Wednesday, February 27, 2008

Sat watching the late night vampire movie when the earth moved. The house shuddered and shook for only a few seconds but long enough for me to go haring around the house to find out what on earth was going on. Mrs C. awakened, the dog excited and racing around our feet. Outside the front door I could see three drunks rolling home and hear birdsong. Not another soul stirred, nothing on the TV news. Surreal...had this really happened, an earth tremor in Grimsby.
The local radio confirmed it: epicentre at Market Rasen and it measured 5.2 on the Richter scale. Bloody hell. Floods,earthquakes and it'll be pestilence next.

Tuesday, February 26, 2008

"The drugs don't work...."

Disappointed with your tablets?

The drugs don't work.
If it is all down to the placebo effect then I am a Dutch dancing monkey. I await the next research article that says the newer anti-depressants do work.There is a common axiom in psychiatry that 1/3 of patients are not helped at all by a specific medication; 1/3 experience some effects and 1/3 are definitely helped by the same medication. Sometimes it takes a number of attempts to find the right medication. What I do agree about is the need to roll out more talking therapies and greater accessibility to these therapies. The anti-depressants lift the mood but it is then that the hard work starts to address the depression and possible reasons for it. The fly in the ointment there is people to give good quality talking therapies is expensive. Sadly, trust managers will opt for the cheap solution of 3 - 5 day staff training courses and the use of CD's. The latter I have little time for because I believe the face-to-face human contact is crucial for any therapy.

Tablets do offer a 'quick' resolution but then isn't that what people want? The choice of prozac and the likelihood that one's mood will improve in 2- 4 weeks. Or, lets talk about it once a week and maybe you'll change in several weeks time. Add the latter to the former and there is a greater possibility of lifting the patients mood. As the mood lifts the opportunity to add the other components to the patients toolbox of managing depression comes in. CBT, exercise, diet, etc... Not offering medication and allowing someone to slide further into the dark pit of depression is harming someone by omission. Stating most medics and nurses are part of a pharmaceutical conspiracy to sedate the nation may be the stuff of dreams for the red top rags and murdochs minions. But the sad reality is that for many people life is shit can be more than a bad day at the office. We also have to differentiate between clinical depression and low mood as a result of life circumstances. The latter can be dreadful for the individual concerned and may respond well to instigating life changes (CBT, other therapies, exercise, diet, buy a dog, dump the useless husband/wife/significant other, change jobs, dance, fly kites, meditate, garden, brew beer, take up graffiti, make model airplanes, you get the picture). Clinical depression (F32.2 & F33.2 .3) however does not respond to "Try cycling round the block a few times more". When your head is empty or distracted by negative thoughts; concentration, motivation and volition are just meaningless words because you just ain't got them. The person talking at you and trying to help may just as well speak Swahili. That is where the anti-depressants come in.
The shit will hit the fan as we deal with people who bin their anti-depressants without medical guidance and experience the return of the depression and /or the rebound effects of suddenly stopping the tablets. Let alone the people who refuse a tried and tested medication to treat their depression. Ho hum....clear the decks and ready for action.


*Ik ben een Nederlandse het dansen aap.

I have always had a love of reading and I can thank one of my junior school teachers for this, Miss Charles. She looked, to my seven year old eyes, about eighty years old but she was probably about fifty-five or so. She helped me with my reading and writing and gave me a love of literature and the huge variety of worlds reading opened the doors to. No.1 son does not read much because computers, TV, DVD's, technology, etc...are more immediate and easily accessible. What worries me is whether his imagination is being engaged and stretched. But some books unlikely to be offered to little 'uns from this excellent site.

I can recommend the site although it isn't always funny but, occasionally it has had Mrs. C reaching for the emergency number as I've had a fit of the giggles. Read and enjoy.


Saturday, February 23, 2008

A more cheerful post today...I've had several hours sleep since and today is 'Super Saturday'...lots of rugby.
How many of you remember this....

I was only nine when it first appeared on TV and I was hooked from the start. A barmy wizard who to modern eyes now looks like an archaeologist from Time Team on his days off. Apart from the usual kids stuff I was into two other things: history and science fiction. Catweazle combined both as well as being funny. There are rumours that Catweazle may be remade and that begs the question. Who will play Catweazle?
Tom Cruise? No, too weird; Gary Oldman or David Thewlis both come to mind. They would also have the screen presence to make him believable. However, post-modern irony and having the correct PC credentials means Catweazle will be played by this delightful person. Now that would be worth watching.


Friday, February 22, 2008

A busy, busy week with lots of assessments, of which many were alcohol problems. So I am now relaxing with a pint of Batemans XXXB in front of me.
Mmmm....that's nice.
It's a strange mixture of feelings awakened in oneself during these assessments because there is little to be done until the person decides to tackle the booze. It is particularly difficult when the person in front of you is unlikely to survive the next six months because of liver failure but they continue to drink. The family want you to admit them/ persuade the specialists to transplant the damaged liver/ change the situation with magical words. The sad thing is that the person has usually had umpteen chances to change their life but the addiction is central to their life and takes precedence over everything else.

An example is that of my sitting beside a woman who vomited copiously into a bucket, wiped her mouth and then swigged from a bottle of cheap whisky. She was naked apart from a blanket and her young children fended for themselves in the house. Another example is that of the professional man, well thought of in his community, who secretly hid the two bottles of wine and several large malt whiskies he consumed each evening from everyone. He came to my attention after being arrested for drink driving and during the night had the 'screaming abdabs' as the custody sergeant told myself and the doctor. The woman agreed to an admission into hospital to help her; the man denied having a drink problem and threatened to sue us and the police. He's dead now, the booze destroyed his heart amongst other things. The woman lapsed several more times but went on to stay clean and look after herself and her kids. Not all alcoholics live in cardboard boxes and drink in your local park. But many of them eventually end up there if the morgue hasn't claimed them first. Having said all of that I will go on to enjoy my beer this evening. Happily I cannot drink too much and know my limits. Twenty odd years ago there were times when I did over indulge but the hangovers and the desire to enjoy more out of life rather than getting pissed up all the time kept me on the straight and narrow. But amongst the strange feelings awakened in me are the memories of friends and family whose lives were and are being destroyed by alcohol.

What are the answers...fuck knows? Putting up the price to stop binge drinking, etc...ain't going to work. It raises extra money in taxes for the govt. and shows how they are taking steps to tackle the problem. Nope. Prohibition in the States, punitive taxes in Scandinavia and lectures from government suits who only know the reality of most ordinary people via the filter of sanitised suitable TV and radio programmes (i.e. not at all)is not the answer.
Anyway, I'm going to play backgammon and listen to Genesis whilst I enjoy my beer.

Thursday, February 21, 2008

I am sure it was Monday....I blinked and now it's Thursday evening. I'd like to tell an exciting tale of aliens, Torchwood and abduction with time travel spinning FX. Instead it's staff off sick and my colleagues and I working our arses off. Do we get thanks? No, we get a wage and all the free verbal abuse we can carry home with us each day. Double on Sundays with Gods blessings. I am actually too tired to go out to the pub...broke as well so that was an easy decision to make. As a part owner of Northern Rock I have a lot of responsibilities to carry. Which 60 millionth am I responsible for and do I have to polish it? Am I responsible for the health and safety of the soon to be ex-employees in my little bit of it? All of that on top of my regular job.
So which bit do you own?


Monday, February 18, 2008

So much for my plans to support my local pub. A shortage of the readies means I have to enjoy tea at home. I guess I'll have to ready the equipment for another batch of home brew to sustain me through the lean times. As I anticipate a hot summer (!) I will pop into my local homebrew shop and look for a summer ale. This time I shall experiment and add some hops near the end of the brew. Roll on pay day and I'll get cracking on that.

I couldn't resist.

Busy weekend at work and the rumour mill is working overtime, as always, in the NHS. Our team is possibly undergoing a change of management and dire predictions are being made. It's a job; I get paid; I like the patients (most of them); I have my own plans for the future if the psychotherapy training recommences and, in this team the paperwork is half that of many of the other teams. As I have whinged before, most of the paperwork is to maintain an army of unnecessary admin staff and managers whose role is to ensure we meet governmental targets and to prove we do our job as we move inexorably towards the privatisation of the NHS. You really won't know what you have got until it's gone. Internal markets my arse.
I must away and prepare for work.

Thursday, February 14, 2008

From Saturday it is 'Visit your local pub more often and drink real ale week' - It's easier to say 'Community Pubs Week'. I shall pop in a few times to my local and do my bit as opposed to my current once a week visits. Much as I like an attractive barmaid (Hello Emma) I would be over like a shot if my hero was serving the beers....

Archaeology, real ale and the blues...a man after my own heart.
He has a passion for field archaeology and wears his passion on his sleeve.
To get in practice and because I am working Saturday evening, I'll pop over tomorrow night for a pint or two.
I also found out yesterday that Fairport Convention are playing at the Pier, Cleethorpes on the 26th Feb. I shall hopefully be bopping and singing along with the rest of them. A band I only discovered five years ago and one I haven't yet seen....when I found out about the gig I was like a dog with two tails anticipating breakfast. Finances are tight but I guess I'll rummage around the furniture for stray coins.
Time to check the Valentines meal I am cooking. Yep! Mrs C and I give Val's day a wide berth - commercialised crap. A curry and an excellent beer tonight followed by football on the telly. How's that for culture?

Wednesday, February 13, 2008

I have no excuses now that my leurgy has finally gone. So, some brisk walking at work today and time on the exercise bike on my return from work. The cycling was at a gentle pace as I have no desire for a ride in the big white taxi. The computer showed the distance...less said about that the better, rpm, speed, pulse rate and calories burned off. What I like is the recovery mode which tells you how fit you are.
"You are a fat bastard" in a Stephen Hawkins voice was a bit of a shock as was his comment "E=MC2..I will double the mass in your case" was also uncalled for. But now I feel just that little bit better...I have finally commenced my 2008 fitness campaign.
As for my long term aims, well...cycling in general and my desire to cycle to the Humber Bridge and back. I might meet young ladies like the one below...nothing beats a fat bottomed girl apart from a fat bottomed girl who owns a brewery.


Tuesday, February 12, 2008

What can I say.

Sunny, warm springlike day at work with lots of light = end of SAD and a spring in my step (ok, less of a limp in my step!)and a smile on my face. A face that over the past several weeks has been mimicking Scrooges miserable old fizzog when more coal is added to the fire. I know this weather is only temporary but hey ho, it's been a much needed tonic. I can cope with snow and cold temperatures but not the grey miserable all too short days. Sadly, we haven't had a proper winter for many years now and possibly may not for some time to come. Maybe we can emulate other areas and some enterprising entrepreneur could build an indoor snowdome in Grimsby or Lincoln. It's a solution as to what to do with Freemo... I'm orf for more tea and listening to this.*


*Bloody video downloads ain't aworking...

Monday, February 11, 2008

Flutter by...

We found one of these in our bedroom this morning resting on the window.

Apparently it is not the earliest sighting this year. I know records of weather changes over the centuries show a natural rise and fall in weather patterns (e.g. Thames freezing over)but, surely this is unusual? It certainly brightened up my day and I hope it is a harbinger of good weather in the months to come. Time to buy the sunfactor 30 and Deet.


Saturday, February 09, 2008

Yes, I am a sick bunny!
There was a programme on TV a few weeks back about a chap who lives near Bodmin Moor who picks up roadkill and eats it. He was preparing a dead badger for his tea and making a tea cosy from the skin. Fair play to yer man, not something I'd subscribe to but, the roadkill is natural, organic and free range. It was legitimately killed by someone's motor and by scraping it off the road, the man is keeping the countryside tidy. For his pains he is subjected to abusive and malicious phone calls from the local numpties who view him as a 'nutter'. He is eccentric but he is harming no one and he is interpreting takeaway from a unique perspective. In the states someone has taken it a step further and makes money out of it.

There are the usual bunny suicides and chicken pancakes along the country lanes but the number of dead badgers does surprise me. The largest roadkill I have seen was a deer on the A180....I bet it wasn't there for long. Didn't the Beatles write a couple of songs about this....
'Rocky Raccoon' and 'Why Don't We Do It In The Road'.


Friday, February 08, 2008

I made a quick trip over to Nottingham yesterday and all went swimmingly except for the one fly in the ointment. A BMW driven by flat capped myopic Albert Pickles. It's a 316 and can go faster than 40 mph but that is the speed he maintained in the middle of the road. Every time I attempted to overtake he sped up!! Now friends will tell you, I am a careful driver and speed doesn't feature too strongly in my daily jaunts around the county. But this twat was causing the mercury to rise.

I can only assume he had traded in his last car for the beemer...

What should have been a flying visit was extended by this twat's behaviour. He nearly caused an accident at one roundabout by sailing straight across it, totally oblivious to the large truck which had right of way. I can only assume he was hurrying to Grantham.


Monday, February 04, 2008

Mrs C. is poorly and I had to nip out and buy her something she could keep in without it being expelled violently from either end. On my return from Sainsbugs I could hear this cacophony of car horns. Turn the corner and there he is:

Sitting in the middle of the road with his tongue hanging out and staring at the nearest car. Except the one in the road was fully grown and extremely large. Funnily enough, not one of the drivers got out of their cars to move him on. A quick scratch and he then nonchalantly wandered across to me and sat down on the kerb, only to start barking at the traffic.
This appears to be a regular thing around here. A few years ago a bull mastiff used to escape it's garden (it stepped over the wall!)and wander the local roads. He often plonked himself dead centre in the road and woe betide any vehicle that tried to move him on. The one time the police turned up they took one look at him and carried on driving. Well, would you fancy removing a dog the size of a horse?

I'm on my hols for a week and look at the delightful view from my window. The new roadworks initiated by the council has done wonders for central Grimsby. 'Scuse me as I reach for my Pina Colada....That's better.

Back in the real world, sadly, although the sun is shining it is bloody cold. Dog and I are suitably footsore after a long walk and the drink I hold is a freshly brewed coffee. Oops, I am being called...

Saturday, February 02, 2008

Catching up on the news and I came across this item. I originally came across a shortened version of it elsewhere which caused the mercury to rise and a bit of anglo-saxon. But reading it in full does give food for thought. I do like the statement "economic house arrest", catchy, pithy and designed to grab one's attention. It also sets the scene for arguing in favour of privatisation of welfare services to 'release' these poor trapped souls into the warm sunlight of the work environment.
I agree that there are people who skive and use the system but, I am not entirely sure about the figures Freud quotes. I have no ideological concerns about using the private sector to run this system, if and when it is up and running. I do have concerns about the incentives and bonuses to get people back to work. People with mild - moderate depression can get back to work with the right level of support, guidance and the empathic understanding of those tasked to get them back to work. That is the crunch...from the written proposal outlined by Freud to the actual everyday practice, well, that sends a shiver down my spine. Who decides what is a 'genuine' illness if not the GP's or other doctors? What work will there be available...A* level burger flipping? What level of support will there be for someone who becomes ill during the proposed initial three year process of working? Certainly from my experience of supporting people with severe and enduring mental illness in dealing with the benefits system, the automaton on the other side of the counter who is bullied encouraged to meet targets and get anyone back to any job is a worrying indicator of things to come.
My concern is the impact of ill thought out and poorly implemented practices upon the poor sods caught in the middle of all of this. The people who are severely mentally ill will undoubtedly be 'fast-tracked' through the process and remain on benefits. However, the process itself may impact upon the health of those individuals. The small group of fraudsters and skivers may be rooted out in time and I can only applaud any impact upon these parasites. But what about those individuals who would like to work but whose mental health problems make returning to work difficult? I'll give an example from my practice many years ago in a large conurbation (who said sociology teaches you nothing!) many miles from here. All anonymised and confidentiality maintained, etc...
Middle-aged artisan, happily married and works hard. Unbeknownst to all around him, he suffers from anxiety and drinks secretly to cope with meeting people and going out and about. He has the mother of breakdowns and eventually comes the way of the local mental health team via a stay in the local MH unit. The secret is out, family and friends know about his anxiety, depression and alcohol problems. What we and his wife know but others don't is that he hears voices when he is anxious. The voices are derogatory, command him to do things and often tell him to kill himself. He is physically fit, the medication and psychological strategies we give him help to manage the anxieties. He returns to work but once again he struggles to cope with the pressures of work and demands made of him. He hides it for a while but he then breaks down and refuses to leave his house. He lost his job after shouting at other workers because he believed they were orchestrating a whispering campaign and it was their voices he heard. He hits the bottle again and it takes a lot of work on our part and his family to help him regain some equilibrium. This happens on and off for two years and eventually he accepts that he needs a long break from work. He has savings and uses those to survive on but he eventually agrees to sign up for benefits. He is ashamed to be on benefits after working for over 30 years but he is not able to work. After a further two years, he is doing voluntary work and he is training to work with animals. He is called in to see the local jobcentre and with the support of the disability officer, ourselves, etc...he takes on a part-time job similar to his previous one because he has the skills and he is keen to work again. He hates being a 'burden' and despite the concerns of ourselves and his family, he is working again. It goes well until some number crunching desk jockey without an ounce of wit amends his benefits...Incapacity benefit is stopped. The man decides to increase his work hours because he has no money and the desk jockey has written stating he is not entitled to it, etc... Luckily the paramedics and police intervened and patched him up after he attempted to kill himself because the voices returned following the stress of working, again in the same environment that precipitated it in the first episode. He was diagnosed with depression and anxiety; then the diagnosis changed to schizoaffective disorder; it was changed several times depending upon the presentation and the psychiatrist whom he saw. Happily, I discovered a few years later that the man is working with animals, he is happy and his life has changed for the better.
My concerns with the new system, when it is implemented, will be the desk jockeys who analyse and interpret the sum total of an individuals life and mental health problems. I expect to get busier than ever when as a result of target and bonus driven private companies the number of breakdowns rise.
By the way, I say when the system is implemented because companies are already recruiting nurses to these jobs to vet the long-term sick. Nurses are cheaper than doctors...