PAUL K LYONS
JOURNAL - 2002 - MAY
2 May 2002
Here I am in Brussels having come on Tuesday night, just in time for May Day with everything closed. I was in deep knee-stress mode when I made the booking, that’s my excuse and I’m sticking to it. But I have brought enough work with me to fill up the day; and I also met up with Fiona for lunch. It wasn’t just Fiona. It was Fiona and Mark, and their two kids Freddy and Elliot, and her mother and her mother’s new husband. Most of the time, I talked with Fiona’s mother about bringing children up. She had four kids; Mark’s parents have five. Fiona, who had her 40th birthday a couple of weeks ago, is close to finishing an MBA course. She wants to get a job at NATO. She told me that Lucy came to visit with Flora and Eliza a while back.
I’ve been typing up Journal 30, the period in Brazil when I was taking pills for the fungus in my body. The journal is half full of dreams, and half full of talk about loneliness and depression - but it seems both the dreams and the depression were side effects of the pills. It is amazing how many of my pre-occupations then are still my pre-occupations today. I even find some wisdom that seems fresh to me, as though I’d never thought of it before!
Here is a poem I wrote at the time. It’s rather apt for my 50th birthday coming up. ‘Listen to a small man, Shouting, It’s half past a life-time, And still nowhere to go.’
Preparations for my fiesta on 26 May are starting to preoccupy me. Mum came down at the weekend, and she, Barbara and I had a party summit, trying to plan the food and drink and games and crockery and so on - there’s a lot of work to do. Most of my close friends and family are certain to come - which should provide a base of 20-30 people - and a fair gaggle of children of various ages. I don’t know about Raoul, Niema, Richard and that crowd. It could be that just Raoul, Andrew and Susie come, or it could be that eight or a dozen of them come. Mum’s going to do quiches and salads; Sarah is going to do trifles; B will do a salad or two and decorations. Julian will be in charge of the drinks - and so on. This is my first party for too long - and it’ll be the first time I’ve dumped my friends on my family and my family on my friends. It’ll probably be awful, but a man’s gotta do what a man’s gotta do.
5 May 2002
My knee continues to preoccupy me. I can get around and do things, but I am oh so hampered. Yesterday I bought a fabulous metal screen at the Godalming auctions, and it was hugely difficult, even with Adam’s help, to get it into the car. In the garden, I soon tire of having to use one leg so much more than the other, and my left/knee, although not hurting as such, does develop a kind of sore tiredness easily. But, what I think about (during the night and during the day sometimes) is what I’m going to say to Mr Paremain when I see him next Tuesday, and how the conversation might develop. Having found - on the internet - a fair amount of information about knees and cysts, I’ve convinced myself that I know exactly what has happened to my knee: a cartilage tear (the meniscus) and an associated popliteal cyst. This can only be dealt with, I’m fairly sure now, by surgery - hopefully by an arthroscopy. So, I fully expect Mr Paremain to book me for one as a result of my consultation on Wednesday - the question is, though, how long will it take? and how long am I going to be hobbling around for?
Arsenal won the FA Cup yesterday against Chelsea. I watched it while listening to an Agatha Christie play on the radio, and doing odd chores here and there. The semi-finals of the snooker cup were on as well, and I watched snatches of that competition too - even though I think watching snooker is fairly close to death.
I lost my temper with Adam yesterday, and shouted at him - loudly. He got his £5 this morning, it’s only the third one this year, so I’ve done reasonably well in controlling the shouting, which had been getting out of hand last year. In line with teenagers everywhere (I suppose), Adam is always trying to establish his independence and control over the world around him. He constantly accuses me of being patronising (when I’m trying to explain something to him, or telling him off for a little thing), even though I’m not really being patronising. He’s very quick to anger now (more so than at any time in his life beforehand, I think), and he’s multi-armoured when it comes to deflecting my accusations or attacking back. One of my main problems with him is separating out the roles between friend and parent, between talking to him (arguing) about some subject or other, and telling him what he should be doing or how he should be behaving. Often I want to stay serious, whether about his behaviour (not washing his hands, not tidying his room, throwing his clean clothes on the floor) or about issues (a film, politics, sexuality), but he flicks the conversation into comedy mode with a facial expression, an action or a comment, and I find it hard to keep a straight face. I can often be heard to say ‘Adam, you’re not listening to the words I’m saying - I may be smiling, but I’m getting cross’; or ‘ADAM, I’m serious’, or ‘ADAM do what I say BEFORE I get cross’.
But despite this, Adam remains a beautiful being. He is funny, warm, an attentive companion, helpful, generous, honest, clever. He has so many grand attributes, I cannot believe he isn’t going to make more of his life, both socially and professionally, than I have.
I have just watched ‘Charade’ on the telly - I was feeling tired and washed out this afternoon. It’s a long time, actually, since I watched a movie on TV in the afternoon. Perfect Sunday afternoon entertainment. And tonight there is ‘West Wing’ - which is the most intelligent TV series I’ve seen, I think, since ‘Between the Lines’. I love it (even though this second series has got a bit more schmaltzy). And, I will watch the ‘Forsyte Saga’ with Damian Lewis and Gina McKee - although a bit top heavy on the costumes and extras (horses and pedestrians crossing the road the moment the scene comes into view), this is a first rate production. And I won’t watch ‘24’, the gripping American series based on 24 episodes in supposedly real time (even though each episode only lasts 45 minutes to allow for US commercials) with Kiefer Sutherland, because it’s making way tonight for live coverage of the snooker final.
Despite my knee and the party preparations, I am going to make a determined effort to write some Kip Fenn over the next two weeks - this will be my last chance to work on it until the summer. I’ve spent today reading over the material I’ve written so far, the first two chapters - I think it’s good, but then I thought BLR, ‘Love Uncovered’ and ‘TomSpin’ were all good too - I still do. Although I always thought Kip Fenn was too ambitious a project and I would never manage it, I was surprised that I managed to make such good headway with the first two chapters, but I’m beginning to worry just a bit that it may only be becoming too difficult now, like ‘The Rats’ did - but I don’t think so, I just need the time and mental space to focus on it.
My knee needs an update. Since the physiotherapist stopped my exercises because of the cyst on the back of my knee and told me I needed to see the orthopaedic surgeon again, all my mental life was focused on the 8 May appointment. I collected dozens of articles on the internet about knee damage, meniscus tears, cysts, arthroscopy etc. and rehearsed over and over again what I might say to the surgeon. The appointment couldn’t come soon enough. I hobbled up to the hospital from the Tesco car park, arriving only about five minutes early. Surprisingly, I was called in almost immediately. But it wasn’t Mr Paremain who came in to see me, but one of his registrars (whose name I forget). I asked him if he’d read the notes, and he said yes (although he didn’t seem to have them with him). He looked at my knee for about two minutes, asked me a couple of questions, and then suggested I have an MRI scan. I asked how long that would take. He said he didn’t know. It was about this time that I started to lose my cool. I can’t remember exactly how the conversation went, but I argued back. I wanted to know what an MRI scan would achieve. He said something about it helping to show what the problem was and whether I would need surgery. I wanted to know what would happen if it showed that surgery wasn’t needed - how would my knee be repaired. I told him that I had read quite a lot, and that I thought it was a meniscus tear, and that this had caused the cyst. He wasn’t very interested in the cyst, and I showed him some of the information I had gathered on the internet (having already asked me pompously whether I had any medical training, he now scorned material that could be found on the internet). Eventually, I asked for a second opinion, and he immediately said ‘this relationship has broken down’ and walked out of the room. I was very stressed by this time, especially since I thought the registrar was working instead of Mr Paremain not with him - and I didn’t know what would happen next. In fact, Mr Paremain came in (he can’t have exchanged more than a few words with the registrar) and started to examine my knee again. I’d put my papers away by this time, but I carried on talking about the cyst. He also didn’t take the cyst very seriously - and didn’t seem to think much of my idea that it was symptomatic of a meniscus tear (I don’t think I put it quite so clearly as that). Neither did he have any notes from the physiotherapist. I told him that it was causing havoc in my life, and that I was walking less well now than when I had seen him three weeks previously. Any how, he looked and tested the knee quite thoroughly, and then said I should have an arthroscopy. He talked about it as being necessary so that the knee could be looked at in a relaxed state (i.e. with me under a general anaesthetic) but he admitted on my questioning that it is possible to remove and cut cartilage in the procedures (which I already knew). From my reading and my symptoms, I’m sure I have a torn meniscus and that part of the tear is ‘locking’ my knee (i.e. preventing it from straightening). Whether there’s a fucked up cruciate ligament as well I don’t know (I suspect so), but I’m hoping, preying its the meniscus cartilage that is preventing my knee from straightening, and that Mr Paremain will be able to resolve that on Wednesday.
Yes, that was the big shock - that he’s going to do the arthroscopy next week, so soon. I have to be at the hospital at 8am, and B will pick me up some time in the afternoon. I’m likely to be very groggy; and unwell for days, I suppose - and my knee is likely to hurt, which will be a bummer since it’s never hurt once since the Sunday of the accident.
Although all I want at the moment is to be able to walk, I do worry about whether I’ll be able to play volleyball again - I lie in bed thinking about it, and I can’t see how I can. Is that cowardice talking, or just plain common sense?
I was close to tears a couple of times in the hospital. Once, when I was waiting for Mr Paremain to check his diary to see when he could fit me in for an arthroscopy. I was sitting on a chair in the consulting room, feeling relieved on the one hand that I would be having an arthroscopy very shortly (which could mean real progress, unlike a scan which would be nothing more than an extra month of limping), but, on the other, I was stressed out and depressed from the encounter with the two doctors. Then, half an hour later, having trekked a long way to the Day Surgery Unit, I was sitting in the empty waiting room when a woman pushed a teenage girl in a wheelchair into the room. She talked to the girl as though she were a baby, and when a nurse came out to talk to her, the woman told her the girl wouldn’t speak (even though she seemed to be murmuring to a doll), and so they spoke about her together as though she were a one year old or a favourite pet. My head was swinging backwards and forwards from self-interest and preservation, needing to fight my corner and press for my interests, and the realisation that so many, many people are far worse off than I am.
And then I got to thinking about how horrible old age will be for me. I hate pain, I hate discomfort, I hate people doing things for, I hate not being independent. It’s not death I fear - how can anyone fear death, once you’re dead, you’d dead - it’s old age, illness, disease, physical unwellness, incapability that I fear . . . and they are just around the corner.
I got a letter from Guildford Hospital today with details about the surgery (no eating or drinking from midnight - apart from one small black tea before 6am - which is fine for those who are going to be operated on at 9 or 10, but it seems that Mr Paremain is squeezing me into his lunch hour - so the sister said, which means I won’t be under the knife until midday or later, by which time I’ll be parched).
There was a train crash at Potter’s Bar last night - seven people killed and scores injured. There’ll be another round of industrial and political soul-responsibility searching, and endless calls for more money to be pumped into safety measures. The day before there was a bad car accident round the corner, outside the post office. Thursley Road was blocked with ambulances and police cars for several hours. Apparently, a driver had a heart attack, and his car careered off the road into the fence by the paper shop. The driver died; but if it had happened five minutes later that area would have been teeming with schoolkids, and some might have died too.
In the Middle East, another Palestinian kills himself in order to kill Israelis too - as if to prove to Sharon that his invasion and destruction of parts of the nascent Palestine didn’t achieve a thing. How much longer can Arafat last - his days must be numbered, and who then will fill his place?
Friday 17 May
I am still utterly pre-occupied with my knee. The operation on Wednesday went far more smoothly then I expected. Barbara took me into the Day Surgery Unit at about 8am. The waiting room was full of patients and their friends/family. Along with seven other men, I was then shown into a small ward with eight trolley beds, and assigned no 3. I sat down in the armchair and read my paper. About half an hour later, a nurse came and took details from me (mostly the same details I had provided twice already to the unit - once on a form I filled out a week previously when I came straight from the fracture clinic for my pre-op preparation, and once in reception on this morning). She told me my operation would be at about 9:30 (which was much earlier than I expected), and that I should be collectable at about 12:30, and that a nurse would call ‘my lift’. I called B at work to tell her roughly when she would be needed. I tried to read more, but this was quite difficult with various conversations taking place through the curtains nearby. The friendly anaesthetist came for a quick chat. I told him it had taken me nearly two weeks to recover the last time I’d gone under, and he told me, with a smile, that anaesthetics have come a long way since then. The surly serious Mr Paremain came for a quick chat, and asked me to sign a consent form. I tried to read, but by now I was getting a little nervous. The nurse asked me to get changed into the surgical nightgown and get into the bed. About 9:45 I was wheeled through to the anaesthetist’s room. I chatted to the nurse for a while, as they waited for the operation in the connecting theatre room to finish, and then I was given a prick in the back of my hand. About 15 seconds later, the anaesthetist said something like ‘you should be leaving us now’. I heard these words, and then slipped instantly into unconsciousness.
Around 11, I was awake. Well, I thought I was awake. There was a huge tight bandage on my knee, but it didn’t hurt. A doctor came to talk to me. He told me, I think, that a piece of cartilage had been cut away - I recall he used the term ‘half-moon’. He also said something about my cruciate ligament being damaged, I think. That was all I was told. I was given a cup of tea, and, a little while later, a sandwich, which made me a little nauseous. Otherwise, I tried to read. A bit later, I was told I could sit in the chair, and a bit later still I was told I could get dressed (whereas the chap in the bed next to me, who had been operated on before me, slept and looked groggy and wasn’t allowed to get up). I couldn’t believe how alert and fit and ungroggy I felt. At about 1pm, I asked if my lift had been called. It hadn’t but the nurse (there only seemed to be one by this time) came with various bits of paperwork. She told me I should leave the bandage on until Friday when I had an appointment with the physiotherapy department. She also told me the physiotherapist would have my op notes. So I’m looking forward to finding out what the surgeons discovered on Wednesday.
Even though I’ve had no post-op effects whatsoever (apart from my knee being about as injured as it was the day of the volleyball accident), I took the whole of yesterday off - I lazed on the sofa, reading a new Mankell thriller, and watching the Sri Lankan batsmen pummel the English bowlers at Lords.
This morning, though, I’ve been at the computer. As usual, I typed up 500-800 words from an old diary. I’m on diary 30 at the moment (and have been for a couple of months) - this concerns the middle period of my time in Brazil. I typed up entries about seeing and hearing, for the first time, Astor Piazzollo on a TV show hosted by Chico Buarque and Caetano Veloso. I write that I must get a cassette of his accordion music. Since then, Piazzollo has been a firm favourite - I don’t know if he would get into my desert island eight, but I regularly play his music. But, the only reason I mention this is that, no sooner had I finished typing the sentence, than I heard, on the radio, the Radio Three presenter announcing a Piazzollo song.
I drove to the hospital, although I know I should not have done. And I parked far away in Tesco’s because there’s always such a crowd in the hospital car park, which is only marginally nearer. But the walk took it out of me. Somehow, I was expecting my knee to be well on the way to repair by now, and that the operation would leave me more mobile not less. The physiotherapist, Alison (the same one I saw prior to the arthroscopy) unwrapped my bandage gingerly to reveal two blood spots on either side of the kneecap with strip bandage protecting them from the outside. She told me to be careful of infection (not to get the wounds wet) and to try and restart my exercises. However, with the bandages off, the knee feels very tender and swollen, and, although I can hobble around with a bent knee, I can’t do anything useful with the knee at all - thus today is the third full day I’ve spent lying on the sofa watching tv and reading.
Alison had the surgeon’s notes and informed me that I had done damage to cartilage on both sides of the knee, including a bucket handle tear on the inner side, and to the cruciate ligament. She said the cartilage would be fine (i.e. would repair itself), but that she would be trying to treat the cruciate ligament damage ‘conservatively’ by strengthening other muscles around the knee to take over the work of the ligament. After six weeks, the surgeon will re-assess the situation. I asked how I could have done so much damage and not been in any pain. She had no idea.
But I remain deeply worried that the arthroscopy has done more damage to my knee than was there in the first place. I cannot straighten it, there is more tightness at the back than before, and sometimes when I walk, the knee feels so wrong, almost twisted inside. Also the kneecap still feels too far forward like it did before, and the wounds where the holes were made are also tender - although hopefully not infected (which is a common problem). My worry about the knee continues to undermine my concentration and ability to get on with anything. Yesterday I cried about it.
Last night and this morning, I have another medical complication to worry about - only not mine this time, but Adam’s. Last week, he showed me a rash on his body, which I thought might be a skin reaction to soap or washing powder. But, by the weekend, it appears to have covered his entire trunk. B and I both dived into our medical books, and concluded that it was German Measles, but for the fact that B thought Adam had had an MMR jab when he was tiny. There was a certain amount of confusion between us about this, not least because we couldn’t be sure exactly when the rash started, and because every source of information about German Measles had a different idea of how long a person remains infectious. I think we agreed yesterday that Adam would have to stay off school, which under normal circumstances would have been fine, but, unfortunately, he has the last of his year 10 exams today and tomorrow, and it would be stupid for him to miss them without good reason.
When I rang NHS Direct last night, I was told the infectious period lasted until seven days after the spots first appear. When I quizzed Adam in the middle of the week as to when he first noticed the spots, he was rather vague, but we worked out that it must have been at the w/e. Thus, I reasoned this morning, if the spots first appeared last w/e then Adam should not be infectious any longer, and he could reasonably go to school. I rang B to explain my reasoning. She would not be convinced; and insisted that I call the doctor and the school. I was cross, but gave way. 8:30 on a Monday morning is not the best time to be phoning either the school or the doctor but I persevered. I still hoped I might be able to get the all clear somehow and take Adam into school in time for the exams. But, in this I failed - much to Adam’s amusement. After several phone calls to the surgery and some confusion, I established that Adam had indeed had an MMR vaccine in 1989, and that Adam should go down to the surgery for a blood test (he’s there now).
He’s back now. It’s not German measles, and it’s not infectious, but the doc doesn’t know what it is. I’ve just taken him into school.
Paul K Lyons
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