Talking turkey

It's a shame to use this blog title so early on, because I'm sure there will be much more appropriate posts later on, and I haven't even started working there full time. But I've done a couple of sessions at the turkey farm to get to know the people and processes involved in generating a third of the business turnover in just six weeks of the year. I haven't made the acquaintance of any of the turkeys, because I won't have the chance to say goodbye. They are fairly unattractive beasts, with pale skin and black beady eyes. Even the noise they make is less melodious than the chickens in the next shed - yes, the firm also raises and sells cockerels at this time of year.

The business operates from two sites, one of which runs all year round, but buys in products that it processes - separating the different parts of the birds for different purposes, cooking some of it, and just selling other parts. I now know the difference between a turkey crown, a saddle and a boneless breast. This is a premium quality operation, selling high value poultry and game products (not just turkey) to butchers, delicatessens and restaurants, with only a small proportion going to individual customers who usually come and collect their orders, although online orders can be placed.

The site where I'm based is closed down for six months of the year, and for another four it just raises the chicks. The activity leading up to Christmas becomes more and more hectic, people are stressed and sleep-deprived, but at the end of December 24 it's all over. There's a bit of follow up accounting in January and everything is thoroughly cleaned up, and that's the end of it until another load of chicks is delivered in the summer.

I've been told that the operation I'm working on is also 'traditional', which includes hanging the birds for 10 days as well as some other vague procedures that I haven't asked too much about. This means that for a Christmas order, all the slaughtering is done by 14 December at the very latest, and at that point you know what birds are available to be sold - how many, and in what weight range (from 3 to 14 kg dressed weight for the whole birds). With any luck, the dressed weights will have been correctly estimated from the freshly slaughtered birds, and the demand from customers correctly estimated to match availability at the different weights. As long as Delia doesn't tell everyone to buy a smaller turkey (which she did a couple of years ago), then we should be all right.

My job involves working back from the orders and delivery dates that customers have specified, and deciding how many birds of which weights in what order will need to go through the process of dressing and packing to fulfil those orders. There are various practical constraints that make this much more difficult than it sounds, plus the nature of customers who are vague with their orders and change their minds at the last minute. And I have to keep track of the crates that hold the delivered products - they need to be returned because they are only rented for this short period.

I have a small office with a desk, a computer, a printer and a convection heater. A gang of local lads and Polish workers do all the hard work, managed by permanent staff. It starts today, I think, and ends on 24 December, when either I shall emerge victorious or slink away defeated. I'm pretty sure it will be the former.

What I've been reading

Homicide
by David Simon

"The scene is Baltimore. Twice every three days another citizen is shot, stabbed, or bludgeoned to death. At the centre of this hurricane of crime is the city's homicide unit, a small brotherhood of men confronted by the darkest of American visions. David Simon was the first reporter ever to gain unlimited access to a homicide unit, and his remarkable book is both a compelling account of casework and an investigation into our culture of violence."

David Simon went on to write 'The Wire', one of the best TV shows I have ever watched. So I bought this for Mr A, and after he'd finished reading, it was my turn. It is a very fat book, following a year in the life of the homicide police teams working in Baltimore, a world of which I have little idea other than what I'd seen on 'The Wire'. It's well written and interesting enough to keep me reading, although there are few satisfying outcomes and obviously no trace of a plot, given that it is non-fiction written by a journalist.

The Secret History
by Donna Tartt

narrated by Donna Tartt

"A misfit at an exclusive New England college, Richard finds kindred spirits in the five eccentric students of his ancient Greek class. But his new friends have a horrific secret. When blackmail and violence threaten to blow their privileged lives apart, they drag Richard into the nightmare that engulfs them."

Quite a long book, and no long car journeys means a fragmented read, but sufficiently tight narrative meant that I kept up with the plot. It's an odd book, because the murder happens right at the start, and there's no mystery involved in who played a part, but the whole book serves to describe why it happened, and what happened next. You hear a lot about the participants, and I understood a bit about them by the end, but none is particularly attractive and there's little 'relaxation' when bad things aren't happening. Well written, a good read, but somehow unsatisfying.

Gormenghast
by Mervyn Peake

"Titus, 77th Lord Groan of Gormenghast, is restless in his cobwebbed kingdom of crumbling towers and ivied quadrangles, dank passages and battlements elbow-deep in moss. The castle is instinct with spreading evil: Titus's father, his twin sisters and several castle officials have met terrible and secret ends and Titus feels that, if he isn't destined for a similar fate, his life can only ever be an endless round of pre-ordained ritual. Somehow he must cut off the evil at source - or escape into the unknown world beyond Gormenghast."

This is the second book of the trilogy, and much like the first, uses language like a bludgeon to beat you into submission. New word from this book: 'marcid', which means 'Lean, withered, characterized by emaciation.' This book is much the same as the first, quite a lot happens but very, very slowly until quite near the end, incorporating lots and lots of words, but evoking an inordinately vivid image of the action and the location. I have the third book ready to go, but I'll need to read something a bit lighter after these three hefty books.

Paid employment

I didn't get the short term part time job, but they gave great feedback. There were 59 applicants of whom they shortlisted 9, and I was the second in line for the job, which, given the circumstances, is ideal. I felt I did a better interview, and the feedback on my responses was fair, and reflected my strengths and weaknesses very well.

I have the next interview to look forward to, for which I have to prepare a presentation, and for which I have also bought a pair of lady shoes. With heels. The sort you have to wear with tights rather than socks. I haven't worn a pair of these for at least ten years, and I don't think I'll be wearing these very often - granted they are elegant, but so uncomfortable! They aren't only for interviews, but to go with the dresses/skirts that I fit into now, on the slight chance that there will be an event for which they are suitable. The badminton Christmas event might be the time, but if there's any walking about or dancing I'll have to take a spare pair without heels.

I've been playing badminton three times a week for the last few weeks, and I came home at 10.30 on Friday thinking that it was all getting a bit much. I never thought I'd reach the point where I would be happy not to play, but there it was. But badminton has brought a surprising benefit alongside the playing - through one of the members of the club, I have a job until the New Year, working on a local turkey farm. Sorting out Christmas orders and deliveries, starting this week.

I know absolutely nothing about retail, or poultry, and have never worked in any business even slightly like this one, but I'm confident that I can do the job so I'll give it a go. If nothing else, it should provide blog fodder alongside a bit of money. And, the first person has signed up to go on one of my Coeliac UK Store Tours!

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It's Tuesday morning, I was about to publish this, just had a chat with Lola II, and looked at my mobile phone, where there was a message.

The dilemma I wrote about a few posts ago (where I had two interviews but the second job was more attractive than the first) has resolved itself, in more ways than one. Obviously I didn't get the first job, and was gearing up for the interview for the second. I contacted the department to find out if I could visit ahead of the interviews, and find out more about what they did. During that phone call, the manager said that unfortunately the job had to be changed from permanent to a 12-month fixed term contract. At the same time, another job I had applied for with the same NHS Trust had also notified applicants of a similar change.

Yesterday I started on the presentation that was required for the interview, by reading one of the key reference documents and making notes. It was quite interesting, and related well to my previous employment in the disability field.

The message this morning stated that "due to recent Divisional re-organisational changes, this post has been withdrawn ... please do not attend the interview you have booked."

Movember

We are two-thirds of the way through the month of Movember. Not a spelling mistake, but a name reflecting the increasingly popular initiative to raise awareness of and funding for prostate and testicular cancers, by growing a moustache through the month of November. I like this cause.

Although I am female, I feel little solidarity for the pervasive ladies-only attitude that delights in the discussion of shoes, clothes, bags and Strictly Come Dancing. I don't feel part of the sisterhood that elevates women into a 'special' category and excludes men as somehow of lesser importance. I thoroughly endorse the Pink Ribbon campaign in support of breast cancer, and I will always support the pink-themed women-only 5k and 10k runs, but I really like the fact that for a change, men are doing something that women can't - growing moustaches - and sticking them in our faces. Figuratively and literally.

At the pub there are many unlikely moustaches on display, and at least three of my Facebook friends are taking part. I'm writing about one of these in particular. Let's call him Bruce, for that is his name.

I have known Bruce for more than a quarter of a century. We first met at university (my first time round), did the same degree, and became friends at some point in that first year. It could even have been the first week, but it's too long ago to remember. I don't think I will ever find better friends than those people whom I first met through those wonderful, heady three years at uni. We still see each other, sometimes at New Year, and occasionally at other times, and I have written about several of these occasions on this blog. CERNoise even wrote a post for the blog not that long ago.

Back to Bruce. Some random facts:

• His origins are proudly Australian.
• He owned a corkscrew known as the 'wiggle and twist'.
• He was a skilled playing member of the university tiddlywinks club (I was an unskilled drinking member). 
• He learned to unicycle with me.
• He used to be a diver (from diving boards, not sub-aqua) until he hurt his back. Now he cycles a lot and competes in triathlons.
• He bought me a toaster 25 years ago, and it is still the one I use every day.
• He is one of the best human beings in the whole world.

Here is a short statement from the man himself:

"This year, I am growing a fine moustache for Movember, which is a charity dedicated to men's health. On average men live less long than women - there is a theory that part of the reason is because men are fundamentally more stupid and fail to go get themselves checked out for diseases like testicular cancer and prostate cancer.

"Having talked to people about this, I reckon this is a pretty good theory backed up by evidence. I propose the following test - if you have to put your reading glasses on to read your iPhone and you stand up to pee, then go see a doctor once a year for a checkup. Works for me!

"Please donate to http://mobro.co/brucedevlin if you think the tash warrants a small donation to save lives."

And here is his moustache, proudly displayed, and calling out for your contribution to the cause. Go and donate now!

Meeting and interview

Ooh, I'm very late with this post. No excuses, except that my life isn't jam-packed full of things to share out in public. Two events only: a meeting and an interview.

The meeting was the local branch of Coeliac UK, held in a church hall and very well attended. This may have been because there was a food demonstration by Juvela, which always means a) free food and b) other giveaways from this major player in gluten-free retail. I arrived only just in time and took a chair at the back, which unfortunately meant that I was far too close to the horrible children who were at the back because they wouldn't shut up. I felt alternately desperately sorry for their mother and close to battering them to death with a chair. If I hadn't wanted to talk to the dietitian who was there, I really don't think I would have stayed, even for the free food, which I didn't actually get.

The cookery demo took place at the front, obviously, but on the same level as the chairs, so anyone more than three rows back (and there were about 15 rows altogether) couldn't see anything except the top of the presenter's head. Because of the kids, we had trouble hearing anything either, and I imagine some of the older folks with less acute hearing wouldn't have heard much even without the kids. But I stayed, through the long, tedious 90 minutes of demo, catching glimpses of stollen, pizza, cake and pastry. At the end, while everyone else mobbed the table at the front, I went to talk to the dietitian, who at the start had briefly spoken to the room about the gluten-free situation in the hospital where she works.

The regulations for gluten-free labelling are changing at the end of this year, when products labelled 'gluten-free' must have a verified gluten content of less than 20 parts per million (ppm), and 'very low gluten' will mean 21-100 ppm. A third classification of 'no gluten-containing ingredients' will indicate products that are likely to be safe but will not have been tested to establish the definitive gluten content. This has caused some upheaval in the food industry, and the dietitian was there to talk about the food service in the hospital, and to reassure members that there would be gluten-free food if they were admitted. There isn't a great variety, though, and if I needed to eat gluten-free I definitely wouldn't want to be there more than a week.

In terms of job opportunities, the dietitian (who is the Dietetic Manager in the region) confirmed that there aren't any. We had quite a long chat about this and that, but that was the end result. She's given me her email address and I shall send my CV, but I don't expect anything to come of it, at least in the short term. In the long term, what I've achieved is to have a chat with someone who's a senior dietitian and who may remember me as that graduate who bought her a cup of tea at that Coeliac UK meeting.

The interview was almost as unsatisfying, but I won't go into detail, except that it was for a part-time post that only lasts until March 2012, which has both benefits and drawbacks. And obviously I don't know if I will be offered it, and if I am, whether I will accept. I am looking forward to the other interview in a couple of weeks, and still have three 'live' applications and another suitable vacancy to apply for today. So I'd better get on with that.

A glimmer of hope

The last few days have been quite a roller-coaster ride; I've been up and down like a yo-yo. I've been making much more coherent attempts to put together a plan towards employment rather than waiting for my job applications to bear fruit. This was partly prompted by the opportunity from Coeliac UK to run store tours, and then assisted by sister D who made it her business to help me find, or create, work opportunities.

I finally persuaded two well-known supermarkets in a not-very-nearby town to let me escort people with coeliac disease and family members around their stores. I had no idea this would be so difficult, given that absolutely no input is required from the supermarkets except 'permission'. If I was thinking of working with them in some way that required them to actually DO anything, then based on this experience I would think again.

To start with, neither of the supermarket employees I spoke to had work-based email addresses that I could use. So I sent one letter by post, which the employee claimed had not arrived after a week. The other said I could use his personal email but he couldn't access it from work, so an evening had to pass between me sending him messages and him being able to discuss the contents. And he said he didn't receive the first message that I sent.

No work-based email? Two of the Big Four supermarkets in the UK? It seems unbelievable that they can be expected to do their jobs in this way. Anyway, the dates and times for my tours are set, and now I have to recruit participants.

The contact that sister D found for me has also borne fruit, in the form of an offer of three days of 'work experience' in a hospital not too far away. I've asked what this might consist of, but as yet have no idea. I've been given a very long form to complete and post back, which will enable an 'honorary contract' to be created after they've done a full Criminal Records Bureau check. All for three days, which may or may not be related to dietetics. We'll see what comes of this effort.

I've kept in touch via Facebook with a very few students, all of whom have now got jobs and started work. On Monday I was so despondent about this, and about the number of job applications I've made (23) in comparison with interviews awarded (three, and only one since July) that I appealed to my course tutors and referees - who are dietetic managers - for help. My plaintive email was rewarded by wonderfully helpful responses, going to the length of reading and commenting on an example of one of my 'personal statements'. The consensus is that it is much too long, so I followed their advice with the application I submitted yesterday, and brutally shortened it down to just over 2 pages, making sure to include the bits that they suggested were the most interesting.

Immediately following this, but clearly not in any way consequential, messages came through offering me two (count 'em, TWO) interviews for jobs where the closing date for applications was long, long ago, and in one case we had passed the stated date for interviews to have taken place. So either that information was wrong, or they held interviews and failed to appoint on the first round, which seems extremely unlikely, but you never know.

While this is very welcome news, it leaves me with a potential dilemma. The first interview is on Monday, for a job that is only part time (19 hours per week), temporary (until the end of March 2012) but too far away for commuting so I'd have to stay overnight for at least two nights a week, and possibly three. Costs would be almost as high as for a full time job, but for only half the money. The second interview is a much more desirable job, full time, permanent and well within commuting distance, but the trouble is that this interview is not for another three weeks.

If (and it's a big if) they offer me the job after the first interview, what should I do? Ask them to wait until I know about the other job, which will be up to a month for a contract that would only be four months anyway? Or accept the job but still go for the other interview and break the bad news only if I get that job? Or can you think of another option?

New treatments for Type 2 Diabetes

I went to my second local meeting of Diabetes UK last week, and it was well worth the trip. It's an odd group - the majority of members are well over retirement age, and the primary function of the group is definitely fundraising, with regular raffles, tombolas and fundraising events. Once a month at these meetings, though, they also have a lecture - I wrote about the last one, which was all about feet. This time, we had the local diabetes consultant talking about the newest developments in treatment of Type 2 Diabetes Mellitus (T2DM).

Type 2 Diabetes

Unlike type 1, where insulin is lacking, the primary symptom in T2DM is insulin resistance. When food is consumed the carbohydrate is broken down into glucose, which circulates in the blood before being used for energy or stored. As blood glucose levels rise, insulin is secreted by beta cells in the pancreas, and insulin is what facilitates the exit of glucose from the bloodstream. (I've written a post about this before). Because people with T2DM are resistant to the action of insulin, the levels of glucose in the blood remain higher for longer, and more insulin is secreted to try and deal with it, so levels of insulin are also high.

The disease is progressive, and over time the ability of the pancreas to secrete these large amounts of insulin decreases - it actually seems to 'wear out' - and eventually insulin replacement therapy may be needed, by injection, as for a person with type 1. At that point, the main difference between type 1 and type 2 is the insulin resistance; in T2DM the amount of insulin that has to be injected is very much greater.

Historical treatments

The main pharmacological treatments historically for T2DM have been aimed at overcoming insulin resistance (metformin), and stimulating insulin production while the pancreas is still able to produce any (sulphonylureas, pioglitazone). Another treatment that can be prescribed is a glucosidase inhibitor (acarbose), which inhibits the digestion of carbohydrate in the gut so that it does not enter the bloodstream, but often produces severe flatulence.

Alongside these medicines, exercise removes glucose from the blood independently of insulin, diet can help moderate high levels of blood sugar, and both diet and exercise can produce weight loss, which independently reduces insulin resistance. The recent news report of recovery of normal blood sugar levels after eight weeks on a 600 kcal/day diet (and similar remission following gastric surgery) may be attributable to this weight loss effect. And it's clear that obesity is one of the major risk factors for type 2 diabetes, so losing weight reduces risk, incidence, and severity.

Incretins

The new treatments are based on another finding - that the gut produces hormones, called incretins, which stimulate insulin secretion when carbohydrate is digested. This 'amplification' of the effect of glucose stimulating insulin secretion is smaller in people with T2DM, so injectable forms of one of these incretins (Glucagon-like peptide 1 or GLP-1) have been developed. Because the effect only happens when carbohydrate is digested, these GLP-1 agonists don't provoke hypoglycaemia (when blood glucose falls dangerously low). The two drugs currently available are exenatide (Byetta) and liraglutide (Victoza).

As well as increasing insulin production, incretins keep blood sugar levels low by suppressing glucagon secretion - glucagon stimulates the liver to release stored glucose into the blood, when fasting, for example. They slow gastric emptying so people feel fuller for longer, and they also seem to act on the brain to reduce appetite - these factors contribute to the treatment by facilitating weight loss. Animal studies have also demonstrated that incretins halt the degeneration of the insulin-secreting cells in the pancreas, which would be an added bonus if it is true for humans.

Side effects are nausea, an unpleasant feeling of fullness, and possibly an increased risk of pancreatitis. Because the drugs are not exact replicas of human GLP-1 there is also the possibility of the body's immune system generating antibodies which reduce its effectiveness. Future development work is taking place around reducing the number of injections by producing a longer-acting version, and slow release via an implantable device.

Other new treatments

Natural incretins are very short-lived, which is why the GLP-1 agonist drugs are not quite the same as the human versions - they have been designed to hang around a bit longer. GLP-1 is broken down in the body by an enzyme called DPP-4, and a class of drugs called gliptins inhibit the activity of DPP-4, thus preventing the breakdown of GLP-1 and increasing its availability in the body. Gliptins can be taken as tablets, which gives them an advantage over injectable incretins.

Another class of drugs being investigated are glucose re-uptake inhibitors. At all times our blood is being filtered through the kidneys, with unwanted components passing through to the bladder for excretion in urine, while the majority of the blood and its contents are re-absorbed back into the bloodstream. Glucose goes through this process, with nearly 100% being re-absorbed as long as blood levels are not too high. Glucose in the urine is one of the diagnostic criteria for diabetes, when there is so much glucose in the blood that it 'overflows' into the urine.

Glucose re-uptake inhibitors inhibit the channels in the kidneys that reabsorb glucose, so preventing re-uptake and forcing excretion of glucose in the urine even when blood levels are not sky-high. This will lower blood glucose levels slightly, improving blood glucose control and also leading to a small amount of weight loss (but less than with GLP-1 agonists). The down sides are potential urinary tract infections (because bacteria love sugary urine), and a dehydrating effect.

The last development that the speaker mentioned briefly were new types of insulin: ultra short acting and ultra long acting, which can help with both type 2 and type 1 diabetes.

And finally

After the lecture, I asked the consultant about his work with dietitians and any inside knowledge of whether there might be any opportunities for voluntary or unpaid work or work experience. He was moderately encouraging, and I have emailed him as we agreed, but so far have heard nothing.

First time karaoke

My goodness, last night was fun. My first ever attempt at karaoke, and I was very unsure whether I would like it or not. Lola II set it up at a place she had been before, so that was a good sign, and it was in a very private establishment rather than a bar with loads of strangers or anything, and with just two other friends. Actually, there was one of Lola II's school friends (but I'd met her lots of times) and the other was one of sister D's friends whom I'd met only once, but who is Karaoke King. And it was brilliant, and for two hours we all sang and danced our hearts out, and I loved it. Very unexpectedly wonderful.

This was obviously in London, where I am having a 'holiday'. On Thursday, I travelled down and met dad and we went to an event at the Wellcome Collection, called 'A Cook's Tour', advertised as an exploration of 'the role of food, remedies and global interchange in our medical and cultural lives from the 17th century onwards'. It started with a short tour of relevant artifacts in the collection, and then a couple of lectures with some of the ancient books and manuscripts. It was no better than OK, and the final speaker wasn't very good, but some of it was interesting. The blurring of the distinction between culinary and medicinal use for many exotic spices, and the idea a few centuries back that local remedies rather than exotic imports were best for a local population.

Then I had dinner with sister D, and lunch next day with another old friend from school, who is going to join us on the planned Woodwind Orchestra day in January. I had a quick look at the Private Eye retrospective at the Victoria and Albert museum, and then on to the karaoke, followed by sushi.

The only other event of note up to this point on the trip has been the replacement of the smoke alarm battery at mum and dad's house, which, after being ignored for nine years, started to beep every 20 seconds. It hasn't bothered them too much up to now because a) they can't really hear it that well, and b) it's in the kitchen, a long way from their bedroom. I arrived on Thursday night, however, and realised within minutes that the job could not be put off until next day because a) I can hear it rather well and b) I was going to be sleeping in the room next to the kitchen. It proved to be a rather difficult job, but the alternative was unthinkable, and I managed it in the end. And I unscrambled dad's email, where somehow a filter had been applied that hid any email in his Inbox that he had read, goodness knows how.

Now I am supervising Lola II's admin, which she won't do unless extreme measures are applied (in this case a force field preventing her from leaving the room). Then we will have moderate fun in some as yet unspecified manner until we drive back over to mum and dad's with Mr M, a new computer for mum, a tent in the boot, anticipation of another family gathering tomorrow, joy in our hearts and a song in our souls. Because that appears to be the impact that karaoke has on a Lola.

Officially seeking work

I have at long last had to bite the bullet and become acquainted with our local Jobcentre Plus (JCP). Despite the fresh decoration and modernity of the surroundings, what a depressing, soulless place it is - I wouldn't change jobs with the people who work there for anything. Obviously they have to ensure that I am not a parasite upon the state and fulfil all the criteria for their assistance, but it is done in such a complicated and unhelpful way.

The adviser I talked to could neither type nor spell, and I had to dictate the word 'dietitian' very slowly, letter by letter. The job does not appear in their database, and so I am coded as looking for work primarily as a Healthcare Manager (Dietitian) and secondarily as an Occupational Hygienist (Dietitian Assistant), neither of which is remotely true. She had never come across the language 'Hebrew' before and I had to explain what it is, and how to spell it. I am not optimistic that I will receive any useful advice or assistance from JCP, but I might possibly get some money, which may go some way to making up for the experience of going there. Mr A says I should just talk to Smurf and work a few hours in the pub to make as much money as they will give me, but without the pain. I shall see if JCP can come up with anything useful that might help me first.

I wasted a morning on an application for a job that was withdrawn in the afternoon, but there have been another two since then, neither of them local. I have spent some meaningful and useful time exploring options for delivering 'Store Tours' at supermarkets on behalf of Coeliac UK. Patients with coeliac disease and members of their families can sign up to go round a supermarket with a dietitian, and talk about gluten-free shopping and healthy eating with coeliac disease. I can earn expenses while doing something useful, but it will no doubt play havoc with my interaction with JCP. It would probably take the entire duration of my jobseeker interview for that particular adviser to type the word 'coeliac'.

In the process of liaising with a dietetic department (in order to ensure that I have enough 'customers' for my store tours) I may be offered some unpaid work using Excel spreadsheets, which will keep me busy and give me some contact with the real world of dietetics, even if it may not increase my chances of getting an interview. Similarly, another piece of work I am doing is at the request of the university course manager, who is editing a book about choosing dietetics as a career, and I am writing the chapter about deciding where to study. My sister D has been working on my behalf as well, and I have been encouraged to take some further steps that are well outside my comfort zone of operation. It all helps if it leads to employment.