The shock news that NHSEngland is being taken over by the Department for Health and Social care Services. Lots of meetings already to think about each of the huge stakeholders’concerns. Clearly both NHSE and DHSC will be slimmed down. Lots of early retirements, reduncancies and integration of ICBs. The cost will be massive. Hopefully this ‘disrecorganisation’ , not sure if that is the right word! will allow the likes of Jerome to do what he does best without the bureaucratic micro managers of the NHS messing it all up. My worry is that this will cause demotivation and distraction until sorted. Let’s hold our breath and watch.

After last week’s trip up I found myself in A and E …

Sunday x-ray, knee brace and crutches. Speed efficiency and empathy from amazing ‘trauma-nurse’. She also told me the ‘fracture clinic would be calling Monday.

Monday no call.

Tuesday no call. But I rang the number I had been given for this eventuality. A person rang me back. ‘The fracture clinic is virtual. You do not need to come in to be seen’. You will be called today. No-one did.

Wednesday nothing.

Thursday a physio rang. We have decided you do not need a knee brace. You are fine. You need physio we will refer you. The waiting list is 2 months minimum.

Wow how amazing that they can assess over the phone and no need for CT MRI or anything. Amazing. Virtually possible to zoom down the mobile phone line without even a camera on,. Isn’t that just fabulous. Virtually impossible to see the knee, assess the ligament damage and assess the movement.

Only thing is my knee by then was a sort of balloon. It kept giving way too. By sheer luck I managed to get a physio appointment next morning at the private clinic most of the family has accessed over the years! Physio did all his tests and pushes and pulls and…..urgent referral to private consultant. He is thinking ACL.

8.00 Saturday found me at a swanky hospital in Hitchin. Miraculously I had gained BUPA authorisation. I think every other body part is excluded but right knee is acceptable. Even more miraculously I took the BUPA form to the GP for signature. The receptionist explained that no I could not pay over the counter. The form would take 28 days to sign. The admin team would call. I smiled and waved. ( Madagascar syle). In fact I had scribbled a note on the form apologising for the urgency and that I already had an appointment booked. Actually at that point I hadn’t ,but this is a method I have used before. Top tip…keep calm and make up an appointment within the week ahead. Hallelujah…a person rang me to ask for £50 over the phone. Once her machine worked that was done. then the letter was ready, signed and the only GP words typed were ‘ see attached discharge letter from A and E ‘ . £6 per word that cost me!

That happened on Friday. 48 hours turnaround. Nearly impossible.

Back in Hitchin nice surgeon. He had actually helped me during the covid left knee issue! Diagnosis: PCL maybe ACL maybe bone posterior cruciate ligament….possibly
lateral collateral ligament cannot fully exclude a lateral meniscus tear or a trabecular bone injury.

….need further investigation

an MRI scan.
MRI needs the company reps to advise/ attend to make sure the magnetic field does not pull the implants out! ie spinal cord stimulator and a sacral nerve stimulator. Nearly impossible.

Hinged brace. Physio etc. Amazing that actually all this makes sense. Knee is really not too bad with the brace and the wonders of face to face appointments cannot be overestimated!

Virtually impossible-Doesn’t mean it can’t, but the odds are so slim the costs and benefits of expecting it aren’t worth it. Nearly impossible – “Nearly” is a synonym and possible definition of “virtually”. All but impossible, more or less impossible, nigh impossible, near impossible 

Next week starting tomorrow I am at a UKCS conference. That is UK Continence Society with the incredible Prof Laura. She is presenting our findings from the University Of Birmingham study we have done. Whoop.

Please forgive my giggles as I type. The co-chair of the conference is none other than Dipstick himself. He may well be surprised to see me in the audience. If he does talk to me I will say its the only way I’ve been able to get a face to face appointment with him, after the MRI of two years ago, on my bladder bits. I promise I really will behave properly. Another coincidence is that the venue is the very same place as last weeks’ gala dinner with Pete Reed and Kadena Cox. What on earth am I doing? It is virtually impossible to think back to BC life before catheters only to find myself AC ..after catheters in the world of continence clincians academics and Olympians.