chrishansenhome: (London Stabbie)
One of the things that Stabby has to do is attend meetings. Some are more pleasant than others. Stabby believed that tonight's meeting would be a good one as dinner was provided and free food makes Stabby very happy indeed.

One fact you need to know is that London Stabby has a complication of diabetes called "Charcot Foot" (Don't open this unless you have no aversion to reading about horrible medical conditions. You have been warned.)

Stabby's foot doctor is the world expert on care of diabetic feet: three out of the first six books that come up in an Amazon search were co-authored by Prof. Edmonds. So Stabby now walks around with an air cast (which made his recent plane trips a breeze: wheelchairs to and from airplanes meant that Stabby got on the plane first and got wheeled through security and immigration).

However, the air cast invites quite a bit of attention. Stabby can get on a bus, point to the air cast, and the cute young man who is sitting in the Priority Seat gives up his seat cheerfully. However, some people feel compelled to enquire after Stabby's health. There are good ways to do that, and bad ways.

The good way is to look concerned and say, "Oh dear, what's happened to your leg?" Stabby likes this, as it doesn't imply that he has caused his infirmity. He relates the fact that it's a diabetic complication and surgery will be required next year. This is kindness on the part of the questioner as it is concern without causation.

The less good way is to look concerned and ask, "Oh dear, what have you done to yourself?" While Stabby has indirectly caused this condition by being overweight and an avid trencherman, Stabby didn't trip over the cat, fall down the stairs, or jump out of a bedroom window 10 seconds in front of an enraged spouse. Stabby prefers the good way, but this way just invites the answer, "I have diabetic foot ulcers."

The worst way is to chuckle and ask Stabby, "You've been skiing, I see!" And, of course, Stabby's enjoyment of his free dinner was ruined by someone saying just that.

Stabby replied tartly, recounting his aversion to this method of enquiring after his pedal condition. And, for once, Stabby continued to rail about this for around 5 minutes, startling everyone else at the meeting (which, luckily, hadn't actually begun at that point).

Stabby believes that there is a special place in the Underworld for people who make light of other people's infirmities, whatever they might be. He has an extra air cast upstairs, from a previous bout of foot complications, and will gladly imprison in the air cast the next person who asks him whether he's been skiing. He will even pump it up to 40 rather than 30 or 20, and watch the poor victim squirm in the cast's viselike grip. Stabby isn't so cruel as to leave it on this person until the onset of gangrene, however. There are some depths to which Stabby will not stoop.
chrishansenhome: (Default)
As an amateur genealogist, I'm always looking around for new facts about my family. I've finally downloaded a copy of the book written in the 1880's about my mother's family. I've discovered that Samuel F.B. Morse was my second cousin 6 times removed. (1)

I have also discovered that I have something called trigger finger, which at the moment is not painful, only uncomfortable. Apparently it is one of a number of hand complications that may develop in diabetics. Oh joy. If it persists, I can get an injection of steroids into the sheath surrounding the tendon, which normally relieves the symptoms. In some cases minor surgery is needed. The doctor said that if I liked, she could do it in the surgery, or I could go to the Hand Clinic. I told her that since I'm already being seen in the Foot Clinic, I'd rather not have to go to a Hand Clinic as well—one end is enough.

The Gauguin exhibition at Tate Modern is well worth seeing. It's on until mid-January 2011. If you're in London, or even in the UK, you should definitely try to get tickets and go to see it. We went on Wednesday, the day before it officially opened, as it was an open day for Tate members. It wasn't very crowded, thank goodness. I overrode HWMBO's objections and bought the catalogue. This is the first London exhibition of Gauguin in more than 50 years.

(1) For those who don't know who he was, he is the gentleman who invented the telegraph and Morse code. (2)
(2) For those who don't know what a telegraph is, it was the first electrical instrument that was capable of communicating over long distances using Morse code, natch.
chrishansenhome: (Default)
Well, I seem to have survived both the Fat Doctor and the Foot Doctor.

I arrived at St. Thomas's Hospital around 9:45 for a 10:10am appointment. I went to the clinic, and stood in a queue behind a gentleman who hadn't shown up for his appointment and was arguing with the receptionist about making another appointment. She couldn't do it (because "the computer says 'Nooooooo...'") but he didn't believe her. Finally I checked in and went to sit down and wait for the surgeon.

A short nurse came out and bellowed my name. I followed, and she said, "Take your shoes off to be weighed." Well, I had my air boot on and that takes a few minutes to remove and the same amount of time to put on. I said, "I can't take this off; please just weigh me and take off about 2-1/2 kilograms." She looked at me and barked (and I do mean 'barked'): "Take your shoes off. Do you want me to lie? Doing that would be lying."

At that point I was ready to put on my coat and walk out. I said, "Well, I'm not taking this boot off. Do what you like." She said, "So you refuse to be weighed then." and wrote that down on the piece of paper. "Sit down."

I went back to the waiting area ready to explode. Someone sitting behind me went over to the receptionist and complained about a bad smell in the area. For a moment I thought that maybe I hadn't showered, but it turned out that someone was having a leg ulcer cleaned out in another room and the smell was unpleasant for some. However, I couldn't smell anything at all.

The short nurse emerged with a spray bottle of air freshener and told people to move to another area to wait. As I couldn't smell it I stayed put along with one other person. The nurse sprayed the air freshener around and muttered to the other person (I guess that "refusing to be weighed" means that I am a non-person) that we will all smell after we're dead and the stench was only dead flesh so it was natural. After she toddled off, I looked at the other person and we wondered what planet Nurse Ratchett came from.

The nurse then asked me to come along with her. In passing she opened a door and muttered something I didn't catch, so I continued to follow her. She rounded on me and said, "I told you to wait in the examining room!" I truly hadn't heard her. So I went into the examining room and waited for the Fat Doctor (ie, Bariatric Surgeon).

After about 20 minutes he knocked on the door and swept in with an entourage consisting of a dietician and a student. We discussed options and he recommended that my case be presented to the Primary Care Trust for funding. If it is funded, there is then a 3-month wait for the operation. Gastric bypasses have been found to not only help people lose weight, but in type-II diabetics they seem to reduce insulin resistance. There are a few side effects, and I'll have to eat stuff that's been liquidised in a blender for a couple of weeks, but I'm willing to do it in pursuit of weight loss and diabetic improvement.

I took the opportunity to mention how rude I thought the nurse had been. The doctor said that he had no problem with weighing me with my boot on, and the dietician took me to the nurse's station, shooed her out, and weighed me and reduced it by 2-1/2 kg, just as I'd suggested. No problem. They will speak to the nurse.

Off to the bus stop for a 148 to the Elephant and Castle, then change for a 40 to Denmark Hill and Kings for my appointment with the Foot Doctor. As I'd taken my infected foot into my own hands and started taking antibiotics but not called the foot clinic, I was ready for a bollocking from Tim, the cute Diabetic Podiatrist. But when I got there, I said to him, "I'll tell you what happened last week if you promise not to shout at me." He smiled and said, "I never shout." which I can believe. I told him and he said, "Fine! I'll give you a prescription for two more weeks.

The ulcer on my left foot has significantly reduced in size. There doesn't seem to be any problem with the right foot at the moment. So, he dressed both feet and I went on my way.

I missed the Centre Drop-In this noon, but decided to have linguini with butter and garlic this evening just to spite the diabetes. I expect I will have high blood sugar tomorrow morning, but I am feeling quite well this evening.

Yesterday

Oct. 3rd, 2009 01:40 pm
chrishansenhome: (Default)
As most of you will be aware, I'm a diabetic and constantly have to go to the quack for this checkup or that checkup. For my foot I go to Kings College Hospital Diabetic Foot Clinic. For diabetes itself, I am currently attending the Diabetic Clinic at St. Thomas's Hospital. I go to my own GP for prescriptions and anything other than diabetes.

A couple of months ago I got a letter saying that I had an appointment with the lipid nurse at the Diabetic Clinic at St. Thomas's. OK, no problem. That's all the letter said. No instructions about what to bring (urine sample, perhaps) nor restrictions on whether I could eat before the appointment.

The rest of the background to this is that, while taking simvastatin my cholesterol has been normal to low (for a diabetic) and my ratio of good to bad cholesterol has also been very good. So seeing the lipid nurse or doctor isn't top-of-mind for me.

Yesterday I turned up at St. Thomas's at around 11:05 am, saw the receptionist, then went to wait. The nurse's assistant came out and took my blood pressure (127 /71!) and weight (not so good). To the waiting room again, where a few minutes later the lipid nurse emerged and called my name. Into her office we went. She is from a middle European country and had the accent to match.

She started by asking a few questions which others had asked me before in the clinic, and the answers to which were on her computer. Then she said, "You've been fasting, haven't you?" I said, "No, I haven't." "Why not?" "The letter I got didn't request me to fast and the time of the appointment (11:30am) wasn't conducive to fasting, anyway."

She looked at me: "You should have known when you made the appointment that you needed to fast." "Hold on," I said, "First, I didn't make the appointment—the clinic made it. Second, I'm diabetic, on insulin at night, so morning fasting could be dangerous for me." She was wearing my last nerve very thin indeed. She then ordered me to fast whenever I come to the lipid doctor or nurse.

Then she came to my record and asked me whether I had any family. I mentioned that I was married in a civil partnership. She said, "There's nothing here to allow for a civil partnership. I'll put you down as 'Cohabiting'." I replied, "No you won't! Civil partnership is equivalent to marriage, so you will put me down as married." Nerve is now even thinner.

She then said, "Do you have brothers and sisters?" I replied, "Yes, one of each." "We must make sure they know that they are at risk for diabetes and hypertension genetically." I looked at her and, as calmly as I could, said, "My brother had a heart attack at the very same age I did, with angioplasty and a stent, just as I had. He was at the same time diagnosed with diabetes. I think he knows already. My sister is well aware of my brother's and my situations, so I'm certain she knows of her own risk as well. In any case, they both live in America so the NHS won't be taking care of them anytime soon."

She then proceeded to lecture me on the evils of bariatric surgery, telling me about the grim side effects and promoting the virtues of simply eating less and exercising more. I had really had enough, and told her that I had been lectured like this for the last 50 years or so, and none of it was helpful enough to help me to lose weight. I know all this. What I need is help to lose weight, and bariatric surgery is my last hope of outside help bar wiring my teeth shut; it has also been shown that certain types of bariatric surgery assist in fighting off insulin resistance in your body, even before weight loss has begun.

She ended the appointment by giving me a ticket to have blood drawn for lipid testing, saying that the fact that I hadn't fasted didn't matter, really. Some other tests would be run and when she got the results she would send them along to me. I told her: "I already get enough bumpf from the NHS—please don't send me the results unless I need to follow up on them in some way or other. She countered: "We like to keep our patients involved in their treatment." I had to be firm: "Let's save the NHS some money and not send results unless something or other needs to be done, please. Thank you." Reluctantly, she agreed.

Those who are familiar with the "Carry On..." movies will remember the Matron, Hattie Jacques, who was a blunt, no-nonsense head nurse in many of the films. The Lipid Nurse reminded me of the Matron, so sure of what she knew and imposing it on everyone else in the hospital. It goes to show you that a good "bedside manner" is vital when doctors or nurses are dealing with patients; how much brighter and useful would this appointment have been if the Lipid Nurse's manner had been helpful instead of confrontational.

I emerged, had my blood taken by a lovely nurse (all the nursing staff who do the routine vital signs in the Diabetic Clinic are a joy, especially the dishy young man who was also in the Cardiac Intensive Care unit when I was recovering from my heart attack) and then marched back to the bus for the trip home and to lunch in the church Drop-In. I was not best pleased.
chrishansenhome: (Default)
Had one piece of good news and three pieces of bad news today.

First, the good news. The ulcer on my left foot seems to be healing. Whether this is due to the ultrasound treatment or to the extra attention it's getting (debridement 2-3 times a week, lots of dressing materials, the boot) I don't care. I see them again on Friday. A plus is that I get to see the cute (straight) Filipino male nurse because he gives me the treatments.

Now, the bad news. There was a blister on my right foot. Last time around I told the podiatrist to leave it alone, but this time we conferred and he seemed to think that it needed to be cut out. The only good part of this is that there wasn't anything leaking over there so he put a dressing on it and we'll keep an eye on it, but it's OK at the moment.

When I got home I looked at my post, and there was a report from one of the pension plans I have put money into in the past. Last year my pension lost around £2.5K of value. I suppose it's only to be expected, but it's a bummer nonetheless.

The last piece of bad news was at the Diabetic Clinic at St. Thomas's. Other than the cute male nurse who took my blood pressure and milked me of some precious bodily fluids, there was nothing good about it. The diabetic nurse and I agreed that I need to start on insulin. My long-term hemoglobin test was 11 last week, and this is quite high. I shall be starting with 10ml of long-lasting insulin before I go to bed. Take my blood sugar in the morning before eating. If it's over 7 more days than not, increase by 20ml. Do this until my morning blood sugar gets to between 4-6.

The problem with insulin is that it helps you put on weight. At the present moment I can't go to the gym until this ulcer closes (even if I felt like it, I'm certain they wouldn't be happy with someone walking around with an open wound). Since the insulin converts the sugar in your blood into something you can use, you will use more of it when on insulin. So I will have to radically cut down on my intake. This will be difficult and painful. Then when I'm able, back to the gym for lots of cardio.

The diabetic nurse must be used to talking to people sad about their health situation. She was very helpful—although she was not convinced that my intestinal reaction to the lizard spit was autonomic neuropathy and seemed to think I was, perhaps, a bit wussy about it. I've learned how to inject the insulin and that it actually doesn't have to be refrigerated all the time, just up to the time you start using it. The injection instrument is a pen, kind of like the lizard spit pen but with variable dosage.

So now I'm home feeling sorry for myself. I hope I'll snap out of it.
chrishansenhome: (Default)
I went into Kings College Hospital Diabetic Foot Clinic this morning for my first study foot treatment. More pictures were taken of the wound and they said it seemed to be healing. This is good, but I don't get out of the treatment yet.

It's an ultrasound treatment that is applied to the wound. The kicker is that, depending on which envelope I picked out of a box, it could be a dummy treatment or the real thing. Only the nurse applying the treatment knows which one was used.

The machine looks like a printer and sounds a bit like a very lethargic popcorn machine. There were two nurses there, a very cute Filipino male nurse and a black female nurse. I was quite disappointed when the male nurse told me he was recovering from surgery to fix a blockage in his vas deferens so he could father children. Darn!

I will be getting a payment at the end of this that will be useful, I think. Even if I got the dummy treatment, they are paying more attention to my foot and that's all to the good. I got a huge shopping bag of goodies to dress the foot with and instructions on how to do it. They also gave me a boot, shown in two beautiful pictures below, that's designed to take pressure off the ulcer and allow it to heal. The problem is that it's very difficult to walk in it and I need a cane to keep from falling over. It feels like there is a great big rubber ball under the arch of my foot. The pictures are here:





I go back on Monday for the second treatment. Hurray. Monday afternoon I go to the Diabetic Clinic at St. Thomas's to gently tell them that I gave up the lizard spit because of the side effects and demand to go on insulin. Oh joy...
chrishansenhome: (Default)
My foot is still bothering me. When I went to the foot clinic the day I returned from the United States, the podiatrist helpfully not only took off my left big toenail (her comment was: "That was the easiest toenail removal I've ever done."—not that the comment made me feel any better) but also cut out a blood blister that was on the ball of my left foot. This was bandaged with a support pad and instructions to return in 2 weeks.

The wound has wept and bled continuously for the past two weeks plus. The podiatrist who saw me last Wednesday said that it was coming along fine, but I wonder. It's still weeping. There is no pain of course (I no longer have any meaningful feeling in my feet) but it's very inconvenient and is keeping me from moving around much. I am to see them again in two weeks (and continue taking the antibiotics, of course) but I will have to ask them then whether there is anything further they can do.

The kicker (appropriate for toes, I suppose) is that, strictly speaking, I don't believe that this needed to be done. I have in the past had blood blisters under my skin on the sole of my foot. What normally happens is that the fluid, after a couple of days, dries out and, a few weeks or months later, the "scab" comes to the surface and is worn away as normal as the skin on my foot renews itself. I wasn't even aware of this particular problem before they cut it out. So I'm wondering what I should do. In the future I might ask that they either don't cut such things out (if they find them), or explain to me why the normal course of events is not good enough.

When I got back from the US, there was a letter waiting for me that informed me that I had a meeting with a lipid specialist and a dietician on June 30th. I was puzzled as at my last diabetic clinic appointment no one had mentioned that this was to happen. However, as I am nothing but dutiful, I trotted along this morning.

The lipid guy (who saw me 15 minutes late) was nice, and we had a good conversation, but some things stood out for me:
  • Even though they had measured my height when I first went to the Diabetic Clinic, they insisted on taking it again. I am not convinced that the likelihood of my height changing from then (last August) to now is very high—though non-zero.

  • About three months ago I went to take a fasting blood test for cholesterol. Everything was good to super-good (bad cholesterol is low, good cholesterol is high, total cholesterol is low). My diet hasn't changed between then and now. He wanted to take another blood test (and this one non-fasting). I said that referring to the previous test in my records would be a good thing instead of sticking me again. Thyroid blood tests have been taken repeatedly in the past and found no problems. So why stick me again? He wanted to fool around with my feet, and I said that I had had enough fooling around with my feet in the past month for my own comfort.

  • The dietician (a man, unusually, but his badge indicated "Head of Dietetics", so male privilege wins out—also possibly a Friend of Dorothy) discussed various things with me. After looking at my usual intake he was rather glum. He said, "Normally after talking to a patient I can put my finger on an easy win for weight loss—cut out the gallon of ice cream a week, for example. You don't have any easy wins in your diet. Portion control is the only way forward and, as you have said, sometimes that is very difficult when dealing with the kind of things you eat, such as pasta."

  • When the question of bariatric surgery came up, it turns out that I am just a bit too thin to qualify for it on the NHS. They require a BMI of 35; mine is 34.2. We discussed some of the new insights into bariatric surgery and diabetes that have surfaced recently, including the duodenal stent and duodenal resection, both of which seem to also lessen the amount of insulin resistance the patient experiences and in the preponderance of cases actually bring the blood sugar down to normal before there is any significant weight loss. He wasn't too familiar with them (although he did mention the "duodenal stent" which is the technical name for the procedure I described to him) and, like all the other people I see, remains convinced that rather than try something of this nature it's better to make the gluttons pay for their past sins. Of course, he didn't put it that way, but there is a reluctance on the part of health professionals concerned with weight and eating to accept the fact that people who have had weight problems all their lives can greatly benefit from something more than a pat on the back and a kitchen scale.

  • There was one piece of good news: my blood pressure, without having taken my diuretic this morning, was 127/73, which is almost totally normal. The doxyzosin that they started me on a month ago seems to have lowered my blood pressure significantly, even without the diuretic. This is good news, although I would prefer to have had it happen through weight loss.

So now I'm back home blogging about it. I'm relatively glum about all this, The fact that the NHS is not only not joined up between hospital trusts themselves and between hospitals and GP is bad enough: even within the same clinic they are not joined up between different health practitioners. This is worrying, because it's now up to me to "coordinate" all this stuff on my own and pipe up when a doctor or other health practitioner tells me something or asks me to do something or undergo a test. As I get older, doing this effectively will be more and more difficult.

The really infuriating thing about it is that the doctors and health practitioners accept it with a sigh. When you bring it up they are as indignant as you are about it, but do not seem to think there is anything to be done about it. Yes there is: ensure that stuff is online and print out or give access to this information to those who need it and those who are collecting it. The form that the nurse who took my height recorded it on should have been printed out anew with that information on it already. The lipid doctor should have been able to look at my cholesterol tests from a few months ago and note them. If he felt that it was worthwhile to take them again for some reason, he could then have cogently explained to me the reason for retaking them ("We normally feel that such tests should be done every 3 months." or "We think these tests are not accurate for [reason] and would like to do them again."). His only reaction was "Oh, if you don't want these tests that's OK." If he felt strongly about it he should have pressed a bit and given reasons. I suspect he always does these tests on people who see him with no regard to whether they had been done before.

The other example of this is the repeated appointments that they make for me to have my retinas photographed in order to ensure that I do not develop diabetic retinopathy. When I call (and get a recording) and explain to the recording that I'm already under the care of St. Thomas's for diabetic retinopathy and do not need to go for screening, they respond with a new appointment. Only when I get an actual human being, who needs two repetitions to understand that I have it already and do not need to be screened for it, can I get the appointment cancelled.

When I explained this to the doctor at the Diabetic Clinic last year, he told me that it was his fault (at last, someone takes responsibility!). Apparently, when some people go for screening and are cleared, they are dropped from the computer and can later develop it without knowing it. These appointments are sent to everyone on the Diabetic Clinic's patient list in order to ensure that anyone who was dropped is seen regularly. I think that there is probably also a government target for the number of retinopathy screenings that are done and, for every one they do, they get a certain amount of extra funding. Thus, they want everyone to have it done, whether they need it or not.

Now don't get me wrong: the NHS is a great institution and has always given me the greatest level of care that was necessary. However, like all institutions it could do better. Being joined up would be a big step toward getting better. Those patients who cannot keep track of their treatment or who do not ask questions may have repeated tests or slip through the cracks. Let's see how things develop.
chrishansenhome: (Default)
...and I've lost 8 kilograms (around 17-1/2 lbs) since I was last weighed at the hospital 9 days ago.

The Autonomic Neuropathy Diet--lose 8 kg in a week (but don't stray too far from the toilet).

I would have made a terrible advertising copywriter.
chrishansenhome: (Default)
After hoping that the codeine prescribed yesterday by my GP would stop the symptoms of autonomic neuropathy, I was bitterly disappointed this morning to (1) still have the one problem, and (2) add to it projectile vomiting from the other end. I am really weak at the moment (although as of this writing all the symptoms seem to have abated, of course!) so I've cancelled my trips to Marblehead, DC, and New York, including my 35th college reunion. Yes, I know I could probably buy a cheap ticket to New York but, really, my heart's not in it now. I saw HWMBO off this afternoon as he is going to Marblehead to see an old friend of his from Singapore who has travelled from San Francisco to Boston to see him. He is probably getting on the plane right about now.

I feel very lonely without him.
chrishansenhome: (Default)
One of the joys that long-term diabetics have to look forward to is intestinal trouble. This can be due to one of three things: an infection, a reaction to metformin (one of the drugs that diabetis often take), or autonomic neuropathy. What's that when it's at home? Your innards are, of course, run from nerves. Neuropathy is when the nerves die. The autonomic nervous system is what keeps your stomach, small and large intestines, and probably God only knows what else going.

Cut for reasons of keeping details from the squeamish... )

I finally called my GP this morning and we discussed my "diagnosis" of autonomic neuropathy. She prescribed something called Lomotil and it seems to (in conjunction with my observation that the symptoms were diminishing) have relieved the diarrhea. I am leaning to the conclusion that the exenatide, which delays emptying of the stomach, might have something to do with this. I shall be getting one more pen but will ask for an urgent appointment at the diabetic clinic when I get back from the US ande ask that they stop the exenatide and start me on insulin. No point in delaying the inevitable now, and since I've now gotten used to injecting myself, there's no difference in injecting lizard spit from injecting insulin.

I ate my first full meal since Sunday this evening. I also slept for 4 hours this afternoon in my bed.

Now to figure out what triggers the condition (it's not present all the time—there seem to be foods that might set it off) and stop eating it.

I've probably lost quite a bit of weight, on the bright side (I suppose there must always be a bright side).

(thanks to [livejournal.com profile] am0 for telling me about this a while back; I would never have figured it out on my own)
chrishansenhome: (Default)
The landlord and I decided that the amount of ivy on the wall was excessive and starting to become a hazard to the building and the outside wall of the garden. So, they got their gardener to come by to remove it.

This was a two stage process, as in between I had to go to St. Thomas's for my month's checkup for the lizard spit medication I'm now injecting for better control of diabetes. We sawed, we pulled, we used a hoe, he used a strimmer and hedge clippers to take the ivy off the walls. I went to the appointment and he went elsewhere to do another job.

The appointment was very short. They took my weight and blood pressure, and the nurse and I talked about the past month of injections. It's been pretty uneventful. None of the promised side effects have materialised (nausea is the most prominent). We discussed disposing of the sharps box—Southwark has a service which will come and collect it and give me another box. Sometimes when I prime the injection pen (you turn a knob at the back end of it, then pull it out and turn it a little bit more) fluid drips out of the needle—once it actually spurted out in a stream. She didn't seem concerned about it. Then I got my prescription for the high-test stuff (10mg dosage) and went downstairs to have it filled. And waited 50 minutes for that to happen. Faugh.

When he returned he bagged up the pile of ivy—we had eleven bags of clippings. He took away the bags and scraped some more ivy that had lost contact with its roots off the wall. I then mowed the lawn. He was also nice enough to trim two of the more predatory bushes out back. We now have more garden than we had yesterday (more space, that is).

Even though I did little, I somehow feel very accomplished, and the gardener said that he thought it was the nicest back garden he'd ever seen in SE1.

Got the bumpf for registration for my college reunion. There are still members of the Class of 1944 (that's 65 years ago—they are in their mid- to late-80's now) around! The program looks good and I'm very happy. In addition, one of my suggestions has been taken up: we have one event where the 1974 alumni of Columbia College, Barnard, and the Columbia School of Engineering all get together over a drink. I didn't see any of the other two groups 5 years ago. We had considerable contact with them when we were in university because we took courses at Barnard (a lot of the Latin and Greek courses were over there because of the outstanding Classics faculty at Barnard) and the Engineering people not only took some classes with us, but they lived in the same dormitories. Hooray! Maybe I'll see some of my old Barnard and Engineering friends too, along with Thom Chu, who was (I believe) 10 or 15 years behond me but who will also be attending the reunion and who is a friend from Integrity/New York days. Hooray!!!
chrishansenhome: (Default)
...and welcome to it.

Saturday I received my ISEB Practitioner's Certificate in Software Test Management. This virtually completes my certification with ISEB--I could take the Practitioner's Certificate in Software Test Analysis but probably won't as it does cost a bit of money. I will now try to get contract work as a tutor for the three certifications I now have. There is some money in it and I enjoy teaching. We shall see about this.

There are few jobs out there; I have had a few nibbles via email but most are in out-of-the-way places for very small salaries. That's not very attractive for me, as my net would be pretty small.

Nothing to say about Sunday; church, then home. [livejournal.com profile] kingbitch went out to lunch with us to a Pizza Express in Soho. Then HWMBO and I walked to Fopp and I bought some books, CDs, and a DVD of Le Diner de Cons, which I saw in the theatre but would like to see again. Oddly enough, as I was browsing the shelves I thought, "I'd like to see Le Diner de Cons again," and looking down at the bottom shelf, which I hadn't looked at before, there it was! Obviously someone wanted me to buy it, so I did. Will watch soon.

Monday I did virtually nothing. This is depressing, but I think that a goodly amount of time away from work will help me sort out my brain. In addition, being out of work means that it's probably good not to go out and buy anything including lunch, coffee, or what have you.

Tuesday I went to the Diabetic Clinic at St. Thomas's. When I got there my friend Helen from the Friday Drop-In at St. Matthew's was there also, raising cain as usual. She is in her late 60's and is very firm about her wants and needs, so waiting in a waiting room is not a happy time for her. We chatted for a while and I told her that I was apt to have to inject a drug for type II diabetes. She said, "You should ask them about the pill I'm taking--sitaglyptin. You don't want to inject, do you?" I told her, "No, I don't want to inject, but it seems there is little alternative and I have to trust the doctor." She wasn't having it, but then she got called in for her blood test and we ended it there.

My blood test was OK, I think, and my blood pressure seems to have been a bit lower--the result of the increased dosage of blood pressure drug I got last time I was there, I suppose. The practice nurse called me in, and we discussed the drug: exenatide. It is injected, but not with a syringe, with a pen. You have to put the needle on the pen, dial up the dose, take a chunk of your tum between thumb and fingers, and insert the needle and press the plunger, counting to 10. Then remove the needle, take it off the pen and dispose of it in the sharps box, and recap the pen. We practiced on a squeezy pig, and then with a pen full of saline on myself. No sweat. So we started on it yesterday evening. I have to take it about 1 hour before breakfast and dinner. The needle is amazingly small and you can hardly feel it, if at all. So I got the prescription, waited at the pharmacy, and walked home. The diabetes practice nurse is very good, very helpful, and really took away all fear of being stuck with a needle.

This is almost it, I think. If this medication doesn't work, then it's insulin for me. The good part about it is that now that I am used to giving myself injections (he says, after having done four in two days) insulin doesn't hold as many terrors for me. The problem with insulin is that it tends to get you to put on weight. This is bad for a diabetic. I want to keep away from it as long as I can. Once I do have to go on it, I shall have to cut down what I eat to the bare minimum to keep me alive.

Today, Wednesday, I got the guest room ready for [livejournal.com profile] mc4bbs and did some shopping. The rod that serves as the hinge in back of the toilet seat was about to break, so I needed to replace it. What a pain in the arse that is! I had to take the hinges and brackets off, clean underneath, try to put the new brackets on, find that they didn't fit, put the old brackets back on, thread the rod through the two parts of the seat, sweat like a horse, and swear like a trooper. I wish they'd make these things easy.

Tomorrow is a meeting of the New Lammas Lands Defence Committee, where I'll have to apologise for not keeping the website up to date, and figure out where we go from here.

Friday I have lunch with one of the other delegates to the ISEB Practitioner's course to talk about testing stuff. Then I have to get my new glasses from Otto Opticians and rest from my labours.
chrishansenhome: (Default)
I would ask everyone to send good thoughts my way...I'm off to Cambodia and will be there until Saturday. I am concerned about my feet, as there will be much walking, and I suspect that I will not be doing as much as I would have liked to do. I will need all the good thoughts (and prayers, if you're into that) as I can get.

When I get back to London, I will really have to ride herd on the diabetic foot clinic to get me proper shoes and trainers that are cushioned enough so that I don't get blisters or abrasions on my feet. I asked them about going private (as I could afford it), but they said that they would refer me to their orthotics clinic and that they didn't trust outside suppliers. However, had I gone ahead, I would have had proper orthotic shoes that I could use now. They haven't as yet referred me. I have an appointment second week of November and I will bring it up again then.

I also think that if this can't be remedied, I may have to reconsider coming to hot climates. I am unutterably sad at this, but if the doctors can't or won't help me, I'm left with no alternative. I pray that this isn't the case, and that something can be done. I can't believe that the NHS can't help me with this.

Thanks for reading this; I will keep in touch via Live Journal and Twitter (@chrishansenhome) as I am able.
chrishansenhome: (Default)
Thanks (I think!) to [livejournal.com profile] atldaddybear comes today's recipe, which would be guaranteed to kill me almost instantly were I to eat even a little piece of it.

If I wanted to off myself pleasurably, I would go to the Krispy Kreme on High Holborn, buy some of their product, make this recipe, and eat the entire thing. I guarantee that I would be walking up to St. Peter within a few hours.

Even better than dying in the saddle, I'd say.
chrishansenhome: (Default)
Those who have been following my blog for a while know that just after my heart attack in February came a pretty bad infection in the third toe of my right food. That was cured with antibiotics and some aggressive scalpel work.

Over the weekend I noticed that my left big toenail was loose. When I wiggled it, some fluid oozed out from under it. It wasn't infected, but more like what fills a blister. After the last time, when my foot was neglected in favour of my heart, I was not taking any chances, so called the foot clinic yesterday and had an appointment today. I was preceded by a very nice but garrulous (she was originally from Dublin, natch) woman who told me almost everything about herself, from her daughter's two failed marriages to her knee replacement which was still giving her trouble. She rolled up her trouser leg to show me how swollen it was.

When I went in, the podiatric nurse looked at it and said, "Well, we'll have to clip off some of the nail: it's loose anyway so it'll come off if I don't cut it off." and got something that looked like garden shears and went to it. After looking at it, she said, "It's not infected, but you're very prudent to come in. We'll dress it, you should continue to dress it, and then come in next week." So she dressed it, and if you think I wouldn't show a pic, you're wrong.

So there it is. I shall have to keep it dry and dress it myself for a couple of weeks, as the earliest they could squeeze me in was the 22nd. No gym until then. But hopefully it will heal up soon. The nurse advised me to take a toenail file to them every few days to try to prevent this from happening again. As it is I now never go barefoot, choose my shoes carefully (Crocs have a diabetic version and HWMBO may be able to get me a pair in Singapore...), and rub moisturising cream into them every morning, evening, and after a shower at the gym. Now I have to take an industrial file to 'em as well.

I think I need to have a threeway marriage and find a foot fetishist who's into keeping my feet healthy.
chrishansenhome: (Default)
Went back to Kings College Hospital for a toe check-up. The doctor looked at it, said how much he thought it had improved, cut off a little bit of dead skin, and promptly said that I should go back on the antibiotics for another two weeks just to make sure that we'd "gotten all the bugs". Luckily, this time I'll only be on amoxicillin and flucoxicillin, and not on either the shot-in-the-bot or the tablet-with-which-you-must-not-drink-any-alcohol. I'll just have to ensure that I take the flucoxicillin on an empty stomach.

I'll be taking my last dose at breakfast on the day I leave for the US.
chrishansenhome: (Default)
I went to the gym yesterday, nitroglycerine spray in tow. I did 1/2 hour on the stationary bicycle at about 1/2 the maximum resistance. I worked up a sweat, but the beta-blocker ensured that my heart rate never went above 110 bpm. No shortness of breath, no chest pains, no need for the nitro.

So, I'm feeling much bolder about it and will start going regularly again. That will make the GBP 42 I pay for it each month worthwhile.
chrishansenhome: (Default)
Finally got my last shot in the bot this morning. I am so glad that's over. Now hopefully my toe will return to its normal size and the cardiologist will say encouraging things on Monday. My butt looks like a war zone, with bruises and plasters all over (I've gotten most of them off, I think...) However, if the infection is gone, it's worth it. I may have a bourbon and diet Coke tomorrow afternoon to celebrate.

For those of you in the Boston area, I'll be back there from Easter Monday through the following Sunday. If you're amenable, I'd love a meeting for lunch or dinner some day.

[livejournal.com profile] spwebsdesign has arrived and is now sleeping it off upstairs. We went to Tottenham Court Road for lunch and afterwards got him a mobile phone and together we went to Brick Lane to buy rye bread for tomorrow's breakfast. Tuckered us both out.
chrishansenhome: (Default)
Went to Kings College Hospital yesterday to see the foot quack. He is happy with the progress of healing, and says that there is only a little ulcer left. He scraped away some dead skin and used something that looked very much like a set of wire cutters to trim my toenails. Very scary.

Even scarier was his comment that had I waited another day or so to come in I would have had to be hospitalised. So I cheated that by the skin of my...toes...yet again. He also said that when he scraped out the infection before (the squeamish might want to avoid the next clause) a piece of bone fell out. I'm glad he didn't mention that to me at the time. They want to see me again on April 3rd. I hope that it will be entirely healed.

Now off to the nurse to get today's shot in the bot. Next Tuesday is the last day for that, thank God.
chrishansenhome: (Default)
I have been under treatment since Tuesday...every day I've gone to the GP's office to get shot in the bot and have the toe dressed.

Today I stole a look at the toe while the nurse was away getting a dressing. It actually looks pretty good on the bottom now...not out of the woods but not bruised and red. So I think that we're turning the corner. Over the weekend I have to go to the Aylesbury Health Clinic to get my shot and the dressing done, because the District Nurses (=Visiting Nurses in the US) want to come in the morning and I am not free Saturday or Sunday morning. Hopefully when I return to Kings College Hospital on Thursday I'll be well on the way to being cured and won't need another weekend of antibiotics.

I've postponed my cardiac rehab appointment until next month as I'm not too happy to do that while I'm trying to take care of the other problem.

Thanks to all those who have sent good thoughts my way...much appreciated!

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