A&H

Referee Inactive - The patient is diagnosed

Apart from colds and the occasional cough I don't do "ill".

I got a major surprise on Wednesday of this week when I woke up to find that I couldn't straighten my left arm. I appeared to have acquired a lump the size (and colour) of a small lemon on my left elbow and it was sore. Sore is an understatement. Sore is when you bump your head on a cupboard door. Sore is when stub your toe. Sore is when you graze your knee.

Sore is not how you would describe the sense of agony you experience when you hit your thumb (hard!) with a hammer nor when you stand on an upturned electrical plug in the dark nor when you break a glass while washing up and realise that the washing up water is turning bright red. Imagine all of those sensations combined and multiplied at least threefold (plus sticking your arm on a recently used hotplate for good measure) and that's how it felt when I turned over in bed, brushing my elbow against the pillow. My shouts (I don't tend to do screaming) could be heard 3 doors away!

Like most men I used to be reluctant to visit my GP but since they diagnosed my heart condition 3 years ago and consigned me to a life of taking a small tablet every day, I have quite grown to like the man and wife team who always seem to be on duty at my local medical centre. It was Mrs L who looked at my arm on Wednesday morning and was on the verge of sending me away with a prescription for antibiotics when she changed her mind. She was concerned that the infection and swelling could be masking a more serious condition. But I'm getting ahead of myself ...

Now it's time for some words of advice ... if you ever bump your elbow, notice that the skin is dried and cracked, don't ever try to pick the skin away. If you do insist on doing that and it breaks open and begins to ooze pus, please don't think that washing it, keeping it clean and taking care not to bump it again, will address the situation. That's exactly what I did and just a week or so later I found myself referred to the local National Health Service (NHS) Hospital Trust with a suspected case of septic arthritis.

So back to Wednesday ... I made my way to the hospital which was in a different town from where I live but still only a 15 minute drive and went to Accident & Emergency where my doctor's fax referring me for examination had arrived shortly before I did. After around 40 minutes I was taken through for initial assessment by a nurse. The pre-treatment assessment of patients was immortalised in the tv series M*A*S*H as soldiers were assessed in triage and this is just what it felt like. I was being prioritised.

Quite rightly the fat bald man wearing a fleece bearing the logo FA Referee was lower priority than the middle aged lady with the suspected broken ankle, the elderly lady in the wheelchair who had been brought in from a care home and the sister of a player I refereed a couple of times a few seasons ago. She had been brought in because of a large blood clot in her leg and her brother was only too glad to break up his boredom of waiting for her treatment by chatting to me about local football!

After another hour or so, I was examined by Dr AM who was concerned about my elbow but was also very interested in my cardio-myopathy. He referred me for an x-ray to check if there was anything inside the elbow which might have caused the infection and to an orthopaedic specialist to confirm my course of treatment. My x-rays were completed by a very young looking student radiographer who must have done a good job as they revealed two foreign bodies inside my arm and then I met the orthopaedic specialist.

Dr H was also very interested in my cardio-myopathy but took a long time over examining my elbow, before advising I needed some antibiotics. I had visions of being given a huge injection before being packed off home with boxes of brightly coloured tablets but it was not to be. I was to become a guest of the NHS on Ward 37 - the surgical assessment ward! It seemed that the initial treatment plan was to be a massive overload of two antibiotics (flucloxicillin and benzylpenicillin) delivered by intravenous (IV) drip to get the infection under control and then this might have to be followed up with surgery. Not what I had planned this week ...
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