The Value Of A Train Captain
The Docklands Light Railway in East London is driverless, with trains controlled automatically. But each train has an onboard Train Captain, who is a cross between a traditional guard, a ticket checker and almost a tourist guide. Today two incidents showed why the system is so good.
As we left Bank station to travel in the tunnel to Shadwell, I heard a slight commotion behind me. As I was changing trains at the next station, I got up as we approached and found that a small boy of about five or six had got on without his mother. But the Train Captain was in command and had ascertained that his mother was following on the next train and that they’d be reunited at Shadwell. He also found a responsible lady to wait with the child until the train arrived. I think as it happened, the mother had got in another carriage on the train, so she found him, without the child having to wait on the platform with the volunteer.
It had been handled very professionally and another Train Captain told me it happens all the time, normally because the shopping gets put on more carefully than the children.
The other incident was very much run-of-the-mill with a twist.
On another train, the Train Captain took over the driving of the train, as they sometimes do. As he’d had to move another five or six-year-old boy out of the way to open the driver’s console, he then showed him what the various controls were for, in a very professional manner.
What A Wunch Of Bankers
According to various reports, of which this article in the Mail is typical, the total cost of the PPI scandal is over £18 billion. That works out at four hundred pounds for every adult in the UK.
I got caught, in that when C died, I needed to get a new John Lewis credit card, as previously my card was a second one on her account. But Waitrose didn’t advise me to uncheck the box, if I didn’t want PPI.
I have since got all my money back, by just filling in a form and posting it to their credit card services.
Conclusions From Self Testing My INR Daily
Tomorrow, it will be eleven weeks since I started self testing my INR on a daily basis. The results are here.
I should say that after I had my stroke, an eminent cardiologist said that if I got my Warfarin right, I wouldn’t have another stroke.
So can I come to any conclusions from the tests I have been taking?
I did miss one day early on, but otherwise I’ve taken the test successfully on a daily basis.
I’ve now developed a daily routine in the morning, where I do my stretching and exercises after checking my computer, then have a shower and breakfast, before doing the washing-up by hand, which warms my hands. I then take the test and only rarely do I fail first time and need a second strip.
So the first conclusion, is develop a routine for when you do your tests, that suits your personality and lifestyle.
One thing that you notice from the tests, is that there is quite a large variation between days. A change of 0.5 in the INR, either up or down is not uncommon. This is not a problem, but it could with some people worry them and then they might start to chase their target INR, by constantly changing the dose.
Hot days incidentally, do seem to try to force the INR upwards and although you won’t find this on the Internet, a medical professional has told me that it happens.
I use a very simple manual algorithm, based on my training and experience as a Control Engineer. I know from when I was living in Suffolk, that a Warfarin level of 4 mg. a day is about right to meet my target of 2.5. So I use a simple algorithm, summarised as follows.
INR less than or equal to 2.2, take 5 mg.
INR higher than or equal to 2.8, take 3 mg.
INR between 2.2 and 2,8, take 4 mg.
So how has my INR behaved?
If I look at the average value of the last 28 days, it is 2.56 and this rolling 28 day average has been within 0.1 of 2.5 for the last seven weeks. I couldn’t calculate it before, as I didn’t have enough data. An interesting figure is that the standard deviation of the readings is about 0.3. Effectively this says that nearly all of the readings are within 2.2 and 2.8, which is within my target range of between 2 and 3.
So as the patient, I think I could safely say that my simple algorithm works.
But perhaps what is most interesting is that the 28 day average for the dose I’m taking is around 3.8 mg. So rounding this to the nearest tablets, that means if I can’t take a reading for some reason, then I should take 4 mg.
So I can conclude that the daily testing has given me a very sensible daily dose, which is virtually the same, as I took, when the tests were done by nurses, hospitals and laboratories, at great expense to the NHS.
So should all those going on Warfarin be assessed to see, if they could self-test their INR levels?
I believe they should! And it’s not just me!
An organisation called the Anticoagulation Self-Monitoring Alliance is pushing for more self testing. Be cynical if you like, but it is part-funded by Roche, who make the self testing meters.
On the other hand, how many diabetics test their blood sugar levels regularly and have a better lifestyle because of it?
Depression Or Just Fed-Up?
They are talking about depression on BBC Breakfast this morning, saying that more anti-depressants are being prescribed.
Over the years, I used to suffer from mild depression, but generally my mother or later my wife, used to pull me out of it.
Since being diagnosed as a coeliac, fifteen years ago, I haven’t seemed to have suffered much, if at all. And it’s not that I haven’t had something to get depressed about, what with the death of my wife and son to cancer and my stroke!
But then due to my gluten-free diet, I’m getting all the vitamins I need, as my gut now works properly.
But I’ve been rather fed up in the last few weeks, as I don’t like the hot weather, the lack of an intelligent lady to take to art galleries, the theatre or the cinema, the non-progress on my building works and no football to watch live or on the television.
It all gets better this weekend with the football season starting for Ipswich at Reading and Stevenage!
All I really need now, is someone, preferably female and intelligent, to share meals and experiences.
I do wonder how many of those prescribed anti-depressants, just need a decent experience or two to give them a lift!
Hydrogen – The New Green Superfuel
I found this article from one of my Internet trawls. It describes how in remote areas, excess energy from a local wind farm or solar panels can be used to create hydrogen, which is then stored and used as a fuel.
This is very much experimental at the moment, but it is a simple solution to the problem of providing continuous power in remote locations.
We will be seeing lots of sensible solutions like this in the future.
The Anonymous Widower 