Treatment plan

On Friday I attend outpatient Oncology for the fitting of my 'Mask' (I do like Jim Carey movies). If you want to know a bit more about the preparations for radiotherapy  try the very informative /reliable Macmillan site:

 http://www.macmillan.org.uk/Cancerinformation/Cancertreatment/Treatmenttypes/Radiotherapy/Beingtreated/Radiotherapymasks.aspx

Then the following Monday 4th February I am due to start Radiotherapy, my first of six over a two week period. I cant say I am looking forward to the prospect of side effects, particularly i) hair loss, albeit this is delayed and may take some weeks to occur. Moreover hair loss is not something new and I have had to get used to this for some time. My  charming sons will no doubt have a field day on this one. I have already incorporated a hat into my regular apparel as I don't like drawing attention to  the scar on my skull  whether at home or in public. And ii) Exhaustion: This is highly likely & regrettable as each moment seems so precious and I want to make the most of it

Coping: As previous by a) Developing routine for the basics b) incorporating meditation & gentle yoga plus exercise whilst extending myself a bit more each day-week c) the generous support and kindness of all you well wishers. Listening to Anne and the boys whose' common sense moderates my excess (most of the time)
d) The Blog: as a way to update folks without having to recount the same information repeatedly; to manage my thoughts and feelings; as a place to start a dialogue about the NHS & the quality of Care and treatment which is clearly happening and needs arising to counteract the mainstream media
 (see my introduction to the Blog and my motivation)
I am hoping to call into my two places of work ,using the train (due to the fixed two year driving ban) and see my colleges check my in tray(emails) etc

Symptoms
not currently getting headaches or visual disturbances (unless very tired)
Some labile emotions (quick to well up) if something reminds me of the past ,triggers  thoughts about the uncertainty of the future
Fastidiousness about knowing where things are ,in control and what I have previously referred to as 'reverse nesting'.
Pesky upper respiratory tract cough with usual signs (I wont go into detail you have all had chest infections at  some point to some degree!) which kicks in when tired and inhibits sleep ,social discourse etc. A colleague suggested there is a prevalent "100 day cough " going around. I hope it does not  last  that long.
Exhaustion: I find I get completely knackered at certain times of day then irritable and sensitive to criticism and fussing at which time I try to do some mindfulness meditation

Institutions continued, and update

What makes Britain great #four [our respect and enjoyment of the countryside 'green& pleasant land' and all those institutions ,farmers,landowners ,supporters who maintain access for the wider population]; 
Here are some initial pictures of me trying to do something healthy,normal and part of self care routine -a walk on a local byway in the fresh air with my little &eldest ,sister and her dog that thinks he's a Hippo,a 'Hippodogamous'  no less.
Following on from earlier emphasis on what makes Britain great, I am continuing to pose some themes of what I believe are important institutions [NHS being a key which binds us all together in a unifying way which we undermine to the detriment of us all].. I’m being fairly open ended about “institutions” (see number #5: multiculturalism,pubs and football).  Again, the purpose is to stimulate discussion, but in particular in relation to the NHS and the care I have received, and that of others. This is dependent on highly skilled and caring people from around the world. I’m not sure what I feel about us,a wealthy UK  poaching such valuable individuals from less well off countries. Nevertheless, it’s clearly to our benefit, and I like to think our best practice is then dispersed throughout the world by the example of the NHS. When I was an inpatient, there were so many people representing so many countries, I had to take a atlas in to overcome my ignorance. 

Tom Archer spotted (the shoot)

Ken worthy( executive ) taxi sand Rory the' HippoDogamous'

and ensure you clear up  your dogs dodos!

This one's for Julie

You go out of your way to find some space and you run into someone you  used to work with what are the chances?

Great British Institutions #4; Public Access to the countryside

 The combined   efforts of all those organisations and  associations (e.g.  National Trust, Farming industry, English Heritage, landowners, Ordnance Survey etc. In the maintenance of our green and pleasant land allowing all of us to benefit through public access

Though I have always lived in Cities/towns I have generally had ready access to the country side and enjoy being going out for walk in parks, woods, and using the permitted paths, bridle ways etc. I really don’t mind the conditions as long as I am prepared with adequate footwear and clothing. My mother was equally keen and would suggest a ‘constitutional’ post Sunday dinner (rather than slump in front of the TV as all the carbohydrates are being processed- unused-absorbed).

Well wishers sustaining my recovery
my good friend Peter who  knows a thing or two about  George Kelly's Personal Construct Theory -PCT ( surly a precursor to Beck's et al  Cognitive Behavioral Therapy -CBT ? from which current CBT could perhaps learn a thing or two :Article to follow in time ''snakes & ladders'   and Michael Whites Narrative Therapy amongst other things. Visits with his delightful daughter Rachel (one and a half) to cheer me up and get my sons old toys out from the attic

Good old playmobile. My boys could not resist joining in the fun.

Happy Family .Article on Personal Construct Theory to follow.

#5: Multiculturalism

I wanted to emphasize the importance to the NHS (and I believe wider UK society) .Thirty percent of NHS professionals were born overseas. That would certainly reflect my recent experience of being an inpatient in the NHS. I was treated with the highest standard of care and professionalism from so many kind and friendly people from all manner of places.  Working collectively for the benefit of patients, relatives and their colleagues. This has been my experience throughout the thirty years I have worked in the NHS. I have worked and lived in a diverse range of  multicultural cities and towns (including  areas of marked social deprivation & very well heeled East  Anglia Towns, inner city London for six years). I don’t have a problem with the notion of multiculturalism and immigrants coming to work & settle in the UK (I might if I did not have live my current comfortable and well off standard of living).

Return to the work environment

Minus use of car. Used another GB institution, the public transportation system (mainly the railway) and the reliable the telephone box (not red, alas).  This was particularly stressful, as not only have I lost the use of the car after 35 years, my case load at work has to be handed over so that the patients received the necessary treatment. For me this was an almighty emphasis that I will not be going back to as it was before, and I will have to seriously consider my work goals and aims. Career? Future?

Let the train take the strain

hrnv

This is where it all started.hence me clinging on for dear life.

Overflowing inbox.Thanks for all the emails telling me my mailbox was full!

For some reason the term “bucket list” keeps coming to mind. I am not sure who suggested I get a 911 Porsche ;hardly  fits with the mandatory 2 year driving ban, and it wouldn't be the same with Anne at the wheel and me as a passenger. I have had thoughts about what I can get away with,( criminality wise) but that will have to be kept under wraps so as to avoid accusations of premeditation. 

Good news NHS Stories:

My Colleague’s husband had his esophagus reconstructed from other parts of his body and is recovering very well. Incredible intervention and exemplary care reported back.,Albeit some of the post operative supplies needed a bit of sorting.Its the small things that can really make a difference.any way best wishes to P and a speedy recovery.

Keep reporting your own NHS positive news stories,   accounts or those of  others past present and future
, 

Sustained by the ususal. Lots of well wishers. Cake, beer, visitors. At times we all get a bit overwhelmed emotionally, so that’s all expected and normal. We’re still treating ourselves with hats and now on second batches thereof

New slippers are generally a significant adjustment.Out with the old in with the new .Thank you to my colleagues in the  NCMHT for the collection

Rocky Road ahead to recovery?Thank you Alan & Nicki

Work held its annual  Christmas Secret Santa (bran tub to some of you] albeit two months late as I have been off due to the tumours.  .I have tested the beer quality  which is superb. Thank  you
whoever the 'secret person is '.

Sustenance

I know how Peter's feeling

The A Team

Hurdle #3

Smile

Meeting with the oncology team; Consultant, Specialist nurse and   Radio therapy-Radiographer.   If you want to know a bit more about ‘these roles’ you might look at http://www.nhscareers . Lots more information, to assimilate and  make some sense of. Whole new set of options open up at this stage including the implications for the future (driving, continuing where I left off with my career?) What directions to go in life and what remains? My nemesis remaining with me and affecting me for the rest of my life and worst case a decline in faculties (particularly executive function: see relevant factsheet at https://www.headway.org.uk/Factsheets.aspx which just about governs everything

Sorry!

The images & size (the largest being small plum the others about half this) of the tumour were pretty stark; Nevertheless I was pleased I had the opportunity to face my nemesis and see it for what it is; an uninvited invader who’s main body sits in my right frontal lobe & parietal white matter about the size of a plumb 40mm  x31mm, extending inferiorly & medially into the body of the corpus callosum (bit that connects the two halves of the brain. There are two others, ‘relatives ‘about the size of grapes and it is likely that they connect. This is important in determining treatment as the tumours cover a large part of the cerebrum (brain). Surgery is not considered an option .There is no cure. Treatment is about ‘control of the tumour to limit its impact on brain function. I have it and the potential threat for the rest of my life. So had better get on with it!

The staff were as usual highly professional, expert and caring and I could not have asked for better provision. My endeavour to promote the NHS continues. Please join me via the blog with your own accounts.

 The prospect of Hurdle #4 (treatment) the prospect of Hurdle #4 (treatment)

Mates.

Next week as part of Radiotherapy, I will have a facial mask constructed out of moulded plastic which is used to guide the radiation precisely. The following week I start the Radio therapy with three sessions (about ten minutes long) per week for two weeks. One common symptom is hair loss though this tends to occur after the event. Some reddening of surrounding skin, somnolence (falling asleep) and fatigue - exhaustion.

I will remain on the Steroids as the tumors cause swelling and the most likely cause of the headaches and visual problems to the effect on other parts of the brain. Thankfully these symptoms have significantly subsided. I am permitted moderate amounts of alcohol the effects of which are enhanced by the Steroids- every cloud has a silver lining!

The blogging team

Biopsy results part one 24/1/13

Please read with caution it’s not the best news therefore perhaps ensure you have someone around for support, if needed.

The name of the tumours is Astrocytic which is sometimes known as glioblastoma multiform (GBM) depending on the grade (severity – 1-4). Mine is grade 4: the most aggressive. If you want to understand and explore related information around this I recommend the Macmillan.org.uk site. The likely treatment being radiotherapy (where’s your best man when you need him?). Cause ‘unknown’;  genetic predisposition ‘unlikely’ (though mum died as a result of complications from lymphoma ) ‘their presence may have only been a short time; months’  as indicated by the onset of symptoms, how long they have been there  is impossible to say for certain.

Another post tomorrow after seeing the oncologists

Normal family stuff

All my own work

NH 24/01/13

Period prior to the “results “of the Biopsy

I know this is another massive hurdle as we (the family& friends) approach tomorrow afternoons, outpatients’ certainly on a par with the Biopsy as far as I am concerned-‘make or break?  Emotions are running high in the Harmer household. Nevertheless we are holding up well due to combination of forces that have come together naturally plus some hard work from the home team.

Thanks to the numerous well wishers and all the support, this has been overwhelming, and has come in every shape & guise; from near and far. Looking after each other, lots of hugs, talking.

Drawing upon our individual and combined strength. There has already been a great deal of positive that has spontaneously come out of this ‘bombshell’. I hope some of you will benefit and as I continue to do so in the same way as I have gained in strength and wisdom, hope for humanity from this whole experience. It’s great to be human on this amazing planet.

I am sticking to my meditation and yoga as well as a routine for all the basics whilst pushing myself a bit more each day. Fortunately the boys are sensible enough to carry on with their lives as normal (putting The White Stripes & Arctic Monkeys on my iPod and playing it loud, arguing, coming in at all hours etc) so ensuring some sense of normality. I have tried to venture out in spite of the snow though tend to go with another.

Yesterday Rory and I witnessed a fairly disturbing incident outside the Coop on Mill road where an altercation erupted amongst a group of street drinkers. Fairly normal stuff again for those of you familiar with area. At one point a perpetrator was threatening another of the group with a wine bottle. I think Rory thought I was going to intervene so he grabbed me by the arm in a restrictive/protective manner (as if I or anyone would be daft enough to take on anyone waving a bottle, whilst drunk and in an agitated state?). Lessons in life – Common sense. I was taken back twenty years ago when I used to walk the boys as toddlers home from school and we would see the heroin users injecting themselves in the grounds of a local church. Or would venture into the old public toilets (since demolished and rebuilt) where we would manoeuvre around the discarded needles and assembled somewhat intimidating (though never threatening to the kids; there is humanity in us all however deeply buried and glazed over by drink) drugs users. Things have improved thanks to the combined efforts of the council, drug/street support workers, police and community.  

I still don’t have a mobile. Little sister (EK) and her wonderful husband (Nick) have loaned me a couple of modern devices (as locals the lifts dropping off at the hospital have been so helpful reducing the stress of hospital car parking, which I promise to learn to use an join the vast majority. Therefore I did not ring 999. Instead, I phoned 911 which is what I thought was the non emergency number (that’s for the USA). When I dialled the 101 the incident had already been phoned in by two others as an emergency as I/Rory feared at the time. Rory pointed out that he had seen a couple of school girls walking by as it was happening who looked pretty spooked by the incident.

Symptoms: Headaches, vision disturbances have not been a particular problem in the last few days. I have felt consistently apprehensive and at times moderately anxious & have some common physical/motor symptoms, dry mouth, and restlessness, feeling on edge. My mood is holding up and though I have moments of emotional lability where some small gesture or act of kindness either directed at me or others (perhaps something from the radio or news item); something I see in Anne or the boys that triggers thoughts about the past, the future and tears well up albeit momentary unless of course Anne joins in and the flood gates remain open.

Behaviour

I notice I am in what I call “Reverse Nesting” mode. I have this need to feel that everything is in place and sorted; just in case? Not that I doubt that my eldest son could take up his rights and responsibilities under primogeniture.

Outcomes

I have eschewed looking up anything about tumours and the treatment prognosis etc, etc. I feel there is no point until we know what we are dealing with. As I say, this is a hurdle which we will overcome. Taking value in each moment at a time. Tonight I have enjoyed a wonderful supper, some music (Jake Thackeray), good conversation (Ferrets!), and beer. And now I’m off to the pub with my good friend PM and RT, who sorted me a Richard Thompson ticket. All normal stuff. Life is sweet.

And some of the music I have been listening to - because Friday night will always be music night (even from Wednesday):

Nic Jones: Canadee I O

Chris Wood: John Ball

Jay Z: Give it to Me

NH 23/01/2013

First of Ten #GreatBritishInstitutions that bind society

Good Evening. In this blog, as well as the usual discussion of my health, I will be covering two extra topics: advice on commenting, and (what I hope) will be an ongoing series of Ten Great British Institutions that are worthy of support as they bring us together and bind us as as society.The NHS possibly being the most important ? and therefore worth preserving .We undermine, neglect &sometimes abuse these 'institutions' to the detriment to our sense of community

Still, at least the weather's on our side.

Symptoms: The headaches have not been a problem for a few weeks and are readily treated with prescribed analgesics. The worst of the visual disturbances have significantly reduced which Anne & I think coincided with the halving of the steroids. Mood is holding up.

Reduced Eye site, Motivation? I have not felt inclined to read a book, newspaper, magazine, watch TV, pick up the banjo since the headaches began. I hope to schedule some of these activities into the daily routine.

Exhaustion: I find myself on the go for most of the waking day and go to bed at my normal (when working time). My behavior is a bit obsessive about detail, wanting to remember stuff, wanting to feel in control and where things are located- anxiety-apprehension?.

Fear of the future and the enormity of the situation for me and my family: e.g. Minimum two year forced driving ban; those who know me pre morbidly will recognize this. I feel sensitive to criticism (fortunately my three sons carry on doing their thing as normal as possible so I having to adjust, desensitize)

Apparently, if the 90 minute soccer game was reduced by ten minutes, Spurs would be top of the league

Aims: I would prefer to get back to work as soon as able, to continue doing what I was doing. However, the logistics and reality will be very much dependent on the biopsy results and subsequent treatments.

Coping: Continuing to develop a routine that ensures all the activities of daily living (Roper N., Logan W.W. & Tierney A.J. 1980) are being met in a balanced way and aiming all the while to be independent of others being influenced by Dorothea Orem’s Self-Care Theory.

Taking each step at a time. Moment to moment

Drawing on my experience as a Cognitive Behavioral Therapist; Meditation (as previously described and referenced with the usual caveats, gentle standing yoga. Plenty of support from   family, colleagues and friends.

'Aged P' - 'Quality Surveyor , retired' - 'Therapist Guru' - 'Albus Dumbledore' +  Usual suspects

Limiting use of phone/internet/PC etc. (I had stopped using Twitter as the headaches kicked in and reduced Facebook time). Establishing normality, coping with rumination & worrying.  Stepped Problem solving.

Rory's Normal Stuff

These models were being advocated during my general nurse training and practice. They seemed like Common Sense at the time and for me remain valid. I have been out of general nursing/mental health ward based work so have little sense of their current use /practice/evidence base. Any comments from fellow nurses welcome to the blog (see below for guidelines)

I understand that in order to make a post you have to sign up with the blog.

 I am led to believe this is becoming standard practice so as to introduce a level of moderation to deal with the nasty (bullies, harasser’s etc elements in our society who have driven some commentators off line (I would like to read Stan Collymore’s account of his experience.

I will endeavor to monitor and respond to any comments. However, with the results due imminently and possible treatments. I may be incapacitated.

Nevertheless ,the actual blogger/IT person (JH) may be able to keep an eye on things in addition to his full time job/own life

Now, for the first two of my #Ten Great British Institutions [which unite/bind British society]

1)The NHS& The Charitable Partners (e,g, Macmillan)Who  they Work Alongside:

I of course continue to receive quality care and professionalism as I await my results. These are provisionally planned to happen this Thursday, and I will use the blog to update the majority. Attached to the package is access to Nurse Specialists (NHS /Macmillan) who are readily available for advice. I have only used them once which I found sufficiently reassuring.

I have also observed a considerable amount of excellent care and professionalism by the majority of NHS staff afforded to my father-in-law, who needed admission to the same hospital where my biopsy occurred less than a week ago. I am extremely grateful to all those involved and am absolutely certain he is getting first class care and treatment. I wish him a steady recovery and my love and best wishes to his Anne’s mum and my extended family at this demanding time.

So many people have been sharing their overwhelmingly personal positive experiences about the care and treatment received from the NHS. Some has made some constructive criticism about how things could have been done different. I would encourage all of you to share these with the providers in the first instance if not already done so. You are welcome to use the blog for these comments (though please read my early request about ratios of positive to negatives as I want this to be a useful, productive discussion).

Supportive and pretty relatives

Regaining some of the lost kilos. Fuel Food for my activities.

#GreatBritishInstuitions;#2:Pubs and Ale (alcohol)

I have been trying to locate a quote about the importance of the pub to our society/culture. It was made by some observer ‘foreigner’? Diplomat? And basically goes along the line that the pub is so fundamental that without it we lose something vital. Anyway, get in touch if you think you can inform me!

Brewed locally, fresh as a daisy. And a good price too!

Moderate alcohol is permitted in my circumstances. You need to check with your own doctors whether this is the same for you. I would say I have been a moderate drinker/pub user since eighteen, with some binge behaviors which I tend to use to wind down at the end of the week. My preference is for a decent pint of locally brewed ale in a familiar pub. I will come back and talk about my views on pubs & the unacceptable misuse of Alcohol which causes so many problems in society for us all. Hopefully, I will be able to share a story belonging to my friend (PM), who’s father experience of the pub is heart warning and encapsulates so much about what is so important. If any one of you liked what people got out of visiting an American version ’Cheers’  you will know what I am talking about. Sadly our pubs are closing at a staggering rate due to a number of combining factors .CAMRA are out there doing their bit to halt the decline.

http://www.camra.org.uk/

Normal behavior resumes

Build Up to the Results - Thursday?

Joseph is back from his break, so is now taking dictation, and moderating. The dressing on my biopsy has been removed by Nurse Anne, and here's a picture:

Herr Frankenstein

Hats are multifunctional

Our plan for this week is to cover a couple of subject matters, which are not directly related to NHS care, but are relevant to my wellbeing. One of the subjects we will be discussing are ale and pubs, being, along with the NHS, one of the gels that bind us at a society. These institutions we undermine at our peril. The nature of British policing, the BBC, multiculturalism and its relation to the NHS, extremism, and why the BBC shouldn't use the term "Jihadist". I'd also really like people to start commenting!

Common Sense Care

Tips for improving your visiting /experience

& how you might contribute to the overall wellbeing.

All common sense stuff so apologies in advance if I am stating the obvious. Nevertheless, I have decades of experience of observing bedside behaviours and continue to see things which could easily be improved for all concerned with at no cost

This is not prescriptive: this is about working in collaboration with patients, relatives and staff. If everyone adopted this approach, if everyone considered adopting some of these measures, I am confident that all would benefit.

·        Tips for visitors:

·        Aim is to :

 to prevent hazards of spillage which then results in a major procedure of changing beds, pyjamas etc.

Gathering information
i) Read in advance the information provided from the relevant internet sites for the specific ward you are visiting. Including visiting times, restrictions, infection control, Job roles, uniforms etc. Check the relevant hospitals webpage; finding this out in advance will enhance your experience, as well as preventing unnecessary demands upon busy staff.

Staff Roles: And remember, there are three hundred NHS roles known! So, fathoming out who's who and what their responsibilities are ensures that you are talking to the right person, and that your expectations will be realistic.Here's a informative webpage from a leading NHS hospital.

ii) Shift patterns (when the staff work either early – afternoon (overlap), evening, night session operate a 'named nurse’ system.  If in doubt about what to do, check with the member of staff who has been allocated to look after your particular relative for the current shift.  Typically they will be managing half a dozen patients (dependent on level of need) in the same bay or adjoin bedrooms, 'Who has been allotted to look after your relative for the particular shift? They may be working alongside a Health Care Assistant along with the Domestic cleaners (who are not usually permitted to provide hands on patient care), and the housekeepers who bring around the water jug and allotted times as deal with food ordering, provision. Where needed on high dependency wards, staff are deployed to help assist with feeding. This might be something you want to help out with, Check first with the named nurse Plenty of common sense, e.g. if food needs cutting up placing serviette to prevent spills to clothes/bedding

iii) Recharging: Hospital is as much about rest so do not feel it’s necessary to /entertain then overtax the person. They will be happy to have the company of a familiar face

iv) Avoid fussing & go with what they want. Encouraging them to do what they are able for themselves

v) There is normally kit available to each patient as electronic bed lifts. Call buttons etc. You might ensure these are within hands reach and that they are able to operate themselves.

Common Sense: I hope this information is not coming across as patronizing. I mean no harm and believe we can all work together to maximize care provision to those in need, and an improved experience for patients/relatives/staff. If you want to know more about where I am coming from, Read the blog and comment. Let’s Spread the word...

this en suit is gold standard .and is usually reserved where  patients needs necessitate  a separate room.

vii) Urine bottle. Don't be afraid of this essential bit of kit. It’s imperative that the patient is able to relieve themselves bedside if unable to walk to the toilet (which has to be the preferred option, however if you escort to a nearby toilet  check with the named nurse first that it’s OK and you are confident. Sometimes urine output is recorded from the bottle.

vii) Bed tables are sometimes a bit awkward. They normally rise automatically to touch and lower by pressing a leaver. These are best positioned such that the patient can readily access the things they most need i.e. a drink of water (if allowed sometimes there are restrictions on medical grounds. If in doubt ask the named nurse). All common sense really. An uncluttered table is always going to be preferable  to prevent hazards of spillage which then results in a major procedure of changing beds, pajamas etc .particulalarlyy where food ,juice and food is spilt as this may look unsightly and . Prevention is always better than cure

Uncluttered bed table within ready access to patient.
Free of potential Hazard. Upright posture being preferable 

viii) Positioning including meal times: There are options i) get your relative to electronically raise  themselves with the kit provided if available into an upright sitting position  which aids normal breathing and  helps to prevent chest infection. At meal times the back rest to a regular eating position that suits them.Have you ever successfully lay prone and tried to eat drink without spilling?.Common sense. ii) Check with the named nurse if it’s OK for the person your are visiting are able to to sit upright in the adjoining chair with the table ideally placed or sit on the edge of the bed with feet on floor. With a drip (intro venous) infusion in your arm, confusion its sometimes tricky to poor oneself a drink of water from the jug or to cut food items. This is something you might consider.

When first getting on to the bed, think where first to place ones posterior and where it’s likely to be until the next excursion. Then swing legs up onto the bed, Prevents unnecessary lifting etc.

good evening.Blog likely to be on brief hold as i) Family crisis as another significant member of the extended family was admitted to hospital yesterday and is being subjected to the NHS care ii) the Blogger (Joseph ) has gone to London to be with his fiance.He normally manages data entry,images,links and everything blog related.
Neil  19;34 18/1/13

Contacting Me

I've had several people wondering how best to get in touch with me, so I'll answer that here.

People I don't personally know & have never met:
My first preference would be through comments on the blog. I want to start a discussion here, and it's good to have feedback.

Work related matters: through Newmarket CMHT where you can leave a message Tel@01638 558650 or Bury CMHT Tel: 01284 775259

Friends and Family : you will already either have my email/Facebook/Telephone/address etc.

thanks and regards
Neil 17/1/13

Biopsy

Done and I am here to tell the tale what a relief! That feels as if the family & I have crossed a massive hurdle and I am now able to move into the next phase.

Harrison Ford 'Indie' + Hulk makes A great combination ' Hindie? {Lets stick with Paddy!] and a dear in-law
 A Cambridge' adventurer extraordinaire.Top builder. 

I will try not to repeat in detail the issues that we struggled with most in the build up. Many of the requisite preparations were relatively stress free and plane sailing, facilitated by expert/caring NHS Staff including all the porters transferring me ably me from one place to another with their humor, ceaseless courtesy.

Sustenance

The anaesthetic team: reassuringly explaining all stages of process allaying anxiety as best they are able.

The Operation-Medical team: Thanks a million for trying to save my life, I wish you all best. I didn't feel a thing. The post operative discharge letter clearly explains what transpired and this is helpful. In essence, three samples have been removed from the main (plum sized) tumor by ‘frontal stealth guided biopsy’. I will no doubt have more to say about this matter as things progress, and the ongoing plan of treatment and care. Thanks for coming to update me post surgery albeit I perhaps should have waited until Anne was with me. I apologies if my questions were in any way inappropriate or disrespectful my head was mightily spangled.

Thank you!

The Recovery Team: The first seen on regaining consciousness who gently monitor those vital few minutes post operation. It was a pleasure to exchange small talk. I learnt and retained more about West Africa in that brief and fascinating discourse than from years of mainstream media

Radiology /Computerized Tomography- post biopsy : if you want information about this and other NHS procedures you might try http://www.nhs.uk/conditions/ct-scan/pages/introduction.aspx.

However this was not needed in my case as the caring/professional NHS staff on hand give as much information and reassurance as needed. This was also my third CT. I had needed one on the day of admission to Accident and Emergency which indicated the presence of the Tumours, prompting a more detailed MRI – Multi Resonance Imaging. I found the MRI more of a challenge than the CT, however Staff speak through microphone throughout and provide a call button if needed. Details of which are available from the NHS at

http://www.nhs.uk/conditions/MRI-scan/Pages/Introduction.aspx

As there was concern that my Tumours might be secondary (Metastases) from some primary source elsewhere I underwent CT scan of the upper body (chest/abdomen). My understanding of the rational for this in my case would be to then target the least invasive & risky source of the problem if located elsewhere. Common sense.

Personal Opinion: I was probably in a fairly strong state before embarking on this marathon.  I have in recent years endeavored to work towards a healthier lifestyle which comes down to healthy eating, regular exercise, and reduced alcohol as recommended by DOH advice. Stop smoking.

I began smoking age eleven as it was then the trend and managed to quit about a year ago, when I switched to using an electronic replica. I was never a heavy smoker though my usage varied over time and was habitually associated with aspects of my social life. I might come back to smoking & related issues at some other time on the blog.

Love and caramel slice

NH 16/1/2013

Oh (Dear) Matron

Tulips and the winter moon: beautiful things I have seen this week

What makes a good nurse?

Best ask someone who has been on the receiving end for decades, so with his prior consent, I will quote my neighbour on the ward having formed a connection as you do where there is shared distress (empathy) & basic needs are being met:

“A quality nurse knows your needs before being asked”

(Mark: 2013)

In thinking about this post to the blog, I was taken back almost thirty years to my time as a trainee then staff nurse on a busy surgical ward, trying to manage the night shift in high bed occupancy North London General Hospital. Where I struggled to cope with balancing the demands of the increasing:

i)                 Technical aspects

ii)                Managerial aspects of the role/shift that had been insidiously, then relentlessly introduced since I started my training (in 1983 prior to the introduction of Project 2000 in 1986 the year I qualified and began practicing which probably revolutionised training & nursing at this time in its history)

iii)               Trying to meet the basic care needs (ADLs) of the highly dependent post operative patients who I felt responsible for.

I wrote to the Nursing Times about my dilemma, & though I did not give details of my place of work, I was duly hauled in by the ‘matron’ who told me about how in “in our day, we rolled up our sleeves and got on with it”.

At the time, I felt as if my distress was ignored and left invalidated. Feeling inadequate and uncared for, I promptly sought support  elsewhere and found  a group (the ‘Radical Nurses’ which I think  had set up in the early  1980’s  culminating in the “Defend the NHS”:March & rally on the 22^nd September 1982 with an estimated 120.000 taking part). This group I joined, which happened to meet locally where I was living at the time. I continued as a staff nurse (general) as my colleagues were fantastic nurses, dynamic, professional & caring

 ‘Oh dear matron’. [All current Nurse Leadership)

I do wonder whether this struggle has continued throughout the last three decades and currenly continues for others.If so, what are its consequences and hope to explore and stimulate debate via the blog. I am interested in exploring a number of themes
1) What are  the core nursing roles and how do we balance our core roles with ever increasing expectations increasing managerial/technical (medical)procedures demanded/expected of the profession?
2) Does the current reward/progress/advancement arrangements favor managerial/technical over core nursing care?
3) Is this this future and are new recruits keen for this?
       

What is nursing and what makes a good nurse

·        Nursing Values

·        Nurse Theories

·        Nursing Models

·        Supervision for Nursing

·        The Nursing Process

·        Valuing  rewarding, nurses
I would like to stimulate a parallel discussion within Mental health Nursing
i 

Please leave your thoughts below!

NH 17/1/2013