Friday, 21 October 2016

Nephrology With John Cleese

I started my last entry with the intention of telling you all about my week as a whole, but then I got side-tracked by the Halifax and Huddersfield story. It turned into something much larger than I had expected when I looked at the notes. Yes, I do make notes before I put this shit together. It isn't just thrown up out of thin air. Well, sometimes it is, but not that often. The more perceptive among you can probably tell which entries I made notes for and which I made up on the spot. Go on have a look. Test your knowledge of Memoirs Of A Fire Hazard. Alright don't. Go and do something more interesting like watching Homes Under The Hammer or Decimate.

So again don't be surprised if this gets hijacked by one particular subject again. That's because this week was the week that I had to have my four-monthly visit to the nephrologist. This was a routine, matter-of-fact process for a long time, but recently it has again become the source of great anxiety, and therefore blogworthy again. Which is a shame for you but anyway...The reason it is again causing me stress and worry is that on the last two occasions I have visited the clinic I have been hauled back into A & E later that same day to have treatment to have my potassium levels lowered. I'm not entirely sure what potassium is or what it does and why having too much of it is a bad thing, I have just accepted it as something bad which goes along with having kidneys like paella. The only advice I have been given to make sure it stays low is to keep taking my sodium bicarbonate (salt, effectively) regularly and to stay away from bananas and too much milk. Apparently they are my kryptonite. If you ever want to bump me off just invite me round for dinner and serve me bananas and milk. I'll be dead in no time, leaving you with only the worry of where to hide my cold, dead body.

My appointment was at St.Helens hospital (red zone, they do love their colour coding there) at 2.00pm. We had left Liverpool where Emma and I both work at 1.00pm which should have given us plenty of time. However, Edge Lane Drive is down to one lane for reasons best known to itself, and it takes an hour and ten minutes to get to the hospital. So I apologise to the receptionist for being 10 minutes late for my appointment and she looks concerned at first, as if I might have to come back another day, but then relaxes when I explain that I am here for nephrology. Clearly they don't send anybody away who is in need of nephrology, lest their kidneys explode all over the red zone d├ęcor upon hearing such disappointing news. Personally I would have been doing a little dance had they sent me away. I wasn't in the mood for this shit.

Being late was advantageous. Ordinarily we are left waiting around for 20-30 minutes after the appointment time before I even get to the stage where they take my blood pressure and get me to pee in a bottle. The latter gives them an indication of my kidney function which, frankly, is the single and only piece of information I am interested in. My kidneys normally operate at about 30% of their capacity which sounds dramatic until you consider that they have been at that level since I was first diagnosed with kidney disease in 2007.

So yes, being late. Somehow this had bumped me up the batting order and I was taken for my tests almost immediately, and then sent back to wait only for a further five or 10 minutes before seeing the consultant. This could be the key to getting the NHS to run more efficiently. All this time we have wasted by turning up on time for appointments when things could have been done much more quickly just by getting everyone to be 10 minutes late. Why didn't Jeremy Cu.....Hunt think of that? My blood pressure is high again by the way, but you know the birds sing, the sun shines and Stephen's blood pressure is high. It's a moribund fact of life which worries only the hysterical and the odd medical professional. And maybe Emma and my mum although the jury remains out on whether they fall into the former category. Personally, I couldn't give a fuck. I'm on tablets for that as well, by the way. The high blood pressure, I mean, not the not giving a fuck. I hardly need medication for that as there are plenty of other things in this world that I do stress about.

Not least among which are these little thrice-yearly chats with the consultant. As he calls me in Emma remarks that he looks a lot like John Cleese. This is true, despite the fact that he is Asian. He is tall and wiry thin, with a small ratty moustache and a long, slap-headed dome where his noggin should be. Like if John Cleese had played a part in Coneheads or the Tefal adverts. Unlike Cleese the specialist, who never introduces himself by name but instead only offers a handshake and a thank you for coming, is utterly humourless. Not only that, but he's every bit as irritating as I expect him to be. He insists on going through the whole back story of my kidney disease, recounting every infection, illness or increased heart rate I have ever experienced as a result of it and blah blah blah. And so at that point I bite.



I've promised myself, in an attempt not to get too stressed about this whole charade, that I will just keep quiet and not go into causing trouble in an empty house mode. But when it comes to it I can't help myself. I'm exasperated as to why we have to go through all of the events of the last nine years all over again. I just want him to tell me what my kidney function is and throw me back out on to the streets. Or at least to the blood testing department. But he doesn't. Instead he lectures me about the importance of reviewing and monitoring everything over and over and over and over with absolutely no regard for the fact that it places me under unnecessary stress. Why does nobody seem to understand that I don't really want to know too much about my condition unless we get to the point where I need something more than I am already experiencing in terms of treatment? Helpfully, he explains to me that kidney disease does not have any symptoms until it is too late, which if nothing else is a sack of bullshit because I experience plenty of symptoms (back pain, groin pain, recurring infections, terminal grumpiness) none of which mean that it is now too late. As I said, I have been this way for nine years. Perhaps longer in the case of the terminal grumpiness.

Eventually he sends me away (probably got sick of my bitching) and I head off for my blood test. The consultant has increased my dose of sodium bicarbonate which is basically salt. Apparently low sodium means high potassium which after all is what we are really trying to avoid in the absence of actual kidney failure. So I need more sodium. The problem is that you have to get it from the hospital pharmacy where apparently there is a 45-minute wait for collection of medicines. There are about 18 people due to go into have a blood test before me but that does not equate to 45 minutes worth. In the event it only takes 25 minutes and they just accept my claim that I have a pre-payment card even though I can't physically produce it. I have paid for it online, it just hasn't arrived at my house yet. I'm not even sure it is supposed to. I have an email confirming it and they may have some electronic method of verification which eliminates the need for them to ask me about it but I have another theory. Predictably. And it is this. A lot of the time pharmacies assume that because you have a wheelchair under your backside you don't pay for prescriptions. People who don't work don't pay for prescriptions, and people who have health issues like diabetes and so forth, so you can see where we are going with this. Of course I do work, but if the dunderheaded in society are going to assume that it is impossible for me to be employed then I am not going to insist on handing over £8+ every time I need some kind of medication or health-related product just because I can't produce my pre-payment card.

By 3.30pm I am home and that is when the real anxiety kicks in. I spend the next eight hours looking at the time on my phone, waiting for it to ring. I am fully expecting someone from the hospital to call to say that my potassium is too high and that I need to get down to A & E immediately lest my heart explode. If the call comes then it entails a long, long wait alongside people who have managed to get cans of lager wedged up their arseholes and the like before another blood test and an ECG. Numerous ECG's have shown up nothing in terms of a heart defect but that doesn't stop them checking it all the same. They're very thorough. Last time, the first blood test showed that the potassium level was too high which then led to my being led into a holding/treatment room where I was pumped with mysterious fluids which physically sting when they enter the body. It's not the most painful thing in the world, don't get me wrong. Nobody is donating bone marrow here, but it's uncomfortable and time-consuming enough to ruin a perfectly good Tuesday evening.



The anxiety grows as I try to watch a bit of television. I am sure that Ordinary Lies and the third episode of Westworld are much better than I remember them. In the first some bloke thinks his wife, the woman who did a really good jive on Strictly 73 years ago, is having an affair and so he takes the berserk step of installing CCTV in his house. He then finds out that what she is actually doing (maybe as well as the affair, they don't say) is hunting down paedophiles vigilante style after their own daughter was abused by some perv who was subsequently cleared of any wrongdoing. In addition, the man spies his son snogging on his sofa with a girl under the age of consent which causes all kinds of wtf-ery and screaming and carrying on. Meanwhile in Westworld, the bearded one from Boardwalk Empire has weird conversations with a female robot played by Evan Rachel Wood, while Ed Harris causes all kinds of mayhem on a horse and Anthony Hopkins keeps the spirit of Hannibal Lecter alive with his softly spoken sinister schtick. I think that's the basic plot, anyway. There might be a bit more to it. These shows are ok but hardly the groundbreaking telly that their host broadcasters would like us to believe they are, but then as I say I was looking at my phone the whole time and wondering what time I would get home from A & E if it came right at that moment. It's entirely possible that I missed the point completely.

Mercifully, as the credits roll on Westworld and I wonder what just happened here, the phone has not rang and is now not likely to. They never leave it this late to contact me about high potassium because of their own claim that my heart could literally break if it is not addressed quickly. They would have told me by now if there was a problem. All of which means I am up for work in the morning (Wednesday) and for the first time I can remember in quite some time I actually feel quite glad about it.



Oh, we didn't get to the rest of the week again, did we? Sorry about that. Maybe later....




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