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Thursday, October 23, 2014

Away from Berkhamsted

Not wanting to stay within a town centre we decided to leave Berko and head up to the summit level at Tring. There had been a stoppage along the cutting as an Ash tree had fallen across the canal and we had in mind there might just be some wood left for us.
Lack of boat movement and the fact water is pumped up from below ground has resulted in the usual crystal clear water.

 The recent high winds from the tail end of hurricane Gonzalo snapped this mature Ash tree. Amazing how quick it all disappears once a stoppage notice is published.
 We still had quite a lot but it is very wet and will need to be split and dried.
 Jaq helps make the pile bigger. This is about half of our total cut so worth the journey.

No sooner had we moored for the night when along came London`s most popular couple and two of our favourite people. Doug and James on Nb Chance.

We would also like to add our thanks to Robert on wb. Wind in the Willows who I missed off my last blog post(Jaq was not amused). Robert thanks for looking after the boat and topping up the batteries while we were at the Royal Free.

Wednesday, October 22, 2014

My on/off relationship with NHS contiues

I`m not sure how far around the world Margaret Thatchers 1980 speech traveled,  from which came that slogan "the Lady`s not for turning" but here in the UK it is still in the minds of millions.
Relax everyone, the blog is not going political but love her or hate her I am in the same frame of mind. She had made her mind up as to her goal and would battle through the obstacles. Our goal is still the same; to get the surgery's finished, recover and go cruising over great distances. This crew is not for turning.

Ok all breathe out here`s what you were hoping to read from line one.
Yesterday I was phoned with a new date for surgery, Nov. 3rd, and was told I would be phoned this morning, they phoned mid morning, with the hotel reference number. I can`t knock the efficiency of the Royal Free as to making appointments and returning phone calls. Sadly the number of beds and the workings of the NHS are not under their control.

  • The UK had 2.8 physicians per 1,000 people in 2012, compared to 4.0 in Germany, 3.9 in Italy, 3.8 in Spain, 3.3 in France, 3.3 in Australia, 2.7 in New Zealand and 2.5 in Canada.
  • The UK had 2.8** hospital beds per 1,000 people in 2012, compared to 8.3 in Germany, 6.3 in France, 3.4 in Italy, 3.0 in Spain and 2.8 in New Zealand. 
  • **It was 4.2 in 2003. USA was 3.3. LINK to bed facts.
  • NHS net expenditure (resource plus capital, minus depreciation) has increased from £64.173 billion in 2003/04 to £109.721bn in 2013/14. Planned expenditure for 2013/14 is £113.035bn. 
  • The money spent per capita on NHS services in England has risen from £1,287 in 2003/04 to £1,979 in 2010/11.  
  • Link HERE to all above Red NHS facts.
 All of us can offer some theory about what happened to this country since the time it was Great Britain to the present UK. As with politics, religion and what toilet is best on a boat we must all agree to differ and not fall out.

What I can say as it concerns only me is that although I have two of Mr C`s squatters on my Liver their days are numbered. I am not in imminent danger of dying and another ten days will soon pass. Jaq will as always will nurse me back to health and we will get on with our plans. As for the Stoma reversal that can wait, having been using the side door instead of the back for a year now a bit longer is no problem.

We have been over the past 14 months had our set backs and cancelled surgery is not new to the crew of Nb Valerie. Jaq has taken this badly because as an American health is dealt with pretty swiftly. Me? I probably like most Brits are totally frustrated that having paid for something getting it delivered is a nightmare, customer service once again letting us down.

Overall our NHS is in a bad way but it has and will continue to perform some pretty remarkable things for a lot of people. Nothing is perfect in this world and it never will be so my advice is take it as it comes, don`t stress as that might kill you before your illness.
With people like you all out there and of course my Jaq I feel strong not only in body but mentally as well.
The advice I give to the grand kids is "if you don`t like something change it as you only get one life so don`t mess it up"

Ok see you all next time I`ll be here fighting my corner so a big thank you for all your support.
Hi to the guy that walked by and said hello Valerie, like your blog.
The couple who stopped by for a chat, names have gone, school run!!! met you before.
Lovely A who came aboard for lunch.
K and S who are taking us to lunch later in the week.

Thanks to EVERYONE worldwide.

Monday, October 20, 2014

A Hard Day's Night

"The sudden disappointment of a hope leaves a scar which the ultimate fulfillment of that hope never entirely removes." ~Thomas Hardy, British writer

   Here we go again, five steps forward and nine steps back. It was with guarded optimism in my bosom that I helped Les pack our bag and get ready for our overnight stay in London last night, prior to checking Les in at the Royal Free Hospital this morning for surgery to remove two cancerous lesions and thirty percent of his liver. 

   (Most folks who follow our blog are well aware of the terrible debacle we both faced this very week last year when Les was undergoing surgery and recovery for bowel cancer. It was my first experience with the NHS and it left me with a bitter taste that hasn't disappeared. Those who wish to do so may read or re-visit those hellish posts here and here.) 
    The Premier Inn is located behind and just across the street from the back of the Royal Free Hospital. I guess I should have recognized Sod's law in action at the check-in desk when we gave the girl the reservation number provided by staff at the RFH, and she brightly chirped, "Michael Biggs?" Correct reservation number--wrong first name. 
   We dropped our bags in the room and headed off for a walk around the neighborhood and up on Hampstead Heath, scoping out restaurants along the way which we might consider for dinner later. After a bracing walk through Autumn leafy lined lanes, and a good stroll across the Heath, we settled on dinner at the hotel restaurant.
   Although it was my birthday, I was too tired to give much thought to celebrations. Not only did I have Les' impending surgery on my mind, but a phone call from the States earlier in the day informed me that a best beloved very close to me has also been diagnosed with cancer. I am back to sleeping only four hours a night and the dark rings under my eyes are testament to that old survival mode which says life is once more a struggle to endure and sleep only comes with exhaustion. 
   After dinner we went back to our room and indulged in deep, hot, sensuous....baths (you thought I was going to say sex didn't you?!!).
   As anyone who lives aboard a narrow boat will tell you, for most of us baths are a pure luxury. Not only is there no room for a tub in a bathroom four foot square, but a tub takes too much water--hot or otherwise. On NB Valerie three minute showers are the norm. So we each had a turn soaking in a steaming hot tub full of water.
   Afterwards we were instructed by an NHS leaflet on preparing the patient for organ surgery, to use one packet of Clinell surgical wipes and wipe the patient's body ALL over, allowing five minutes for skin to air dry before dressing--once after a shower the night before surgery and again in the morning before coming to hospital. Wiping done, I watched as Les ran back and forth in front of the bed flapping his arms like a kid, until we both fell into fits of hysterical laughter. Les did warn me when he proposed in 2010, that he loved to laugh and we would be doing a lot of it; he has kept his sense of humor--or humour--whichever you prefer, as well as his word.
   Soon it was time to drink the Pro Nutria pre-surgery carbohydrate drinks which are a part of "accelerated recovery." We watched Downton Abbey, the BBC news, and then turned out the lights and lay too edgy to sleep, cuddled like spoons in the dark. 
   Our phone alarms went off at five a.m. and it was time for Les to drink his final two pre-surgery drinks before we dressed, gathered our belongings, and headed off in the early morning dark to walk across the street, down a back drive way and into the Royal Free Hospital. 
   Up on the third floor and through a door marked Day Surgery and SAA (Surgical Admissions Area) we were met with a wide hallway lined with chairs full of patients with clipboards in hand, filling our paperwork. We approached the check-in desk where a woman with a face like a slapped ass barked at Les as he gave his name, "wait your turn."
   She then called out "anyone who hasn't finished checking in please approach the desk." After six minutes of studiously ignoring us, she finally turned to Les and demanded to see his letter. Well we didn't have a letter as he was contacted by phone for everything. She sourly turned on her stool, sorted through sets of paperwork and finally found his, sighing, "Well no are inpatient aren't you?"
   While we sat down to double check and complete the admissions paperwork she handed us attached to a clipboard, the enclosed area suddenly heaved with a tangle of more than fifty patients and their loved ones, queuing awkwardly at the check-in desk. Les duly queued as well, handed his clipboard and papers back in, and we found a chair down the hall in a quieter section. Eventually his name was called and we entered a small room divided in two by a pleated paper curtain.
   It was here we met two very nice, bright nurses who came to double check Les' admission paperwork, take his blood pressure, swab him for MRSA, and explain the pre-and-post-surgery process, followed by a quick visit from Professor Davidson who looked bright eyed and bushy tailed, the anesthetist and other members of the surgical team.
   We were both highly challenged to hear what was being said to us over the chatter on the other side of the curtain which left us privy to all the personal details of some other patient--a woman whose surgery will include some plastic re-constructive surgery with skin flaps; might as well not bother with paper curtains and pretend privacy...
   A phlebotomist came 'round and Les had his five minutes of terror and severe discomfort (he has a deep phobia of needles) as vials were prepped with labels and the needle inserted, and then moved around a bit after which four vials of blood were drawn. So far, so good we thought despite the rude woman at the main SAA desk, everyone else was cheerful, polite, engaged, and ready to get the surgery started. 
   A lovely enhanced recovery nurse came and had a long chat with us about what to expect after surgery and she took my phone number, promising to call me as soon as she knew anything about Les' condition. We were ushered into a large lounge down the hall with big, overstuffed recliners and asked to wait while they double checked with the floor matron who booked ICU rooms. Sit we did and wait, for two and half hours after which we were called into the previous small room, met with a member of the surgical team and informed Les' surgery was canceled as there were no ICU rooms available! 
   The young surgical tech explained that over the weekend other hospitals who had no room for critically ill patients had delivered them to the RFH and as a consequence there was no room available for Les. The booking matron had to decide who needed the rooms most--someone who had just come through surgery at another hospital--or Les, who was considered "healthy and not in need of a bed." I pointed out that my husband--told he required immediate surgery on his liver to remove metastasized bowel cancer--was not well at all or he wouldn't be there waiting for surgery.
   The technician explained that we would be contacted with another possible surgery date hopefully within a week as Professor Davidson operates Mondays, Wednesdays, and Fridays. I asked if his next surgery date could also be canceled at the last minute for lack of a room and he apologetically said yes. He also informed us that Professor Davidson had fought tooth and nail in an effort to procure ICU lodgings for my husband--to no avail.
   Basically we were told that a full team of surgeons, technicians, nurses and an operating theatre stood by for two and a half hours waiting--for nothing!! Add the cost of the hotel room (£112) and our out-of-pocket costs for train fare to and from the boat, bus fare, dinner, and breakfast for me and it quickly becomes a VERY expensive scenario underscoring once more the inability of the NHS to function efficiently while wasting tax payers' money.
   Meanwhile back in the States my loved one who received a cancer diagnosis last week was operated on Saturday and the tumors were removed. This despite the fact their health insurance isn't the best by a long shot. This person is a member of the working class poor in America and still gets better, more timely health care than Les can receive--and they haven't paid years in advance for it either, while the government gains the benefits on the interest of British citizens' hard earned wages over decades.
   I am tired and I feel fragile. I've spent a year fighting for Les' life against this ugly disease. I've fought my own battle against it twice in the last eight years. I've lost a brother-in-law two weeks previously to liver cancer and been told one of my very best beloveds in this world is facing their own battle with cancer; and I cannot count on the NHS to function efficiently in Les' case...I've been told to "be of good cheer, remain hopeful, don't let it get to me, be patient"...but I am all out of understanding, patience, hope, goodwill, and cheer. My teeth ache from gritty determination and I long for a system I can count on in a time of desperate need. I know this too will pass, but not without leaving me with more scars on my soul.

Sunday, October 19, 2014

Happy Birthday

Happy boothday coopercake.(private joke)

Sorry Jaq but for the second year running my surgeries have dwarfed your birthday. I will as you know make it up to you. Thanks for my life Jaq. Love you.XXXXXXXX

Saturday, October 18, 2014

A little sleep and all`s well.

Nervous? who me, no no no, it`s just another surgery and I had one a year ago two days past.
Yes of course I`m nervous and very edgy as it seems going into major surgery for the first time last year is not quite the same as this one. Five to six hours on the table and minimum of 24 hours in intensive care is no walk on nearby Hampstead Heath.

The liver performs more than 500 different functions in the body. As part of the digestive system, the liver aids the body in fat digestion, manufactures and secretes bile, regulates the levels of chemicals in the blood, synthesizes proteins, filters waste products from the bloodstream, and receives nutrient-rich blood from the gastrointestinal tract and either stores or transforms these nutrients into chemicals that are used elsewhere in the body.

It weighs about 3 pounds and the 30% they will remove equates to about a pound. I must state now I do not recommend this as a diet, perhaps six hours jogging on the Heath would be an easier option to lose a pound.

The last few days have thankfully been hectic, less time to think about Monday, with many jobs to be completed, the wood stove being the last to receive some attention. It`s been swept had the new throat plate installed and the fire cement around the chimney collar replaced. The latter is something I do each year as vibration can cause cracks in the cement that are not visible. Just chipping out the top layer and inserting fresh give peace of mind even though we have smoke and carbon monoxide alarms.
Today I`ve been into town 3 times and to the rubbish bin across the canal twice. All totally unnecessary but just kept me occupied. Yep nerves. 

Jaq says her FaceBook page is alive with prayers, good wishes and positive thoughts from all over the world. Thank you all. Jaq will of course keep updating both blogger and FB.

Always worth a visit to nearby Hampstead Heath when attending the hospital. There must be ten or twelve ponds across the heath. No canal boats but there is one for model boats. Three swimming ponds, womens, mens and mixed.
I remember as a kid when living in Paddington my dad bringing me to the heath on holiday weekends where the fair would be spread half way across the heath.

Below some pics when I went for the recent pre-op check up.
Walking up to the heath from the hospital.

No.1 pond

Mixed swimming pond

No.2 pond

Zippos circus is visiting
 Ok this is a boating blog.
Nb Valhalla stopped opposite us for water today. 

Wednesday, October 15, 2014

Life in the Fast Lane

"I wanted to be a veterinarian until I saw a video of a vet performing surgery on a dog. Then I decided I wanted to be a pianist." ~Amy Lee

   All righty then! The staff at The Royal Free Hospital are totally on top of things. When we met with Professor D and his assistant on October 7th, we were told that Les needed to come in the following week for a pre-op appointment after which surgery would be scheduled sometime between then and November 2nd.
    Les was called by phone last week and an appointment was booked for pre-op and fitness assessment on Tuesday the 14th of October--yesterday. Off he went on the train down to London. My phone rang an hour and half after Les' scheduled appointment time. It was Dear Sir whose quavery voice informed me that he passed his pre-op and fitness exam with flying colors and his surgery was scheduled for Monday October 20th. That is next Monday!!!
   Since we live on a boat and have to travel from so far away to get down to London, Les was told the RFH would book us a room at the nearby Premier Inn for Sunday the 19th, and someone would follow up with the details. Sure enough my phone rang this afternoon about 1 p.m. and the staff person on the line said the room had been booked and she gave us a reservation number. Job done!!
   The difference between this experience and our previous horror show mis-adventure last year at Watford General Hospital is like the difference between margarine and butter. This folks is the real deal--quick and efficient service such as one could get in the States which places the needs of the patient front and center, which begs the question: if the Royal Free Hospital--which is a part of the NHS--can operate with 21st century efficiency (not one single letter has been mailed; all appointments had been made over the phone or in person--imagine!!!) why can't the rest of the bloody surgeons, doctors, nurses, clinics, tests, hospitals, etc. etc. etc. which are also a part of the NHS bring their daily operations into the 21st century and begin functioning efficiently as well? It seems the true answer is "because we don't want to; we don't like change." 
   While Les was in London I was at home trying not to stew and keeping busy. I washed two loads of clothes, changed the bed linens, defrosted the freezer, cleaned out the cupboards, brought out winter clothes and put away summer duds, prepped an online Tesco order for delivery tomorrow, graded student coursework and answered emails. 
   I also took some time to enjoy nature. Slapton is a lovely quiet place at this time of year. Ours was the only boat moored below the lock. I saw a blond Mink swimming, and three Cormorants fishing together; two adults and a juvenile. 
   Les arrived back home last night in a total tizzy. He's nervous and edgy about this next operation and who could blame him given the debacle that occurred last time? My tizzy concerns being a mountain woman traveling alone in and out of London. We made a dry run of it last week to meet the surgeon. I will purchase a weekly rail pass and my Oyster bus pass is topped up. I'm sure I'll figure it all out and be just fine. It's just a huge jump for someone who was born in the Alaskan Territories and grew up pretty much in the sticks. I'm trying to view it as Jaq's big adventure.
   We have a list of things that need doing before Sunday so we are people on a mission--which is great because it leaves little time for ruminating on the future. 
   Each day has its specific goals which will see us preparing the boat and stove for winter, registering as a temporary patient at Rothschild Surgery in Tring, making a trip to Watford to pick up some packages and mail from our daughter-in-law, getting a Tesco delivery-check, filling up with diesel and coal-check, and moving the boat each day until we reach Berko where we will moor while Les is in hospital. From there the rail station is a five  minute walk with service pretty much all day and night.  It takes about 40 minutes from there to Euston Station and a quick 20 minute trip by bus to hospital.
   The day before Les is released from hospital I will move the boat up to to where we were last year this time, so he comes home to some place quiet, dark, and peaceful where he will begin recovery and we will have easy access to visiting nurses, Tesco deliveries, water and rubbish. 
   In our new food habits, we have made the acquaintance of Quorn vegetarian meat fee products made from mycoprotein. The chicken flavored products are delicious and we are working them into our menu which includes lots of veg, fresh homemade bread and yogurt and a raft of supplements.  I'm adjusting old favorite recipes to meet our new dietary habits which is challenging and fun. As they say over here, "A dog is not just for Christmas--it's for life." Just so with our new eating habits.

Sunday, October 12, 2014

Things that need attention now!

 The Vetus water lubricated cutlass bearing is fantastic when it doesn`t leak. The bit that leaks is the brass coloured piece with the prop shaft exiting on it`s way to the gearbox coupling. Within the unit are two rubber seals and all that`s needed by way of lubrication is some silicone grease.
The cutlass bearing receives water to cool it and any excess will pass up the black tube next to that Red valve and exit via the weed hatch. Trouble has been the water has been getting past the rubber seals and dripping excessively.
 Many years back in 2007 I called out a Vetus engineer to fix the same problem. He had no explanation other than it had been fitted wrongly as to why it was leaking on an 18 month old boat. Anyway having watched him change the unit it was quite clear I could do it easily. So I made sure I kept the old unit and just purchased some new seals at just a few pounds per pair. The complete part from Vetus is £98 ($156).

The seals fit one in each side of the unit
Over the years I have changed the unit twice and done the job on a friends boat.
Previously removing the unit let water come in at a steady rate. Not a "we`re gonna sink" rate but about a half bucket full. This time I picked up a tip on the canal forum that said that tying of a piece of rag around the prop would slow the rate of water.
The trick worked and less than a cup of water came in at a fast drizzle.
So back in 2007 again in about 2011 and now today is not my idea of a decent system. The engine alignment can make the unit leak but mine is perfect with the prop shaft needing no guidance as I slide it back from within the weed hatch into the gearbox coupling.

Just something that needs attention before the surgery as I will be in no condition to do much for a few months.

Next job will be putting the glazing film over the insides of most of the windows to stop the condensation and help keep the warmth in over winter. Last year our friends Ken and Sue (Nb Cleddau) did the job while I was having the bowel cancer surgery.

Final job will be the wood stove that needs a new throat plate that should be on it`s way now.
We have fuel arriving in the form of diesel and coal via Juels fuel boat that is due on Tuesday. Hoping to find some more wood in the next few weeks but that is not a certainty so I can see our wood pile being depleted before winter ends as my wood cutting post op will be nil for quite a while.