Wednesday, 16 January 2013

Post Biopsy (the Biopsy was done on Sunday pm 13th January)

Saw this on the patio

Post Biopsy (the Biopsy was done on Sunday pm 13th January):
Massive visual problems.   Worst   period Sunday - Monday -   Tuesday   15th    January 2013 by far.
·        Not sure why? Best not presume and will leave to the professionals to determine what the cause of the symptoms. I guess having a biopsy + tumour may in itself be the reason.

·        Being sleep deprived ( almost inevitable as an inpatient on a busy ward)

·        Massive disruption to bodies usual intake of sustenance having been through x 3 “nil-by-mouth” regimes within three days.

·        Side effects of Steroids? I have minimised use of analgesics therefore I don’t expect it’s this.

·        Constipation (Maltesers problem: see previous has appeared to double in size!)  I assume it’s inevitable when mobility is reduced as an inpatient. Fortunately my nursing background has enabled me to make sense of this and intervene as required. Do ensure you seek professional guidance for your own needs on this matter from the staff caring for you. Dietician visits with sound advice.

·        Visual stimulus. It’s snowing. This adds to my stress as it means I will be going out of the ward for the first time in a snow flurry. My confidence in walking has already been undermined for some time now. I experiences a fear of falling/harm due to the visual problems. Anne not a keen driver at the best of times.

The whole journey from the bedside to home was pretty unpleasant. I know that in my home environment I will be able to adjust and settle into routine, in the knowledge that family and friends are also less burdened with having to visit. Struggling with the power of the car front halogen lights much in evidence and the snow, people, cars busy, busy. Visual hallucinations: +++. Akin to being in a virtual ‘Ghostbusters’ movie. With ghostly apparitions in 3D, lunging through the windows, gesticulating. Not grotesque, unnerving; as this is one of my favourites perhaps it’s associated with memory?

The rooms at home appear as if they have altered in some way. Walls/doors have been move? Pictures missing? Ceilings curved?
Decorating? Anne reassures that nothing has altered.

Werewolf hand: my left hand looks different (I was thrilled by American werewolf in London so perhaps some memory stuff going on here?)
Managed a few hours sleep overnight, however. Managed a few hours of quality sleep on Monday night. Visuals start up after waking with shifting peripheral disturbances flashing lights plus a new phenomena where furnishings appear to contain moving beings (a bit like the ground shifting in the film ‘Shivers’)
Coping by trying to maintain routine, Grounding.  Simple easy to use guided (on MP3) meditation and gentle standing yoga.

Thank you for your messages of support


NH 16/1/2013






Monday, 14 January 2013

Biopsy Update


Hullo all.
I had my biopsy at three o’clock yesterday afternoon, and I returned home at five o’clock today. I will blog more about this tomorrow, but just a brief update because things are hard to keep track of at the moment.
Before I begin with some pictures and videos of my stay in hospital, I will mention a few themes I will be returning to in futures blogs:

-Job Roles in the NHS: The official NHS website suggests over 300 different careers, each with different levels within them (and often their own uniform). The hospital at which I am staying alone lists 16 uniforms on its website!

-The Ward Team, and their interactions: I won’t say much now, but I have experienced both the patient and carer perspectives, and I want to share my thoughts.



Arrival and support


Me in hospital


Pseudo Blogger.The real power behind the data entry and technical stuff is my  whiz of a son Joseph.Who  is  also due to marry the Delightful Lucy  .What a welcome addition to the family and  such positive news in contrast to the bad stuff. Oh and why not take up learning Japanese on top of your day job!



Saturday, 12 January 2013

Week Two: Hospital Visit


1)      Brief overview: I had thought that week two might have resulted in some clarity about the nature of the tumors and the relevant treatment. However, this was always going to be a false dawn. I understand that there are hundreds of different types, grades, and that there are essential and time consuming processes that have to be covered before getting on to definitive’s. On one level I had already considered the prospect of ongoing, long standing uncertainty in relation to the lesions for the rest of my life, and the need for acceptance of the feelings of worry that inevitably coincide. I am delighted to be in week two, and continue to take each moment to moment, day, week at a time. I am practicing the development of my Awareness of these moments.
I saw magpies on the roof of my hospital

I started this blog to rebalance the criticism to which the NHS is subjected, but to do so I must give a full report of my care: the good and the bad. On 4th January, I was given the date of Friday 11th for my biopsy. I was to arrive at the hospital at 7am that day, and was to receive nil by mouth from 12am the night before to after my operation. I arrived at this time, and was kept at the hospital, sitting, waiting. A patient patient. Visiting hours finished at 12. Delicate negotiation was required, but my wife was eventually allowed to stay with me. It was not til 7:30pm that I was told I would not be having the operation that day, and that I could have something to eat (which arrived around 8pm). I was to be kept at the hospital overnight, and it was my impression that the operation would be carried out the next day. However, at half past four today, I was told I could go home, and return tomorrow (at 10am). At no point in this process was I given any reason for these delays, and I do feel that I could have been better informed.

I appreciate that hospitals and specialty services are under constant states of unexpected demand, and that the nature of health needs are increasingly complex and multi dimensional, requiring expertise from across a wide range of medical specialities. These are in turn all dependent on each other forming a complex puzzle, which is shifting according to response to treatment and changes in conditions of the patients and their needs. My process is thus unlikely to be a linear one. Instead, the shifting sands I face lead to frustration and tension. Nevertheless, I trust in our magnificent NHS, who I continue to believe are relentlessly striving to save life whilst minimising distress and complication. My brain biopsy is likely to occur this weekend. Subject to whatever crisis occurs in the region.
Treats I enjoyed on my return home

1)     Main Symptoms
i)                 Visual disturbances:
These persist and are perhaps currently the most intrusive symptom. They continue as previously described manifesting as a pulsating area of rainbow coloured lights in my left temporal region, the colours of the rainbow. They tend to sweep outwards or from below going up and over my head. Today as I returned from hospital it was is I was noticing Christmas Trees in people’s houses or decorating the local community... Distortions in the known environment. Mirroring of spaces, giving the impression that areas exist that I know on one level cannot be so. Familiar room /wall space seemingly larger and more spacious. Which can be highly anxiety provoking and disorientating?
ii)                Pain-Discomfort as a dull ache:
 I am convinced the prescribed medication is helping and I have the option of “as needed” painkillers as prescribed. I am using Common Sense as much as possible. I don’t expect to be pain free with lesions shunting bits of my brain out of sync, leaving other parts to compensate
iii)              Fatigue- Tiredness:
 This week I have made sure to rest as able and being a neuro-surgical ward there are specified down times where intrusions (visitors/Mobile) use is discouraged. Common sense.
iv)              Unsteady gait; Disorientation:
 Taking things steady, holding on to things.
v)               Memory:
 Lots forgotten, therefore I keep a confidential journal, I have to note down names of the many people I come into contact with, but do not intend on including them in this blog.
vi)              Constipation:
Due to change, reduced mobility etc, I try to maintain necessary fluids and fruit, subject to advice and guidance from professionals. Much of it is Common Sense. Having been on “nil –by – mouth” in expectation of brain biopsy, I may have lost some excessive fat: a bonus!
vii)             Anxiety: I try to be aware of my normal breathing, focusing on an aspect of the breath. Seek guidance from a suitable professional on this matter.

2)     Coping: As previous. These are only personal thoughts & expediencies you must take responsibility for seeking appropriate medical advice for your own symptoms. I do not suggest any of my coping behaviours in any professional capacity or sanction any of the content. I use common sense combining advice from professionals, NHS Evidence: NICE /Direct. I mean no harm
Routine: As previous. Thanks to the ward staff for accommodating me with my routine.
Which includes some standing yoga, Meditation and Activities of daily living including rest.
I am fortunate to have been given some time ago mp3 player with headphones, thus limiting disruption and disturbance of my family at home and my fellow inpatients when on the ward. More detail on the specifics of the coping strategies as we go along & subject to technical support and permission from authors I might try to upload some recordings of myself in my home.
Confidentiality: Assurance I have not and do not intend on making any recordings whilst in inpatient settings. And will do my upmost to prevent any information indicating specific fellow patients, staff .

Dinner cooked by J.

3) Contacts: Support from fellow patients & their families in addition to my own
4) Today’s Personal Positive NHS News: All week I have personally witnessed and received fantastic hands on caring/clinical /support from those looking after me and my fellow patients. I would encourage anyone who does not to arrange and plan a time to speak to the appropriate person at the appropriate time. In an honest, Common sense manner. Bear in mind my ratio (see previously) and adopt a non judgemental, non critical compassionate stance (more on this at another time).

Thursday, 10 January 2013

Thursday 10th day eight


Thursday 10th January 2013: Day eight of knowing that my head is beset with major problems. And continuing the now established format I will post about my 1) symptoms, 2) coping, 3) contacts and a new entry, 4) Personal positive NHS news item. Finally, whatever else I determine at the time. I will endeavour to illustrate where possible subject to the technical support available to me and would like to try some humour, however, I have always been rather serious and know that my delivery leaves much to interpretation.

I'll be interspersing this blog with pictures of what I have been doing.

1)     Symptoms:
Visual disturbances a) Pulsating/flashing lights in the Left temporal area have occurred frequently throughout the day; 15-20 times?  And its only 18:18hrs! Difficult to know whether this is an increase on previous, (the log will hopefully provide me and others with  some accuracy). These have varied in severity and I am in the process of devising a rating for this dependent on  whether there is accompanying peripheral visual disturbance, discomfort–pain, duration, derealisation, disorientation, anxiety–panic Fear; exhaustion etc, etc .I am sure that anxiety –adrenaline exacerbates all the symptoms

2) Coping: As previously stated. These are a few ideas on what I am trying to use to manage myself. You must seek professional guidance from your own professionals, I mean no harm and don’t claim any expertise in relation to your condition or in relation to any of the strategies I am sharing. Use common sense. NHS Direct and NICE are obvious useful sources of information along with your General Practice and local health services.
Grounding: myself and saying something concrete such as my name, address, occupation etc. Steadying myself by holding on to furniture, walls etc when spinning and disorientated. Sitting down, not undertaking potentially hazardous procedures, e.g. boiling kettle, and using sharps for food preparation; using stairs and showers when symptomatic. Regular use of Save function  when documenting. Common Sense!
Routine: This is beginning to take shape with regular meal times, medication, meditation & basis standing yoga. With plenty of sustenance such as fluids, fruit, treats. I have dropped the caffeine in coffee fearing it will worsen my symptoms. Regular breaks to counteract fatigue.



 Ring fencing time for contact with others including phone calls and strict limits on using any equipment such as laptop, PC mobile. I find I am more inclined and able to do the blog stuff etc on an evening with the aid of Joseph who is a wiz and helps to minimise time and frustration. Shoulder massage from RH
Sausage and Mash
Sausage, tumor, and mash

Normal stuff. Odd chores, washing up and listening to the boys tell me about their day and listening to their activities, music (Foals) today and the usual spats, arguments etc. They certainly have good reason to be feeling on edge.  Gently extending myself to do as much as previously did using Common sense. I made myself a salad lunch which is not unusual as I would normally prepare each morning to take to work. RH recorded the process on a DVD which I will be able to use for comparison once treatment begins. I was delighted that my motor skills have not been significantly impaired.

All my own work


3) Contacts: good to see the in-laws today so they may feel reassured that I am doing reasonably well in the circumstances. And yesterday’s visit from my good friend PM who sensibly suggested we plan a visit to a pub for a pint of local ale in the near future (subject to medical advice).

4) Today’s Personal Positive NHS News :  Anne & elderly relatives being well looked after by  community staff.



10/01/13

Wednesday, 9 January 2013

Food Blogging!

Here's what I've been appreciating and grounding myself with this week.

Again, after today, I will be using my own photographs

Prawn Biryani

Scrambled Eggs

Grapes

Marmite

Maltesers





Bird Blogging!

On a lighter note, here are some of the birds we have been seeing in our garden in this dramatic week! Hopefully, in coming weeks I can show you some of my own photographs of them.

The Green Woodpecker








Surviving Week One


Surviving /Living life to the full
I have survived a whole week with the tumors. This has been the most eventful period in my life. My symptoms continue to spangle my head; however I find sharing in this way a big relief ‘cathartic’? I plan on continuing whilst able to express myself through words. Many thanks to JH for the technical help, and attempting to edit the content after his hard day at work. Also ongoing thanks to RH for his patience in trying to teach his father how to use a mobile and text. Today I sent my first ever text on a personal matter. This is a steep learning curve. If I can do it with this hindrance in my head, there is potential for everyone to embrace technology. To FH and AH for my day to day safety and wellbeing.

My blog is likely to consist of three regular themes:
1)      Symptoms
Visual
Perceptual disturbances are perhaps the most dramatic and disturbing. And as yet I am unable to gauge whether they are getting worse, what exacerbates them, and what stops them (if anything). Having a brain lesion has meant I am banned from driving which I totally understand. Though having passed my driving test at eighteen it’s big change which hasn’t yet sunk in. I have not dared to venture out on my bike which was always my preferred choice for getting around town. Moreover it means that Anne is doing the driving where previously I would have led where driving was necessary. I will not attempt to identify or personally thank people in this blog. Many thanks for the offers to help out with this as needed which Anne will take up as necessary. Not that we were over dependent on the car day to day, week to week, apart from in my job which I am unable to perform for the time being. Hopefully this may change in time. I suspect I will not be allowed behind a wheel for some years.

The intensity of the visual disturbances is not consistent and may be mild to severe. What is consistent is the presence of the sensation of a flashing light about my right temporal area. At the moment it is without noise, in contrast to the four-five week period prior to admission when it was accompanied by a loud whooshing sound which I thought was closest to hearing a wind turbine when standing close as able, with accompanying intolerable headaches.
Headaches are present daily, though nowhere near as bad as in the build up when they were severe and intolerable. I am convinced the medication is helping along with the other coping strategies.

Coincidentally a visual has just started with the emerging flashing, like the Swedish Christmas candle, (I am sticking to this as without music and sound, amusement arcade, disco ball does not fit and Kaldescope images are two dimensional to effectively help me to convey or reflections from a river/pond from the sun) multi coloured light with green, white and pinks. This one lasted for about 20-30 seconds and did not include the more distressing elements. These involve the opening up of the peripheral vision as if I can see all around and at its most intense, walls and structures seem to have melted away hence, my use of the term ‘derealisation’.  The peripheral visual problems envelop my whole perception and seem to emerge from below going over and around my head. Today, this experience has occurred between eight and ten times. I should point out, that I am always aware of the nature of these perceptual disturbances! I believe it is the brain compensating for the effect of the lesions on the visual and cognitive centres. It is best described as imagining that what I perceive in front of me is mirrored behind me.

 I have not yet felt depersonalization, perhaps because of the techniques applied as described. When this happened in the shower earlier today felt exposed to potential onlookers and is pretty scary. It also happened when Anne and I were out the front of the house. She had gone back in closing the door believing I was able to make my way in via the side gate. When I turned to try and orientate myself, I felt totally lost and almost panicked (I used breathing and grounding). I know I am have a potential risk of serious mental breakdown and reassure myself that I am not losing my sanity, attributing my current problems to the tumors. However, I am realistic enough to recognise that depression will be a real risk in the future. I have not experienced auditory or other hallucinations though within the peripheral vision it is difficult to make out stuff and I sometimes wonder if Anne or someone else is standing alongside me. Because of the anxiety I experience, I am also hypervigilant to potential threat. Confidence is reduced, and I am not sure what memory how my memory is being affected. I am certainly compensating by writing lots of stuff down.

Constipation (warning: poo)
Today I realised I had become constipated which manifested as, excuse my language, as if the content of a packet of Maltesers had been inserted into my rectum. However, once this was aided, I was able to pass normal motion. What a relief! So for now, on plenty of fluids and fruits, and my appetite has remained buoyant.

Other’s Observations:
FH reckons things are better on an evening, when my mood is improved.

Limbs
I have noticed a couple of involuntary jerkings of the legs whilst lying down in a relax manner.

 2) My personal strategies for managing.
I am writing this to benefit others, and to provide myself with a documented record of the condition that is accessible to my carers. However as stated previously, you MUST seek professional guidance from your own GP/doctor before attempting or embarking upon anything that you are interested in. You are responsible. I mean no harm and wish you all well. Common sense.
Gradually establishing a routine for each hour of the day which covers all ‘Activities of Daily Living ‘(Ref Roper N). Therefore times for going to bed, getting up, meals and medication; Rest and activity including limiting time engage in blog use of screens. Limiting phone/house calls. I have not yet got the routine where I would like it to be mainly because the symptoms are so unpredictable. ‘shifting sands’ and affect concentration and everything I attempt.

Medication: I have been prescribed steroids to reduce the associated swelling which will hopefully realign the bits of the brain shunted out of place by the Tumors and no doubt messing up mental functions. Prescribed pain killers as needed. I have continued to use the subjective scale used in hospital for gauging my own pain scoring out of ten [I presume ten is severe –extreme & perhaps need to check this out]
Normal Activities as much as possible. Washing up, taking bins out helping out with cooking etc.
Appreciating  nature.  Lots of birds about at the moment.
 I continue to use Mindful meditation and yoga as a general coping strategy as well as routine and common sense when it comes to pacing and not taking on activities which may place others at risk. Which I suspect is helping with my mood and anxiety – fear and worrying

Grounding: I experience derealisation when the visual disturbances become intense therefore I ground myself by placing my feet on the floor, sometimes bare footed, usually sitting upright. I might hold onto something if the experience comes on whilst mobilizing or if I am in the shower or walking up stairs. Awareness of smells, of food, of taste.

Risk  management: I always let the family know what I am doing and in what part of the house I am in. I leave toilet and bathroom doors unlocked for ready access. The boys understand the reason for the recovery position which is something you could all explore on the internet if you don’t already know.

3) Contacts.
 I really struggle to remember details about who has contacted me, visited, and when; therefore I have to write this down as I go along. It links also to 2), as the messages and cards, sympathies and offers of prayer. Relentless support from family and friends and their willingness to accommodate my behaviour changes.