Hogmanay

Ring out the False

Ring in the True

Ring out the Old

Ring in the New

Wishing you

a Healthy and a Happy

New Year

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Cold Turkey

Like many people in the first world, our palates have become somewhat jaded from gorging on festive fare. The number of ways in which turkey, gammon, sausages, stuffing and sprouts can be served is indeed limited. On top of this problem of plenty, I’ve also been suffering from agitation, insomnia, anxiety, the sweats, muscle aches, cramps and diarrhoea. This is not because I didn’t get what I wanted from Santa, but because I stopped taking opioids (morphine-based painkillers) on Christmas Day and I’ve got withdrawal symptoms. I haven’t yet seen any pink elephants climbing the walls, but I guess there is still time.

When I left hospital three months ago I was taking 50 mg of morphine a day. A thoracotomy (the opening up of your ribs) is one of the most painful surgical incisions. My morphine dosage was very slowly stepped down until three weeks ago, when I finished the course and began to rely entirely on prescription strength co-codamol tablets. Codeine is also an opioid and, as I have found, very hard on the stomach. On Christmas Eve we opened a bottle of champagne, the first we’d had all year, and my stomach became very sore after just half a glass. I stopped drinking and had a long discussion with T, who had severe stomach problems in the past. The next day I stopped the co-codamol tablets and returned to the painkilling patch on my left side and straight paracetamol. I also began a short course of omeprazole to help heal the stomach. My festive season was thus turkey full and alcohol free.

The pain in my left side had been reducing very steadily, but the wound got stirred up during Rex’s disappearance. Firstly, I climbed over the back fence, pulling up with both arms, whilst looking for him in the field behind the house. Secondly, T accidentally knocked the right side of my face when I was leaning forward and I flinched backwards, pulling the muscles of my left side. These two pulls in quick succession seem to have irritated the drain site and put me back into plenty of pain. The drain site is at the bottom of my ribs, on the left side, where a tube was inserted into the lung cavity during surgery. The tube was removed and the hole stitched up before I left hospital. In the weeks after the operation it was possibly the most painful place on my body, although there was plenty of competition. So what has probably happened is that an internal scar, called an adhesion, around the drain site has been torn a little and has irritated a nerve. The painkilling patch is working well and in a few weeks I expect the tear will heal and the nerve will settle down again. I’m pretty confident that I haven’t done anything bad to the hernia repair.

In the meantime, I also have to cope with the withdrawal symptoms from the opioids. I am shocked at how strong they’ve been. I have hardly slept these past few days and I feel easily agitated and very anxious. Despite this, I’m glad to say that I don’t feel drawn to re-start taking opioids (I still have a bottle of liquid morphine on the bedside table). No wonder long-term addicts find it so difficult to get off smack for good. I’ve read that the withdrawal symptoms are most intensive for the first two weeks and after that they decline. The only upside is that I don’t have to take laxatives anymore. 

Happy Christmas

The most wonderful time of the year can also be the most awful. I’m not thinking of the rampant consumerism but of the very mixed feelings that this most intense of our annual festivals inevitably brings. At Christmas we celebrate our relationships with family and friends (through cards, phone-calls, visits and shared meals), but in so doing we are also much more aware of our ties to those people who were once close to us, but who have since departed through death or separation. Christmas is the time of family and friends and at the same time it is also the time of loss and loneliness. It is a festival that is inevitably bitter-sweet.

I always find Christmas a difficult time. Thirty one years ago my first wife and I had just bought our first house and had moved in just before Xmas. But in early January she was killed in an accident. It took a long time before I could bear to open the door of the new house. And when I did I found the house full of boxes from the business of moving in that for her would always be unfinished. Everyone has their story. A good friend of mine’s grandmother died at home on Xmas day. When his mother went back to the house her elder relatives were rapidly removing all of the decorations.

For tens of thousands of years humans have celebrated a Midwinter festival. It happens at the darkest, coldest and most deathly time of the year, when life seems at its lowest ebb: many animals hibernate, most plants are dormant or died back. It is unsurprising that our ancestors were moved to mark this important festival by the bringing in of symbols of life to the hearth (evergreen conifers, holly, ivy, mistletoe) and the sacrifice of an animal to mark the point at which the year turned from the dark, cold and death towards the light, new life and regeneration of the spring.

It is also unsurprising that early Christians, some 1700 years ago, should have selected this Midwinter festival as the point in the year at which to celebrate the birth of Jesus. It was entirely symbolically appropriate to piggyback the Christian festival onto the pre-exisiting one: the bringing of new light into the Midwinter world of darkness and death. This point was deliberately chosen for the festival of Christmas as early scholars and historical records suggest that the birth of Jesus actually took place in midsummer.

However you choose to celebrate Christmas, may I wish you the very best relationships with your nearest and dearest as well as the very best honouring of your ties to your dearly departed. May you feel rested and reinvigorated on your journey into the New Year. My dearest T and I will be celebrating quietly at home with Rex. We have sprigs of evergreen plants on the front door and have a conifer erected at the hearth. The tree is lit by real candles that I bought in Germany. We shall raise a glass to you all.

Lies and Threats

Unsurprisingly, Rex has been out of sorts since his ordeal. When he arrived home, after his release from imprisonment on the farm, he was very thirsty and hungry. He devoured a couple of days rations in several hours, and then howled during the night. The next day he seemed depressed. Since then he has been eating normally and seems to have picked up a little in mood. We have been reassuring him with lots of stroking and plenty of treats. We took him to the vet who examined him and pronounced him fit and reasonably well. Rex is certainly a resilient dog, he probably learnt this because of the maltreatment he had for the first year of his life with the old farmer. The vet also told me that a dog could only live for around four days without water. So Rex had been rescued just in time.

I reported the incident to the police. They told me it was a case of animal cruelty, which made it the responsibility of the local council. I rang the officer in charge. He took down the details but told me that a successful prosecution was unlikely because there was no independent evidence of the crime. Unfortunately a dog is unable to give evidence against its abuser. He said he would visit the old farmer and give him a stern warning that any subsequent problem with him would lead to a prosecution. I wasn’t satisfied, but this seemed the best option available. Later in the week, the officer reported to me that he had visited the old farmer and had warned him, and he had denied all knowledge of the crime.

I also spoke to a near neighbour about the old farmer. They told me that his wife had left him with their young child, so the old farmer had been on his own for forty years. They said that he came from a strange family. Apparently the old farmer and his brother were known for playing vicious tricks on people for their own perverse amusement. Several decades ago they had tricked a simple farm labourer up on top of a building they were constructing and he fell 30 feet and broke several bones, but could easily have been killed.  The locking up of Rex without food and water was in the same vein. This confirmed my gut feeling that the old farmer is unbalanced and dangerous.

As the week wore on, I spoke to several other neighbours about Rex. One told me that he had visited the old farmer when Rex was missing and asked him if he had seen the dog. The old farmer replied that he hadn’t seen him, but he was glad that he was missing because he didn’t want to see him again. And this dreadful lie was spoken when he had our dog locked up just a few yards away. The other told me that the old farmer had recently told him that he was very angry with me for reporting him to the RSPCA about not feeding his own dog properly. I shook my head and laughed. The old farmer had now produced a further lie to try and deflect attention from his own dirty deeds. I then gave my neighbour the true story.

We were speaking together below the farm towards the end of the lane. Just as we finished talking, the old farmer came around a bend on his tractor. He stopped, dismounted the tractor and began shouting at me.

‘Why did you bloody report me to the RSPCA?’

‘Because you tried to kill our dog,’ I shouted back angrily. ‘You locked him up for over three days without food and water.’

‘I didn’t do that,’ he shouted

‘Oh yes you did.’ I glowered. ‘Rex would be dead now if I hadn’t rescued him from the shed you locked him in.’

He growled at me and shook his head.

‘And I reported you to the Police,’ I shouted, ‘so you’d better be careful, they’re watching you.’

‘And you’d better watch out,’ he shouted, pointing his finger at me. ‘If I see you or that bloody dog around my yard again, I’ll do you.’

At that point he turned to get back on his tractor. I set off up the lane with Rex. I was fuming at his brazen duplicity. Five lies about Rex and two threats in one week. As I strode along I made a mental note of our exchange. When I got home, I wrote everything down and reported the lies and threats to the police and to the local authority.

Later on I told T what had happened. She sympathised and hugged me, then gave a faint smile.

‘Well, you’ve now become a fully-fledged member of NI society,’ she said.

I looked at her quizzically. ‘What do you mean?’

‘You’re involved in a feud with one of your neighbours.’

I smiled ruefully. ‘It’s only taken me 20 years.’

Kidnapped

A week ago Rex went missing. At first we weren’t too worried. He had a habit of occasionally visiting the farmyard where he had lived for a year. It was only a quarter of a mile down the lane and he went there to see the old farmer’s new dog. But when we went down to the farm to collect Rex, he was nowhere to be found. Then the snow came and we began to worry more. The next morning we again went to the farm and asked the old farmer if he had seen Rex. He told us he had seen him the day before but not since. Rather uncharacteristically, he told us that he hoped Rex would come back soon. As the icy weather set in, our worries increased. We began to go further afield, asking people and calling for Rex beside old barns and suchlike where he might be hiding out. But we had no luck at all.

After a couple of days we were terribly anxious and filled with a deep foreboding that something bad had happened. We remembered that the old farmer had threatened to shoot him and usually complained to us about Rex visiting his yard, for he believed that Rex was a bad influence on his new dog. Then a ray of hope, a neighbour told us they had seen a Facebook post about a stray collie that had been seen about three miles away. As T began to search for the post, I drove to the area where the stray dog had been seen and began to ask around. The backroads were very icy and I had to go very carefully. For several hours I met people who had not seen a stray collie. Then I met a farmer who said he had seen a young collie a couple of days ago. My spirits lifted. I made house to house enquiries. Many people were not at home. The remainder seemed helpful and concerned. I left our number written on pages torn from a notebook.

I got home late afternoon. T had finally tracked down the Facebook post. It was on a local ‘lost and found’ page. We scanned the hazy picture of the stray collie. He was very like our Rex, even down to the white patch on his tail. But it wasn’t him. Our spirits fell through the floor. We returned to the awful suspicion that the old farmer had killed him. After all, he had both motive (however unbalanced) and opportunity (the farmyard was the last place Rex had been seen). And he had acted suspiciously when we had asked him on the Friday about Rex, by not complaining about the dog coming in to his yard. I knew that the old farmer always visited a family member on Sunday afternoons. I decided to go down to the farm and have a good look around whilst he was not at home.

As I strode down the lane the light was fading. I feared that I would find a crime scene, with the stiff, dead body of Rex with gunshot wounds out the back of a barn somewhere. I sighed and steeled myself, I had to find out what had happened to our wee dog. As I walked into the yard there was a low bark from some stone outbuildings. I looked up the yard and saw the farmer’s new dog tethered there. The bark had come from another dog. I shouted Rex and whistled for him. No response. I pushed open the door of the first outbuilding, it was full of debris and had only half a roof. As I came out I looked up. Framed in a small high open window was Rex’s wee face. I shouted to him. He bobbed his head to me.

My heart flew as I ran around the stone barn looking for a way in to the upper floor. On the other side of the yard was a flight of stone steps covered in unbroken snow. At the top was a bolted door. I pushed it open. Rex ran out between my legs and raced across the yard. I glanced around the gloomy room, I could see neither food nor water. I ran out into the lane after Rex, calling to him. He was already far up the lane on the way to our house. Despite the icy conditions, a great well of happiness and warmth came over me. Rex was saved.

As I walked home, I realised that the old farmer had intended to kill Rex in the most horrible way. He had locked him in the outbuilding on Thursday, probably around lunchtime. The snow had come on Thursday evening and the steps up to Rex’s prison were still covered in unbroken snow when I rescued him on Sunday. He had been in there for over three days without any food and water.. A dog can’t survive for much more than four days without water. And the old farmer had lied to us on the Friday morning when we had asked him where Rex was. Our wee dog had been imprisoned on the farm all of the time. But for now my only concern was Rex, the old farmer was a problem for another day.

Young Love

The surgeon told me that the wound in my ribs would be painful for three months. He wasn’t wrong. It’s ten weeks since my surgery. The pain has diminished but it is still stubbornly there. I feel it most often at night. I haven’t found a position to lie in that doesn’t put some pressure on my ribs. I have to get up straight away after waking, as standing up eases the soreness of the night. The pain in the daytime mainly comes from simple movements such as twisting and stretching, or when I use my arms to do something without thinking. Despite having a nap most days, I find that by the evening I’m rather tired. After tea I pretty much conk out. Recently I’ve been invited to all sorts of evening events, many of them in Belfast thirty miles away. It is of course the season to be jolly. But I’ve had to decline them all.

I’ve now graduated to the lowest dose of morphine, 5mg time-release over 12 hours. I take this at night. During the day I take co-codamol to the same value. I have prescription strength tablets, each of which have 15mg of codeine. I was told by the pharmacist that this is equivalent to 1mg of morphine. The co-codamol tablets you can buy over the counter in a pharmacy are half of this strength. So I have come down from 50mg a day of morphine when I left hospital, to 10mg a day now. I hope that I can be off opioids entirely by the New Year. I’m very much looking forward to the time when I don’t have to take three sachets of laxatives a day in order to keep regular.

The surgeon also told me that walking was the key to recovery. I go walking twice a day, most days, usually with Rex. He is happy going up and down the lane, taking excursions into the fields to follow animal trails. But I’m afraid I have to report that his affair with Glen, the blacksmith’s dog, has taken a turn for the worse. For a long time they were very much in love. They would greet each other affectionately, with licks and nips to the face and neck. Then Rex would mount Glen and pump away at his backside whilst growling enthusiastically. Then Glen would mount Rex. This sexual turn-taking could go on for a while. Indeed, when I eventually walked off and called Rex he would very reluctantly join me, but would soon return to Glen after hearing his plaintive cries.

The last time they met all seemed to be going as normal, until their rumpy-pumpy suddenly turned into a full-scale fight. I don’t know why. Both dogs leapt at each other, snarling and biting. It was a ferocious melee of twisting bodies, each trying to pin the other down and bite them. The fight spun across the lane as I looked on startled and helpless. Then, suddenly, it was over. Glen ran away and Rex stood in the lane shaking and panting through foam-flecked lips. As we all know, the path of young love does not run smooth.

Rex, Pavlov and Automobiles

It’s now nine weeks since my surgery and I have built up to walking four miles a day. I do this in two walks; one in the morning after breakfast and one in the afternoon after my nap. The first walk is down the lane to the end and back. The second walk is down the lane to the old railway bridge and back, finishing up with a loop of the laneway. The laneway has a fairly steep hill. At first I was just glad to get to the top. Recently I have begun to stride out on the hill and have found that I still arrive at the top without getting out of breath. I’m delighted, for this is something that I wouldn’t have been able to achieve, pre-op.

Both of these walks are done with Rex. Sometimes we are also joined by T. I’m still trying to stop Rex chasing cars. I read online that this is a distorted hunting behaviour and as such is instinctive. No wonder it is proving so difficult to stop. When he is in car chasing mode he seems to take no notice of anything else. One of the online suggestions was that distraction by a loud noise could interrupt his chasing behaviour. I found an old whistle I had bought in a junk shop. It was a referee’s whistle with a pea inside it, called the Acme Thunderer. It was loud and shrill.

I waited till Rex was about to start his chase of a car and then gave him a blast on the whistle. He stopped in his tracks and looked very confused. I called him over. He seemed disorientated. I called him again. He came and I gave him a treat. Delighted with this success, I tried the whistle again later in the walk when another car came. Rex stopped in his tracks again. When I got home I told T what had happened. We were both delighted to have found a solution to the car chasing problem.

The next day I set out confidently on the walk with the whistle on a cord around my neck. After a while a car came. I gave Rex a blast on the whistle. He completely ignored it and raced away after the car. Confused, I wondered if I had blown the whistle at the wrong moment. Later in the walk another car came by. I blew the whistle again as loud as I could. Rex again completely ignored it, bounding away after the car and biting at its wheels.

I pondered the problem. I think it demonstrates that Rex is a quick learner. The first day of the whistle he was startled by the sound and that interrupted his chasing. On the second day he had learnt the sound and the whistle wasn’t a problem for him anymore, so he continued with his instinctive behaviour. I pondered further, remembering the story about Pavlov and how he had conditioned dogs by ringing a bell when they were being fed. Afterwards they would salivate at the sound of the bell, without any food being present.

Actually, when I looked it up I found that Pavlov had in fact never done this experiment. It is an apocryphal story that appears to have originated from a bad translation of one of his research papers written in Russian. He was a vivisectionist who used dogs in his medical experiments, many of which were pretty gruesome. What he actually reported was that the dogs salivated at the sight of his assistants white coats, because these were the people that fed them. He never used bells with the dogs.

Anyway, I decided I would try and teach Rex to associate the whistle with food. Each time I gave him something to eat I blew the whistle. At first he seemed a bit confused by this, but then he just wolfed the food down as normal. What I’m hoping to do next week is to start blowing the same whistle when Rex is about to chase a car. Hopefully his desire for food might override his desire to chase. I’ll have a pocketful of treats ready. I think it’s worth a try.

Driving and Dental Surgery

Over the past week I have made the thirty mile journey up to Belfast three times; on two of these occasions I drove myself. I suppose I have been fledging, testing my wings to see what I can manage. I had to put a pillow against my side under the seatbelt, but I completed the drives okay. I took it steadily, after eight weeks off I felt a little rusty. I was tired and my side was sore when I got back home each time, but I was pleased with my achievement.

The first trip was for the sixteenth edition of The Squat Pen, part of the CS Lewis Festival. I am very thankful to my co-host Ray Givans who did much of the organising of the event. My contribution was mainly to the online publicity. We were in a new venue, the deconsecrated St Martin’s Church, which was an excellent space but in a rather out of the way location without parking nearby. All of the contributors gave great performances to a smaller than usual audience. Our special thanks go to Paul Maddern, who stepped in as our main reader when Fred Johnston pulled out through illness. Indeed November must be the illest month, as I had to step in and select the Desert Island Poem at short notice, after Mary Montague pulled out with a sore throat.

Second was for the AGM of Cancer Focus NI. This is a great local organisation that provides fantastic support for cancer sufferers and their families. Since my diagnosis in 2011 I have benefitted from a range of their services, including counselling and residential workshops on learning to live with cancer. Indeed, I have been an active member of the Sing for Life Community Choir since it was founded by Cancer Focus in 2013. I had put my name forward to serve as a Non-Executive Director and Trustee and I’m delighted to say that I was elected. I’m looking forward to helping to give something back to this important and much needed local organisation.

Third was for an appointment with Dr Mark Diamond for a dental implant at his specialist clinic on the Antrim Road. He is the most experienced implant dentist in NI, having done this work for twenty years, and his clinic is referrals only from other dentists. I needed to be there because I have some poor teeth. This is due to a combination of gum disease, inherited from my mother, and decades of poor dental treatment. I had been referred to him from my normal dentist because I had reached the end of treatment for the tooth in question, it had first split and then had been extracted.

The treatment began with my mouth being numbed by a series of injections. Then I had a panoramic scan done of my full mouth. Mark showed me the results. He could see exactly how much bone I had in my lower jaw and where the main nerve ran. This meant he could decide how deep to drill and the exact right size of implant to insert. The next step was he and his nurse putting on surgical gowns, gloves and masks. Then the surgical treatment began.

He first cut open my gum to expose the jawbone. Then he began to drill down into the jawbone. It sounds dramatic but you don’t feel anything. He used a long straight drill rather than the small one used to drill into teeth. It took a little while. He told me that I have a tough jawbone. And when the hole had been drilled deep enough, he screwed in a titanium bolt with a little torque wrench. It felt like someone doing DIY on your mouth. The wrench clicked as he screwed in the bolt until it reached the correct tension. The titanium bolt has a threaded top into which a removable cap is screwed. Then he stitched up my gum.

The implant bolt is left in your jaw for at least three months for the bone to grow strongly around it, before the next steps are taken. I drove home with a numb mouth and a short course of antibiotics to ensure there would be no infection. After a couple of hours the injections had worn off and my jaw was a little sore. I took a couple of co-codamol and rinsed my mouth with warm salty water. I’d have to eat on the other side of my mouth for a few days. But, in comparison to the other operations I’d had in recent years, this was nothing to make a fuss about.

Sleep and Sex

Over the past week I have been transitioning from sleeping upright against a pile of pillows to sleeping lying down. It’s not been easy going from ten pillows to just one. I had been sleeping upright for seven weeks and I’d got used to it. Sleeping flat seemed very odd; it felt like my legs were higher than my head. When I woke up after sleeping upright, my neck and legs were very stiff. When I woke up after sleeping flat, my ribs felt like I had been several rounds with a heavyweight boxer. I think it’s because the mattress puts more pressure on your ribs when lying flat and you also move around more in your sleep.

Anyway, I persisted and now I can sleep the whole night lying flat. Despite waking up with sore ribs every couple of hours, I managed to sleep my normal nine hours or so last night. It’s another good step towards normality. Although, I would normally go to sleep on my left side and I can’t do that because of the wound. In the morning I still get up straight away as standing up relieves the accumulated soreness of the night. As the activities of the day inevitably bring tirednesss and soreness, in the afternoons I still go for a nap but I don’t always manage to fall asleep. Sometimes I just rest for an hour or so.

In the sunshine on Sunday, T and I did a three mile loop walk around lanes from the house. Despite the route having several small hills in it, I managed it fine. My breathing already seems better than it was before the op.  I still take Rex on walks down the lane and back twice a day. I’m trying to stop him chasing cars but with limited success. My current strategy is to teach him to come to me when I call ‘here’ and to give him a treat when he does. When a car comes along the lane I shout ‘here’ loudly and once or twice this has interrupted his desire to chase and somewhat hesitantly he has come to me for a treat. A few times he stopped chasing the car when I called and chased his tail in circles in the middle of the road and another time he ran off madly across a field instead.

The blacksmith down the lane has got a new dog, a male short-haired collie called Glen. The first time they met Glen jumped up and placed his front paws around Rex’s neck and began to lick and bite him playfully. Rex eagerly did the same back to him. There was plenty of growling. Then Glen mounted Rex from behind and began to pump away at his arse with his little red willy out. After a while, Rex leapt on Glen from behind and began to pump away at him. But Rex didn’t have his willy out and was also pumping away at Glen’s thigh rather than his arse. Methinks Rex is a little more innocent than Glen, but he has discovered sex and each time we walk down the lane he keenly looks out for Glen. The blacksmith now calls them ‘the lovebirds’.

A Review with the Surgeon

Almost six weeks since the surgery and I was on my way to Belfast to see the surgeon for a review. It was the first time I had travelled that far since leaving hospital. Indeed, I was retracing my steps. I never really paid attention to it before, but a car journey is full of low level vibration, presumably from the road surface. Then you get jolts from potholes and braking and cornering. All of this irritates the wound. I placed a pillow at my side, between my torso and the edge of the seat, and this helped a little. It seemed a long way.

After five weeks at home, I feel I’ve definitely turned a corner. My recent improvement feels secure. I am now fully independent in the house, being able to manage my own washing, dressing and feeding. I make my own breakfast and lunch. T always makes tea. My morphine prescription has been reduced again to 20mg a day, in two 12 hour long-release tablets. This together with the Lidocaine patch and Paracetamol is managing the pain. I am walking for over an hour each day. But I am still unable to lie flat for any length of time.

When I was discharged from the Royal I was given a form for an X-ray. This was to be taken half an hour before my review appointment. We did as requested and then went to wait in Outpatients. As usual there was a delay. When I went in to see him, the surgeon had my X-rays up on his screen. He showed me the difference between today’s and the one taken pre-op. My left diaphragm was now fully down (the X-ray is taken on full inspiration) and my entire left lung appeared to be inflated. Previously my left lung was squashed up, as half of its space was taken up by my stomach. Now there was no visible difference between my left and right lungs.

Today’s X-ray looks very good, he told me. I asked him how much of the functioning of my left lung I would get back. He said that I would get a lot more than I had before but not 100%, as the mesh patch would not work as well as my native tissue. The exact change would be measured by the breathing tests I did annually with my Respiratory Consultant. He advised me not to do these for at least three months as they would be putting stress on the repair. He also told me that the main stressors on the repair to the diaphragm were coughing and straining on the toilet in constipation.

I took off my top and he inspected the wound. He pointed out the four large surgical scars on my torso to a junior colleague and said I looked like a surgical model. I didn’t ask if he wanted to book me in for any lectures. He told me that the wound was healing well but that I needed to be careful for six months as this is how long it would take for the intercostal muscles, which join the ribs together, to fully repair. He told me that my regular walking was very good and I could slowly increase the exercise I was doing. He also said that I could now start to drive again.

We drove back from Belfast around 4pm, the rush hour traffic was building up, my wound was sore and I was tired. I wouldn’t be rushing to start driving again. And even then I would begin with just some local trips. But this was another good step forward on my return to normality.

A Sense of Improvement

Its four weeks since the surgery and my third full week at home. I’ve probably been improving very slowly all of the time, but over the past week I’ve felt a noticeable improvement. For a start I’ve become more independent. I can now take all of my own clothes off and put them all on in the morning. I can even stick my own Lidocaine patch on my side. Last week T had to put my socks and my patch on before she went to work. My morphine prescription has been reduced but I don’t feel that I am in any more pain. I was taking 50mg a day when I left hospital, now I am on 30mg a day.

My life has settled into a routine of recuperation. I still sleep a lot. I generally get nine hours each night and a nap of one to two hours each afternoon. I can’t lie flat, I’m still sleeping semi-upright against a pile of pillows. I now get myself up and make my own breakfast. I take T her cereal in bed if she is not working. After breakfast I take the dog for a walk. I can walk slowly without significant pain and we have been to the bottom of the lane and back (a distance of two miles) each day this week. The consultant told me that regular walking was the key to recovery from a thoracotomy.  

During the walk I let Rex run free because he is too strong and will pull me on the lead and hurt my wound. Despite lots of effort we haven’t managed to stop him chasing cars. I think it is caused by fear that has been displaced into aggression. Although he is also afraid of cattle and sheep, but just cowers from these creatures. He also loves to chase rabbits.

After the walk I get Rex his breakfast and then rest for a couple of hours. I sometimes do some work on the computer but that tends to hurt my side after a while, using my arms and hands on the keyboard and mouse works my ribs. Sometimes I watch TV, Inspector Morse is often on late mornings. I make myself a lunch of fruit salad and toast. The aim is to help my digestion and keep me regular. I still take four packets of laxative a day.

After lunch I have a nap. Mostly I don’t feel tired, but I close the curtains, put my earplugs in and I am away for an hour or two. I then get up and take the dog for another walk. This time we go halfway to the bottom of the lane and back, one mile. By the time we get back, T is usually home from work. She makes tea and does the clearing up. We relax for the rest of the evening and go to bed around 10.30.

For a few days my friend Phil from the New Forest was visiting. He fitted in easily, going for walks or reading whilst I was resting. One day he came back with a couple of pounds of sloes, ready for making sloe gin. Another day we went out to the coast and took Rex. He is fine in a car as long as you hold him. Rex sat in the footwell and rested his head between my knees. We parked at Nine Arches and followed the boardwalk to Murlough Bay. I managed the walk alright as it is about a mile and half there and back. Rex enjoyed running wild across the beach but was afraid of the sea.

I found that the journey in the car was a surprisingly painful experience. The vibrations, cornering and acceleration/deceleration caused constant low level pain and then there were the potholes. I’m not allowed to drive at the moment. I don’t think I will be planning to go anywhere by car for a wee while.

The Contours of Pain

The second week out of hospital presents different challenges to the first. With the tireless T always ready to help, we are slowly adjusting to my pain and to my incapacity. In the last couple of days I’ve become able to get into and out of bed by myself. I can also put my own trousers and shoes on, although not my socks and pants. I am feeble and awkward in my movements so T supervises me carefully. I have become like a toddler who needs to be closely watched in case they get themselves into trouble. She has placed a small brass bell, shaped like a woman with a wide skirt, at my bedside which I ring if I need help. All of this progress is very recent. It has only happened because my pain is now being much better managed.

For a long time the level of pain continued unchanged. It was relentless. It began in my wound and stabbed across my ribs into my abdomen. Pain turns you in on yourself. You are stuck in an oppressive private world. You withdraw from anything that causes the pain. And you have to take a deep breath and prepare yourself for any unavoidable movement that you know will cause pain. For me, this meant any movement of my torso and arms. I moved reluctantly and remained for hours after settling in bed or in an armchair. As every step was painful, I had to force myself to walk a little and do some breathing exercises.

I recalled what the surgeon had told me about nerve pain at our meetings before the operation. He explained that nerves run along each rib in grooves that follow the top and bottom edges of the rib. In doing a thoracotomy he would place me on my side, slit the intercostal muscles that hold the two ribs together from back to front and then insert a mechanical device which spreads the ribs wide to make the space for the procedure on the diaphragm and lung beneath. He explained that some nerve damage was inevitable, but the extent of it depended on how deep or shallow the grooves in my ribs were and how well recessed my nerves were in these grooves. At night my back and ribs were so painful that I imagined that my nerves had been well and truly crushed in the surgery.

When I was on the ward in the Royal I met a Pharmacist called Mal who consulted with each patient about their pain and the options for pain relief. He told me that I couldn’t take the two main drugs they would give patients for nerve pain. Pregabalin was one, which I had been given previously and had taken an adverse reaction to. The other was Diclofenac, in a category of drug called NSAIDS, which I couldn’t take because I only had one kidney.  Instead I was put on a drug called Nefopam. I had been taking this three times a day but I didn’t think it was having much effect on my pain.

I rang the ward to ask for their help. I spoke to a junior doctor who was preoccupied with patients on the ward and who wouldn’t venture an opinion on the alternative drugs I could take. I asked her to pass on a message to Mal the Pharmacist or to ask one of the senior doctors to ring me. No-one rang. I tried the ward again the next day and asked for Mal. They told me to ring the Pharmacy Department. I rang them. They told me that Mal was at work in the hospital but they would text him my number. Hours passed, I felt that I was being left on my own with the pain.

The phone rang. It was Mal. I thanked him and explained the problem. He considered it carefully. In the short run I could take more Morphine, but this wasn’t advisable because of the bad side effects on my digestion and the risks of addiction. Indeed they wanted me on the minimum dose possible and wouldn’t want to increase it. He said the only real other option was a pain-killing patch which I would wear for 12 hours each day. It was called Lidocaine and was most often used for shingles.

Armed with this knowledge I went to my new GP practice the next day. I got a locum. He listened to my story, gave me two more weeks supply of Morphine but said he wouldn’t be able to prescribe Lidocaine without some documentation from the Hospital. I left the surgery exasperated and unhappy.  When I got home I rang the Hospital and asked for Mal again. He rang me back a couple of hours later. I explained the problem. He looked up Lidocaine and found that it was only licensed in General Practice for use against shingles. He told me I would have to get one of the senior doctors on the ward to contact my GP. My heart sank. I knew this would be next to impossible, given how busy they were.

I spent another painful and unhappy night. The next morning Mal rang me again. After our phone call yesterday he had gone back to the ward and discussed my case with one of the doctors. He wanted the name and phone number of my GP. I thanked him profusely. A couple of hours later I got a call from one of the Thoracic consultants, he had spoken to my GP and I would be prescribed Lidocaine. I thanked God for the conscientious and hardworking Mal who had helped me out after I had been discharged from his responsibility.

The Lidocaine patches are A5 in size. T sticks one down my back, below the wound, and one across my ribs at the side. They feel very cool to the skin and sting a little. They are not magic, but they do take the pain down a notch. They make it possible to for me to carefully embark on simple movements. I’m delighted that I don’t have to wake T each time I want to get into or out of bed. They make short walks manageable. They also make it possible to try too much and get severe stabs of pain during, and aching soreness after, some movements. Despite this, I toddle on. 

Easement

The first week out of hospital isn’t easy. T has cared for me tirelessly. But away from hospital you are left with your wound, your incapacity and your drugs. There is no doctor or nurse on hand to check you over when you are feeling strange. You are at the start of a long journey of recovery that will take many weeks. Most of the online advice seems to suggest that you should expect some initial setbacks.

My bed is comfortable but not in any way adjustable. On the first night we piled up all the pillows from the house and T carefully lowered me back against them. The slow descent was very painful. I gasped with relief when resting semi-upright against the pillows and managed to sleep for a few hours. I woke up stiff and in pain. T helped me up and I walked to the toilet to unstiffen my bones. I took a shot of morphine before she lowered me back against the pillows. This performance was repeated before morning and has been every night since.

T also has to help dress me. I can’t bend sideways or downwards. It is like being a child again. She holds my pants and trousers open for me and I put one leg in and then the other. I can put my top on myself but she has to put my socks on and do my laces up for me. After this I can get around the house alright. After breakfast I make myself walk for five minutes before I sit in the armchair, which I can just about get into and out of myself. Daytime TV is as bad as it was last year.

The pain in my ribs is always there, it rises and falls: sometimes a sharp stab or burning sensation, other times a grinding ache. Its constancy wears you down. The morphine only takes the edge off it. I’m very tired and sleep for a couple of hours each afternoon. I don’t have any energy or enthusiasm but I make myself go for little walks and do my breathing exercises. I also don’t have much appetite; I’m managing about half of what I would normally eat. Despite their challenges, all of these problems are to some degree anticipatable or normal for the situation I am in.

The problem with my guts was different and worrying. Since the operation I have been very bloated with cramping in my bowels. Despite taking four packets of laxatives a day, I had not passed anything, not even wind since I was discharged. Indeed, the only bowel motion I’d had at all was due to an enema in the Royal and felt very abnormal. I’d had enemas prior to discharge on each of my previous times in hospital. They had followed the same pattern. The enema softened an impacted stool and induced cramping and convulsions in your rectum sufficient to pass it. After the log was gone the bowels began to work normally. But this time there had been no impacted stool, just minor cramping and a small amount of diarrhoea.

During the surgery my stomach and bowels had been moved from my thorax into my abdomen. This meant that there was the potential for some obstruction. The symptoms for a partial obstruction were those that I was having. After several days the bloating and cramping became worse. We went to see the GP. She felt and sounded my abdomen. She wasn’t sure whether there was an obstruction or not and sent me for an X-ray.

I had the X-ray done at a shiny new health centre in Banbridge on Friday. The pictures were sent to Craigavon Hospital marked ‘urgent’. By the end of the day the GP rang to say no report had come through. She advised us to go to A&E if my symptoms got worse over the weekend. On Sunday I was more bloated and crampy. T rang the Out of Hours service. They asked me to come in that evening for an examination at Daisy Hill Hospital. The doctor gave me a cursory glance and a quick prod without using her stethoscope and sent me away with gelatine suppositories.

I woke early on Monday morning in more pain. We decided to go to A&E at Craigavon. Arriving at 9am, the waiting room was fairly empty and I was attended to quickly. They checked my X-ray and told me there was no obstruction visible. They said that my colon was full two thirds of the way around, but my rectum was empty. So the enema in the Royal had only shifted a little of the constipation. They said another enema wouldn’t help and I would have to increase the dose of laxatives and that eventually this would work. The source of the problem was the morphine, which had the side effect of slowing my bowels almost to a standstill.

Reassured we went home. I took more laxatives and waited. Later on I had a semi-normal bowel motion. After thirteen days it felt so good to have my normal functions restored. As the bloating and cramping began to reduce, my mind turned to the grand medieval toilet I had seen at a ruined monastery near York. The monks had diverted a stream and built several dozen stone seats back-to-back over it. As far as ancient toilets go, it was an advanced design complete with running water. The building was called the House of Easement. 

Confessions of a Morphine-drinker

I’m home from hospital. The surgery was last Tuesday afternoon and took three hours. After several more hours in the recovery room, I was back on the ward. The surgeon told me that the procedure had been a success. I had a foot-long wound across my back and around my side, held together by a line of surgical clips. But I felt little pain, only mild discomfort in my shoulder. I had an epidural line inserted into my spine between my shoulder blades which pumped in Fentanyl, a very strong synthetic opiate, making the central band of my ribs completely numb. This had been there throughout the operation and would stay to enable me to reinflate my lung without pain.

The surgeon found that my stomach had become twisted through the hole in my diaphragm and had stuck to the lower part of my left lung, with my spleen compressed against my ribcage. No wonder I had gastric and breathing problems. The surgeon also said that correcting these defects had been very timely as serious and potentially fatal problems could easily have developed. He told me that my diaphragm was thick and healthy with a good blood supply (a legacy from many years of running and mountaineering) so that the mesh repair should be strong and lasting. I was very relieved, as I went into this surgery not knowing what exactly would be found and whether a repair would be possible.

For the first two days I was attached to eight different devices. My vital signs were recorded and monitored, I had an oxygen mask, a saline drip, the Fentanyl was pumped in through the epidural, and my chest was drained of fluid as was my bladder. There were tubes and lines everywhere. I felt exhausted and lightheaded. On the second day I was got out of bed for several hours and moved around the ward by two physiotherapists who carried all the equipment and shouted encouragement.

On the third day the chest drain and the epidural were removed. Then came the pain. It stabbed across my back around my side and into the centre of my chest with every little move of my torso. They gave me morphine, but it wasn’t enough. They increased the dose. It still wasn’t enough. They added in another type of painkiller and gave me liquid morphine on demand. This began to take the edge of the pain.

They said I would soon be ready to go home. I complained, I was barely able to move myself off the bed and into the chair. My prostate came to my aid. When they took out the catheter I was hardly able to pee. They put the catheter back in, at the third attempt, and put me on prostate reducing drugs. I sat in bed with a very sore penis and stabbing pains across my chest.

Nights were the worst. However comfortably the bed had been set up, I would invariably wake up a few hours later in agony. I would ring the nurse and request my morphine. She would bring it in a small needle-less syringe. I would squirt the morphine into my mouth and suck the end of the syringe. It tasted both salty and remotely fruity. But it worked and quickly. A warmth spread across my wounded chest and I would relax into sleep, until I again woke in agony.

After two more days the catheter was taken out and my pee was normal. They gave me an enema, which worked, and pronounced me fit to be discharged. I said I wasn’t sure that I was ready to go home because my guts didn't feel right and asked to stay for one more night. They told me firmly that I was being discharged and that my bed had been booked for another patient who needed surgery.

After work, T drove me home. People rushed past us, scooting back for tea or to the supermarket. The busyness of everything seemed faintly absurd. The sun was setting and newly fallen leaves skidded on the wind. I was glad to be at her side again. Despite the challenges, we would make the best of it. After all I had a big bag of medications with me, including my own bottle of liquid morphine.

Apple Picking, Scan and Surgery

Our house is suffused with mellow fruitfulness. The apple tree produced a bumper crop of about a thousand apples. We cooked loads and stored the fruit in the freezer. We gave bagfuls of them away to friends and neighbours. Still hundreds of apples lie on newspapers in the living room and lounge. After apple picking came two weighty pieces of medical news. Both arrived on the same day.

First I learnt that my latest CT scan is clear. Needless to say this is an enormous relief. It means that I have been clear of cancer for one whole year, as I was discharged from hospital in September last year after cancer surgery. Following months of recuperation, I was left with a nagging pain in my side. I was told by the surgeon that this was nerve damage. Over recent months the pain has slowly diminished and today I only feel it on a bad day.

Second I got a letter from the Royal Hospital Belfast telling me I am planned to be admitted next Monday for surgery on Tuesday. This was a bit of a shock. I had been expecting this call in June and when it didn’t come I put the surgery to the back of my mind and got on with enjoying the summer. We had a lovely staycation with plenty of fine trips. Now this stay of execution has been suddenly rescinded.

The surgery is to repair a hernia in my left diaphragm that was caused by the first big cancer operation I had in 2011. Since then much of my stomach has been in my thorax depressing my left lung. After a while I got used to this problem and managed to live an active life despite it. But I have been persuaded that it is important to get this hernia fixed to improve my symptoms and to guard against future problems and deterioration. I have been getting troublesome gastric symptoms (IBS) over the last year and am now on the FODMAP diet.

This is a big operation, a thoracotomy. This means that they cut between my ribs and open my thorax. Then the surgeon can see the exact nature of the hernia and the level of difficulty of the repair. This is not clear on the imaging that has been done thus far. The surgeon with then cut my stomach from the diaphragm, reposition it in my abdomen and patch the hole with mesh.

I am expected to be in hospital for around two weeks. The recuperation is long and slow as I can’t put any strain on my diaphragm for at least three months. And my rejoined ribs will be extremely painful. I hope that next year I can begin to build up my strength and fitness and restart singing, hillwalking and cycling.

Unlike each of my other operations, this is elective surgery. It is my choice whether to have it. And since the letter came I have been plagued by fears that I will be worse off after the surgery. Alongside this is the resentment that I have to go through another year of pain and incapacity just because of a mistake that a surgeon made.

As the surgery is elective, it is also the NHS’s choice when to do it. I have to ring the ward on Monday morning and check if I can still be admitted that day. A more urgent case could have come along over the weekend and I would be displaced and postponed.

There is of course a long list of things that need to be done around the house before I go in to hospital. I am steadily working my way through them with much trepidation. T is doing similarly, in the knowledge that she will have to look after me and Rex together over the coming months. It’s not going to be easy.

Rex

The old farmer down the lane got a new dog and wanted rid of his old dog, Rex. He told us that Rex was ‘no bloody good’ and he was going to shoot him. We said that Rex was a fine, friendly dog. The old farmer insisted Rex was ‘no bloody good’, but said he would give him to us if we wanted him. We thought for a while. Now Rex the farm dog is our dog.

The old farmer kept Rex chained up for most of the day. Sometimes Rex would be loose and would often walk with us when we went down to the bottom of the lane and back. Sometimes he would come all the way up to our house and then stay around in our garden until dusk, when I would walk him back to the farm.

Rex always seemed hungry. We made a point of giving him food whenever we could because we thought that the old farmer wasn’t feeding him properly. This situation got worse when the new dog arrived. Rex was displaced from his spot in the yard and shut away somewhere each evening. He seemed hungrier and thinner; the new dog was being given most of the food.

We bought Rex a large wooden kennel and put it under the bay window at the front of the house. We were told that we would have to keep him chained up for a while before he got used to his new surroundings. I got a long chain, twenty five feet, which was tethered beside the kennel. He could run onto the lawn and go as far as the front door.

The first night Rex refused to go into the kennel and slept on the doormat inside the front porch. He howled during the small hours. The next day I tried to coax him into the kennel with food, but he still refused to enter it. That night he again slept on the doormat and howled. The next morning T stroked him and sang, ‘How much is that Doggie in the Window?’ for him. He enjoyed it.

I quizzed several local dog owners about why he wouldn’t go into the kennel. The first said that he was bound to go in, just give him time. The other said perhaps he was scared of it because he had been locked up in a small dark space. This seemed most likely, and probably happened after he was displaced by the new dog at the farm.

The third night he again slept on the doormat but didn’t howl. Rex seems to have rapidly got used to us and his new home. He is only 18 months old and seems eager to learn. We take him on walks on a lead as, whilst at the farm, he developed a bad habit of chasing cars. When a car comes by we make him sit and when he tries to leap up and chase it we say firmly no and push him back down to sitting. After the car has gone and he remains sitting we give him a treat.

Yesterday, I let him off the chain and he happily ran around our large garden and didn’t try to run back to the farm. He went into our neighbour’s garden, but came back when called. I patted him on the head enthusiastically. His head was wet and sticky. He had been rolling in fox shit. Ah, the joys of dog ownership.

Revisiting Donegal

To mark the end of summer we headed to Dunfanaghy for a short break. T was keen to revisit places where she had holidayed as a child. And my first holiday after moving to NI nineteen years ago had been a cycle-tour of Donegal. The weather forecast was for rain, but we struck it lucky. On each day of our trip the sun shone brightly, the sea sparkled and the hills gleamed. Whilst there was the occasional rain shower too, they soon passed and the sunshine was restored.

We stayed at The Mill in Dunfanaghy, an award-winning restaurant with well appointed rooms. It was formerly a flax mill and then the home and studio of Frank Eggington, who painted acclaimed watercolours of Donegal. The Mill is run by the grand-daughter of the artist and her husband is the head chef. Paintings line the walls throughout, many by Frank Eggington himself, alongside collections of oriental pottery. Our room looked out over a reed-lined lake towards Muckish.

Building on a succession of awards for its food and hospitality, The Mill won the prize of best restaurant in Ulster this year. It offers a six-course menu. You relax in armchairs in the lounge and make your selections, appetite whetted by home-smoked olives and a small glass of gazpacho. For my starter I had goat from Horn Head on a bed of finely chopped bacon and potatoes. After a sorbet, my main was local lamb, served three different ways: a chop, a steak and a croquette, garnished with samphire and kale. My dessert was lemon tart with lime sorbet coated with meringue. Afterwards we struggled back to the lounge for coffee and petit-fours. And after a sound sleep we went  down to an indulgent breakfast, with home-made carragheen, preserves, stewed fruits and breads, followed by the best fry I have ever tasted, with organic meats, duck eggs and home-made potato bread.

No wonder The Mill has won so many awards, every course of each meal was extremely well prepared and presented. After such luxurious repasts we needed to be active. On the first day we went to Ards Friary and walked around the coast and into the Forest Park. It is a very unspoilt peninsula: just sea, sandy beaches, rocky outcrops and trees. Across Sheephaven Bay you could see the long strand of Tramore and the developments around Downings.

On the second day I went cycling, as T searched for the old haunts from her childhood. She drove me to Creeslough and I cycled to Carrigart then across the new bridge onto the Fanad and around the coast to Fanad Head. As I arrived a rainstorm began, just as it had nineteen years before, and I ended up sheltering under the same trees. After half an hour it cleared. I then returned via Milford and around Mulroy Bay back to Creeslough. I had forgotten how hilly the roads of Donegal are. I had climbed to the top of Slieve Donard in the 52 miles I covered. By the end I was so tired that I had to rest on the bed before I was able to summon the energy to go down for the evening meal.

On the third day we went sightseeing. T delightedly showed me the places she had visited the day before. We drove and walked around Horn Head, got fantastic views out to Tory Island, climbed to the battlements of Doe Castle, had lunch in McNutt’s Cafe at Downings and went walking on Tramore Strand. After we did the Atlantic Drive and then went over the new bridge to Fanad, ending up at the lighthouse. As the sun began to slide down towards the shining sea we had to set off for our return journey. We had packed plenty into our break and we were pretty tired. But it was good to know that all these riches were only three and a half hours drive from our house. And the past was not such a far country.

Tour of Meath

This sounds like a cycle race. But it was a tour that T and I just did by car. We were exploring ancient sites chosen by Peter Harbison, the former head of the National Museum of Ireland. I was given a copy of his guide book ‘Monuments of Ireland’ as a going away present from my job in England when I left to join Queen’s. The book was given to me by Des, a young colleague from Mayo, and it has been by far the best and most used present I received.

That was in December 1997, during those almost twenty years I have travelled through every county of this island by bicycle searching out the ancient sites he picked out as the most interesting. It has been a process of exploration as many of these ancient sites are difficult to find. They are often in fields surrounded by cattle, behind new bungalows and rarely signposted. You need a good OS map to find most of the sites in the guide and even then some still remained undiscovered.

The Irish approach to antiquity appears to be benign neglect. The ruins are usually left alone and rarely exploited by the heritage industry. I am all for this. I can’t stand interpretative centres with their mock ups and models, as you often get in England, I want to experience the real thing.

We started in Ardee. This is the only town I know with three castles on the main street. They are tower houses. The sort that you got a government grant to help build in medieval times. You find these throughout the Pale. Then we went on to Cruicetown, which was a settlement built by the de Crys family around 1200. They were Normans. All that remains is a ruined church in the middle of a field of cattle with later family tombs in it. We picnicked there using a large flat tomb as a table. Interestingly, over centuries the spelling of the family name changes to Cruise. So is this quiet site now in danger of being overrun by Scientologists and film fans?

The next stop was Kells, which had a large monastery founded by monks from Iona who were fleeing the Vikings. The Book of Kells was said to have been written there in the 9th Century. But the monastery was raided repeatedly by the Vikings and the Irish and burnt and the Book stolen. All that remains of this is a large round tower and four high crosses, most of which are in a dilapidated state.

Travelling back in time, we went on to the Hill of Ward. This is a splendid isolated hill with earthworks. It was said to have been founded by Lug and dedicated to the sacred fire. For thousands of years there were gatherings here to celebrate the passing of autumn and the beginning of winter. In ancient times, all the men of Ireland were called to take part. This was the feast of Samhain, which has been sort of transposed into Halloween. From the top of the hill you can clearly see Slieve Gullion and the Wicklow mountains.

We spent a good while at Trim, the town with the greatest concentration of ancient sites in Meath. It has the largest and best preserved Norman castle in Ireland, which featured in Braveheart (this Australian-Scottish epic was all filmed in Ireland)). Along a lovely riverside path beside the Boyne is a huge 12th century monastic settlement, as well as remnants of a 14th century abbey, town walls and tower.

Then we followed the Boyne up to Bective Abbey, a well preserved Cistercian monastery with a fine cloister. We ended up at Duleek at the remains of an Augustinian priory, where the youth of the town were hanging out, smoking dope and having pizza delivered. They sat on a large flat tombstone and ate their repast. We repaired to the restaurant next door, which happened to be in an old church. It had been a grand day out that had ranged over many centuries, a salutary lesson in learning from the past and living for today.

FODMAP

I’ve begun a diet. I’m not trying to lose weight but to improve my digestion. Over the past year in particular I’ve been getting symptoms of bloating, cramping, wind and diarrhoea. I don’t have these uncomfortable symptoms all of the time, they seem to flare up intermittently and unpredictably. T, who had previously suffered from IBS, did some research into my problems and came up with the FODMAP diet. I’ve tried it for a week and there has been a marked improvement.

The diet originates from research done at Monash University in Australia. They looked at the chemical structures of food and its absorption through the digestive system. They found that some foods were very poorly absorbed and the residues of these foods became fermented by the bacteria present in your gut, producing the bad symptoms. They then classified different foods by how absorbable they were. The FODMAP diet has been tried and tested over the past decade and is now recommended by the NHS.

For the past week I’ve been eating only foods that are relatively easily absorbable and doing my best to avoid those that are not. The FODMAP chart is quite odd. The badly absorbed vegetables include onion and garlic (two foods that I already instinctively avoided) but also peas, mushrooms and cauliflower. The easily absorbed fruit includes bananas and grapes but not raisins and sultanas as their chemical structure is changed by the drying process. You have to keep checking the list. I keep a copy in my pocket

I reckon that my flare-ups could easily have been associated with eating foods from the poorly absorbed list. It’s particularly difficult where processed foods are concerned as you have to scan a long list of ingredients. Indeed many of the sweeteners used in low-calorie foods and drinks are on the avoid list. The research also suggested that having bowel surgery (which I had a year ago) was likely to increase the irritability of your bowel.

The recommendation is that you eat only foods that are easily absorbable for at least four weeks to see if your symptoms improve. After that you can try and reintroduce foods from the poorly absorbed list as some people can tolerate some of these, but you should only do this one food at a time.

I’ve found that my symptoms have improved after only one week. Yesterday I went for a long bike ride. Previously all my long bike rides had left me with bloating and cramps in the latter stages. I changed my Kit-Kats and Snickers for nut and cereal bars and ate only dark chocolate. I also took some cheese and oatcakes. I kept the bananas. I was delighted that I managed a round trip of 65 miles through Co Meath without any gut problems. 

Of Mice and Mother-in-Laws

Les Dawson built a comedy career around a series of mother-in-law jokes. A notorious one goes: ‘I can always tell when my mother-in-law is coming to stay, the mice come out and throw themselves onto the traps.’ It was the day before T’s mother was due to stay with us. T suddenly screamed. I rushed from my study to see what was happening. T was in the corridor, one hand to her mouth, the other pointing. Streaking past me along the corridor was a mouse.

The mouse ran into the front room.

We pursued it and closed the door behind us.

‘Now we’ve got it’, I said.

The mouse was lying low.

I slowly moved an armchair and peeked behind it.

T screamed again.

The mouse ran out, along the skirting board and behind the TV unit.

I strode forward, trying to flush it out.

The mouse stayed under cover.

T handed me an umbrella.

I looked quizzically at her.

‘You can bash it’, she said.

The mouse must have heard. It ran across the room and past the fireplace.

T screamed piercingly.

The mouse was behind us at the closed door. It was small and brown and desperately trying to find a way out.

I glanced at the crooked handle of the umbrella and back to the mouse. I didn’t want to kill it.

‘Can we catch it?’, I said.

We scanned the room, there was nothing to hand that would work.

The mouse was running backwards and forwards along the base of the door.

Resignedly, I grasped the umbrella.

The mouse stopped halfway along the door and began to squirm under. It’s rear legs and tail wriggled, then it disappeared.

I snatched open the door and peered along the corridor.

The mouse was nowhere to be seen.

We called him Usain and put down traps. It was the first mouse I had seen in the house for years. The next day T’s mother arrived. The visit went well. Each morning we checked the traps but Usain hadn’t thrown himself onto any of them. In Cyril’s continuing absence, we also thought about putting a poster on the front door: Cat Wanted, Enquire Within.