Poor Quality Arthritis
I mentioned in an earlier post, that a couple of weeks ago, I was suffering arthritis in my right knee. This was probably the reason, why after the stroke, my left leg was stronger than my right.
But after some physio ten days ago, it seems to have gone or at least died down. I also went t0 the physio yesterday and she said it was a lot better.
I’m saying thanks for small mercies.
Should We Licence Cannabis?
I have never taken recreational drugs and probably never will. I also feel that our current strategy against drugs is a total failure and probably just makes things worse.
So it was very refreshing to read the views of Professor Roger Pertwee on the BBC. His views about licensing sales, should be taken seriously. After all, getting criminals out of the loop, ensuring quality and protecting health are probably more important.
But his views will be totally ignored. All we will do is go on building more prisons, so we can lock everybody up!
Dr. Rosemary Leonard is Horrified
The very sensible BBC Breakfast doctor is horrified. And rightly so!
So what is she horrified about. A BBC Scotland report has shown that people are turning to homeopathy instead of conventional vaccinations, such as MMR.
These cranks should be stopped as the only way homeopathy can work is by a placebo affect. It has no scientific basis whatsoever.
As someone who has suffered the death of his wife and child in recent years, I would not recommend suffering bereavement to anybody. But some of these stupid parents will find out the pain if they persist in using homeopathy, on their children. You could argue it’s child abuse!
Is There A Need for a National Anticoagulation Service?
Like many people in this country, I’m on Warfarin. This means that I have a blood test every week or so and answer a few questions about how you are getting on and if you have missed a dose. The hospital managing your anticoagulation service, then does the analysis for your INR and calculates your daily dose and date of the next test. If there is a change in the dose, you are told immediately by phone, usually within twelve hours of the blood test. On the next day, you get a letter from the hospital confirming the dose and giving the date of the next test.
I have found that one of the subsidiary effects of my stroke, is a need to solve problems and design systems that work. So after the problems with the phones last week, where if there had been a dose change, they wouldn’t have been able to phone, I got to thinking about how the service could be improved.
So what problems can I see?
- For me giving blood for a test is very easy. Although I am right-handed, because of my gammy left arm, I prefer the test to be taken out of my right arm. A week ago, they took blood in the hospital on the Friday and then I had another test on the Monday for the Warfarin. It was no problem at all. But my late wife, C, found giving blood for a test almost impossible. So we’re all different.
- The letter I get for each dose, is one of those awful NHS letters, that because of my hand, I find very difficult to open. Or I would, if I didn’t have a very good pair of scissors! There must be many on Warfarin, who have much worse hands than me!
- I live in the countryside and I have the blood test either at the GP surgery or at my local hospital. As I can’t drive, this means I have to make sure on test days, my driver comes in. It’s not a great expense and I usually do all my food shopping at the same time, but it could difficult for those who have to go to the local hospital, where transport is difficult.
- Perhaps my biggest problem, is that I travel a lot and might not be in the right place for a test. I can have them a day late, but I like to be precise in getting my dosage right! This travelling might also mean that I don’t get the letter until a few days after the test. This doesn’t matter as regards the dosage, but knowing the next test date might be important.
So what is available to improve the excellent service, I get from the NHS. And in these times of austerity, could a service be designed that was not only failsafe but cost less to run?
There are machines now to self-test for your INR, just like diabetics test for the amount of insulin they need. I used to think that this might be the way to go for me, as I’m pretty tech-savvy, but the machines aren’t cheap and it means that when I travelled, I’d need to take it with me. I’ve tried hard to avoid carrying excess baggage for years and now that I’m not as strong as I was, I don’t want to start adding to it. And my gammy left hand might drop and break it!
On the other hand, these machines only take a pin-prick of blood. So would they be much better for people like my late wife?
Technology has also moved on in the fields of communication and I now am reminded of my hospital appointments by SMS message. So there must be ways that technology can improve the service!
So what could a service look like?
I have said in the title to this post, that it might be National, but that might bring in other problems, like Data Protection. Incidentally, I don’t bother about that for my health records, as anyway most of my problems are already available to everybody in this blog.
Like now it should be based on a network of testing stations. There could be two sorts; ones that worked as now and sent the blood samples to the hospital and others that worked using pin-prick style machines, which give a direct INR reading. In the case of the simpler systems, all it would need would then be to enter them into the Service through a web page or even by phone to the hospital. Obviously, various routes could be allowed, so that patients who might be confused, weren’t upset.
The advantages of multiple testing stations are that you can go to the one that is most convenient. Suppose too, that pharmacists were licensed to do the test, so that you could do your test when you went to the shops. It would be much easier for me to go to Boots in Newmarket, than have to go all the way to the West Suffolk Hospital, because the blood nurse at the surgery was too busy or on holiday.
Multiple testing stations would also mean that, when I was travelling, all I’d need to do was find an accredited testing station.
As the testing stations would get your INR almost instantly, once it was in the Service, the results would be immediately available.
But it is in the distribution of those results that the greatest improvements can be made. We have five basic methods of communication; letter, e-mail, phone, mobile phone and SMS message. You should be able to choose how you want to be told and all of them can now be done automatically. I would take an SMS message with a letter for backup.
I elieve that properly designed such a system would work very well. The problem with it would be that some anti-coagulant departments in hospitals would no longer be needed. So what would the Unions have to say on that one!
The Jigsaw Starts to Fit Together!
Oxford University has today published findings, that show that cocktails of various vitamin B’s might actually help in the treatment of Alzeimher’s.
I’ve covered this sort of work before in Keeping the Brain Healthy.
I’m no medic, but the more you delve into this subject, the more it seems that the B vitamins are more and more important.
Now I’ve Got A Gammy Knee!
Over the last couple of days, I’ve had a minor difficulty getting up from a chair. I was just getting a bit of pain in my right knee. I had to see the GP yesterday and she looked at it. I had thought it might be something to do with the stroke, but it was just a touch of arthritis. As I was seeing the physio after the GP, she had something else to do and she gave it some therapy. It’s a lot better this morning.
The gastroenterologist I saw on Friday last week told me that I had some sort of bio-chemical problem and this was resulting in my poor nails. They took some blood to check what it was.
Now before I was diagnosed as a coeliac, I had lots of problems and pain in my left knee. These had started when I was about 25 and one doctor in those days, suggested I had an operation. When we moved to Suffolk in 1975, a new doctor, recommended some exercises and except for the odd stickiness when I got up from the floor, I never had any more problems.
All of these knee problems got a lot better with a gluten-free diet.
So now it’s the other knee!
Ever since I’ve had the stroke, I’ve worried that something is wrong with the bio-chemistry of my body. I’ll laugh like a drain if I’m low on vitamin B12!
But what do I know about medicine! Not a lot! But I do know my body!
In addition to the knee and nails, I’ve also got a certain amount of the runs and I am sleeping a lot and very well. The latter is probably due to the body needing time to recover.
A Pain Diary
This is a set of notes to see if I can find the best strategy for controlling the pain.
Tuesday, 31st August
10:00 – The pain in my jaw, face and arm is bad. I’ll give it 7/10.
11:00 – The doctor gives me some 15 mg. codiene tablets and says to take one or two, three times a day. He says it won’t hurt if I mix them with paracetamol.
12:00 – I take two codiene and one paracetamol tablets.
13:00 – Lunch is one of Waitrose tiffins, which I feel helps my mouth.
14:00 – Pain is down to about 5/10 and I sleep for perhaps an hour.
17:00 – I’ve done quite a bit of typing this afternoon, so the left hand isn’t too bad. Pain still 5/10.
19:00 – Pain now about 6/10, so I’ve taken another two codiene.
20:00 – Supper was a tuna steak, peas and sauce followed by raspberries and yoghurt. It was surprisingly easy to eat and the fruit and yoghurt was very soothing. I should say that I still eat peas with my right hand, using the fork as a spoon. Pain is now about 4/10.
Wednesday 1st Setember
06:00 – I have just got up after a good night’s sleep or at least a very reasonable one. I didn’t take one of the sleeping pills either. Pain is about 3/10.
07:00 – Just taken one codiene and one paracetamol.
12:00 – On the way to Lingfield, I took two codiene and one paracetamol to keep the pain level to about 4/10.
17:00 – Supper was pasta in Carlucciuo’s with a still lemonade. Pain still about 4/10.
19:00 – On the train home to Whittlesford, I actually slept for twenty minutes or so, so the pain level was probably a bit less. I didn’t end up in Cambridge either!
21:00 – Just cook one codiene and one paracetamol before bed. I’m trying to keep the number I take each day to below the maximum, as that gives me a margin for if the pain gets worth. Pain is probably at a 3/10 level.
Thursday 2nd September
07:00 Woke up after a good night’s sleep. Pain in the face after a cup of tea. Perhaps 4/10.
08:00 – Took one codiene and one paracetamol.
11:00 – I went to see a physiotherapist, who used some electrical therapy on my arm and also said that some of problems there were because I don’t sit straight up.
15:00 – I’ve peeled a few potatoes for a fish pie and the cold water and the movement seems to hsve eased the pain in my wrist. The pain level is about 3/10.
22:00 – As with yesterday, I have a codiene and a paracetamol before going to bed. The pain level is about 3/10.
Friday 3rd September
07:00 – Slept well with no problems.
09:00 – Took one codiene and a paracetamol. Pain level about 4/10.
18:00 – Took one codiene and a paracetamol. Pain level about 4/10. Pain mainly in a tooth. Did find that a slice of Marian’s chocolate cake had a beneficial effect.
Saturday 4th September
07:00 My arm wasn’t good in the morning and I had a bit of trouble putting a shirt on as I couldn’t find the left arm-hole.
22:00 – I didn’t have too much pain all day and had perhaps one paracetamol, when I got up and one in the evening. Pain level about 4/10.
Sunday 5th September
07:00 – I woke up much better this morning after a lot of sleep. I took a paracetamol. The pain level was 3/10.
21:00 – Not much pain at 3/10 and I’ll probably take a paracetamol before I retire.
Monday 6th September
07:00 – I slept well with little pain. Perhaps about 5/10.
I Can’t Sleep!
Since I had the stroke, I’ve always been able to sleep. But not tonight, as the pain in my face is too much and I reckon if I’ve had an hour of sleep, I’ve been lucky!
I’ve taken a couple of paracetamol tablets and they have made no difference.
It’s now three o’clock in the morning and I’ve got up to listen to the radio and play on the computer. At least my typing is fine!
So let’s hope the pain is a sign that my brain is getting to grips with my body again!
Using NHS Direct
Because of my pain, I felt like a pain killer might be an idea. So I searched the NHS Direct web site and I couldn’t find anything that might help.
Eventually I gave up searching and phoned them directly.
I was on the phone for perhaps ten minutes before I got through to a nurse, after answering a load of questions. The nurse reapeated some of these questions and then quizzed me extensively to check I wasn’t aving another stroke. She did say that if I thought I was having another I should phone 999 immediately.
When we got to talking pain killers, she said I wasn’t to take an aspirin as I was on Warfarin. But paracetamol was OK. So as I had some, possibly of a dubious age though as it had Victoria Regina stamped on the tin, I took one.
The system did work, but it was rather bureaucratic and over protective. Let’s hope the 111 system is better. A chat to a competent nurse or pharmacist is what I wanted and that is what I got. Will I still get that under 111?
After Stroke Pain
When I left hospital three months ago, I wasn’t in much pain. I suppose I’m not really now, but I do have an itchy scalp, pain in the left side of my face, in my left wrist and in my humerus, which was broken when I was about fourteen. Reading a piece on the National Stroke Association’s website, this pain may be caused by the brain misreading the sensations sent through the nerves and not nerve damage. It also says that conventional medicines aren’t very good at countering the pain.
The paper also says that you could end up misusing drugs. It’s a bit difficult when you don’t take them. But despite the advice I did take an aspirin.
I don’t know about it, but it is something that I must discuss with my doctor.
The Anonymous Widower 