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…

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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? I had run out of clean knickers and I wasn’t about to put dirty ones back on.

“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.

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The Traumatic Trauma Ward

Two cheerful young men in green scrubs came by in the early hours and introduced themselves as orthopaedic doctors.

I said “hi, can I have some morphine please?”

Codeine was not making any difference, there was an intense burning pain in the joint and if I moved my arm it was so strong I would cry out. Then there was the constant ache.

They exchanged glances. “Yes we can sort that. We have had another look at your X-rays and we think you probably don’t have an open fracture after all, so your operation can’t be prioritised. We might send you home for a week or two and bring you back in for the operation.”

I thought about trying to manage the agony with codeine.

“I want to stay in hospital until the operation.”

The medics acknowledged this and left.

I needed the toilet but I was on my own. I wasn’t prepared to pee myself and I couldn’t reach the buzzer.

Fortunately two support workers down the corridor heard me scream from the shooting pain of my muscles pulling my fracture apart, and one had to help me off the toilet.

After that I finally got morphine, but then a high-pitched voice jarred me awake. It was coming down the corridor accompanied by the squeak of wheels.

Lily was an advocate of LGBTQ rights, she said, and she wanted to be a counsellor for the LGBTQ community because one had really helped her.

She had been using a pedestrian crossing because the traffic lights had changed to red. A taxi had sped through and over her, breaking her back and legs. The driver had got witnesses to agree with his side of the story, that the lights were actually on green.

When she was not telling everyone about it, she was moaning in agony.

I was kept nil by mouth the next day, so I missed breakfast and lunch.

In the morning I waved goodbye to the smiley staff who had helped me, as I was wheeled out of the Theatre Recovery Unit and onto the orthopaedic ward. I hoped it would be quieter. It wasn’t.

The orthopaedic ward was larger and open plan, with a blocked dirty toilet and one shower serving 12 patients. The spare toilet and shower were both broken. Unlike the Theatre Recovery ward, it was usually fully occupied and half staffed.

My four day neon hell of noise and pain had begun.

It was Sunday morning and a woman was being gently and firmly reassured by a nun.

Next to her was 88 year old Brenda, who was visited by her son and the two laughed together. She was outspoken and her bright eyes took everything in. She beckoned me over and we had some good chats. She had survived breast cancer and then she had had a fall. She said she would probably die soon. “You seem pretty healthy, I don’t think so” I said. “Oh love” she smiled, “I’m not afraid of death, I know I don’t have long left, that’s just how it is. My husband passed eight years ago so I don’t mind, I’m ready. I’ve already survived breast cancer” she said proudly.

The table was put on the side of my broken elbow, so I could not reach anything and no staff were available. They had even put the call bell out of reach. I lay there looking at the clock, counting the hours until my boyfriend would break the monotony.

Finally, my first meal of the day was served, a flavoursome beef curry. My boyfriend brought home-made banana cake for dessert and it was so comforting to see him.

He brought in my medication which I had not had for two days. A nurse had not arranged it as she promised, when she refused to let him bring it in onto the Theatre ward.

Night fell and so did the staffing levels. Once again I was without morphine for hours and I couldn’t help making a noise about it, it was the only way of processing the mental stress of being in constant agony and helpless.

I apologised to my fellow inmates as I groaned through the hours, waiting for two nurses to be able to sign off the only thing that would let me sleep.

I played a pain management meditation and calmed down as I watched the clouds lighten. Pain was part of life, it was temporary and it wasn’t always a bad thing. I shouldn’t resist it or be worried about it.

A bed pan was brought but I somehow wet myself and an exhausted zombie nurse had to change the bed. She said how she was on her fourth or fifth 12 hour night shift.

The closest patients both had dementia, one lovely lady was unsettled by my moaning and repeatedly asked if I was ok. The woman opposite repeatedly asked for help even though she didn’t need it. Flustered staff checked and eventually she was ignored. This seemed to increase her harassment of them.

When I finally got morphine I was still in too much pain to sleep, so I got the nurse to get the doctor. Finally, a girl in her 20s sympathetically doubled the dose so I could finally drift off. As the dosage increase hit my system I suddenly vomited, and then spilt some on myself putting the bowl on the table. I had to sleep in it as no one was available to change the bed again.

Maybe I would get surgery tomorrow…

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A Sharp Brake

Bluebells illuminated the forest floor, birdsong reverberated, bright green leaves curled round us and treecreeper birds hopped up to the heavens as we cycled through the woods. Abdominal cramps slowed my progress up a disused side road leading up to the main road.

Years of temperature changes and heavy rains had carved a ditch up one side. The concrete underbelly had been exposed, jagged rocks protruding like blunted shark’s teeth.

Having made it to the top I admitted defeat. “Go on, have a nice ride” I said, “I can’t manage it”. My boyfriend protested, but accepted it and I rolled back downhill.

I should get off and walk, I thought, the road was so uneven. But my suspension would take it.

Towards the bottom, I was speeding towards the ditch, so I gently squeezed the brakes and skidded. Abruptly, like the wheels, time accelerated. Instinctively I braked too hard as I slid, catapulting myself over the handlebars. I was aware of flying and saw that my arm was held out at 90 degrees, protecting my head. I shut my eyes and braced myself for impact.

I was rolling onto my left elbow.

An overwhelming burning sensation had doubled me over. It was impossible to tell where it was coming from, my brain would not compute.

I wondered when someone would find me. I tried to get up but my body would not allow it. Putting weight on my cut right elbow made me scream, so I let my forehead support my weight so I could see whether anyone was coming down. At least it wasn’t my writing hand.

I decided to keep screaming, it was comforting to think that somehow my boyfriend may hear me. It also helped to slow my breathing down. My fitness tracker watch somehow had not been smashed and my pulse shot from 80 to 130 beats per minute, as my body trembled in shock, my temperature dropping.

After the second bout of screaming, my boyfriend blurred into view, jumping off with the bike still moving, wide-eyed.

Seeing my position and pain, he said “we need to call an ambulance.” My rational brain woke up. “My phone is in my bag” I croaked, struggling to speak loudly.

Our first Good Samaritan stopped, a tall, middle-aged man wearing glasses. My boyfriend did not have his phone and had not processed what I had said. “Does he have What Three Words” I asked. Incredibly, the stranger had the GPS application.

My boyfriend put me on the speakerphone and in between shrieks I answered. I was warned that an ambulance could take up to three hours.

They apologised, that was the non-urgent wait time as my life wasn’t immediately at risk. I wondered whether I would eventually pass out in agony.

My boyfriend jumped back on his bike to get the car.

Then Adam, my second knight in shining armour, rode to the rescue. He whipped out a full first aid kit, keeping me warm with a silver blanket and a thermal coat from his backpack.

“Yep, that looks broken” he said, and helped me to shuffle off the road on my bottom so I could rest against the wall.

With his encouragement I dared to extend my elbow slightly so it was supported on my helmet. The burning, pulsating sensation was increasing and I was glad that this kind man was keeping me company.

Distracting me, he told me how he had been a mountain bike guide for decades. He loved the outdoors. If I had not braked as hard I would have been OK, you have to let yourself skid.

My boyfriend arrived about 15 minutes later and we stashed my bike in a cottage driveway.

Every bump and corner caused strong shooting pains. The full waiting room of patients stared in horror as I staggered into Accident and Emergency like a zombie from Shaun of the Dead, my bruised and swollen elbow dangling out.

Administrators put me to the top of the queue and within minutes I was being checked over by a friendly triage doctor.

As she helped me into a hospital gown, I asked “it’s just a standard break isn’t it?”

“I think that’s optimistic.”

“They can just put a pot on it and send me home can’t they?”

“Again, I think that’s optimistic” she smiled.

“Go on, what do you think it is?”

She winced at my bulbous hinge joint. “I’d say it’s an open fracture, I don’t think you’ll be going home tonight.”

“Oh.”

We waited about an uncomfortable hour for assessment. I could not bend my elbow enough to sit down, so I was glad my boyfriend was there for me to lean on and he put a comforting arm round me. The patients sat in silence, until a man walked in, cheerfully telling someone on his mobile phone how he had sliced the top of his thumb off whilst preparing dinner.

An intact elbow for comparison.

The X-ray was interesting, it still looked like an elbow, until the medic pointed to where the olecranon, the funny bone, had slipped, the internal injury and the air that had infiltrated the joint.

A nurse tried to lift the elbow to put a pillow under it and ran off after I screamed, sending medics running to my aid. “Open fracture” I explained, they nodded and left.

WARNING: GORY WOUND

Then it was time for a temporary cast. I would not lie down as it increased the pain, so they made an exception for me and started it with me standing, then gave me gas and air as they urged me to get on the bed. I experienced a powerful bout of nausea followed by nearly blacking out. “It worked” the nurse said “or that would’ve really hurt.”

There was a panel of medics in scrubs looking at computer screens in front of me like traffic control.

Woozily, I slowly hauled myself up and asked a nurse where the toilet was. “I’ll show you when I’ve finished this”, she replied. Then she conferred with another nurse and I blearily followed that woman past resus until she sat down at another A and E ward.

“Sorry, I thought you were showing me where the toilet was”.

“Er, no” she responded, completely bewildered, “you’re best off going back”. After she pointed me there I got lost again, walking into “resus”, past people gasping for breath, staring wide-eyed at the ceiling. This was more intense than my holding area. It was a relief when I bumped into the cast lady.

“What are you doing here?” she asked kindly, and showed me to the toilet.

It took over three hours to get a bed. The Theatre Recovery Unit was a long ward with many rooms. Mine was only half full. The nurse, Joy, was either elsewhere, chatting about her recent holiday with support worker Gloria, or telling demented Doris to go back to bed. Doris would then get up again, preferring to twirl a chair at the nurse station.

I smiled at a bespectacled middle-aged lady opposite and she just stared gloomily back and asked Joy “can I go home tomorrow?”.

After being kept “nil by mouth” pending the “highly unlikely” possibility of surgery, I was finally given a ham sandwich for dinner at 10.30pm, when I begged for it. Maybe I would get my elbow fixed the following day…

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Pros of Lockdown

We have basically been in some form of lockdown for about four months this year.

Lockdown Two has now morphed into a new (and arguably improved) Tier 3. We are in month two and this time I was ready for it – I had even bought my jigsaw puzzle to help me enjoy my time.

There are some nice differences this time around – you can enjoy little luxuries like a haircut, beauty treatment or shopping. And to think, we used to take those forgranted and moan about having to go.

After two months of lockdown my hair had become a shiny orange fluff ball, so I was relieved to get that sorted. So were my parents, who were fed up of being dazzled by my brassy tones. It wasn’t cheap to sort out my faded purple hair from the summer either. What was I thinking? Why did no one warn me it would fade to a Prince Harry shade of ginger?

After paying extra on top of an already pricey chop I resolved never to dye my hair any unnatural colour again. Except maybe red…

Anyway, I was thinking of calling this article Pros and Cons of Lockdown, like my Pros and Cons of Being Unemployed, which I wrote to help me manage the negative feelings associated with being unemployed.

But lets look on the bright side shall we?

But how do I get through this? you ask. Where the hell is the silver lining? Prepare to reframe…

  • You don’t have to go to that horrendously tedious wedding rehearsal/christening etc
  • You don’t have to be subjected to any unpleasant odours from others.

You don’t have to take the bus and spend your morning commute with Eau de Methane or B.O Parfum. Which brings me on to my next point…

  • No packed/hot/smelly/noisy/dirty/annoying/long/traffic jam commute

If you’re not an essential worker then gone (at least temporarily) are the days of shouting at the car in front, honking and wiping sweat off your forehead, as time ticks closer to you calling in late. Or alternatively dicing with death on your flimsy bike, squashed against frenzied rush-hour car commuters. You have been told by the government to work from home wherever possible, so you can work with music, with a cat on your lap and enjoy your home comforts, with the added bonus of keeping your germs there as well.

  • You can wear anything and you can retire your makeup collection

No one cares what you’re wearing. So why not stay in your onesie? Why not have a duvet day? Even when you go out, no one would notice what you’re wearing. They’d just be walking on the road to avoid your potential viral breath. And who cares if you woke up like this?? No one’s going to know!

  • You might save money.

Looking at my bank balance for the first time after lockdown I couldn’t believe how much I had been spending on buses, work lunches, meals out and drinks out. But of course I still try and support my local restaurants by doing takeaways now and again and I look forward to dining out again.

  • You can’t miss out on much

That party you weren’t invited to? No longer happening so no need to be jealous and think of all the reasons why you might not have been on the list. Everyone’s missing out now, you’re all in the same boat.

  • We appreciate the little things

That chat with your regular guy/girl behind the till? Bet you never even thought about it before, yet over March/April/May when you couldn’t do much at all, somehow that short exchange made your day. Or you had some restrictions relaxed and suddenly, going shopping was a novelty when you had previously loathed every second of it. You noticed things you didn’t have time for when you were busy, like the light on the trees, the local birds. It makes you appreciate what you have instead of grasping for the next thing.

  • We can slow down and smell the coffee

We have the time to slow down and are free from the busy schedules, the dashing from activity to activity, the relentless go go go of daily life. We can reflect and work on self development.

  • We value essential workers even more

It is funny to think that this time last year, we did not even really use the term. That Thursday clap reminded us how lucky we are to have our NHS, care staff, retailers, bin men – everyone who we (sometimes literally) cannot live without and who work so hard to keep our services running smoothly. Suddenly the unsung heroes of society were getting the attention and credit they deserved.

  • We value our family/friends more

When times got hard, it was our family and friends who lifted our spirits and reminded us that this was only temporary. They gave us so much kindness and support and we felt so lucky to have them in our lives.

  • We help each other more

The response to the NHS Volunteers scheme was so inspiring – 700 applicants in a few days.

  • We learnt more about hygiene and infectious disease

Now the general public have some awareness about how germs spread and how to minimise that, we may perhaps see a reduction in infectious diseases like flu that threaten to overwhelm our NHS some winters.

  • We prioritise our health

With the threat of increased risk from Covid from additional weight, we heaved ourselves off the sofa and went for a walk, started jogging, joined the gym and in my case, got into indoor climbing. I bought all the gear and I am ready for any “problem”, armed with my knowledge of various hand and footholds, confident that any “problem” can be “solved” if you just look at bits of hard plastic stuck to a wall for long enough.

The effects of an increase in public health led to sportswear selling out. On one website specialising in leggings the stock completely sold out. Most sports headphones had sold out.

We ate better food – fruit and vegetables sold out for the first time in living memory.

We have also ensured we look after our mental health and self-care days became popular – taking a day of annual leave purely to do things which are beneficial to your mental health. Lavender products sold out. The New Zealand government even gives its citizens a day of annual leave specifically for improving mental health. We know now how important it is to be emotionally resilient and aware of our needs.

  • We might make more time for our loved ones

Suddenly I was making more time for my friends at the weekend, rather than mostly just seeing my boyfriend. Because…

  • It sped up our love lives

New couples moved in together and had a crash test of their relationship. Some didn’t make it, but many did, including (so far) mine.

  • It encourages creativity

We have time for that painting, drawing or sketch and some people do painting competitions.

We got absorbed in new projects and hobbies

For me it was a jigsaw puzzle and climbing, for others it was knitting, house decorating, home improvements, reading, crosswords, painting, drawing, gardening, maybe even origami.

My lockdown project – 1000 pieces! It was perfect as it occupied me for the whole month and was finished in time for Tier 3. Now I need one for Tier 3…
  • It encouraged us to be flexible and adaptable

We had to think outside the box. We can’t meet indoors but we can…go walking and get a takeaway drink/bring a thermos as a replacement for going to the cafe. The fact that we could only see friends outdoors got people into walking.

We had to change most things – our routine, lifestyle, hobbies and activities. But we found new ones. We found out what worked for us and we surprised ourselves by thriving. No bread? We’d just bake it. No flour? We’d just have something else for lunch. No toilet roll? ……..there’s not really a replacement for that.

  • We have a greater sense of community

It may have been short-lived, but clapping with our neighbours and helping others felt so wholesome.

  • We have the British sense of humour

If you go anywhere else in the world it might not be understood, but our quirky poking fun at anything attitude helps. From advocating the exercise benefits of opening a bottle of wine, to wearing a box to keep people at the right distance.

Comedians give us free performances from their living rooms as we laugh about how surreal this is.

Now I can colour in mindfully or mindlessly depending on my mood!

Of course, times are hard for so many now. I won’t even go into that as I’ll pop your happy balloon. But today I read an inspiring article which changed my perspective. It was an interview with Michael J. Fox.

The actor has lived with Parkinsons for more than half his life. Parkinsons is a nasty degenerative disease. Determined to stay positive, he learnt to walk again and was able to convince others that he could live independently. Unsteady on his feet, he fell over one day and broke his leg. He was just recovering from that after coming out of hospital, when he tripped and shattered his arm.

Lying on the floor with a broken arm and unable to reach his phone for help, it was the lowest point in his life. He nearly gave up on his optimism, but he soon realised that he had come to rely on it. Whilst he accepts that looking on the bright side does not solve every issue, accepting his situation and not letting sorrow engulf him had enabled him to make the best of things.

I tested this theory out and challenged myself to only say cheerful things. I lasted about a day but I felt so much better for it. My mind was tuned to recognise happy moments and the small things that enriched life, like my morning cup of tea, rather than things I could not change that I did not like. I still try to keep to this and my friend said I have become more positive as a result.

Buddhist philosophy gets this spot on – if you don’t like something, change it, and if you can’t change it, why worry!

So whatever is happening right now, try to focus on these points:

  • what you can do, not what you can’t
  • what you have, not what you don’t have
  • what lifts you up, not what brings you down,

because my grandmother was right when she told me: “Smile and the world smiles with you.”

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A Sardinian September

Booking a holiday during a pandemic is fraught. Will I have to cancel? Will I get my money back?

We had booked Rome for March. Obviously we couldn’t go. We booked France for June and that also wasn’t an option, as my boyfriend can’t isolate with his work. Then we booked Sardinia for September. Third time lucky?

The company, Much Better Adventures, kept us updated with the Covid rules at our destination and we were able to go.

I was so excited. How had we managed to escape England in the middle of a pandemic?

We didn’t even need to get a Covid test as there was an outstanding appeal on the rule. Surprisingly there were no controls at the Italian airport at all. We appeared to be the only passengers around and the arrivals hall was empty.

Sardinians were very relaxed. They didn’t really bother to social distance, they could still spend time in large family groups, laughing at chatting. Although they were supposed to wear a mask outdoors, most of them didn’t bother. We only saw two policemen, one was on his phone and the other was more interested in us crazy tourists than any crime.

It was a refreshing change from the panicky Brits, dashing about and glaring at anyone who coughed.

We arrived a day or two before our scheduled activity in Alghero and went swimming at a lovely local beach. Unfortunately it was so popular that the only spot to stop at was a bit of rock in the sea. The snorkelling was pathetic after The Philippines (which is said to have some of the best snorkelling in the world). I only saw a few brown and grey coloured fish. Then a massive dark cloud raced towards us and soon enough it emptied its contents, leaving the sunbathers sprinting for the car. Of course as Yorkshire folk we saw it coming and were nearly home and dry before any of the Italians even moved.

We went on a delightful boat tour round the islands. The snorkelling was rubbish again, it was hardly worth bothering. I really want to return to The Philippines to see the kaleidoscope of rainbow coral, fish and the giant clams. One day.

We were going for a sea kayaking holiday with Much Better Adventures. We had a lovely American guide who had made the island his home. We stayed in a lovely hotel that did dinner, on a farm. The kayaking mostly got rained off, but we got one day of good weather where we could try it.

Unfortunately I had just been diagnosed with Graves disease so I was pretty tired, but I could sleep for an hour or so before dinner. The doctor had said I could go if I took it easy, as I was still on medication to keep my heart rate low. The guides were great about it and told me to let them know if I was struggling. I managed to kayak out and then had to kayak and rest, kayak and rest to get into the nearest bay to be picked up. Luckily we had a double kayak so my boyfriend did most of the work with his ex-rower biceps.

The scenery was beautiful – sun sparkling on bright blue waves, cliffs with scrubby bushes and trees everywhere, the odd beach or 16th century watch tower. The island to the left of Italy was covered in mountains and trees. There were no queues for anything and the “main tourist street” was empty.

Bosa castle

We explored the town of Bosa, where all the houses were painted bright colours and they had a small red brick castle on the hill, built in the 1100s. It had some fantastic wall paintings from around that era that they had found in the chapel. The colours shone depicting angels, saints and apostles.

We also explored some of the towns and had ice cream almost every day, as they make such great flavours with their Mediterranean fruit. Our guide said it was sad how the main tourist street in the town was now empty, and that many people were going to lose their livelihoods.

We marvelled at museums full of ancient artefacts, dating from 4000BC, from before the Iron Age. They had the Nuragic people, unique to Sardinia, who built spectacular sacrifice monuments out of dark big stone blocks. They also knew how to cast in bronze, fashioning lots of warrior, shaman and mother and child figures and statues. The island had then been conquered by the Phoenicians, the Greeks, the Romans and the Vandals.

We visited some vast ruins near the sea. One, Nora, was established by the Phoenicians as a trading post and still had towering white Greek-style pillars and mosaics and the ruins of Roman temples and baths. The Romans had abandoned it when they were attacked from the sea, during the period where the empire was crumbling.

Another was originally a Nuragic settlement (tribes who lived on Sardinia for 600 years around 4000BC). You could tell where the Romans had built on top with their paler stone and bricks, and it still had a Roman road. Both sites were still being dug up by archaeologists.

A Nuragic animal sacrifice monument from 4000BC, complete with an obelisk (out of shot on the left).

We returned refreshed and victorious that against all odds, we had made it abroad, with no quarantine being imposed in our absence.

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Climbing Through Covid

Indoor climbing is keeping me going through this Covid madness.

We are in lockdown, but we can still do this and see our friends outdoors in public spaces. This meant that the local farm was really busy at the weekend.

We have been told not to leave our region. It reminds me of stories from the Plague, or “Black Death” of the 1600s, when a local Derbyshire village, Eyam, heroically quarantined themselves. This saved the village next to it from certain death and disease.

There is something therapeutic about focussing on how to solve a problem on the wall. Your life suddenly seems less rocky and all you have is the knobbly footholds and handholds in front of you.

Does anyone know how to climb volumes? Those big triangular blocks with smooth edges baffle me.

Despite the fact that I am scared of heights, I am fine if I’m roped up with someone I trust.

We all need something to get us through these trying times. What is your hobby?

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A Grave Illness

Not everyone gets the above symptoms but these are some of the only visible signs of the illness.

Most people have no idea what Graves Disease is. Neither did I until I was diagnosed.

I was hoping it was thyroiditis – a temporary inflammation of the thyroid.

Graves Disease is an autoimmune disorder where your immune system attacks your thyroid gland, causing too much thyroid hormone to be produced. You can find out all about it in this video.

What you probably don’t know is that this little butterfly-shaped tissue in your neck controls almost every organ in your body and its processes.

At first, I wondered whether I had lung damage from my Covid-19 experience in April.

I rang the GP and she asked me to come down to the surgery that day. I had to use a walking stick as I was so tired going there that I thought I would faint. I was breathless and tired, sleepy and my heart was pounding.

The GP came out to meet me at the staff entrance in full Covid kit, but she soon relaxed.

“I’m pretty sure you don’t have Covid” she said. “You don’t even have a cough and your sats are fine.”

“I’m so sorry” I said, “I didn’t want to waste your time”.

I had had an ambulance called for me in June when I thought Covid was coming back and was breathless and coughing. I didn’t end up going to hospital to get it checked, but I know now that it was Graves rearing its ugly head.

“Lets just check your pulse. Stand up….sit down. She frowned.

Stand up again. Ok, you can sit down. Sorry can you stand up for me one more time?”

The doctor was still frowning.

“No, there’s definitely something going on. Your heart is racing. When you just stood up, your heart rate jumped to 130, then 105 the next time and 90 the third time.”

“90 is pretty normal isn’t it?”.

“90 isn’t bad but it shot up to 130 when you first stood up, even though you’ve been waiting, what, 15 minutes?”

“Yes.”

“I want you to have a blood test.”

I was put on a beta blocker, propanolol, which slows your heart rate down. If your heart rate is high over a long period of time it can cause an arrhythmia, which can eventually lead to heart failure.

Then I got the call. “It’s highly likely you have Graves Disease“. This is known in Europe as Basedow’s Disease. About 1% of the population have an overactive thyroid, of which about 80-95% of them have this caused by Graves Disease.

I felt exhausted and had dizzy spells. After just a walk I would sleep for an hour or two and yet I would be wide awake at night, sometimes taking until 6am to finally fall asleep. I read that it’s because the disorder overstimulates the nervous system. There was plenty of research about an underactive thyroid, but not much about an overactive thyroid, despite the fact that in rare cases it can kill you. This is known as a thyroid storm.

It took two weeks to get the medication I really needed – Carbimazole. This decreases the elevated thyroid hormones in your blood.

I had to ring the hospital or the GP regularly to chase it. I was told to double my dose of Propanolol. I then started getting even more tired and was mostly in bed, apart from short local walks when I had a brief respite from the jetlag tiredness. Kalms One a Night helped me sleep, and valerian tea.

I got my neck and eyes checked, as Graves causes eye problems in 30% of patients. That was fine as expected.

The other conditions that may lead to hyperthyroidism (an overactive thyroid) are nodules – lumps that affect thyroid function which is mostly seen in older patients.

According to internet research it will take 3-8 weeks for the Carbimazole to work.

I bought a “pre-payment” prescription certificate. This means that instead of paying £115-200 a year I instead pay £108. Those with an underactive thyroid gland get their medication for free, so there is a petition asking for equal treatment rights.

You have two treatment options after your course of Carbimazole is complete, but if you choose one, block and replace, your treatment is free. This is because the additional medication for this, Levothyroxine, is a synthetic hormone replacement for those who have had their thyroid gland removed – it has to be taken or the patient will get ill.

https://petition.parliament.uk/petitions/553013

On the 19th February I will have another blood test and then the level of thyroid hormone in my blood should be down to normal levels. Once I stop taking the Carbimazole I need to wait two years to give blood. I am not sure why it takes so long to be able to donate again.

An aunt has Graves Disease and the endocrinologist (a specialist doctor) told me that it is more likely if you have family history. She developed symptoms after she had her first baby. High levels of thyroid hormone in the blood can pass to the foetus and lead to low birth weight, prematurity and miscarriage.

The gene can apparently be activated by severe stress or trauma, pregnancy or bad illness according to Dr Google.

I am convinced that having Covid in April triggered a gene for Graves Disease. Months later I started getting tired and breathless doing my normal exercise again and I even had mania – abnormally high energy levels. One day I went for a two hour hilly bike ride. I was then awake most of the night as I wasn’t tired. This happens because energy levels initially rise at the onset of hyperthyroidism.

There is a small study of about 200 patients that has linked thyroiditis to Covid, as an infection in the upper respiratory tract (the throat) is close to the thyroid in the neck. You can feel the gland move if you put one hand either side of your neck and swallow.

You don’t have to have the gene to get Graves Disease, it can happen to anyone. It is more common in women and usually develops between the age of 20-40.

If you have a tremor (shaking hands) and you get breathless with activity, or you have any of the other symptoms on this list, ask your GP for a blood test.

If you have an overactive thyroid, you can join the BTF Hyperthyroidism Facebook group for support.

Updated 03.02.2021

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Lockdown: Take Two

So here we go again – lockdown, but this time by region – otherwise known as “whack-a-mole”.

The aim of the game is to stop Covid-19 spreading down the country from the north.

To this end, our Prime Minster has tonight announced a new tiered system for managing national outbreaks:

Tier 1 (Medium) – Meeting in groups of no more than six.

Tier 2 (High, formerly known as restrictions/partial lockdown) – No meeting between different households indoors, outdoor meetings of up to six still allowed, hospitality venues remain open.

Tier 3 (Very high, formerly known as lockdown) – No meeting between different households either indoors or outdoors, hospitality venues to be open only if they serve food.

Most areas of the UK will now be under Tier 2.

Liverpool, with the second highest rate in the country, will be at Tier 3. Nottingham, leading the Covid surge, is on Tier 2 because their hospitals are not as overwhelmed as in Liverpool. Liverpool hospitals have declared that they have nearly as many admissions as they did back in April. Nightingale hospitals in the North are poised to open again as the second wave is crashes down upon us.

Some could see this coming from the summer, while the media was complaining about people who dared to enjoy UK beaches. Infections were minimal and everyone breathed a sigh of relief. Others even started to question whether there really would be a second wave.

But I remember the ominous warning from Professor Tim Spector, of the national “Zoe” Covid-19 assessment app: “it is highly likely that we will see an increase in infection rates if schools go back in September”.

As predicted, the mass return of young people to educational institutions has been a source of many local outbreaks scattered around the country since September, until recently concentrated in the North of England but now, across the whole of Yorkshire, its talons reaching further and further south. Herd immunity is too dangerous because it involves too many deaths, as transmission increases, so does the hospital admission rate for over 65s.

Birley Halls student accommodation, Manchester Metropolitan University on September 28, 2020. (Photo by Paul ELLIS / AFP) (Photo by PAUL ELLIS/AFP via Getty Images)

Students paying over £9000 a year tuition fees are finding themselves sequestered to their flats, with universities literally struggling to cater to their needs as they are forced to survive on a spluttering stream of junk food. Sheffield and Newcastle universities have each had around 700 cases. This has contributed to cases doubling this week in Sheffield, for example, from 200 to 400 cases per 100 000.

Everyone is just hoping that the chaos will be over by Christmas, so we can still see our loved ones. But it all depends on us pulling together and tolerating restrictions to bring transmission down.

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Tagbilaran to Bohol – A dance with danger

Bohol is connected to Panglao by a bridge so I needed a lift over. This part of my trip did not go well.

The only issue with visiting The Philippines is that whilst it feels quite safe, as a tourist you might as well be a walking wallet. A minority of locals take great pleasure in trying to con you or fleece you. It’s a lucrative business and tired travellers are easy prey.

I was collected from Mithi Resort and Spa by their free transfer van. I had pre-booked a connecting taxi from the port of Tagbilaran, over on Bohol, once we got there. You do this on social media, it’s cheaper as you can haggle and ask a few companies to get the best price.

When we got to the port, none of the taxis were marked. I asked the van man to tell me where the Valleroso and Ralle taxi was (a reputable taxi company based on Panglao). He started having a chat with a driver that I presumed was from that company and told me that this was my guy.

Wrong.

As soon as I got in the taxi and he showed me a price list and tried to charge me three times what I had already agreed. We had arranged a price in advance I told him, you’re not from Valleroso and Ralle are you?

But I was tired and it was so hot, I couldn’t be bothered to look for the driver I’d booked. He should’ve been standing there waiting.

So I took a chance.

Bad decision.

The man was in his thirties with a greasy face and a leering grin. He started flirting with me and seemed to enjoy it, despite my obvious discomfort.

Come swimming with me, he said. I’ll have to wear just my boxers but I can show you all the best coral. And after I can give you a massage.

No thanks.

But it’ll be fun! Come on. It’s ok, it’s ok, don’t worry!

He kept saying that but it didn’t help.

After what seemed like forever, we were finally at my waterfront hotel, two hours later.

I wait for you and we go swimming yes?

Maybe, I said, I’ll think about it.

I was hot and tired. It would be so nice to go for a swim. But was it safe? Probably not. As much as I wanted to see the coral, I wasn’t an idiot.

The hotel staff scrunched their nose up at this rogue and did not seem impressed. Another sign.

I came out again. Sorry I’m not interested I said. He deserved stronger words than that. He then aggressively demanded twice the price I had agreed with Valleroso and Ralle and I reluctantly parted with more cash.

I was distressed and went back to my room fuming. Anything could have happened. I had been so stupid, I had to be careful, I had to remember that as a lone female I was an attractive target. Too attractive clearly. I wondered whether he had tried that before.

At least the hotel, Dive Star, was nice. It was right next to the sea and you could hear it singing you to sleep at night. In the evening you could see all the traditional fishing boats motoring by, a pleasant hum.

I had arrived just in time for the sunset through the palm trees. I sat on a bamboo chair on the balcony and drank iced water. It was perfect.

The room was made in the local style with bamboo and rattan. There was even a small lizard scurrying about, but he kept out of the way. He’d left me a poo present on the bed. Charming.

The next day, I wondered whether I could trust the local tour guides.

I would go with the hotel’s list. Hopefully they would be reliable.

A tall, smiling local turned up and said he would take me wherever I wanted to go. I said I would trust his suggestions.

He was friendly and good company and we eventually started to have a good chat. I told him my taxi experience and he frowned and said there were not many people like that on the island but it did happen around the port of Tagbilaran because it was a hub for tourists.

He reassured me that I could trust him and anyway, he was happily married with a wife and two year old son. His second marriage he laughed, the first one didn’t work out.

I breathed a sigh of relief. His name was Peter and he was new to the business, having spent several years shipping scrap metal around the world. He was gregarious and lively, chatting to everyone we met and making them as happy as he was.

We were going to have fun!

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