Thursday, 11 June 2020

Corona Confusion Redux

A while back I wrote about the confusion surrounding my May nephrology appointment, unfortunately things didn’t get much clearer.

Getting my bloods done was straightforward; I called the GP surgery on the morning and an hour later it was done. I suspect the surgery has been pretty quiet during the pandemic (I’ve heard similar about other local surgeries). Vetting patients by phone before granting appointments, plus the advice to stay away unless you really need help, seems to have dissuaded malingerers (my Mum spent decades working in social care and believed many GP appointments were simply attention seeking).

Previously I wrote how I’d emailed the hospital to clarify if my scheduled video clinic appointment was going ahead as a letter I received referred to an in-patient appointment instead. Sadly, nobody bothered to respond to that enquiry; I should have known better than to email the NHS. However, I did receive a phone call from the Nephrology Department a week before the appointment warning I might get skipped from the list; basically, I may (or may not) receive a telephone call at the allotted time. My results would be reviewed and I might be called and if I wasn’t I’d get a letter in due course. As for the video clinic, no mention.

In advance of the appointment I took my usual home blood pressure readings and found they’d moved in to the high category over the last couple of months, I made a note to discuss with the consultant if they called.
The time of the appointment came and went, there was no phone call, then just before lunch someone from the video clinic called and asked why I hadn’t joined? Was it because I didn’t have a suitable device? I pointed out the joining instructions had never arrived, and besides it was now supposed to be a call (although by that point I obviously wasn’t getting one). They were apologetic about for confusion. I mentioned my blood pressure concerns but told them I’d speak to my GP.

So, I called the GP surgery about my blood pressure and a short while later the GP called me back, I explained how I’d been passed over and he increased my blood pressure medication with the intention of reviewing about a month down the line. Sorted.

Later in the afternoon I got a call from the Nephrology Department, apparently the video clinic had passed on my blood pressure concerns. They said someone should have called me the week before to warn I might be skipped, I said ‘they did’ and explained it had been the video clinic that had called me asking me why I’d not attended. Another apology for confusion was offered. It became clear the video clinic and the Nephrology Department had no idea what each other were doing. The video clinic is being run out of East Surrey Hospital where I usually have my appointments, but all Nephrology clinics are currently over the phone from St. Helier Hospital.  I explained my GP was dealing with the blood pressure and I would await the consultant’s letter.

A couple of weeks went by and no letter, but a new appointment for November arrived without a blood test form. This made me nervous, I’d gone from appointments every three to four months, to a whole year elapsing without seeing a nephrologist. I waited another week and called the appointments line to find out what was happening. I was assured a letter was due to be sent out and they’d raise a query about the blood test. 

As fate had it the letter arrived later that day, and there was a blood test form with it. I now know my kidney function is stable, hence the six-month follow up, but there was no mention of the test I had to confirm last year’s Hep-B vaccinations course was successful. This is a bit annoying as this test has been repeatedly missed off. Unfortunately, the blood test form was also missing half my usual tests, so that will need resolving before November. All in all, it’s been pretty frustrating! 

Wednesday, 29 April 2020

2020 Goals Update

In my last post I said this one would follow in a few days; that it’s been closer to two weeks is a good indication of how life is going at the moment. I set myself some new annual goals back in February and this is the first time I’ve gotten around to reviewing progress.

One. The forever delayed podcast. Still forever delayed. I have plenty of plans but other stuff just gets in the way.

Two. Strength & Fitness. I’ve made some good progress with the weights set I got for Christmas, especially since lockdown began. I now wish I’d bought more weights than I did as it’s been impossible getting hold of extra plates from Decathlon. I’ve found some really good workouts on Youtube that make use of dumbbells, barbells and floor exercises, and have been doing programmes between twenty-five and forty-five minutes around four times a week. I did have a slight setback early last week when I strained my back, and was initially concerned about a recurrence of an old sciatic disc injury, but I’ve made a good recovery since and have started to build back up resistance again. On the running front I’ve been going out two or three times a week, doing 5k at least once a week. I managed a personal best of under thirty-nine minutes a couple of weeks ago, but so far haven’t managed to get beyond 5k.

Three. Stabilise weight at 100kg. This is one area I have gone backwards. Two months ago, before lockdown, I was 104kg, now I’m 106kg. A quarter to a half of that weight may be muscle gain from regular lifting, but at least half is fat or at best water retention. The lockdown has made it very difficult to maintain intermittent fasting and time restricted eating. I’m working from home full time, my wife and kids are also home, the successful diet routine just doesn’t fit. It’s not that I’ve been binge eating, but I’m eating three meals and a snack on most days (the kids have been doing a lot of home baking). I’ve also been drinking more beer, not every day and not binging, but as I don’t have to get up at six most mornings and there’s rarely any place I need to drive, there’s no real barrier to unwinding with a few cold ones. Hopefully, if I can keep my fitness up, I can restart my diet once my routine allows.

Four. Improve Technical Knowledge. I’ve been doing some cool stuff with DAX and Power BI at work, and I recently took part in a week long hack using telemetry data where I used PowerApps for the first time. It was genuinely interesting and with a bit of support from Microsoft I built a mobile app that wrote back to a SQL Server database. The plan was also to look at streaming data in Power BI for the first time, but unfortunately the hack was cut short due to the pandemic and the longer-term project it was queuing up has been paused for a few months. I’m hoping I’ll be put back on it when it does restart. It looked like I might get furloughed at the end of last week, instead I’ve been reassigned to a different team, which is not a bad thing as I’m going to be exposed to Azure Data Explorer and Azure Synapse for the first time.

Monday, 13 April 2020

Corona Confusion

Long-time no blog. Despite being in lockdown for three weeks I still don’t seem to have time for my writing. The demands of home schooling the kids whilst both my wife and I work from home has eaten away some of the time gains from losing the commute and pausing the usual treadmill of domestic activities. I’ll write a proper update on my goals later this week, this post is about how the Covid-19 pandemic has affected my CKD treatment. 

To date, thankfully, it’s been a case of potential rather than actual disruption, but I am a little nervous. I managed to get a repeat on my prescription for another two months, despite the review date passing in January, so I’m good there. However, there is some confusion around the renal clinic appointment I’m due in early May, and a little uncertainty over the pre-clinic tests.

After my last appointment, the nephrologist suggested I might like to join a video clinic trial. My CKD is on a managed decline, and staying free of serious illness, I might have five or six years before I need transplant of dialysis. Of course, there’s a very big IF in that scenario, especially now we’ve got a dangerous pandemic raging across the globe. So, the new strategy was to alternate video clinic appointments with out-patient appointments at the hospital, and if there were any hits to the function I’d be back on more frequent in-patient clinics. 

This sounded good, I could simply pop into one of the privacy booths at work and do the consultation on a tablet, rather than taking time off work or going into the office late and fighting for a desk.

A few months back the instructions for joining the video clinic arrived and we were all set. Then when everything kicked off I wondered if it might be cancelled, till a couple of weeks ago I got a letter saying it was still going ahead. Good news. But, (why does there always have to be a But?) the letter stated that I was going to receive a telephone consultation instead of the planned in-patient appointment at the hospital. This has obviously made me a little nervous as there never was a planned in-patient appointment, as the letter suggested I emailed the appointments people about a week ago to find out if it was the video clinic is going ahead as planned, or is it that appointment that has been switched to a telephone call. I haven’t yet received a response.

On the tests front things are also switched up, although this could be to my advantage. My GP surgery used to do blood tests on Tuesday and Thursday mornings, the samples being sent off to the hospital lab before lunch. As I usually work from home on Wednesday’s those slots were typically no good for me. So, a week or so before my appointment I’d drive to the hospital after the school run and wait for a drop in blood and urine test. Now I’m home permanently I thought I’d book a blood test at the surgery instead; only to find it is no longer booking appointments for anything. Instead I spoke to one of the GP’s last week and she told me I should ring up first thing on the day I want it and they’ll give me a slot. As there’s no longer any appointments tests are being done every morning, the only challenge is getting a place in the queue early enough to get it done before the samples have to be despatched to the lab. To hedge matters I’ll start trying for an appointment about a week earlier than normal, giving me a few shots at getting it done before I have to fall back on a hospital drop-in.

Saturday, 15 February 2020

Personal Goals for 2020

I’m a very late getting around to this, because I’ve simply been too busy to write anything for this blog let alone make significant progress on personal objectives. However, in parts, the approach worked well last year. So, I’m going to do again, but I’m going to be slightly less prescriptive in some of my goals, as it’s more about achieving self-actualisation than a laundry list of stuff to do. So, things like home improvement and maintenance (which I often have little choice but do) and long-shot vanity projects are out. Instead I’m looking for progression in the things I’m already working towards.

One. Get a podcast out there. Not necessarily one of the scripts I have been developing for the last few years, which needs substantial effort and collaboration to realise, but maybe something simpler. I have an idea which should be much easier to get off the ground, and if it works might be a catalyst for what I really want to do.

Two. Improve physical strength and fitness. I’m now running 5k at least once a week, I’m slow, but twelve months ago I struggled with 100m. Now I want to build on that. I’ve purchased a weight set I can use at home (getting to a gym regularly is pretty much impossible), so I want to build up my core strength. In the medium term I’d like to get my 5k time down from around forty minutes, to closer to thirty minutes. That’s a big ask, as it means losing two minutes per kilometre off my pace. I’m going to start by mixing my runs with faster but shorter distances to build pace. Longer-term I’d like to get my distance up to 10k.    

Three. Stabilise my weight at 100kg. I’m currently weighing in between 103 and 104kg. That’s around 12kg lighter than twelve months ago, but 100kg is the weight the consultant told me I needed to get down to when I started out on my CKD journey about eight years ago.

Four. Improve my technical knowledge. I don’t want to make this one specific to a particular programming language such as DAX or Python, instead I want to continue upskilling. Last year I made significant progress learning DAX, and I recently achieved my Azure Fundamentals certification, but I want to kick on from here. For most of my career in Business Intelligence I’ve relied on my natural strengths as an analyst and coupled it with an ability pick up and be competent on the basics technically, but in recent years I’ve been pushed away from my comfort zone into the development side of BI, and that has meant going beyond just basic competence on the technical skills.

Monday, 6 January 2020

2019 Goals Review

So, a year ago I set myself a series of goals, they weren’t hard and fast, but more a series of things I wanted to work towards. I also knew that some of them were unlikely to go anywhere, especially those lower down the list. Overall, I’m reasonably pleased with the outcomes.

One. The Podcast. This one was the biggest disappointment, despite some really good progress. I have got the first few scripts finished, I got my recording cube set up and I did some practice recordings, but I was unable to find collaborators I needed. I’m going to keeping pushing this, but I’m considering a change of track away from a multiple cast production to some monologues, but more of that another time.

Two. Run 5k. I completed a GPS confirmed 5k run in December, it took me forty minutes or a pace of roughly eight minutes per kilometre. For the last few months I’ve regularly been running between three and four kilometres, so I still have some work to put in to get be a regular 5k runner, but I now know this distance is something I am perfectly capable of. But from the start of the year, where a couple of minutes running left me breathless I've made some huge strides (pun intended).

Three. Weight down to 108kg. At the close of the year I was weighing in at 104kg, although a bit of a blow out over the new year period saw that rise to 106kg but I’m taking steps to get back on track again. Whichever way I look at it, I’m lighter now than I have been for more than a decade, probably more than fifteen years. More importantly the weight loss and the improved fitness appear to be helping stabilise my kidney function. Since the weight loss kicked-in I’ve had no signs of gout and I’m less prone to muscle cramps. At my last Renal clinic in November the Nephrologist suggested I could get another five to seven years before I need dialysis or transplant intervention (although this is heavily caveated by the risks of any sudden hits caused by illness).

Four. Learn Dax. I’ve made plenty of good progress here. I’m using basic DAX at work fairly regularly although my systematic knowledge of the language in patchy. I have the ‘definitive’ manual now, I have some training coming up later this month on Azure Fundamentals, and I’m supposed to be getting an invite to a Microsoft Ignite event showcasing developments on the Power Platform.

Five. Garage project. This never happened. There were always too many other things that needed doing first. Although I still plan to do this some work in the back garden has a higher priority for the spring.

Six. Learn Python (or R). I never expected to get far with this, despite a few false starts. It’s something I’m still pushing to do, but lack of time means it is likely to be a slow burner.

Seven. Learn Latin. A bit of a hopeless vanity project. Something I’ll revisit in the future, but probably not for some time.

I’ll be putting together some new goals this week, although I might have a little bit of a rethink about how specific they are, and whether it’s a bad idea to be too prescriptive around some of the self-development I want to achieve given the time pressures.

Sunday, 1 December 2019

Goals update thirteen

One. Although I’ve had the offer of help from my daughter's drama teacher, I’ve been a bit reluctant to push this at the moment as I know she is really busy till mid-December staging two different amateur productions (as well as her day job). I’ve sent a copy of the first episode to a friend to proof read and offer criticism, after that I’ll think about how I proceed. I realise I’m running out of time if I want to get the first episode out before Christmas, but I don’t want to disrupt other people’s projects.

Two. I’m still running two or three times a week for half an hour. I’ve started using the Runkeeper app to track my progress and it shows how variable the distance covered can be in those thirty minutes depending on route taken. It has shown me that my typical distance is actually closer to 4k than 5k, so I’m looking for a route which will give me a confirmed 5k to put this one to bed.

Three. I’m down to 105kg continuing with the mix of intermittent fasting and time restricted eating, the rate of weight loss has dropped off significantly, but I’m no longer being as strict with my diet. I'm not sure I'll see further weight loss this side of Christmas, I think for now I need to work on consolidating my losses and perhaps changing my exercise routine, before having another stab at things early in the new year. I had my Nephrologist review last week and the doctor I saw was happy with my progress, but I'll write another post about that when I get time.

Four. My DAX book is still on order, although I am picking up bits and pieces for work I could do with some more challenging use cases.

Five. No work on the garage side door, it’s probably getting too late for this year. I had to make some emergency repairs to the garden fence following the storm in early November and I still need to put back a paving slab I removed to do it. I'm also pretty sure there are a bunch of small things my wife will want resolving before the hordes descend upon us at Christmas.

Six. The Python book I’ve had for the last couple of months is still untouched, but I'm working at home over Christmas so I'm going to make an effort to do a few exercises.

Seven. Nothing. Always a stretch, there's no chance I'll be doing anything on this before the end of the year.

Friday, 18 October 2019

Goals update twelve

One. I contacted the local drama group a few weeks ago about supplying voices for the project but had no response from them. Fortunately, my wife is friendly with a local drama teacher who has offered help out, I know she has the know how and contacts to make it happen. I have two scripts ready to send to her for review and should have the third ready this weekend. I’m going to ask a friend to proof read them before I send them.

Two. I’m now on week nine of the programme, the thirty-minute run. I estimate I’m managing 4.5km in those thirty minutes, so within touching distance of the goal.  

Three. Goal met. My weight earlier this week was 106.1kg, although I’ve been around 107kg for a couple of weeks. I’m not entirely sure my diet is healthy; I’ve basically been doing intermittent fasting/time restricted eating half the week and eating what I want the rest of the week.

Four. I’ve placed an order for the definitive DAX guide on Amazon, but suggested delivery time is a couple of months! My main worry is the card I’ve used to pay for it will expire before it arrives!

Five. Bunch of stuff to do this weekend, but still not hot round to the garage door.

Six. I’ve had the book on Python nearly six weeks, but still haven’t had time to work with it yet.

Seven. Nothing.