Wednesday, 19 April 2017

Care in the community

I am very pleased to have typed a few lines last week. It was after reading the leaflets of the candidates for the Metro Mayor. The letter got printed on page 10 of the No 270 issue of a local journal TheWeekIn ...
 I find this very sad and hopeless from the start. We are going to have some beginning of a devolution. I received the information through the letter box. It explains carefully what to do.
However, when I start reading each of the candidates pledges I cannot see that care appears anywhere. There are people living independently in the West of England who strive to manage their care. This means recruiting and employing their own staff with a social care personal budget.
I think there is a possible aspect of the education and future of the West of England that should be prominently brought forward in any #WEvote debate. There is need of training a well-motivated, skilled cohort of people of any age that would be after all well housed. Furthermore, having good transport, they would be able to provide care in the community.
 Why has it not come to the notice of any one yet? It would make the like of me feel included in the future of the West of England.

Wednesday, 8 February 2017

Toe spreaders and foot care

I have left you rather a long time sat on the loo. I am sorry about this. I hope that you managed to get dressed. Forgive me, I have been rather busy...
There is something very important that I must write about today. I have written about podiatry before. It is very important to get a regular podiatry appointment: if your mobility is reduced in the lower limbs you may get into difficulties at some stage when you fancy cutting your toe nails.

My first idea was not the brightest..I had been told that social care did not permit the care assistant to cut toe nails. Even if I was not a diabetic. My eye sight was not good, my ataxia in my arms was not helpful so I bought an extra large long handled pair of scissors. What a waste! I could not use these. I could not find any qualified and wheelchair accessible podiatrist (/poʊˈdaɪətrɪst/ poh-dye-eh-trist). I could not go anywhere near one if I had known one

I found myself trapped by the system. I did not know a friendly supporting person that would have simplified this for me. I hear that in some part of the country they talk about a "care navigator".

I bought a pack of emery files. I had a first toe nail infection before I got referred to the podiatrist. As you will understand it I got a bit obsessed in trying to avoid the infection that remained a threat. There where moments of poor staffing in my area for the toe clipping service with barely any explanation. I had difficulties getting the staff sent to me by the commissioned care company sent by the social services of Bath and North East Somerset to help me file my toe nails at home when I felt pain.

I will cut short this painful story after six toe nail infections to the same bit of the same toe...oh and some
abuse from a care worker. I got myself in the not very frequent toe nail clipping clinic available in my community.

I got in the rhythm: phone after two weeks then filing and clipping two weeks before an appointment...That will take care of odd sharpness. When one day I remarked to the podiatrist that my MS was definitely affecting my toes. I was always twitching and having toes flexing upwards. At the same time I was still using an NHS wheelchair with no foot rests... I explained each time that it was easier for me to approach the loo to empty my catheter leg bag. My commode was always on the loo, just in case.

The very good idea was to buy following a podiatrist's appointment a pair of gel looped toe spreaders. It reduced some of the spasms. I have not needed botulinum toxin injections perfomed by a neurologist and a radiologistsince. Any spasms are due to forgetting the spreaders or placing them wrongly.

These bought spreaders were too wide and my second toe turned black although I did not feel pain. This went on for a couple of years.

I worried about this and mentioned it to the podiatrist. I was lucky, it was very easy to shape a couple of
LR looking at bespoke toe spreaders.
spreaders that would fit me. They are part of my routine. They get rinsed at night and drip dry until the next day. They are individual, lightweight and very important to my well being. They are not interchangeable. They have helped feel less spasms in my right leg. I feel that my leg is less contracted. I am able to use foot rest indoors on my wheelchair now. The Wheelchair Service finally got it that I needed to remove these. I can lift them now, they are light. They have also a heal strap. I got this after pestering and contacting the company that sold it to the NHS.  I know I will be able to remove and replace my feet on my foot rest easily. It has become very "normal". I even followed some advice regarding the angle of my knee to have a good posture. I have less fatigue and no cramps on the right leg.

So, I think that podiatry care should be automatically included in any care plan for a person with many symptoms of Multiple Sclerosis. Why did it take me so long to get to this result? How many people have the same problem? Why did I have six toe nail infections in two years?

Wednesday, 2 November 2016

Having MS and finding it hard to go to work

This morning I found this very interesting in the Society Guardian. Disabled people have every reason to be sceptical about new Tory work plans by Frances Ryan.

I think that you should read it attentively! When I still had a job I was told I did not meet the criteria to get help. Yet, I took longer and fell a lot getting dressed. I could not shut the front door and lock the door without falling. I fell on my way to the car. 

I have a strong suspicion that things have become harder and "assessments" more heartless especially for People with Multiple Sclerosis or MS. I have had to introduce dirt during polite assessments...When I say dirt I mean it! Continence is something that people with MS try to keep quiet about. I went to work with a change of clothes. I tried to stay in work although I felt discarded in any present or future plan of the school.
Things are becoming harder.

It is very difficult to recruit staff to work the social care hours needed to help you go to work and contribute as you feel you should.

I do like this article. It has a good picture too! The best quote is:

After all, a job is little good if your local council has cut the personal assistant who helps you get dressed in the morning or the DWP have removed your mobility car. While they’re at it, they could push funding into the Access to Work scheme, rather than continuing to gut it.
Thanks Frances Ryan for seeing my thoughts. 

Thursday, 13 October 2016

Buying home care products for MS

Now, that is it… I take the plunge and will breach the delicate subject of continence and home care products. When Multiple Sclerosis (MS) progresses, there is a sad common aspect that remains very private…it is continence. Do talk about this to your neurologist. It works very well: in the Bristol Brain Centre I have a whole multidisciplinary team looking after me. There is no holiday; I got a letter from the Urology team today!
Home care products

Meanwhile, there is the domiciliary care that needs to be managed! It might involve buying gloves for the assistance that you receive and continence pads…so you can keep yourself looking and feeling your best, whatever your condition. 

I had found a company that provided me with products very reliably. However, due to some changes of their business they have stopped the online shop! Oh bother! 

They are now hoping to work only with the care sector!

I do not like this expression!

I hope to still be able to buy from them on the telephone. This beats buying packs of bags one at a time or feeling lucky to find any at the supermarket. 

My next question was about being VAT exempt...They have stopped that as well...When your orders are over £50, the delivery was free. I did not speak longer to find out if they still to that. It was softening the blow. It is also discreet and dignified to have them delivered. It is helping to find a way of getting supplies  without nursing staff telling you that you do not qualify for any help according to their criteria.

I was offered some advice by the company. I should get a letter from my GP to say that I qualify for VAT exemption because of my condition. Good but a far too long shot. The secretaries and receptionists of surgeries are ace at getting the wrong end of a stick. They did as they phoned this morning saying they did not understand what was needed.

I had sent my scan of my PIP letter that says for sure I have Secondary Progressive Multiple Sclerosis - SPMS! This seems to have worked...I got a VAT refund. I will phone the company again to check if this will be used for other continence products or mobility devices.

Have you found an easy way to get the products you need online in the United Kingdom? Have you found a good online supply that delivers to your home? Is it without VAT for People with a chronic condition like MS?  Let me know :)

Thursday, 4 August 2016

Right hip imbalance with MS

I have developed a weakness on the right over 40 years. It will add to your Multiple Sclerosis (MS). It settles without you noticing. It might have started without MS but it will speed up with MS.

After 3 months in hospital (pneumonia and pleurisy resulted in poor core stability, 5 years of sleeping on my left (to accommodate a catheter leg bag and try to stop snoring) and not using the footrests on the wheelchair, I could not stand, lift my right arm and straighten my right leg.

I had a pain in the right groin and the right gluteus. I had spasms. I also had 6 toe nail infections to the same toe over 2 years. It is at the very end of the sciatic nerve.

I had spasms in the big toe and because I had worn high heels and narrow shoes my toes were also overlapping. It is a complex fashion induced problem which is not caused by MS as any neurologist would say at first. It is a consequence of living with MS. Like the chicken and the egg!

On New Year Eve 2015
You may have contracted your muscles on the right to withdraw your foot to avoid the front wheel of the chair at the same time of pinching your sciatic nerve as you sleep turned to the left and felt weak when putting your foot down because of the infection and the over riding toe. I am improving with bespoke toe spreaders, some botulinum toxin (botox) injections in the right psoas iliacus and right adductor (only 3 times), 2mg of Tizanidine (no painkillers) , losing weight, using a CPAP machine (sleep apnea) and a very strong determination. I also managed this with the help of a neurologist who was at the centre of a multidisciplinary team of a National Health Service (NHS), wide availability of good information from the charity MS Research, Treatment and Education ( full of expertise and helpful) and MS Society in the UK (it is good to join) among others.

I just found some good advice from the NHS to avoid the bad posture to settle and leave anybody fighting the odds later.

Sunday, 21 February 2016

Standing at home with frames

Rotunda rotating transfer frame
Take courage. I am proud of you. I was told repeatedly that I would not be standing again in 2008. They gave me a tiny rotunda (rotating frame) that was all they had in Bath and North East Somerset at the time.
I think the staff had been trying very hard to appease me. They had no equipment for any case like mine. There is more time and energy given for people who have had a stroke.
They were not taking it really seriously. I gave them the idea to time my standing. In this day and age, no one thought of using a mobile telephone for this.
It is bad luck when you reach the Secondary Progressive stage of Multiple Sclerosis (MS). You feel helpless against the lack of understanding of the condition. Frankly, I was raging and very upset by the situation.

Standing in front of my worktop
I kept a log: date, time, time standing, feeling (positive or negative). Get a pad of lined paper; you are going to enjoy this! I stood improvising instead in my kitchen in front of the worktop. I called again six months later to show them. They were impressed...

Standing with Cricket Panache
Then by 2011, I had had a new neurologist at the Bristol Brain Centre with a physiotherapist that obtained a Cricket Panache transfer frame. It was a strain on my wrists without locking the knees. 

Quest88 or Helga
I was very lucky I somehow inherited a frame which the MS Unit at Bristol had been given by a technician after his Mum passed away. It has been checked over by Quest88 has it is an old model and I got a new sling belt. As you see it needs patience, courage and some determination. They even have come with trainee students and physiotherapists returning to the career after a few years away...Bliss. I just have self-referred myself once more. They may be very busy with a three months waiting list. They need to see what I am doing on my own so they do not tell anyone that they will not stand again. 

Monday, 1 February 2016

Bladder infections and catheters

I again had a battle to get a bladder infection treated sooner than the norm :). It goes from no action to prescription of antibiotics...I could design a board game but the theme is so unsavoury that the backers of Dragon's Den  would turn it down. It is full of trickery. The main culprits are the in-dwelling bladder catheter and Escherichia coli or E coli.

Too long story here, I cut down to the last few weeks in January 2016. A district nurse from Sirona was starting to comment about my drinking too much! Funny, I keep the bladder flushed as I keep the bugs away also with D-Mannose and HRT. She took the sample using a syringe; it was pink. I said that it stinks of bad stew.

The leg bag is clear and the sample from the bladder taken with a syringe through the port at top of the leg bag is getting the residue. The bottom of the barrel so to speak...

The surgery had sent her. They were interested to know as a urologist, at the Bristol Brain
Bristol Brain Centre in Elgar House
at Southmead New Hospital
Centre in the New Hospital in Southmead in North Bristol, had not been successful with his sample which had blood and smelt awful. The sample of catheters are not taken seriously once it reaches the laboratory...

I had to stress that I had started feeling very dizzy with vertigo, I had spasms in my right leg. I developed a toe nail infection. I woke up feeling cramped with painful heavy limbs and behind the neck and shoulders. I started a course of antibiotics last Tuesday: co-amoxiclav 500/ 125mg. Just after the first tablet I felt glowing inside. It is wonderful.

Now, I can catch up with leg exercises which had been left to the side as I was feeling sluggish to say the least. I phoned the surgery a couple of days after starting the treatment of antibiotics to give my feedback. I think it is very easy for the system to ignore a wheelchair user with Multiple Sclerosis (MS). This can ruin our quality of life. Had I been standing on my pins, they would have taken more notice!