Sunday, 31 August 2008

The dentist

This has been the most expensive month in recent memory. I'm not looking for sympathy, funds are available, but the car service at the start of the month was a major one that included replacing the cam belt. I bought Mr A a birthday present of the second day of a paragliding course, food and drink for the party, and then I went to the dentist.

Visiting the dentist is one of the three most unpleasant experiences that I regularly put myself through, the others being cervical smears and blood donation, in case you were interested. Actually, blood donation isn't that bad. At least they give you a biscuit afterwards.

I have always suffered at the hands of dentists. The first visits I remember were as a child, when Uncle Leslie was our dentist. It was dentistry that is now obsolete - a mechanical drill that made that ominous high-pitched mosquito whine, no anaesthesia, that smell of the friction of drill against tooth enamel, and magical blobs of mercury rolling around on a little plate before being transformed into a paste that was forced into our teeth. Then when it was all over, the offer of some sort of treat, perhaps a small toy? My memory of that is vague. I remember that the drilling hurt, but not unbearably. I think I dislike the needles more.

After Uncle Leslie retired, the dentist wasn't such a long way away, but then he wasn't family either. I remember him as a grim-faced man who never smiled, never indulged in small talk, didn't care to put you at your ease with a kind word, just got on with the job. He's still my parents' dentist, and perhaps he is a very good one, but I didn't like him at all. And of course there were more fillings. Brushing my teeth was never an activity I looked forward to, unlike eating chocolate.

Then there was a period of about 8 years when I was treated at the Great Ormond Street Hospital in London, and I still remember Mr Mars, a lovely, kind man. Serious dentistry was required: my teeth were pointing in all directions except the right one. As well as removing four teeth to make space for the others, I had to have one removed that was coming through my palate. Mr Mars applied the sort of brace that produces an effect like James Bond's arch enemy Jaws, which is about as traumatic as it gets for a fairly insecure 13-year-old just starting to become obsessed with appearance. There isn't a single photo of me smiling in the whole of this period.

The first dentist I registered with under my own steam (rather than through my parents) was a revelation. He treated me as an intelligent person, talked about what was going on in my mouth, and had a camera and a screen so I could see what needed doing. I think there was even a mirror so I could watch the whole thing. Unfortunately, I didn't live there for more than a couple of visits. The dentist in Manchester was OK. Not as bad as the worst, but not as good as the best.

Now my dentist is Chris, and he's a happy, cheery soul. He and his wife were friends with the couple that we bought our house from, and it turns out he went to school with Smurf, the landlord of the pub next door, who Chris remembers as the cool kid in the class. It turns out that the most pressing need within my buccal cavity is not in Chris's department, but demands the attention of Laura, the Hygienist. No more caries, now I have pockets. Apparently these form between tooth and gum, harbour bacteria, and are the dental equivalent of War Crimes, Child Abuse, and Genocide combined. Pockets are Pure Evil, as they say in the film 'Time Bandits'.

Pockets are dealt with in a number of ways. The use of interdental brushes and anti-bacterial gel or mouthwash is one. But mainly, Laura gets out a variety of medieval torture instruments, puts me through an hour of excruciating discomfort, charges a small fortune, and then makes another appointment so she can do it again. She also has a pierced tongue - this labels her a masochist as well as a sadist. She masks these tendencies well in social situations.

As a full-time student, I am entitled to 100% free dentistry treatment on the NHS. To see Chris and Laura, I have to have private treatment, as they don't offer an NHS service any more. I suspect that I am likely to keep my teeth longer if I continue to see Chris and Laura, but actually I have no idea whether their advice is sound.

They have treated me for several years and have achieved definite improvements in eliminating the evil pockets, but there are two areas that are resisting all efforts to heal. I have an ache at the base of my neck in the mornings and signs of abfraction on a number of teeth, which suggests that I am grinding my teeth at night (bruxism). An appliance is recommended that should prevent the grinding and allow complete healing: only £350, and it will last indefinitely. Laura has one: she can't sleep without it any more. Oh, Lord.

If anyone has any expertise on the mysterious art of dentistry, feel free to share. Otherwise I'll just dose myself up with enough painkillers to numb my bank balance, and go for the recommended anti-bruxism appliance. Perhaps in a couple of months, when the car, the paragliding and the party have worn off.

Thursday, 28 August 2008

Diabetes clinic

Apart from being away from home and in a hospital cell or library dungeon during the day and an isolation unit during the evening and night, it's been a bit less miserable and slightly more interesting recently. I'm getting used to the confinement and disempowerment and all that stuff, and it was curry day for lunch again. Only a week and a bit to go.

I went to a multi-disciplinary meeting of the Palliative Care Team at the local hospice yesterday. It wasn't a very long or interesting meeting, but loads of people were there, including doctors, specialist community and hospital nurses, the chaplain, clinical psychologists, social services, Macmillan nurses and the palliative care and oncology specialist dietitian. What essentially happened was that they talked about all the people needing palliative care who were in hospital, in the hospice, new referrals, and those that had died (the RIP's). The lady I wrote about two weeks ago when I was on the ward was on the RIP list. She had lasted three weeks from her admission to hospital, and she wasn't even aware that she had cancer when she went in.

The diabetes clinic last Friday was really interesting. I have a friend with diabetes so I thought I knew a bit about it, but I certainly had no idea of the complexity of the condition and its treatment and the dietary implications. Rotherham runs a specialist diabetes service that brings together doctors, nurses, dietitians and others who have expertise in the treatment and management of people with diabetes in the same building. Every so often (maybe once a month) they have a clinic specifically for 18-22 year-olds, as this is the time when the responsibility for managing diet, injections and everything else tends to move from parents to children. And there's a lot of responsibility, much more than I had known about before.

They now think that type 1 diabetes is an auto-immune disorder, where the body destroys the pancreatic cells that produce insulin. Insulin is the hormone that allows you to store the food you eat so you can use it for energy later on. Without insulin, all the carbohydrate that is broken down into glucose in your intestines goes into the blood, but doesn't get stored, and goes straight out in the urine. Before insulin was synthesised and purified, life expectancy was short following diagnosis because people essentially starved - no matter how much they ate, it all came out in the urine. The essence of treatment of diabetes is to replicate the insulin levels of someone who still has intact control of their blood sugar.

In most of us, a rising blood sugar level triggers secretion of insulin. After we eat, blood sugar levels rise as the food is digested, broken down and transferred into the bloodstream. Insulin allows the liver and other cells around the body to convert the sugar into fat. When blood sugar levels fall and we need energy, glucagon (also secreted by the pancreas) stimulates the liver to convert fat into glucose, off it goes into the blood and around the body to where it's needed. Nothing is wrong with glucagon homeostasis in most people with diabetes. They just need the right amount of insulin at the right time. Too little and the glucose isn't stored (and in the long term, too much glucose in the blood has other nasty effects); too much and the blood glucose level drops, the brain is starved of fuel and goes haywire - a hypoglycaemic attack, or 'hypo'. Interestingly, someone with untreated diabetes can't have a hypo, there's always too much sugar in their blood.

We only had two patients turn up at the clinic (and I was there ALL DAY.) Both of them were candidates for a new insulin regime. I hadn't appreciated just how many types of insulin there are, the differences being how long it takes before they act and how long they last. Previously, both the lads had been on a regime where they took intermediate acting insulin twice a day, which meant that no matter what, they had to make sure they ate enough at regular intervals to avoid a hypo. The insulin was in charge, they had to follow its direction.

The new regime involves a background dose of long-acting insulin, injected once a day, and then shots of quick-onset short-acting insulin, injected whenever needed, usually when having food or drink. Insulin has to be injected because it needs to get into the blood, but it is one of the hormones in the body that is a simple protein, like others we eat as food. If it were taken orally, it would be digested in the stomach and gut and wouldn't reach the bloodstream intact.

The disadvantage of this 'basal-bolus' regime is that it involves many more injections - two with the old regime, at least four with the new, and possibly more. The advantage is that the person is back in charge - they control the insulin rather than the other way round. They can eat what and when they please, as long as they calculate and administer the right amount of insulin. They can miss a meal, have a kebab, exercise as they please, and have a carbohydrate-free meal should they wish, all of which were difficult to manage before. There's a transition period even for this new regime while the patient works out how to manage the system, but once it's in place, it seems to work a treat. One of the patients who's been on the new system for five months whooped and punched the air when he got the results of the HbA1c blood test that indicates how good his blood glucose control has been over the last 3 months. He was pretty happy.

Anyway, I learned a lot about diabetes in that hour or so, and was also impressed by the maturity and self-possession of these two young men. I'm sure I didn't take anything like as much responsibility for my life and future health when I was their age. I'd tell you about it if my parents weren't listening.

I learned lots more than this - what happens when you're ill, the effects of alcohol, adjusting for exercise, 'carbohydrate counting', pregnancy and ante-natal care, when to take yourself to A&E, and the courses available for people to help them manage their condition. I heard about the results of a survey of clinicians, who were asked what the treatment for a hypo is. Only 20% knew what to do (short answer: administer glucose). The day didn't even touch on type 2 diabetes, the sort that is closely linked to overweight and obesity.

On Tuesday I went out to watch how the enteral feed regimes were reviewed for three patients in a nursing home. Yesterday I spent some of the morning with a Speech and Language Therapist (SALT) assessing dysphagia on the wards - that's anything to do with swallowing. There's remarkably little collaboration between dysphagia specialists and dietitians in the hospital. It seems entirely possible for the SALT to impose a 'nil by mouth' regime because of some swallowing malfunction, and for a referral to be made to a dietitian only when the patient has lost two stone after a fortnight on nothing but intravenous fluid. But perhaps I'm wrong and there are infallible mechanisms to ensure that nobody forgets that people need food in order to recover from whatever it is they're in hospital for.

Today I shadowed a dietitian in a brand new clinic for people with respiratory problems, common in this area where people worked in mining and steel and smoked forty a day in their time off. I learned a lot about how to use a dietetic consultation to build rapport and trust rather than to acquire useful information and provide dietetic advice. Very useful indeed, probably the best lesson I've learned in my time here so far.

Wednesday, 27 August 2008

Deputy Lola

As Lola I’s last post said, I visited her at the weekend. Now with her last words ringing in my ears - “I can’t believe I have to go back to prison camp tomorrow…”, I am guessing that the prison camp regime has completely consumed her(boom-boom!) and so blogging has had to take second place.

I once had a fortune cookie that read “It may be that your sole purpose in life is simply to serve as a warning to others”. If I had a Blog fortune cookie, it would probably read “It may be that your Blog entries in life are simply to make Lola I look good”.

So, the weekend. The number of things we managed to fit into a short amount of time is remarkable – amongst other things, getting a car washed, buying a pair of shoes, sausages & mash (an enormous wait but lots of gravy to make up for it), a visit to two shops looking for caustic soda (successful), a big box of herbs (successful), a paint pad (unsuccessful) and a lampshade (semi-successful). We took photos of glass dishes that we then emailed to Mum (doesn’t everyone?), watched Galaxy Quest on old-fashioned video with Mr A, watched a little bit of the Olympics, and made an obligatory visit to the pub.

But it wasn’t all play. Oh no, Lola had some homework to do. She had to complete more of her famous workbook. She had already looked at quantities and prices of certain supermarket food items on the internet, ultimately working out the nutritional value of them. Or something. Her mission (and she had no choice but to accept it) was to do the same in a non-supermarket shop.

Our first attempt failed. The shop assistant said he would get in trouble with the manager, since we could be from a supermarket wanting to compare prices. Next door at another shop, we overwhelmed the poor shop assistant with our enthusiasm and obvious student-like appearance. Waving the impressive chopped-down tree, otherwise known as the workbook, seemed to convince him that Lola really was a student and that there would be a hefty detention for her if we didn’t get this assignment done. Either that or he was scared of getting a life-threatening paper cut.

There was a fair division of labour. Lola read out the item we needed, I identified its location, prioritising our plan of attack so that we handled everything at the back of the shop first just in case the manager was to return and throw us out. I whispered weights, prices and mumbled helpful things like “You look at the jam, I’ll find out how much the peas are, do the sugar whilst you’re at it, but let’s not do the crisps until the end”. I’m sure to get a mention in her dissertation.

Eventually when we emerged into the bright sunshine with a bar of chocolate each (well it would have been rude not to have bought anything), it felt like being released out of neon prison. I imagine Lola is feeling like that in Rotherham every day…

Saturday, 23 August 2008

The Placement Workbook

Turns out I did have some time to write a bit more that day. I'd done as much of my workbook as I could for the time being.

The workbook is the equivalent of the stroppy supervisor standing over me telling me what to do. It's a monster. 70-odd pages divided into sections covering the ward work, food analysis, shadowing dietitians and an Induction section at the start with questions like "How do you warn everyone else of a fire?" Actually, that's an easy one, a more challenging question was "Where is the Health and Safety manual kept in the department in which you are based?" I asked four or five people who had never heard of it; the fire officer didn't know, neither did two of the first aiders I asked, and finally the H&S rep said it was 'in the main office'. He didn't say which office (there are several), and I'd had enough by then, so that's what I put in the workbook.

The biggest single task in the workbook (and it's one of many tasks) is to analyse a day's food intake for energy, protein, carbohydrate, fat and two other nutrients (iron and calcium, say). Then work out the cost of the whole thing per portion if you were to buy the ingredients in a supermarket, and the same again for a smaller local shop. Then do the whole thing again, but with low sugar/low fat versions of everything: nutrient content and cost in a supermarket and smaller shop. Then, of course, comment on the findings.

Another big job is to create a 7-day meal plan for a family of four including parents and two children aged 4 and 7 who eat ready meals/convenience food 4 times a week - then price the whole thing within a budget of £40. Thankfully, I don't have to analyse the nutrient content of this one, unlike the Buffet Lunch task. For a budget of £1.50 per person, I have to create a real buffet for members of the department, making a lower fat version of one savoury dish and a lower sugar version of one sweet dish, and labelling these with energy, fat and sugar content per portion. I present it to the supervising dietitian, and am quizzed on the whole thing at length before it gets eaten. The workbook proudly states that I can use the facilities in the Dietetic Department Kitchen - this contains a sink and a microwave and no work surfaces, not even a table. I've scheduled my lunch for a Monday and I'll be doing any necessary cooking at home.

In the catering department I've been comparing the size of portions of hospital food with the 'standard' textbook portions, and looking at the different versions available for gluten-free, diabetic, pureed/minced and high protein menus. I tasted three different rice puddings, and none of them was very nice. It's not surprising that rice pudding gets a bad name - perhaps this is why I wouldn't touch the stuff for twenty years after leaving school. Properly made rice pudding is delicious; this was rather bland and tasteless, not even very sweet. I've got the recipe: you'll need 4 gallons water, 4 lb milk powder, 4 lb rice, 2 lb sugar and 2 tins evaporated milk to make some for yourself (and 199 friends). But I don't recommend it.

The dietetic department is quite big for a not-very-big hospital (around 800 beds.) The department is divided into different 'teams', but these seem conceptual rather than relating to the type of work undertaken. Some dietitians work in the hospital, some in the community, and some specialise in a field like oncology and palliative care, diabetes, and enteral feeding - that's when a liquid feed is put directly into the stomach, either via a naso-gastric tube or through a 'PEG' directly through the stomach wall. Yesterday I was shadowing a diabetes specialist. I might write about that later - the diabetes stuff was absolutely fascinating, but it was also the most annoying frustrating experience at the same time.

Most of the dietitians are friendly, but this seems directly proportional to their seniority. Perhaps the newer, younger ones remember more clearly how grim it was to be a student on a placement; the older ones are really rather snooty, and the manager is very fierce. Alyson is looking after me; she is a Dietetic Assistant, the lowest of the low. DA's can do quite a lot of the work of the registered dietitians, but not all, because they haven't done the degree I'm doing and aren't registered. Alyson is definitely the nicest of the lot, and the most normal of them all.

Being Saturday now, I'm home again for the weekend, including the Bank Holiday on Monday. Lola II is coming to visit, which makes up for the music festival that I was going to attend being cancelled, again. Last year it was flooded off, this time it's something to do with licensing. Maybe next year...

Thursday, 21 August 2008

Week two in Rotherham

It is REALLY difficult to blog from here. First of all there's the times that the library is open in comparison with the times that I have available - the overlap is not large. The computers are a little sluggish anyway, plus the Internet filter messes with access and makes things more complicated. And now that I'm into the second week, I've got a feeling for the amount of stuff that I'm required to actually do, and then record that I've done, and then say how I felt about doing it and how I felt about recording that I did it, and how I felt about that.

On Monday I helped the Dietetic Assistant with stocktaking the food supplement store room. Does that sound thrilling? No, I thought not, and it wasn't.

I've been in the Catering department for the last three days - they prepare everything on site except the Halal food that is bought in ready packed. The chap looking after us wasn't very good at delegating, so most of the time I was standing around watching him do things. He couldn't seem to answer my questions at the same time as doing the job, so he started to get behind, so in the end I stopped asking questions.

Yesterday I helped on the conveyor belt that is used to assemble the patients' lunches from the menu cards they fill in - I was on gravy and parsley sauce. Again, not the intellectually challenging information-packed day I was hoping for.

Tomorrow the dietitian I was supposed to be with is off sick, and I was hoping (vainly) that I would have a bit of spare time. Doesn't look like it. I don't think I'll mind working with the dietitian, as long as there's something interesting going on.

It's a pity to let the blog opportunity pass, but I'm really not in the mood for blogging at the times when I can actually get to a computer, like now - I'm about to go to the hospital restaurant for lunch. It's curry day!

Saturday, 16 August 2008

What I've been reading

Image of the book cover
Bits of Me are Falling Apart
by William Leith

"With his trademark darkly humorous mix of personal story and social commentary, Leith attempts to answer the question: is everything really falling apart? Or is it just him? He examines the ageing process in humans, and in everything else as well, from the universe to the banking system. And he comes to realise that, even if he can't solve the problems of the world, at least he has a thorough understanding of failure."
The first of my extensive collection of birthday books bought with my birthday book tokens, or in this case, given to me at our birthday party. Boy, this one is a downer. I can't even let Mr A look at it, in case he is moved to take his own life, or more likely, hunt down the author and kill him with an axe for being so self-indulgently miserable. I could only bear to read it because I was relentlessly chipper and optimistic about my life while I was reading it (on our short holiday to Kent).

To summarise: the author is having a bad day in the course of a bad year following a bad life in most ways up to this point. I am not optimistic about his future, and I resent the fact that a good friend of mine has supported his whining misery by supplying him with royalties by buying this book, and potentially encouraging him to write another one. Steer clear.

Thursday, 14 August 2008

On the ward

I've just checked - the library's open until 8pm tonight, so you get a blog post, even though I've just finished my three days on Fitzwilliam Ward and haven't eaten since 10 am. See how much I care. By the way, dear family, this means I won't be speaking to you on the phone today, I've had enough of hanging out of the window or sitting on the bench outside the residences just to get a mobile signal.

I can't say that I'm enjoying it yet, although I'm much less pathetic and miserable now. Obviously, my time outside work is particularly dull, but working on the ward isn't that interesting either. I think it's the frustration at the lack of control anyone has over what's going on. Three or four people are messing with each patient at any time: Health Care Assistants (or Nursing Auxiliaries) wash them, dress them and look after food and meal service; nurses do all the routine medical stuff like adjusting drips and oxygen and tube feeds, and handing out medication. Physios visit every day, Occupational Therapists, Social Workers, Dietitians and Speech and Language Therapists drop in now and again, and of course there are the doctors. Something can go wrong at any stage, from missing medications to food not turning up to someone falling over or weeing on the floor. All you can do is deal with it when it happens, there's no way to prevent any of it.

Everyone can be recognised by the colour of their uniforms, except the doctors, who don't wear uniforms apart from the mandatory stethoscope (not just in Carry On Doctor, then). Phlebotomist - white with light green trim. HCA - thin blue stripe with blue flashes. Student Dietitian - stupid white dress, and, let's see, is she wearing trousers with it? How ridiculous.

I'm not qualified in any way so I'm not allowed to touch the patients or have anything to do with their clinical care. Occupational Health very nearly prohibited me from the ward because of a sore patch on my hand - not for their safety, but for mine. I have remained very aware that two of the patients have MRSA and one has scabies.

I am allowed to talk to them, but actually only two or three are a) conscious, b) sentient and c) intelligible. And that includes the Yorkshire accent; I'm starting to say 'owt' when I mean 'anything', which sounds really silly from someone brought up in Essex. It's a Care of the Elderly ward, once known as Geriatric, which may explain the lack of sparkling conversation.

I'm also allowed to get involved in the meal service, so I've been serving meals and clearing up afterwards, and even helping to feed a couple of patients. One lady with dementia insisted on holding my hand at the same time, which made things very difficult indeed, but I only dropped one spoonful down her front.

Most of the time, though, I just latch on to someone who looks like they're doing something interesting. I've watched wound cleaning and dressing, a tracheotomy being cleaned out, the phlebotomist taking blood, a PEG feed being set up that goes straight from a bag into the stomach through a tube, and lots more. I have learned a very large number of abbreviations, of which my favourite is 'TTO', which means the medications and stuff that a patient takes away on discharge. It stands for 'To Take 'Ome'.

Today I sat in on a review between representatives from the health and social services sectors to decide whether a woman's care needs were health or social, which is what determines who pays. She's got Parkinson's and dementia, she has hardly any swallow reflex and isn't suitable for feeding through a tube. She can eat five teaspoons of double cream consistency at a time. I don't think anyone will be paying for her care for very long. Another lady was admitted to the ward at the start of August with a chest infection, but otherwise she was feeling OK. The tests showed that she has cancer of the lung, stomach and bowel, and the Macmillan nurse told me yesterday that she reckoned another 72 hours would be as much as she would expect. She arranged a transfer to a hospice and phoned the lady's son. That would have been a difficult phone call.

I asked the nurses whether all this frailty and imminent death starts to get them down. One said that she can manage perfectly well because it's a ward for the elderly and that's what happens when you're old. She has more difficulty coping when she's looking after young people.

It has been an interesting experience on the ward, but I'm glad it's over. One nice thing about it has been that it's a refreshing change to be encouraging people to eat as much high protein and high energy food as possible, rather than in real life when everyone's trying to eat less and lose weight.

I'm going home tomorrow for the weekend, and on Sunday night I'll be returning with the car, which will do a lot to reduce the isolation of having to live in this godforsaken backwater. Don't expect me to waste time on blogging! Although, actually, I do have a couple of posts that I've written and not published, so I might treat you to those if you're lucky.

Wednesday, 13 August 2008

First bulletin from Rotherham

Lola II wasn't far wrong when she described my situation on Monday. The accommodation I've been given is on the hospital site, and consists of a bedroom in a 4-bed flat with a kitchen, toilet and bathroom. There are three of us living there: the other two are a final year Pharmacy student and another Nottingham Dietetics student on her A placement. There are two other Dietetic students on B placement living in neighbouring flats, so they will be starting their fourth year when they finish here.

Mr A drove up with me on Sunday, and after dropping my stuff in the room we went out to look around Rotherham, and to find somewhere to eat. Two hours later we had seen the city centre, which was utterly deserted, and then driven round in search of somewhere, anywhere, that we could buy food. We even stopped at three different pubs, but not only did they not serve food, they didn't even have any proper beer. We couldn't find any shops at all. We ended up at one of those chain restaurants that are associated with hotels.

Mr A drove off in the car, and I was left in a dingy room that smelled a bit funny, with one bar mobile signal, no landline phone or Internet connection, no TV, no shops (or anything else) within walking distance, and no social facilities whatever. Neither the hospital nor the residences have any meeting place where you might go and watch TV, or meet other people who are similarly marooned in the wastes of South Yorkshire.

I felt pretty low on Sunday, but not as bad as at the end of Monday, when I had discovered that the public Internet points were not where I had been told they were, and the only access was in the staff Library (limited opening times). I am in the Library now, after examining very carefully the hospital's Internet access policies for personal use. Most of the websites I want to look at (blogs, web email) trigger a warning that my access contravenes the criteria of their filter and will be logged.

Not only that, but I have been made to wear a dress. This may not sound very serious, but on top of everything else, I would have preferred to wear something that makes me comfortable rather than uncomfortable. In all the aspects of the hospital that I have encountered so far, and bearing in mind that I've only done three days, the dress is the most upsetting of the lot. We reached a compromise, so I am wearing trousers with my stupid dress. I'm not sure what I would have done if that had been refused. Disobeyed, probably, and I am still planning to disobey, but it rather depends on my getting to the Linen Store while it is open.

All the other students went out for a drink last night; I was working until 9 pm so I missed out on that social opportunity as well. Then I didn't sleep very well, and started this morning at 7 am, so I'm shattered now. I still have to do a bit more work before tomorrow.

I've finished moaning now. With any luck I'll get a proper amount of sleep tonight, and can write tomorrow about some things that are more interesting than my personal woes.

Monday, 11 August 2008

Nurse Lola

Hello there, Lola II here. My first posting on Lola Life and I'm going to start by asking a favour.

Lola just phoned me. Day 1 of her clinical placement in Rotherham and it sounds GRIM. The work itself will be interesting, but her accommodation situation is awful. Just hearing her describe it in a wobbly voice brought a lump to my throat. If I could, I would jump into my helicopter and surprise her with a dark chocolate bounty bar, some chickpeas, and Johnny Depp. Sadly I don't have a helicopter, the dark chocolate bounty bar probably wouldn't last the journey, chances are her accomodation doesn't have a tin opener and I'm saving Johnny for a special occasion. Plus I've just started a new job, so heading north at no notice probably isn't a good idea...

So, happy readers, here is your mission, should you choose to accept it. Lola is hoping to find somewhere to get onto the internet tomorrow morning, so it would be great if you could all leave a comment to this post to cheer her up. Just to spur you on, she's living in prison cell-type student digs without a car, internet access or any friends or family nearby. No pressure.

Here are some questions to choose from:

1. If you had to choose the single most valuable thing you ever learned, what would it be?
2. If you could eat one food in any quantity for the rest of your life with no ill effects whatsoever, what food would you choose?
3. If you had to select any food that bests represents your personality, what would it be?

I hope you lovely people in BlogLand will leave a comment. In the meantime, Lola, here are some pictures to cheer you up.

So good, they names a shop after her!

The trickiest photo set-up


Sunday, 10 August 2008

Clinical Placement A

Back in October, we first year students were allocated hospitals for our 'A' placements. This means we would be working in a hospital for four weeks, shadowing various members of the Dietetic department plus caterers, nurses and who knows what else. I was placed in the fair city of Rotherham. I wrote about it at the time, with little enthusiasm.

At last the time has come, and my placement starts tomorrow, which means I will be absent from home for four weeks, living in a shared student house in the grounds of Rotherham Hospital. I am still feeling a little bit aggrieved that my circumstances were not taken into account - it doesn't entirely matter where a 19-year-old who normally lives with parents is placed, but it's decidedly inconvenient for an adult running a household to be removed for a month. I shall be making my case a little more strongly next time, especially as the 'B' and 'C' placements last three months rather than just one month.

I expect I will continue to post to this blog, for two reasons: a) the stuff I see and do in the hospital is likely to be extremely interesting, and b) there will be sod all else for me to do in my spare time. I have unrealistic expectations of doing some exercise, perhaps seeing some films, but what I'm most likely to do is reading and writing and blogging. The stuff they've sent me suggests that I will have access to computers - if that doesn't happen, my life will indeed be miserable for four weeks.

Friday, 8 August 2008

A couple of days in Kent

Sunset through cloud over the seaWe've been doing nothing very much in Whitstable for a couple of days. Mr A and I have been before when we wandered around doing nothing very much, but I think we outdid ourselves this time.

When we arrived on Wednesday evening we had dinner in a tapas restaurant (paella and sardines). That's it for Wednesday. On Thursday we started with breakfast at the B&B (wonderful smoked salmon and scrambled eggs), I did some blogging, Mr A dealt with some work-related phone calls, we walked around and looked at the sea and the harbour, had lunch (crab sandwiches and brown shrimps) on the sea wall, then sat on the little terrace of the B&B reading books and the newspaper. Then we had fish and chips for supper on the sea wall again, walked (not very far) to a different pub and had a pint each, came back to the B&B for some more reading, and then watched 'Never Mind the Buzzcocks' on a tiny TV with poor reception in our room. Breakfast on Friday: more delicious smoked salmon and scrambled eggs.

The weather was perfect, sunny but not too hot, with a breeze, although the first night there was a proper thunderstorm with full lightning display. We came home via another attractive Kentish village, Egerton, which happens to contain the church where Mr A's parents were married more than 50 years ago. We went on to The Forstal, a nearby village where his grandmother lived until Mr A was about 8 years old, and then had lunch opposite Pluckley school where his grandmother was the headmistress.

Egerton church tower seen behind an apple treeAltogether, a very enjoyable and mostly relaxing couple of days. I'm thinking of asking for a very similar birthday present next year.

Wednesday, 6 August 2008

96th birthday party

It's been quite difficult getting started on writing this. I really was exhausted by the whole weekend, then had early starts on Monday and Tuesday, and yesterday was Mr A's birthday so there was stuff to do for that, and all the other things that get in the way of the reflective mood I need for writing.

What an event it was, though. Preparing for it was hard enough, what with the shopping, cooking and cleaning and (in Mr A's case) video editing. We started early on the big day: I finished setting out the food and Mr A looked after the drink and fashioned his waterproofing solution in case of rain, because the weather really did look threatening. Nearly everything was done by the time the first guests arrived, and then the sun came out.

And what do you know, we both enjoyed it! A constant stream of friends turned up, starting at 12 noon on Saturday, with people still arriving on Sunday morning for brunch. The last of the guests left at about 3pm on Sunday.

People at the partyWe had quite a few tables and lots of chairs in the garden, because it's much easier to eat lunch and chat when sitting down with your plate and glass on a table. It was great that people who know us from all sorts of different activities all turned up, mixed and mingled: Mr A's Plymouth-Dakar crowd, my badminton friends, our neighbours, Random Badgers from the pub quiz team, friends from when we lived in Manchester, from my previous work, from my current university and from university the first time round, old friends of Mr A's from when he was a young man in Dorset, and our families, of course. Some of them won't thank me for the pictures I included in the collage.

The food went down very well, and the quantity I made was just about right. The Boy's new girlfriend even brought a homemade fig and almond flan, which was delicious, and she's very nice too. Lola II made brownies, and wrote Interesting Facts on greaseproof paper so that at the end of each brownie there was an Interesting Fact. And then at about 6 o'clock we trooped over to the pub, where we'd arranged to show the DVD of the Plymouth-Dakar charity trip that Mr A and others went on over Christmas and New Year 2005-6.

Part of the whole party idea was that it would be the only way to impose a deadline that would force Mr A to edit the footage he'd taken on this trip. But he's the relaxed kind of guy who leaves everything to the last possible minute, so it was no surprise when he found that he couldn't save the finished file in a format that would allow it to be played on a standard DVD player. So it had to be played on a computer. But the projector in the pub worked through a television...

By sheer chance, The Boy had a projector in his suitcase. Balanced on a bar stool on a table, it was the perfect height for the big screen, with ad-hoc cables to the sound system, which only fell out a couple of times. There was far too much noise and chatter to hear the soundtrack properly anyway, but Mr A had added captions to make it a bit clearer what was going on. It went down very well, even with those who hadn't been on the trip.

Lola erecting tentAfter the DVD, some stayed in the pub while I led a party back to the house to clear the garden to make room for tents. From then on there were two separate wings of the party: one at home and the other in the pub, according to mood and taste. Tents were pitched, the party continued until it was closing time, at which point everyone still awake was in the pub. So we just carried on. Table football, a bottle of whisky, mingling with the locals and the charming Smurf keeping a watchful eye on proceedings... until after 1 am.

I'm too old for this sort of activity at the best of times, but after a 17-hour day including a lock-in it's tough to get up at 8.30 because the campers from your garden are milling about in your kitchen looking for coffee. I suppose I could have just let them get on with it, but I take my hostess responsibilities seriously. Coffee, tea, croissants, and I finally had time to eat my brownie which Lola II had thoughtfully saved and hidden for me. Did you know that all porcupines float in water?

The subject of unicycling was raised - so a demonstration was called for. Some campers departed, but more guests arrived, and the weather was perfect for sitting around in the garden again. Eventually we decided that Sunday lunch in the pub was called for, but it was packed to the rafters with bowlers. Have I mentioned that the English Women's National Bowling competition is taking place on the greens at the end of the road? It meant that there were only four roast dinners left and we had to wait quite a long time for those. I don't mind, it's worth it to have such a great pub next door.

Bowling in front of the Cricketers pubThe poor bowlers have had a good deal of rain since Sunday. I've now returned the borrowed wine glasses, taken the car for a service, been to the dentist, checked out my university timetable for next term, posted off a couple of mooched books, mopped floors, done a ton of washing up and laundry (curse this rain), sorted my accommodation for the next month in Rotherham, spent my birthday book tokens, had my hair cut, toiled over this blog post, and much more. All with the rain pouring down. Tonight Mr A and I are going on my birthday trip to Whitstable for two nights, and the forecast looks like rain and more rain. Luckily, I've got all those books to read!

All in all, the party was a grand success, but I don't think we'll be repeating all the effort for our 98th next year. Perhaps when we reach the century?

Monday, 4 August 2008

The morning after the weekend

In another six hours or so, when The Boy leaves, our house will return to our sole possession. It's always nice to have loved ones to stay, but I like it when everyone goes and we get our normal life back.

I'm really tired, and the house still needs some cleaning up, although all the washing up is done now and the garden's cleared of tents, chairs, tables, unicycles and balloons. A prospective client is coming later to have a meeting with Mr A and The Boy, so the route that he takes from the front door to the office needs to be acceptable, and I could do with another hour or two in bed before I'll have completely caught up with sleep requirements. There are photos to transfer to the PC and it's Mr A's birthday tomorrow so I must get things sorted out for that too. Writing about the party will have to wait until all that is done. Maybe tomorrow.

But today, I have an announcement. I have to admit that some of my stories have fallen short of Lola II's standards of full disclosure. This is mostly because I'm too lazy to write everything down, so some significant, important and hilarious activities are usually heavily edited, or even left out entirely. Now, not only does Lola II now have a Blogger identity, but I have set her up to be a Team Member. So she'll be able to complete my account with her own, supplementary postings to this blog. I know you'll love what she writes, too. A side effect may be that I raise the standard of my posts, knowing that she's on my tail!

View from pub garden down to Corfe Castle[This is not our garden, but one of Lola II's pictures from our camping trip, sitting in the pub garden looking down onto Corfe Castle.]