Family Money: “Leaving on a jet plane...”
By Leslie
Wright,
Managing director of Westminster Portfolio Services (Thailand) Ltd.
So you want to be a carefree expat.
Are you sure you’ve tidied up your UK tax situation?
In common with many overseas tax authorities, the UK Inland Revenue
assesses tax status and liability on a case-by-case basis according to
general principles - and it can get complicated.
Regrettably, most offshore IFAs are not qualified to
give expert tax advice to UK domiciles, let alone other nationalities!
Some offer simplistic solutions - “Put it all into a trust” - which
may be fine for some, impractical for others.
For instance, you can’t readily transfer real estate
into a trust - and certainly not the villa in Ibiza or Phuket. This would
have to be sold to a company first and the shares assigned to the trust -
which may generate capital gains tax, not to mention complications with
the bank if you’d mortgaged the property - not to mention the problems
that might arise later if the heirs wanted to divide or sell the property,
only to discover that Thailand doesn’t recognise offshore trusts, and an
offshore company cannot own real estate (other than a condominium) in
Thailand.
Unless your situation is very simple, and your UK
holdings minimal, it is generally best to deal with the UK IRD through a
professional tax adviser such as your UK accountant - who himself may have
little idea how offshore investments or trusts work. You may well need
more than one experienced professional to guide you through the
ramifications.
In any case, the IRD should be informed in advance of
your departure by completing form P85 to declare that you are going. (A
range of guidance leaflets and forms may be downloaded from the IRD
website, www.inlandrevenue. gov.uk)
If you’re away from UK for less than a full tax year
(6th April to 5th April) you will remain liable to UK tax. To avoid tax on
your foreign earnings and income, you must be non-resident in the UK for
at least one complete UK tax year, as discussed in the IRD’s guidance
leaflet IR20.
And no matter how long you remain non-resident,
you’re still liable to tax on income derived in UK, such as property
rentals, dividends, etc., which should be declared in an annual return.
Banking & Finance
Many expatriates arrange their financial affairs around
two bank accounts. They have a local bank account to fund day-to-day
living expenses in the country they are living in; and a secure offshore
bank account in which to receive salary payments and in which to
accumulate savings, or keep their cash reserve.
Since the introduction of international anti-money
laundering regulations, you can no longer march into a country with a
suitcase of cash - as many expat residents of Pattaya once did. If you
transfer a significant sum of money into the country where you are going
to live, for example to buy a property, this may have tax implications.
Keep all records of the inward transfer and of what you then do with the
money.
In Thailand, for instance, you can only get Central
Bank of Thailand permission to transfer money out (except for trivial
amounts) that had previously been remitted in - and to your own bank
account (not the girlfriend’s.) Nowadays, your local bank may ask what
any inbound remittance is for, and issue you with a Tor.Tor.3 certificate
if the money’s going to be used to buy a condo, or a Tor.Tor.4 if it’s
for other purposes.
Planning an Investment Strategy
Living as an expatriate can be an opportunity to build
up wealth. However, not all the investment opportunities you encounter
will be right for you. Never let greed blind prudence. A prudent
investment strategy would be to start by building up a cash reserve in
secure offshore high-interest accounts.
As you develop your expertise, you may become
interested in other opportunities, including offshore funds investing in a
range of markets and different types of asset. For many capital investors,
buying units in funds through tax-efficient collective investment vehicles
such as offshore insurance bonds is the simplest and most flexible way to
go.
In any case, you should take professional advice before
you commit your money to anything new. If you are reluctant to make your
own investment decisions, one option is to use a specialist
portfolio-management service.
Your UK Tax-Efficient Portfolio
If you have pre-existing ISAs (individual savings
accounts), you may continue to hold them while you are non-resident for
tax purposes, but you may not make further ISA investments until you
resume UK residence.
You would be similarly ineligible to invest in most
other UK tax-efficient investments while you are non-UK resident. For
instance, you may not be able to keep up UK tax-efficient pension
contributions while you are overseas.
Depending on the period you expect to remain offshore,
it may be appropriate to invest in offshore savings plans - either
open-ended or for a fixed term - to make up for this. But remember to
discuss the long-term tax-efficiency of any such plan with your IFA before
making any commitments.
UK Property
You can sell your UK property, or find tenants to rent
it, or leave it empty. If you sell, you liquidate an asset that might
otherwise be a worry. The proceeds can be reinvested in a flexible
offshore tax-efficient vehicle which could be conservatively stanced for
safety - for instance, an offshore insurance bond holding only
money-market funds, with-profits, property and TEP funds, rather than
higher-risk funds which could lose value in a market downturn.
If you rent out your existing UK property, you might
use a property manager to find and manage tenants, collect rents, pay
bills such as property insurance, and forward mail. One useful contact
might be the Association of Residential Property Letting Agents (ARLA).
As mentioned earlier, you are liable to tax according
to income tax rules on rents you receive from your property, which should
be declared to the IRD. Full details of the Non-Resident Landlords scheme
can be found on the IRD website.
It makes sense to insure your property adequately
against the usual risks of fire, flood and theft, but also against tenant
damage and vandalism - and this should be done before your departure.
Ensuring you’ve clarified and tidied up your tax
situation will enable you to enjoy your life as an expatriate with one
less worry.
Personal Directions: Taking time out
By Christina Dodd,
founder and managing director of Incorp Trining Associates
How long has it been since you had a really good holiday?
One, two three years ... longer? How long has it been since you were able to
be on your own for a whole day and do the things that you wanted to do, and
not what everyone else wanted to do? How long has it been since you had time
to yourself to just think without any distractions? Probably far too long is
my guess. Time to ourselves - our own private time - is a very rare commodity
indeed these days.
Personal quality time is something most people treasure but
are unable to attain. Work and getting on with the daily chores in life take
so much energy and effort it seems like the idea of finally being alone to
pursue some of the things you enjoy doing moves further and further out of
reach. I’m not meaning to sound selfish when I talk about personal quality
time - I just think that it is an important aspect of our lives that needs to
be fulfilled and not pushed aside and forgotten.
We need to take time out to reflect, review, rebuild,
enquire and discover more about who we are and where we are going. We need
time to indulge in the things that we like doing purely for our own
gratification once in a while to remind us that we, too, exist and need to
quench certain desires. But with all the distractions going on around us at
our busy offices or in the home with the young ones, how can we achieve that?
How can we take that so well deserved rest or break from the chaos?
The reality of it is that most of us don’t and we end up
with increasing stress levels and declining states of health. Tempers flare,
we get cranky and grouchy and are really not nice people to be around. We tend
to complain and whinge more often than not and never give a kind word to
anyone because we are so miserable with our own lot. Sounds like a pretty
horrible place to be doesn’t it? Sadly, however, a lot of us live there.
Being pulled in several directions at once, juggling
multiple priorities, lamenting about the difficulties of not having enough
time to enjoy the pleasures of life, and handling all sorts of pressures and
stress can lead to feelings of being totally overwhelmed, overworked and not
appreciated by anyone.
One of the more rewarding sides of my training career has
been my involvement in a series of programs that have enabled people to
literally take time out and to review their own personal energy, to see where
there’s a power outage, where a fuse has blown and begin the process of
repairing the damage or putting preventative measures in place. This also
includes looking at how we use our time and energy and how we might use those
assets differently to achieve the results we want in a more relaxed, content
way. Knowing what we need to operate at our own optimal level and being clear
about what is important in our lives can enable us to make better choices
about how and where to focus our energy and efforts.
In many ways we all need direction both in a professional
and personal sense. Being all grown up doesn’t necessarily mean that we have
all the answers and make no mistakes. We suffer as we grow into older adults,
and the learning process is never over. We have to continue to devote some
time to this process, and if we don’t, we are in trouble.
I recall a program I conducted in Singapore with a group of
executives who had been highly stressed-out and were in great need of catching
their breath and bringing their pace back to within sound and healthy limits.
They were incredible achievers setting what they felt at the time were
realistic and achievable targets. And not taking anything away from them -
they performed brilliantly for the company. But not without a price to pay -
their health - which also had a ripple effect on their professional skills
which had an effect on the staff around them and so on.
Of all the activities and materials designed for the
program which ran over a two day period, they seemed to give the greater
response to those sessions which looked at the inner child and the building of
relationships, moments of self assessment and reflection, times of sharing
their deepest thoughts and desires. In terms of the inner child, they spent
time pretending to be seven years old all over again, remembering the happiest
times of their childhood and colouring in their dreams on large pieces of
white paper with bright new crayons. It was a time to be peaceful and alone in
their thoughts which was something these young executives had not been able to
experience for a long time. They seemed to take on the characteristics of
playful children in a playground.
They took to sharing their private thoughts and personal
secrets with their partners in the training, like ducks take to water. After
this experience it was almost as if a great burden had suddenly been lifted
and they were able to discard a lot of emotional baggage that had been
creating problems and causing anguish in their lives. Finally, at the end of
the program, they were then ready to move forward with a deeper understanding
and awareness of themselves and of what was most important in their lives.
Finding focus and having the time to devote to doing this
proved to be a very worthwhile experience for this group of young people. It
was an investment well spent and allowed those executives to maintain their
positions and to go from strength to strength. Of course this kind of program
has become an integral part of the company’s training schedule and is
considered a vital safety valve in what the management regard as a
pressure-cooker industry. But I believe that all fields of industry need to
take a closer look at the people that they employ and their particular
professional and personal needs. It’s always wise to practice a bit of
preventative medicine rather than having to find a cure.
Humans are extremely resilient and have strong instincts
for survival. They fight back and bounce back in extraordinary circumstances.
But despite this, they need to be constantly reassured and accepted. They need
to be regarded as important and require certain levels of attention that some
times we overlook. In the workplace it is crucial that employees are treated
this way. This does not mean pampering to their needs without thought and due
consideration. It does mean realizing that every employee is an individual
first and foremost, and through building on their existing qualities and
strengths and improving upon their personal and interpersonal skills, they
will become better equipped to perform in their roles as managers and leaders,
presenters and communicators, team builders and team players.
I am continually surprised by the ability of people. Some
have a natural talent or gift to excel and some require coaching and guidance.
But at the end of the day, everyone has their own unique attributes and
strengths that drive them forward. To take time out to “top up the tank”
or to “give more flavour to the stock” is such a small price to pay when
we look at the possibilities that lay ahead and what can be achieved.
Until next time, have a great week!
Should you require our assistance in providing some quality
“time out” for staff at your company or organization, please don’t
hesitate to email me at christina.dodd @incorptraining.com or contact me at
Incorp Training Associates in Bangkok.
The Doctor's Consultation by Dr. Iain Corness: Have you got piles? And I don’t mean money!
Piles are one of the most common ailments around.
Embarrassing and often a pain in the bottom, to coin a very apt phrase! The
medical term for Piles is Haemorrhoids, which shows why we don’t commonly
use that name - too long and too hard to spell! I have often said that the
reason that the medical course is 6 years is that it takes 5 years to learn
how to spell the long words, but then, I’m joking of course.
So just what are piles and do you get them from sitting on
wet grass? Let’s deal with the grass first. You do not get Piles from
sitting on anything, be it grass, newly mown or otherwise. End of the grass
story. Piles are simply ‘varicose veins’ of the anus. You see, around the
edge of the anus there is a very rich plexus of arteries and veins and it is
possible for the veins to become distended and eventually form a grape-like
structure that can even protrude from the anus itself. A classical “Pile”.
The biggest problem with Haemorrhoids is acute bleeding.
Embarrassing as mentioned before, but can actually be such as to run you out
of iron and you end up anaemic. Other symptoms include local soiling,
discomfort and prolapse. You can also get a thrombosis in one of these
protruding piles that can be very painful indeed. Ask anyone who has ever had
one (or two).
There are lots of theories as to why we get haemorrhoids.
Many women feel that they are the result of pregnancy or straining during
childbirth, but since men get them as well that would appear to shoot that
theory down in flames. A lack of dietary fibre has also been given the nod as
a cause, but personally I am not convinced, as many people with great fibre
diets still get Piles. Constipation and straining at toilet does appear to
have a bearing, but I honestly feel that the real reason relates very simply
to our stage of development in the history of mankind.
My theory (Darwinian, I admit) is as follows - we used to
walk on all fours, like all the other quadrupeds. Look at our first cousins,
the monkeys, and they are still wandering around with knuckles in the dirt,
but many moons ago after seeing our reflections, we decided we looked better
standing on our hind legs, so we learned to walk erect. This was fine, other
than the fact that the valves in the veins in our legs and ano-rectal region
were not up to the additional pressure the column of blood was exerting from
the heart, now a metre or so higher than the valves. Straight out
hydrodynamics.
Fortunately Piles are relatively easy to fix, and the
common rubber-banding technique will be successful for most. The only real
danger in this condition is in ignoring the bleeding, thinking, “It’s only
piles.” As mentioned before, this bleeding can lead to anaemia, but the
biggest problem can be the fact that rectal bleeding might just be a symptom
of cancer, and not haemorrhoids, and it is possible to have both complaints.
The answer is to never ignore bleeding (from any cause) and
get your doctor to check. It may be embarrassing - but it could be life
saving.
Agony Column
Dear Hillary,
Recently I was walking to my favourite bar when the
skies opened up. I was ducking in and out of doorways trying to dodge the
rain. Outside a tailor shop my wet shoes slid on the shop’s ceramic
tiles and I totally lost my balance. I reached out and grabbed hold of a
portable rack of neckties in an attempt to steady myself, but I crashed
onto the tiles with a pile of gaudy coloured neckties falling on top of
me. I must have hit my head because for a moment I didn’t know if I was
in Thailand, tile land or tie land. The tailor came out of the shop
gesturing wildly with his hands and shouting at me in his native tongue.
Why can’t shop owners use non slip tiles in their premises, am I under
any obligation to wash or pay for all those ties that are now just a soggy
mess, and where in Pattaya can I learn the Indian language so that I can
interpret what the tailor was yelling at me?
Mighty Mouse
Dear MM,
You certainly do seem to bring trouble on yourself,
don’t you, Petal. Now you are getting tied up with Indians and wondering
if you should learn another foreign language and cement more ethnic ties,
or was that get the ethnic cement off the ties? The first aspect of this
problem is tied in with where you were walking. You should know by now
that footpaths outside tailor shops are for displaying gaudy shirts, wind
cheaters which say JAG - UAR or FER - RARI and the aforementioned racks
full of ties. They are not for walking on, and even if it is raining that
is no excuse. Now as far as your problem with getting tongue-tied when
discussing family ties with Indian tailors, this is not a huge setback, as
they all speak Thai. So try Thai regarding the tie. There you are Petal,
I’ve really tried for you this time!
Dear Hillary,
I am getting married in a couple of weeks to a
wonderful Thai girl who has never given me any problems like all the ones
I read about in your column Hillary. However, the other day she asked if I
minded if some of the people from her village called in to see her, so I
just said OK, but when I got home there was about two dozen of them all
over the house, in front of the TV, lying on the settees, sitting on the
steps and drinking beer. If they had said excuse me or something like that
I would not have been so annoyed, but they stayed there for two days
before they went back. Every night I had to pick my way through all the
bodies. I really cracked up in the end and they left. Now my girlfriend is
sulking and she is giving me a hard time, because I raised my voice in the
house. Do you think I was being unfair, Hillary? Or is my girlfriend being
unreasonable? I think I really have to clear this up before the wedding,
so can you answer quickly. If it costs some money for a quick reply
that’s OK too.
The Groom
Dear Groom,
Costs some money? Costs some money? How dare you,
young man! I will have you know that there is complete transparency in all
of Hillary’s dealings. Money? I do this column as a service to the
readers, not as a way of gaining income. (Anyway, the old skinflint’s
salary he gives me wouldn’t even keep me in one box of chocolates and a
bottle of beer a month, let alone champagne! Not that I am hinting, mind
you!) So back to your pre-event problems. All sounds a bit like Groom’s
Fairy Tales to me. Are you sure you are not suffering from cold feet? It
is quite normal, you know. You should also have known by now that this is
normal behaviour in Thai families, and that is what you are joining. You
live in Thailand, you are contemplating marrying a Thai and you will be
responsible for all of the family’s needs, be that feed, water or money,
or even medicine for the buffalo. This is expected, as well as showing
that you have ‘jai yen yen’ (a ‘cool’ heart). Your fianc้e
is upset that you have not shown jai yen yen, even more than she is upset
at your not welcoming her village people. I think you have to groom
yourself a little more before becoming the groom, Mr. Groom.
Dear Hillary,
I have noticed that you are always telling the
foreigners who write in that they should learn the Thai language. Does
that include the writing as well? I wonder if this is really all that
necessary, as in all the bars I go to the girls speak English and in
hotels it is easy to find people who speak English, don’t you agree?
English Ernie
Dear EE,
Try driving around up-country and reading the (Thai
only) road signs if you don’t think it is important to read Thai. As far
as speaking the language is concerned, wait till you are fluent and you
will find out what the girls in the bars really think of you after the
usual welcome, “Sexy man, sit down please!”
|
Camera Class: Phame as a Photographer!
by Snapshot
Any camera owner who has ever read any photo books or
magazines will have heard of famous photographers who are still remembered for
their art. Names like Ansel Adams, Henri Cartier-Bresson, Irving Penn, David
Bailey and Joel Myerowitz spring to mind, but you can add David Hume Kennerly to
that list. Now I must admit I did not know of this chap (who is still very much
alive, by the way) until my photographic friend Ernie Kuehnelt brought him to my
attention.
Photo by
Henri Cartier-Bresson
Turns out that Kennerly is a Pulitzer Prize winning
photojournalist who has covered 8 presidential campaigns in the US and shot 35
covers for Time and Newsweek, which are 35 more than you or me. However, what
brought him to the fore was a project he did in the year 2000. His goal was to
record world life and culture, especially in America that year. To do this he
travelled across 38 states and 7 countries, taking black and white photographs.
One a day!
The diverse shots, and they are truly diverse, from shots of
his sons looking at his broken leg, to a vacant parking lot in South Carolina,
have been put together into a show which is on display in the celebrated
Smithsonian Institute in Washington until December 29th this year (you can still
get there if you hurry).
Now the article this week is not to get you to book a flight
to the US of A, but is to show you that by having a project you can produce a
body of work that can become an important work of art and even make you famous.
If you don’t believe me, try this. A lady decided that on
her birthday she would have a photo of herself taken in the nude. She was in her
early 20’s from memory, and now, 30 years later, she is still doing this
project. Every birthday, a birthday suit picture! Medical science got to hear of
this and it turns out that this is the only existing record of personal aging in
the world, to span such a distance in time. We all have photos from our teens
over which we wince when we see them and compare them to how we look now, 10,
20, 30, 40 years later or whatever. But do you have the intervening shots? And
one a year, catalogued? Of course you don’t.
So what can you do to get yourself into the annals of
photographic history? The answer for the average photographer has to be a
progression of some type. This photographic work stands on the fact that you are
recording something happening over a period of time. It is not a body of work
that exists because of its great photographic technique.
Now some of these have been done before, but here are a few
ideas to get you started. Record a flower opening and closing - one shot every
hour during the daylight. Place them side by side, in order from the left, and
you have just made a photographic statement. (By the way, it must be from the
left, because we read from left to right, unless you are into some Arabic or
Chinese writings.)
Did you ever see the film “A Zed and Two Noughts”? In it
they recorded, by serial photography, the decomposition of once living tissue,
dogs, cats, etc. The finale was the “stars” arranging time-lapse photography
of their own demises. You could extend your flower shots to include the birth
and death of the flower. Again, this would be an interesting piece of work that
would really tell a story.
So can you see where I am headed? A temple from dawn to dusk, a mountain
taken every day for a week, a baby every day for a year. The subjects are only
limited by your imagination. Let it work over time and give you a photo project
to work on. You never know, you could end up being exhibited in the Smithsonian
Institute.
Recipes from Rattana: Chicken Fried Rice (Khao Pad Gai)
This is a real Thai standard that can be had at any
restaurant or roadside eatery. You can substitute pork for the chicken, or even
shrimps or crab, or a combination. This is a great recipe to use up what is
left in the refrigerator! The cooked rice should be yesterday’s as well!
Ingredients Serves 2
Chicken breast pieces 1/2 cup
Vegetable oil 2 tbspns
Tomato, thinly sliced 1
Soy sauce 2 tspns
Ground pepper (prik Thai) 1 pinch
Fish sauce 2 tspns
Egg 1
Pre-cooked rice 1 cup
Onion, chopped 1/2
Garlic, minced 2 cloves
Medium red chilli sliced 2
Cooking Method
Heat the wok with the oil until it is very hot (smoking) and
very quickly stir-fry the chicken. Push the chicken to one side of the wok and
crack the egg into the pan and quickly scramble, chop into small pieces and
then place to one side with the chicken. Add the day old cooked rice and all
the other ingredients and mix them all together with the chicken, egg and rice.
Stir fry, mixing all the time for two minutes and sprinkle with ground white
pepper.
Serve with sliced cucumber and two wedges of lime.
Battling the Crab By Leslie Wright: Part 5 of a 6-part series about fighting cancer
Side effects
In my case, I had been prescribed a cocktail of four
chemotherapy drugs, which were each administered over a three-day period,
together with significant amounts of intravenous saline solution to flush
the chemicals through the body. Obviously one has to be a hospital
in-patient for this; and in my case, the regime called for six sessions,
about 3~4 weeks apart.
As things turned out, I was again one of the fortunate
ones who suffered relatively few side effects. Some people feel constantly
nauseous and cannot keep any food down; I was relatively unaffected in this
regard - but it’s wise to stick to bland food.
The first week after each round of in-patient
chemotherapy I felt more or less okay, but the effects generally hit in the
second week. Indeed the oncologist recommended I take convalescent leave
during this period. I would ache all over and feel like I had had a bad dose
of flu. There were days when I could hardly crawl from the bed to the
bathroom. I’d have little appetite. I’d constantly develop gas in my
stomach, which soda water helped a lot to relieve. I’d be constipated for
days on end, despite taking laxatives prescribed for this expected side
effect. Not pleasant, but many people have it far worse than I did.
The chemotherapy also significantly affected my white
blood count (WBC), lowering it to near-danger level. I was advised to be
very careful to eat only cooked foods - steamed or boiled, not fried; and no
raw foods like lettuce, and to peel fruit, since germs on the skin and
surfaces could do me real harm whilst my immune system was in a weakened
state.
The third week I’d start to feel better, and if my WBC
was up above the critical level, we’d schedule the next round of
chemotherapy. Otherwise, we’d postpone it for a week.
While white blood cells last only a few days, and are
quickly regenerated by the body, red blood cells last about three months,
and are not so quickly regenerated. As the months passed my red blood count
(RBC) was also slowly dropping, to the point where at month 4 of treatment I
was having to inject myself every third day with a drug to stimulate red
blood cell production. (And this drug was expensive: Bt.4,900 per one-time
syringe!)
The after-effects of the third round of chemotherapy were
probably the worst, and by the sixth round I was feeling significantly
better.
Of course, in the initial period I was undergoing daily
radiation therapy (which involved travelling up to Bangkok and back to
Pattaya every day, 5 days a week - a tiring journey at the best of times) as
well as chemotherapy, so it is not really surprising that my strength should
have suffered during this period.
After the first round of 24 radiation treatments, we then
scheduled another round of 12 treatments, focussing on the other vertebra
which on the MRI-scan had showed signs that it might have a cancerous
lesion. (It wasn’t definite, and the only way to have been sure would be
to do a bone biopsy, which is invasive and apparently very painful, so we
elected to go ahead with the radiation therapy - just in case.)
After the tests at the end of round 6 of chemotherapy
showed that I was effectively in remission, my radiologist recommended that
I should undergo a further round of 20 prophylactic radiation treatments on
my brain.
The reason for this is simply that while the chemotherapy
drugs will have penetrated all the organs of the body and hopefully killed
any microscopic lesions that may have been developing elsewhere than the
main tumour site, the chemotherapy drugs do not cross the blood/brain
barrier, so will not have ‘cleansed’ the brain. And 30% of small-cell
carcinoma patients develop lesions in the brain. And these can lead to
blindness and/or deafness and/or dumbness and/or short-term memory loss
and/or long-term memory loss and/or paralysis and/or death, depending on
where they are located. Not a pleasant prospect, and one which I’d rather
avoid if possible. So it seemed a good idea to proceed with the prophylactic
(preventative) radiation treatments, which meant once again travelling back
& forth to Bangkok every day for the whole month of June.
I had been warned that one of the side effects of the
radiation would be total hair loss - my hair, after turning completely white
within one month of the initial diagnosis, but never falling out completely,
had actually started to grow back and regain some colour. But as I write
this I have only about 24 wispy strands left - but it’s fashionable these
days to be bald, and as my radiologist pointed out, I save money on shampoo.
Another of the side effects would be my face turning red,
like a bad sunburn. I was not told that my skin would also dry up and itch
constantly - and the temptation to scratch has to be resisted, because one
would inadvertently break the skin and end up with unsightly scabs.
Having one’s brain ‘fried’ causes it to swell,
which results in headaches; fatigue is another side effect, but
paradoxically, although I felt constantly tired, I couldn’t sleep
properly. That started back around month 2 of chemotherapy, and my
oncologist had prescribed some mild sedatives to help in this regard.
(To be concluded next week)
A mother’s worst nightmare Part
5
By Lesley Warner
The following morning she left to book into the hospital
in quite a nervous state worried about the first of the operations. She said
she didn’t want to be put to sleep again. The operation was on the Monday
for 4-5 hours so we knew that we couldn’t see her, the surgeon had already
said that her injuries were complicated and that was why there were several
different doctors, specialising in different fields, involved in her case.
They planned to take skin from the buttock for the
shoulder and hand, and skin from the good eye for the bad eye. When we
arrived we didn’t really know what to expect and she looked very
uncomfortable with a cast on her right hand and arm, in a sling hanging from
a drip stand. There was a dressing on her eye and she was wriggling around
with a sore backside and neck. It turned out that there was not enough skin
on the good eye so they took it from her neck the results were excellent.
She had looked skeletal before having no flesh beside the eye; the surgeon
had built it up and remade the eyelid.
When I questioned the fact that they had not mended her
bones and only patched the hole in the shoulder, they said it was because
the orthopaedic surgeon was not available and the shoulder needed a metal
plate, pinning and possibly muscle from the chest wall. They were unsure of
whether it was a muscle or nerve problem. I asked when they would fix the
shoulder and I was told vaguely when the graft was healed; maybe 6 weeks,
bearing in mind we were already into the 6th week after the accident.
At this point I was losing patience and understood the
horror tales of the NHS. I said to the doctor, “In case you hadn’t
noticed there is a perfectly good hand on the end of that arm.” He
answered, “Yes I see your point.” I then said, “What about the bone
broken in her wrist on the bad hand?” I could tell the doctor didn’t
know she had a bone broken between the wrist and thumb. He obviously
hadn’t read her medical notes.
The middle finger was wired but would be no use because
of infection and the index finger is indescribable having no bone above the
knuckle, at least they cut off the top of the thumb and grafted a new bit.
The doctor said they will do more work with them but Emma decided against
amputation in case there are other options available in the future.
Eventually when they removed the cast after a week they
had to put a special plastic mould around the wrist to prevent more damage
to the thumb, and then decided that she should have been wearing a sling for
6 weeks to prevent the movement in the bad shoulder. The arm was now hanging
on the front of her body and the wound had moved from the front to the back.
I asked Emma how she felt about her friend who was
driving, and she answered, “How would you feel about your best friend? She
doesn’t stop being my friend just because she was driving. She didn’t do
it on purpose did she?” I can’t feel the same and cannot bring myself to
talk to the girl and neither can Emma’s husband, but maybe it’s
different from our side, we were the one’s that nearly lost her.
Now she just has to wait and see what improvements will
be made from the future operations, but she has great healing powers and an
enviable determination. It’s difficult to explain, I suppose I thought she
would be different but she’s not, she’s still my beautiful Emma.
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