Archives: Transplant

Better than average

Today has been a pretty impressively brilliant day.

It was another Harefield appointment, my first in six weeks after MC told me that it was a bit pointless coming back until they had clear data on whether my CMV had retreated for good or not.  So he had sent me away with instructions to send in bloods every 2 weeks to keep a check on things and that if I hit the 3 month mark with no adverse effects or without showing anything above a zero on my CMV then he’d take me off the Valganciclovir I’ve been on since May and see if my body will cope without it without submitting to CMV again.

Seeing him today with a month-and-a-half of clear results, he was suitable pleased and happy for me to drop my Valgan and continue with everything else, albeit being very much more aware and careful about the first signs of CMV infection, necessitated by the fact that CMV can very rapidly kick-start rejection of the not-very-good kind, which could do my serious damage.

That said, though, he came out with something I wasn’t expecting to hear at all.  Although I may feel like I’ve had a fair number of blips, he thinks I’m doing incredibly well and – going by his experience of CF patients post-transplant – thinks I now stand a better-than-average chance of 5-year survival.

At the time of my transplant, I was quoted statistics saying that 73% of people make it through the first year, and within that 27% that don’t are included people who may die on the table or suffer serious post-operative complications.  Once you stretch the survival period to 5-years, the odds stand at 50/50, but MC now believes that for me the benchmark can be shifted from 50/50 at 5 years to 50/50 to make 10 years.

Another decade of life is better than I think many of us dared to hope.  I said before my transplant if I’m given just six months of a new life I’d be happy.  Time enough to play with my Godsons, experience the things I’d not been able to do for breathlessness and lack of energy, learn to do things on a whim again.  Having slipped past that stage back in May, albeit in the middle of a CMV/EBV attack, I’ve felt contented with my lot, whatever is thrown at me next.  To know now that there’s a very real possibility of a future worth planning for is too incomparable for words.

I’m aware every day that someone, somewhere has lost someone they loved very dearly.  I just hope I can make enough use of the extra time I’ve been given to show them what a truly wonderful gift they have given not just me, but my family, too.

Monkey

What an awesome day today has been – one of the best since my transplant.

Today I achieved something I’d never have thought I could achieve and done something I never thought I’d see myself doing even before my transplant.

We had my Godson up for the day with his mum and dad at my ‘rents and another family of really close friends with two kids as well and we all traipsed across Willen lake to the high-rope course on the far side of the sports lake.

This thing is pretty epic – a collection of fairly challenging obstacles suspended around 20 feet above the ground on the first level, with an upper level twice that height.  All harnessed and hard-hatted up, we set off around the first level.

The interesting thing about the course is that it’s not really possible to get down once you’ve started, so by way of a tester they put the most intimidating obstacles first, so if you really, really don’t like it, you can turn back.  I must confess, halfway through traversing the 10′ wide section of climbing wall with the world’s tiniest footholds, I seriously considered it.

I’m glad I didn’t though, as the rest of the course was pure joy.  I only struggled at one point, which was a section which required excellent balance (not something I’m renowned for) and good upper-body strength (something which has yet to grace my new body).  With that out of the way, the rest of the course was *relatively* easy.

I was disappointed that the lower level required so much physical exertion that I didn’t have anything left in the tank to attempt the higher, more challenging level this time around, but it gives me a great incentive to build my strength and stamina back up and conquer it next time.

The final step of the course is a 50’ rope drop from a tower in the centre of the courses.  Hooked onto a decelerating wire, you step off a platform for a few moments of free-fall before the rope goes taught and the drum begins to slow you down, depositing you on your feet/butt at the bottom a couple of seconds later at a manageable speed.

Before my op, healthy or not, I wouldn’t not have dreamed of doing something like that in a million years.  To be honest, I’m still not entirely sure what possessed me to to it today, but I did.  I stood at the top, harnessed up and clipped on and wondered out loud what I was doing there before serenely stepping off the platform and dropping to the floor in a matter of seconds.  On the way down it was the most horrible thing I’ve ever done, but as soon as I hit the floor I wanted to go again.

Doing a course like that really rammed home once again the astonishing difference these new lungs have made to my life.  Even after completing it, I still had enough energy to go back to Mum and Dad’s and play in the garden with everyone, as we got through games of Butthead, Scatch and footie.  It’s an amazing feeling to finally be able to run around and play in the garden with people again.

I always said before my op that Transplant is a bit of a gamble – there’s no way of knowing how long it’s going to last for and what your quality of life is going to be like, but I said I’d be happy if all I got was an extra six months and the opportunity to play football with my Godsons again.  This weekend, as I ran and missed yet another perfectly weighted cross just wide of the far post, it occurred to me that I’ve now hit both of those milestones.  Everything I wanted before my transplant, I’ve got – I couldn’t be more blessed and feel more happy and content with my life than I do right now.

Transplant is amazing. Full stop.

Ticking over

Under pressure from outside sources (no names, Lisa), I have forced myself to my desk to write an update.  I had – honestly – been intending an update for a while, including some back-dated film reviews (it’s been a busy week on the film front) but just haven’t seemed to find the time to do it.

My energy is still coming in fits and starts.  After a busy and productive week last week, this week has been a little more relaxed and less work-focused.  The new issue of CF Talk is taking shape, but is now at a stage where I’m waiting for our writers to draft their articles and send them in, leaving me without a great deal to do other than sit and wait.

Live Life Then Give Life is going from strength to strength since our charity registration came through and there are a number of projects being mooted between us as I speak, sadly none of which I’m at liberty to disclose just now.  If you live in the Manchester area, though, what this space over the next couple of weeks because we may have something exciting to announce.

I have also got myself back on the writing wagon, having taken my Headliners screenplay up to 40 pages and still going, which had really excited me as I whenever a hospital is around and about I seem to lose a great chunk of my creativity and imagination.

In fairness, I suppose it’s not the hospital so much as the condition I’m in.  After all, if a hospital stay is called for it means I’m not doing well and if I’m not feeling well then, as has always been the case, my creativity and artistic expression is the first thing to go.

Next week I’m due to give a speech at the Ipswich Press Ball about CF, which I’m really looking forward to – black tie events always excite me, mostly because the old performer in me loves getting dressed up and being the centre of attention.  Unusually for me, I have actually written my speech this time.  It’s not long, only a couple of minutes, which I would normally busk my way through relying on my natural charm, wisdom and eloquence, but clearly my faith in myself has deserted me.

Actually, quite apart from this being a posher and more official deal to the kind of speech I’ve made in the past, I also had some strong ideas for the speech that I didn’t want to lose in the weeks building up to the speech.  In the process of getting my ideas down on paper I got carried away and ended up writing the whole thing.  After the ball, I’ll pop the text up on here for you all to peruse and tell me where I went wrong.

Other than that, not much has been happening, really.  Although looking back over what I’ve just written I realise I started by saying I’ve not been doing much but have now clearly proved I’ve actually been quite busy.

Next week is hopefully dedicated to CF Talk and preparing articles for submission to the designers, with a short break away in Ipswich at my Godfather’s place for a couple of days of proper chillage before the Ball.

Promise I’ll have more updates on the boring things soon, and won’t leave it so long.  Mind you, how often have I said that…?

Setting the pace

Another trip to Harefield yesterday, this time just for a clinic visit. Was all a bit silly, really, since by the time they saw me in clinic they hadn’t had my blood results back, so they didn’t know if they needed to change any of my meds or do anything else, which meant the whole visit was a bit pointless. Apart, I suppose, from the fact that they can at least look at the blood work today to see if anything troubling has come up.

The last couple of days have been pretty busy and I’m feeling it catch up with me today. It’s a very odd feeling, different to my rest-periods from before. I can have a couple of days of being very busy and working flat-out, but then need to take a day off, but it all seems a little unpredictable at the moment. Before my op I had got used to the fact that if I did something, the next day would have to be a rest day. Now, though, sometimes I can get away with doing lots and other times it seems like I need to rest more than usual.

I’m sure this is all part and parcel of the recovery process, coupled with the fact that my body is still working it’s way back to full strength after the virus double-whammy of last month. What still boggles my mind, though, is that even when I’m tired and need a bit of rest, I can still do things. Before the transplant, if I was tired it was an all-encompassing tiredness that wouldn’t let up until I’d slept it off, no matter what time of day or night it was. Now, it’s more of a general slow-down – everything just takes a little longer and I don’t feel as sharp as I was, but I’m by no means bed-ridden.

What’s funny is that I kind of assume that this is the general “normal people” kind of tiredness, but since I’ve never experienced it before, I’ve no idea if it’s a “normal” thing or not – whether I’ll get used to it and stay like this or whether it’s a transplant thing that will change in time.

There are so many things to learn about a new body post-transplant that go way beyond just getting used to having breath in your lungs. I’m getting there, slowly but surely, and learning new things everyday. Even six months on, it’s still a journey of discovery and it’s still as exciting now as it was when I took my first steps back to my room on the ward.

Incarceration

It’s taken me a while to get around to writing about my admission for two weeks almost a month ago, but that’s because I’ve still not really managed to wrap my head around the whole deal.

The two weeks I spent on the ward in Harefield in the middle of May were the hardest two weeks of “inmate” time I’ve spent for a long time and I’m not entirely sure why. Perhaps it was something to do with being on an open ward, something I’ve only experienced once or twice in my life, despite numerous, often lengthy, hospital admissions. Perhaps it was because I was missing out on the holiday with a big group of friends that K and I had been planning for close on 3 months.

Above everything, though, I think I struggled more than I have for a while because something in my brain told me I was passed all this. My new lungs have had an amazing start. A minor hiccup after 2 weeks not withstanding, they’ve gone from strength to strength and my lung function has been steadily rising, my exercise tolerance going with it. I even completed the famed last mile of Tresco with my brother and started entertaining thoughts of doing the whole thing next year.

So I suppose I had kind of taken my eyes off the post-transplant complications ball and started to enjoy life without a second thought for whatever else was going on, assuming everything was tickety-boo. Which is, I suppose, a lesson in itself. While new lungs mean great new things, you can never take their health for granted and even though I’d been booming for the last three months, it doesn’t take much to send the body reeling.

The chest pains I’d been worried about were initially diagnosed as Gastritis, but when I saw the team at Harefield I had managed to spike a good-looking temperature to go with the pain and nausea, leaving them little choice but to admit me. For the first 24-48 hours the cause of my ailments seemed a mystery to the docs, until they got my CMV count back, at which point they were more contented, knowing that they knew how to deal with it now that it had been properly identified.

There’s something disconcerting about being given drugs intravenously which are so toxic the nurses have to wear gloves and the pregnant women aren’t even allowed to touch the packaging. Knowing they can’t go near while you watch it being pumped into your veins is pretty bizarre and something I’ve never got used to, despite a history of high-caliber potions in my time.

When I was moved to the open ward, which happened to coincide with K’s departure on the holiday with our friends (at my insistence, I must add, and under considerable duress) and I dropped into a pretty deep funk. It’s the lowest I’ve been since the darkest days of the early post-transplant period and there didn’t seem to be a whole lot going for me at the time.

I’m slightly ashamed of myself now for letting it all get on top of me so much, since at the end of the day I was still a good deal healthier than I had been not 6 months ago, but for some reason (or, I suppose, a myriad of reasons) I couldn’t raise my spirits at all.

Luckily, at Dad’s suggestion, I managed to secure a weekend release while the guys were all away. The ‘rents agreed to drive me in for my doses of anti-biotics twice a day, but I was free to go home for food, rest and over-night sleep, something I’d been getting very little of on the ward, what with the world’s loudest talker on one side and the telly addict on the other.

Eventually, thank goodness, my consultant, the amazing Doc C returned from his paternity leave in the middle of the next week and on his first round of the day told me I was free to head home as they expected my viral load to be low enough to no longer necessitate the use of the IV drugs, enabling a switch to the more home-friendly orals.

I hadn’t been happier than that afternoon when I got back to the flat just after K returned from the holiday and we could just chill out on the sofa and enjoy each other’s company again after nearly a week apart – pretty much the longest we’ve spent away from each other since we got together.

Getting used to the ups and downs of transplant is clearly taking me longer than I thought it would. My mind appears convinced that things can only go well, so any minor hiccup is a bigger deal than it ought to be because it carries with it something of a heavy shock value. I need to keep reminding myself that it was only 6 months ago that I had new lungs fitted and that I still have a way to go to fully recover, however good I may feel right now.

So I’m trying to take things a little more slowly, although how long that will last we’ll have to wait and see. The main thing for me at the moment is doing what I can to avoid what Doc C affectionately calls the “Superman complex”, whereby people (mostly men) post-transplant start to see themselves as indestructible and slacken off their meds and treatments. It’s hardly the way to say thank you for the greatest gift of all, so I’m determined to stay away from it and keep myself at my best.

3-day B’day

Sorry for the delay in postage, but I’ve been rather enjoying my timely escape from the inner sanctum of Harefield for a fab 3-day birthday.

Saturday was spent mostly with K’s parents, who took us out for the day around a couple of nice local spots, including a great little farm shop near where they live, which has all kinds of great home-made farm-type stuff, plus a load of great, fresh produce of the sort I’m not allowed to eat any more, which made me very jealous of all the people picking up fresh black pudding and some tasty looking soft/blue cheeses.  That said, I did have a very tasty bowl of soup with crusty French bread for lunch, which went down well.

A light lunch was all important as the evening was spent with my parents, my brother and my bro’s best mate and his girlfriend (who I’ve not seen for ages) at The Birch, a really nice restaurant just outside of MK.  It does the most amazing selection of fresh, seasonal vegetables and prime cuts of meat, alongside a full menu of great seasonal dishes.  I’m not a big fish eater, but I had the most delicious fillet of sea bass, one of my faves, which was cooked to perfection.

Sunday, my actual birthday, started slowly after the late night the night before, but I was soon up and about, opening the myriad cards K had laid out for me all nicely, then chilling out a little with S&S who came over to say hey and show off their engagement ring, which had been presented whilst they were away on holiday in the lakes (the less said about which the better, seeing as everyone had a great time while I was locked away).  It’s very cool for both of them, though, as they are clearly deliriously happy, despite having come to the dawning realisation that weddings actually cost money.

Around lunchtime we headed over to the ‘rents again to grab a BBQ with my Aunt and a selection of her troupe – some of whom had better things to do and others of whom tried using the excuse of being in Africa at the time, which I felt a little lame.  Of course, being post-op, BBQ is now off the menu for me, but I still had the same grub in the same delicious flavours, only it meant a little more work for Mum, having to bake mine instead of passing them off to Dad for the barbie, as is the usual Lewington bat-plan for weekends.

You truly find out who your friends are when you’re forced out into the rain to cook people a nice barbie (and my dad is an awesome BBQ chef).  Not a pleasant thought for Dad, who spent the entire time outside on his lonesome cooking up a storm, which everyone else seemed only too happy to eat.

Still, he didn’t seem to object too much and we had a great get-together.  For me, celebrations like these are all about the family – getting together, catching up, laughing, enjoying each others’ company.  I’m very blessed in having such a close-knit family who actually enjoy spending time with each other.  All too often I hear people moaning or complaining about having to spend time with people in their family “because they ought to”, but in our family we spend time together because we want to.

It’s also great to know that the other family I’m being assimilated into feel the same way – their just as close as us, even if the age-range is slightly more strung-out, but they enjoy seeing each other and spending time together.

I love the fact that my family relationships are more like friendships, things you actively keep going and people you want to keep in touch with, rather than a familial devotion to keeping abreast of what’s going on and meeting up only for the enforced holidays of Christmas and such.  It’s nice to be part of something where we get so much joy from each other in such simple things.

Sunday night, K and I got back home and just chilled on the sofa with a movie, before Dazz turned up completely unannounced from Leeds to surprise me.  It’s an unbelievably awesome gesture for someone to travel this far to see me just for my b’day when petrol costs what it does and he’s still to find a job up there (well, still to look for a job up their…).  It was great to see him and, although it rather spoiled my plans for an early night, we had a great evening sitting chatting and playing Buzz.

In the morning, after rolling out of bed a little later than planned, K and I hit Borders to find a way of spending the vouchers I’d been given.  I picked up an awesome Indiana Jones book, but struck out on DVDs as all the ones I usually want to pick up when I’ve got some cash weren’t around and all the cheap ones in the sale were either already in my collection or just plain rubbish (or both).

After we’d mooched about for a while in the heavenly B, we headed off to the pub we affectionately know as Old Spoons and settled in for a drink or two, being joined at stages by S&S, Cliff, Dazz and his fam.  It passed a couple of pleasant hours before we had to excuse ourselves to the awesomely exciting task of hitting Tesco, which we did at speed, before returning to the flat, collapsing on the sofa, grabbing some dinner and catching a movie.

Three day birthdays rock so much more than regular, plain old boring single days.  It’s the advantage of being born at the end of May when you nearly always wind up celebrating on a Bank Holiday weekend. Hooray for May birthdays.

I’ll be back later in the week with a summary of my incarceration and let you know how I’m getting on.

Escape

It’s Oli, back again after my enforced 2 week absence.

This is only going to be a quick one, though, to shout out loud to everyone that I FINALLY ESCAPED.  I don’t know why, but the last two weeks have been two of the hardest I’ve experienced in quite a while.  I know the immediate post-op period was harder, but other than that, this has been the toughest hospital stay I’ve had in a long while.

I’ll try to write a fuller update and coverage of the last couple of weeks sometime tomorrow, but for now I just wanted to thank you all for your lovely comments, emails and text messages and to let you know that I’m very thankfully out in time to enjoy this weekend properly, feeling much better if a little tired from the lack of sleep in the Big House.

Hope everyone’s well, more updates soon.  And thanks to K for her updates again!

Who’d be a parent?

This weekend has been manic and really, really tiring, but wonderful at the same time.

I woke up Saturday with the pains in my chest not abating in the slightest.  I’ve still got a stock of Tramadol which I often take for pain in my scar overnight but haven’t used during the daytime for a good few months now.  I’ve been forced back onto them by the pains in my chest again, which is a real drag as it means I can’t drive when I’m on them.

Still, I downed a couple of Tramadol in the morning when we woke up and then stayed in bed for most of the morning while K did kiddie-prep for the arrival of our two nieces in the afternoon.  A while ago we agreed to have them over for the night, Liv being 3, JJ 11, as their ‘rents had plans.  The plans fell through but we figured we’d have them over anyway as we love spending time with them and Liv especially was so excited about it.

I honestly thought we’d have to cancel when I woke in the morning, such was the pain in my chest I knew I wouldn’t be able to do much to occupy them, but K was adamant she could do it herself if the worst came to the worst.

So they rocked up with their mum and little bro around 3pm, then stayed solo later when they headed off home.  The first thing we did was make some little wooden spoon people, which was great fun, although I didn’t actually get a spoon of my own, since there were only 3.  I was relegated to being Liv’s glue-operator, at her beck and call for blobbing when she needed it.

After dinner, we (well, K and the kids) made some cakes, which they threw in the oven to cook while we got the littl’un ready for bed and read her a story.  Once K had rescued the ever-so-slightly over-cooked cakes from the oven, we sat down and played a board game with JJ, before discovering Liv sitting up in bed unable to sleep.

Eventually, after another story and a bit of a grizzle/cry for her mum, we managed to get her off to sleep and we settled into a game of Scrabble with big sis, which was great fun, even though I lost to the always competitive K by 2 points.

It’s funny when I play board games because I’m really not a competitive person – I’m happy enough to play the game, not really bothered if I win or lose.  But if someone else who’s playing is competitive, it somehow turns me into a competitive monster.  I’m happy enough when everyone is chilled and happy playing a game, but if someone is really competitive, I just really, really want to beat them.  I’ve no idea why or where it comes from, but there you go.

Once we were done with Scrabble, JJ headed off to bed only to find little sis had managed to roll herself into a position with her head on one pillow and her feet on the other side of the bed on her sister’s pillow.  Having gently moved her back to her side, the light of her sister coming to bed woke Liv up and we proceeded into a round of very, very tearful calls for mummy.

Eventually, after a call home and a promise that mummy would come get her if she got some sleep (I hate lying to children, but it was a parentally-sanctioned lie, so I felt slightly better about it), Liv settled down and no sooner had she stopped crying than she passed out into slumber again.  Bushed from the day, K and I weren’t long behind, although my night’s sleep was pretty poor since my brain was tuned in to picking up even the slightest peep coming from the bedroom in case the littl’un woke up again.

As it was, we didn’t hear another peep out of either of them until they came into our room at 7.30 the next morning, pretty respectable as mornings go.  We all settled on the sofa bed in our PJs and watched the Incredibles while K, JJ and I slowly brought ourselves to consciousness and Liv ran around jumping all over us like a mini-loony.

Once we’d breakfasted and got dressed, we iced the cakes for their little bro’s birthday party then played a couple of rounds of Tiddlywinks (what an awesome game!) and made a birthday card, at which point it was about time to head home with them.  We took them back and were greeted by an incredibly happy, smiley little brother, who was delighted to have his sisters home to celebrate his 2nd birthday.  I’m not sure he entirely grasped the concept of a birthday, but he was enjoying it all the same.

We hung around for a couple of hours, playing with some of the new toys, reading some books and saying hey to the other family and friends who turned up throughout the start of the afternoon.  Unfortunately we couldn’t stay day because Nana has a bit of a chest infection, which I obviously need to steer clear of, so we had to split the afternoon in half for us to visit early on and Nana to come along after.

Instead, we headed over to my ‘rents to have a great Sunday roast with my mum’s two brothers, one of whom was over from Luxembourg with his wife, and my cousins.  My mum and her siblings are absolutely priceless entertainment value when they all get together and today was no exception.  It was one of the nicest, most raucous, most fun family lunches I’ve had in a really long time.

By the time we got home around 7 in the evening, K and I were shattered.  We have no idea how parents cope with kids 24/7 since we were completely run into the ground after just 24 hours.  We have a new found respect for our brothers and sisters now, since we clearly showed how weak and rubbish we are.  I’m just glad that, unlike K, I don’t have to go to work tomorrow so I can chill out and not worry about anything.

Well, something’s wrong

Today’s been the weirdest day, and my first real experience of “illness” for three or four months.  I’ve had no energy at all, I’ve been in bed most of the day and hardly been able to keep my eyes open.  Added to which, I’ve had some really bad pains in my chest which I can’t figure out the source of – they could be muscular or bruising around my scar, but they don’t feel too drastic or lung-related so I’m not too worried.

It’s really odd being unwell again, though, because I’ve not laid in bed for an entire day since before my op.  I don’t like it at all.  Well, the staying in bed part I can handle, but not when it’s enforced because of not feeling well.  I’m sure it’ll all clear up soon, though.

Flashbacks (of many kinds)

Last night I sat at my computer, whiling away the time until K had finished in the bathroom before heading to bed and I started reading back through my old blogs. I had to moderate a spam message which had attached itself to a posting in mid-December, which lead me right back into the heart of the post-transplant ups-and-downs and I felt a sudden urge to go back to the start and read all through the Transplant from the day of the call.

I’ve read bits and pieces of K’s postings from while I was on the ward and, of course, all of the messages that were left for me while I was going through it. It’s still weird, though, reading back through such thorough descriptions of all the various events which went on, particularly in the first couple of weeks, which are still pretty much a blur to me, although reading the blogs I realise I actually haven’t forgotten as much as I thought I had.

That first month seems a world away from where I sit here, but Sunday marked the 5 month point since I had my op – it’s amazing how quickly the world moves.

Today has been K’s day – she finally finished her college course, which I rather unhelpfully got in the way of before Christmas – handing in her dissertation and doing a presentation to her main tutor. He has told her that she’s already passed with the highest grade possible (Level 3) without even having handed her dissertation in and that her presentation was the best and most professional he’s ever received for a student.

Now, we all know that K is wonderful, amazing, intelligent and a whole load of other incredibly positive adjectives as well, but it often passes her by completely. Having someone who actually matters (as opposed to… you know… me) tell it to her, and to have a piece of paper telling her it’s true, seems to have made the world of difference as for at least a few hours today, she actually believed it herself.

After picking her up from her presentation, all bouncing, bubbly and beautiful, we headed to the flicks to catch Flashbacks of a Fool, the new Daniel Craig film. No one can say that since being passed the mantel of Bond that Craig’s left himself open to type-casting. He’s working incredibly hard to make sure that all the time he’s contracted as Bond, he’s not letting his career slide, turning in some great performances in smaller, more independent fair like this. And he is excellent in it, let me assure you. There’s a scene towards the end of the film where he confronts/approaches/meets Claire Forlani’s character (something of a blast from his past) in a graveyard and his eyes are simply mesmerizing.

The film itself is a cleverly-structured deconstruction of the life of a Hollywood mega-star for whom bad news forces him to remember a time he’s spent a lifetime trying to escape from. What could be scene as a somewhat hokey narrative device become an interesting and plausible plot device by being plastered across the film’s title. Knowing you’re going to be dealing with flashbacks restrains you from dismissing them as is so common in modern movie-making. What’s more, they’re actually accomplished in a much more deft and sensible manner than many films who aren’t so up-front about their usage.

The cast is uniformly excellent, with a couple of exceptions who don’t really need mentioning as the don’t really spoil the film. The flashback sequence is perhaps a little on the slow side, perhaps a touch too long, but it’s impact is undeniable and the Daniel Craig bookends so riveting and absorbing you forgive the sluggishness of the middle portion.

It’s undoubtedly one to check out, although it’s not the most happy, uplifting film in the world. Precise and carefully, considerately put together, but heart-warming it is not. Check it out, if you don’t mind taking a tissue or two.