The 13th was not my lucky day – my final heart operation

The 13th has always been my lucky day, probably because I’m unlucky generally.

I had the monster variety of Covid in 2020 followed by autoimmune Graves Disease, which sped my heart up (tachycardia), an irregular heartbeat after that (ventricular bigeminy), with an ectopic pregnancy and a compound fracture of the olecranon in between. I call it the Covid curse.

Bad luck comes in threes, so I was covered, surely?

At my pre-operative appointment for fixing my heart with burning, I did not ask about the risks. If there was a risk of death, I did not want to know, I just wanted the 60-80% chance to be better.

I was given a leaflet for a different condition, ventricular tachycardia, which said there was only a 1-2% risk of death if you had structural heart disease, and I did not. My condition was “too rare for a leaflet”.

I walked onto the ward optimistic. It was ten months after I was told I would need it as my condition had worsened. It was finally time, and sooner than the anticipated 1.5 years. I had got so unwell that I could easily sleep in the day as well as all night and most of the morning, and I had a day when I nearly fainted gardening. I had to push through the constant crushing fatigue every day.

I would be leaving later that day, this was the last time I needed to experience this, only this time I would be under general anaesthetic, unable to feel the electrocutions. This time my boyfriend was there to kiss me goodbye, as well as my mum. I told her I would contact her as soon as I had come round.

I would be in the operating theatre for 2-3 hours and then a week later I’d be back doing my usual activities, including driving.

I waited….and waited. Time seemed even longer than last year. Eventually, about an hour later, the lovely radiologist from last time explained that the theatre team were ready to start but my consultant had not arrived yet. She had held my hand when I was crying out with every burn last time. It’s cheaper to be burned awake.

I had been joined by two patients pushed in by paramedics. One was a pale overweight lady in her early 60s. The other was a man around the same age, who had been transferred from another hospital. He said it was an absolute disgrace that he had been moved to the city, as he was the sole carer for his wife in the nearby town, and it had been difficult to get care for her.

Surgery

When I was wheeled in about an hour later than expected, I was warmly greeted by a large medical team, slightly larger than when I had been cut into and burned whilst awake – I now had an anaesthetic team as well. There was another equally compassionate radiologist, who was nicely chatty which really helped. She affixed large cold pads to my back, which I later realised were for shocking me back to life.

There was the anaesthetist who I’d had the pre-operative appointment with. After being on a support group and seeing chat about sore throats after breathing tubes I had asked about this and he had said this happens if the tube is too big for the size of the throat. I asked whether I could have an oxygen mask instead and he said that would not be suitable. He kindly used one to put me to sleep. I closed my eyes ready for the inevitable and then realised he needed my eyes open so he knew when the general anaesthetic was working, as he reminded me. He said the mixture was often commented on as a mixture of the smell of a swimming pool and vanilla. This gave me something else to think about as my brain suddenly switched to sleep mode and everything went black.

***

“She’s opening her eyes” said one of two shadowy figures at the foot of my bed in a grey blurry room.

A woman checked monitors above me and there was the radiologist that had held my hand first time, but when I greeted her she responded with averted eyes and moved away quickly. Strange.

My consultant appeared and said “Hello. You won’t be going home today I’m afraid, I know that’ll be disappointing.”

“Aw no! Why?”

“It’s probably best I explain when you’re not so groggy and have come round more.”

“No I’m awake enough, please tell me.”

He sighed heavily. “After the first attempt we thought it had been successful. We wait 15 minutes to see if the arrhythmia comes back. After 14 minutes unfortunately it returned.

So we went in again, wider and deeper, treated you and waited again. This time, after 19 minutes, your artery was narrowing with the swelling, so we put a balloon in.

We’re going to need to keep you in to monitor you. Your mum has arrived and is waiting to see you.”

“Oh good, thanks.”

What I didn’t know was that my mum had called the hospital after not hearing anything by 2pm (I had arrived for 7.15am and the operation should’ve taken 2-3 hours). My surgery had ended up taking almost five hours. The consultant had explained extensively to her.

I was still trying to process what I’d been told with my treacle brain. What did he mean by my artery was narrowing? What would be the impact of that? How long would I be in hospital? I hoped it would be a more pleasant experience than when I broke my elbow.

The ECG of my heart attack (where the lines go down instead of up!).

Intensive Care

I was wheeled into Intensive Care. There weren’t as many beds here as a standard ward, maybe four, and then two separate rooms when there would’ve been 10. The second day I had the best nursing care I’d ever received. The man was always available and so attentive. I did not even mind when he accidentally flushed general anaesthetic into me, he asked what was wrong and immediately tipped my feet up to get the blood to my head. A colleague came over and explained what he needed to do next time. Small mistakes should be learning opportunities not feared due to punishment.

Both consultants who had operated on me came to see me. My consultant explained again what had happened, ending with “I’m on annual leave tomorrow, so if you have any questions please ask my colleague.”

“Enjoy your holiday” I said.

“I wouldn’t call it that, and I’m not sure I’ll enjoy it” he muttered, as he left.

The first time round, when burned awake, I had had one canula in my hand to administer fentanyl.

This time, now that I was in the calm of Intensive Care, I noticed I had a line into my left arm giving me a wonderful 0.6mg dose of GTN – lovely stuff that keeps your arteries dilated and stopped me feeling a lot of the inflammation, making it a background ache. I had a plastic arterial bracelet on my right hand keeping that shut.

At least two of the ten patients in there had had heart attacks due to having infections with temperatures of 39. The lady next to me coughed occasionally.

I was comfortable and able to wash myself in bed with paper-towel style wash-cloths. My every need was met. As soon as I called for a commode it would be pushed in. The lights were bright but I had my eye mask. It was quiet so I could rest.

From First Class to Economy

The next night I was suddenly wheeled down to a basement ward with one small window at the end. These patients did not have curtains pulled around them. The beds did not have cardiac monitoring. I was scared. I had been told I had just had a heart attack, and I had a constant ache in my chest, but they didn’t need to monitor me?

A bright light shone in my face. At 11pm I asked whether it could be switched off, but the nurse said “sorry, we haven’t finished our observations yet, as soon as we have, we will.” This was completed about half an hour later.

All the patients in my bay had dementia. One was not aware she had a catheter in and cried out repeatedly for a bed pan. I got the nurse and told her I thought the patient could not remember to use the call bell.

The nurse attended to the patient, but she insisted on using a bed pan, so the staff sat her on it and told her to use her call bell when she was finished, despite me having told the nurse that this was not possible. So then the patient cried out repeatedly for help and then got upset that she had been left, which resulted in her pulling out her catheter. The staff then returned and told her off and waited while she used the bed pan this time.

The chest pain still prevented me from lying flat or even breathing deeply. Now that I was no longer on the intravenous GTN, the chest ache had ramped up to an intense heartburn sensation. At some point early in the morning I got fed up of trying to sleep – the paracetamol was useless. As usual, the nurse’s station next to me was completely empty. I hauled myself on a wounded thigh down the corridor to get respite.

“Please can I have some codeine?”

“Why?”

“I have backache and chest ache.”

The next morning, the arrhythmia specialist consultant that had assisted with my surgery apologised and said there was a mix up with the notes so myself and another patient had been taken to the wrong ward. We both should’ve been on heart monitoring.

It was just as well we had been taken to the wrong ward.

Shortly after, I was pushed into in a lighter more modern ward upstairs, a nurse quietly told me not to use the toilet for the women’s bay, as that was potentially contaminated by a superbug called CEP, which Google said was like MRSA. The affected patient had been wheeled elsewhere, but the eight patients already on the ward were all spoken to by Infection Control. This meant that every time I went to the toilet I had to put the toilet seat down, and every time I took a shower (carefully avoiding my chest leads), I had to avoid touching the poo stain on the curtain. I complained but nothing happened and the sheet was still signed as if the bathroom had been cleaned. It was only “cleaned” once a day.

This ward had the advantage of telemetry, meaning my heart could be monitored remotely, as long as I carried a slightly heavy small box with me. This meant I could do a little exercise walking to the toilet and back, and it freed up the nurses to deal with the dementia patients.

I was still unable to lie flat when trying to sleep, but this was now the least of my problems.

Sue was in the midst of a dementia episode. She said that Graham was going to collect her as she was going to Skeggie. She had her suitcases packed. The nurses continuously told her that she was in hospital. Occasionally she would realise she was in hospital, and ask which one and how she got there. At 10pm she decided she was going to Skegness and attempted to leave, whereupon the nurses had to call Graham to speak to her. After some cajoling she settled, but continued to talk loudly throughout the night and all the next morning. The nurses promised Sue that she would be leaving the next day and hoped that she would forget about that. Luckily she did.

“I USED TO SMOKE 25 FAGS A DAY AND GUESS HOW MANY I CUT IT DOWN TO?”

“I don’t know, what did you cut it down to?” the nurse replied, smiling.

“FIVE”.

About half an hour later, Sue was on the move again, and right up to the nurse’s station beside me.

“I used to smoke 25 fags a day, you’ll never guess how many I smoke now.”

“Five” I replied.

“Six” she said.

“See, you’re bothering the patients Sue, you need to keep your voice down.”

“Ok, understood nurse”, she said, and shuffled off.

The next afternoon, Graham arrived and said that he had never seen his mum like this and that she hadn’t slept for four days. When he arrived, Sue slept all afternoon and until 5am that night with poor Graham sitting in the chair next to her. Her brother had died of polio when he was only seven, too early for the vaccine that would save so many lives.

A nurse had forgotten to give me paracetamol until I called her, Sue was taking up most of their attention.

Every day I received a stinging shot of blood-thinning medication to my stomach. It would sting for about five minutes after. One afternoon, I grabbed a bit of muscle along with my belly fat and the needle the nurse brandished was enthusiastically plunged into the muscle.

“ARGHHHH!”.

“All done” the nurse said, as she marched off grinning.

I watched as the woman opposite me was stabbed. She didn’t react at all.

“When I heard that woman cry out I thought that was going to be bad, but I didn’t feel a thing.”

I was taken down to a cold basement for a scan of my heart, where a bored and irritated young woman pressed a rollerball hard against my chest, sometimes painfully. Fortunately my boyfriend was there, and it didn’t hurt as much if I looked at him. Google later told me that looking at a loved one actually reduces pain.

Day 4

On the fourth day an enthusiastic middle-aged doctor with a bald head, wearing turquoise scrubs shut the curtains behind him. “I was the guy that put the balloon in. I was observed by one of the most experienced doctors we have here, he’s done the procedure for years so we were lucky that he was there, giving instructions.”

“Thank you. How long was the artery closed for?”

“Only two to three minutes, we were quick. You have fluid round your heart, but don’t worry, it’s only a tiny little bit.”

“How much?”

“One millimetre. I know it’ll be disappointing news, but we need to keep you in for an extra night and we’ll check it tomorrow. If it goes down or even if it stays the same, you can go home.”

“Ok.”

I unpacked my things again and had a face mask that evening, which gave me a brief relief from the incessant tropical heat. The healthcare assistant offering me tea or coffee couldn’t believe his eyes.

Having my mobile Echo scan to check the fluid round my heart. It was compressing my right ventricle.

The next day, the fluid round my heart still hadn’t increased. This time I had the first class scan on the ward, with a doctor that didn’t hurt me.

I was finally allowed to go home, only I needed someone with me, as I was only allowed to walk for five minutes once or twice a day, couldn’t lift anything heavy, and I wasn’t going to be able to drive for four weeks, so I went to my parents house.

A day or two later I was finally able to lie flat, and after the four nights of sleep deprivation in hospital I could finally sleep.

Are NHS waiting lists increasing the pressure on antenatal services?

I am still waiting for a routine heart operation, which I was told I would need in January this year.

I had a failed attempt at it last year – I couldn’t be burned whilst awake, even on the maximum dose of fentanyl. I then got better, only to get worse again months later.

I am told there are ten patients in front of me and I would be “lucky to be operated on before Christmas”.

Consultants in my local hospital all have patients on six month waiting lists for routine heart operations.

Someone else I know has 28 patients in front of him for the same operation. He got on the waiting list a few months later than me. His wait is probably also 1.5 years (6 months to see a consultant, a year for the appointment before the operation, then another 6 months before the operation). But he was told if he paid £20 000, he could get the operation next month.

How can this be right?

I am 39 and have been medically advised (since last year) against having children until after the operation. The BBC series Babies is the first that I know of that shows how it feels to be involuntarily childless. I was told that there was a backlog of cardiology patients before Covid and that this has increased pressure on an already overstretched service.

When I worked in antenatal, the service was already stretched. The department barely had what they needed.

A woman of advanced maternal age is 35 or above, because there is an increased risk of complications being pregnant.

If you have a health condition that increases your risk and if are advised against pregnancy until treatment, you face a choice.

Do you have a “high-risk” consultant-led pregnancy? This involves more appointments, more midwife monitoring and more worry.

Or do you wait until after your operation, knowing that you may either be unable to conceive by that time, or have an increased risk of complications to you and your baby?

AI gave me the following comparison, which I need to check…

Ages 35–39

• Maternal: Miscarriage risk rises to 20%.
• Increased likelihood of gestational diabetes, preeclampsia, and placenta previa. There is a higher chance of requiring a caesarean section.
• Foetal: Risk of chromosomal abnormalities increases (Down syndrome risk is approximately 1 in 300 at age 35). There is an increased risk of stillbirth.

Age 40 and Older

• Maternal: Miscarriage risk jumps to 40%,
• Maternal mortality, severe morbidity, and postpartum haemorrhage risks are significantly accelerated.
• Foetal: The chance of genetic defects is nearly seven times higher than in mothers under 20, and the risk of Down Syndrome reaches about 1% at age 40. There are higher rates of restricted growth and neonatal admissions.

Caesarean birth rates increased considerably between 2018/19 and 2023, with unplanned caesarean births increasing from 15% to 23%. This is whilst the UK faces a dire shortage of midwives – 2 500 are needed.

The Gov.UK website states “The rate of neonatal admissions has increased in the UK. This upward trend of is primarily driven by a rise in extremely premature births (below 24 weeks gestation) and an increase in full-term admissions, often linked to a higher number of induced labours and caesarean sections.”

Despite recent improvements, the British Heart Foundation notes that nearly four in ten cardiology patients still wait longer than the standard 18 weeks. This statistic points to the immense pressure currently facing the NHS. The British Heart Foundation has repeatedly warned that because cardiac conditions are time-sensitive, these prolonged delays put thousands of patients at high risk of avoidable heart attacks, progressive heart failure, and premature death.

Waiting lists are prioritised by clinical need. Where they are routine, should they be factoring in women of advanced maternal age, if their health condition increases their risk in pregnancy?

Waiting for my second heart operation – Covid 2020 reflections

Apologies, it’s been so long since I last posted! Thank you to my loyal followers for keeping me on your list, it means a lot.

I’m happy to say that we finally got our dream home after we played dirty – we offered comfortably in excess of the guide price, on the condition that they’d take the house off the market. We had lost a house from someone else doing this, a lucky escape as the chimney needed work already.

After five days the house was taken off the market with two offers at guide price already, and it needed a full renovation. We then even managed to get £15 000 off because it was mis-sold as having an extra bedroom, which could not be used as a bedroom due to it being built before building regulations came in in the 1990s, so it was not fire-compliant.

It took us eight weeks to buy it and I had to chase every professional involved except the mortgage brokers, who ensured we bought the house on time by asking me what was happening when the solicitor wasn’t doing anything. He said he wasn’t doing anything because he hadn’t been paid. My boyfriend had forgotten. We completed the sale on the last day before stamp duty would have increased and cost us an extra £11 000. I couldn’t use my savings because they were in a Lifetime ISA. Luckily I had a small amount in another account and used this, so I was still able to be joint owner of the house, and I now have something for my retirement.

The whole house needs renovation and it will probably take us about 20 years and my boyfriend’s savings. But we’re happy and the view of the surrounding woods and countryside on the horizon is a gift every time we open the curtains. It is close enough for my parents to babysit in future and a stone’s throw from a local nursery, infant and junior school just over the road. Perfect! We even have a park and and a train station a short walk away. The stress of buying the house led me to needing a heart operation, as the amount of irregular beats increased to 40% of them.

But how did that start?

Six years ago I came face-to-face with my own mortality.

As I lay there with the feeling that someone was sitting on my chest and squeezing my windpipe, I wondered how long it would take for someone to find me dead. I hoped it wouldn’t be so long that I smelled. I wanted to turn over but my body wouldn’t obey.

Incubating Covid – the day before, in April 2020 whilst on a bike ride.

That morning I had managed to drag myself to the windowsill of my Velux window above my bed and inhale when the wind blew. Sweet relief I explained to my worried manager, who was calling every day. He later said he was checking to see if I was still alive. I Googled “struggling to breathe + Covid” and Google said if my lips were blue I should go to hospital urgently. I looked in the mirror and my lips were fine. I told myself that this thing came in waves – mercifully it gave me a break occasionally, unlike any virus I’d ever had.

If I had another bout of struggling to breathe I’d go in and face the bright lights, noise and chaos. But for now I was going to enjoy the peace and quiet and comfort of my own bed.

Two weeks later I was four kilogrammes lighter, as I had struggled to get down two flights of stairs to feed myself. One day all I had was a cereal bar, but I really enjoyed it, more than I normally would. Luckily I had been able to stay hydrated with the sink next to my room.

April 2020, my first trip out after two weeks isolating.

My boyfriend was finally back from working away, and after enviously looking at others enjoying a walk outside, I was finally able to leave the house, and walk to a local farm. I was exhausted but so grateful to be alive, and what a time to have escaped death. My eyes feasted on bluebells carpeting the wood, and I soundbathed in the music of the birds. It was a mild May and a good time to be recuperating in the warm sunshine, appreciating the blossom and flowers while I recovered my strength over eight weeks, starting with walks around the block.

After what I presumed to be long Covid, I celebrated my survival by buying a fitness tracker watch. Two weeks after that and advice from the GP to rest and stop trying to exercise, I felt better. Always listen to your body!

Months later I had a weekend when I was full of energy. I went for a 2.5 hour bike ride to a local village, zipping up and down hills, and then lay awake most of the night wired. Days after I crashed. My energy levels dropped through the floor that I was lying on and I couldn’t find the strength to even sit up. I was still struggling to walk longer than half a mile, and when I found hills difficult, I dialled NHS 111 in a panic.

“I think I’ve got Covid lung damage”.

I went to my urgent GP referral with the help of a walking stick as I couldn’t afford a car or a taxi, and buses were too unreliable (and still are). The doctor came out in full hazmat, seeing me outside the back door of the surgery. I was sitting there breathless.

She listened to my chest and took my pulse and then her tension melted away.

“Stand up. Sit down…can you stand up again for me?…

How long is it since you arrived here?”

“15 minutes”.

“I don’t think it’s Covid, your heart rate is still fast. I used to work in endocrinology when I was training, and your symptoms would fit with an overactive thyroid.”

I had no idea that the thyroid gland was your body’s engine. It regulated almost every system – your weight, your heart rate, your sleep…as my body fought the 2020 Covid monster, it had accidentally knocked out my thyroid gland, so now I was struggling to put on weight, getting five hour sleeps and feeling wired and tearful. My hair was coming out in small clumps. This was the most distressing symptom as I realised my hair made me feel feminine and I felt strange about it falling out. The hairdresser asked me what had happened. Adrenal fatigue was even worse than the fatigue after Covid, it hit me like a ton of bricks.

Beta blockers managed my sped-up heart and it eventually slowed down again. After a call to NHS 111, paramedics had come out and taken me to Accident and Emergency and asked if I’d had any issues with potassium absorption. I had an irregular ECG, but the doctors at Accident and Emergency said I was fine and sent me home.

Three years and a half later, I had contraception put in the wrong place and told doctors to remove it repeatedly over the course of a week, involving sleep loss, two GP appointments and three attendances at Accident and Emergency. No I could not wait until next month, this was not normal for me and I knew what it was. I was correct. But when I had my pulse taken with the hospital GP she had that frown, just like the one that told me I had an overactive thyroid (Graves Disease). She put the audio on for the pulse monitor and we heard my heartbeat slow down before resuming the normal rhythm.

I’d already been to A and E just a day or so before. “I’m not going to drop dead though am I?” I joked.

“With a heart rate as slow as that, you might.”

The A and E doctor was not amused. “Why are you here?” I wanted to retort “why do you think I’m here at 4am on a work day, having waited six hours?” but instead I said “the GP sent me”. She raised her eyebrows and sent me home.

The GP called. “How are you feeling? Your results were normal.”

“My watch says my pulse drops to the 40s overnight.”

“Ok I’d better refer you. It’s probably fine but we’d better make sure if your watch is still saying that.”

After my heart was sped up by the Graves Disease I got from Covid, it went out of rhythm and I developed ventricular bigeminy, where every heartbeat is followed by an irregular beat, called Premature Ventricular Contractions – the heart has extra beats from the lower chambers instead of the upper chambers. I’m really lucky that a medical mistake led to it being found – the silver lining.

I couldn’t tolerate my first heart operation under local anaesthetic. What they didn’t tell me is that you can’t anaesthetise the heart, so the local anaesthetic was only for where they inserted the catheters into my veins, feeding them up past my hip (tickling my hip from the inside, a strange feeling) and into my heart. It was like being electrocuted and after three burns I asked the surgeon to stop. It was only so I could collect myself, but he didn’t want to continue after that.

Months later, the amount of irregular heartbeats was too low for an operation, but months after that, the check that may have got me discharged was too high in irregular heartbeats again, so I had to go back onto the waiting list to get on to the waiting list.

I was told that it was approximately six months long. I have now got on to the operation waiting list, or at least, the waiting list for the appointment before the operation. The NHS is broken and needs more taxpayer subsidising, but that won’t get a politician votes. One person in the ablation support group had even paid £250 to get to the top of the queue with her consultant, as she, like me, was in her late 30s and wanted children. All I can do is leave it to fate – whatever nature decides. I turn 39 this year and I have borderline fertility. It may be a choice between a healthy heart or a baby. This is the state of our NHS. I’m tired but I’m still able to play netball, thank goodness. I barely notice it, unlike the other patients on the list with atrial fibrillation. My dad recently developed this and has had two trips to A and E before being put on a strong medication which has thankfully stabilised him, at least for now.

We have been waiting to start a family for a year, as last year I was referred to anti-natal (in my case), where I saw three doctors. They discussed my medical records and the cardiology professor there advised me against having children until I had the ablation operation. They freeze or burn the tissue off that causes the abnormal electrical signals with keyhole surgery, one of the many marvels of modern medicine. In America they now do Pulse Field Ablation, inserting a balloon into the heart and using pulses of electricity through it, in a less damaging and more accurate procedure. Before ablation was discovered, patients would have eventually died of cardiomyopathy – a disease of the heart muscle where the heart weakens, the left ventricle dilates and pumps less. Research suggests this happens over around 6-8 years. Thankfully, beta blockers manage premature ventricular contractions (PVCs) by blocking the effects of adrenaline on the heart, slowing down the heart rate and reducing the force of contractions.

Before the operation

After the failed operation

Hopefully the long wait for my health to return to normal after Covid will be over in months this year, the end of a long journey of ill health which is mercifully better than most. My heart goes out to anyone still suffering from it, and to the families affected by death from it. Thousands continue to die before their time from it. I have never had a virus like the 2020 variant and I hope vaccines continue to keep pace with it. I was relieved to read that the most recent variant to escape the vaccine is mild. I got flu this winter and that was worse than the last time I had Covid. I have had it three times now.

Recently there was the scare over Meningitis B, which thankfully is harder to transmit and was quickly contained.

I’ll never forget the panic on seeing empty supermarket shelves. My sister was a gynaecology doctor and was reassigned to work on Covid wards, working 12 and sometimes 14 hour shifts, as she didn’t go home until her work was done. She was exhausted and spent two weeks worrying as her mask couldn’t be properly fitted – they didn’t have the right size. Some hospitals had to decide who lived and who died as they got short of oxygen. It was our 1918 flu pandemic and a defining moment in our history. First it was in China, then it was in Italy. We were in denial about it reaching our shores. Then we heard it had arrived and suddenly toilet roll and tins were hard to find.

So how did I get it?

Shopping for a friend whose boyfriend had asthma. Rather me than him – I probably saved his life, by nearly sacrificing my own.

The Autumn/Winter 2024 Housing Market

We have been looking for a house on and off for years now so I want to share a further update on what I have learnt. It could save you time, trouble and possibly money (if you did not read this and made a mortgage mistake!).

At the moment, properties are selling in two to three weeks on average. Viewing slots are still getting full as soon as two days before. However, unlike when we started looking in 2021, we have the time to go for a second viewing. Buyers are more cautious now that interest rates are higher.

The best time to look

Book viewings in the autumn. There is a summer rush when prices rise with the competition, it peaks from May-July and tails off from September. By December there are hardly any properties left and the ones that are tend to have been on the market for months or are the result of people passing away. Most families aim to move in spring/summer.

Things to look for

Rooves

The expensive stuff tends to be rooves – when was the roof last replaced? If there is an accessible roof space, ensure you view it to see whether this needs work – is there any sign of water damage or rotten wood?

Space

Do you have the space already or will it need that? If so, will the value increase enough to cover what you’ll spend on it when you sell? You can estimate this by looking at how prices have risen in that area in the past five years or so.

If you are buying a cheaper house with a view to doing an extension, is planning permission likely to be granted – do the neighbours have a similar extension? Is there suitable space?

One house we looked at had an extension joining on to the neighbour’s house, which may make putting a second storey on top of it problematic.

If it has a ground floor extension, is the building work suitable for adding a storey on top? As some extensions aren’t suitable for a floor to be added on to it, a fact I was not aware of.

Spray foam

If they have this just forget it, it’s too much trouble and a lot of mortgage companies will not even give you one if they know. This is from my builder cousin – he said spray foam is ALWAYS a problem. It rots the wood near it as there isn’t enough air circulation. It costs about £4 000 to remove and then if you need to replace the roof as well the costs will escalate.

Drainage/water damage

Is water collecting at the front of the house? this could affect the foundations which would be incredibly costly to sort and if there is any concern about this, a structural survey may be needed.

If there’s a leak in the roof it could cause damage from the top. Damp can be expensive to fix, as can any rotten woodwork.

Estate agents

Ignore what they say, they’ll tell you anything and try to direct your attention away from any issues and distract you with the good stuff. Many are dishonest, like the one that said the roof looked fine. It had a tile missing and my builder cousin said as it didn’t have felt, it had NEVER been replaced. A new roof is approximately £10 000 to £20 000.

Offers

Offer the guide price first as a maximum, and ask the estate agent to let you know if there are any other offers. You may have more room to manoeuvre if there are not any others. But you also need to see if you can find out why no-one else has made one. This could be a red flag.

Be aware of dirty tactics – one buyer asked the estate agent to let them know what offer would take the house off the market. Clearly done by someone with more money than sense, and of course it worked. The house ended up going for more than £25 000 over the guide price. And it was a “doer-upper” – it needed work. Another buyer wrote a “begging letter” explaining how good the area would be for their child. As there were two identical offers, that was what made the difference.

Must-haves

Decide what your “must-haves” are – do you need a garden or is it not important to you? do you have bicycles, a motorcycle or a moped? If so, you might want a garage. Do you have an electric/hybrid car? If so, you might need a driveway to plug it in.

Prices

Prices where I am have risen but not by much because of the interest rate rises. Remember this when you decide on your budget – you do not want to be trapped in an unaffordable mortgage and have to sell.

Prices vary quite considerably between areas – you may get a lot more space if you go for a slightly less sought-after area – is it vital that the catchment school is outstanding, rather than good?

The most important thing is DON’T RUSH.

It’s important to keep a level head when parting with your life savings!

My Charity Run Challenge

On 30th August 2022 I started my charity challenge run. 100 miles in 12 months, what could go wrong?

Now I have plantar fasciitis – achy feet. It turns out when you run 100 miles in 8 months, you wear down your trainer soles a lot quicker than with walking, and then they do not protect your feet from the concrete.

The first month I ran a mile a day and my longest run was 9 miles. I went from struggling to run a mile to having so much stamina that I didn’t get tired until I had run 7 miles. My heart beat more efficiently, so I had to run further and faster to get the same health benefits, as my heart rate did not increase as much. My calves became more muscular so my leggings became tight and I had no problems with my weight, dropping a dress size.

I had bought the best pair of trail run trainers (off-road) and road running trainers that I could. I ran so much that I needed a new set of clothes for it while the others were waiting to be washed. I started out doing it properly – mixing in resistance training to keep my muscles strong and incorporating rest days for my muscles. I built up the mileage gradually.

By March I got lazy and my mileage dropped. Then in April, after a month of not doing anything, I was walking to work when I got achy shins, and then they ached for two weeks while I rested. After that, I went to see the coronation, eventually getting to see it on a screen in Hyde Park. We walked for over 12 miles trying to get past Buckingham Palace cordons to our hotel on the other side, in Westminster. Eventually I asked a policeman, who said that you couldn’t get past the palace on foot either in front or behind it, you could only get past it on the Tube.

I tried one run when I got back and that was fine, but my feet ached after it. My feet were sore after netball, and then, one day, I had to turn back after a mile. Then I couldn’t stand for hours in a museum without the aches and a new very mild stabbing pain. It had become chronic. I took ibuprofen, which then aggravated my IBS, but no pain no gain.

Why did I take on the challenge?

I had to focus on a project after suffering an ectopic pregnancy in June 2022. Whilst the physical aspect of it was over fairly quickly, the psychological aspect took longer to heal from. All my brain knew was that I was pregnant and then I wasn’t, so it processed it as if a baby had died, rather than a bunch of cells disintegrating.

There was no support for the psychological impact from the NHS – you only get that after three miscarriages. This makes no sense, as I would probably be more prepared should it happen again. I had no idea what was happening with me and how it would progress, and NHS staff had no time to tell me either, one nurse did not know. For me, knowledge is power, and The Ectopic Pregnancy Trust gave me that, the power to understand what on earth was happening to me, and why.

So what have I learnt from my running challenge so far?

• Check the soles of your trainers and replace them when they wear down.
• Use a fitness tracker watch to easily track your miles/kilometres and heart rate.
• Get gait analysis if possible to work out whether your running style means you need a particular type of support in your trainers. Some running shops do this. You can also work out whether your foot rolls on impact by checking the soles of your trainers.
• Mix in resistance work (weights).
• Include rest days.
• Try and include most of your running on mud, grass or gravel. This has less impact on your muscles and bones than concrete or tarmac and means you will be less likely to get an injury.
• Ensure you have enough running outfits, and have cold and warm weather ones.
• Use a foam/plastic roller on your calves after your run. This helped me avoid injury.
• If you get an injury, rest until it is healed. You can keep your stamina up by doing non-impact exercise such as cycling or swimming.
• It is amazing for your mental and physical health.
• Build up the mileage slowly, it is ok to start small.
• See your GP if you experience any injuries or aches that do not resolve with rest.

I have experienced a better quality of life from doing more exercise.

Listen to your body and once the stamina kicks in you’ll enjoy it more.

Until then, enjoy the feeling after you run, the relaxation, contentment and sleeping better.

My ADHD Diagnosis Journey

I have always been different, no matter how hard I tried to fit in.

When I went on holiday with a friend to Vietnam and Cambodia, I realised something was interfering with the trip. For some reason I found it really hard to organise myself and to avoid forgetting things. What was wrong with me?

At 14 I had the maths age of an 11 year old and the verbal reasoning score of a 16 year old. Maths was boring, so I just didn’t pay attention and doodled or daydreamed instead. The educational psychology assessment meant that I did not have to do Design and Technology GCSE. Before I was exempt I nearly broke a sewing machine needle when I got distracted, and made muffins without dough (inedible) as I couldn’t follow the steps without getting distracted.

I tried to do a nursing degree, but it took me an extra week than it should have to learn leg bandaging, after seeing two different techniques. After this I was diagnosed with a “non-specific learning difficulty.”

I got distracted during the assessment by a noise in the waiting room, and felt maybe I hadn’t performed well because of that. I got withdrawn from the nursing degree as I was “not consistent and competent enough”. This was just after I had seen a disability assistant, who said that with strategies I could learn what I needed to. The Royal College of Nursing said I had suffered discrimination and were willing to take the case further, but I realised that I could not learn the practical skills and was unsure why. I was not stupid, so why had I been trailing behind my course mates? As my personal tutor had suggested I had autism, like her son, I went to the GP.

I got referred. Back in 2018, the NHS wait was a mere six months. It’s now four years.

The consultant psychologist asked me to tell her about my life for an hour. She then said “I wouldn’t worry, most of my patients with ADHD [Attention Deficit Hyperactivity Disorder] struggle to have relationships and hold down a job, so you’re doing well.” She signposted me to a local support group. I apparently did not have ADHD badly enough for a diagnosis. I also did not have autism.

I went to the group, and for the first time, I sat in a room full of people where I felt I was on the same wavelength and I could understand them. We talked fast, we had lots of ideas, we were emotional, we were interesting. Here, for the first time, I fit in. They spoke of being let down by the NHS and their struggles firstly to get assessed and then to get medication and to get changes to this. They spoke of mistakes and failures in their lives that they felt had been caused directly or indirectly through ADHD, and they sought help in managing the chaos.

ADHD continued to affect me, but I did not do much research, as I reassured myself that the NHS had told me I did not have it badly. It was a spectrum and I was at the mild end of it, so I was fine. My boyfriend and friends disagreed. I had gone from my mum organising things for me and finding lost property to my boyfriend doing that. I was so frustrated – why couldn’t I do this like most of the people I knew? What was wrong with me, and what on earth could I do about it?

After some research, I realised that I had not been adequately assessed on my life before the age of 12. This meant that I could not have been diagnosed with it, as you had to have it before then. I asked the GP for a reassessment, explaining how it affected me on a daily basis. However, weeks later, they informed me that the reassessment request had been declined due to insufficient evidence of ADHD. I was so frustrated, upset and angry. So I just had to keep struggling? I was fed up of being distracted, emotional and forgetting things.

I could not afford a private assessment and I was lucky that my boyfriend could. He shelled out £1200 and within weeks I had an appointment with a psychiatrist. There were no private appointments in my city, so we had to travel to a city nearby.

Before the appointment, my mum and my boyfriend completed a questionnaire and I was asked to bring school reports. “Your boyfriend scored you 9/9” the psychiatrist explained, “and your mum scored you 4/9 for your childhood, which is one below the threshold for diagnosis. However, it is possible that your parents compensated for any difficulties during that time, and so they might not have been as noticeable. Have you brought your school reports?”. She read through every single one up to the age of 12, nodding and making notes.

“There’s enough here for me to score you 5/9 for your childhood”.

She then asked me about my life and how ADHD affected me. At the end of the appointment she confirmed that I had it, and I proudly announced it to my boyfriend in the waiting room. We had finally come to the end of the assessment journey.

I feel that I have been let down by the NHS and as a result I have had years more of difficulty due to a flawed assessment.

The BBC Panorama programme on ADHD has received 1800 complaints and counting. A reporter who was told by an NHS psychiatrist that he did not have it went to three private clinics, where he was assessed by a pharmacist, a trainee nurse with a supervisor, and a psychologist, who was more interested in playing with her hair. In my opinion only a psychiatrist should be able to diagnose patients. Unfortunately due to staffing, the NHS as well as private clinics have trained up psychologists, nurses and pharmacists to deliver the assessments, and from what I saw on the programme, they were not of good quality. The clinicians were asking leading questions. But the reporter was also answering as if he had ADHD.

I’m glad that I got assessed by a psychiatrist and that the process was thorough. I feel sorry for those who have shelled out and have been let down. I also feel bad for those who, like me, were let down by the NHS. I am also disappointed that patients are not offered CBT therapy for ADHD, to help them manage things such as emotional dysregulation. All diagnoses should come with support for patients to understand the condition, how it affects them, to come to terms with it, and to work out how to mitigate it. It is not simply enough to say right lets put you on medication.

The reporter’s programme and article was unbalanced – it only included how the private clinics had got it wrong. The NHS psychiatrist on the programme then wrote a more balanced article for The Guardian where he explained that many NHS patients had resorted to private assessments due to waiting lists, and that there were undoubtedly many sound diagnoses from the private system.

The problem is that the BBC article and programme discredited the private system to the effect that two family members and a friend have now suggested I don’t have it. What’s ironic is that they’ve all seen the impact it has on my life, and theirs, as they reunite me with items left at theirs, or put a “phone, keys, wallet” post-it on the door…

My Ectopic Pregnancy

Around one in 90 women in the UK experience an ectopic pregnancy, and most of those take place in the fallopian tubes.

Unfortunately, in the unlikely event that you do get pregnant with a coil, there is a raised risk of an ectopic pregnancy, which means the embryo cannot grow.

I had my second copper coil, otherwise known as an Intra Uterine Device, in 2018.

I had come back from an epic hike round the Pyrenees – a mountain range in the south of France. We had driven down there to explore the area and walk the five day “Pass’Aran” route.

When my period did not arrive, Google reassured me that this could be caused by low progesterone (hormone) levels, which could be caused by “extreme exercise”.

Then I had sore breasts, and once again Google said this was due to low progesterone levels, but as I was also feeling a bit more tired than usual, I checked with a pregnancy test.

Pregnant.

It didn’t say Not Pregnant. It must be a mistake.

1-2 weeks (it confusingly showed 2-3, but this meant weeks since conception which the leaflet explained was 1-2 weeks pregnant).

So it was early. I walked around swearing, head in hands. What was I going to do?

Did I want it? It was so inconvenient – we were in the process of buying a house, my boyfriend works away, we were going to New Zealand…now was not the time.

But I could not kill something that was both of us and I could not kill something I really wanted. Yes it wasn’t the right time but when was?

I didn’t have time to process, I had to get to work.

But I had to get dressed first and find the few bigger clothes I’d bought from another time I temporarily gained weight.

I wondered who to tell. Should I tell anyone but Jonny?

Maybe Jonny wouldn’t want it and then there’s the shame of abortion, so I wouldn’t tell anyone. I didn’t want anyone judging me.

I couldn’t keep it in and I needed emotional support, so I confided in a close friend and it really helped. Her cousin had had an ectopic pregnancy it turned out, and they had also found out at six weeks. She had her fallopian tube removed, as the embryo can damage it. At least we are born with two.

Before seeing the GP I wanted to talk to Jonny – then I could ask for an abortion as well as a scan if needed. He was shocked and froze but he wasn’t annoyed or upset as I expected. He said we should see what was going on with it first, before we made a decision. Ever the pragmatist.

“Is that the only one you did?”

“No, it’s the third.”

“Oh………Is there anything else that could make it test positive?”

“No Jonny!”

The next morning I contacted the GP first thing and filled in an online form. Almost immediately I was text with the first appointment of the day. I explained how I’d started spotting instead of a period and then how my breasts had become sore and that as of Thursday night, it looked like I was having a period.

The doctor examined me and referred me to the Gynae Accident and Emergency department at the local hospital for a scan (my second time as an emergency patient in a year). She said to make sure Jonny was with me and to tell Gynae if I had symptoms that would suggest even more of an emergency, like pain or heavy bleeding.

After an hour of waiting at reception, the nurse did a safeguarding and general information interview. “From your dates you’d be six weeks pregnant” she said.

She took me round for a urine and blood test and after waiting for ages, I had a scan.

I was excited as I held my boyfriend’s hand down the corridor, wondering how he’d feel when he saw our baby.

“Do you want me to show you the embryo if I can find it?” the nurse asked.

“Yes please” I replied. “Jonny, do you want to see it?”

“Yes” he said, looking both excited and confused.

I had read that an embryo of six weeks sent out an electrical signal that sounds like a heartbeat on a scan. It would be the size of a pomegranate seed and look like a tadpole.

I waited to hear the signal.

There was silence and a lot of prodding. It was uncomfortable but didn’t hurt.

“I’m very sorry to tell you this, but I can’t find a pregnancy in your uterus. I can confirm that it’s likely to be an ectopic pregnancy, which means it’s growing outside of your uterus.” I was devastated.

“It’s growing next to your ovary.”

“Next to the ovary?? outside the uterus?? not on the ovary then??”

“Do you want to see?”

“Yes please”.

The nurse rotated the screen and there was the dark space of my ovary and then a dark space next to it that looked like a comma stuck to my ovary. I couldn’t make out any details as it was grainy.

“I can’t be certain, but that may be the sac there.”

It was so strange to see, but it made it feel more real and I was glad for that, as it helped me to accept that this was really happening, and I needed to get my head around it.

Not only was I pregnant, but it could not continue. I knew logically that was good as it was the wrong time for us, but it didn’t make it feel any better emotionally.

How? why? why me?

I then waited two more hours for the blood test results.

Jonny came up with lunch. I felt sorry for the other pregnant ladies, who had also been waiting hours. One woman had an overweight partner who was snoring loudly and continuously falling off his chair. He hadn’t got her any lunch, but if he did there was a risk that he wouldn’t hear what the nurse had to say. I wondered why they didn’t have a ticket system, like they did with blood tests.

The doctor called me in, finally.

He explained about the pregnancy hormone they had measured for. I replied “oh yes, Human Immunoglobulin something…”

“yes, that one. It’s at 500. We need to wait and see what happens, because there is a still a chance that you are pregnant in the uterus and we can’t see it, as it is so early.”

“But I thought there was a mass?”

“Yes, but that could just be a cyst.”

“So we will have you back in in two days to see what has happened. If it doubles it is likely to be in your uterus. If it doesn’t then we can confirm an ectopic pregnancy.”

My treatment options were:

1. Expectant management – waiting to miscarry (and hoping I didn’t die from a ruptured fallopian tube).
2. Have an injection to stop the cells growing, and make them reabsorb into the body (genius).
3. Have my fallopian tube removed with keyhole (laparoscopic) surgery (also genius, but less chance of getting pregnant in future).

I felt fortunate that as of the 1980s, option 2 had also become available. The drug was previously only used in cancer treatment but has no bad side effects. Also, keyhole surgery has drastically reduced the time you need to spend in hospital – you can leave the same day instead of being on bed rest for weeks.

Google informed me that 500 HcG was the average reading for five weeks of a pregnancy in the uterus.

Dame Laura Kenny, the Olympic medal-winning cyclist, has recently spoken out about her ectopic pregnancy experience and this is why I’m blogging about it – it helped me to read about other women’s experiences.

I was relieved that hospital was done with. I had a missed a day of work and I was emotionally drained.

When I got home I lay on the sofa for a while, but life goes on, I had a night out with the netball girls.

Turns out you can’t enjoy alcohol pregnant – it just made me feel sick.

And so did a Dr Pepper can and a frangipani almond croissant. I didn’t like salad before, but now I want lots of dark leafy green salad and steak. Your body craves what it needs.

Best to act like it isn’t happening! I’m at the back putting.

What we learnt from the property market

Apologies, it has been so long since my last post. I got discharged an an outpatient after months of physiotherapy, some hydrotherapy and an overnight splint, as my arm is now just 5 degrees off full extension. I can now lift 20kg with my biceps and even do press ups, but I can still only lift 2.5kg with the triceps.

After the accident I could only straighten my arm by about 75%, so getting it to 95% was really rewarding. I managed to get subsidised gym membership, a fantastic government scheme that is usually enjoyed by diabetics and those with high blood pressure. It must save the NHS a fortune.

Life got busy as we started looking for our first family home for when we have children.

Jonny would like babies in about two years, but I would like it to be a year. Or now. If your partner is broody, just get a career-enhancing job and leave the country. Problem solved.

We have been looking at houses since Summer 2021, on and off. Things have only got worse. At the start it was normal for houses to go £30,000 over the guide price. Now they sell for up to £60,000 over the asking price in the areas we are looking. A house in a bad school catchment area (a school rated as requiring improvement) will be on the market for up to £80,000 less. We are looking for somewhere close to the city but the closer you get in a nice area, the more the price increases. You get more for your money the further you go from the city centre.

We got a lot of our furniture for free or at a discount on apps such as Gumtree and NextDoor. A couple giving away an oak coffee table said that they bought their house for £40,000 about forty years ago. Houses in that area are now about £500,000. My friend bought her two bedroom flat near the city centre for £80,000 eight years ago and she has just sold it for £130,000 without renovating anything.

Our criteria are a garden, a drive, a garage and a good secondary school catchment. We have looked at so many houses where they ended up having a pocket garden because the owners extended into it, and “three bedroom” houses where one is a box room that you couldn’t swing a cat in. We want cats. I am also missing a garden.

We pay almost as much as a mortgage for our two bedroom rental. I would not be surprised if the state of the housing market is what is keeping the UK population down.

Even a “doer-upper” which is a shell of a house that needs building and decorating work sold for £410,000. Yes it had four bedrooms, but no carpets or furniture. My cousin is a builder and warned me against the craze for buying a ruin, doing it up is not always cheaper than buying it renovated.

So what have I learnt from this frustrating journey?

1. Viewings often get booked up within 48 hours, 24 hours if it’s a high demand area and property. Call the estate agent. We missed out on a house because the estate agent said they would “let us know”.
2. Don’t get caught up in a bidding war frenzy. Look at what it cost for the last buyer, look at what other similar properties in the area sold for and if it gets overpriced, walk away.
3. If you plan on having children or have them already, don’t forget to check the school catchment area.
4. Think about the house from a practical point of view and ignore the cosmetic aspects. Yes, it may have a new kitchen, but could you relax in the garden? can you easily commute to work?
5. Questions we ask are how old the boiler is, when windows were put in if they look old, if it has a flat roof, when that was installed, why they are moving, whether they are in a chain and what is happening with that, and whether it has had any offers already.
6. At the moment properties we look at usually have an offer after a week and sell in two weeks, usually for £50,000 or £60,000 over the asking price.
7. Budget so that you can offer about £50,000 over the asking price.
8. Remember that as a first-time buyer you are attractive to a vendor wanting a quick move, so do not feel pressured.
9. Make sure you have useful local shops within walking distance if possible, such as a post office, pharmacy, grocery shop.
10. Enjoy it and do not stress, you will find the right(move) property if you just keep looking.

ORIF recovery – my metal elbow

I am now enjoying being four months post-op. In the last two months I have made so much progress.

I can now tie my hair up and wash it properly.

Hydrotherapy and intensive physiotherapy has enabled me regain a “functional” range of movement of 100 degrees, considered to be enough to perform daily tasks.

Hydrotherapy was my favourite appointment – a warm swimming pool with just your physio and one other patient and you did slow and gentle stretches and resistance exercises with various props.

I also have a thermaplastic splint fitted to wear at night, which I am told would cost £30, but is free thanks to our NHS.

I have just been allowed to lift up to 5kg. I have finally been allowed to put a little weight through the arm, like doing standing press ups.

I am not yet able to go on long bike rides or run on unsteady ground because the muscles in my bad arm are weak which makes me unbalanced when I’m moving.

I am now allowed to use the physio gym with its padded exercise bike, treadmill and basketball hoop to help with conditioning, building and strengthening muscle.

The therapy I am receiving is outstanding. I have gone from only being able to bend my arm 90 degrees to being able to flex it fully. I am now just 10-20 degrees off full extension as well.

My arm still aches or stings if I lift anything too heavy or rest it on a desk without having regular breaks. The tricep exercises hurt quite a lot – that muscle hangs loose, but the bicep is coming along nicely and after three weeks of being able to put weight on it for the first time, I already feel stronger.

I am continuing with daily exercises and practicing goal shooting when I can, as I am determined to get back to playing netball as soon as possible, hopefully back to my position as Goal Shooter. I also really miss climbing, but it will be another few months at least, I am told, before I can be discharged. I need to build up my triceps muscle and be able to fall safely. Hopefully it won’t be much longer now…

My New Titanium Elbow

“You’ve got your bum out” a nurse said.

“I know” I replied. They’d given me a broken bloody gown and I had a broken bloody elbow.

How was I supposed to tie it with one working arm?

“Your bum’s hanging out” a middle-aged patient said, offended.

“I know, they gave me a broken gown!” I replied. A shower would sort it.

A wet wipe clean had never looked so appealing.

Your mission was to heave yourself out of bed with your abdomen and your good arm, without making your elbow spasm, causing a horrific shooting pain.

Then you had to get to the wet room down the hallway to the left, again without moving your bad arm, and early, otherwise it was always occupied. Annoyingly, you had to hobble past a closer shower, which was out of order the whole four days I was on that ward.

“‘Scuse me” the nurse looked flustered.

“Can you tie my hair for me please?” relieved, she obliged.

I had been told that I was definitely having surgery today (day three) and I was determined to be clean for it.

Somehow I washed everything using one arm and a bit of creativity (resting a leg on a grab rail, keeping liquid soap steady on your shoulder…). I wondered how I was allowed to risk another fracture on a daily basis. Later I was not surprised to find that falls were the most commonly reported health and safety incident in England and Wales in hospital, with over 240 000 a year reported.

If I had fallen on my bad arm before the bone was healed, I would have had a “comminuted peri-prosthetic fracture” – a particularly complex fracture made worse by the interaction of internal metalwork on bone.

Nurses only had time for observations, support workers only had time to help with meals and making the beds. And my ward had a “very good” level of staffing according to the Royal College of Nursing.

A support worker came round and fussed about my table being “messy”.

I had most of my belongings there because that was the only way I could access them. But without asking, she chucked everything in a plastic bag saying it was a hazard, and shoved it in a cupboard out of reach.

I had a felt tip arrow drawn on me and three visits from various members of the surgical team.

They were so kind, helpful and understanding. They also explained that the reason I was in so much pain was because when my arm muscles contracted they were pulling my fracture apart.

ORIF surgery was Open Reduction and Internal Fixation.

I was going to have a titanium plate inserted over my elbow and that would be screwed into the bones to hold it together. They would clean out the wound first and remove any smashed bone. I would need months of physiotherapy. I was reassured that I was first on their list after lunch.

I was given the option of an uncomfortable one and a half hour surgery lying on my side conscious, being pushed and pulled about, or general anaesthetic, so I opted for the latter. They said they might have to insert a breathing tube but I didn’t want to be intubated so they said they would use a mask instead.

“You’ve become sensitised to pain” the anaesthetist observed, “that’s understandable given the nature of your injury.”

They looked enthusiastic and alert and and appeared to enjoy their work. I was even allowed to gingerly climb onto the operating table so I didn’t have spasms from being transferred. The mask was placed over my mouth and nose with an air gap but the anaesthetist saw that I was still conscious and sorted it.

***

I came to with a jolt in an unfamiliar white ward, like some kind of afterlife.

There were no curtains, just rows of beds, except I couldn’t see the other patients. Two curious faces loomed above me in green scrubs. Suddenly my body started convulsing.

The figures above me said something about pethidine and I was injected. My body relaxed and I felt much better as they whisked me back to the Trauma Ward.