Looking back

The last year has been pretty good, I think - at least, casting my mind back has not made me wince as it might have in previous years. We started with a very fine New Year's Eve party at the Cricketers - the last, as it turned out, with Smurf in charge.

Then there was snow, I had a couple of exams, then a weekend break on Dartmoor and then a return to the throes of term time study. Lola II moved house and celebrated her birthday and started going out with Mr M (not necessarily in that order); what a year she has had!. Looking at my diary for January to March, there seems to be little there other than travelling to university and Monday night badminton, before respite comes in April with the Easter break, but ongoing coursework no doubt.

Five exams turned up in May, after which Mr A and I managed a lovely holiday in Bruges. Then it was 12 weeks of clinical placement, which was probably the most intense period of self-examination, skills development and technical progress I have ever experienced. It had its ups and downs, but went very well on the whole - the manager of the department wrote some very encouraging feedback on the review form.

Our bathroom was transformed, but we end the year as we ended 2009 - with a great hole in a ceiling (kitchen rather than living room this time). It's water that does all the damage in this country, but at least we don't have cockroaches, bedbugs, ants or termites. The exterior of the house was also fully restored, and I'm still loving the look of it every time I come home.

Various other entertainments took place over the summer - the beer and film festival, the food and drink festival, a camping trip or two, and then it was back to school for the final year. Mr A took his first exam since leaving uni the first time round, and did rather well (but he's as bad as me, not satisfied unless he's done his best). Unlike previous years, the trusty car had presented no problems at all until someone decided to nudge into it gently, propelling me into a vortex of insurance claim and hire car heaven.

October and November were quite social months: we went to Devon, Bristol, Towcester and London to see various friends and relatives, and then I went to Coventry to see some people with coeliac disease. In December, we even invited people into the hallowed cloisters of Lola Towers for dinner. Monday night badminton continued, and term ended, and I have continued to toil on, getting coursework finished, and hoping to move on to revision before it's too late. And I have also read and written about nearly 30 books during the year.

As might be expected, I have also caught whatever it is that Mr A has. It is not yet serious - a bit of a cough, and three hours in bed on Monday afternoon, but I think we can expect worse over the coming weeks. Typical, just in time for the revision and exam period. But I went for a walk, and it has rained, and the temperature has been above freezing for three whole days with more to come, so much of the snow has now gone. Good news for our New Year holiday in the Peak District, and for travelling 50 miles to the exam in January, and for airport and flight availability for our snowboard holiday (although that's a month away and anything could happen by then). Meanwhile, Mr A continues to cough.

So that's it for 2010, it's been fun. I'm hoping that 2011 will be just as good if not better!

Festival confinement

All of Christmas Day was spent on my very favourite activities: opening presents, eating, reading books, watching films, eating some more and reading more books. Mr A gave me Stephen Fry's autobiography and I gave him Mark Kermode's book about the movies, and we had each read about half by the end of the day.

Mr A did most of the cooking, despite being ill, and only asked me to do the Yorkshire puddings and open the oysters, which are my special skillz. I volunteered for breakfast scrambled eggs with smoked salmon duties as well, given that I knew he would be doing everything else, and he's not very well. Christmas day food was a triumph, with the roast beef, potatoes and vegetables done to perfection, and plenty of leftovers for the next few days.

Mr A has also been having a bit of a dessert frenzy over the past few days, considering that he's a bit unwell and at normal times we never have anything sweet after the meal. He made junket with the rennet his dad gave him, and then a magnificent treacle tart, and apple crumble, all over the space of two days. We haven't touched the junket yet, the treacle tart is now in the freezer, and I had one lot of apple crumble but he didn't even finish his. He has not yet emerged this morning, and I wouldn't blame him for staying in bed, he really isn't very well. I'm not sure I mentioned that.

The temperature outside has been as low as ever over the past few days, and with a big hole in the kitchen ceiling and an unreliable central heating controller we have been a little chilly on occasion. I haven't actually stepped outside the house for three days, two of which have been fully occupied by this stupid coursework, which is very nearly finished but always takes longer than it should. I'm determined to go for a walk today. The temperature on my PC widget now shows a balmy 3 degrees, and the forecast is for above-zero temperatures for the next few days, so we might see some thawing at last.

Snow and water

OK, we are a little bit 'had enough of this' at Lola Towers now. It has been a most exciting winter season, but we are ready for the spring now, and would rather like some daffodils to break out along with sunshine and temperatures, oh, I don't know, somewhere above freezing would be good? Definitely above the minus 18 degrees Celsius that it was the other night when I couldn't sleep and got up to service your blog requirements, which is what I do when I can't sleep. My computer has one of those Microsoft widgets that tells you the temperature, and Microsoft are clearly on the ball because Royal Leamington Spa is one of the locations that you can have. It is telling me minus 1 degree at the moment, and it is snowing again, quite hard.

Don't get me wrong, I love the snow. Snow is fun to play in, fun to walk in, tobogganing on Mr A's toboggan is some of the best fun in the world, in fact it is one of the reasons I agreed to go out with him all those years ago. You can see I set quite a high bar with relationships: "You say you don't have a great home-made toboggan? Oh, I'm sorry, I don't think I can see you any more. We're just not compatible."

Snow is particularly good for snowboarding, which is what Mr A and I were forced to do on Tuesday afternoon. I say 'forced' because it would have been quite a good thing if we could have not had our second snowboarding lesson at that point, but it was booked and paid for (and quite expensive) and they are quite firm about non-refundable non-transferable bookings. It would have been nice not to go snowboarding because when we phoned a plumber after that indoor waterfall happened on Monday evening, he said he could come on Tuesday afternoon.

You may be surprised to hear that in a way, it was a good thing after all that we went snowboarding and the plumber didn't come until Wednesday. This was because, after surviving quite nicely with the mains cold water turned off - we still had a full hot water tank to use for essentials - we experienced a second indoor waterfall on Tuesday in much the same location in the kitchen as the Monday event, but this time hooray! it was hot water coming in. That stopped when the hot water tank was empty, but from that point until the plumber finished, we had no running water at all. And we turned the heating off, just because we weren't entirely certain that the heating system is 100% separate from the tap water and didn't want to tempt fate.

Having no water or heating is inconvenient, but actually not too bad in reality. We had an open fire in the living room, many quilts and duvets, thermal underwear, gas to cook with and electricity for the kettle and essential appliances (i.e. the computers, electric blanket). If the electricity were to fail, well, then we'd just have to move out, even if the house were toasty warm. No Internet? I don't think I could cope.

Anyway, the plumbers came, saw and conquered, and we are left with a large hole in the kitchen ceiling and a mystery as to why there were completely unlagged hot and cold water pipes in that location in the first place. I say 'were' because they have now been cut and blocked off, and if we discover anything that no longer works, we will know what they were for. Our best guess is that there was once a sink on a wall that no longer has one. But unlagged copper pipes? and running along an exposed wall? That's just asking for trouble.

What with the cleaning up afterwards, another day passed without a trace of coursework being done. So I spent all of Wednesday on justifying my chosen community nutrition intervention, which will be for people with dementia being cared for in their own homes in Warwickshire. I'm guessing that I've done about half the necessary work for this bit of coursework, and then I have to finish my research project and do some revision. But this will be the last Christmas/New Year holiday ruined by having to study!

So here we are, all ready to go, Mr A poised over the stove and ready to collect the oysters from the fishmonger. I am, as usual, at my desk ready to do some Christmas Eve coursework, presents littered under the large format camera tree substitute. I hope you all have as good a time as we're going to have.

Domestic turmoil

It is nearly That Time of Year, and I am behind with everything, just because I got a little bit drunk one evening and then it snowed. It snowed a lot, actually, and has been very cold ever since, so the roads are treacherous and I thought that I might walk to badminton, which is quite a long way. I was sure that someone would offer me a lift home, because I made cakes out of cornflakes for everyone. And they did, mentioning that I could have had a lift there as well if I'd asked, but I didn't think of it.

Mr A and The Boy's tobogganing expedition was not a great success, because there was too much snow that had not yet been packed down. The Boy's train to the next stop of his tour was also cancelled, which was a little worrying for him, but the next one ran OK. I started to feel that I was missing the beauty of snow-covered Leamington, so I went out on an expedition to take photos and buy some essential supplies (e.g. chocolate).

Other than that, I have not been working as hard as I might, getting distracted quite easily. Our house has been throwing challenges at us - it experienced a power cut in the middle of the night, which meant the heating timer was reset and the heating didn't come on in the morning as it should, giving us a brief twinge of panic (and frostbite) until the boiler successfully fired up. The timer is Not Very Well though, allowing access to most functions except the one that turns the central heating on and off on demand. It still does everything else, so we are ignoring it for the time being and hoping that it will get better by itself.

The washing machine has also showed signs of rebellion by spewing water over the floor. A process of elimination revealed that the outlet pipe had accumulated a plug of detritus which we removed, but a seal was weakened on some other pipes that we took apart during the process of elimination, so we're catching the drips and will attend to it when we have more strength. It could be a lot worse, but just writing this is tempting fate. There are still a whole lot more appliances and devices around the house that could join in the revolt and make our lives uncomfortable in the current subzero temperatures.

I have done a small amount of work, and my research project supervisor was kind enough to telephone so that I didn't have to turn up in person for a meeting. All is well, she gave me much useful advice, but I need to actually do the work, and time is slipping by. I have a great deal to do before we go on a real holiday to a place where there may be no Internet access for a week.

Final note: I wrote most of the above yesterday. When I got home from badminton, Mr A was in the kitchen mopping up water that had been coming in from above the window. It is a mystery where it is coming from, because there is a flat roof above the kitchen, but we have called a plumber and are living on minimal water until tomorrow. Unfortunately we have our second snowboard lesson this afternoon, which they stress very emphatically is non-transferable and non-refundable. Perhaps there are showers there we could use...

Eating, drinking and snowboarding

Ooh, I've been busy. Really busy. Obviously I finished the first draft of the research project report in time, and emailed it over to my supervisor by the end of Wednesday. This allowed me to have my proper weekend on Thursday and Friday, and boy did I make use of that weekend. A bit too much, really.

On Thursday I tidied up a bit so I could find my desk, but abandoned that to go to Birmingham for the day. I was meeting people at the end of the day, but found a film that I thought might be good, featuring the gorgeous Johnny Depp. But I went early enough so that I could have lunch at Cafe Soya, which has not gone out of business in the three and a half years since I stopped working in Birmingham and single-handedly funding its existence. It is delicious, and so much better than its competitors, and I had wonton dumpling soup noodles, and they were wonderful.

I met up with friends I used to work with, and caught up with some office news, most of it tales of redundancy and jobseeking and pain. But we cheered ourselves up with some Glühwein in the Frankfurt market that sets itself up in central Birmingham every Christmas, and had some schnitzel, and walked about a bit looking at the stalls on the way to the pub that we like which was too full to sit down in so we went to another pub that we like that was too noisy. But we stayed there anyway and had some beer and then I caught the train back home. It was only delayed half an hour for the half-hour journey. All in all, a very long day.

Now this was all very well and I had a lovely time, but Glühwein before any food plus beer afterwards and a late night because of train delays made me rather tired and emotional. In fact, it was a great deal more than my system is used to, and the thing that I should have remembered is that on Friday morning, very early indeed, Mr A and I were having our first snowboard lesson.

We were awake and up in time, and got there ready to go at the allotted time, but I really was feeling rough despite the pints of water I'd drunk (and the paracetamol), and although I took some breakfast with me, I really couldn't eat it. So there I was, out on the slope on my snowboard, telling my legs and feet to do things they really didn't know how to do, without any fuel to allow them to do it. It all made perfect sense based on my newly acquired dietetic knowledge, but the fact was, I couldn't eat the muesli until two hours later when we had a break. I was transformed after that, and by the end of the session was feeling much better, sliding forwards and backwards, and we had even started making turns.

When we came out, it had actually been snowing, which made it feel even more exciting and holiday-like, and we're really looking forward to the second lesson next week and the holiday at the end of January. But the journey home was quite slow, and then all I could manage was a bath and a bit of lunch and then off to bed for a couple of hours. More like three hours, actually.

The Boy came to visit in the evening, as part of his Christmas tour of parents, so I did manage to get up again for supper (another Jamie triumph from Mr A) but then sent them off to the pub so I could complete my rehabilitation ready for work on Saturday. The weekend's truly over for me, so I'm back to coursework this morning. It's been snowing pretty hard here, so the last I've seen of Mr A and The Boy was them heading off for the slopes of the golf course with the toboggan...

Markets, and I am a winner (again)

Sunday's fun was promised, so Sunday's fun is what you shall have. We decided to reward ourselves for Saturday's toil by going out somewhere, and settled on Spitalfields and the Columbia Road markets. I suggested that we set off quite early, and then felt quite guilty about that, because as proper employed working people Lola II and Mr M don't get many opportunities to sleep late.

We took a detour to Petticoat Lane, which is a haven for clothes, luggage and the usual tat of an outdoor market. Spitalfields itself is a more upmarket place than I expected - I think I was imagining an indoor Petticoat Lane, but here were beautiful things with prices to match. Lunch was at Wagamama, because we were a bit too cold to enjoy street food, although if I'd seen Brick Lane market beforehand then I might have changed my mind. It would have taken forever, though, because I would have had to examine every stall before making a choice, and there were a lot of stalls. Lola II and I both had pork dumpling soup and shared a portion of noodles. Yum. Mr M had a rice dish that he wasn't that keen on.

Columbia Road market sells plants and flowers, and at this time of year, a lot of Christmas trees too. It was nearing the end of opening hours, and traders were knocking their prices down, and it was quite narrow and there were a lot of people. Mr M bought hyacinth bulbs and Lola II bought a cactus and I bought the same type of cactus and gave it to mum when I visited later in the day. Mum's very good at raising cactuses, and then giving them to me when they are about to flower. I get all the colourful display, and then they die, I don't know why. I also adjusted the security light and had a cup of tea and a square of tiramisu before borrowing a book for the tube journey back to Lola II, because I'd forgotten to bring one and it's too noisy underground to listen to podcasts.

Coming back home on Monday morning, I settled down to carry on writing up my research project. I am glad to report that of course, I will finish it in time to send a draft to my supervisor on Thursday. That won't stop me from worrying, and complaining about having to spend so much time on it.

Anyway, Monday night is badminton night, and the club staged its annual tournament. You may remember that last year, with my partner S, we won! This time things started looking up when we were freakily drawn as partners again. And we won again! The little trophy has returned to its spot on the trophy shelf, and we are better off by another bottle of wine. I think next year the draw will have to be done differently so we don't end up as partners again, just to give someone else a chance.

Interviewing the furniture

I'm now happily taking a break in lovely London with the luscious Lola II and the marvellous Mr M. Before coming down here, Mr A and I celebrated the end of term with a trip to the Red Lion, in which we ate dinner, drank great beer, and caught up with Smurf, who happened to be working there. It's a great feeling, to be welcomed to a pub by someone you know, directed to the best table, given a recommendation for the guest beer, introduced to other punters, and generally looked after.

What with the feeling of end-of-term freedom and a generalised love for all humanity, I became quite tipsy. Which meant that I didn't get up until after 9 a.m. on Friday, gathered all my stuff, mislaid my ipod, found it again, and made it down to London in time for Japanese lunch with Lola II, who took the day off work in my honour. And because she has quite a lot of time owed to her. Salmon hand roll and tempura udon ramen, in case you wondered. Delicious.

We spent the afternoon catching up with Lola Life, which is after all the main focus of this blog. I think I am allowed to reveal (I will check) that she and Mr M are planning to live together, starting in the New Year, so I asked if there were any further preparations. I was expecting to hear about practical issues like hiring a van or complex financial spreadsheets, but what she said was "We've been preparing to interview the furniture." I'm not sure that this statement, written down, conveys the utter lunacy of conducting formal interviews to see which furniture will join them in the combined accommodation, but it still makes me laugh thinking about it now.

In the evening, Lola II's music group was meeting informally at someone's house to play a few things together. Lola II was prepared to miss it on my behalf, but I bravely volunteered to join in, bringing my clarinet out of its sullen retirement on a high shelf in my office. I think it must be at least five years since I took it out of its case, so I was a little nervous, but it went very well. It's extraordinary how your fingers remember things that you don't consciously know, especially when you are plunged into the world of 13/8 time signatures and a double sharp thrown in without warning. I had a wonderful time.

Saturday was a day for business. Despite repeated attempts to set her up for independent living, Lola II seems incapable of dealing with the inevitable administration that accompanies an employed adult homeowner. I had to force her into her office and set up an imaginary forcefield, prison guards, and a complicated system of parole to ensure that it was all either thrown away or filed. And I had to fend off Mr M's attempts to evade security on Lola II's behalf, by smuggling a metal file inside a newspaper for 'recycling', to break through the prison bars. He was sent upstairs to assemble a wardrobe, and then to get our lunch (bagels and salt beef).

We worked through the day, Lola II filed and threw stuff away, and Mr M assembled a great deal of wardrobe. They had a longstanding dinner engagement in the evening, which allowed me to indulge in my second Japanese fix of the weekend: aromatic duck with rice and another salmon roll. Delicious again. Then I did some homework for school, which is starting to make me panic a little bit because I have to hand in a draft next week and it doesn't feel like I've done enough.

More news of Sunday's fun to follow (probably).

Tube feeding

The end of term is nigh, but I am prolonging the agony by extending the time to finish a draft of my project report. Looking on the bright side, I have handed in another piece of work, and if my project report looks reasonable then I'll only have one major assignment for the holidays, as well as revising for the one exam that we have in January. So I might be out walking a lot more over the New Year - last time I was revising so much that I could only spend one day out with friends.

Since Monday there have been two whole days at uni, whizzing through a load more 'stuff that might be useful one day'. Patient safety, a carbohydrate counting exercise, the role of research in dietetics and the value of weight management in groups, some peer-assisted learning about psychosocial factors relating to food choice, going through practice exam questions, and a seminar about the upcoming and final clinical placement.

Meanwhile I handed in the coursework where we had to choose an aspect of dietetic practice and plan a research study as if we had a day a week for 12 months to carry it out. I chose to write about tube feeding in hospital, and how patient-centred our dietetic practice is (or isn't).

It's clearly very important to gain consent for placing the tube, either by passing via the nose or by endoscopic and surgical placement directly through the stomach wall - these are invasive processes, one of which involves an incision. But consent is very rarely gained explicitly for the process of feeding, it seems to be implied by consent to the placement of the feeding tube.

It's the dietitian's job to work out how much feed to give through the tube, and make an initial guess at the right type of feed. There are different types: some more concentrated than others, with and without fibre, and some specialised ones like low sodium or lactose-free. The amount needed is calculated on the basis of the patient's nutritional requirements (usually related to the patient's weight, any stress or trauma, level of activity, and desired weight loss or gain), an estimate of what they are managing to eat by themselves, and any other relevant health conditions. But it is always a guess, and the patient needs to be monitored for change in body weight and any unwanted symptoms like constipation.

What I saw on my last placement was that the 'regimen' for feeding was written up by the dietitian for implementation by nursing staff without any discussion with the patient. Admittedly, when feeding is started the patient is often in no fit condition to express an opinion, and just wants the professionals to get on with it and make them better. But sometimes feeding needs to be continued for a prolonged amount of time, sometimes indefinitely, and in those situations it seems to me that there are choices that ought to be discussed, and aren't.

The main ones are method of feeding and timing. There are two options for tube feeding: you can use a pump that delivers a volume at a constant rate over a defined period of time: 100 ml/hour for 16 hours, for example, which could be overnight or through the day. Or you can 'bolus' feed using a 50 ml syringe, to squirt food into the stomach several times a day over a period of about half an hour each time.

The factors that dictate which method is used seemed to be (a) convenience: it's much easier to set up a feed once a day than manage bolus feeding several times, and (b) it is thought to be more convenient for the patient to be attached to a pump through the night so that there is more freedom during the day. So the default feeding regimen tended to be pump feeding for 16 hours overnight.

I'm not sure that this is what I would want long term. Mealtimes become irrelevant if you're being drip-fed overnight, but they are one of the few things that interrupt the boredom of a prolonged hospital stay. Feeding overnight means that you can't sleep flat - you have to be propped up to make sure the food goes down rather than up. Anyway, my research idea is all about asking patients what they would prefer, and I've handed it in now, so I plan to forget all about it as soon as possible.

Today we had our very last ever lecture on this course! The sobering thought, however, is what the future holds: I have a meeting with my project supervisor and with my placement supervisor, an exam and a viva, a 12-week clinical placement, a couple of revision sessions and the final assessment towards the end of May 2011, and then it's all over! In just six months' time, I may have a job. Interesting times ahead...

Dinner party

Doesn't time just fly by? I've been trying to churn out something interesting every three days, but my life doesn't have that many thrills, and now that the time for another post has come round again I'm a bit short of material.

Over the past week or two I've been working, occasionally punctuated by badminton, going to the vegetable shop, and last night, a dinner party. It's only the second dinner party we've hosted in this house, and went much better than the first. I was less ambitious with the food, and didn't over-cater too much at all (we've only got soup and some vegetables left). The company was loquacious and congenial, although there was a little bit too much talk of internal combustion engines of various sorts. It turned out that one of the party once sold a precious classic car to the father of another. It's a small world, except that a self-selected group of friends is likely to have something in common - in this case, cars and bikes.

We invited one couple to stay overnight. Our spare bed is in my 'office', and I made the mistake of leaving my computer in there. Given that I was the first to go to bed, at 2 a.m. it is perhaps unsurprising that they have not yet emerged, it is 9.30 a.m. and I have been up for some time and am getting twitchy about losing a morning's work, with deadlines looming.

What I've been reading

Second Class Male
by Stan Madeley

"Whether he's offering himself up for adoption to Elton John or attempting to hypnotize Derren Brown by letter, Stan Madeley (by deed poll) is a fearless and dynamic correspondent. Boldly billing himself as Britain's top Richard Madeley lookalike, he uses his so-called celebrity status as an innovative excuse to plague, pester and pen letters to many well-known faces, politicians and organisations, with hilarious results."

Now that I've read this, I can genuinely endorse it as unexpectedly addictive, and laugh out loud funny in places. It's slightly formulaic, but that just means I was looking forward to finding out what tagline the 'Stanley Madeley Experience Live!' would have in the next ridiculous letter. He has a comic turn of phrase that I love, but the gems are the responses from the public figures and companies that he writes to - David Dimbleby, David Attenborough, the Pope, Michael Howard - especially when they enter into the spirit of the joke. The principle is not new (I remember glancing through The Timewaster Letters a few years back) but Stan's letters are much more enjoyable and inventive than the ones in that book. So the offer's still on - if someone would like me to send them a free copy of the book (one that I have bought, not my signed one), just let me know in the comments.



The Turn of the Screw
by Henry James

narrated by B. J. Harrison

"The narrator is a young governess, sent off to a country house to take charge of two orphaned children. She finds a pleasant house and a comfortable housekeeper, while the children are beautiful and charming. But she soon begins to feel the presence of intense evil."

This is actually the second time I have listened to this story, with a different narrator this time. Mr A came into the kitchen and heard a little bit, asked who the author was, and concluded that he wouldn't be reading any Henry James in future. My last audio Henry James was awful - the blog post was from when I put up the post before I'd finished the book, so it doesn't say so, but I don't recommend it. This one is just about OK, but disappointing, and I'm now very worried that if I were to read 'Portrait of a Lady' again, I wouldn't like it.



My Man Jeeves
by P. G. Wodehouse

narrated by Simon Prebble

"Containing drafts of stories later rewritten for other collections, My Man Jeeves offers a fascinating insight into the genesis of comic literature’s most celebrated double-act. All the stories are set in New York, four of them featuring Jeeves and Wooster themselves; the rest concerning Reggie Pepper, an earlier version of Bertie. Plots involve the usual cast of amiable young clots, choleric millionaires, chorus-girls and vulpine aunts."

I hadn't realised until I scouted for the quote above that this contained stories that later re-appeared in more polished form. I thought I'd just read them before, or seen them in TV form. The narrator, who was so brilliant when reading 'Jonathan Strange & Mr Norrell', somehow isn't as natural with Jeeves and Wooster as Jonathan Cecil is. But Mr Wodehouse's prose makes up for most deficiencies in plot or narration.