My ankles

I am writing about my ankles because they are the cause of my present inactivity – I am sitting in my kitchen with my feet up on a chair, having taken analgesics (both paracetamol and dihydrocodeine). Having had four operations on my right ankle for osteoarthritis, hree in Hull and one here in Sheffield, I had a fall (due t,;

en my left ankle was very twisted to the horizontal pointing to my right foot), which,, with my right foot, I quickly returned to its normal position, but was sent to A&E the next day.

At A&E they did x-rays, and decided there was a fracture, so plastered the ankle and admitted me to the ward There, an orthopaedic registrar pronounced the x-rays to be normal, removed the plaster, and sent me home in a large boot. A week and a half later, reviewed at the fracture clinic wuth new, weight-bearing x-rays, they clearly saw a fracture, technically a “Maisonneuve” fracture, comprising a nondisplced fracture of the fibula and tibio-fibular joint, and the deltoid ligament.

I think the lesson from this mix-up is to pay attention to the “history” (the patient’s story) – I really did see my foot at right angles to normal, and reduced the dislocation there and then. When asked if it was very painful I had replied, “I don’t remember” which may have de-valued the testimony, But I had just fallen down, in a bus shelter, and may not have felt much pain,

Mr Chris Blundell, my orthopaedic surgeon who did the last operation on my right ankle, did the surgery yesterday, screw fixing the tibia-fibular joint and the detiod ligament. He advised me hat I could weight-bear “immediately”. The nerve blocks done by the anaesthetist were active until about 3am this morning, when I was woken with pain, and, despite paracetamol and dihydrocodeine 30mg, walking is pretty painful. I have been referred to the wonderful Sheffiled Enablement Team for chronic neurological conditions, and also to Community Physiotherapy.

Carnoustie

Janet and I bought this flat in Carnoustie in 2009, nine years ago, soon after I retired, and have never regretted it. It’s a haven of peace, a castle of solitude if I need that, but equally a place to host family and friends. We have several longstanding friends in Dundee, dating back to when we lived here from 1979 to 1984. This was my first academic post, as lecturer in General Practice, under the late Prof Jimmy Knox, and Campbell Murdoch, who now lives, retired, in New Zealand.

Tomorrow I am invited to Sunday Lunch with friends John and Gill, whom we have know since the early days, when John was the very excelent Orthodontist who corrected Emma’s teeth. We were also part of the same church in Dundee, where John and Gill continue to play key roles. This is the Steeple Church ( http://www.thesteeplechurch.org.uk ) where I dropped in yesterday and spent a very happy hour with the present minister, Robert Calvert (who very recently gained his PhD in theology in the Netherlands!).

We talked about making church more accessible to the “unchurched”, that vast majority of city dwellers for whom church is at th very least distant, and at worst, threatening. I told him of the recent changes at Christchurch Stannington, where instead of a regular 10-30am sevrice of Communion every Sunday, we now have on the first and third Sundays each month a cafe-style service, with round tables seating about 8-10, and related activities for the children. The first Sunday in called “Explore” and deals with absolutely basic core beliefs, as an introduction to the Christian Faith for those completely unfamiliar with it. The third Sunday’s service is called “Connect” and replaced the “Messy Church” held monthly in the afternoon. This service is about growing in the Christian Faith, and like the Explore service, we encourage discussion at the tables, after the short talk.

Steeple Church reaches out in its own ways, by employing two Parish Nurses, whose roles resemble a District Nurse with elements of Heath Visiitng and Counselling. The premises are used by other organisations, which is of mutual benefit, as the is some income for the church. There are regular meetings for prayer, and a mid-week gathering, where the topic is as likely to be concerned with the environment as with personal salvation. This echoes what Robert was telling me, that he viewed salvation as including the whole earth, a theme well known to another hero of mine, Professor Tom Wright, of St Andrews University.

I will add a couple of poems I wrote at Carnoustie, which may have appeared here before, but which, if so, deserve repetition!

Carnoustie beach

Lapping waves splash gently on the shore,

a soft wind strokes my cheek 

and makes a low swooshing sound against my eardrum.

The light forces my eyes to squint against its brilliance

as it reflects off silver sand and sparkling sea.

A swallow shoots past, a gull flaps and soars,

sparrows chatter in the dune grass,

a willow tit chirps its abrasive voice,

and the waves softly lap against the gentle shore.

Above me clouds assemble in a congruence of gloom,

far away to the north east, white and fluffy overhead, 

almost black in the far distance. It looks like rain.

And still the soft waves gently lap the sloping shore.

From the darkening sky silver gobbets spatter the windscreen,

the road submerges under watery sheets,

flumes of spray squirt sideways from lorries, and visibility falls. 

And at the beach the waves continue their lapping.

But summer showers soon stop and sun shines,

the clouds again assume their picturesque beauty,

and all is calm. The gently lapping waves 

still tickle the beach, teasing the silver sand to sleep.

Peter Campion 22/6/09 at Carnoustie, Angus.

Psalm 84

Familiar walls of chalky stone

silently absorbed centuries of prayer

prayed in silence, or in chorus,

or spoken by one for many,

in such well-remembered words. 

Walls and rafters, space and time, 

enfold a living, breathing, praying 

body, Christ’s own, sublime,

his hands, his voice, his feet,

his salt and light, his disciples.

Solid walls but open doors:

no gate to bar the sheep

from entering this fold.

Not really enclosed,

but embracing all, for his sake.

One day in your presence is

far better than a thousand anywhere else.

I had rather stand at the door of your house

than spend my time selfishly elsewhere.

My place is with you, O my God.

Peter Campion, after Psalm 84.  20^thAugust 2009.

More on PSP, and holidays planned

Coming close to the end of August, and I am glad to be able to say that I am doing alright, apart from a recurrent inguinal hernia, which is being operated on next week. As I’ve had at least two such operations before, I fully expect to be up and about the day following, and perhaps I’ll even get to the Amnesty International letter writing session later the next day. I have taken on the duties of arraning these from October, so I’ll ty to get there!

PSP continues to cause me to fall over, but no more than a year ago. In fact, I seem to have learned ot to cope with it so the falls worry me less. There is certainly no evidence of progression, as far as I can tell. I am however very dependent on my two lovely daughters, Emma and Rachel, and their respective spouses, Jamys and Phil, who tend to feed me at weekends, and do my garden and other jobs midweek.

I am in the process of arranging for three holidays (!) in the next 6 months: I’m going to China in October (fly there, High Speed Trains between cities), then a short cruise to Casablanca, Spain and Portugal at the end of November/start of December, an finally another “rail” trip with son Tom to India next February. I will write about each as they happen. I suppose I’m thinking I had better do these things before I deteriorate, and it’s too late!.

It is almost a year since my dear wife Janet died, and so far I’ve managed to survive grief, partly though writing poetry (below). I’ll write more on this next time.

Sonnet on life after Janet

My life goes on, I live alone, I miss

her very much, today I used her purse:

I think of her sheer sensibility,

her wisdom, when it came to what to spend.

My Janet seemed the embodiment of wisdom,

I’d ask her how we should respond to pleas

from Christian Aid, or Barnabas, or Tearfund,

and usually her number exceeded mine!

I shall continue to be guided by her,

remembering her words restraining me,

her generosity to those who need it

her deep concern for those with less than we.

My Janet showed the kindness from above

And I was most blessed to have been her love.

Peter Campion, 12/10/18

Wood Turning

Thursday evenings, alternate weeks, are SHEFFIELD Woodturning Club nights, which I always enjoy. We have two sorts of session: either “hands on”, when lathes and other euipment are set out, and senior members tutor less experienced members; or a demonstration, usually by an invited expert, when we sit in rows and watch an expert actually making a particular piece, and may also have examples of finished work.

Tonight I took along with me most of my chisels, hoping that Graham, who had been tutoring me for the two previous hands on sessions, would be able to show me how best to sharpen my tools. He was, and I now have blades not only sharp, but shaped like Graham’s own tools, which I had used previously. He had taught me to angle the gouge quite differently from the way I had done it before, and which did lead to “snatching” and unintended cutting.

I shall now return to the piece I was working on, to try and recover a useful shape, using properly shaped and sharpened bowl gouges. I also have the task of buying a “jig” which holds the gouge in a suitable fixed position against the grindig wheel, and is really essential for accurate grinding.

Easter

I’m heading for Carnoustie the Easter, just for a few days. Being on my own, without Janet, still gets to me, usually when I’m sitting in my armchair and imagine she is in the other one, but when I look here is no-one there!

Looking forward to seeing again my Hull friends Lily and Waleed, from Sudan, although Lily likes to think of herself as Ehiopian (which of course she is). They have promised to take me to an Ethiopian restaurant in Sheffield.

I wonder whether they know that the leader of Sudan has been overthrown in a military coup.

PSP further explored

Had a valuable evening session at the Crown & Glove with my dear friend Andrew, during which we reflected on how I have reacted to the diagnosis of PSP – to which everyone who has any sort of health connection expressed deep sorrow! I do feel people feel sorry for me, yet I still regard it as a challenge, a cognitive challenge to avoid falls at all costs, and a physical challenge to strengthen those muscle grouos which at present are noticeably weak.

Then we discussed our sehared eoxerience of prostate cancer – in my case treated five years ago by radical prostatectomy, with regular follow-up showing undetectable PSA, and in Andrew’s case “watchful waiting”, with the possibilty now of a slight rise in PSA, about 5 (normal).

More on PSP

I have no doubt, having read several reviews incluing the up to date diagnostic criteria, that I have PSP. I fell today in the kitchen, with hardly any trigger, just tipped backwards and staggered, until I fell on my bottom against a settee. I managed, with difficulty, to get up immediately.

I am worried that the frequency of my falls, and the general weakness, are progressing fast. I shall try to monitor closely how symptoms my progress. I see my GP next week. I hope he understands.

The other concern is dementia, clearly a feature of PSP, but since I managed the Guarian Quick Crossword in ten mintutes, I can’t be that bad!

“PSP”

PSP is easy to say, clearly stands for something else, but does not yet fall into the realm of commonly understood abbreviations. Indeed it may not sound familiar to many medics, yet it represents a syndrome (a well defined collection of symptoms and signs) first described in 1964. PSP stands for Progressive Supranuclear Palsy. The first word is fairly clear – people with this condition have median survival of 9 years from onset, that is to say, half will die less than 9 year for onset, and half will live longer. The second word is complicated – the “nuclei” are a part of the brain stem, and in the post-mortem studies of the brains of these patients, abnormailities are found in this part of the brain stem, above the bits tnat control eye movements. “Palsy” is an old word for paralysis, or weakness, and this is a key feature of the condition.

PSP seems to be casued by the accumulation of an abnormal substance, “tau” protein, leading to loss of brain cells. The reason for this “tauopthy” is unknown, but the genetics are being explored. There is no suggestion that the condition is inherited or passed down the generations.

My illness, initially labelled, is is commonly the case, as Parkinson’s Disease, first showed itslelf when I kept falling off my bicycle, more than two years ago. The second neurologist who saw me, Professor Bandmann in Sheffield, said at out first meeting that he wondered whather PSP was the diagnosis. On our third meeting, last week, he expressed a high degree of confidence that this is what I’ve got.

The main features of my illness that fit ths diagnosis of PSP are akinesia (slowness in inititatng movement), loss of control of balance, seen mainly in frequent backwards falls, and possibly a reduction in downward gaze.

I have been greatly helped by using a walking frame, initially loaned by the excellent physio Department, and more recently a 4-wheeler bought from the very excellent Wicker store in Sheffield. This has brakes and a seat and goes outdoors, and fits easily into Ton’s Smart car. More controversially, before the PSP label was so firmly attached I acquired an electric assisted tricycle, which I ride with complete abandon, travelling independently across Sheffield. The “complete abandon” is quite possibly another feature of PSP – a psychological dysfunction due to the brain disease where control is lost of risk.

I’ll add more later.

“Call the midwife”

I’m watching the new series of “Call the Midwife” on BBC1, a programme which Janet used to enjoy bacuse it is so reminiscent of the time she was a pupil midwife in Camberwell, South London, and then a midwife in the East End. The verisimilitude is remarkable, and the way the writers combine medical accuracy with sheer compassion is quite extraordinary.

I admit that a tear came to my eye as I began to watch the programme, and wanted to call Janet that it was starting. I am coming to terms with my bereveament, and am looking forward to my holiday, cruising up the Amazon, in a few days.

There follow two poems I wrote eight and twelve years ago respectively.

Lost embryo (written in 2010)

So looked for, hoped for, prayed for,

that not yet in existence entity

conceived, yet not yet, 

this concept-child of their dreams,

assisted by gifts of eggs, of sperm, 

sometimes even a womb. 

In vivo to in vitro, to vivo again.

But this life is so fragile,

these fleeting embryos give up 

the struggle for personhood,  

and potential parents grieve

the loss of the child they craved 

but will now not know.

Let the children

(written in 2006, from Mark 10:13-16)

As newborn babes they barely breathe,

need ventilators, drips, and tubes;

so helpless, weak, without defence.

Let little children come to me:

my kingdom comes for such as these.

A baby’s cry seems so intense,

insistent, loud, it never ends

until that baby’s needs are met.

Let little children come to me:

my kingdom comes for such as these.

In simple trust a baby smiles

at those who feed and clothe them, change

their nappies, look with loving gaze.

Let little children come to me:

my kingdom comes for such as these.

Once Jesus lifted up a child

and said to followers then, and now 

(who may have missed the point of faith):

Let little children come to me:

my kingdom comes for such as these.

Peter Campion, 16^thApril 2006 

Leaving Carnoustie, alone

I’m on a train going home from Carnoustie, and today I have felt grief more acutely than for a while. If Janet were with me we would be on the train together, and if she was at home I’d have phoned her about my progress, and also would surely have told her about my near-miss errors, such as buying a ticket for yesterday, and discovering it yesterday evening when I went to the station to pick up the ticket from the machine. I phoned the Cross Country call centre, and I must say the people there are so very helpful. The woman reassured me, and then managed to cancel the ticket and issue a new one, with a full rebate due after I post the unused tickets back to them.

I just miss talking to her, about this and that. Rachel knows this because I have now lumbered her with this role.

Theresa, my next door neighbour in the flats, drove me to the station, and to my horror, carried my bags onto the platform! She my age at least! Oh well, give me grace to acceot help!

I thought I’d put a poem up on this site, but I can’t see it, so here it is, apologies if it appears twice…

 
 
                                    Widowerhood
When Janet died, I became a widower,
wrote it on many forms, when asked for marital status.
I live alone, spend less on food, employ a cleaner,
and paid a lawyer to update the Land Registry.
 
Simply telling people has been a strain:
I can’t assume that people know, but how 
do I know who doesn’t know? I sent emails, 
and have a list of those who sent “condolences”.
 
I bought a Christmas e-card, not expensive,
which let me write a Christmas wish to many:
the e-card enabled me to send a hundred cards,
and less than twenty by post, to dinosaur friends.
 
“Condolence”, meaning to be sad alongside, 
comes close, except mostly I don’t feel sad.
But this is good, not paralysed by grief,
as surely many others are, my life goes on.
 
Grief does impose, as when I go to talk, 
To share a thought, ask her what she thinks. 
Sometimes I weep, when talking about her 
and say, “I believe she’s with our God in glory.”
 
And often then I will recount a reason
why time is different for us and God:
God’s time embraces, surrounds, enfolds
our linear time, as fish bowl contains the fish.
 
God sees what we think has not happened yet:
Janet has been judged, and welcomed home, 
because she trusted Jesus’ sacrifice for her,
and she’s with that “great cloud of witnesses”.
 
I do miss Janet, miss her caring love,
her friendship, foresight, sheer preparedness. 
She was so sensitive to the needs of others, 
Oh, how I need to be like that!
 
Peter Campion, 2019 (written four months after Janet’s death).