My MTB

My PICPMB Blog
Lydia E. Pinkham's Vegetable Compound
Blog 026 - 3 September 2012

My MTB

I have a condition known as Peripheral Neuropathy (PN). It started six years ago with a pain in the ball of my left foot. It is now mostly characterised by my feet having become numb/prickly. I also experience painful soles, but not to the extent that it affects my lifestyle.So while these sensations may vary in terms of their intensity, but they never let up. The numbness at times also creeps up my legs, and that manifests itself in terms of a sensation that is akin to wearing stockings. The going could get tough, PN is not likely to kill you. You can read more about it on the web. Here is a PDF copy that I put together of a writeup I found on the Internet. It is useful in so much as it is written in a sense to inform those that have to interact with someone suffering from PN. The original appears on this site.

The first intervention to solve my initial foot problem was a back operation. I had a Wallace Cage fitted at the bottom (L4/L5) of the lumbar region of my spine. Unfortunately that operation result in a nick to my dura (sheath around the spinal cord) and quite a bad leak. After an attempted recovery period of six weeks, I had to wait (lie in bed for another 4 weeks) for the wound to heal to the point that another operation could be performed to fix the leak. My foot problem did not improve. and so I sought a second opinion. This time the neurosurgeon sent me to a neurologist who diagnosed the PN (probably hereditary), some nerve damage and Tarsal Tunnel Syndrome (TTS). Think carpal, but in the foot rather than the hand. An operation to deal with the TTS also did not help matters.

I continued to see the neurologist on a regular basis as my condition gradually worsened. Recently the neurologist redid the nerve conduction tests on my legs, and this time, also on my arms. The difference between the two seemed marked enough for him to suggest that I be treated using a course of IVIG (Intravenous immunoglobulin. IVIG is a sterile solution of concentrated antibodies extracted from a pool of blood donated by tens of thousands of healthy donors. It is administered into a vein to treat disorders of the immune system or to boost immune response to serious illness. The treatment is expensive, but the medical aid agreed to the treatment, and so I started the IVIG course.

The first infusion took eighteen hours and the second, a month later, twelve. Both treatments required a night in Entabeni Hospital in Durban, a stones throw away from The University of Natal, my alma mata. From what I understood regarding the arrangements for the first infusion, was that if I got there early enough, it would be a day visit. On the day, the hospital was short of beds, and so I only checked in at 11:00 AM. No problem, I would drive back to Pietermaritzburg (PMB) in the dark. Fortunately, just in case there was a problem, I put my toothbrush and sleeping shorts into the swimming tog bag that lies in the boot (trunk) of my car.

On arriving in the ward, I found my bed at a height that reminded me of my back-op. Being tall, I was happy for it to stay that way. The admission nurse would not have any of it, and it was lowered. I did not think about it again, until yesterday, during my second infusion, but more about that shortly. Once I was settled on my bed, I waited until 1:00 PM for the neurologist. The first infusion was to be precede by a lumbar puncture, and he did an excellent job, I did not feel a thing. The IVIG then arrived and the drip went up. It all went very well, and the next day I left after lunch.

Hospital stays are of course never easy, and I shared a ward with a foreign seamen who had been in a comma of sorts for more than a month, and was about to be repatriated. I then remember what my brother in law, who has now settled in Germany, had to tell me about his hospital experience. When he ended up in a hospital in Germany for the first time, he quickly realised that he had to learn to converse in German asap, as he could never quite understand what would be done to him next. The poor guy next to me did not say a thing, he simply stared at the wall and moaned periodically. Tough!

As I travelled from PMB to Durban for my second infusion a month later, I found myself listening to a debate of SAFM about African Sangomas and the practice of burning witches. The debate was interesting and as expected, pitched black against white and africans against westerners. Interestingly, it also pitched males against females, and africans against themselves. It was also not unexpected when a caller suggested that, if an African dug up some roots and mixed them into a muti in some way, it would be deemed to be witch craft. On the other hand, if a white male dug up the same root and used an extract from that root to derive and manufacture a drug, it would be deemed to be science. That comment reminded me of Lilly the Pink and her famous Medicinal Compound. The recording of the song that was popular during my youth, was a modernisation of an older folk song titled The Ballad of Lydia Pinkham, a purveyor of a Vegetable Compound. That in turn left me wondering whether Lydia was ever accused of witch craft.

Once again on arriving in the ward, I found my bed at a height that reminded me of my back-op. Ironically this time the bed stayed at that height, simply because it could not be adjusted. I was happy enough. This time I was sharing the ward with a fellow PN sufferer, one who snored and spluttered louder than anyone I have had to share a ward with before. That aside, he was a most pleasant fellow, and about ten years older than myself. He had travelled from Dundee for his infusion, and his PN was also more acute than my own.

Once we had settled down, we were both left waiting for the process to start. This time the drips arrived before the neurologist. When he arrived, he performed his assessments and at one point commented on the speed of the drips, which in terms of his assessment, which turned out to be correct, were running too slowly. Then for the first time, I became party to adjusting the speed of my own drip, bearing in mind that if it ran too fast, it could cause complications. It was also then that I also realised that lying on my high bed, I was much closer to my drip bottle than I was during my previous visit., so that too needed to be factored into my drip adjustments. So I Googled "drips per minute versus milliliters per hour", and found several "nursing instruction" sites dealing with the theory and the associated calculations. I soon had my drip purring like a kitten. It also left me thinking that this time round, the nurse had used the regulating device on the drip to set the drip rate, and was happy to accept that the rate was correct, and left like that. Quite different from the nurse on my previous visit, who was on top of her game when it came to setting up the drip. She could look at the rate at which the drip was dripping, and adjust it accordingly, subsequently checking that the flow i.e., "milliliters per unit of time", was correct.

By 2:00 AM my IVIG infusion was complete. I showered, dressed, and headed for the check-out. The sister (actually a brother) on duty only agreed to release me once I promised to phone him when I reached Pietermaritzburg. I then left and found the road as quite as I expected it to be. But only until I experienced one of my most pleasant surprises in may years. The traffic slowed, not for an accident, which is often the case on the N3 between Pietermaritzburg and Durban, but because the road was being resurfaced under lights. Amazing. I saw that in Perth Australia whilst visiting my daughter and her family for Christmas. I was impressed at the time. I never in my wildest dreams, it was after all about 3:30 AM, did I expect to see it in South Africa! After that, I reckon I could have been forgiven if had forgotten to phone the brother, but I did not.


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