Tag Archives: Operation

Tornado Tawse

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It was Jacqueline’s turn to earn herself a new nickname this week. Irene and I were standing discussing something (something very important you understand, we would never stand around gossiping) when something whizzed past us so quickly that it was almost invisible. My eyes tried to follow, but the thing moved so rapidly that I wasn’t able to focus. Fortunately Irene’s younger eyes were more efficient.

‘It was Jacqueline,’ she said with a smile. ‘She’s just so fast all the time.’

I couldn’t help but grin. ‘That’s true,’ I said. ‘The only way you can tell if she’s been there, is because everything  is suddenly tidy.’

‘Yes,’ Irene agreed. ‘Everything sparkles after she’s whisked through.’ And so Tornado Tawse was born.

But by now there was a sad look on Irene’s face. ‘When do I get a nickname?’ she asked. ‘Nearly everyone else has one.’

‘What about Scary Boss Lady Junior?’ I said, but she shook her head.

‘It has to be something like Magne’s, you know, starting with the same letter.’

‘You mean something like Impetuous Irene?’ I said. She looked at me suspiciously.

‘What does Impetuous mean?’

I thought about that for a moment. I didn’t know the Norwegian. ‘Well, jumping into things without thinking about them. Kind of crazy and wild.’

At this point there was a disturbance of the air, and we realised that Jacqueline was hurtling past. ‘Hey Jacqueline,’ I called out. ‘What’s impetuous in Norwegian?’ (Jacqueline is Norwegian, born of British parents, so she is bilingual).

Jacqueline stopped, but after a moment’s thought, she admitted that she didn’t know either.

‘Why?’ she asked.

‘We’re trying to think of a nickname for Irene. Something starting with ‘i’,’ I said.

An evil grin spread over Jacqueline’s face. ‘Irritating?’ she offered. ‘Irrational?’

Irene’s eyes widened as she glared at Tornado Tawse. ‘How about Irresistible?’ she said. ‘Incredible? Inspiring?’ I was glad to see she was smiling again.

‘Actually,’ I said. ‘I think that Impestuous Irene, is my favourite.’

‘What does that mean?’ she asked.

‘Absolutely nothing,’ I replied. Personally I like it. It may be a made up word, but it definitely suits her.

Thursday was a whirlwind day. It started quietly, and I had time to clean both the dental room, and the lab before the first operation, which was a cat spay of Marita’s. It turned out to be rather a difficult one, as the chest was quite deep and the ovarian pedicles were tight and so I scrubbed up to hold everything out of the way so that she could tie them off safely. It all went very well.

After we had finished, I saw a beautiful English Setter going into Magne’s room, and something made me follow. There then followed an interesting history taking session between Magne and the owner, which I managed to follow almost in its entirety, despite the fact that both were speaking quite quickly. I also, to my pleasure, came up with the correct diagnosis. The pleasure was only related to my diagnostic prowess, however. From the owner and animal point of view, it wasn’t great news because the lovely dog was suffering from pyometra. For those who don’t know, pyometra is an infection within the uterus. In some cases this is obvious because pus is discharged, but in some cases the cervix is closed and there is an internal build-up, and that is particularly risky as there is a chance of rupture. Magne and I took the bitch through to the ultrasound machine, and Wivek came and confirmed the diagnosis and measured the size of the uterus, which was quite distended.

I was unsure whether Magne would have time to go ahead with the operation immediately. Dagny wasn’t there, and she normally assists, but as the dog was already sedated, it was better to go ahead. I considered offering to operate alone (with Jacqueline to monitor the anaesthetic) but as it is normal here for two vets to work together on such operations, I didn’t want to risk anything going wrong. I’ve done many such operations alone in Scotland, but they were quite a long time ago now.

Anyway, after only a short consultation with the owner, and with Gerd, Mellifluous Magne announced that he would go ahead with the operation. He asked me to get the patient prepared while he saw his last patient of the morning, so with Jacqueline’s help I put in a catheter, set up a drip and intubated her. Jaqueline had set up the anaesthetic machine, and very smoothly everything was set in place.

The operation went amazingly well. I repeated my actions of the cat spay, holding everything out of the way for Magne to tie off the ovarian pedicles, and the enormous uterus was removed safely. All that remained was for me to stitch up, and Magne seemed delighted with that too.

After lunch, I helped Marita with another cat spay. It’s an odd thing. Normally a bitch pyo would be a complicated operation, and a cat spay straightforward, but not on this day. Cat spay number two was very unusual. Again I scrubbed in as Marita was having difficulty locating the uterus, and between us, we eventually managed to find what seemed to be the left ovary, which looked cystic. Odder still though, there was no uterus attached. We called Dagny through, just to make sure, and for a moment, my heart was in my mouth. If she immediately pulled out a normal uterus, I was going to look rather stupid, however she only found the same thing as we had, so after a brief discussion, she told us to go ahead and remove the one ovary that we had found. It was very unusual. There had been no sign of a scar on the midline when we went in, and after the operation, we carefully felt the cat’s flank, but there didn’t seem to be a scar there either. Anyway, after I had sutured the second cat-spay, it was time to go home, and I collapsed into my car tired but happy after a very busy day.

It only remains to say that the Julebord (Christmas party) is tomorrow. Irene, Jacqueline and I are all getting together for a beauty session. Irene always looks stunning, so I’m relying on her to do me proud. Hopefully there will be some photos to share.

Co-Operation

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Tuesday morning began well with Dagny and Magne operating to remove the most enormous piece of detached cartilage I have ever seen from a dogs shoulder joint. It went so smoothly that I had a good feeling about the remainder of the day. Reality reasserted itself when I went through and carefully laid the dog in the kennel… and stood up, bashing my head off the door of the left upper kennel. Instinctively recoiling, I ricocheted and thumped the other side of my head on the door of the other kennel. It was that kind of day.

Next came a mammary tumour, which I had seen on the computer. I confess I had expected a dog (I saw the operation, and didn’t check the species because mammary tumours in dogs are incredibly common, and in cats incredibly rare). Again the same pattern, the operation itself went very well. I was doing this one on Magne’s behalf because he was running slightly behind schedule. As I inserted the last stitch, stripped my gloves off and walked out of theatre to wash my hands, Mobility Magne rushed into the room, brandishing a cat cage at arms length.

‘Can you do something with this,’ he gasped, before disappearing. I confess, I was somewhat surprised, but as the most disgusting stink assailed me, I realised that the cat in question had deposited something utterly rank in the cage. Luckily I have a strong stomach, so without further ado, I cleaned up the mess. Being a vet really is a very glamorous job. I am reminded at such moments, of James Herriot, comparing his vocation with that of a small animal surgeon and humorously self-deprecating as usual. He mentions that after his operations, “the final scene would have been of Herriot the great surgeon swilling the floor with mop and bucket”. Well even though I now work in small-animal practice, it’s not so very different. ReMorseful Magne (see what I did there) did proffer a partial explanation later when he told me that the awful smell was literally making him gag.

In the afternoon, I had a cat spay booked in, but somewhat to my surprise, two turned up. The owners, after being told by Magne that I sutured very beautifully, had asked that I be allowed to spay their cat, but they seemed confused when they arrived and saw only me. They had been expecting Magne to supervise. Fortunately at this moment, the man himself turned up and smoothed everything over. The highlight of my afternoon however, was when Irene was attempting to shave up the second spay for me. Because most cats here are spayed midline, she needed to be reminded of the landmarks I use when deciding where to incise. She had the cat laid out on a chair and seemed to be paying close attention as she felt around for the bony protuberances of the hip and thighbone. Finally, she found what she thought felt right.

‘Am I in the right place?’ she asked. Rounding the corner of the table to take a look, I was somewhat surprised to see her eyes were close to shut as she concentrated fiercely on what she was feeling, and that one of her fingers was on the shoulder and the other somewhere on the neck.

‘Um… well it would be if the cat was the right way round.’ I commented with a giggle. Fully expecting her to join in with my hilarity at this very funny joke, I was amazed when she opened her eyes wide and looked mortified. She really hadn’t noticed.

‘This stays strictly between us.’ Red-faced, she tried to silence me, but unfortunately nothing so amusing ever stays private here and she did continue giggling at herself for at least half-an-hour, so I guess she must have seen the funny side. I fear she may try to get her revenge by commenting to mention the very loud fart I let out when I was bending over to clean the floor in room B last week, but of course everyone will know that couldn’t possibly be true. I could never be so crudie.

Thursday morning began with a Caesarean. Dagny and Magne again, working as a team. Magne did the first part of the operation while Dagny revived the puppies, and then Dagny took over to stitch up. There were four healthy puppies, which is always a lovely event. Dagny had only had two hours sleep, but was still working as efficiently as ever. I have a feeling that her amazing cheekbones can get her through almost anything because she looked as good as ever too. Fortunately after the operation, she was able to go home and get a couple of hours sleep before the lunchtime meeting.

This weeks picture shows Wivek operating. It doesn’t get much more glamorous than this.

Fest!

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There’s only a week left until Christmas, but there is still lots going on in Tu. Tuesday started with a bitch spay. The patient was a lovely little dog, and naturally her owner was worried. Happily, with Dagny and Magne’s nimble fingers, the operation was very swift and her owner was hugely relieved to see her friend back safely. Even with surgery that seems routine to us,  for every owner it’s a unique and frightening experience.

For some reason, every time I walked into the laboratory, Marita was there using the hairdryer. We have quite a lot of technical equipment in Tu, but there are also some much more down-to-earth items that we use, and the hairdryer is one of them. It’s used on microscope slides to dry the material before staining and to me this is usually a very prosaic action, but as Marita stood there with her left foot at a rakish angle, right hand merrily oscillating, she looked very glamorous. Maybe in a previous life she was a stylist to a famous film star.

Although the day was busy, somehow in the afternoon, Magne and I managed to sit down for a cup of coffee. I think it must be a first for us to have time to do that. As well as coffee, Magne took a chocolate from his advent calendar and immediately afterwards he began to cough. I wondered whether he was so over-excited that he was choking, but when I asked he assured me it was only kennel cough and he acquired it because he hadn’t been vaccinated with sufficient aquavit.

Thursday was the day of our Christmas lunch in the klinikk, but before that, I had to help Magne clean out a dog’s ears. Pio, who weighed in at about seventy kilos was probably the biggest dog I have ever seen. Happily, he was also very good-natured. He and I had a lovely cuddle.

Pio
Pio

As for the fest (party) of the title, everyone in the clinic was invited, including the large animal vets whose office is in the same building. In the UK, an office Christmas party might consist of crisps and mince pies, or on a good day, sausage rolls and turkey sandwiches. Here they serve risgrøt, or rice porridge,  which is liberally sprinkled with sugar and cinnamon, and garnished with butter. I still always find it slightly disconcerting to be presented with a plate of rice-pudding for lunch, but it’s definitely not objectionable. Somewhere in the risgrøt, there is usually an almond or two, and whoever finds one wins a prize. In this case, the winnings were three large bars of chocolate, and they were won by Gerd, Jaqueline and Jan-Arne.

Of course, no Christmas party would be complete without the Christmas Banter. This year it was provided by Scary Boss Lady and her Whipping Boy. It began with Dagny laughing at Jan-Arne for the fact that he had been caught for a second time leaving his trousers on the  floor of the changing room. Then she asked,

‘Is it true as well that you came to work in your pyjamas?’ Jan-Arne flushed slightly, but valiantly defended himself.

‘Well at least I don’t scuff my feet along the ground when I come in in the morning.’

Dagny frowned and shook her head. ‘I don’t scuff my feet.’

‘You do. Everyone can hear when you arrive.’

Dagny opened her eyes wide. ‘It isn’t true,’ she said and looked challengingly around the room. ‘A show of hands please, who can tell when I come in?’

I fear that the vote would have been unanimous, if only I had been keeping up properly with the conversation, but as usual, I was five steps behind.

I suspect that Dagny is one of those people who believe that attack is the best form of defence, and so she returned to a subject that had been going on since before the meal had started.

‘Well at least I didn’t open the chocolates that were meant to be eaten with this lunch. I think you should give your bar of chocolate back so we can all share it. Without another word, Jan-Arne carefully lifted up his prize and slid it into his pocket.

But all in all, it just goes to show, that however much effort you make, and however far you travel at Christmas, there will still always be someone who has to argue over who it was that ate all the chocolates.

Holiday

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Even after many years, I still greet Christmas and the New Year with a heightened sense of joy that I don’t have to work on either day. All round the world, many wonderful people in the emergency services give up those days to help others, and I send my good wishes to all my friends and colleagues who have been, and will be working over the holiday period this year. I expect when I return tomorrow, there may be a few Christmas related cases. It only takes a moment or two for a dog to eat something that he or she shouldn’t, and chocolate and raisins can be toxic for dogs, as well as the simple problem of too much turkey.

Last Tuesday, the day began as I walked through the prep-room on the way to change into my uniform.  Linus, (whose picture you can see at the top of the page) had been very ill and vomiting for a few days, and he was in a lot of pain and seemed utterly exhausted. His abdomen was so painful that Dagny had to sedate him to examine him properly, and when she did, she could feel something. Whatever it was, it wasn’t visible on the x-ray (some items show up clearly, but not all do) so the only way to help Linus was an exploratory operation. His owners were naturally very fearful. Linus is eleven years old and as the lump wasn’t visible on the x-rays, it could be anything from a peach-stone to a tumour.

As Dagny readied herself for surgery, I prepared Linus for the operation. The monitors attached, I was concerned to find that the oxygen levels in Linus’ blood were very low: not very surprising as I could see that his gums were pale, nothing like the fresh pink colour they are in a healthy dog. I turned the intravenous drip as fast as it would go, and kept the anaesthetic levels to a minimum as Dagny began to cut.

It didn’t take long for her to locate the lump, and it was immediately obvious that it was a foreign body and not a tumour. The gut was inflamed where whatever-it-was had already passed through. I opened up the set of special clamps and the  multiple packs of gauze I had ready and Dangy placed them around the gut to keep everything clean.

Pausing for a moment, she looked up and smiled. ‘What do you think?’ she asked. ‘I’m betting on a kongle!’ Kongle is Norwegian for pine cone. Her attention firmly back on her work , she cut carefully into the segment of intestine and drew out what proved indeed to be a section of pine cone. Poor Linus. No wonder it had been so painful.

From that point in the operation, it was obvious that things were improving. As Linus’ guts began to function again and the fluids from the drip got to work, his oxygen levels climbed from sixty-two right up into the high nineties, which is where they should be when everything is functioning well.

‘Would you mind just quickly going and telling his owners that it wasn’t a tumour?’ Dagny asked, as with the hole in the gut closed, she began to stitch the abdominal muscles. ‘They were so worried.’  As everything was stable, I was delighted to run through and tell them. What better Christmas present could there possibly be for me and them?

There are one or two things I find difficult about being an assistant. It’s not so easy for me to telephone owners and ask for an update, as I might do with one of my own patients. But I hope that the signs that I saw during that operation boded well for Linus and that he and his owners have had a wonderful Christmas together.

Merry Christmas everybody.

 

Benedict who?

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New Year is almost here. I feel I have come a long way in 2014. Strange to think that less than a year ago, I drew up outside Tu Dyreklinikk and decided it was too daunting to walk in and ask if I could look around. I’m glad I changed my mind. That decision allowed me to meet some wonderful new friends, and has given me the opportunity to return to a life I hadn’t realised I was missing so much.

As I said in my last post, I was pleased that I was not working over Christmas. Jan-Arne was however, and somehow he managed to get himself on the front page of our local newspaper, JaerBladet after a Japanese Akita called Frøya accidentally got hold of a whole fruit and nut bar. Happily for Frøya’s owners, Jan-Arne was able to treat her, and by the next day, she was fine.

The picture at the top of the page is another of Jan-Arne’s patients. Lukas is a young Staffordshire Bull terrier with itchy skin. Feel better soon Lukas.

This week, I have only worked one day because New Year falls on a Thursday. I spent most of yesterday in theatre with Magne and Wivek. As usual I was on anaesthetic duty and it was an interesting day for me as Wivek was trying out a new form of pain relief called Recuvyra. Recuvyra is an opioid pain-killer, which is applied to the skin of a dog under its coat. It lasts for four days, so for operations which require analgesia for a few days, it is a good alternative to remaining in hospital, or coming back in for several days for injections. As always with new treatments, it will be interesting to hear from the clients how they got on. Yesterday’s patient, a sweet little Tibetan Spaniel with a displaced hip, seemed very stable throughout her anaesthetic and contented during the recovery period so I hope that when she went home, everything continued to go well. I remember when I started out in veterinary practice, there was much less consideration given to pain-relief, and very few pain-killers readily available. It’s one area where I feel the veterinary profession has made enormous leaps in progress and it is important for our patients that we keep up.

There were a few things that made me laugh. Obviously my Norwegian is still patchy, as when I asked Wivek how big the bladder dog was, (a lovely Schnauzer which was suffering from stones in her urine) she told me it was about the size of a grape. She was referring to the stones of course. No idea how I would go about anaesthetising a dog that weighed less than a box of matches.

For some reason, I was having difficulty with intravenous catheters, probably because Wivek was watching, and she always makes it look so simple. It’s much easier to find the vein with good lighting, so before I made my second attempt of the day (on the Schnauzer), I walked over and switched on the big overhead light. Except somehow, I got the wrong switch. I confess I was surprised when the light failed to come on, but not quite as surprised as Magne, who suddenly found himself plunged into darkness as he waited for us in the operating room. His face was a picture as he emerged.

The high point of the day though, was the moment when Wivek and I were discussing the Christmas period.

‘I went to see a film yesterday,’ she said, and gazed into the air for a moment. ‘I can’t remember the name of it though.’ She shrugged and then looked down to continue her suturing.

‘Not very memorable then,’ I suggested.

She frowned. ‘Good film, not a good name,’ she said. ‘It was about Alan Turing.’

‘Oh,’ I said. ‘The one with Benedict Cumberbatch?’

I have never seen such a blank look on anyone’s face. ‘Benedict who?’ she said. ‘I don’t know his name. The one who played Sherlock Holmes.’

I confess I was astonished. I thought that everyone in the universe knew who Benedict Cumberbatch was. Even if we had woken up the patient and asked her in dog language who it was that played Sherlock Holmes, she would probably have barked his name. So there you have it. If you want to consult Wivipedia, it’s probably better to stick to animals and Norwegian cookery. Whatever you do, don’t consult her about Tom Cruise. For her that would be Mission Impossible.

Anyway, to all of you who have supported me this year, thank you very much. I can hear fireworks outside already. By midnight, the sky will be bursting with light and colour. Happy Hogmanay, and I hope you have a wonderful time in 2015.

 

 

Heartwarming

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We do get asked some bizarre questions now and then. This weeks prize goes to one of Jan-Arne’s clients, who wanted to know whether we could do a test to see if his dog was gay as he had failed to show interest when presented with a bitch in heat. Although he was almost certain, Jan-Arne, conscientious to the last, came to check with me and invited me into the room to look at the patient. Of course, there was nothing significant to find.

‘He just doesn’t like women,’ his owner commented to me after I had checked out his pet’s (entirelly normal) testes. It crossed my mind to reply that his dog seemed to like me perfectly well, but he seemed like a lovely man and he had been kind enough to speak in English after all (one of only two non-British clients who chose that path this week).

‘Some men just don’t.’ I replied with a shrug. ‘It’s nothing to worry about.’ Of course, it may be that given another bitch, his dog might change his mind. Love can be a fickle thing.

It has been a week of contrasts and working every day this week has meant I played a full part in all the drama at both ends of the spectrum. It is often the case that when a very old pet is reaching the end of its natural life, there comes a time when it needs a great deal of care. Sometimes just how much is brought home to an owner when they are faced with the decision of how to find someone to take responsibility for their animal during the vacation. It isn’t always possible. Even if you choose to take a holiday where your pet goes on your journey with you, it isn’t always suitable for an animal that is nearing the end of its life to travel at all and sometimes difficult decisions have to be made. The contrast to this has been seen in the number of kittens I have seen this week which have been found and adopted by their finders. The real generosity of some of our pet owners is deeply heart warming.

There was no sad ending for Ludwig, a delightful young Cairn terrier. Ludwig first arrived at the clinic on a Sunday evening, vomiting and in agony. After initially thinking that his pain was abdominal, Marita quickly discovered that poor Ludwig was actually suffering from a testicular torsion. He was given strong pain-killers and his excruciating condition was resolved by careful castration of the affected testicle.

To Marita’s delight, when he returned on Tuesday, as soon as Ludwig saw her across the waiting room, he  launched himself towards her and greeted her with delight. It has often been a source of rueful irony to me, that having loved animals enough to become a vet,  so many of them regard me with at best, suspicion and at worst, fear and dislike.  The only times I have seen this truly reversed was in the emergency clinic. It happened enough to convince me that when an animal comes into the clinic in real genuine pain, and you are the person who gives them relief, then there is no doubt that they feel grateful. I think anyone experiencing this would be left in no doubt of the complex nature of a dog’s consciousness.

I asked Ludwig’s owner if I could take his photo for my blog, and as he was too busy sniffing around the consulting room to pose, Marita picked him up for a cuddle. He immediately took advantage of the situation by kissing her most enthusiastically. Despite the fact that Marita likes him very much indeed, I’m not sure she enjoyed the experience as much as he did.IMG_6515

 

 

 

 

 

 

IMG_6516IMG_6514Still, understandably, she was both happy, and delighted with his reaction. There are few things better than knowing you have done a great job, especially when the result is seeing a lovely young animal make a full and happy recovery. If they like you as well, that really is the icing on the cake.

 

Todays featured image is of Turbo Trine, Irene’s lovely dog, who had been in to have her teeth cleaned.

 

Bottom

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Monday morning, Marion and I headed up to Ognaheia. Sandwiches and coffee and some Norwegian scenery. I was feeling good.

IMG_4724

Monday night saw Marita, Jacqueline and me heading into Stavanger for some Continuing Professional Development (CPD). VetScan (the diagnostic imaging company, which carried out the MRI on Lusi) will be starting up in Stavanger later this year, and Stavanger Smådyrklinikk had invited a speaker from the UK to come and talk to us about CT scans. Although it was interesting, it went on later than I had thought, and as I drove home at eleven o’clock, I found myself feeling unusually tired.

Tuesday morning dawned, and I was still tired. I couldn’t really understand this, as there was nothing obviously wrong, so I drove to work, and dragged myself around, trying to find some enthusiasm for cleaning. I realise that enthusiasm for cleaning sounds almost like a contradiction in terms, but usually I find an odd enjoyment in it at work, but on this day I was very relieved when Magne claimed me to help him with an operation.

The patient was a young Yorkshire Terrier, which had an inguinal hernia, and happily for me, her anaesthetic was very stable. It’s always a relief when the oxygen sats remain steadily between 98 and 100 percent. I found myself watching Magne as he carefully worked around the defect, meticulously dissecting away some protruding fat and tying off the larger blood vessels. Having closed the hole, he turned his eyes to me and smiled.

‘What are you thinking?’ he asked.

I confess that at that particular moment, I wasn’t feeling all that well, and what I was actually thinking “I wonder if I passed out, whether Magne would attend to me first, or whether he would stay sterile and just call for someone to help me”, however it seemed melodramatic to say that and my brain seemed stuck. Faced with my dumb silence, he fortunately made things easier for my befuddled mind.

‘What do you think? Is it closed?’ he clarified. With relief, I said I thought it looked good, and he continued with the task of closing up the wound. I don’t know whether  Irene sensed something was wrong with me, but happily she came into theatre and gave me a hand at the end of the op. I was very glad she was there, as I just felt dysfunctional.

Of course, after twelve, I have started to consult. Fortunately the flow of adrenaline did seem to help a little. It was another male dog with urinary tract problems, and so at least, after last week, I felt I had some idea of what I was looking for. Before they arrived, I went into the consulting room that Magne usually uses, and tried to sit down. Somehow as I tried to hoist myself up, the chair slipped away from me, and I sat down very suddenly on the ground. Limping through, I found Marita.

‘Have you broken your tailbone?’ she asked. ‘Do you call it a tailbone in English?’ I was able to assure her that I hadn’t.

‘It’s only my bottom that’s broken,’ I told her. I didn’t enjoy the consultation. I don’t feel it went very well, which I guess wasn’t surprising under the circumstances, but I do know that with Wivek’s help, everything was done very thoroughly.

Wednesday night was really odd. I had felt unwell most of the day, and the night was riddled with weird dreams. At one point, I dreamed that Magne was sweeping the floor, and with admiral logic, I worked out that I must be dreaming. After all, I concluded, Magne never sweeps the floor. Having at some level congratulated myself for my deductive abilities, I went back to sleep and for some reason Magne made another appearance, but this time he seemed to have gone crazy. This time I was more confused. I couldn’t be sure that I was dreaming as although I could be certain Magne wouldn’t sweep, it definitely didn’t seem impossible that he could go mad. With hindsight, the fact that Magne’s irrational behaviour involved turning over a table and sitting cross-legged trying to fish in the underside of it using a rod made of spaghetti might have been a bit of a giveaway. I think possibly I might have been a bit feverish at that point.

Suffice it to say, I didn’t go to work yesterday. I wasn’t looking forward to phoning in, but Irene made it easy for me.

‘Have you got the flu as well? she asked. ‘Dagny has been struggling with it all week.’ I don’t know whether it’s flu, or some other virus, but I am certainly exhausted. So if you have read all this, and it doesn’t make much sense, then I can only apologise that you have wasted the past five minutes. Still, at least I have made it out of bed today. Maybe by next Tuesday, I will be smart enough to start consulting again. For the moment, daytime TV is beckoning. Have a good weekend.