In a curious limbo

The outside world seems sometimes far away and somewhat threatening.

I look forward to seeing progress on the new bassin at home (Jacky’s is off on a well deserved break to warmer climes, but it is apparently well advanced, with drains and concrete form complete). The new kitchen is also slooowly and painfully taking shape. (Be warned, those who buy an Ikea kitchen, all existing electrical appliances bought elsewhere don’t fit in easily.) Next week I have a team coming to clean the house out and I have started to look into suppliers of ready made meals, as it will be some time before I will be up to much cooking. (Sadly the suppliers of the best frozen goods don’t deliver in my area so it looks like SuperU for me.)

All this is because in theory my time here comes to an end on Friday 24 January. But Margaret and Hans don’t think me ready for home living, particularly because of the state of my hand. Nor does Joceline, my Le Vigan kine, who rang me yesterday urging me to have an interim stay at Les Chataigniers, the very good convalescent place about five km from my house, where Margaret and Hans went a couple of years ago, following Margaret’s fall and Hans’ back operation.

So this morning I asked to see the Assistant Siciale – I suppose the equivalent of a hospital almoner. She said it was impossible for me to transfer to Les Chataigniers as it is in the same category of reeducation as my current clinic. So the options are go home as planned, or extend my stay here for a week. Only the doctor can authorize this, so she is going to report back to him, drawing attention to the fact that I’m a widow with no nearby family or close neighbours.

She also discussed the funding of home help, confirming what I knew already, that my income was too high to qualify for help with housework. I’m already resigned to the fact that I will now have to pay for work in the house as well as garden and am thinking of employing people from the local C.A.T.(the Centre d’Aide par le Travail) – people with learning difficulties working under supervision – to do my housework. They are already doing next week’s major clean.

Self sufficiency – and first shower for 2 months

I have a long way to go!

Today’s challenge was how to take off and put on my reduced thoraco by myself.  It would have helped if I had been given some instructions. When I finally asked Brigitte, my afternoon kine, how it was supposed to do it, she replied ‘with difficulty’ yet sort of showed me.

By this evening I have cracked it. Taking off is fairly easy. For putting it on, the secret is to leave the upper arm band (1) already set up, prop the whole contraption on a table, slide my arm through The first arm band, attach the lower arm band (3), put my right arm through its sling (2a round right shoulder) stand up against a wall and fling the rest of this extended strap behind my back, using the wall to help catch the other end. After a few attempts I catch the strap and secure it to the remaining bit of front armoury (2b).
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Another milestone: I can touch the opposite shoulder – but not yet dry under the arm. I can now walk with my arm hanging down and not feeling like a dead weight. Lifting my arm right up is still difficult and apparently man oeuvres behind my back come much later. Just google images of shoulder to see why this is the most complex joint in the body!
I continue to be concerned by the lack of power and mobility in my hand and wrist. Nobody else has this problem. The general view is I should keep on exercising them. But this morning the kine muttered perhaps arthritis has taken more of a hold after this long period of immobility. Please no!

Poppy

A break from endless health sagas, this lovely photo Margaret has just sent of Poppy.  It does make me miss her – but I know she is having a ball staying with Hans and Margaret,

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En sevrage

I learnt a new French word today – my first day when I am allowed to take off my thoraco for mealtimes. after lu nah I went up to a group of aide soignantes to ask them to put my armour of torture back on, and they exclaimed with pleasure:

“Ah Madame Allen, enfon vous  êtes en sevrage!”

i asked them to spell the word so I could look it up and one said anxiously not to be alarmed if the dictionary referred to alcoholics – it is also used for former drug takers and indeed, babies.  Ah, I said, it must be the equivalent of ‘weaning’, which indeed it is.  (The verb is server.)

Lucie, my morning kiné, began by taking off the bottom corset part – already a big relief, even though I still have to go around (and more important) sleep with my arm stuck out, held in place by a residual metal front piece and a shoulder strap.

Before: 20140109_thoraco

After:

 

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You see the giant waistband part of the scaffolding is off.  It felt exciting and liberating to sit at lunch like a normal person.  But also somewhat alarming, as my left fingers and hand are not working properly and my wrist hurts – hence the daily ‘Bain écossais’. I’m praying this will disappear with increased movement.

Lucie also gave me a handout with all the things I must not do until further notice, including lifting – not even a jug of water.  No fear of that, given my pathetic left hand.

The next excitement will be tomorrow morning when I can take off the thoraco to have my first shower for two months!

if you look up thoraco you won’t find it.  It is the familiar termed used by people for this armoire – which does not appear to have an English equivalent.  Instead of my surgeon’ strict adherence to a period of total immobility followed by this period of heavily supervised slow rehabilitation, in England it seems to be the usual quick hospital trip followed by stiff upper lip, ie exercises at home plus a sling.

Stage three: gradual removal of thoraco

Today I start my last two weeks here. Regardless of whether I am ready or not I get the impression that ten weeks after the op is the absolute limit for shoulder replacement. More usually it is six weeks.

luckily my nights have been improving marginally. I’m getting five to six hours, albeit in chunks of little more than an hour a time, with restless periods in between, when I eat clementines – for something to do.  So I’m in better shape to embark on new challenges than a week ago , when I was at a very low ebb.

Off now to the swimming pool, where I expect to walk to the water without the mini plastic thoraco.  Then we will see.

Weekend visitors

Yesterday my lovely young friend, Alice, trekked over from Octon – over an hour of driving – to see me. She is like a wonderful breath of fresh air. Full of enthusiasm, kindness and generosity. Last time she left me a vast basket of fruit. This time she hung a bag of msalad ingredients out of the window.
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Today I’m going out to a restaurant with my friends Sylvia and Yves.
Many hours later…
Another great visit from two of my best friends. We went to a restaurant in nearby St Gely. It is difficult to translate “raffiné”. Not really ‘refined’, more: elegant, sophisticated – and expensive! Yes, it was a very tasty and enjoyable meal. Here is what I ate:
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technology can cause headaches!
When it came to paying I discovered that in two months out of circulation I had forgotten my card number! So Sylvia ended paying and me reimbursing later. Back in my room I offered to update Sylvia’s iphone – forgetting to first ask her if she knew her apple user I’d and password! She didn’t know she had a user id…so she drove home with a non-operational phone. A bit of telephone support has sorted things out, though she cannot check the 3G connection as the internet is more intermittent than here.

Changed room again

There I was in swimming pool, doing my pathetic attempts to raise  my arms straight up, when Brigitte came to ask if I minded changing room. No problem, I said.  So after my kine sessions I had to rush upstairs to pack.  What a mortifying experience: apart from the difficulty in doing everything with one hand, my possessions have doubled in neatly eight weeks.  Eventually the aide soignante had to do two trips, one with my two cases and the second with a trolley piled with sundry, plastic bags, bottles of Pellegrino, a basket of fruit and a tall delicate white orchid.

nobody explained the move but I think I was occupying a room on the higher dependency floor, with more staff around to help.  In some ways I should be glad to leave a rather sad north-facing room, above the kitchen and delivery area and next to the cupboards where cleaning and nursing staff  fill their trolleys (and chat).  But it was my little corner, right at the end of the corridor and I like the staff.  I was very touched when the woman mainly responsible for cleaning my room rushed up to me exclaiming that it was sad I was ‘abandoning’ them and she would miss me.

My new room – 104 – ison the first floor, which because of the slope of the land, is virtually ground floor, facing the car park, so very public (regretfully I close my shutters at night).  It is dangerously close to a coffee machine…. And when I’m allowed to use the stairs, only a few steps down to the ground floor where all the physio goes on.   I fel I’m more exposed to the possible thefts people talk about, so take more effort to hide my computer.

There is a curious waste of space.  It is designed as a single room and yet there is an area big enough to fit a second bed in.  I reckon it was built in the seventies and not decorated since!  See my bathroom

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The cost of rééducation

This week we  all got our factures – bills – for the period ending 31 st December.  As the week progressed I heard more and more tales of woe : people who thought their single room was covered by their mutuelle but then found it wasn’t.

i have met at least three people who have switched to sharing to avoid further crippling costs. My friend Fréderic, the guitarist turned Ryanair employee who is forever smiling and gregarious, was looking particularly glum.  He had received a bill for 2700€ and when he challenged his mutuelle they explained that his insurance only covered a month a year in a single room.  So he is back sharing with someone who snores.  He was more cheerful a day later when his dad said he would pay the bill so he could concentrate on getting better.

My bill is for 2218€, but I’m hoping most if not all will be reimbursed by my mutuelle,

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I rang my insurance to confirm they would indeed be reimbursing me and then  settled this interim bill.  The clinic is  going to hold my cheque for a few weeks until Swisslife, my mutuelle, coughs up.

I also queried why I only got back 592€ rather than the 1000€ I paid the previous clinic for the surgeon’s ‘dépassement d’honoraires’ – the amount he charged over and above the official sum covered by the national health system.  I have not quite got my head round the complexity of French administrative jargon, or the sums involved, but I think it is because Swisslife reimburse up to 200% of some tariff, and his fee exceeded this by a long way.  When you think that every day he does a shoulder replacement at whatever the official fee is plus 1000€, not to mention spending the morning doing ‘cheaper’ work (eg 600€ dépassement), he is not short of a bob or two. Against this, it has to be remembered that shoulder replacement is extremely delicate – something approaching 30 muscles are involved – requiring a huge experience to get the expertise.  My surgeon, Teissier, is one of the leaders in France.

 

 

French health system creaks at the seams

I am so lucky to have been operated on by a top ( albeit greedy) shoulder surgeon and to have this lengthy rehabilitation  period with excellent physiotherapy.  But, but…. How long will this last?

My young kiné, Lucie, was at a low ebb this morning.  Apparently there was a meeting with management this morning in which they were warned that 2014 would be a difficult year.  I took this as meaning more work and no more staff.  At present there are ten kiné and five ergo posts. They work non stop all day long in twenty minute chunks and are always running to catch up.  holiday periods are clearly a particular bone of contention.

One of the kine posts is still not filled and I wondered why, assuming the salary is not good.  But at lunch Pierre explained to me that the law is about to change: at present profesions like kinés can open a cabinet and be self employed wherever they like and get referrals from hospitals and GPs.  Soon they will only be able to do this where there is a perceived need, eg Pas de Calais rather than near the Mediterranean.  Young physios are rushing to get established before the deadline – hence the lack of applications for this clinic.

A Scottish bath

to deal with my hand and wrist,which are not working well after seven weeks of immobility, an additional session has been added to my morning routine: 15 minutes in ‘le bain écossais’.  I soak my hand alternately in hot and cold water.  Luckily the cold is not as icy as  the bath that some of the young with sports injuries have to face (with apparent nonchalance, while we all sit the other side of the screen, listening to the ice, relieved it is not us).