Yet more books and matters medical

Books first: I'm still enjoying Lindsey Davis's Falco series. Last night I finished listening to an audio book of Saturnalia - which is one of the later books in the series. This sees Falco - married to Helena Justina and with two small daughters - trying to wend his way through the Roman celebrations of the feast of Saturnalia keep a clear head, solve a murder and find the missing Barbarian Priestess Veleda as well as rescuing his brother -in-law Justinus. I've also read Venus in Copper - which is number three in the series and have just started number four - The Iron Hand of Mars.

In between forays into ancient Rome I've been reading some more of Patricia Wentworth's excellent crime novels featuring Miss Maud Silver, who knits imperturbably through all her cases and still manages to unravel the mystery by staying, unnoticed in the background. The two books I've read in the last few days are Latter End and Eternity Ring - both excellent mysteries which kept me guessing until pretty nearly the end.

I am currently reading Royal Pain by Rhys Bowen about Lady Georgiana - 34th in line to the British throne - who has a Bavarian princess billeted on her by order of the Queen. Princess Hannelore is the 'pain' of the title. The book is set in the 1930s and is quite amusing and well written. I should have started with the first one but as this one was only 0.99 in an Amazon ebook sale I thought I'd try this one first. I am enjoying it and I think I shall probably go on to read the rest in the series.

Matters medical

My OH - MJR - has a chronic lung condition, lung fibrosis, for which there is no known cure apart from a transplant and for which the only treatment is oxygen. He has been on oxygen at night for the last 6 years and it was increased from 11 hours to 15 hours in every 24 late last year. He also has a portable cylinder for use when he is out of the house.

Every so often he has to wear a machine which measures his oxygen levels and pulse rate overnight and whose results can be downloaded to a computer and analysed. He had one of these machines in March. Yesterday he received a letter saying he could stop using his oxygen because the results of his test in March were good.

My immediate reaction was what??!!!! accompanied by one or two rather stronger words than that. In May he had an operation and it was touch and go whether that went ahead because his oxygen levels were so low before the operation. All the time he was in there they were giving him oxygen - every time he took his mask off to drink the alarms went off. We think on reflection that they may have thought that the machine he wore in March was while he was not on oxygen when in fact it was while he was on oxygen - or that they've got him mixed up with someone else.

He has a pulse-oximeter himself and wore it last night to see what the results were without oxygen and is currently downloading them to a computer ready to print out and send to the hospital with a fairly strongly worded letter. When he was wearing the machine yesterday and just lying in bed his oxygen levels were 88% - a normal healthy person would have oxygen levels in the high 90s. I know when he was first put on oxygen our GP said if it went down to 85% regularly during the day he would have to be on oxygen 24 hours a day.

I'm usually very complimentary of the NHS especially in this area but now I'm getting annoyed with them. In January MJR ended up in hospital because he'd been given too high a dose of Warfarin to prevent blood clots and was bleeding from his kidneys. Once again the GP has done the same thing and given him too high a dose for too long and his INR is dangerously high which means if he has an accident he could bleed to death. I'm keeping him away from anything sharp.

He has avoided hospital this time only because he isn't bleeding from anywhere - well as far as we know he isn't - and he has stopped taking Warfarin for a few days and is due to have it checked again tomorrow. So this is the second time in just over six months that he's been give the wrong dose for a sustained period of time. They use a computer programme to assess the dose but clearly there is something wrong with it as they were getting on better deciding on the dose themselves as it was almost always stable and needed little variation in the number of tablets he took.

We are not happy bunnies.

America and the NHS

No the two things aren't linked it's just the two news items which are hitting the headlines at the moment.

It is an historic day for America and probably for the world. Barack Obama's success in the presidential elections must mark a turning point in American politics. On the other hand you could say that if America is an egalitarian country - as it is always trying to say it is - then the colour and origins or even the sex of the president are irrelevant. It is certainly a triumph for America's version of democracy.

The NHS - the co-payments issue. I do have mixed feelings about this. Yes it seems immoral people should be penalised by having to pay for drugs the NHS cannot afford to fund. I do not think we are creating a two tier system as we already have that in the sense of private health insurance. Also people have always had the option to pay for private treatment if they wish and can afford it. Why not have the best of both worlds?

What does worry me is that drug research, because there are almost always vested interests involved, is not always reported fairly and accurately - see the book Bad Science mentioned in yesterday's post. Patients, when seriously ill, may not have enough information to make an informed choice about which drug is best for them because drug companies are in the business of selling drugs and making a profit. They could end up paying a fortune for something which may not prolong their lives as much as they have been told it will. It must be difficult to make a rational decision in such circumstances.

On the same theme, I have yet to read a story where someone has been denied a drug by the NHS which will actually provide a cure for their condition. Which is food for thought.

Books etc

I finished reading 'In stitches' by Dr Nick Edwards over the weekend and all engrossing it was too. It just shows how people misuse the emergency services as well as showing the heroic work the staff of an A & E near you do. Needs to be read as an antidote to politicians pontificating about how much they've done for the NHS and programmes like'Casualty'. It's written in blog type format and started off life as a blog, so it's easy to read but it doesn't undermine the serious points the author is trying to make. The most important of which is the unintended consequences of arbitrary targets - for example the time limit which means that more people are admitted than is medically necessary to stop the department breaching its four hour target of either admitting or discharging people. I recommend it as necessary reading to see the NHS from the point of view of the people who work in it.

Looking back at previous posts, I have now finished 'Dark Hearts of Chicago' and recommend it to anyone who likes historical novels with a well researched background.

I have also read over the last week or so: Sally Nicoll's 'Bets and the City' about what happened when a novice decides to take up spreadbetting on the financial markets - think Nick Leeson on a smaller scale. I put myself off the idea for life! This is not for me.

I like Catherine Fox's writing - her latest is 'Fight the Good Fight' about how a clergyman's wife in her forties got to grips with Judo. Her style is always humorous but she has some profound observations to make about life in general and about her life as a vicar's wife.

I'm currently reading chick-lit in the shape of Carole Matthews' 'The Chocolate Lover's Club.' It prompted me to search the internet for quality chocolates. They all sound totally drool worthy but the prices are completely OTT - £45 for a box of chocolates?? Not even a big box at that. I'll stick to Thorntons or Green & Black or even my local Lidl who do some very good chocolate at a very low price - 3 longish sticks of 36%, 55% or 80% cocao solids - very moreish without breaking the bank.

I have succumbed in recent weeks to the power of internet grocery shopping. Much though I dislike Tesco I now place an internet order about every three weeks. It saves me so much energy not to speak of diesel and aggro and time that I came to the conclusion it was worth it. I only did it the first time because I was feeling very unwell - a trip in the middle of the night to casualty had rather knocked me for six. I'd nearly passed out and wasn't feeling any better half an hour later. I could not have wished for better treatment - this was 2.00am on a Tuesday morning, so I did not have to wait - blood pressure ecg etc did not reveal anything major except blood pressure slightly too low. My GP suggested a few hours later - I'd been recommended to go as soon as I could - that I might have a virus. I presume that meant he hadn't got a clue and thought I'd recover on my own - which I duly did. But I did feel very shaky for several days afterwards - hence my conversion to internet shopping. I could not fault the treatment I received at the hands of the A & E staff at the Boston Pilgrim Hospital so a big thank you to them. That's UK not USA.

Back to the reading - I still have the latest Harry Potter unread on the pile. I'm not sure why. I'm sure I'll get around to it eventually.

Back to work tomorrow. I know I'm getting ready for retirement when I start thinking that provided I manage to retire at 60 there's only 4 more August Bank Holidays before the happy day. Roll on retirement!