Chapter 49
Martin was at his desk waiting for the next patient when his phone rang. "Ellingham."
"Hey Mart. I spoke to Carol and the 15th March is good for us. What time do you want us there?" Chris Parsons sounded delighted to be visiting them.
"How about 1:00pm, Chris. Are you bringing the boys, as well?"
"No, that's the beauty of that Sunday. They go to their grandparents that weekend, so when our time with you is over, we'll go and pick them up." Martin could hear the smile in Chris' voice.
"That's fine Chris, although they would have been welcome as well."
"Okay, Mart we'll see you on the 15th. By the way, well done on getting that fisherman sorted, from off that boat." Chris was pleased to pass on some good news for a change, instead of relaying complaints from Martin's patients.
"Just doing my job, Chris." Martin brushed off the compliment in his usual deprecating manner.
"Well, it is appreciated. Bye for now." Chris rang off, leaving Martin feeling somewhat gratified to hear that his efforts weren't going unnoticed.
Louisa went to school feeling pleased that it was nearly the weekend. Her classes were still as demanding but the glow of the approaching time off lessened the burden.
In the staffroom she was asked occasionally how she was feeling after her accident, and she was happy tell folk that she was improving every day. Pippa came over at lunchtime, "Got any plans for the weekend then, Louisa?"
"Not so you'd notice, Pippa. Just the same-old, same-old. Feels like a bit of a rut at times, but given I'm still recovering, probably just as well. What about you? Are you tripping the light fantastic?"
Pippa snorted, "not with two teenage boys in the menagerie! They've been invited to a birthday party in Delabole on Saturday afternoon, so I'll be press-ganged into taking them, I suppose. Sunday I'll be catching up with the housework I've not been able to do during the week!"
They nattered on until they were called back to their classrooms.
Louisa left early in order to go and see Dr. Lewis. As usual Martin went with her and they were both looking forward to the new scan which should show how the baby was growing.
On entering Dr Lewis' room, he bade her sit on the chair first. "How are you doing after your accident, Louisa? Have you had any problems such as muscle spasms, any bleeding?"
She was pleased to be able to report that she'd had none of those problems. "How long before I will be able to feel the baby move?" she asked him.
"It varies from woman to woman, but mostly in about the fifth month you should start to feel twinges. Have you felt anything now?
Louisa told him that she hadn't but that she wanted to know so that she was as prepared as she could be for when it happened. Her eyes sparkled at the thought.
"If you don't have any more question, perhaps you'd like to go through and prepare for the scan?
Once she'd left the room Dr. Lewis turned to Martin, "Have you noticed any after effects of her accident?"
"No, beyond the bruising, which was quite extensive. However, that is now fading and she has been able to return to work. She's told me that she has made the children go to her desk, rather than going to theirs, which means she doesn't have to bend down as much. She does appear to be well, but a little tired when she comes in. This is to be expected at this stage, though," Martin gave a brief synopsis of Louisa's condition to date.
Dr Lewis nodded and ushered Martin through to the scan room. As usual Louisa was readied for the scan. She gripped Martin's hand when he went to sit by her, and together they watched the picture build. Now Louisa could see outlines of what she took to be arms and legs as well as the fluttering heartbeat.
"Things look to be entirely normal, in there," smiled Dr. Lewis. I'll print off the pictures for you and then you can go, unless you've a question?"
Louisa smiled at him, "No I think I'm fine with that. Martin?"
Martin shook his head "I've not got any." His eyes were a little red, but only Louisa noticed.
Once they were back in the car, they looked at the pictures, with Martin pointing out the various features which were now solidifying into a proper baby!
On the way home, Louisa persuaded Martin to go to Bert's for their tea. He grimaced, but acknowledged that Bert had been kind to supply the chowder, and visit Louisa.
Bert had set up a corner table with screens around and a stove which gave off a fair bit of warmth. When he saw them coming, he was delighted. "Doc, Louiser, good to see you. You come for a meal, then?"
"If you've a spare table Bert, then yes please?"
"You can have this here corner table with the heater. Now let me get you the menus."
He waddled away to get them and was soon back. "Martin opted for his usual fish with veg and Louisa decided upon shepherd's pie with a small amount of veg. Water was to be their chosen beverage.
They waited for their meals but kept their coats on, because despite their coats and the heater, there was still a bit of a chill in the air.
Thankfully their meals were swiftly served and Bert stopped to enquire after Louiser's health. "Quite a scare, you 'ad there, I'll be bound. It's very good to see you out and about."
Louisa smiled and acknowledged his comment.
"Right, you enjoy your meal and I'll see if you want some dessert later." He smiled and walked off.
They finished their meals, thanked Bert, declined any desserts, paid their bill and retired to their home.
"Phew, said Louisa. I was starting to get chilly sat there."
"You sit on the couch and I'll make us a cup of tea." Martin took her coat to hang up and then filled the kettle.
"Bert looks as though he's still losing weight, Martin."
Martin nodded, but said no more.
"Do you want to go to Joan's tomorrow afternoon? Or have you something else planned?"
"Well, I thought I'd go and get my haircut, so I can drop you off, do that and then pick you up again?" Martin would be happy with some time to himself.
Louisa got her phone out and rang Joan. They talked for a minute, with Louisa saying they had another photo to show her. Joan was happy that they would be stopping by.
Martin awoke early and turned to watch Louisa. He switched his alarm off, lest it wake the sleeping beauty and gently reached out to touch her cheek. She murmured and simply turned over. He gave her one last adoring look and then got up.
Showered and dressed he went down to make his breakfast. He'd just sat down when there was a loud knock on the front door. "Now what?" he grumbled to himself.
When he opened the door, there was Mrs Tishell looking a bit harassed. "Yes, Mrs Tishell, what can I do for you?"
"Oh, Doctor Ellingham, have you seen this?" she waved a copy of the latest MHRA under his nose.
"Since I don't take that magazine, no I haven't." Martin's impatience was beginning to rise.
"It says, that several warfarin batches have been recalled due to a potential contamination issue. I know you keep some on hand and I thought you ought to know toot sweet, (tout de suite) in case you have any of those batches. Here, I'll leave you the magazine so that you can check for the recalled batches." She thrust the magazine at him and then went back down the hill.
"Thank you, Mrs Tishell," he called after her.
A wave of her arm was all the acknowledgement he got.
After he'd finished his breakfast and washed up, he took the magazine into the surgery and began to look at his warfarin supplies. He found a defective batch and decided to take it to the chemist later, so that she could see to disposing of it safely.
When the first patient came in, he was unsurprised to see Chippy Miller strolling in. He was however, surprised to see his arm already in a plaster cast. "What's happened there, Mr Miller?"
"Fell down some stairs at a pub in Delabole, Doc. Ambulance man took me to 'ospital and they said it were broken. They put the cast on and told me to contact you."
"Hm, I see. One moment Mr Miller." He reached out and turned on his computer. When it was fully operational, he checked his incoming mail, where he found a report pertaining to Miller's accident. He quickly scanned it and learned that Mr Miller had a greenstick fracture of the ulna bone. This type of injury needs support, which the cast supplies. It also takes about 6 weeks to heal.
"Did they explain at the hospital what the treatment of this would entail?"
"Only that I haven't to get the cast wet, and that it'll take a while to heal. I'm a fisherman Doc, how can I keep this dry?"
"Well Mr Miller, as you've often been in my surgery to try and obtain a sick-note, you will be pleased to hear you can have one for an initial four weeks. I would repeat to you not to get the cast wet and not to be doing any heavy lifting with that arm. Do not put anything under the cast to scratch your skin, as any itchiness will go away in a few days' time. Do you need any painkillers at the moment?"
Chippy thought for a minute. "I do need some tablets because me arm is aching. How do I keep the cast dry when I'm having me shower?"
Martin wrote out the prescription for the ibuprofen. "Take one of these tablets every 6 hours, during the day, for the next three days. Then take just one if you need it. Do you understand that? "
Chippy nodded.
"As for keeping the cast dry, get Mrs Miller to put a plastic bin bag over your arm and tie it at the top so that water doesn't get in. Then when you are in the shower keep that arm raised out of the water. When you are dry again, remove the bag."
"Ah, that's a good idea Doc!" remarked Chippy.
Martin rolled his eyes and said "Yes. Was there anything else? Good, make an appointment for four weeks' time. If you experience any more discomfort before then, come back and see me."
The next three patients required prescription renewals. Martin checked them all over and compared their current health with their case notes. All three of them needed more tablets. He wrote out their prescriptions and they all left to go and see Mrs Tishell.
The door opened slowly and Bert hove into view. "Mornin' Doc. Come to see you for a check-up."
"Right Bert, don't sit down, take your shoes off and stand on the scales." He waved at the scales in the corner.
Bert reluctantly did as he was bid and waited for Martin to record his weight. Martin sat back down and then said, "Well done, Bert. You've now lost 28lbs! You must keep going though, as you still have more to lose."
Bert grimaced, "Really Doc? I miss eating me puds and having me pints down the pub…"
"Bert, you were diagnosed with a progressive illness which I'm afraid, won't get any better. If you keep your weight down and maintain some fitness and eat healthily you will put off the day when you become more ill."
"I don't know if I can, Doc. It's getting harder and harder." Bert looked really down in the dumps.
"Did you ever smoke, Bert?"
"Why yes, before Al were born. Gave it up when Mary became pregnant."
"How did you kick the habit?"
"Took some doing, Doc. Time after time I wanted a drag, but I'd think about the baby and knew I couldn't do it. I remember pacing up and down trying to stop thinking about it. Eventually the craving left."
"This is similar to that, Bert. However, in the case of food it is much harder because you have to continue eating to stay alive. You can't stop eating altogether. Now, you knew you couldn't smoke around the baby, but you packed in the smoking. Al's obviously not a baby, but soon, in the not-too-distant future I expect he'll marry and possibly have children. Don't you want to be a grandfather?"
Bert looked shell-shocked. "You mean if I keep on eating the wrong stuff, I won't be around to play with my gran'kids?"
"I can't say for certain Bert, but there is a good chance that would be the case. I should also add that you may have left it too late anyway. My advice Bert is, think of your future grandchildren and moderate your food intake. Now, let's get some checks done on your heart and collarbone." He took out his stethoscope and listened to Bert's heart. Eventually he'd completed the information gathering and was able to tell Bert that his blood pressure had come down, which was a good sign and that the collarbone appeared healed.
"Right, Doc, I'll think on what you said. Thanks." With that Bert went out of the door looking like a man who had the world on his shoulders.
Lucy Merchant was next in. She described the first few days of her period as being extremely painful. Her flow of blood was very heavy. "Can you do anything, Doc?"
"How old were you when you first began your periods?"
"I were 14, Doc."
He checked her notes, and you are 17 now?"
"Yes."
"Are you sexually active, Miss Merchant?"
"No Doc, I don't 'ave a regular boyfriend."
"Describe the pain for me."
"I get a lot of pain here, (pointing to her lower abdomen) and an ache in my back. Sometimes when the pain hits my tummy, I'm bent double."
"Any diarrhoea, bloating, or headaches?"
"No Doc, not that I've noticed.
"Have you tried painkillers at all?"
"Yes, but they only slightly lessen the pain, and I feel like I have to have more of them." Lucy appeared very upset at this point. "Me Mam said it will go away eventually, but I dunno Doc, I've got exams coming up in 4 months' time and I can't concentrate."
"You may have what's called primary dysmenorrhoea which means that your body produces a large amount of prostaglandins. These chemicals cause your womb to contract and that causes the pain. I'll prescribe a course of stronger painkillers and we'll see where you are in two months' time. Does the pain last for the whole of your period, or just the first few days?"
"Just the first two days, Doc.
Martin nodded and wrote out a prescription for stronger ibuprofen tablets than those obtainable just over-the-counter tablets. "It's important that you follow the directions on the box and don't exceed the stated dose. You can also help yourself by drinking plenty of fluids, wear looser fitting clothes during your period and perhaps taking a hot water bottle to bed with you. Do you smoke, at all?"
"No, I don't smoke. I don't see the point of it."
"That's good, don't start smoking then, and you will save yourself a lot of trouble, later on." Martin was approving of this news.
"As I said, follow the instructions on the box and come back and see me after two more periods, alright?"
Lucy nodded, "Thanks Doc."
Two more follow-up checks finished Martin's morning.
He gave the patient notes to Pauline for filing and then told her he was going down to see Mrs Tishell.
"How come, Doc?"
"Just some faulty tablets to return for her to dispose of safely." Martin elaborated, holding back the urge to tell her that it was none of her business.
"Can I go after I've filed these, then Doc."
Martin agreed. "See you Monday, Pauline." He'd picked up the copy of the MHRA and was also returning that.
He caught Mrs Tishell just before she closed the shop. "I found a faulty batch of the warfarin. Thanks for your timely warning, and here's your magazine back." Martin handed over both of them.
"Oh, it was noo trouble Doctor Ellingham. Glad to be of assistance." She batted her eyelashes coyly at him.
"You will see the tablets are disposed of safely, won't you?" He asked.
"The manufacturers have asked for them to be returned, so yes, I expect that they will destroy them."
Martin nodded and left to go home.