Disclaimer

BEFORE YOU START: Please note that although I currently volunteer for both the Stroke Association and Age UK, the views expressed in this blog are strictly my own. I am not a spokesperson for either (or, indeed, for any) organisation. I am based in the UK and the blog therefore has a UK bias - I've tried to use the Glossary to explain any terms which might be ambiguous, but if you think there is anything I've missed, please message me.

Friday, 30 November 2018

The UK's European deal

I must admit that I've thought that the EU was flawed, and have done for some years. I won't get sidetracked by going into the details, but I'm broadly in support of Tony Benn here. Whose views are all over the web. I don't accept Benn's premise that the UK system is at all better than the EU system - the UK has just as many flaws - but I agree with Tony's analysis, as far as the things that are wrong with the EU. To the point where I'd happily be out of it. I have European friends and think the idea of some pan-European organisation where we all practise brotherly love toward each other is a great idea. But I don't think the EU organisation is it. Yanis Varoufakis's writings add to my belief, although his conclusion is to remain and reform. I don't think the EU will reform, so therefore I'll walk. I don't particularly fear a rise of nationalism, because I think you argue the issue. I don't see the EU as a buffer to prevent future conflicts. I think where I disagree with my European friends is that they might. But then for a lot of them, their grandparents have either been occupied by a foreign power, or have themselves been occupiers, so my friends' perspective will be different to mine.

After the referendum, my view on the EU, frankly, became irrelevant. What then became relevant was how we were governed - whether we were governed by a beast which listened to the population, or whether we were governed by one which thought it should dictate. Certainly, for me, government is consensual. We pay our taxes, we (mostly) don't break the law, because we recognise that our society is the better for it.

I can understand May's deal. She's basically no more than a go-between. She's playing devil's advocate, and presenting what she thinks is the "best" deal that the UK will get from the EU. And the EU have agreed with her. Whether the UK Parliament will subsequently agree that the deal is a good one  is another matter.

But I harp back to the 52:48 nature of the referendum vote. To me, I think if you have a vote which is that close, you have to come up with something pretty diluted in order to try and reconcile these two factions. The majority might well have said "Leave", but I think we need to recognise that 48% of our countrymen wanted to stay in the EU. I can see where many Brexiteers are coming from, because they live in a world where it's right that 50.1% of the vote gives 100% of the power, but I don't agree with it.

I think that you have to compromise.  The most we can hope for is to reclaim governance (and this might be where May's deal falls down). Plus, you also need an acceptance that things might become clearer with the passage of time. We've been fifty years getting intertwined with the EU so I don't for a minute think we'll finalize the precise relationship we want with the EU in just two or three years. So, there are bound to be things where we either want to be closer to, or further from, the EU, so we need to not tie the hands of our successors. To hear things like "the UK can't withdraw from something unless the EU member states agree" seems unacceptable. We all need to be able to withdraw from X, in the knowledge that the other party might do Y as a result.

I do think that what I'm hearing from the politicians, btw, just exacerbates the situation. From Labour we hear no more detail that "the deal is a shambles". Why? From the government, we hear that the deal delivers on Brexit. Again, why? More specifically, it might deliver Brexit but how does it affect trade and jobs? And, there seems to be acknowledgement that people voted to leave because of concern over immigration (I didn't), so how have you satisfied them? You come to the conclusion that most politicians are just toeing the line, saying what they've been told to say. That they likely don't fully understand the deal either. At least with somebody like Jacob Rees-Mogg I've heard some kind of reasons why he doesn't like it. I mean, there's probably little on which Mogg and I would agree politically, but I think he's gone some way to adding clarity to the debate here.

Wednesday, 28 November 2018

Sugar Spreadsheet

My wife reckons that nobody is interested in this, but I'll share it nonetheless.

The spreadsheet where I record all my sugar is here. I've shared it to my web site folder, so hopefully you can see it. It comes down as a .xlsm file, which can be recognised by Excel 2016, which you get from Office 365. XLSM presumably means "a spreadsheet containing macros".

The spreadsheet has about 4 rows of dummy data, just so you can see what you have to enter. You just need to enter the time, date and value. Other columns are optional i I record how much insulin I take, and what monitor I use to measure - and those with a grey background are calculated.

To calculate statistics, just hit the button in the top-right, and follow the instructions. I've put a little macro under there which will ask for the first row you want to calculate stats for, and the last row. It'll then work out when was "one month ago", and write the number of entries, the average and the standard deviation in columns E, F and G. Please note that where you just have one reading for the last month, the mean will just be that reading. And, you need at least 2 readings during the last month in order to calculate a standard deviation, so with just this sample data, each cell in Column G shows an error (which will go away as you add that second row).

The macro is very basic, its main purpose is to work out which days are within the last month. it is quite crude, will expect the data to be in chronological order, and will behave unreliably id not. I really developed it for myself rather than for public consumption.

Software provided on a "best endeavours" basis. The macro is written in a language called VBScript, which I've never ever seen in the last 10 years! You can view and change the source code, in any case.

Job Hunt

As part of my job search, I signed up to a site called reed.co.uk, and set up a search. I asked for all jobs within a 10-mile radius. I know from other job search engines that this search yields 20-25 jobs per day, many of which are at the local hospital. So, imagine my surprise when their search email told me that, in the course of just 24 hours, there were more than 350 jobs!

I saw straight away that their search contained jobs that were not 10 miles from Salisbury, but 50! I mean, what is the use in that? Someone has obviously decided that it is better for their site to send out wodges on information, even though it is irrelevant, than to send a smaller amount of "correct" information. Answering my own question, presumably this allows them to say to employers, "hey, we pushed your add to a zillion people!". no matter that to most of those people, the ad was irrelevant.

It kind-of brings into sharp focus exactly who this site is aimed at. They're obviously a company, out to make a profit, and the way they make money is by commission when they place someone in a job. Any service they appear to offer to candidates is purely a means to an end. It's a bit like Facebook - you think you're taking part in some nonsense quiz, and all of a sudden Cambridge Analytica are telling you who to vote for.

So my dilemma is straightforward. Do I continue with these emails, in which case I'm headed for a lot of wasted time manually sifting through their false positives, or do I can the search, write it off as a waste of time, and hope that if that dream job does come along, I find out about it anyway from one of my other searches?

Sunday, 18 November 2018

HBA1C

I don't bother much with my HBA1C reading. I haven't had it taken since February - in fact the last time I even went to my doctor's surgery, they were sufficiently unhelpful that I ended up complaining about them.

NB - it is not worth complaining about UK doctors' surgeries. There's a whole machine aimed at deflecting complaints

A good description of HBA1C appears here, but I will attempt to give my own description below.

Your HBA1C is your glycated haemoglobin. Haemoglobin is found in your red blood cells - they're the cells that carry oxygen through the body and basically enable us to function. Your blood also carries glucose (sugar) around in it, and over time, it combines with the haemoglobin somehow (I don't understand how it combines, but that's a whole level lower than I need to go). Glycated Haemoglobin is just a measure of these "combined" cells. The act of combining takes time, so the HBA1C is seen very much as an average reading over time. To give a context, "time", here, is 1½ or 2 months, and of course it is an ongoing process. So, from one day to the next, you wouldn't expect your HBA1C to change much. As you might expect, the HBA1C number is a ratio of glycated  cells to other cells.

If you're not a diabetic, your body produces insulin and combats the sugar in your bloodstream, and the amount of this glycated haemoglobin is at quite a low level  - below 42 mmol/mol is thought of as "normal", although there's a small range above this (up to 48 mmol/mol) which is informally labelled "pre-diabetes". I say "informal", because it isn't a real diagnosis - it just means that the likelihood is that you'll go on to develop diabetes. When someone is diabetic, there's more glucose sloshing around, more combination, and therefore that ratio is higher - speaking from experience, my HBA1C has at times been over 100 (it's a lot lower than that now).

HBA1C is quite important because this is the value used by clinicians to make diagnoses, and, if necessary, to determine what medication you have.

Anyway, having spent all this time describing HBA1C, I don't bother with it much. Instead, I prick my finger at least every day. This is something I can do in the convenience of my own bathroom, rather than having to go somewhere and give a syringe of blood. The glucometer measures everything that much more directly - how much glucose there is in the blood at a certain point in time. That's the key, though, at a certain point in time. It's a spot-value.

The other thing is that the amount of glucose in the blood is not only dependent on whether you are diabetic or not, but on what you've just eaten. When you eat (or drink) something, your body takes time to digest it, so you might have raised sugar levels for some time afterwards.

The way I try and get around this is by measuring my blood sugar every day when I get up. Because I do it after a night's sleep, I know that anything I might have eaten the day before should have been well-and-truly digested, so I'm measuring a kind-of baseline value. Then I write (i.e. copy) it down in a spreadsheet. This is why I like my glucometers to connect with the computer in some way. Anyway, I end up with a bunch of spot-values - I'm almost 900 so far - and looking at past readings I'm able to see how my sugar is behaving over time. I just use straight statistics (i.e. available out-of-the-box with something like Excel) to get an idea of what my sugar does over long periods. I generally look at the last month, so the same kind of timescale as the HBA1C, and work out the average value and a measure of its variance called the standard deviation. I remember back to when I studied maths, and these values are universally-accepted ways to measure things. So I end up with average values which are as useful as the HBA1C values.

But I've pretty much mentioned all this before, in other posts, I think. I used to take readings every day, then look at periodic readings - every 3 months, say - and calculate this average value, to give me an idea of how my long-term sugar varied.There were two parts to this - identifying which values to use, and actually doing the calculation. Doing the calculation itself was trivial, but identifying which cells to use, I did manually. The trouble is, months have a variable number of days, and in any case, sometimes I've taken several readings per day, so "a month" might be 28 readings, or it might be 100 readings!.

But this weekend, I put my programming head on and developed a macro (small program) for Microsoft Excel which worked out these calculations for me. I mean, I've programmed stuff for Excel before, but 10 years ago and, even then, only to solve a specific problem. Fortunately, little had changed, other than menus etc. to find my way in. So, the result? For every data point, every day, I'm able to calculate, automatically which readings are within that last month, i.e. which readings to use and to discard, then to when calculate statistics. For every reading. So I end up with this:



The average graph, obviously I don't want that to go to zero, else I'd be dead! But it'd be nice to get down to the kind of numbers I was at before ever I was diabetic. Of course, I can get lower numbers by taking more and more insulin, but I'd rather keep the insulin dose as low as possible, so it is a halfway house. I'm hoping to be more ambitious in the future. The SD measures how much this average varies, and ideally I'd like this to get to zero. But I know how different food can cause fluctuations in the sugar (which, let's face it, isn't going to change), so I'm not sure whether that will improve at all.

I'm not be completely finished yet, though. In theory, these values should just get calculated every time I open the spreadsheet, but quite often I'm opening it and seeing:


so there may be a little more work to do.

I think what I need to aim for is something that can be calculated when I say so (for most readings, that'll only be once) then just store the value in the cell.

Friday, 16 November 2018

Clearance

My mum and Dad both died in 2012. They left a 3-bedroom semi, full to the brim with belongings. I spent much of 2013 clearing the place out, and finally sold up in 2014. The big stuff, the furniture, beds, wardrobes etc., I put into storage where it has remained ever since.

We went up to the storage facility on Monday to sort out, once and for all, the stuff that was valuable to us. There wasn't a great deal of monetary value in it, both my parents came from very humble backgrounds, and the "valuables" amounted to just 1/4 of all that had been in storage. Even some of that was taking some of my mum's furniture, with a view to like-for-like replacement of some of our stuff.

Anyway, the storage people put me in touch with a house clearance company, who've looked inside the units containing the items I'm letting go of. And they said they'd give me £200 for the lot. I know my mum had some stuff they'll never be able to sell, I know that the £200 takes account of the costs they'll incur, but for a couple who lived until roughly 70 each, it's sad that their worldly goods come down to this.

Thursday, 15 November 2018

Thoughts about jobs

I've been thinking about this for a while, so finally I thought I'd put something down.

I had an interview about a month ago, it made me reflect on the issues facing disabled people.

I mean, often when we go to interviews, we're nervous about what it will contain, what will be asked etc. I wasn't so much in this case - I have many years experience in the field of software development, although (a) most recently it was at a far ore senior level than I was being recruited for, (b) my experience was in different technologies than what they were looking for, although there was some crossover, and (c) I'd been out of the industry for five years. I'd like to think that (c) isn't a factor but I'm bound not to be as sharp as when I was immersed in IT every day.

But it made me think, the issues were not the interview itself, but just getting ready and dressed up, getting up the flight of stairs to the interview room, signing in and out at their reception. And so on. It's kind of weird that everything is back to front now - doing the job would have been easy enough but the issues are all the peripheral things!

Self-regulation

It's funny, I tested myself when I got up this morning, at around 7:30. 9.8, about average. I made myself a cup of tea but didn't have any breakfast yet. Because my sugar wasn't overly high, I didn't take my insulin just yet.

One thing happened after another, and before I knew it, it was 10:30am. Out of interest, I tested myself again. 9.2. I'd had nothing in between apart from that cup of tea, and there's very little carb in that.

I mean, I'm wary of reading too much into decimal places, but possibly this gives an indication of how well (i.e. badly) I'm able to regulate my own sugar level.

Wednesday, 14 November 2018

Dry Mouth

I had a strange incident on Monday. We went to arrange to get my mum's stuff out of storage, and all the while I had a really dry mouth. To the point where my voice didn't sound right (i.e. not how it usually sounds). Now, I usually take this as a telltale sign that my sugar is high, but I couldn't particularly think of anything I'd eaten which would make it so.

Sure enough, when we got home, the dryness had eased somewhat and I tested my sugar - which was down at 8. For me, that's low. Indeed, my morning sugars have been around 7 ever since.

So I must remember that whilst high sugar levels can be a cause of dry mouth (before the stroke I drank far more fluids, when I assume my sugar was that much higher), there are other things that can cause it. I need to try and find out what.

Tuesday, 13 November 2018

PIP

It has been so long, I'd just assumed my PIP had been sorted and would continue as before. But I got a letter yesterday from the DWP saying they would no longer grant the mobility part of the benefit. I still get the main chunk but the mobility part is about 20%.

I hear of lots of appeals against PIP decisions, and I read that there is something like a 70% success rate. So the moral is that the DWP often get things wrong.

I've been busy these last couple of days, but will need to look at this tomorrow and maybe Thursday. First things first, their scoring system is out there in the public domain, so I can quite easily run through their assessment questions and see, foremost, whether I have any grounds to appeal. I suppose, after that, (assuming I do have grounds to appeal) I'll need to contact someone to help me through the process.

All grief I can do without.

Saturday, 10 November 2018

Blue Badges

Therewas a news story a few days ago. It wasn't mega-news but enough to make the BBC's web site.

https://www.bbc.co.uk/news/uk-england-kent-46115444?fbclid=IwAR36mirBhNbmnu9hV-SqHsiN6w75TajYHBzFixEIRKTTuF1BVul1XmgC6rg

The story is basically a woman, who has a small son who's disabled, got a rude note on her windscreen for using a blue-badge parking space. Apparently, she was displaying a perfectly-valid permit in the vehicle.

I've seen this from both sides. Often, people don't appear to be disabled, and I think people must just assume because of that, that they aren't disabled. Some of my stroke buddies, say, have problems with their eyes - of course we don't see this when we see them. It highlights how looks can be deceptive.

On the other hand, we sometimes go to the supermarket at lunchtime, and I will see a white van parked in a disabled bay, the van has no badge on display and the driver invariably turns up 5 minutes later, sandwich in hand. So I do think abuse takes place.

For me, the badge is the key. I got mine by virtue of having PIP, so I already jumped through the necessary hoops to get that, although it was granted by the local authority not by the DWP. I think my permit lasts until 2019, although I still (today) receive PIP (I had an assessment a few months ago), so there's no reason to think that the renewal won't be straightforward. The badge lives in the glove box of the car, so, in theory, it is always with us.

Friday, 9 November 2018

Readvertising

It is an interesting conundrum. I see the same job, for the same salary, posted again and again. I can see, if you're a poster, that you might assume that someone, who might be perfect for the role, might not have seen the job that time around, so it might be worth advertising the same job again.

But I'm seeing jobs that are just being re-advertised for months on end, at the same salary. If someone were looking for that job, don't you think they'd have seen the ad by now?

It leads me to an interesting question - at what point do you, as a recruiter, throw your hands up in surrender and accept that there whilst there might be nobody sufficiently skilled to do the job, there might also be something wrong with the job which stops people from applying. It might be the job description itself, the conditions, or the salary. But surely it can't be particularly fruitful to just re-advertise the job again and again?

Friday, 2 November 2018

Blood Pressure

I don't much mention my blood pressure, but it has always been high and I have taken medication for it for several years. I used to worry more about my blood pressure than I did my diabetes, although these days I just take the meds and think "que sera sera".

In fact the only two things in my life which have ever been abnormal (i.e. non-average readings, I hate the word "normal") are my blood pressure and my diabetes. So, when looking for the causes of the stroke, these are prime candidates. Indeed, after the stroke, all of my meds were changed - and I can't help thinking that the meds I took before the stroke were not the most appropriate for me. But my blood pressure, certainly, is a lot lower now than then, back into a recommended range.

These days, I keep tabs on both my sugar and my blood pressure. With my diabetes, I can take the insulin and also balance my sugar levels with what I eat, plus I measure it daily so have many results. With the blood pressure, it's not as easy. I can take the meds, but there's not much else. I can't get the exercise I once did because of my disability, and frankly, even when I cycled hundreds of miles per month, it didn't make much difference. I used to keep sufficient tabs on things even then, to know that. So I'm kind-of left thinking that if a stroke is gonna happen, it's gonna happen. Plus, because there's not as much I can do, I measure it monthly, approximately.