Interlude

The plan had been to write a second post about Norfolk a couple of days after the first.  Plans don't always go as I'd hope, and this time it certainly hasn't.  A day or two after my last post I started to feel grotty.  It wasn't anything particularly tangible - a deep fatigue and malaise, and an inability even to think properly.  I was hoping it was just a bad day of some kind as I was supposed to be going to Liverpool the next day to meet up with some good friends from the Open University.

That night (Thursday) I had an awful night.  I didn't sleep well, I was very restless, I just didn't feel well, and when my alarm went off on Friday morning I felt awful.  My insides decided they'd prefer to be on the outside and my temperature was up to 39.7C.  There was absolutely no way I was going to get to Liverpool, but to be honest, I felt too ill to be too disappointed.

I couldn't keep my meds down, and I was concerned that my asthma would get completely out of control because of that.  My temperature wasn't responding to the tiny amount of paracetamol that I did manage to get inside me, and I was becoming dehydrated.  I rang the GP.  When I said to the receptionist that I think I needed a home visit she sounded a bit incredulous, but really she should know that I would never ask for a home visit if there was any chance I could get to the surgery.  She said that the doctor might just phone me, instead of visiting.

The doctor did ring me, but he said he was quite concerned so would do a home visit too.  I unlocked the door the next time I got up to go to the bathroom, and when Dr Cn arrived he let himself in.  He could see that I really wasn't well, and he was also worried that I wasn't able to keep my meds down, so he prescribed some Buccastem -  an antisickness tablet that dissolves slowly in the mouth.  He then rang the local pharmacy and got them to deliver it to my home, telling them that I was in no way well enough to go to the pharmacy myself.  I then gave them the prescription Dr Cn had left when they came around with the meds.

The day passed in a haze with weird dreams of high temperature, interspersed with many, many trips to the bathroom.  The doctor then rang me again before he left work for home at the end of the day.  He asked if I'd be okay.  I said that I probably would, but I was thinking, 'I don't know.  You're the doctor.'  Anyway, he told me that I should contact the out of hours doctors immediately if I got any worse or was at all worried.  I promised I would.

The cat was obviously really worried as he wouldn't leave my side.  This may sound odd, but Zach is very sensitive, and when I'm ill at night with my asthma he pats my face gently with his paw until I wake up.  He then watches me intently until I'm sorted and breathing easier.  He didn't need to wake me on the Friday, but he did stay glued to my side, following me into the bathroom and watching me closely all the time.  W came round in the evening and she realised that Zach must be starving because he hadn't touched his food in the kitchen.  He wouldn't go through to the kitchen because he was too busy guarding me, but W brought his food into my bedroom and he snaffled it down.

W was brilliant (as ever).  She cleaned my toilet and the bin that I'd earlier vomited in because I couldn't get to the bathroom fast enough.  She went back to her house and brought her fan back to mine to try to help cool me down.  She sat with me for several hours until I was fast asleep, sometime in the early hours of the morning.

Saturday was much the same as Friday, but I was getting more dehydrated.  When W came round in the evening she went to the supermarket for me to get some rehydration salts (and she also came back with some beautiful flowers that cheered me up loads).  She checked the ingredients in the shop.  I checked the ingredients when she got to mine with them.  W checked the ingredients again.  I checked the ingredients again, and again for luck.  There didn't seem to be anything in them that I am allergic to, so I set to trying to get them into me and keep them down.

Twenty or so minutes after taking the rehydration salts I was lying in bed (in fresh sheets that W had just changed for me) when I realised that I was itching a lot.  Then my eyes started to get itchy and sore and my left eye was swelling up.  I took some antihistamine, but still, my lungs began to tighten and I could feel my throat beginning to swell.  When my nebuliser did nothing to ease the chest tightness and wheezing, and I was being more sick than I had been, I knew I had to take my epi-pen.  I was heading towards anaphylaxis.

The protocol for anaphylaxis is that when you use an epi-pen you have to go to hospital.  You should also call an ambulance to get to hospital.  I hate ambulances.  I did go to hospital, but W took me in her car...  Thankfully, we got there no problem, and possibly quicker than in an ambulance as it was a Saturday night in Newcastle.

I was seen as soon as we went into A&E, and taken straight through for treatment.  The department was full of drunks and people laid out on trolleys in various states of drunken unconsciousness.  The bloke in the bed next to me was absolutely wasted, and trying to get up despite being in head blocks because he had a suspected broken neck.  The poor nurses really had their hands full.  But regardless of that, they were great with me.

Once I was stabilised in A&E I was taken to the Emergency Admissions Unit where I spent the rest of the night and most of the next day.  The anaphylaxis was settling well, but I still had a high temperature, I was still vomiting, and I still had bad diarrhoea so I was far from well.  The medics said they wanted to keep me in for a while, but said that they'd probably keep me in my side room on EAU.  This is why it was a particular surprise when the porter came to take me to the ward.  Nobody had told me I was going to the ward, or what kind of ward it was, so it was even more of a surprise when the porter said I was going to the ward for Tropical Diseases!

It turned out that the ward for Tropical Diseases is also the ward for Infectious Diseases, which gastroenteritis certainly is, and a ward for those with compromised immune systems.  Nonetheless, it was still somewhat unnerving to be going there, and even more so when I arrived.  The Tropical and Infectious Diseases ward is the only ward on the top floor of an isolated part of the hospital.  The corridor leading to the ward is locked.  The door going on to the ward is locked.  There is a red light above the door that indicates when someone on the ward has something particularly nasty.  Each patient has their own room, and each room has a double door/airlock entry system.  Each cubicle can have the pressure inside adapted (I guess some tropical diseases affect pressures, or something), and each room has a camera on the wall so that the patient can be watched with medical staff requiring as little contact as possible.  At night time the camera lens is encircled by red LED eyelashes so that the patient can still be seen in the dark.  The windows in the room don't open.  People hardly ever come in, and when they do they're clad in apron and gloves.  You see these kinds of wards on apocalyptic sci-fi films, but you never think they really exist.  You think there must be some artistic licence for dramatic effect, but no, they do really exist, and I found myself on one.  It was all very, very surreal.

I was on the T&ID ward for three days before coming home on Wednesday evening.  I'm a lot better than I was - so, so much better than I was - but I'm still not right.  It turned out that the gastroenteritis was a bacterial bug, and one that's reportable to the Health Protection Agency, so apparently I might get a call from them to see if they can locate the source of the infection.  I have an idea, but I'll leave it up to the HPA to confirm or otherwise.

I am now completely wiped out.  I still don't feel terribly well, and apparently I could have some symptoms for up to four weeks!  I think this is going to be a slow recovery, and definitely not helped by the anaphylactic reaction.  W and I have contacted the manufacturers of the rehydration salts about that.  The only thing it can have been that caused the reaction is the flavouring, for which the ingredients weren't listed, and under the 'side effects' section in the patient information leaflet it says, 'None known.'  I've filled in a couple of forms for them, and they're also sending one of the sachets off to Germany to be analysed, so at least they're taking it seriously, although I'm still going to try to get in touch with them to find out what the ingredients are in the flavouring.  It's important that I know.  Either there's something in it that I know I am allergic to, but which isn't listed in the ingredients, or I have developed an allergy to something else.  I just hope they give me the information I need.

It's been quite some week.  I'm hoping for a much less eventful week this week.

Something I could do without

When I got the news about Nn I felt as though I couldn't cope with the stress of my stupid carers coming so I cancelled them for two weeks. It seems incredibly ridiculous that the people who are supposed to be helping me are actually causing more stress, but they are. Today was their first time back here and I was dreading it. I received the time sheet on Saturday so knew who to expect, and was dismayed to see that I'm stuck with the most incompetent of them all for each of this week's visits.

Tonight I wanted Stupid Carer Woman (SCW) to make a pasta sauce. I gave her a recipe. A very easy recipe for a basic tomato sauce with the addition of mushrooms and fresh basil, reminding her that both these ingredients would need to be very well washed because of the stuff that gets sprayed on them and to which I'm allergic. Fine. Left her to it while I finished off what I was doing on the computer, until she called me back asking if 'saute the onions' means to slice them. Feeling despair begin to spread over me I explained what 'saute' means, and went through the rest of the recipe for any more difficult words ... such as 'cook'!

I went off to have my bath, afterwards coming back through to find that what SCW had made actually looked okay. A huge surprise. I had my dinner about an hour ago, and was equally surprised that it tasted okay ... not fantastic, and it had a bit of weird after-taste, but okay. However, I'm now very itchy scratchy, rather wheezy, and my insides feel squiffy. I suspect that SCW didn't wash the mushrooms and basil very well, because this feels very much like an allergic reaction to something, and I haven't eaten anything else that I could be allergic to. I'm hoping beyond hope that this doesn't progress into anaphylaxis, but either way, this is something I really could do without.

Master Chef meets Krypton Factor

You may know that I have a lot of allergies, most of which are anaphylactic, and many of which are to foods. The main things I'm allergic to are preservatives and colourings, and you'd be surprised at what you'd find these in, even in so-called healthy foods. One of the consequences of these allergies is that I can't eat any ready meals so I have to have all my food cooked from scratched. Yes, real cooking! I quite enjoy cooking, but I'm very limited these days in how much I can do because of my tendency to pass out when standing due to the POTS and vasovagal syncope. It's not very safe to faint whilst standing over a lit gas hob so these days I have carers come to cook for me three evenings a week. It can be a bit tying sometimes if I have things to do, or I want to be out, or if they turn up early, and I've never been the best at planning meals ahead so sometimes I get a little frustrated at having to be organised with this kind of thing. It's made a little trickier by the fact that they come at 4.30pm, which is far too early to have dinner so I need to think of things that I can either re-heat quickly later on or that take a long time to cook. Last year W bought me a slow cooker and that's been a god-send with these carers as they can do all the cooking bits then set the slow cooker away to do its stuff so that a few hours later I can have tea at a much more sensible time. Marvellous. All I need do is provide the recipe and ingredients...

It would, however, seem that cooking is an alien concept to many of the carers who come to me and the tasks I lay before them are akin to those on the Krypton Factor. Now it's not like I ask for anything particularly complicated - in fact that's another challenge for me as I have to try to find simple recipes - except that the mere thought of cooking anything other than a ready meal or heating up a takeaway appears to be very complicated. I have several different carers come to cook for me and I only really have confidence in one of them. They're all lovely people, yes, but you wouldn't find them on Master Chef. I had one who, on her first visit here, told me that her father is a chef so I optimistically thought that he may have passed on some of his culinary skills to her. Nope. She had to ask me how to cut the leek I'd put out with the ingredients for my dinner. On one of the days the following week a very sweet young carer (maybe in her late teens or very early twenties) came. She pointed at the pile of ingredients on the bench, made her face Dali-esque and squawked, 'What's that?!' It was a sweet potato. The day she came and I had a raw beetroot I'd been given on the bench I thought she was going to run away in fear so I had to reassure her very quickly that it wasn't part of that night's dinner; it was just on the bench as a place to put it. I then had to explain that it was a fresh beetroot, and no, not all beetroot comes pickled in jars. Bless her ... and God help me!

I guess I don't mind so much if the person who comes is honest about their cooking ability. I can allow for inexperience. I can prepare myself for perhaps not the tastiest meal I've ever had. So long as they make sure all the veg etc is suitably washed so that they don't accidentally kill me then I can pretty much let them off. It's when they're 'misleading' about their culinary skills that it gets me. I had one woman come - another friendly character - who, when I explained about my allergies and therefore the need to do 'from scratch' cooking, assured me that she was a good cook. She told me that she'd been married to a Morrocan man for seven years so had cooked all his meals from the raw ingredients and was quite experienced. After tasting the soup she made me I wonder if she's still married to the Moroccan man or if in fact he's dead. I set her the challenge of making me butternut squash and carrot soup with a little ginger and chilli. As always I'd set out the ingredients on the bench. As always I presumed she'd follow the recipe in terms of quantities, and I even provided scales for weighing out any ingredients she needed to weigh. I went off to have my bath (the heat of a bath or shower makes passing out more likely so I have a bath while the carer's around in case there are any problems) and left her to make the soup. When I returned to the kitchen I discovered that she hadn't actually fried the onions, garlic, ginger, chili, or any of the veg before adding the stock (homemade stock as I can't have the bought stuff); she'd simply chopped it all up, put it in the enormous pan, and filled said pan with all of the stock I had. And it was only after she'd left that I realised she had no discernment at all regarding quantities. She had used a whole green chili, a whole root of ginger, and a whole bulb of garlic! I let the thing, the concoction, the pot of poison bubble away in the hope that maybe it wouldn't be so bad really, but after I'd blitzed it in the liquidiser and tasted the tiniest of tiny amounts there was no fooling myself into thinking that this was edible. It had somehow transformed itself from appetising and tasty fresh vegetables to some kind of anti-food. I think I had boiled egg that night instead. The next time she turned up I lied that I was going to my dad's for dinner that night, but I still needed her there while I had a bath. I don't remember what I ended up doing for tea in the end, but I couldn't face sampling her cooking again, that was for sure. On the bright side, as she wasn't cooking for me that evening she offered to do other stuff so she did my ironing. The carer who comes on a Wednesday morning is supposed to do my ironing as well as the cleaning, but the one I've had most since my regular Wednesday carer left the agency is rubbish at ironing, doesn't like doing it, complains all the time she is doing it, and doesn't do very much of it. Needless to say, there was rather a lot of ironing to do. It all got done and I also didn't have to suffer her cooking. Bonus!

I had yet another carer come tonight. I have to say that she was ever such a lovely person, and she did in the end manage to follow the recipe and produce a very nice dinner in the slow cooker for me. However, I also have to say that it is quite miraculous that she managed to follow the recipe and produce a very nice dinner in the slow cooker for me. When I told her that she'd be cooking from scratch she looked terrified, aghast, distraught. She came clean that she doesn't cook. I told her not to worry as I'd put all the ingredients out along with the recipe, and assured her that a slow cooker is really easy to use. She'd never seen a slow cooker before. She doesn't even use a conventional cooker. She lives off sandwiches. This was going to be a challenge ... for us both. Right then, time for some education. I introduced her to the concepts of fresh vegetables, cartons of butter beans, and uncooked wholegrain rice. I gave her her first sighting of saffron, and explained that she should use only a very tiny amount as it's so blooming expensive. That scared her. I got her a pan and showed her how to light the hob. I showed her the recipe book. I thought she was going to collapse with repressed hysteria. 'Oh,' she squeaked through tightened vocal chords, 'I've never used a recipe before. I'm not sure that I can. I mean, I'll try, but I'm scared. I've never done it before. It looks so complicated.' We read through the recipe together, and I explained that yes, she would have to use the hob a little bit to brown the leeks ... and I explained what 'browning the leeks' meant, and I reassured her that she'd be fine, and I went off to hide in the bath. After a while I could hear a lot of clattering and I could smell burning, but I figured that being in the bath surrounded by water was perhaps the safest place to be if the carer was going to accidentally set fire to the flat, so I stayed put and hoped I'd still have a kitchen by the time I plucked up the courage to get out of the bath and back to the carer. Thankfully I do still have a kitchen, and despite the burning smell I see no evidence of there having been any flames. When I reappeared though she did say that she hadn't washed the butter beans, and asked how she was meant to do that so I said to use either the sieve or the colander. She looked at me blankly. I showed her what a sieve looks like.

Pushing it

Last time I wrote (far too long ago) I was in the final throes of my children's literature Open University course. I think I was doing the final assignment, but still had the ECA (End of Course Assessment - extended essay thing) to do ... or I might have been doing the ECA. Anyway, either way I was very busy and very tired and my lungs were going downhill. I managed to get both bits of work done, amazingly, although I have no idea how much sense my ECA makes as I was getting more and more poorly as time progressed and it was a real race against time. I didn't think I'd get the ECA done if I'm honest, but I did, and then I filled in an extenuating circumstances form, sent that off (with medical evidence to follow), and then went to hospital. On the Thursday, which I think was 20th May, I had to see my GP for a review of my newish med for the POTS, and he wasn't at all happy with my lungs. He wanted me in hospital that day, but I still had 1200 words of ECA to write at that time so I said that I couldn't go in. This was stupid, but at the time it was all I could think - I had to get the ECA done and sent in or I'd fail the course. Whether it was purely the POTS or a combination of POTS and worsening asthma, by the end of Thursday I couldn't stand up long enough to make a cup of tea without passing out, so things really were miserable and now I can see that they weren't safe either, but at the time I couldn't discern this. Well I got the essay done, and sent it off through the ether at something like 11:30 pm. I should've gone straight to hospital then, but I didn't. I knew that I couldn't go straight to Ward 29 at Freeman at that time of day and I didn't want to go to A&E if I could avoid it, so I hung on until Friday, which was really stupid, and as it turned out Ward 29 didn't have any beds so I had to go to A&E in the end after all. By this time I definitely wasn't thinking straight and was sitting at home wondering how I was going to get to hospital, and even considering going on the bus! Thankfully I had a moment of lucidity when I remembered about the existence of ambulances so called 999 and had the paramedics with me within 10 minutes. When I got to A&E the docs were very worried and I went straight into resus, where the consultant kept saying to the other doctors and nurses around me, 'Be airway alert! Be airway alert! We may lose it without a lot of warning. Be airway alert!' If I'd had the breath and the energy I might have pointed out that I was still conscious and this was doing nothing for my anxiety levels, but I had neither breath nor energy enough so just gasped my way through it as it was ascertained that I was now in respiratory failure with a pO2 of 6 (anything lower than 8 is respiratory failure) and a pCO2 also of 6, which is just about normal, but is not a good sign in conjunction with the low pO2. Basically I was desperately ill, and the docs were sure they were going to have to ventilate. They decided to hold off for half an hour, see if the aminophylline they were starting was going to have any effect, along with back-t0-back nebulisers, then repeat the blood gases and take it from there. In the meantime they decided to put in an arterial line so that they didn't have to keep stabbing me for gases, and I'd need one anyway if I was going to be vented. My arteries are so scarred from having had so many arterial lines that it took an hour to get one in, and ultimately they could only get it in my foot! The hour it took to get in was very hard work breathing wise (and fear wise), but it did give me just long enough for my gases to pick up enough to avoid immediate life support - an obvious relief in many ways, although also difficult as I was so tired I could've done with the rest really. Either way, I was still too poorly to be transferred from A&E to RVI, even to RVI ITU so I went to ITU at the General Hospital, where A&E is. I hadn't been in that ITU as a patient before, and hadn't been in there as a visitor since my close friend Carol died there at the end of 2005. It was difficult going there now as a patient. At least I wasn't in the same bed that Carol had had, although I was in the bed opposite so found myself looking over that way and remembering a lot.

It was touch and go for most of the night whether or not I would need to be vented or have BiPAP, but ultimately I got through without. I was hugely exhausted by the morning and still very poorly, but was able to be transferred to Ward 29 at Freeman by the middle of the afternoon. I'm still on Ward 29. I came off the aminophylline infusion on Friday, which is always a step in the right direction, and although I'm still on the oxygen (4l/m) I'm doing okay. However, for the first time I'm having horrendous problems with water retention. My whole body has been incredibly swollen, stretched, and bloated. For several days my legs were so full of fluid that I could barely bend my knees, and my hips are still incredibly swollen and tender. It's horrible. It's painful. It's been making me very miserable. Over the past few days the docs have prescribed furosemide for me, at first in tablet-form, but then by IV as the tablets weren't doing anything. I am gradually losing the fluid, but I've still a way to go and still very uncomfortable. I haven't had this problem before - a little oedema from inactivity, but nothing anywhere near like this - and I don't know why it's happened this time. I don't know if the docs know either...

Then, just to top things off, last night I asked for the usual evening mug of hot chocolate (the last hot drink of the day at around 8pm is a milky one if you want it :o) ), but instead of the normal Cadbury's drinking chocolate that I'm okay with the student nurse gave me Ovaltine. I took one small sip, realised it wasn't the right stuff and proceeded to have an allergic reaction to the milk powder in the Ovaltine. I'm fine with fresh milk, but milk powder has preservatives in it that I can't have. So had a double dose of two different antihistamines, 2 double-dose nebulisers, and 2 epi-pens, and although I felt rubbish I have survived to tell the tale. The junior doc came to see me while I was in the throes of the reaction, and she called in the registrar, who's a bit of a chocolate teapot doctor so wasn't much use for anything, and the junior then ended up calling ITU just to make them aware of me and my situation, although I was fairly certain by that time that I was going to be okay. I was. The staff kept a close eye on me all through the night, and I made it through, albeit it feeling rotton, and miserable and grotty. I rather suspect that the student nurse spent a lot of the small hours of last night learning about anaphylaxis.

This is not the best start to my summer holidays after a hard 9 months of study.

Saving my bacon

I was supposed to have my swine 'flu vaccination at the GP surgery on Tuesday. I went along to the appointment, the nurse went through the usual precautionary questions, and then we went through the ingredients of the vaccine and it turned out there was something in it I'm allergic to - a sulphate. She went through to speak to one of the doctors who said that in light of this, they couldn't give me the jab without my first speaking to my asthma consultant, especially as it transpires that a lot of people with multiple allergies are having adverse reactions to the injection. I came home, rang my consultant and left a message with his secretary, who phoned me back on Thursday saying that Dr H (my consultant) had weighed up the risks and decided that I should have the swine 'flu vaccine, but that they should give it to me in hospital, so I went up to the ward on Friday morning. It was a very strange experience waiting to be injected with something I knew I was allergic to - planned anaphylaxis ... very odd. I wondered if it was something similar to being on death row, although for very different reasons - ultimately to have my life saved, rather than certainly ended.

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Dr. H came to see me before the ward round, went through the risks (i.e. anaphylaxis and death!), got me to sign the consent form, and then had the F1 put a cannula in so that I could have IV chlorphenamine (Piriton) before being given the vaccine. This would hopefully stave off an allergic reaction, although it would also make me sleepy.

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J, the Charge Nurse, came with the IV and the jab, asked if I was ready, pumped me full of chlorphenamine, waited 5 minutes for it to whoosh around my body, then stabbed me in the arm with the potential killer jab. All we could do then was wait and see what happened, but at least I hadn't blown up into a Becky balloon and dropped dead immediately. After a while my lungs started to get tight and my sats dropped to 91%, but they were sorted with a couple of oxygen-driven nebulisers, and everything else was okay, thanks to the prophylactic chlorphenamine. I stayed on the ward until just gone 7pm to make sure all stayed okay (there can be a delay in the occurance of a reaction, and if there has been a reaction (which the lung-grumpiness was almost certainly due to) there can be a second wave reaction later), and then I was free to go home. It was a weird experience walking onto the ward in the morning as I'm usually gasping and struggling to breathe at all when I arrive on Ward 29, and it was even weirder to walk off the ward the same day ... a good experience though :o) And hopefully, I'll now be safe from getting swine 'flu :o) My bacon has been saved!

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The same cannot be said regarding the whole passing out thing, which is still going on. When I was discharged from hospital the week before last with this the doctor had said that I should get an appointment for the falls and syncope clinic for two weeks time, which would mean I ought to be seen next week. This being the case I was expecting an appointment letter sometime during last week, but nothing came so I phoned the clinic on Thursday to ask what was happening. When I explained what I'd been told about getting an appointment for two weeks time the receptionist laughed and said that there was at least a nine week waiting list. She then went on to tell me that the consultant hasn't even put the referral in yet! The swine! Not only has he not done what he said he would, but I was told porkies about the time-scale, so now goodness knows how long I'll have to wait. I'm going to call the consultant's secretary on Monday to ask when I can expect the referral to be sent, and perhaps say that I'm not impressed that it hasn't been sent all ready as it's really not good to be passing out practically everyday, and not safe either - I fainted while I was cooking the other day, and it could've been really bad if I'd fallen onto the hob ... although it may have speeded up the referral, I guess ...

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On a positive note, I have got an appointment for the 24-hour ECG, which may throw some light on what's going on, but only if it's something to do with my heart. Anyway, I go for that next Thursday morning, and then obviously have to go back on Friday morning, but I don't know when I'll get any results from it, or even who the results will be sent to as the referral to the falls and syncope clinic hasn't yet happened and I'd thought it was going to them. I might ask if it can be sent to my GP so that I can at least know it's going somewhere, and somewhere I can access them.

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Now then, keeping on the theme of pigs - having my bacon saved from swine 'flu, swines of doctors who don't do what they say they're going to, and flying pigs for getting appointments - I was sent an email the other day that made me laugh a lot. I thought I'd share it with you so read on for a giggle. Oh, and apparently it really was sent to David Milliband.

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Nigel Johnson-Hill

Park Farm

Milland

Liphook

GU30 7JT

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Rt Hon David Milliband MP
Secretary of State.
Department for Environment, Farming and Rural Affairs (DEFRA)
Nobel House
17 Smith Square
London
SW1P 3JR

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16th July 2009

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Dear Secretary of State,

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My friend, who is in farming at the moment, recently received a cheque for £3,000 from the Rural Payments Agency for not rearing pigs. I would now like to join the "not rearing pigs" business.

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In your opinion, what is the best kind of farm not to rear pigs on, and which is the best breed of pigs not to rear? I want to be sure I approach this endeavour in keeping with all government policies, as dictated by the EU under the Common Agricultural Policy.

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I would prefer not to rear bacon pigs, but if this is not the type you want not rearing, I will just as gladly not rear porkers. Are there any advantages in not rearing rare breeds such as Sadlebacks or Gloucester Old Spots, or are there too many people already not rearing these?

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As I see it, the hardest part of this programme will be keeping an accurate record of how many pigs I haven't reared. Are there any Government or Local Authority courses on this?

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My friend is very satisfied with this business. He has been rearing pigs for forty years or so, and the best he ever made on them was £1,422 in 1968. That is - until this year, when he received a cheque for not rearing any.

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If I get £3,000 for not rearing 50 pigs, will I get £6,000 for not rearing 100? I plan to operate on a small scale at first, holding myself down to about 4,000 pigs not raised, which will mean about £240,000 for the first year. As I become more expert in not rearing pigs, I plan to be more ambitious, perhaps increasing to, say, 40,000 pigs not reared in my second year, for which I should expect about £2.4 million from your department. Incidentally, I wonder if I would be eligible to receive tradeable carbon credits for all these pigs not producing harmful and polluting methane gases?

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Another point: these pigs that I plan not to rear will not eat 2,000 tonnes of cereals. I understand that you also pay farmers for not growing crops. Will I qualify for payments for not growing cereals to not feed the pigs I don't rear?

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I am also considering the "not milking cows" business, so please send any information you have on that too. Please could you also include the current DEFRA advice on set aside fields? Can this be done on an e-commerce basis with virtual fields (of which I seem to have several thousand hectares)?

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In view of the above you will realise that I will be totally unemployed, and will therefore qualify for unemployment benefits. I shall of course be voting for your party at the next general election.

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Yours faithfully,

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Nigel Johnson-Hill

Check up

Let me start with another apology for again neglecting my blog. For the most part I've been enjoying having a break from studies so busy doing fun stuff :o) I've also been getting the paperwork sorted for my holiday to France in 10 days time :oD I'm very excited and have all my medical stuff translated into French now, thanks to a rather wonderful OU peer who read my blog, lives in France and offered her services of translation for my paperwork and if I have any medical problems while I'm out there. She's a marvel.

So now for today's post.

A couple of weeks ago I was getting twinges of toothache so I made an appointment with the dentist, but the earliest I could get was yesterday and of course, as is the way with these things, almost as soon as I made the appointment the toothache disappeared. As it had been some time since I'd seen the dentist (about a year, because as it turned out there was something wrong with their appointment recall system and I hadn't received the last appointment they'd sent out) I kept yesterday's appointment for a check up. I explained to Mr V (the dentist) that I'd had toothache when I'd made the appointment and when he checked my teeth he said there were no cavities, but my teeth were very sensitive and there was some gum recession. He said I should use a sensodyne mouthwash, but I pointed out to him that I'm allergic to mint/menthol so can't use it and haven't found a mouthwash I can use, and also that I'm allergic to colourings and all the mouthwashes I've seen are not only minty, but are always a lurid pink, blue or green. Mr V seemed to find it difficult to get his head around this for a while, but eventually did and said to use warm, salty water instead of a mouthwash. Anyway, he said that all he needed to do was a scale and polish, but as my teeth are so sensitive I'd be writhing around in the chair with pain if he did them there and then, so advised me to use the salt water mouthwash this week and he'd put some fluoride varnish on my teeth that should help and mean that when he does the scale and polish next week the pain shouldn't be too bad. He smeared the pastey varnish on my teeth and sent me on my way. The pastey varnish, though, had a taste that I vaguely recognised but couldn't identify ... until I was going down the dental surgery stairs and my lips started to swell. It was banana. I didn't go back up to the surgery, instead opting to go back to the car and get home as soon as I could, but by the time I got back to the car my lips were really quite swollen, my tongue was fizzy and swelling, my throat was itchy, my eyes were itchy and, I was feeling a bit nauseous and my lungs were tightening. I took a double dose (as prescribed by the immunologist) of each of the antihistamines I'm prescribed for severe allergic reaction and used my nebuliser. I probably shouldn't have driven, but all I could think was that I needed to get home, so that's what I did, whereupon I continued on with the meds, sat with my Epi-Pens, phone, mobile and care alarm next to me and hoped that the antihistamines would kick in. I probably ought to have sought medical help, and I certainly don't advise taking the risk that I did, but I got lucky and things did begin to settle. Once I was well enough I thought I should probably call the dental surgery, tell them what had happened and find out the name and ingredients of the thing the dentist had smeared on my teeth. I spoke to the receptionist rather than Mr V, and she was very concerned, but also very helpful. It turned out the stuff was called Duraphat, and she asked me if I wanted to speak to Mr V. I didn't think there was an awful lot of point in talking to him as there was now little he could do, but a couple of minutes after I put the phone down Mr V rang me, sounding very worried and said that he wanted to see me straight away. The dental practice has two surgeries and he was doing his afternoon surgery at the practice so that's where I was to go, but seeing as I thought I probably shouldn't drive I wasn't sure how I was going to get there so Mr V offered to pay for a taxi. That's what I did. Between ending the call and arriving at the surgery Mr V had spoken to them at the dental hospital and they advised that I either see my GP or go to A & E. Personally I didn't think there was an awful lot of point in doing either of these things now as I was better than I had been, even though I still didn't feel 100%, but Mr V wasn't happy so I opted for phoning my GP to ask them for advice. Mr V gave me their phone and waited while I called. I spoke to Michelle - one of the GP receptionists I know well - and explained the situation. She said I'd need to speak to the on-call doctor, that they'd call me back, but she couldn't say when that would be, so I prepared myself for a long wait at the dental surgery. Mr V was going to have to go somewhere before too long, but wanted me to stay at the surgery so the other dentists there could keep an eye on me while we waited for the GP to call back. He spoke to the first of the other dentists, explaining what had happened, who was as surprised as Mr V at the reaction I'd had (Mr V said he'd never heard of an allergic reaction to Duraphat, and hadn't known about bananas containing benzoates, but that that explained my reaction) and asked him to keep a close eye on me. He then went into the second of the other dentists and did the explanation thing, but came out saying that this other dentist's patient was a nurse and she'd said that I should go to A & E, and that I should go soon because otherwise the queues would start to build up. Mr V seemed very relieved to have this second opinion that I ought to be seen by a doctor and it was decided that that's what would happen. Again he offered to pay for a taxi for me to get to A&E, but first I had to call my GP surgery to tell them what was happening and that I now wouldn't need them to call me back. Michelle asked if the dentist was getting me an ambulance and when I told her that no, I was getting a taxi she said, 'A taxi. That's an interesting approach ... well, you know where we are if need us.'

I have to say that I felt like a bit of a twit arriving at A&E displaying few symptoms of severe allergic reaction by now, but saying how things had been earlier, but they were okay (although saying that I probably should have gone earlier) and I was seen fairly quickly. The doctor was rather patronising and obviously hadn't read the copious notes they have on me from my multiple admissions for my asthma. He questioned my 'possession' of so many different antihistamines, until I explained that they were prescribed by the immunologist; he questioned how I had access to a nebuliser (!) so I then had to explain about my asthma; he questioned my allergy to mint (I keep a list of all my meds and allergies and I'd given him this list) simply because he hadn't heard of it before. Anyway, after examining me he said that mostly I was okay, but I was tachycardic, breathing a little quickly and my peak flow was a bit low at 165, so he prescribed more nebulisers and said they'd keep me there for a while to make sure that I didn't have a second wave (biphasic reaction). After a couple of hours or so a different, much less patronising doctor came to see me, saying that the first one had now gone off shift but had handed me over. He redid my peak flow, which had picked up to 250 and he felt I was probably okay to go home, but because of my history (he'd looked at my notes) he didn't want me to feel like I was being pushed out before I was ready and he'd be happy to keep me in overnight if I felt like I needed to be. I didn't think I needed that and I felt lots better, though very tired by now. The doc checked that I had an Epi-Pen, was a little worried that I live alone, but reassured that I have the community care alarm. He gave me strict instructions to keep that beside me, the Epi-Pen beside me, all my other meds beside me and the phone beside me all evening/night, and if there was any deterioration at all then I was to 'dial the 9s' immediately.

I have now had the very weird, but very good experience of walking out of A&E! I don't know when the last time that happened was. In fact it was such an exciting experience for me that I had to take a photo of the exit/entrance as proof of it. Here's the photo:

Today I'm okay, but still very tired and still have that post-poisoned feeling so I've done very, very little, which is rather boring and very frustrating.

Even though things turned out okay in the end, yesterday really wasn't the day I'd had planned.

Uncertainty

My lungs are still tight and bagpipey and last night was quite a struggle, which made sleeping difficult and it didn't happen until sometime around 5am. I was tired, but my lungs just wouldn't settle enough to let me fall into a slumber, which is what I really needed (aside from being able to breahe easily). I don't know what's going on. I mean, I don't know why they're so grumpy at the moment, other than the fact that they're often grumpy for no reason. It's all rather frustrating, and quite frankly it's boring too!

On a positive note, it seems as though the coldiness I thought I felt has gone, and so may have been residual allerginess from the hops plant reaction last week. I know that it seems rather a long time from Wednesday to Sunday (or was it Monday???) to still be feeling the effects of an allergy, but they can be like that. After recovering from an anaphylactic reaction, I can be wiped out for a week or more, and my body usually aches with an intense exhaustion so that it almost hurts even to touch the bed that I'm lying on at the time. It's very strange, and I'm not sure I can describe it all that well ... all I can say is that at those times it definitely feels as though I've been poisoned. So although I've not been this bad from last week's reaction, and it wasn't anaphylactic, the pseudo-coldiness could have been an allergy hangover. That doesn't really explain the current lung tightness though, but then, as I say, my lungs never need an excuse - I think they just get bored of doing the same in/out thing all the time.

I went up to the hospital today, but managed to steer clear of all doctors who know me :o) Actually, I did see one of the ITU docs in the corridor, but I managed to scoot into the lift before they could notice that my lungs aren't behaving themselves too well. No, on this rare occasion I wasn't there for myself, but for a friend who's in there. He's thankfully on the mend now, but he's had quite a rough time of it over the past few months with one thing and another, so he's looking a bit wiped out. I always find it a bit odd visiting others in hospital, because I'm so used to being the patient. There's a certain skill to being a good visitor, and I'm not sure that I have it, because although I know what I like from a visitor when I'm an inpatient (and it varies depending on my stage of ill-health or betterness), other people like other things. Sometimes I need just to have someone sit with me and maybe hold my hand; other times I need very basic conversation - reminding what day of the week it is and how long I've been in hospital. Sometimes I need to be distracted from a desperate state of breathlessness by hearing all about what others are up to, or perhaps, even in that state being 'allowed' to tell them my fears or my random thoughts. Sometimes I want to cry with my visitors, or laugh with them. Sometimes I want to play cards. Sometimes I'm not sure if I even want visitors, and that's a very strange state, because you kind of wait all day for visitors to arrive, but then shortly after they do you wish they were gone again. There's nothing very logical about it ... it's just that visitors can be exhausting as well as stimulating, and it takes someone quite skilled in the art of hospital visiting to be able to judge what is needed by the patient at any particular time. I've had much more 'practise' at being the patient on the receiving end of visitors than of being a hospital visitor, so when I visited E today, I felt a little unsure of myself at first, though he seemed to be at a point of quite liking having company, but not wanting people to stay too long. I hope I judged it correctly. In the end I left so that I could find somewhere to use my nebuliser that wouldn't scare a passing nurse into thinking they should contact my ward, not that I was that tight, but I needed to 'do some breathing'.

I'm still hoping that this lung tightness is a blip that might resolve itself, rather than the beginnings of a downward spiral. Time will tell.

What a 'nana

There has been rather a long time between postings, so apologies for that, though it has been unavoidable.

As an asthmatic, Guy Fawkes Night is always something of a hazard with the fireworks and bonfire smoke-filled air, but I try not to let it rule my life and go out to events with caution. This year (on 5th November) a friend was having a small gathering at her house in Gateshead – just across the river from Newcastle where I live – where we were to meet, then head up to the local park to watch the fireworks display, before going back to Caroline’s for homemade soup and rice pudding. I survived the walk to the park, the fireworks, the bonfire smoke-filled air and the walk back. I survived the soup that Caroline and Andy had made especially for me, catering for my stupidly long list of severe allergies. I was slain by a sip of Sainsbury’s Tropical Fruit Juice. I can’t have juice made from concentrate, and I was so excited by the fact that all four of the juices Caroline had were 100% not from concentrate, that I forgot to concentrate myself and didn’t look to check the ingredients. I wasn’t expecting a fruit juice to have banana in it so was dismayed when I tasted its distinctive flavour in the small sip of the drink I had. I immediately loaded myself up with double doses of two antihistamines, but the tingling lips and fizzy tongue had already started. I took myself off to the bathroom where I was promptly sick, and I could feel my mouth and throat begin to swell. One of my friends, Katherine, came in to see how I was, bringing my EpiPens with her and I quickly stabbed myself with the first. Too late though and I knew that I had to get to hospital, but I also needed just to get away from the rest of the group, because it’s really no fun being watched in horror and fear as you get increasingly unwell. Katherine and Georgina took me down to my car and we set off for the hospital (G drove, not me!). This would’ve been a better plan if any of us had known where the hospital in Gateshead is, but we didn’t and I was getting worse, with my breathing becoming more laboured by the minute. G decided to pull over at a T-junction where there were two clear road signs, K called for the ambulance, and I stabbed myself with my second EpiPen. I have to say that I was very impressed with the speed of the paramedics and we only had to wait about 5 minutes, if that, before they arrived. They were then very good with me, taking full note of all my allergies and medication and treatment protocol, all of which I keep with me on laminated cards so that I don’t have to try to explain it all when I can’t breathe. After several attempts at getting a cannula (needle) in, but failing in part because I was shutting down and in part because my veins are so scarred from over-use, they gave up and whisked me off to the QE hospital in Gateshead. Thankfully, unlike us, they knew where they were going.

The A&E staff were ready and waiting for me in resus with their anaphylaxis kit out and nebulisers at the ready, though I’d already had two more shots of adrenaline and nebs in the ambulance. Unfortunately my breathing was still going downhill and my tongue and throat were still swelling so I was very quickly seen by the intensive care team. Again I was impressed by how attentive all in A&E were to my treatment protocol etc, and how much they asked me what helps in these situations, thereby recognising that I live with this all the time and have a lot of experience of managing it (not all medics/hospitals/places I’ve landed have been like this and it is a very frightening experience). It took the medics in A&E a long while to get any venous access too, but they did eventually succeed and were able to give me the IV steroids I needed and the aminophylline drip that usually helps my lungs. The swelling of my mouth and throat eventually began to subside, but the anaphylaxis had set off my asthma in big style and this wasn’t abating to any degree so I was taken up to intensive care. They explained that they didn’t want to ventilate me if they could avoid it, but that they may have to if things didn’t improve or if I became very tired, which is good because I’ve been ventilated five times and hate it ... understandably. However, things didn’t pick up and I was becoming exhausted so one of the docs got all the intubation kit out and drew up all the drugs to put me to sleep, whilst another one tried to get a second cannula in me so that they had enough venous access to get the drugs into me. He had about 20 goes all together but couldn’t, however hard he tried, get one in. They abandoned ventilation and instead looked at each other, looked at me, and looked scared. This is never good. I knew that all I could do was to battle on with what little energy I had left and concentrate on getting every breath in and then out as best as I could. I was scared. I was beyond exhaustion. I was desperate to give up, but I knew that if I did then I would die. Eventually, somehow, I came through the worst of it, though not without the medics trying again to get another cannula in to put me to sleep for venting. I could’ve cried. It had all started around 9:15pm and it didn’t begin to settle until lunch time the following day. It is like running at full speed up a mountain, whilst breathing through a straw filled with foam, and unable to stop at any point for a rest or replenishing of energy reserves.

I stayed in ITU at the QE until Friday 9th November when I was transferred to my usual ward at my usual hospital (Ward 29 at Freeman Hospital, Newcastle). All at the QE had been great and treated me very well, but it is always a relief to be back where they know me and I don’t have to do any explaining, and they know how quickly things can go spectacularly wrong with me. Indeed, in the early hours of Saturday – 5:30am – it all went horribly pear-shaped again and I was back to square one with the asthma. The Freeman’s ITU team came up to see me, and they wanted to take me downstairs to be with them, but there were no ITU or HDU beds at all so they got the outreach team to HDU me up on the ward, which was a new experience for all involved. Again it was another long hard battle, with the Carbon Dioxide levels in my blood (pCO2) going stupidly high, which is a bad sign, and I wondered if I was going to end up being vented, but at last, at around 1:30am on Sunday it broke and settled. Aching from the effort of trying to breathe, utterly worn out by the huge set-back on top of the exhaustion from the anaphylaxis/asthma attack earlier in the week, I collapsed into sleep. I do Olympic sleeping after bad attacks (I call it The Big Sleep stage), and this time slept from the early hours of Sunday until Tuesday evening. Even after The Big Sleep it takes more time to recover more fully and for my oxygen levels to pick up, and it’s usually not until after The Big Sleep that they try to start weaning down the aminophylline as I have frequently gone splat during the weaning process in the past. Come Thursday afternoon though the aminophylline was successfully down, and by Sunday we’d managed to get me off the supplemental oxygen all together. It’s Monday evening now and I’ve just got home. How lovely it is to be back in the land of the living.