Chapter 127
The next morning they were rudely awakened by a loud crash of thunder and the sound of rain beating up against the bedroom window. Louisa jumped and clutched hold of him, "Martin!"
He was just as startled, but held onto her firmly. "Shush, it's just thunder. The rain is also very heavy, can you hear it now?"
"Oh, it frightened me for a minute, there. I thought the house was falling down!"
"No, not quite. This house has been here for more than a century. I'm sure it has seen bigger storms than this."
She raised herself up to look at his bedside clock. "Still too early to get up, even for you." She lay back down and looked up at him. Her hand began to wander across his chest.
Smiling he put his arm around her and drew her close, before kissing her gently. "We'll just have to wait and see what else will happen then, won't we?"
The rain continued to hammer down, but they were lost in their own world and didn't notice.
Eventually Martin's alarm went off and he groaned slightly, which woke Louisa. She blinked, blearily at him. "Is it still raining?"
"Pouring down."
"Look on the bright side, Martin. This will probably keep the malingerers away!"
"Hm. You might be right there. I'm going for my shower. You stay there."
"Yes, Handsome. I'll just do that."
He was smiling as he went into the bathroom.
Louisa snuggled down under the blankets and began to drift back off to sleep. When he came out, she was snoring, so he got dressed and left her there.
He made his own breakfast, and then the restorative espresso. The letterbox rattled and he went to collect the papers. However, it was the post which had arrived. (Dave must have been up early, he thought.) He picked up the envelopes and sorted through them.
Going back to the table he sat down and opened them, choosing the PCT one first.
"Good morning, Dr Ellingham,
I write to inform you of my impending visit on Tuesday. I will be there by 10:30a.m. and look forward to meeting you.
Yours sincerely,
Gary Matthews.
Martin grunted. He'd probably have to rearrange the appointments of some of his patients.
He went through the rest of the mail, some electricity and gas bills, a reminder he was due for a dental check-up and various bits of advertising junk. Nothing for Louisa.
A second rattling of the letterbox indicated that the papers had now arrived, although when he checked his watch, he knew he would only be able to have a cursory glance at them.
There was nothing of immediate note which caught his eye, so he left them on the table and went to the consulting room to peruse the patient notes for this morning's visitors. The door was open and he heard the phone ring and then a voice saying, "Mrs Peters. Sorry Doc. Have to cancel this morning's appointment."
He removed the docket for Mrs Peters from the pile in front of him. Ten minutes later, John Appleyard called to cancel, quickly followed by Mary Albright.
He was now down to only 10 patients. Plus any walk-ins, which given the weather, seemed very unlikely. Pauline's voice calling "Mornin' Doc," echoed through to him.
"Yes," was his monosyllabic reply.
She clip-clopped through to the kitchen and prepared her coffee. After she returned to her desk, she checked the answerphone. "Three cancellations, Doc," she called out.
"So I gathered."
At 8:30 his first patient, Robin Banks came in to be signed off the sick.
"How are you feeling, Mr Banks?"
"Quite well, Doc. At least I ain't coughin' no more."
"Open your shirt for me, so that I can listen to your chest."
Martin waited to one side until he could place his stethoscope onto bare skin. He listened and then moved to the other side. All he could hear sounded normal. "Have you any more pains in your chest, or arms Mr Banks?"
Banks shook his head. "Nah Doc. I feel much better now. I took that medicine just like you said, an' I'm much better."
Martin signed off the sicknote and handed it over. "Come back to me if you get a recurrence of the coughing."
"OK Doc. Thanks." He took the proffered paperwork and left.
Next in to see him was Carrie Wilson. From previous meetings he knew she had hypochondriacal tendencies. "Yes Mrs Wilson, what can I do for you?"
"Oh Doctor, I've been having a lot of pain in my chest. Do you think it could be the onset of a heart attack?"
"I'll need to ask you some questions and have a listen to your heart before I can formulate any diagnosis, Mrs Wilson. Please unbutton your blouse."
After she'd complied, he used his stethoscope to listen to her heartbeat. All sounded as it should.
"Mrs Wilson, can you describe the pain you feel?"
"Yes. It's a burning sensation in my chest. I've had it for a few weeks now."
"Have you changed your diet, recently?"
"Not really, although I have discovered this new Indian restaurant in Delabole. Their food is absolutely delicious. Have you tried it?"
"No. Mrs Wilson, how often do you eat spicy foods?"
"Well, I like spices and have them for most of my main meals. The Indian food has been a new addition since I found the place about 6 weeks ago." She batted her eyelids at Martin, looking for a response, but got nothing other than his usual deadpan expression.
"Do you have any other symptoms you've noticed?"
She blushed, "Well I am passing more wind than I used to. I've lost some weight as well. Perhaps you can tell?" She leaned forward to enhance her bosom.
"It sounds to me as though you have developed an intolerance to spicy foods, Mrs Wilson. I suggest you cut back on the fancy foods and resume a blander diet. If you still feel the same in a month's time, come back and see me."
"So I'm not having a heart attack, doctor?"
"No, I don't think so. It seems it's more likely to be indigestion from all the spicy food you now take."
"Oh. Well thank you doctor. I'll do as you suggest." She got up and left, somewhat irritated that it was just indigestion.
Martin sighed. "Next patient!" he called.
Joe King came in.
"How can I help you, Mr King?"
"I've got a pain in my right leg. It seems to be getting worse."
"Whereabouts in your leg?"
"Me calf, Doc. Just here." Mr King pointed to where the pain seemed to come from.
"Have you had any falls, or been bumped by anything?"
"No, Doc. It just started up last week. I thought it would go away on its own, but it hasn't."
Martin got up and pulled the screen out from its folded position. "Go behind the screen and lower your trousers to the floor. Call me when you're ready."
Mr King did as he was told and then called, "Ready Doc."
When Martin went to look at him, he eyed both legs and could see that the right one was swollen, compared to the left one. "Would you stand still, and I'll look at your calves from behind."
The view from behind showed that not only was the right leg swollen, there was also a red rash beginning. "I'm just going to touch your legs, Mr King." Martin warned the man so that he didn't startle and fall. Again there was a difference in the temperature between the two legs. The right one was much warmer. "Alright, you may get dressed now."
When the old man returned to his seat, Martin told him, "I think you have a deep vein thrombosis, which means that a blood clot has developed in your right calf and is stopping the flow of blood through your veins. Can you get someone to take you to the hospital for an ultrasound scan?"
"I can drive Doc, I can take meself."
"No, you need to get someone else. There is a danger that the clot could break up and travel through your body to your lungs. This could result in what we call a pulmonary embolism, and is potentially life-threatening. Therefore somebody else needs to drive you. Today."
Mr King's eyes widened. "Oh. Oh well, in that case I can phone me son, and he'll come to drive me."
"Please do so, and I will inform the hospital you are on your way."
Joe took out his phone and called his son. "Maurice? Can you drive me to the 'ospital? Doc says I need a scan straight away. Yes, it's important, I wouldn't have bloody phoned you, otherwise. I'm still at the surgery. Pick me up from there!" Mr King said, "Sorry Doc, for swearing. Kids!" he tutted.
If y'er right Doc, what will they do?"
"Once they've scanned your leg it will show how your blood is moving through your leg. While you're waiting for the scan, they will probably give you an injection of heparin, which is a blood-thinning drug. Assuming there is a clot, they will probably prescribe a course of warfarin, another anticoagulant, or blood thinning, tablet. The course of tablets will last at least three months, and then you will be re-assessed."
Mr King nodded to himself. "Will I be OK after that?"
"You should be, but the hospital will ask you things like – how much exercise do you take, do you smoke, have you had a clot before?" Obviously if you do smoke, they will recommend that you stop. You should get plenty of exercise and not sit in an armchair all day."
"Right Doc. Thanks. I'll go and wait in reception for my son to come."
When the old man had gone Martin contacted the hospital and requested an immediate scan, adding his suspicions about a DVT. Luckily the person on duty had dealt with Martin before and was therefore much more cooperative.
Martin quickly wrote the notes of the visit and then called for the next patient.
"Next two have cancelled, Doc. You've time for a break before the next one is due in." Pauline suggested.
"Yes. I'll do that."
Louisa was sat at the table drinking tea when he walked in. she looked up and smiled, making him draw in a deep breath.
"Good morning. Are you well, after the excitement of the storm?"
"Morning Martin, yes, I'm fine. The aftermath left me a little tired, but in a good way. I slept in a for longer than usual." She grinned at him.
Blushing, he just said "hmm." And proceeded to make his own drink.
"You were right, about this morning. Three patients have cancelled, and so far, no-one has walked in."
He'd just sat down to drink it when Joan's "Only me," reverberated through the kitchen.
"Morning you two," she said as she carried in a tray of left-over veg. "It's raining cats and dogs out there!"
"Hello Joan, would you like a cuppa? I've only got a couple of biscuits, but no cake to offer?"
"Thanks Louisa, the tea will be enough." she cast a pointed glance at Martin.
Martin offered no comment simply asking "How are you, Auntie Joan?"
"I feel better than I have done for some time, Marty. Those tablets you gave me, seem to be working."
"Good." Was his only response.
"I'm going home to batten the hatches and read for the rest of the day. What are you two doing?"
"Well I'd thought about going into Wadebridge for a look-see, but like you I'll settle for a quiet afternoon. Maybe some housework, but I'm sure I can hear a book calling!" Louisa laughed as she said the latter part.
Martin chipped in with, "Read my BMJ's. I'm getting very behind in that."
"Oh, what exciting lives we do lead. Never mind, the forecast for tomorrow is for wind, but also sunshine."
"Did you hear that thunder this morning, Joan? It nearly scared me half to death! It must have been nearly on top of us."
"No, I'm happy to say I didn't. When I'm asleep I'm more or less, dead to the world."
"Right, I'll have to go back. My next patient is probably waiting. Bye, Auntie Joan. Louisa."
"See you later, Martin." She smiled at him and it made him feel better.
Joan and Louisa spent the next half hour discussing events in the village and surrounding areas. Eventually Joan said she must go.
"Thanks for the veg, Joan. I might make some soup for lunch with that."
"No problem, Louisa. It would only go on the compost heap if you didn't have it."
Once Joan had gone, Louisa set to and tidied up before making the soup. They didn't have any fresh crusty bread so she made some croutons to put on top. Satisfied, she went upstairs to tidy the bathroom and bedroom.
The rest of the day worked out pretty much as they'd expected.