MEDICAL MATTERS

[Stanley]

Quite right Cathy, not enough thought given to mother and child and funnily enough some women protest as well! More about their personal hang-ups I think.
This has reminded me of the old trick to stop a woman's milk if it was thought necessary. A big dose of Epitome Salts! Nurse Hunt, the Barlick rabbit-catcher recommended it to Vera when she couldn't produce enough milk for Margaret, she said it was better to swap completely to formula milk than struggle on, better for both Vera and the baby. It worked like a charm.....

[Tizer]

Epitome Salts? Is that the Barlick name for Epsom Salts?

[Cathy]

I nearly asked that, but then thought better of it (Just in case... hehe)

[Stanley]

I like it! Should have been Epsom of course but I can't see the spell checker clearly......

[Tizer]

I wonder if it's called Epsom salts because they make you run as fast as the racehorses?

[Stanley]

Named because it was first identified in the water of a mineral spring in Epsom? There was a tremendous vogue for hydrotherapy in the 18th and 19th centuries. Towns like Ilkley and Harrogate capitalised on the fact they had foul tasting springs. The worse it tasted the better it was for you! There is a 'sulphur well' on the side of the Skipton Road near Broughton Hall and people used to get a bottle of it for a cure for almost everything. Lister Well on the moor above Barlick had a similar reputation.

[Stanley]

I had a sudden acute pain in my forearm yesterday that made it useless. I avoided anti inflammatory pills, I know how bad they are for me. Plenty of rubbing with old fashioned embrocation and today it's 100% better. I think I did it carrying the Hoover upstairs with my hand bend at a backward facing angle. Glad it's going but I could have done without it!

[LizG]

I use Rapidgel. It's an anti-inflammatory gel for horses. Apparently most jars are sold for use on humans not horses. Good stuff.

[Stanley]

If I'd had it I would have used it Liz... But Wintergreen Oil is quite old fashioned now.... It makes good penetrating oil as well!

[Stanley]

Nature is taking its course. I realised last night I was washing and drying my face with two hands! First time for three days..... I can't help thinking of the number of people who call an ambulance for something as minor as this and clog A&E. For instance, they all know that a pain in the arm is a sure sign of a heart attack..... A bit of common sense would go a long way.....

[Stanley]

Arm back to normal/ Lovely Xmas pressie!

[LizG]

Glad to hear it. Use both arms to carry next time.

[Stanley]

I've given it some thought Liz. I need one hand for the bannister so I'll just put it on my shoulder.... That will be OK!
What many people forget is that there are more accidents in the home than anywhere else and a bit of thought can save a lot of trouble. Most dangerous place in the house is the last three steps on the stairs.....

[PanBiker]

Spent the best part of the day in Airedale Emergency department today. I woke up this morning with the right side of my face completely numb, no sensation at all and dead to the touch. When I tried to push myself up in bed with my right arm I found that was dead also. The feeling came back into my face but then I was getting muscular spasms in my arm and uncontrollable cramping in the fingers of my right hand. Within 5 minutes or so these symptoms had subsided but they were not the same as the odd dead arm or whatever that you get when laid awkwardly.

I put myself through the shower but thought it prudent to ring the NHS 111 help line for advice. It took ten minutes to be connected and I asked if It would be a good idea to get myself on to A&E, she insisted on the 15 minutes of questions. The young lady took my reposes and then consulted a medic, she then came back on and asked if I would accept an emergency ambulance which would take be to Blackburn. I agreed but expressed a preference to go to Airedale if possible. Off she went to confirm the ambulance but found that she could not instigate it from her console so suggested I rang 999. She added that she would raise an internal investigation as to why she could not get me an ambulance. I said that as my symptoms had gone I felt it a waste of resources to ring 999 and order up an emergency response vehicle with all the bells and whistles and would it not be better to simply let my son take me to the hospital, she agreed and told me to go directly to the emergency clinic. The 111 call took just over 30 minutes in which time I could have already have been at A&E.

We were there within 20 minutes and I was tagged and put into the cue for triage. It was 11.30am, the waiting area was half full be then with a mixture of folk, quite few with breaks of one sort or another and a farmer by the look of him with a dislocated shoulder. Our wait was about an hour and I was called straight through to a treatment bay, a short while later the nurse came to do my initial assessment it was exactly 1.00pm. She eyed me over as I related my earlier symptoms. She hooked me up to the ECG machine and then after taking my BP unhooked me and removed all the pads then went to retreive the printout which usually emerges at the nurses station. She came back to tell me she would have to do it again as my results would not print out. So she went for a portable ECG that prints out directly, five minutes later we were sorted and she had her trace. Bloods next so four tubes full out of my right arm which is the one normally offered when donating. Initial test complete so off she went with her booty and said the doctor would call to see me when my results were back. No eating or drinking in the meantime.

The doctor came at about 2.30pm and started her tests, nothing wrong with my ECG trace or the blood test they had got back so far. She did a full pulmonary and neurological examination, plus eyes, ears, throat etc then refexes and sensation tests all came out OK. She said she woul like a urine sample from me but I had literally just been to the loo two minutes before she turned up to do my examination. I had agreen light now for drinking so did 4 cups full of water and waited awhile for nature to take its course. She had said that I would not need to be admitted as I no longer had any symptoms and all my test were good so far but woul confirm after my urine sample had been processed and the last of my blood test came through. Fifteen minutes later I managed to produce the sample which was turned round quite quickly. Doctor came back after another 20 minutes with the results of my bloods and although my symptoms were not classic they were 80% in line with a TIA episode. I was dosed with 500mg of Asprin and told to take 75mg each day until attending the TIA clinic where my results would be reviewed again by a stroke specialist, she has booked me an appointment for 10.00am on Monday.

I feel perfectly normal at the moment but that is the nature of a TIA, I have had no slurring of speech, facial distortion or visual impairment which I suppose is on the better side for a positive prognosis. We'll see what they say on Monday.

[Sue]

Wow what a day. Hope all is ok

[Wendyf]

Fingers crossed that you have come through it OK Ian.

[Tripps]

I would have called 999 immediately following the symptoms you describe, following a recent experience.

I had an episode where I wanted the doctor to come out and check me out last October. Typical man - didn't want to make a fuss. They refused and insisting on immediately calling 999 for me.

The GP said they had better facilities than she had! A paramedic was at the house literally within 5 minutes. He had an portable ECG machine, and in another five minutes I was wired up. The big ambulance arrived within about half an hour, and I was in A&E twenty minutes later. The 'golden hour'.

Not sure why you would prefer one hospital over another. We don't really have that choice.

[Stanley]

Bloody hell Ian! We can do without anything like that. It's put me in Three Men in a Boat syndrome (when the bloke read the medical dictionary and found he had everything except housemaid's knee). Glad it wasn't a full blown stroke but look after yourself! Now, about those pins and needles in my left hand.....

[Nolic]

Take care Ian. Nolic

[David Whipp]

Blooming heck Ian, don't mess about if it happens again.

[Tizer]

Glad to hear you've come out of it unscathed, Ian. Did you get over-stressed by the Christmas festivities perhaps, or forget your tin hat? (Only joking, but then we've got to joke haven't we, stiff upper lip and all that! )

[PanBiker]

Not sure why you would prefer one hospital over another. We don't really have that choice.

We do Tripps, from my point of view Airedale is a lot more convenient, my daughter lives in Silsden five minutes drive away. All or medicals have been sorted there, births, deaths, cancer, surgery when required and the odd trip to A&E when our kids broke themselves (mainly our Dan playing hockey). It's a lot easier to get to than the other side of Blackburn (we don't have emergency at Burnley any more). Bottom line is that I trust the place. Not to say that I would not accept help from any quarter if push really came to shove.

The 111 service could not raise me an ambulance and my lad was with me so going straight to Airedale was the easiest and quickest option.

I will report here that the A&E department is now very swish after its multi million pound refurbishment more like the medical wing on the USS Enterprise. The nurses and doctors were fantastic and you could not tell on the wing that they were short staffed over the holidays and under so much pressure. The waiting room was rammed when we came out but there was an air of calm and professionalism on the unit, very reassuring when you are feeling vulnerable.

Thank you all for your comments.

No further episodes to report so we'll see what the specialist says tomorrow.

[Tripps]

Blooming heck Ian, don't mess about if it happens again.

That says everything I intended to convey.

[Stanley]

Ian, I like your description of the Airedale A&E department. The NHS is a political football and there are plenty of opponents who highlight things that go wrong and not the 99% that go well. That's why so many of us see a disconnect between our experience and what the doom-sayers tell us.

[PanBiker]

I attended ward 5 at Airedale Hospital today which is the Stroke Unit. I was there to see the consultant who I had been passed onto from my visit to A&E on Saturday.

Sally took me on as I had been banned from driving until further tests or evaluation by the specialist. The TIA clinic is located just inside the entrance to the ward and we were welcomed by the TIA clinician nurse who took us into the waiting room and explained why I had been referred to the unit and that the consultant would be along shortly to discuss my test results that the department had received from my emergency visit. Whilst I was waiting for the consultant she took my blood pressure and made a note. She then explained that TIA's are normally caused by small clots entering the brain, they can also be caused by plaque build up within the carotid arteries that deliver blood to the brain. If the plaque build up is excessive it can restrict the blood flow, also pieces of plaque can become detached which again can cause reduced blood flow.

A few minutes later we were shown into the consultants office and introduced to Dr Mawer, he explained that he had reviewed my results and asked me to run through the symptoms that I had experienced again. He then asked if there was any family history of any neurological problems that I was aware of including Stroke or Heart Disease. He said that the symptoms I had related did not automatically equate to a TIA event although they could be indicators. He said he would like me to have a carotid artery scan and then bring the results back for him to add to the picture and allow him to make a more accurate prognosis.

The nurse took us upstairs to another unit and explained the procedure on the way. She said there were a only two areas within the body that can produce clots, one is the heart and the other is within the carotid arterial system that distributes blood around the body. We have left and right carotid arteries than run from the heart up each side of the neck and then behind the ears into the brain. Clots produced within the aortic system would be indicated by an arrhythmic heart beat which is why they hooked me up to the ECG when I was in emergency. My ECG results were perfectly normal so they had to look elsewhere hence the referral to the stroke unit and the need for further tests. She explained that the scanning process is non invasive and uses the same ultrasound techniques as fetal scanning and should take no longer than 15 to 20 minutes. She dropped us off in the waiting room and said that the nurse would produce the results from the scan and hand them to us to take back down to the stroke unit.

I only waited about 5 minutes and was called into the scanning room. It's quite a straightforward process and the nurse asked me to lay back on the couch, she then put some tissues around my shirt neck to stop the gel she had to use getting onto my clothes. She explained that once the tests started I would hear various beeps and clicks and that I would also hear swishing noises as she observed and measured the blood flow in each artery. She started on the right hand side, all I had to do was tilt my head back and turn my head to the left. She spent about 5 minutes tracking up and down the artery looking for plaque build up within the walls, then she switched on the doppler ultrasound which produces a colour picture of the blood flowing within the artery and allows her to measure the flow rate. One side done in less than 10 minutes and then the process repeated on the left side. A quick wipe down to get rid of the gel and I'm done. She showed me out and asked me to take a seat while she prepared the results. A quick read of the "Dalesman" and 5 minutes later we were on our way back downstairs clutching my scan results.

Arriving back at the TIA clinic we were told the consultant had been called up onto the ward so there would be a short wait, she took the results from us and put them on his desk and offered to make us a brew while we we were waiting, coffee for Sally and tea for me. There was a new arrival in the waiting room who had come in with a companion. We chatted, no more than ten minutes and were then called back into the consulting room. He welcomed us back and we could see he was already looking at my results from the scan. He leafed through the various readouts and images and then said with his opening statement that he did not think that I had suffered a TIA and my results did not indicate any risk of stroke.

He went on to explain that my ECG was perfectly normal, no arrhythmic traces, my blood tests had all come back negative as had my urine test, my blood pressure was well within limits and my carotid artery scan results were all positive, no appreciable plaque build up and a good flow rate to the brain. He explained that my symptoms were only partially attributable to a potential TIA. The fact that the numbness experienced in my face subsided and then moved to my arm along with the cramping were not in themselves typical of a TIA. Most events present themselves with additional drooping of the facial muscles, blurred vision and all symptoms are present at the same time. The symptoms of a TIA usually take 30 - 60 minutes, sometimes 24 hours to subside. With all my results clear and only partial symptoms presented he has pronounced me as sure as he can be free of the immediate risk of stroke. He told me not to continue with the Aspirin and continue as normal. Just to confirm I asked him if I was still OK to climb up hills and ride my bike until my lungs hurt. He said by all means, keep that up as long as you can, your current health, reflected in your test results is testament that it's not doing you any harm. That's good enough for me.

He will pass all my results back to my GP and he has recommended that I make an appointment with him after our local surgery is fully back up and running after the New Year so no immediate panic. He suggested I get my cholesterol checked as a matter of course.

So what caused my symptoms? Once I got to the stroke unit and the nurse started explaining the physiology of which areas they were looking at I mentioned that I had been hospitalised with Quinsy, and that I had been told the procedure of draining the abscess has left a void behind my left tonsil that is susceptible to re-infection. I have to seek antibiotics at the first sign of reinfection. I had a near miss with this last year when I recognised the onset of the condition again. My doctor was on holiday but I explained to Dr Hare and she concurred and sorted me with my normal magic pills.

I have had a quite heavy cold which started just after Carla's wedding on the 21st. It started with a sore throat but without any obvious infection, just sore, a heavy cough and lots of mucus, typical winter cold really, I kept my eye on my throat but I lost the soreness after a couple of days and was just left with the mucus and the odd bouts of coughing spasms. The consultant did elude to viral infection as a possible cause of my symptoms. I am wondering if the sore throat I had led to some infection to the site of my previous peritonsillar abscess which in itself is in the same vicinity as my left carotid artery. I suppose temporary swelling there could have impacted on the artery and caused the blip. The heaviest and most severely infected mucus flow was on the left as well. Difficult to diagnose as the symptoms are no longer there

Thinking back, I seem to have weakness for infection down the left hand side of my head. My quinsy was at the left, I have had ear infections at the left and am currently bunged up with wax at that side. A number of years ago I had what turned out to be a serious sinus infection again at the left. It initially presented as toothache and it was an orbital dental X Ray that showed up the infection in my sinus. That one was so bad it impacted my optic nerves and I could not stand up at one point as my eyes were oscillating and could not focus, which was a bit scary at the time, everytime I stood up I fell over backwards as the ground looked to be moving under my feet, very strange sensation. Cross spectrum AB's eventually sorted me out.

I know a lot more about human physiology after today, it's fascinating stuff how it's all linked up and what impacts what. Best outcome I could have hoped for so onward and upward.

Back to my doctor for his two pennorth and get my ears sorted. I'll be a new man!