Tuesday, 16 December 2014

Christmas parties

Table strewn with crackers, streamers, bottles, glasses and other party debris

If you're waiting for the post about SGLT2 inhibition (and I'm not sure why you would be), it's on its way, but things more exciting and noteworthy have been cropping up to postpone the pleasure. The last few days have produced anecdotes that made me think "That would be great for the blog", and I'm writing this when I should really be working on the family calendar, and I've got to go to town in a bit, so time is short.

Short anecdote about a patient first: it was the first appointment of the day, the patient was slightly early, and as we walk from the waiting area to my room I generally ask how things are going in a general, casual everyday manner. The patient said "Pretty good, I've lost a stone [14 lb, about 6.4 kg]."

That's a good start to a consultation. When we're sitting down, I follow up with "So tell me, how did you manage to lose all that weight?" The patient looked at me in an odd way, as if I were a little bit dim, and said "I just did what you told me to do!"

So that was a good start to the day.

Further anecdotes result from the slew of Christmas parties that I've been at - the second and third were on Friday and Saturday nights. The second party was at a large hotel and conference centre, where at least three different events were being held concurrently, parking was being marshalled, and we were met at the entrance by a couple of burly security men asking to look in our handbags.

"What can they be looking for?" I wonder. "Has there been violence with weapons in the past? Do I look like someone who is hiding a knife in her bag? Are they expecting jihadists?" My naive questions are answered as I join our party in the main hall. One of my colleagues greets me with "Did they search your bag? I can't take my coat off yet, I've got a bottle of vodka in my pants" and she showed me the bulge in the front of her dress. Not only was she aware of the measures being taken to safeguard the takings of the hotel bar, but she had gone to great lengths to bypass them. I last saw her as she was being helped from the dance floor.

I am regarded as a mixture between an alien and a prude because I always drive to and from these parties, along with my other non-drinking (usually pregnant) colleagues. A different approach to alcohol applied to the third Christmas party with a different team, who had decided to use the teenage principle of 'pre-loading'. We were invited to pre-party cocktails, where I found a couple of colleagues who had rather overdone it. We all made it to the venue (a Masonic Hall) but they didn't last long enough to have their starters before having to be collected and taken home by a husband - I found out later that they had been pre-pre-loading with wine at another colleague's house even before the cocktails.

With two out of nine of our party already down and out, we enjoyed the meal and waited to see what would happen next. It was entirely organised by and for the hospital staff and was fundraising for dementia care, so I was expecting a live band and a raffle alternating with the disco, as is usual at this type of event. Instead, a tall, flamboyantly dressed woman introduced as 'Sabrina' entered the room and started to dance and mime along to the music. A surprisingly muscular, thick-waisted, slim-hipped woman...

As drag acts go, this was a corker. Not too naughty, very funny, it had me grinning and clapping and laughing until my face hurt. After the first number, one of my colleagues, a lovely chatty lady now wearing party antlers, stage-whispered to her neighbour "I think it's a man dressed as a woman!"

She and I were first on the dance floor when the disco started, and for a change the DJ had adopted the approach of playing music that made people want to dance - surprisingly rare in my experience. I've only got one more Christmas party coming up, and I doubt that it will be better than this last one.

Wednesday, 10 December 2014


Greenery around a pond
Groombridge Place, June 2013
The week following Lola II's visit is a busy one. Work then badminton club #1 on Monday, work then a badminton match with club #2 on Tuesday, work then choir practice on Wednesday, work on Thursday then...

It’s a nightmare. Thursday night: no Internet at home. I’m off to badminton club #2 so I don’t mind so much, but when the Internet hasn’t returned on Friday night, it becomes serious. Mr A was at his work’s Christmas do on Friday night, which involved bowling, dinner and an overnight stay, all paid for (that’s the private sector for you) and I was looking forward to an evening to myself. I had various online jobs lined up, among them blogging and creating the family calendar, which is a fairly long and tedious process (although well worth it for the results in the end). So I had to phone the ISP.

Part of the pain of investigating the issue is that the Internet wifi router is in Mr A’s office, which is full to the brim with ‘belongings’. I imagine Mr A and I use different words to describe the contents of his office, but even aside from that, the overhead lights do not work and it is dusty; very, very dusty.

First of all, the operator in the ISP's call centre did not recognise our phone number. The address and post code did not help either. I started to imagine that our account did not exist, which would explain the lack of service, but when I fished out a bill (thank goodness I had printed the bill, otherwise things would have been even more difficult) and quoted the account number, my existence was confirmed.

So then: the usual tests on the router, for which I had to wear a head torch (no overhead light) and take time out to sneeze repeatedly (the dust) combined with picking my way through the ‘belongings’. And then find the phone (sneeze), to discover there was no dial tone. Although Mr A had recently managed to replace the batteries, I could not trust just the one handset, so had to unearth another (sneeze), but still no dial tone. So it’s the phone line that’s faulty, and I was given a timescale of two to four days for repair.

What can you do with no Internet? I could use my data plan via mobile phone, but the screen is so small and I can’t bear to type on it, plus the blogging account is different from my email account so there’s lots of logging in and out and trying to remember passwords. “I know,” I thought, “the pub next door advertises free wifi! I can go there!”

Of course it is Friday night, one of the busiest times for the best pub in Leamington, but I managed to find a spot to set up the laptop – unfortunately not near an electrical socket, so I had just an hour or two while the battery lasted. It would be rude to take advantage of the free wifi without buying a drink, so I treated myself to a pint rather than my usual half pint, on the basis that it would have to last a couple of hours. And then the computer wouldn’t connect to the Internet. Rebooting, ‘repairing’ the connection, ‘resetting the IP adapter’ – nothing. The battery was pretty much exhausted by the time I had finished trying, so I had no choice but to finish my pint and go home, still Internet-free.

So I resorted to sitting on the sofa and watching a film instead, which was fine but didn’t get the calendar done. On Saturday, it meant I had lots of time to clean the house, and I’d rented another carpet cleaning machine, this time checking that the plug was as it should be. Mr A collected the cleaned and shortened curtains, so they had to be adjusted and re-hung, and the carpet cleaning machine taken back to the rental shop, and then I couldn’t stand it any longer and went to the library for two hours to use their wifi for the bare minimum of tasks - uploading the last blog post, Facebook, downloading podcasts, and some cash needed transferring between accounts.

No Internet service on Sunday either, but not too bad because I was off to a lunch in the occasional series hosted by H&B oop north. Travelling by motorway on Sunday morning wasn’t bad at all, and I arrived early in order to impart some of my diabetes dietary wisdom. Unfortunately for the other guests, this meant that their attention was repeatedly drawn to the carbohydrate content of various snacks. It was a pleasure to mingle with such a pleasant group of people, though.

On my return – still no Internet. Things were getting desperate – I’d cleaned a lot of things in the house already, and eventually I was forced into writing Christmas cards. I don’t think I’ve initiated the Christmas card writing session in living memory; it’s one of the things that Mr A does. It made me think how useful it would be if the Internet were to disappear at the time of the Tax Return. Then we watched another film. Still no family calendar.

Monday – no Internet. To be honest, I wasn’t expecting any progress over the weekend, and the four days I’d been quoted wouldn’t end until Tuesday evening. There was badminton anyway, so I had no problem occupying myself. And by Tuesday, when I was bracing myself for a difficult conversation with the ISP call centre about why it hadn’t been fixed, it was fixed.

But there is no time for family calendars on weekdays; there’s barely time for blogging, and catching up with the four days missing from my online life. It will have to wait until next weekend.

Saturday, 6 December 2014

Two Lolas and a weekend

Lola II, waving
September 2014
Hello, Lola II here.

Every so often, Lola I comes over to help me do some of the jobbies that accumulate around the house. Last weekend I visited Lola Towers to return the favour.


I’m having a lovely time at Lola Towers and I’ve only been here for 24 hours, there’s still another 15 to go!

I’ve been struggling a little to maintain the weight loss I achieved and so I gave Lola advance notice that I would need her help over the weekend. In return I received this proposed menu:
Friday night
Frittata + salad

Breakfast = cereal or toast or poached egg
Lunch = game soup with matzah balls
Supper = stir fry (fish or chicken or turkey)

Breakfast = egg + smoked salmon, or tomatoes if you'd rather, or cereal

How does that sound?
I responded that I was very happy with her suggestions and that I’d recommend her to my friends. I did note, however, that the absence of cake seemed odd. Visiting Lola, after all, is like a holiday and what kind of a holiday is it if you don’t have cake?

The courgette and bean frittata and salad were delicious, only slightly marred by the rancid salad dressing served with it (unfortunately just a touch older than Mother Nature intended when she invented oil...) This morning’s breakfast ended up being leftover frittata and salad and fresh dressing. Lunch? Add matzah balls to anything and I’ll wolf food down. Supper? Supper was absolutely was delicious and nice and filling, which is a crucial requirement to stop seconds and fridge picking later. The only addition was that we each bought a cake and shared them for dessert. Phew, it is a holiday after all.

Four out of five meals later, I must say it has felt very much like a detox retreat. Very healthy food, healthy portions, lots of filling vegetables and all cooked for me by Lovely Lola. It’s been lovely and I’m ready now for the treat of a delicious roast chicken lunch I’m expecting tomorrow, cooked by Mr M’s mummy at her place.

The primary goal for Saturday morning was to make a List. Not just any list, a Lola List. Lola’s lists are always clearly written, quite extensive and with items put in order of priority or timing. I think meals are added so that we can cross them off; I imagine she’s not really fearful of forgetting. My role when it comes to lists is to write things on them when Lola’s not looking - this time she got a star and a ‘very good’.

I’d say we got 90% of the planned jobbies done and even had time for a little sit down after lunch and a sing-song to help Lola practise for her Christmas Carol concert. Lola is singing alto so I had to sing soprano. Considering at one time I was thinking of singing tenor in a choir, singing at heights to shatter wine glasses had the unexpected result of me getting tooth ache! What’s that all about?? All I can think is that a nerve near my vocal chords area was affected by my unnatural exertions and transmitted its moaning message into my teeth, probably hoping for sympathy. Luckily all’s fine now and my career as an opera singer can continue on the same lines as it was before this traumatic experience.

The evening programme has so far been dictated by me. There’s a very good Doctor Who episode called Blink that I felt Lola I needed to see. I take my responsibility of ensuring she is kept up to date with popular culture very seriously. I mean if I don’t, who will? Who else will happily give an extensive blow-by-blow account of the latest doings and, to be frank, who else will Lola have the patience to listen to...  She might find herself in a pub quiz with success hinged upon getting one question right - “which Doctor Who character moves when you’re not looking at it?” My teachings could make the difference between team disaster and Lola being carried around on shoulders. She anticipated being scared by the episode and she was a bit. I think I helped by calling out that the people currently threatened with danger were going to be okay, although I was careful to clarify my point by adding that, well, they’re not going to be okay but they’ll be alright. Of course this didn’t really help Lola, other than distracting her for a moment from the TV tension.

We’re now sitting feet to feet on the sofa under a duvet, which always reminds me of the Grandpas and Grandmas in Charlie and the Chocolate Factory. Tomorrow’s excitement is Carpet Cleaning. We have the machine, we have the cleaning fluid, who knows what excitement is lurking!


Breakfast of a mushroom omelette for me, smoked salmon omelette for Lola, and then we were down to Operation Carpet Clean. Shifting furniture was the priority to allow for hoovering. Meanwhile I was desperately trying to finish a scarf I’ve been knitting for Lola for probably well over a year. I had knitted myself one that stretched and ended up long and narrow and so, very cleverly, I made this one wide and short. Not so clever, it seems, since upon completion it clearly wasn’t going to stretch. We had a jolly good giggle when I showed her the finished product. The good news is that my attractive pattern looked very nice. The less good news is that I had added stitches onto rows that resulted in an interesting variety of widths throughout. I enthusiastically announced that no-one else would have a scarf like it, and Lola confidently agreed.

Plug with 2 very bent prongs
Back to Operation Carpet Clean: the machine was ready, the cleaning fluid poured in, the ‘before’ photos taken, the tension was mounting, all that was needed was for the wondrous machine to be plugged in and... the plug was broken! Disaster. All of Lola’s hopes and dreams, shattered by someone who had previously either driven over it or discovered, after bending two of the prongs with their bare hands, that they were better suited to be a strong man in a circus and kindly returned the machine to the shop before doing so. She told me afterwards that there was a lot of apologising and a refund, followed by a hastily scribbled note insisting that Lola should be given a discount when she does finally hire one that works. Other than Operation Carpet Clean having to be postponed, it’s been a really lovely weekend with the two Lolas together, as it always is.

And the roast dinner? As delicious as expected.

Lola I wearing a scarf and a smile

Sunday, 30 November 2014

Race report and news of Lola Towers

Rose bud with yellow rose behind
Groombridge Place, June 2013
The trip last weekend was to the darkest depths of Surrey, to assist at a 10k forest race organised by our friends. The race consisted of running 5k on road and forest tracks, then round an obstacle course including a river jump, then 5k back to the start. For a fleeting moment when it was first announced I considered actually working towards running the course, but I came to my senses and dropped that idea pretty quickly. I haven't been running recently - it's dark, it's cold, and I've got a lot of other stuff on my plate at the moment (as mentioned in one of my previous blog posts).

We headed south on Saturday and arrived in time to glimpse some of the immense amount of organisation that has been put into this little enterprise. Permission had to be gained from all sorts of different agencies including Highways, Forestry Commission, St Johns Ambulance and probably others, plus the advertising, timekeeping equipment, signage, clothing, T shirts, medals and prizes, catering and much, much more. Lists were very much in evidence - lists of runners, marshalls, equipment, tasks, schedules, phone numbers. There was a slight relaxation of organisational duties for a period on Saturday night, but the day of the race started at 6am with signage being put up.

Unfortunately it turned out to be one of the wettest days of the year, and didn't stop raining heavily for the whole of the race. The part of the obstacle course when runners had to jump across the river was usually just a bit more than a step over a bit of a stream, but the water level rose by at least a foot during the morning and runners were having to wade across a torrent up to their knees. When they returned to the start it truly looked as though they had been swimming rather than running, and some of the marshalls were in a similar condition.

Mr A and I had volunteered to be marshalls, and Mr A was put in charge of car parking while I was dealing with catering at race HQ. Mr A was clad head to toe in weatherproof motorcycle gear but I was thankfully indoors, serving up bacon butties, tea and cake. It all went very well, the St John's team weren't needed, and the home-made lemon drizzle cake went down particularly well - home-made by the organisers, not by me. They put such a lot of work into the event, but the turnout was good and despite the saturating conditions the runners seemed to enjoy it. There's going to be another one next year too; maybe I'll volunteer again.

Then on Tuesday, back at Lola Towers, the long-awaited fuse box replacement started. The electrician turned up exactly when he said he would, which is always a good sign, especially as I'd taken the day off work. He thought the job would take a day and a half, but knowing how unpredictable Lola Towers can be I wasn't surprised when the timescale started to slip. The installation of the new box took the first half day as anticipated, but one of the new switches kept tripping, suggesting a fault somewhere on one of the circuits. Electrician Bill spent the rest of the day a) narrowing down the possible location of the fault while b) ensuring that the heating would be operational at the end of the day, which it was.

On Wednesday he returned, and managed to improve things to the extent that the switch stopped tripping, but was still not happy with the test results, plus he had to do the bit of the job that entails connecting the gas and water supplies to the electrical earth. I had to go back to work so I didn't see how he got on, but at the end of the day we had a chat on the phone and he admitted he'd have to be back on Thursday. This has been an expensive week - the electrical job is going to cost a bit more than what was quoted, plus the car had its service on Tuesday and needed a new battery and two new tyres.

On the plus side, I got a lot done on my day off work. After twenty years I'm having the living room curtains cleaned for probably the first (or possibly the second) time, and then after twelve years of being temporarily tacked up I'm getting them shortened properly. I'm not even doing it myself - they were cleaned at a launderette and taken to a shop for shortening. That's the kind of mood I'm in.

I also went to another 'Diabetes Education Club' lecture at Warwick University - this is a bi-monthly evening event for Diabetes Healthcare Professionals. Last time it was my colleagues talking and demonstrating low carb items, this time it was all about Sodium-Glucose Transporter (SGLT2) inhibition as a treatment for high blood glucose. Want to know more? All will be revealed shortly.

Thursday, 27 November 2014

What I've been reading

Image of the book cover

Cat's Eye
by Margaret Atwood

narrated by Laurel Lefkow
"Elaine Risley, a painter, returns to Toronto to find herself overwhelmed by her past. Memories of childhood - unbearable betrayals and cruelties - surface relentlessly, forcing her to confront the spectre of Cordelia, once her best friend and tormentor, who has haunted her for 40 years."
After the experience of reading The Blind Assassin where I wanted to read it again as soon as I'd finished, this was a huge let-down. It's an account of a child growing up in Toronto, and there is no discernible story arc whatsoever. She goes to school, goes to college, has friends, marries, is a painter. Nothing to pique the interest, or hold any dramatic tension. Don't bother. And the audio editing is rubbish too.

Image of the book cover

The Island of Dr Moreau
by H. G. Wells

narrated by B. J. Harrison
"Adrift in a dinghy, Edward Prendick, the sole survivor of a shipwreck, is rescued by a passing boat which leaves him on the island home of the sinister Dr. Moreau - a brilliant scientist whose notorious experiments in vivisection have caused him to abandon the civilised world."
It's an oddly prophetic Victorian story that develops the theme of melding human and animal in a way that some consider similarly ethically dubious in our society - genetic modification. There's not much substance to the story, and in places it is pretty horrible in its description of animal cruelty and mutilation. The main character is pretty bland and the others seem exaggerated, but it's interesting for its insight into the imaginative thinking of the time.

Image of the book cover

Mystery Mile
by Margery Allingham

narrated by Francis Matthews
"Judge Crowdy Lobbett has found evidence pointing to the identity of the criminal mastermind behind the deadly Simister gang. After four attempts on his life, he ends up seeking the help of the enigmatic and unorthodox amateur sleuth, Albert Campion."
Quite a good story and very competently narrated. Not really up to the standard of Lord Peter Wimsey or Hercule Poirot, but good enough to keep me interested. I wish I knew of a contemporary crime writer who could write something in the proper 'whodunnit' spirit but without the violence and gore that seems to be compulsory for anything set later than 1950.

Image of the book cover

The Sum of All Kisses
by Julia Quinn
"Hugh Prentice has never had patience for dramatic females, and if Lady Sarah Pleinsworth has ever been acquainted with the words shy or retiring, she's long since tossed them out the window. But Sarah has never forgiven Hugh for the duel he fought that nearly destroyed her family."
A silly Regency romance because I couldn't face anything too heavy. All the others in this blog post are audio, which I listen to in the car. Actually concentrating on the written word at home seems too much like hard work at the moment.

Image of the book cover

Cat Out Of Hell
by Lynne Truss

narrated by Mike Grady
"A cottage on the coast on a windy evening. Under a pool of yellow light, two figures face each other across a kitchen table. A man and a cat. The man clears his throat, and leans forward, expectant. 'Shall we begin?' says the cat..."
I've read the author's non-fiction classic 'Eats Shoots and Leaves' and enjoyed it very much, and this novel was in a '3 for 2' offer so I thought I'd give it a go. It's fine, and I enjoyed it. Not a timeless classic, but so very few books are!

Saturday, 22 November 2014

Singing and parking

Rose on trellis with grey skies behind
Peckover House, August 2014
I am saying 'yes' to too many things.

I like doing all the things I do at work and in the evenings and weekends.

My house is not as I want it to be.

I am clinging on by my fingertips, as always.

But do not worry, I am calm. It will be OK.

There has been a lot of activity, days and evenings, evidenced by lack of blog updating. Three lots of badminton, a finance meeting one evening and a choir practice this week. I wrote the rest of this blog post a week ago, and rather than hang on to it any longer, I might as well press 'Publish'. Mr A and I are about to head off on a trip south, so no time in the rest of the weekend either - perhaps there will be time for a report next week.

The choir is just one more thing. I like to sing, and around this time of year there are some great opportunities to belt out some top tunes. In the Trust newsletter there was a call for volunteers to form a scratch choir for the festive season including a couple of concerts, and all finished by mid-December. I've been thinking for a few years about singing in a carol service, so a couple of weeks ago I found myself in a draughty room with a few other similar minded people and an old keyboard.

The person who came up with the idea and who's leading the group (and who owns the keyboard) is a member of a different choir, but not its leader. All credit to her for giving it a go, but there are little frustrations that are utterly unimportant, but niggling. She described an arpeggio as a scale. She counts us in at a different tempo to that of the music. She has chosen some carols and managed to print the music for us, but they are set much too high so that anyone who isn't a proper soprano can't sing them.

She is encouraging us to sing the harmony parts (especially if we can't reach the high notes) but she doesn't read music particularly well so is having trouble picking out the parts on the keyboard (I haven't let on that I can play the piano). The rehearsals are alternating weekly between two locations, both almost impossible to find. But I like her, and I like her enterprise and enthusiasm and positivity and tenacity, and I am happy to give my support and encouragement. I am happy to participate in an enterprise where the quality will be pretty poor (my prediction after three out of five rehearsals) but it will be fun. And you never know, it might turn out much better than I expect. Things often do.

At work, the great news is that at last my parking campaign has succeeded, and the top management has arranged exactly what I would have wished, so that course participants can pay for parking for the four specific days of the course at £3.20 a day. I am getting better at delivering the patient education courses too, but clinics (where I see patients one-to-one) are very variable. Sometimes I get a run of people doing well who are happy and grateful; sometimes clinics are filled with people who find it all too difficult and aren't doing so well. Just recently, it's been more of the latter.

Sunday, 9 November 2014

Tradesmen, employment and growing old

Monkey puzzle tree (araucaria)
Peckover House, August 2014 (photo credit: Lola II)
Tradesmen update: I have finally got hold of the electrician and we have agreed a date for the fuse box to be replaced, which will mean a day and a half without power. I have booked the day off work, and had some pleasant thoughts about doing some fun things like perhaps going off for a quick ski in the Snowdome to keep my ski legs trim - my ski holiday is now booked for February. Then I realised that this would be the perfect time to get the car serviced as I need it to get to work every other day. The car is up for a long service medal, as it has now completed more than 200,000 miles.

Employment update: Mr A has scored a full time permanent job and has now been employed for a week; so far he is enjoying it. Meanwhile, I have delivered half of my first DESMOND course for people newly diagnosed with Type 2 Diabetes, and the first day of my third course for people with Type 1 Diabetes. DESMOND is a national programme with quality assessment and a requirement to adopt a particular delivery style which includes much questioning of participants and withholding of answers unless they really can't work it out for themselves. The Type 1 course is not quality assessed or peer reviewed, which means that I am only really getting into my stride third time round.

Update on growing old: I have new glasses! and new (trial) contact lenses! I love the glasses, they are varifocals and it has taken me no time at all to get used to them. The contact lenses, on the other hand, are proving more challenging. What the optician suggested was to have two different prescriptions, so my dominant eye would have the lens set up for distance and the lens in my other eye would be for near sight and reading. They provided me with five pairs of two sorts of lenses so I could try them out for comfort. I've had a go at one type for a week, and I don't like it at all - instead of having clear sight for distance and near viewing my eyes seem to confuse the focus and I can't see clearly at any distance. So that's not such a success - but I'll try the other brand in case the problem is with the lenses rather than the prescription.

More growing old news - happy birthday mum! She and dad kindly hosted a very small celebration attended by Lola II, Mr M, myself and another friend during which we watched a film that was made for my school's 60th birthday in 1979. See the odd children! and their antiquated school uniform! Laugh at the teachers' 70s cars, outfits and hairstyles! The undisputed highlight was the orchestra, featuring your very own Lola I and Sister D, with me wearing the biggest specciest specs you can imagine. It was the 70s! Big specs were the fashion item! I still have the massive specs in a drawer, and they are so heavy that I'm surprised my teenage ears weren't pulled completely off.

Brief update on not growing old - badminton club no. 2 have suffered an early retirement by one of their veteran ladies, and asked me very nicely if I could play in a match, so I said yes. Then I found out it was for their 1st mixed team in Division 1 of the league. It wasn't as bad as I expected; I was only made to look like an amateur by their first pair and we managed to scrape wins in the other two sets, mostly because my partner ran around like a maniac picking up everything while I fannied about near the net doing very little. Good fun.

In other news, I combined the trip to London with a bit of time with Lola II and Mr M. They took me to Southall and fed me a delicious authentic Punjabi meal, and I was supposed to help with some household jobs, but I don't remember contributing very much at all. I have a load of jobs for them to help with when they pay a return visit, and I wonder if they will manage to get away with doing as little as I did?

Friday, 31 October 2014

Transition and technology

Blue thistles
Vounaki, Greece, June 2014
I went to a study day last week, which has sent me into a spin. It was great, it was really interesting, there were loads of new ideas and people sharing their experience, and ever since coming back I have been vacillating between wanting to change the world, and wanting to keep my head down and just do my job.

In my previous career, I reached some people of influence, and feel that I made a bit of a difference in their thinking. That was on a few special occasions. The majority of the time I felt very much as though I was beating my forehead against a very solid brick wall. Not so much because of external resistance (although the resistance is always there), but because my own approach often missed the doorway, hence the brick wall. If I could only have found the way in, maybe I could have made more of a difference than I did.

It is a reflection of my own self-knowledge of what I am good at, and much more importantly, what I am not so good at. I am very good at remembering. I can do analytical thought. Give me a set of principles and I will derive pathways and outcomes, and I will make them practical, realistic and achievable. I will listen very hard, and make sure that people understand what they need to understand and try to ensure they feel supported and positive as they do so. My inherent pessimism lowers expectations, and rather than assuming "this will work" I imagine "what's the worst that could happen?" and try to make everything simple and failsafe.

But I am not a salesperson. I cannot spin the truth into a persuasive argument. I cannot achieve my own ends or the greater good by manipulating the listener out of their own entrenched position. I am no politician.

An example: the parking regime where I work has changed. Parking for 30 minutes is free; up to 3 hours is £1.60, 3 to 5 hours is £4.50 and more than 5 hours is £7.00. We run a course which lasts for about 6 hours, from 9 a.m to 3 p.m. or thereabouts. If you were coming on our course, how would you pay for your parking? Would you pay £7, or could you imagine an alternative payment option? Would you be keen to get away promptly at the end, or take the opportunity to linger to get the most out of the healthcare professionals who are leading the course?

From about 11.45 a.m. all of our course participants stop paying attention to what's going on in the room, and start thinking about getting out to their cars to avoid getting parking fines, and then up they get and excuse themselves one by one. This also happens to be the most intense period of the day, when we are covering the most difficult and yet important aspect of the subject. It's the part of the course that demands the most concentration, not the least. And at the end of the day they can't wait to get away, to make sure to avoid a parking fine.

I have spoken to the hospital management about how to avoid this disruption to our course. I have not yet found a way to convince them that it would be better for patient care to allow our participants to pay an acceptable amount in some other way. They have suggested that we restructure the course to build in a break at the critical time. I have lots to cover and little enough time as it is, and giving them a 15 minute break just makes everything run late. I haven't even been able to persuade my colleagues to support me in my one-woman campaign.

Anyway, this is just an example to demonstrate that my powers of persuasion are weak and ineffectual. Attending a study day that highlights all sorts of ways that we could improve our service just makes me tired, because improvement implies change, and persuading people to change is not what I do best. Add to that the fact that I haven't even been in my current job for a year, so am not yet 100% sure what it is that we do, let alone whether we do it effectively or in the best way that we can. I am also working with experienced professionals who have been doing their jobs for a very long time indeed, which means that they are fairly sure of themselves and somewhat more resistant to the upstart pushing for change than they might be if they were young and dynamic and a little insecure.

Spotty purple flower
Peckover House, August 2014
The study day was about Transition, which is defined as a planned move from paediatric to adult services. This is a difficult time for young people with diabetes - not only are there many physical, emotional and social changes going on, but it is a time of rebellion and trying to fit in, hormones are raging, they may be changing schools, moving to university, getting a job for the first time, leaving home, having new experiences including sex, drugs, alcohol, tattoos, piercings, gigs and music festivals. Where does long term management of a chronic disease fit in? What is the role of the parent in managing or giving up control of blood glucose monitoring and insulin administration, and who is in charge - the adolescent or the parent? And what about leaving behind healthcare professionals you may have known all your life to attend appointments with a brand new team of complete strangers?

Let me be clear. I have no idea whether we run transition well or not in our service. I know that one of the Diabetes Specialist Nurses attends a transition clinic over at the main hospital, but I don't really know what goes on; I am not involved in any way. So should I be involved? One of the speakers made the valid point that those who are diagnosed as children may actually have a poor knowledge of their condition because most of the education and help was aimed at their parents. They may be going through a pretty tough time as adolescents, and are not likely to want to attract a whole lot of attention to a health condition that is difficult to manage at the best of times. So if we aren't helping them through this and we could be doing better, then surely we should try harder?

And then, I think, why don't I just do my job and keep quiet? Nobody will thank me for getting involved, I don't really know what I'm talking about, I don't even have two years of experience in diabetes and know virtually nothing about paediatric care.

As well as the technical aspects of the transition service, the day also covered a new approach to insulin dosage for Type 1 Diabetes based not only on counting grams of carbohydrate but also fat and protein. We heard about a project in Scotland which has developed some really interesting and useful materials for use in transition clinics. There was also a focus at this study day on the world of young people and the use of social media in the management of diabetes.

This social media and technology that young people are so comfortable with - well, the building where I work doesn't have wi-fi cover. We don't even have a mobile phone signal to speak of, and I don't have a work mobile phone. Our computers are so old that the operating system is no longer supported by Microsoft, and locked down so tightly that many useful websites either fail to display properly, or we are simply prevented from accessing them. The idea of using Skype or Facebook or Twitter or even text messages to improve the service we provide is laughable.

We were told that Pinterest and Instagram are the rage, Facebook is a bit old but Twitter can be quite useful. On the back of this, I have now set up a Twitter account and 'followed' a very select few diabetes-related people and organisations, but so far it has matched my expectations (which were very low). I haven't learned anything useful or gained insight into the lives of people with diabetes, but it's early days and I'm not even sure I understand what it's all about yet. And of course I can't do anything with it at work - it's blocked on the PC, and there's no mobile phone signal so I can't access it on my phone.

One of the diabetes consultants has been identified as an Innovation Champion for the Trust. That is the obvious place to start, talking to this doctor about what might be possible, realistic or necessary. But I am still in two minds. Perhaps I should just keep quiet and do my job.

Two colourful flowers
Temperate House, Leamington Spa, October 2014

Sunday, 26 October 2014

Kwells are my friends

On the ground waiting to launch
September 2014
In case you weren't aware, and why should you be, 'Kwells' is the brand name for hyoscine hydrobromide, also known as scopolamine, and a remedy for motion sickness. And what's more, from my limited experience (one dose), it appears to work. After the unexpected but debilitating nausea I experienced during my first glider flight, I crowd-sourced suggestions via Facebook and was advised of the Kwells option. I don't much like taking medicines, but rather than endure prolonged nausea or forego a free flight, I decided to give it a go.

On my first visit to the gliding club with Lola II and Mr M, we were very much the honoured guests. We weren't made to do any work, we could sit around in the clubhouse or outside, enjoying the warm day and chatting to various people who wandered past and introduced themselves. This time, I was advised that I really should turn up at the start of the day and put my name on the list to fly and attend the morning briefing. So that's what I did.

Getting there at 9.30 I was among the last to arrive - many had already been there for more than an hour. They set up the airfield layout (which depends on the wind direction), sited the winch half a mile away across the field, got the planes out and checked them over, and probably did a load more things I'm not aware of. I was wearing trainers and it was strongly suggested that I'd need more waterproof shoes, so after the briefing I nipped home and changed.

I understood about half of the briefing - the bits where people volunteered for jobs and verified that they'd done the necessary checks and visitors were introduced and specific requests were made for assistance and people were asked to pay fees they owed. The technical stuff went right over my head - weather and wind forecasts and likely thermal activity and some more information that I have no idea about.

I was looked after by Phil, who is a most congenial character, and didn't hesitate to share the most scurrilous gossip about other club members. Like why the catering we had enjoyed at my last visit had changed to basic self-service - it was because of an argument about cake (yes, really) but nobody liked the member who had made all the fuss so nobody minded that the committee had judged him to be at fault, and his wife had withdrawn her catering services in a huff.

I was the only woman there except for a lady in the office who didn't seem about to do any flying. All of the members were extremely welcoming, and told me all sorts of stories at the drop of a hat. Some of them were decidedly peculiar (the people not the stories), but I'd rather feel welcome in the midst of some peculiar people than be ignored (cf. local Diabetes UK group). I found out a great deal about the technicalities of flying, including the advantages and pitfalls of using a winch for launching, a bit about how people are taught to fly, how instructors are trained, how the cables for launch used to be steel and are now synthetic, what can happen if the cable breaks during launch, and some safety procedures. I also found out a great deal about the personal lives of some of the members, local politics on motorised gliders, and how to acquire a large amount of wood for a Guy Fawkes bonfire.

When it was my turn to fly, Phil did a quick recap of the instrument panel and reminded me how to bail out, and we were off. The launch was as quick and violent as I remembered, and my stomach lurched ominously, but once we were up I felt fine, and was able to do a lot more this time. A couple of times Phil let me have full control, only taking control back when it was clear I was having a bit of trouble coping with the many different streams of information from the attitude of the plane to the instrumentation. As I said when we were back in the clubhouse and someone asked me how I got on: "I seemed to manage OK, and nobody died."

Conditions were not brilliant. The weather was grey, the wind was gusty, and Phil said that it was a difficult day for flying. Nobody was up for very long because there was no thermal activity at all. My first flight was ten minutes - the previous time it had been thirteen - and Phil gave me a chance to have another go but we only managed eight minutes airborne, mostly because he was letting me do a lot more of the flying that time and it takes more expertise than I possess to actually stay up for very long.

After the flying, I went down the field and had a look at the winch working, and then to the control tower (actually a computer on the top deck of a stationary double decker bus) where everyone's flights are logged. Nobody that day had flown more than 15 minutes at a time, so I didn't feel too bad about my efforts.

Although they all hoped I'd be back, I won't be returning, because there's just no time in my life for the commitment. It isn't the sort of hobby you can do in less than a day at a time, because there are a lot of jobs that need to be performed in order to allow people to fly safely, and it wouldn't be polite to turn up and expect to fly and go home again. Apart from all the setting up at the start of the day, there are at least five people needed for a launch: one to signal, one to hold the glider horizontal, one in the control tower/bus, one at the winch, and in my case, an instructor too. Someone also needs to drive the truck to bring the cable back after a launch and drive out to a glider once it's landed to tow it back to the start. Then all the kit and caboodle needs to be put away nicely at the end of a day.

It was a very interesting day, learning all about the technicalities of flying and many things I hadn't even considered before - trim, air brakes, flaps and rudders, wind speed, air speed and ground speed, waves and thermals. Maybe when I retire I'll come back to it.

View of me and the instructor

Monday, 13 October 2014

She flies like a bird...

View from the cockpit
Gliding, September 2014
The last two weeks have been frankly, ridiculous. I don't know why everything had to happen all at once, but it did, and if I hadn't had a blog post about my reading in the pipeline last week you wouldn't have heard a peep out of me.

So, first, my glider flight. This was a birthday present from the lovely Mr M and Lola II, and replaced the one that had to be cancelled in Lincolnshire because of the high winds. Lola II and Mr M took me to a nearby airfield, and we were welcomed at the Clubhouse by all sorts of friendly people willing to share their stories while they addressed some sort of problem with the glider. There was another visitor ahead of me in the schedule, so we had to wait quite a while, but the weather was pleasant and warm and we could have a bit of a chat and watch the launching and landing procedures.

The gliders at this club are launched by a winch rather than being towed up by a plane, and it is quite spectacular to watch. In just a few seconds you go up at a 40 degree angle from zero to sixty miles an hour at 1200 feet. Barry gave me the safety talk and went through the instrument panel before I strapped on the parachute and climbed into the tiny cockpit in the front. It was all dual control, and the flight was designated a 'trial lesson' so in theory I would be given some flying to do, but Barry did ask me to keep my hands away from the controls while we took off.

So far, so good. From this point onwards, however, it didn't go so well. I was rather looking forward to the take off, as I have no problem with acceleration in normal planes or on motorbikes. Unfortunately, as we were thrown up into the air, my stomach somehow didn't go with us, and within just a few seconds after being launched I started to feel very sick. As we circled on a thermal, Barry talked a bit about what he was doing and I directed the fresh air blower into my face and tried very hard to think about something other than the nausea.

The scenery was pleasant but the sensation was not. Barry let me have a go at driving for a second or two, but very soon it was time to land, and to be honest, I wasn't sorry. With nowhere to throw up except on my own lap, I was really glad to have avoided that outcome. Barry marked up my log book - we had been in the air for 13 minutes, although it felt much longer. Lola II was ready to protest at the short duration of the experience, but I reassured her that it was fine, and please don't make me go up again...

I couldn't eat anything for the rest of the day. Advice via Facebook and from friends suggests I could have a go at using the very effective motion sickness treatments available over the counter, because the package includes a second flight within two months. We'll see.

Then the two weeks of mayhem started. Within these two weeks: I went to the Diabetes Education Club at Warwick University, where my colleagues gave a talk to a group of interested health professionals (Doctors, GPs, Nurses in GP practices and Dietitians) about the very low carb diet options that we offer patients; I spent two days in London being trained as a DESMOND educator; my oldest friends from school came to visit; I participated in a public meeting organised by the local Clinical Commissioning Group and Diabetes UK to consult service users about what they want from their Diabetes Services; I went to a comedy gig to see Marcus Brigstocke at Warwick Arts Centre; I attended a branch meeting of the West Midlands British Dietetic Association all about the gastrointestinal tract and various disorders that can arise; another friend came to stay before going to a show at the NEC up the road; I have played in a badminton match (we won!); I have been to see a film and done two runs of about 30 minutes each. I have also renewed the car insurance, and been to the optician. The car has also celebrated the milestone of reaching 200,000 miles by starting to act a bit flaky if it's left without being used for a day or two.

All of these things were worthwhile, satisfying and mostly enjoyable (except for renewing the car insurance, which is one of the most painful and frustrating tasks in the whole world). The one I was looking forward to the most was the optician, and over the next week or two I shall be trying out different contact lenses, followed by receiving my new, varifocal glasses. As an indicator of advancing age this step is unwelcome, but in terms of being able to read comfortably again, I am looking forward to it immensely.

Another view from the cockpit