Tag: health and wellbeing

An inconvenient wheeze

Published on by francesmanwaring.com2 Comments

“Will it kill me?” I ask, fed up with the obfuscation that’s going on, staring him straight in the eye.

“Er … no,“ he replies, eyes focused, consultant-like, into the space above my head. 

Yay, I’m not in danger of carking it any time soon. At least, not from this. Great news, even though I do wish the man would volunteer some information instead of me having to drag it out of him like a mother trying to understand how their teenager’s school day went. Nodding to the squadron of pigs primed for take-off on the grass outside the window, I persevere with the list of questions I’ve prepared in advance.

“Will it get worse as I get older?” 

“No evidence that it will. You need to get flu jabs and stay away from people with colds,” is the best he can do after a lengthy contemplation of the inside of his eyelids. Interestingly, no mention of Covid implications. Well, I guess there’s no community outbreak currently, so I’ll give him a pass on that.

Silence descends on the room after this burst of conversational brio, and we stare at each-others’ shoes like a pair of accountants at a party, wondering who’s going to be brave enough to speak first.

What is it about medical consultants? They may be brilliant in their fields, but the ones I’ve experienced share a startling inability to communicate on any level that could remotely be called human. 

Many people believe that our stresses and emotional issues manifest in physical ways. I tend to agree with this as I’ve had minor respiratory problems for as long as I remember. My breathing kit is like a litmus test of my emotional equilibrium. When I get stressed, my voice gets all husky and breathless — think Marlyn Monroe singing happy birthday to JFK — and I get mild symptoms of a cold. As it’s always been short-lived, I’ve never really thought too much about it.  

At some point a couple of years ago, it stopped being an occasional thing. I reached some sort of tipping point where I’m coughing a lot — a worrying amount. The first year of joined-up-coughing, it stops for the summer. The second-year, it doesn’t. I’m not over-concerned as many people in New Zealand have coughs bestowed by our high pollen count from all the horticulture and similar. By mid-2019, it’s bad enough that I figure a visit to my GP is in order. Having put me through some rudimentary tests, she fobbed me off – somewhat predictably — with antihistamines. Pointless waste of time. Cough, cough, cough. Time passes, I box on. It’s my new norm. I just assume I’m stuck with it. 

By August last year, I’m notably worse and wheezing has long since entered the frame. So, I go back to see said GP, who finally accepts something is wrong, and I’m in front of a respiratory specialist faster than you can say Chronic Constructive Pulmonary Disease. The speed is courtesy of my eye-wateringly expensive private health care policy, which I’m deeply grateful I have kept going when handed the bill. It turns out, and this will likely surprise no-one — it certainly didn’t surprise me – that I have severe Asthma. However, this diagnosis was off the back of a lot of tests, and I was seriously relieved it wasn’t something much worse.

Just as an aside, try being a severe Asthmatic in the time of Covid — talk about an inconvenient wheeze. Convincing scared people that you’ve been hacking your lungs up since long before Covid-19 was even a blob on a laboratory microscope is tricky. They don’t tend to hang around long enough to appreciate the finer points of a dry cough (Covid) versus a wheezy damp one (Asthma). Forget social distancing; we’re talking crossing the street, making the sign of the ‘evil eye’ in their scramble to put as much distance as possible between them and you. And believe me, you do not want to have a coughing fit in the supermarket queue. The one benefit of coughing as if you have a 60-a-day fag habit? People stay the Hell away from you so are out of range of any ‘aerosols’ they might otherwise generously share.

But back to our action-packed story.

“I think the meds are making me worse,” I say somewhat confrontationally.

This elicits no response if you ignore the facial tick that’s starting to manifest.

“So, what happens if I stop taking them?”

“Why don’t you stop until they’ve cleared your system and then start again to see if there is any difference?” he says after another interminable silence.

This seems like quite a good wheeze if you’ll forgive the pun.

“How long will that take?”

“Couple of months.”

And that pretty much wraps it up. I sense we’re in the throes of a break-up. By this time, we have seen quite a bit of each other, and I have become accustomed to his face like Henry Higgins in My Fair Lady. Leaving for the final time, I feel a little aggrieved that he’s just booting me out into the wide world without even the safety net of a six-month callback. Doesn’t he care? Haven’t we gone to Hell and back together? This little pity party lasts as long as it takes to get out of the building. Then I think, “So what? I’ve been on my own before. I can do it. Anyway, who wants to go on stuffing their system with pharmaceuticals when there are other fun options like hypnotherapy to explore?”

Of course, I’m exaggerating in the interests of a good story, and I do my specialist a disservice. He tried hard. As we worked our way through the tools in his toolbox searching for a panacea, he visibly deflated as each failed to be The One. I think he saw me as the proverbial riddle, wrapped in a mystery inside an enigma that he was a bit peeved not to be able to solve. Damn it, why wasn’t I responding to the pharmacopoeia of Symbicort Turbohalers et al. on offer? I was pretty peeved myself. For a person whose favourite activities include singing and bushwalking, I’d hoped for better. Cough, cough, cough. Wheeze, wheeze, wheeze.

The trouble was, his toolbox was limited to the range of available medications, and there was no thought to try and identify the underlying causes or discuss this as an alternative to consider. These days, medication is generally the treatment of first resort, whatever the condition. Many things can trigger Asthma, but I do not doubt that mine resulted from a layering of traumatic events over several years, which caused no end of stress and sleepless nights. Then came a pandemic which didn’t exactly diminish the anxiety levels. 

Even though the medical outcome was disappointing — I badly wanted a quick, easy fix — I also didn’t want to be on large doses of inhaled whatever for the rest of my life and I stopped. Three weeks later, I’m sure you’ll be happy to know, I’m still here and none the worse for wear. If anything, I’m a bit better. The whole episode has helped me think differently about many things that I probably wouldn’t have if the meds had worked. As a result, I’m feeling happier and more in control, hopefully building a virtuous circle of improving lung function. 

Whatever happens from here, my pesky, inconvenient wheeze might just get me bumped up the Covid jabbing-order. Whether this is a silver lining, depends on where you sit on vaccines. I’ll take the win.

Ghosts from Christmases past #2: Hip hip hooray!

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Spending Christmas in hospital would not high on my Dear Santa wish list. I apologise in advance to all those dedicated and wonderful doctors and nurses who are rostered on through holidays to look after the hapless hoardes who are ill or break themselves at Christmas. Nope, those guys do a heroic job. But hospital at Christmas – it’s just not living the dream is it? It has to be said, I have been one of the hapless Christmas A&E admissions, having snapped my Achilles tendon on holiday on Christmas Eve a few years ago and I was truly grateful (a) that it happened in the early morning so I wasn’t competing with all the drunks that clog the system later in the day/night and (b) that those dedicated and wonderful types were with great good grace (amen) to put this Humpty together again without any kings’ horses or men in sight.

Still and all, a festive hospital visit is just not anyone’s top choice as a holiday destination. And yet, fifteen years ago, it actually was. I needed what is amusingly referred to as ‘elective surgery’. Elective because you can, in theory, choose whether to have it or not, and when, as the condition doesn’t need to be dealt to at a particular time — i.e. it isn’t life threatening. The whole elective thing is laughable. Big yeah right! In many cases there is a choice, but that happens when your surgeon accepts that your pain is so extreme that you’d likely go insane if you had to bear it for a nano-second longer.

To give you the back story, I had both hip joints replaced in my late thirties. I was unusually young, but by no means unique. There were a number of things wrong with me each one of which on its own wouldn’t have been much of an issue, but collectively combined to wreck the joints. Because of my age, my surgeon held the surgery off as long as he could because he was worried about future complications — the prostheses only last so long and there are only so many times you can effectively replace the replacements because apparently you run out of femur to play with (sorry if this is a little close to the … er … bone for some). It was all about probabilities. How long the replacement joints would last, how long I would live If the first was shorter than anticipated and the latter longer, I faced seeing my life out in a wheel chair. In any case, my condition deteriorated at a rate that would have made an Apollo Space Craft seem laboured. Movement became very limited, quality of life nose-dived and ultimately the pain became so bad he relented. I had both of them ‘done’ within a year of each other. Happy days!

Anyway, the ops were a tremendous success. I got my life and mobility back, the pain was miraculously gone and I was a happy little camper. Then several years later comes ‘The Fall. Before you get worried about my state of innocence, I don’t mean fall in the Biblical sense. No, my fall was getting a bit carried away at an al fresco party and missed my footing in the dark on the edge of some concrete circle we’d turned into an impromptu dance floor. Seemed like a great idea at the time. Wouldn’t have been too big a deal if I hadn’t landed so hard that one of my prostheses came loose. Back to limping, pain and the certainty of more surgery.

This time, there was no question of the surgeon putting up a fight — the revision clearly needed to be done and it was only a question of when. Luckily for me, I have a private health care plan which meant I really was in a position to choose a time that would be the least disruptive to my life. The first slot that my surgeon could offer was just before Christmas, meaning I would be in hospital for Christmas and Boxing Day. The next option was weeks away and, once I’d thought about it and got over the poor me aspect of it all, the Christmas timing was actually ideal. The private hospital I went to was very close to my house, so easy for family visits and minimal unscheduled time off work.

In all seriousness, apart from the fact that undergoing surgery of this sort is not a walk in the woods, once I’d got over the immediate effects of the anaesthetic and the post op trauma had passed, it was actually quite fun. I had a lovely big airy room on the corner of the hospital all to myself. The nurses were a great bunch, some were old friends from previous incarcerations. I think they were grateful to swop stories with someone who was under 85 to be honest as they dropped in more than was strictly necessary and we had a lot of laughs. It didn’t stop there. I had had more visitors than I probably would have had at home, and I didn’t have to lift a finger on the festive cooking front. The food wasn’t half bad, particularly a pretty yummy (for an institution) roast turkey dinner on the big day, washed down with one of those cute little miniature bottles of a hearty red and the decorations were pretty flash. Best of all, I didn’t have to suffer through all the endless repetitions of canned Christmas music. By the way, does anyone other than me find the whole idea that Santa sees you while you’re sleeping and knows when you’re awake a bit creepy and stalkerish? Anyway, I was out by New Year and well into the familiar rehab routine.

Now that we’re in the hiatus between Christmas and New Year, there’s a bit of time to ruminate about stuff. This morning, in one of those desultory conversations one has with friends and family, my mother and I somehow meandered into comparing the vintage of our artificial joints. Tragic, I know but hips seem to be our family thing. We’ve all had them done. Big difference is when they were done; grandfather (late eighties and only one), father (early eighties and only one), uncle (well into his sixties and only one), mother (both — late fifties and early sixties) and sister (mid-fifties — one so far, but counting down to the next). Then there was me in my late thirties, not sure what happened there! Anyway, my mother’s first prosthesis is a venerable 25 whereas mine is a stripling at 20. No-one really knows how long they will last because everyone’s activity levels are different. Equally the vast majority of the recipients of artificial hips are quite old and so it’s difficult to measure average lifespans as the first one generally sees them out. However, 20 is thought to be a pretty good age, so mum and I were musing how much longer ours would hold out.

We also reprised a regular foray into imagining what our parallel universes would have thrown up  if this amazing technology had not been available to us. To be honest, It doesn’t bear thinking about. If we’d been born before the middle of the last century, we’d both likely be cripples, even if either of us was still alive.Early attempts at hip replacement were carried out in Germany in 1891 using ivory to substitute for the femur head. These were attached with nickel-plated screws, Plaster of Paris and glue. Hmmmm. Not surprising this approach didn’t take off. The pre-cursor to current techniques was pioneered in 1940 in South Carolina by US surgeon Dr Austin T Moore who performed the first metallic hip replacement surgery.  A more sophisticated version – the ‘Austin Moore Prothesis’ — was introduced in 1952 and is apparently still used occasionally. Like modern hip implants, it is inserted into the medullary canal of the femur, and depends on bone growth through a hole in the stem for long-term attachment. Another apology here if this creeps anyone out!

It’s always so tempting to think about the golden age that we perceive existed in our grand parents’ eras. Apparently, every generation since the newspapers rolled off the early printing presses felt this sort of nostalgia for imagined glories past, underlined by a fear of change and what it means for the future. Every time I get caught in this sentimentality for the halcyon past, all I have to do is think about my great good luck in living now and being on the receiving end of the incredible medical science and technology that is our norm. Even with all the problems we’re facing as a species, I’m grateful from the bottom of my soul that surgical advances have allowed me to live a full, pain free and normal life. When I think of Christmas miracles, my hospital experience in 2003 would have to be one of them. If we can achieve all this, surely we clever, inventive Simians, can find the tools to figure out the other stuff. Hip hip hooray to that!

 

 

 

 

 

 

Sing long and prosper!

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I love to sing! Like Barry Manilow, music was my first love and it’s still way ahead of some of my subsequent loves I can tell you! (By the way, where is Bazza now … and does anyone care?) When I was a kid, I used to drive my sister insane by warbling away in the morning from the moment I got up — what a happy little songbird I must have been, trilling away in my own little dawn chorus! To be honest it wasn’t just my sister I irritated. This compulsion to sing has gone on to irritate flatmates, partners, workmates and basically anyone within my orbit in the early morning! I live alone at the moment and I even irritate myself from time to time. But none of this has ever stopped me and I expect, again like the aforementioned Manilow, music will be one of my last loves.

OK, you get it, I really do love music in general and singing in particular. Over the years, I’ve sung in festivals, backed a band (that didn’t make it), formed a duo for music at functions as well as being a member of a number of different choirs. At the moment, I sing with the Orpheus Choir of Wellington. Orpheus is a symphonic choir. That means there are enough of us — up to 150 at any given time — to credibly sing some of the biggest choral works that exist. I’m no Maria Callas, but I’m truly grateful to be able to perform at this level. In the year since I joined, we’ve covered the sublime (Mozart’s seminal Requiem Mass) to the ridiculous (nonsense verses by Ogden Nash set to music), and everything in between. I’ve sung music I didn’t know existed (Vaughan Williams’ Sea Symphony) as well as life-long favourites (Beethoven’s oh-so-famous Ode to Joy, the finale to his towering Ninth Symphony). We’ve performed everywhere from concert hall to cathedral, from Zoo to street festival.

Last weekend, we staged a couple of the most spectacular and difficult of all choral works; James MacMillan’s Seven Last Words from the Cross and Leonard Bernstein’s Chichester Psalms. In the astonishing acoustic of Wellington’s cavernous Art-Deco cathedral, my friend who attended reported that it was a visceral and moving couple of hours.

For sure, this type of music is not to everyone’s taste, but there are so many alternatives to enjoy. Who’s never sung in the shower? Believe me, if you haven’t you’re missing out big time! If that’s not your thing, you can get your armchair rocker on with the help of software like SingStar, hit a Karaoke bar and astonish/amuse your friends or simply let rip to your favourite playlist whilst driving. You don’t even have to be any good at singing to enjoy it. As Henry van Dyke so beautifully put it, “the woods would be a very silent place if no birds sang except those that sang best.”

But the greatest thing about singing — and this is something all singers innately understand — is that it’s not just fun, it’s incredibly good for us. There’s a growing (and credible) body of evidence about the physical and psychological benefits derived from singing; stress relief, better sleep, improved heart and lung capacity, possibly even longer life. Apparently, like eating a bar of chocolate, singing releases those much vaunted feel good endorphins, so beloved of exercise fiends … but without the calories! Singing in a group is thought to be particularly beneficial because of the increased sense of community, belonging and shared endeavour it brings. That’s certainly true for me. Singing is also considered to increase mental awareness, concentration and memory.

While it’s early days for this sort of research, it not difficult to believe. Experts in early human history believe that people sang out their feelings long before they were able to speak their thoughts. This was not singing in the sense that we know it. The fist human utterances were limited to mimicry of the sounds people heard in nature — birdsong, the roaring of animals and the crooning of babies. This early ‘singing’ would have been an individual thing with the individual having no thought of communicating ideas and feelings to anyone else. It’s not known when the singing of meaningful, communicative sounds began, but it was likely a key step in the evolution of language.

Even after the development of language, song retained a central place in building and strengthening communities and societies — I don’t believe there is any race or culture on earth, even the most remote or cut off, that doesn’t sing. Singing is ancient and universal. It’s a means of invoking the gods with prayers and incantations, celebrating rites of passage with chants and songs, and recounting history and heroic feats. Some cultures even have creation myths where they were sung into existence. To this day, song has much more importance in our lives than simply for entertainment. We still lullaby our babies to sleep, hum under our breaths when walking in scary places in the dark, get together and lift up our voices in praise of whatever we feel is worthy of praise, create anthems to imbue national pride and support our sports teams, schools and other social groupings.

As I said at the start, I love to sing. I couldn’t agree more with Marty Rubin’s sentiment, “walking alone I sing to myself and am content.” I love it even more now that science is confirming its connection to my on-going health and wellbeing. Or, as Kathleen Long put it in Chasing Rainbows, “In your life, you either chose to sing a rainbow, or you don’t — keep singing.” That’s what I intend to do and I hope anyone who’s reading this will too. If so, to borrow from the Vulcan, we should all sing long and prosper.

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