Tuesday, 16 May 2017

Mixed Blessings

I had three medical appointments last week, two planned well in advance, the third a late addition at the GPs request. 

Early on Tuesday I had my regular check in with the Nephrology Consultant; having failed to lose any weight since my last visit (in fact I'd gained 0.5kg) I had some slight trepidation. It turned out my recent bloods had produced my best CKD results for several years and my blood pressure readings are also acceptable, so she was actually very happy with the progress. I explained I've been making efforts to maintain good fitness despite the flat lining weight loss, and she agreed this is definitely making a positive difference. So we’re sticking with the current regime and I said I’d talk to my GP about weight management (although I'm pretty sure the status report to my GP will include the usual weight based admonishments). 

Later the same morning I had my annual review at the GP surgery. The nurse was initially perplexed about why I was there even though the review had been initiated by the surgery, but things were quickly resolved. I also pointed out I'd been sent a further request to make an appointment with a GP to discuss blood test results, basically indicating something required the attention of a GP rather than a nurse (a similar thing happened last year, so I suspected another pre-diabetes flag). 

For the second time that day I was weighed and had my blood pressure taken, fortunately the results were consistent, although I'm now pretty certain my scales at home weigh c.0.5kg heavier than those at the hospital and GP surgery. Pretty much everything in the blood test was fine, cholesterol, liver function etc… It also turned out the HbA1c test that set off the pre-diabetes flag last year ago was now back in the healthy range, my improved activity levels probably reversing early stage pre-diabetes. There was just one exception; the thyroid part of the blood test was flagging a warning which needed to be discussed with a GP. 

So on Friday afternoon I went back to see the new GP at the practice. Unfortunately having managed to knock off work early to get there I found the surgery (in fact the whole local NHS Trust) had fallen prey to the much publicised cyber hack. So the GP couldn’t see my blood test results. Fortunately I was able to explain about the thyroid deficiency flag (that being the only issue flagged) and the GP briefly explained the symptoms of an underactive thyroid. She asked if I was aware I was suffering from any, which I'm not, and she asked if there is any history of thyroid problems in my family, and there is, my Mum has a problem. But as I'm not demonstrating any of the major symptoms of an underactive thyroid, and she couldn’t see my results, she decided not to start treatment but go with the usual next step of retesting in three months. We didn’t get around to talking about weight management, but she said she would call me on Monday to discuss things further, when the system would hopefully be back up. 

The problem with this situation is that it’s tempting to focus on the under active thyroid and retro fit my recent difficulties losing weight on to it. There are weight related issues with this condition, but it’s probably a convenient self-delusion narrative to follow when the truth is that losing weight is just very difficult to achieve even with sensible eating and exercise. Unfortunately nobody was home for most of yesterday, there were two calls from unknown numbers on my home answerphone, but no messages, and I didn’t receive a call on my mobile. So I’m going to give the surgery a call today, although I suspect they are trying desperately to catch-up from Friday.

Friday, 12 May 2017

The Chimp Paradox: a review

I've just finished reading the Chimp Paradox by Professor Steve Peters, a psychiatrist who teaches at the University of Sheffield, who is highly regarded in the field of sports psychology. I actually read it in two chunks, I started a few months ago, got half way through and decided to read some other things before coming back to it. That's probably a good clue to my feelings about it. It's not unusual for me to be reading more than one book at a time, and it's not untypical for me to pause part way through some of them because I feel like reading something else. Usually I pause non-fiction works because I want a short-term fix of fiction, or I've been temporarily gripped by a different book. A pause is a sign it hasn't entirely gripped me, but coming back to it is a sign that it's interesting or useful enough to warrant finishing.

The Chimp Paradox can loosely be described as a 'self-help' book, the first such I've ever read, and is based on a 'Mind Management' model that Prof Peters has developed to assist patients (who include big names in British sport) to better deal with the pressures they face. The idea is the model can help the subject better understand their own behaviour and impulses and manage them to make them to be more successful, confident and happy. 

At the core of the book is the idea that our personality can be split into 'human' (our rational selves) and 'chimp' (our emotional selves), and the ways in which these two interact influences the way we engage with the events we face. Essentially the book offers help on understanding how our inner chimp can disrupt us and offers strategies to managing it. I can see some interesting overlaps between this model and the 'System 1 / System 2' model outlined by psychologist Daniel Kahneman in his celebrated book Thinking, Fast and Slow (currently paused two thirds through on my bookshelf). 

I must admit I'm generally cynical towards 'self-help' books, but I picked up this one because it I thought it might be help my career development, it didn't make any screechy boasts to be a panacea (which seems typical of US published lifestyle coaching/self-help efforts) and it had some credible endorsements like Olympic cyclist Sir Chris Hoy. 

So what are my thoughts? Well, without wishing to sound flippant, a lot of it reads like formalised common sense and is pretty much in key with my own thoughts. It's a gross simplification, but I'd summarise the advice as don't taking headstrong, emotional approaches to problems, take a step back, a deep breath and think before acting. It was far from a waste of time, but probably not what I really need to push my career development. I think Prof Peters approach will be most beneficial to those suffering chronic stress or struggling to control destructive emotional patterns. It might have been more valuable to me a couple of years ago when I was under stress working in a dysfunctional organisation, but I'm in a better place now. However, the techniques espoused offer only partial mitigation to my previous situation, unequal power relations make challenging dysfunctional hierarchies extremely difficult and exiting is not trivial when you're financially dependent on sticking it out. 

Not a waste of time, almost certainly worth having as a backup should things get tough in the future, but maybe I need to find something more specific to my career development objective.

Tuesday, 9 May 2017

The Semen Test Farce

Some subjects are just ripe for comedy; the semen tests required after a vasectomy are a case in point.
I received two test forms from my GP a little while ago. Unfortunately, there were no further instructions; queue the first gag about what sort of instructions a man needs to have a wank! The forms specified a particular container, but not how to get one or where to submit it afterwards. So I called reception at the surgery and asked them; queue next gag about discussing wanking with a woman you don't even know!
Unfortunately, the receptionist was new and didn't know what to do (I'm sure there's another gag there somewhere). She suggested I discuss it with the phlebotomist when getting my bloods done the following week. What a bloody palaver (geddit?)! But at least I was getting somewhere, surely? So, I discussed with the phlebotomist, only she was new too; but she did tell me that semen tests usually need to submitted to the hospital lab within one hour of production. That's pretty useful to know.
I tell the phlebotomist I'm going to the hospital next week, so I could drop one off then. Sounds like a good idea, we concur. She tells me I can get the requested container from reception, unfortunately no further information comes with it. The day before I go to the hospital I think it might be a good idea to find out where to take my sample, I’m presuming it's where the blood tests get done? Hmmm, I better check the hospital website!
Oh dear, it’s a good job I did check rather than just rock up with a tub of jizz. It seems you cannot simply turn up in working hours like with blood and urine tests, semen tests require an appointment, well an appointment to hand the container through the hatch in the window. And lo, there's more useful information, don't wank or have sex for three days before you produce the sample and make sure you keep it warm (but not too warm)!
One call to the appointments line later and it turns out the earliest possible appointment is five weeks away! How useful would it have been to be notified of all this stuff with the forms? As the hospital is a thirty minute drive from home, in completely the wrong direction for work, and they only do tests before 2pm Monday to Friday, it's all a bit of a ball ache (boom boom)! Of course, I could have timed the test to coincide with my latest Consultant appointment, well if the process had been properly explained from the start! Now I need to arrange additional time off work to sort out!
Semen tests are funny. Not!

Tuesday, 2 May 2017

Seven days is all she wrote, a kind of ultimatum note

No this isn't a post about a Sting track, it's me mildly panicking that I'm just one week out from my next Consultant's appointment and currently weighing in at 112.7kg. Due to a combination of things, not least my daughter's first holy communion at the weekend, I've let my diet slip a bit in the last couple of weeks and hence a rise in my weight. So I'm desperately trying to get down to 111kg for next week.
I said after my last appointment I'd made a rod for my own back by unexpectedly weighing in at 111kg, and so it has proved. For most of the past four months I've fluctuated between 111kg and 112kg and it's been pretty difficult to get below no matter what I've done, in fact when I have dropped below 111kg it has been mostly fluke. So I've stepped up my exercise regime to try and hit 15 thousand steps a day and I'm trying to forgo alcohol and chocolate for the next seven days.
Next Tuesday I've also got my annual medical at the GP surgery (it says I'm seeing a nurse but last year I ended up seeing a GP) so I’m going to ask about a Wellbeing prescription, this is a scheme being offered in conjunction with the local authorities to help make interventions into issues such as weight loss, smoking, mental health etc. It will be interesting to see if meaningful help is available to assist my weight loss efforts, I’m trying not to be prejudiced but knowing how tight funding is in both the NHS and local authorities I’m a little cynical. My gut instinct is that it won’t lead to the expert help I’m really looking for, but is probably going to be generic, lowest common denominator advice. Still, it won’t hurt to ask.
As I’m going to be at the hospital on Tuesday I’m going to drop off my first semen sample to test if my vasectomy has been effective. I was supposed to do it a couple of weeks ago but haven’t had chance. Apparently, the sample needs to be at the hospital within an hour of being produced, which makes it slightly awkward. I picked up the correct bottle at the GP surgery this morning when I had my bloods done, so next Tuesday’s visit to the hospital is going to be a little different!