Monday, 31 December 2018

Beirut, Berlin and Beyond

According to my cycle computer, I’ve cycled on 105 days this year (since April) and travelled a total of 3362 miles with 47500 feet of ascent. That’s the equivalent of cycling from here to Beirut. I’ve averaged 89 miles a week on the bike and 32 miles per ride. Over the same period, I’ve walked 1142 miles (an average of 22 miles a week). That’s the equivalent of walking from here to Berlin. After years of poor health and incapacity, I feel I am getting some of my strength and fitness back.

2018 has been the first year, out of the past four, in which I haven’t been in hospital for major surgery during the autumn. At this time a year ago, I’d been taking opioids for three months following surgery and was about to embark on several weeks of cold turkey (not the festive fowl). Three years ago, I was in hospital on Christmas Day. This change for the better is undoubtedly cause for celebration. Long may it continue.

My last big operation (September 2017) was to repair a problem caused by previous surgery. Thankfully the op was successful and I now have two fully functioning lungs again. The best recovery is walking. Nursing staff force you to get out of bed the day after surgery, and then help you to take tentative steps. When you can walk to the toilet unaided (and do your business) you are discharged.

At home I walked every day, however painful my ribs and abdomen felt. At first this was just around the house, T supporting me. Then we managed short walks outside. Eventually I could walk unaided and embarked on short trips down the lane. After some months, I had graduated to easy walks in Castlewellan and Tolleymore Forest Parks.

As my strength improved, I tentatively began cycling. I started out on easier rides along the canal towpath, making a habit of stopping at the excellent Petty Sessions Cafe. Then I graduated to hillier rides through the lanes and drumlins of South Down. Eventually, in the good summer weather, I took the bike on the car to Louth and Meath for longer rides. My longest ride of the year was in August, a loop through Meath of 63 miles. Normally, I would stop cycling in the winter. But because it has been relatively mild, I’m still heading out two or three times a week and riding 40 miles or so at one go – just because I can. If the mild weather continues, I could soon be in Kabul.

None of this activity has been without pain. My new surgical scar has joined my four old scars and together they can ache pretty badly. I have learnt to accept this chronic pain as the price of survival. I need to use pain relief and grit my teeth, then rest up. I know that attempting activities on consecutive days is out of the question.

I’ve come a long way over the past year in more ways than one. I'd like to thank all the friends and family who have encouraged and supported me on this journey. Your help has been invaluable. Thank you so much. But most of all I’d like to thank the ever dependable and resourceful T, who has been with me every step of the way.

A Happy New Year to one and all.

Saturday, 22 December 2018

Christmas Presents

I received an early Christmas present from the NHS this week. It was an appointment for an investigation. And it wasn’t on my list for Santa. Remarkably, the appointment date was just three weeks after my GP had referred me. Given the extra-long waiting lists in NI, which are worse than in Britain, this appointment appeared at the speed of light. At last it seems there is an advantage to the bad medical history I’ve acquired over recent years – I get put to the front of the queue.

The investigation was a gastroscopy, a camera down into the stomach. I needed this investigation because I’d been having a range of gastric problems since the surgery a year ago to repair my diaphragm, and return my stomach from my thorax to my abdomen. I wasn’t looking forward to it at all. I’d had a gastroscopy seven years previously in the City Hospital and I vividly recalled plenty of gagging and choking.

We had to go to a hospital that was an hour’s drive away, the South Tyrone in Dungannon.  I took an early breakfast then fasted and we arrived at lunchtime. Even though I was having a single investigation, the full admissions procedure was followed: medical history, allergies, next of kin, etc. I was then led from the waiting room into a small theatre. I sat on the table and the doctor sprayed the inside of my throat with anaesthetic. I lay on my side and they put a bib around my throat and connected me up to check my vital signs. I was given a mouth guard to bite on. I began to think of the rudimentary operations that take place in Western films with the patient biting on a piece of wood as their body is cut open. However, the guard had a hole in it and the doctor began to insert a long black tube into my mouth. I tensed myself for the ordeal.

But there was no gagging and choking. The tube slid down easily, almost without sensation. The doctor and nurse were looking at a screen and saying encouraging things to me, like ‘almost there, you’re doing well’. Then he stopped inserting the tube into my mouth. ‘We’re just going to take some samples’, he said. The nurse fed a long thin cable down inside the black tube. ‘There’, said the doctor. The nurse clicked the end of the cable and I felt a slight pinch. They took another sample then he withdrew the long black tube.

The doctor told me that they couldn’t complete the investigation because there was still food in my stomach, despite my breakfast (a bowl of porage) having been over six hours ago. Either I had a slow digestion or it had been slowed by my anxiety about the procedure. They decided I would be rebooked for another gastroscopy in early January, but this time I would be fasting overnight.

What they did find was that I had significant inflammation at the end of my oesophagus. The samples would be sent to the lab to investigate the cause. The most likely explanation was that it was due to stomach acid reflux. But it could also be caused by a range of other things, such as infection. At home I looked up the other possibilities, only to find that the inflammation could also be cancerous. That was a festive present I hadn’t bargained for.

Monday, 10 December 2018

Secret Dublin

We’re back from a day out in Dublin. The city was thronged with Xmas shoppers. T joined them. I spent four hours in a Concern Worldwide Board meeting, which discussed the implications of Brexit for the charity’s work. Every scenario was negative and a distraction from the core mission of helping the poorest of the poor. Afterwards, to clear my head, I went walking in Iveagh Gardens, one of Dublin’s secret places. On the way home, we visited two intriguing exhibitions at the Irish Museum of Modern Art.

The Iveagh Gardens are hidden away between Camden Street, where Concern’s offices are located, and Stephen’s Green. Entirely surrounded by buildings and a wall, it is a small public park in the centre of Dublin that is always peaceful and quiet. The space was once the private garden of the Earl of Clonmel, who accessed it via an underground passage from his Georgian townhouse so as not to have to encounter the great unwashed. Later the gardens were sold to the Guinness family who kept it as their private domain until it was donated to the State as a public park. Iveagh Gardens contains lawns, mature trees, statues, a waterfall and a maze. There is a sunken lawn, which is Ireland’s only purpose built archery field, under which is reputed to be buried the body of an elephant that died in Dublin Zoo.

My walk was bracing, it cleared my head from the madness of Brexit very effectively. Unfortunately, I knew this would only be temporary as the lunacy would keep on going all around us. Cool rain fell and spattered the gravel paths which were already somewhat puddled.  It took me about ten minutes to do a circuit of the park and I saw no-one else. I decided on another lap. The only sound was a bell, which I took to be from one of the trams in the street outside, but it kept tolling until I realised it was the bell of the park keeper who was about to lock the gate.

IMMA at Kilmainham is a little out of the way, but always worth a visit. The two current exhibitions are interestingly related. Mary Swanzy was an Irish Cubist who exhibited at the Paris Salons alongside Pablo Picasso. This retrospective covers the range of her work from cubist pieces to more recent symbolist and allegorical paintings. Wolfgang Tillmans is a German photographer who won the Turner Prize in 2000. His work is intriguing, odd landscapes and portraits that are framed in unusual ways. I really enjoyed his large-scale images from Africa, the USA and South America, especially one of the Sahara. He also had one room sparsely filled with smaller images of an open-heart operation. Several were close-ups of machines with complex arrays of piping, filled with blood, that were keeping the patient alive. Having had this operation seven and a half years ago, it sent a shiver down my spine.

Sunday, 2 December 2018

The Joys of Winter Cycling

Despite the winter weather, I’m still cycling regularly. Two or three times a week, depending on the conditions, I put my layers on: four on my top and feet, three on my legs, two pairs of gloves and a fleece-lined cap that covers my ears. It takes me about a quarter of an hour to get all of this kit on. I feel a little like a medieval knight preparing for a tournament; I wish I had a squire to help me. And why am I doing this? Because, I can.

For each of the past three years I have had a major operation in the autumn. This means that I’ve spent each previous winter in recovery, each spring building up my strength and each summer doing activities, such as cycling and walking. All with the prospect of having to go back into hospital to be cut open and having to cope with the pain and incapacity of it all over again. 

I’m delighted to say that I’m still all clear and there is no surgery on the horizon. So this is the first year that the pattern has been broken and I am celebrating that fact by continuing my cycling into the winter. I don’t know how long I will keep going. I’m not masochistic, I’ve only been going out on the bike if the temperature is above 5 degrees and it isn’t raining. But with the relatively mild winter so far, that has made many days possible. I’m glad to be able to do it at all and I can feel the strength coming back into my legs.Unfortunately, post-operative pain is cumulative and I have now amassed a variety of scars on my torso which regulate how much I can do and how often. 

There is a fellowship of winter bike riders. Even on the busiest routes, such as the Newry Canal Cycleway, you don’t come across many people braving the conditions. We give one another a cheery wave or a greeting and stop to check if we see another rider with a problem. Yesterday on the cycleway I saw only two other riders, one of whom I know well as he is also a member of the Sing for Life Choir. It had been a drizzly morning. I set off at midday, trusting the Norwegian Weather Forecast (which is usually very accurate) that it would soon clear. Unfortunately it didn’t subside until mid-afternoon and by then I was damp and cold, despite it being 8 degrees, having had to go though some shallow flood water on the cyclepath from Scarva to Portadown.

When cycling, you are always colder than the actual air temperature because you are travelling through it at speed and get steadily chilled. In the summer, this is lovely and cooling, particularly when the temperature is above 25 degrees. In the winter, you need to stop regularly and walk around to heat up, or better still go into a warm cafe and have a hot drink or soup. My favourite stopping place is the Petty Sessions cafe in Poyntzpass. Currently they have a very large fir tree in front of the cafe complete with Xmas lights. You always get a warm welcome from Helena Gamble and her helpful staff. The food is great, they do fine soup and Irish Stew as well as fantastic fruit pies (made by Mrs Copeland). Admittedly, it is sometimes hard to motivate yourself to go outside and get on the bike again.