Tough Love

Thursday, 06th July, 2023

Today I have an appointment with another nurse practitioner. Including two appointments I’ve missed, this is now my eighth NHS appointment in my new domain since June 12th. Same old new NHS, so subtlety different. This nurse, like the one who gave me my LHRH Antagonist injection (a cancer treatment), I like straight away. Not far off my age, thirty-five plus professional years, honest and compassionate, she has that no-nonsense but fair and caring approach I have come to love. 

She embodies how the NHS was meant to be..

I’ve found with the mental health professionals I’ve come to know privately, they deploy a tough-but-caring approach. They can turn off the emotion like a switch. With the nurse practitioners it seems subtly different. Still a no-nonsense approach, but with an unmeasurable but detectable caring dimension and I like this better. You’re not left wondering. 

She looks down at my swollen right leg and says nothing. In these circumstances I like nothing, it means she’s thinking, considering. If she’s considering, that means she’s considering options. That means she either knows what she’s talking about or hasn’t a clue. From the look on her face, I know which it is.

In terms of bloggery, this is a tough one. At inception I thought I’d divide my ramblings into cancer and MS, readers who had no interest in one or the other wouldn’t have to trawl. But there’s another aspect to what’s been going on in my body that is neither.

My right knee is shot (saved for later) and although it is my right side that is affected by MS I am suspicious of coincidence, when it comes to knees there’s a fifty-fifty chance of the knee being in the effected area and this is probably age and rugged-youth related (the NHS is confident MS is a major factor, and although too much sport and too many miles over rough trainers with heavy weights in the Army I assume that affects both equally). In 2018 I had problems with multiple and large Pulmonary Embolisms (emboli?) in both lungs. These were break-always from DVTs in my right calf which were attributed to diminishing exercise patterns (and, probably, too much sitting down). These DVTs, there must have been a few of them to cause ‘multiple’ PEs had damaged the gates of the veins, so I was told. As must be obvious to everybody, the heart beats, so blood is pumped around the body in pulses. In the pause of a pump, gravity would cause the returning blood, blood that has visited and been used by, say muscles, and is returning to the heart via the veins, to flow back down the leg. There are gates that close in the vein to stop this happening, with the next beat blood is forced back through the gates and continues on its journey. Damaged gates causes a gravity-fed build-up of fluid.

My swelling was immediately (after the pause) identified as lymphodema by Jane. If the folk in Cheltenham knew it was this, I wasn’t exposed to the word. Lymphodema can be inherited, my mother had terribly swollen lower legs, and is often associated with cancer cures; I’m still going to go with DVT damage, it feels right. Jane rummaged in a cupboard somewhere and came back with some heavy-duty skin-coloured bandages, compression bandages, that she wrapped around my lower limb. The compression, squeezing, forces excess fluid back up the limb. It’s blisteringly hot at the moment so I’m anticipating problems with itching, as if I was in a cast, but it also feels like a possible solution as opposed to the last five years of that’s-just-how-it-is.

Now. Here’s the thing. The swelling isn’t painful, or uncomfortable. It means my foot won’t fit in a shoe and my leg won’t go down normal trousers, but it isn’t debilitating. But it sure as hell plays with my mind. It’s unsightly.

Takes a deep breath … how on earth can I consider taking my clothes off in front of a woman when she’d be confronted with this? (Testosterone blockers aren’t foe ever, right?) The body disabling effects of MS are bad enough, but with an explanation they might at least get me a sympathy vote. This is just a ‘Ewh!’ moment waiting too happen. And here’s the other here’s the thing. Even if it isn’t, even if there’s a woman out there who would see beyond the ugliness of the swelling (and, let’s be honest here, a rather large beer belly …) there isn’t in my mind. And that causes a withdrawal, a withdrawal from one of the most natural (in theory), pleasurable (sometimes) and connection-making (hopefully) aspects of being a human being: sex.