It’s amazing the damage a little critter can do

My left leg – 20th August 2025 © Ricky Yates

Between 02.00 and 11.00 on Saturday 16th August 2025, I seriously vomited five or six times. During that Saturday, the lower part of my left leg, together with my ankle and foot, became swollen, red and painful. At the time, I didn’t associate the two events.

I assumed the vomiting was because of something I’d eaten. And my left calf and foot are always slightly bigger than their opposite numbers on my right leg, ever since August 2015, when a deep vein thrombosis (DVT) escaped from there and became a pulmonary embolism in my lung, as described in this post.

After a day of resting and not sleeping very well that night, on Sunday morning I was still feeling quite unwell and also not very mobile. So I made the reluctant decision that I couldn’t officiate and preach at the Frauenkirche that evening, the first time I’ve ever had to cancel a service since I took up my Dresden responsibilities almost ten years ago. Thankfully, my friend and colleague Andrew Allen, stepped into the breech.

After another uncomfortable night and no improvement during Monday 18th, late that afternoon, I decided the time had come to go to my local hospital in Decín and seek medical help. Fortunately, I had a friend staying with me, my first guest in my renovated upstairs rooms. We were unable to get a taxi and so Libor, husband of Sona, the boss of Restaurace U Soni, kindly drove us to the hospital.

At the hospital, I was seen by a nurse and had some blood samples taken. Then I saw the duty doctor who told me that I needed to be admitted to hospital that evening, in order for the infection in my leg to be treated with antibiotics and pain killers, fed intravenously. The doctor fortunately, had some English and used Google translate on his phone when he became unstuck. My friend got back to my house by taxi and the following day came to the hospital by bus, bring me clothes, pyjamas, toiletries etc.

The ward whilst receiving antibiotics intravenously © Ricky Yates

I took this photo from my bed whilst receiving antibiotics intravenously. It gives you an idea of the four-bedded ward where I spent three nights. Every morning, the doctor came around to see each of the patients. He only spoke to me in Czech, most of which I didn’t understand. He didn’t seem to have a word of English. Fortunately, a couple of the nurses spoke fluent English, the one who got me to fill out my consent forms was particularly helpful. Czech hospital food was as unappetising as I remember it being ten years previously in Vojenská nemocnice in Prague 🙁

On the morning of Thursday 21st August, the doctor told me that I was being discharged and could go home. That was one bit of his Czech that I did understand 😉 I was presented with four prescriptions, (two for further antibiotics, one for anti-inflammatory tablets and one for pain relief), and a two-page report about me and my time in hospital, obviously all in Czech. But from the report, I finally found out what I had been diagnosed with – Erysipelas.

Erysipelas, historically known as St Anthony’s Fire, is a bacterial infection of the skin and the lymphatic system. Its origin is the bacterium Streptococcus pyogenes, almost certainly caused by an insect bite. When I wrote this on Facebook, along with the photo of my leg at the beginning of this post, a friend commented that, ‘It’s amazing the damage a little critter can do’, a sentiment with which I completely agree and why I have chosen it as the title for this blog post. One of the symptoms of being infected with Streptococcus pyogenesis, is vomiting. The two events of the morning of Saturday 16th August were connected.

Whilst I’ve now lived in Stará Oleška for over eight years, I’ve remained registered with my GP practice, Young & Co, in Prague. This is for a number of reasons. They have looked after me brilliantly since my pulmonary embolism in August 2015. All the doctors have to be able to speak English. And going on a train trip to Prague once every six weeks to have my INR,(the level of thinness of my blood), checked, makes for a nice day out.

But having to travel there with a badly swollen leg, has been a little more difficult. So far I’ve been for five follow up visits, the first on Monday 25th August, the most recent on Thursday 25th September. Both my regular GP, Dr Josef Stonawski, and the boss of the practice, Dr Adriana Youngová, have been very helpful and supportive. Whilst the infection has been dealt with and I no longer have pain or numbness in my left leg, it is still swollen. Dr Youngová told me that I will probably have to take the anti-inflammatory tablets for up to three months which means I have another five weeks to go.

The other problem that has caused me to make frequent visits is that the antibiotics have totally upset my INR – a well-known problem. My INR is meant to be between 2.0 and 3.0. On 25th August it was 4.2. Having reduced my Warfarin intake, on 2nd September it was 1.6. on my last visit it was 2.9, just within range, but still rather high. And this has caused me further problems.

On my last visit to my GP practice, on the morning of Thursday 25th September, I had an appointment in the afternoon with my dermatologist, at Vojenská nemocnice. This was to investigate a scabby lump, near the bottom of my problematic left leg. Is it a Basel Cell Carcinoma to be treated with liquid nitrogen? Or is it a leg ulcer requiring different treatment? But to extract a small sample for testing would involve an incision in my leg and with my INR being 2.9, my dermatologist is afraid I will bleed too much.

As a result, tomorrow morning I am being admitted to Vojenská nemocnice for four or five days, whilst my INR is reduced and closely monitored and then appropriate treatment will follow. It will be a very early start to catch the 05.40 bus from the village, to then catch the 06.25 train from Decín to Prague, in order to reach the hospital by 09.00. So I’m off to bed as soon as I’ve successfully posted this text.

The Dermatology building at Vojenská nemocnice © Ricky Yates

That was the week that was

My hospital bed © Ricky Yates
My hospital bed © Ricky Yates

Last Sunday morning (2nd August), I was getting dressed, ready to travel by tram into central Prague for our Sung Eucharist at St. Clement’s, when I became extremely breathless. Sybille describes me as ‘hyperventilating’ and I honestly thought I was about to faint. After sitting still for about five minutes, the breathlessness eased. However, by that time, I’d missed the tram I was going to catch, so we agreed instead, that I would drive us to Church as I seemed to be OK when sitting. Knowing what we know now, it was a daft decision!

I somehow managed to both celebrate the Eucharist and preach. But I had great difficulty singing the hymns and other sung parts of our liturgy. I have never missed a Sunday service through ill health in the nearly seven years I’ve been in Prague and I was determined that that record was not going to be broken. But it remains a miracle that I ever completed the service.

Following post-service refreshments, I managed to drive us both home and walk to a nearby bar-restaurant garden for lunch. But I spent most of the rest of the day resting, planning to visit my GP, first-thing on Monday morning.

My GP practice is based three tram stops away from the Chaplaincy flat at Vítezné námestí. It is called Young & Co, as the practice was founded and is headed by Dr. Adriana Youngová, a female Czech GP who is married to an Englishman, Timothy Young, hence her unusual surname. No Czech surname begins with the letter ‘Y’ which has caused me problems on numerous occasions. So I find it quite amusing that the head of my Czech GP practice, courtesy of her marriage, now has the same problem as I do 🙂 One bonus is that all the surgery staff, know how to pronounce my surname correctly, because of their boss!

On the morning of Monday 3rd August, I was seen by another of the practice GPs, Dr. Hana Škodová. She asked me lots of questions and along with Sybille, seemed somewhat mystified that I had no other symptoms other than being breathless. The practice nurse took blood from me so that various tests could be made. This was the first of what seems like umpteen needles that have been stuck into me this past week, either to extract blood or inject me with various substances. ‘Pin cushion’ probably best describes how my body currently feels 🙁 I was also sent off to have my chest x-rayed and told that I would receive a phone call later in the day, once the first results of my blood tests were available.

Early on Monday afternoon, the phone rang. It was my GP surgery. One result from the first blood tests indicated that I almost certainly had a pulmonary embolism – a blood clot in my lung. I was to call an ambulance and get myself to the nearest hospital emergency department ASAP! The surgery kindly emailed me the test results, with the offending result highlighted in red, so I could print them off and have something to give to both the ambulance and hospital staff.

Sybille helped me pack a bag, presuming that I would be spending a few nights in hospital and also called the ambulance. Despite being able to walk into the ambulance, the driver decided I was an emergency case and proceeded to drive me to hospital at high speed with siren blaring and blue lights flashing! So I arrived in the Emergency Department of Vojenská Nemocnice, the Military Hospital.

Once again, needles were stuck into me and blood was taken for more tests. When the results of these tests came back, confirming everything the GP surgery had discovered, I was then sent for a CT scan. Iodine was injected into me 🙁 , to enable clearer scan definitions, and the machine itself, kindly spoke to me in English, telling me when to hold my breath and when to breathe out.

I was wheeled back to the Emergency Department where the Doctor told me, even though she had yet to look at the scan results, the technicians had confirmed that I had a huge pulmonary embolism. I was to be immediately admitted to a cardiology ward of the hospital.

Therefore I spent from late afternoon on Monday 3rd, to just before lunchtime on Wednesday 5th August, as a cardiac patient of Vojenská Nemocnice, the Military Hospital. During that time, I started receiving twice daily injections into my lower abdomen, as well as taking a once daily tablet of warfarin, both with the intention of thinning my blood and helping the embolism to break up and disperse.

On the morning of Tuesday 4th August, I had an ultra sound scan of my heart which showed it to be in good order, other than a slightly enlarged right ventricle, caused by the embolism. One of the encouraging things that has come out of this whole experience is that nearly every test has shown that my body is in good order. My blood pressure is fine, my kidneys are working normally, and my heart has no problems.

However, on Tuesday afternoon, I had a further ultra sound scan of the lower part of both of my legs. Whilst my right leg is completely OK, unfortunately the scan found several thrombosis in the calf of my left leg. It was one of these that decided to leave the lower part of my left leg, and become an embolism in my lung 🙁

Ten years ago, in 2005, I had a thrombosis behind my left knee. But after treatment with warfarin, it completely dispersed and a year later, I was once more allowed to be a blood donor. Therefore the medics are still unclear as to why this problem should have reoccurred, when my left leg has been perfectly fine for the past ten years.

Late on the morning of Wednesday 5th August, I was discharged from hospital. I was given:

A prescription for further twice daily injections into my lower abdomen, the last of which is due to be administered tomorrow morning. I’m grateful to be married to a former nurse who has been administering these, rather than having to do so myself.

A prescription for warfarin tablets, currently to be taken once daily, first thing in the morning.

A prescription for full length compression stockings for both of my legs.

A three page report, outlining what had been discovered about me during my hospitalisation, and outlining various courses of action for my GP.

On Thursday 6th August, I once more met with Dr. Hana Škodová. She explained the contents of the report and the whole variety of further tests that I need to have in the coming weeks. Once more I had blood taken, to check my INR level – to decide the exact amount of warfarin I need to take to thin my blood sufficiently, without becoming so thin that I bleed too easily. I’m due back to see her tomorrow morning.

So after a very eventful week, I am grateful:

  • Just to be alive! Untreated, what happened could easily have killed me.

  • For wonderful, high quality medical care, totally free of charge, because I and the Church as my employer, pay into a compulsory health care scheme.

  • For the prayers and best wishes of so many people.

What does in mean for my future?:

  • That I will have to take warfarin, ‘rat poison’ as Sybille calls it, for the rest of my life.

  • That I will now have to be very careful not to cut or injure myself as it will be far more difficult to get any wound to heal.

  • The end of my cricket playing career as I cannot put myself at risk of being hit by a cricket ball. Therefore keeping wicket for Prague Barbarians CC on Saturday 18th July will go down as my last appearance as a player on the cricket field. Whilst we lost that match against Vinohrady CC, I didn’t let a single bye, so it is an appropriate note on which to end my career.

One final note:

Last Friday, if my arithmetic is correct, I passed the age my mother was when she died in April 1980. But my experience this past week, has been an important reminder of my own mortality. I, and every other human being on this planet, will not live forever. All of us need to live our lives in recognition of that important fact.