Difficult return

It should have been lovely coming back home. But I seem to have just faced problems.

It started by my discovering I had somehow lost (not been given back?) my French sim card for my phone. So I had to spend yesterday going back to Montpellier to get another phone card.

It is cold and wet. (Inevitable, of course, after the incredible September we had.) This will be a challenge next week, when I sleep/camp in my new bedroom, where the only improvement since the summer is it at least has doors now.

My lodger Sébastien came up to tell me that there was yet another roof leak which I will need to sort out. October is a bad time to find builders who repair roofs.

Worst of all, the cold which I caught in Azrou, has developed into something pretty nasty. I’m not just sneezing and developing my usual bronchial hack, but I have a slight temperature, feel tired and shivery and very sorry for myself.

Jude and family arrive on Saturday. I must somehow get better by then – and tell the weather to behave.

Oh, and Brexit… … Johnson may get his numbers on Saturday and we will have a Brexit that will be even worse than Theresa May’s. Corbyn is doing his usual faffing around, the chances of a second referendum seem slim, and if/when there is a general election, we have the sickening prospect of several years of Johnson as PM. So half the British population, including me and all my family and friends, will be unhappy and angry.

Discharged

I have just had my annual checkup with my nice radiologist, Docteur Kerr, in the not so nice (grim) cancer centre in Montpellier, and she has discharged me! Now I have just an annual scan and visit to the gynaecologist – unless things change.

Dr Kerr agreed that last year’s dramas were undoubtedly partly caused by the effects of the radiotherapy, but the good news is that from now on the damaged cells are replaced by good ones.  

Some effects remain, however.  The damage to my intestines means I have joined the large band of elderly people who have a risk of developing diverticulitis. So I must pay attention to what I eat,in particular avoiding too many fibrous vegetables.

Given the initial grim prognosis of what was a rare and aggressive cancer, I am very lucky to have this good outcome.  It is largely thanks to the gynaecologue in Ganges, Dr Maistre, who spotted something was not right and who sent me swiftly for surgery to Dr Courtois in Montpellier.  The early intervention meant that although the uterus was over 80% cancerous, nothing had passed beyond.

Just a pity that the removal of lymph glands as a precaution has left me with a life sentence of wearing compression stockings.  Not appreciated when temperatures hit 30 degrees as they still are.

A year ago

Today a year ago was my first day in the Clinique in Ganges after having been rushed into hospital with a perforated duodenal ulcer.

What a nightmare that was. And it was the first of three health dramas: I was back in an ambulance six weeks later for what turned out to be an intestinal occlusion. Then in September I was back a third time, for an operation to have the occlusion and hernia fixed – side effects of the cancer treatment in 2015.

Charlotte, my lovely phsyio, was reminding me of this today. No wonder she and the GP are so firm that it is too early to contemplate having my arthritic knee replaced. Trouble is that the history with the duodenal ulcer means that all anti-inflammatories are banned, including products rubbed on locally.

The drama a year ago happened days after the Ecole de Musique’s orchestra accompanied two Chaplin films – a thoroughly enjoyable experience had I been feeling better – and two weeks before I was due to play a solo in the end of year concert.

That is another reason I have been remembering last year. I got an email when in Lisbon saying that that there would be an end of year concert for the cellists on 11th June and would I play the Bach Allemande which I performed in April again. I am now discovering how quickly I can forget a piece if I don’t play it every day. And yet another challenge for my bad case of ‘trace’ – performance nerves.

End of a chapter

On Monday I went to Montpellier to see the surgeon who performed the thermocoagulation procedure on my back. Sadly it was to report it had not worked.

The idea – so far as I could understand the medical explanations in French – was to burn off the nerve ends in the offending part of the spine, in my case in the last two lumber vertebrae. It is regarded as a non-invasive procedure with no known side effects, though with apparently about a 50 per cent success rate.

Unfortunately I am part of the other 50%: I still have the pain further down, in the sacrum area. It really is not the most acute pain I have had, but it is chronic and wakes me up every two hours during the night.

The surgeon, Dr Dhenin, was very sympathetic and regretted he had not been able to help. As the arthritis in the lumber vertebrae is not yet “catastrophique”, we agreed that there was no point discussing further surgery. So he wished me good luck with an indefinite programme of physiotherapy.

So Charlotte, my lovely physiotherapist, continues to massage my back and go through a series of exercises to try to improve the mobility in the sacro-iliac area, as well as introducing new exercises (now I am safely over last year’s three dramas) to restore some strength to my abdominal muscles.

Biology was on my list of most disliked subjects at school (art, biology, needlework, cooking and gym). The first two shared a requirement for artistic dexterity and visual memory (all those names of bones and flowers…) which I did not have. It is ironic that now I am getting Charlotte to give me lessons in anatomy and I attempt to grasp some understanding of the three -dimensional images I see on the internet.

It’s only a cold

You are not well? they ask.  It’s only a cold, you reply. Nothing to write home about.

But how all-encompassing a cold can be, shutting down one’s ability to function. First that ominous shivery feeling, a general malaithe sore throat, the blocked nose, the headache.  All coming out of nowhere, in a matter of hours.

And the nights.  One night after another, when all the symptoms rush in, competing to stop you sleeping. Worst of all, when the cold moves to the chest, hours of coughing and coughing., unable to quell that deep tickle. Sitting up does not help. Nor does wandering round the house. Raiding the fridge has lost its appeal. Reading is too much like hard work. Even music is irritating.

Then the days are long, tired out after the sleepless nights. Quite well in the morning, thank you. But come evening the coughing takes a hold, and you approach night with no pleasure.

Well, my little cold only lasted a week.  But what a long week. Then at last yesterday I turned the corner. My head cleared.  Lots of coughing and nose-blowing to clear the system out, and now I am back to normal.

This seems to a particular strain which is doing the rounds locally. My friend, Margaret, had a shorter version last week,  and today I witnessed Dessa (who came to lunch today) becoming overwhelmed.

But it was only a cold. And now mine is on its way out. So tomorrow: back to normal life.

Day surgery

Wednesday’s experience of day surgery – or chirurgie ambulatoire– was relatively stress free. The visit to the Clinique St Jean in Montpellier was to have the thermocoagulation treatment agreed on a month ago.

First the ritual of repeated bétadine (antiseptic) showers – head to foot – the evening before and the the morning. And then, because I would not be able to drive myself back, I had the usual VSL (ambulance taxi) trip to Montpellier.  My driver was Sonia, the photography and drone enthusiast who is responsible for my entering the world of drones.  So we had an amiable trip down, discussing photography and techie subjects.

Then, suddenly into the world of hospitals as I was ushered up to room with half a dozen beds in the day surgery wing and handed the usual pile of paper clothes to change into.  But someone has performed miracles: instead of the usual too small outfits with immodest openings at the back, I was given a far more fetching set of garments.  The trousers were, literals huge, like giant pyjamas with a drawer string to hold them up.  And the top was an equally generous-sized tunic which amazingly went all the way round – no acres of flesh to bare to the world. (Instead, when the anaesthetist wanted to put electrodes on my skin, she simply tore little holes into the paper!)

I even enjoyed the inevitable wait near the operating room, lying on my stretcher in front of a television where there was a fascinating program about the Big Bang (pronounced beeg bong in French).  I was disappointed to be collected by a porter before the end of the program.

Dr Dhenin, the surgeon, was again reassuringly polite and friendly, as were the nurses assisting, who went to great lengths to accommodate the mobility problems of my shoulders when I was stretched out on the operating table on my front.

The disconcerting thing about day surgery under local anaesthetics is of course that you are only too aware of the lack of dignity of lying on your tummy while the surgeon performed on the base of your spine.  But the whole procedure was rapid and painless (helped by some additional cocktail in the anaesthetic, I suspect) and soon the surgeon was shaking my hand and saying he would see me in a month.

Then, after the usual boring hour or so in recovery before being allowed to go, and then back home in the VSL.  That was perhaps the least pleasant part of the day.  It is difficult to describe my symptoms, but for the rest of the day until about midnight I felt distinctly unwell – distressed, restless, unable to concentrate or do anything, and more aware of the misbehaving lumbars 4 and 5 than usual.  I imagine it was a reaction to the anaesthetic, but it is the first time that has happened to me.

Luckily by morning I felt back to normal. It now remains to be see how effective the treatment has been. I now know of four people in this area who have had this treatment (which I had never heard of before).  Of these, three said it made a great improvement, though the effect only lasts a year or two.

A difficult week

Wow, over a week has passed since I last wrote.  This time has been dominated by my car.  Tuesday was a busy day – first the Bréau Christmas lunch for pensioners and then an afternoon of music rehearsals.

After a morning battling with the airport’s non-functioning system of booking a parking place for next week’s trip to the UK, I was late. I climbed into my car, turned the ignition and – nothing, The lights were on, so not a flat battery, but nothing turned over and during several attempts various warning messages flashed by. Oh dear, an electronic problem.

I got to the lunch, thanks to my friends Charles and Pierre.  (Didn’t enjoy it as I had a splitting headache and 96 pensioners packed into too small a space did not help.).

Then on to my first cello event, my lesson with Anne, driving an old car belonging to Charles and Pierre’s. In between this and my next appointment, I rushed round, talking to my insurers and others, establishing that getting my car to the garage in Montpellier could cost me over €200!

This did not help my next performance, with Jean Sebastian, the pianist – my last rehearsal before next month’s concert. Nor did my headache. Then before my final musical event – rehearsing with beginners for another ‘audition’ next week, I rang my garage.

Now why did I not do that earlier?  I discovered that I was still under a service contract, despite being into my second year of ownership, and that my car would be picked up and taken to Montpellier for free.  Phew!

So Wednesday morning a guy turned up with his lorry, got the car working, thus establishing there was a problem with the battery, but insisted that the electronics needed checking over as this failure was not normal. So I said goodbye to my little car, all set to see it again the following day.

Then I started to feel ill.  I realise now the headache had been the start.  By the evening it began to feel horribly like another occlusion.  I was not in a good place.  At midnight, in a calm moment, I packed my bag in anticipation of another trip to the clinic at Ganges.

Then I was sick, very sick, twice. And miraculously by 2am I felt things calming down. I managed to doze through the rest of the night and, amazing, in the morning I felt weak but better. Emergency averted, I hoped.  Just as well, as my next challenge was getting to medical appointments in Montpellier by the afternoon.

With my borrowed car (not fit for long journeys), I drove to le Vigan, took the bus to Montpellier (what a bargain – €1.60 for 70 km) and continued by tram and then on foot (in the pouring rain) to the Clinique St Jean. I was there to see an anaesthetist, in preparation for the thermocoagulation injection into my spine next month. Then on, still in freezing rain, to an appointment with a specialist physio, who measured my mobility before the event and will see me again after.

I had hoped to return in my car, but of course it was not ready, so back home by tram and bus. Actually it was a jolly occasion.  I sat at the front and one of my neighbours said as I entered “Ah, voici la violoncelliste”. She was a former councillor in le Vigan who used to attend our concerts regularly.  The woman next to me was also very cheery (I kept quiet when she enthused about the gilets jaunes). The driver joined in the conversations too.  I discovered his family have the magnificent old house at the far end of the Vieux Pont, the splendid romanesque bridge in le Vigan.

Thursday, after thankfully an uneventful night, I was back in the bus to Montpellier to collect my car.  This was a three hour journey – bus followed by two trams, so I was relieved to find that my car was indeed ready.  And even more relieved that I did not have to pay a penny.  (I don’t like the fact that the receptionist at this huge Mercedes and Smart garage greets me by name – I have had uncomfortably too many visits here in the last year.) Nobody could explain the electronic fault, but they replaced the battery, rebooted the electronics system and ran various tests.  I still love my car, despite its heavy reliance on electronics and potentially expensive bills in the future.

Oh and I forgot to mention that I had been ringing Lionel, my builder, regularly, chastising him for not coming to look at my roof leak. This week he came, apologetic for the long delay.  The crack in the cement at the top of the roof was found (caused he thought by the summer heat) and repaired, so hopefully all is now well.

Lionel had brought his team from a bigger job the other side of Ganges.  He said that there was now so little money available for building in the le Vigan area that he had had to move his business to places between Ganges and Montpellier.  Another worrying indicator that the economic life of our area is in jeopardy.

Now this weekend I must practise the cello to make up for the three days of not touching my instrument.

Closing one health chapter

This morning I had my three month checkup after the hernia operation at the start of September.  Cross fingers all is fine and I should be able to put this dire year – perforated stomach ulcer, intestinal blockage (occlusion) and hernia operation – behind me.

My lovely surgeon, Dr Glaise, is no longer at Ganges.  She is away on maternity leave and then moves to the Clinique St Roch in Montpellier.  Her replacement, Dr Essome, seems amiable, though it is too early to know about his professional competence.

I asked him about the muscular discomfort I get elsewhere in the abdomen, particularly just below the ribs.  He explained that this discomfort is natural as the body adjusts to the alien object that has been inserted. The patch (which is lower – at what is left of tummy button) is attached to muscles which travel vertically, hence you feel elsewhere than the location of the operation, and as my patch was so large, more muscles have been affected.

He reassured me that this was not a sign that the hernia operation had not worked and I could now resume normal life (with prudence): discard the dreaded corset and, more crucial, end the limit on lifting anything heavier than two kilos.  And he confirmed that my physio could go ahead and have sessions to strengthen my abdomen muscles.

The conversation then took an unexpected turn.  Where did I come from?  London, I said, and you? The Cameroons, he replied – and switched into English.  He was born in francophone Cameroon, in Douala (which I visited way back in 1966), but grew up speaking both English and French as well as local languages.  Then he trained as a doctor in Italy, so added Italian to his repertoire!

He now lives in Montpellier and commutes daily to work in Ganges, where he takes up his permanent post in January.  I wished him good luck and said I hoped that, sadly, I would not be seeing him again@!

 

More health stuff

Sometimes my life seems to consist of a flurry of health-related appointments. Apart from my two physio appointments, this week I will have had blood tests in le Vigan, foot and ankle xrays in Ganges, and two visits to specialists in Montpellier.

The xrays were a bit of a waste of time; they simply confirmed that my left foot and ankle are very arthritic, so that there is little more that the podologue, who has been checking on my insoles, can do to ease the discomfort.

On Monday I saw an endocrinologist in Montpellier to discuss the blood test results (deficit of selenium and zinc) and my continuing loss of hair.  She was very reassuring and said my hair will grow back again, now that I am recovering from all my innards dramas and am no longer on a limited diet,  and has prescribed treatments for the next six months to increase my mineral and vitamin levels. I still cannot get over the sensation of touching my head and feeling how little hair I have.  I now know how bad this must feel for chemeo patients, you lose a bit of your identity, and I look forward to growing more hair in 2019.

On Tuesday I was back in Montpellier, this time to see a surgeon to discuss the possibility of an injection to ease the pain in my back (which is not acute, but wakes me up every two hours at night). This is the latest in my string of attempts to sort out my back problems, having abandoned the medication prescribed by a neurologist, Dr Lionnet, earlier this year because of the side effects.

I was extremely impressed by Dr Dhenin, who specialises in spine surgery. It is so rare to meet a surgeon who is personable, with very strong communication skills and at the same time an air of evident authority and competence.

He turned the screen round so he could better explain to me what he was seeing when he looked at the MRI and scan from last year.  He showed the path of the spinal cord on the MRI and said that, though the spinal canal in the lumbar area was narrow, it was not yet ‘catastrophique’.  He turned to the scans, and showed how the arthritis was particularly bad in the 4th and 5th lumbar vertebrae. He was pretty sure (as is Charlotte, my physio) that this is the cause of the pain.

He has proposed – and I have agreed to – a procedure called thermocoagulation.  From what I can understand this involves injecting electrodes (under local anaesthetic) into the lumbar area in order to effectively burn off nerve ends in the two offending vertebrae and the disc.

Of course I realised afterwards, when being interrogated by my daughter, Kate (far more efficient at analysing information and asking pertinent questions), that I have only the vaguest understanding of what is going to be done. Unfortunately it is a procedure which was sniffed at by NICE back in 2002 and therefore I can find little on the internet to clarify my confusion.

I have confidence in Dr Dhenin, however. I am not the only one: at a village lunch today I talked to someone who had this done last year and regards Dr Dhenin as his saviour. He is also the surgeon who performed much more dramatic spinal surgery on my friend, Margaret, who is another of his fans.

The procedure will be done, as an outpatient, on 2nd January.  Meanwhile I have to see to the usual round of preparatory visits such as trips to see the anaesthetist.

 

 

 

 

Thumbs up from surgeon

Yesterday was my one month check-up with my surgeon, Dr Glaise, after the hernias/éventrations op.

It is always a pleasure to see Dr Glaise – such a splendid combination of friendly empathy and at the same time a sense of competence and authority.

She listened to my prepared list of questions and concerns and then looked at my tummy. “Oh, that’s very good,” she said.   “Yes, apparently I have a surgeon with an excellent reputation”, I replied.  She laughed, and said she had not been fishing for compliments, but was simply pleased that the scar had healed well. (I no longer need dressings – just some protection to prevent rubbing by the dreaded corset.)

She said it was now OK to drive, bend down, put on my compression stockings myself – do most things, provided I am cautious.  Only a few negatives:  for the next six months I must carry on wearing the corset and, most important of all, I must simply not lift or carry anything weighing more than two kilos, including rucksacks, she said, looking accusingly at the lightweight rucksack I had brought containing my medical records and xrays.

More long term, unfortunately, I must continue taking the prescribed laxatives indefinitely. Dr Glaise said that the damage to my gut following the cancer and its treatment, and now the occlusion and hernias, was unfortunately permanent. Hmm.  Without going into details I have to review my plans to return to India or, failing that, to take further trips out of Europe: the medical component of my luggage continues to grow.

At eight and a half weeks pregnant, Dr Glaise looks wonderful, but is approaching her last day in surgery. I asked her, apologising if it was indiscreet, whether she would be returning to Ganges after maternity leave.  No, she said.  She had been offered a once in a lifetime opportunity: to set up a gastroenterology unit at the Clinique St Roch in Montpellier.  This is the clinic where my other female surgeon, Marion Bertrand, has performed three operations, a second left hip replacement , a right shoulder replacement and subsequent surgery to deal with tendon and adherence pain in this shoulder.. So, even if I don’t like the commercial-industrial feel of the building, this clinic is one of Montpellier’s best.  It confirms my earlier gut (sorry) feeling that Dr Glaise is a high-class surgeon.

Since saying goodbye to her, I have reclaimed my car (now in pristine condition following the insurance job on the two bashes earlier this year), done my first supermarket shop (involving putting things one by one from the trolley into my car and at the other end, reversing this laborious process – pity we don’t have home deliveries in the country, and I have notified the nice nurses that I no longer need them to deal with my compression stockings.  I think I will keep on the meals on wheels for another week, rather than rushing into shopping and cooking, though tomorrow Odile and I are going to do a joint shop/cook to fill my freezer with more soup for the evenings.