Give blood

Just back from failed first attempt at blood donation. Medical problem needs checking with GP before the red stuff can flow free. Was asked if I'd ever had unprotected oral or anal sex with another male. Question came as a bit of a surprise, because I thought they only offered tea and biscuits afterwards...

Parliament just got a little bit more supreme - now to keep up the pressure

The Labour MP Clive Efford secured a highly symbolic victory in a debate on his Private Members' the National Health Service (Amended Duties and Powers) Bill on Friday 21 November to roll back NHS privatisation and remove the NHS from the controversial Transatlantic Trade and Investment Partnership Treaty negotiations(TTIP. During the debate, in which Tory MPs were conspicuous by their absence, Labour Health shadow Andy Burnham pointed out that over 60 of their number have links to private health companies, many of which are US-owned; just the kind of multinational business that would benefit greatly if TTIP passes into law – doubly so, if the Coalition keep the NHS within the scope of the Treaty. Paradoxically, for a party that pays a lot of lip service to the convention of ‘parliamentary sovereignty’ or ‘supremacy’, the Tories seem very keen to give large chunks of it away to foreign-owned businesses. TTIP would allow such businesses to sue our government if it dared to pass any future laws that threatened to undo privatisations or reduced their perceived ability to make expected profits on UK-based deals. In reality, therefore, TTIP puts the British people (the ones Cameron likes to bang on about) at the mercy of the profits of foreign and multinational business (those who have such a problem paying out taxes, remember?) And Cameron is very keen on TTIP. He wants the deal signed with almost indecent haste, and said only this week that he wanted ‘rocket boosters’ putting under the negotiations, ridiculing those who argue against it for having only ‘weak arguments’ and dismissing fears that it will be used to force further NHS privatisation as ‘nonsense’. Parliamentary sovereignty has two main features: first, there is the unwritten rule (called a ‘convention’) that parliament can pass a law on any subject it fancies – because that’s the democratic will of the people (yeah, right); and second, parliament can’t ‘bind its successors’, which means any law passed by the current parliament could be repealed by one sitting in future – we don’t have any ‘entrenched’ laws – unlike the written constitutions of the US, France or the Irish Republic, for example. So by forcing through TTIP and making sure parliament passed domestic legislation to give effect to it in this country, Cameron was hoping to make NHS privatisation unstoppable, because he’d effectively given away the power of parliament to stop it in future. After all, MPs with shares in private health companies won’t be took keen to cut off the profits from their own investments, and a future parliament would be wary of incurring legal costs if a foreign company took the UK to court because it had legislate in a way that was damaging to their supreme right to make money. TTIP, like Cameron’s line of reasoning is dangerous and needs to be stopped. Clive Efford’s PMB has to become law, for all our sakes.

Playing doctors at the Chemist

Routine collection of a repeat prescription was enlivened by the announcement that the pharmacist on duty wanted to review my medication. This turned out to be a short discussion in a rather cramped 'consultation room' that they've craftily hived-off from a storeroom. Working through a list of my medication, the pharmacist seemed most concerned to know whether I needed to take rabeprozal sodium every day - and what would happen if I didn't?
Now, these questions rather highlight the facile nature of the review exercise: this medication was prescribed several years ago to treat a hereditary condition that affects the duodenum's ability to prevent stomach acid entering the oesophagus. Rebeprozal is a proton pump inhibitor (PPI) that stops me enduring perpetual heartburn caused by acid reflux. Asking the question means the pharmacist didn't know the obvious answer, and caused me to wonder why she'd decided to second guess my GP, who also regularly reviews my medication - the key difference being that, whereas the pharmacist dispenses, the physician prescribes. And I'm interested to know who has decided that essential and time-honoured division should now be eroded by the pill-counters.

A stumble on the stairs

Although I asked him not to laugh, the chap at the till in M&S at Leeds Station apparently couldn't stop himself when I answered his question about my finger. 'I tripped on the stairs', the first part of the answer went OK. But when I followed it up with 'all my weight landed on my right hand and I ended up with a chipped bone in my little finger (not, NHS 111 operator please note, my 'pinky'), the chuckle barrier broke. And when I finished by saying that just about everything in the known universe that I'd encountered since seemed magnetically attracted to the spot, well I don't know if he'll manage to finish his shift.
The break was diagnosed and dealt with by the staff at Calderdale Royal Hospital A&E, a department under threat of closure from shortsighted penny-pinching NHS beancounters. They must be resisted at all costs. Preferably given forced enemas by Linda the capable and friendly nurse practitioner who strapped up my finger hopefully administered in a public place, while an effigy of the excreable Hunt burns slowly in the background.

One night's stay in hospital, one MRI scan, TWO surveys...

Yesterday afternoon I returned from a 24-hour, unplanned, stay in hospital necessitated by a suspected TIA (mini sroke). Minor symptoms on Sunday afternoon led to admission after a visit to A&E (don't worry, Mr Hunt; we were told to go if I experienced such symptoms after a planned visit to clinic the previous Saturday, so I wasn't wasting resources). Before I could be discharged, after being seen by my consultant who arranged for the MRI and discussed the outcome with me, I was interviewed in person for one survey and given another to be completed on a pre-paid postcard. The face-to-face interview involved completion of the usual 'on a scale of 1 to 5' questions, which included such shoe-ins as 'how would you rate the food' and 'what do you think of the decor' - neither of which are going to be too high on the list of improvements, given the current state of NHS funding. Most difficult to reduce to a 1 to 5 response was the question about quality of sleep. It was very poor, but this was because I'd been allocated a bed - at short notice on a Sunday afternoon - in a high dependency stroke unit, where my three fellow 'roomies' needed round the clock care from a dedicated, hard-working team of medical professionals. If lights turned on and off during the night and medics conferring at nearby bedsides disturbed me, lack of sleep was a small inconvenience to me alongside the care the other patients obviously needed. On a scale of 1-5, sleep quality was accorded a '2', but I made sure the scribe recorded my reasons at length. Higher up on the facile question scale was the single question on the pre-paid card: how likely would I be to recommend this hospital to a friend or relative in need of similar care? I've decided to save the NHS the postage on this, as it smacks too much of vapid customer satsfaction league-tables. But the answer is: should you find yourself suffering the symptoms of a stroke or mini-stroke in Halifax or its environs, the staff on Ward 6 at Calderdale Royal Hospital do their utmost to treat and reassure, given the constraints currently facing the NHS, and if you have a friend or loved-one being treated on that ward, they are - on the evidence of my experience - treated with a high-level of care and respect. Sorry there's no appropriate column on the survey for that testimonial, but dedicated, well-trained professional healthcare can't be reduced to a simple box-ticking exercise. So if your'e looking to save NHS resources, the questionnaire culture should be the first to go.

A run in with a big prick

Nurses aren't trained to take blood samples. A useless fact - unless you've just agreed to be guinea pig (human pin-cushion) for a staff nurse's first attempt; as I did on Saturday. As if the TIA 'mini-stroke' clinic wasn't scary enough, the nurse in charge of blood letting and pressure checking decided to ask me if I 'minded' being first victim for her colleague. OK, take a walk on the wild-side, I thought, after all, it's just a 'little scratch', so they usually say when taking a sample. Enter staff nurse in training with trolley and look of steely determination. The needle was prepped and she went at the task like a Tommy preparing to clear a trench in a bayonet charge. Pausing only to observe I'd given her a 'good vein' and to line up the needle, in she went. Still got the purple welt two days later. Whereas the pinprick from this morning's professionally phlebotomist-taken sample has already faded into memory. Now who feels the little prick?

Tramadol – did the doctor really know best?

I was given Tramadol in hospital to relive pain after a left knee arthroscopy. About an hour later, the physiotherapist had to help me back into bed. My temperature had rocketed and I felt about to keel over during her demonstration of how to ascend and descend stairs with a walking stick. She was assisted in her efforts by the ward sister, who left me with the words “if they ever ask if you’re allergic to any painkillers – say Tramadol, it doesn’t agree with you”. Well, my knees are both the same age, and this August it was the turn of my right knee to have its cartlidge tidied-up, as the doctor put it – making it sound more like something you’d do in a garden, rather than in an operating theatre under general anaesthetic. There then followed the painkiller allergy/intolerance question, to which I mentioned the Tramadol incident. “Oh, I don’t think it could have been Tramadol. After all, you’d also been on morphine. And it was an hour after you’d been given it before you had the problem” was his response – to which I replied that I didn’t want to risk a repeat performance; I was also mindful that I was being sent home as soon as I came round from the anaesthetic, and didn’t want to have an adverse reaction when I got home, leaving my wife and sons to have to deal with the immediate consequences of what the medics quaintly call a ‘contraindication’. Funnily enough, the question reared its head when I was in the hands of the anaesthetist and his two theatre nursing assistants as they prepared me for surgery. One nurse backed me to the hilt – she’d also had an adverse reaction to Tramadol and told me to stick to Co-codamol. That was just before the general anaesthetic took effect.