Miscarriage survival tips

I've really ummed and ahhed about writing this, for several reasons, but you know the drill by now - I deal with major life events by writing about them. I'm not writing this for sympathy or attention; one thing I have realised is that miscarriage is very common, but people don't talk about it. And I think they probably should, if they feel able to. I was talking to my very wise sister-in-law about this and she pointed out that if I've written about cancer and cochlear implants and that didn't seem odd at all, why should miscarriage be any different? We decided that we women are being oppressed by the shame of talking about our reproductive tracts. So here goes with my attempt at breaking the taboo...

You will remember that the cochlear implant process was triggered by my irrational panic that I would not be able to understand my offspring, if and when I had them. Completely idiotic; I am reliably informed that children are perfectly trainable and can be made to speak with perfect elocution if necessary. Anyway, we still went off for assessments and now over a year later I sit here with an implanted left ear, hearing myself bashing away at the keys, my breathing, David's breathing, Rhubarb's seriously weird little yawns, the fire crackling, etc etc.

No babies wailing yet though, as unfortunately my uterus doesn't seem to be good at hanging on to pregnancies. I had a positive pregnancy test after a few months of trying, back in November. Hurrah, jubilation etc etc, downloaded baby tracking apps so I could know what size fruit my baby was each week, started planning nurseries and maternity leave. Then I started spotting on Christmas Day, and after the worst night shift of my life (on the labour ward of all places) had a scan at the Early Pregnancy Assessment Unit. I still remember how kind the nurse was: she said, "the pregnancy is measuring between 5 and 6 weeks and I'm sorry but I can't see a heartbeat."

I opted for expectant management  - which is basically just waiting. Went home, family and David fed me wine, brought hot water bottles, and were generally excellent. It wasn't as bad as I was expecting, but I did very actively manage my pain with all the painkillers I could get my hands on. Eventually passed everything after about a week, and cracked back on with work and trying again and in general trying to get back to being positive and chirpy. Second pregnancy happened surprisingly quickly - joyfully told David all about evidence showing that pregnancies conceived within 6 months of a miscarriage had better outcomes etc etc. Despite this, I actually refused to get properly excited until I got to 9 weeks ish, started to let my guard down and talk about maternity leave plans, then started spotting again. Tried all the usual things to convince self it was normal pregnancy bleeding, but alas scan at EPAC (on exactly same 10 week milestone) was again bad news, though this time it had at least got to 8 weeks before giving up the ghost. Surprisingly calm this time but this may be because I was expecting it pretty much from conception, and also I had actually slept instead of being on night shift all night helping deliver other people's babies.

Have opted for expectant management again and am in a horrible limbo where nothing is happening and am walking around with an 8 week fetus that stopped developing 2 weeks ago. I try not to think about that part too often, but I can completely understand how some women opt straight for surgical management so they can move on pronto. We're planning to wait a little longer and then try medical management to hurry it up if nothing happens. Anyway in between trying to revise for my exam on Saturday (ironically am sitting the DRCOG, or Diploma in Obstetrics and Gynaecology, which I'm sure will have lots of questions on miscarriage) I have decided to write some of my thoughts down in the hope that this will help someone else who needs it.

Tips for surviving miscarriage:
1. Painkillers. Get lots: ibuprofen, paracetamol and codeine if you can. Take them regularly and don't wait for the cramps to get bad again before you take the next lot.
2. Extra absorbent sanitary towels (no tampons due to risk of infection)
3. Hot water bottles - multiple
4. Hot baths
5. Gin
6. Chocolate
7. Family, friends, husbands - are all brilliant at filling your hot water bottles when you can't stand up, and bringing you wine and cuddles. Use them :)
8. Films
9. Be really kind to yourself. None of this "I did something wrong" rubbish. You didn't. Nearly all early miscarriages are caused by a chromosomal abnormality incompatible with life. I personally find it comforting to think this is my body's way of saying, "Noooope you don't want that one, it was just a practice. We'll start over."
10. In the same vein: go for a haircut, have a massage, go for a nice lunch, buy yourself a ridiculously posh bottle of gin, buy some pretty flowers, paint your nails etc etc. Just be nice to yourself. I have recently bought myself a ridiculous copper milk pan from John Lewis. (Cookware makes me tick.)
11. Gin
12. Talk if you want to talk - don't if you don't; the way you react is the right way for you.
13. Remember your other half has lost a baby too, check he or she is OK, often. David and I did a lot of this
14. Trying again - normally medics will say wait a cycle before trying again. There is no medical reason to do so, except for easy dating and also emotional healing. If you really want to crack on, crack on once the bleeding has stopped.
15. Facebook - just unfollow all the people posting bump pics and scan pics - they are really happy and excited, but this doesn't mean you can always feel happy for them. Also remember that due to the taboo around fertility and miscarriage, a lot of people will have had difficulties getting said babies that you don't necessarily know about. Just breathe, click unfollow, and tell yourself one day it will be you.
16. Work - take as much time off as you need. I've been lucky to work in some wonderful and supportive teams. There is no point dragging yourself to work during one of the worst times of your life; you are more likely to end up sobbing in the loos and being no use to anyone. Doctors in particular seem to try and struggle through this sort of thing like it's a badge of honour or a sign of strength. Just don't. The team can manage without you, stay home and rest. If you really want to go to work because you love work (weirdo), or because staying at home is driving you crackers, then make sure someone knows who can support you if you do start to crack.
17. Find a furry animal, preferably a corgi, and cuddle it a lot, whether it wants cuddles or not:

18. Gin.

This advice below from the Miscarriage Association is good.

A word of etiquette advice: just don't ask people if they're trying again, or indeed when they're trying for babies, or anything. If they want to tell you, they will. Seriously, it's none of your business otherwise. I've found that as soon as you get married, you're fair game for people to ask you extremely personal and nosy questions. No. Just no. (Also, if you think posting a pregnancy April Fool's joke is funny, then I'm sorry, but it really isn't.)

Oooh I feel better already. I really hope that this helps somebody else who might be going through the same utterly crap experience. Another friend I've spoken to said to remember that there's always hope; I found this immensely comforting, clinging on to my hope, and hope you do too.

10 months in

How has 6 months flown by since my last post? Life has got in the way rather but I have been constantly surprised at my new hearing! Actually no that's a lie. I have been intermittently surprised at my new hearing, but I've stopped thinking of it as "new". It's now just my hearing, which is much better than it used to be. My family have stopped being surprised that I can hear them with my back to them. Last night we watched Paddington Bear and I heard a mistake in the subtitles - 107 instead of 101! David was very excited.

I went for my retuning a couple of weeks ago, and met a new audiologist called Vicky. We did the usual listening to quietest sounds, where I sat and listened for sounds and must have driven Vicky crazy by saying "2! No, 3! No, 4!" for 20 minutes. She didn't do the loudest sounds as Jen had done my ESRT last time, and that tends not to change too much. She then changed my programme according to what I had heard on my quietest sounds. The new program wasn't as noticeably different as the last few have been, but I could tell that it was different in some way. 

Then we did my BKB sentence testing again - last time I had got to 67% compared to 16% pre-implant, in my left ear. This time I found it a bit easier but had no idea how well I was doing until we stopped and Vicky said, in awe, "You got 90%!"

I had no idea that it would be that splendid a score - but I was very happy with it! Only 10 months after switch-on too! Hopefully it will continue to improve and I'll be getting 100% at some point - I'm told my brain will carry on plastically changing for up to 2 years - fantastic. I really should be working harder at using the phone - I can still really only call David from the car when I finish work. I think if I had been able to use the phone before, I would have fallen back into using it very quickly, but because the grooves of my life have settled into Whatsapp and texting and email it's much easier to carry on in those grooves. I must get out of my comfort zone! 

Vicky was so pleased with my progress I am now on yearly follow up, but I'm seeing Sandra next week for some more help with using the phone. On that note I am off to order some more T loop ear hooks from Connevans. Will report back with how I get on.

Four months in

This will be a short one because I am on-call all weekend from tomorrow (weep weep). I have been for a retuning today though and that's always a good time to blog about my ever-improving hearing.

My audiologist today was Jen, whom I haven't seen since my switch-on so it was nice to see her again, especially given the massive changes in between now and 4 months ago! 

She started off by doing some ESRT (electrical stapedial reflex threshold) testing on me. I never really learned much audiology in medical school and the intricacies of this were mostly beyond me. However, in a nutshell: the acoustic reflex in normal hearing people lifts the stapedius off the eardrum when a loud noise is heard, to protect your hearing. You can also stimulate it electrically (hence the catchy name for ESRT). This is a useful objective method for deciding how much stimulus to put into an implant, and it makes sense to use it as an upper limit, or comfort threshold, for the stimulus going in - I imagine it mimics natural physiology. After Jen had done this and adjusted my programming, none of the loudest beeps were uncomfortable (unlike last time).  

We did the pure tone audiometry again and this time I have finally made it into the "ideal range" on my audiogram! This is between 20-30dB, just outside normal hearing. They don't aim for "normal hearing" (i.e. above 20dB) because apparently the all-important speech sounds start to get compressed at that point as the frequencies get too saturated. 

I then did the BKB test again... The moment of truth - how much would I have objectively improved?! When being assessed back in December, I got 6% with my left ear, 24% with my right, and 42% using both ears. Obviously this time we were just testing how well the implant was working, so we only used my implanted ear. I struggled more than I thought I would without the hearing aid, but I still got 62%!!! From 6% to 62% is INSANE. INSANE improvement. AAAAAAAH!!!!!

As Jen pointed out, if I had both the CI and my hearing aid, and was listening to someone whose voice I know really well, the score would be much higher. I do feel as though my "real-world" performance is actually better than 62%, though I don't go around trying to put a number on it - I can just tell it is drastically improved. 

I have also met up with my CI buddy Jeanette today and our stalwart friend Mavis; we had a really interesting conversation about our different experiences and how the CIs have changed our lives. I find it fascinating and inspiring how well Jeanette is using the phone - I still haven't plucked up the courage to call many people other than David! We also have slightly different experiences of music - while I feel I get the best of both worlds from my CI and hearing aid (which still gives me an acoustic, smooth sound), Jeanette has found that bilateral CIs make the sound very clear but not as smooth yet. We are hatching a plan to go to the Sage for a classy musical evening out - I am very excited about this, as the Sage has hitherto merely been a pretty building on the Quayside for me.

I will write another update when I have seen Sandra in the next couple of weeks - and I may need to have another little angry junior doctor vent before that. But for now I had better dislodge the corgi from the sofa and get to bed - beauty sleep is required! 

Hell hath no fury like a junior doctor scorn'd

This is a bit of a change in subject matter for this blog, but I have been watching and reading with horror the furore about junior doctors' pay and felt compelled to put my tuppenceworth in. I've actually delayed writing anything for a few days because otherwise there would have been too much swearing involved and my grandma and grandad would be appalled. A few days later I am slightly calmer but not much.

I love the NHS. It has: diagnosed my profound deafness as a baby, given me hearing aids and speech therapy; diagnosed my coeliac disease and provided me with gluten-free food (before gluten-free and paleo were fashionable and when all was available was foot-breaking bricks of bread); diagnosed my Hodgkin's lymphoma and saved my life with chemotherapy and radiotherapy; and with my cochlear implant it has given me a whole new world of sound that I could only imagine before. It has also cared for some of my nearest and dearest in their life-threatening illnesses and at the end of their lives. I'm truly, heart-swellingly proud to work for such an organisation and give back a little bit of what it has given me.

I am however dismayed and demoralised at the recent developments. I should start by explaining how our pay works for non-doctors: we get a basic salary – starting at around £22,000 for an F1 – but are compensated for the many antisocial hours we work with our “banded pay”. This is graded according to the number of antisocial hours (outside of 7am to 7pm, Monday to Friday i.e. evenings, weekends, nights). 1A is the highest band and pays 40% - 50%. So working weekends and nights is slightly less crap because at least you feel you are being fairly remunerated. GP trainees also get a training supplement (45% of basic salary) – this is based on the average supplement that is received across all hospital specialties, so that there is not a financial disincentive for trainees taking up general practice rather than a hospital specialty.

I also have a £45k student loan from my 5 year degree, and also have to pay GMC registration fees (£300 a year), BMA fees (£222), exam fees and course fees. Oh and medical indemnity – as GP trainees our indemnity fees are £1,200 a year as well. We can claim these back in part when training, but not after we become GPs.

I qualified in June 2012, aged 24. Over the last 3 years of working as a doctor, I have missed Christmases, New Years, birthday parties, weddings. This Christmas I will be spending Christmas Day and Boxing Day nights helping to deliver babies and seeing urgent gynaecology patients. I have been verbally abused by drunks in A&E, and scratched, kicked, and bitten by confused dementia patients. I have been covered in blood, amniotic fluid, faeces, urine, vomit (fortunately not all on the same day). I have seen people die in front of me – literally seen the life leave their eyes. I have assisted emergency caesarean sections and helped bring new babies into the world. I have run to many crash calls and been part of the team trying to bring someone back to life. I have consoled grieving relatives; I have held dying people's hands and stroked their hair. I have worked for 12 hours straight only managing to pee once and gulp water whenever possible to prevent my own acute kidney injury.

Please do not think I am either whinging for sympathy or being arrogant - I am not complaining about any of the above. I went into medicine knowing it would be hard and a long slog, and I feel I am fairly remunerated for my work. I love my job and I feel very lucky to have a career that has such a positive influence on so many people's lives.

HOWEVER. On the background of public sector pay freezes for the last several years, the Department of Health is announcing that they want to cut junior doctors' pay even further. This along with an 11% pay rise for MPs!!! An “independent review body” - the DDRB – I doubt any of them have ever worked a night shift in their lives – have suggested removing our out of hours supplement, among other changes which you can read about here.

The proposals – which are shrouded in mystery, apparently because they would “bias public opinion” if they were revealed in their entirety – hmmm I wonder why?! - would increase our basic salary (splendid, more tax to pay and more NI/pension contributions), and would CUT our out of hours pay by stretching the “normal hours” to 7am to 10pm, Monday to SATURDAY. So I would be paid the same for going to work all day Saturday as going to work all day Monday. The proposed changes also remove any penalties that trusts incur for overworking their doctors, so there will be no incentive for them not to put us on completely insane rotas. Specialties that do lots of out of hours work (e.g. A&E, anaesthetics) will be hit the hardest. They also want to remove the GP trainees' supplement, resulting in a 45% pay cut. GP and A&E are some of the hardest specialities to recruit to and this is completely counter-intuitive.

The BMA (the doctors' trade union) walked away from talks because of unreasonable demands and refused to go back because a condition of returning to negotiations was accepting the DDRB recommendations without question. The DoH have said they will unilaterally impose these pay reforms on us, which rather begs the question of why they bothered trying to negotiate in the first place...

They are also unveiling new physician assistant jobs at £50k a year – more than double an FY1's salary. A physician assistant has 2 years' training, and works alongside doctors doing things like taking bloods, cannulas, histories, but can pass any decision-making onto a doctor. A bit like a paralegal getting paid more than the lawyer. This strikes me as similar to going out and buying lots of shiny new buckets to distract from the fact that the ship is sinking. How is this short-sighted and ill-thought-out idea to help with the NHS recruitment crisis?!

I will try not to be too political. However I am very cynical about the motive behind all this – given that the Secretary of State co-authored a book on how to dismantle the NHS , has no medical experience, and his sole qualification appears to be a degree in PPE from Oxford. And when there were 220,000 signatures on a petition to debate a vote of no confidence in Jeremy Hunt, but all that was achieved was this debacle, I think I can be forgiven for seriously losing my faith in this government (not that I had much anyway).

I could have a much better life in New Zealand or Australia or Canada but my family is here. I can't really imagine being that far away from them especially while trying to bring up my own family. Having said that, I have still applied for my “certificate of good standing” (a document you get from the GMC verifying your registration with them) so I can escape if necessary.

I've said it before - it is not about the money – it's about how valued we feel as professionals. If it was about the money I would either a) not have gone into medicine or b) have gone to the Antipodes already. Or I would sit back and watch the NHS being dismantled while I locumed and made a fortune. If our healthcare system gets privatised and becomes like the American system – doctors won't lose out. In a country where there is already a shortage of doctors, it will be an employee's market. We are not fighting this because we are greedy money-grabbing bastards – we are fighting this because we believe in everyone's right to have free healthcare at the point of need.

We are fighting on our patients' behalf, while the mainstream, right-wing media largely fails to report our struggles. Please support us – write to your MP. Let them know you support us. We don't like striking because we worry about our patients, so the government think they have us over a barrel. However I would support a strike, because I genuinely believe our patients will be at greater risk if these contract reforms go through. Do you really want your doctor to be seeing you at the end of a 15 day stretch? Please listen to your doctors when we tell you this is not safe, that we are stretched to breaking point already, and that we are in danger of losing a precious national institution.

The life aquatic

Hello again!

Apologies for the long delay in updates - I have been on lots of baby-delivering on-calls, but have also been away on holiday which was lovely. We go to this amazing place in Devon most years and are always fortunate with the weather - after retooning to the very grey Northeast I am deeply tempted to move back down there and live out my days as a hippy GP in Totnes.

The swimming pools are the highlight of the holiday (after the cider and cheese and walks) and we all go and splash about every day, often twice a day. Normally I take my hearing aids out and rely on lipreading to chat to people while swimming or in the hot tub. However this year I had my Cochlear Aquakit! Practically as soon as we had arrived, I excitedly pushed my implant into its little silicon body-stocking, put on the Aqua coil and rushed out to the pool. This is me right before:

and an action shot:

It is SO EXCITING! I can go underwater and blow bubbles and hear them! I could hear David's bizarre underwater voice and my own splashes as I swam around, and instead of swimming to me to pat me for my attention, people could shout for my attention and I could turn around to see them! AAAAAAAH! 

Mum and I swam 60 lengths the final morning and could chat all the way. Splendid. 

The sound is a bit muffled and I got a lot of noise interference when I walked, probably because there was more transmission through the protective case touching the microphone. This didn't seem as apparent when swimming though. 

It is so exciting - after years of being worried about going near a pool wearing my hearing aids in case I forgot and just jumped in - to be able to run and jump in and hear my own "AAARGH" at the cold water! (Am still Southern pansy despite 9 years in the Toon). And swimming which has always been a very silent experience is now a delight of bubbles and splashes and talking to people. The joy! 

We also headed to the Eden Project in Cornwall which was stunning, just like last time (with fewer proposals however - as David has already shackled me to him in wedlock). 

After spending a week eating my bodyweight in scones and cheese, we headed back up to Nottingham for the wedding of the year. It was so lovely to watch one of my oldest friends get married and I shed a little tear or two ... Hearing-wise, I struggled a little in the church but that was because it's always hard to put yourself in a good place to lipread at weddings, and a lot of the talking is done facing away from the congregation. I managed to follow the vows though and it was all rather magical. The best thing was being able to follow most of the speeches and laugh at the jokes like everyone else! 

Actually, no. The best thing was staying up til 5am dancing at the silent disco because I could hear the music through the headphones! I still haven't rushed into the world of music with open arms, but I was so amazed at how much more of the beat I could follow - without the implant it was just bumbling rumbling background noise, but with it back on came a beat and an urge to jive (and also dance like my dad.)

I still couldn't tell you which instruments were being used or any of the lyrics but it was all very exciting. I've just had a go at listening to "Home" by Edward Sharpe and the Magnetic Zeros which has always been one of my favourites just for the lyrics and general loveliness - surprised at how much easier it is to follow the lyrics and the different melodies. Obviously still not the same as a hearing person but I feel I am getting much more out of listening. Wow! Also, the Clash's "London Calling" is AMAZING. I can hear the drums and guitar - v. exciting.

I'm noticing more and more that I can pick up what people are saying without looking at them - last night I could hear snippets of a conversation going on in the lounge before I went in, and when driving people home from town on Friday night I could hear some phrases and words from the back seat. I still couldn't follow a complete conversation without looking, and if people turn their heads away from me and mumble I still get a bit frustrated and have to remind them that I am not suddenly magically "normal-eared". But on the whole, life is so much easier.

A note on batteries: I have a good system going now - a "big" battery will tend to last 2 days, while the "little" one will last a good day/day and a half. This is great as I had previously been really worried about having to constantly change them in the middle of an on-call, or being caught short without them. In fact, this was one of the things that nearly put me off getting the implant. It's so hard to imagine how I would do without it now, but I think that pre-implant I had no idea what it would be like, so I grabbed at all the things I could imagine, like batteries and a magnet feeling weird and all the possible side effects. Now I'm on the other side these things pretty much pale into insignificance next to my new ninja hearing, but I would have no way to explain this to my pre-implant self.

I'm 3 months in now and this is better than I could have ever imagined. I've not had my 3 month follow up appointments yet with Ruth or Sandra but this should happen soonish I think - I'm particularly excited to see Ruth because this time we are doing my BKB scores and I can see an actual objective measure of my improvement!

Until next time kids! xx

P.S. Almost forgot the obligatory corgi pic:

Being a hearing ninja

Greetings all! 

Sorry for my long hiatus in updates - the implant is still working (wonderfully so) and I have not had a breakdown after the shock of going back to work. I've now moved jobs to Obstetrics and Gynaecology (as another part of my GP training) and am trying to fill all the woeful gaps in my knowledge. Definitely need to work on my upper body strength so I am a bit better at assisting Caesarean sections; my limp noodle arms are pretty much useless at holding a retractor for longer than 30 seconds. I am also practising not fainting whenever I see a cervix get sliced into.  I would like to point out however that even in the middle of a vasovagal attack I was still able to hear the theatre nurse saying, "It's the heat of the lights you see..." while I had my head between my knees! Nearly passed out again from the surprise. 

Have also been home to Nottingham for a lovely relaxing weekend of waddling around eating. 

I had a retuning with Ruth a few weeks ago, which was fairly straightforward; she did the usual beep test and rejiggled the inputs accordingly. As we're getting closer to a final map she has only given me 2 programmes to go away with. Writing this has reminded me that I should try moving up to the second one ... goodness me that's loud! It might actually be too loud as the keys clacking are giving me lots of little jolts ... back down again for a bit...

We also did another PTA/audiogram which was pretty good, though the improvement isn't as drastic as the last one. I had been hoping to get into the ideal range on this appointment so I was secretly a tiny bit disappointed. I told Sandra about this when I saw her the week after, and she very wisely pointed out that great audiogram results don't always translate into great "real world" results. She thinks I'm doing far better than she would expect of someone with my hearing loss (i.e. severely gimpy ears since birth). Am v. smug at this. She tried me with some listening exercises which were a bit like a McCormick Toy Test for grown-ups - "put the teapot on the table". We also did a bit of "guess the f or v" (fat/vat) which is viendishly hard. 

I can follow nearly all (95%?) of Harry Potter now, with my eyes closed (when using both CI and hearing aid). Last night David tried reading out random sentences from HP, and with the CI on I got them all! If I slipped the CI off I got a wash of sound but was only able to pick out the odd word. With the CI back on the sound all crystallised into words in the most beautiful way. 

It's difficult to describe how my CI and hearing aid mesh together - I can tell I'm getting different input from both ears, but they don't jar at all. If I try to describe it using an arty farty visual metaphor, it's as though the CI sound is the line drawing and the acoustic sound from the HA is the colour wash - together they give a balanced picture, but without the CI "line" you wouldn't be able to tell what the picture was. (this is the best example I can find in a hasty google search)

The other way I think of it is as though the CI is "top half" sound and the HA is "bottom half" sound, though that's not really as accurate because the CI actually gives a great range across all the frequencies. the ones I notice the most are the new, higher frequencies.

This weekend we popped up to the Taylors' to say hello and were unsuspectingly coerced into various wedding prep duties. One of these was painting signs with Caroline - we were painting side by side but still chattering away, and Caroline was completely flabbergasted when I replied to all her questions without looking at her! I could also hear all of baby Evelyn's adorable squeaks of pyromaniac joy! HURRAY I'M A HEARING NINJA.

I must point out that on some occasions I am definitely not a ninja - it's still difficult to follow what new people are saying, in noisy environments - mumbly consultants in theatre staff rooms, for example. However, whenever I feel myself getting dispirited about this all I have to do is lift the implant off for a moment and remind myself how I used to manage with some astoundingly rubbish hearing, and how lucky I am to have this new and wonderful technology making it all a lot easier than before.

Phone calls! OMG PHONE CALLS. I've never been able to use the phone, ever. My friend Jeanette had a go with the phone the day after her switch on (she could understand speech straightaway but I still think she was very brave!!) and had her confidence a bit knocked because she found it really difficult. Now however she is a phone-using pro. Being a complete pansy in the first place I hadn't even thought about phones until Sandra asked if I'd tried calling anyone. She thinks I am at the stage now where I might be able to manage it, so I've started calling David when I finish work, ostensibly for "rehab" but really to warn him to get dinner ready for his hangry wife. I find it quite hard with just the CI ear, so I tend to use speakerphone when in the car, just so I can use both ears.* 

* David here: be wary of using speakerphone on your phone! It may not be obvious to the HI, but mobiles do some strange things in speakerphone mode to prevent feedback loops - when the phone emits the other person's voice, it has to figure out whether to mute the microphone to stop the sound going back to the speaker. All-in-all I think it can only add confusion to an already alien experience. While we are still trying to figure out the best way to do phone calls, the feeling is to keep it slow, ask simple questions, give simple answers etc.

garden flowers

"Why must I wear this??"

I also managed to understand Janet when she called yesterday and asked if I would like to go for a run, though I now wish that I had feigned incomprehension and put the phone down, because running hurts.

On my next follow up with Ruth we will be repeating my BKB sentence testing - watch this space!

In other news the garden and Hotbin appear to be coping without my fulltime input, and Rhubarb is as cute (and long-suffering) as ever. 

Back to work

Last week, with two months of guilt-free lie-ins and full-time gardening behind me (for the last time until retirement), I approached the new hospital in a state of gloom. Northumbria Specialist Emergency Care Hospital (NSECH) opened while I was off, so I returned to work at a completely different place, just to make the transition extra-relaxing... It's a rather swizzy new place; it looks very clean and feels mainly empty, which I quite like. 

Swipe card difficulties and forgotten ICE passwords aside, it's all going rather well. I'm doing a phased return, which means I'm doing half my shift lengths for the first couple of weeks. This is really helpful, as it's rather tiring jumping back into the working world. I still struggle with all the things I used to struggle with, but I can tell already that it's slightly easier, even 6 weeks in. (I have also found that - as usual - cake makes everything better. Particularly this Mary Berry one but with rhubarb instead of apples.)

Things I have done so far:

Talked to patients - I should point out that this has always been fine. Wherever I work (GP, A&E, CotE, haematology etc) I always start with a spiel: "Hello, I'm Roz, I'm one of the doctors; I can't hear too well/my hearing's terrible*, so I lipread people, but we'll be fine!" then finish with a winning smile.

*Bizarrely, I don't really like saying deaf or hard of hearing; I think it sounds too serious. 

This works like a charm every time. If I forget to say it I end up having to shoehorn it in later, which gets awkward and makes patients feel bad. I also feel like it shifts a bit of responsibility for the conversation onto the patient; they know what they have to do to help me hear them, so they do it. 

With the implant I find I'm not having to ask patients to repeat themselves as much, which is a bonus. 

Stuck various types of needles in patients -  fun as always

Written lots of discharge letters - not as fun

Looked at lots of phones ringing - and thanked God I can't actually answer them. (I have yet to try doing any phone calls really - unless you count Janet ringing me, saying a random word like "monkey" and hanging up. I live in fear.)

Written notes on consultant reviews /ward rounds - I hate this. I really hate this. Possibly because I've always avoided it as much as possible - I normally find a nice colleague and give them the notes instead. I cannot lipread the patient, consultant, +/- some relatives, AND write beautiful tidy medicolegally-compliant notes at the same time. Often I try to listen and then write the notes in afterwards, which only works if we're not too busy. If there are a zillion patients to see and a mumbly consultant I just run away and do jobs instead. 

Because I'm still not really at the stage where I can hear without lipreading, I still struggle writing notes. But I feel a little more confident and am trying to give it more of a go! (I WILL OWN YOU, CONTEMPORANEOUS HANDWRITTEN MEDICAL NOTES.)

Followed a lot of handovers  - without too much difficulty, despite approximately 1000 phones ringing at the same time. I use my usual tricks of sitting where I can see everyone, and using the board as a guide, as well as peeking at colleagues' handover sheets. It is SO much easier to hear in noise with my new high frequencies - it really brings speech out from background noise.

Sometimes I take my implant off my head when following a conversation, just to see what it's like. I just can't believe how flat the sound goes! It's as though someone has taken all the sound I get, chopped the top off it and given back the bottom half. I cannot fathom how I have managed with bottom-half sound all my life. I love noticing things like how people say their "s"s (yes, "sausages" is still my favourite word). I can sometimes pick up words and phrases without lipreading. I tried on a ward round yesterday and heard the consultant say "and how is the constipation?" 

Just as parents don't see how much their children grow from week to week, I don't notice how much I'm improving gradually from day-to-day. But I do suddenly notice the things that I pick up without lipreading, or when people point out to me how much better I'm following them. For example, today we went to Janet's to watch Wimbledon, and I heard my friend Romeela say, "Where's Miguel?" loud and clear - but I was standing behind her at the time! Nearly dropped a strawberry in surprise. 

Another milestone was - of course - Harry Potter related. David read me the whole Forbidden Forest chapter while I lay with my eyes closed and repeated back what he'd said. This was so he knew that a) I wasn't asleep and b) was understanding every word. WITH MY EYES CLOSED! aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaah! I still had to get him to repeat some sentences, so the whole process took a bit longer than just listening, but WHOOHOO!

I've not been sure how much to wear my hearing aid with the implant. Obviously for work I need all the help I can get, so I wear both to work. At home I suppose I should be having some implant-only time but it feels a bit of a step-back to remove half of my hearing. I'm not convinced that it matters too much once my brain is past the initial "WHAT THE FLIP IS THIS ELECTRICITY??" stage; plus the end goal is that I wear both together. I'm already really happy to do this, and I know that the sounds will continue to blend until I can't really feel the join between hearing aid and implant sound. Any experts/fellow cyborgs out there - feel free to offer opinions! 

Follow up plans - I've been moving up through my processor volume levels as usual - level 4 tomorrow. I have my 4 week follow up in a couple of weeks (which will be 7 weeks post-activation). They are planning to repeat my BKB sentence testing - how exciting! I see Sandra, my keyworker, the week after. 

Hadrian's wall

Other than working, I have welcomed middle age with open arms by joining the National Trust and going on various fun day trips to places like Housteads and Gibside.... 

Have also grown some peas, beans, rhubarb, a small meadow and procured the best rosebush ever. When can I retire?

David Austin - Lady Emma Hamilton. SMELLS DIVINE