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Feeling good

Feeling good

So this week we have spent four nights in the Lake District, hoping to do some tough hill walking for the first two days and something less arduous for the third. In anticipation, hubby did all the planning and all I had to do was turn up. He felt it was a holiday and I felt it was a training camp. It turned out to be both.

So here are the things I learnt (well, those that are relevant to the Coast to Coast!) :

  1. I felt physically OK in terms of fitness. Hell, we walked up Helvellyn – 3000 feet and I didn’t crumble.  I felt mentally OK in terms of capability. Unfortunately I twisted my knee which made downhill bloody hard going. But am hoping it’s nothing serious. It was helped using hubby’s knee support and Nurofen. Luckily his torn cartilage didn’t play up enough to need the support himself. But we might need to think about carrying a spare….
  2. I felt absolutely fine the following morning – in complete contrast to the previous Lake District escapade. Probably because I did a bit of stretching when we’d finished.
  3. The terrain is really hard going. All those bloody rocks and stones. It’s as if the walking isn’t bad enough, there’s the hills themselves but on top of that is the terrain. The South Downs and Chilterns are just not a remote substitute or training ground. Everything underfoot is uneven and we were doing it in perfect conditions. Given rain the slipperiness would be really tricky.
  4. The weather can be mental – baking sun in April meant we should have had protection that can’t be sweated off. And some kind of headband to keep the sweat out of my face. My little towelling wristband was a godsend.
  5. Even Shellac got destroyed scrambling up rocks. No nail varnish on the Coast to Coast!
  6. Testing out socks gave me a blister on the final day. They were ones without liners so I think I’m going to stick to sock liners.
  7. Look before you leap – obvious but equally applies to cutting what I thought was a toenail that was pressing in to me. Transpires I cut the top off a blister with nail clippers..
  8. Compeed is way better than the generic alternatives from the likes of Superdrug.
  9. I got too hot in my Craghopper long trousers which up to now have been my favourites. They’re only going to be worn if it is unseasonably cold in June.
  10. My new Berghaus long sleeve stripy top and Jack Wolfskin jacket were great. But think I need a top with a collar to stop rucksack rubbing as when I didn’t have the jacket on I could feel it a the base of my neck. Ah a retail opportunity…
  11. And the Lakes own gin, Bedrock, has convinced me it is the drink for me. Ah, another retail opportunity…
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Training update 2

April 1, 2015

So I’m half way through my Personal Training  – the Coast to Coast walk starts in just under ten weeks. We have our first serious test next week with three days walking in the Lakes (hubby’s knees permitting). And I’m ready for it. I continue to feel stronger and fitter despite continuing to go out and get lashed. And despite being unable to get past chips on a menu. But I’m still drinking the water and not drinking alcohol unless I’m socialising (and yes, weekends at home count as socialising). So I’ve cut down on that front. And I continue to do PT twice a week and hopefully they are getting harder as I’m getting fitter. Still enjoying the outside fresh air and feel better all day. Then this weekend just gone I felt great. No, really great. I suddenly actually felt fit again. Yes, I’m still purple in class and sweat more than anyone I know, but I feel stronger. Still not light on my feet or agile, but definitely stronger. And mentally more prepared!

And I’ve lost a stone. It’s bloody hard work – the ‘making healthier choices/thinking about what I’m eating’ –  much harder than the physical stuff . Probably because the physical stuff at the moment lasts an hour or perhaps two whereas I’m constantly thinking about food! And living with an incredible cook whose baked goods I find really hard to resist. And going out a lot. But getting there. Getting there. Fingers crossed.

Taken ten days ago

Taken ten days ago

There were no tears!

February 23, 2015

The headline says it all. The first walking test weekend went well. The weather was glorious and the walking not too arduous. Yes there were undulating hills over the Seven Sisters but we walked the 12+ miles relatively easily I thought and got back to the pub on the picturesque green in plenty of time for a bath before spending the evening rehydrating with alcohol and refuelling with carbs. The next day, after a fabulous full Sussex breakfast, we set off for a short stroll supposedly with magnificent views after  a bit of a climb.

10855043_10204815869088890_4577714971959697561_o The walk turned out to be longer than planned due mainly to us being unable to decipher the description of where the walk actually started. The book was ambiguous, but eventually we decided to follow the numerous little old ladies who seemed to know where they were going. The going was soft. Squelchy in fact and a good test for the boots. My core didn’t let me down and I didn’t fall over at all, although I may have overbalanced a few times as I slid on the clay. Up to the Iron Age fortification and a panoramic view to the sea in one direction and the Downs in the other.

seven sistersThen our guidebook again confused us and we ended up crawling over and under barbed wire fences, through crops and in to a heavily fenced area with numerous buildings in it. And huge signs saying it was private property and walkers had no right of way. So we strode through to the main road and had no idea which direction we needed to walk. The compass couldn’t help as we didn’t know where we were. There was no mobile signal. So we flagged a van driver down and asked him where the village was and went on our way. Probably had added a good couple of miles on to our intended four and a half mile expedition, but the torrential rain that was forecast didn’t appear until we were in the car heading home. Perfect timing.

 

Training update!

February 20, 2015

So, I’ve had a Personal Trainer twice a week for the last six weeks. All in preparation for the big Coast to Coast walk in June. And i have tried to take on board everything she says. Even when I don’t know the evidence base for it; I’ve decided to simply put my trust in her methods, shut the fuck up and get on with it. So I am drinking only one cup of coffee a day, 1.5 – 2 litres of water a day (but NOT from a plastic bottle at work I hasten to add) and trying to eat more healthily. But her role is not to advise me as a dietician – my main goal is to be fitter and stronger and a nice side effect would be to lose weight but that’s not the focus.  The focus is on being able to do the coast to coast.

And I am feeling much fitter and stronger. And I am fitter and stronger. She’s given me a much more positive outlook on my capabilities. And helped me stop using my trapezius muscles for everything. And to try to find my core. And I particularly enjoy our outdoor sessions in the park. For the last two sessions I have actually looked forward to them. This is a new feeling. And yesterday we did the measurements to see how my body is changing. And I’d lost 6 pounds. Not much considering the fundamental change in eating habits I’ve undertaken (but not when I’m out or when there’s Sunday roast or a special occasion obviously), but she thinks it is fat loss rather than water as I’ve lost 8cm from my waist, 2 cm from each upper arm and 6 cm from each thigh. So hopefully I’m a tiny bit leaner and quite a bit fitter.

The test will come this weekend when hubby and I go away and are walking for a couple of days. He’s told me there’s no crying allowed this time. Let’s hope it’s smiles all the way and no snivelling silently. I’ll make sure I’m not crying aloud whatever happens.

Sometimes I love my job

September 17, 2013

Last week had a day in point. Uptown at a hotel so the team i was training could be off site. I had four hours of their time and a brief to discuss issues to do with being out ‘in the field’ as its known as opposed to the particular issues of being in head office which is what my training usually concentrates on. So I’d spent quite a bit of time pulling a presentation and exercises together trying to make what can be viewed as an essentially dry subject in to something a little more fun. A bit more practical application and less this is what the rules say. So exercises, scenarios, quizzes, yes no cards. You get the drift. And it’s a bespoke session for this particular team so I’ve not tried it out before so don’t know exactly how the timings will run. Have I got enough stuff? Will I run out of time to get through it all? It’s a bit of a whistle in the wind but all down to how much interactivity and discussion, challenge and debate I allow. Because that’s the best bit really. The on-the-spot Q and As. The real stuff they are dealing with – what should they have done in this situation? So often training is theoretical, hypothetical and avoids giving clear direction – as these are the judgement calls that need to be made and people can find it difficult. But that’s the bit I probably enjoy the most as it shows people are actually engaging with the session and coming up with stuff that will actually help them in their day job.

The four hours flew by for me – might have seemed longer for them – but grabbed a nice buffet lunch and headed back to Paddington station only 3 minutes away. Perfect placement for me. Then off for a meeting with an agency to discuss a conference that is happening next month and the agenda, presentations and the like need to be decided and sorted. Three hours flew by and hopefully much was decided so it felt a worthwhile meeting as opposed to the pointless work-avoidance, decision-revision scenarios they so often are as I may have mentioned.

Then straight to the train station and uptown to a burlesque show via Pizza Express. Oh yes, it was a great day from beginning to end. Full on to full off (apart from nipple tassels) and loving every second.

Learning on the job

April 30, 2013

When I was a junior doctor I worked an average of 104 hours a week. Continually seeing patients and practicing medicine. And that’s what it was. Practice. Practice. Practice. The hours were awful, but it did mean I got to see a lot of cases and got lots of experience in a relatively short period of time so that I was able to make judgement calls on appropriate treatment for individuals. I also had to know when I was out of my depth and call for more senior help. There is no shame in that – it is considered a requisite that a doctor knows their limitations and asks for help. The more you see and discuss, the more you learn and your limitations lessen. And anaesthetics was the absolute dogs bollocks for training – one to one with a more senior colleague as I already talked about.

In contrast it seems to me that many organsiations do not use this ‘apprenticeship’ approach to training, but rely on the new incumbent to find their own way without the benefit of a wiser, more experienced pair of hands to call on easily and at any time. There may be a number of online training modules to click though. Perhaps even a live training session. But that’s it really. Their boss will quite often have no actual experience of the job that the new incumbent is doing, because he or she has been promoted from elsewhere in the business and is busy learning their own new role. Or even if they know their role in temrs of being able to ‘manage’ the team (what IS that exactly?), they don’t neccessarily have the requisite years under the belt or grey hairs on the head to have seen and done enough to advise on the actual job itself.

Organsisations often seem to value youth and ambition over experience and cynicism. I can’t think why. Well, youth are often cheaper. But they are nowhere near as valuable. Unfortunately organisations don’t ever have a space on personal development forms to say “I just want to keep doing what I’m doing. Hopefully getting better and better, but to be honest I’m pretty fucking good already.”

I have blogged before about us old dogs . A bit of dirt under the fingernails from scrabbling around to make things work, or repairing stuff after a cock up, means we know how to take safe short cuts and know when we are careering towards a cliff edge. We can pass all this experience on to those less well travelled so that they learn to drive their own paths whilst we sit in the passenger seat and give them the navigational options. And always have our hand hovering over the handbrake if need be. It allows them to develop in a safe environment and gives the business the benefit of our expertise coupled with their enthusiasm. What’s not to love?

Choosing anaesthetics

August 22, 2012

Wish I’d had one of these all those years ago

Choosing careers must be difficult. At least having studied medicine you kind of don’t have to think about it for a while as you are on a pre-trodden treadmill  But you do have to choose which branch of medicine to specialise in.

After my Houseman year I opted to for Anaesthetics. It is by far the best specialty. Perhaps Emergency Medicine runs a close second. Basically it is really practical, immediate, covers every type of patient and disease, includes Intensive Care and lots of  life and death  stuff. You have shedloads of individual responsibility – no need to consult with others about what you are doing, but work in a group environment so get the banter and human contact.

And it is incredibly well taught. That last one makes it fundamentally different from so many other specialties which tend to leave one to get on with it and learn by osmosis and experience. Anaesthetics on the other hand is very much direct Consultant and other seniors teaching juniors on a one to one basis. After all, you can’t risk a patient’s life by leaving them in completely untrained hands. And anaesthetics is all about life and death. Putting people to slepp, paralysing them so they can’t breathe, making their blood pressure drop. All good fun and physiological games. For a purpose of course.

I did my training back in London. I’d had my year out and loved it, but pined for the city on two counts. One is snobbery – as a London graduate I believed I would get better training in a London teaching hospital, and the other is just London itself.

And so it was I rolled up to The London Hospital in Whitechapel, the East End of London. It’s so long ago it wasn’t even Royal at that time. And I  joined the large Anaesthetics department, along with a number of other new SHOs (Senior House Officers). They say starting Anaesthetics is 99% terror and 1% boredom. And that by the time you are a Consultant it is 99% boredom and 1% terror. I disagree with the high boredom factor, but the terror part is certainly true at the beginning. But that’s where the fantastic training comes in. Plus an entire new breed of people who I had never really noticed as a medical student – the ODAs. Operating Department Assistants. I think they are now called Practitioners or some other arse wank title, but to me they are ODAs. Bloody fantastic. They are practical help in theatre, and can assist the anaesthetist, the surgeon or in recovery. They will prepare the room, lay out the drugs, clean the equipment and all that kind of stuff. Obviously as the anaesthetist you are ultimately responsible for  what happens to the patient, but it is wonderful to have someone you can trust to physically move machinery, get the ECG leads out, do lots of the basic tasks. And even more important they have usually got years of experience and can really help when you are doing stuff on your own and things don’t go quite according to plan.

A good ODA will prepare a patient in the anaesthetic room, putting them at ease and chatting whilst you are finishing off the previous patient. Not literally finishing off (fingers crossed), but taking them to recovery or whatever. They will draw up the drugs, label them and pass them to you as you need them, and pass the correct equipment at the right time. They might even put a needle in ready for the drugs to be injected.

It was routine to put a tube in to the trachea (windpipe) when operating for a long time or on the abdomen (because you need to paralyse all the muscles so the abdomen will relax and allow the surgeon easy access, but it also means paralysing the respiratory muscles) and usually it is very straightforward once you have the knack. But very occasionally it isn’t straightforward and a good ODA will be worth their weight in gold as they get you different equipment and suggest new strategies you might not have thought of if you are relatively new.  They will also go get help when they think you need it!

Anaesthetics is not dissimilar to cookery – there are a thousand different recipes for the cocktails to put you to sleep and every anaesthetist has their favourite ways of anaesthetising for certain operations. Different operations require different cocktails and different patients require different cocktails within that so there are plenty of permutations to consider. And the human is a living organ (we hope) and things change as the operation progresses. And the anaesthetist is responsible for keeping that person alive and giving the surgeon optimal operating conditions. So the patient doesn’t move when the scalpel goes in for example. Or their blood pressure doesn’t shoot up and make them bleed excessively. And they wake up without pain when the operation is over. And ideally without feeling sick too.  It’s all a balancing act – too much anaesthetic and you might not wake up, not enough and you might feel it or remember it.

And we also got to do Intensive Care too – another critical care area full of practical procedures, challenging problems and very sick people.

One of the many pluses of doing anaesthetics is you get to wear scrubs the whole time so you don’t have to worry about work clothes. The hospital supplies you with standard cotton (usually blue or green) trousers and a top. Or a dress.  I always wore trousers, even with a dress. And lovely white clogs or wellington boots. Topped off with a hat and mask and you are good to go. On the wards you might add a white coat, but basically you wander round in jim jams all day. Then throw them in the laundry basket on your way out of work. Result.

The other big plus is that other doctors are nearly always pleased and relieved to see you because you are usually only called in when they need your immediate help – getting a line in when everyone else has tried and failed, resuscitating when the shit has hit the fan, taking charge of the very very sick and unconscious patient. Oh yes, anaesthetics is one of the coolest specialties.  And I had never been cool in my entire life. Until now. And I loved it.

Jim jams for work. What’s not to love?

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