Sometimes life gets in the way

Posted by CATH

We had a quiet Christmas, and went up to Loughborough to meet friends immediately afterwards. 

As soon as we had got back Alan started to say that he seemed to be seeing green flashes, and 'patterns' in his eyes, but couldn't even identify which eye. Since he had some problems with his eyes a few years ago he has had quite a lot of dark spots, known as 'floaters', in his eyes, and has had them re-checked. Last time he was told to put up with it unless they increase drastically. He was aware of a lot of these, but they hadn't really increased a lot over a short space of time.  However, within a day or so he was worried enough to contact our optician and arrange for an appointment the following day.

I went with him, because he knew that his pupils would be dilated, and wouldn't then be able to drive. He went in to see the optician fairly quickly, but fortunately I had taken my knitting with me because after two hours of waiting I had to move the car because our parking had run out. Back at the opticians he was finally coming out of the examination room. The optician had been unable to see anything wrong with his eyes, and had got his supervising opthalmic optician to check. However, they had done a 'field of vision' test, which showed considerable loss of vision on the left side of his right eye. They wanted to do the test again, and Alan opted to have it done the following day, as his eyes were now so tired he wasn't sure that any test would be valid.

The following day the test was done again - only an hour and a half wait that time. The optician said that definitely there was nothing wrong inside the eye - but the field of vision seemed somewhat worse than the previous day - and that the most likely cause was a pituitary tumour pressing on the optic nerve. He was referring Alan to our GP, who would send him for an MRI scan.

Not surprisingly, we were fairly devastated by this news. It also made sense because this is exactly what happened to a former colleague of mine, who discovered a brain tumour at a visit to the optician, and had to have surgery and many months off work. Other people I have known with brain tumours haven't been so lucky. We tried hard not to talk about it, but both of us had some very dark thoughts.

After a day or so of fretting Alan rang our surgery, who said that he had been referred to Stoke Mandeville for further tests. Ringing Stoke Mandeville eventually got a time for an appointment on Monday the 12th January.

We decided to go up to Flamingo for the weekend, to get on with the refurbishment, and to forget about the things that neither of us wanted to talk about.

SATURDAY 10th JANUARY

We drove up to Flamingo, and got the heating going. Around six o'clock I was sitting in the boat, while Alan went to get some things from the car. I heard a bit of a noise outside, not really sure what it was, but I went outside to find the marina in pitch darkness - the lights were not working - and Alan up to his neck in the near freezing water. 

The first thing to do was to get a lantern, because I couldn't even see where he was. Then we took several minutes to manage to drag him out onto the pontoon. In the boat we stripped him off as he was shivering badly, while a small cut on his finger dripped blood onto the floor. He had lost his glasses in the fall, plus the 25kg bag of coal that he had been bringing to the boat.

He had been right under, and was mucky and his feet were very muddy. We hadn't been on the boat long enough to heat the water so I boiled a kettle of water and we started to wash him down - at which point I discovered the gaping cut behind his left ear. This was far too big for me to try to treat, and he would probably need antibiotics, so he needed to go to A & E.

This wouldn't be simple, because we had Odin with us, and we were not prepared to leave him alone on the boat while we spent hours queueing at A & E. So eventually, after some deliberations, we decided that I would drive Alan to A & E, leave him there while I went back to the boat with Odin, and then, when Alan was finished there he could ring me and I'd pick him up. 

Unfortunately we'd left the Sat Nav at home but it didn't take too long to get to Northampton General Hospital, because we just drove towards Northampton, and then followed the big H signs. Getting back to the boat in the dark with no Sat Nav was much harder, and took at least twice as long as the journey there. 

I had just got back to the boat when my phone rang. It was Alan, he had been seen immediately, could I pick him up? So I set off again, found the hospital easily, and once again drove all over Northampton trying to get back to the marina.

He had the cut behind his ear steri-stripped, his left arm was in a sling because he had torn a ligament. His knee hurt and he had extensive bruising up the inside of his right leg, and he had a small dressing on his finger - which they had X-rayed, but fortunately was not broken.

So, not a lot of work got done on the boat for the rest of the weekend, although we did got to complain about the non-working lights. Alan couldn't lift much, and we eventually set off back for home ready for the difficult appointment on Monday.

MONDAY 13th JANUARY

Stoke Mandeville. I took my knitting again, which frankly was sensible given that we spent a great many hours there. Tests were done, redone and a retinal scan taken. What we heard was both a massive relief, and a new worry.

There was definitely a problem in the eye - retinal detachment. So, no brain tumour, but because of the delays, with the redoing of the test, and the referral through the GP, rather than straight to an eye hospital (plus bashing his head while falling in the cut) the retina needed dealing with very quickly. They tried to get him into the John Radcliffe eye hospital that afternoon, but couldn't get through. We waited. The reception staff went home. One of the doctors went home saying that his colleague was still trying to get him into John Radcliffe. Finally, as the evening wore on he got an appointment for JR the following day. I drove home feeling exhausted and wrung out, we got David to heat us some chips, then we went to bed to fall into a fitful sleep. 

TUESDAY 14th JANUARY

John Radcliffe. Oxford. A long wait at first, then the surgeon looked in Alan's eyes again. "They should have been able to see this." He explained that the tears were very close to the centre of the retina, and that he was hoping to save the macula before it detached. The macula is the centre of the retina, and is involved with detailed vision. If the retina is repaired before the macula detaches, then there is a very good prognosis for 'reading vision'. If the macula detaches, then the percentage chance of detailed vision falls to less than 20%. Mr Peh, the surgeon, explained exactly what he would be doing - which he explained as 'welding inside your eye with a laser'.

Did Alan want a local anaesthetic, or a general? Given that Alan was a very nervous patient when he had his cataract done, and was advised not to have a local for eye ops in future he said 'general', especially as the operation would take at least an hour and a half. Of course, this means that you need an anaesthetist, and so Alan was put on the emergency list to wait for one.

Alan was put to lie on his right side (fortunately, as his left shoulder is very painful), so that gravity would help to prevent any more damage to the retina. They told me I should go away until about 6 pm as there was nothing more I could do, so I caught a bus into Oxford for a few hours. I spent far too much time (and money) in the Oxford Yarn Store, where the kindly lady in the shop made me a cup of tea while I browsed. I then caught the bus back through the heavy Oxford traffic.

Alan had not been to surgery, and was now starving, since he had only had a light meal before 6 am. We thought it unlikely that anything would happen, because it was so late, but Alan was concerned because he knew that time was of the essence with retinal surgery. 

Then, suddenly, at 8 pm, doctors and porters arrived and he set off for surgery. I went home, and got a phone call from the ward at about 11:30 which Alan had insisted that they do because he knew that I would be fretting until I had heard that he was OK. "Ring at about 10 am," the nurse said.

WEDNESDAY 14th JANUARY

I spent a very frustrating time trying to get through to the hospital. I couldn't get hold of Alan on his phone, because, in all the stress of the weekend he had managed to leave it on the boat. The only person I was able to speak to who knew anything told me to ring back again later, and of course....

Mid morning the phone rang, which I assumed would be the JR. No, it was Northampton General. The radiologist had reviewed the X-rays from Saturday, and Alan has a fractured finger - I was told to get him to see our GP.

In the end I got fed up with not knowing what was going on at the JR, and because visiting hours started at 2:00 pm, I set off anyway.

In the morning Alan had woken up, and although he had a patch over his eye, it was clear to him that he couldn't see anything in the eye, everything was blurred. He didn't find out until he saw Mr Peh again in the middle of the day that this is to be expected. A 'gas bubble' is inserted into the eye to press the repaired retina against the back of the eye while it (hopefully) heals. This takes a number of weeks to disperse during which time vision is blurred. A pity that no-one warned him of this beforehand. This also means that it is not going to be possible to know how successful, or not, the operation has been for some weeks.

Of course, everyone turns up for visiting hours at the same time, and all the car parks had long queues, tempers were fraying and I was half expecting to see fisticuffs, so I drove off a mile or so away and rang the hospital. This time, miraculously, I got through, and got to speak to Alan, who had already managed to ring home and had found out that I was on my way. They were planning on discharging him that afternoon, he would ring me when it was time to collect him. So I knitted in the car until twilight, then drove to the hospital when I got the call. It would be nice to say that he arrived at the car immediately, but I had to wait some 40 minutes, becoming more worried, until he finally turned up at the car. He had his medications, but no instructions for aftercare, or the eyeshield he should have. In the end he had just decided that he would work out what to do when he got home.

THURSDAY 15th JANUARY

Fortunately Alan got a late morning appointment at the GP, who couldn't have been more helpful. We must have been in his surgery for close on an hour, while he rang JR for aftercare information (they said they would ring Alan, which they have just done at nearly 6:00 pm). He rang Northampton who will send a fracture clinic appointment. He took detailed notes, gave advice, and arranged for Alan's finger to be strapped up, and for him to be given a tetanus injection.

JOHN RADCLIFFE

A flagship hospital, the surgeon was very helpful and clear, the other doctors gave confidence, the nurses were friendly and helpful. But... no-one seems to know what is going on at any time. I couldn't get information, phones rang for ages, people said they would ring back and didn't. Alan was left in a wheelchair by a porter who went off saying he'd be back in a few minutes, but didn't ever return. Alan eventually had to get nearby receptionists to work out where he should be. Is this symptomatic of the breakdown of the NHS? On the other hand.... Alan passed through the A & E at Northampton in less than an hour on a Saturday night, including two X-rays.

WHAT NEXT?

Alan has an appointment at JR in about 10 days. We won't begin to know how successful or otherwise the operation has been until then.