chrishansenhome

As some of you may be aware, I have had diabetic foot problems for years. After the last operation, around a year ago, my recovery was going well until the Diabetic Foot Clinic put a "Scotch" cast, also called a "clamshell" cast, on my right foot after the operation wound had healed. Unfortunately, this second cast rubbed another ulcer into my foot. I had therefore had to have a second operation to debride that ulcer. That was originally scheduled for August, but due to a shortage of beds that date was cancelled. It was rescheduled for September, but that date, too, was cancelled.

Finally it was re-re-scheduled for Friday, October 9th. I was told by letter to be ready to come in early that morning, after waiting for a green light from the admissions desk the evening before. At 7:30pm on Thursday night, I hadn't packed or eaten dinner, and HWMBO was away at a table tennis match. The phone rang, and I was steeled for a third cancellation. But no, it was the admissions desk. A lovely voice told me, "We have a bed foryou. Can you come in this evening?" This evening??? I thought it was supposed to be Friday morning. "I'm not packed, and I haven't eaten dinner." I replied, and the admissions nurse assured me that it didn't matter. I could eat and pack, and turn up whenever. The hospital wanted to put me on a machine that could test my blood sugar and administer either insulin or glucose, depending on the levels. This would be done that evening. So, I hurriedly ate, packed, and called a cab. I called HWMBO twice to tell him what happened, but as he was in a match his phone was off and I couldn't get through. I left messages.

When I got to the ward at about 10pm, I was admitted, shown to bed 10, and when they took a blood sugar reading I was told that I needn't be on that machine. This was the first of several infelicities.

The second one was inserting the cannula. A nurse tried twice to put one in my right arm before I went to sleep, and failed both times. A doctor came Friday morning and got it first time. Cannulae are very painful during insertion, so by this time I'd had three sets of painful punctures. More to come, sadly.

The hospital beds and pillows are made of some durable plastic/rubber material, that always makes me sweat at night as they radiate heat back at you. So I sweated my way through the night, with no food or water except a sip to take my pills the next morning, until I was wheeled down to the operating room at 11am. I woke up at around 1pm, and waited an hour before a nurse from the ward could be spared to get me back to the ward, which is at the other end of the hospital.

I was not allowed to put any weight on my right foot, so when I needed to use the toilet I had to ring for a nurse, who would bring a commode, not to use, but to wheel me to the toilet. This continued until the next Tuesday. There is nothing worse than having to inform the nurse when you needed to get to the toilet. At night I had urine bottles, but I had to stand to use them and that was a bit dodgy for my foot.

A chaplain turned up on Saturday and gave me Communion, which was much appreciated. A bit later in the week my friend Mother Sheila, who is retired from parish work but helps out in the hospital, came by, so I was not completely abandoned.

During the weekend two older guys who seemed to know each other had very loud conversations on the ward. There were 5 beds in my room, separated by translucent curtains, so whatever was said in one cubicle was audible in all. The older guys had quite a long conversation on Viagra, which I really didn't want to hear about. Their opinion was that it wasn't very good at stiffening, but it helped to delay the eventual orgasm. Thanks, guys.

Another older gentleman (I say older, but he was only 69) who had diabetes, was virtually blind, and had had some sort of operation on his tummy that ended in a stoma) was in the corner, and he was quite ill, especially during the night. It became very difficult to sleep.

So Monday dawned. The weekday routine is that a nurse comes around at around 6am to do observations. This includes blood pressure, temperature, and blood gases. If you are asleep, they wake you up to take them. They might drop by at 3am to take your blood sugar. This is majorly annoying, but they were trying to forestall low blood sugar episodes, a few of which happened to me during the night. More on that later. They also dispense pills. I brought all my own pills, as the one time I let them dole them out they had confused my pills with my neighbour's, whose name was very similar to mine (Hansen/Hassan). I've not let them feed me pills since. And, every time they came in to do observations they would ask me how much pain I was in, on a scale of 1 to 10. Sometimes I said 0, and sometimes -10. They'd then ask if I needed paracetamol (US=Tylenol) and I'd refuse it. It was a 5 times daily ritual.

At 7 or so they came and attached a drip to my cannula to deliver intravenous metronidazole, and then administered coamoxiclav (Augmentin) by a bolus (basically, a big syringe) into the cannula. After Saturday the dressing on the cannula became wet, and it had to be removed and another one inserted (after two tries). They allow them to stay in for a maximum of three days, so I had two more during the rest of the week. The metronidazole was discontinued on Tuesday as there was no evidence from the material they took out of my foot that I had bugs that responded to it. But the intravenous coamoxiclav continued until my last day.

At around 2pm Monday afternoon the diabetic podiatrist showed up, took off the bandages, and showed the result to the surgeon, who admired his own handiwork. I was told that I'd get a special boot that would take pressure off the front of my foot, but it didn't turn up until Wednesday, before which HWMBO had brought one from home for me. Once I had the boot I could hobble to the toilet unassisted.

Oh, have I mentioned the food? It has not improved markedly since I was there last. As my blood sugar continued to be low, I ate things I would not normally eat, such as Macaroni Cheese and Omelette with Cheesy Potatoes. These were relatively good. I had Roast Beef with Roast Potatoes the first night, and it was grim. One of the "waiters" had the habit of announcing himself in a very high falsetto voice, "Tea or Coffee" he'd squeak. We also got lots of biscuits and cakes as teatime treats. I would not normally eat these, but I was worried about low blood sugar so I took them when offered and either ate them then or saved them for the next hypo.

I had a hard time understanding why, taking my prescribed doses of insulin and eating things loaded with carbs, my blood sugar was still going low at awkward times. Once the metronidazole was discontinued, my blood sugar slowly returned to normal, mostly. So I believe that the antibiotics, either singly or together, were causing my hypos. But in the meantime there is nothing like waking up shaky and seeing 4.1, or 3.8 on the blood monitor.

The week continued in this vein (no pun intended), and the weekend came. Weekends in that institution are very quiet, as no specialists are around, so a generalist puts his or her head around the curtain and asks how you are. They usually don't know anything specific about your care and thus one learns to say, "Fine!" and leave it at that.

On Monday the surgeon came around again, looked at the wound, and said that it was healing nicely and that after a cast was fitted I could go home. I couldn't use the stairs (our flat is on the ground floor, and there is a toilet on the ground floor, so I could avoid stairs for a while) and I wasn't to move more than 10 paces in any direction. They promised to come back and cast the foot so I could go home on Monday evening, but no one came by.

On Tuesday the ward podiatrist was so busy that, finally, at around 4pm, I was wheeled down to the clinic and one of the podiatrists down there cast my foot. HWMBO was there in my cubicle, and as one of the podiatrists is Chinese and always asks after him, I called him and told him to come down to the clinic to meet her.

The physiotherapist had shown up on Tuesday morning and was annoyed that I didn't have my cast yet. She said, "You should stay in until tomorrow so I can fit you with crutches." I told her not on her life would I do that. She was most annoyed but I wasn't going to wait around. Some physiotherapists from the local GP practice will see me in a few weeks, by which time I should be well on the way to healing.

Finally, on Tuesday morning a pharmacist came around and confirmed that I would be taking oral coamoxiclav, and she'd be bringing it up before I was released. When she finally came around, I was shocked to find that they had given me one box of every medication I take, including nitroglycerin spray. I already have two of those, so told the pharmacist to take that one back. Apparently they send you home with two weeks' worth of your medications in case you can't get out to get a new prescription. I'd just gotten one, so my cupboard is chock full of medication.

Anyway, they wheeled me down to the transit area and we called a cab. By this time my left hip was feeling quite painful, and when we got home I could hardly hobble into the door. I spent the night in agony, and most of Wednesday too. It's subsided now, thank goodness, but friends who are massage therapists have told me that after prolonged bedrest the hip muscles shrink a little (as they aren't used much) and that might be what caused the pain. By Thursday the pain subsided, and now I'm relatively pain free.

I go to the Diabetic Foot Clinic next Wednesday so the surgeon can remove the cast and see how well the healing process is. I can hardly wait.

I can't remember how long ago it was that I posted a non-link or non-joke post here. Suffice it to say it was at least a couple of months ago.

Feet: As you may remember, I had an operation in November to remove the top of my left fifth metatarsal and the bottom of my little toe bone. Because of neuropathy, these two bones had moved so that their tips pointed out the left side of my foot rather than forward, as they should. This created a situation where any ulcer in that spot would not heal and the bones were exposed, causing an infection. This operation was a success, and after 3 weeks I was allowed home. I had a PICC line inserted (my third) and this remains in my arm as of today. I have entertained the District Nurse each day for three months to administer ertapenem through the PICC line.

Meanwhile, my CRP declined from a high level to 3.4 (as of two weeks ago). Anything under 5 is considered normal. Thus, I agitated for discontinuation of the IV antibiotics. I am now on oral antibiotics and will (all things being equal) have the PICC line removed next Monday.

The podiatrist I saw last Monday finally explained to me why I always get blisters on my big toes and the balls of my feet. Apparently, my foot bones have essentially been frozen by arthritis. Thus, instead of giving when I walk, they slide against the insole of my shoe and produce blisters, which, if they are opened can get infected and cause amputations. So the orthotist is going to make me a (third!) pair of orthopedic shoes which will minimise the sliding inside and use the sole to assist my walking. I won't see those until May.

Travel: I haven't done any in three years, and I need to go to Boston to see my brother and sister. Currently I'm scheduled to travel in April, and will be buying the tickets shortly. When I know the dates I'll post again. They will be around the third Tuesday of April.

Masonry: I am coming to the end of my two-year stint as Worshipful Master of Goliath Lodge here in London. We have initiated six men, passed two, and raised three. This is quite a good number for a London lodge, where there are thousands of lodges and a lot of choice. I have personally memorised the initiation, passing, and 1/2 the raising ceremonies, and am about to memorise the Installation ceremony for my successor. It's been a very fruitful two years, and I've learned a lot. By the way, there is no Masonic world government, no Illuminati, no goats involved, and no terrible secrets. Masonry is a group of good men who learn ritual, contribute to charity, and dine together. We don't have the time or the inclination to seek world domination. We are also not a religion, and I have discovered nothing in Freemasonry that is opposed to any religion of which I am aware (Perhaps Jedi Masters might have a bit of a problem with it).

I am continuing my progression through Mark Masonry (I am now Senior Deacon of Tower Hamlets Lodge of MMM), Royal Ark Mariners (likewise), the Operatives, and the Order of the Secret Monitor. I continually get invited to join other side orders, but I have to demur as the amount of money involved, as well as the time and the travel, militate against joining any other orders.

Home: Not much going on here. HWMBO returned to Singapore for nearly three weeks to visit his family. His mum has Parkinson's, and is not in great shape. It's good that he spent time there with her.

The Diocese of Southwark has appointed two new Area Bishops, one of whom is our Archdeacon. I am glad that we haven't lost Michael to another Diocese, but sad that we will have to have a new Archdeacon. The consecration of these two new bishops will be on March 21st.

I continue to read all your blogs daily, and contribute when I can. Will try to post more regularly.

It struck me that I haven't updated on my foot situation very much lately, so here it is, along with picture (non gory but graphic).

The last two Mondays I've gone into the Foot Clinic so that the orthopods can take a look at it and tell me how lucky I am that they didn't amputate my little toe. However, two Mondays ago the podiatrist in charge of the orthopedic patients didn't realise that I was one, so she took me off the list. Thus, I waited for 4 hours to be seen by the podiatrist, and another 2 hours to get my IV antibiotic. I was livid.

Monday of this week I was on the list, was seen by the orthopods, they pronounced healing going well, but I was still there for 5 hours waiting for the IV.

This has made me very annoyed, but luckily I don't have to go back for another 3 weeks. At that point, the gold wire coming out of my little toe will be removed and my foot will be put into a cast. Oh joy.

I gathered enough courage to look at the wound yesterday. It wasn't quite as gory as I thought it would be. There is a little fluid discharge, but the wound itself is clean and dry, and filling in nicely. It's very red, which means that the blood is getting to the surface to make more cells.

I have had to cancel my US trip in December, as the quacks say that I won't be fit to travel. Crumbs, I say.

Now here, behind a cut, is the picture of my toes. Note the gold wire coming out of the top of my little toe. It's there to stiffen it since there is no bony connection between my toe and my foot.

( Picture behind a cut for the sake of the squeamish )

I'm reminded that I haven't given y'all an update on the foot situation for a while.

The ulcer on my right foot is scar tissue only, and they hack away at it every few weeks. The scar tissue is permanent, they say. Oh, well, at least I have my right foot.

The ulcer on my left big toe has healed; there is still some rough skin on it but that will slough away in time, if the podiatrists don't hack it off next week.

The ulcer on the left side of my left foot has gone down to the bone. You may remember that the one on the right side of my right foot did too, but it healed before my name came up on the waiting list. This one seems to be infected (although not too seriously), so they have given me amoxicillin, flucloxacillin, ciprofloxacin, and metronidazole. These four antibiotics seriously kill nearly every bacterium known to man, and probably a lot more besides. They affect my digestion, but I will draw a veil over that. Flucloxacillin has to be taken on an empty stomach 4x daily, so you cannot eat one hour before or after taking it. Ciprofloxacin is interfered with by calcium and iron preparation, so you can't have milk or Tums-like medications two hours before or after taking it, 2x day. Metronidazole is taken 3x daily, and you cannot drink alcohol while you are taking it. Amoxicillin is pretty easy: 3x daily and no dietary restrictions. I am down to a daily routine that manages to observe all these restrictions. I'm amazed.

Two Mondays ago I went to the clinic and got looked at by an orthopedic surgeon. They quacked over my X-rays. The podiatrist told me they were exciting: I guess that her life is a bit dull. The bone behind my little toe has twisted so that the end of it is protruding from the left side of the foot preventing the ulcer from healing. What they propose to do is shave off the end of that bone, wire the joint up temporarily, and stitch up the ulcer. I am unsure, but they may also put my left leg in a cast. I will be left with that well-known medical condition, floppy toe. I told them that I can hardly move it anyway, so it doesn't really matter.

Yesterday I got the note from the hospital: I'm to go in for pre-assessment this coming Thursday (it conflicts with a Foot Clinic appointment so I will have to call them on Monday to see what to do), and then make myself ready for admission on Monday November 1st, and surgery on Tuesday November 2. I am assuming it will be under general anesthesia. I need to put down a list of questions to ask the surgeon beforehand. I think that I will be released either November 3rd or 4th.

So, next week, wish me luck! If all goes well, I think my feet will be in OK shape within a month or so, assuming that I don't go around walking miles and miles and rubbing the skin to create another ulcer... :-(

Part of this I can't talk about, as it upsets me too much. It doesn't have anything to do with my health, but it left me a gibbering wreck for most of the afternoon. It is not bad, and it will not leave me with anything but nightmares. Enough of that. I would talk about it but it would squick you all out and if HWMBO ever found out (no, it has nothing to do with any other human being) he would be squicked even more than me. So, enough of that. Sorry to be so opaque. Maybe I can talk about it in the future.

Second: my new monitor. I bought a new Samsung monitor, 24" (but who's a size queen—not me!) as mine was a bit smaller and HWMBO's even smaller and older still. So the plan was to install the Samsung monitor on my desk, my Dell monitor on his computer, and then his current Dell monitor upstairs, moving the Sun Sparcstation 5 up there.

The Samsung B2430 is a good monitor: very sharp, good controls, just barely fits on my desktop, but that's OK—I counted on that. What pisses me off is the truly abysmal setup for the driver and the software. It is, unfortunately, not plug-and-play. I suspect that most monitors aren't. However, what I do expect is that when I put the CD in the drive, and select the model number, the setup works fine. This didn't.

My default browser is Chrome. Unfortunately, the setup for the monitor driver installation is integrated with your browser—as long as your default browser is IE. If it is something else, the installation program trundles silently along, then falls off a cliff after around 3 minutes and tells you that, sorry old chap, you need IE to install this driver automatically. Otherwise, run it from the CD.

So I went to the CD and ran the installation. The first thing it did was uninstall a driver that it had previously installed. OMGWTF??? It told me it hadn't installed the driver! Well, perhaps it only installed part of the driver. Then when I tried to reinstall the driver it told me (after much faffing around) that it couldn't find the driver on the CD. Lather. Rinse. Repeat twice.

As a software tester I do not take NO for an answer. So I changed my default browser to IE and installed it automatically. Of course (you guessed it!) IE first uninstalled the driver and then reinstalled it, this time successfully. The monitor now works and I have a lot more desktop real estate as well as a very good resolution and wonderful video. But I was reduced to swearing maniacally at Samsung, the driver, the installer, and life in general. My grandfather used to get like that when something he was doing around the house didn't work. I take after him.

The only installer that beats Samsung for idiocy is the HP software installer. I presume that the programmer who wrote HP's installer moved over to Samsung to infuriate a new generation of computer users. London Stabbie would like to talk to him. Sternly. He might not survive the encounter.

Third, I did not have to have a visit from the District Nurse today, for the first time since I left the hospital. I have been having recurring bouts of tinnitus in my right ear, but couldn't figure out what was causing it. When I looked at the information folder that comes with the teicoplanin (the antibiotic I was taking each day) I discovered that tinnitus is a recognised side-effect. Oh, crap. So when I went to the foot clinic yesterday, I told the doctor that I thought I ought to be switched off the teicoplanin because of tinnitus. He conferred with the Professor, who said, "You'll have to have a blood test to see whether you are still infected and one for renal function."

Oh, crap and crap. When Ian (the cute Pinoy nurse) came to draw blood out of my PICC line, we got 1-1/2 vials out. Then, nothing! The PICC line was clogged. I am now a veteran of this, so I waited while Ian got a 5ml syringe (this one has the highest pressure) and pushed some saline into the line. It then unclogged, but what a pain in the arse. Luckily the clot was not very big or else I'd have had a coronary right there—I now know why they have a resuscitation kit there.

The Professor said I'd have to wait for the results of the blood test. So I waited. Had my lunch (they supplied the insulin), and then waited some more. I was there, in total, from 10:30am to 4:30pm. Ian then came out and asked if I was allergic to penicillin. For the umpteenth time, I said that I wasn't; they should have known that, as I was taking amoxicillin and flucloxicillin for months last year. But, this is a new year, and new possibilities for allergic reactions, I suppose. I don't want Stabbie to get after Ian; he's too cute for that (but straight). But someone needs to pay. I shall think and get back to you. They now gave me a prescription for…amoxicillin and flucloxicillin. Just what I'd had before. I was so upset and annoyed by this time that I just went home.

I got the "welcome" news that I probably have two to four weeks to wait before they debride the bone out of the wound on the side of my foot. Oh joy. That particular ulcer will not start to heal until the bone is out of the way. One of the wound specialists said that I should have the Foot Clinic do it as I have no feeling in my feet. Well, I'd rather they took precautions with local anesthetics than discover, belatedly, that I actually do have a bit of feeling on that side.

I know that lots of other people have had crap weeks, some of whom are on my lj friends list. My woes are mine alone, and I do not compare them with anyone else's woes. I hope that all our woes are taken care of, soon. Stabbie's onto mine as we speak!

I actually don't want to dwell on the low points. Suffice it to say that I will be returning to the retinal clinic at St. Thomas's Hospital in 6 months rather than a year. They are not concerned enough to do laser surgery, but as I have just begun insulin therapy for my diabetes, that fact can have an adverse effect on retinal health and they did see several new pinpoint hemorrhages. The ophthalmologist, very helpful guy that he was, also remarked, "Oh, you have the beginnings of a cataract there in your right eye. We don't have to worry about it now, but in ten or twenty years we can deal with it. Diabetics often begin growing cataracts earlier." Thanks a whole bunch. Even adding, "Your eyesight is excellent." doesn't make up for any of that.

The good part is that I was dilated (by a very pleasant student nurse) relatively early as I arrived at around 1:15 pm for a 1:50 pm appointment. Thus, I was one of the first of the afternoon cattle-call to get asked in for examination. Normally, if you arrive close to your appointment time you end up waiting forever because the illuminati arrived early and got dilated first.

The foot clinic on Wednesday was interesting. They told me to report to X-ray when I arrived for a foot x-ray to ensure that I did not have osteomyelitis (bone infection). With the amount of antibiotic they've been pumping into me, and the fact that my foot bones don't feel infected (I now know very well what a bone infection in my feet feels like…), I was dubious that any infection would be found, but I dutifully showed up at X-ray at 10 am and told their reception who I was. "No, there's no appointment for you today." "Oh," said I, "I guess I'll toddle down the hall to the foot clinic and give 'em hell. She told me to wait a moment, checked her computer ("Computer says 'Nooooooo…'") and said, "They've made you an appointment for next week. We can take you now; have a seat."

So I got my x-ray (the young male eye-candy in the waiting area comes from the fact that lots of young men have bone injuries that require x-rays), then walked down to the Diabetic Foot Clinic. They unwrapped my foot and I gave them a bit of heck not for the x-ray mixup but for the fact that their fax to the District Nurses had specified one type of dressing (that the District Nurses had difficulty getting) and forbade substitutions unless they checked back with the Clinic. I established on Monday that they had checked back and approved a substitution, but this all happened on Friday and the nurse who visited hadn't said it was approved. She just allowed me to refuse to have my foot re-dressed. Luckily, there was no lasting damage and it's been sorted out, but I do wish that when they use form faxes they cross out parts that do not apply to the particular patient.

The podiatrist then wrapped up my foot well in padding, but unfortunately, not well enough. I was in agony all evening Wednesday until Thursday morning when the District Nurses arrived—a team of two, one of whom is a Souf Lunnoner of a certain age and really witty and very able. She wrapped it up correctly and I could actually stand and walk without pain again. I wish that whatever she has could be bottled and administered to the podiatrists at the Foot Clinic. As most of their patients don't feel anything in their feet, they are rather cavalier about pain and I believe tend to discount it when a patient actually does feel something in their feet.

Then came time for my antibiotic. They administered four boli: saline, antibiotic, saline, and hepsal (which stands in the line and prevents clots). Last time the second saline was not administered. I asked them why so much and they said they just were told to do it that way. They gave me so much fluid that I joked that I had at least an extra pint in me after I left. They are supposed to replace the port (the end of the line into which the syringes go) once weekly but the replacement port they found screwed onto the line but the cover couldn't be removed. I told them to put the old one back (after a very good wipedown with alcohol wipes) and speak to the IV nurse about getting the right supplies.

Today the District Nurse team came again and helpfully had forgotten to bring alcohol wipes for the line. I went into the kitchen and brought out a handful of Lens Wipes that I bought in the US a while back and which I use to clean my computer screen. They are exactly the same as the ones the nurses use so we were again in business. I hope they'll bring more tomorrow as I wouldn't like them to run through my entire supply of screen cleaners. They did bring an empty archive box into which they've put all my dressing material. I'll have enough of this stuff to open a pharmacy when I'm through, I think. It has tidied up the living room a bit.

HWMBO went to work late as he had an offsite meeting. So when he came back he was a bit tired, so we went out to Nando's for dinner. I dealt with some correspondence afterward, and now to bed.

As it tends to do, Time marches on, even when one is incarcerated in the hospital. On the health front, my foot seems to be improving, according to the Professor. It was re-dressed again today (with my help, as the wound specialist was at the European Wound Conference in Geneva, Switzerland, and enjoying herself with junkets onto the lake and the like) and the vacuum pump put back on. I was also taken down to X-Ray for a PICC line to be installed, just as during my last stay as a guest of the NHS. The external part of the line is slightly different than the last one, but it works as well, and thhe cannula has been removed. However, it looks like the Professor won't let me out this week or, seemingly, next. I am going quietly crazy.

The ambience of the ward, however, has been spoiled by our newest inmate. I'll call him H. H is from Surrey (judging by his accent), and he has spent much of the last year in hospitals. He had a spinal operation last year that went wrong (a surgeon mistakenly perforated his colon). This resulted in infections and finally in a large wound and a colostomy. He is in litigation with the NHS, but more importantly, he is a singularly demanding person.

There are limited food choices on the menu here, and most of us confine ourselves to what is on offer. Breakfast is cereal, porridge, or toast, with coffee, tea, or hot chocolate. There is sugar available for those who can use it. Most of us here are diabetics (H is not diabetic) so eschew the sugar and jam for our toast.

H wanted toast, 2 glasses of milk, and porridge (=US oatmeal). He wanted sugar and salt, as (he repeatedly said) no self-respecting Scot would eat oatmeal without salt. The breakfast trolley does not carry salt. He went spare. Then the breakfast server said that he could not have 2 glasses of milk as it would not leave enough milk for the rest of the patients' cereal. Complaining about this kept him occupied until lunch. I was livid, as I don't particularly like hearing that kind of groundless complaint.

At lunch I got sugared Jello, not sugar-free. Rather than complain, I gave H my Jello as well as a packet of salt (hopefully he'll save it for use tomorrow morning).

This afternoon, one of the nurses, a nice older Caribbean woman who has always treated me very well, was asked to change H's dressings. Now H is very particular about how his dressings should be done, but the nurse was doing it the way she was taught. For 45 minutes he argued with her about the dressings, getting louder and louder. I found this quite upsetting. Now he does have the right to get the dressings done as he wishes them to be done, but he didn't make that clear beforehand. So he is now trying to complain to the NHS about the nurse (who doesn't seem to mind) and about his treatment generally. I am not looking forward to tomorrow.

Now if Mr. McDonald were still around, perhaps he could return and strangle H like he tried to strangle P, my previous neighbour. No jury would convict him.

Jesus wept.

I am going into Kings for a day today for intense antibiotics. Then out tomorrow for my installation. Probably in again on Thursday for an extended stay. Good thoughts and prayers (if you do 'em) would be much appreciated.

I have scheduled visits to my GP's practice each day for my injection. I am feeling slightly better (but not out of the woods yet) and feel that the injections and the pill are helping.

So this morning I get a call from the GP's surgery where the receptionist said, brightly, "Sorry, Nurse E is ill today and we've cancelled your appointment." "But, but, I need this antibiotic desperately. I need it every day!" "We'll call you back."

I decided to call the District Nurse (=US Visiting Nurse) and throw myself on her mercy. About 15 minutes later, she called me back and said that they would slot me in.

Now I am very grateful to them. But my life is suddenly flashing before me, and it's not good. Depression looms like a black cloud over my life, and has done for almost a year now.

Had I known this was going to happen, I would have just let my toenail fall off naturally last year rather than go in for all these consequences to be set into motion.

I discovered that the ulcer on my right foot was not doing very well a few days ago, so I started myself on metronidazole (the infamous Flagyl) and went to the foot clinic today.

The good news first: the cast on my left foot was removed and the podiatrist pronounced herself pleased with the results. However, I would need to have another one put on today and removed in two weeks. We shall see how this transpires.

The bad news is that there is a serious infection in my right foot. The podiatrist listened to the blood circulation in that foot and decided to send me up to the vascular clinic for them to take a closer look. I went upstairs and a very cute specialist (radiographer? radiologist? I'm not sure what he is…) told me to take off my jeans. He asked me to lie on a table while he slathered my tummy and my left leg in K-Y jelly and started up his ultrasound machine. He also took the blood pressure in my ankle and my arm. He began by telling me that since the arteries in my legs start in the abdomen, he'd begin there. He wanted to assure himself that I didn't have an aneurysm. ANEURISM?! I cried? He assured me it was just as a safety precaution. Once he'd finished looking at the arteries in my abdomen (and found no aneurisms), he ran his machine down my thigh and saw a bit of calcification but no blockage. However, when he got down to my ankle he found a significant spot where the blood flow was constricted. By this time I was sitting up and watching his monitor and found it fascinating, in a grim kind of way. He then let me towel off the K-Y, put my jeans back on, and make my way back down to the Foot Clinic. The podiatrist said that I should come for the vascular leg clinic in a week and a half. They would assess whether I needed angioplasty or not. It's day surgery and no stent will be placed, unlike my heart angioplasty. That is, if they decide I ought to have it. Meanwhile, I need a shot in the bot every day for the next two weeks and oral metronidazole. I went home quite discouraged.

But my discouragement was not to end then. I had put in a prescription refill request for Insulatard (long-lasting insulin) a week ago at my GPs. They had forgotten to include it in the previous refill. When I got home, the prescription was not in my mailbox. So I called the GP, and they scrabbled around for a bit until they found it. "Good!" I said, "I'll be right down."

I came down and got the prescription. Now, recall that I got refills of everything around a month ago. I looked at the prescription and discovered, to my horror, that they had filled nearly the entire set of my medications. By this time I was so unsettled that I said, "Well, having extras of everyting won't be TOO bad…" and went to the pharmacy. They filled the prescription, suggested I should contact the practice manager at my GP's, and I toddled home with two shopping bags full of medication.

Well.

When I got home I discovered, to even more horror, that they had filled everything but had given me a prescription of 5mg of amlodipine, rather than 10mg (I was upped to 10 mg a while back and that has been fine); had prescribed gliclazide, which I haven't taken since November when I was hospitalised, and had given me two boxes of Insulatard, rather than three.

Now if I were a little old 98 year old man, I might not have noticed that the amlodipine was 1/2 its usual strength, and only taken one a day. The stroke that would follow would have been quite preventable. I might have decided that they wanted me to start taking the gliclazide again, which might screw up my blood sugar.

I need to think about whether I should write the practice manager and point out the last three prescriptions that were not written correctly. I believe it's the staff, not the doctors, who are negligent. But it's making me seriously think of changing GP practices. When I get older and more senile (if I do get much older, that is…) mistakes like this might kill me faster than my ailments are kiling me already.

Now I have to chase up the district nurse, who is meant to be giving me my injection tomorrow and Sunday. Another worry.