Heads or tails?

It's been a funny old week, I went on the Underground for the first time, jogged all of about 5 metres for a bus (just making it!), gone through the full emotional spectrum, and done a family xmas party which tired me out for about two days.

The physical recovery was the easy bit though, and now I'm battling with the bang to my head. I'd strongly advise any of you, when paragliding, to mind out for your bonse, head injuries are really rubbish, believe me. My head's affecting my walking, talking, my memory, emotional state and my eyes (giving me double vision) - all a bit frustrating to be honest. My impatience isn't really helping things either though.
Have a great xmas and good luck to those having to negotiate snow to get to where their going, but mind your noggin!

4kms All-In

Dear All,

After two or three days of getting emotional and feeling sorry for myself, I finally had a good day today. The snow/ice melted to the point where Victoria Park came on the horizon. I walked there with the use of a couple of ski poles and did a whole lap with Mum. This is probably an expedition of 4km all-in, so I'm hugely pleased with the progress.

I also saw my GP for the first time this afternoon, and he seemed very pleased with my progress. During the nights I'm waking several times with the muscles on my front completely tight and stiff. My weak back (due to operation) doesn't oppose this, and my back bends and stiffens, really hurting me. The GP has prescribed me something for this so that I can maximise my sleep. My small brain needs all the sleep/help it can get you see.

Well done England!!!

A Second Chance

A message from James Poole – 1 December 2010 (Bulletin No.13)

Right, it's James here – signing in for the first time and obviously pretty excited to be still alive - hooray! I’ve Just read the preceding diary entries, so the bar is high.

My memory is a bit shabby. I’ve totally forgotten my accident and 5 subsequent weeks as well as (amusingly) the week or so beforehand. The reason that this is amusing is that I badgered my brother and girlfriend to come round, on the Saturday before my paragliding debacle to watch the Ironman (triathlon) World Championships in Hawaii on the internet. Of course 9 hours watching TV isn't that exciting and they both fell asleep - with me, sad as it sounds, glued to the action. Well anyway, our (British) girl Chrissie Wellington, the two times defending champion wasn't racing because she was ill (big shock, because she was expected to win the race). But it was a full 7 weeks after the triathlon that my brother told me this and it registered in my head!

I have also been reminded by a couple of colleagues I worked with at Cooper Gay that I spent the week before my accident nicking a bit of their business in Qatar off them. They were very gracious during their recent visit I might add.

So it's memory, my walking, talking and my eyesight that the head injury is affecting. I really wouldn't recommend a head injury if you can possibly avoid it. It's pretty frustrating, trust me. I also get a bit emotional. I feel as if I am in two places, one – glad to be alive, determined to get better and pleased with how my recovery is going, and a second which is at times despondent and frustrated. This is a pretty negative place. I simply want to be better but recognise that there are going to be highs and lows, they're just unavoidable.

Physically I'm doing well considering the state I was in: broken neck, 10 broken ribs and a broken collarbone. I'm over the moon with the way everything is healing. I went for a 100 metre walk on day 1 out of hospital and 1km on day 4. I was so pleased and felt like I'd broken my personal best for the marathon - amazing! I'm clearly going to have to re-think my ideas about exercising, or at least the measures because my training log for the week leading up to my accident includes a session that says: "25 miles at average pace, ok run". I'm now in a different world.

I’m getting a second chance – in this new world and I'm hugely appreciative of the support that my family and girlfriend have/are giving me through the recovery phase. I've been let out of hospital on the basis that an adult oversees me, so my Mum is working from my home (not the Lakes) during the daytime and my girlfriend looks after me overnight. I'm hugely thankful for this - I'm just so pleased to be out of hospital.

I'd also like to thank all my friends who have visited me – in Newcastle and in London. Having people over is something I look forward to, enjoy when it happens and remember afterwards. This is improving my life and I'm sure it's speeding up my recovery. Thanks also to everyone who has been thinking of me - I really appreciate your support.

110 Metre Endurance Walking Competition

It’s Duncan here again. I’m sitting here alone in Cumbria – well, alone that is apart from Radia De Longhi, who is nestling between my knees.

You’ll all know that James came out of the Royal London a week ago. Penny and I had about 30 minutes notice of this. We appeared (from Cumbria) at about 1700 hours. James told us “I’m coming out today”. We thought “no, chum, you’re off your trolley”. His nurse then appeared and said “We’re discharging James this evening”. So to our surprise, we found ourselves taking him home (to his flat) at about 1900 hours. James, it transpired was, after all, on his trolley. Although of course, he had to come off it in order to get out.

He’s delighted with this move and it is undoubtedly the best thing for him. His flat offers attractive surroundings and the catering is much better at Flat 11, Victoria Wharf than it was in the Mile End Road.

He’s made great strides with his walking. His 90 year old grandmother, Nana, would have beaten him by a long chalk in a 110 metre endurance walking competition on 23^rd November (James wouldn’t have finished). By 26^th November, however, he was up to 1km, which would have given Nana a run for her money. Things are looking up.

His eyesight is also looking up, so to speak. The wonkiness has reduced and his eyes are becoming more aligned.

Friday was a busy day. Apart from a gruelling walk in the sunshine along a towpath, across a footpath and through a park, he had several visitors – Anna, Michael and a contingent of medical chaps from Tower Hamlets. The latter (Gaby, Susan and Alan) came to do an assessment. This took two hours, most of which was An Inquisition. The objective of the visit was to find out what was necessary to get James back to work. The result was that he will get some help on physio, with his eyesight and some help on return to work skills (managing his programme and that sort of thing). He then demonstrated that he could walk safely up and downstairs, knew that 999 was the right number to ring to get the fire brigade, didn’t know how to turn the water off (I must find out from our plumber how to do this up here in Cumbria) and was able to articulate his goals quite clearly.

The goals are:

· Carry on going out with his girlfriend (whom he described as a superstar)

· Get back to work

· Get running again

Anything that we can do to help in these areas will doubtless be appreciated!

The Gaby/ Susan/ Alan team were extremely impressed with James’ progress. They said that they were astonished that he was recovering as fast as he is – so that’s good news.

Having been fed through a nasal gastric tube for 4weeks with a continuous drip liquid, James’ stomach has shrunk. It hasn’t had to accommodate large sporadic insurance lunches. Until it’s stretched back to normal size, capacity (and so energy intake) is limited, so he’s still inclined to get tired. Several of you have sent very welcome and tasty hampers/ parcels and these will all help. Mental picture – goose, foie gras – I’m sure that you get the general idea.

A couple of other things:

1. Thank you all very much for your continued support, interest and presents.

2. James’ university friend, Raj, is seeking contributions to a birthday present for James (who attained the ripe old age of 28 on Thursday last week). Some of you may have picked this up from an email which came out last week. Raj’s idea is to get James an iPad and load it with some pictures of James. Several of my cynical colleagues thought that this was a scam. Well, it wasn’t. If you would like to support the idea, you can send me a cheque (Duncan Poole, Whinfell Hall, Low Lorton, Cumbria CA13 0RQ), I’ll pay the cheques into my account and then forward the money to Raj for him to bring the idea to fruition. He’ll still need the photos direct. As I said to Raj (post issue of email), I thought that it would be prudent not to buy anything until he had cash in hand - many of you have been very generous already with time, accommodation, food, flowers etc.

James will have a go at the next bulletin – he’s keeping a diary, which rivals that of other diarist greats like Samuel Pepys and Bridget Jones.

Cheerio to you all for now,

With love from Penny, Bean & James and Alasdair in London,

And me (in chilly Cumbrian isolation – Radia De Longhi is an oil filled radiator, by the way, and not much of a substitute for Penny),

Duncan

29^th November 2010.

'Home Sweet Home'

Hello everyone – Penny here this time!

Duncan and I arrived in London yesterday afternoon, expecting James’s discharge from The Royal London Hospital to be imminent. And how. Within 45 minutes we’d had briefings from a selection of medical, nursing and rehab professionals, pocketed the paperwork, gathered together the boy’s belongings and eased our way (oh so gently) into a taxi. Whitechapel Road mid-rush hour is a bit of a shock to the senses for Cumbrian country bumpkins like us – so imagine how James must have felt. However, this was nothing compared to the exhilaration (and emotion) of stepping inside his flat, the first time for more than five weeks.

Enough excitement for one afternoon. James was soon ready to show off a skill he’s rapidly perfecting – the power nap. It’s a nifty trick, strongly recommended by early morning TV presenters and neuropsychologists alike. Why not give it a try?

By mid evening, James and Bean were finally able to enjoy a bit of peace, quiet, pasta and garlic bread a deux (other members of the extended Team Poole maintaining a discreet distance – i.e. downstairs).

The morning after the night before and James still can’t quite believe his luck – or that he’s really home (and not being constantly interrupted by necessary but tedious hospital routines). A leisurely shower and breakfast were enough to prompt a brief siesta – good work! We’re planning a little bit of fresh air mid afternoon, but will see how things go. Doubtless he’ll want to listen to The Archers first!

He's Mending

Yesterday was the end of week 5 since James’ fall to earth. Today is the beginning of week six. In the last 36 days, he has managed to break some dozen or so bones in his body, most in more than one place, damage his brain (“severely” although we’ll come back to that) and do something or other to his right eye. all of these injuries seem (to us) to be mending extremely quickly, indeed the Royal London Hospital have it in mind to discharge him into the bosom of his family (and, of course, St Bean is an integral part of both the bosom and the family in question, do try to keep abreast of the metaphor) in the next few days.

Newcastle General Hospital did an absolutely fantastic job. He was discharged from NGH on Saturday 13 November and the hospital, doubtless exhausted by the effort of having to deal with James, has now closed. Should anybody be inclined to have an accident paragliding off Carrock Fell despite reading these reports, they will find henceforward themselves whisked to the Royal Victoria Infirmary instead. I’m not sure that James really enjoyed his stay at the NGH but they certainly did him proud. When he was there his grasp on reality was gradually tightening, he came to realise that:

• he wasn’t in a hotel,
• the not-hotel , i.e. the hospital, was in neither Seaford nor Scarborough and
• the prime minister was Cameron (not, thank heaven) Blair or Brown

He did perceptively remark on the number of Geordies among the staff. Anyway, last Saturday an NHS ambulance and two nurse drivers “repatriated” him safely to Mile End Road, London E1. I hadn’t hitherto regarded London as a being in a country distinct from NuT, but maybe the Geordies have that view of the world.

I was somewhat surprised to find out that the nurse/drivers were apparently brothers. Of an age (mid 50s – a very good vintage), Tommy and Dave didn’t look at all like brothers. Very different build (although both Geordies), their common surname was Pts. I remarked on the fact that they didn’t look like brothers and how did one pronounce the unusual name or was it an abbreviation, perhaps for Potts? A slightly tense pause ensued, there was a bit of eye ball swivelling (with the benefit of hindsight, this was probably their reflex action in search of a straitjacket) and then the reply came that PTS stood for Passenger Transport Services and wasn’t a surname at all (and that they weren’t brothers).

On the medical front, the view is that the Royal London can’t do much more for The Boy. He’s mending very well. He will have an ophthalmological appointment in 3-4 weeks time – the delay being to allow Mother Nature to carry on doing her bit. His consultant neuropsychologist says that there’s no concern about his physical recovery and his life expectancy is unimpaired. The eyesight is manageable. Even if Mother Nature can’t quite get things back to what they were pre-crash, he can wear glasses.

The brain injury? Well, it is “severe”. Now, of course, I have absolutely no professional experience of brain injuries and a lot of my friends and family would unkindly say that I have little experience of a brain either, but if his injury is severe, there must be some pretty extreme words further down the spectrum to describe worse injuries. The James Poole that we have today is pretty compos mentis: he is a bit vague when he gets tired, but vegetable he isn’t. Yesterday when I was telling him about a drain clearing exercise that I had been undertaking round the back of the house (in Lorton), he could clearly picture the drains and their covering grates (which for some reason don’t keep the leaves out). He recognises all of his visitors and connects them with their lives/ interests/ jobs. He enjoys the Home Service on the wireless (bit of an improvement on Five Live). We have to look out for anxiety, boredom and depression and will need to make sure that he doesn’t get overstimulated. He cannot be relied upon to look after himself yet - he’ll need somebody to keep an eye on him when he’s in his flat (but he is way past the level where he would benefit from day care at Homerton Rehab Clinic).

In terms of return to work, we’ll have to wait and see: James would like to get back to work, but the consultant said that this should be on a phased basis. The consultant’s opinion (not quite sure what this is based on) was that James has a high octane job and that this wasn’t the same as being a roadsweeper (indeed were James a roadsweeper, he could go back to work as soon as he has built up more muscle tone). I thought that this was interesting: most of my colleagues think that work in the insurance industry consists entirely of large lunches (planning, eating, drinking, digesting, getting somebody else to pay the bill). Since I’m the only insurance professional that most of them have met/ know (in my singleton capacity at the Nuclear Decommissioning Authority), I’m mystified as to the origin of this misapprehension.

The consultant did say that James’ employers shouldn’t concentrate purely on the physical side and that we would all need to watch out for the recovery of his high level cognitive abilities (planning, problem solving, multi-tasking etc). Encouragingly, the consultant said that there are lots of coping strategies, many including what he called cheating with a Blackberry. This is probably an area where James has no little experience already.

Penny and I go back to London tomorrow morning. She will stay in London for the week, I’m going to Bristol and Berkeley Tuesday-Thursday and then back to London for Friday. During this coming week we expect to see James back in his flat. We don’t know yet what we are supposed to do with him. Gently increasing physical activity and games are what we think is appropriate, along with some looking after of himself, making cups of tea for his carers and visitors, a bit of light shopping and interaction with the natives of Bethnal Green. We have to get some instructions/ guidance from the pros.

Reports back from Bean, James and Alasdair this evening:

Bean is at Nando’s buying spicy chicken fajitas to augment the Royal London’s cuisine. She has been busy moving sofa beds around the Home Counties this weekend and, of course and blessedly, loyally and lovingly looking after her inamorato.
James has had a raft of visitors over the weekend from school and work.
Alasdair is with James as I bidigtally peck at the keyboard


Many thanks for all of the marvellous continued help and support. I’ve been fed and watered by Cumbrians this past week, taken to an Anniversary of Flood presentation arranged under the auspices of the Institution of Civil Engineers and delivered by Cockermouth Mountain Rescue (mercifully long on civility and short on engineering), and this weekend Penny and I have been looked after by our many friends up here – entertained to tea, dinner, elevenses, lunch and tea. I’m not sure that we’ve been able to reciprocate very adequately – our conversation has been dominated by ribs, clavicles, interpedunculate cisterns, oculomotor nerves, skulls and neuropsychologists, which must be a bit dull. James has had lots of visitors and there are more in the pipeline. James joins Penny, Bean, Alasdair and me in saying that your interest and continued support mean an enormous amount to us. Muchos gracias! (Incidentally James asked his consultant about whether his ability to speak Spanish would be impaired. The consultant said no, foreign languages are at a “low level”. I’ve got reservations about James’ ability in this area anyway: Penny, Alasdair and I have not forgotten the occasion in Vittoria when we were confronted by James Poole procured tapas which included some deep-fried cartilaginous material – yes, you could say that he had made a pig’s ear of ordering – it certainly wasn’t a silk purse).

Adios amigos!

With love from us all

Duncan

P.S.: I hope that this bulletin is OK. I was mildly admonished for a couple of remarks in the last bulletin. One related to James and his bed, but in this respect everything is fine. The other related to the light over the dining room table – the expression “recreation”, of course, referred to snooker - nothing else.

After 57 years, 9 months and 4 days, I have come to accept such criticism philosophically.

I imagine that England’s other great men of letters have had to put up with this sort of thing too.

Dorothy: William, don’t you think that “host of golden daffodils” would scan rather better than “crowd of yellow flowers of the genus Narcissus”
Anne: William, that bit at the beginning of Romeo and Juliet about mistress’s circle is a bit risqué, dear
And so on!

D

Visiting James

Hello,

This is Alasdair, James' brother and temporary P.A.

I have set up an email account to help organise James's time. Using Google calendars, Beanie and I will do our best to enable all those who have expressed an interest in visiting James to do so. When James is ready to organise visits himself he can then take over this email account and fire me!

James transferred from Newcastle to London on Saturday and is now in Ward AW4 at the Royal London Hospital, Whitechapel Road. His short term memory is a little hazy, so he’s forgotten some of the visits to Newcastle made by friends and family. He’s very apologetic about this, but now much better at remembering things. Understandably, he needs lots of sleep – but when he’s awake he’s alert, talkative and responsive.

Visitors are very important at this point in the recovery process and Team Poole would like to open the proverbial doors. To help structure James's day we’d like to suggest that if you want to visit James you book a slot. Visiting times for AW4 are between 2.30pm and 7.30pm and we have been suggested twenty minute slots. This timing should be strictly adhered to as we have been advised by the medics that frequent rest periods are crucial to James's recovery. We mustn’t wear him out. As time goes by, you will be able to visit him more frequently and for longer periods of time.

To book a slot, just reply to this email address and we will book you in for a visit. Alternatively, contact me on:

Alasdair: 07859 024750

or Beanie: 07740 576182

We will confirm your visit by email, text or carrier pigeon as soon as possible.

Weekends are going to be very busy. Please bear in mind that those coming from further afield may only be able to visit at the weekend.

I will regularly send out a spreadsheet showing James's availability.

With love and thanks

Team Poole
wwwjdp251182.blogspot.com/

"Game on, frankly!"

Team Poole has flown South!

Newcastle did us proud, and in some ways we were rather sad to leave. I’ve lost count of the number of people who lavished their medical/nursing/domestic/motivational/love bombing/mucking out skills on James – a very big thank-you to every single one of you.

Tommy and David were Saturday’s ambulance transfer crew for the road trip to London. With a cheerful “Hi ho, hi ho, it’s off to ....” (or the Geordie equivalent) they hit the road at 10.00am, delivering their precious bundle to Ward AW4 at The Royal London, Whitechapel Road (and into the arms of J’s beloved Bean) just over five hours later. Duncan and I collected our belongings from Simon & Pauline’s flat in Newcastle (for which, once again, many thanks!) and beetled down the A1, heading for James’s flat in Mile End, just over a mile from the hospital.

The rest of the week-end was pretty sociable for everyone and James happily received several visitors, took in multiple siestas and got acquainted with his new surroundings. The prospect of a Nando’s Mexican takeway (conveniently located just across the road from the hospital) is definitely pepping him up – as will the hot chilli sauce he says he wants liberally doused on the chicken wrap at the top of his snack wish list!

It really is the season of mists and mellow fruitfulness here in London. I went out for a jog along the Regent’s Canal towpath and round Victoria Park this morning and got a real endorphin hit from the autumn colours and hazy sunshine. OK, I also stopped off at a rather chi chi cafe in London Fields for a hyper strong coffee and two thick slices of liberally buttered and jammed toast – thus completely cancelling out the benefits of the exercise, but hey .....

James is in line for a medical assessment today – and his new physio regime should also kick in (quite literally, as football seems to be part of the deal). The whole ‘rehab’ scene is a bit of an unknown quantity for Team Poole, but to quote James from the end of last week: “Game on, frankly!”

We’ll let you know how things go!

Penny X

Carboloading in Anticipation

Hello everyone

A super speedy update this time, as I'm hotdesking!

We've heard this afternoon that James's transfer to The Royal London Hospital in Whitechapel is planned for this coming Friday, 12 November. He's over the moon about his 'upgrade' and thanks EVERYONE who has helped him get to this next stage. The journey will be tiring, but James is already carboloading in anticipation!

Tomorrow we're off to the Royal Victoria Infirmary, in Newcastle city centre, for an ophthalmological assessment. The effort that is going into planning the logistics of this particular exercise are impressive - and the experience means that we'll be fully fired up and ready for the marathon ahead.

More anon - and next time, I'll wax a bit more lyrical!!

Penny X

Good Manners

Duncan here.

Penny has been on duty this week. Alasdair went down to London on Wednesday 27 October, Bean went off to win (as predicted in bulletin last week - come to me for racing tips in future) 5 medals (G, 2S, 2B) and to set a new European record for the ladies 25-29 4X100m freestyle relay in Sheffield before driving back to London. I hitched a lift off Sister Alison and Brother in Law Colin ending up in James’ flat for a couple of nights last Saturday and Sunday.

Team Poole has now reconvened for the weekend of 6 and 7 November in Newcastle – and it’s rather fun to be back together again. This past week, Penny has been updating you all – my take on the week is as follows.

On Monday, Bean and I dropped in on Willis (James’ employers), where we received a very kind, sympathetic and courteous reception from Graham Knight and J’s team. We handed over sick note no.1. Graham gave me a cryptic message to deliver to James, which I duly did by phone and with Brother Nigel acting as an intermediary. This provoked an immediate and positive response from The Boy – recognition.

I went over on Tuesday for the evening to NuT and had a bit of a chat with him. Tracy day (see PJP’s bulletins no.)

Wednesday was a great day, he ate some Shredded Wheat, had a chat with a Polish nurse about Poland and was able to tell his mother the frequency of Radio 1. (Truth to tell, I was a bit disappointed, I would have hoped for the frequency of the Home Programme or the Third Programme or at least Classic FM. While we are on the subject of the Home Service, what a relief to have a journalist free day on Friday when they went on strike – perhaps the BBC should get rid of them altogether?).

On Thursday, Bean’s view was that he was making sense for 70-80% of the time. The rest of the time he was off with the cuckoos. This seems a bit of an improvement on his pre-accident state. He was also having to draw objects and he had a bit of an eye check (from his occupational therapist) – he’ll need a bit more help in this area.

Friday saw an improvement in his drawing abilities, more speaking, some walking.

Today, he’s better still.

So, to summarise:

Physically – mending very well. His surgical slices and sutures are super-healing. He has a scar on the left side of his face on the jaw line, several scars on the front of his chest where the surgeons ‘went in’ to do his ribs and a 12” scar which curves below his left shoulder blade (also rib plating related). This makes it look as if he’s been bitten by a great white shark. The eyes – well we’ll see and so, doubtless, does he – he’s sporting a saucy, rakish and piratical eye patch at the moment to manage his double vision.

Emotionally – seems pretty stable. He’s frightfully lovey-dovey with Bean, filially affectionate to Penny and does manly hand shakes (not hugs) with his male visitors(including Alasdair and me).

Mentally – as you would expect, we are anxious about this. He seems to have become extremely polite. I remarked on this to Bean, who said that he always is.

Well, if so, it’s a characteristic which he’s managed to conceal pretty well from me for the last 27 years and 346 days. I mentioned this to Brother Nigel this morning: he was able to:

a)reassure me and
b)startled me with his worldly cynicism (not a trait that one associates with BN).

Nigel said that he’s bound to be feeling vulnerable at the moment and the best way to get looked after well is to be polite. He also realises that he’ll need a bit of help in the future and so he’s banking on good manners to secure future service. That’s a relief – I thought that we were seeing personality change.

On the mental front, we’ve been visiting the Headway website (charity, www.headway.org). I’m sorry to say that this doesn’t paint an encouraging picture at all – in short, bad news, I’m afraid. Headway has a comprehensive site and one of the sections deals with the ‘Emotional & Behavioural Effects of Brain Injury’. I screwed up my courage and visited this page. There are 11 distinct traits to look out for:

1. Agitation
2. Explosive anger and irritability
3. Lack of awareness and insight
4. Impulsivity and disinhibition
5. Emotional lability (means laughs and cries easily)
6. Apathy and poor motivation
7. Depression
8. Anxiety
9. Inflexibility and obsessionality
10. Sexual problems
11. Self centredness

It’s pretty clear that all of these are conspicous – we are clearly dealing with a text book situation . I’ll give you examples of all of these, just to get the message home.

1. Especially when making scrambled egg.
2. Yes, presents with this when required to do DIY
3. Yes, ask Penny and Alasdair for examples
4. Well documented evidence of this over the past 3 weeks
5. Also lots of laughs, tears in the last 3 weeks
6. Ask previous work colleagues
7. Ditto
8. Eternal pension funding angst
9. Performance of pension fund
10. Well, we’ve had to change the light fitting in the dining room to accommodate our “recreational activities” recently
11. Note that the last few paragraphs apply to the author not to James at all.

Yes, I’m afraid, dear reader, that I must have had a trauma induced brain injury in the past. I can’t actually remember when this was, but then I wouldn’t be able to, would I? That’s the sneaky thing, which probably proves it beyond all doubt. I do remember modifying the angle of my nose when I rear-ended my brother’s toboggan in 1962 – perhaps we can trace the brain injury to the same event? Anyway, given that I’ve managed to cope with brain injury for the last 48 years, had a moderately successful (interesting too) career, a happy marriage and produced a couple of fine lads, I can’t see that James will have any problem bouncing back.

Other news:

It’s a shame that that German fellow (derivation from the Arabic for peasant – fella, if you are interested) has gone back to No 1 St Peter’s Square, The Vatican. A chat with him might have helped. I want to nominate Bean for a sainthood.

This isn’t something that I know much about (along with pretty much everything else under the sun, as you’ll have realised by now). I discussed it with her and she seemed to be up for it. I said that she would have to be St Bean of something and she thought that Fenham (where the hospital is in NuT) would be good. I suggested that perhaps she could also take on insurance brokers and paragliders – she was “cool with this” too. Bean reckoned that there might be a few problems at the moment, what with spending cuts and all, although perhaps there are non-stipendiary saints?

On mature consideration (apart from not really knowing how to go about it – vague recollection of a book by Morris West) since being a saint might rule out certain activities (it undoubtedly would rule out what Jas was suggesting on Tuesday night, Wednesday night, Thursday night, Friday night), I think that I’ll leave it for a bit. However, she definitely deserves to be canonised.

Bean went to the Royal Geographical Society on Tuesday night, met Michael Palin and he very kindly recorded a get well message for Jas on Bean’s I Phone. Alasdair is researching how to post this on the blog. Bean didn’t buy his book but did buy a map of Orissa, which Michael Palin autographed for her.

This afternoon, Rachel Hawes, the anaesthetist on the Great North Air Ambulance helicopter which rescued Jas, metaphorically dropped in to see him. She said that he had crashed to earth half way up Carrock Fell in a place where a helicopter couldn’t land. The solution had been for her to knock him out, for him to be loaded onto a sled by the Keswick Mountain Rescue and then the sled was slid/ carried to the bottom of the hill, whence the helicopter whisked him to NGH A&E (at 190 mph). The rescue took about 2 hours. We’ll do some digging on this in the next few weeks. Now that I don’t weep so much (obviously becoming less emotionally labile), I can cope with this. James has decided to provide some publicity for the GNAA and KMR by way of a thank you. (Since loads of people have written to us offering support, I’ll set up something to enable donations to be made in recognition of the help provided to JDP, should anybody wish to say “thank you” in this form. Penny and I and the Poole Siblings all intend to do this).

The mother (Sarah) of a girl (Becky) who was briefly on the same ward as Jas went to a school in Whitby which was run by the order of sisters who organised some prayers for James – see bulletin 1. A celebratory visit to Whitby is planned when the patients are better.

Once again, many thanks to you all for visits, support, emails, flowers, wine, lifts, meals, accommodation, book suggestions (On The Edge, by Richard & Mindy Hammond) and kindness – you are a marvellous bunch of friends! This is something of a life-changing event for us.

With best wishes

Team Poole

'Hospital issue' chocolate cake

Bulletin 6 2 November 2010

So, farewell Tracy (in case you need reminding, this is I-Phone predictive text for ‘Goodbye Tracheostomy’). We welcomed you with open arms, but to be quite honest, you became a bit of a pain in the neck. Gone, but not forgotten.

Today has been incredible. Around mid-morning, a multi-disciplinary team meeting convened around J’s bed. I sat in the ward dayroom, twiddling my thumbs. J’s Uncle Nigel and Auntie Ali nipped off for a late breakfast at their hotel around the corner, having done the early shift while I sorted out my poorly Polo (more of that later). Walking back to the Neuroscience Unit at the hospital, Nigel and Ali spotted a magnificent rainbow, photographed it and texted the picture to me. An omen? Not half.

Within the hour, Tracy was consigned to the hazardous waste receptacle – thanks to the gentle ministrations of delightful outreach team member Ingrid.

Next to arrive were the physio team. Knock ME down with a feather if they didn’t get James out of bed, onto his feet and ‘walked him’ a good distance down the corridor, womanfully supporting him under his armpits - with various bits of (dangly) medical paraphernalia adding to the spectacle.

Back to bed for James, a short rest and then enter Helen, the wonderful rehab supremo. Calmly and reassuringly, she offered James some information about the ‘status quo’ and asked him a few questions, prompting quiet but remarkably accurate responses. One question went like this: “Have you got a significant other, James?” “Yes,” he said. What followed was clear and insistent: “Victoria” (aka Bean, as you’ll know).

Another quiet interlude and next on the scene was Holly, the Speech Language Therapist. Working gently and methodically, Holly explained that she wanted to know how well James could swallow, following Tracy’s departure. First he managed half a teaspoon of water, then a bit more. This was followed by a main course of peach yoghurt, rounded off – unbelievably for someone who’s been on naso-gastric tube administered Osmolite for more than a fortnight – with a morsel of quite dry ‘hospital issue’ chocolate cake. Not for the first time during this saga, I was utterly speechless. And J’s effort throughout the proceedings brought beads of sweat to his brow and tears to EVERYONE’s eyes!

I’ve come back to our lovely borrowed flat for some supper – expertly prepared from a rather random selection of ingredients (sorry, Nigella – but thanks, Alison!) by Duncan (hot foot from West Cumbria) and Diana (D’s second cousin, who has flown in, courtesy of KLM, from the South of France today).

Thanks everyone – your thoughts, prayers and good wishes are doing the boy (and us) a power of good!

Penny X

P.S. Bet you weren’t expecting a commercial break for Kwik Fit, were you? Yesterday, just when I thought that nothing else could possibly go wrong, my car sighed and expired. Luckily (we seem to have shedloads of the stuff) this happened in the car park just outside our borrowed flat. Right next door, you guessed it, there’s a branch of Kwik Fit. I arrived just as the manager was closing up for the day and explained my plight. A true gentleman, he cheerfully agreed to sort out the car this morning and even offered to drive me back to the hospital if the taxi he’d ordered for me didn’t arrive “within 5 minutes”. The Polo is now back in action (something mysterious to do with the throttle – Tracy, were you having a laugh?) So next time your vehicle is on the blink, please head straight for Kwik Fit!

Farewell Tracheostomy

01/11/10

Hello everyone – Penny here (currently brow mopper-in-chief)

Apologies for the businesslike bullets that follow, but it’s been a hectic day here at mission control and I could do with a dollop of beauty sleep.

Since Duncan’s last bulletin, James has:

• Cooperated, more or less, with an impressive number of medical interventions
• Greeted his Uncle Nigel & Auntie Ali with a beaming smile
• Blown kisses down a mobile phone to Bean (aaaahhs from everyone present)
• Tolerated the Archers Omnibus on the radio, just to keep me sweet (OK, he didn’t actually have much choice in the matter!)
• Responded with a wry grin to some darts-related banter from his mate Brett (aka Crazy Horse) – though what he wanted to say is probably unrepeatable anyway.

Tomorrow promises plenty more action, so depending on your preferred method, please direct your thoughts/prayers/wishes on a star to James’s next milestone .....

‘GOODBYE TRACY’ (my I-Phone’s ‘predictive’ alternative for ‘FAREWELL TRACHEOSTOMY!’)

Thanks for your continuing support: cards, phone messages, emails, visits and efforts to re-re-adjust my waistline!

Penny X

"He's doin Canny"

It’s Duncan, here (again!)

At the end of Bulletin 3, I’d lost the casserole and James was moving to the High Dependency Unit. There’s exciting further news on both counts.

Firstly, the casserole has turned up. I went into my office in Whitehaven yesterday, got hugged quite a lot (on which more anon) and apart from concern about James, there was a good deal of interest in the Mystery of the Missing Casserole. Well, I opened a Flora tub yesterday and, lo and behold, there was the casserole. Amazing!
Your minds can be set at rest on that score. I know, I shouldn’t have got into such a stew about it.

Secondly, James. He swept through the High Dependency Unit (as my father would have said, “like a dose of salts”) in a couple of days. I was discussing his progress with an HDU nurse who said “he’s doin’ canny” an expression which I took to be Geordie approbation. Anyway, he’s done so canny that he’s now in another ward – Ward 31. He’s in his own little cubicle.

In terms of mental condition, he’s making good progress. There’s no problem with his comprehension, he answers questions with squeezes (whatever happens to be in squeezing range).

Physical stuff, he can do a thumbs up, he follows with his eyes, his physios sat him on the edge of his bed yesterday, he’s got good core strength, he gets tired fairly quickly and can’t talk unless his “trachy” is adjusted, which hasn’t been done when Penny and I have been there in the last couple of days. He is still on painkillers which make him drowsy. His arms and legs seem OK if feeble.

So in the last 13 days, we’ve progressed from a situation where, had he not been resuscitated, he would have been brain dead in a few minutes or everything dead in a few more minutes or paralysed from the neck down had there been a little more movement (a few mms probably) to having a James who is definitely alive, moving all his limbs and understanding what we say. So, result!

His eyes look a bit odd – a bit glassy – but in this respect he is also improving. As one of my colleagues kindly reassured me yesterday “he’s bound to look a bit odd with you as his father”.

We think that the medical team will keep him in Ward 31 for a week or so, resolve the trachy, swallowing/ coughing etc and then send him down to London. We are arranging a meeting with his consultant to discuss the best place. Because he’s in need of physio, brain, chest and possibly eyes, he’ll need a multi expertise place: Kings, The Royal London in Whitechapel or St George’s in Tooting have been mentioned. The Whitechapel place would be convenient for a lot of his mates.

His immediate support team (Bean, Penny, Alasdair and I) are also returning to some degree of normality. I haven’t liked to enquire too closely about the girls’ dress sizes (which to be honest, I don’t really understand. I can visualise heights, waists, hips and chests/ busts but I’m not quite clear how this all comes together in a single dress size. What size is a slender 6 foot woman or a clinically obese lass of 4’ 11?). Alasdair is also OK after a rather turgid time last week. I was told that I looked a bit haggard yesterday, which is an improvement on last week when I looked “bloody awful”.

Alasdair has now gone back to London to his flat and work. Many thanks to ABMA for their support. Bean is going to win a swimming competition in Sheffield this weekend. I’m going to London for a meeting on Monday and will return to Lorton and the office on Tuesday - I’ll come over for a few evenings in the week. Penny stays here (in charge) with support from The Poole Siblings and their esteemed spouses through to mid-next week, plus support on a day by day basis from one of my cousins and some friends of James. She’ll be staying in an absolutely sensational borrowed flat (more marvellous friends of friends).

Next weekend, Alasdair and Bean will come up and I will come over ………….unless, of course, The Boy has gone off to London! We’ll keep you posted.

Thank you all for your continued interest and support. You’ve been great – food, chocolate, flowers, cards, texts, phone calls, blog posts, emails, general supportive interest, medical interpretation and advice and hugs galore.

I’ll close on the subject of hug etiquette and my complete ignorance of this (yeah, and pretty much all else too). I hope that I haven’t inadvertently caused offence in the Hugging Department. Normally (well over the last 34 years), the hugger has been Penny and she gets kissed when she hugs me. Otherwise men get a firm handshake, women get a chaste little kiss on left and right cheeks.

In the maelstrom of emotion that has constituted life from about 1800 hours on16 October 2010 up to today, I’ve been hugged by loads of beautiful women, which triggers (per Pavlov’s dog) a kissing response, and I’ve been halfway through a manly handshake only to find myself swept into an embrace Mediterranée. One then has to untangle hands and slap each other on the back. So if you are a girl (and got kissed, sort of by mistake) or you are a bloke (and ended up with a knuckled chest), I apologise. I’m trying to do better.

With love from us all (& James)

Penny, Bean, Alasdair and Duncan

The Recovery Phase

Thank you all for your kind responses and blog posts.

Should you so desire, you can find out a lot about nuclear emergency planning from the Department of Energy and Climate Change website (DECC). The planning process divides the “timeline” in two: there is an emergency phase and a recovery phase. The emergency phase is the sexy, glamorous bit with heroes and heroines (heropersons), flashing blue lights, breathing apparatus, fires, newspaper reporters, headlines and so on – it’s the bit that Hollywood turns into films. The recovery phase, worthy and important but not sexy, takes the affected community back to normality after the fires are out and when the heroes have gone off to be heroic elsewhere. (Since you are probably wondering, yes, Duncan is a small-time player in the unsexy bit-no change there).

James’ predicament is a bit like this – it’s his personal Chernobyl. He is now firmly out of the emergency phase (helicopters, resuscitation, back from the brink, blood, operations etc) and into the recovery phase. There’s nothing left to operate on (apart from the removal of his neck plate in 4 months or so). His lungs are returning to normality.

He had an MRI scan yesterday and the neurosurgeon had a chat with us afterwards.
The scan showed that there had been a small amount of bleeding at the point where the spinal cord comes into the brain (the interpeduncular cistern, since you ask) and this has:

• Affected his oculomotor nerve (which accounts for the curiously dilated pupil in his right eye). If this doesn’t mend itself of its own accord, it can be corrected with glasses. What he sees is a rather blurred picture out of that eye, a bit like the effect of eye droplets that opticians sometimes use to dilate the pupil. The other eye is OK.

• Caused some weakness in his left side, which can be resolved by the physioterrorists (joke).

He still has his tracheostomy. This is necessary to manage the vomit risk. Were he to vomit, he couldn’t necessarily deal with the result by spitting it out or swallowing it – so it (i.e. the vomit) might trickle down into his lungs and that ain’t good news. So, the “trachey” stays in place for the time being. The arrangement reduces his conversational capacity to an occasional hoarse whisper. I thought that you would be interested in this – we had sputum in Bulletin 2.
He is also doped up on opiates. His chest pain (caused by the extensive rib damage) is significant. This makes him intermittently dozy. He reserves maximum responsiveness for Bean and his friends.

Apart from that, he had a good day yesterday with some old school mates (nothing wrong with his memory of various sordid teenage escapades).

What next? Our (i.e. Penny and Duncan’s) idea had been to get him over to Lorton so that we could look after him until he was better. I was thinking about this in the wee small hours one night last week and decided that it really didn’t make much sense. The Boy will get more social variety in London and more visitors. It is easier for friends, relations, work colleagues etc to drop in. Penny can operate her business from James’ flat, I can get down without much trouble. Newcastle General Hospital seem to agree with this. John Macfarlane (one of our stalwart Cumbrian supporters) looked a bit crestfallen when we mentioned this: he had wanted to go running with James before James was well so that he (John) would be able to keep up with him.

We don’t know when this relocation will be – perhaps in the next week or two? We’ll keep you posted.

Not much other news.

1. Penny and Bean have apparently both dropped a dress size.

2. I’m in trouble because I lost a casserole, brought up by Sister Barbara. There was a slightly astonished silence when I disclosed this last night on the ‘phone. “How can you lose a casserole, Duncan? I put it into the car for you, you can’t have just lost it!”

Could there be a link between these points? Anyway, should you be travelling between Newcastle Central Station, Newcastle General Hospital and 21 Simonburn Road, Fenham and you come across a stray casserole, by all means tuck in – it’ll probably help you to maintain your dress size.

Thanks again for all of your good wishes. We’ll continue to keep you posted.

With best wishes from

Penny, Bean, Alasdair & Duncan.

Update

Thank you all for your kind responses and blog posts.

Today, James has been promoted (within the Critical Care Facility) from Intensive Care to High Dependency. This recognises that his breathing needs less aid than it did. It changes the nurse: patient ratio from 1:1 to 1:2. It means that we’ve been chucked out of the hospital accommodation. We still get a preferential parking rate. He also starts a physiotherapy/rehabilitation routine. We have to supply pyjamas (or a nightie!), shower gel, toothbrush etc.

We’ve been advised that head injury patients progress is slow. James is breaking the mould (why stop at ribs, clavicle, vertebrae?). We (and the nurses) reckon that he’s making excellent progress. His doctors (like the nurses – marvellous) are more guarded. I rationalise this on the basis that they don’t want to raise expectations ergo they present the gloomiest picture ergo this cannot be generally representative. So, Team Poole is splendidly optimistic and positive.

An example of this:

James’ Aunt Barbara came to see him last weekend – about 24 hours after the crash. She was disgruntled after sitting with him for 30 minutes because he couldn’t be bothered to open his eyes or even acknowledge her existence. I had a chat with James before she dropped in Sunday afternoon. It was a bit of a one-sided conversation, indeed it was more of a monologue, but I represented the benefits of good manners in general, the correlation between manners and Christmas presents, Aunt sensitivity, Aunt travelling times, consequences for father if son didn’t perform etc.

James responded by looking at Barbara, squeezing her hand, not pulling all his drips and drains out, and finally, when Sunil (the Nurse) adjusted the tracheoscopy, James whispered answers to a few (admittedly rather fatuous) questions – favourite colour –blue (useful come to think of it, it’ll help Bean when she’s pyjama shopping at John Lewis today), name of prime minister (we probably all know that) and confirmation that he knew that he was in a hospital.

Also, Sunil tried eyes: we’ve been a bit anxious about this, they look a bit wonky. Anyway, Sunil held up some fingers and James counted (or guessed) three. As it happens, he was:

A) right,

B) his maths appears to have improved, and

C) he can’t have double vision .

The upshot was that Barbara left thoroughly Regruntled. Well done, James!

A second example:

When offered the choice (for a minute while one of them went to fetch something) between the company of his girlfriend, Bean, and that of a girl friend, Charlotte, who was visiting and had been telling him about the excellent fish pie that she had made for Team Poole the previous evening, he very forcefully opted for Bean.

Clearly, he can understand what’s going on and there’s nothing wrong with his libido or hand/arm strength. Charlotte (far from being offended by the implied aspersion on her conversation topic and fish pie prowess) kindly said that it was one of the most romantic things that she’d seen in her life. Charlotte’s fish pie was one of the most welcome dishes that I’ve had, by the way.

The medical team are very conscious of the risks of infection. They’ve cultured a few bacteria from James’ sputum (spit etc). There are three types of baddy but not in sufficient quantity to cause concern and apparently on balance it’s better not to zap them because in so doing one would zap other goody bacteria. The risk is being carefully monitored.

That’s it for now – Team Poole is lodged in a house borrowed from Charlotte’s extremely kind and generous friends for 6 days, then some of us will take a flat and the others will revert to weekend visits.

Thanks again for all of your good wishes. We’ll continue to keep you posted.

With best wishes from

Penny, Bean, Alasdair & Duncan.

PHOENIX

Hallo everybody, this is Duncan (James’ dad speaking),

Over the past 6 days, we have had fantastic support from rescuers, relations, friends, colleagues and people that we don’t know at all, but who have kindly taken us into their thoughts. We have been deluged by so many texts and calls that it has been difficult to reply to them all. We’ve decided to update you by email/blog because we otherwise can’t cope: Newcastle, which has a fantastic hospital called the Newcastle General, has not got a large enough pigeon population to send out daily messages to the 100+ people who’ve been in touch. If you know of anybody who may be interested, please pass this on to them.

The Before

The Accident happened last Saturday afternoon 16/10/10. James had come up to stay with us in Cumbria for a couple of nights and took himself off paragliding to Carrock Fell, which is the Mecca of paragliders nearest to us and given the prevailing weather conditions. The weather was good, he was having a really good day, witness two texts, one which featured as a message on twitter:

16 Oct 2010 11:54

Followed the wind round to carrock fell and bizarrely there are a few other pilots here. Cumbrian autumnal colours are stunning

16 Oct 2010 13:09

Amazing flight from top of Carrock Fell. 30 mins of pretty good Lakeland views....It’s a bit fresher than Turkey though!


The After

By 1800, he hadn’t got home. Penny and I had been invited out by some friends to a ceilidh and so had catered for James. Penny rang his mobile to issue a string of instructions about (very expensive) fillet steak, (Sainsbury’s not very expensive) Montepulciano, Güs and reblochon. The phone was answered by Matthew Cadamy, who announced himself as the A&E consultant to Newcastle General. Matthew said that James was in hospital, serious head injury, we should come over, was he allergic to anything (A: dogs), was he up to date with his jabs (A: don’t know).
We left immediately and got over to Newcastle in 2 hours. On the way, we rang Alasdair (James’ brother) who was on his way to a 1950’s party in Russell Square and Bean (Victoria Beaney) who is James’ Significant Other. By 0200 hours on Sunday, Bean (having driven), Alasdair (who had trained up and, as an aside, I recommend giving Newcastle Central Station a pretty wide berth at midnight on a Saturday), Penny and I were assembled and visiting the Boy in relays.

He wasn’t a pretty sight.

The damage inventory is:

Damaged C1 and C2 vertebrae (transl: top two in spine), an unresponsive right pupil, a gash about 3 inches long on his jaw, a broken clavicle, about 10 broken ribs (some with more than one break) on the left of his rib cage and a collapsed lung. He was on food drips, saline drips, 4 lots of drug drips and a life support (breathing thing) machine.

Since this is intended to be a quick update, I’ll close on the accident and the present position.

The Accident

He crashed, hard, into some rocks and ended up badly injured and scrunched up.
I’ve spoken on the phone to the ‘Good Samaritans’ who got to the scene of the crash first. One, Jim Stilling, is a paramedic, the other, Jonathan May, is a trained first aider. He was airlifted out by helicopter officer i/c Colin Clark (North Air Ambulance) and enjoyed (!) a 19-20 minute ride to NGH. I’m not going to write much about what they said. The keyboard isn’t waterproof. Suffice it to say, these marvellous guys saved his life – the expression used was that he received Rolls Royce treatment on the ground. So more on that, anon.

The Present

James has been in and out of surgery to repair his damaged body.

The first was an operation to connect base of skull to C3 and C4. This immobilises his head and so protects his spinal cord – this took some 3-4 hours on Monday afternoon. Tuesday saw a tracheotomy. On Thursday, he had an operation on his ribs, using what looks like Meccano on the X ray, to hold the bits of broken bone together. As an Ironman, he has now been upgraded to feature titanium, which we understand is a lighter and stronger material. This lifts the 15 or so pieces of rib off his left lung, helps him to breathe, means that the bones will knit together suitably aligned, preserves the capacity of his lung and reduces pain in the short and long terms.
There’s no question that he’s on the mend. The reactions are back to external stimuli, he also responds extremely well to Bean (and follows her instructions – other than when she tells him to let go of her hands), Penny and the rest of us get responses on hand grasping and eye-opening. This is particularly encouraging for Bean – it’s clear that he recognises her particularly and is obedient for at least some of the time (wise man). Penny and I gave up trying to get any obedience years ago. His medics are pleased with his progress – it’s gradual but they have told us not to expect him to sit up suddenly and invite us off down the pub for a few beers. We can wait – he’s coming back.

I’ll close on a few acknowledgments – many thanks to all who’ve prayed for him (including the congregation of York Minster, Gary and Flora & Co and the Sisters of the Order of the Holy Paraclete and the Speldhurst community), to John & Rosamund, Veronica Beaney and Poole siblings who’ve visited and looked after us, to, Dave, Brett, Martha, Aaron, Rosie (and baby Lucy – what a tonic she is!), Kim & Tom, Hinksy & Kirsty, Cols and Charlotte who’ve come to Newcastle, also to all who have thought of/texted/rung us and sent their support. We’ve also had welcome hospitality from friends in Newcastle, Claudia and Iona (and James).
I would also like to acknowledge the support, sympathy and understanding that the employers of the Core Team (Penny, Alasdair, Bean and me) and, of course, James have given us. So, many thanks to Willis, Total, ABMA, Godwin Symons’ clients and the Nuclear Decommissioning Authority.

With love from us all,

Penny, Bean, Alasdair and me.
Team Poole still standing!