Country walk #4 ...

Look what St. Anley discovered yesterday ...



Blue berrys.

Not being a seasoned forager, he declined to pluck or taste this fruit, but later showed the image to Mrs St. A.

"They are sloes, (prunus spinosa,)" she declared.

Now all I need are ...

• 500 grams of these berries
• 250 grams of sugar
• one litre of gin

 ... and considerable patience!

Country Walk # 3 ...

Earlier St. Anley exulted about golden fields of barley.
Now look what has happened ...

As it says in the folk song ...
They've cut him off at the knee!

... and bunged him on a cart.

Then hired men with crabtree sticks cut him skin from bone.
And the miller has served him worse than this ...
                                    He's geround him between two stones.

See/hear http://youtu.be/_NNgLqz89Z8

Doubtless, the wheat will be next ...

Such is the cycle of agriculture.

Country walk #2

With camera battery fully charged, St. Anley resumes the commentary.

I wrote about the main road.
There are two interesting establishments ...



A very fine farm shop that sells local produce.



A hostelry for refreshment ...
not open yet!

Here is the stile over which St. Anley hopped ...

Now he's on his way home, retracing some of the route of the outward journey.
Here is a miscellany of images ...



A dog on wheels.

 

One lost shoe.

Two lost shoes.

Benign clouds.

 

 

Thornham Marina.

Rocks over which thou shalt not climb.

Detritus.

Horse riders.

Horse poo.

Pollination.
Look carefully ... you'll see a bee.
 

The sign reads:
"There's no such thing as the Dog Poo Fairy."

Now, it's back through the copse ...

Rest a while.

 

A desirable residence available for rent.



 

Somebody wants to build houses on Maybush Orchard.

 

 



Don't let them!
You can sign a petition at http://www.savemaybushorchard.com/

Nearly home ...

This is St. Anley's local pub.
It's not very good, and it's shut!

Things you might see on a walk in the country #1 ...

Now, let us be a little more cheerful.

St. Anley is temporarily disabled from riding his bicycle, owing to inability to operate the rear brake with his left hand.
So he has taken up the daily habit of exploring the countryside in the vicinity of his new home on foot.

His home is on a new development on which building is still in progress.
There has been some vandalism ...

Closer inspection behind damaged gate reveals squatters ...

They look rather nice people.

Only a few hundred yards southwards there is access to the countryside through a kissing gate ...

Regrettably, St. Anley is alone.

In an open space two rabbits take cover ...



You can just see their tales.

Emerging from the copse St A exults and praises the Almighty as he encounters a golden field of barley ... 

Cue now for the late Eva Cassidy ...

 

 

 

Then there's more wildlife ...

 

 

A Tortoiseshell?

From little acorns do mighty oaks grow ...

Following the outflow of Ham Brook, St. A arrives at the shore of an inlet of Chichester Harbour (AONB) ...



Reed beds.

A little farther on he discovers a seemingly abandoned bicycle ...

It doesn't look in too bad a condition.
Just needs a little lubrication.
I'd prefer the saddle a tad higher.

 Then ... disaster ...

This way?
That way?
Which way?

St Anley endeavours to take more photos but his camera battery is exhausted.
He will have to do it all again tomorrow to continue this illustrated guide.
It shall be done before he goes to the hospital to have those stitches removed.

A serious social comment follows ...

It is noticeable that, during his off-road promenade, St. Anley met only a few people and several dogs.
They all wished him a good morning or said, "Hello," with cheerful smiles.
(I mean the people, of course. One dog growled intimidatingly!)
Courteous pleasantries were exchanged about the weather, the beauty of our surroundings and our good fortune to live near such an Area of Outstanding Natural Beauty.

The walk home, (not here illustrated,) involved walking just a few hundred yards along a main road where there was noisy, polluting traffic.
There were many people, and a dog or three.
None of them bore smiles, nor offered pleasant greetings.
(Not even a menacing whimper was forthcoming from the Jack-Russell!)
So I hopped over a stile back on to less-trodden paths where the people you meet are cheerful and sociable ...

and there's dog poo!

 



To be continued ...

Dupuytren's #7

Post-op Day 9:

Blood!

Phone hospital ...
"There is blood seeping through my dressing."
Nurse enquires, "Have you contacted your GP?"
"You are in his care until we see you next Tuesday."
"No," replies St. Anley.
"Shall I go to A & E?"
"Ooh, no!" she says, "Don't you know that there's a national crisis in hospital emergency departments!"

Phone GP surgery ...
Tracey answers.
I explain the situation.
"Well, Dr *** is away on study leave. You can see another doctor if you like."
"I like ..." I say.
"Fine," says Tracey, " Come along next Friday at 2.40pm."
"That's too long," I protest. "I'm due back in out-patients on Tuesday. Can't I see the practice nurse?"
"No," says Tracey, "... not until you've seen the doctor."

St. Anley explores bathroom cabinet in hopes of finding a new, clean bandage.

Found it!

Now, in Mrs St. A's absence, this could be tricky!

Dupuytren's #6

Post-op day 8 …

St. Anley attends the ‘dressing clinic’ at his local infirmary in hopes of being relieved of a very heavy splint and having his stitches removed.
This time only the volunteer in reception asks me for my personal details. Everyone else knows who I am.
Was my earlier behaviour that memorable?

I wait patiently in a waiting area occupied by unfortunate people whose trauma is clearly much greater than my own.
Mrs. St. A. accompanies me … because she is concerned for my wellbeing?
No, I just want her take take some photographs!

Nurse F**** appears. She crosses herself and genuflects whilst calling out, “Saint Anley!”
“May my wife come too?” I ask.
“Of course,” replies Nurse, “But will she be OK with the sight of blood?”

Nurse gently cuts away the outer bandaging and removes the plaster slab. “That’s a weight off my arm,” announces St. Anley. Beneath this is some dressing material impregnated with something that looks like boiling pitch.

This is pulled away to reveal …

Now, that's what I call a Z-plasty.

“Oh, it’s not healed yet,” exclaims Nurse.
“I’ll get the doctor to take a look.”

Pretty lady-doctor appears who, to St. A’s disappointment, doesn’t want to know his phone number.

• “No, it’s not completely healed,” she agrees.
• “Can you make a fist?”
• “Ouch!”
• “Now spread your fingers.”
• “More ouch!”

She proceeds to evaluate my sensation and concludes that my pinkie is completely numb, and there is a patch of my palm that has no sensation.
“That’s fine,” she says, “That will recover.”

Mrs. St. A. summarily takes another photo because she has to depart; she has better things to do.




Goodbye, dear!

The stitches are left in place.
Nurse applies a new, clean dressing ...

“Come back on Tuesday to see the hand-therapist.”

Dupuytren's #5

Concerning recovery from regional blockade of the brachial plexus ...

Yesterday I wrote about regional anaesthesia involving an injection of local anaesthetic in the area of the brachial plexus. The anaesthetist told me that the effects would last for about 16 hours.
I described the surreal, dismembering experience of its onset and effects.
What follows is an account of the recovery.


My anaesthetist favoured the supraclavicular approach.

The operation lasted about 1 hour and 45 minutes, whereupon St. Anley is wheeled to a recovery area.
The staff here are different to those he met earlier, so, here we go again:
“Please tell me your full name.”
Etcetera, etcetera …

“Would you like a cup of tea?”
“Ooh, yes please; milk, no sugar.”
Tea duly arrives with two biscuits on the saucer.

St. A. is right-handed, so he has no difficulty in manoeuvring the cup to his lips to partake of the gloriously refreshing liquid.
Now, the biscuits: they are securely encased in a cellophane wrapping, but the nurse who brought them has gone elsewhere.
St. A. holds the packet in his right hand and vainly tries to bite through the cellophane.
Another nurse notices the struggle and asks, “Would you like some help?”
“Yes, please.”
Whilst unwrapping the digestives she enquires, “What’s your full name, DOB, address, telephone number … ?!”

I have absolutely no control over my left arm which has been suspended from a drip-stand by a pillow case.
“You may get dressed now,” says a third nurse.
Clearly, I should have come in with elastic-waisted trousers, and why, oh why, did I feel the need to wear a tie?

Nurse helps me by putting ‘bad’ arm into my shirt first.
I successfully manipulate my trousers onto my legs, but, with some embarrassment, I have to ask, “Please, can you do up my flies?”
All this takes some time, and St. A. begins to understand that the next few hours are going to present some significant challenges.
Eventually made decent and having discarded the tie, a triangular sling to support useless arm is constructed.

The first nurse returns.
We seem to be making progress as she doesn‘t need to ask my name!
Various bits of paperwork are completed and post-operative instructions passed on.
“Will Mrs. Saint Anley be collecting you?”
“Would you like us to give her a ring?
“What’s the telephone number?
“Oh, it’s alright, I’ve got it here!”

Mrs. St. A. duly arrives and transports me to our home, whereafter she diligently attends to my every need.
I still have no sensation in my left arm, so I have to be careful not to injure it by bumping into obstacles.
 
By the middle of the evening comes the very faintest notion that my motor facilities are returning.
First, my arm begins to move from the shoulder joint.
It does so with no cerebration on my part, and to no purpose.
It twitches, it gyrates vigorously, it abducts quite spontaneously.
I know it’s doing all these things because I can see it. However, my sense of its position in space has not returned, so, with my eyes closed, I don’t know where it is.

Then, I seem to be able to flex at the elbow, and the arm, totally unbidden, assumes a near-robotic waving motion.
"Have you seen someone you know?" enquires my wife!

By bedtime I still have no sensation, so I retire to a single bed since Mrs. St. A. wants to avoid being struck by a spontaneously moving plaster-clad arm in the middle of the night.
As instructed, I support the ‘bad’ arm on a pillow alongside me. ‘Bad’ arm, however, has other ideas and launches itself fitfully into the nearby wall.
No matter … I feel no pain.
The wall will polyfill and repaint!

I sleep surprisingly well until about 3.00am when I am awoken by that pleasant, warm, tingling sensation I described at the onset of anaesthesia.
“Ah, it’s wearing off,” I say to myself.

After that comes itching. I try scratching, but still with no real sensation, that makes no difference.

Eventually, all the chorea-form involuntary movements cease, and I can accurately identify the position of my arm in space.
I practise touching the tip of my nose with my index finger … YES!

By daybreak, I can feel light touch at my finger-tips.

What is demonstrated by this experience is that there are various modalities of sensation that recover at different rates, all somewhat later than motor function ...

• First comes tingling and temperature sensation.
• Nobody seems to know what the sensation of itch is all about, or why scratching alleviates it.
• Then comes joint-position sense.
• Light touch apparently takes a long time.

 
Pain comes last of all.

Now I know why I was prescribed those strong analgesics to take home from the hospital!