Sunday, 7 February 2016

War of the Roses

Flowering shrubs with the Chicago skyline in the background
Chicago, June 2015
I wish I'd thought of this title for that previous post, but it still applies because despite another three sessions on the roses there are still thorny remains on the lawn. It really is a monster. I have done a few other house-related chores - shown another potential builder around the garage and bought a saw to cut an Acer down to size. The front door has been a bit sticky recently so I've also bought a rasp and a chisel to try and avoid having to use the back door, which is equally difficult to lock from the outside. It's still early days in this long campaign to make my place of residence habitable, but I do dally with the idea of just living in a tent somewhere with a more temperate climate. Except I don't have a tent at the moment. In fact, despite extensive camping activity, I have never owned a tent, just exploited those around me who do.

I have been given a late 50th birthday present by Lola II and especially by Mr M. Together with four other friends, I have tasted nine different single malt whiskies. This is a small part of Mr M's collection, which he inherited from his father. I can honestly say that none of us was particularly interested in whisky, and at least four out of the five didn't really like whisky, but we gave it our best shot and I like it much more now. Mr M asked us what flavours we could pick out, and at the start it was pretty much 'whisky', but by the eighth tot I could almost tell them apart. There was lots of lovely food as well, and everyone stayed over and we went for a bit of a walk on Sunday, and it was a delightful weekend.

The following week was a bit full on with badminton - Ladies matches on Monday and on Friday, and a club night on Thursday. There are four ladies in a team, and we only have three regular players. The fourth has to be rounded up from a pool of candidates, and one of these fell over and hurt her knee quite badly in a previous match. We recruited another fairly reluctant player to join the team for the next match, and about an hour later she fell over and broke her wrist. Another lady is on a fairly lengthy holiday in some part of Africa, and by now we're running out, because another had a pre-existing tenpin bowling commitment. In desperation I approached a couple of random players I know from other clubs, one of whom had never played a Ladies match before, and they said yes and played and it was fine. So now we have another two possibilities, and maybe things won't get so desperate next time.

This week I've got two matches again - Mixed this time, and I'm not responsible for recruitment, so that's a relief. I'm having a bit of a break from the garden to get some admin done, including booking that ski holiday, which is most exciting as we are planning to go to Bulgaria and I've never been there before. I'm also getting those warnings that my cut price energy tariff is about to end at which point I'll be put on the standard suck-you-dry tariff, so there's a bit of computer-bashing required there too. The sleeves have now been attached to the dress I'm making for Sister D.

Meanwhile Lola Towers is fighting back - it has clearly detected a threat to the unchallenged entropy it has enjoyed for so many years, and detached the floorboard in the loft to which the ladder is attached. The ladder can still be used, but not retracted.

Work, then. I miss the accounts that I used to write about things I learned during my degree. I particularly enjoy the peculiar challenges that my patients present me with but I am, of course, unable to write about them because they would potentially identify the people in question, and that is something that I'm not allowed to do. What I should do is write them down privately, and then amalgamate stories in some anonymous way so the interesting aspects can be included here. I haven't got round to doing any such thing.

In general I can say that trying to support people who have diabetes in achieving their dietary aims is fascinating, given that the only tools I have at my disposal are my words. Medicines and treatments are used by Doctors and Nurses, but Dietitians have only theories of behaviour change, evidence-based approaches, experience of what has previously worked or not, and knowledge of human nature.

The most usual consultation in January starts with me asking "How are things going" and the response coming back "Not so good". Obviously Christmas is a difficult time when it comes to dietary restraint, and the next step of the consultation is to find something that has gone well. "Well done for only going off track for two days/a week/two weeks/a month" (as applicable). "So you haven't lost any weight, but at least you haven't gained any either," is another common approach, together with "In the last month/week/few days your blood glucose readings have been quite good." This one is rarely used, because most people 'forget' to bring their meter or diary even though this is what changes or suggestions are usually based on. There are so many ways of trying to move someone forward rather than endlessly rehashing past failures. The rest of your life starts today.

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