It Started With A Snore - Part 8

So, as I said previously, we arrived at the shiny new Foundation Hospital clinic early on the appointed Saturday morning. I must admit to approaching all of this with a degree of trepidation, as there is a limit to how many times anyone wants bits chopped off them and I seem to be pushing the ceiling of this quite hard at the moment.

Parking myself on the operating chair, I was immediately surrounded by nurses and the man himself. I decided to alert them straight away to my status as a fully paid-up Wimp and to warn them that I had no intention of watching any of the proceedings at all. They seemed pretty happy with this and we commenced a series of local anaesthetic injections into the back of my mouth. This was a bit hit and miss. Essentially, the Consultant put a series of shots in, waited a bit, poked the area with something sharp and, if I reacted (which I did) had a few more goes with the local. Eventually we both agreed that we seemed to have numbed the area sufficiently and he set to work with, what I assume was, a laser.

Now, I’m afraid that I can’t give you chapter and verse about this as I had my eyes tightly closed throughout but my sensation was one of two lines being ‘drawn’ diagonally down either side of the back of my throat (the overlong uvula presumably). There was a short break between each one, as there was only a relatively brief window of opportunity before the gagging reflex kicked in as a consequence of my tongue being held down and out of the way by a spatula. There was no pain, just a dull sensation. Then came the final bit where the ‘limiting’ of the palate presumably took place. I was aware of a much more sustained sensation travelling slowly across the area laterally and this time there was some pain. I clenched the chair and hoped this would be over soon and was assured by the Consultant that “we’re nearly there”. Seconds later, I was told that it was all over. “Do you want to see it?”, he asked. I weighed this up. On one hand, I really could do without any more gore. On the other, I had the natural human curiosity of wanting to see what had come out of me (it’s the same instinct that makes us look in a handkerchief after we’ve used it, for no apparent reason). I looked down into the kidney dish and was immediately struck by 1. How much of it there was and, 2. The fact that it was the sort of pink favoured by a certain girls’ doll. This wasn’t just pink, it was PINK. I had never really thought of my innards as being powder pink. It really didn’t seem masculine enough.

Wheeled gratefully back to the comfortable lounge area, I was given some time to recover. Before I could go home, I had to demonstrate that I could swallow a drink of something and then I was given a supply of pain-relief tablets and warned that I would have an excruciatingly sore throat for one week and a moderately painful throat for another week but should be ok after that. This seemed unlikely at the time, as I couldn’t feel a thing and was congratulating myself on how much easier it had all been than I expected. By the time I got home, I was beginning to see what they meant. They had warned me to avoid any hard foodstuffs for a couple of days and we were casting round to think of what I could eat. My wife came up with the bright idea of (amongst other things) microwaving a tomato so that it was mushy and edible. Seemed a good idea until I tried it. I had no idea that tomatoes were so acidic! It was like pouring sulphuric acid down my throat, so we gave up on that idea.
The prognosis proved to be exactly right. The first week was diabolical and pretty miserable, whereas Week 2 was just like having a very bad sore throat. After two weeks, all was normal again and (touch wood) has remained so ever since. I do still snore (they never promised that would stop) but I rarely have occasions when I awake in a blind panic, unable to breathe. My wife tells me that my snoring is nowhere near as loud as it was, although my companions from the walking weekend (see I was a stranger and ye took me in) are not convinced about this.

Would I recommend the procedure to anyone else? Well, the alternative, in my case, would have been spending every night attached to a CPAP (Continuous Positive Airways Pressure) machine. On the whole, I think I prefer to have had a couple of weeks of pain and discomfort, as opposed to a lifetime strapped to one of those, but it is clearly an individual choice and you need to consult with your Specialist to see what he/she thinks. I don’t know if my ‘limited palatoplasty’ will be a permanent solution or whether my ‘girl’s bedroom’ pink innards will grow back and set about trying to suffocate me each and every night again. All I can say is that, right now, just over a year since the operation, everything seems to be fine.

Night, night.

It Started With A Snore - Part 7

WARNING – THIS ARTICLE CONTAINS PRAISE FOR THE NHS. Readers of a nervous disposition* are advised to look away now!

* Whatever happened to ‘those of a nervous disposition’ that announcers used to warn in dark tones before programmes of particular gore or menace? Did they die out due to natural selection? Nowadays we’re just shown the gore and menace anyway, and then pointed toward an appropriate counselling service “if you’ve been affected by any of the issues in tonight’s programme”.

I had visions of my ‘limited palatoplasty’ (which, we have determined, is not some obscure antipodean marsupial) taking place around the time of the next ice age, given my previous experience of the geological timescales that the NHS used to adhere to. As I had private health insurance (don’t all throw things at once, it has proved to be the difference between life and death in the past) I decided to try to get my money’s worth and see if they would arrange the surgical procedure. My Consultant had warned me that this might be an uphill struggle, but I started the claim procedure anyway. Not unsurprisingly, they would not agree to fund my operation without further and better particulars from the Consultant, so we started a potentially lengthy game of ‘pass the buck’.

However, to my astonishment, (this is where the first praise for the NHS comes in, so you may want to look away now), the NHS appointment arrived before the private health people had even had chance to refuse me formally! I was to attend a clinic in a couple of week’s time, on a Saturday morning!!

I apologise unreservedly for the plethora of exclamation marks, but I think this warrants it. For years, it has been an unwritten rule that you could only be safely ill during normal office hours, Monday to Friday, because the NHS did not see the need for Consultants to be on hand at any other time. So, to have an operation scheduled for a Saturday morning was really ground-breaking. I think the cause of this was the introduction of a set of clinics run by a private healthcare provider, but within our local hospital, with the remit of addressing those areas where long waiting lists had previously dominated. My appointment was for this new facility but the operation would be conducted by my usual Consultant.

So, I reported to this brand new, spotless facility with its comfortable furniture in bright, primary colours on Saturday morning and was ushered into a very well appointed clinic for some pre-op checks. There was even a beautifully appointed changing room with lockers for your personal belongings. Pretty soon, dressed in my surgical gown, I was wheeled (I really don’t know why you’re not allowed to walk) into the operating room for the Great Man to do his worst, or hopefully, his best.

It Started With A Snore - Part 6

There are many ‘least favourite aspects’ of hospital attendance but I think the waiting around is in my Top 5. The NHS have, over the decades, become quite adept at giving the erstwhile patient the semblance of progress without actually delivering it. At the ENT clinic, for example, we first joined a relatively large group of people in the main waiting area. Then we were called in by the nurse acting for the consultant. The more optimistic might assume that this was the appointment, but no, this was for a few brief tests and form filling. This having achieved whatever it was intended to achieve, we return to the main melee before being called again. Is this the appointment? Is it bunny rabbits! This time we are corralled with another group of people, all of whom were called from the main waiting area some time before us and who have been fighting for the few available seats in this corridor, leading to the great one’s rooms, ever since.

All of this would be bearable if the reading matter available offered any likelihood of entertainment. Where do they get their magazines from? On my last visit, the choice consisted of “British Show Pony Monthly”, “Distribution Handling” and “Hello”. It says something about me that I was drawn to “Distribution Handling” but who in their right mind donates these magazines? At best, the first two must have a very specialised and limited audience and the third one probably should have. Why they feel the need to foist their arcane choices of reading matter on the sick and the lame is beyond me. You would think that some enterprising magazine publisher might have seen the possibilities of such a captive audience and filled the waiting rooms with their offerings, gratis.

Eventually, I reached the consulting room of my ENT specialist and he gave me the results of my second sleep monitor test (called for, apparently, because they found it difficult to believe the results of the first attempt). Yes, I have sleep apnoea. Not only do I snore stentoriously but I also stop breathing, quite frequently, for periods of up to a minute at a time. He went through a range of options, the majority of which wouldn’t work for me, and recommended a surgical intervention followed by a CPAP (Continuous Positive Airways Pressure) machine if that didn’t do the trick. The surgical intervention was a ‘limited palatoplasty’, which sounded to me like one of those weird Australian marsupials:

“Oh yeah, Bruce, what you’ve got there is one of them Limited Palatoplasty’s. They’re kinda cute but they bite like buggery and they’ve got a poisonous snout. Go great on a barbie though!”

His view was that, whilst this was unlikely to provide a cure, it just might do so and was therefore worth a try. I signed the requisite form and awaited my date with the laser.

It Started With A Snore - Part 5

Also titled "They Also Wait Who Only Stand..." (with apologies to John Milton - not that he could give a monkey's)

Those of you who didn’t run away screaming at the sight of the author in T-shirt and accompanying sleep monitor paraphernalia, looking like somebody of interest to Crimewatch UK, may well have gone on to read the last article in which we left our hero(?) slumbering and snoring whilst wired up to the gills? If so, now read on...

The whole tangle of wires and monitors was shovelled back into the laptop case the following morning and whisked back to the relevant clinic by 10.00 am, as requested, for downloading and delivery to the next lucky recipient. I felt as if I’d had a pretty disturbed night, being acutely aware that any sudden movement (not that I’m known for those) might detach the whole apparatus. This drew a snort of derision from my good lady the following morning who referred to me as “snoring like a stuck pig” all night (no, I don’t know what that is either, but I get the general drift).

Having returned all of the equipment, the only thing to do now was to wait for the results. It was therefore, with some surprise, that we opened a letter from the hospital inviting me to attend to be fitted with a sleep monitor. We called them. We said there must be some mistake as we had already done this bit. They rummaged through their records and eventually came back to say that, no, there was no mistake; they needed to run the tests again. Of course, a note to this effect on the letter would have saved a phone call and their time answering it, but apparently doing anything other than send the standard letter would stretch the NHS to its limits.

So, we went through the whole process again and another few weeks drifted aimlessly by. Not that I was deprived of medical attention during this hiatus as my GP called me in to discuss the results of the Well Man clinic I had inadvertently let myself in for. These proved to be exactly the opposite of what I expected (cholesterol normal, blood pressure high-ish) but he had to admit defeat and refer me to the Opthalmic Consultant, which meant yet another trip to the hospital, albeit a different clinic this time.

As I said, right at the start of these articles, “I seem to have been seeing quite a bit of the medical profession recently. Or, I suppose more accurately, the medical profession have been seeing quite a bit of me” and, for someone who’s not that keen on hospitals, and all that goes with them, I seem to have become something of a fixture and fitting without apparently having anything wrong with me!

It Started With A Snore - Part 4

I went trotting off to my local Health Centre with a song in my heart and a kind word for everybody. I came back a physical and mental wreck. Whenever you are called to see a Practice Nurse, you have to bring an offering with you. It doesn’t matter what you are being tested for, somewhere along the line it will involve a urine sample. What she (and it is usually a she) does with all of these, goodness only knows. Perhaps she operates a tannery on the side? You always have to hope that your appointment doesn’t follow a good night down the pub (for you, not her...oh, I don’t know though) – a urine sample with a head on it is not generally seen as an indicator of a healthy lifestyle.

I presented my offering, which she took without much gratitude it seemed to me. I know that, on meeting a girl for the first time, it is a slightly unusual transaction but she did ask for it and I had gone to the time and trouble to provide it (not that it involved too much of either, if truth be told). She took my blood pressure with one of those electronic sphygmomanometerS (all right, all right, blood pressure machines if you insist). Inevitably, because I was in a Doctor’s surgery and surrounded by people in white coats with sharp instruments, the reading was high. We decided to wait a little while and have another go. This was where it all went wrong. Whilst we were waiting, she decided to review my medical notes. The conversation went something like this:

Nurse: “Ah! I see you’ve been very naughty.”
Self: “Have I? In what way?”
Nurse: “You haven’t had a Well Man review for 9 years have you?”
Self: “Probably not, whatever it is. Is that a problem?”
Nurse: “Oh no, we can do it now, while you’re here.”

And before I knew it, we were rattling through a questionnaire and she was opening a hypodermic syringe. One of the reasons that I tend to avoid doctors and nurses like the plague (unless, of course, I’ve got the plague, which is an entirely different matter) is their predilection for sticking needles into you. I am not a big fan of needles. Many years ago I went for a diabetes test that involved myself and a like-minded group of people spending an entire morning in hospital having our blood sampled every half-hour to check the progress of a glucose drink consumed at the start of the test. All went well with blood samples 1 and 2, but by No. 3 I had wound myself up to such a pitch that the nurse was having to prop me up with her shoulder as she took the sample, to stop me crashing to the ground. Needless (but unfortunately not needle-less) to say, Numbers 4,5 and 6 were taken as I laid flat out on a trolley-bed, drifting in an out of consciousness. This is not an exercise that anyone has rushed to repeat.

I explained my fully qualified state of wimpishness to the Nurse and, to be fair, she was great at keeping me engaged in conversation and it really didn’t hurt much at all. Nevertheless, I was aware of a cold sweat enveloping me and my colour draining away. This was therefore not a good time to be taking my blood pressure again and, sure enough, it was now at a level whereby, with a prick of the thumb, I could have spray-painted the Sistine Chapel. Not unsurprisingly, I would be referred to the Doctor, who would also tell me the results of my blood test.

The Sleep Monitor test rather intrigued me and I was curious to see how this would be done on an out-patient basis. For years, sleep monitoring used to be done in hospital, with the patient being wired up to various machines and then encouraged to sleep as normally as possible. Of course, hospitals now are desperate to avoid anything that involves patients actually staying there (and so are most patients). The Nurse at the Hospital Clinic ran through the various aspects of the kit “This goes around your chest like so, this one around your tummy, these go into your nose and this goes down your sleeve and attaches to your finger like so”, leads were attached to a central monitor and the whole mess was shovelled into a sort-of laptop case. I was to sleep with all of this tonight and return it to the clinic by 10.00 the following day.

I think the attached pictures will tell you more than I ever can about the apparatus that I ended up wearing to bed. When my wife managed to stop laughing, she helped me sort all of this out, as best she could and I then, gingerly, edged into bed.
“You’ll never get to sleep with all of that on” was the last thing she said as the light went out.

I can’t report my answer. I was already snoring.

It Started With A Snore - Part 3

One thing that I have become aware of, through bitter experience, is that the medical profession are pathologically incapable of resisting the urge to test people for something. Doesn’t matter what – just something! I’ll bet you’ve had this conversation many times before:
A: My GP has referred me to see a Consultant
B: Oh that’s good, hopefully they’ll get you sorted out at last. When are you seeing him/her?
A: Well, I don’t know yet. They want me to have some tests done first...
It doesn’t matter if it is something that your GP has been testing you for, ever since God was a lad (or lass, dependent on your viewpoint), the Consultant will want his/her own tests done. For thy Consultant is a jealous Consultant and ye shall have no other Consultant/Medical Practitioner other than him/her (unless, of course, whatever you think you’re suffering from relates to another specialism, in which case you can clear off and stop bothering him/her).
You may recall, if you have nothing better to remember in your life, that at the end of the last article I had not only been referred to an ENT specialist for my snoring/sleep apnoea but also, in the space of a few weeks, to an Opthalmologist for possible deterioration of the retina (not that I wanted him to provide that, if you see what I mean, but to find out if I had got it and, if so, why?).
Up until then, I had felt fine. Now I was beginning to feel like the subject of that old Stanley Holloway song “My Word, You Do Look Queer!” (which used to be a regular on Children’s Choice but which I imagine has died a very un-PC death in recent years). I wondered if others were shaking their heads pityingly as I shambled past, wondering at my ability to stay upright and breathe at the same time. I took to giving people brave little smiles, and somehow managed to avoid being arrested.
So, within the space of a few days, I received a letter from the local Health Centre inviting me to join them for a jolly session of ‘Test the Blood Pressure’ with the Practice Nurse, so that the GP could rule out any obvious causes for my alleged retinal deterioration before giving in and sending me to the Consultant. Additionally, I received a letter from the ENT clinic at our local hospital, inviting me to be fitted for a sleep monitor, prior to my visit to the ENT specialist. Of these two appointments, the one with the Practice Nurse proved to be the most unexpectedly difficult.

It Started With A Snore - Part 2

The continuing story of my brush with the medical profession:

Anyway, I finally got in to see a Doctor. Not, of course, at the appointed time. The appointment is simply a work of fiction designed to keep the waiting room full and the receptionist’s PC tidy. The major improvement in the NHS, with its new focus on ‘customer care’, is that they now apologise for your wait, whereas before you were just supposed to grin and bear it. They don’t, of course, mean it. If they did, they would do something about it. No, this is the Public Sector (and it seems to be pretty widespread) equivalent of “Have a Nice Day”. At my last appointment, the Doctor opened the consultation with the immortal words, “Sorry you have been kept waiting, I’ll have to keep this short if I’m to catch up” which I thought rather missed the point!

This last appointment was the culmination of two year’s of sporadic visits to the Doctor (I was going to say “to my Doctor” but as I’ve never seen the same one twice, it is a bit tricky to know who that is supposed to be) to try to get something done about my snoring/sleep apnoea. Throughout this time, the Doctor and I have been involved in the long dance in which I seek to see a Specialist and he does everything in his power to avoid referring me. Therefore, I have been sequentially urged to; lose weight (tick), cut down on my drinking (tick), and take regular exercise designed to increase my upper body strength (tick again – I may be suffering from ticks!). All of these things, I’m sure, have been beneficial but haven’t made a blind bit of difference to my snoring/sleep apnoea (you always know an ailment is getting serious when the spelling gets weird). It is at this point that you realise that the primary function of the G.P. is to keep you as far away as possible from the rest of the NHS at any cost (which is, of course, what they are trying to avoid…any cost). On this occasion, I must have caught him in a generous mood, or he had just run out of alternative therapies, because I recounted my symptoms yet again and asked to be referred – and I was!

At the same time as all of this was going on, I attended my regular biennial appointment with the Optician. Like most people of my age, I discovered some time ago that if I was ever to read small print again, I would either have to get longer arms or glasses. As a consequence, every two years I get shut into a small, darkened room with a total stranger who crawls all over me, pointing a piercing light into my previously untroubled eye, and getting closer to me than is usually possible without going through a form of marriage. As a matter of interest, why does having one’s eyes tested mean being plunged into a dark room and having a piercing white light shone into the pupils? Intuitively, it doesn’t seem like the wisest of ideas, does it? My particular bête noir is the glaucoma test in which a puff of air is directed at each eye. Surely I can’t be the only one who jumps a mile in the air each time, no matter how many times I experience it, and fetch my head a nasty crack against the apparatus? Or am I just a complete idiot?

Unusually, this particular check-up didn’t result in yet another prescription for glasses but, instead, a recommendation that I should be referred to a Consultant for investigation of possible degeneration of the retina. So, in the space of a few days, I had gone from having no contact with Consultants at all for years on end, to suddenly having two take an interest in me. The medical profession had me in the palm of their latex-gloved hands (which is not a happy image), and it could only get worse!

If you’ll permit me, I’ll continue with this medical tale of woe in the next exciting (?) episode. Until then, keep taking the tablets.

It Started With A Snore - Part 1

In a previous post (I Was A Stranger And Ye Took Me In) I mentioned that I had been consigned to a bedroom on my own, on a different floor, by my mates whilst on a 'walking weekend' because of my snoring. I promised then that I would explain more, and here it is. This series of articles first appeared in Mature Times and were intended to be something of a diary of events. Now read on...

I seem to have been seeing quite a bit of the medical profession recently. Or, I suppose more accurately, the medical profession have been seeing quite a bit of me. Now, before you get too concerned (as if) I should say, at this juncture, that I am not, to the best of my knowledge and belief, ill (excuse me whilst I grab a large lump of wood to ward off any gestures of supreme irony by a malevolent Fate). I have, however, been checked to within an inch of my life. Let me explain.

It started with a snore. In fact, it may well end with a snore, but we’ll come to that later. For years my poor wife has endeavoured, with a great deal of fortitude, to sleep with my nocturnal ‘noises off’ bellowing in her ears. I, of course, have slept on soundly, safe in the knowledge (from previous expensive experience) that no amount of strips applied to the nose, herbal gargles or specially contoured pillows make any difference (when I referred to a malevolent Fate earlier, I think that the fact that light sleepers are invariably attracted to those with stentorian snores is a pretty good indicator of the existence of this particular force). Anyway, all this changed as soon as it became apparent that I had started to stop breathing (or stopped starting to breathe…if you see what I mean?) Hurling yourself awake in the wee small hours, seized with the absolute certainty that you’re about to snuff it, tends to put a crimp in your otherwise peaceful slumbers, and this was only on the occasions when I knew that I had stopped breathing. The upshot of all this was a trip to the Doctor’s to see about a consultation with a specialist. This was about two years ago.

Have you tried making an appointment to see your friendly, local GP recently? I only ask because I am now aware that there is a technique to this. Being ill isn’t sufficient to warrant an early appointment. The novice will ring the Surgery hopefully, perhaps mid-morning, with the expectation of getting an appointment in the next 24 hours. No chance! If you’re lucky, you might get the promise of a slot a week on Thursday. If you want to see a Doctor on the same day of telephoning, then you will need to join a determined band who will commence ringing the Surgery at precisely 8.00 a.m. in an effort to grab one of the few, jealously guarded, ‘emergency appointments’ that are held for that day. By 8.10 a.m. these will have been snapped up for the day and everyone else, regardless of condition, will have to join the grim band of telephoners tomorrow. Being at death’s door might help, but is no guarantee of medical attention. Of course, you only get to know all of this if you are a habitué of the Surgery. The occasional putative patient discovers this only by bitter experience and either gets better regardless, or clogs up the Accident & Emergency service of the local hospital.

The reason that you can’t get an appointment for love or money is because the ‘chronically ill’ have got them all sewn up (to coin a phrase) for months on end. Now, please don’t think that I’m belittling the troubles of those who have a chronic illness of any nature, I am not. My beef is with a system that does not make proper allowance for the vast majority of the population who only need to access their Doctor once in a blue moon, and then discover that it would be easier to book a place on the International Space Station. I was amazed to find (when I finally gained access to the Surgery) that it was like a miniature social club, full of little groups who meet on a weekly or monthly basis as they wait for their latest test or check-up. When they finally come out from their appointment, they do so with a prescription the size of the Dead Sea Scrolls, sufficient to bring a tear of joy to Jesse Boot’s eye. In addition, they will have a list of follow-on appointments that will take ages to arrange with the Receptionist and which will keep them happily occupied until next Michaelmas.

You can find all of Philip's stories in his three compilations:  Philip Whiteland's Author Page