Small goals

Borovets, February 2016

It is positively ages since I came back from skiing, and it feels as though I have been tired the whole time. Obviously I have been ill which often results in tiredness, but even though I do have days off I seem to have filled them full of things that need to be done and I could do with having a day when I actually have a rest. I tried last Sunday, but still felt I had to catch up with all the email that I had neglected for the whole week.

In terms of productivity I have achieved many very small goals. Some goals are very, very small, like buying a new iron, which for most people may take an hour or so, but because I have to make things complicated I first have to research online to see how much irons cost before applying for the right value of vouchers using the points amassed but not yet redeemed from my TV-watching days (and what do points mean?) Then I wait for the vouchers to arrive through the post, wait for the day when I can go to the shop, and loiter indecisively for far too long cursing the small domestic items market for having far too much choice. I eventually choose. I am amazed by how little such small domestic items cost. I have underspent my vouchers by £10.01 and am left with a spare £10 voucher and a gift card containing the grand sum of 1p. They couldn't even donate it to charity.

The gadget I ordered to allow me to transfer photos from my camera to my laptop arrived, so you get bonus skiing pictures in this post which is entirely unrelated to skiing. I am also having an argument with Amazon over an esoteric aspect of their business that is too tedious to relate here but means I cannot cancel an order that hasn't been delivered and cannot replace the undelivered item without incurring a cost greater than the value of the item.

Other small goals - I have indulged in the luxury of a professional cleaner for a one-off blitz of the dirtiest areas of Lola Towers, which I have to admit were as filthy as anything I have ever seen. I felt much more like a normal person when, for the first time in 15 years, I brushed my teeth in the bathroom upstairs rather than the shower room downstairs. A very small goal achieved. Life is sometimes peculiar and complicated and a bit sad.

A less than sunny day in Borovets

Work news. As Dietitians working in Diabetes my team and I are often called upon to advise on weight management (which usually, but not always, means weight reduction). The quirks of NHS commissioning mean that in the setting where I work the eligible population is small and relatively unchanging, so I don't have enough people to maintain a group, and I had to disband my Very Low Carb Lifestyle group when I was getting no more than 2 people to turn up for a session. The population in the neighbouring city is larger and they have access to many more potential customers. A formal education programme is available to people diagnosed with Type 2 Diabetes within a year of their diagnosis, but after that they only used to get one-to-one half-hour appointments with a Nurse or Dietitian.

I have been working with my colleagues to develop a course delivered for two hours a month for three or four months that can help fill this gap. It has been a difficult and frustrating experience, because none of us has much time outside of clinic commitments, and dates were set and patients invited to attend the course before a programme was developed. My colleagues are caring, intelligent and committed practitioners, but there was no way this was going to be a success, and unfortunately I had to sit in and watch the sessions unfold, and it was messy. So despite my best efforts to stay out of it, I ended up with the job of coming up with a sensible way forward.

The first thing I did was to try and establish what the overall aim or purpose of the course was - a simple statement in one or two sentences was what I was after. I discovered that there was a divergence of views even on this fundamental matter. After we'd settled this initial issue, I spent some hours working on the nitty gritty of learning outcomes, key messages and timings of sessions as well as the proposed content. I've squeezed everything into three sessions, but then I got roped in to help out and discovered that my timings are probably hopelessly unachievable. Meanwhile everyone who needs to discuss what I've proposed and come up with some sort of consensus has been on holiday. Including me.

It has certainly been a heartsink kind of project, and I'm no longer even sure that my own ideas are feasible. We're going to talk about it some more in a meeting coming up shortly, so my faith may be restored then.