I  haven’t written because there is nothing much new to say. I continue to sleep very badly and my daily physio is still at the passive stage, that is  two daily sessions on the machine that raises my arm up and down (I have progressed from 50 to 85 and should aim at 180 degrees) and a massage with Audrey (pronounced O-dree) my physio.

I seem to have spent  much of my free time over the past three days trying to catch up on sleep! Tomorrow I am going to talk to the doctor about an injection in my back. Not having the [painless  but irritating) spasms would be one less thing to keep me awake.  I now have a routine: I collect a mug of hot chocolate from the machine Downstairs and sit with my Kindle or iPad in a comfy armchair in the sitting area at the end of our corridor.

I was sitting there this morning when the maths teacher, whom I like but still don’t know her name, came up in her wheelchair, bearing a copy of Le Monde Diplomatique.  This inevitably prompted another discussion about politics.

She then said she had seen me on my machine and asked how the rééducation  was going. I replied slowly, as I am still in the passive stage, and added that what worried me was that by the time I reached the stage of moving my arm myself  I could be nearing the end of my stay here, as the doctor had been talking of me leaving mid December.

We both agreed that there seemed to be more and more talk of protocols with regard to the recovery time allocated for the various replacement operations – knee, hip and shoulder.  Difficult to know how to translate protocols,  they seem to be half way between rules and norms. Fine if you live in a town, preferably with someone else, and with physio services nearby, as the idea is that you continue  daily sessions from home. My companion pointed out that even then there is the cost of travelling to the physio, which is not covered by the CPAM.

A visitor passing by overheard our conversation and put in a defense of the system, we think from the position of somebody in health administration, After he left, my companion said this  confirmed the reasons were economic rather than driven by the needs of the patient..

I know  there is abuse  of the splendid French health system, but it is alarming to see the signs that it is drifting in the direction of  The British system. It does need some grown-up planning to ensure that where possible people can continue the right treatment from home but recognise that for some this may not be possible. So for example financial help to get to the physio would be cheaper than paying for a hospital bed. And transferring to a lower cost place (like the maison de repos where I was last year) should be possible at a later stage. The current rules are that you cannot switch establishments after leaving hospital.

Having said that I do hope  I can stay here longer. It is a well run place. Apart from one surly woman at reception,  the staff are universally efficient and friendly and by hospital standards the food is really good.

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