Tuesday, 24 January 2017

Progress

Close up of striped leaves
Krakow Botanical Gardens, July 2016
The upstairs spare room is starting to become properly habitable. I've cleaned and polished the floor and installed a bed, and I'm using the table in front of a window for my ebay photographic activity. That, by the way, is going extraordinarily well, and I continue to laugh out loud whenever I am notified that someone has bought another bit of useless junk for £1.99. Two of my esteemed customers are even located so close that I have actually hand-delivered their purchases. Don't get me wrong, I'm glad they are buying because otherwise the hours I spend on photography and online listing would be a pointless waste of effort, but really, I feel sorry for their families. At some point they will have to do what I'm doing, unless they have the grim determination to build a bonfire.

I'm also starting to repopulate the loft. I don't want to fill it right up again, but it's nice to be able to store a few things in a moderately accessible way. The next task will be to get the spare room painted, and then convert it to half office, half bedroom. With just one exterior wall and two radiators it's a lot warmer than my bedroom which has three out of four exterior walls and only one small radiator, so I may decide to move in for the winter. I've spent a comfortable night in there as an experiment, but it will need curtains before it's any use in summer.

I haven't written about patients for a while. They continue to propose marriage - another one last week. Most aren't in the marrying mood and tend to be fairly recalcitrant when it comes to making dietary changes. I enjoy the teaching most, where people turn up knowing very little except what they've read in the press or heard from a doctor or nurse with no real knowledge of diet. They usually go away knowing a lot more, whether it has been a one-to-one consultation or a Type 1 or Type 2 group education session.

I would love to give a blow by blow description of some of the consultations that I'm involved with. I think I'm getting better at working with the usual range of 'reasons' people give for not doing what they have told me they intend to do. The one the continually irks me is when we embark upon the 'weight loss' conversation, and the first response is about not being able to exercise - arthritis, or fibromyalgia, or a bad back, or anything really. Exercise is hopeless for weight loss, but the resistance to weight loss by actually eating less is immense. I have a poster on the wall which says, for example, that 178 kcal or just three custard cream biscuits is the calorie equivalent of 37 minutes brisk walking. The calories in a single pint of lager are the equivalent of 53 minutes of brisk walking.

The DESMOND programme for people with Type 2 Diabetes has a nice script for introducing the weight loss session.
- What causes our weight to change? [food and activity]
- What happens to your weight if the amount of calories you get from food is the same as the number of calories that you burn off through activity? [it stays the same]
- If our weight starts to go up, what do you think has changed? [eating more and/or doing less activity]
- What would need to happen for someone to lose weight? [eat less and/or do more activity]
- What about people who are less mobile, and whose activity may be limited? What else can they do if they want to change their weight? [ha ha, got you there, you have no choice but to say 'eat less']

I know I shouldn't, but I get a small thrill if I manage to get someone to admit that losing weight is still possible even if they cannot run a marathon or play squash. Or walk to the car. I shouldn't feel that way because while we all know in our heart of hearts that eating less will allow us to lose weight, it's incredibly difficult to achieve. It's supposed to be my job to help, and I continue to try, but I do think that those who succeed tend to do it in spite of me rather than because of my input.

Anyway, back to the LTRP - I spent a happy day in Birmingham looking for household goods, and while I didn't buy anything spectacular I did make a few decisions on what might happen next, and I've since bought lampshades. The prospective builder and the airing cupboard carpenter have visited, and the people from the kitchen shop also got back to me with details of an alternative builder. I will have to address my naming conventions soon, as I am reaching the end of the vowel supply with only Ulf and Ylf to go. I may repurpose the name Elf, because I'm not planning to use the original man any more. I'm not going to ask Olf the Builder to quote for the kitchen build either. Ilf the Handyman, however, is a permanent fixture; I intend to keep him for as long as he can wield a screwdriver.

I also went to another Barn Dance with badminton friends who are very enthusiastic about Barn Dances. I feel satisfied that I have given it a good try, but I don't really like it. We had a discussion about the next badminton social event, and reached the conclusion that it needs to be indoors, not food-based, including physical activity but not so noisy that we can't hear each other speak. It was pointed out that what we were describing sounds a lot like badminton.

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