Dr Jekyll & Mrs Hyde

I have pangs of conscience writing about my Alzheimer's suffering mother-in-law on this blog but it's supposed to be a retirement blog and it's something that looms very large in our retirement at the moment and I'm sure that it will loom large in other retiree's lives.  I'm not going to damage her dignity with a photo this time as she isn't looking her best having been (as I wrote earlier in the week) rushed into hospital in the early hours of Sunday . I can't praise Ward 11b in Southport hospital enough for the way that they looked after Flo for the four nights of her stay. She was given constant attention and kept comfortable throughout.


She's back at her care home now and on medication to help with a chest infection (possibly pneumonia) that resulted in an irregular heartbeat and breathlessness. Her colour has returned and her breathing is back to normal; the problem lies in her mental state. Whenever we visited the hospital we could hear Flo (she has a loud and distinctive London accent) long before we reached the ward entrance. Invariably she was laughing and in good spirits. The second that Marion and I were in view this changed and she would slump onto the bed crying and claiming a myriad of aches and pains - perhaps we just have this effect on some people. So our visits would pass with Flo in abject misery for the full hour and us lost for anything positive to say. The ward staff expressed surprise at the changes that came over her and they told us that she had been walking around freely for hours on end. When we came to collect her at four p.m yesterday she insisted that she couldn't walk and we had to get a wheelchair. In the past she has always been good on her feet.


This Jekyll and Hyde behavior continued as we left the ward - big smiles and huge hugs and kisses for the nursing staff together with 'You take care' at the top of her voice - followed by a constant litany of complaints en route to the car, during the drive and again when we walked her back to her room. On arrival in the room a carer welcomed her and the mask was switched again to huge hugs, laughter and smiles only to disappear the second that the carer left and the miserable mask returned.


I know that Alzheimer's is a terrible disease and it must be horrendous for Flo and every one else who suffers from it but there is certainly still something there in her brain that allows these huge changes in mood between the one that we get and the one that's on show to others. Perhaps the bad mood is the real Flo and she feels comfortable enough with us to show her true colours or perhaps we are being punished and seen as responsible for confining her to a home after other family members told her she would never be put in one. Whichever it is, it's extremely dispiriting as our frequent visits are tinged with a foreboding gloom that is difficult to feel positive about.

We do feel positive however about this evening when our friends Mark and Nita Jones from Workhouse Marketing in Ribchester are visiting and we're off to The Vincent in Southport for a bite to eat. That's the place where Wayne Rooney's meal at Christmas ended up costing him £250k. I hope it's a bit cheaper for us. Mark and Nita have cause to celebrate as their son Tom's The Whalley Wine Shop won the prestigious Independent Drinks Retailer Of The Year at the Off Licence News awards in London earlier this week - and well deserved it was too. It's a super little shop with a wonderful selection of fine wines, beers and spirits coupled with excellent advice and great service.


I'm busy preparing a talk on metal detecting for a local history society in the Yorkshire Dales on Wednesday. I hope that the snow holds off. One of the themes of my talk is how the public sees detector users and I think this advert just about sums it up.

NHS Hip Replacement. Getting Discharged.

It's Wednesday. About forty eight hours ago I was on the operating table but now I am walking back to the ward from the bathroom having washed and shaved myself. I say walking but it is really a case of dragging myself along on crutches. As I enter the main ward I meet my fellow patients properly for the first time. Graham who has worked outdoors all his life looks slim, tanned and healthy, Bob less so. The three of us look like triplets with our one elephantine and one normal leg. Bob and Graham have had knees done. We congratulate each other on our fine progress to date and I return to my single room. It's been pleasant having company for a few minutes but I want to recuperate in silence - and then there's the problem.

I haven't mentioned "the problem" on previous blogs as it's a little delicate and not something one normally shouts to the world. But the aim of this record is to give those who are going to have a hip replacement on the NHS an idea of what to expect and so I better give you the full story. Since I arrived back from theatre on Monday I have been creating enough gas to fire a small condensing boiler. Totally uncontrollable, the gas surfaces regularly throughout the day and forty eight hours on there's no sign of it blowing over. I believe that it's the result of painkillers causing constipation and constipation causing flatulence and I'm on some sort of windy merry go round until either the painkillers or the constipation die down.

Charlie the physio has given me some exercises to do in bed to speed recovery. One of these, the buttock clench, leaves me giving involuntary renditions of Colonel Bogey - and I'm supposed to repeat this hourly. I knew that private room would have its benefits and this is certainly one of them.

I fill in my time by starting to read nother novel. Like Bees To Honey by Caroline Smailes hails from the same The Friday Project stable as the excellent Confessions of a GP that I flew through yesterday. This is a wonderful and extremely original book. The author uses an interesting repetitive writing style combined with some highly innovative type setting to produce a unique reading experience. The book's theme is coming to terms with loss but this is done in such a different way to other rites of passage novels and when I tell you that it involves a beer swilling Jesus with scarlet toenails residing in Malta and competing for popularity with John Lennon you will appreciate that it is no everyday book. I can't put it down. I love it.

I don't flake out after Marion's visit this time and watch Arsenal play their Champions League match whilst reading The Guardian at the same time as the match is pretty dull. The nurses hint that I am making good enough progress to be sent home tomorrow. My spirits lift.

It's Thursday and potentially discharge day. I follow all of yesterday's lessons exactly and have myself washed and shaved in no time. I'm quite chuffed with my progress but Mr Ali arrives in the room and tells me that my walking is rubbish and I should be bending my leg more. It's not that easy after eighteen months of stiff legged limping, even more so with a leg that's ballooned to double its normal size. Anyway, he's happy with his handiwork. He tells me that my hip was a mess and he has cut off several chunks of arthritic growths of bone known as ossification (I think). He gives me a copy of my x ray as a souvenir and tells me that once I have walked up some stairs I am free to go.

Charlie wheels me to the hospital stairwell, It's freezing after the warmth of the ward and my teeth are chattering. But I want to master this and secure my release. He gives me a simple mnemonic "The Good The Bad And The Ugly" great for a film buff like me. I make a comment about Sergio Leone but it misses its target. I'm up the steps and down again in ten minutes. I feel like waving my crutches in the air in celebration. It's painful but it has  allowed me the chance to return home and at around 3pm, just over three days since admission Marion will be able to drive me back to Southport.

NHS Hip Replacement. The Post Op Days. Continued

It's 6 am Wednesday. I saw my consultant surgeon Mr Al briefly yesterday when he checked out my wounds and sent me for an X ray. He told me that I should expect my leg to swell up. I'm glad that he did as when I look down at my toes it appears that I have had a transplant from an elephant donor. My right leg is enormous and with the cuffs inflating and deflating around it I feel as if I am being pumped up and am not far from the point at which explosion becomes inevitable. But, as I am forewarned, I am forearmed and don't panic.

Last night has not been so good. It's still less than forty eight hours since I arrived in hospital but the feel good drugs that gave me such a high on Monday have now run their course and I flaked out completely the second that Marion left the ward. At around 10pm the nurses on their rounds had startled me awake from a deep sleep and I went into a fit of uncontrollable shivering for a minute or so as I came to my senses. I was detached from the monitor and from then onwards the monitor would simply be wheeled in as necessary. I start another shivering fit as I survey my elephantine limb. But a few deep breaths bring me back under control and I reach for Confessions of a GP.

Dr Benjamin Daniels is a pseudonym to protect patient confidentiality. His book is written at a cracking pace and crammed full of short three or four page chapters. One of our best friends is from a medical family and her mother was, her sister is and her son will be a GP. I know from our conversations that Benjamin is telling it as it is it and I laugh out loud at some of the observations that he makes. Having said that, the book is not aimed at the funny bone alone and there are a number of more poignant anecdotes such as examining his reaction to a paedophile who is sleeping in his own excrement or visiting a patient so morbidly obese that maggots have taken up residence between his thighs. I fly through the pages.

The ward starts to hum into life at around seven. Today's crop of nervous patients are starting to arrive with their equally nervous partners. I can hear them in the main ward but in my inner sanctum I am alone with my book although I have a steady stream of visitors. I have done my utmost to learn the names of everybody who has been looking after me and to find out a bit about them. The array of different uniforms is fascinating. A lady in green starts to clean my room. She is lucky to have a daughter who recently qualified as a barrister  who gives her a lift every morning. Her other daughter is a flight attendant with Easy Jet. There are lots of workers in pink tunics. Liz is a grandma and hopes to retire in five years. She is finding it a nightmare to get to work as the local roads are like an ice rink. Another has given up her season ticket at St Helens in favour of a visit to the Cheltenham Gold Cup. Student nurse uniforms come in two colours - grey for squeamish "Susan" and her pal from Edge Hill University and White for Gemma from UCLAN who used to be at school with my Goddaughter Kate. I learn about so many sons and daughters. I hear about the benefits of an insulin pump from a nurse whose diabetic induced renal failure led to three years of painful dialysis (I saw the scars) before a kidney transplant.

They are all, without exception, a credit to the NHS. Their uncomplaining positive attitude lifts the spirits of the place and gives me a feel good feeling however bad I feel. Nobody does this better than Jenny who I assume to be what we used to call matron or sister, I don't ask her her title. She has a dark blue uniform and runs the place with military efficiency without dropping the humanity for a second. I am so impressed by her hands on attitude and willingness to muck in and share the workload with everyone.

After breakfast my ankle cuffs are removed. The cannula is next to go and then finally it's time for the catheter to be pulled gently from where it has nested for the last two days. I've never experienced a catheter in my bladder before but I have to say that I have become quite attached to it in more ways than the obvious. There's something strange about watching a steady trickle of urine leaving your body and filling a bag alongside you while you have no sensation of what is going on. I could see it becoming popular with lads out on the town who don't want to leave their seat in the bar or be caught by the police pissing in doorways after closing time. There would invariably be machismo discussions on whose bag was filling the quickest. I'd happily insert them myself into some of the incontinents on row 65 of the Kop who somehow manage to take three trips to the loo inside ninety minutes.

My physio Charlie (white tunic, royal blue trousers) joins me at ten and moves me onto crutches. He is joined by Occupational Therapist Claire (white tunic,green trousers) and together they walk me to the bathroom and instruct me how to wash and shave myself safely and then leave me to it. Independence at last. I feel good and refreshed. I discover that Claire was in my daughter Sarah's class at school.

Back to the ward and I'm starting to feel that I'm making good progress.

NHS Hip Replacement. The post op days.

It's 4pm Monday. Marion has just left after visiting time and I'm starting to take in my surroundings. I've only been in hospital for nine hours but the op has been and gone. Whatever stimulant they gave me at the end of the operation, it's one hell of an upper and I don't think that I have felt as alert in years. I find time to make a couple of phone calls from my bedside. I'm linked up to one of those monitors that you always see in films and there are all sorts of electronic charts creating a constant stream of data being fed into it by a number of electrodes. I'm wearing some snazzy white stockings to reduce the risk of DVT and around each of my calves is an inflatable cuff that rhythmically expands and contracts at regular intervals. A similar cuff is attached to my arm and my blood pressure is monitored through this.


I find that there's a clip on my index finger and that sends info on my oxygen levels to the monitor. Unfortunately my circulation is poor so the monitor keeps going into alarm and bringing in one of the nursing staff. "You don't have Reynauds?" she asks."I did when I was small" - that explains it. So I keep massaging my fingers to save the nurses wasting their time.


I'm still wearing just a hospital gown. From my groin area a clear tube carries a regular stream of urine from my bladder into a plastic bag. From my leg wound another tube is full of blood directed into another bag and to the cannula in the back of my hand there's a tube sending fluid in the opposite direction. The cannula that had earlier been the gateway for my sedatives is now channelling a nutritious saline drip into my body. Later in the day the same cannula is used to deliver anti-biotics and to empty my full blood bag back into me - the ultimate in recycling. Best of all, shortly before lights out I get a dose of a morphine painkiller that works instantly.


I planned to read during my stay and I carry on with The Finkler Question. When Marion comes back at 6.30, I've had a few slices of bread and some soup and we spend the visiting time planning my TV viewing. I love Monday's on the BBC and after Marion leaves I start with University Challenge and , being in my own room, I can shout my (usually wrong)answers at the telly. Then there's Miranda. I adore Miranda. Then there's Liverpool writer Jimmy McGovern's brilliant drama The Accused. Andy Serkis is a low life stalker who wastes his money on gambling and abandons his wheelchair bound MS suffering wife for the unaware victim of his stalking. Blimey Jimmy anyone watching this would think that scousers were miserable bastards. Viewing finishes with Coogan and Brydon's culinary journey around the North West - The Trip. Brilliant.

I spend a few minutes doing the Professor Layton puzzles on the Nintendo DS before the morphine kicks in and I'm fast asleep.


It's six on Tuesday morning and before the ward gets active I finish The Finkler Question. I bought this specially for hospital as it was acclaimed as a comic novel and I could do with a laugh. There's no questioning that it is a brilliant literary work which draws the reader into the inner sanctum of Jewishness. But comedic? I see it as more tragic but maybe that's my state of mind. I start a new novel The Silver Linings Play Book by Matthew Quick. Breakfast of Weetabix and toast bulked up with my own pear and banana is welcome. At nine I am visited by a couple of care workers who help me to have a bed bath. There's no point in prudity or modesty although the women do treat me with great dignity.


A few minutes later I'm feeling refreshed and wearing a T Shirt and some clean boxer shorts. A nurse comes in and asks me if I mind a couple of student nurses getting involved. "Not at all". I chat to the girls and discover that they enrolled in September and today is their first work experience and their very first step into hands on nursing. And their first "hands on" experience? Checking my backside for bed sores - that's a memory that will stay with them. Actually one of them - I'll call her Susan- had another experience that she won't forget in a hurry a few minutes later. After checking my bum, the next job is to remove the drain from my wound. "Ok girls stand back and watch this" says the leader. I watch Susan and her colleague as the lead nurse pulls the long blood filled tune from deep inside my leg. Susan turns green and then white and I ask if she's OK. "Do you mind if I step outside?" she asks and the poor kid has to leave. I've certainly created an impression.

As morning progresses I'm unhooked from the monitor and told that the physio will be be along soon. By eleven o'clock, less than twenty four hours after the op, Charlie the physio helps me to my feet and into my zimmer frame which I use to drag myself a few feet to the bedside chair. There I remain for the rest of the day reading The Silver Linings Play Book which, a few questionable plot issues apart, is a highly entertaining study of depression and recovery from mental illness. I fly through the pages and by visiting time I've finished it. We do the Guardian Quick Crossword and Marion brings me some books published under the Friday Project label by Scott Pack who blogs and tweets entertainingly as meandmybigmouth (he's on my blog list up at the right). I choose Confessions of a GP by Dr Benjamin Daniels as it seems somehow appropriate and Like Bees To Honey by Caroline Smailes. I eat some pasta and the nursing staff help me back into bed. At the six pm visiting slot Marion once again helps me to choose my TV viewing schedule. She heads for home at eight and I settle back to watch and fall immediately into a heavy sleep.

NHS Hip Replacement. A Personal Experience

When I was working, one of the things that I enjoyed the most was our regular weekly work football sessions. Up to twelve of us from all parts of the business would take part in an hour or so of healthy competition and I liked the way that it gave everyone the opportunity to get to know others in various parts of the company - an assembly worker might be on the same side as me the MD with the Marketing director playing alongside the service engineer. I enjoyed it so much that I didn't give up when I started to suffer regular injuries about four years ago and it was only when I picked up what I thought was a groin strain in April 2009 that I reluctantly hung up my trainers. Months of visits to the GP and the groin strain didn't improve. I tried a chiropractor without success and then finally a new doctor suggested I see a physiotherapist. I'll never forget the physio's words as I limped into his waiting room for my appointment. He took one look at me and said "You're here about the groin strain". "Yes". "That's not a groin strain, that's your hip." And there in thirty seconds, after three months of misdiagnosis, I had my answer.


Within a couple of weeks I was seeing an orthopedic consultant who explained that my hip had been arthritic for years and would need replacing. He told me everything about the procedure and asked if I would like to be booked in. Running our own company it was not that simple to take out a couple of months for recovery so I said that I would work towards it. We had had a number of companies interested in buying our business so Marion and I decided to take the plunge and sell up before booking in for the operation.


Fortunately we achieved a sale quite quickly and in January 2010 the business was no longer ours. However we had promised our new owners that we would work for them until 30th November to ensure a smooth transfer and I did not want to renege on that deal. We returned to see the consultant and asked if I could be booked in for the first available date after 30th November. We retired last Tuesday and on Monday this week I found myself in Ormskirk General Hospital orthopedic wing at seven o'clock sharp.

And less than six hours later this is what my hip looked like. I certainly seemed to have hit the jackpot and I really should have bought a lottery ticket on that day as just about everything that could have gone right did so.


I don't support private medicine. I don't think it is fair that those who pay can jump the queue ahead of those that can't and I think that we should all be treated as equals. Having said that it would be a pretty valid argument to say that those who do pay are saving the rest of the taxpayers a substantial sum. Anyway I read in my admission booklet that a single bed ward was available at a small extra charge and to phone in advance to check availability. I phoned and it was available and there was no charge - stroke of luck number one. I found myself in a pleasant and quiet room. When other patients asked how I had wangled it I simply asked if they had read the booklet - they hadn't.


My next bit of good news was that I was first on the list which meant that I had less time to feel nervous and the staff would be at their least tired. The good news continued to roll as Mr Ali the foremost consultant orthopedic surgeon in the area popped in and confirmed that he would be doing the operation in person. I hope that this was a result of all the effort I made in losing almost three stone at his suggestion before the op. After Mr Ali's quick briefing, a few blood tests, blood pressure and other readings and some consent forms to sign, my bad leg was marked with a big arrow and I was wheeled down to surgery. A few apprehensive moments chatting to other patients in the pre-op holding area followed before I was wheeled into theatre. Yet another stroke of luck. I was greeted by the consultant anaesthetist - I could not be in better hands. He explained the anesthetic procedure would involve a needle in my back which would numb my lower body. I told him that I got squeamish watching Casualty and didn't want to hear my bones being sawn through. He reassured me that he would give me a happy drug that would mean that I would know nothing about it. A cold spray on my back and a cannula being inserted in my hand was the last I remember.


The next words I heard were Mr Ali saying that it was all done. I could sense someone pushing at my thigh and I was suddenly wide awake and incredulous that it was indeed all over and I had felt nothing. I have had more painful visits to the loo. By one o'clock I was back in my room sitting up, eating a slice of toast and drinking tea. I started to read a new book. At 3pm Marion came to visit for an hour and returned at 6 for two more. I managed to complete the quick crossword, do a few puzzles on the Nintendo DS and almost finish reading The Finkler Question before flaking out exhausted at 10. What an incredible event it had been. I was treated so well by everyone from the consultants to the porters and the support staff on the ward had been exceptionally caring. I'll continue writing about the rest of the experience and the three nights in hospital as I make my recovery. 


Until then I'll leave you with my favourite act for tonight's X Factor final. I have put my entire Betfair account on Cher. I doubt that she will win, but if the audience vote on whether somebody has something special about them rather than being merely a good singer, there's only one real winner.