There's only just enough room for a wheelie-bin. Ella's ersatz café racer won't go through.
I had words about it last week, this week they've been disregarded.
The house that the driver is visiting has a driveway but no cars parked on it or in front of it... they're all in front of our place. Go figure.
As per my recent conversation with the GP surgery's receptionist...
Yes, I know that the results show that I have health issues. When I made the appointment for the first test I told you that the results would be out-of-limits. I told the nurse the same when the samples for that first test were being taken. I know the cause and I'm undergoing the treatment. A further test isn't going to make it any better.
No, I won't be arranging a telephone appointment to discuss the results - I already know what's wrong with me, it's been going on for over three and a half years and is documented in both my GP patient record and my Haematology patient record at LRI.
Please RTFM!
It's that time of year again - time for my Annual Vascular Review at my GP's Leicestershire-based surgery.
At least once a week I attend the Hambleton Suite at Leicester Royal Infirmary where I have my observations and weight recorded, then I have blood samples taken from my Hickman Line for a full suite of tests, then the line is dressed, then I attend a session with the Senior Specialist Dietitian, then I attend a review with one of the Consultant Haematologists. What they don't know about my body and blood isn't worth knowing.
You'd think that I'd not need to give yet more blood samples to the GP's phlebotomist in order for the Vascular Nurses to have something to work with, but it's not so. They have to take separate samples so that they can send them to their preferred test facility over the county line in Coventry, Warwickshire. That's because the Vascular Nurses' system can't access my Leicestershire hospital records.
Because of this, I have to take up an unnecessary appointment slot to provide unnecessary blood samples for a suite of unnecessary tests. Furthermore, I have to have at least one unnecessary hole in the arm because the GP's phlebotomist is not allowed to take blood samples from my Hickman Line.
I really don't get why there's such a communications block. It's a farce.
By contrast, I also have to attend monthly sessions with the Community Heart Failure Specialist Nurse at Hinckley Health Centre - when she wanted to take bloods for tests I told her that weekly tests were ongoing at the Leicester Royal, and she was able to access their results online within seconds, thus saving time, money, test resources and arm-holes.
So go figure why the NHS is cash-strapped.
Chris kindly went over to LRI on Saturday to collect my 25mg Ciclosporin capsules. I mentioned it in clinic today and the consultant understood the issue and gave me a prescription for yet another denomination - 50mg - just in case the dose changes again. Also on that prescription was a request for a month's supply of Isavuconazole, an antifungal drug that I'll be on long-term and which I will run out of at 10pm tonight.
I went to the on-site pharmacy and after a long wait was presented with the 50mg Ciclosporin capsules. The Isavuconazole, however, wasn't in stock. They've had to put in an urgent order which means yet another trip to the hospital tomorrow to collect it.
So, that'll be three trips to LRI on three consecutive days (my next clinic appointment will be on Thursday).
Did nobody tell these people that I'm supposed to be at home getting some R&R?
On the subject of Ciclosporin, it's the only drug in my TTO stash that's "variable-dose". In theory they measure what's in me every time I provide a blood sample in clinic, and if the levels aren't right they call me later to tell me to adjust the dose.
Curiously, the never-before-seen specialist registrar that assessed me and my results in Thursday's clinic didn't mention a dose-change despite having the test results right in front of her (yes, the results were available to her because the consultation was 4 hours and ten minutes late).
But a few minutes ago I took a call from one of the BMTU senior nurses... my ciclosporin level was low on Thursday... can I increase the dose from 100mg to 125mg from Saturday morning onwards?
Well, no, I can't. In its infinite wisdom, the hospital pharmacy provided only 100mg capsules when I was discharged, and those capsules can't be divided.
So it's looking like another trip to Leicester tomorrow to collect a prescription for smaller capsules... if they can find a bank-holiday weekend doc to write up the script.
And there I was, looking forward to a relaxing long weekend.
Arse.
02:20 - I went to the ward desk to ask if there was any sign of one of the meds that I was told would be prescribed on Wednesday night. I wasn't pushy, I could see that the duty doctor was busy so I waited politely, patiently and quietly, standing next to an agency/cover/bank nurse who I've never seen before. I had no idea that they were dealing with a major problem.
From there, the conversation could have gone in many directions, with hindsight the favoured one for the crisis at hand would have been "we're dealing with a critical situation - a patient has gone into cardiac arrest, we can't attend to anything else at the moment".
But no. Instead, it took a different turn.
Without preamble, said nurse piped up with a brusque "Is it a doctor question or a nurse question?"
Unaware of the crisis, I replied with "It's a doctor question, that's why I'm waiting for the doctor. If it was a nurse question then waiting for the doctor while standing next to a nurse would be a really dumb thing to do".
Her simplistic repost of "He's dealing with a sick patient" could draw only one response...
"We're all sick in here, all 21 of us".
Now that morning has broken and the aftermath of the night has been revealed, it's obvious that our conversation could have gone much better. I have made my apology to the duty doctor and have commended him for his actions. The nurse was nowhere to be seen.
