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I am acutely aware that I haven't really posted anything except police logs (as funny as they are) for the past few months. So, here's the update.

My feet are still troubling me. On New Year's Eve I had only a very small ulcer on my right foot. The head podiatrist at the Foot Clinic said that she wanted to put it in a cast, so that the small ulcer would heal in time for my trip to Australia and New Zealand in March/April this year. So I agreed.

A week and a half later, I was going to visit Tate Britain, so I got on the bus. Upon alighting, I began to walk toward the museum when I noticed a tan-coloured foam coming out of the front of the cast. I immediately took a cab to Kings College Hospital. They cut off the cast and discovered that it had eaten an ulcer into my big toe. The good news was that the ulcer on the bottom was a bit better, but everything else was pretty torn up. It had eroded my toenail and was quite messy. However, it had not gone down to the bone. So they prescribed an intramuscular injection of antibiotic and sent me home after five hours in the clinic. I was truly despondent.

As before, I took responsibility for my own intramuscular injections. I am through with waiting for the nurse to arrive and give me an injection, all of which takes around 5 minutes but for which I am chained to the house for hours. I had to sign a waiver, but that's OK.

When I went back last Thursday they said it looked much better. However, the antibiotic I was given hadn't been the right one for the bug they found in the wound. So I got yet another antibiotic (ertapenem) which, thank goodness, is now able to be administered intramuscularly. Previously it had to be administered by an IV, which would have meant another PICC line. So I'm still giving myself the injection every morning, into the top of my thigh, and it seems to be working. I have not cancelled my trip, and I don't think I will unless things get worse and I'm advised to by the doctors and podiatrists. February will be the month in which I sketch out my trip and the things I want to do.

HWMBO is now in Singapore to visit his family and friends. His mother is still declining slowly, and he needs to go to see her as often as possible. He took Qatar Airways as it was the cheapest, with a connection in Doha. He left on Monday evening, made his flight easily at Heathrow and, despite the weather, it took off. Unfortunately, the connection was so tight that he missed it in Doha, thus having to layover one night in a hotel. Instead of arriving in Singapore on Tuesday, he arrived on Wednesday. So he's now adjusting to the heat.

Every once in a while something strikes me as worth blogging about, but I often don't get around to it. This is a shame, but it often ends up on Facebook. I don't know what this will mean for me, but I guess I ought to just sit down and blog when something interesting strikes me.
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I haven't been updating as frequently. I am wondering why this is, and have to conclude that reading other people's blogs and interacting on Facebook are more interesting than blogging and Twitter (which I have also neglected). So let's recap.

First and foremost, I am now officially retired. I have stopped even receiving emails about job openings. After the age of 55, the law here allows one to start receiving the private pension money one has accrued during working life. I have three such pensions, from my last three employers, and the total in the pot is in the low six-figures in pounds sterling. The law here also allows one to take 1/4 of that money as a lump sum, and then put 3/4 into an annuity. So that's what I did.

I will be 60 years old in November, and with the state of my health not markedly improving (although not rapidly declining) I felt that taking my occupational pension now was the best move I could make. I have secured a guaranteed income for at least ten years of around £430 (around US $700) per month.

In two years, I will become eligible for my US Social Security payment. It will be around US $990 (£615) per month. This will be a large addition to our household income. (Edited the amounts as I got them wrong the first time.)

Thus, what to do with the lump sum that has or will hit my account soon?

A friend from Manchester dropped down here to spend a weekend with us, and we decided to go to the relatively new Westfield Stratford to shop. After a lovely lunch at Balans, marred only by the absence of a WiFi signal in the restaurant, resulting in a bit of a problem with the card payment, we strolled to the Apple Store, where I bought a new iPad, 64GB, with WiFi only, in white.

I am enjoying setting it up (mostly). When iOS6 became available, I was alerted by my Singaporean friends on Facebook (thanks, guys!) and downloaded it to both my iPhone and my iPad. I have noted the silliness around the new iMaps, but I rarely use it. I will connect to Google Maps through Opera if I need to navigate. It is always fun playing with new toys. I have now succumbed to iPods (I have a Nano 8GB and a full 80 GB version), iPhones, and iPads. I still resist Mac computers.

As we left the Apple Store and headed around the corner, we passed a stall out in the centre of the shopping centre. They are well-placed to intercept customers coming out of the Apple Store, and one (very cute) salesman intercepted me and sold me a cover and a film protector for the screen. He wanted to sell me Bluetooth headphones, but I wisely refrained.

Over the weekend we ate at C&R Café in Chinatown twice, and Nicky (our Mancunian friend) ate there once on his own. I had to demur the second time and only had roti canai (excessively oily, I fear) and gado-gado (which was quite good). I feared the effects of too much white rice on my blood sugar.

On Wednesday I used a bit more of my money to engage a guy to extend the patio in the back garden. Here's what it looked like Wednesday morning before he began work:

As you can see, the grass was rather sparse for a couple of reasons. Our picnic table was placed over the patch, but more important, the sun rarely shines fully on that patch because of the position of the building and the fence. It got muddy and it was unpleasant to sit at the table.

He worked very hard, and by 1 pm the area looked like this:

I put the chairs and table on it, and this afternoon enjoyed a coffee sitting out there, on a dry level surface. It's wonderful!

Yesterday I travelled to the O2 shopping centre on Finchley Road to visit the Sainsbury there. It competes in my affections with the Waitrose at Westfield Shepherds Bush. The Tesco at the Elephant is OK for staples like milk and bread, but if you want something tastier or more out-of-the-ordinary, you have to go elsewhere.

And today, I voted in the US Federal elections. US citizens resident in other countries are allowed to vote for Federal offices only (both in primaries and general elections). In previous elections the City and County of San Francisco, where I last voted in the US when I lived there, sent a paper ballot with lots of envelopes. One had to fill out an interior envelope, placing the voting paper inside it and sealing it, then place it in an outer envelope. The difficulty is that my return address here was printed on the outer envelope in such a way that the Royal Mail always returned it to me. To avoid this I would have to draw a square around the election department's address with a big black "TO:" and one around my return address with a big black "FROM:".

This time I got an email with a link to my ballot in .pdf format. I downloaded it, printed it out, voted (Obama, Feinstein, and Pelosi), and sent the ballot back in plenty of time in my own envelopes.

My feet seem to be OK. I keep my fingers continuously crossed. I can walk around for three or four hours without any discomfort when I wear my new orthopedic shoes. On Thursday I return to the orthotist to have everything evaluated. I will be bringing my old pair of shoes to be resoled and insoled so that I will have two pairs of usable shoes. I have one small ulcer on my left foot, but have not had antibiotics for three weeks.

Finally, what else will I be doing with my lump sum? I have decided that, before I get too old and sick to travel I will take a trip (as I premised in a previous entry) next March and April to Singapore, New Zealand, and Australia. I have never been south of the Equator, and have friends in Australia who I would love to see. I think I will spend a week in Singapore getting used to the time zone, then travel to New Zealand for a week, then Sydney for a week, Melbourne for a week, and then mooch around for a week before returning to Singapore for another week, then back to London.

I will be going to Trailfinders next week to discuss this trip. I would like to spend around £4,000, but would be willing to spend more if necessary. Any ideas about what to see in Australia and New Zealand would be welcome. Bali has also been mentioned as somewhere to go. My friends in Singapore should look out for me in March and April; I hope to see lots of you then.
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This morning I went to the Foot Clinic for the normal 3-week foot checkup. While it took me around an hour and a half to be seen, the news was good: the wound from the operation in November has finally closed. So, I no longer need a dressing or pad on my left foot. I also no longer need to take antibiotics. I will have an emergency prescription for two weeks, just in case (I'll take that to the US with me) but I won't be taking them routinely.

The more worrying appointment was this afternoon. In January I went to Guys Hospital to have pictures taken of my retinas. As you may or may not be aware, my diabetes diagnosis was made in 1992 because I had diabetic retinopathy and laser surgery. Since then I've had to regularly attend the eye clinic at St. Thomas's to have an opthalmologist take a look. Last year, instead of having me make an appointment at St. Thomas's, they "discharged" me to Guys for retinal pictures. I duly went and had pictures taken. A couple of days later I got a letter saying that the person who examined the pictures had some concerns, so they had made an appointment at St. Thomas's.

Well, I went there at 2 pm, was dilated, and then a scan was taken, followed by an examination by a (very cute) ophthalmologist. He took a look and said that everything was fine. My question to him was: why was I discharged to Guys, and then what was of concern to the people over there that they referred me back to St. Thomas's. He didn't know, and fumbled around for a meaningful answer. I suspect that they try to save money by discharging people to Guys when their eyes are stable, but my examination record didn't follow me there. So the people at Guys were concerned about something that hadn't changed and that wasn't concerning. So, I'm back on a yearly exam schedule with St. Thomas's. No more pictures at Guys.

So, I had a celebratory mocha at Starbucks on my way home.
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It all started yesterday afternoon. A phone call came as I was about to tuck into my lunch. I answered the phone and the Indian voice at the other end of the line said that he was from "XXX Accident". Ambulance chasers interrupting my lunch to find out whether I'd had an accident lately. I told him, "You ought to be ashamed of yourself, you piece of shit!" and hung up. I was so annoyed that I forgot to take my insulin and metformin.

I then did some surfing on the web when the phone rang again. The voice identified itself as "Leslie from the Diabetic Foot Clinic" and proceeded to ask me whether I could come in on Friday, as the nurse needed to give me an antibiotic. I asked her what the difficulty was, but she said that she "wasn't medically trained" so couldn't say anything. I told her I'd come in Friday afternoon, and proceeded to worry my way through dinner and a very restless night.

The only good parts of the day were a meeting with the Archdeacon this morning which helped us both get the Deanery Synod meeting and the minutes of the Archdeaconry Pastoral and Mission Committee (which should have been taken by the former Area Dean but weren't) settled. In the middle of the meeting HWMBO called me and told me that he had lost his wallet on the bus—he was going to try to track it down. Bad news.

Then I went downstairs in the diocesan office building and attended a very fruitful focus group session with other tenants of housing associations in this area of London, talking about scrutiny of our housing associations and how we can be involved with it. Lunch followed. The session was a bit rambunctious because people came with specific complaints rather than thinking about the general procedures for getting complaints looked into. However, the leader was good and kept the bitching-and-moaning to an absolute minimum. Good session, especially since it was only 2 hours long.

Then I went home to find HWMBO's wallet on the kitchen table with a note: he has gone home after he drew a blank with the bus people. So that was good news.

Then on to the Diabetic Foot Clinic, still in my suit and tie. I sat in the waiting room as usual, read my Grauniad, and waited for 1-1/2 hours for the nurse to see me. When he finally "noticed" I was there, he came over and said, "We need to give you some antibiotics—can you take erythromycin?" I told him that I could and he went away to scare up a doctor to write a prescription. It's odd that in a hospital doctors are so difficult to find.

He returned without the prescription and I asked him which bug I had. It's a kind of streptococcus, but I told him, "That's what they found when I was here last week. I'm taking amoxicillin for it." He looked at me, and looked at the bug they'd found, and said, "Oh, this one is sensitive to amoxicillin."

I looked at him and said, "I see. So this entire visit was unnecessary." He grinned sheepishly. I wasn't grinning. "Well, while I'm here get the Professor to prescribe another 2 weeks of amoxicillin as what I have will run out in a week." He got that and I left.

I have said before that the greatest problem with the NHS is not funding, it's communication. The denizens of the Health Service do not communicate effectively. Obviously the podiatrist hadn't put the fact that he'd prescribed amoxicillin last week into my file. When the nurse saw that this bug was still present, he thought I wasn't taking any antibiotic and called me in.

So I went home and had a bourbon and Diet Coke. Some situations call for extreme action. I thought of calling London Stabbie in on this case, but he just can't be arsed to deal with cold-call ambulance chasers and incompetent nurses and podiatrists. They are beneath his dignity.
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It's not been a quiet week here. However, I've not blogged for a while (except for cutesy stuff and whatever meagre Tweets I could scare up) so here goes nothing.

You may recall that my main desktop computer went all funny a while back. And you may also recall that our dear friend BK in Singapore put together a new desktop computer for me, all shiny and new with Windows 7 and all sorts of stuff on it. And, of course, my backup NAS box frying was a joy.

So I had a dilemma. However, Her Majesty somewhat showed the way forward in that by writing me a cheque for a tax refund that is 2 years overdue. I am going to send part of that off to our savings account, but have used about a third of it to get our systems rationalised here.

I bought an HP Home Media Smart Server EX490, and two 2TB disks to go with the 1TB disk already in it. I bought 2x2GB memory sticks and a half-height graphics card for the computer with the rest of that money.

First off, the disks and server came, and what a pain in the rump setting it up. The manual is in .pdf format, which is fine. However, it is not on the media that came with the server; you have to winkle it out of the HP website.

Worse than that, there is no indication that you have to do any more than install the two extra disks in it to get them to format and start working. Their LEDs blink, and I thought that meant they were formatting. Wrong. When I finally could read the manual, I discovered that the blinking meant that the disk wasn't installed at all. I had to do it manually in a menu that had no indication that you could do such a thing.

Third, there is a function on the server which will allow you to "collect" your videos, pictures, and music onto the server, which will then stream it to any device you've got handy. However, the server continuously told me that the software on my computer (not on the server) was incompatible with the server and I had to uninstall it then reinstall it. I did that, and got the same message. After a lot of research, I discovered the following Mongolian clusterfuck:
  • When the server is turned on and the OS is installed on it, the server merrily goes to Windows Update and requests the newest version of its OS.

  • This newest version of the OS does not update the software on your PC.

  • Thus the two versions are incompatible, and to fix it, you have to uninstall the software from the PC and reinstall it not from the DVD that came with the server but from the server itself, using a web interface.
None of this is intuitive.

The good thing is that it automatically backs up your computers if they're on during the night (or any time you set it for).

I then installed the software on the new computer, and got an intermittent connection. I had to install a Belkin WiFi stick to get a reliable connection to the network. Now that's done, I'm hoping that the backup and the Media Collection software will do their work relatively silently.

Once the music and videos are safely ensconced on the server, I shall (I hope) install the software on the munged-up desktop and back it up. Then I can transfer stuff to my heart's content here and finally move this computer downstairs to my study.

I will then wipe the old computer and try to put Vista 64bit on it for HWMBO.

Otherwise, we have had a relatively quiet time. We went to our friends' place for dinner Friday, bringing a bottle of Moet and a very good bottle of red. The food was fantastic and the company even more so. It's great having friends like that.

On Wednesday evening I initiated a man 5 years older than I am into Freemasonry. I enjoyed the ceremony, apart from blanking out several times on my lines. The initiate is a black cab driver, and he had four cab driver friends with him who were already Freemasons. The first time I stopped for a prompt, all four of them loudly tried to prompt me. I looked at them and said, "One prompter, please." and I had no further problem. The dinner was even nice, and I enjoyed the evening immensely. I have been elected to a second consecutive year as Master of the Lodge as my Senior Warden does not want to advance this year. He's getting married in May and has just started his own business, and wants another year to get himself settled.

I continue on IV antibiotics. They seem to have done the trick, but the operation I'm waiting for is apt to be a more permanent and less intrusive solution.

This coming week I will have to go to the foot clinic and get more antibiotics, as well as ask them about going private for the operation. The Masonic charities might stump up some money for that to happen, as it looks like the waiting list is not getting any shorter and I am getting more and more frustrated with the delays. I am visiting a Lodge on Thursday where a friend is being installed as Master, and preaching on Sunday, as well as attending the installation of Bishop Christopher as Bishop of Southwark in the afternoon.
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The people I normally see at the Foot Clinic are podiatrists who specialise in diabetic foot treatment. They are all very nice and professional (although they do tend to raise their voices when they talk to patients, assuming we're all deaf—and many are, of course, but that's just an aside).

If I lived in Peterborough, I might have been treated by this guy, who seems to have let his Christianity get in the way of his professionalism. Of course, it doesn't seem to have gotten in the way of his taking on private patients without informing the National Health Service. Funny, that.
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Last night I was rattled enough that I didn't actually pull my entire Thunderbird profile over from the desktop machine, including the all-crucial Mail database. When i got back from the quack this afternoon, I made a complete copy onto my thumbdrive and copied that to the netbook. Aside from a few glitches, it seems to be working and I can now send, receive, and file away emails.

The quack has put me on IV antibiotics again. There is a new pesky bug in the bone under my second right toe. The rest of the ulcers are healing nicely. They will be doing another X-ray next Wednesday and then have a consultation (yet again) with the orthopedic surgeons. I now have to wait at home every day until the district nurse comes. I may have to give them another box of biscuits. This is for two weeks and we will see what transpires.
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I went to the Diabetic Foot Clinic yesterday.

Long post under the cut to save the uninterested )
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I went to the foot clinic this morning wearing my air cast. When the podiatrist took off my dressings, he said, "The ulcer has gotten bigger. I think we need to put your foot in a cast." A real cast. So, after a while I left the foot clinic with a cast nearly up to my knee. I'm not wild about it (I almost had to slit my jean leg to get my leg out of them) but there seems to be no alternative. As the professor said to me, "We don't have a diabetic problem any more, it's a mechanical problem." Immobilisation is the only alternative.

So, I hobbled home, went to the church drop-in, and then to Tesco's to pick up stuff for dinner. The bean and ham soup is cooking now, and I'm just sitting down trying to get used to the cast. The bottom of my left foot is pretty sore, with a searing pain every couple of minutes on the left-hand side.

They said to come back in two weeks and they'd look at the bottom of the cast. If it was soaked, or if I was in pain, they'd take the cast off. Otherwise, it's apt to be on for a month, I think.

I am so depressed I can't tell you…
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It's not been a quiet week at the Elephant and Castle, except for Monday.

Tuesday Goliath had our Lodge of Instruction. Something that Freemasons have to do regularly is rehearse the ritual. In most Masonic jurisdictions the ritual must be memorised. One particular ceremony can take up to an hour, and may be conducted by one man. So, rehearsal is serious stuff indeed. My friend Nadeem, whom I nominated for the Lodge, picks me up at Northwick Park station on the Metropolitan line and we go to Harrow Masonic Centre and have a beverage in the bar while waiting for the meeting to start. The meeting was very emo as there was a bit of a dispute about some parts of the ritual. I thus proposed to make a leaflet detailing the differences between our Goliath ritual and the standard Taylor's Working. This I did, and we'll be publishing it in May after I assume the Mastership of the Lodge. Only problem was: Microsoft Publisher. The final leaflet came to 19 pages plus one blank page, and no matter what I did, I couldn't get page 18 to flow onto page 19. Whoever invented Microsoft Publisher needs to be corrected somehow. I suggest the cat o' nine tails, myself.

Wednesday was my swine flu vaccination. The good thing is that it was free. The bad thing was that the nurse was running 1/2 hour behind. I know that I shouldn't complain, but if I were 1/2 hour late for an appointment I'd get hell in a handbasket. My right arm ached for a couple of days afterward, and I had a very deep hypo on Thursday which I can't explain with what I was eating or the amount of insulin I was taking. I wonder whether the inoculation did something.

HWMBO was off Wednesday through Friday so on Wednesday afternoon we went to the Turner and the Masters exhibition at Tate Britain on Millbank. It closed today (Sunday January 31) so we thought we'd better go see it. Well, as it was the afternoon and a weekday we thought we'd have an easy time of it, but the exhibition was stuffed. Lots of people who wait until the end of an exhibition to see it were there, and many were elderly and had canes, just like me (I was using mine as my back was killing me…see Thursday for more informaiton on that). I felt that while it was slightly interesting, the Tate often has Turner exhibitions because it has most of the Turners that are extant, as Turner left most of his paintings that he had at his death to the nation and the nation gave most of them to the Tate. As it was kind of a comparison between Turner and other artists, if you weren't paying attention in Art History class (and I wasn't) much of the exhibition was not very illuminating.

Thursday I went to the Foot Clinic at Kings to be fitted for orthopedic shoes and insoles. I have been waiting for this for years (but didn't get on the official waiting list until December). The assessor (fancy name for the shoe fitter) was very nice, perhaps batting for Our Team, and sharing my first name as well. While he was measuring my feet for the shoes, he asked me how my back was faring because of the pressure boot—I told him that my back was killing me. Every time I got up from sitting on the bed while wearing the boot my back felt like someone had stabbed me in the kidney. He said, "Wait a minute!" and took my shoe (not the boot!) away. A minute later he returned with a device that raised the boot by about an inch. This instantly fixed my back problem and my gait is now normal, as both shoes are on a level. I was as delighted as a young kid on Christmas morning who got all the presents he asked for and no coal in his stocking. While measuring he rolled my trouserleg up and said, "It's like the Masons." and I replied, "Funny you should say that; I'm a Freemason." and we discussed that for a while. I shall bring a brochure when I take delivery of the shoes. They're black wingtips with laces.

Thursday night we went out with our friends Ard, Leslie, Eddie, and Christina to Belgo at Covent Garden. HWMBO tried a couple of Belgian beera, but I stuck to Diet Coke. The wait staff were all dressed in monk's robes, for some odd reason…perhaps because a lot of Belgian beer is brewed by monks. Lots of mussels were consumed (not by me), and I had a steak and frites, which were excellent. Then off for dessert. We walked from Belgo to Old Compton Street and Chinatown, and finally ended up at C&R Café and Restaurant for "dessert. As they have a £6 minimum per person, HWMBO and Leslie ordered some other stuff. The reviews are mixed, but we enjoyed what we had. I had an iced Milo and a sago pudding as dessert. One of the side dishes that Leslie ordered was a kind of meat loaf phyllo pastry spring roll…this was fantastic and I want to go back and have more.

Friday I returned to the Foot Clinic for the last appointment under the study I've been in. Well, I got in there and when the podiatrist came in I showed him the new device on my shoe and said, "Why didn't I get one of these when you gave me the boot?" He looked at the nurse and said, "I didn't know we had any in stock." The ulcer is still there, but much smaller. However, now that I'm out of the study I do not get free supplies from the clinic; I have to have them prescribed by my GP. That's a pain. Oh well, they are cautiously optimistic about it and I go back for a regular appointment in two weeks.

After the appointment I had to wait in the waiting area for a prescription. The usual doctor, Prof. Edmonds, wasn't there on Friday so I waited for 1/2 hour while they scraped up a doctor. Then the nurse came up to me with the prescription and said, "We forgot to do something for your last appointment." and I had to come back, take my boot and shoe off, and have her test the bottoms of my feet for feeling (I don't have any). The podiatrist just laughed and said to her, "I told you that we could just fill it in ourselves." but no dice. I was seriously late for lunch at the Drop-In.

Saturday morning I received something I'd bought from eBay in the US. Coffee connoiseurs among you will sneer at me, but I am now the proud possessor of a 6-cup Pyrex coffee percolator.

Now I realise that perked coffee tastes burnt and isn't the best quality according to coffee mavens. However, I have memories of my childhood, when we had instant coffee most of the time, but when company came my mother hiked out the Pyrex percolator and made REAL coffee, as opposed to instant. Now neither my brother nor my sister drinks coffee nowadays, but I'm seriously addicted. And when I fire up the percolator on Monday afternoon and have a cup of real perked coffee, I guarantee that I will be transported back to my childhood and I'll hear my mother say to me, while she poured me a cup of real perked coffee, "You really shouldn't be drinking this stuff; it'll stunt your growth." Would that it had.

Saturday afternoon we went to the Serpentine gallery via the 360 bus. This is a really great way for us to get to Museum Alley near South Kensington. No muss, no fuss, and a one-seat ride. Very convenient. I enjoy this bus route, which goes by the Imperial War Museum, through a housing estate and up to Albert Embankment, swings by the Vauxhall Bus Station and my gym, then crosses Vauxhall Bridge next to MI6 HQ. Then through Mayfair and along the river to the Royal Chelsea Hospital, the home of the Chelsea Pensioners. then down the road to Sloane Square and past Peter Jones, the quite posh store in the John Lewis family of shops which includes Waitrose. Then past the Conran Shop, with lots of merchandise we can't afford and the Michelin Building toward South Kensington Tube Station and the various museums in the area such as the Natural History Museum, the Science Museum, and the Royal Geographical Society next to Imperial College London, ending up in front of the Royal Albert Hall and the Albert Memorial, certainly one of the most garish and curious memorials to a lost love ever erected.

Pictures behind a cut of some of the sights along the 360 bus route )

On the way to the Serpentine we stopped in the Gents' just beyond the Albert Memorial and interrupted what was probably a bit of the old slap and tickle between two guys at the urinals.

The Serpentine Gallery had an exhibition of modern design that was interesting; it including such things as the OLPC laptop and the bumper of a Lamborghini.

There was an area in the central gallery with Kindles, TV screens, and various displays. All the Kindles were occupied, and we didn't fancy waiting around. So back home to coffee and then dinner with our friend Mark at the Indian restaurant at the Elephant and Castle Shopping Centre. Mark was ogling the waiters, who were all Bangladeshi and very good-looking, especially Aziz.

This morning we had church as usual: it was the observance of Candlemas, and the major attraction of Candlemas is that I can put the candelabra away until Easter. The candles drip on the carpet and are a real nuisance: I refer to them as "the forest fire".

So that was my week.
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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.
chrishansenhome: (Default)
I have two appointments with quacks this morning. The second one is the usual foot appointment. I think I'm going to catch hell because my right foot became infected the day after my last appointment two weeks ago and I just started taking the antibiotics again that they had left me with the last time. This was two weeks ago, and I suspect they'll be annoyed. Tough. It seems to have worked as the right foot is OK again. I'll just ask for more antibiotics.

The first appointment is at St. Thomas's Hospital with the Fat Doctor—Bariatric Surgeon. I am presuming that this will be an initial evaluation to see whether they should pursue some kind of bariatric surgery on me, either a gastric band or a gastric resection. I'm in favour of the latter because of its effects on diabetes is patients who have had the operation. We shall see. I'm a bit nervous about the appointment so I hope it goes well. If he's anywhere near the attitude of the lipid nurse a month ago, I'm outta there.
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)
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)
Well, I'm in Shanghai. It's quite smoggy, a bit overcast, but our host, Choo Beng, is very gracious. We went shopping last night and the prices are quite reasonable. We haven't bought anything yet, but DVDs and the like, even licit ones (as opposed to illicit pirates ones) are very cheap.

What isn't cheap is medical care. My toe got to the point yesterday where I decided I needed to see a physician. So today we found ourselves at the Expat Doctor's office. It's quite posh, very up to date care, and a very nice Chinese woman doctor. Yes, my toe is slightly infected. They dressed it for me, gave me loads of stuff to keep it dressed, gave me an antibiotic to take for two weeks, and a bill for 2035 yuan. That is about GBP 130. Not that my toe is not worth 10 times that amount.

I took the opportunity to ask her why I seem to be prone to this problem when I come to the tropics, and she thinks that, even though I bring the most comfortable shoes I have, my feet swell up enough in the humidity to make them too tight to wear. So, it's diabetic crocs for me from now on.

We went to a Hong Kong restaurant for lunch, and had duck, chicken, tofu, and broccoli, with rice. A bit of mango ice to end with. It was quite nice, even though the rather sharp-faced woman at the next table was chatting away at her mobile phone all the time while eating, which was kind of distracting. They also had a very bizarre kind of rack, which I will be showing you all later on and asking for a guess as to what it is.

I'm staying at home keeping quiet, while HWMBO and Choo Beng are traipsing around. Tonight we'll be dining with their friends Jane, her husband, and their family. Should be nice. Then another antibiotic pill, and to bed.

I have discovered that LogMeIn works from China as well. This is interesting, as I cannot access my livejournal directly.
chrishansenhome: (Default)
Got up this morning and discovered that a blister on my right big toe had burst. I find it difficult to understand why I have such trouble with my feet when I am here. Could it be that the heat makes them swell and that chafes in the shoes which fit perfectly in the UK? Anyway, bought some special blister plasters and will try to get some proper dressings while I'm in Shanghai. I'm certain that someone will be able to assist. I shall keep it clean and as dry as possible. If it's still weeping when I get back, I shall see a doctor here and get some antibiotics as well as proper dressings.

Next time I come I shall take advice on good shoes to wear so that chafing will be kept to a minimum. I'll probably look like an old man on his last legs, but I don't care...I am so tired of my feet.

In other news: didn't do much today. I went to Bishan shopping centre and had a MosBurger. For those not familiar with Singapore, MosBurger is a Japanese burger chain. Their burgers are small compared to McD's and Burger King, but they are very tasty. I had that, small fries, and a diet Coke. Bought a book to read during lunch, and found it so riveting I came back home and finished it. The Interpretation of Murder by Jed Rubenfeld is a murder mystery set in 1909 New York, with Sigmund Freud, Carl Jung, and various other real people as part of the plot. Really good. [ profile] spwebdesign, I'll try to bring it back as I think it might be something you would like (although not a serious book).

This evening I met [ profile] kingbitch for dinner and a drink. He is so nice and sweet and funny that if I weren't married to HWMBO, I'd propose immediately. He will be a great catch for someone as he's not only good looking, but great company. We then went to Tantrics and I met [ profile] nicekit for the first time. Also a sweetheart, and I'm so glad that I can meet all these people on my travels. Then home, packed, and now to bed.
chrishansenhome: (Default)
Man with shoe fetish walks free
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)
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.

[ 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.

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