Friday, 9 June 2017

Swigging On A Shit Smoothie As Your Arms Fall Off

It's been an eventful week.

This time last week I had got home from work and started to feel my heart beating a little too fast. It had actually started on the Tuesday but when it settled down throughout the day on Wednesday I thought it had passed. But by the time I'd got home and eaten it was quickening, my breath was shortening and I could feel a feint tingle in my arms. I woke up very early on Thursday morning, unable to sleep. The quickening was rapidly becoming a palpitation if not a pounding. I was going back to the hospital.

I'd been here before of course. In 2013 I spent two July nights in Whiston Hospital during which I had to endure a permanent catheter and spent several nervous hours awaiting the results of a kidney scan. At that point I hadn't had my kidney function measured since 2007. I didn't want to know, frankly. Buried my head in the sand. If my kidneys were going to fail they were going to do so as I fell from my chair in some dingy karaoke bar, not after years of life-altering dialysis. I still feel that way about it. The only difference is that now, having had that experience, I've learned that there are ways and means of keeping the worst at bay. But those ways and means involve engaging with a nephrologist three or four times a year and taking a boat load of drugs like a good boy. You do what you must.

So I had some idea what to expect with these symptoms when I arrived at A & E early on Thursday morning. The first thing they do is a blood test and an ECG. The first of many, countless blood tests as it turned out. The nurse couldn't find a vein. She jabbed me twice in my right arm and twice in my left, all after several minutes of tapping and general manipulation of my apparently bloodless limbs. No joy. She suggested that it might be because, this being early morning, I could be dehydrated. I hadn't thought to have a drink before I came out. I just wanted to get to the hospital, get on with the business in hand and get home.

The ECG had shown my heart rate at 108 bpm. This is above what is considered the normal range for anybody but for me it's outrageously high. Anyone who knows me well will testify that I am not exactly excitable. My heart rate would be unlikely to raise to that level unless I was being chased by a lion or I'd opened my wardrobe to find Jennifer Lawrence hiding in it. I haven't even got a wardrobe. Not one you can hide in and certainly not if you're an instantly recognisable Hollywood superstar.

With the nurse unable to locate my blood I was moved to a small treatment room within A & E. The doctor would have to try. Dr Bob. Bob wasn't his full name but that's what they called him. His full name was unpronouncable and for it to appear here would rely on my having seen it written somewhere online and the use of copy and paste. It seemed odd at the time to think that Dr Bob would have any greater blood testing skills than the nurse. Surely she does it more often while he's away looking at charts, making life-changing decisions and whispering? Doctors do an awful lot of whispering in my experience. It makes me nervous and adds to my dislike of them. Predictably, Dr Bob couldn't find a vein either. It must have taken him another half a dozen attempts during which he was not shy about moving the angle of the needle in my arm to try to persuade more blood to flow. The medical equivalent of twisting the knife. They do some heroic work medical professionals but it takes a certain type of someone to be able to wiggle a needle around in someone's vein so matter-of-factly.

Finally successful, he left me in that tratment room alone for fully 45 minutes except for the time it took to hobble back to the waiting area to phone my boss at work to let her know what was going on There was no mobile signal in the treatment room and while it's probably fair enough to assume that patients in need of urgent attention aren't going to prioritise updating their Facebook status it would have been nice to have been able to make a phone call from where I was. They offered me the use of their phone but that still would have involved a pathetic shuffle to another room. I was already feeling the effects of the multiple injections I'd been having in the search for my blood. It's hard to push a chair when your wrists and arms are bruising up.

I needed a cannula. The waiting - 45 minutes for Dr Bob to come back and check on me and easily another hour waiting for the result of the test - ended with the news that my potassium was at 7.4, over two points above what is considered safe. The short explanation for this is that mashed kidneys like mine can't get rid of potassium as a healthy kidney can. Something to do with a lowering of sodium bicarbonate, to give you what Jennifer Anniston used to call the science bit. So the cannula - in layman's terms a tube inserted into the body as a means of getting unpalatable but useful substances into the body - was specifically so that I could immediately be drip fed sodium bicarbonate, glucose and insulin.

I was familiar with those things from my 2013 visit. They're standard for dragging your potassium levels down from the stratosphere. Yet there were a couple of surprises in store. Firstly came the nebuliser, a breathing mask held to the nose and mouth which enables you to basically inhale mist with destructive properties. They use it to treat cystic fibrosis. I had a friend who had to use one every day at school. Probably still does. Not at school, obviously but you know what I mean. Yet here I am dramatising 15 minutes of it for your reading pleasure. I don't know I'm born. In truth it isn't particularly unpleasant. Just annoying and a bit disconcerting the first time you are asked to use it. It helped to relieve the shortness of breath almost immediately to be fair. Tsk...medical experts....Still, I wouldn't want to have to use it regularly. It's I would find as I was repeatedly presented with it by the nurses in the days that followed.

The second surprise was a notch up on the unpleasantness scale. The nurse distracted me with chit-chat about how she knew me from my job, before placing a small paper cup down on the trolley in front of me. She told me she'd need me to drink the contents, that it was something else that would help bring my potassium level down. I wasn't keen to begin with. I'm a tablets person more than a medicines person. Who isn't? I've never encountered any medicine that tasted like anything other than liquid animal waste, and this wasn't going to buck the trend by the looks of it. It was an orangey-brown shade, the colour of a cup of tea you made two weeks ago and forgot to either drink or pour down the sink. It tasted every bit as foul as it looked. That sour, putrid taste so common in medicines was accompanied by a vile chalkiness of the kind you might expect to encounter if you chewed on a handful of painkillers. It's called Calcium Resonium and I recommend that you avoid it at all costs. It's basically a Shit Smoothie.

It was going to take six whole hours to fully administer the amount of sodium bicarbonate I had been prescribed. I wasn't going home tonight. I was still in the A & E treatment room as a very distressed young girl in the room opposite was carted off to Aintree Hospital where, she was assured, they had what she needed in the ear, nose and throat department. That's another troubling facet of hospital stays. You come across people in all kinds of states of hysteria and most often you don't get to find out what happens to them when they or you are moved elsewhere. In 2013 there were a couple of similar cases and the even more disturbing memory of an almost completely yellow man being shouted at by nurses for complaining about the prospect of being sent back to the nursing home. He looked gravely ill, the colour of a Simpsons character. I never saw the girl opposite again.

Two and a half further hours passed sleepily on the sodium drip, the glucose and insulin having already run their course. I asked to be unhooked so that I could go to the toilet (which one young nurse mortifyingly took as a request to be physically taken to the toilet...who trains these fucking people?...oh..) and that's when things got complicated. When I came back I was informed that I was being moved to Ward 1B. It was 6.00pm, around 10 hours after I had reported to A & E. They would hook me back up to the sodium when I'd been transferred.

My new nurse on 1B asked me a series of boring, scarcely relevant questions before suffering from her own dose of the local nursing disease of being unable to treat me. I had two cannulas in by now and she couldn't get my sodium drip to resume via any of them. She just complained that the machine was beeping and giving her an error message as if I would have some wise advice on what to do about it. Then she left and returned several times, fiddling and twiddling around with it until she was satisfied that it was up and running. She left me alone for a couple of hours during which I answered a few messages I had received, called my mum and messed around on social media until hopefully I felt sleepy. Except in hospital I don't really get sleepy at night. It's too light, too much conversation going on outside the room in the corridor and in other rooms on the ward. All of which you can hear every word of. So what I was really doing was waiting for my exhausted, emotional state to knock me out. It never really did.

That is due in no small part to the fact that I had to spend most of the night still hooked up to the sodium drip. At around 9.00 the nurse came back in and told me that the sodium had not been feeding into me properly. At all. Not for the two and a half hours that I thought I'd been on it in A & E and not for the three hours since I'd arrived on 1B! I'd been prescribed six hours of this stuff remember. That meant that, toilet breaks aside (and I don't go in the night no matter how many young nurses offer to assist me, what kind of people do that?), I'd have to be hooked up till 3.00 the next morning! It was going to be a long, long night....And it was. If I managed two hours sleep I did well. It didn't help that a nurse came into my room at 11.40pm with another Shit Smoothie and some sodium tablets. They had other priorities. I can understand that. It's the NHS. But if I'm low priority then you can understand why they find it such a hard sell when they tell me that high potassium can stop my heart. Which is it? Is my condition dangerous or not? If it is then why isn't my treatment high priority?

Now the real floater in the pint here was that I had an important appointment on Saturday night. We'd bought tickets to see Robbie Williams at Manchester's Etihad Stadium. So I had to get out of there before then. I have previous for discharging myself from hospital without permission and would have done it again had it come to it. This is Robbie Williams we're talking about and anyway have you seen the price of a Manchester city centre hotel? It's not something you want to be cancelling, much less contemplating that cancellation over a Shit Smoothie and soggy toast on a Saturday night in June. But I didn't really want to have to discharge myself any more than I wanted to cancel the hotel and miss the gig. It would have only resulted in a worsening of my condition and a return visit. That was on the cards anyway as it turned out, but at least if I didn't force the issue I could say that it wasn't totally my doing.

At around 10.40am on Friday, following another round of all the treatments, a doctor came to see me. As they took yet more blood (I was starting to bruise in places you don't bruise by now) the doctor told me that if the latest test showed a big enough reduction in my potassium levels I'd be sent on my way home. If that sounded encouraging I was remembering that I'd had three blood tests in the previous 12 hours and not been advised of a single result. As positive as the doctor had sounded I couldn't help feeling that they were keeping something back from me which couldn't be good. Why withold good news? The more I thought about it the more I started to believe my potassium had sky-rocketed and that I'd be here for as long as Alan Partridge was in that hotel. Surrounded by blonde bastards.

Then the waiting resumed. The bed was at least more comfortable than an A & E treatment room but no less stressful for that. One of the few good things about being in hospital is that you get a bed that you can incline and recline remotely at the touch of a button. Hours of fun. makes it easier than lifting yourself up and back down again as required when your arms are falling off. I had my blood pressure checked around lunchtime and then again around 3.00pm. On that latter occasion the nurse told me that rather than start packing up to go home I should get ready to be taken for another ECG. The lunchtime test had shown my heart rate was up just above 100 bpm again. I was tacchycardic, she said. You hear this a lot on Holby, usually reserved for the most horrifically injured single appearance characters whose survival is far from assured. The kind that fall off buildings or get mown down by Masdas. Just as I was explaining this latest setback to Emma as she got back from the coffee shop the nurse came back in and said that my 3.00 reading was much lower. I was no longer tacchycardic and so there'd be no second ECG. No one-off appearance on Holby.

At around 3.40pm, five hours after they had taken the latest blood test the doctor confirmed my potassium had shrunk to 5.7. This is what they call the upper end of normal but the important thing, the only bit I really listened to actually, was that I was being released. I was going to Manchester. To The Etihad. To Robbie. On one condition. Since my potassium was still fairly high albeit in the safe range I was told I would have to come back on Sunday for yet another blood test. I'd have to come in, have the test and then wait around for an hour and a half to two hours in case the result meant more treatment. It seemed like there were better ways to spend a Sunday. What's more I had no veins left. Barely any limbs left. But I agreed immediately just to get out of there, with just the nagging feeling at the back of my mind that a few beers at the gig could land me a quick return to the ward.

But what are you going to do? It's Robbie.

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