Is there anyone able to help? Chapter 13

working woman technology computer
Photo by Startup Stock Photos on Pexels.com

Five weeks after the accident I was still confined to bed 🛏 . I was managing to navigate the stairs with help and take a shower 🚿 if my husband was around. I was still in considerable pain 💊 and this was limiting everyday normal physical activity. The same might be said about my brain,  🧠 as it was being impacted  by both boredom and meds. So I could not work.

The home visit for my ESA remained elusive so I had no choice now but to chase it up. From my call log I identified the number☎️  I used before to ring for an update. Learning from previous failures  I called at 11am which,  even with the crystal maze element,  🔮proved useful as it was answered within 20 minutes. In fact this caught me a little by surprise; Mozart  was playing on a loop on loudspeaker on my phone. The monotonous lilt was boring me into a semi-slumber, although the relaxation 😋 was a welcome relief,  when a brisk “Hello” interrupted my reverie. I grabbed the phone  before she had the chance to hang up and managed to articulate reasonably quickly  that I was calling about my planned home visit. Was that a stifled a laugh? 🤪

This was the call that rumbled the dirty tricks 😡. deployed by the previous two encumbents.  Claims were recorded over the phone at this call centre.  Not emailed. Despite the two earlier calls to this number I  learned, despite my details having been taken, they had no trace of 😵 me. She was about to start the process of form filling when I begged her to check again.  Up to this point I must have been speaking Swahili 💩 as she could hear me  but  clearly not understand what I was on about. I’m  unaware of what exactly caused her to stop in her tracks and  check some other system,  but she finally found my details and lo and behold  agreed I had been referred for a home 🏡visit. My elation was short lived, but she could not help me,  I now had to call the DWP.

The DWP has a slightly less confusing version of the crystal maze 🔮to permit  you access  to a human person. I felt quite smug to have made it through on the first attempt. This was another trick.  The human person that answered my call  was only programmed to provide responses to the right questions. There are no clues🔬 provided as to what these questions are. There is a strong assumption that you have  been on Mastermind 📺 with DWP/ESA as your specialist subject. No normal, polite interactive conversation  where you each take turns at trying to find common ground where they assess your need and direct your enquiry, here. Every thing was responded to with  with a sneering 🤨combination of “I don’t know what you are talking about”,  “who gave you this number?”  “This is not a Universal Credit Line”

I don’t know if it was the pain, the boredom, the frustration,  or my patent  lack of ability in all matters benefit, but I lost it. 🤬 He had the ability to put me through to a Job Centre in my area but  was electing not to. I fumed and snarled, (articulately of course) the rabid dog 🐕 was back, go Jax ! And somewhere in the tirade I must have appealed to his inner conscience, either that or he just wanted rid of me, because mid stream🐸 he put me through to a helpful person at the Job Centre………….

You need to eat well to climb Everest. Chapter 11

I:Daniel Blake was a moving and tragic story 😕 of  a man denied employment and support allowance (ESA)  when he falls ill and cannot work.  The dramamentry was designed to evoke extreme responses at the horror 😈 and unfairness of the bureaucracy that engulfs the system.  It made me desperately sad, and deeply ashamed at the way we treat those in need.

However here I was in a similar situation albeit less dramatic.   Reflecting on my experience I’d suggest navigating the process is akin to conquering Everest.🏔  For the uninitiated  the best place to start is Google.👀  This promptly directed me to the government site for all things ESA. I wasn’t actually prepared to leave my brain 🧠 at the depository but after an initial forage into the unknown it was clear mine was not wired for this particular  escape room. It would have been helpful 😺 to know someone who had done it before but I only had Daniel Blake and we know how that story unfolded.

Climbers burn 20,000 calories on the day of the summit climb on Everest  and an average of 10,000 a day on the rest of the climb. My appetite 👅 hasn’t been that great so I wasn’t particularly  physically able for this  challenge either.  It affected my ability to process effectively the information available; confusion  😵 began on the website.  There are 3 types of ESA, new style, contributory and income related. I selected contributory, easy. Well you’d think so. Although there are 3 types  an important distinction before you decide on your choice depends on whether or not you live in a Universal Credit 👾 postcode. This is important as it immediately reduces your choice  from 3 to 2 types. Universal Credit it seems  is not universal at all.  😡

I typed in my postcode and reviewed the extensive list before I deduced that I did not live in a Universal Credit area.❌  Except I do.✅  Told you brains are not useful. You can only claim contributory ESA if you don’t live in a Universal Credit area. As far as I could see I didn’t, so I phoned ☎️ to make the claim. That’s when my climb to the summit definitely  demanded more calories; it took 90 minutes to answer the call.  “Sorry you need to make a claim for new ESA you live in a Universal Credit area” “ How do I do that?”You’ve guessed it another  number and another 90 minute wait on the phone.⏰

You need to be entitled to claim Universal Credit if you want to claim new style ESA.  Universal credit is a benefit based on your income. I do not meet the eligibility for Universal Credit. I know I’ve made sufficient contributions but according to the new rules and guidance I won’t get it. 🐷 This is immaterial however as I was claiming contributory ESA which is incorporated in new style ESA but only in Universal Credit areas.  Still with me? I’m losing sight of that summit, and the will to live.  🤢

My call was now ringing well after closing time but determinedly I hung on. It was answered  but rather than have a meaningful or informed conversation I was hurriedly asked for my details and sent a claim form by email  and rather smugly  I was thinking  “Yes I’ve smashed it!” 🤩

I completed the form and then combed the website for the next steps. OK maybe I didn’t comb more of a skim.  Eureka! Its the job centre. I despatched my husband 🙃 off to our local job centre with the completed, printed form in a discreet envelope ( he doesn’t like drawing attention to himself) and he dropped it off before making a bolt for the exit. He’s much better at escape rooms than me.  🤪

There I am lying staring at the ceiling when the phone rings, “ Hello, Is that Jacqueline? It’s the job centre here, you’ve dropped off your claim for ESA,  sorry you don’t do this. You need to make a claim over the phone then make an appointment at the job centre, can you get the person who dropped this off to come back for it………………”

😲

photography of man in black hooded jacket and red backpack facing snow covered mountain
Photo by Avinash Patel on Pexels.com

 

Hamstring Injuries- the facts. Chapter 9

Once diagnosed and home I was keen to explore 🤓  more about this injury. I went straight to  Google only to discover it was limited in this regard. Particularly the NHS website  which states “grade 3 – a complete muscle tear. Severe hamstring tears  will usually be very painful, tender, swollen and bruised. There may have been a “popping” sensation at the time of the injury and you’ll be unable to use the affected leg.”

According to  the much more detailed Wikipedia “A grade 3 hamstring strain is a severe injury. There is an immediate burning 🔥or stabbing pain ⚡️and the individual is unable to walk without pain. The muscle is completely torn and after a few days  a large bruise 🌑 may appear below the injury site caused by the bleeding within the tissues.”

The Wikipedia description is more akin to my own experience.  My report on my initial visit to A&E was that the muscle was burning, on fire 🔥,  it felt like a dead leg and I was unable to walk or sit. Although not evident at this presentation, the bruising 🌑 appeared when we were in Harrogate 3 days after the event and was certainly visible on the second visit. I felt I had made the correct representation of my symptoms but it had not resulted in a diagnosis at either of these  visits to A&E and I’m still not sure why that was the case.

There were also a couple of blogs 📄 from doctors or physio’s who had also sustained  a hamstring strain but most of the information related to lesser injuries sustained as a result of training or sports  🏋️‍♂️ and threw no light on my situation.

However I did find some academic studies that  reported sufficiently on  Grade 3 injuries to suggest a diagnosis was possible. Grade 3s were more commonly  associated with slips 🤸‍♂️ and falls (caused by block heel boots). Individuals aged between 40-60  👵🏼 (I just made that) were more at risk  and women 👧  (definitely made that)  were approximately 3 times more likely to suffer hamstring strain than males with the majority of these being  from non-sporting scenarios.  (again those block heel boots)  Yep, it was all out there,  but I’m guessing Wikipedia is not on the trainee doctor reading list.😨

And, with the absence of diagnosis, of course comes the guaranteed lack of treatment. 🔬The recommended treatment for this injury is  the RICE protocol — rest, ice, compression and elevation.  This treatment is the same regardless of the severity of the injury, and should be commenced within the first five days.  RICE  is primarily used to reduce bleeding and damage within the muscle tissue. Of course this would have been useful if that was what I had been advised but the first and second visit to A&E failed to even identify the problem.  😳

In the immediate aftermath I needed to know this. Instead of going to Harrogate I should have been home with my hamstring  rested in an elevated position with an ice pack applied for twenty minutes every two hours.  Lower grade strains can easily become worse if the hamstring is not rested properly. Bleeding needs to be reduced but in my case this had not been addressed and my blood loss was significant. 🤭 Complete ruptures require surgical repair and rehabilitation but as I had not had my diagnosis for over a week the window for repair had apparently weakened and surgery was less likely.

On this evidence an apology from the consultant  does seem appropriate, but I have also raised this as a concern with the NHS so that others with the same problem get  the right help when its needed…….

close up of eyeglasses on book
Photo by ugurlu photographer on Pexels.com

 

 

In Sickness and in Health. Chapter 8

The occupational therapist 👨‍🔬 was enthusiastically promoting the benefits  of the zimmer and raised toilet seat 🚽 to someone of my disposition when my husband returned.  I could see his eyes widen 👁 as I shimmied along on the zimmer, but it was the realisation that the  raised toilet seat  was also for me that made them water.  He wanted to be subtle but  his obvious horror🙀  was palpable. I knew he was doing everything he could to divert his thoughts from my ablutions and the assistance 🛀 he might need to provide. As I said in previous blogs,  our marriage 💑  vows ( much like my hamstring)  were being stretched to their limits.

I know him.  His  future flickered fleetingly before him; me in my  tartan slippers, rolled down stockings,  woolly housecoat and  curlers 👵🏼. But that wasn’t his biggest worry, no he was  wondering how the hell he was  going to get this equipment out of the hospital and into his car without anyone  👤 seeing  him. He didn’t hear a word any one said for the next ten minutes as he frantically worked out his escape plan.

I attempted to roll off the bed into my crutches with all the glamour and class 💃  of Marilyn Munro but  in reality was  more like Patsy  from AbFab tumbling out of the car legs akimbo🤸‍♂️ with the Bolinger 🍾 unscathed.    My husband had already disappeared conducting a surveillance of the immediate environs for anyone that might know him. Leaving me  to pile my newly acquired  household accessories  high on the zimmer,  much like a Thai flitting on a moped 🛵.  I edged out of the cubicle hoping to achieve a seamless exit with a single manoeuvre, a big enough challenge without a hamstring injury. Needless to say I failed. 🌀

When he caught sight of me 😲, common sense returned momentarily as he put me on a seat, planked the gear at my side and revealed his detailed plan on how we could leave without fear of being noticed.  This plan worked reasonably well  until the electronic door  🚧 in the ambulance entrance closed behind him leaving me abandoned with the raised toilet seat in a hospital no man’s land. If it wasn’t for the morphine dulling my senses I would have cried,  instead I sat there numbly 🤐waiting for the next ambulance to arrive and set me free.

In that moment of solitude I had time to digest the discharge 🤯 advice; to rest at least for 6 weeks,  with the longer term repair likely to take up to 9 months. I’m a pretty active individual; was cycling 🚴‍♀️ , playing badminton 🏸, walking🚶‍♀️ and of course enjoying frequent holidays🌴🌞.   Suddenly the enormity of this situation hit me;  I was going no where fast in this corridor and it would be the same with this injury. It was going  to significantly impact on my social, leisure and working life  and I had no idea how I might get through it.🙊

Within minutes my hero 👼 was back, realising he’d lost me, laughing at himself and finally accepting the toilet seat 🚽 was his responsibility.  In that moment I knew he would  get me through this 💞and I was in awe of  his commitment to me, while he grappled with more immediate matters. With a swift gaze around the exit, he swung the toilet seat  over his shoulder shielding his face from the passing public and threw it in the boot. Such was his haste to escape unnoticed he drove 500yds before he realised the tailgate was still open and the whole world could see what was in the boot.🤣🤣🤣

selective focus photo of gray metal folding walker
Photo by rawpixel.com on Pexels.com

 

 

Strike #3 Chapter 7

I entered A&E for the third time somewhat relieved 😕 that, on this occasion,  I had a diagnosis. While waiting to be seen I heard a nurse 👩‍🔧 call out to everyone, and no-one in particular, that they were at 4 breaches (presumably of the four hour waiting time). The four-hour A&E waiting time 🕰 target is a pledge set out in the NHS Mandate.  The operational standard is that at least 95% of patients attending A&E should be  admitted, transferred or discharged within four hours. On this visit, as with the previous two,  I was discharged around the 4 hour mark.

I would argue this level of performance is more applicable to McDonalds 🍔  than our hospitals.🏨  It is only likely to hinder treatment and hamper diagnosis especially in situations a little bit more complex  than ordinary. It’s  not just patients🤒  who suffer,  staff  are likely to be frustrated and constrained 😡 in their effectiveness  by such measures.  It’s not unrealistic to presume that in my situation this measure did impact  on the effectiveness or  accuracy of my diagnosis.

Additionally, without question,  on each visit I made resources were stretched 🤯 to the limit  with the sheer volume of people presenting.  I have no idea to what extent the people waiting required to attend A&E but I’d put my pension on  at least a quarter of them being able to be treated elsewhere.  🤧 This compounds the 4 hour measurement exponentially and its not difficult to see why errors are made, it also underlines why our expectations can rarely be met.

There was a very different response on my third visit, and this was entirely due to the intervention of the Musculoskeletal Consultant Radiologist. 🤩 Thanks to his personal representation of the facts (and his opinion of them), the on call A&E Consultant managed my admission. This by no means resulted in favourable treatment, I still had to lay on a bed 🛏 in the corridor for the most part of the visit.   But she did have a purpose as I was to find out later.

For the first time bloods 💉 and blood pressure 📿 were taken. Both were low and explained by the large blood loss when the hamstring  ruptured suggesting why I was feeling so poorly and lacked any appetite.  My blood count hadn’t been taken on the first or second visits so it was difficult to see if it was improving 🔬 but on the plus side I had just managed to avoid transfusion this visit.

The Trauma Team (you may recall I was referred on the first visit) take referrals 📥 from A&E. They hadn’t yet contacted me but I was still  hopeful they would. However the Consultant disavowed me of that expectation; having  reviewed my notes  🗂 following the first discharge, they determined that their intervention in my case was unnecessary.

The Consultant  was surprised 😳 about this herself  admitting she had made an assumption that referrals for similar  injuries  would at least warrant contact.   I slowly realised why the radiologist had been so angry  and she saw this.  Without prompt she offered an apology on behalf of the NHS.  I could see this was an uncomfortable truth for us both and awkwardly 🙄  I dismissed it as if it didn’t matter, but it had. It mattered  a lot that she did that and  I was so thankful.

There’s very little you can do for a stage 3 hamstring other than wait for it to heal, but the consultant  re-referred me to the Trauma Team and summoned the Occupational Therapist to assess my mobility needs.  My husband was dispatched to collect my medication 💊💊 and I began to relax to the point of sharing a joke, we’d mended the professional rift between us, order had been restored. We even shared a laugh 🤼‍♀️ about the need to provide me (at my age) with some assistance at home.

Then the OT arrived with a zimmer and raised toilet seat…………………………………

access building business care
Photo by Pixabay on Pexels.com

 

 

Blue Brogues with pink lining. Chapter 6

When the telephone ☎️ rings early in the morning, in our house anyway,  it’s generally been sad news. So the call at 8am the morning after Ben, was answered in trepidation, but instead  it was good news! 😀   I had an appointment with an ultrasound scan at 1030. I was elated and immediately guilty  that I had been so disparaging of Ben.😢

In stark constrast to last Friday when my preparations included getting my nails done and wearing block heel boots. 👢This Friday, owing to the fall,  I had to wear my clown 🤡shoes; (my husbands name for them) ultra comfortable, flat brogues in bright blue leather with pink leather lining. Suitably adorned with sensible shoes,  👞 loose clothing and crutches under arm my husband drove me to our local hospital. The journey, only 7 minutes long, was excruciatingly painful.😬

Again like Frankenstein🧟‍♂️  I stumbled  into the department where the scan would take place while my husband parked the car.  Rather nervously I gave my details to the receptionist fearing that someone had made a prank call👅 ( Ben?) and I  had  in fact no appointment at all. But after a few tentative clicks 💻 of the computer she directed me to have a seat.💺 Now, as you know,  this is not an easy manoeuvre for me but my options were limited.  I sat, clinging to my crutches and with the walk in taking its toll, my distress 🤦‍♀️ was palpable.

A nurse 👩‍🔧 wandered past and, wowed by my shoes, she stopped in her tracks to admire them only then noticing at this point I was wincing in pain.  She swung into immediate Nurse Mode and got me onto a bed🛏 , thank you so much shoes!  She then went off to try to hurry my appointment on but advised me I was being seen by a consultant👩🏻‍⚕️  so  would have to wait.   I didn’t mind this, it gave me some comfort, although I nervously admitted to my husband I was worried they would not find anything wrong. I had lost all confidence in my own assessment of my condition.😟

When the Consultant  arrived he was brusque 😠 and I felt instantly guilty at being there. He slaggered gel across the front of my leg and asked me what happened. I regailed the story in summary.  “When were you in A&E ?”   “A week ago” I whimpered  and  fresh from the Ben experience felt again I was wasting his time. “And last night” I added . He asked me to flip over. ( like it was easy)  and slaggered more gel on the sore bit of my leg. “ They have asked me to scan the wrong part”  he seethed.  He seemed astonished 😱 at the discolouration on the injury site  and asked if I was in pain or unwell.  “Both”  I mumbled. He sighed and muttered under his breath and I caught “ it beggars belief”. “OK”  he said “get dressed.”  “Am I ok?” I enquired.  “ You have the worst hamstring injury I have ever seen.” 🤐

I have to admit I broke down in tears 😭 with relief at this statement. He outlined the size of the tear; width 5cms, the depth 6cms and length 18 cms accompanied by a massive  blood clot. He suggested I had lost a lot of blood 💉 and I should never have been sent home. He  summoned my husband into the room.  “Take her back to book her into A&E while I make this report personally”, he stated  “this  warrants it.” 🎉

person putting bandages on another person s knee
Photo by rawpixel.com on Pexels.com

 

Strike #2 chapter 5

It’s never straightforward getting from A-B is it? The train ran  so late  we missed our lift. My husband organised a taxi to take me to the doctor then drive him to collect our grandkids👫.  The train had made us both late and stress 🤹‍♂️ levels were extremely high. The rabid dog 🐕 stuck  with me as we parted company for our respective appointments.

Naturally  the dog didn’t make it into my consultation but I was in some distress😢  by then and my  leg was swollen so badly I thought my jeans 👖 would need to be cut off.  The GP took one look at me and advised a second visit to A&E  🏩 for further investigation was necessary.

My poor husband was trying to make the kids their tea 🍱  when I summoned him back to my GP to transport me to A&E. He dispatched me rushing back to make sure the oven hadn’t incinerated the chicken nuggets.🔥

A&E was busy; I was informed at check in there would be a three hour wait. 3️⃣ OMG three hours…😩.  I grabbed a seat closest to the exit, but sitting down was just impossible. My containment of the rabid dog now manifested into  tears  😭 the pain, gnawing so much now, was unbearable, I was close to hysteria😜 .

Around me mayhem 👀 ensued, its hard to accept that everyone there was actually an emergency although I’m mindful of assumptions. Everyone appeared to contain their distress more than me, even kids. Some lovesick  👨‍❤️‍💋‍👨teenagers,  supported by their friends did well to conceal any obvious signs of ailment. 🤒  A number of kids in football ⚽️  attire  with blood stained 🤕 faces,  suggested  theirs hadn’t been  the friendliest  match, and numerous older people 👵🏼watched  every newcomer with nervous anticipation 🙀 that they might lose their turn.

After an hour I was called for triage where I was offered some pain relief 💊💊. With only a chair to sit in I was in major  discomfort. Once through the first tier, 🚑🚑🚑 3  ambulances arrived with more patients and I  was in this line waiting to move closer to a doctor.  Chaos didn’t seem to cover it.

Then it was my turn and we met Ben. 🧛🏻‍♂️ Ben is well versed in the habits of  hysterical women.  He has nice 🐝  manners. He has honed his bedside manner 🛏 to relax you.  He tried to establish what we really wanted as he noticed we had been at A&E  last week!  Isn’t it  tedious 🗂 these people who keep coming back?  “What do you need to happen?”  He was  acutely patronising 👺  and despite my GP referral it was evident he thought we were time wasting. “I need further investigation”  I sobbed 😪 “I need to be admitted to get the pain sorted”  But any idiot  🤪 could read the signs that was never going to happen.  Ben thought it appropriate to examine my leg  but he was perplexed.  As with his peers last week he didn’t know what was wrong. “I think you should go home and I’ll try to get a scan for next week”  he said washing his hands. “She needs pain relief”  said my husband, “ its 15p at Asda” he replied 🤫 smiling and  extending his  hand as he dismissed me. “ It was so  nice to see you in A&E.” It’s not a blinking holiday Ben!!!!!!

“I don’t think they believe me I wept” as I stuttered toward the car……………………..

 

man wearing gray collared top
Photo by Miguel Arcanjo Saddi on Pexels.com