Watering under my bridge

I've been blogging for the last three months about my experiences of having a septoplasty, a procedure to correct a deviated septum, because I couldn’t find much information online. I thought recording my own journey from start to finish might be useful for other people having a similar procedure through the NHS Greater Glasgow and Clyde board…at least until I had a different procedure on the day. Still, I think it’s worthwhile finishing the blogs.

This might be my last post on the nose, as I had my post-operative follow up assessment on Friday, 15^th January, roughly five weeks after my procedure, with Mr. T, the surgeon who operated on me. He used the word ‘operation’, so I feel less bashful about using it here, although what I had done was still relatively minor. He asked me if things had changed for the better, got worse, or stayed the same. I answered quite truthfully, that all things considered, my nose is much the same as it was before the surgery. He had a look, both with his naked eye, and an endoscope, and he seemed to share my opinion, but observed that there was still some crusting in my nose as a result of the diathermy he carried out.

He explained that while I was under general anaesthetic, he’d had a closer inspection of the interior of my nose, and decided that the issue was less with my septum, which lies in the middle of the nose, but my turbinates, which are…kinda…behind the cheeks. Look, I'm not an ear, nose, and throat specialist. He then made a couple of incisions into the mucous lining that covers the turbinate using a tool which an electrical current is run through, cauterising the underlying tissue. In theory, as the cauterised tissue scars, it should shrink and reduce the blockage in my nose. He noted that turbinate reduction does have a fair chance of not working, and unfortunately it hasn't worked for me. He offered the option of trying the same procedure again, and straightening out my septum while he was at it, but I opted not to go down that route.

As Mr. T is not convinced the above would be any more successful a second time around, there doesn't appear to be any further surgical option for me; I just have a crap nose. Mr T. has prescribed me with a nasal decongestant, which he thinks I can use long-term (which I imply to mean forever and ever.) I guess I’d convinced myself that having a septoplasty would dramatically improve my quality of life, so to be back to square one, with the implication that this is a chronic condition, is a little dispiriting. However, my nose hasn't quite finished healing yet, so there might potentially be a little improvement yet to come.

As for the subject of my worsening sense of smell, Mr. T told me that smell wasn't normally linked with nasal congestion, and that mine shouldn't be so depleted at a relatively young age. As such, he’s referred me for a scan of my head and/or nasal cavity, to confirm, in his words, that there isn't anything ‘weird and wonderful going on up there’. Which is slightly alarming. So, I guess I'm due at least one more trip to the hospital with my hooter. I do have the go-ahead to start exercising again though…

I was going to write a conclusion, pondering the question 'would I do it all again?' but I didn't have the operation I was supposed to, and the replacement procedure didn't work, and I'm not taking up the option of having either of the two procedures, so I guess the answer is no? Even though it's yes? Although the NHS haven't as yet got to the root of what 's wrong with my nose, they have been thoroughly professional and lovely, in my experience, so I wouldn't be worried should I ever require anything else done. 

Diathermy to Turbinate - One Week Later

Okay, it’s not strictly a full week later, more like six and a half days. In terms of my nose, I feel okay. For the first five days after I had diathermy to my nasal turbinate, my nose ran a lot. It was like having a bad cold, but the mucous that was coming out was a weird adobe colour. And the more physical activity I did, the redder the discharge became. I had a doctor’s line for a week, so I thought I would take things easy and let my body heal itself.

Now, my nose has cleared up, and has returned to how it was before my procedure; that is, I've got a fair amount of air going through the left nostril, and not much through the right. As far as I understand it, it might be weeks or even months before I notice any real improvement in my right nostril. And even then, it might not last long – months, a few years. In retrospect, if I’d been told my options were to reduce the turbinate, or do nothing, I might have chosen do nothing. A septoplasty was a far more tantalising and long-term solution. As it stands, I'm beginning to wonder if I'm doomed to a lifetime of crap breathing. I spoke to my uncle the other night; he mentioned that he’s had much the same issues as me with his nose over the decades. Still, I need to give the diathermy time to do its job before I completely write it off.

As mentioned before, diathermy of the turbinates attempts to reduce their size by cauterizing their internal structure. As scar tissue forms internally, the turbinates shrink. I'm not sure how long this process is supposed to take and as I've previously mentioned, the mucous lining of my nose went into overdrive almost immediately after the procedure. I'm going to try and get an appointment with my GP to ask his advice, as I think I'm still at least a month away from a follow-up appointment with the ENT consultant.

My sleeping hasn’t improved any. In fact, the last week it’s been terrible – five hours a night. However, while that’s partly been due to the mucous build up, it’s mostly been due to back pain. I’ve been having issues with my back for most of my life, but they've been steadily getting worse over the last 18 months or so. I had an appointment with a physio last month, and she suggested that I might have mild scoliosis, which is slightly alarming. However, in the last few weeks the pain has racked up a few notches – the internet suggests I'm perhaps having a sciatica attack. It’s not exactly pleasant, and I think it might be hindering my recovery a little.

So, if you’re considering having diathermy to your turbinates, and you’re not sure what to expect, I can summarise my experience below. Everyone’s different after all.

• The actual time spent in theatre was quite short – around half an hour.
• I didn't experience a huge amount of pain. I guess this is because the diathermy tool only leaves small holes in the lining of the nose. I did have a headache for a few days, an intermittent sore throat, and the occasional mild dull pain where the right side of my nose meets the cheek.
• My nose generated a lot of mucous for a week afterwards – mostly this was a very mild pink, though it got more red if I over-exerted or the blood rushed to my head.
• Generally, I felt a bit lethargic for the first few days afterwards. I suppose this is normal, as your body is using energy to heal itself. The recovery period in general felt like having a pretty heavy cold. 
• I've not had any other side effects, like dental pain, black eyes etc., although the back of my hand is a bit bruised and tender from the cannula insertion.
• I've had a few days off work, which is probably useful, particularly when you work in a large office with lots of other people, and it’s December…

I’ll blog again when I have my follow up appointment with the surgeon.

The Recovery Period

I suppose, technically, my recovery period started as soon as I came round from the general anaesthetic (I'm going to call it GA for short from now on.) I think it takes the body a little while to fully reboot following GA – certainly, it wasn't until 4pm on the day of my procedure, three hours after I came round, that my nose started to fill up with mucous. I'm led to believe that’s normal after a procedure in that area. Around the same time, I noticed that the mucousy discharge was occasionally light pink in colour; again, this is a bit of blood flushing out, and it too is normal.

Other than that, I felt pretty good. As mentioned in the previous post, I left the recovery ward with some saline solution to douche out my nose, and a week’s sick line. I've been taking paracetamol every six hours or so, but in general I haven’t experienced too much pain. I'm heeding medical advice that I’ve had a GA and undergone surgery, albeit a very minor one, so I'm trying not to overdo things. I got a decent night’s sleep at my sister’s, despite waking up at 5am, again. In terms of appetite, there’s not much happening there. I had some toast, and some crumpets, and a couple of sandwiches in the first 28 hours, which is a fraction of what I’d normally eat in a similar time period.

I douched my nose for the first time the day after; I was given a pack of three 20ml bottles of saline solution, and a syringe to inject them. It wasn't a complete success; my right nostril was too congested, so it all just came straight back out again. When I did it later, I did both nostrils.

My sister drove me from her house back to mine, stopping at a couple of shops on the way. Generally being in shops taxes my patience, so they were probably a good test of how I'm getting on. I feel that I have something a little worse than a heavy cold, but not quite as bad as flu; running nose, tiredness, occasional pain about the face, headache, lack of appetite, with the caveat that I can’t blow my nose to try and ease the pressure, at least not for the first two-three days. Writing on Saturday night, two-and-a-half days after the procedure, I still feel a bit fluey – I haven’t been eating a huge amount, I'm still getting a wee bit of blood in my mucous, and a bit of sinus pain. Any information I can find on recuperation for my exact procedure suggests I should rest for a week, and avoid places that are full of people with the lurgy. The thought of driving down to the shop crossed my mind earlier, but even if I was feeling up to it, I don’t think it would have been a good idea.

In terms of prognosis, I'm not entirely sure what’s going to happen in the next few weeks, because as mentioned earlier there’s not a lot of info out there on the internet. In retrospect, that would probably be my own complain with my treatment at the hospital; because I didn't have the same procedure that I went in for, I feel that I don’t have the same information about the procedure, recovery, prognosis etc. that I gleaned over the weeks leading up to my supposed septoplasty. I think the nurse on the ward thought I was being a bit neurotic, but I genuinely wasn't sure what to do with the nasal douches, what medication to take, how long I should hole myself up like a hermit.

I've got a doctor’s line for a week. I've been told not to take any exercise until I see the consultant again, which could be in up to 8 weeks’ time. What will be interesting is what happens with the site of the incision, such that it is. Slow and steady.

The Day of Surgery

Preamble – I apologise for the rambling nature of this blog post. I've tried to faithfully record my operation for two reasons; firstly, for my own record, before the details fade from my memory. Secondly, as I've mentioned earlier, while researching septoplasties, I didn't find many accounts of the process, and especially few relating to NHS health trusts in my area. If this does help anyone, then great. If it doesn't, I have my own record of my first ever in patient experience.

I haven't been sleeping well recently due to some ongoing back pain, and I don't tend to sleep at all before big events anyway, so I was never going to get a good eight hours. I went to bed around 9:30pm, and slept fitfully. My sleep app recorded me waking and falling asleep four times over the course of the night, before I eventually woke irrevocably at 5am. This wasn't such a bad thing; it was recommended I have a cup of water at 6am anyway, the last thing I could ingest as part of my fast before my anaesthetic. I lay in bed for a while until I had my water, and was then showered, dressed and out of the house by 6:30am. As you’re not allowed to drive after a general anaesthetic, I was taking the bus the couple of miles to Gartnavel. As I don't really trust buses, I wanted to leave plenty of wriggle room - unusually, I even packed my bag the night before, unprecedented levels of preparation for me. As a result, I arrived at hospital at 7am, a whole hour earlier than the time on my appointment letter. Thankfully, the surgical admission unit was already open for business, so I was able to get admitted straight away (I was the first day case patient to arrive.) I would meet a lot of nurses and doctors throughout the course of the day, and I can’t remember all their names, but they were all lovely and friendly and did their best to put me at ease, which isn't an easy task. I first saw Akua (I think), who checked my details. She wasn't aware that I'd had a pre-op assessment at another hospital, and seem frustrated the other hospital hadn't passed that information on when I told her. This meant she had to repeat everything that had been done at the pre-op – pulse and blood pressure readings, health questionnaire, height and weight (used by the anaesthetist to calculate how much anaesthesia you need.) She fastened an identity band on my wrist, and then returned me to the waiting area.

The next person I saw was the anaesthetist, who asked me many of the same questions I'd already been asked. I was reading the book ‘Adapt’ by Tim Harford, which describes how organisations become successful by learning from their mistakes; while I was in the waiting area in admission, I happened to read a passage which recounted the multiple security steps many organisations have in place, to try and catch cataclysmic failures before they happen. Clearly the NHS have a similar philosophy in place, where patients’ details are checked continuously to make sure they’re in the right place and having the right procedure carried out. Between 8 and 9am I met my surgeon for the first time. Mr. T is a pleasant Greek, and as he looked over my notes from the consultant that first examined me (Mr. B), he told me he didn't think that a deviated septum was my problem. Instead, he felt I had problems with the turbinates on the right side of my nose, but he'd carry out a closer inspection while I was under (‘Examination under Anaesthetic’,) and then proceed from there. I signed the consent form, and he told me he'd see me later. I had another short wait before I was invited to change into a gown (actually 2 gowns; one worn with the opening at the back, one with the opening at the front,) paper pants (far more comfortable than they sound), and a pair of foam foot-covering things I shall call ‘shlippers’. I'd brought my own slippers, but was told I couldn't wear them.

I then went through to another waiting area where a few other day case patients were waiting for a bed, and to be taken through to the anaesthetic room. Four of us were sitting in facing chairs, in matching gowns and wristbands anxiously awaiting our fates and it reminded me of the following scene from Hostel 2:

After a couple of hours (which I whiled away reading ‘What If?’ by Randall Munroe and filling in a questionnaire on nasal symptoms for Mr. T, it was my turn to get ready. A pleasant young doctor/nurse named Emma (I think) took me to my bed and got me ready, taking my outer gown and shlippers, covering me with blankets, and giving me a surgical cap to wear. She told me there was still a patient in theatre ahead of me, but she was getting me ready now to make things quicker when it was time to go. True to her word, she was back in ten minutes or so, and wheeled my bed the short distance to the anaesthetic room.

There, I was greeted by the male anaesthetist I'd met that morning, plus another female anaesthetist (I can’t remember either of their names.) They set about getting me ready, placing a cannula in the back of my left hand, to allow them to administer the anaesthetic, any other medication, and a drip. While the anaesthetist was pushing the needle into the back of my hand, ‘Emma’ patted my shoulder comfortingly. I'm okay with needles, being a regular blood/platelets donor, but I appreciated the gesture nevertheless. The team then fitted three sensors to my chest; one just below each collarbone, and one on the left side of my ribcage. Completing the electronic monitoring, they strapped a blood-pressure cuff around my right arm, and placed a blood-oxygen clip on my finger. The male anaesthetist emptied a syringe into my cannula, and told me I might become a bit woozy; I remember nothing after that. Not the cliché of counting back from 10, not feeling sleepy, nothing.

I came to in the recovery room, with no way of knowing how long I had been in the operating theatre for. I had a breathing mask over my mouth and nose, but I wasn't in too much pain, other than my right front upper tooth, and the back of my throat. Both are normal; the dental nerves run close to the nose, and the breathing tubes inserted during general anaesthetics often scrape the throat, apparently. I didn't, and haven’t experienced any nausea. The nurse at my side told me the surgeon had done a different procedure to what I'd gone in for, but I was perhaps still a little too out of it to comprehend her properly. I was on a drip, but she let me have a couple of cups of water, and some paracetamol, to help with the pain. After what felt like ten minutes in recovery, possibly longer, I was taken up to a ward to begin the observation phase.

Before your surgery, a nurse checks what your normal pulse and blood pressure (obs) is, as a baseline. Then, post-surgery, they check your readings every hour or so to make sure you're getting back to that baseline. Hospitals don’t discharge you until you've eaten, drank, and passed urine and your obs are what they should be.

I was wheeled into the observation ward at roughly quarter past one, and slid from the trolley onto the ward bed. The ward nurses measured my obs and checked in on me on a regular basis. Shortly, I had some toast, and a jug of water to drink from, and I amused myself by reading some more of my book and letting the world know I'd survived.  My surgeon appeared at half past three, and confirmed that he hadn't done a septoplasty. Instead, he had indeed felt that my turbinates were my problem, so he'd reduced these with a cauterising tool. He then gave me instructions to douche my nose with saline over the next few weeks.  A short while later, another lovely nurse (Mary, I think, a second year student around the same age as me) removed my cannula (how I can’t remember her name for certain when I was staring at her namebadge throughout that fairly painful process, I attribute to the anaesthesia), and brought me some orange juice, just in time for my sister and my niece to arrive to collect me. When you've had a general anaesthetic, hospitals mandate that you should be looked after by someone for 24 hours afterwards, and that you shouldn't do too much. My sister had volunteered to be my carer for the night, so I was free to go with my letter of discharge, my sick line, and my nasal douches.

In my sister’s house, I noted that my discharge letter was printed off by my surgeon at 12:12pm. The last time I looked at a clock in the surgery unit, the time was half-past elevenish. Allowing for ten minutes preparation, I think I must have spent around half an hour in theatre. I sent a message to my sister just after I arrived on the observation award, at 1:18pm. I don’t feel like I spent an hour in the recovery room...but assuming the clock on the computer that printed the letter is right, I think the approximate timeline of the day is as follows;

07:00 Arrive at hospital

07:10 Admitted

08:00 Speak to anaesthetist

08:30 Speak to surgeon

09:00 Change into gowns

09:30 Arrive in pre-surgery waiting

11:30 Prep for anaesthesia

11:40 Anaesthesia

11:42 EUA/Surgery

12:12 Recovery

13:18 Observation

16:30 Discharge

My discharge letter does show the full title of the procedure I had – Submucous Diathermy to Turbinate of Nose. Having spent the previous two months preparing and researching septoplasties, to undergo another procedure entirely has messed with my head a little. I've tried to read up a little on what this new procedure actually involves. The nose is apparently much bigger internally than that little flesh triangle that protrudes from our faces. There’s a lot of bone and cartilage in there; the first consultant I saw thought my chronic rhinitis was due to a deviated septum, which is a kink in the cartilage in the middle of your nose. However, there are sea-shell shaped (their Latin name is Nasal Concha) bone shelves in your nose, called turbinates. You have a pair of three, either side of the nose, and the largest can be similar in length to an index finger. The turbinates are covered with mucosal tissue, and effectively they act as a filter for air before it enters your lungs. Mr. T clearly thinks my rhinitis (runny & blocked nose, loss of sense of smell, sneezing) has been caused by turbinate hypertrophy, or swelling, in other words. Unlike septoplasty, there’s less information on the internet for submucous diathermy (other than its abbreviation being SMD), but it appears to involve using a cauterising tool to shrink the troublesome turbinate, while leaving the mucous membrane that sits atop it intact. I'm somewhat unclear as to whether this means shrinking the turbinate bone itself or the underside of the mucous lining atop it. While I thought that a septoplasty was a relatively minor operation, it appears that an SMD is even less complex, and since I came round from surgery, I haven’t experienced too much pain. I have however been taking paracetamol on a regular basis.

I have to confess to being incredibly anxious in the 10 days or so leading up to my procedure (I don’t think I can call it an operation with a straight face any more.) I said as much to the anaesthetist in the morning, hoping he might give me something to settle my nerves. He reassured me the process was quite low in risk; I was fairly accepting of the risk, but I'm just one of those people that gets nervous about things. Still, as I mentioned previously, the nurses and doctors were brilliant and fussed over me to an extent even I found acceptable. As far as my nose goes, it’ll probably be between 2 weeks to 2 months before I notice if there’s been any improvement. Guess I’ll just have to be…ah, I've already used that gag, haven’t I? 

The Pre-Operative Assessment

I’d probably write a blog about my experiences during my upcoming septoplasty operation anyway, because I enjoy writing, and I think it’s important to record my experiences, because memories fade, and are subjective at the best of times.

Doing my research into the procedure though, it’s become evident to me that not all operations/health boards/patients are created equal. There seem to be a lot of differences in the way neighbouring NHS trusts in the UK go about their business, and I've found it difficult to find any accounts of anyone having undergone the same procedure as me in the same health board as me. I'm probably worrying too much about Having An Operation, but I thought I’d try and include as much detail in these blog posts in case anyone else from Glasgow finds themselves looking for an account of what happens throughout the entire process.

As I mentioned in my last post, on Saturday I received my appointment letter for my pre-operative assessment. On Monday, while I was trying to check with my manager that they were okay with me attending the pre-op, my mobile started ringing. It was an 0800 number, and as I dithered about answering it, thinking it might be some sort of scam, it went to voicemail. Checking the message, it was from the appointments department at Gartnavel, so I rang them back immediately. “We can offer you a date for your procedure,” the lady on the other end of the phone told me. “10^th December.” The stylus was ripped from the record of my mind. “10^th of December,” I could only mindlessly repeat. “I’ll need to think about it.” “That’s fine, but could you let me know by 1pm?”

The letter I received when I was added to the waiting list stated that the absolute latest I would undergo my op would be the 12^th January, so that was the date I had in mind, and had planned for. A date almost five weeks earlier was entirely unexpected. I’d been worrying about the surgery and recovery time eating into my festive period, but some quick mental arithmetic informed me that even with two week’s recovery, I should be in decent shape by Christmas Eve. That was encouraging, so I confirmed with my bosses, and phoned back to accept the appointment.

I wondered in my last post if my symptoms are getting worse, or if I'm just imagining it. I do seem to be experiencing a fair amount of pain in my sinuses, I'm constantly having low-grade headaches, and the entire front of my face feels incredibly muggy. This might be down to the fact that it’s been raining in Glasgow a fair amount the last couple of weeks (it normally rains less than you’d imagine.) My sleep app, which records my movement in bed at night, suggests that I'm more restless and my sleep is worse when the weather is wet. The trouble is, I've no idea if this is normal for humans, or it’s symptomatic of people with sinus problems. Oh, and I'm sneezing a lot as well.

The most complicated part of my pre-op was getting to the hospital. While the Royal Infirmary is my nearest hospital, it's a near two mile walk. I didn't particularly want to turn up for a physical assessment being a bit sweaty and smelly, which ruled out walking. My manager informed me that parking at the Royal is terrible, so I decided to get the bus. The trouble with public transport in Glasgow is that it's atrocious. It's deregulated, and not joined up, and under-funded. I had planned on buying an electronic ticket using the First Bus app, but it transpires they don't do day tickets via the app. As I didn't have any change, I had to walk to Buchanan Bus Station.

Like most bus stations, Buchanan is not a place where logic thrives. Trying to work out which bus to get, and where it departs from requires a fair amount of local knowledge, patience, and time. Online timetables say one thing, the printed timetables another. The comings and goings of the buses themselves don't agree with either. Google maps told me I was better walking to Cathedral Street and catching a 38, so I did, and I was at the hospital within a few minutes, and 15 minutes early for my assessment.

Regarding the pre-op itself, I felt like I do when I take my car for an MOT; nervous about what close inspection might throw up. The world’s worst disease, found only in me, and named for me. But my examination was over in 15 minutes. I was asked a few questions about my general health, had I had an anaesthetic before, do I have any dental veneers (yes, one.) Then my nurse measured my height and weight, and recorded my blood pressure and pulse. She fielded a couple of questions that I had, and then I was free to go.

There was one small element of confusion, when we were discussing who would collect me from the hospital after my operation. Logistically it would probably be easier for me to stay overnight, and the nurse said that wouldn't be a problem at the Queen Elizabeth. “But my operation’s at Gartnavel,” I told her. “Oh,” she replied. “Well, they don’t have beds. You couldn't stay overnight there.” I got the bus back into town, bought my lunch, and waited for another bus that would take me back to my flat. After 20 minutes, no buses for either of the routes I can take had turned up, so I walked the mile or so home.

As I’d arranged my appointment over the phone on Monday, I still hadn't received a letter of confirmation. When I got back to the flat, there was still no sign of it, so I phoned the number I’d been given on Monday. They told me to phone my consultant’s secretary, which eventually cleared up the confusion. The consultant I’d first seen, Mr. B, operates at Queen Elizabeth. It transpires a different consultant, Mr. T (I know,) operates at Gartnavel. And evidently that’s where the first free appointment is. I was given the option of rescheduling, at the Queen Elizabeth, but I feel committed to the date now.

Having got the pre-op out of the way, I feel a little more relaxed now. I think I was actually more concerned about latent illnesses being exposed during my assessment than the surgery itself (latent illnesses remaining undiagnosed I'm quite comfortable with; out of sight, out of mind.) As for the operation itself, I suspect I’ll be doped up to my eyeballs most of the time I'm not awake, so that’s not such a big deal. The next seven days will fly in, in all likelihood. 

Nose 3

I'm the sort of guy that worries about everything in my life, so it'll be no surprise to you to learn that the spectre of my upcoming nasal surgery is continually lurking in the abandoned amusement park that is my mind. I related in my last post how I was a little frustrated at the lack of definitive information about what I can expect on the day, and I'm still mostly in the dark (mostly.) I did speak to my friend Emily about her experience undergoing surgery, and while it did settle my mind a little, the caveat remains that Emily's op was more complex, and involved a different NHS health board. Two, I think.

I've been wondering recently if my deviated septum symptoms are getting worse, if I'm just more hyper-aware of them, or if the increasingly cold weather is having an effect. I've been sneezing a lot, even the good (left) nostril feels blocked, and I've been experiencing some mild sinus pain. In addition, I've tried to walk while eating recently, and that hasn't really gone well; within a few seconds of starting mastication (stuffin' mah face), I find myself gasping for air.

Since my visit to the consultant, I've wondered if my breathing affects my sleep, and I read somewhere that if you have to consciously aid your inhalations, because you feel you're not getting enough oxygen, when you're sleeping, you won't be able to do that, and so you might wake yourself up to get more air. I'm not conscious of this happening, but the sleep app I use does suggest that I wake up on average 2-3 times a night. I'm not yet sure if this is normal or not.

I took a long walk yesterday morning in the cold November rain, and when I got home there was an appointment letter from the NHS, inviting me to a pre-operative consultation, to assess my health and ensure I'm fit for surgery, and for me to glean any further information. My appointment is next week, at the Royal Infirmary; my previous letter about the waiting list was from Gartnavel. So, that's a little confusing; do Gartnavel just oversee appointments for the north of Glasgow, or are various stages of the process handled by the nearest facility capable to do so? I suppose in the grand scheme of things, it's no big deal whether the procedure itself takes place in Gartnavel or the Royal.

A number of people whose blogs I've found through Google, and Emily, had their pre-ops a week before their surgery. I'm also a wee bit concerned by that; ideally I'd like my op to take place in early January, to allow me to enjoy the festive period. I've got a few, rare (social!) things on over the next few weeks. I'm sure Emily said she received her surgery date at the same time as her pre-op date; perhaps I should have received another letter with the date of the actual surgery? 

Still, I'll have the chance to ask questions at my appointment next week. In preparation for the assessment, I've been brushing up on my medical history. Generally, I've been quite a healthy person, with no underlying conditions...that I'm aware of. I had a physiotherapist appointment on Friday, and she told me she thinks I have mild scoliosis, but I don't think that's anything to be too worried about. Most of my surveys of hospital interiors have come as a result of minor injuries and trips to accident and emergency, but there have been a few outliers.

I'm not sure if it still happens, but teenagers in the United Kingdom used to receive inoculations to prevent against tuberculosis. You would leave class one day, visit the nurse, have some testing serum injected into your forearm (known as the Heaf test, in my day), and depending on how your skin reacted, you would either receive the BCG (Bacillus Calmette–Guérin) vaccine, or you would get a trip to the hospital for a nice chest x-ray. My skin did react, and so I had my lungs x-rayed, but I never received any treatment, or vaccination. As my mother was my guardian at the time, and therefore the point of contact regarding consent and information, and as she can be a little bit scatty in this respect, I never did find out what the story was behind the x-ray. And it bugged me a little. I mentioned it to the physio on Friday while we were talking about my medical history, and she’d had the same experience. It transpires that if your skin reacts to the Heaf test, but your x-ray doesn't show tuberculosis, it implies you've been exposed to the disease when you were younger, and developed a natural immunity. Which makes sense to me.

I've only actually been admitted to hospital twice in my life. Once was when I was born. The second occasion was five years ago. I’d been taking stronger and stronger anti-inflammatories to combat an ear infection, and one morning I took them without enough food in my stomach, due to my complete lack of appetite. Within a few hours, I was in the emergency surgery unit at the local hospital with the worst (to date, still the worst) pain I've ever experienced. While it eventually turned out to be gastritis, an inflammation of the stomach lining caused by the anti-inflammatories, a not-especially serious condition, I did find myself wired up to an electrocardiogram machine, and on a drip for a while. A week or so later, a trip to the ear, nose and throat department in the hospital revealed that my ear infection was actually a cyst in my ear canal; I don’t think anti-inflammatories would have helped.

I wrote about the subjectivity of memory in my last post. While I was in the emergency surgery unit, a nurse affixed a red identity wristband to my arm, after having asked if I was allergic to anything. I am; penicillin, but that’s another long story. I thought that my allergy was written on the bracelet, but digging it out on Friday, it appears it wasn't. Further investigation suggests that the NHS, again, have a bit of a mixed bag policy as far as patient ID bands go. Some use different colours for different reasons; red for allergy, yellow for fall risk, etc. Some use coloured bands in addition to the standard white ID band. Some use coloured bands instead of the white ID band (as in my case above.) Some note the allergy on the band, some don’t. In a guidance document I found online, it was suggested that allergies should not be noted on ID bands, as care-givers should cross-reference the patient’s ID with their notes before any medication is administered. All of the above reinforces that there’s a fair amount of inconsistency in the NHS, but that’s perhaps to be expected in an organisation of its size. It does however mean that I'm still not quite sure about what awaits me over the next six weeks (yes, I'm very aware this is all paralysis through analysis.)

Still, I guess I'm about to find out…

Nose 2

A few years ago, I developed a bit of a problem with my knee. It swelled up one week, and when it returned to normal size, I found I couldn't ascend or descend stairs or run without experiencing a sharp pain.  I saw three physios, did a lot of strengthening exercises, and lost three stone in weight before it got any better.

Looking back on my contemporaneous blogs a year or so later, it amazed me that I'd managed to forget just how bad my knee had become and how limited my range of movement was. That's not surprising; human beings tend to process memories through a filter of subjectivity, and sometimes we selectively forget things. Remembering this, I'm going to record in this blog all the problems that I'm having that I ascribe to my deviated septum, in order to better ascertain in the future if the septoplasty was a success.

My diagnosis was somewhat unusual for me. I'm quite possibly a hypochondriac, so sometimes I collate physical symptoms and then convince myself that I have all manner horrific illnesses that match those symptoms. With my nose however, I received a formal diagnosis before I became aware of all the associated potential symptoms. I've always felt that my nose isn't right, but the two most annoying aspects about it have been that I can't breathe through it very well, and that it constantly feels like there's something stuck up there. My visiting the doctor was the result of finally becoming fed up with the two sensations noted above.

Since receiving a formal diagnosis, I've done a bit more reading into the symptoms of a deviated septum, and some of them are pretty familiar. According to Wikipedia, the symptoms of a deviated septum include the following:

Infections of the sinus - This I don't think I suffer from, but I am aware that my nose gets bunged up a hell of a lot.

Sleep apnoea - Potentially. Sleep apnoea is a condition where an individual stops breathing during the night, the brain notices a build-up of carbon dioxide, and signals the body to wake up. Generally sufferers don't know this has happened, but they do notice that they suffer from daytime tiredness. I've been using a sleep app for the last few years. It records how much I move in bed, and from that infers how much time I've spent in deep sleep, light sleep and awake. Without fail, I seem to wake up 2-3 times a night. However, sufferers of sleep apnoea wake a lot more than that – generally 5 to 10 times an hour.

Snoring - Yup.

Repetitive sneezing - I actually do this a lot. Apropos of nothing, in the office, I will suddenly start sneezing away. I had attributed it to my nose being interrupted by paper motes floating about the office, but in retrospect perhaps not.

Facial pain - In line with the infections of the sinus, I do regularly experience pain at either side of my nose and behind my eyes. Again, this might be related to spending all day staring at a computer screen.

Nosebleeds - Don't experience this at all.

Difficulty with breathing - This is certainly true. I can't breathe through my nose much; while my nostril is okay, I think it gets overloaded from having to do the work of two. I struggled to walk and eat at the same time, and I noticed that playing football the other night I found it really difficult to breathe at all. Of course, this may have been due to the cold.

Mild to severe loss of the ability to smell - This is certainly a concern.

I've also developed a mild case of gingivitis between my two front teeth, and apparently this can be caused by breathing predominantly through the mouth at night, which I do. The nose is far better at filtering bacteria from air than the mouth is, and so at night this can all fester in your gub. On top of all that, whenever I'm outside, my nose is running. Always. It’s ludicrous.

That’s everything I can think of for now. I’ll add anything else I can think of in later posts, to try and get the fullest picture I can of just how conked out my conk is.

Days of Lines and Noses

I've never been on the waiting list for an operation before. It’s a curiously discombobulating experience, mainly because I have no idea when the surgery will actually be scheduled, and that’s a massive known unknown. While I'm familiar with the long periods of nothingness between my GP referring me to the hospital for a consultation, and receiving the letter that confirms my appointment, that’s a slightly different kettle of fish. I've been to four such consultations in the last few years, but each one has lasted an hour at most. None of them have involved a two week physical convalescence. I think that’s what I'm most concerned about.

My letter confirming I was on the waiting list stated that I am ‘guaranteed to be admitted for treatment within 12 weeks.’ The 12^th of January 2016 is the latest date I should expect the operation to be carried out. That’s almost as much as I know. Ideally, they would schedule me in between the 6^th and the 12^th January – otherwise, I'm a little concerned that my festive period would be disrupted. I have a few nights out, a friend’s birthday do/Star Wars showing, and 2 weeks’ annual leave planned at Christmas; I would be a little disappointed if I missed out on any of that, even if it were for the long-term good of my health. So, I've been trying to find out more about what's likely to happen, partly due to my increased research dependency.

When I was studying Standard Grade Art at secondary school, the teacher emphasised the importance of research when preparing to start work on a drawing or painting. I wasn't particularly receptive of this wisdom when I was 14 – surely I knew what an apple looked like? However, over the intervening 20 years, I've come to value the importance of research, through my studies and my professional career. Today, in my job, I have to be able to put contracts in place for various, disparate commodities, and quite often the subject matter can be things I've had no real prior knowledge of. Learning about the product, or the service, rapidly, is key.

I like to write fiction in my spare time, with the semi-serious aim of one day being a published novelist. Again, as I've grown older, I've found that the time I spend researching my stories outstrips the time I spend actually writing (of course, some of this ‘research’ is diversion; like good writers, I procrastinate a lot.) I find that I have to completely understand all facets of the story I'm trying to tell, lest it appear inauthentic. This is probably a reaction to 30 years of being exposed to popular culture that is riddled with plot holes and factual errors, and dedicating several person hours to reading TVTropes.org from cover to cover.

If you’re not familiar with TV Tropes, it’s a fantastic wiki-style site where users (or Tropers) catalogue the various conventions, crutches and plot devices (tropes) that fiction writers often use when creating films, TV shows, etc. One of the Super Tropes documented on the site is ‘Reality is Unrealistic’, which collects a series of tropes that describe the disconnect between what culture portrays as ‘reality’, and what reality actually is. These tropes cover situations that arise when the viewer or reader thinks a situation described in fiction lacks verisimilitude, but which is actually firmly based in actual science or real life events. A very quick example might be that Brigadoon wasn't filmed in Scotland, because the location scout allegedly couldn't find anywhere that looked Scottish enough. Take a look at the trope page; there are many more examples.

Clearly for writers, there’s a danger that no matter how much or how little research they do, there’s a danger that the end product of their endeavours comes across as realistic, or unrealistic, depending on cosseted by TV and film their audience is. While I await my letter inviting me to have the inside of my nose hit with a hammer (I'm assuming that’s what they’ll do, I haven’t looked into the actual procedure too closely,) I've been trying to find out what I should expect to happen, as a patient.

The NHS being is a large UK-wide bureaucracy, but there are devolved elements in all four constituent countries. Each country’s service is then further broken down into regional trusts, and some (but not all) of these trusts have issued their own guidance on septoplasties. Apart from the trust carrying out my operation. There are a number of minor differences in each guidance, mostly relating to things like the time spent in hospital post-op (a few hours to overnight) to the recovery period (one week to two weeks.) However, I suppose every patient and case is different, and requires different treatment. At this stage, therefore, I still don’t quite know what to expect. My research has uncovered a fair amount of variables.

I'm taking part in National Novel Writing Month (NaNoWriMo) again this month, a contest of sorts where you challenge yourself to write a 50,000 word in 30 consecutive calendar days.  As alluded to earlier, I find myself being drawn towards more and more research, fastidiously working out the logistics that underpin the characters’ existence. But sometimes I worry that I'm doing too much research, and that it’s stifling my creativity. My experience of reading up about my septoplasty suggests that my experience of the procedure might be very different to someone that had their op in Ayrshire, or Devonshire. They might find my account of my surgery less realistic, because there are things that our respective NHS boards and specialists did differently, or our physicalities are not quite the same.

Hopefully, this will inspire me to be less anal about the levels of research I'm doing. The great thing about novels is that they capture a world that doesn't exist. They’re escapist and fantastical, and I'm not entirely sure readers would mind if I made up the location of a motel in the Florida Keys that my protagonist spends a night in, instead of spending time in Google Earth trying to find one that actually exists. I think verisimilitude is important, but I'm worried that I've become a slave to realism. Back to the Future is one of my favourite films, a ridiculously tightly-plotted tale with some of the finest mise-en-scene in cinema. Yes, Robert Zemeckis and Robert Gale did pain-staking research for all three films in the trilogy, but the central premise still involves travelling through time in a DeLorean. Great fiction doesn't have to be realistic.

Waiting to Inhale

As far as I can remember, I've had a problem with my nose; I've never been able to breathe properly through it and I'm constantly suffering colds, and as for the snotters! They’re beyond a joke. More recently I've become aware of an alarming degradation in my senses of smell and taste. It dismayed me when I could no longer smell that wonderful cold, metallic tang that seems to permeate Glasgow in Autumn and Winter, as I associated it with some particularly vivid sense memories.

For most of my life, I've tolerated all these problems, and the persistent feeling that there's something up there, blocking my airwaves, but this acceptance has dwindled over the last few years, for a multitude of reasons. Firstly, I took up running, cycling, and swimming in a way I’d never previously done, and I became more aware of my own breathing. Secondly, someone told me that human beings are actually supposed to breathe in through their noses. Our noses have all sorts of filters and what not that clean and optimise the air we inhale before it enters our lungs. Thirdly, I discovered a list of associated problems that can afflict us so-called 'mouthbreathers'; headaches, sinus problems, gingivitis, disrupted sleep...

Lastly, one evening I happened to be watching an episode of ‘Embarrassing Bodies’ where one of the programme’s resident doctors received treatment for nasal polyps, as they were reducing her sense of smell and affecting her breathing. My ears pricked up. Could polyps be my problem? I decided to go to arrange an appointment with my doctor and once more set out my nose woes.

I'd been to see a GP many years ago about my nose not working, but other than her noting that there seemed to be 'something' (very non-committal) going on, nothing came of it. My current doctor wasn't sure he could see anything of note, and prescribed me a nasal decongestant.  After a few months of using the decongestant, I made a follow-up appointment to told him it had had no effect. He prescribed a stronger decongestant, and referred me to the ENT department at the local hospital. On the 7th September, I received a letter inviting me to an appointment in the Ear, Nose and Throat Department of the nearby Royal Infirmary in Glasgow, six weeks hence; a fairly rapid turnaround in my experience of specialist consultations. 

In the meantime, I realised I hadn't donated platelets in a while, so I headed down to the donor centre to arrange an appointment. (Because I have O negative blood, and an abundant supply of platelets, I recently switched to donating platelets instead of whole blood.) While I was there I remembered that the Blood Transfusion Service can be a bit funny about accepting you for a donation if you have an upcoming medical appointment (doctor, dentist, etc,) so I mentioned this to the nurse. “What are you seeing the consultant about?” she asked me. “Problems with my nose,” I told her. “I think it might be polyps.” Almost off-handedly, she commented “Probably a deviated septum,” and that I should come back after I’d seen the specialist. After I left the clinic, I looked up what a deviated septum was. 

Humans are supposed to have a strip of cartilage and bone running up the centre of their noses, dividing the two nostrils. This is known as the nasal septum. It’s not entirely uncommon for the septum to be somewhat crooked, but in some cases, the cartilage can deviate more severely to one side or the other (or in some cases both!), causing that nostril to become blocked. Many of the symptoms of a deviated septum are similar to those of polyps, so that gave me something to think about.

The day of the appointment was this Monday; as the Royal Infirmary is only a couple of miles or so away from my flat, I walked over, taking my camera to snap anything I saw of interest on the way. I wasn't kept waiting too long before being called into my appointment. The consultant was as consultants are quite often stereotyped in medical dramas; earnest and a little matter-of-fact. He was accompanied by a medical student, who was Welsh and had a very Welsh name. The consultant asked me a few questions about my nose and my breathing, if I had any allergies, and if either nostril was worse than the other. I replied that the right was far worse, and so he looked at that one first, with his naked eye and a flashlight. Within literally seconds, he had diagnosed a badly deviated septum that is blocking a fair amount of my right nostril. 

He then took a closer look up each nostril with a fibre optic camera, which wasn't an entirely pleasant experience. That done, he confirmed his diagnosis, and informed me that, if I wished, I could undergo a minor operation to realign my septum, known as a septoplasty.

I was a little taken aback, if I'm being entirely honest. I wasn't really expecting him to say there was anything that could be done. I’d read about septoplasties after my conversation in the Blood Transfusion Service , but I suppose I had resigned myself to being told that my nose wasn't that bad, that I’d lived with it this long, and so on. I had to ask him for a little more information, then asked if I could think about it. He said of course. So I went on to work, where I mulled my decision over with my colleagues, then returned home for further reflection, and to sleep on it. 

‘Operation’ is a pretty big word, both literally, and figuratively. When I was perhaps six or seven years old, my father took me up to Glasgow one day. A trip to the big city was always exciting, and I wasn't even concerned when we entered the dental hospital on Sauchiehall Street. I was taken into a room and sat in a chair, and a nice man put a mask over my face. 

When I awoke, some time later, in a waiting room (not even a recovery room) I had had four milk teeth removed, and blood was gushing from my mouth. I was terrified. That to date has been my only experience of a general anaesthetic, and it wasn't particularly enjoyable. I suppose I can understand why parents didn't mention to me that I needed to have four molars removed to make room for my adult set (perhaps they did and I’d just become engrossed in some wheel trims, as I did back then.) The only other time I've had a procedure done (cyst removal under local anaesthetic) I was 15 or so, and my mother must have given consent. However, this time the consent for someone removing parts of my body with sharp implements remained solely with me. It was my decision.

I did some research into the operation online, its risks and benefits, and spoke to some friends and family that have had similar procedures. I'm not double-checking the figure for obvious reasons, but I think you're more likely to die during an operation than you are to win the lottery. My sense of smell worsening, or the surgeon failing to straighten the cartilage adequately are more likely complications. However, on balance, I decided that having the surgery would benefit me. The next day I phoned the hospital and asked to be added to the waiting list. 

For much of the rest of the week, I've been wondering if I made the right decision (although I'm sure I have), and searching Google for a little more information on what’s involved in day surgery. You see, I do worry about things a bit, and it’d be nice to know every small detail in advance…I am a fan of the NHS, but it is a huge bureaucracy, and no two units/hospitals/trusts seem to do the same thing the same way. If you search for ‘septoplasty’ NHS, you’ll find a bewildering array of pdfs, docs and Power Point presentations, all saying much the same thing in slightly different ways. Will I need a pre-assessment? Will I be in hospital for one day, or overnight? Where the hell will I find a responsible adult to look after me for 24 hours? Some details are still up in the air.

Still, a least one of my questions has been answered. I received a letter in the post this morning from Gartnavel General, confirming that I've been added to their waiting list, and they guarantee that I’ll be operated on before the 12th January 2016. Just the 12 weeks to fret and worry. I'm sorry, I'm not very patient. 

But I'm positive. I hope this procedure will help with the uncomfortable breathing that I've had to put up with for most of my life. I may see small improvements, but small improvements can add up. 

Here’s hoping.

I’ll keep you posted. 

Nuevo Leon State Highway 1 Spur

Ten years ago, I still dreamed of being a rock star. I was playing guitar for a Birmingham-based indie band, and we were in the process of recording a demo CD. It was a very exciting time.

Fast forward five years, and I was barely playing music at all. I hardly ever picked up my guitar, and while I once had been writing virtually a song a week at university (they weren’t great songs, but that’s not the point), I was experiencing a long fallow period.

In addition, I was struggling to get used to the recording software I was using. It all seemed to complicated, compared to my trusty technique of using two tape cassette recorders to create multi-track demos of the song ideas I was coming up with.

And then, on one of the social media platforms I’m a member of, someone alerted me to the Wikipedia album game. The premise was simple; you navigated to the Wikipedia homepage, pressed the ‘random article’ button 13 times, and this gave you your album title and a dozen track titles. At a loose end, as I regularly am, I dutifully did as instructed, and then a thought occurred to me: why don’t I actually record the album?

My thought process was thus; if I kept the songs simple, and avoided instruments that were difficult to record, such as electric guitar, bass and drums, and I came up with songs quickly and instinctively, like Paul McCartney did with his Flaming Pie album, I could have the album recorded in double time. Lyrics, arrangements, recordings; all should be done promptly, without getting bogged down in thinking too much. I should keep things fresh.

That was four years ago…needless to say life got in the way a little. But I now have a decent recording set up, and the band I’m a part of ebbs and flows a little, so I’m ready to embark on the process of getting these songs finished and into the world. I don’t have set rules as such, but I am following the ethos of mainly using acoustic instruments, while I grow more experienced at engineering and mixing, but that’s not to say a full band sound is completely verboten. I should improve enough to give it a go.

I will be creating a bespoke illustration for each song. I’ve long neglected my drawing and painting skills (a ‘D’ in A Level art, I’ll have you know.) I’ve felt somewhat guilty about that, so it’s a good excuse to blow the dust off my art materials. With practise, the illustrations should improve as well.

So that’s it. Without any further ado, I present the first track from ‘Nuevo Leon State Highway 1 Spur’, Sixth Street Historic District. I hope you enjoy it.

Edinburgh Half Marathon

I’m not exactly sure who it was that talked me into entering this year’s Edinburgh half-marathon, part of a weekend devoted to running events in Scotland’s capital. It was either Jude, or Faye from work, or a combination of the two. Nevertheless, on the 19th January I decided to bite the bullet and sign up for a race that was twice the distance of anything I’d ever attempted before.

Of course, entering a race four months in advance allows plenty of time for things to go wrong, in a musculoskeletal sense. While my knees aren’t currently giving me the bother they had been for a while, the gremlin of shin splints always appears to be lurking. As mentioned in my last blog, a few weeks ago I decided to take up the offer of a second game of 5-a-side football in a week. Since then, my shins just haven’t felt right. They haven’t been painful as much as threatened to down tools. As such, I’ve been resting as much as I can, playing one game of football a week and doing lower impact activities such as spin.

This was my fourth running race, and fifth race overall, including last year’s cycle from Glasgow to Edinburgh. I don’t sleep well before such things anyway, and I found myself up most of the night worrying about how my shins would react. I had to get up at 4:30am in order to have breakfast and drive to Edinburgh, to make the 8am start, and as a result I only mustered four hours’ sleep at most.

The drive to Edinburgh was quiet and straight-forward, despite the haar, and before too long I had reached my starting pen on Regent Road, where I stripped out of my tracksuit and deposited my belongings on the truck that would carry them down to the finishing line in Musselburgh. I had made a loose arrangement to meet Jude at the starting line, but I couldn’t find her and I’d left my phone in the car. As I stood in the cold Edinburgh morning, wearing just a running vest, rain began to fall on the massed runners and once again I began to wonder if all this was worth it. It had just dawned on me that the truck with my gear would have already left by the time Jude appeared out of nowhere, having accidentally gone to the other starting line on London Road. Feeling a little more invigorated, and with our cohort starting much later than 8am, we finally set off on our 13.1 mile journey.

At the start: spot the marathon runner and the 10k runner…

The last distance run I’d been on, around Paisley, I’d struggled to reach 3km before my lower legs started to cramp up, but with the first half of the Half being mostly downhill, and with some raceday adrenalin to thank, we were at mile 1 before I knew it. It hadn’t occurred to me that the distance markers would be in miles and not kilometres, so this gave me a further little confidence fillip; after all, 13 is less than 21.

Falling into something of a groove, and with Jude keeping the pace, we passed Holyrood and Meadowbank Stadium, and made our way down through Leith towards the sea front at Portobello. Having just about reached halfway, Jude offered me a gel. I’d never tried one before, and was a little reluctant to introduce something new and untested, but I accepted, mainly due to memories of last year’s glycogen collapse during the cycle. It was a very odd experience, and my mouth just couldn’t get used to the texture and consistency of the gel. Still, I managed to ingest most of it, and we continued on our way. By this stage, I’d not only run the furthest I’d ever run in one go, I’d also set a new personal best for a 10k. My confidence continued to grow, but I set myself a plan, and a contingency. Plan A was to run for as long as possible. Plan B was to run until the 10 mile mark, walk a couple of miles, then run the last little segment.

New Street, Musselburgh

However, we seemed to miss the 9 mile marker, at Portobello racecourse, so by the time we hit 10 miles, I got an added boost by being further ahead than I thought I was. We carried on into what was the worst section of the course, and the worst part of the day, for me. The majority of miles 11 to 13 involved heading down one side of the road to Prestonpans, and then doubling back towards the race course on the other. I loathe running laps of this nature anyway, but as we continued down the Ravensheugh Road, with no sign of the turn, and knowing we had to cover the same distance back, I began to despair a little. The wall was coming for me. Eventually, at 12.75 miles, I paused, exhausted.

My break lasted little more than a stride before Jude politely informed me that I was not stopping there. We were nearly at the finish line. I was to pump my scrawny chicken legs, like the stuporous funker I was. So I did. I kept going, cramp and all, and within a few minutes Jude pointed out the 13 mile marker.

As we rounded the corner into Pinkie Playing Fields, I could see the finish line a few dozen yards ahead. I hurpled towards it, not so glad to see anything since the finish line of the Pedal for Scotland cycle the previous year (there must be something about Edinburgh).

Somehow (although probably 40% thanks to Jude) I had managed to run 21 kilometres in a little over 2 hours. I’d never run farther than 6km in one go before. Somehow I’d fallen into an automatic process of putting one foot in front of the other, and as soon as I stopped, various body parts rushed their damage reports to my brain and I had to have a little bit of a lie down.

I know what it looks like, but I don’t think I had enough blood left for that.

After the race we collected our belongings, made our way back into town, and ate and drank carbs while trying to work out how to get back to Straiton. The Edinburgh bus network isn’t as effective on a Sunday, I’ve learned. Eventually we made our way back to my car, and stopping off for donuts at Hermiston, headed back to Glasgow, tired but happy.

It’s been two days since the run, and my body still aches, notably the calves, quads and nipples (friction, you see). I don’t think that’s unusual, and I’m happy to take a week or so to rest before I start to worry about anything being untoward.

While the pain in my body (hopefully) recedes, I can reflect more on what an achievement Sunday was for me, and how much I’ve improved as a runner over the last couple of years. I’m also acutely aware that I have to up my game again, with a marathon booked for April of next year.

Next up: a mini-triathlon thing in four weeks, and a 10k at the end of August. Then…we shall see.

May 2014 Update

Human beings are a very subjective bunch, and our memories are particularly subjective. I’ve found this blog has been very helpful in allowing me to look back at the state of my health and fitness over the last two years and assess where I’ve improved and what elements I’ve let slip more objectively.

Therefore, it’s more important that I record how I’m feeling more often than I have been. I won’t be able to draw comparisons if I don’t. So, without further ado…

As I write this, the Edinburgh Half Marathon, which I’ve entered, is exactly 3 weeks away. While I’d like to be better prepared than I am, I think I’m doing okay. I’ve been running every Sunday for the last few weeks, steadily increasing the distance I’ve covered. Hopefully by the 18th, I’ll have reached 75% of the race day distance. I’m not too far off.

I’m playing 5-a-side football once a week, and feel that I’ve hit a reasonably consistent level of performance. That’s probably mostly due to my increased fitness and stamina, so it’s good that my hard work is having a result. I’m trying to fit in visits to the gym, and I’ve also started going back to Spin the last few weeks, in lieu of my bicycle having a puncture, again.

In terms of aches and pains, both knees like to moan, but they’re not able to hamper my activities much. I’ve got a bit of a tight muscle in my left arse cheek, which I actually had a few massages to try and address, but it’s still lingering a little. I’ve perhaps neglected my core in recent months, but it’s been almost impossible to get booked into the Pilates class I like. Perhaps I need to find a new one.

The shin splints have been acting up a bit this year, mainly when I try and run uphill. In order to address this, I’ve been avoiding hills. Thankfully, the Edinburgh Half is mostly downhill. I jest, and it’s something that concerns me, but it’s just something else I have to manage.

I have agreed to play football on Tuesday lunchtime at work. This could be interesting, and I’m interested to see how my body holds up. Shona always said that I have to have more confidence in my knee, but I guess I’m a worrier by nature. Next Sunday will be telling.

One of the reasons I started this blog was to track my progress as I slowly nursed my body towards and through my first 10k. I achieved that in August of last year, and so in the sprit of continuous improvement (which is the one thing humans do well), I decided to enter a half-marathon this year. As if to highlight my improvement, I’m now doing training runs that are slightly longer than 10k.

I’m confident about completing the half, if nothing else. So what’s my next target after that? Yup. I’ve entered the 2015 Paris Marathon. I could barely dream of even considering such a thing two years ago, and I have a year to go before it happens, but as the Japanese say, kaizen.

February 2014 Update

Well, it’s been four months since I last posted something on here. That was an account of the 80km Pedal for Scotland cycle ride from Glasgow to Edinburgh I took part in last September. Since then…I’ll be honest. I have perhaps let the fitness regime slide a little. In my defence, winter arrived, completely unexpectedly…

Following a festive period where I took a couple of weeks off from watching what I ate and exercising, I put on a little weight (around a stone, or 5kg). However, as I’d signed up for my friend Graham’s 28-day personal training course, I wasn’t too concerned.  And while, after 11 circuit training classes and 3 personal training sessions, I’ve only lost a little weight (currently I’m at 88kgs, ish), I am slimmer and empirically fitter.

The fitness goals for the next few months are fairly simple; I’ve entered the Edinburgh Marathon Festival half-marathon in May, and I want to develop a more nutritious and varied diet. Both represent fairly large challenges for me though. I’m still not brilliant at running long distances, although I think improvement there is simply a matter of perseverance. I’ve got three Parkruns under my belt already this year, and I’m looking to add a second running session per week to my training schedule, where I may concentrate on speed work.

As far as eating goes, I’ve been concerned about my diet for many years, and it first came to a head when I hit 17 and a quarter stones a couple of years ago. However, I’m also acutely aware that I completely ran out of energy towards the end of Pedal for Scotland, and that was most likely due to my poor understanding of nutrition. I have come to broadly understand how calories work, but the finer points of sports nutrition escape me, so that’s something I have to work on. I have been experimenting with protein shakes, and trying to eat a lot more clean than I ever have before, but I’m wary about making wholesale changes to my diet at any one time. It’s more difficult to sustain.

As far as other sports go, I’ve decided to stop playing five-a-side football for a while; not because of injury thankfully, but because I simply wasn’t enjoying it very much, for reasons I can’t delineate. I’d also planned on entering a triathlon this year, but that notion has been stymied for various reasons, not least because of the fact that I can’t swim very well. I’ve read a book on swimming techniques, but I think I need some advice from a coach. As for cycling, the bike is in hibernation, and will be until the clocks go forward again. I just don’t feel safe cycling on the local streets in this light and this weather.

And the knee, the main reason I started this blog? It’s okay. I don’t think it’ll ever be 100% again, but apart from a slight pain when I climb stairs, it’s as good as I could expect it to be. How it will feel after a half-marathon is another story…

I Want to Ride My Bicycle

I’m definitely getting older. Well, that’s what the optician, dentist and physiotherapist told me within the space of a week last month.

Ahead of The Big Cycle, I’d booked an appointment with Achilles Heel because I felt my knee, which I’d injured at football in June, was still continuing to act up a little. My ‘usual’ physio, Shona, was still on maternity leave, but I saw another therapist who was equally positive and reassuring. I’d aggravated the medial ligament, but it would heal, and running and cycling would help. Emma also gave my tight calf muscle a massage, which made it feel a hundred times better.

I’ve found from my half-dozen or so visits to Achilles Heel that their physios are very good at addressing the mental side of injury, working with you to increase confidence and understanding of what your body is still capable of, and what you can achieve with a rehabilitation programme.

While I’d said that I was going to try and avoid football until after the cycle, the guys being a man short the Thursday beforehand resulted in me playing after all. I then told myself that I wouldn’t run around daft. Which I did. However, Emma had given me some stretches to do after exercise, which I did before the 22-mile drive home. I also applied RICE (Rest, Ice, Compression, Elevation) to the knee before I went to bed. It seemed to help; I had markedly less pain for the following two days.

On the Saturday, I tried to prepare for the cycle as best I could, but it was something of a leap into the unknown. The longest I’d cycled in one go before was just over 50km, so I was definitely pushing myself farther.  Nevertheless, I packed my bag the night before, and tried to get a decent night’s sleep. My train for Glasgow was at 9:30am.

I met up with the rest of my retinue at the People’s Palace; Graeme had dropped out for personal reasons, but Gail and Craig were still there. Mike had brought two of his friends, Tony and Robbie. Over the course of the route, we would split into two groups of three.

By the first stop, at Drumpellier Park, near Coatbridge, we’d lost sight of Mike, Tony and Robbie. We refuelled for ten minutes, before pressing on with the next stage, through Airdrie and out of the Glasgow conurbation, to the countryside and the small town of Avonbridge. This was the part of the route with the highest elevation, of around 227 metres above sea level. From here, it was a skoosh towards Edinburgh. Or so I thought…while that would turn out to not be precisely the case, soon after we left Avonbridge, in the one-street village of Standburn, I happened to glance to my right and noticed the southern tower of the Forth Road Bridge, which my great-uncle helped build. We were getting closer.

It was mostly downhill to Linlithgow, where we stopped for a late lunch.  I had planned to eat something substantial here, but the queues for the complimentary pasta and sandwiches put me off. Craig and I ended up on Linlithgow High Street looking for a sandwich shop. I eventually bought a banana and ate a caramel wafer, which would later come back to haunt me.

We were also able to deduce at this point, through the wonders of modern telecommunications, that Tony’s gears had exploded at some point before we’d even left Glasgow. While one of the course mechanics had tried to MacGyver his bike, it was a write-off. Mike and Robbie had managed to catch us up however, which indicates just how much faster their average pace was.

Linlithgow Castle

Craig and Robbie discuss the ride so far.

Linlithgow Castle feeding station

Linlithgow to Kirkliston was something of a climb again, and I got the distinct impression that I was starting to run out of puff. The last of the five feeding stations was at Kirkliston, and I gleefully took the opportunity to take on more sustenance, only to have something of a tete-a-tete with a steward, who told me I couldn’t leave my bike where it was, amidst a field strewn with other bikes. I muttered under my breath, and left in the huff, being the sort of person that is willing to cut off his nose to spite his face.

As I suspect I’d become somewhat undernourished, the last seven miles turned into a Nietzchean battle between mind and matter. At least, that’s what it felt like the latest time the land began to rise in elevation YET AGAIN. By the time we reached the suburbs of Edinburgh, I felt as if I was beginning to lose my mind. I’d fallen behind Craig and Gail at Davidson’s Mains, and the only thing that kept me going amid the pain in my legs, arse and back was the estimate that I couldn’t be much farther than a couple of miles from the finishing line.

I’d familiarised myself with the route beforehand, to an extent. When the cycle path crossed West Coates, I knew it wasn’t far. Indeed, Scotland’s national rugby stadium was literally round the corner. I only had to make it across the apron, through the tunnel, and down the running track, and I was across the finishing line.

The route then took us back out of the other side of the stadium, where we received our medals and the opportunity to dismount our bikes for a while, to the blessed relief of every part of my body south of my navel. I completed the ride in just under six-and-a-half hours; Gail and Craig were slightly faster.

Thankfully, we didn’t have to cycle back. We’d paid for coach transport, and for our bikes to be returned to Glasgow Green by courier. Unfortunately, I still had to cycle back to Central station, and then from Neilston station to my house. Thankfully, that was almost literally all downhill. I rewarded myself for my exertions with chips, cake and lager, and an increased sense of satisfaction.

The following week I tried to avoid exercise as much as I could. While I am a lot fitter than I’ve been for years, I was still acutely aware that my leg muscles were grumbling morosely about their mistreatment. I was able to play 5s on the Thursday night, and this is where things got interesting…

While I suspected that I might have felt the ill-effects of the cycle, I actually played one of my best games in years. I felt fit, strong and fast, free from any of the niggling aches and pains that have piped up whenever I’ve tried to play football in recent years.

The last week, I’ve tried to get back into the swing of my exercise regime. I didn’t make it to the gym much, and I discovered the rear tyre on my bike has a puncture. I didn’t feel my performance at 5s on Thursday was anywhere near as good as the previous week, but I did manage to secure a new personal best at parkrun on Saturday morning.

Right now, I feel okay, and I’m planning next year’s athletic endeavours. On Sunday, I went to Bellahouston Park to cheer on my friend Helen in her first triathlon. I had considered entering myself, but it transpired I’d never be able to raise the sponsorship required to take part, but it had planted a seed. Over the winter months, when it’s too dark and cold and windy to run and cycle, I’m going to learn to swim properly. Oh, I can swim a bit, breaststroke mainly. But that’s not going to cut it in a triathlon. I need to get my front crawl down pat. Additionally, my fellow gym/running bunny, Jude and I have also decided that we’re both going to enter the Edinburgh half-marathon next year.

So those are my new targets. And I will meet them. Oh, and you can still donate to our JustGiving page, should you wish.

My three sporting achievements: Paisley 10k (2013), Wolverhampton University 3rds F.C. Most Improved Player 2002-2003, and the Fresh ‘n’ Lo Pedal For Scotland (2013)

Born to Run

I’ve always ran; while playing football or British Bulldog, or trying to shake off that feeling of euphoria you get after seeing a really good action film at the cinema. However, I’ve never been a runner. As a sport, plodding around an oval or across country never really appealed to me.

And then I began to to experience the strangest desire to run. I’m not sure when it started, but I think it was after watching joggers bob along the pathways in Central Park in New York in the spring 0f 2008. And if I’m being honest, I think it was a reaction to the fact I’d recently developed shin splints. Now you want to run?

However, for the next five years, the very thought of being able to go out for a five km run that didn’t involve chasing a ball seemed unlikely. Playing five a side twice a week caused my lower legs to ache, to the point where I was barely able to run during games. I had x-rays done, orthotic insoles fitted, even an MRI; nothing unusual showed up.

Then, last summer, my right knee swelled up apropos of nothing. When it returned to its normal dimensions, it did so with a cadence of sharp pain, most noticeable when I climbed stairs. I went back to the doctor, who referred me to the physiotherapy department at the hospital. They diagnosed bursitis and referred me to the physiotherapist at the local health centre. He diagnosed a muscular imbalance and gave me acupuncture and exercises.

I started playing football again, but before long the knee was tender and swollen after games. Nearing the end of my tether, I booked an appointment with Achilles Heel Sports Injuries Clinic in Glasgow. Shona there suspected I’d suffered anterior cruciate ligament damage, and also had some scar tissue behind the knee cap, but that it wasn’t anything I couldn’t compensate for. Over the course of four or five months, she helped me work out a programme of exercises to strengthen the knee, and as my confidence grew, the notion of running returned.

I bought a pair of £95 running shoes, that allegedly address my over-pronation issues, downloaded a running coaching app, and started pounding the streets of my hometown on Saturday mornings. Initially, it was hard work, but my legs felt okay. Distance running is a very different beast to the sort of running I was used to in football, which is more of a mixture of sprints, short bursts, jogging, and the occasional standing still waiting on Davey retrieving the ball from the other side of the fence. It was around this time I saw the Paisley 10k advertised, and the idea of entering a race took hold again.

With something to aim for, I continued training, although this was interrupted in June when I managed to trip over the ball at football and twist my good knee. I rested for five or so weeks, which ate into my preparation time, and only returned to training three weeks ago. Last week I ran at Parkrun in Pollok Park for the first time, and completed the five kilometre course in a time of 33 minutes. I’d done about as much as I could.

I did buy a magazine book on how to get started in running last week, but aside from that I didn’t do a great deal of research into how to maximise my performance. I was willing to write today’s event off to an extent, due to my knee, and the fact it was my first race. I was more concerned about lasting the course than doing it in style.

I did okay, I guess. 1 hour and seven minutes, which represents an age grade of 39.85%, which according to the Runner’s World website represents

Your age-graded score is the ratio of the approximate world-record time for your age and gender divided by your actual time.

To score 100% you would need a time of 27:10.

Your age-graded time is your finish time adjusted to that of an open division participant using a factor for age and gender. Thus, the times for women and older participants are adjusted downward, while the times for most open division participants (such as 25-year-old men) remain the same.

That actually represents a slight improvement on my performance at last week’s 5k, where I scored 39.55%.

The best thing about today’s race was crossing the finishing line, getting a medal, and knowing I’d finished the damn thing. The best thing about today was the shower I had about an hour after I finished. As I type this, I have a compression bandage and anti-inflammatory gel on my left knee, and an ice pack freezing in the kitchen. Everything below my waist hurts; my hips, my quads, my knees, my hamstrings, my feet. I have half a notion to enter another 10k this year to see if I can improve my time, but I have a physio appointment on Wednesday that may dictate if I’m forced to rest up for the foreseeable, or if I can keep running.

Right now, I’m sore but I’m happy. I’ve achieved something that I set out to do, and I did so by working my arse off, and trying not to get too despondent with the litany of niggling injuries I’ve had the last five years. I haven’t always been able to see those sort of rewards for my endeavours, so this is definitely a boon.

August 2013 Update

The comeback continues. In my last update, I wrote about how I’d sprained my knee playing football, and how I was worried it had jeopardised my participation in the upcoming 10k road race run and 75km cycle to Edinburgh I’d signed up for.

Thankfully, the knee appears to have healed quite well over the last nine weeks, due mostly to a period of enforced rest from exercise I guess. Four weeks after the original injury, I’d attempted to play football again, and I just didn’t feel right the following day. However, two and a half weeks ago, lying on my bed on a comfortably warm and sunny Sunday afternoon, I decided that it was too nice a day not to get out for half an hour or so on the bike.

Thankfully, there was no major reaction from the joint this time. Encouraged by that, I’ve logged 118.3km in the last 18 days. 50.4km of that was accounted for by a 3 hour long ride out to Lochwinnoch and back last Sunday, which equates to roughly two-thirds of the distance of the Pedal for Scotland course. With that challenge being less than five weeks away, I’m now feeling a little more confident about my ability to last the distance than I was in July.

I managed to get out for a run as well last Saturday. I’m still making quite a slow pace, but I’m more wary about what running will do to my knees than the cycling. In fact, the app I use suggest I should be running three times a week, rather than the once I’m currently managing. We’ll see if that changes over time, but at the moment I’m working towards completing the 10k in less than an hour. I’ve potentially only another two training sessions before the race though.

In other fitness news, my college assignment is (hopefully) done and dusted, so I’m getting back into the gym, and last night my sister and I attended our first Muay Thai class. I’m still not sure where I stand on pugilism, but her neighbour runs the class, and she asked me if I wanted to go…

I did karate for six months or so last year, and I am intrigued by the notion of being able to handle myself, ostensibly for self-defence purposes, but…I do like punching things. This may represent a way for me to dissipate my permanently tumultuous anger in a controlled fashion.

Interestingly, the instructor asked me what hand and foot I preferred, and when I told him the left, he suggested I adopt the southpaw stance. However, the vestiges of the karate training led me to continually fall naturally into an orthodox stance (you learn the orthodox stance in karate, regardless of your limb dominance). My sister also suggested that my right hand was more powerful, although I don’t know if that’s because I was attempting to punch harder with that hand. Anyway, aside from the combat element, it was an extremely good hour’s workout.

I won’t update again until the second week of September. By then I should have completed both my 10k and my bike ride. Wish me luck!