Monday, 28 September 2009

The Blue Box

I am feeling so much better that I am beginning to wonder what all all the fuss was about. My temperature is down to normal and the infection seems to have gone. There is some residual gunk and coughing but it is as nothing compared to last week. It will take another week or so before I'm back to what passes as normal for me but I can live with that.

I would certainly have ended up on a respiratory ward at St Helier or the Brompton Hospital had it not been for one particular piece of kit. At times of crisis our home can resemble a reasonably equipped emergency facility what a BiPap ventilator, a nebuliser, ceiling hoists, profiling bed, air mattress, Oxygen, a drugs cabinet with a significant street value, and a blue box the size of a large bread-bin, known in our home as 'the cough machine', but more technically, by my consultant at least, as a Cough Assist Mechanical Insufflator-Exsufflator.

The Cough Assist Mechanical Insufflator-Exsufflator is a genuinely life saving bit of tech. Without it I would either be dead or on permanent ventilation. The machine works by clearing secretions by gradually applying a positive pressure to the airways and then rapidly switching to negative pressure. Apparently the rapid shift in pressure produces a high expiratory flow, simulating a natural cough. The reality is more akin to having someone Dyson your lungs on full power. The effect is unsettling and uncomfortable but infinitely preferable to hours of ineffectual hacking coughs that simply exhaust you, or, sessions of chest pounding physiotherapy that induce near psychopathic hatred of the person pummelling you.

Way back in 2000 I was very ill with Pneumonia resulting as a complication from Pancreatitis. I was in intensive care and high dependency wards for months and for most of the time had a tracheotomy. A tracheotomy, for those unfamiliar with the procedure, is where someone, preferably a doctor, makes a hole in your neck and feeds a tube into your lungs for air to be drawn through, or, as in my case, for someone to stick a suction tube in and vacuum your lungs for gunk. Having a nervous F2 wielding a scalpel at your throat while you are passing out from lack of Oxygen rates pretty low on my list of things to do again. The advantage of the cough machine is that it is totally non-invasive. It removes secretions without the need for someone sticking a plastic straw through an unnatural orifice in your neck. I'm not sure how much such machines cost but they must be cheaper than spending days, weeks or months in hospital.

Even today, when I am feeling so much better, I have already used the blue machine twice. Once again I am grateful to be living in a country with a national health service that provides such equipment free at the point of need.

In the light of all above, it might seem churlish to moan about another freely provided piece of absolutely necessary kit, but this morning, just at a critical juncture in the preparation for a shower, my new multi-thousand pound, state-of-the-art, rinky-dink wheelchair stopped working. The control panel LCD screen simply states there is a system error and the thing refuses to budge. Fortunately, the ever unreliable Serco, have failed to collect my old wheelchair and so I am back in that until an engineer with a degree in computer science can get here tomorrow. I have had the new chair ten days, most of those I've been too ill to do anything other than sit, so I doubt the problem is overuse. Mind you, I wouldn't put it past Matty to have reprogrammed it to play Marvel Ultimate Alliance 2.

Until next time.


  1. I am familiar with the cough assist! Technology is a blessing.

    Oh no about the broken chair! Maybe we should send it a "you better get well really fast" card. Glad you have the backup.

  2. I don't think you are being churlish to moan about essential kit. As a taxpayer I am appalled that the British army have been sent into war zones without the correct equipment, and it is equally galling that you don't have a chair that works properly. Surely it has been tested for reliability before you, as the end customer, get it. We live in a first world country, and you shouldn't have to wait ages for these things to be repaired. They are a necessity and in this case someone has a job fixing it (unlike my pair of shoes). You didn’t ask for this illness, and the best is not too good for you.

    Thinking ahead, is there another one of these Cough Assist Mechanical Insufflator-Exsufflator’s to hand in case your main one breaks down? By to hand I mean somewhere a local hospital can get one 24-7. By the sounds of it, pretty good kit.

    You can manage without the new chair right now but what happens when they collect the old one. You need to speak to the McLaren F1 team. They should be able to reconfigure the programme remotely as they did for their road car back in 1991. After all why can't your chair be plugged in and remotely accessed?
    A warning though:
    If McLaren agree to do it, you will need a FIA Super Licence and can then take out Rubens Barrichello on the first corner in Japan, thus ensuring a Brit wins the world F1 title and thereby repaying the NHS all in one go.
    Glad you are feeling better.


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