My grandson Otto celebrated his seventh birthday today. I was sad not to be there but FaceTime (Apple equivalent of skype) meant I could see he was having a good time, and could sing (increasingly out of tune) ‘Happy Birthday’.
Otto’s current obsession is James Bond, so his party on Saturday consisted of a 007 film and as you can see, the cake kept to the theme. I had made the party invitation a couple of weeks ago and here is Otto’s photo from it.
For the past week we have been having the most glorious weather: day after day of sun, blue skies, birds (and my resident frogs) announcing the coming of spring, masonry bees hunting for homes in the cracks round my doors, and people burning bonfires and preparing for planting.
Across the valley the horses are in chirpy form (here they are viewed from my bedroom window).
Nearer home there are the unwelcome signs of processional caterpillars creating nests in the pine in front of my terrace.
Today I made it, despite my ankle, as far as Margaret’s house, seeing for myself the road in front of Hans and Margaret’s house, which has now completely collapsed, causing complete chaos as people from Serres and Salagosse now have to use the narrow back road across the valley (and the trip from Margaret’s house to me involves a complete circuit of the valley). It is apparently going to be closed for months as first some government department has to give permission to use river water to repair the wall!
One of the frustrations of my shoulder problems is that I am not able to drive and have to ask others to do my shopping and to take me for medical and other appointments. Margaret is of course my main support and I am so grateful. I’m also helped by Dorothy and – new arrival – Odile – who is living in my gite (more about her later). Yesterday Margaret took me to the le Vigan market – my first pleasure outing (apart from the two family visits when in the clinique) for nearly four months! What bliss. We sat at Dominique’s, the Italian cafe owner, basking in the sun and watching the life of the market in front of us.
Incredibly, after a difficult ten days, the zona (shingles) is becoming history. I no longer have that sharp pain, the blisters are scabbing, and I can sit in relative ease!
Method? Take the traditional medicines – but also the homeopathic products like rhus tox, and visit the local healers. Please don’t scream in incredulity my dear friends trained to believe only in medicine backed by scientific evidence. Just as during my radiotherapy, this is what one does here and I go along with the local pressures from friends – provided I am also receiving the accredited medication or treatment. Apart from anything else I got to meet an absolutely delightful man (recommended by my physiotherapist) who as usual won’t accept any payment, but was delighted to receive my gift of two pots of honey.
All I can say is that I was expecting this nasty shingles to go on so much longer and – having of course read the worst case scenarios on the internet – feared in case I might be in that small minority with ongoing pain which can last months or even years. Instead I am left with a case of extreme fatigue and some tummy trouble which (given the location of the shingles) is possibly related.
So now I’m back to where I was ten days ago: facing the nightmare of what to do about the recurring sharp shoulder pains which make all idea of continuing active rehabilitation out of the questions for now. Both Joceline my physiotherapist and Maelle my doctor have been most sympathetic. Joceline massaged the muscles of the shoulder blade (omoplate) – she could not touch the arm as the biceps tendons were too painful. Maelle expressed distress at the outcome of the operation. She has put by an hour tomorrow to manipulate my shoulder to understand better the problem and hopefully help alleviate the pain.
Given the dramas of shingles and shoulder I had neither the time nor the energy to broach the further developments in the problems of arthritis in my left ankle, right knee and spine… …
Can anything else go wrong? I have just been diagnosed with shingles – on my bottom, or “fesses” as the French say. Not only is this an extremely undignified place to suffer complaints, the extreme pain which I am beginning to realise is part of a bad shingles attack makes lying or sitting equally uncomfortable, not aided by needing to avoid putting wait on my problematic shoulder and arm.
It all started last weekend, when I came out of the centre de rééducation. Sunday night was when I ate the readymade meal past its best by date – followed by diarrhea the next day, which for the rest of the week I have been linking, erroneously, with my growing feeling of malaise. So when I started to feel discomfort in the nether regions I falsely thought this was my punishment for Sunday night folly.
The pain got worse on Friday – why do health problems always develop as the weekend approaches? – and I noticed that one buttock was covered in blisters. All very mysterious. I already have a doctor’s appointment for next Thursday, but I decided that I would not wait and would try to see her on Monday. But then a pretty miserable day yesterday plus two even more miserable nights and I decided this morning to go to Urgences (A&E) in Ganges. In order not to endlessly depend on Margaret, I rang Thiebaut Taxis to get me there.
What a revelation: I have for the first time experienced how one should deal with emergencies (in the past I have simply got into the car and driven to Ganges). M Thiébaut told me that they were the taxi/VSL company on call this weekend, but first I would need to phone the emergency number 15 for assessment of my problem. Quickly and efficiently the guy at 15 cotancted the GP on call this weekend, described my symptoms, and when I said I could not drive to the doctor, arranged that she would come to me.
Dr. Martinez comes from Bez not le Vigan, so I had never heard of her, but she was extremely nice, sympathetic and efficient. I tried to give her a précis of the events of the past week in case any were relevant (although I forgot to tell her I had no abdominal lymph glands), but she did not need that background. After one look at my bum she said I had shingles (vous avez un zona). She said it was likely to become extremely painful, partly because of my age and partly its location at the base of the central spinal nerve system and treatment needed to start immediately (what I have read on the internet since makes me wonder if I did not leave contacting a doctor till too late). She wrote a prescription for Valaciclovir, one of the standard treatments for shingles, some Tramadol in case the pain got too bad, and some homeopathic remedies. Margaret and I then made a dash for le Vigan and the pharmacie on call and got all except one of the homeopathic medicines.
No magic change yet and I fear I have some unpleasant days ahead. And tomorrow I have to phone to cancel my daily physio and pool sessions until the shingles have gone. Now I’m looking at websites which talk about diet and shingles. There seems to be a consensus that one should eat foods with Lysine and avoid those Arginine until the shingles attack is over. If that is the case then here is my diet for the immediate future:
Foods with Lysine
Foods with Arginine
The Cévennes are full of a rich variety of people who have sought refuge from the world’s more routine life styles. Dorothy is one.
I first met Dorothy at one of the pizza nights at la Corconne, the campsite where we spent 14 summers. It has always been a gathering place for ‘soixante-cinq huitards’ (historically Escapees from cities like Paris following the 1968 movements) and their successors. Dorothy was there with a young French jazz guitarist.
A year or two ago I employed Dorothy to do a massive spring clean of our former house, now the gîte. What stood her apart as an exceptional cleaner was that she was the only one to painstakingly take down and dust every book.
So Dorothy was an obvious choice when I needed this house cleaning up after the messy bathroom changes while I was in hospital. I came back to a wonderfully spotless house and since the weekend she has been helping put boxes of things back in the bathroom and passage outside. Look at this photo. Anyone who knows me will confirm it is probably the only time in its life that the sheets and towels cupboard will have things folded so perfectly.
i had planned to pay for a taxi to take me to Ganges this week. Instead Dorothy has taken this on, adding help like shopping and walking Poppy while I was at the physio, and when she saw I was in too much pain, cooked my supper on Monday evening.
Apart from being hyper efficient and generous, Dorothy is intelligent and good company. As I learn more about her life I get constant surprises. She is a Trinidadian, one of five siblings (many of whom have ended up in the US and with whom she cannot talk about politics!). She has a doctorate in entomology and spent several years in industry, working on research into insect repellents, before deciding a life as a research chemist was not for her.
Next stop was Paris where she took an intensive French language course as well as qualifications in teaching English to foreigners. And then on to the Cévennes, with her guitarist partner, since replaced by a Belgian chef.
i get the feeling that Dorothy is at another crossroads. But her future will certainly not be in research and cities.
The return home is proving more difficult than I had anticipated. I had expected to be tired, and indeed did settle for a ready made meal on Sunday evening (too tired to check its expiry date – with potentially disastrous consequences!) But I had not anticipated the aftermath of the first physiotherapy session.
Choosing a physio had been problematic as I needed somebody who could see me several times a week and who had a pool – essential for shoulder rehabilitation. There are only two physios with pools, one in le Vigan and one in Ganges. I neither like the le Vigan one – been there before, and anyhow Margaret had confirmed he was full up. So I had booked in with the Ganges one, Monsieur Eymann. He is used by the surgeons in the Ganges clinic and Hans was pleased with his treatment there.
First impressions were good. The cabinet was full of the usual array of physio equipment and an assortment of people pedalling, pulling or swimming away, in other words, the physio is ‘managing’ the treatment for several people at once – not like my usual one-to-one weekly sessions with Joceline, but the price to pay for daily treatment and a pool.
M. Eymann listened attentively to my account of the problems, read the doctor’s report, and did his own authoritative exploratory check of my shoulder movements. He then set me several tasks, involving pulling elastic cords in various directions. He explained that the purpose was to strengthen the deltoid muscle – the only one controlling shoulder movement in a reverse shoulder replacement , as the coiff (collection of muscles) no longer exists. Tackling mobility of the biceps – the muscle which appears to have given me so much pain so far – would not be started yet.
All very fine, and I felt encouraged as I could feel a sense of the deltoid muscle being put to work, but no pain. Until I was leaving the cabinet, when I was almost doubled up with shooting pains everywhere. Luckily I had paid Dorothy, the woman who had just spring cleaned my house for me, to drive me to and from Ganges. She stayed to cook my supper, as I was in no state to do anything.
The pain continued till one in the morning, when it eased off but did not disappear entirely. Back in Ganges again I told M. Eymann this. He started the usual, gentle, movements of my arm – but had to stop immediately as I doubled over with renewed pain. OK he said, the only rééducation possible today was a session in the pool, to release the tightened muscles. And sure enough, after 45 minutes of repeated gentle movements, the pain subsided.
This was the point at which I began to feel anger and despair. I dressed and sat waiting with two others for M. Eymann’s attention. He was rushing between three small rooms where he was evidently treating patients, perhaps with massages, pausing regularly to give the two student physios instructions for their treatment of people on the various machines. It became evident to me that, as with so many of the local physios, he is seriously overbooked. I was supposed to be waiting for my turn on the Tens machine, but it was midday, I had been there for two hours, with no real quality one to one treatment time. Dorothy was waiting for me outside, so I walked out.
Yesterday evening was once again painful, though not as much as Monday evening. This morning I’m much better, though still not able to move as I was at the weekend without my arm hurting. I’m due to go back on Thursday morning. By then I have to decide how to handle my discussion with M. Eymann. It has to work, as I have no alternative options. Realistically I think I will trim down my expected five sessions a week to three. But I want to get out of him some commitment to routine hands on personal treatment, albeit short, plus a plan on how to tackle my rehabilitation now he has seen firsthand how badly the biceps in particular respond to movement.
I am, incidentally, getting more proficient at distinguishing between joint problems ( the ‘blocking’ of movements by the joints following surgery, and the pain in tendons and muscles, in my case primarily the biceps in the arm ut also the deltoid which plays a pivotal role in holding the new shoulder in place.
There is a frustrating lack of images of reverse shoulders (and how the various tendons are connected) on the web. After all, they have only been available for about 20 years. But here are some images of muscles in a standard, non-operated arm and shoulder.
The biceps muscle is joined to the shoulder by two tendons. These were among the many which had to be cut and later resewn in place during surgery. M. Eymann says my problems are rare but, sadly, not the first time he has come across them; he reckons the pain comes from the area where the biceps were sewn back and the scar is causing the pain.
Margaret and Poppy were there to welcome me yesterday.
Poppy greeted me with gratifyingly enthusiastim. She was crestfallen when Margaret and Hans left – she likes to have her pack all together – but has settled reasonably well. We are having simply awful torrential rain (to make up for the two dry months over Christmas, so I am trying to make her go outside on her own. She is as reluctant as me.
i cannot think how I would have managed without Hans and Margaret. They have been like rocks, visiting, checking on the house, shopping, dealing with my mail, and of course providing a second home for Poppy, who will probably be delighted to return to them daily when I start my physio sessions in Ganges.
I have had a few domestic problems: the central heating system controls were beyond Margaret – and me. I thought I had to simply juggle the system between the tap and tap+radiator symbols, but it seems to keep reverting back to hot water only. The house is not stone cold but the underfloor heating is not its usual snug winter self.
Added to this, there is clearly something wrong with the electrical system. The main, override fuse tripped once last week and twice since I have got back. Tomorrow morning I’m going to establish whether it is one particular circuit at fault or a general overload. For the time being I have disconnected the entire garden system and fingers crossed, the lights are still on.
The other, sadder, discovery is that the eucalyptus tree we planted over Chris’s ashes, on his former vegetable plot, has been brought down again – a third time – in the winter storms. If it survives, I think the answer will be to not let it grow too tall.
On a more cheerful note, I am pleased with my new, nonslip shower and shower screen.
I’m not attempting to restore the house to order – the contents of the bathroom and the passage outside were boxed away during the messy building work – and have recruited help for this tomorrow. I did however manage to cook myself supper last night, though tonight I will be dipping into my well stocked freezer.
So, so far, no major problems caused by my lack of mobility. And not too much pain.
i had booked my VSL home with the local firm I have always used. (Unlike next weeks trips to the physio in Ganges, the journey from clinique to home is paid for by the health system).
I know the Thiébault brothers well from all those radiotherapy trips in 2015, so it feels comfortably familiar being driven by them. Besides, they are really up on any gossip to do with the health system.
M. Thiébaut confirmed that the dramatic cutbacks in the standard rééducation times allowed by the Sécurité Sociale are general and not limited to the Centre Maguelone. What’s more, there are plans for a huge increase in day surgery. When the new clinic is built in Ganges (a few years off as they have hit estimate problems) the building will be adapted to take account of this. Already they are talking of day surgery for hip replacements (provided there are no problems like people living alone)!
Glad my hips and shoulders are done, but there is still my problem knee and ankle to think about (or rather to try not to think about), not to mention the threat of discopathies in my back. Then again, Brexit may get there first … …
Friday was unreal, as I went through the daily ritual of rééducation as if it were just another day, but knowing this was the last time for me, and watching others who have just started, or those, like Marie Laure and the young lad born with no legs, who have months and months ahead.
In a way it was like leaving school: word seemed to have got round that I was leaving and I was met with frequent wishes of ‘bon courage ‘ and ‘bon retour’. And this being France many of the staff, including the main cook, various nurses and aide soignants, a couple of the cleaners, kinés and of course Delphine, the ergothérapeute, kissed me as well. Even Dr Belhassen gave me a sort of hug and said he just wished that they could keep me on for the further rééducation I clearly needed.
As I have not been able to raise my right arm high enough to take photos – even with my iphone – till this week, there has been few illustrations of life here. But here is my attempt on the last day to make up for this.
One of the features of the Centre that I have really liked is the vast collection of excellent photos round the corridors and rooms, mainly very high quality photos from GEO, which I think is some sort of French geographical magazine site. Unfortunately the only one I got round to taking a picture of (including reflection) is this one outside my room.
Then, it was only on my last day, while in the pool, that I looked up and saw the resident peacocks – a male and two females – which visit from the next door establishment (for upmarket alzheimer patients, apparently).
Unfortunately I did not have the phone with me to capture the pool, such a crucial part of the reeducation programme, but here is the ‘mechano’ hall, where most people are moving limbs up and down with weights, or walking between the bars (as is the young man with the newly fitted artificial leg in the picture) and where we shoulder patients go on a machine (not in the picture, but I still have one from the previous shoulder op) which raises our arm up and down for 40 minutes.
An important part of reeducation was ‘playing’ with Delphine – a series of exercises to develop backwards, forwards, sideways and upwards movements of my shoulder and arm. Here is the wood brick tower which I built every day, and then extracted bricks from lower levels to build further levels above – until the whole construction crashes to the table.
I realise I’ve been here three months and not really talked about the food. How could I have been so remiss when I’m so greedy?
I’m not the only one: in a routine of remorseless exercises of rééducation interspersed with periods of inactivity when most people find it hard to occupy themselves, the meals are pivotal points in the day.
I usually get up and shower at 6.30 and await breakfast eagerly. It arrives at 8.15, usually delivered by a charming, smiling woman – on of several of Magebran origin. Normally my favourite meal of the day, breakfast here is sadly nothing to write home about. I have opted for chocolate rather than the indifferent coffee. And the bread roll (‘tartinée ‘ with butter and jam) is not a patch on my own lovely toast (or, on my more virtuous days, porridge).
Lunch, at midi, is in a different class. The entrée is usually a salad and the main dish can be really good. Yesterday we had steak, with a good sauce, excellent potato gratin and peppers. Particular highlights of the week are mussels – and chips, which everybody falls on with gusto. Then we have cheese (proper cheese – not the plastic sort I have had in other clinics), fruit (I’ve lost count of how many clementines I have eaten) and about twice a week a dessert. Marie Laure and I get quite excited on pudding days, but we are not the only ones!
Supper is often of lower quality and the weekends, when many people go home, can be really indifferent. Sad, when those who remain in the clinic need cheering up and entertaining over two long days with no rééducation.
I almost forgot the goûter, at four in the afternoon – hot drink of your choice and on Thursdays a small bun or cake. The French laugh at the English and their afternoon tea, but they are partial to their goûter. (The difference is I see very little snacking between these four daily events.)
So the only real downsides are the weekends – and the vegetables, which are invariably overlooked for my taste.
The result of all this is that I have put on over three kilos here! For the past month I have opted for ‘petite portion’ for the main course – a half portion – but with no sign of a stop to this relentless weight gain. Some serious dieting will be on order when I get home.