Is It A Case of Hail the Hygienist?
Yesterday, I went to see the dental hygienist to have my teeth polished.
She did her usual good job, but she found a small problem with a tooth, that may well have been causing me the pain in the left hand side of my face, that has been plaguing me the last two years, since I returned home from Hong Kong since the stroke.
Let’s hope so!
We shall see next week, when I go to the dentist.
So perhaps, I was right, when I advocated a walk-in hygienist.
Aung San Suu Kyi and the DJ
Years ago, I can remember Dave Lee Travis on Radio 1 on Sunday mornings, whilst I was writing Artemis. I suspect as a young mother in Oxford, Ms Suu Kyi was listening to the same program.
Aung San Suu Kyi then went back to Burma to care for her dying mother and for twenty four years she couldn’t return to the UK, as she feared any return to her family would mean the Generals wouldn’t let go back to Burma. She couldn’t even return for the death of her husband, Michael Aris.
But during those years of isolation in Burma, she did at least have the BBC World Service, which kept her in touch and she listened to the shows of Dave Lee Travis, who briefly met her yesterday.
In some ways I can understand her isolation, although I’ve never suffered like she has. When I had my stroke in Hong Kong, there was only CNN, that I could understand on the television. But at least, I could get BBC Radio 5 at most times through the Internet. Never has a broadcasting channel been so important to my sanity.
Today, Aung San Suu Kyi is praised in the first leader of The Times. The last sentence is something we should all remember.
She not only represents a better future for Burma, but testifies to the resilience of the human spirit in extreme adversity.
I very much agree with that. She has also been an extreme example to me, as to how to cope with the worst that life can throw at you. But then I’m not alone and thousands of miles from my friends and family.
In
How to Cut Down Strokes and Their Effects
The more I learn about strokes the more I know that the one I had in Hong Kong might well have been avoided.
my stroke was caused by atrial fibrillation. This was detected hen I had a small stroke in March 2010. I now feel that I should have been put on Warfarin, but why the doctors didn’t take this route, I do not not know. Could it be that my previous surgery in Suffolk, wouldn’t use a simple hand-held instrument, but still relied on expensive weekly blood tests? I don’t know, but having been on a system based on a machine since moving to London, I can honestly say that the the system is better from a patient’s point of view. My previous cardiologist, who has an International reputation assured me that if I kept my Warfarin regime, I would not have another stroke.
I am now under the care of University College Hospital in London. I happened to tell the nurse doing my electro-cardiogram there, that twenty or so years ago, I had had one that missed a beat in a flying medical. She said that that should have been followed up as it was indicative of atrial fibrillation. Instead over the past twenty years, I’ve had the odd cholesterol and blood pressure tests and that is about all.
It strikes me that, if I had had a proper heart medical, twenty years ago, then my stroke might have been avoided.
But I didn’t even see a cardiologist after my first stroke.
It strikes me that GPs either need to be better trained with regard to heart problems or less reluctant to refer patients to cardiologists.
I was also lucky in that I had my major stroke in Hong Kong.
There I was given a drip of a clot-busting drug, that provably mitigated my lasting problems. It is common place in some countries and regions of the UK. A BBC London report, showed that it saved money against conventional treatment, by avoiding lots of expensive after care. Additionally, in London, you are always taken to a specialist stroke unit.
So it does look like things are improving in the treatment of strokes.
Two Years On
It is now over two years since I had the stroke in Hong Kong and as you know I’ve now moved to London. So how have I improved in the last year? I’ll intersperse the comments into a copy of last year’s post.
So how am I feeling?
Bodily, I have few issues.
My nails used to be firm and hard, but now they are soft and brittle. My toenails are actually worse than my fingers. My nails were always soft before I went gluten-free and I used to bite them badly and my skin too. I’m not biting them now at all.
My nails went bad at the start of the year and aren’t too bad now. If my left hand wasn’t gammy, they would be better as I could cut them properly.
Q 1. Could it be that as my body is repairing itself from the stroke, it’s using up what I need for healthy nails?
I never got an answer to this question, except that this house has a very dry atmosphere. But they were bad soon after the stroke.
I have an almost cramp-like pain in my left lower leg, which is very like the pain I got, when I trod on a razor shell on the beach in Norfolk in the summer of 2009. It tends to get worse at night.
I still have this, but it certainly doesn’t get worse at night. I think also it’s true to say that I’ve had this problem off and on for ten years or so. Sometimes I get it in the right leg, but not at the moment.
My left humerus is also painful a lot of the time at the same place where it was broken by a bully at school. I think as the nerves for my arm and hand pass close to the bone, it affects them at times.
This is still the case and no-one listens except my physio. But then he’s paid to listen.
I did have pain at the end of my spine, but now that has virtually gone unless I sit on the wrong sort of chair. This again was an old injury, which was very much aggravated by the hospital bed in Hong Kong. I should say that I always sleep face down because of the end of my spine, which curls outwards and I get less cramp in my lower leg, which I’ve always had since a child. I can still feel the cold lino, which I used to put my foot on to cure it.
It’s almost as if my old physical problems have come back!
Q. 2 Does your brain develop new pathways to get round the pain from injuries?
I think now, that’s taken as the case.
Facially, I haven’t too much pain, but my scalp and left hand side are rather tender. My skin actually feels like it did at times before I went on a gluten-free diet before I was diagnosed as a coeliac. One of my main symptoms of coeliac disease was chronic dandruff. It went immediately, I changed to a totally gluten-free diet.
It’s come back with a vengeance this winter and I put it down to the hot dry air in the house. I’ve installed air-conditioning to hopefully kill it.
In fact, at some times, I feel like I’ve been glutened. Not seriously, but my motions are rather loose nearly all the time. Full tests at Addenbrooke’s have shown that there is nothing serious there, although I haven’t had another endoscopy to see what my gut is like.
I still do.
I have just re-read a post on this blog, which was a pain diary, describing how I was trying to control the terrible pain I was having last summer, with codeine and paracetamol. It wasn’t that successful and a few days later or so, I collapsed and ended up in Addenbrooke’s. Nothing was done and I just struggled on. And then a few weeks later, I ended up having a fit like symptom, when I was putting on my coat. I can remember feeling a bolt of pain in my humerus and then I went into oscillation. It’s funny, but I may remember something similar happening, just after I broke the bone, as I walked home from school. Addenbrooke’s put me on Keppra to stop it happening again. It hasn’t.
But I did collapse again.
Q.5 Should I keep taking the Keppra?
I’ve changed to Tegretol.
Because of the pain and because it felt like someone was pouring awful muck down my throat, I went to see an ENT specialist to see if my sinuses were bad.
He found everything clear, but thought that I was suffering from a serious pollen allergy. Now as a child, I was very sickly and was always off school. In my first year at Grammar School I virtually missed all the second term. Gradually it got better and it really improved when first we went to live on the 11th floor in the Barbican and later when I started flying aircraft for pleasure.
I’ve also had some bad winters and springs before, but not as bad as this one, when for much of the time, I just couldn’t breathe. Although in the last twenty years or so, I’ve lived on top of a hill with a strong westerly wind and my late wife and I could afford to take holidays in the sun in January. Funnily, my cardiologist,said that everybody should take two weeks in the sun every winter. I did try to do this in April by going to Greece and backpacking around the islands, but was irritated by everyone smoking all the time.
I know from travelling around the UK in the last year, that when I get out of the pollen I feel better. For instance, I went to Barnsley in March on a breezy day to see the football and felt a lot better that day. On the other hand, I walked past a tree-shredding machine at Euston a couple of weeks ago and it set me off coughing for half-an-hour.
Q.6 So why should all of this reaction to allergens get so much worse after the stroke?
On the other hand, in 2009, I was travelling to Holland a lot in the spring and suffered worse than I had done for years. I put it down to different pollens at different times. It was almost as if I got used to the English ones and then when I went to Holland, a load of different ones set me off.
Some days it’s so bad that all I can do is lie down indoors and listen to the radio. On the other hand, when I went down the London sewers, it helped my breathing immensely.
I do this less often, than I used to.
So how am I managing otherwise.
I have no problem getting around on buses and trains and of course by walking. I did fall over on a bad pavement in Upper Street in March, but haven’t hardly stumbled since, especially since I was fitted properly for a pair of trainers. I have no problems using the top decks of buses and climbing up and down ladders.
I like cooking and do quite a bit, although, as there are now so many Carluccio’s with a gluten-free menu, I am lazy quite a bit of the time.
I do eat a lot of soft comfort food, like bananas and ginger cake between meals. But my weight is still the same as it was five or six years ago.
My only problem with cooking is that my left hand diesn’t seem to like hot or cold, although the finger movement is now almost back to normal. I notice this most with my typing, where although I type mainly one-handed, I now use the left properly for the shift. Incidentally, I’ve always typed with my right hand, because of my bad left arm.
My eyesight to the left isn’t good, but in the last month or so, I’ve been able to play table tennis again, something that I couldn’t do a year ago. On the other hand, it does seem to be worst, when my eyes are streaming from the allergies.
Not really much change here, except that my nose seems to leak like a drain. My eyes are a bit better.
It’s Gibbon Time
I took a New Bus for London up to Piccadilly Circus this afternoon and it was surprisingly busy for a Sunday afternoon.
A Busy New Bus for London
When I got off, I used the rear staircase and I found that the vertical hand holds were alternated for my left and right hands. So I swung down the bus like a gibbon. I’m not sure, whether all buses are like that on the top deck. But if they are not, they should be! The slightly rough texture of the hand holds also gives a good grip for my gammy left hand.
Incidentally, note in the picture, how the handholds slant outwards. Does this effectively make the gangway wider? Or just appear so? I must take my tape measure with me to check!
After all, when you are rehabilitating from a stroke, like I am, isn’t it a bit cheaper to get free exercise in everything you do?
My Sense of Smell Seems To Have Returned
Surprisingly, over the last few days, my sense of smell seems to have returned. A lady next to me on a train was chewing spearmint gum and I really smelt it. I can’t say I’ve smelt spearmint that strongly since my stroke.
But that was only one incident out of several.
Paper Isn’t What It Used To Be
I do find reading a newspaper these days to be an absolute trial, as turning the pages in order seems almost impossible.
I did think it was the stroke, but it now appears to me to be the quality of paper that is now used by papers like The Times and The Evening Standard.
Increasingly, I am using the on-line versions of both papers. And others that I don’t buy or pick up.
Is It The Stroke Or The Old Injury?
At school, a bully broke my humerus. He was twisting the arm upside down and hitting the tricep muscle repeatedly. I tried to turn round to hit him back after about twenty minutes or so of this torture and I overbalanced and all the extra pressure on my arm broke it. It sounded like the noise you get, when you snap a raw carrot. I have only ever had it X-rayed once and that was at the old Highlands Hospital in Winchmore Hil, just after the break. I had seen pictures of green-stick fractures and it looked like that, with bits of bone everywhere.
Over the years it has sometimes been very painful. Once about ten years ago, I went to see a doctor and he got a CTScan done on the shoulder, as he thought, that was where the problem was. Since my stroke it sometimes has decided to annoy me. It did quite a bit in Hong Kong, but it couldn’t have been too bad when I was out of hospital, as I was able to drive cars around the yard at the stud. When I first moved to London it couldn’t have been too bad, as I was able to do some interesting metalwork. But it has been very bad over the last couple of weeks and that includes hospital. But you cope and I’ve now found a computer, that will allow me to type easier right handed.
I should say that the hand is generally pretty good and I can use it to help me get up and down stairs on a bus. Last night for instance, whilst standing on the New Bus for London, I was using my left hand.
On the other hand, there have been lengthy periods in my life, when I used to wear my heavy watch on the right hand and I have always slept on my right side or face down, with no weight on my left arm. I even did that as a child before the arm was broken, due to the layout of my first bedroom.
So is the pain in my left are due to this old injury or down to the stroke?
Good Riddance To That Tooth
I broke the tooth many years ago and a couple of dentists had tried to fill it, but it always caused me a certain amount of pain. I don’t remember how I broke it, but I think it might have been on a bread roll in a Michelin-starred restaurant in Italy. The only person, who could know is C, and she has been gone for over four years now.
After the stroke it got painful and no matter what I did, it was giving me pain. Since the stroke it seemed to have got worse and I often thought it smelt of something like rotten fish. It will be three weeks tomorrow, since I had the tooth finally removed in the Royal London.
Since then, I’ve been to dentists twice to have a look at it and one gave me some antibiotics. A few days or so a small piece of tooth came through the gum.
Yeserday though, another piece came out and it was about the size of a child’s front tooth. The gum bled a bit, but by the time I got to bed and after a whisky, it was OK.
I also slept very well and long and woke without any tooth pain. And that means also none in the left hand side of my face for the first time in a year.
Strangely, my left hand seems to be working better in the typing.
It’ll be interesting to see what my dentist says, when he reviews it all on Wednesday.
My only regret is that I’d had it out a year ago. Or even earlier.
Accessing Medical Records On Line
The government is thinking of allowing this.
I’m all for it!
At my previous doctor’s surgery, I was allowed to read my then paper notes with impunity and often did with the nurse when she gave me my B12 injection every couple of months or so. I found the free access very useful, but unfortunately my notes for the first twenty years of my life have been lost and they might have been very helpful in sorting out my various allergies in addition to the coeliac disease.
Over the last few years, I’ve often posted medical details and results of any tests, such as those for cholesterol, in this blog, so I can access them easily, if I need them.
Last summer, when I had the stroke in Hong Kong, some of what I had posted proved a help to the doctors and possibly hastened my recovery. It certainly cut down the number of blood tests.
So, the government’s proposal to put all our medical notes on line is to me a very positive step towards providing better health care. We should also be allowed to add our own comments and observations. For instance, I’ve just had a tooth extracted and that should be added, as should my supervised experiments with Keppra.
The Anonymous Widower 