|Peckover House, August 2014|
Nothing else of any particular interest, although the trip to London produced all the highlights: an urban fox jumping over the fence within a couple of feet of the window we were looking through, my first ever sighting of a jay (although my second sighting came within a week in a completely different location), and participation in the Gulloebl Chinema.
Work is still good, very good. I am practising and learning and practising some more, and reflecting on my performance and receiving and giving feedback. Some patients do very well, in which case their success comes from their own efforts. Some don't do so well, in which case I try to find a different way to help them help themselves. We discuss changing long-established dietary habits. "You're not going to tell me what to do, are you?" said one patient. "That's right," I replied. "You have to decide for yourself what you're going to do, because I'm not going to be there when you're faced with a choice."
The very low carb group is thriving - at least, those who attend seem to be getting on very well. I have had a quick look over my past blog posts, and I don't think I've written about the group before. It comprises all those people who have adopted the very low carb lifestyle to help manage their diabetes, and since September we have been meeting once a month to chat about various aspects of the diet - sometimes someone brings some food they've made for people to taste, we swap recipes, and we had a speaker talking about retinal screening at one meeting. My Broccoli and Stilton Soup was very well received, as were the cheese biscuits that one of the group had made.
I have been recruiting patients to the group at a fairly slow rate, and about half of them decide after the introduction that they aren't going to carry on, but we have about ten regulars now. Everyone is weighed and has their blood pressure measured, and one of our nurses is available to consult about medication changes. They seem to enjoy the meetings and, more importantly, most are enjoying the diet, losing weight, reducing medication and are keen to continue. Only one has dropped out so far, but may return now that the festive season is over.
I participated in a small meeting to discuss our pump clinics. An increasing number of people with diabetes are using insulin pumps, and our existing provision is inadequate, leading to lengthening waiting lists for clinic appointments. There were just four of us: the main diabetes doctor who leads on pumps, our two nurses and me. At the end of the meeting I felt that things were clearer than they were at the beginning, and that is such a rare event nowadays. It looks as though we have found a way to expand the pump service, and I may have a part to play which will also increase my knowledge and skills, which is just what I like.