Preparing for the next stage

i suppose you could say I have conceded partial victory to the other side. On 27 January I’m moving out to La Pasqière and will continue to come here as a day patient for rééducation.

Marie Laure and others thought I should have been fighting harder, resisting the pressure to make me leave, maybe applying to transfer to another centre, and soliciting the support of my surgeon. I think I have given in for various reasons.

First I do recognise that the non- functioning of a shoulder (and hence arm) is nothing compared with patients with the dreadful multiple injuries that come here every day and I would not wish to deny them a room. Also, I think I have been – and continue to be – very lucky when compared with people in my plight in the NHS.

But also there is an element of pragmatism: I don’t agree with those who think I would be successful in an application to transfer to the Clinique Fontfroide. Nor do I reckon that my surgeon, however much I like and respect her, would regard my case as one to pick a fight with one of the best rééducation centres in Montpellier. After all, she is continuing to send her patients here, but at the same time she is not one of the big names (i.e. Expensive) who could threaten to withdraw referrals if she doesn’t get her way.  I will email her, however, so she knows that her instruction that I should stay here until I could raise my arm 90 degrees has been ignored.

It has been an interesting lesson in the ambiguous balance of power between surgeon and establishment applying government guidelines. It is not clear to me yet whether it is just Maguelone ruthlessly applying protocols for length of stay after joint replacements, or whether this is something that has happened everywhere in the last two years since my lengthy stays after left shoulder and hip replacements. I can completely understand the presenting economic case, even though it rides roughshod over individual cases presenting particular problems – like me and my tendons – and the long term total cost of sending someone home if there is not the support structure (in my case, a rural community with inadequate health resources and transport problems). I have seen some worrying cases of people being packed off to homes where they live alone and clearly not in a state for autonomous living.

So, I’m going before pushed. I’m going to a centre run by Catholic volunteers, primarily for people visiting family members in hospital (I suspect the main target group may turn out to be parents of sick children) but also accepting people receiving daily hospital treatment providing they are autonomous. It’s essentially a bed and breakfast place and weekends could be a problem as the centre is closed for five hours on Sundays. At 24 € a day it is cheap – just as well, as it turns out this charge is not covered by my mutuelle, so I will be paying. Evening meals could be a problem (time to start my diet?) but I will continue to get lunch here as part of my status of hospitalisation de jour.

I also get my transport between lodgings and centre paid for by my mutuelle, though the medical secretary here said it was up to me to make the arrangements, and added ‘bonne chance!’. Apparently it is difficult to get the taxis vsl (medical taxis) to do these daily runs because it is not worth their while financially – they make more taking people for dialysis or radiotherapy.

At least this means that I continue to get my daily treatment here for another three and a half weeks.  I especially value my two sessions a day in the pool, which I regard as essential for upper limb injuries, where the water supports all your movements. It’s hard work and it hurts, but I can feel myself improving. Even so, when I asked Delphine if I would reach the 90 degree target before the end of next week she was clearly sceptical, though her language was not as brutal as Dr Belhassen’s .

I saw Dr Belhassen yesterday, by the way, for the injection into my biceps prescribed by the surgeon. So far, no effect, but maybe it will take a day to work  I was however cheered by his evident surprise at the progress I had made since a Friday .  He offered his handshake almost as a challenge  I met it, plus the request to touch my chin, with glowing colours, but failed when ordered to touch my left ear or the top of my head.

i have already told him that my two targets are to be able to drive and to play the cello. Note that cooking and housework are not on the list… …  but perhaps I should have added a third target: to able to take photos  obviously I have not been able to use my camera this winter, but also it is virtually impossible to take photos with my phone : I cannot really hold up the phone with my left hand and press to snap the shot with my left forefinger.  Nor if i hold the phone up with the left hand can i reach high enough up to take a shot with my right forefinger.



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