Deja Vu

In which The Author has a blast from the past

In Walking the Dog I told you about the agony I endured for seven years with pain in my right shoulder. I went into a bit more detail in That Was The Month That Was, when I was talking about Martin’s medical fuck-up. Whether by accident or by design, I seem to have fucked my own luck. Since I published my little summary of January 2013, I’ve been in pain again. I went to the surgery last week and saw Dr Jordan.

As soon as I went into the consulting room I said, ‘I’m glad it’s you, and not Dr Wardrop or Dr Davies.’ He looked a bit surprised, so I explained that I spent an inordinate amount of time in their consulting rooms between 2001 and 2008. ‘If I’d told either of them, “I’ve got this pain in my right shoulder,” they’d have laughed and chucked me out,’ I added. He examined me and seemed to think that there was cause for concern. We went through my history together and decided not to go down the traditional route.

Between 2001 and 2008 I was prescribed umpteen courses of anti-inflammatories and painkillers. Initially, Dr Wardrop was treating me for supraspinatus tendinitis (which sounded reasonable to me.) When the condition didn’t respond to treatment, I had three steroid injections, administered over a period of eighteen months or so. The first one worked for a long time, the second one was less effective, and the third one made very little difference. The circumstances behind the last one were amusing, though.

Dr Paul Matthews was a young GP registrar doing his training at my GPs’ practice. (In fact, he looked so young that my brother initially thought he was there for a week’s work experience from his A Level year.) He’d never given a steroid injection before, so Dr Wardrop was supervising the procedure. When I took my shirt off, Dr Wardrop immediately asked me about my tattoos. They’re based on Ancient Egyptian designs, and it turned out that he’d recently visited Cairo. We started chatting about our shared interest in Egyptology, while poor Paul looked completely lost. It took him two attempts to find the spot, and I’m not sure which of us was more nervous.

The next course of action was referral for an X-ray. I was lucky enough to have this done in Aberdare General Hospital, a short walk from the station and the town centre. It showed a degree of calcification around the shoulder joint, and Dr Wardrop’s first fear was that it might be arthritis. With this in mind, and given the fact that the pain was becoming steadily more unbearable, he referred me for an MRI scan.

When the appointment letter arrived, I booked the day off work and made my way to Prince Charles Hospital, near Merthyr Tydfil. It was a long journey, involving two buses there and two back, and then I had to find my way to the MRI scanner itself. To my surprise, it wasn’t in the hospital. It was in a car park adjacent to the Radiology Department. The whole apparatus was housed in what looked like a Freightliner trailer, able to travel as an articulated lorry. I went up a small ladder into a reception area, gave my details to the nurse, and was then shown onto the set of The Matrix. There was an array of laptops and displays, and two technicians monitoring data as it flashed up.

The scanner itself lived behind a heavy door, and looked like nothing more interesting than a very large washing machine. I’m fortunate that I don’t suffer with claustrophobia, as it must be a truly terrifying experience for anyone who doesn’t like being enclosed. I was given a pair of ear defenders and a handheld switch, which I could press if I felt too uncomfortable or started to panic. One of the technicians spoke to me through the intercom, and then the scanning started.

It was horrendous. Many of my younger friends, like Olly, Helen R., and C— pay good money to listen to loud repetitive banging like that at so-called ‘nightclubs’. I can’t imagine anything more unbearable, to be honest. I’m in the Library at the moment, and builders are working on the roof. Even their hammering is just about tolerable compared to the racket that the MRI scanner made. After a while I felt quite dizzy and sick, and I was very relieved when I was pulled out of the machine and could get some fresh air again.

The results came back a little while later, and I was referred to Mr Karras’ orthopaedic outpatient clinic at Aberdare. He, in turn, referred me on to Mr Geoff Graham at the University of Wales Hospital in Cardiff.

That necessitated another day off work, and it was a lovely early autumn day to stroll through the suburbs from Cathays station. My appointment was for mid-afternoon, so I decided to have lunch in the cafeteria while I had time to kill. The new intake of medical and nursing students had just started their stint at the hospital, and the atmosphere reminded me of the couple of occasions when Glenn and I had taken the Dillons stall at Freshers’ Fairs. Oddly enough, Jason from work rang me while I was doing the crossword to see how my appointment had gone. He must have been reading my mind. I told him that I hadn’t been seen yet, but that he’d have enjoyed sitting with me, looking at all the eager young students. ‘They come in all shapes, sizes and colours,’ I chuckled.

Mr Graham himself was charm personified. I suppose most people’s view of consultants tends to be coloured by the caricatures in Casualty or Holby City, or (even worse) based on Sir Lancelot Spratt in the old Doctor films. Maria knew him, as she’d worked in the Orthopaedics & Trauma Department before moving up to London. She’d told me beforehand that he was a lovely man and the best surgeon in the field. Mr Graham looked at my scan results, examined me thoroughly, and immediately diagnosed an ‘impingement’. He told me that it was a very common condition, although his patients tended to be quite a bit older, and was amenable to routine keyhole surgery. I asked him about a time scale, and he assured me that (because of my age) he’d try and push it through rather more quickly than usual.

The next day in work, with the word ‘impingement’ fresh in my mind, I headed straight for the medical textbooks. I looked it up in Apley’s Concise System of Orthopaedics and Fractures (13th ed, 2005) and read the brief discussion which followed. The bone was pressing on the tendons and muscles, leading to limited mobility and pain. A short list of symptoms followed, and I ran through them in my mind. Difficulty putting on a jacket? Check! Pins and needles following periods of numbness? Check! Pain increasing in intensity through the day, and much worse at night? Check! I was a textbook case!

The operation took place at Llandough Hospital in April 2008. Mother and I had to be there at the crack of dawn, so we drove down through a tremendous thunderstorm and got there before 7 a.m. We joined a few more people who were already waiting, and after a little while my name was called. I suggested to Mother that she went home and waited for me to ring her later on. There was an outside chance that I’d have to stay in overnight, so there wasn’t much point in her waiting around. Failing that, the hospital’s not far from St Fagans. She could spend a few hours at the Museum of Welsh Life and come back later on. I was gowned up and lying on the trolley when Mr Graham put his head round the door.

‘How are you feeling, Steve?’ he asked with a smile.

‘A bit nervous,’ I said truthfully.

‘So am I,’ he chuckled, and vanished again.

I was taken through to the anaesthetist, and was reassured to see Mr Graham’s call-sheet pinned to the wall. My operation was called a sub-acrominal decompression (Maria had tipped me off about the name long before I saw a registrar and he told me what it was called), and Mr Graham and his colleagues were performing three identical procedures that morning. There was no fear that I’d have the wrong operation, or even the right operation on the wrong part of the body.

[A digression: I spoke to a friend of mine last week, who once fractured his ankle playing rugby in school. He spent several hours at Prince Charles Hospital waiting to be treated, only for them to put the wrong leg in plaster. I reminded him of the case in Llanelli some years ago, where a patient had the wrong kidney removed. Blackwell Scientific later issued a textbook called The Kidney at a Glance. I teased the rep, telling him that it explained the Llanelli fuck-up. The consultant must have taken one glance and said, ‘That’s the kidney – get it out!’]

I chatted to the anaesthetist while she administered the pre-med, and then crashed out totally.

After the best sleep I’d had for (literally) years I woke up and there was a pretty redhead standing at the side of my bed. My luck was changing already! I was covered in a blanket, my arm was in a sling across my chest, and I could feel warm air circulating around me. The red-haired nurse explained that my temperature had dropped during the operation, so they were warming me back up. She said, ‘Just relax and don’t worry, you’ll soon be warm as toast.’

I said, ‘Did you really have to mention toast? I’ve been nil by mouth since nine o’clock last night!’ She laughed and wrote something on my notes before wandering off. Fair play to her, a few minutes later she came back with some hot chocolate and a piece of toast. They went down like the food of the Gods, I can tell you. I was still in the recovery room when Mr Graham looked in again, beaming from ear to ear.

‘Everything went according to plan, Steve.’ He explained that the pressure of the bone had torn the tendon, so that had caused the really excruciating pain. He and his team had mended it as part of the operation. It seemed like little short of a miracle. ‘We’ll get you up to the ward and then the physiotherapist will come and see you,’ he said. I thanked him profusely, but he merely shrugged and said, ‘That’s what I’m here for.’

I was taken up to the ward, and started chatting to a patient in the next bed. He’d had quite a complex operation, and was there for a longish stay. He’d been born in Libya, but studied civil engineering in the UK. He’d met his wife while he was working for a British company and they’d settled in Cardiff, well out of the way of the Gadaffi regime. I asked him whether he’d consider going back to his homeland.

‘Only when that bastard’s gone,’ he said vehemently. I wonder if he ever did return, or whether he’s still in Cardiff with his family.

The physiotherapist came by presently. She gave me a list of simple exercises for me to do a few times a day, to build up the strength and mobility in my joint again. By mid-afternoon I’d had something to eat, I’d managed to get dressed (with some difficulty), and I was making my way back to the reception area. I bumped into the redhead from the recovery room, and she seemed surprised that I was going so soon.

Mother was shocked to see me walking towards her, with a big smile on my face. Apart from a couple of visits to the loo, and a walk to the cafeteria at lunchtime, she hadn’t moved from her seat. One of the nurses had given her an update when I came out of the theatre. She’d suggested that Mother could go home and pick me up later on, but Mother knows her limitations.

‘If I go home, I’ll never find my way back again,’ she said, only half-joking. I knew better, of course – if she’d left without me, she’d never have found her way back to Aberdare.

I stayed at Mother’s house while I was recovering, and we took advantage of my enforced holiday and the fine weather to go exploring the wider area (see Making Hay While the Sun Shines).

A month later I was back at Waterstone’s on light duties only, working on the downstairs counter and keeping an eye on the Crime and Fiction sections. A few of the girls asked to see the extent of the damage. They were very disappointed when I showed them three tiny holes – one on the front of my shoulder, one at the back, and one just above my tattoo of the Eye of Horus. Thirty years earlier, I’d probably have had an extensive scar right around the joint. Christos, the massively-haired Greek thrash metal singer who worked with us, asked me if there’d be any long-term effects. I said I’d raised the same concerns with Mr Graham during my consultation:

‘Will I be able to play the piano after the operation?’

‘Oh yes, no trouble at all.’

‘Well, that’s bloody marvellous, because I can’t play a note now!’

Chris laughed loudly at this old joke, and I repeated it a few times to younger friends.

I had to pay a couple more visits to Llandough as follow-up appointments, but after a year or so Mr Graham was satisfied with my progress and signed my final discharge. However, before he did, he warned me that I wasn’t entirely out of the woods. He’d told me that I was considerably younger than most patients with an impingement, and that it could relapse in the future.

That is why I’m currently waiting for the results of Friday’s X-ray. It could just be that I pulled a muscle during a particularly energetic game of Stick with the mad Labrador last week. What worries me is that it doesn’t seem to getting any better as the days go by. My friend Big Ted gave me some pain relief gel, which offers a temporary break from the pain. I’m also knocking back the painkillers again; hence the weird dream I told you about previously (among others!)

I’m eternally grateful that Dr Jordan had the good grace to put me on the Fast Track last week. It could be nothing, but I’ve got a sinking feeling about it. Faced with the prospect of another seven years of hell (especially given that I’d probably be found ‘Fit For Work’ by ATOS), I’d be sorely tempted to take my own life and have done with it all.

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