Darnell strikes a low blow

‘Millions of women have bladder leaks let’s talk about it’, proclaimed a leaflet dropped through my mum’s letterbox this week. Strangely, despite being 89 my mum’s bladder control is phenomenal.  Better in fact, much better than mine.  Mine has a strange mind of its own.

I can walk 3 to 4 hours everywhere around this town and its surroundings with no problem. But as I near the street where we live, my bladder seems to get overexcited. “Steady on”, I tell it. I have noticed that in one’s 60s you begin to address organs and limbs and even other parts of your anatomy as if they are separate entities. I reckon it’s because they tend to play up in unexpected ways on the quality of life. This gives them a sort of character of their own. My knee for example will suddenly dislike steep or downwards slopes.  The pain generated feels as if the knee doesn’t like such slopes and this capricious nature gives it a particular identity of its own.  

My bladder also has a sense of humour. I used to think of it as being darn right malicious but I’ve grown to realise it just has an incredible sense of humour. This means at certain critical points when it is not possible or inappropriate to use a bathroom, at a wedding or funeral service or when being examined in a doctor’s surgery etc my bladder will signal a sudden need.  I call my bladder Darnell because in part I used to say to myself at such times “Darn it!”  The darn grew into a Darnell because something that could be both overexcited and yet so playfully humorous deserved a name.   

This process of addressing body parts continues apace with age until even inanimate objects seem to acquire a personality of their own. A dear aunt of mine comes down into her own kitchen every morning and asks “Where are you, kettle?” She has my sympathy I already have a strange ability to make inanimate objects disappear, such as keys phones etc but as yet I refuse to address them.  Give it another decade and I can imagine quite nasty conversations with these perverse objects which hide so effectively. 

Where was I? Oh yes, my bladder. When I am a good 10 minutes from my destination my bladder begins to sense relief is coming soon and gets over-excited. I usually sit on a small wall and pretend to tie my shoelaces telling my bladder firmly we are not home yet only close! On bad days I feel all my neighbours are noticing my predicament and on good days I don’t care. Given my mum’s camel-like ability to store water for long periods I was perplexed when she produced free coupons for discrete bladder leak pants and pads for me to get while doing the weekly shop. When I asked why she wanted them she shrugged and pointed out that they were free as if we would be fools not to use these freebies popped through our letterbox. The fact they were unneeded did not matter. Reluctantly I found myself in Tesco’s looking at shelf after shelf of bladder protection products trying to identify the brand that corresponded to the coupon in my hand. It was all too confusing so I asked a staff member who was stacking shelves nearby. She suggested ones that seemed to correspond to my coupon and I threw them into my shopping basket with all the other purchases. 

It was only when I reach the checkout and handed through all the groceries that I came upon the bladder protection stuff and remembered my voucher and held it up. The cashier said she wasn’t sure the voucher corresponded to that particular pack. She told me to wait a minute and shouted over to a colleague a few rows away, "Deidre, are these the bladder protection pads that match the coupons?” Deidre couldn’t make out the details of the coupon from that distance and told her many customers to wait while she came over to inspect first the coupon and then the pads. At least two queues of shoppers were now paying close attention to our goings-on. Deirdre frowned confused, “I’m not sure, I made a mistake earlier on and handed out the wrong pads to a customer. Let me call Dave the manager!” 

This whole affair was rapidly turning into a circus. Red-haired Dave arrived but seemed reluctant to tackle this incontinence problem. He explained to the cashiers, “Actually I’m due my break now, let me get Richard”. His voice boomed out “Richard, Richard!” towards a dark-haired man with greasy hair at the back of the store near the freezers. “Richard, can you come and sort out incontinence pads for this lady?” This particular lady wanted to hide under her trolley at this stage but there was no escape. I suggested to the cashier closest to me, “Never mind, leave it.” But she explained she’d already scanned in the pads.  Richard arrived looking worried and announced to both tellers in a concerned voice “I don’t know much about incontinence stuff”. I said “Look, it’s okay I don’t want it anymore.” The teller explained sulkily to the manager, “I’ve already entered the coupon and pads in the system we just need to find the right bladder protection thing it refers to". Fearing Richard would head off looking for more brands and wanting this whole affair over I repeated more firmly, “I don’t want it anymore, I just want to pay for the groceries.” Richard looked relieved and said “Sure, but we just need to remove the voucher and pads from the receipt.” He told a teller to give me the receipt and then said “You just need to go to customer services and they will remove the item and settle the balance.” He smiled relieved the whole thing was no longer a problem needing to be solved.  He accompanied me part of the way to the customer service desk near the door and then stopped and said in a loud voice, “Daphne, could you help this lady!”  

To be honest I wanted to hug this greasy Richard. By this stage, I felt sure he would mention bladder control to this part of the supermarket too.  After all, at this end, there was a whole other audience that didn’t know I was trying to get a product for a leaky bladder. Daphne was suitably helpful and quickly removed the item from my receipt and prepared to give me the money in exchange.  She whispered across the counter to me that many women had found it impossible to find the right product matching the coupon sent out.  That made me feel much better and I began to relax, I smiled and explained my mother was particularly keen on using all coupons that provided free goods.  Daphne, responded, “I know, if there is a coupon available my mum is exactly the same and gets it even if it is something she never eats!”  We both laughed and to be honest I was feeling much better as I awaited the change she was taking out of the till.  

But Darnell would have the last laugh, at that precise moment she struck and I had to take my change and rush into the nearby toilet beside the customer service.  When I emerged from the facility Daphne said nothing but there was a rueful expression on her face that had a small smirk to it.  I could be wrong, I know I am super sensitive, my mother points this out on a daily basis, but I have taken to avoiding Tesco’s for a while.   Even free coupons can cause humiliation to this soul!  

Lessons learned in a dark A&E

Heartbroken by the rows of trolleys packed back to back in corridors at 2 am in a darkened A&E department. Most seem to hold an elderly patient grey-faced and loosely bandaged in a twisted blanket embalming the old and sick. Heads hang off necks too weak to support them. The trolleys are bereft of pillows with cold and plastic surfaces easier to wipe down and clean. Their inhabitants, if strong enough, repeatedly plead for pillows to any passing staff member. Pillows are banned now along with much of the expected humanity one would hope to find in a place of healing. 

They usually only end up here as a last desperate resort. When really in pain beyond endurance or unable to draw breathe properly, the elderly, like my mum at 89, break their daily vow never to go to hospital, and 999 is dialled. Mum’s ambulance had raced from Limavady to Ballymoney to collect her as Coleraine Hospital had all their available ambulances parked outside A&E unable to offload patients.   My Mum was shaking uncontrollably for hours with severe back pain, vomiting, and breathing fast shallow gasps of air until we eventually called the emergency services. 

The ambulance arrived in response to the call in just over half an hour and the dispatcher stayed on the call talking to me while we waited.  A team of three determined ambulance personnel arrived with loads of equipment and quickly checked measured blood and heart measurements. They administered pain relief and insisted on taking my mum to the hospital. They said there were just too many worrisome medical indicators and we reluctantly agreed. They decided to go to Antrim hospital because of the queues outside Coleraine A&E.  But when we arrived outside Antrim A&E there was a five-hour wait in the car park. My poor 89-year-old mother gasped in agony at the hardness of the stretcher in the back of the ambulance. The wait seemed never-ending, those trolleys are not designed for comfort. During that long and unbearable night, I was struck that so many elderly and vulnerable patients are lying for hours and hours waiting for help in such conditions. Some die on these hard-cold trolleys outside hospitals and it seems to go on getting worse and worse instead of being improved. We wouldn’t let a badly injured dog howling in pain sit in the back of the van outside a vet’s so why do we expect the vulnerable, the ill, and stoic elderly to endure such conditions?  

Shame on this system of abuse. Is it due to a lack of funding, gross incompetence, a lack of staff, shortage of beds or equipment, staff burnout, or GPs hiding in the trenches while emergency services face all the flack?  I have no idea, what is wrong with the system. I cannot fault the kind ambulance staff or the over-pressured hospital staff but it is not acceptable. Too many are in corridors or in the back of ambulance vans suffering pain and whatever we are doing is not fixing it. On my worst days, I wonder how truly awful everything will have to get before we throw off this strange stupor and make even small changes to improve these conditions. I know there are amazing souls working their hearts out to try and make a difference it’s just I just feel we need to do more than just applaud them.

When we had eventually entered A&E mum’s trolley was wheeled into a corridor filled with other patients on trolleys end to end like carriages of a train awaiting a missing engine.  In the nearby ward, there is a shouting angry man and there seems to be three staff remonstrating with him.  I think they want him to wear an oxygen mask but he doesn’t want it and shouts violently and aggressively, he pulls it off and the staff tries to reconnect it.  Their arguments go on hour after hour and there is a tiny part of me rather ashamed to resent that this nosy intoxicated patient is draining all the efforts of so many staff.  After all, the softly moaning old lady two trolleys away may need more help but is not getting much attention.  Another patient in the ward is a young teenager who has tried to commit suicide and two staff try to convince her to stay rather than discharge herself immediately.  Her father arrives and joins the team pleading that the results from blood tests need to be checked before she can leave.  She is dressed and standing close to the ward door trying to push past them as they valiantly encourage her to stay.  This discussion lasted a good 40 minutes and was conducted with a lot of shouting.  It seems that, like in most places, those that have the energy to protest louder get a lot more attention.  Even here in this world of sickness and pain, it is the noisy demanding patients that drain valuable resources their way.  The very ill and old have little energy or will to make such demands and just endure the lack of attention, the noise, and the disturbance.  

I stayed by my Mum all night, beside her trolley, on a plastic chair kindly provided by a night nurse.  In the early hours of the morning, I could rub her sore back, and whisper answers to her questions.  In this frightening and foreign place, we had each other.  My Mum hates hospitals and on the rare occasions, she has had to go in refuses to eat or drink and seems to withdraw into herself not speaking to staff.  She can lose so much of her body weight in days.  When the morning shift arrived, I was told to leave the A&E immediately.  

Perhaps if the health system all had looked efficient and professional I would have accepted this better.  But in the chaos of so many patients and shortage of staff, I felt that I was being asked to desert a loved one to uncertain unsteady hands.  I was told they would do some tests on my Mum and I needed to leave but when they finished the tests they no longer allowed me to enter the A&E.  I remonstrated with staff to no avail and waited in a closed hospital café restless like a dog that has left its post.  A nice passing nurse, from a different department, let me back in with her card and I found mum had been moved to a different alcove, she seemed more withdrawn and silent.  The nurse in charge found me back in her A&E and was understandably annoyed and insisted I leave immediately.  I am ashamed to say after an hour or so outside I followed a passing cleaner into A&E who kindly let me in behind her.  This time the head nurse was angrier to find me back again beside my Mum.  I felt like a loyal dog that was being chased from the side of its owner but even embarrassment and shame could not stop me from wanting to be there with mum.  I felt sorry for the already short-staffed A&E department that I was being so unreasonable.  But another part of me could not condone deserting my Mum.  That seemed an even larger more unforgivable wrong.  

I have no answers.  I know so many died alone during this pandemic far from loved ones.  The privilege of those last moments of being there, where it is hardest to be, at the passing of a dear one was denied.  It feels inexcusable and we sense so many other mistakes were made. It is difficult to rectify them all or even reflect on the lessons that need to be learned.  So many hearts have been broken.  Perhaps one solution is to find our humanity again and ensure it is expressed in all the different settings that matter.  One of the important lifelines for those who are ill may well be loved ones.  Even some animals will not leave a wounded family member, surely such instincts should be supported by institutional systems rather than blocked or denied?  

In this depressing world of increasingly isolated living, that leaves so many alone and afraid we must rebuild the vital links with family, friends, and neighbours that fortify all of us.    There are times that instinctually you feel the direction of flow is in a negative direction and you need to consciously head the opposite way.  Perhaps rebuilding broken or neglected human bonds is the upstream movement that all of us need to focus on in these testing times.