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2007 - May 4th - Friday

JH surfaced about 7.30am: as soon as she got up, she noticed blood running down her right forearm from the cannula site; obviously, JH had caught the port of the cannula on her posh gown, or the bedclothes; JH waved her bloody arm at a nurse who mopped up the blood, removed the cannula and applied a plaster!  At about 7.45am, a nurse came round with the breakfast trolley and offered JH some cereal, and bread, spread, and jam/marmalade, and tea of course; he apologised for not having brown bread available [and had no fruit juice].  After breakfast JH got up and dressed; also, after breakfast, JH had no trouble with her gastrocolic reflex that morning; at the moment when JH was standing, dressed, by her bed (but not washed as she had no washing things) an SHO arrived and observed that JH looked like somebody who was ready to go home.  However, JH was informed that – that very morning – Dr Thuraisingham, the Nephrologist, was scheduled to do a Round, so JH stayed put, as requested.



The two ladies sharing the Bay were, apparently, in the final stages of kidney failure – judging from their conversation – about starting on dialysis - and also from the conversation overheard on the Round: IT IS REALLY IMPOSSIBLE TO BE COMPLETELY PRIVATE IN A HOSPITAL WARD BUT JH DID NOT FIND THIS TO BE OF CONCERN TO HER, NEITHER DID SHE FEEL EMBARRASSED ABOUT THE FOURTH OCCUPANT OF THE BAY BEING MALE; the young man gave JH a friendly smile when she remarked that he was surrounded by chattering women. 
 
JH was then visited by the ‘peripatetic’ Pharmacist who asked JH what drugs she was taking, to which, of course, the answer was ‘none’ – so JH explained why she had been admitted just overnight; however, the Pharmacist did get out JH’s prescription sheet and asked if JH was on any medication ‘routinely’; JH explained that she used Ortho Gynest HRT cream once a week at home; the Pharmacist finally found this product listed in her Pharmacopoeia after JH had added information about her distressing ‘symptoms’ experienced due to the run-down of her hormones: but the other patients were much too busy with their own affairs to be listening, no doubt?

When JH’s blood pressure was being checked, the Nurse noticed that JH’s left upper arm had some scratches on it and, subsequently, JH noticed some bruises, in particular, one on the outer aspect of her right thigh (which took at least 3 weeks to disappear): JH hesitates to ‘lay the blame’ for these injuries – presumably acquired when JH was lowered to the floor - at anyone’s door!  The SHO from Bombay, Dr Shail, arrived just as a nurse was doing JH’s observations: he regaled the Nurse with the fact that JH had failed to respond to his encouragement to visit Bombay; JH asked him how long he had been in England, and was told 5 years; therefore, JH wondered how he knew that England was ‘going downhill’ over the last 20 years, and JH also wondered if she was supposed to support his point of view, or disagree with him and tell him that, in actual fact, Little Old England was a Super Place; it became apparent, when said SHO stated that he had passed a casual remark, that – yet again – JH had not understood male humour! 

At some point, a nurse (or  Doctor) appeared with some swabs and took ‘smears’ from JH’s ear, throat (ugh!) and groin, in order to screen her for MRSA; also someone appeared with a marker to write JH’s name on her Bed Board – so that she was identifiable by Dr Thuraisingham.  A lady SHO – with the entourage – introduced JH as being a potential donor of a kidney to a cousin; Dr T interjected ‘. . . distant cousin.’; the lady SHO explained that JH had had her renal angiogram and then ‘seen stars’!  Dr T endorsed what JH had already been told – that JH should have bloods done, and an ECG; Dr T listened carefully to JH’s reiteration of her tale about having been heard to have ectopic beats by her GP, but Dr T endorsed Ray’s reassurance that ‘. . . everyone has the odd ectopic beat!’.  At some point JH had some blood taken, just to measure one specific cardiac enzyme which would - at least 12 hours after her collapse - indicate if she had had a cardiac ‘episode’. JH subsequently learnt, from Jinny Jeffery – who is the Biochemist and with whom JH plays music – that the substance being measured for is actually known as a ‘CARDIAC MARKER’ called troponin T or troponin I.

When the Nurse came to do JH’s ECG she was concerned that one ECG lead was not recording properly; furthermore, she could not used the Ward’s new ECG machine because she had not had her In-Service Training Session therewith!  Because JH was an inpatient, she had to be taken to the ECG Department in the Basement (which she had visit on 3rd May) by a porter, and in a wheelchair!  The porter was a most friendly and chatty gentleman from Bow – just down the road; we talked about anything and everything – so JH asked him what his hobbies were to which her reply ‘drinking’; however, he did qualify this remark by telling JH that, should he turn up for work at the RLH after having had only one drink, he would face dismissal, as consumption of alcohol before ones shift – or during ones shift – was considered a serious disciplinary offence.

JH’s formal ECG was done by a Lady Technician from the Philippines; she asked JH what drugs she was on to which the answer was ‘none’; she looked puzzled and continued to question JH about her past medical history; at some point in the conversation JH mentioned that she had had a renal angiogram; it then became apparent to JH that the Technician had thought that JH had collapsed during a cardiac angiogram!  JH subsequently looked at the request form (which she had custody of in a plastic pocket) and noted that the request said, ‘Angiogram, Collapse, abnormal V1, V2’ – the request did not state that JH had had a renal angiogram; JH was a bit concerned about the ‘abnormal V1, V2’ (tracings from those leads) and wondered if this was because of the faulty lead on the Ward’s old ECG machine.  Anyway, JH was collected by the friendly Porter, and she carried back her ‘banner’ of ECG tracings to the Ward.
 
Dr Thuraisingham had said to JH – in front of his entourage – that JH could go home, as planned, on the train to Plymouth, but Lady SHO told JH that she should wait for the results of the test for the cardiac enzyme; JH asked L-SHO what would happen if the tests were positive, and the L-SHO explained that a request would be made for JH to be seen by a Cardiologist; JH asked if this consultation would be today, in a few days, or next week – as the next two days were the weekend days; JH was delighted to learn that she would be seen by a cardiologist that evening, and she already knew that, if she needed to stay at the RLH, her bed would be kept for her.  By this time it was getting on for lunchtime and JH asked one of the Nurses if JH could stay to have some lunch. 

About 12md, Estella’s daughter arrived with a large packet of fish and chips and a thermos of tea!  This buxom wench offered Jean some of the fish and chips, and offered JH a cup of tea – which JH declined just at that moment; Estella and her daughter started to study the diet sheet, that had been given to Estella, and discuss it at length – which conversation JH found most entertaining.  JH was invited, by the Ward Orderly, to go to the kitchen to choose fish, mash, and peas for lunch, and jelly for sweet: again the meal was rather dry, and the potato was rehydrated ‘pom’, but JH also requested a fresh jug of water.

Another entertaining conversation was had between Jean and the lady from the ‘providers’ of the bedside electronic facilities – JH recollected a conversation between the residents of JHH to the effect that one of them had already spent £70, and, what is more, she was not allowed to bring in a portable TV for her ill relative; everyone was of the opinion that the fee charged for the use of this modern technology was exorbitant, consequently the providing firm were over a million pounds out of pocket but, having then put up their fees, were still going into the red – of course!  During the evening before, JH had offered to loan her earphones to the ill young man, who could not use his console to listen to the TV, because the Ward had run out of disposable earphones; JH’s offer was refused because of the risk of cross infection – although JH did explain that her earphones (which she had found, after they been left behind by a fellow passenger, on a train back from Kendall) did not actually fit into the ear but ‘hung’ on the earlobes.  JH also observed that the patients were obviously allowed to accept incoming calls – and probably make outgoing calls - on their mobiles, as she noted Estella often had one ‘glued’ to her ear.

After lunch, JH asked L-SHO if she could go to JHH to collect her belongings: JH ‘promised’ she would come back to learn the result of her cardiac enzyme test!  JH also expressed the opinion (to the Doctor) that JH’s collapse was due to her bowels being in uproar because she had NOT had the normal gastro-colic reflex ‘in operation’ due to missing breakfast!  JH called into the RLH’s Archive Department to visit their Museum; JH had visited the Museum, some 8 years ago,  with Ann, to see an Exhibition about Elizabeth Garrett Anderson.  JH found the ongoing exhibition of items to do with the history of the development of Medicine and Surgery, and the history of the founding of RLH, most interesting – and bought a book about the History of the Hospital. 

When JH arrived at JHH, she was met by one of the Wardens, Ruth.  Ruth and JH had a long, mutually informative, and friendly chat.  Ruth had previously worked as a Physiotherapist; she explained that, when JH’s sister had rung her up the previous afternoon, she had simply told Ann that JH had been admitted for observation, and that Ann was very relieved that JH was just where she should be.  JH explained that she, herself, had realised that - as her appointment letter for the angiogram had stated that, post-angiogram, JH should be taken home in a taxi, and stay with someone for 24 hours - that JH should not, really, have been referred to JHH to be accommodated; on Ruth questioning Ray about what JH was having done, Ray had replied ‘just a routine investigation’. 

Ruth asked JH if she could photocopy JH’s appointment Letter so that – should she have another patient, referred by the Hospital to occupy accommodation at JHH, and said patient was to undergo a procedure which required him/her to have ‘supervision’ afterwards, she would be able to say that JHH was not a Nursing Home, and refuse the referral; However, JH’s Letter had been lost to JH, after her untimely collapse {or perhaps it was timely as a forewarning}; JH said she had another copy at home and would bring it with her when she came back to stay at JHH prior to seeing the Independent Assessor; arrangements were made for JH to pick up a key to the Home (and a room) from the Security Office on Sunday 13th May, prior to her IA Consultation the following day.
  
JH went to her room to collect her belongs – and took the opportunity to wash her face and clean her teeth; whilst packing, Ruth fetched her to the phone, and JH was most relieved to learn – on speaking to a member of staff on the Ward - that all her tests were normal and that she was discharged!  JH made herself a cup of tea in JHH’s kitchen (as she realised that she would not catch the 4.05pm train) and then – without a rush – made her way to Paddington Station.  Arriving at 4.20pm at Paddington, JH sat and had a hot chocolate and a cookie – because she also realised that her Saver ticket would not be valid on the fast 5.03pm train.  Subsequently, JH rushed with the madding crowd to catch the 6.03pm train – but had to sit, sardine-like {cf public notice, shown many years ago on TV, showing sardines getting in and out of an underground train – to encourage travellers to miss the rush-hour}, on her wheelie seat in the vestibule corridor until she reached Taunton: it is a great mistake to catch the last reasonably-timed train back to Plymouth before a Bank Holiday Weekend!

On reaching her home at about 10.00pm, JH listened to a CM message from big sister who had had trouble, apparently, tracking down little sister; Ann had rung JHH but missed Ruth (who leaves at 4.00pm); she then phoned Devonshire Ward and it took the Staff – by then a different Shift was on duty - a few minutes to ascertain that JH had been discharged after her very brief inpatient stay.  In view of Ann’s anxiety, JH rang her at about 10.30pm, and then regaled Ann with the story of JH’s undignified subsidence to the floor but, after this, the conversation was curtailed as it was, by then, midnight in Germany.



 
 
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