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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.

Taxi ride home

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 … …

End of three months in hospital

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.

Hospital food

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.

Fillon, Le Pen or Macron?

My French friends are agonizing over their particular political trauma. Not as black as Brexit, I suspect, but still, pretty grim.

As in Britain and the States, it is not just the outcome that is depressing, but the knowledge that there are so many millions of people swept off their feet by a populist and anti immigrant agenda.

It is good news if Fillon’s star fades as the result of the sordid nepotism story, as he really represents a totally unappealing right wing programme.  That is, of course provided the even worse nightmare – a victory for Marine Le Pen – comes to nothing.

So who is the ‘saviour’? I don’t know much about Macron but he seems to me to be the Tony Blair of French politics, trying to appeal to both left and right with his newly created party, En Marche.  His main appeal is he is neither Le Pen nor Fillon.

If I were French I would probably vote for Hamon, the doomed young ‘Corbyn’ of the Socialist Party in the first round, and then for Macron in the second round, assuming it becomes a fight beteeen him and Le Pen.

But then, we have learnt to our cost that pollsters have been getting things very wrong over the past year. And already the bizarre system of choosing a candidate for the two main parties had resulted in the favourite being knocked out – and a new party being formed.

There are currently ten candidates for the first round in April, which will be narrowed down to two for the second round in May. Who knows what will happen between now and April!

 

Reminder of future hurdles

On Friday I had the scintigraphie prescribed the previous week.  As the technician came to get me off the (uncomfy) table, he asked what was up with my left ankle.  Nothing, I replied, except arthritis.  Then the doctor dictating the report also picked out the ankle for special comment, then adding the usual list of knees and spine. Cheery, eh?

Difficult for me to understand his report, which is after all meant for the doctor here tomorrow, but I think he was saying the shoulder replacement was a bit spread out but more or less ok.  He suggests that the pain may possibly be a slight algodystrophic reaction. From what I have read on the internet I hope not and any I’m convinced the problem was a tendon and that the worst is over. (Trying to ignore the fact that the shoulder has been hurting more generally this weekend… ..)

Once again I have been struck by the fortitude the most seriously damaged patients here display.

Catherine, the maths teacher who has been here for over a year, at last went back to the hospital for her long awaited graft.  The op was apparently successful albeit major and she now has to wait 6-12 months before putting weight on her leg and starting rééducation to walk again.  Except – we heard that the next day the wound haemorraged and she had to go back into theatre. No more news yet.

Then a young woman has joined us in the pool.  She has two legs badly broken when her wheelchair stuck in a pothole and turned over, and she has to wait several months with her legs stretched out in front of her before the knees can be treated. She apparently has some condition like brittle bones, and although confined to a wheelchair obviously needs to be able to bend her legs.  She was petrified the first time she was gently descended into the pool.  But Pablo, a lovely, gentle Spanish kiné, comes into the water with her and is gradually helping her gain the confidence to relax. What a cruel disease.

Then there is a boy of 18 recently arrived with absolutely no legs, not even real stumps.  He is here to have articial legs fitted and to learn to walk with them.

Meanwhile there had been an influx of new patients, mainly older and with joint replacements, including quite a few shoulders.  The clinique is once again completely full.  I have the feeling of a new ‘generation’ arriving as I prepare to go. This is the first time I leave with so much recovery still to come.  But it is time to move on.

Final chapter in clinique

Things are better, but at the same time unsatisfactory and inconclusive. Mobility is much improved but way behind where I should be at this stage. The mysterious knife-like pain is much reduced (or masked), but still threatening if I try too much and still undiagnosed.

Already by mid-week last week I was slowly increasing mobility. But I am still only lifting my arm to 60 degrees, I use the right hand with difficulty when eating and I can still not touch the top of my head.

The vibration therapy is really helping: I no longer have the violent shooting pains, just warning signs not to overdo it. It is easy to forget that the vibralgic is reducing pain but not removing its causes. Yesterday morning, full of optimism,  I did about a dozen lifts of my arm, first in front and then to one side. An hour later I was temporarily doubled up. The Thursday and Friday Vibralgic sessions had clearly worn off.

The two further exploratory tests prescribed by Dr Belhassen proved abortive.  The medical secretary mistakenly sent me off for a scan rather than scintigraphie on Friday (I was not too distressed as I’m convinced the problem lies with muscles and tendons rather than bones). Then yesterday’s échographie, which was supposed to be done while injecting something in the biceps was totally unsatisfactory. The radiologue more or less said it was pointless sending patients with shoulder replacements for échographies; he could see virtually nothing, let alone enough biceps to do an injection.

Well, that’s it: no more tests to run, still no clear conclusion about the cause of the pain. Yesterday afternoon Dr Belhassen acknowledged there had been some improvement in mobility but gave his opinion that the operation had not been a success.  He was clearly pleased that the Vibralgic had helped and is going to add Tens treatment electrical nerve stimulation. (I’ve already had some electrode therapy, but designed more to stimulate the muscles rather than tackle pain.  I’m not clear yet if the two are different.) Then, he said, there was no more à rééducation centre could do for me (i.e. Pressure to use my place…).

I’ve now been given a definite departure date: 11th February.  Until then I’m being kept as an inpatient rather than lodging out  (I learnt from Delphine that this is because there are no more day patient places, rather than generosity keeping me on full time!)

I’m resigned to this, and the fact that recovery is going to be a long, slow haul, with months of daily physiotherapy sessions. I have found a practice in Ganges with several physiotherapists and a pool.  It’s 25km from the house, so the daily trip is going to be a challenge until I van drive again.  Dr Belhassen is confident I can drive already, using mainly my left hand, provided I can reach the gear stick with my right hand. Let’s hope my insurers are equally sanguine!

 

Mad, Mad and Bad

Every day I wake up and something new and more awful has happened in the world. What Trump is doing is surreal.  Words fail me. All I can do is publish these images posted on Facebook over the last 24 hours.

My surgeon a prosthesis pioneer

There are quite a few amputees here.  Most appear to be waiting for their stumps to strengthen before being fitted with and learning to walk with prostheses – artificial legs.

Traditionally this has been an artificial limb which you put on or take off. I well remember as an undergraduate, when a group of us went swimmining in the River Cherwell, seeing one guy leave his jeans with the articial leg sticking bizarrely up into the air.

I have just been learning that a new, still unusual procedure is to put a titanium implant into the bone of the stump and attach the prosthesis permanently to it.  This is known as osseointegration and sounds very similar to the technology used for my expensive tooth implants!

It  turns out that my surgeon, Marion Bertrand, is the leading pioneer of this technique in France. So far only a handful of amputees have benefited from this procedure. A fellow patient here, a young woman in her late thirties, is awaiting the operation, having formerly had a traditional artificial limb.

All three of her patients here – this young woman, Nadine and me – are really pleased that a woman has made it in the male dominated world of surgeons – and retains qualities of patient care and communication.

Small world

For the past ten dweeks days one of my dining companions has been a woman from near le Vigan: we have the same GP, physio, surgeon, and now, centre de rééducation!

Nadine is very much the sort of strong personality you expect from the Pays Viganais: a retired maths teacher and accountant, active in Amnesty and Restos du Cœurs (the charity which distributes food to the needy), opponent of employing people on the black, and staunch believer in healthy eating and living and alternative medicine.

Her husband, who runs a trout farm, is a gentle, smiling character and – again, small world – Chris and I bought the wood for our bookshelves in the house below from his father (who at 95 is still driving…). His sister is the mother in law of my doctor – and hence related by marriage to Jacky, who built my bassin! And, and – his family (Nouguier) are cousins of Christine Capieu, with whom I used to play music.