Saturday, 5 December 2009

To your very good health (service).

As someone who has relied on the National Health Service (NHS) all my life, I was annoyed by the outrageous attacks on it by American political groups, as part of their agenda to discredit President Obama’s own proposed health care reforms. The NHS is far from perfect. But it has always been there for me. Likewise, it is there to pick up the pieces for those whose private medical care goes drastically wrong or else when their private insurance runs out.

Luckily I have always enjoyed relatively good health. I remember having chicken pox as a child and being rewarded with a jigsaw puzzle and a bunch of grapes for not scratching frantically at my itching body. I also remember being told I would need to go into hospital to have my tonsils taken out and bribed with the prospect of unlimited ice-cream and jelly after the operation. More disquietingly, I discovered that when I was a baby, my mother deliberately placed me in a cot with another child suffering from measles so I would catch it too. That might explain why I am now partially deaf.

It was always a source of puzzlement to me that the schools I attended never seemed to test for hearing, only for sight. At the age of 12 I decided to take matters into my own hands.
“I am deaf, “ I told the school nurse at my annual medical
“You can’t be,” she insisted, adding with baffling adult logic, “If you were, we would have known all about it by now.”
Nevertheless, there must have been something persuasive about my tone because she sent me for tests. I had to sit at a table, wearing a set of headphones with a ruler in my hand. Each time I heard a sound from either headphone, generated at different frequencies, I had to strike the desk with the ruler. I was then sent to see a specialist. “It’s congenital,” he determined.
It has rarely been a problem for me other than that, (as I explained in “Head in the cloud (berries),”  I cannot pinpoint the direction of sound.

I was diagnosed with high blood pressure as a young adult but was reluctant to embark upon a life-long course of treatment. The crunch came when I had a medical at my gym in Chelsea. I was shocked when the personal trainer gave me my blood pressure reading. It was so incredibly high I assumed the old familiar Imperial measurements had somehow been superceded. The trainer later told me that he assumed I was high on drugs. He also admitted that had I been male, he would have rushed me to hospital with a suspected heart attack. His attitude explains why young women are more likely to die of heart disease than men. If you see a man suddenly keel over and clutch his chest in pain, most people assume he is having a heart attack. The same thought does not automatically occur if it is a woman, especially a young woman. The trainer insisted I saw my own doctor.

“Could my high blood pressure have anything to do with the fact that the gym instructor is an extremely good looking man?“ I enquired tentatively of my doctor. He was certainly a fine figure of a man and I used to fantasise about engaging in a set of demanding gymnastics with him not usually offered at most reputable health clubs.
“No,” she replied firmly and listened to my heart through her stethoscope. Then IT happened. I used to get a very odd sensation in my chest from time to time. It was not something I could ever describe adequately and so had never mentioned it. Now it had happened whilst my doctor was examining me.

My doctor decided I needed to attend the heart clinic at St Thomas’s hospital.
“When you go there you will have a battery of preliminary tests. You will also make an appointment to see a consultant at a later date, once all the test results are through,” she explained.
At St Thomas, I had blood pressure readings taken from each arm whilst I was both lying down and standing up. I also had a blood sample taken. The man in front of me fainted when it was his turn! I had freely donated blood in the past so it was not the kind of procedure to alarm me, although I do have a problem giving blood because of the size of my veins.

Blood bank teams came regularly to my former office to encourage staff to donate. I was partly motivated by the desire to earn the same bronze badge, proudly worn by a friend, after she had donated blood on 25 separate occasions. As I had not had breakfast that morning I was sent away and told to ensure I did not give blood on an empty stomach in future, though they still let me have a cup of hot tea and a small packet of custard creams in the recovery room. On the next occasion, they found a vein and I lay on the bed, clenching and unclenching my fist to get the blood pumping into the bag. “This is how they execute people in America,“ I suddenly thought, as images of lethal injections flooded unbidden into my mind.
A doctor came across to me and examined the bag. I had only managed to donate a small amount. He thought it might me due to the sizes of my veins which were, he claimed, significantly smaller than average. That explained why my arm often ends up feeling like a pin cushion whenever nurses or doctors try to insert a needle. I decided to make one last attempt to donate. It proved successful and eventually I won my own bronze badge.

After I stepped off the treadmill at St Thomas’s and had the sticky electrodes removed by the nurse, the printout from the electrocardiogram was examined.
“You’ll need to see a consultant straightaway,” the medic announced solemnly.
It is not often that I wish I had someone with me but sitting unexpectedly outside the consultant’s door was one such occasion.

The consultant proved to be a very friendly man.
“Hop up onto the bed, lie down and raise your skirts so I can examine you,” he said after the formalities were over.
Now I might not have a medical background but even I knew that my heart was not located below my waist. However it seems high blood pressure can adversely affect the kidneys and that was what he needed to check. To my relief they were fine.
The consultant told me I would now need to undertake a range of further tests. I waited whilst he dictated a letter into a microphone apprising my own doctor of the situation. He referred to me “the charming young lady.” I didn’t really think that comment would ever appear on the final version of the letter but a number of years later, having accessed my medical notes, I found it had.

The mobile EGG unit I had to wear for 24 hours gave me no problems, being no larger than a Sony Walkman. The blood pressure device proved far more problematic. I had been told that the device would not start until I had reached home. After that it would go off every half an hour until late in the evening when it would monitor my blood pressure on the hour.
“You must stop whatever you’re doing and sit or lie down when it starts, “ I was warned. Unfortunately it started when I was crossing a busy main road on my way home. I dashed to the other side and sat down on a low brick wall. When I got back into work, the device went haywire. Just as doctors had often struggled to take blood samples off me, so they usually had to try a number of times before they could get a blood pressure reading either The machine was primed to take repeated readings if its initial attempt failed.
“My arm has turned purple,” I wailed to my colleagues, as the alarm would sound yet again and the cuff relentlessly tightened its grip around my reluctant limb.
I was due to have a job interview the following day, still wearing the device. Mercifully I was able to postpone it as I felt my chances of success would be somewhat hampered if the alarm to my monitor sounded during the interview itself.

My own consultant not being available one day I saw another.
“I am not an expert,” she declared to my surprise and bewilderment as to why she was seeing me if that were indeed the case, “but looking through these test results you appear to be fine. Nevertheless, I suggest you make a further appointment to discuss them with your own consultant as planned.”
I followed her advice only to learn that my own consultant had won a place at another hospital. I saw a fellow colleague of his instead.
“You have an enlarged heart and your condition is deteriorating.” he said briskly. Scarcely had I digested this news when he added, “You should come to expect it at YOUR age!
At the time I was in my early 30s.
“You can either continue to have treatment here or through your own GP”, he went on.
I opted for my own GP, whose bedside manner was far superior to his.

My doctor proved to have her own ideas as to how to supplement the drug regime devised by the hospital.
“I have been reading about the beneficial effects of alcohol on some forms of heart disease. I think you need to drink 14 units of alcohol a week but have one day alcohol free,” she said back in her surgery.
I could scarcely believe what I was hearing. A doctor advising a patient to consume alcohol on medical grounds! The catch was I didn’t actually like the taste of alcohol and so rarely drank it. I insisted my doctor wrote down her proposal on her prescription pad. Without such evidence, people might assume it was all the wistful thinking of someone who had indulged in rather too much drink than was good for their health.