Category Archives: Medical
I recently travelled to the US and back, spending time on the East Coast with family and friends and then going to California for a conference. My trip involved six flights total, two for each change of location. Since the last time I flew I’ve developed osteoarthritis in my left hip, which restricts my movement somewhat and makes it painful to walk, and most of the time I use a cane (UK: stick). When I’m not burdened by luggage (even a rolling bag can make things worse) I can usually walk short distances with little pain, but transatlantic travel involves both a carry-on bag and a checked bag, and many airports (especially London Heathrow) require substantial walking. (I’ve learned that when I use Heathrow I often end up having walked a total of five miles on that day.) So I decided to request wheelchair assistance in getting through the various airports. Although this was a necessity for me under the circumstances, it wasn’t all roses.
Herewith the story of my experience.
Newcastle to Washington
For a noontime departure I would ordinarily have taken public transportation (bus and Tyne and Wear Metro) to the airport, which with my senior pass would have been free for me. With two bags and a cane, however, I needed to take a taxi, which cost me about £15 each way.
I managed to get my two bags to the bag drop, walking gingerly, and went to traveller assistance to request a wheelchair. The agent asked for my boarding pass, did something on his computer, and gave it back to me and directed me to a waiting area. Not long thereafter a woman arrived with a specialized wheelchair for airport use (see photo), which was narrow and with a shelf underneath for a carry-on bag. The arms lift to let the person sit from the side, where access is easier. It has a basket in back for a small handbag or something, but mine was too large for it and in any case I also had my cane and the poster I was to present at the conference. The wheelchair got me fast-track through security and boarding. The aide wanted to help with my security baggage management, but this is the sort of thing I have to do myself because I know where my electronics and liquids are and I needed to get them out and put them into the security bin myself. I guess they don’t expect wheelchair passengers to have a laptop, a tablet, a pedometer, and three cell/mobile phones. :-)
London Heathrow (transfer – leave UK)
Wheelchair assistance passengers are asked to wait until all other passengers (I hate hearing transportation companies call them “customers”, but that’s a rant for another time) have deplaned before they leave the aircraft. I guess they think we’ll be slower to get off and will slow the others down, which is probably a reasonable assumption. But they give us aisle seats, which means we have to get up to let our seatmates off and then sit back down to wait. I don’t know what I would have done if I had been completely unable to stand.
I was pleased to note that the wheelchair assistance agent at Newcastle had arranged for assistance at Heathrow as well, and they were waiting for me at the entrance to the jetway (UK: air bridge). That part, at least, is well organized. One aide pushed me to a waiting area inside the airport, where I sat for about 15 minutes, then another one came to get me; he took me to the Special Assistance Lounge in Terminal 5, where I waited for more than two hours for boarding. The description in the airport guide (see link above) is not quite right: the lounge is not “fully catering” because they have a very small number of electrical outlets/sockets in one area of the lounge and because all they have to eat or drink is water and you have to go around the corner a hundred feet or more to get anything else. I didn’t find out about the outlets until I was about to leave the lounge, as the aide didn’t mention them but just placed me in front of one of the TVs. Sigh.
The aide who took me to the lounge insisted that I needed a paper boarding pass (I had checked in online and had a mobile one), so he got one printed. That was probably OK, though, because the lounge staff held onto it while I was there, so that they could ensure another aide was available when my flight was about to board. This time I needed to go to a different area of the terminal, so they sent me with another passenger in a beeping electric cart. We descended in a large elevator to the bowels of Terminal 5, where the ceilings were full of pipes and tubes and the walls were replete with doors that required a badge to open. That was the most interesting part of this experience — getting to see a part of the airport that must be off-limits to most passengers.
I showed the gate agent my mobile boarding pass, and she exclaimed at how high-tech I was. Nobody has ever made such a comment while I was walking without assistance; did she expect me to be senile as well as disabled? Grrrrr…
Washington Dulles (arrival – enter US)
Again, an aide was waiting for me when I arrived. I told her I had Global Entry, and she seemed to know what that was. We got there and she wheeled me up to the kiosk. I know the kiosks accommodate travellers with various disabilities, but I didn’t see any that were low enough to accommodate someone in a wheelchair, so we used a regular one. Because I wasn’t standing, the photo that was supposed to show my face showed instead the crowd in the background behind me. Oops!
Two or three times while I was using the kiosk the aide tried to tell me what to click. The second time, I assured her I was very familiar with how to use it, but I’m not sure she believed me. The third time, I had been thinking about whether what was displayed was correct (I decided it was), but evidently she thought I was confused, and when she said “Click ‘Next'” I lost my patience and said “Don’t rush me!” It later occurred to me that she shouldn’t have been watching at all, let alone telling me how to answer — it’s a matter of both traveller privacy and national security — so when I had my Global Entry renewal interview a couple of days later I reported the incident to the CBP officer (who strongly agreed with me) and said I thought it was probably an issue of airport training of wheelchair aides. I hope they manage to do something about it. In any case, if it ever happens again I’ll be prepared to insist that the aide not even watch. (I hope I don’t need to cross the Atlantic again before I get my hip replaced.)
The same aide got me to the Hertz shuttle bus, whose driver asked if I wanted to give her (the aide) something. It had not previously occurred to me that I needed to tip these people in the US, and I’m afraid that what I gave her was a wee bit less than what is customary. I later looked it up, and the consensus in the discussion forums was for at least $20 for this amount of service. Yowza!
Washington to San Jose
The wheelchair assistance folks were expecting me, and they didn’t have to enter new info into their system. Kudos to the Newcastle folks for arranging the whole shebang.
Washington to Dallas / Ft. Worth (outbound)
This time they were using a regular wheelchair, and the aide placed my carry-on bag between my feet and I had to hold it with my knees. I sailed through security because for this flight I got to go through the TSA Pre-Check line. (Note to readers and especially to the Transportation Security Administration: Pre-Check has the stupidest logo in all of government (see image). The graphic checkmark fails to convey the word “check” and leads most people to call the program “Pre”. Also, not everyone calls that graphic a “check” — Brits call it a “tick”, for example — so even if it did imply a word it wouldn’t necessarily be “check”.)
Except for the logistics of the carry-on bag, this was the smoothest of all my wheelchair adventures so far. My tip this time was, I think, commensurate.
Dallas / Ft. Worth to San Jose (transfer)
A long ride in mostly regular wheelchairs, again with my carry-on between my knees, and with two different aides. The first one was surprised at how far I had to go to my next gate, and he started weaving quickly in and out of the foot traffic, trying to get me to my gate as fast as possible. I asked him not to do so much back-and-forthing, and he said he had to hurry back for another passenger. I pointed out that that was no reason to make me uncomfortable, and he agreed and stopped doing it. The next trip was just from the gate to the door of the plane (down two ramps and a jetway), and I tipped both aides according to the length of the trip.
San Jose (arrival)
Regular wheelchair, as I recall, to the airport shuttle pickup point. No problems.
San Jose to Newcastle
San Jose (departure)
This was the best of my airport wheelchair experiences — although the aide was new and somewhat inexperienced, she was so nice and not in the least patronizing, and as she pushed me we talked about our respective studies. This one I tipped a little more than what I understood was customary for the work and she appreciated it very much. At the gate she put me where I requested, next to an outlet, and I got an hour’s worth of work done. The same aide came back to wheel me to the plane, and after I boarded I felt bad that I been so focused on getting myself to my seat that I hadn’t said a final good-bye to her. What a lovely young woman.
Unfortunately I didn’t get to use Pre-Check this time, as I was on British Airways and they don’t participate in the program. That will make me think twice about using BA for future travel to the US.
London Heathrow (transfer – enter UK)
Again, an aide wheeled me from the plane to a wheelchair waiting area. Since I had four hours before my next flight, I waited there about an hour before they got someone to take me to the Terminal 5 lounge. People kept arriving who had flights earlier than mine, and they were taken first. I agree that people should be taken first who might otherwise risk missing their connections, but I don’t think that someone who has 3.5 hours should be taken before me at 4 hours if I got there half an hour before they did. This waiting area had no sockets and no amenities except toilets. The staff member asked if I had any liquids, and when I said yes she started reciting a list. I looked at her blankly, wondering why she was going on about it, especially as most of the ones on her list are not the kinds of things I carry (odd that she didn’t mention contact lens solutions :-), and she must have thought I didn’t know what she was talking about. I assured her that I was accustomed to flying, saying that I had crossed the Atlantic more than a hundred times (this is true), and then I showed her the plastic bag of fluids from my handbag, which is the way I always carry them. (Strictly speaking they aren’t all liquids, but why quibble with airport staff over physics? :-) I wanted to say to her, “Look, I’ve got arthritis, not dementia.” Grrrr…
The first aide who came to get me in that waiting area was smallish, and she complained about the heaviness of my carry-on bag, so a manager came along and insisted to me that my bag was too heavy and her people were pushers only and not lifters of bags. She said I’d have to lift it myself through security and advised me not to bring so much stuff in the future. This was the only time anyone had complained about having to lift my bag. It doesn’t make sense to me, as most people have carry-on bags and I’d think wheelchair assistance would automatically include assistance with the baggage. The aide didn’t ask what kind of passport I have and automatically took me through the “normal” (UK/EU) side, but fortunately the Border Control agent was understanding (no doubt because I was in a wheelchair) and everything went smoothly from that perspective.
I finally got to the Terminal 5 special assistance lounge, but as I had a lot less time there than I had expected I decided not to dig out my laptop and try to work. Having just come off the longest flight I’d ever had and not having gotten the 3+ hours of sleep that I usually manage to get on transatlantic flights, I was rather jetlagged.
This time it was a shortish distance to the plane from the gate, so I agreed to walk while a BA gate agent wheeled my bag on board.
The aide here was chatty and pleasant, and everything went smoothly. He wheeled me out to the passenger pick-up area and helped load my bags into the taxi.
The pluses of this service were more or less what I expected, except for the first one on the list below. The minuses were much greater than what I expected.
- Having to arrange the service only once, not at each airport for each flight
- Fast-track security and boarding
- Speedy movement through airport
- Not having to do all that walking (duh!)
- No real way (as far as I could tell) to arrange the service to begin on arrival at airport, had to get to bag drop first
- Tips in the US (I think I spent at least $75 in total)
- Waiting in areas and “lounges” with no real amenities
- On landing, being last to deplane
- Heathrow wheelchair assistance manager requiring me to lift my own bag
- BEING TREATED LIKE AN IDIOT
(not all staff did this, but even if it had been only one it would have been too many)
I’d also like to say that on all six flights all of the flight attendents were wonderful. They cheerfully stored my CHI poster in the closet up front, and they treated me well. Thanks very much to British Airways and American Airlines for their great staff.
On the whole, I don’t think I could have made this trip without wheelchair assistance. But I do wonder how I would have managed if I hadn’t been able to stand or walk at all. Something to ponder.
Today I had my first dental care, other than a checkup I had last year just to get started with a local dentist. I had made an appointment for a checkup and “scaling” (the UK term for what we call a “cleaning” in the US), and I was kind of expecting the kind of cleaning I was used to getting. Dentistry is not covered under NHS care for most people, and I’ve been curious to find out how the cost would compare to what I’ve been paying in DC. I expected it to be somewhat less but relatively comparable.
Boy, was I in for a surprise.
Since I arrived in the UK I’ve been flossing more diligently than I did before (although I was never exactly a slouch), because I learned that Brits expect to get a routine scaling/cleaning only once a year (as opposed to twice in the US) and I knew I would have to be more conscientious in my own care of them.
I did such a good job, it turned out, that the dentist didn’t want to do a scaling at all. He said they don’t do them routinely here, and he said I had so little tartar that it wasn’t really necessary except in the lower front. But I said that I wanted one and was prepared to pay, so he did a light once-over and polishing. It was less extensive than what I’ve been getting (possibly because of my recent diligence in flossing) and it took only 15-20 minutes rather than 45.
I was amazed at the fee: a whopping £18. Folks, that’s only about $30. And that included the nitrous oxide. As I recall, the last time I had my teeth cleaned in DC (a year ago), I paid more than six times that much (including nitrous).
Dental care is pretty different here.
I’m finally ready to write about this. I’ve passed a milestone — the 25-pound mark. I’ve dropped almost 27 pounds since my first checkup with my UK GP last January. True, 27 pounds in more than a year is pretty slow, but actually I was a slug last winter and I’ve been working on this only since the middle of August. I’m averaging 0.9 pounds a week, and although I’d be happier if it were faster I’ve got a regime I can live with and manage comfortably, and at my age a pound a week is nothing to be embarrassed about.
It all started last spring, when I noticed that my feet and ankles were getting somewhat swollen at the end of the day. At first I thought it was left over from two transatlantic flights I had made in March, but it hung around. So my GP put me on a diuretic. That didn’t help much, though. So I naturally turned to the Web. I found information provided by the UK National Health Service and the US National Library of Medicine, both of whom said that fluid retention — edema (or “œdema” in the UK) — might be exacerbated by eating too much in the way of carbohydrates. I also discovered the “Two-Day Diet“, which has you eat very low carbs for two days a week (preferably consecutive days) and then eat moderately for the other five. I’ve been on a modified version of that for six months now (I have a little more fat and dairy than they call for on the two days), and I can say I’m more comfortable with it than I’ve been with any other program I’ve tried. And of course we know that the most successful program is the one you can stick with. By the end of the two days I’d kill for a few rich tea biscuits with (no-sugar-added) peanut butter, but I actually find that it’s easier to eat moderately the rest of the week after I’ve gone VLC for two days. I treat myself occasionally, and as long as it’s occasional enough (a dessert once or twice during the five days) I don’t feel bad about it at all.
The other thing I’m doing is getting more exercise. Last year, for example, I rode the Northumbria Shuttle bus whenever I needed to go to the Squires building or the library. This year I’m walking — it’s only just over half a mile, ferpeetsake. I walk to Grainger Market at least twice a week for fruit&veg (as well as chicken and eggs, but I don’t buy those every time), and sometimes I walk downtown and back twice in a day. (Sometimes I stay at home all day, but we’ll pretend that that doesn’t matter.) I aim to average three miles a day, and although I’m not recording my walking (I just notice, at the end of each day, how many steps I’ve walked that day) I think that’s about what I’m averaging.
Why, you may ask, couldn’t I have done this in Maryland? I could have done the eating plan, of course, but the walking is a different matter. Four good reasons come to mind:
- Access. Shopping is not easily walkable from my house in Maryland. The grocery stores are about the same distance from the house as Grainger Market and Morrisons are from my flat in Newcastle, but to reach either of them (and I detest Safeway, so Giant is really the only choice) I’d have to cross catty-corner one of two major intersections that have three lanes of traffic in each direction. Also, I bring my Grainger Market shopping home on the bus, and the buses don’t run as close to my Maryland house as they do to my flat.
- Temperature. For five months or so in Maryland, it’s just too damn hot. In Newcastle, when it gets up to about 23C, people start complaining about how hot it is. (I just laugh. :-) But the DC area usually has at least four months of temps above 30 each day, including probably a month or more of temps 35 or higher. I’ve long said that if I lived someplace where it never got above 30 I’d be in heaven.
- Appeal. The centre of Newcastle is just a nicer place to spend time in than is the commercial district of Wheaton. I know my Montgomery County peeps won’t like hearing that, but they should come visit and they’ll see. (Half of my route to the city centre is not all that appealing, but I can live with that.)
- Safety. Newcastle is far safer for a woman alone to walk around in, especially at night. Except in a few areas, in fact, it’s very safe, and I don’t worry about it.
One might argue that I could have improved the situation by moving into DC. It’s probably true that I would have had much better appeal and access than in Wheaton — perhaps even good enough — but there would still be that pesky heat. DC would be worse, in fact, as the city tends to run about 5F warmer than the part of suburban Maryland where I was living. I’m not sure how the safety compares in the urban areas of DC where I would consider living, but I can’t imagine they’d be as good as Newcastle. And they’d cost more.
Admittedly, I’m less inclined to get out and walk when it’s raining — especially because Newcastle is windy enough to make umbrellas impractical — but today I did it (I needed to go to my GP’s and do my weekly weighing) and I was fine, if slightly damp. I do need to buy a very warm jacket that’s also waterproof — my down jacket is plenty warm enough, but it’s not even remotely water resistant, and I don’t always want to wear my rain poncho over it. (By the time I thought of that this year, nobody had any left in my size.)
I’m feeling better — more energetic and slightly more flexible. I’m not yet seeing much of a difference when I look in the mirror, but a couple of people have remarked on it and my clothes are definitely looser, so I know it’s happening. (Loose jeans in the winter are a good thing, too, as I can wear thermal long underwear beneath them and save on my heating bill. :-) And my ankles are back to normal. (I’m elated about having found a solution to that problem that doesn’t involve medication!) I’m looking forward to improvements in my singing and my sleeping, as well.
Slowly, slowly — but steadily.
This past spring I spent a lot of time at the Royal Victoria Infirmary (RVI), Newcastle’s major hospital. I wasn’t an inpatient but I had to go there several times for tests and discussions because they suspected a problem. (Don’t worry; it turned out to be nothing. Truly.) Some of it was a bit of an ordeal (I have an exceedingly low threshold of pain), but one woman in the clinic was so understanding and empathetic that she made it all almost bearable. As I was leaving one day, I noticed a sign in the lobby urging people to nominate for a “Personal Touch Award” any employee who had provided care “at its very best – with a personal touch”. The sign listed a specific address on the hospital’s website but I didn’t want to take the time to take it down, figuring that I’d just go to the home page and find it from there.
Well, finding it was NOT easy! I finally managed, though, and put in my nomination. The next time I went in I found the patient/customer service representative, told her my story, and suggested that they put a link to this nomination form on the hospital’s home page. She said it made sense and she’d talk to the IT folks about it. Then I went to my appointment and thought no more about it.
This evening I was looking around for some examples of websites I could use in a couple of upcoming presentations (including a class I’m teaching in two weeks on information architecture), and I decided to take a screen shot of the Newcastle Hospitals’ home page. Well, when when I loaded the page I got a wonderful surprise: In the upper right corner, very visible, sat the logo and link to the Personal Touch Award. Gave me the warm fuzzies, it did. (Note: The image I’ve posted is a small part of the home page. Don’t worry — the award bit doesn’t occupy a third of the page! :-)
Sometimes all you have to do is ask, and explain why. Sometimes, people really do listen.
I just got back from having an ultrasound scan of my right shoulder. They took me within a couple of minutes of my appointment time, and once back in the ultrasound area I didn’t have to wait at all. The scan was performed by a radiologist (rather than a radiology tech, as is done in the US), and he was able to tell me right then that there are no tears all the way through my tendons. There may be partial tears, he said (and the ultrasound would not show those), but nothing that goes all the way through. So, no surgery is needed: I just have to take care not to aggravate the situation, and in time my shoulder will heal.
Note: I thought I had posted this already (I wrote it two weeks ago, on the 20th of February), but I have just discovered that it’s still in draft.
It’s an injury to tendons (as I suspected).
I went in for my appointment with the Fracture Clinic this morning, and the specialist told me that neither he nor the radiologist saw a fracture — which is Very Good News. They’re going to make an appointment for me to have an ultrasound scan, and he said something about maybe an MRI. Stay tuned.
Meanwhile I have to treat it gently and avoid doing anything that hurts.
Last Monday morning (more than a week ago) I took a fall — I tripped over the step from my kitchen into my living room (“lounge” here) and went sprawling onto the living-room floor. Fortunately it’s of wood so it had some give, but my right should has been pretty sore. Certain positions and movements of my right arm hurt my shoulder a lot, and sometimes it keeps me awake, so this morning I phoned my GP for an appointment. If you call at 8am you can get a same-day appointment, and it took me half an hour of calling to reach them to make that appointment. They did have an opening, but unfortunately the only one available was with the nurse (not the nurse practitioner). Oh well.
When I described why I was there, the nurse asked if I had been to the Minor Injuries Unit at the hospital, and I said no, I didn’t know about it. So she told me to go there (it’s kind of like a step-down emergency room for less serious problems, staffed by nurse practitioners (NPs) trained in certain kinds of injuries).
While I was in the GP surgery (the doctor’s office) I picked up the four prescriptions that I had previously asked them to write me, and took them upstairs to the pharmacy to have them filled. Total cost: £0.00. (As an NHS patient over the age of 60, I get prescriptions free.) These meds would have cost me something like $400 in the US, even at the “low” prices from the mail-order pharmacy service you get with a health-insurance plan. (I had a high-deductible plan while I was on my own, because the lower premiums saved me more per year than my relatively predictable medical treatments and meds cost me in out-of-pocket expenses.)
So this evening I went to the Royal Victoria Infirmary, which is about 1.5 miles from my flat. The nurse practitioner examined me and sent me for X-rays just to be safe. While I was waiting to be X-rayed a young man was wheeled in, all covered with tattoos and iodine, hooked up to an EKG, and accompanied by a police constable. It’s not clear what had happened, but my first guess was that he had been shot. When I posted that to Facebook, though, my more-UK-knowledgeable friends were shocked. (Guess I was showing my cultural bias: I did, after all, spend 35+ years living just outside Washington DC.) So it’s more likely that he may have been knifed; one of my friends also pointed out that he might even have been the target of an attack, saying that the police do accompany victims to the hospital.
The X-ray procedure was just as I would have expected, and they sent me back to the MIU to await the results. It turns out I have a fractured clavicle. The NP showed it to me on the X-ray; it appears to be about an inch and a half to two inches long, at the shoulder end of the bone. This would explain why certain movements hurt, eh? Anyhow, they made me an appointment for an orthopedic consultation tomorrow morning in the “fracture clinic” but both the NP and the orthopedic consultant on duty this evening thought they probably wouldn’t do much. Guess I’m off carrying my laptop around in my daypack/rucksack for a while, though. Good thing I’ve got a case with a handle.
In all, I was at the hospital for just over an hour. Not bad at all, considering that the time included three rounds of waiting. And nobody said anything about a bill.
I received a letter from the NHS yesterday, informing me that they had made an appointment for me to have a mammogram at the Royal Victoria Infirmary on 22 February. NHS does breast-cancer screening every three years, so I phoned to tell them I had had a mammogram just one year ago and ask them to postpone me for another two years. The very nice lady said that unfortunately that would delete me from their screening altogether, so I told her I’d take the appointment.
My appointment is for 16:24 — that’s 4:24pm. A mammogram appointment is six minutes. Six minutes. How can they do a proper mammo in six minutes? Obviously this does not include the time you need to disrobe and put on the mammo top; that’s no problem. But only six minutes for the procedure itself? Maybe they take only two pictures. Maybe they don’t make you wait in the room while they check the image quality and redo any that are of inadequate quality. I don’t know. (Clearly I’ll find out.)
I told the lady that I have cysts and am always called back for ultrasound. I told her that for the last couple of times, my gynecologist has authorized an ultrasound on the same visit so that I wouldn’t have to be called back for a separate appointment, and I asked if we could do that. The very nice lady thanked me for the information about the cysts but said it would have to be a call-back if they determined they needed to do ultrasound as well. (I wonder if that one will be six minutes too. Sigh.)
I am always reminded of my first mammogram. When I got home from it, Antonio asked me, “How do they read it through all those bones?”
“Bones? What bones?!” I asked, incredulous. “There aren’t any bones in there!”
His eyes grew wide and his mouth got very round. “Ohhhhh.”
Folks, it ain’t a chest X-ray.
Yesterday, for the first time, I went to the “GP Surgery” at which I had registered (in the UK, a “surgery” is a doctor’s office) and saw the nurse practitioner. I went mainly to be able to continue my medications. For two of them, we had to look them up and find the UK equivalents; the other one is available under the same name. Ordinarily, as an international student with “pre-existing conditions” (yeah, right, like menopause is going to go away), I would have to pay for the medications. But as a person who is at least 60 years old and covered by NHS, I don’t have to pay. Hooray!
The nurse told me that appointments are normally limited to ten minutes. Whoa. I don’t know what kinds of conditions would merit more than that (certainly a gyn exam), but that certainly explains why you can usually get a same-day appointment if you phone them in the morning.