by In Wales
Sat Oct 20th, 2007 at 06:17:05 PM EST
I have my annual kidney check up this time of year. Usually it is awful, totally distressing and I dread it. This year, the improvement was remarkable. I thought it was time for an insight into the ups and down of being a service user. It all depends on how it is delivered.
Sobering — diary rescue by Migeru
I have a personal blog and following my experience of the NHS last year I wrote this:
Well, it all sounds so simple on paper. Turn up to the hospital, see the consultant, get my bloods done, leave.
They make it as fucking difficult as possible. Is it really a year since I last went through this? Such an ordeal. They forgot to tell me to do a urine sample this time so at least I escaped the humiliation of wandering up and down the corridor, trying to find a nurse, with a pot of warm piss in my hands.
All my life, I'm the youngest. Every audiology clinic, batty old deaf people with their squeaking hearing aids, fussing with their hair to cover up their defect while their middle aged children shout loudly, "cup of TEA?" and stick a Reader's Digest from the previous decade on their lap.
Nephrology, Corridor of the Living Dead. Not nymphology, like the secretarial typo promised. It terrifies me that maybe I'm looking at my own future. The posters on the toilet doors warn against filling the urine sample pots too full since they have been overflowing of late. On that note, do you know how hard it is to stop yourself once you've started a wee? Especially if you are old and doddery. The average person produces 1-2L of urine per day. Do you know what a mess it makes if you try to pull the sample quickly out of the stream of wee before it reaches overflow point? To feel hot stink run over your fingers, drenching the outside of the pot and you fumble with the screw cap and tissue to wipe it up, but the label is already soaked and wrinkled with a slight tinge of yellow. The yellow colour comes from a pigment called urochrome. Then you have to go and give this to the nurse. Your little mess of kidney dysfunction. She doesn't care, she has to deal with this everyday. She says "leave it there" so you stick it on a random worktop, traces of your own waste on the surface, to be picked up by fingers which then go and touch other things, other people. Passing on molecules of urea, creatine, uric acid. Your mucky water. Piss, spread it around.
So, Corridor of the Living Dead, lined with grey skinned, grey haired, empty souls. In your scalp the melanocyte stem cells die and your hair goes grey. Parallels the death of your soul. There's no melanin pigment to colour the hair anymore. Colour fades out. And you end up lining corridors, with NeverFade solid purple bruises on the backs of your hands and up your arms from dialysis. The colour that left your hair has been replaced by the haemoglobin under the surface of your skin and it clashes with your pastel nylon clothes, and the gold 'elegance' embroidered on the shirt pocket. The shirt that you tuck in under your elastic waist band that digs into the bulges of your life of excess, turgid with water retention that stops you flexing your ankles or your wrists. Doddery little steps. Skin stretched tight and mottled over waterlogged tissue, no matter how hot the weather is. Am I looking at my future?
The staff explain nothing and turn their backs and talk to each other and look right through you and those bruises and pin pricked skin that makes a cold shiver run through their insides. The same shiver you get if you see a dog with it's back legs trapped, tangled and bleeding in a barbed wire fence, whimpering for release. The same grimace.
I look at the wall. Me, with my youth and attitude, I do what the nurses do. I pretend I can't see you. I pretend I can't see what could be me. Apple green with smudges and scuffs. I stare at the wall. The porter in his jeans comes along and scoops up all the biohaz samples in their plastic bags with green and red labels and takes the blood of 50 patients off to the lab where some younger grey souled technician will look at their albumin levels, iron, ions, metabolites and so on. And the numbers will come out and be stored in a computer, a statistical analysis of your kidney dysfunction. A numerical journey to your death.
A consultant talks at me with an accent I can't work out and I have to tell him how I've been this year. I was ill at Easter. I've not put the weight back on. He looks at his numbers. Half a stone. He'll check my bloods. And next year he'll look at the numbers again. Everything is stable. I'm not fit for long term lining of corridors yet.
So the nurse takes my bloods, I stare at the wall. The trick is to relax your arm and you feel it less. I don't look. I stare at another wall, and feel the sharp slide out of the needle, pressure of the cotton wool ball and the pull on my skin of the tape. She turns her back on me again. I'm young, younger than her. Reminders of how fragile your health can be aren't nice. She pretends I'm not there and in one long stride I leave the chair, turqouise plastic coated with foam padding, grab my bag with one hand and smoothly exit the door. I pretend I'm not there either. Without looking at anything but the grey tiled floor, I push the swing doors open and walk out. Down another corridor, down the stairs full of slow walking old people with sticks. Am I looking at my future? Out into the sun. Solar powered skin. Brown, not grey. I rip off the tape. Bright red blood of mine on the cotton wool and a pin prick of red in the middle of a small blue bruise in the crook of my arm. Feel the sun and wait for the bus.
I don't know my future, but right now, I'm so alive.
Well, that was a bit bitter wasn't it? It was the same experience the year before too. I turn up feeling fine and leave feeling as though the lifeforce has drained right out of me. As though I'm contaminated, iller than before. Nothing reassures. Staff attitudes were appalling, they just ignored or were borderline hostile to the patients.
I don't know what process has occurred to create this change in attitude but the difference was very noticeable.
The clinic is still cramped, with patients seated along the edge of a corridor and not in a proper waiting area. Confusion reigns, once you've signed in at reception. Up to 3 people can be in the same room having bloods done at one time with a queue waiting directly outside, looking in. There's not enough room to queue in busy times, and not enough chairs for everyone. I've been in far better organised and more relaxing clinics. A recent report and subsequent news headlines on Wales' kidney service described it as 'third world'. That may have had something to do with the change...
But this time, the staff were all friendly and helpful. They talked to me, I was a real person. I didn't see my drawn out death playing in front of me. It was much more efficient and organised than ever before. And I said thank you and smiled at the nurse as I left.
This year I didn't cry. The difference that the delivery makes.