What I've been reading

Perfume: The Story of a Murderer
by Patrick Süskind

narrated by Sean Barrett

"Survivor, genius, perfumer, killer: This is Jean-Baptiste Grenouille. He is abandoned on the filthy streets of Paris as a child, but grows up to discover he has an extraordinary gift: a sense of smell more powerful than any other human's. Soon, he is creating the most sublime fragrances in all the city."

A strange book, but I liked it. It reads as a normal novel, but has a few elements of fantasy and unreality that spice up the story. Recommended.

The Last Hero: A Discworld Fable
by Terry Pratchett

narrated by Stephen Briggs

"Cohen the Barbarian. He's been a legend in his own lifetime. He can remember the good old days of high adventure, when being a Hero meant one didn't have to worry about aching backs and lawyers and civilization. But these days, he can't always remember just where he put his teeth."

Apparently this is a picture book, and I imagine it would indeed be enhanced by drawings of the characters. I believe it is the last of the Discworld books, and despite his progressive Alzheimers Terry Pratchett manages to produce entertaining and thought-provoking ideas right up to the end.

Six weeks

Six weeks! and I can't remember what life was like before. There is dust everywhere - I make a token effort at cleaning at weekends, but dust-covered normality is restored almost immediately. There are lots of pictures this week, however.

First, the ceiling panels go up, followed by the walls including their extra insulation. The wall nearest the pub is far from straight - none of the walls is straight - but Ulf insists that it must be made straight otherwise the worktops won't look right. Running the best straight line means that the doorway into the rest of the house has to be moved slightly, which is fine because I have decided to replace that door with a new one. Ulf brings me a big thick catalogue for choosing doors and door handles, and I'm getting quite good at choosing things now. Practice makes perfect.

Week 1

Week 4

Week 6

Later in week 6

On Wednesday I came home in the dark (actually, most days now I came home in the dark) and the back door and French doors and windows had been installed! I had to wait until morning to get a proper look, what with there being no light in there. The partition wall acquires its plasterboard surface, and the plastering starts, in the utility room first of all.

Week 3

Week 4

Week 5

Week 6

The last thing to happen is that the perimeters of the room have been cleaned up to allow for the final cement filling before the floor is levelled. When I got home on Friday, in the dark, the skip was gone! I went round to the kitchen to see what progress has been made, and found that there were two fan heaters plugged in and running. I texted Ulf to find out whether they need to run all night, and he replied that it's OK to turn them off. That text message has saved quite a few quid on my electricity bill.

Not the LTRP

Krakow Botanic Gardents, July 2016

All this building activity reminds me of university time when I was learning new things every week, but the desire to blog about the building work all takes up an awful lot of time. I used to have plenty when I was a student, but nowadays not so much.

In case you hadn't noticed, I let the tenth anniversary of my blogging pass without note in the summer. I held no expectation that I'd keep going this long, although I knew that writing is something I enjoy and hoped that blogging would satisfy that urge. There's lots of room for more writing once I 'have more time' (retirement?) including some fiction, perhaps. Or there are the notes of my year of volunteering in Israel, which I planned to turn into a book thirty years ago but never got round to. And I've got a plastic bag of stuff from primary and secondary school days that is begging to be examined - I bet some of it would be blogworthy.

Anyway, the two weeks without days off and the LTRP and extra nights of badminton matches and music group and a trip to see mum and dad have worn me out, with a bonus night of disturbed sleep about a particular patient that I can't even write about, but he/she made me so troubled and disturbed and ANGRY that I couldn't sleep. I didn't even go to badminton on Monday of the second week. Delivering my courses I was getting confused about what I'd delivered to which group.

There's still quite a lot of high level activity around diabetes education following the awarding of a large pot of money to the commissioners who are trying to work out how to spend it. In examining this problem they have realised that they don't know what they are already paying for. Naturally enough they asked someone in the hospital finance or business department how their existing funding is spent, and this person addressed the issue by completely ignoring it until one of the doctors realised what was going on and called a meeting. Thankfully I didn't have to go, but my colleague reported that it went quite well and may have given us a further brief reprieve.

There is another meeting about diabetes education that I will have to attend; they have set up all sorts of 'Task and Finish' groups to try and work out how to spend this money, and have appointed a project manager, so it is possible that all the grant will be spent in finding out how bad the situation is, and no money will be left to do anything about it. In the meantime there are rumours about what will happen when NHS Commissioning is dissolved again, this time in favour of GP Alliances. Fear not, I will let you know exactly how this goes, if it ever happens.

Patient education for Type 2 diabetes has all but ceased with the departure of my Dietitian Team Leader colleague and another member of that dysfunctional team. Courses were cancelled such that there has been only one course delivered between last August and January next year, and it was delivered by me and the ex-Team Leader to only four participants. There are various conspiracy theories about why this should be - when I offered to deliver more I was told that there wasn't really a waiting list. Meanwhile the commissioners are looking at the thousands of people being diagnosed with Type 2 diabetes who are eligible to attend the course and may well wonder why only four people have received any education in six months.

Then out of the blue came the bombshell that one of the people who hasn't delivered a course for about a year has won an award as Educator of the Year, which makes me laugh but everyone else is furious. Hard on the heels of this news is the further update that another member of that team is leaving, although there is a rumour that a new Dietitian Team Leader has been appointed. Nothing confirmed has reached me, though.

I attended a very useful talk about Eating Disorders and Diabetes delivered by the psychiatrist who leads the service for this area. It was an evening meeting in a posh hotel with dinner, and the audience was a mix of doctors, nurses and dietitians but I was the only Diabetes Specialist Dietitian and there were no dietitians or nurses from the main hospital or from the community diabetes service. The other dietitians were from the weight management service, and they told me that a) their psychologist screens patients who have been referred onto the pathway to bariatric surgery but does not treat any eating disorders that are uncovered, and b) while this Eating Disorders service exists for people with diabetes, there is a much lower level of service for people who don't have diabetes. At least they have access to a psychologist - we don't in the adult diabetes service.

I learned about the three main types of eating disorder: Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder, and these are even more prevalent in the population of people with diabetes. Damaging behaviours include purging, laxative abuse and excessive exercise, but with diabetes comes the additional option of insulin restriction, combined with the increased need to focus attention on food and blood glucose that is not necessary for people who don't have diabetes. The existence of Diabetic Ketoacidosis (DKA) which is one effect of insulin restriction also hugely increases the risk of mortality in the diabetic population with an eating disorder.

The service consists of a psychiatrist, a nurse and a dietitian. I'm quite keen to see more of what they do, so will try to set up a visit. Maybe they will come and talk to the diabetes dietitians once we have some again.

Enough of work. The music group is still a lot of fun, but I really need to do some saxophone practice. And having managed by borrowing in previous years I feel obliged to get myself a Christmas jumper for the concert, not least because the church is freezing. Sounds like a hardship, but it's the sort of clothing I'd enjoy wearing at any time of year so not a problem.

The trip to dad and mum, while tiring, was a delight because dad is so much better. The stent that drains excess fluid from his brain was opened to its fullest extent at the last appointment, which could have had adverse side effects but in fact has restored him to nearly his previous state of health. He's still deaf and wobbly on his feet but at least he's talking and showing an interest in what's going on around him. He even asked me how the building work was going. I told him that in future if he's naughty we now have an on/off switch.

Otherwise there's a distinct lack of reading going on except audio books and podcasts in the car.

Week the fifth

Lots of building action this week, although most of it isn't very photogenic. Taking pictures of pipes and cables running along walls and ceilings doesn't result in anything I want to share here. There was quite a lot of rain this week as well, which slowed down progress above the roof but there was much activity below.

Monday
The boards on the sides of the roof are in place, and they have constructed the skeleton of the internal wall dividing the kitchen from the proposed utility room. The corner of  the wall due to receive the boiler was prepared and Plumber Ulf made a start. They took down a bit of the living room ceiling so that pipes and cables could run from the boiler to the heating controller and tank upstairs, and the dust from this operation has reached every nook and cranny of the whole house. Ulf told me that they had done the best they could to seal off the area with plastic sheeting. It didn't entirely work, but I imagine it could have been a lot worse. I emailed a marked up plan of exactly where I want all of the electric sockets and light fittings.

Tuesday
No day off for me again, but I did manage to get home in time to talk to Plumber Ulf about options, including choice of radiators - another occasion where I narrowly averted the choice being made for me. He also told me about a steel pipe that runs outside the house between the meter point in the pavement outside and my stopcock inside - if anything should happen to this pipe the water would have to be turned off at the meter point. Today was also the day for the boiler move, and while Plumber Ulf managed to restore the water supply I didn't have any heating that night. The outside tap was plumbed in, but not in a position I would have chosen had I been asked. Ulf made a good case for where it was, but still.

Wednesday
Heating restored, the boiler is resplendent in its new situation. There are lots of pipes and cables passing above the boarded up door into the house, allowing winter wind to whistle through into the living room bringing a seasoning of dirt with it. Ylf the Kitchen came to measure up at this point to make sure everything would fit. What with the near miss on the radiator, I emailed Ulf the list of things that are pending, and this is where the discussion about stairs continued in earnest. Ulf gave me a price, which was pretty steep, and offered to bring round samples of wood. I made the point that for that price I'd want to see more than samples of wood, and sent him a link to the sort of stairs I wanted, to which Ulf the Stairs simply replied "Sorry Ulf but I don't keep any photos. The stairs will look exactly the same as the link the lady has sent."

Thursday
Concerned about the stairs quote, I got in touch with the manufacturer of the stairs whose picture I sent as an example of what I wanted, in order to clarify the cost involved. Although the French doors and windows and the outside back door have already been ordered, Ulf sent me a picture that doesn't look too bad, and I managed to intercept the order for internal doors and agreed a price for the radiator I want. I'm also home in time to catch Electrician Ulf and talk about the location of sockets, light switches, pendant lights and also the style of sockets I want. Ulf has left me a catalogue to allow me to choose doors and door handles. Today the rubberised roof membrane was stuck down, and they got to work on the lead flashing between the roof and the adjacent wall. I went to sleep for two hours before the evening's badminton match (we lost).

Spot the difference...

Where's the boiler?

Friday
I'm up early because I didn't manage to photograph the site before it got dark yesterday, and Ulf arrives early too, so we have the chance to work things out with the stairs. Ulf has personally guaranteed the quality and appearance, so I'm going with his contractor. He's agreed to help me out with some removals - if I clear the upstairs and downstairs desks, then he and the Henchmen will take my downstairs desk upstairs and get rid of the other one. The building inspector is booked to visit to sign off the roof construction, and by the end of the day the mount for the roof light is in place, the last bit of internal wall is gone, and the plumbing and electrics appear to be ready for boarding up and plastering.

Although it is all going extremely well I'm really getting tired of the whole project now, especially because of the two weeks with no days off, too much badminton, and a busy weekend in the middle. On the other hand, biscuit consumption has been restored thanks to visits from Electrician Ulf and Plumber Ulf.

The fourth week

Temporary kitchen

This week and next I have so badly mismanaged my work schedule that I have to work all five days. This is because of a) the unexpected and extraordinary demand for our course for people with Type 1 diabetes, b) the lack of trained staff to deliver our course for people with Type 2 diabetes, and c) not knowing ahead of time exactly when the building work would happen. So on Tuesday I started delivering a Type 1 course that lasts 4 weeks, on Wednesday I started delivering a Type 2 course that lasts 2 weeks, and on Thursday I continued delivering a Type 1 course that started 2 weeks ago. Monday was a long clinic day and on Friday as well as my usual clinic I had to deliver some more training to Healthcare Assistants and Student Nurses who work on the hospital wards. I also agreed to play in two badminton matches (won one, lost one) as well as usual club night on Monday. What doesn't kill you makes you very, very tired.

Meanwhile on the building site yet again I avert disaster by the skin of my teeth as Ulf continues to nearly make various decisions without sufficient consultation.

Chimney breast, no roof

Some chimney breast, roof joists

No chimney breast, roof on

On Monday more walls came down, ceiling joists appeared and the remaining kitchen radiator was removed. Aware that I wouldn't be around, I emailed Ulf with questions about stairs, damp repairs, doors and windows, radiators, the boiler, the kitchen fitter, electrics and plumbing. We arranged to meet early on Tuesday before work.

I set the alarm for early but was woken late on Tuesday by the skip lorry, because I had forgotten that my alarm doesn't ring on Tuesdays. I managed to get ready in time and had a long chat over the skip with Ulf (and took breakfast to work). Apparently both Skypod Doors and Windows Ulf and Plumber Ulf visited on Monday to measure up, and in his inimitable style Ulf made sweeping assumptions about fittings and installations. So far I have been very lucky in intervening at just the right moment, but it is most disconcerting.

The perpendicular joists appeared on Tuesday so I can now see where the roof light will go in, then the gaps between joists were filled with insulating material, and finally the roof was topped with marine ply. The rubberised membrane was laid on top to keep the wood dry but will be stuck down properly next week. The mount for the skypod was constructed, although Ulf now says it is a roof lantern again. Stages of roof construction in week 4:

Ilf dropped by on Thursday to have a look at progress and seemed to think it looked pretty good. The only other incident of note was unfortunate: some boards had been propped against the side of the skip, and on Saturday morning one of the boards was caught by a gust of wind and broke the tail light of one of my neighbours' cars.

I replaced the slightly soggy biscuits with fresh ones on Friday (bourbons, Maryland choc chip, custard creams) but they weren't touched. What is going on?.

Before and after

By popular request, here's a quick review of the current kitchen works.

Before:

The street is at the top of the plan with the front door, hallway, shower and downstairs toilet on the right, my old office with the sofabed at the top left, living room in the middle with the French doors on the left opening into the garden and the fireplace at the bottom and stairs rising on the right. None of that is changing except the stairs will be replaced. The old kitchen is at the bottom with the door on the left into the garden. It also used to contain the dining table, and cupboards and worktops are not shown along the 'bottom' wall. The radiator was under the high level window on the right.

After:

The kitchen is being extended 'downwards', i.e. towards the back wall of the garden. New French doors will open from a seating area on the left where the sink and the kitchen door were, and a new kitchen door will open into a small utility room at the bottom left which will hold the washing machine, a sink and a tall cupboard. The roof light is shown in the middle and towards the 'top' of the kitchen. The main working area of the kitchen will be along the right-hand wall where the radiator was and also opposite for half the length of the wall, along the side wall of the utility room. The boiler isn't shown on the 'before' plan, but it is going to be moved from the bottom wall to the side wall, probably during the coming week. There's also going to be a worktop/seating area right in the middle.