever have baths – or even think about how people can get out of them?
We had a day to ourselves for wandering and shopping, eating bitterballen at famous Hoppe and watching skaters in the Leidseplein, where, although the weather was warm, stalls were selling those Dutch batter delicacies of winter - oliebollen and proffertjes.
In the evening we watched the BBC programme concerning a purported portrait of Jane Austen. I had taken part in it to tell of the Gallerie de Seine and its owner, Anna de Goguel. But for the completed film they were not interested in her or the gallery, so my efforts were in vain. We found the programme to be extremely boring. There was no story and no conclusion.
Then it was time to return to England, firstly in a train to Brussels that was so crowded that even to get to the WC would have been impossible, and then to the Eurostar check-in at Brussels Midi Station.
At Security, we not only had to queue for a long time, but on passing through the metal detector several times – as I had forgotten to divest myself of various small items, I was asked to take off the belt holding up my trousers. So there I was, with several other men, trying to master plastic boxes of our metal bits and pieces with our trousers falling down.
Then came the rush, the cut and thrust, then the obvious delay as the security precautions had taken so much time. This could have been avoided had we all been allowed to pass through the checking procedures earlier.
Be that as it may, we were on our way home – with trousers secured.