I Wanna Hold Your Hand

July 29th, 2009.

I reported to the second floor of the outpatient wing of the hospital for my laser varicose-vein surgery. I was the third patient of the day; the highly efficient Dr. G. had us stacked up like airplanes in a holding pattern over the Thames on the way to Heathrow.

First stop: an interview with a man named Massoud who took my blood pressure (I WILLED it down to 100/65), my temp and the information about my next of kin, which is always a reassuring thing to be talking about before a surgical procedure. I was issued my white ID bracelet and my red allergy bracelet, although the only thing that happens when I take sulfa drugs is I get a headache. I had been informed by the highly efficient doctor’s highly efficient secretary (administrator?) that I’d be talking to the anesthesiologist, so in an incredibly sexist move on my part, I asked Massoud if that is who he was. No, he is a nurse, he informed me. Oops.

Next stop, a bay with a gurney and a curtain where I donned the attractive blue Johnny gown, the weird space-slippers from 2001: A Space Odyssey, and the highly crunchy disposable non-woven fiber “pants” which are undies in Brit-speak. I donned my iPod and settled in to wait while Dr G. and team worked on patient number two. A long spell of Hildegard von Bingen’s 12th century Canticles of Ecstasy put me in the properly meditative pre-surgical mood.
Perhaps here is where I should mention that I elected to have this procedure done unsedated. As a self-respecting hypnotherapist, I felt that a few needle jabs of lidocaine, which would numb the appropriate areas of my leg, would be sufficient to get the job done. As a former needle-phobe, I am proud of my ability to focus “Down and In” in order to transcend the fear of potential pain. After all, this is the woman who went through six hours of un-drugged pushing in a vain attempt to get that first baby out, courtesy of the birthing hypnotherapy she learned from the head of the Harvard University Counseling Services. Hubster and several friends shuddered at the thought of undergoing any procedure involving needlesunsedated, but I had just had a double-cyst aspiration with lidocaine only (they don’t even OFFER chill-out drugs for that procedure) and the time I had the sewing-machine needle removed from my finger they didn’t drug me either, just gave a jab of numbing lidocaine in my hand while the surgeon “poked around” (which is the technical term) in my fingertip for the sliver of steel that lingered after the rest of the needle was removed.

So when Dr. G. came in, I was resting comfortably wearing the headphones, deep in a past-life reverie about having been a nun in 12th century Germany. When I opened my eyes and raised my head, I think he was a little startled. Massoud had made it clear that most patients elected to be sedated, and HE certainly seemed skeptical of my wish to skip the drug cocktail. Dr G. said “Oh, you’re relaxing!”. We had some homework to do before he could begin the procedure. The all-important Statement of Risk and Legal Waiver had to be signed. I made sure it would be him performing the procedure, and not some team of eager medical students. He assured me that was the case. Then he sat on the floor and asked me to stand in front of him so he could draw on my leg. Whipping out his Sharpie permanent marker, he marked my right leg with his initials, then drew a line down the presumed location of the greater sapehnous vein. This work of art was embellished with squiggles across the shin, above the places where the “varicosities” bulged out in all of their pulsing, painful blue glory. These were the areas of vein to be tied off and extracted in the procedure known as a Phlebectomy. I imagined that he would be going in there with a medical version of a crochet hook, and making fancy knots with sutures, and embellishing the whole thing with a fringe.

While I was standing there being decorated, I remembered the last time I’d had an “ablation” procedure, which was back in 2006. That summer, I had my uterus “zapped” (that is the technical term) by radio waves, from the inside, in order to stop the ridiculously heavy monthly periods that kept me trapped in the house for five days out of every month. The doctor who had done that procedure had been my gynecologist for about ten years, and I knew him well enough to play a little joke on him before the surgery.

How many times have we read about people waking up from surgery having had the wrong kidney removed, or the wrong leg amputated.? Yes, I know that we only have one uterus each, but I decided to identify the proper orifice with marker before that particular procedure, during which I sure as hell would be sedated. So, the morning of my “endometrial ablation”, I took a blue Sharpie marker, and drew an arrow on one thigh. The arrow pointed to the correct opening to the uterus, and was marked “Here”. The other thigh got an arrow pointing to my rear end, with the statement “NOT here”. I got dressed and went off for the day surgery laughing to myself at the joke I was playing on the unsuspecting doctor. When the anesthesiologist resident came around to start my sedation drip, I couldn’t keep it to myself any longer. I told her “I left a message for the doctor”. “Umm hmm” she replied, probably thinking that I was off on my sleepy-time trip already. The next thing I remember about that surgery was being transferred from the rolling gurney to the operating table. I tried to talk. “She’s awake” said the doctor. I tried to mumble “I left you a message”. I’ll never know if they figured out what I was trying to say, as once I was on the table I was completely out, and I was too embarrassed to ask the next time I was propped up on the table for the annual smear job.

So, for the current situation, I let Dr. G. do all the scribbling. He then went to check to see if the operating room was ready, and I took a detour to the loo. When I came out there was no one around, and I had to wander back out to the area near the changing bays with the back of the gown a-flap to find someone to direct me to the operating room, which I entered under my own steam. The staff were not used to the patient arriving on her own, and had already “marked” the surgery time as starting when the doctor went in, until they noticed the table was empty.
The medically-squeamish have my permission to skip this part. Dr. G. explained everything he was about to do, and then did it. From my point of view, it involved injections of lidocaine into the ankle, and then the thigh. I could feel something or other going around down at my ankle, and was told that they were inserting the catheter containing the laser into the greater saphenous vein. More injections up at the thigh area numbed the first area to be “zapped”. The doctor warned me that “some people experience a taste” as the lasering gets started. Almost immediately, I noticed an intense burning smell, and realized that my flesh was on fire from the inside. I wanted to shout “OH MY GOD CAN’T YOU SMELL THAT?” but settled for having one of the nurses hold my hand. I switched my iPod from soothing medieval chanting to the Beatles. As I did not have my glasses on, I couldn’t see the tiny print on the iPod, so had to settle for letting the nurse choose a Beatles album randomly. Unfortunately she did NOT pick “I Wanna Hold Your Hand”, but chose the album Revolver instead.

I figured the more distracted I was the better off I’d be, so I chose the imagery of Dr. G as a little boy, playing with a light saber from Star Wars. This made me laugh, and the nurses looked at me a little oddly. I decided to keep my imagery to myself so as not to embarrass the doctor, just in case he had been a childhood Jedi Knight.

Sooner or later the laser got a tad ahead of the lidocaine, and there was an intense burning sensation in my ankle. At least they were already down in that area, having started up top at my inner thigh. Next, several more injections in the front of my shin, and over the outside ankle bone allowed the doctor to perform the “phlebectomy” procedures, which entails tiny incisions and removals of the painfully bulging veins created by the venous backflow. After about 40 minutes they wrapped up my leg in a huge swath of gauze covered by stretchy tape. My right leg looked like a mummy. I was wheeled back out to the recovery (changing bay) area, where a nurse took my vitals and kept an eye on me. As I had not been sedated, I was allowed to have water immediately. Someone sent down to the kitchen for a tray of sandwiches, and I was served tea right there in recovery, and then was allowed to hobble out to some chairs to consume the sandwiches. Take that, Mt. Auburn Hospital of Cambridge, Massachusetts, and your measly post-surgical packaged crackers! Another half hour of being watched, and I was allowed to leave the scene under my own power.

Meanwhile, Hubster was busy at work. He is not too fond of hospitals or procedures involving needles, (understatement of the century—the astute reader will remember me having to babysit him after his sedated visits to the dentist) so was given permission by me to be far, far away. And far away he was, having planned on being in Croyden for the morning, and Leatherhead for the afternoon. I had been asked several times who was collecting me, and I had to keep telling various personnel that Iwas getting home on my own. Was I taking a cab, they enquired. No, I told them, I live just around the corner and I am planning to walk home. Eyebrows were raised. I figured it was easier not to explain. I reminded them that I had not been sedated during the procedure, then they’d ask again why no one was coming to collect me. I almost had to do a little jig to prove that I was OK to go, but it’s hard to do a jig on a painful leg that is wrapped so tightly that it cannot bend.

I had cleverly purchased an LL Bean collapsible walking stick while in Boston, so used that to assist myself in getting to the elevator (lift). I was sad to see that Fabian was not at his post at the rear reception desk, and took my time meandering through the twists and turns of the hospital’s ground floor. Once I rounded the bend outside the pharmacy, I had a clear view all the way down the corridor to the front reception desk. When they saw me coming, both Kumar (the cashier) and Fabian (receptionist extraordinaire) both came out from behind their desks to cheer me on. I felt like an Olympic athlete as their encouraging cries pulled me closer to the front doors of the hospital. Just when I had been starting to feel very sorry for myself for having to go home alone, Fabian turned around so his back was facing me and said “Marj!! Climb on!! I’ll carry you home!” I declined, as it not only would have been unseemly, but physically impossible with the painful mummified leg. I told Fabian that if he wanted to be my “arm candy” he could walk me home, but he couldn’t really leave his post after all. I had to explain to them that the distance I had to travel was only twice the distance from the hospital’s front door to the nearest corner, which placated them. Off I hobbled into the afternoon sun.

The surgeon had allowed me to go home even though I didn’t have the required thigh-high surgical stocking. I was advised to get them at a pharmacy down on Wigmore Street. On a whim, I hobbled PAST the front door to A Flat on Abbey Road to the bottom of Hill Road, and turned the corner onto Nugent Terrace. A small independent “chemist” (pharmacy) is located there. I picked up a package of NuRofen PLUS (the over-the-counter Ibuprofen plus Codeine, if you can believe that) and enquired about the grade-2 compression stockings. AHA! The pharmacist, who USED to work down at the Big Chemist’s on Wigmore Street, knew EXACTLY what I needed, and had some in the back room! He said he didn’t even think that Big Chemist even had them in stock any more. My good leg was duly measured as to circumference at ankle, knee and thigh, and Voila! A pair of Size Medium Sand-coloured Grade 2 compression thigh-high open-toe stockings were mine for only seventeen pounds. The kindly chemist even threw in a pair of Grade 2 closed-toe panty-hose for good measure, for free, because they didn’t have a use-by date on them and he knew they were fairly old and couldn’t really sell them and I needed them, after all.

Thus endeth my excitement for the day. I hobbled back to the flat, took two NuRofen PLUS, and stretched out on the sofa for the duration. Hubster had arranged to be home in time to make dinner. The rest of the day is a blur.

Epilogue: It is now three weeks later. The surgeon had suggested that the recovery period could be anywhere from a couple of days to a couple of weeks. He reported that one patient had been back out on the golf course after two days. I think that would have been impossible in my case. For one thing, I would have had to have take a golf lesson. For another, I could not straighten the leg without pain. Walking was helpful, as it stretched out the scar-tissue that was my former vein, but after a period of having the leg bent, as in overnight, stretching it out the next day was a big challenge. After two days I did hike up to Swiss Cottage, the neighborhood a half-mile to the north, to purchase small appliances for the new flat. I was able to haul a toaster, a coffee maker, an iron, and something else back in my Turbo Cart while using the cane, but that amount of effort on Friday morning wiped me out for the rest of the day. Every day around 3 pm I had to put my feet up. The blood in my right leg had to find a new way to leave my leg (via the deep veins instead of the peripheral ones) and it seemed a little confused in the beginning. There would be twinges of pain and odd bubbling sensations mixed in with the general achiness.
I used the cane for two weeks. It was most helpful in letting the car drivers know that one would be going through the zebra crossings s-l-o-w-l-y. It also got me a seat on the bus on more than one occasion. My walking mechanics were off for two weeks, also, with a shortened stride on the right side and the left leg taking the brunt of the work, resulting in LEFT leg pain, and hip and knee pain in both legs. Walking was both good for stretching the scarred vein, but not so good for the rest of my lower half.

Today’s follow-up visit with Dr. G. has revealed two things: One, the leg is healing well. Two, The second floor, where I had my surgery, has been closed due to the fact that the floor has been found to be "sloping". This is in a building that was completely renovated only eighteen months ago. All the consultants have had to time-share space on the lower floor. I guess I got onto the surgical schedule just in time. Third: When I told Dr. G about moving my belongings through the Famous Zebra Crossing on the 40th Anniversary of the Crossing of Abbey Road, he told me that his birthday is August 8th, the very day I was out there being interviewed. I think that was a good omen.

HOT FLASH!! BLOGMAMA Interviewed on SKY NEWS!

Yes, the quote I gave to Sky News was one of four featured interviews shown on the Live at Five program. The snippet aired at 6:30 pm; we have it recorded on the box but don't know how to get it onto this blog.
"It's become a shrine, I think. They come and sign the wall; they don't realize that it gets painted over every two months. People are celebrating the music, and what it has meant to their lives."
Of course, I said a lot more, but that was the sound bite that made the news!!

Come Together

It was forty years ago today that the cover photograph for the Beatles' album Abbey Road was shot by Iain Macmillan. It was also almost seventy years since the beginning of the London "Blitz". Oh No! "Don't mention the war!" as Basil Fawlty would say. But here, the bombings of WWII in 1939 and the innocuous crossing of Abbey Road by four talented musicians in 1969 have given way to the celebration of both the musicians themselves, and the era of peace and love to which they gave voice. The intersection of Abbey Road and Grove End Road has become a focal point for hundreds of tourist photographs every week, as Beatles fans re-enact the crossing, with one member of their party shoeless and another holding a cigarette. It has also become a nexus for the very Universal Peace and Love referred to in many Beatles songs. If a geographic place could be said to have energy or emotion, this place would be Love, Love, Love.

Today on Abbey Road, NW8, London, thousands of people of all ages and from all over the globe gathered to commemorate what may just be the most famous pedestrian crossing of all time.
The zebra crossing at the corner of Abbey and Grove End Roads became the scene of a street party. Musicians with guitars, music fans, gawking tourists, and locals all gathered. The sheer numbers of people clogged the roads, stopping traffic for approximately an hour. The riders of two particular buses, the 139 from Waterloo and the 189 from West Hampstead were treated to an upper-deck view of all the shenanigans.

At exactly 11:35 am, the time the original photo was shot, several re-enactors dressed as John and Paul (have we seen these guys on youtube.com pretending they ARE John and Paul?) actually crossed the road. The throngs were so close that only a few got to actually SEE this auspicious moment. Everyone else just enjoyed the party atmosphere, singing along with a rotating list of guitar players who were set up near the benches outside of Neville Court.
In an attempt to chronicle the moment, intrepid BlogMama took time out from moving house to be on the scene. Hubster and I had already run several loads of clothing and personal belongings over to the new flat on the other side of Abbey Road. We passed through the famous pedestrian crossing several times with our rolling luggage, full on the way over, and empty on the way back. By half past ten in the morning, the crowd, which has started out at 9 am in the dozens, had swelled to hundreds if not several thousands. It would no longer be possible to get rolling luggage through the throngs.

I went out with the idea of getting everyone there to sign my “guest list”, attempting to chronicle for posterity who attended the morning’s festivities. The first family I approached was American. Americans are known to be friendly, right? This particular middle-aged lady looked like she was a deer in the headlights. WHY was I doing this? WHAT purpose did it serve? WHY was I asking such personal questions? WHY did I require her age? I guess she didn’t realize that she would be part of a moment in history, or perhaps she did! She was a bit rude in her refusal to answer my questions. Not to be denied, I pressed on. I made a point to ask people of all ages and nationalities to sign. There was no particular pattern to my asking, but also no perceivable pattern to who turned down my request to be listed on this blog. People of all ages and nationalities were happy to be a part of aflatonabbeyroad.blogspot.com’s chronicle of the event.

It took about an hour for me to collect 37 signatures. Some of these folks were happy to provide their email addresses, others chose not to do so. Here they are, in the order in which they were collected. Please note: anyone under the age of 18 had express permission from a parent to have their name included on this list:

Name age Hometown
Richell Perry 22 Kingscliff, Australia
Melissa Heffernan 21 Australia, now London
Dave Neustrom 28 America
Sue Neustrom 58 Chicago, USA
Stela Sty… (illegible) 40+ London
Cathy Heikurinen 51 Oakville, Toronto, Canada
David Stark 56 London
Maxim Pokrovsky 40 Moscow
Dorothy McCuller “mature” Gallup, New Mexico, USA
Nichola Stephenson 35 Leicester, UK
Paul Williams 57 London
Daniele Merlani 27 Milan, Italy
Samantha Acquaviva 21 Milano, Italy
Jupiter John 109 (?) London
Richard Rigby 57 London
George Carter 15 London
Margaret Baker 71 London
Gloria & Mark Frankel 76, 66 London
Anthony Cooper 44.4 London
Eddie Rack 48 Germany
Rolf Seemann 48 Germany
Daniel Godoy 23 Zaragoza, Spain
Lidia Palanos 27 Madrid, Spain
Allen Miller 57 Vancouver, BC, Canada
Carlo Ritchi 43 Milan, Italy
Al___ Moguar? 27 Milan, Italy
Karen Purvis 47 London
Lou/Lore? Go…? 14 Belgium
Abby Dees 43 Los Angeles, CA, USA
Lori Catellier 44 Chicago, USA
Taylor Blumenberg 24 Charleston, SC
Bert Tolhamp 47 Amersterdam
Tom Cleaver 23 London
The Leon Family Guadalajara, Mexico
The White Family Denmark
Adrian Main 49 London
Juan 11 Xativa, Spain
Paco Codina 55 Xativa, Spain

At this point, the policeman (a regular “Bobby”, not the gentleman in the “Incident Response” vest) cleared us all out of the road. I wound up on the corner where the musicians were playing to the sing-along crowd. After a rousing round of Hey Jude and I Wanna Hold Your Hand, I was approached by a reporter and cameraman from Sky News.
After a series of questions, I summarized my woman-on-the-street point of view by saying that I thought the Abbey Road zebra crossing had become a sort of shrine, where people came to celebrate the music of the Beatles and the impact it has had on their lives.

I guess I’ll have to watch the news tonight to see if they include me in their report! Of course I put a plug in for the blog….

Thanks to everyone who participated in today's Love-Fest on Abbey Road!

She’s Got Legs… (ZZ Top)

Astute readers may recall that during a long-haul flight to the US in the spring, I developed severe pain in both shins and ankles that curtailed my physical activities for some weeks.
After about a month, I self-diagnosed the pain as having been caused by venous valve “blow-out” on the flight, resulting in varicose veins of the shins.

Before leaving London for Boston in June, I contacted the office of a vascular surgeon recommended to me by my NHS GP. She said that waiting for treatment on the NHS would take years, and that I should be evaluated right away since the pain was affecting my ability to be mobile. This particular specialist is so in demand that there was a 6-week waiting period. The doctor’s wonderful secretary booked me in for a consultation on a Monday, andfor a procedure on the Wednesday of that same week. If the surgeon found something that needed surgical attention, it would be able to be taken care of right away.

So, off I went to the hospital around the corner to consult with “Dr. G”, who unfortunately for me was a tad late for his previous appointment. I was ready to create a fuss, so it was a good thing I had brought my knitting to the waiting room as it helped to calm me. Once in his office, he took notes as I described the saga of my veins, and then he conducted an ultra-sound scan of the veins in my legs. The Doppler technology clearly showed reflux (the valves not closing all the way when they are supposed to, resulting in backflow into the superficial leg veins) in the greater Saphenous vein. In the leg with the greater pain, it was occurring just below the knee as well as higher up in the thigh near the groin. So that explains the intermittent fluttery sensations there! The other leg has “just” the faulty valve below the knee, but also something called a “Boyd’s perforator”, which is the vein bulging out looking for someplace for the backed up blood to flow.

It was interesting to learn that the painful shin veins were not the entire problem, and that the foundation for the symptoms was much higher up in a large vein, near the knee and groin, and it was especially interesting to see it all displayed in glorious color on the Doppler scan. I felt like I had a weather map of my circulatory system on display, and that instead of the movement of clouds towards and away from the scanner showing an impending thunderstorm or tornado, it was showing a backflow of blood going the wrong way in my veins. I clearly remembered being taught about the Doppler effect on sound waves in one of my high school science classes, with the sound of a train horn’s pitch rising as the source of the sound gets nearer to the listener, and the pitch sounding lower as the train moves away. The movement of the stars in space (reddish stars moving towards earth, with the light wavelength shortening, and stars appearing to be blue moving away from earth, their visible light wavelengths appearing to lengthen) and now, even blood flow, can be illustrated by a computer program that red and blue colors to blood moving through the circulatory system. Hooray for Herr Doppler (Austria, 1842) !

The treatment of choice for the vascular reflux is laser surgery, where a catheter containing a tiny laser is inserted in the greater saphenous vein from ankle to upper thigh, and the valves and vein tissue are ablated (I believe “zapped” is the technical term) under local anesthesia. The protruding vein portions are then removed surgically through tiny incisions “the size of a freckle”. Recovery time is a week or two, although Dr. G. said he had one patient back on the golf course within two days of the surgery.

I was glad to be already booked in to the surgery schedule by the highly efficient Veron Williams, so only had two nights and one day to worry about the actual surgery. Although I had already done my internet research homework and knew what to expect IF I had the diagnosis, and was fairly certain that I had diagnosed myself correctly, it was a relief to learn from the surgeon that he considered the procedure to be warranted in my individual case, and that it was a pretty routine procedure from his point of view.

I will describe my day of surgery and the week that followed it in a separate entry.