Friday 29 April 2016

Leicester

Tree-lined pedestrian pathway

This was a Lola II birthday weekend, postponed from when her birthday actually took place because we have both been a bit busy most weekends. By all rights it should therefore have been warmer than late February, but it wasn't really. Apart from the chilly days it was a brilliant weekend.

We started with the accommodation on Friday, which was not our usual guesthouse or B&B, but a private residence booked through AirBnB, belonging to Muriel. Muriel was Not Very Well so our contact with her was quite limited, but we were out most of the time so it didn't matter. She has some very interesting wallpaper but the room was comfortable and there was Redbush tea.

We decided that Leicester is quite good. Many of its inhabitants have got over the discovery of the skeleton of King Richard III in favour of their football team (although the city still displays an RIII logo on lamp posts, posters and anything else it can think of). Leicester City Football Club has unexpectedly emerged from obscurity and is almost in a position to win the League, and everyone seems to be rather excited and nervous about it.

On Friday we ate at a rather meat-focused restaurant, but on the way home we passed a small Japanese restaurant that looked very promising, so that was Saturday's dinner venue sorted.

Lola I in pretend shop with trolley and list
On Saturday we decided to head for the Tourist Information Office, but were waylaid by some loitering market researchers. I persuaded Lola II that it might be interesting, and so it was - rather than answering a few questions off a clipboard in the street we were taken into an office and answered rather a lot of questions about shampoo, toothpaste and cereal. Then we had to pretend to shop for shampoo in a pretend shop with a real trolley while being filmed, and lastly answer a trillion questions about three types of shampoo, many of which were stupid. Did the pictures of shampoo make me think that it was 'efficient'? or 'natural'? or 'smell good'? Stupidest of all given that there was no information about price, did it look like 'value for money'? Good luck to them analysing my answers. They gave us each a £5 Boots voucher so I suppose it wasn't three quarters of an hour completely wasted (they'd said it would be 15 minutes).

Lola I trying to eat an eclair

Leicester Market is good and there was a 'Continental' market going on too with some wonderful-looking cheeses. We found a deli for lunch and I had an eclair from the Boulangerie stall which showered me with icing sugar and anointed me with cream. Then we made our way to the Jewry Wall Museum and a guided tour of the Roman baths. This was less interesting than I'd hoped because once you've seen a few Roman baths what more is there to say? And there wasn't actually much to see except the foundations, not even a trace of hypocaust, but there was a very large Roman wall. It was pretty cold and the guide clearly knew a lot but spent many words conveying minimal information. Kathleen Kenyon was the original archaeologist who worked on the site in one of her very earliest jobs, so that was a bit interesting. Being told how the original residents would have welcomed the warmth of a Roman bath house made us reflect that we would too.

Tomb of Richard III with Lola II
After that we sat in a cafe drinking tea until we'd warmed up, then had a look around the cathedral, where Richard III was re-interred about a year ago. His tomb is rather impressive and there was a guide hanging around whom we quizzed for some time. She doesn't think the king was all that bad, and her view is that he was slandered by poets and playwrights; times were different and politics was pretty ruthless back then. She had attended the re-interment and was responsible for the bit of the church where Benedict Cumberbatch, Julian Fellowes and Robert Lindsay were seated.

Leaving the cathedral we made our way to where we remembered the Japanese restaurant was, but there it wasn't. Eventually with the help of Google we found it elsewhere in quite a different spot from where we remembered. It was also a little disappointing, as the rice was formed into nigiri by a machine and rather small pieces of pre-sliced fish out of the fridge simply placed on top. Several of the dishes were better than the sushi, but there was quite a lot of confusion with the order and Lola II's chicken was undercooked (they took that off the bill).

Sushi, agedashi tofu, edamame, gyoza
The evening's entertainment was provided by a performance of 'Legally Blonde' the musical, which went very well. There was a small incident with a bar of chocolate - when I went to get some water I though how hilarious Lola II would find it to hide some chocolate that was in my bag, so I moved it to a less obvious place and then completely forgot that I'd done it. When I came back and looked for the chocolate I was halfway through accusing Lola II of hilariously hiding it when I remembered what I'd done. We both thought that was very funny indeed.

Last notable event of Saturday - we ordered a minicab by phone to take us back after the performance, and the driver phoned to say he was waiting in a silver Zafira car. What are the chance of two identical silver Zafira cars waiting in front of the theatre? The man waiting for his wife was very nice about it, and we didn't actually get into his car...

Half timbered house
Sunday started with another visit to the market Boulangerie (chocolate twist and pain au raisin this time). We had a bit of time to spare before our next booked event, so we walked along a pretty road converted for pedestrian use and found the Art Gallery, but it wasn't yet open. The tours we'd booked were of the Magazine Gateway (gateway to a monastical complex not the city, and which in more recent times housed arms) and Wygston's House (15th century half-timbered with Georgian and Victorian extensions about to be sold off and converted into a restaurant due to lack of public funds for restoration). The guide for these two tours was much better, even though it was still very cold to be standing around in unheated buildings.

Several curries, rice, naan, chapattiLeicester is famed for its Golden Mile - a bit like Rusholme in Manchester, it holds a concentration of Indian restaurants, and we chose one that was busy on the basis that it was likely to be good. It was delicious and very good value. There was just enough time for a quick look in one of the rooms of the Art Gallery that was now open before Lola II had to catch her train.

Leicester - I'd go back for the curries, but not for the sushi. And good luck with the football.

Lola II and the chaat

Tuesday 19 April 2016

Lola Towers Renovation Project

Two runners rounding the bend from the road into the park
Lead runners entering Victoria Park, April 2016
It's all going quite well. Handyman Ilf has turned out to be quite a find. I have been told rather a lot about his misspent youth and past history along with some details of his current situation while he has run his hand disapprovingly over my damp walls, tutted at my leaking tap and dodgy door hinges, and frowned at the situation with the loft ladder. We have discussed where I might acquire door handles and light fittings and he has expressed the surprise I am accustomed to hearing at the idea of a woman who has trouble with shopping.

I came home from work to find that the door which has been falling off its hinges now opens and closes as if by magic. I even opened and closed it several times, like an imbecile, just for the joy of being able to do it. I could not have anticipated the pleasure of shutting a door that previously would not shut. I feel I have already said too much on this subject, but I am going to get up, go to the door and open and close it again. Now I will stop talking about the door, but in terms of the pleasure to cost ratio, this is looking like a pretty high number.

Ilf has also been working on the loft ladder, polyfilla'd a few holes, done a couple of small electrical jobs and fixed the outside tap. He has advised me against using the shower for a while so as to allow the room to dry out thoroughly, at which point we may be more successful at getting paint to stick on the ceiling. I await his invoice but unless he wants to be paid in unicorn tears there's very little that will stop me from insisting that he continues to minister to my every whim, at least in terms of DIY.

The shopping didn't go too badly either and I only had to go back two or three times to decide what I really wanted and just once to replace a thing. I have bought light fittings and door handles and made decisions on other aspects of the Project, and Ilf is planning to return next week for more. Meanwhile, Olf and his assistant have arrived to start on the garage.

At the weekend I managed to make the final push towards emptying the garage, right down to taking the oil-soaked pieces of carpet to the tip, along with four bin bags of assorted small rubbish and some bigger pieces. It is a surprisingly large space and I am faced with the real prospect of actually being able to put my car inside. Not yet, because the door is still not independently lockable - it relies on a couple of lockable shackles set into the concrete in front of the door. But soon.

While I was outside working on the garage clearance I had time to have some lovely conversations with neighbours, and I even went and watched the Regency Run, a local 10k race that goes pretty much past my front door. The weather was fine, as it is today for Olf and his assistant. Further henchmen have visited to measure up the garage windows and assess the state of the electrics. It will not be finished this week, but I am confident. Now I'm going to open and close that door again. Oooh, lovely.

Many runners in the park
Regency Run 2016, in Victoria Park

Wednesday 13 April 2016

Ski France and Home News

Covered wooden bridge and church with mountain slope behind
Moûtiers, April 2016
It's been a busy fortnight for me, so nothing unusual there. There was my second ski holiday of 2016, followed by a week containing (as well as work) one badminton club night, two badminton matches (we lost both) and an introduction to Buddhism and meditation. I'm behind with everything, not just this blog.

Before Easter I managed to finish the dress I've been making for sister D, and posted it off to her. That dress pattern has been very good value - three dresses made and possibly one more to come! I also managed to negotiate a 9% discount on a new ski jacket and trousers, which were still jolly expensive but fit perfectly, unlike my previous ski clothing which was low price/low quality and bought for a larger version of me.

The ski holiday was with friends who had arranged all transport and accommodation independently in order to maximise the time available for skiing. On a normal package you fly out and arrive in the resort on day 1, head back on day 8 and have six days skiing in between.  What we did was travel by train overnight to arrive in the resort and ski on day 1, and head back on day 8 after a morning's skiing. So eight days skiing in total.

The travelling wasn't bad - Eurostar to Paris, then local sleeper train to Moûtiers, then local bus to Méribel, and the same in reverse for the way back. We had some time to kill in Paris on the way out and in Moûtiers on the way back, so there was a tiny bit of French sightseeing as well. Ski conditions were variable - one gloriously sunny day, one day when everything shut down at lunchtime because of wind, one day when clouds were a bit low and visibility came and went quite suddenly, the other days a combination of sun, cloud, wind and rain. But we skied every day and it was fine.

I only fell over properly once, but unfortunately I did something nasty to my left shoulder which is still rather painful. If it had been my right shoulder I could have avoided playing in those two lost badminton matches - thankfully we are being demoted next season so maybe we'll manage to win a match or two next year.

The introduction to Buddhism and meditation was very interesting, and the first of four weekly sessions. Nothing revelatory to announce here yet, but I'll keep you posted because I think I'll have something to say by the end. At the weekend I journeyed south to help mum clear out some of the accumulated detritus of a lifetime, which is ultimately necessary but rather dispiriting, and which I am starting to regret slightly. Anyway, it's in a box not in the bin so there is time to retrieve the situation. Maybe my gay abandon has resulted from the clearing out of 15 years worth of accumulated detritus from the garage at Lola Towers in preparation for remedial work. Still not finished and more trips required to the tip.

The Lola Towers Renovation Project (LTRP) continues apace with yet another workman coming round to look at some small jobs - very small in comparison with the garage, but if completed then they will add materially to my personal happiness (at least as much as learning to meditate, if not more). The only down side is that about half of the small jobs need input from me in terms of locating and buying things. It's not enough to tell the workman that I want this or that light fitting replaced, I've actually got to choose what I want it replaced with. Not easy for a non-shopper like me.

The workman - let's follow a theme to its fullest extent and call him Ilf - seems like a nice chap, enthusiastic and very talkative, and he certainly describes himself as the kind of workman I want. He's actually coming back to get started tomorrow, so either he's very keen and sees the potential goldmine that the LTRP represents, or he's not very good and hasn't got any other work at the moment. We'll soon find out, and you will be among the first to know about it.

I have also reached the point where my expanding waistline can no longer be ignored, and I have designed and instituted a set of Diet Rules for the next 5 weeks. These are designed to disrupt the bad habits I have acquired and embed a new set of habits that I hope will become the new normal. You may imagine the type of situation I am trying to prevent if I let on that one of the rules is 'No more than 100g of dark chocolate a week'. I'm not prepared to reveal the level of weekly chocolate that previously prevailed.

Five skiers lined up (almost) ready to go

Sunday 3 April 2016

New(ish) Type 2 guidelines

Long grass, thistles and fir trees
Harlow Carr, July 2015
On one of my recent days off I visited an old friend, which was so tremendously rejuvenating that I definitely didn't mind spending four hours in the car getting there and back. I can't explain how satisfying it feels to have in depth interesting conversations about anything and everything with someone who has known me for more than thirty years and is entirely on the same wavelength.

I use this blog partly for therapy, to sort out my thoughts and opinions by writing them down. I don't know why it's better than a private diary, but somehow it is. However, there are many issues that are unsuitable for public scrutiny, and simply cannot be included no matter how much I would like to wrestle them onto the screen. On that day I talked privately about many of these issues, and feel all the better for it. My friend is wise, and sensible, and I feel lucky to be able to tap into that wisdom and sense.

At the end of that day I attended another Diabetes Education Club evening - I can report that this time the buffet was loads better than the standard sandwiches and cold sausages. In terms of the meeting content, it was all about the finished NICE guideline about the treatment of Type 2 Diabetes. This took about a year to finalise because there was uproar when the first draft was published. I've had a look back through the blog and it doesn't look like I wrote about it at the time.

In primary care, most GPs are not diabetes specialists, so the guidelines published by NICE are intended to help these non-specialists choose the right way forward for the patient in front of them. These same guidelines are also supposed to inform patients of how their treatment should be managed, help organisations assess whether the care they provide to patients is of good quality, and also allow Clinical Commissioning Groups (CCGs) to ensure they are getting value for money in the services they are responsible for. A tall order.

The problem was a difficult one. People with Type 2 Diabetes come in all shapes and sizes, the treatment options are very varied and the range is growing all the time. The guidelines are drawn up with strict parameters - they must be based on evidence, so if nobody has bothered to do a formal trial then no evidence exists. [There is a fairly famous paper highlighting this issue which describes the design of a formal trial to compare mortality when jumping from a plane with and without a parachute.] The guidelines must also take cost into account, so an expensive treatment would have to show significant benefit beyond that of a cheaper treatment.

The uproar at the draft was because a strong recommendation was made for a medication that had pretty much been sidelined by most medical practitioners. I can't comment on why this obsolete treatment was brought out of obscurity, but I imagine it was because sufficient evidence existed of its benefit, and it must be very cheap. To their credit NICE took account of the feedback, amended the draft, repeated the consultation process, and eventually published an amended version which seems to have better reflected consensus within the diabetes community.

The most amusing moment of the evening for me was when it was pointed out that the previous guideline had recommended low dose aspirin for lowering of cardiovascular risk in people with Type 2 Diabetes, but this recommendation had been reversed in the latest version. "What are we supposed to do," asked one doctor plaintively, "when patients ask why we told them to do one thing then and something different now?" "You should try being a Dietitian," I pointed out. "We have to do that all the time."

This led into a conversation about the latest dietary options. I have many of these conversations with Dietitians, so it was interesting to hear what  these GPs thought. One was very much in favour of Very Low Carbohydrate diets, while another favoured the Very Low Calorie option. Both of these are perfectly valid choices, but the Dietitian's skills lie in helping the individual to decide what is right for them. The relevant guidelines follow this kind of pathway:
1. The most effective lifestyle therapy in Type 2 Diabetes is weight loss
2. There is no evidence about the best way to lose weight and keep it off
3. So the best diet for a particular individual is the diet a) that works and b) is sustainable, whatever it consists of.

I was going to put in provisos about 'nutritionally complete' but for most people if the diet consists of nothing but cabbage soup or 100% marshmallows it will probably fail the 'sustainable' criterion. So yes, I will stand by 'whatever it is'.

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