Last week I had my fifth visit to A&E. My first was 20 or so years ago when I thought I had twisted my ankle. Initially I didn’t do anything about it but when it continued to be painful and my foot was pretty shades of blue and yellow I went along to A&E and said “I think I have broken my ankle“. They looked at it, said “Yes you probably have” and sent me on my way – it was too late for any intervention and taking an x-ray would have been a waste of time. My third visit two years ago is documented in Beetroot is not my colour and my fourth in A new word.
Now for my fifth visit. When I saw my oncologist at the end of September I was a bit concerned that a raised PSA plus the fact I was getting up several times a night meant that something nasty was going on with my cancer. The oncologist assured me that my nocturnal habits were nothing to do with the cancer and suggested that I talk to my GP about taking an additional drug. So I started on tamsulosin and she organised a bladder ultrasound.
Now the thought of a bladder ultrasound was not music to my ears. Back at the end of 2015 I had one and it turned out to be a not very pleasant experience. I had to drink two litres of water an hour beforehand and then go into Wycombe for a scan. The plan was for a scan of a full bladder, I would then go for a pee and return for a second scan to see how much my bladder had emptied. Great in theory but having held myself in for the first scan I found I couldn’t go for a pee. So the second scan was not very informative! I then drove home with an ever increasing urge to pee which got more and more painful until I was able to stop and relieve myself. Fortunately this second scan was not as dire or painful. It revealed an enlarged prostate – about twice the size it would have been when I was 25 years old. (Apparently the prostate has a growth spurt as you are growing up and then settles down to a walnut size – 25ml – until you hit 25, and then grows steadily for the rest of your life).
But I get ahead of myself. Gradually over the last year I have been getting up more frequently during the night. It has been quite variable but got to the point where I was noting in my diary if I didn’t get up at all but by September it was getting quite annoying (hence the discussion mentioned earlier). Then through October things steadily got worse both night and day. Too often and too little. So first step was tamsulosin and the bladder scan.
A couple of weeks later it was no better, in fact if anything it was worse. I had a scheduled appointment with my GP and we discussed the bladder scan results and changed to a different set of tablets (tolterodine tartrate). She set up an urology appointment for December in case there was insufficient progress. The end game could be the “apple core” operation but in the meantime if my plumbing stopped working it would mean a trip to A&E and catheterisation.
At the end of October I had my worst night yet – up 20 times and the title of Bill Bryson’s 2015 book that I mentioned way back in my second post seemed entirely appropriate. I must admit that over the past couple of weeks I hadn’t been much use to anyone.
I managed to get an appointment with my GP. She said we should try a third tablet, solifenacin, and gave me a printout of my bladder scan results ‘just in case’. It appears that I have an overactive bladder although by that evening when my plumbing had packed up that was not what it felt like. So it was off to A&E which fortunately wasn’t too busy. There were a lot of people in green scrubs walking around although I didn’t actually see anything happening – that must all have happened in the side rooms.
I had another bladder scan and I found that my blood pressure had rocketed to 186/97 when it was usually closer to 130/70. I paced around for a while until I was sorted out. It was the sort of thing that made me wince to think about but wasn’t too bad. I did twitch (to put it mildly) a couple of times. I am pretty certain I didn’t injure anybody. It was a great relief. We were home by 2.30 next morning.
What happens next I am not sure, we will just have to wait and see. But it is definitely an improvement on the position two weeks ago.
“Hold on a mo, you said that was your fifth visit but you’ve only told us about four” I hear those of you who can count saying. “What about your second visit to A&E?“. This was when we were rescuers for our local wildlife hospital. We got all the bigger (and sometimes messier) animals – swans, foxes, badgers and deer. This time it was one of the smaller deer, a muntjac, which had been hit by a car and was concussed. It was spotted by another driver who was able to pick it up and put it in the front footwell of their car. I was told that it was very docile. However when I opened the car door and went to grab an antler (always my first move with a male muntjac) he immediately leapt up and bounced around the car, onto the parcel shelf, into me and on to the parcel shelf. My face felt wet and I realised that I had a couple of cuts. I shut the door and stepped back. After liberal application of elastoplast I returned with a large net which I put over him before grabbing his antlers and picking him up. I put him in a deer-shaped box and took him back to the hospital. By the next day he had recovered well enough to be released. Meanwhile I headed off to A&E where I was patched up with stitches on my cheek and above my eye. It could have been much worse. The rather noticeable gauze and tape covering much of my face caused a number of comments at work the next day.
So a bit of drama for me but put into perspective by the services and ceremonies this weekend around the country marking the centenary of the armistice.
Both my Grandfathers served in the First World War, one in the Royal Army Medical Corps and one in the British Expeditionary Force and then the Royal Flying Corps. My Grandmother’s brother paid the ultimate price (which I described in A casualty of war).