wendy house

My physiotherapist pointed out that moving my elbow to complete some of the physio excersizes was actually “cheating”.

No cheating allowed.

I’ve since noticed that I’ve developed a whole range of little movement cheats to compensate for a slightly rigid wrist. For example, notice how the upper line of the thumb and back of the hand (from the wrist) hasn’t moved in these two photographs – yet the tilt of the glass has changed.  I can mimic gintly tilting a stemmed wine glass by moving it with my little pinkie.

Can you see the offending digit in action?

tut tut!

what did you do to your arm?

broke it

How did you do that?

fell off a bike and landed on the curb

Does it hurt?

Yes

I think she was trying to make conversation. I totally failed to help out. Her assumption that blamed me - ‘how did you do that?‘, rather than unplaced blame ‘how did that happen?’ , for the break coupled with no obvious empathy made it was easy to forget to be generous to this stranger

The UK provides “Statutory Sick Pay” SSP to provide people who are temporarily unemployed (up to 28 weeks per annum) due to ill health with an income – becuase employers are not required to pay them while they are ill. Small and medium sized businesses cannot afford to give thier employees the benefit of normal pay during illness.

The standard weekly rate for SSP is £85.85 a week. Try living on that!  My weekly living costs, even without work related travel are substantially more than £85.85 per week.

My sick note is for 4 weeks off work from the date of the operation, 5 weeks after the accident. If I took that time I would have to live-off my savings. I started working again before my savings were touched.

I can’t afford to be sick

12noon 7th September

18 days after surgery Jess walked me through my exercise regime – to be repeated once an hour for 15 minutes. That’s intense, almost no room to do anything else!

1. Lie forearm on a table. Keep the elbow still and roll forearm left then right as far as it will go.
2. Move thumb across the palm then away from the palm – as far as it will go.
3. Move each finger back as far as it will go and hold for 20 seconds.
4. Curl all fingers  into a grip position – squeeze a foam ball
5. Move hand from wrist – backwards and forwards, side to side, as far as it will go.

Massage the skin around he scar with a good moisturizer to encourage healing and blood flow.

It feels like a ritual, casting a spell…

Repeat 3 times:

me: Hello, my name is Wendy House. On Wednesday 29th August during my appointment at the fracture clinic the Dr told me that I would have my first physiotherapy session next week, which is this week. The receptionist told me that I would recive a letter with the appointment time – I haven’t recived a letter and I’d like to check what time my appointment is.

I’ll forward you to the [name] department.

Reach the Physiotherapy department and eventually get a good result:

They shouldn’t tell you to phone us.

me: They didn’t. They said I’d get a letter, and I haven’t so I decided to phone you.

They shouldn’t have said that – we don’t send out letters.

You’re not on my system. Hang on while I look at these files.

Oh! you’re right on the top with a note to phone you and make a direct appointment – broken arm. It will take some time to enter all this data but I can make the appointment now. Will 11.40 on Thursday suit you?

me: Yes. Do I go to the same place as before? The fracture clinic on Floor 2.

No!  Go to physiotherapy.

me: So I’ll walk in the main entrance and ask reception to point me to physiotherapy?

No! They could send you anywhere. Are you driving?

me: (giggles) No, I’m on foot

Go to accident and emergency, stand at the entrance facing the main car park and we’re on you’re left

me: Thankyou

4pm 28th August: 6 inch scar revealed

10 days since the operation, with my arm in a cast, I returned to the Fracture Clinic for my first follow-up appointment. The statuesque painted blonde nurse admires the neatness of my scar and stitches as she removes the cast. The petite naturelle orthopeadic physiotherapist also compliments the neat scar that’s healing well.

Is that all you can move it?

It hurts quite a lot….

The physiotherapist demonstrated a regime of daily exercises.  Our schedule involves weekly physio check-up sessions and an overall progress check in mid October. After explaining this she just stood up and left the room.

I sat there in silence for a while, It was a wierd segue. Was this the end of the session? Was she coming back? Was someone-else coming in? Should I leave now? The statuesque painted blonde nurse wandered in and gave me a ‘sick note’ for my employer – so they can claim my Statutary Sick Pay.

Do I leave now? Will the appointment times be sent to me?

Go to reception, they’ll sort the appointments

The young receptionist was flustered. She couldn’t work out how to book my Physio appointments. I was the 3rd patient this afternoon that had asked them to arrange this type of appointment….

The patient behind me in the line laughed:

I used to work at this hospital, there’s a 2 week waiting list for a physio appointment, you wont get one next week!

The young receptionist looked bewildered, earnestly asking me:

Do YOU work at the hospital?

No. I’m just a patient. The blonde nurse sent me here when I asked if the appointments would be sent to me.

Oh, if you don’t mind waiting I’ll go and ask them

Thankyou, I don’t mind waiting at all

She smiled, her wonderfully humble and respectful way added a little joy to this otherwise dour place.

6pm (ish)  18th August *

I can’t be sure of the time when I came round. I wasn’t screaming. A nurse noticed me gain consciousness, she was prepared with my request for a pain killer

This is the equivalent of drinking a bottle of Vodka, but it doesn’t taste as nice

A porter wheeled me back to the ward where I greeted my fellow patients and happily climbed back into bed 26. As I started to snuggledown ready for a drug-enhanced dreamy sleep

Stout Agency Nurse walked over with a big smile:

You can go home now

Instant tears. She pulled the curtain around my bed as I spouted all the reasons that I felt that I couldnt go home now:

• I wasn’t stable -  I could hardly stand up!
• I would have to use public transport which the patient guide recommended that I should not do (no lift arranged until tomorrow)

• there is noone at home to look after me for the critical 24hrs after the surgery.

She told me that I had misunderstood. Naughty me misunderstanding while I’m drugged-up. She wasn’t sending me home right now. I asked her to leave me alone, which thankfully she did.

Then I climbed out of bed, opened the curtains to my neighbouring patients who were all real sweeties gently teasing me about this and that.

3.30pm 18th August

The stout nurse bought over 2 of those ‘operation gowns’ – knee-length, short-sleave baggy jackets with small ties. She asked me to wear one with the ties at the back and one over the top with the ties at the front.

Where are your ID tags?

I ‘ve never been given any

You must have ID tags

She wandered off and returned with 2 plastic strips showing my name and date of birth, attached one around my good wrist and the other on my ankle. Strange dresses and plastic wristbands?  Just like going to a festival!

We’re walking to the operation Theatre? Should I wear my sandals?

Stout nurse grabbed my arm and used this, unnecessary, technique to steer me down the corridor towards the Ward’s reception desk. At the reception desk she confirmed the name and route to the operating Theatre. I didn’t take notes. As we walked the hospital corridors where other people were fully dressed stout nurse explained that she was an agency nurse so she didn’t know her way around this hospital.

We got lost.

Stout agency nurse asked directions and we found the right set of swipe-card operated doubledoors. The nurse told me that she had meant to borrow a swipecard from the ward reception, but forgot.

I started crying.

Are you in pain?

A flood of words burst through my tears about how disconcerting it was when you have to walk in a silly dress amongst fully clothed people, how scarey it is to have surgery, and how getting lost then being locked out of the operating theatre just adds to a general level of distress.

You’re not in pain?

Normal pain for a broken and dislocated tibia

She didn’t understand. I put some effort into quelling the tears, wiping my face on the sleeve of the operating theatre gown. A lady’s face appeared in the round window of the secure doors. She wore green and a little hat. Her body-posture inspired confidence.

The anesthetists assisstant greeted us. She looked me in the eye as she told me her name, her role and started explaining what was going to happen. I gave the agency nurse my sandals as I climbed onto the operating table. I told her about the times before that I’d had a general anasthetic and how I was scared of waking-up screaming in pain like my last operation. The last thing I remember before waking up was her reassurance that I wouldn’t wake-up screaming in pain….

 8am 18th August: on the Trauma ward

Healing with the NHS feels like one long ‘wait’ punctuated by the occassional specialist randomnly dropping gems of information.

I woke on the Trauma ward as a young chap with glasses and a neat short-back and sides arrived.  Ed, Mr. Powell-Smith, with his side-kick scribbling in a note-pad by bed 26. My bed. Ed explained that he was the Royal Berkshire’s expert hand and wrist surgeon,  I was scheduled for a 4pm operation but that might be delayed if someone with more urgent surgical needs arrived during the day.

The day passed way too quickly for a girl who’s terrified of surgery. It passed interestingly enough, too quickly.

The kindly lady in bed 24 was recovering from an appendix removal last night.  She wanted to use the commode (wheel chair with a toilet in it) rather that the bedpan (Cardboard bucket shoved under your bum in the bed). It’s a dignity and comfort preference.  More comfortable and dignified to sit up. For the staff its more awkward to find the commode; wheel it to the patients bed; help the patient out of bed onto the commode; wait; help the patient back into bed afterwards then empty the commode. The stout ward nurse argued with the lady in Bed 24. The nurse didn’t want to let the lady use the commode. The lady started crying, the nurse bought the commode.  Afterwards I listened to the lady in bed 24 tell me about her illness and her family. She wasn’t tearful when she was listened to. She was witty and bright.

The lady in bed 25 was a retired costume designer for Hammer films. She told me how Marlon Brandon used to phone her at home and what a naughty boy he was.  Nicolas Cage was an arrogant idiot with an unnecessarily oversized entourage! We all became lost in her wonderful stories about film stars dead and young.

The stout nurse came round. She didn’t believe that I’d seen the surgeon because there was no mention of it in my hospital notes. Can you see a theme emerging here? She started arguing with me. Again, it felt like I was being blamed, accused of lying, when hospital notes are incomplete. I stood my ground without tearing-up:

I don’t know why it isn’t in your hospital notes, but he did come round and he did talk to me. I can describe him, he’s short and young with a neat haircut and glasses. I’m on the operating schedule for 4pm.  I made a note of it in my book, would you like to check my note book?

The stout nurse looked grumpy, she didn’t want to see me notebook, she harumphed off. To the lady in bed number 27.  When the stout nurse left the lady in bed number 27 – the lady was crying. I bought the lady in bed 27 some hankies and fresh water for her jug. Not terribly helpful but it showed we all noticed and cared.

I shivered as I wondered whether the stout nurse’s talent, for making patients cry, gave her pleasure

9pm 17th August: check-in

Friday night on a Trauma ward was set against a background chorus of quiet crying, distressed mumbling and snoring. A blanket of private sadnesses reverberating through the ward.

The lady at Ward reception wasn’t expecting a patient to checkin. She went off to find someone who might know about me. A 2 inch thick folder of patient notes lay on the reception table facing me. I read my name on the cover. Mainly empty forms, no X-Rays, no notes, a couple of interesting letters from my GP. The lady returned.

Bed 26, follow me

The silver haired patient in bed 24, opposite, smiled and nodded in a silent welcoming way.

2pm 16th August: Hospital check-in arranged

After nearly 5hrs witing at the RBH fracture clinic a young lady wearing a white jacket and stethoscope tells me what’s going on. Hooray!

There’s a hand and wrist specialist surgeon on duty covering Accident & Emergency over the weekend. Since the operation will be tricky they want a specialist to do it so they’re going to book me a bed in the Trauma ward for the weekend and the specialist will operate on me inbetween the accidents coming-in.

So, hospital checkin on the 17th August after 7pm.

Meanwhile, I provide Pre-op information to a nurse in another building. The nurse gives me a large glossie brochure about coming into hospital.

Don’t you just want to climb onto that trolley?  So welcoming…

12.30pm 16th August

After the X-Rays I retrurned to my normal status of main corridor fire hazard. A nurse came out from the back rooms, moved a child off a chair and sat me down in that chair.

The consultant has seen your X-Ray’s, he thinks they are quite serious and you need an operation. He’s called our hand and wrist specialist who agrees. So please wait here.

As she leaves I start crying.  I’m not sure if it’s because:

• of the relief that RBH have actually considered my injury.
• a nurse has been nice to me – rather than treat me as an inconvenient object.
• reaffirmation that my injury is quite serious – I’m scared of surgery.
• I’m developing a bad habit – cry way too easily.

Luckily this time I’ve been accompanied by two large monogrammed white (mens) Hankeys that can handle the waterfall

12noon 16th August

nurse: you must go to X-Ray

wendy: have they seen the X-Rays from Worthing?

nurse: the consultant wants so see today’s X-Ray

wendy: ok

Waiting outside the X-Ray room I chat with a shy Welsh man on crutches. He’s holding a CD from Pontypridd.

Were you on Holiday in Wales?

No, visiting my daughter who lives there now

He explains that the Reading hospital system can’t view his CD copies of his X-Rays, so he’s having the X-Ray’s done again. I suspect the same is true for me, but my nurse was focussed on what can and should happen rather than what doesn’t work.

The CD contains an executible file for a small program that views the X-Rays and enables them to be exported into standard file formats. It was easy to view on my PC. I suspect RBH’s system prevents users from being able to run exectuibles from CDs – for security reasons.

11am 16th August

A nurse announces that the clinics for 2 specific doctors are running 90 minutes late and 2 hours late. I have no idea which Doctor I’m seeing, no paper appointment.

Another nurse moves the people with fractures out of the main corridor to allow hospital traffic to pass. She explains to us that standing in the corridor is a fire risk.

I’m the only person with a fractured arm, everyone ese has an injury to thier legs. Standing on crutches in the main hospital corridor.

I grin at the man who has a mini plaster cast on his toe. He looks suitably embarressed.

4pm 15th August: RBH are not expecting me.

I wandered to the Royal Berkshire Hospital (RBH) to

• find out where I needed to go.
• personally doublecheck tomorrows appointment time.
• hand-over my Worthing Hospital CD of notes and X-rays.

The Royal Berkshire Fracture Clinic weren’t expecting me.  They had no appointment booked and no record of a phonecall about me. They didn’t want my CD to check my notes in advance of the non-existent appointment. I felt betrayed by Worthing hospital not having clearly established the appointment with RBH.

The RBH Fracture clinic reception staff were not happy at my turning-up, unannounced. They tutted and huffed at the inconvenience. I quietly cried. They ignored my tears making it easier to let those tears flow.

They double-booked me into the a clinic on the morning of the 16th.

1pm 14th August

Worthing hosppital gave me a CD with my data on it. They told me this includes notes and X-Ray. I was to carry this information to the Royal Berkshire Hospital (RBH) in Reading town. Apparantly, human hand delivery is more secure and reliable than using a cloud based system or encrypted email….

I was impressed that the two hospitals use compatible healthcare software so they can share electronic data. This assumption was wrong. I thought I was being transferred.  This assumption was also wrong. I was told that the RBH fracture clinic was expecting me at 8am on the August 16th. Guess what? Sigh…

Time to catch a few busses and a few trains…

When you’ve got a broken arm everything takes longer and people are more able to offer help… an elderly gentleman helped me to carry my small bag onto a bus.

 8pm 14th August: Arriving in Reading

Home with my cuddly kitty, fresh bed linen, and tea on tap. A wonderful sense of relief.

A long journey in less than 2 days and more to come…

12noon 14th August

ward nurse: I can’t find your drug chart, you don’t seem to have a drug chart!

She looked flustered

wendy: I’ve made a note of what drugs I’ve been given and the times they were given to me, if that helps?

The nurse looked more relieved as I read my notes to her. The Worthing hospital team never found my drugs chart. From what I’ve seen of their documentation it omits many key details and is frequently inaccurate – for example the name of my GP is wrong and I repeatedly pointed this out. They normally replied by telling me it was actually accurate on some other document that I hadn’t seen. As if getting the information right on one document makes it ok to have it wrong on this one. This is frighteningly poor reasoning for people that are looking after my health.

When I was let out from Worthing the junior doctor (F2) said that I didn’t have a drugs chart because when I was admitted (reported to reception of the A&E) I’d said that I wasn’t

• normally taking any drugs
• allergic to any drugs

I was impressed by how this explanation actually implicitly blamed me for the fact that while in hospital, where they gave me drugs, no-one bothered to keep a written track record of what drugs I’d been given, in what doses, and at what times. Their blazé (not our fault) attitude to their behaviour that produced a major patient safety risk was quite Flabberghasting!

8am 14th August

A flock of Doctors swoop into the ward and bounce from bed to bed with the senior Doctor asking the more junior doctors for thier opinions and quizzing the patient.

By listening to thier garbling I managed to find out that:

• I need surgery.
• Worthing will not be able to operate on me before Thursday and most likely after that depending on what other emergencies arrive.
• Worthing want me to go to my local Hospital (Royal Berkshire) because it’s more convenient. I cried, I felt like I was merely being shifted off thier lists…to start again on another list…
• Doing the paper work to let me physically leave the hospital takes 5 hours.

midnight 13th/14th August

By midnight I’m tired, in pain, lonely, nowhere to go, no book to read and with the prospect of 10 more hours of this.

Barely holding back the tears of temporary, pure, sadness.

I’ll feel better after a good sleep. I’m a talented sleeper. I can sleep almost anywhere. I lay my jacket on the floor against the wall in a quieter part of A&E, then gently lay myself on top of it and started drifting into much needed sleep.

This action removed my invisibility-to-hospital-staff cloak. Staff started waking me up to ask me what was happening.

I don’t know….

mumbled between my tears

Within 10 minutes they’d moved me to a ward and a bed.

8pm 13th August

The unnamed Australian is about to go off shift.

He explains that I need an operation to ‘pin’ the arm. It’s a tricky operation and he wants a good night’s sleep before doing it. They’ll be keeping me in over night for “Obs”, but there are no beds available so I’ll have to stay in the A&E waiting room.

Broken arm. Dead cell-phone. I wonder what more the night holds.

The surgeon injected some drug into the fracture before pulling my arm to ‘reduce’ the misalignment of the broken pieces.

It hurt a lot.

I screamed a bit.

He gave me a lovely hug, just like a parent with a hurt child. That moment of thoughtful kindness was wonderful and helped keep my spirits from crashing dramatically across the next 4 hours. Instead they slowly spiralled downwards

6.30pm 13th August

Doctors are easiest to recognise because they mainly wear a stethoscope around their neck. None of the staff  introduced themselves – no name, no role. They’ve done away with these useful basics. They occassionally use my name to call me out of the increasingly amorphous queue in the waiting area.

Staff were all wearing different uniforms, I don’t know what the different colours and styles mean. Maybe I don’t need to know, maybe the uniforms are for the staff to know who they are, not for the patients. I saw:

• White tops with collars
• Light-blue tops with collars
• Royal blue tops with collars
• Green jump-suits
• Blue jump-suits
• Pink Jump-suits

Things changed slightly after my 6.30pm X-Rays. I became the “Smiths Fracture“. I could evesdrop on the staff talking amongst themselves about me- the fracture.

4.30pm 13th August

After two and a half hours waiting – Triage was disappointingly short. The nurse asked exactly the same questions as the paramedic. Both people wrote copious notes on everything I said. This felt reassuring, more scribblers!

2 hours after triage a young female in one of the many hospital uniforms asked me to tell her what had happened. She also took notes and aked familiar questions.

I started crying.

Are you in pain?

Just normal broken arm pain, I’m crying because I’m upset and don’t know what’s happening.

Do you want some pain killers?

No, I just had some at 4.30pm, thanks, I’d like to know what’s happening (blub)

Everyones’ notes were on paper, on different clip boards. The notes never seemed to get collated, read, or used. I was beginning to get the impression that different specialists weren’t sharing inormation terribly well.

2.00pm 13th August

Do people have to wait hours for ambulances?  I felt a little bit guilty about an ambulance being called because I didn’t need any ambulance-fancy equipment or go-faster Sirens.

I persuaded the young paramedic to take me to Worthing A&E, less that 5 minutes drive away, even without sirens. Standing-room only in the waiting room, good job the curb hadn’t attacked my legs!

Facebook confirmed that my relatives are not shy about liking that I have broken my arm despite the clear social convention to avoid liking such things. The Brit’s normally start thier comments with an empathetic variation on “Ouch!” and the USA people go straight in with the positive get well wishes.

It was so good to feel the waves of empathy and positivism…

1.30pm 13th August

That’s a very neat catheter

Morphine didn’t kill the pain, Morphine meant I no longer cared about the pain.

The paramedic talked about his early career as we waited for the ambulace. He looked all of 25 years old. His early career had been in London. The people weren’t polite, he’d started to ‘burn out’ and get ‘cynical’. Here, on the south coast, people are polite and friendly. As if on cue, an old man from a nearby house offered us tea and biscuits.

1.00pm 13th August

Riding along, following my instructor, I drove too fast into a bend and ended up punching the curb. Not a good move.

A conscientious paramedic was on the scene within 10 minutes followed by 2 police cars because this was a Road Traffic Accident (RTA).

The police apologised for breathalising me. I was being way too sensible to be drunk. Not even a hint of last night’s glass of wine was hanging around.

Instructor: you should call your partner, get ‘em to pick you up from the hospital

wendy: I’m on holiday alone, I don’t have a partner and my family all live on the west coast, so there’s no-one nearby to call. I’ll be able to find a bus to get me out of hospital