Kaleidoscopic Lights

Weekend
It was a Saturday morning..
[Ed: If I may interrupt.]
Why?
[Ed: I've been thinking..]
That's new..
[Ed: I noticed that you will every now and then drop some medical terms into the narrative.]
Yes if I remember rightly I will use some clinical terminology. Is that OK?
[Ed: Yes of course. I was just wondering if I should give some background information via links to our Colloquialisms / Background page.]
Didn't think we had one!
[Ed: We do now.]
Ok, but don't go mad with it. Now can I carry on?
[Ed: Sure.]
Good. Now where was I? Oh yes.

It was a Saturday morning; I was working on the computer at the time to get some paperwork finished. While starring at the screen a small ring with a band of psychedelic pulsating and shimmering triangles appeared off centre in my right and only functioning eye. It looked like a diamond with the edges flickering in the light as if it would rotate. If I tried to look directly at it, it would move off and react like those floaters one gets in the eye.

It was obvious that this phenomenon was going on in my head and not in my eye but I still closed it to make sure and of course the light show was still there. The ring slowly expanded allowing me to see through it with the band of triangles staying the same width. Over what was maybe ten minutes the ring had expanded to fill the perimeter of my eye and then it slowly disappeared out of sight. Of course I couldn’t find a picture of what I saw as it was, let's call it an ‘irritation’ of my primary visual cortex. The closest representation I could find was the picture on the right.

In the meantime I had turned off the computer and had gone down stairs. I thought it could be a circulation problem so I measured my blood pressure which turned out to be normal. After the lights had gone I took it easy for a few hours. As I get quite concerned when it comes to my one and only working eye, I made a mental note to go to my ophthalmologist first thing Monday morning and let her have a look.

Its typical, things turn up like this at the weekend or on Friday evenings. I was at my routine visit only the week before and my retina was okay, only my cataract needs removing sometime. I’m dreading this as the logistics is a little more difficult when you don’t have a second eye to help while the other one is bandage up post Op.

On the Saturday evening we were out with friends for a meal. On returning as I was approaching the front door it started again and followed the same route as before. Not as intense as in the morning and maybe a little shorter in duration before disappearing off the optical stage. My level of concern went up a notch as it wasn’t going to be just a one off visionary experience.

These kaleidoscopic effects can appear due to ocular migraines. Thankfully I have never had migraines. My mother had them her whole life, the banging one's head against the wall type. Well the rest of the evening and night was without repeats.

Sunday morning we took a drive to our local lake to take a walk around it. As we left the car the skies opened up and it started to hail. The temperature dropped rapidly from 14C to 7C and so we quickly returned back to the car. As we were sitting there listening to the hail battering the car roof the ring of triangles appeared again and followed the same routine as before. H drove home and I took it easy for the rest of the day.


Monday
So first thing Monday morning we were at our ophthalmologist standing in line waiting for the surgery to open. She had a good look at the back of my eye and found a few minor capillary bleedings and in combination with my three ‘sightings’ at the weekend decided it could well be a TIA, a form of mini stroke.
I felt alright in general but I didn’t feel like I was going to play it down, quite the contrary, as she had also diagnosed a TIA by H a few years before which was later confirmed by a neurologist. She said I should go to our ‘house doctor’ and get hooked up for a 24h ECG and BP monitoring. She wrote a note for our doctor and we left and went over the road to his surgery.

I’m not sure how it is where you are but here on a Monday morning surgery waiting rooms are jam packed. I put a mask on and found myself a seat while H went and made a ruckus at the desk insuring we wouldn’t be sitting around half a day due to not having an appointment.
H came back and sat in a just vacated chair and gave me what looked like a smile, which was difficult to interpret as she also had a mask on. Well it looked like she had made an impression as within ten minutes we were called in.

He looked at the note from our ophthalmologist, listened to short version of the weekend ‘sightings’ and decided, as he didn't have the appropriate monitoring equipment, that it would be better to go immediately and see a neurologist in our local hospital.
He printed out some of my latest medical reports, got through on the phone to a Dr. WH, the head of the neurological department and explained my case. After the call he said I will be expected at the hospital ASAP. We thanked him and we were off.

The only possibility to see anyone officially at short notice at the hospital is to go through the emergency room (ER) portal. The problem is it can take up to three to six hours (from previous experiences and metrics) before you get looked at. Quicker of course if you are wheeled in with limbs are unreal angles or blood soaked bandages.
But walking in of one's own accord and looking like you will not spontaneously collapse, usually means a lot of sitting around and looking at a large info screen waiting for one’s ticket code to appear, and then wandering off in the direction of the room indicated.

After a five minute drive H let me out at the ER entrance and drove off to park the car in the multi-story car park. I didn’t wait for her as it would take some time to park and return so I went straight into the ER area.
As I was ‘expected’ I naively went directly to the window where two receptionists were sitting in what looked like a semi-fortified room with panzer glass. As soon as one of them stopped shuffling paperwork around and looked up I stared to speak but was immediately interrupted with a silent wave of the hand in the direction of the ticket dispenser.

I smiled indicating I understood the gesture turned went over to the machine and pressed a tiny lost looking red button displayed in the middle of an oversized touch screen.
Nothing happened.
I tried again, and again nothing happened.
I was about to attempt a third press when a man sitting a little way off said “Just a quick tap” as I looked at him he gave me a smile. I returned the smile and with a quick tap at the screen, as if it might bite me, a ticket appeared with a murmur from a slit beneath it. I removed the ticket, gave the man a nod and returned to the reception window.
I showed her my ticket and as she waited I pushed with difficulty my paperwork through a small slit in the thick glass and said the magic words “Dr. WK is expecting me.”

She looked up at me, I smiled. She, still unimpressed, looked back at my paperwork and then pointed at the ticket in my hand and then at the info screen taking up most of one wall in the waiting area. I took this to imply that there was no overhaul lane in their procedures and I was to comeback when my number appeared.
So I took the hint and as there were no seats facing the screen I moved away from the reception area allowing someone else to get the same silent treatment I had just received. I then just stood around waiting while keeping an eye on the screen and comparing acoustically announced new codes to the one on my ticket. I hoped H would get back to the waiting area from parking the car before I disappeared into the inner sanctum of the ER.

Unluckily my code came up within two minutes and so I returned back to the glass wall I had just left. I was directed to a large door next to the waiting area and told to go and sit in the ‘Red Area’. H was nowhere in sight so I approached the over large door which by the look of it was used to wheel in and out bed laden guests. As it didn’t open automatically as I approached it, I looked around for an optical sensor to flap my arms about in front of.
I saw some way back from the door on the wall a large flat oblong button held in place with what looked like at least half a roll of red duct tape. I went over and pressed it with the palm of my hand hoping the door would open before the button fell off the wall. The door swung open in my direction and I had to step back pretty quick to stop it colliding with me.

There appeared a long corridor with staff wandering about but no indication of this ‘Red Area’. That is until I looked down and saw what was probably the rest of the red duct tape roll stuck to the floor. It divided the corridor from an open area off to the left with a few seats in it. I took it that this was the ‘Red Area’ where I was to take a seat and wait.
I entered and found an elderly person occupying one of the seats. He was alone and grumbling to himself. I decided to take a seat a little way off, donned a mask and did my best to ignore him. He had a small suitcase with him so I suspected that he was also waiting to be ‘processed’.

Suddenly a door open directly opposite to where we were sitting and a name was called out from within. Our grumbler acknowledged this with a "Here!"
The voice from the void half shouted "Then get yourself in here, I’ve only got ten minutes per patient!"
Our grumbler grumbled something under his breath stood up and with case in tow entered the room with the door closing quickly behind him. Well as I was the only other person sitting in the Red Area I speculated that I should be next and in ten minutes at the latest.

Without looking at the clock I had the feeling the timing was correct as the door opened and Mr. Grumpy was ejected and immediately with case in tow wandered off deeper into the ER catacombs. As I watch him I heard my name, pronounced correctly for a change, emitting command like from the room.
I stood and entered giving the nurse a smile which prompted her to say "So, I haven’t that much time.."
“Ten minutes I hear.” I answered.
She looked up with “Correct. Strip down to your trousers”.
I did as I was told and sat down on the hospital couch indicated with gesture of her head.
I looked around.
The room was small and gave the impression that it was primary a storage room for unused equipment and racks of small med. articles and on second thoughts used as an examination room.
The nurse browsed quickly though the paperwork that had been handed through from reception and then asked me why I was here. As she had just looked to see why I was here, I humoured her by starting to explain what had happened at the weekend up to arriving in the ER. As I was talking I was wired up for a five channel ECG, finger clipped for O₂, blood pressure taken, a shunt added to my left arm and blood taken from my right arm.

After finishing my narrative, which I suspect was only to stop me from asking stupid questions while she was busy, I was allowed to dress. I made sure I didn’t get tangled in the ECG cables still stuck to my chest and steer clear of the shunt protruding from my left arm. As she was finished before my ten minutes were up, probably because I hadn’t interrupted her in her work, she accompanied me out into the corridor.
As she pointed down it to the far end, she said in a friendly manner “Go to the end turn left and look for the room of Dr. WK”. I thanked her and was off.

I found the door and was about to sit down on one of the chairs outside when Dr. WK arrived and after a short conformation of who I was she asked me to wait a moment and she would come out and get me. She then disappeared into her room. I had a quick check to see if H had messaged me on my phone, but no, nothing. Almost immediately the door opened and I was ushered in with a friendly smile.
She asked me about the symptoms that lead me to go to my ophthalmologist and what she had found. Following this she went through the classical NIH Stroke Scale/Score (NIHSS) test (eye movements, strength, reflexes and sensors etc.). As the result showed nothing acute we talked about next steps.

As there were a number of examinations that still had to be done I had two possibilities. Out patients or stay in hospital until the tests were done. Out patients would be time consuming due to difficulty getting appointments and would entail a lot of time in waiting rooms. ’In patients’ would be more effective time wise and with the added benefit of being under observation and monitored for the next 48 hours.
We both decided it would be best to stay. I thanked her for her time and while she made arrangements for a CT and a bed in the Stroke Unit, I went out into the corridor to try and contact H.

She answered to say she was still in the ER waiting area because nobody behind the panzer glass could be sure where I was. As I was giving H alternative directions to the one I took to get to my present location, Dr WK came out and gave me the ok. I thanked her and went to intercept H on the way to the Radiology dept.


Computer Tomography
On arrival I was immediately shown into the CT room. I removed my shoes and coat and was then asked to lie down.
After a few adjustments getting me comfortable, which is always a problem with my curved back, they asked if I was allergic to intravenous contrast material. I thought about it for a moment and said I had no idea. I had two other CT previously that year one for my lower back and one for my right foot but without contrast material.
I asked for the name of the material they were going to use so I would be able to name it next time if I ended up reacting to it this time! Well I didn’t react following administration apart from my bladder wanting to spend a penny and as l promptly forgot the name they gave me as I was leaving, I’m back to square one when it comes to answering the allergy question before the next CT.


Stroke Unit
So after getting my head scanned it was then off to the Stroke Unit. We knew where it was as I had spent a few days there following my TGA in 2017 (see 'A matter of forgetfulness').
We arrived at the control area and I gave my name we were shown to a room with a single bed. Ah! I thought, VIP treatment, not bad.
As H now knew my whereabouts for the next few days she left to go home and pack an overnight bag, my iPad, power packs and a few books and Sudoku's for the duration.
As I was taking a look around at my surroundings an orderly came in and hooked me up to the blood pressure monitor and plugged me into the ECG monitor with the cables from ER.
I wasn’t sure how his German was as he wasn’t talkative and just smiled the whole time. He left, and as it was now midday, returned almost immediately with my lunch, Grünkohl with Mettwurst, a yogurt and a bottle of water.
I was a little surprised that I got something without asking, because in my experience unexpected guests is a concept that usually causes headaches and disruption in hospital kitchens.

Before leaving me to my lunch the orderly thought he had to show me how to operate the communication screen by selecting a TV channel with a football match. I smiled and thanked him, he smiled back and as soon as he had left I selected something else.
Football is the last thing I would watch anywhere.
I tried to connect my phone to the system via Wi-Fi which surprisingly worked without having to identify myself with the system. Then I saw at the bottom of the screen a woman’s name. It looked like she was still active in the system and the hospital admin hadn’t deactivated the account from the terminal. That would also explain the meal turning up as it did, it was probably meant for her!

After finishing the meal I realised I had to visit the bathroom. It was now a long time since my hectic cup of tea before leaving the house that morning. I had two choices. Ring the bell so that someone would come and ‘officially’ unplug me from the ECG and BP modules with a repeat manoeuvre to plug me back in on my return, or do it myself. I decided on the latter. The staff have more important things to do than spend time disconnecting and reconnecting me to the monitoring system.
I removed the tube to the BP cuff, unplugged the ECG multi-cable and went to the toilet room. It didn't take long for someone to come into my room and not finding me call out if everything was ok.
I was a little puzzled with all this concern and then it dawned on me that I was on an 'intensive' ward and not on a 'normal' one! An alarm going off here could have a different level of urgency than elsewhere.
I called back “Yes, everything ok!”
After I returned the nurse was still there.
I said “I didn't want to disturb you.”
She said “No problem, that’s why we are here!”
While she went about reconnecting me I mentioned to her I would need to be regularly away from the monitors, especially at night. When she was finished, she hesitated a moment and then showed me how to turn the ECG off and on again when I was away from the bed so that it would stop the alarm going off in the control room. I thanked her and she left.

After spending some time on the phone with H agreeing on what to pack in the overnight bag, I decided I wanted to watch YouTube on my phone and to check my emails via the hospital Wi-Fi.
Somehow I had lost the connection. I checked the screen and the name at the bottom had disappeared. Ok that meant the previous occupier of the room was deactivated and I would have to log in under my name.

The screen had the possibility to login using a patient's ID bracelet but I didn’t have one as I used the ‘emergency route’ to this room and not the normal scheduled one. The only paperwork I had was from the nurse who gave me forms to fill out on my arrival. On one of the forms there was a label from the hospital with my details and a barcode. I took it that this would be the same barcode as on a bracelet if I had had one.
I activated the screen and waved the barcode in front of what I thought was the pinhole camera. After moving the barcode around a while the system recognised it with a beep and my name appeared at the bottom of the screen! I had connectivity again this time under my own name and not a previous occupier of the room.

Sometime later H turned up and we packed the contents of the case in a cupboard and draws around the room. We speculated on how long my stay would be. There was to be an echocardiogram and a good look at my carotid arteries. I thought if I get one examination per day than I’ll be out Wednesday morning in plenty of time to go to my biannual urology appointment in the afternoon. If I had to stay longer, then I thought rather naïvely as it turned out, I could take the ten minute walk to the urologist and back as exercise instead of being confined to wandering around the hospital corridors.

H left to get home before dark as she hadn’t been driving that much and her cataracts didn’t help when confronted with the star burst of car lights.
Soon after H had left I got a welcoming visit from Dr. B responsible for the Stroke Unit. We chatted awhile and he showed me where on the monitoring tower, which was recording my data, how to dim the indirect wall lights.
He sort of boasted that he was the only one that knew where the switch was. I sort of believed him as it was on the back of the tower under a multicoloured cable salad without a label.

Before leaving he mentioned that on the ECG paper strip from the ER there was an atrial fibrillation (Afib) peek indicated and that it had to be followed up. But until then more data had to be collected. I joked that it was nice that I got VIP treatment in having a room to myself even without being privately insured. He laughed and said that everybody on this ward gets VIP treatment independent of insurance status.

I got the usual hospital food at six o’clock which was two rolls with something indefinable to lay or smear on to them based on either cheese or sausage. Luckily there was also a recognisable yogurt included. I spent most of the evening on my iPad with the constant beep of the ECG monitor and other typical intensive care background noises. Sometimes raised female chatter could be heard coming from the nurses control room just opposite or the staff recreation room next door.

At eight I got my finger pricked for glucose. And as the BP monitor was measuring every hour and it was hurting quite a bit when in action I asked if it was necessary having it throughout the night as it was bound to keep waking me up every hour. The nurse turned the ECG beep off and set the BP interval to two hours for the night. A compromise I could try and sleep with. I read until about eleven and then tried to find a position that would not compromise the shunt arm and minimise the tangle potential with the ECG cables.

The night wasn’t that good. I only slept through one BP action and unplugged myself twice. I don’t normally sleep that deep due to my back problem and being in a hospital bed and wired up didn’t help matters. In addition there was a lot of nightly female chatter coming from the nurses’ recreation room. At about two came the nightly ritual of a nurse putting on all the lights in the room and waking me up to see if I was sleeping ok. Shielding my eyes from the bright lights I mumbled something incoherent and she left wishing me a good night.

Tuesday
I woke at about eight, unplugged myself and visited the bathroom. I got dressed and plugged myself in again. Just as I was about to start checking my emails two nurses came in to draw blood. I prefer it to be taken from my left arm, although it has got a little necrotic from numerous blood lettings over the years, compared to my right arm which tries to hide the fact that it have any veins at all.
As the shunt was already occupying the left arm I suggested they could tap it from there. But no that was not allowed it had to be taken from somewhere else.
One of the two nurses said upfront that if she couldn’t get blood after the second attempt she would give up. And that is what happened. The other nurse wasn't any better and so they decided I would have to wait for the assistance doctor to come and have a go.
Half an hour later she came in introduced herself and without any problem finding a vein disappeared with a couple of samples of my blood.

Next up was my breakfast, well so I thought.
One of the other nurses S, came in with my breakfast and placed it in front of me on my side table. And as I thanked her I did a double take. I had seen her the day before when I had arrived and she had taken us to my room. But today she looked different. I then realised she was wearing full makeup that one would possibly wear for going out in the evening. It looked good but a little out of place for work and in relationship to what her colleagues was wearing way over the top as if they hardly had any on at all.

She left and before I could take the knife to the lonely roll on my plate she was back again. I looked up to one of those smiles where you know there’s going be a request imminent. And I was right.
She said "There is a film crew from Galileo on the ward filming, and they want a scene of a patient getting their breakfast and would I mind being the patient?"
I was a little taken back and as I wasn’t going anywhere I said "No problem."

She then grabbed my breakfast tray and as she was leaving said I must remember not to look at the camera. I smiled to myself as it wasn’t really necessary to tell me that. Almost immediately the door opened and in came S with my tray and the film crew following her filming.
She placed the tray in front of me as before, I thanked her in English and German. She then left and the film crew carried on filming me for another five seconds and then left as silently as they had had arrived. The whole sequence was over in less than ten seconds.
How am I so sure of the timing when I didn’t look at what the crew were doing? Well it helps when one makes a copy of the broadcast from Galileo's online library.

Sometime later one of the crew with a clip board came back and asked if I would give permission to use the film sequence in their report. I said by all means, to which he handed me the clipboard and said I needed to give written permission so they wouldn’t get any possible legal backlash. As I was filling in my data, I asked the clipboard man what was the report about.
He said it was part of a series about different professions, what they earn and what monthly costs they have. This time it was about nurses. As he took the clipboard back he mentioned it would probably be aired before Christmas. He made sure I had signed the form, thanked me and left. I thought that was that, but no, my role as extra was not yet over.

At about eleven I had a visit from a lady from the catering department who wanted information about my eating preferences for the week. I had three choices for lunch and hardly any for what turned out to be a light supper at six o’clock. She noted my choices and even though I didn’t expect to be there long she insisted on taking my preferences for the rest of the week. Soon after she left my lunch arrived. Surprisingly it was what I had chosen that morning.

At about two o’clock S came in and said, slightly embarrassed, that I would have to move to a double room. I had been surprised on arrival that I had got a single room. I suspect it was as no other bed was free at such short notice. And now I was going to be ‘downgraded’. I somehow knew my luck wouldn’t hold.
S explained that they needed the single room for a patient that was in her last hours and to have a place so that her relations could say their farewells in private. As she was not the quietest of patients and needed regular help throughout the night, this was not helping her room partner trying to get some sleep.
I asked when do I need to move and she said ASAP. She said collect everything and throw it all on the bed. So I collected my toiletries as S unplugged the monitoring tower. She took the detached monitoring screen and placed it in the corner of the room and then wheeled the tower out of the room.
At the time I thought the extra removal of the monitor screen instead of just moving the complete tower a little unusual. I collected everything in my cupboard and what was hanging around and deposited it on the bed.

I was just finished when the two nurses that had tried to draw blood the previous day came in and with haste and some difficulty manoeuvred the bed out of the room. I grabbed my half empty suitcase and quickly followed so as to not lose them. The picture above, taken from the TV film, is my bed being wheeled out of my ex-VIP room.

It wasn't far to my new room as the Stroke Unit isn't that large. They wheeled my bed into the room but had to promptly reverse and wheel it out again as the space next to the window was still occupied with a bed plus the dying lady. With a little confusion they got the bed plus lady and her monitoring tower out into the corridor and my bed and tower into the vacant space.

While they manoeuvred the lady and tower in the direction on my now vacated room I entered and introduced myself to the young man in the neighbouring bed. He seemed relieved that his previous room partner had finally left. A nurse later came in to remove the screen that had been erected between the beds as it wasn't need anymore. It’s unusual to have mixed sexes in one room but the Stoke Unit is an intensive care unit and only has 12 beds and so there is a certain amount of compromise needed.

I had just finished storing away the stuff I had thrown onto the bed before my hastily retreat, when I had a surprise visit from a friend who ‘just happened to be in the area’. H must have prompted him where I was and why. As I was telling A about my light show at the weekend S turned up again with the film crew in tow!
She asked if I wouldn't mind taking part in another scene of the film. I said ok and they started to film. This time she was taking my blood pressure, O₂ with a finger clip and blood from my finger for glucose (the picture above is take from the TV film). Throughout this she was stopping turning to the camera and answering questions from a member of the film crew.
She did everything very professionally.

After S left with the crew following her, the clipboard man appeared again. He started to ask me if I would give my permission to use the film sequence when he stopped in mid sentence with a puzzled look on his face. I smiled and said I had already given permission.
His puzzled look turned into a smile as he realised where he had seen me that morning. It was in another room! I think this had confused him and he probably wondered why I was occupying two rooms and if possibly I was an extra hired by the hospital.
His smile turned into a little laugh and as he was about to leave he noticed A sitting a little way off from my bed. He must have realised that A could have been filmed because he asked A if he could have permission to use any of the material if he had been filmed. When A said ok, he got the clipboard treatment.

After the clipboard man had left I told A about being roped in by S as an ‘extra’ for the report and that she was being followed about being filmed and asked general questions about what she was earning and her spending as a nurse. Then it clicked. That was why S was wearing so much makeup; it was for her scenes before the camera! I found out later when I saw the film, that she was the main character of the report.

After A had left I decided to login to the communication screen which I realised was much smaller than the one in my previous room. I took this as a subtle hint that the size of the screen indicated in some way the level of accommodation one received. I went through the barcode registration procedure for a second time and linked to the hospital Wi-Fi. I was just about to relax and check my emails when S turned up with that look on her face.
Now what, I thought!
“Sorry” she said “You have to leave as we need your bed.”
“Leave!?” I said with a confused look on my face.
“Yes, there is a bed for you on Ward Four, room 4018. Sorry about that!”
“Ok” I said, “Shall I throw everything on the bed as before?”
“No” she said “Not this time the bed stays here. There is no hurry; you can take your time packing.”
So that is what I did.

I said goodbye to my neighbour that I had hardly had time to talk to, made sure I had all my things packed and wandered off looking for Ward Four and my room. I thought I would have time to relax waiting for my examinations but until now it had been rather hectic, interesting but mainly hectic, not what I had expected.
As I was wheeling my case out of the ward, I realised my urologist appointment was tomorrow afternoon and I still hadn’t seen anybody to discuss the chance to go or not. Eventually I found the reception room of Ward Four, introduced myself and was shown to my room.
The room was quite large and of the two beds the one nearest the window was unoccupied.
I took this as mine and wandered over and sat on it facing the other bed occupied with a sleeping man in, I guessed, his 80s. I found out later he was 82. I sat there a little reluctant to unpack because
a) I didn’t want to wake him and
b) as soon as I was finished unpacking, someone would come in and say sorry we need your bed..
I thought I would not tempt fate for now and so I occupied myself with logging into the hospital system for the third time using an even smaller communication monitor than before.

After a while Mr. M woke up and we introduced ourselves. He had been here over two weeks until they finally found out what was causing him to lose every now and again control of his head so that it fell forward on to his chest. We chatted a while until he was picked up for a CT.
I spent my time sitting around reading/surfing or talking to H on the phone updating her on my film debut and being thrown out of the Stroke Unit to now reside on a normal ward. As nobody came to officially plug me into the tower I suspected the continuous monitoring was over.

With this I decided to roam about a bit and see if I could get somewhere a cup of tea. I found an area with a few tables and chairs and one of those machines that allows you to select different coffees. A coffee cost money but hot water and tea bags were free. Luckily there was an Assam tea among the selection of herbal teas and it was surprisingly not that bad. This reminds me of other times concerning tea and hospital stays which I will relate about later.
I decided to try and ring my urologist and explain my predicament of being close by but possibly not close enough to be able to come to my appointment the next day. My urologist is on the same campus as the hospital and I could just about see his offices from my window about 230 meters away (with compliments of Google earth). In the picture the red arrow indicates where my room was and the blue arrow the offices of my Urologist.

I spent a lot of time trying to get through, but I always got the engaged signal. After multiple cups of tea and dialling, I gave up. I rang H and we agreed I would ask at the morning rounds how to handle my appointment. The last thing was to miss it as it would mean another half a year before I would get a new one. I had had this problem once before when I was sick and couldn’t go. I had rang up and cancelled allowing my slot to go to someone else, but the next available slot was still six months later. (see 'Mr P and the Appointment'). As I was sitting there Dr. B found me to say he would pick me up later for another examination. I had wondered if my idea of one examination per day would hold. It looked like it would.

I took the opportunity to tell him my predicament with my urologist appointment. My idea was, if I was still here tomorrow, to walkover that is ‘walk-under’, as there’s a tunnel complex on the campus, to my appointment and be back within the hour. Dr. B said that was not possible from an insurance point of view. Inpatients were not allowed to roam about alone outside the hospital grounds and although the medical centre (where my urologist had his surgery) was on the ‘campus’ it was outside the hospital. Also due to staff shortage there was no chance of having an orderly accompany me for the visit.

I then mentioned that I had tried multiple times to contact the surgery but to no avail. I gave him the name of my urologist. He said he would get someone to try and get through, explain the situation and get a new appointment. I thanked him and after he left I wandered back to my room.
I was a little sceptical about if any of his staff would have time to try and phone. On the other hand there was a good chance, if the hospital ever got through, that after explaining the situation and asking for a new appointment that they would get an appointment sooner than if I had got through and asked for one.

On arriving back I was alone and aired the room as best I could. Mr. M was after about an hour wheeled back into the room and took a nap. Later he talked to Mrs. M via the communication screen as his mobile was somehow on the blink. As he didn’t have headphones on I got to hear both sides of the conversation. I got the impression that his wife was the more talkative of the two. I heard an underlying expression of disapproval or disappointment in her tone and she reproached him for not ringing her more often.
His answer was that his phone wasn’t working properly and hadn’t realised she had tried to ring him. He added that now that they could talk over the hospital phone system everything would be better. I heard in her reply that she wasn’t 100% convinced of his explanation.

After the call we talked a little. As he knew I had heard both sides of the call he explained that his wife was 82 like himself and was not mobile without help. This frustrated her and also because he has been away from home for so long. Her moaning was understandable but it still got on his nerves. She thought he was always in his room and when she called wondered why he wouldn’t answer. And as he had been alone for the last week there had been no one in the room when he was away to say that the phone had rung.


Carotid Ultrasonography
One of the examinations that I discussed with Dr. WK was having a look at my carotid arteries to see if there is anything there that shouldn't be. I knew what to expect as I had them checked by my last Stroke Unit visit in 2019.
That is they were checked twice.
The first round was solo from an assistance doctor that asked upfront if she could ‘practice’ while she waited for her chief to come. I of course said yes and that everyone has to learn and she should go ahead and take her time. She was pleased that I agreed.

She spent a lot of time repeating procedures and making a lot of notes. The only unpleasant thing was the pressure of the transducer on the neck when she had to go deeper. From my position most of the time I could see the screen and hear the acoustic echoes characteristic of Doppler examinations.
I know relatively little about neck anatomy and its arteries and unless one is very knowledgeable of the area one cannot relate it to the two dimensional black/white outlines displayed on the screen. One needs a lot of time to become an expert in welding the transducer to look with the correct angle and depth to see what one wants to see and then display the blood flow and take measurements.

After about 45 minutes her chief turned up and apologised for the delay. They discussed what the assistant had done and then the chief went through the whole procedure again in training mode. In total I was there for 90 minutes! Even with an extensive examination nothing was found which was a relief at the time.

So late afternoon five years later Dr. B came in and we were off to let him have a look. On the way he asked if it would be alright if Dr. C (the one who took my blood the day before) could come to give her the chance to observe the procedure. I had a Déjà vu to my last ultrasound described above as I said ok, no problem. I started to wonder if I would be back in my room before my untouched evening meal would be removed for the night.

We arrived at a small room where most of the space was taken up by the ultrasound machine and examination couch. Dr. B mentioned that the atrial fibrillation (AFib) that had appeared in the ECG from the ER on Monday, hadn’t turn up again in the Stroke Unit ECG data.
Dr. B was a little perplexed by this. Still he recommended that I should take an anticoagulant in future and I would get one of the NOACs for the evening and morning.
As I took my position on the couch Dr. C came in. I jokingly ask her if she would like to have a go when Dr. B was finished. She thanked me for the offer but declined and would just watch and learn. I mused that maybe when we were finished I would get something to eat.

Dr. B started and explained in detail where he was in my neck and what he was looking at. I followed as best I could, which was very little, asking a few questions along the way. He gave me the impression that he was fully ok with me asking questions and integrated them into the lesson for Dr. C. At one point he found the stenosis in the P2 segment of the left posterior cerebral artery (PCA) that appeared in the CT.
He showed it to me. It was a contortion act to turn and look at the screen without Dr. B losing the site, angle and depth with the transducer. I saw a small lighter area along the wall of an artery representing the stenosis. It measured 3mm long.

He found nothing else and said my arteries are in a general good condition for my age. After about an hour we were finished, they both thanked me for my patience and as I was about to depart to my room when Dr. C mentioned that she had tried to get through to my urologist but nobody had answered. She then had the idea of sending them a fax!

I was a little surprised with this but as I thought about it I remembered seeing a fax machine in the reception area. I mentioned this to her and commented that there was a good chance of it being seen in the morning at the latest. I thanked her and hoped we would get a reaction.

On my return to my room I looked up the posterior cerebral artery. It supplies, among other regions, the occipital visual cerebral cortex where visual information is processed. Although we didn’t talk about a possible connection to my kaleidoscopic lights, the stenosis could well have been, if only in part, an explanation for them.

Not long after my return our meals arrived. We both sat next to the window and the radiator that was on full blast. Luckily the weather outside was cold otherwise it would have been far too hot to sit there. Mr. M liked having a very warm room, and so I only aired the room when he wasn’t there which was quite often.
Our table by the window had two chairs one a plain stool and the other an armchair. Although Mr. M had used the armchair until then he tried to insist that I use it. I declined and said that as he mainly stayed on his bed over the day I would use the armchair unless we have our meals together. He accepted this arrangement with a smile.
I was pleased that we got on very well together and that we both were not notorious snorers keeping each other awake at night. The meal was as the previous evening, boring. At least I got something even with my unplanned relocation manoeuvre.


Medication
When one has to stay in hospital you are not usually allowed to take your own medications with you, there could be exceptions but I’ve never experienced them. They asked me as soon as I had settled in about my meds. Due in part being dyslexic I can’t for the life of me spell or correctly pronounce medication names even though I worked in a clinical environment for most of my working life.
To compensate for this I have a list on paper with their names, doses and when I take them. In addition to the meds there is a list of all my relevant illnesses, ailments, examinations/results and OPs I’ve had over the years. A sort of concise medical history. I can use this as reference for questions typically asked for, either verbally or in the forms one gets when starting out with a new specialist or having a CT / MRT X-rays etc.

As I wasn’t prepared that morning to find myself ending up in hospital, I only had a version on my phone which I use as reference when I forget the paper version. I showed the assistant doctor the list and she copied it to her notes, she also noted down my medical history.
With hindsight I realised that trying to copying text from a small screen of a mobile is not an ideal way of transferring data. I mention it here because the data transfer was not 100% correct. I will come back to this later.

On the evening of my arrival I got a mini plastic cup with my evening tablets. I eyed the contents critically as i have one more than usual and two of them were not the shape and colour that I normally remove from the blisters at home.
Before the nurse left I asked what the ‘new’ tablets were. She looked them up and confirmed they were correct but as two separate drugs where I normally have the combined version at home.
Mix-ups with meds can happen and I’m wary about what I swallow in hospitals (that includes food unfortunately). The next morning, the same procedure, this time with two unfamiliar tablets. Both turned out to be correct. They were just from different pharmaceutical companies to the ones I had at home and so down they went.

As it was now my second evening in hospital, I received my meds not in a mini cup but in a 6cm wide transparent cellophane strip. Each tablet separate and labelled with my name, patient code, when to take and drug details!
Okay I don’t end up in hospital that often but this was new to me. I looked up what I had before me. The strip was created by a fully automated system called medication pouch packaging.
It seems to take a day or so before one’s presence is registered to get one’s medication so. Had a slight problem to begin getting the ‘pouches’ open so as to not send the tablet off to unexplored regions of the room, but I got the knack of it pretty quick.
The system is much better than asking about unfamiliar shapes and colours of pills. Also I suspect with this method that they were not touched by human hands.

H had decided not to visit as the weather was deteriorating. This turned out to be a good idea as it started to snow early afternoon and continued throughout the night. This was the first snow of the year, but not the last.

The night was much quieter than the previous one. There wasn’t the sporadic background chatter from a staff room next door and, as I wasn’t hooked up, the tower remained silent throughout the night. We still had our two in the morning visitor, but this time with a torch instead of turning on all the room lights. As soon as she received our garbled murmurings to her ‘Everything okay here?’, she disappeared as quietly as she had come.


Wednesday
The next morning breakfast came at a civilised time between eight and nine. As I have my breakfast I will, as I hinted above, ramble on a bit about my experience with tea and hospitals.
It was in the mid-60s when I had to have an eye Op. to reduce the ocular pressure. I was fourteen at the time and the first time in hospital. Ok, fourteen years earlier I was born in the same hospital but I don’t think that counts.
The wards in those days were a large room with up to 10 beds in two rows against the walls. I was the youngest on the ward and I had to wait a couple days before my Op.

As I was pre Op. and didn't have to lie down quietly on my bed all day, I was until then ‘kicked’ out of bed every morning at six o’clock to make tea for the other patients. Of course as this was Britain it was strong black tea. I could never understand why sick people had to be woken up so early! I think it had to do at the time with the three shifts of eight hours for the nursing staff.
At home I never had to make tea, and even if I had it would have been just a pot for three. Here it was a pot for at least ten, with enough for a second cup. I had no idea how much tea to add to the pot. Someone showed me on my first morning but I was still groggy from being woken up so early to take any real notice. Luckily the patients awake gave me hints to the amount of tea and brewing time. This helpfulness was probably self-preservation so they got something at least drinkable.
I wheeled the heavy tea pot around the ward on a trolley doing my best to lift and pour the tea into the cups without spilling any. The pot at first was almost impossible to pick up and pour, after a while it got easier with each cup.

Unfortunately the eye Op. had only a temporary effect and I had to keep taking eye drops to keep the pressure down. Years later in the 80s here in Germany I was again in hospital because of a retina detachment in the same eye. The morning after the Op. I asked the nurse for a cup of tea.
She asked “What would I like, you can have peppermint, rose-hip or chamomile?”
Herbal teas were the last thing I wanted. I wasn’t sick!
I declined, “No thank you, could I have a black tea?
The nurse’s eyes widened as if I had asked for hard drugs!
With a horrified voice “You can’t have black tea!”
I asked “Why not?”
I think with the look on her face that she was not entirely sure and just mumbled something about caffeine, blood pressure and hospital rules. I gave in and let her choose. I can’t remember what I got only that it was wet, lukewarm and had a taste outside my comfort zone.
And now I was again in hospital with a help yourself choice of not only ‘regular’ herbal teas but also the ‘dreaded’ black tea and even coffee!

As I and Mr. M were having breakfast, I got a call from H telling me I had an email from my Urologist with a new appointment in two weeks and not as I expected in six months. So it looked like the fax had worked!
After breakfast Mr. M had a couple of calls with Mrs. M via the communication system with the theme being mainly about that Mr. M doesn’t ring her enough. Mr. M tried to tell her that he wasn’t always in his room and needed the chance to sleep now and then. Mrs. M understood this but was frustrated that she was alone most of the day.

Sometime later Mr. M was picked up for physiotherapy. As soon as he was gone the phone in his com system started to ring. As Mr. M had only talked with his wife since I had arrived I suspected the call must be from her. And with Mr. M just leaving the call would go unanswered and I surmised that Mrs. M would get frustrated again and Mr. M would end up back in the dog house.

I went over to his screen and saw the telephone number that was calling. In our previous conversations we knew roughly where the other lived and as the area code of the caller was from the area where Mr. M lived I suspected the call must be from Mrs. M.
I decided to pick up.

I clicked on the call icon and as I heard the voice of Mrs. M starting to say something to her ‘husband’ I interrupted her in mid-sentence. I explained to her that her husband was not here and introduced myself as his neighbour. She was a little taken back at first hearing an unexpected voice but then after I informed her of where Mr. M was she thanked me for the information.
We exchanged a few pleasantries and I ended the call with telling her I would inform Mr. M on his return that she had called. She was happy with this, thanked me and hung up.

When Mr. M returned I told him that after he had left the phone had rung and as I thought it could only be his wife and as an unanswered call could have further repercussions I took the call. Mr. M was relieved that Mrs. M was happy with my intervention, he thanked me and immediately rang his wife.


Transthoracic Echocardiography
Late afternoon I was informed that I had to go to the cardiology for a transthoracic echocardiogram. As this was my last scheduled examination, it probably meant I would be going home in the morning. As the cardiology was ’in house’ I thought I wouldn’t have to wait and would be back in my room pretty quick, so I just left as I was.
That was a failure.
If you remember I mentioned that the heating in our room was always full on and why. This reflected in what I wore while in the room and for the short journeys to get a tea and fill up my water bottle.
I had left with my thin jogging trousers and a T-shirt. As soon as I was out of the ward and in open country the temperature sank rapidly. By the time I got to the cardiology and sat down outside in the corridor with other patients I was quite cold and it was very draughty due to the window at the end of the corridor being open. I had totally forgotten that it was snowing outside.

I would have probably held out if I was called quickly but by the look of the row of people sitting and standing around I suspected I would be there for a long time. Although I had just let the staff know I was there, I decided to ask if I could go back to my room to get my cardigan and be back in about ten minutes.
They had no problem with this and I was off. Entering my room was like opening an oven door. I dug my cardigan out of my case; I hadn't needed it until then and hurried back, registered my return and surprisingly sat down where I was before.
As I looked around it looked just the same, nobody had disappeared and nobody new had appeared. This confirmed that it was a good idea to have gone back and got something warm to wear. Surprisingly it was only a 20 minute wait until I was called.
I was shown into a cubicle and after locking myself in I was asked to strip to the waste. I exited by another door into a semi-darkened room.
As my eyes adjusted to the subdued lighting I was asked to lie down on a couch on my left side. From my position I had a good view of the monitor and the operator went through what we were looking at.
Now and then he would ask me to hold my breath. When he was finished he informed me, as I was rubbing off the rest of the gel from my chest with paper towels, that I had a mild mitral valve regurgitation.
In other words the value located between the upper left chamber (left atrium) and lower left chamber (left ventricle) was a little leaky. Also the left atrium was moderately dilated. After our talk I was allowed to get dressed and return to my room.

I was back in time for the evening meal. As before bread with something to lay or smear on to it. I also got my strip of ‘pouched’ evening tablets. In the strip was the new NOAC anticoagulant. I was a little sceptical in taking it as Dr. B gave me the impression of not being 100% sure if I needed it with the one off AFib curve.
I decided to delay taking it until the morning and my ‘debriefing’ with the Cardiologist. I spent the rest of the day with reading, talking to H, watching YT videos and catching up on unfinished samurai Sudoku's.


Thursday
In the morning I don't remember our nightly two o’clock visitor, maybe she had been there and I had got used to being triggered to mumble in my sleep or she was now on day duty waking up patients, no idea. From my morning strip of tablets I again ‘forgot’ to take the NOAC.

Mid-morning I was in the patient cafeteria area getting a tea when a doctor came in and asked if I was me. I answered to the affirmative and he introduced himself as Dr. N the Cardiologist that Dr. B had mentioned would visit me sometime that day.
He joined me at my table and as we were alone he started to go through the results of the tests from the last three days. Almost immediately Dr. B turned up and joined us and asked Dr. N his opinion of the marked AFib in the ECG from Monday as it was the only one in my ECG data since that reading.

Dr. N looked at the readout and the curve marked with AFib. He paused a moment and said it was not an AFib at all. Dr. B was relieved with this and so was I. As there was no evidence of AFib it would, at this time, not be necessary to take an anticoagulant.

They discussed my other test results and recommended a beta blocker, a statin for my raised cholesterol and to take 100mg ASS ‘Protect’ every day. The Protect version is coated so that it would not dissolve in the stomach and cause possible problems but pass through and be absorbed in the intestine.
After Dr. N had left I mentioned to Dr. B that I hadn’t taken the NOAC the previous evening and at breakfast as I wanted to wait and see the results of the meeting with the Cardiologist.
Dr. B paused a moment gave me a nod and a smile and then informed me I could go home but would have to wait until the pre-final discharge letter was finalised and signed. I thanked him and his team for the professional care over the last three days and went back to my room to pack.

I was glad to be soon home and have a proper cup of tea and be in my own bed that night. I had a short talk with Mr. M who was a little sad that I was going but also happy as they finally found out what was causing his problem. I wished him well and left to get my discharge letter.

I didn't have to wait long and after my farewells got a taxi home.
H was very surprised I was home as I hadn’t given her any hint that I was going to be discharged so soon, although we thought it was going to be that day.


Home again
Over a lovely cup of tea I read the discharge letter. In the first section there is a summary of my medical history. I recognised it as an exact copy of the list from my phone that I had showed Dr. C on my arrival. Unfortunately instead of transcribing ‘neg. prostatic neoplasia‘ the ‘neg’ was missing, so I was now documented as having a neoplasia in my past!

If I hadn’t read the report the neoplasia would have appeared in the final report and possibly added to my hospital records and find its way into the records of my medical insurance company. I rang up Dr. C and told her about the missing negative. In the final version of the discharge letter that arrived two months later it was corrected to ‘non-malignant prostatic neoplasia’. With hindsight it would have been better if I had written non-malignant than just ‘neg.’ in the first place.

Soon here in Germany we will have the chance to get a card allowing access to one’s our own medical data stored by the medical insurance company. I have decided that I will only allow others access to the stored data if I have the chance to first check the data against my own accumulative database and if necessary have it corrected and/or updated beforehand.

Mistakes can happen and incorrect data stored with possible dire consequences. With my three days in hospital I nearly ended up taking an anticoagulant that was at this time not needed, and having documented in my medical records a neoplasia that I didn't have.