The note that crept in

As systems are wont to do

Not that he needed to eavesdrop,
Nor stand at a door kept open with a prop,
It was written between the lines,
The new realities it seeks and clearly defines,
As they whisper in hushed tones,
The citadels shiver with the moans and groans,
A moment of indiscretion,
Brings forth the stark facts of a revelation,
Obviously, an explanation was sought,
Then came an apology to stem a rage to report,
Maybe it is still in process,
Before we make it something we confess,
And some time of just waiting,
Your breath belaboured and then abating,
What the future holds is heaving,
Trust the Lord to keep in the land of the living.

Telling new tales again in blood

Just for the blood

I winced in nearly excruciating pain as the phlebotomist tried to extract 10 vials of blood from my veins and was most assuredly doing it from a muscle or tissue in my arm. The flow had stopped early and the wriggle room she found was a bruising stab with push and ease to fill the vials with blood.

This was the most ever that had been extracted for tests since I attended a follow-up consultation for my biannual checkups. In my discussion with the consultant registrar who saw me on Wednesday morning, I presented all my concerns with the results I had been getting for the past 8 months to determine any trends to address issues early.

Before giving blood, I was asked for a urine sample, the colour was richly white wine yellow and not too bad a bouquet, as I explained to the nurse to account for the fact that I had a prostate biopsy a few weeks ago, and this might affect the quality of the urine sample. It was however the most painful blood clinic I ever attended.

Even when they could not find blood and I had been punctured to the effect that I could pass for Swiss cheese, pain was never a component of that experience as this was, the comforting just-a-scratch statement before you are stabbed with a hypodermic needle was replaced with the phrase, ‘almost done’ and there were still 5 vials to go. It was her poor technique and nothing to do with me having latent or actual belonephobia, which could easily induce the fear of medical procedures if I remember the staple gun sound of the biopsy procedure.

Turning up and turning out

However, the day started slowing with what was a night of not enough sleep and as I planned my journey to the hospital, I decided on an easier ride that took me through backroads I have walked many times but never plied in a vehicle. The driver was the first of many who complimented me. The desire to present a sunny disposition regardless of the circumstances remains one I enjoy.

As I stepped out of the vehicle when we got to the hospital, a nurse stopped me in my tracks too and with her compliments said words to the effect, “It is nice to see a gentleman take the time to dress up nicely.” It might be a hospital where we all come to a humbling of our humanity, but that should not mean the absence of humour, goodness, brightness, and something to put a smile on people’s faces. I think my mere appearance did as much for some.

More than miscellaneous

Having printed out my notes from that last visit that needed updating and corrections, we dealt with my health, my welfare, my social situation, the many questions I had, the opportunities for a new line of therapies I was not ready to assume until I had read up on the study. Strangely, medical decisions had been made to include this in our regimen even as Europe, Australia, and New Zealand, along with China and Japan did not have any participants in the cohort study. I had my misgivings.

As I asked for another serum folate check which determines whether I have a folic acid deficiency, another one could not be booked as there had to be a 90-day lapse from the last check in the hospital systems. I then realised that my general practice and the hospital shared the same blood laboratory. The hospital had visibility of all the results, whereas my general practice could only see the results of the tests they had ordered.

The integration and agglomeration of systems cannot come sooner, they need to be reading from the same set of data, not repeating tests to confirm situations. I sought and got an alignment of my pill regimes which had gone askew since 2018 but had me putting in a new prescription for one of them last month because my usual April – October consultations had drifted to November – May, and now is on a June – December biannual cycle.

It was a nice outing to the hospital, not much bruising in my arm and I caught up on much-needed sleep.

Men's things - VIII

Interpreting bloods and dreams

In preparation for my biannual consultation today, I printed out sheaves of information for which in the analysis I would hope to have satisfactory, convincing, and comforting medical assessments of the situation. Like the kings of old, their dreams then and our blood results today, need interpretation. They hold some keys to the future.

The bloods have been telling wild stories of rage and range that has led me into many lairs of the medical establishment for observation, through inspections, radiography, biopsies, and another set of appointments and scheduled tests. It is tough if a king cannot remember what they dreamt, just as it is difficult if you cannot review your blood and other results to ask pertinent questions.

Silence is never an option

Having a long-term health condition you have effectively managed for about 15 years gives you some experience handling how doctors relay or disseminate information. You have to read the obvious and then read between the lines. In the UK, they are not as direct and forthcoming as our Dutch neighbours, they are reserved though a certain cohort is abrupt with a patrimonial bedside manner.

The Dutch are interventionists, they do not wait and see how things develop, they go after the issue with alacrity and immediacy. I recall my Dutch doctor saying, “This looks serious, I have to refer you.” She was already on the phone making appointments and speaking with urgency, I could be in no doubt about the seriousness of the situation. When I saw the professor, a few days later, he said, “We have a bed for you upstairs.” That was the beginning of an 18-night stay in the hospital in September 2009.

That compared to how three different health institutions vacillated for almost 3 years on a co-morbidity that could be treated and then I was put on new therapeutic drugs, but this was after I had a conversation along the lines of, “I am well aware of my mortality, what are you going to do about this co-morbidity?”

We have to talk about it

Regardless of who you are seeing, it is evident you must have a good understanding and grasp of your situation and give full voice to your concerns unrelentingly until you get satisfactory answers leading to hopefully, your desired outcomes.

Next week, I will be attending a follow-up consultation to discuss the results of the transperineal prostate biopsy I had just over 3 weeks ago. What has been scheduled has left me almost falling off my seat. There is a multidisciplinary team (MDT) with the qualifications of pelvic and urology along with the elephant in the room, who have set something up for the day after with no detail and this has an expiry of a year hence. As it comes under the topic of upcoming tests and procedures, I am left wondering, is this adopting a wait-and-see approach, or there is really nothing to see, and we are just in close monitoring?

You can bet I have many questions for all my follow-up consultations, I am not a tough customer, just one who knows what everyone should know for themselves. “It is my body first before it is your Guinea pig.” Selah!

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NB: I use bloods to mean blood tests.

Thought Picnic: Taking a sniff at the stalk

A stalker strikes again

There is a saying that could be haunting as it could be disturbing, but rather than consider the saying it is the thought of being stalked or watched without knowing that you have featured as a target in a sniper scope.

Without being confronted, you are affronted by an invasion seeking to upset and discombobulate, someone aims to remotely control your every move inducing a sense of paranoia and caution leaving you wondering whether you are safe from harm.

I have navigated many such stalking episodes over the years that go back decades and have had experiences of attempted blackmail, threat of exposure, or possible embarrassment. I have addressed many such occasions with the resolve that I will not allow myself to be compromised and become a pawn at the behest of some cowardly agent seeking to cause distress.

Scuppered by recalcitrance

Where I could have had an ally and supporter in these issues, there has been a blank refusal to share pertinent information to help terminate the ability of such nefarious persons to sow discord and distrust. It is their prerogative to decide what they think is best even after persuasive arguments have been made to suggest a united front against an unseen enemy against using such material to insinuate betrayal.

One thing I will not abide with is chicanery by those who should know better. I can be impulsive as much as I can be decisive. What seems a done deal can quite easily be cancelled, I will not stand for threat, innuendo, or inference. I am deeply invested, and I can also cut my losses.

The less said, the better

I suppose I will not be treated as an adult, as I am being confronted with the undertones of an allegation. In that case, I will not cower in the fear of dread of being found wanting because of some failings that could both be expressed in the propensity for a liaison without essentially acting on it. An alter ego can be an outlet for certain frustrations, it separates the real from the imagined.

Many emotions are difficult to express in the kind of directness and detail demanded, however, I will not address this elsewhere. To say I am annoyed is an understatement, when I choose to be silent over expressing my thoughts, I have decided to be foolish, dumb, defenceless, and incapable – it is sometimes the smartest thing to do. You never know, when the time is right, what was left unsaid will have more than any impact imaginable.

Trains, bloodstains, and brains

A deathly train smash

You are always trying to figure out what persuades people to bring it all to an end. Our sorrowfully sympathetic inclination is then put upon by the public stage they have adopted to bring the screaming crescendo of existence to the deafening silence of an ignominious end on a busy intercity railway line.

You do wonder if this was deliberate, a murder perhaps, or an accident. Only some days before, the transport police published a YouTube video of a near miss at a railway crossing.

A pedestrian in a pique of nonsensical urgency had clambered over the lowered barrier gate, ignoring the flashing lights or the siren to cross and be on their way. Just as a speeding train missed sending him splattering into oblivion.

Easy living interrupted

Over an hour's wait of being detained on our train at Milton Keynes Central railway station, we were told that the remains and quite likely in many places had been removed and we might soon be proceeding to London having enjoyed the train company's generosity of a free bottle of still water.

You cannot be left in any doubt, that the incident of a human being impeding a fast-moving train is almost always irrecoverable. The definiteness of being a goner is as sure as the going is quite gone that we can agree the person is totally gone.

In the aftermath of it

We may never know the name of this victim of seemingly untenable circumstances that defy understanding. That we are caught in this temporary delay for the eternal departure of another should neither be seen as selfish nor selfless, for but the grace of God go we.

There may be regrets as there might be mourning. The emergency services attending another gruesome sight that might haunt or leave them inured, after witnessing similar tragic endings and cleanups.

As we pray for the repose of the soul of the too swiftly despatched, may journey mercies attend us to our destinations.

Life can be a fleeting thing, O that we may have the joy of living to be thankful regardless of what experiences we have had. I arrived safely over 2 hours behind schedule, I am grateful for life, security, safety, and hope.

Men's things - VII

Now I know the time

Only yesterday, I was writing about waiting for the next appointment to discuss the results of the adult histopathology labs ordered on my last visit after the transperineal prostate biopsy which leaves little room for comfort at the thought of it.

This morning, a new appointment arrived in my mailbox with a link to the hospital trust portal where you can review what is expected of you on your next visit.

It sheds no further detail apart from the name of the consultant I might be seeing and the option to bring a friend or relative along. The reliability of ‘friend’, the one who was to accompany me for the biopsy is questionable and no fault of his beyond the apparently recondite lack of facility.

Needing someone to lean on

I might have to inform my neighbour as she upbraided me sternly for not letting her know I was off to the hospital for a quite involved procedure.

Strangely, in preparation for the other visit, I was informed of the one-stop-shop service, I cannot recall the suggestion to bring someone along, it was loaded with possibilities without indicating any actualities, which makes it seem ominous that I might need a shoulder to lean on.

Obviously, I would be asked to produce a urine sample on demand or under duress before I see the consultant who trained in Manchester and holds several supervisory positions in clinical, educational, and training institutions. In my earlier feedback, I remonstrated about not being given the full details that informed the decision to do a biopsy until I asked questions and asked to see the MRI scans.

In my own time, at my own pace

I have resolved, whatever the outcome, I will take my time to decide on the next steps. For what it is worth, no one would want to lose the efficacy and function of the prostate gland and on one of those sessions where I heard a talk on prostate health, one of the speakers did say there is expertise to ensure it is not totally excised that you become a eunuch blessed with a protuberance.

That thought alone, I should banish from my mind. I already have my delayed biannual checkup scheduled for June and a week later, this one. Better to just think of the summer of love and the beauty of the flowers in fields and meadows. What bliss, what bliss indeed.

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Lever whatever forever

Some broken hearts do mend

Sometimes, I am caught in introspection and think about what makes a day significant that I might not recall. As I stepped out of the bath this morning, after my shower, two things came to the fore.

The passage of a week and what might have been a 51^st birthday but sadly a posthumous one, and almost 15 years since he passed. You are reminded that there are people who for the time they were in your life, for good or bad, and no matter the length of time, you cannot forget.

Whilst I rarely now think of Christopher Clark and less so of what could have been, for the time that I knew him and the headiness of silly that I acquired in my dealings with him, I know how just the chemistry between people can disarm, that any reasonableness is lost to deep emotional connection.

Let yourself be human

On reflection, I wonder how I got caught out, yet I am glad I allowed myself to be vulnerable, to be a fool in love, to understand that sometimes I need to break away and protect my heart as some dealings reveal the depth of your fragility. You learn tough lessons about relationships and even think you will never let go again.

Never is a funny reaction, it is for that moment most of the time than forever. I rarely ever think in the never, because, if ever something else presents, what you sever out of never is not usually the lever to whatever happens in the ever beyond the present. Putting things behind you for the possibility of being surprised and offered the opportunity to do something new must be one amazing pleasure of life.

With life there must be a readiness to enjoy, to find and understand love, to have that fragile heart handled by such caring hands and to embrace the wonderful that many miss or never see. Any other questions and there are many that course through your mind like dodgem cars in an amusement park, you’ll find the answers to, along the way.