Ski report

Skiing was fantastic. This was despite the fact that we had a chalet host so laid back that his face had become infected. We had to make our own breakfast on the last day because he got wasted and didn't turn up for work. Those of you who think I am a bit whinger for moaning about that should realize that you would definitely be whinging too if you could imagine making your own breakfast in a hotel or turning up at a cafe and them handing you a spatchelor and telling you to get on with it and that will be 8 pounds please. The really annoying thing was that we had given him his tip the night before and he had blatantly used this to get himself so munted that he then didn't even do the job he is paid for never mind the service above and beyond which I consider a tip to be the reward for. The food in the chalet was also not a patch on last year. It had that bare minimum feel about it. As a for instance one of the starters was a risotto which whilst well cooked and quite tasty was presented ungarnished plonked in the middle of a white plate and the risotto itself was all white. When I saw it I thought it was just a pile of rice and I was looking around for a couple of minutes for the sauce to go on top. This was followed up by a pork chop with new pots and green beans. It was fine but last year it was WOW. Skiing was also fantastic despite the fact we had a room overlooked in two directions. It was like being in a shop window. We had to close the curtains at all times or people would just look right at us as they walked by the chalet. And this room had twin beds. We pushed them together but I fell down the gap every night waking up with my knee on the floor jammed between two bedframes. Skiing was also fantastic despite the fact that the snow was pants. You could get about an hour and a half of skiing on a nice surface per day. That was from about 10.30 to midday. Before that and it was yesterdays slush frozen into massive ridges and bumps and after that it was slush. You could get a bit more if you went higher and I managed to get down a red run comfortably on my own.
Skiing was fantastic because of the simple fact that I was with fantastic people who kept me entertained at all times. My great friends the Rs were again excellent teachers when we were skiing together and full of boisterous banter when we weren't. This year I had the pleasure of skiing with N who took excellent care of A especially on the last day and basically made her fall in love with skiing as much as I have. L and J were lovely and great fun. AW was hilariously deaf and gay and great company as usual. Everyone made an effort to involve and support A and this was really important to me and they didn't let me down. A herself surprised me with her bravery on the slopes and her ability to get on with people who have vastly different opinions to her own. In short I am a very lucky chap.

RIP Elsie Morgan

My Nana passed away on Sunday 16^th of April at the age of 84 having suffered a massive stroke on the preceding Monday. She was given a matter of hours to live initially as her blood pressure and respiratory rate were very labile and family members rushed from all over the country to be at her bedside. In fact once she had some fluid resuscitation she perked up a fair bit. Due to the fact she had been on the floor for up to 15 hours and was behind on fluids. She looked quite stable once this was corrected. She had a complete dense left sided hemiparesis but was conscious and aware of her surroundings. She could communicate by writing with her right hand but her motor function was too poor on the left of her face for her to articulate words well enough to be properly understood. Almost the whole of her very large family made it in to see her. Those that didn’t were out of the country. Her two surviving brothers, four children, five of her eight grandchildren and two of her five great grand children all managed to be with her in her last few days and had the chance to say goodbye. She was initially in quite good spirits cracking jokes with us. Later on, however, as her conscious level again started to decline she seemed in less good spirits and indicated several times that she had had enough and wanted to go. She had looked after my grandfather for several years after he had a similar stroke. She knew what was in store for her if she survived and that her independent active lifestyle was, almost certainly, going to be significantly reduced. The prospect of finding Nan a place in a nursing home in the knowledge that she would certainly not like the idea was looming however the insult of the stroke and aspiration pneumonia from her period of unconsciousness in the end compounded into an insurmountable hurdle even for this tough and determined woman and she died at 10.30am Easter Sunday morning.

She received an excellent standard of care from the medical and nursing teams at Stoke Mandeville including a head CT within 12 hours of arrival, early recognition and treatment of dehydration, aspiration pneumonia and early onset of nasogastric feeding. She was turned, washed, and changed regularly and the nursing staff were, on the whole, very tolerant of the large number of visitors. The medical team and the nursing staff also were very tolerant of me sticking my oar in whenever I could collar them. I spoke to her consultant and every member of his team and to most of the sisters on the ward and I was impressed by their professionalism and competence. I know from experience that having a medically qualified relative interfering is a real headache and you spend ages dealing with them to the detriment of actually getting on with the delivery of care. I tried really hard not to be one of those relatives but in some ways I think it is inevitable that you will want to be involved to a greater extent than medically naïve relatives. I more fully realize now that because they sit there next to just one patient they are more aware of the time it takes for the team to react to a change in the circumstances of that patient.

Her funeral is tomorrow.

So nearly skiing

The holiday to Cor Cheval is finally in sight. It couldn't come too soon to be honest. I'm fed up of working and cooking and all of the chores you can avoid whilst on hols. A is having a tough time at work with the possibilities of redundancy hanging over her head. Even though she hates her job she needs to find another one before she leaves this. Sadly her attempts to get another job (her recent interview) were unsuccessful. They told her that they needed someone to come in and make 10% cuts. That's not really her style, she's not really a hatchet woman more a give everyone a job for life and a 35 hour maximum week woman so she is probably better off where she is for now.
I can hardly take the inanity of my RMO job at C. Every time they call me I know its going to be for crap. Crap that requires no clinical skill, no diagnostic ability in short no brain. "Can you come and write Lady Fartymore-Smithe up for a warm flannel?". "Can you go to pharmacy and get ten build up milkshakes because pharmacy has closed?". I feel like Gordon Ramsey being forced to flip burgers in MaccyD's.
The other day I saw a family hand over 5k in cash to a manager to pay for this old chap to be admitted. He has diabetes and a bit of a chest infection. He doesn't need inpatient care. Any fool can see that. He needs a bit of TLC and some antibiotic pills. His consultant who he was admitted under communicated to me only through a nurse gave the following instructions. Take blood and give i.v. antibiotics and he would probably be in tomorrow to see him. He hadn't seen the patient. And couldn't be bothered to come in or even to have a conversation with me. He just takes his cut of that cash that family handed over. The family get shit care for their Dad. They'd be better off in the NHS at least they'd get seen by a medical team not a surgical SHO they'd get the right treatment not commands issued blind to the clinical situation over the phone. He wouldn't have been admitted but then he didn't need that. But he'd be better of checked into the Hilton and he could take his pills there.