The Anonymous Widower

INR by Handheld Monitor

I had my first experience of this tonight and it worked well and took just a couple of minutes.

Some health professionals have said to me before that they don’t like the system, but as a patient it’s certainly less stressful than giving a blood sample. Or it certainly was for me.

My INR had hardly changed but the software used with the monitor, gave me a much more complicated schedule of Warfarin doses, than I used to get in Suffolk. Could it be that in Suffolk, the anti-coagulant team simplified the schedule, so that less patients got confused?

I won’t comment on all this from a medical point of view, but given a choice I would take the monitor route, as I got my result there and then and I suffered little or no discomfort.

But speaking as a trained control engineer and a competent software engineer, the software that works with the monitor, may be something that could be improved to make Warfarin regimes less complicated or prone to error.

January 4, 2011 Posted by | Health | , | 3 Comments

Laptops in Hospital – 2

I put a post on this earlier and today as I travelled to try to see the eclipse, I got talking to a lady who happened to be a hospital physio working with stroke patients. I asked her whether they allowed patients to have laptops and she said they did to a certain extent.  But they were always worried that they’d get stolen.

The latter may be true, but if hospitals have a crime problem, it should not be allowed to get in the way of patients’ care and well-being, Iit should also be properly solved.

I also think that most patients would also accept having the coputer in hospital at their own risk. I certainly would and would make sure it was a rather elderly but reliable machine.

January 4, 2011 Posted by | Computing, Health | , | 3 Comments

Up Early Again

I’m watching the cricket at three in the morning, after perhaps six hours sleep.  I think it would be better, if I could sleep a bit more, but then I have various niggles that can’t really be described as pain, but that give me a bit of discomfort.  I think that a physio is somebody I need to do some work on my arm and now the bottom end of my spine, which seems to be hurting from sitting down a lot. But then, it’s always hurt a bit, as it sticks out and constantly used to bang it.  Some cars I used to find very uncomfortable to sit in or drive.

January 4, 2011 Posted by | Health | Leave a comment

Laptops in Hospital

In a previous post, some of the comments were about smart phones in hospitals.

I’m all for allowing patients to have laptops in hospital.  I had my stroke in Hong Kong and I was allowed one there.  It allowed me to do things like listen to Radio 5, talk on Skype, do the Sudokus in The Times and send e-mails, that I wouldn’t have been able to do otherwise.

I could also have done things like watch videos, which I never do anyway.

In Addenbrooke’s laptops were effectively banned and I don’t think it helped me.

The reason they are banned is that if they were allowed, it would mean they’d lose all that money they get from that crap Patientline system.  The bandwidth wouldn’t be a problem, as they can now get enough Megabits easily.

The laptops could also be integrated into patient care and support.  For instance, a physio in Hong Kong told me that typing would help my hands work properly again.  She was right!

So let’s have some 21st century, healthcare thinking!

Remember too, that happy patients are less trouble for staff and might even leave earlier.

To me allowing laptops in hospital is a no-brainer.  But then what do I know about healthcare?  But I have seen good healthcare at work and know what works.

I am also in contact with universities, where they are developing computer games to help stroke patients.  Let’s make those free and downloadable!

January 2, 2011 Posted by | Computing, Health | , , , , , | 6 Comments

The Golden Age of Tunneling

London is one of the most dug under cities in the world and has been for many years.

The first large tunnels under London were Sir Joseph Bazalgette‘s Victorian sewers, built  in response to the Great Stink. In some ways it was a large and very expensive scheme, but it started the clean-up of the Thames and effectively removed cholera from the City. It was in some ways the first great project, as it did what it said in the spec, vast numbers of people weren’t killed builling it and lots of it still works today. It is all documented in an excellent book; The Great Stink of London: Sir Joseph Bazalgette and the Cleansing of the Victorian Metropolis, which should be compulsory reading for anybody who wants to call themselves a project manager.

Then came the Underground described so well in the Christian Wolmar’s book; The Subterranean Railway: How the London Underground Was Built and How it Changed the City Forever.

Since the Second World War, we have seen a few tunneling projects and the reuse of some of the old ones.

The Victoria Line, the world’s first totally automated passenger railway was built in the 1960s. We missed a trick here, as we never realised what we had built. So the automation was vacuum tube, but for well over thirty years it showed how a well-designed underground railway could perform.  It is now being upgraded with new signalling and new trains and the old reliability is rumoured to be suffering. Everybody is blaming the convenient scapegoat of the old 1967 trains running in partnership with the new ones, until all the new are delivered.  I don’t! I blame bad project design and management. In the 1960s they got the automation absolutely  correct and created a good system.  They should have replaced all the old stuff with something that was modern and compatible and then built new trains, that were compatible with the old signalling.

They should also have used the principles of the line; no junctions, totally underground, hump-backed stations to save energy, full automation to create new lines where they were needed.  But they didn’t, as the Victoria Line wasn’t sexy and didn’t appeal to the vanity of politicians. But it was and still is a superb design.

The Jubilee Line was then created by splitting the Bakerloo.  The extension to Stratford was built on a grand scale and has some of the most amazing stations in the world.  Was it the first example of bad co-operation between bankers and politicians, designed to appeal to both their vanities? It was also designed to serve that other monument to the vanity of politicians; the Dome.

In some ways a lot of the design of the extension of the Jubilee line, with large stations and platform edge doors were an attempt to future proof the line  and in some ways, this has been vindicated by the decision to stage the 2012 Olympics at Stratford and the decision to build other lines which interchange with it. Only time will tell if the original cost was worth it.

In some ways the design of the Jubilee shows just how good the design of the Victoria was and the trick we missed was not building  the Jubilee to the principles of the earlier line.  Even now, despite being still a relatively new line, it is still being constantly upgraded.

There was also the building of High Speed One, which tunneled into St. Pancras from East London. Did they get this right? Substantially yes and it seems to work, although the Eurostar trains have suffered reliability problems.  But that’s not down to the tunnels.

Other unqualified successes are the Docklands Light Railway extensions to Lewisham and Woolwich in tunnels under the Thames. The original DLR was built down to a cost, but in some ways this has proven to be a virtue, as like Topsy it keeps growing and has earned a big place in the hearts of those who use it.  It will also play a big part in getting people to the Olympics.

But two of London’s most successful tunneling projects are reuse of old tunnels; Thameslink and the East London Line.

Thameslink was originally built by connecting the suburban lines running out of St. Pancras to those running south of London to Gatwick and Brighton using the old Snow Hill Tunnel. The economic argument says that as you do away with expensive terminal platforms in London, you can spend the money to buy more trains and electrify the lines. Thameslink was a victim of it’s own success and the necessary upgrades with a new station over the river at Blackfriars and twelve-coach trains are running many years late and billions of pounds over budget. Perhaps we needed a less elaborate Julibee Line, that interfaced properly with Thameslink?

The new East London Line uses the Thames Tunnel under the Thames. In some ways, it is a modest scheme, but I believe that like the DLR, it’ll prove to be an unqualified success. It surely must be the only new railway in the world running through a tunnel built in the first half of the nineteenth century.  The tunnel surely is the supreme monument to its creator, Sir Marc Brunel and his more famous son, Isambard Kingdom Brunel, who was engineer in charge for much of the building.

Now, two major tunneling projects are in progress; CrossRail, which is actually being built and High Speed Two, which is just being planned. I am dubious about the latter, as I think that the money could be better spent upgrading existing lines and trains.

But in some ways to London, the most important scheme is the creation of electrical cable tunnels under the city to carry the high voltage mains here, there and everywhere.  This PDF explains the project and shows how good thinking and engineering can benefit everyone.

So perhaps the golden age of tunneling will arrive in the next few years.

December 28, 2010 Posted by | Health, World | , , , , , , , , | 6 Comments

Going Back to Bed as a Happy Bunny

It’s now approaching 4:30 and I’ve just watched an interesting ninety minutes of cricket as Australia decided to give England a lot of catching practice and became all out for just 98 runs.

So I’ve just made myself a LemSip and after I’ve drunk that and listened to the news, I’ll go back to bed and see if I can get back to sleep again. I suppose though I did get about six hours sleep overnight.

The LemSip is an odd flavour; Wild Berry and Hot Orange. If I need to buy some more, I’ll buy the traditional.

Hopefully, it will be alright when I get up in the morning, but England did look a bit collapsible in the last Test and I’ve got Ipswich today, tubes permitting.  Town will have to try to play as well as they did in the snow eight days ago.

December 26, 2010 Posted by | Health, Sport | , , , | Leave a comment

A Revelation on the Essex Road

Over the last few weeks I have been increasingly drowsy during some days.  I have put it down to the Keppra I have been taking and going to bed late the night before. But in researching Keppra, I had found that several serious sites say that the side effects of the drug, may be mitigated by taking vitamin B6. Now coeliacs may be deficient in B6, as they don’t eat some of the foods like breakfast cereals, that are enriched with the vitamin.  It’s a bit more complicated than that, but this paper from the Netherlands has shown links, between coeliacs, vitamin B6 and strokes.

So could this be the problem? My vitamin B6 levels may be too low to help the Keppra! After all it hasn’t been checked for several months, which was before I started taking the Keppra.

So I walked straight into a pharmacist and bought some tablets.

They can’t do me any harm, but just might help to get a proper balance between being asleep and awake.

December 23, 2010 Posted by | Health | 2 Comments

Snuggling Down

Today, I’d intended to do a lot more, but the cold weather was against it.

So I met my new cleaner and got her instructions on to what I needed to buy to do the cleaning! I then went to Maplins to get a long HDMI cable, so that I could watch the football on a large screen. I’ve actually mounted the television on a swivel, so that I can watch it either from the living room or the kitchen off it.

I’ll watch the football, whilst having supper of a microwaved cod Mornay from Marks and then get over the electric blanket and under the duvet. I’d like to wake a bit later, but hopefully still early enough to see the eclipse of the moon.

I

December 20, 2010 Posted by | Food, Health, World | | 4 Comments

The Day I Met the Queen

Turning out and weeding the files is mainly a depressing occupation.  But then occasionally, you come across a little gem.  I thought I’d lost this card, which was the invitation from the Palace to attend a Queen’s Award Reception.

Invitation to a Reception

Let’s say it was one of the best parties, I’ve ever been to!

The setting was msgnificent, the staff were attentive and welcoming and all in all you couldn’t have wanted for anything.

Three of us went, myself, Richard and John.

We met the Queen, the Duke of Edinburgh and actually talked for quite a time with the Duke of Kent.  It was also one of the first receptions, that Diana Spencer attended and most of the guests seemed to spend their time trying to talk to her. It wasn’t the most edifying of spectacles and we just enjoyed the setting, the food and the wine.  But not too much, as would you believe some captains of industry, did over indulge on the hospitality.

Metier won two Queen’s Awards, but you won’t find them on the Internet.  If I have one secret ambition it would be to win one for technology, but I’m a bit long in the tooth and too much of a wreck now!

But then everybody who has had a stroke should look to Louis Pasteur, who did some of his best work many years after he had had several.

December 8, 2010 Posted by | Computing, Health | , , | 12 Comments

Dr. Rosemary Recommends Aspirin

Research published today, says we should all take aspirin.  The sane Doctor Rosemary Leonard on the BBC this morning, has said that she probably will and recommends you talk to your doctor about it.

Aspirin is a remarkable drug, that was known to the ancient Egyptians according to the definitive book on the subject.

Aspirin: The Extraordinary Story of a Wonder Drug

December 7, 2010 Posted by | Health, News | | Leave a comment