Which is the odd one out? National - Health - Service

I recently read an article about the Jeremy Kyle show, in which it was suggested that, for some, this is the only way they can access essential health- and other care like social and psychological support. It was even claimed that there was some sort of class-related disparity in the way the NHS provides care. An example was given of a woman who had become physically addicted to prescription painkillers after an accident. When she went to her GP for help, he allegedly stopped her prescription cold, without taking into account her physical dependency. This 'forced' her to buy tablets illegally in the street. When asked why she did not go to the doctor for help, she replied: "They don't have time for the likes of me." The journalist held this up as an example that people like her were alienated from and ignored by the medical profession.

I have to wonder though. If doctors don't care for her, who treated her after the accident? Who prescribed pain relief in the first place? Kirk takes potentially addictive prescription painkillers, but he is careful to stick to the recommended dose and monitors his intake to avoid developing a physical dependency, even if that means suffering pain instead. I very much suspect this woman did not follow her medication guidelines and allowed herself to get addicted. She then visited her GP for more prescriptions. No sign of reluctance to access health care yet! She had no interest in getting help to quit her addiction, she wanted it enabled. Quite rightly her GP refused. And that's when it suddenly becomes a class thing. He has no time for her because she's 'working class', not because she's an addict and a drug-seeker. Sure.

In the article people who were - I suppose - not 'like her' were described as 'middle-class' and 'yummy mummy'. Apparently, the latter are articulate, know their rights and demand appropriate care when they need it. And apparently, because they look after themselves, they are somehow depriving others of proper care. Don't we pay taxes? Isn't it 'national' health service? There should be enough provision to see all. Why are there such long waiting lists for everything? Why do we never get to see the consultant? Kirk has an endocrine problem that he practically diagnosed himself and he has had to fight every step of the way to get proper treatment for it. Meanwhile, in the same department he sees type II diabetics who refuse to stick to their diets and are unwilling to take their medication properly. Whether that's class related I don't really care. They're getting more and better 'service' because their own behaviour makes them ill. They risk fits and comas, they risk their limbs and their lives and they are continually seen and helped and treated for all these avoidable conditions they have brought upon themselves. Meanwhile Kirk who is not at fault for the microadenoma in his brain and who is careful to follow guidelines, avoids developing emergency conditions like fits and comas. Inadvertently, this also means he avoids getting seen at all. He's a low priority. He gets to go on the waiting list because he's not going to let himself acutely die in the meantime. So much for service.

If there is any truth in a class disparity in the NHS, I'd argue it is the middle classes missing out. We follow the guidelines so we don't end up in A&E with overdoses, addictions or missed doses. We take prescriptions and wouldn't dream of buying dodgy tablet illegally on the street, even if our prescription was stopped. We book appointments through the proper channels and wait months, rather than clog up the system with real or imagined emergencies. We suffer in silence. And suffering isn't good for our health.

So which is the odd one out? National - Health - or Service? None of them. They're all untrue.

Avatar vs. Dragon

I was reading SFX magazine today and apparently, James Cameron is going to future-proof the next two instalments of Avatar so they will still be ahead of all the rest technically.

Now it may be because I only watched Avatar last week, in 2D at home on the telly, but what impressed me wasn't the technical part. Yes, the visuals were pretty and the world was big and shiny, but I wasn't bowled over. Like most reviewers, I was incredibly underwhelmed by the 'dances with smurfs' plot line. A nice enough flick, but hardly the future of film.

What I liked were the details of the environment. This movie, combined with my imagination full of a Peter Hamilton reading marathon I recently completed, makes for a fascinating world which I wish they'd explore in future films. The corporation exploiting Pandora for financial gain - including the military trappings, cool armoured suits and insidious plots to either ingratiate the natives or cow them into submission - reminded me of Fallen Dragon, a great early Hamilton. While in Avatar, the corporation is simply shoved into the 'baddy' slot of a simplistic nature=good, capitalism=bad setup, in Hamilton's book, they have another side to them. Hamilton's corporation uses a capitalist method to achieve the humanist goal of improving the human condition. Whether those goals justify the means is left open to interpretation.

How about showing us the more human side of the corporation in Avatar as well? Why are they mining unobtainium? Perhaps it is needed to provide resources to an overcrowded and miserable planet Earth. Perhaps they use it to build ftl engines to start an era of expansion and progress. Clearly, the world they are from is far from perfect. For example, the treatment Jake needs to repair his legs exists, but is not available to all. But perhaps the economic benefit of unobtainium would actually improve the living conditions for all humans. We don't know this, but there's two whole films in which we might find out.

In Fallen Dragon a completely alien being with huge reserves of intergalactic knowledge encounters people and adapts its own and human technology to fight off the threat posed by the returning invading corporation. In Avatar the scene is set for a similar development. A human element has been introduced to the mother tree on Pandora, and if that planet has any sense, it will prepare itself for the return of the corporation with even more impressive military force than those uber-cool armour suits.

I'm interested in seeing what Pandora is capable of. Is the planet as a whole sentient, or is it a network more like 'the internet' with no particular goals or will of it's own? Is all communication 'wired' through the connecting plugs found on most creatures and plants or is there some kind of wireless connection as well? How aware is Pandora of what goes on on the surface? Given the response of nature during the final battle, it would seem there is a form of sentience or direction to Pandora, but it was not something even the Na'vi had seen before. Perhaps human elements like free will, adaptability, a scientific mind, bravery, or a sense of discovery entered the fairly stable but stagnant planet 'mind' as a result of the downloading of Grace and Jake? How much more might it change? How powerful is it? What are it's weaknesses?

What's very important is that this all-natural environment is not portrayed simplistically as entirely good and filled with noble but misunderstood savages. Even the scary predators were only hated by the human invaders because they had no 'understanding' of the way of life on Pandora. What rubbish. Tribal societies are no nobler than any other. Nature isn't moral at all. Plenty of things are not good about life on Pandora. For example there seems to be a rigid inescapable social structure. Let's see some of the limitations and downsides as well. If this film is meant to be future-proof, it better become a lot more morally ambiguous and interesting, besides being visually stunning.

Cortisol... check! Last one to go

After a recent blood test - by recent I mean a few weeks of course, we are talking NHS here - it turns out that as we suspected, Kirk's cortisol levels are now worryingly low. This was to be expected. For the past year, his pituitary gland has been gradually shutting down all production of adult growth hormone, testosterone, thyroid stimulating hormone, and now cortisol. The good news is: it doesn't do anything else so nothing else can go wrong. Unless the adenoma turns into a prolactinoma, but that's unlikely. If it was going to, it would be one by now.

Cortisol deficiency is a bit scary. It's the hormone that the body uses to cope with stresses. It is given in standard daily doses, but sufferers need to carry an 'emergency' dose with them to deal with unexpected stresses. And they have to take extra doses, for example when they're fighting an infection. If levels of cortisol are too low to help the body cope, then the person can suffer some sort of crisis and black out. I'm not quite clear on the details yet, but surely Kirk will learn more from the consultant later this week.

But, ever the optimist, I now look forward to seeing my husband gradually improve as all the different replacement therapies are tweaked and balanced out. With any luck, his condition will stabilize and he might be able to regain the strength, health, and fitness he has lost over the past 18 months of deterioration. Maybe, in a few years, he might return to work? If only the tailored exercise and rehab programs that are recommended for his condition were actually available on the NHS. But that would mean they have to have personal and sustained attention for a patient with individual symptoms. Good luck with that.

Optimism and reality don't match.

University tuition fees

I strongly believe that if there is one thing a government should never skimp on, it's education. I support a free education for all, up to and including university.

It is incomprehensible to me how education can be seen as a privilege, a boon, as if it is some sort of luxury item that some children are unfairly allowed to have while others languish without. Clearly, if that even were the case, the best solution would be to make it free to access for all who want it. But apparently it isn't fair that taxpayers should foot the bill for the education of children that are not their own, who will then, with their degrees, earn more than others.

I would argue that it is eminently fair. People with university degrees become our doctors, lawyers, architects, engineers, teachers, journalists, politicians, HR personnel, PA's, museum directors, game designers,... There is not a single taxpayer in the country who will not, at at least one point in their life, enjoy the services of a person with an education. Why should not a small part of their taxes go towards making that education happen?

It also makes no difference whether the average graduate ends up becoming a higher earner in the future than the average taxpayer who paid for them to get their degree. No individual taxpayer is responsible for subsidising the education of any single graduate so it is unfair to compare the wages of specific individuals to highlight the huge 'disparity' in their incomes. Also, the graduate's earnings are situated in the realm of the potential. They might or might not earn more than someone else in the future. This cannot be accurately predicted. What we do know, is that while the average graduate is engaged in study, they are not earning any money at all and therefore by definition poorer than any taxpayer. It seems fair to me that at that point in time, those with money support those with none, as long as they are engaged in such a worthwhile endeavour as a higher education.

Our economy has ever more need of highly skilled employees and ever less use for the unskilled or low-skilled that could be turned out of education at 16 or even 18 years old. Cutting off subsidized education at that point discourages local young people from getting the skills they need to get work. Even if some degrees don't seem immediately useful, just having a large portion of the population highly educated is always good. Highly educated people are statistically healthier (less cost to NHS), less likely to commit crimes (less cost in justice), and more likely to be employed (less cost in benefits). They also earn more and therefore pay more income tax. Which, incidentally, can then be turned into more subsidy for the next generation of students.

Oddly enough, the UK government has recently raised the maximum tuition fee for one year in higher education to £9000. No matter, they say, it can be borrowed and paid back, so it should not stop the poor from participating. In fact, it will only need to be paid back if and when the graduate earns more than £20,000 a year. The interest rates will be favourable too. Except of course if you really earn a lot, because then your interest rates go up and up, well beyond market rates. (This helps to pay for all those whose loans are never repaid.) You can't even pay it back early to avoid paying interest, if you happen to have a windfall. The more you earn, the larger your debt becomes.

The clever ones will, if of a lazy disposition, give the whole thing a miss, because the monetary reward is no enticement. Why study hard for years to go into a demanding job if your take-home pay is just as low as if you hadn't? The clever and eager will take their excellent education and their degrees elsewhere and leave the debt behind. And it's all those clever people you really want to attract to higher education and have in your high-skilled professions.

It seems to me like there is no way you could make higher education less attractive and less accessible if you tried. In the short term, raising tuition fees may reduce government spending, but in the long term we can look forward to a country full of ignorant oafs.

Pope approves condom use?!

I was just looking through the paper for some inspiration for my daily blog post, and discovered the Pope has just approved the use of condoms to prevent the spread of infections.
About time!
It always seemed like such an obvious moral argument to me.

The Church, being Catholic, upholds the ideal of only procreational sex and that only within wedlock. However, the Catholic Church also believes in the reality that people are flawed and don't always do what they are expected to. They call humans sinful. In any case they admit that extramarital sex does occur. What else are confession and forgiveness for?

A person not using a condom would commit the moral sin of adultery - causing emotional hurt and moral corruption - and add to it the more physical sin of exposing their partner(s) to potentially lethal infections. Clearly, it is arithmetically better to commit just the one sin and mitigate it by doing it responsibly?

And there is a difference between the two sins as well. I would say that the emotional harm and moral corruption are limited in scope and reversible. That sin can be corrected. However, the physical infection is at present medically incurable and thereby not reversible by any measure of repentance or conversion (unless you count on miracles - but even if you believe in those, they will never cure millions but only individuals). Also, the physical infection may be passed on to innocents like babies or the unwitting spouse of an infected cheater. Doctrine states that God has given you a body and the duty to look after it, and using a condom when 'the spirit is weak' at least leaves 'the flesh' intact so the person can live on and perhaps even strengthen their spirit.

Although I am quite romantically partial to the idea of marriage and faithfulness, I'm not saying I agree with the Church on their definitions of sins and morals. I just find it so simple to defend the use of condoms entirely in accordance with their own doctrines and beliefs, that I've always been surprised with their view on safe sex.

Perhaps there's hope yet.

Working from home

I work from home.
It sounds like a luxury and in a way it is. I don't have to squeeze into a hot tube train with too many other people every morning and every night. I can just tumble out of bed and work in my dressing gown while sipping tea.

Supposedly, it allows me to spend more time with my family, but that's actually trickier than it seems. True, I'm 'home'. I'm physically there, sitting by my computer right where they can see and touch me. However, my employer does actually expect me to work. I do shifts and need to be logged in and online at set times, and the work I do is logged. So even though it seems like I'm there for them, my family has to cope without me. This entails its own special kind of working-mother-guilt. Mothers who work outside of the home, don't have to see the housework not being done. They don't have to witness their toddler being ignored while watching too many hours of Cbeebies. They don't actively have to be the one doing the ignoring! They can drop off their child at the lovely local nursery, secure in the belief that their child is getting the best care money can buy.

Paying for child care is not an option for me though. The whole reason I work at all, is because we need the money as long as Kirk is ill. He is now the house-husband, responsible for child care and school runs, cooking and laundry. But because he is ill, he cannot and should not be expected to do a perfect job. And then there's another case of guilt because I'm working and making him do more than he is able. I'm supposed to be caring for him.

So I can either provide my husband and children with all the care and attention they need and should have, but then we'd be broke and eventually homeless - or I can work to help pay the bills, but then I have to watch Kirk overexert himself and the kids spend too much time in front of a screen. But I'm sure there's worse mothers out there.
And with the money I make, I hope to buy a Kinect for Christmas. I'll still ignore the kids, but maybe they'll at least get moving in front of the screen.

Get well soon!

One of the worst things about Kirk's broken pituitary is that nobody understands what's wrong with him. He's been home for more than a year now and unable to work. Summer before last, he finally gave in and stopped working. The GP could find nothing wrong and was about to write it off as 'stress' or chronic fatigue syndrome. After some research on the internet, we guessed it might be an endocrine issue and as Kirk had private insurance through work, the GP grudgingly gave a referral.

Turns out it wasn't stress. It was a pituitary micro-adenoma; a benign tumour on the pituitary gland that was causing the pituitary to shut down. Unfortunately, this is a chronic condition so after the diagnosis, we were sent back to the caring surroundings of the NHS.

More info on http://www.pituitary.org.uk/

The pituitary is responsible for releasing several hormones into the body. You might think an adult doesn't have much need of hormones but nothing is further from the truth. Thanks to hormones, people can recuperate from the stresses of everyday life. And I'm not talking about those things that are generally considered stressful like angry bosses, deadlines, paying the bills; or physical stresses like running a marathon. Everything little thing we do every day puts some level of stress on our body and mind. That's why we have a rest, eat some chocolate, and sleep. Mostly while we sleep, but also generally throughout the day, our pituitary releases hormones as we need them. That's how we add and maintain muscle mass and bone density; it's how we deal with the mental stresses of the day; it's how we build up strength and resilience.

Without his pituitary functioning properly, Kirk has been losing muscle mass but gaining weight, he's developed memory and concentration problems and easily becomes agitated or even depressed, he comes down with every infection that is going around. He's constantly fatigued and in pain. Resting doesn't help and only prescription pain medication even takes the edge off.

And there's where it gets annoying. Try and explain this to all those people who unwittingly ask: "How are you?" What silly suggestions we get! Everybody is tired after a long day of work and school runs and housework. Everybody is so used to hyperbole, that the meaning of the words 'fatigue' and 'pain' are lost. Have we tried their favourite brand of multivitamins? Perhaps some acupuncture or pilates will help? If some other part of one's body stopped functioning, like a leg or a lung or even a heart, would anyone suggest herbal remedies and a cranial osteopath? Of course not. But it's just one of those 'invisible' illnesses, isn't it?

Out of the mouths of children...

I read an article today that claimed research had shown that lone children are happier than those with siblings. Having four kids of my own made me sit up and take note. My children seem well pleased at having siblings, so much so that they do occasionally beg for more of them!

Apparently a significant number of children had reported being kicked or hit by siblings. They also resented having to share toys and space with their brothers and sisters, and of course they had to compete for their parents' attention. Indeed, it struck me that these are utterly obvious and common afflictions of children with siblings. These so-called findings were then collated into the assumption that children who suffer such a life, are surely unhappy. How strange that these researchers did not take into account the love, attention, support and company children enjoy when they have siblings. Might not the constant availability of a playmate or mentor, the assured presence of a playground bodyguard, the support of a sibling in later life, more than cancel out the 'unhappiness' caused by having to share a room or wait your turn on the Xbox?

What a self-centered definition of happiness these researchers used as well! Sharing space makes children unhappy? Well, they better get over it, because when we grow up, we have to go on the tube a lot. Not to mention share our bed and bathroom with our life-partners. Having to share may send some toddlers into fits, arguably supporting the 'unhappiness' hypothesis, but so does having to eat vegetables. Yet no-one argues we should excuse them from the table to avoid this unhappiness because eating well is good for them. I pity the child who never learned to share, and grows up to find that they cannot have everything they want, and amazingly, the world is not fair. The shock and disappointment upon that realization after such a 'happy' childhood, would certainly scupper any attempts at happiness ever after.

When you have siblings, you have to compete for your parents' attention, you have to share your toys and your space. Would you rather it comes as a complete surprise to your children that, in the real world, they have to compete for the attention of employers?

Having parents and toys all to oneself may make for short-term pleasure, but with my kids, I intend to aim for the long-term happiness of well-adjusted mature adults.

Strictly Anne!

I admit it. I'm watching this year's Strictly Come Dancing, and I'm loving it. I'm rooting for Anne Widdecombe to win. Unlike the judges, I'm seeing some real improvements in her dancing. She's actually getting a lot of steps right and she's really trying; she's not just acting silly. So what if it's not graceful!

Anne Widdecombe is one of several 'good' female role-models currently on that show this season. Some of the 'older' ladies are amazingly fit and limber for their age, some are admirably overcoming their insecurities, and all come across as independent and confident. And then there's those young pretty things. Nice to look at, but so little substance.

Anne is my favourite. She should be the ultimate feminist hero.

She is a single woman who independently reached an influential and powerful position in life, and in a sector traditionally dominated by men. She most certainly did not - no offence intended - use her looks to get where she is, nor did has she ever played any kind of minority card. She is there on merit alone and there's plenty of merit to go around. I admire her obvious intelligence, her perseverance, the way she's always right and can speak to the point. Few politicians can pull off media appearances the way she can. I've seen her on comedy shows like Have I got news for you and she does the best deadpan. She can be funny and she's always clever. I doubt she'd ever get caught expressing 'gaffes' into a forgotten microphone, as I strongly suspect she is always, even while remaining unfailingly polite and forbearing, honestly speaking her mind.

Safe to say, she's one of my favourite people to watch on Strictly and she's also my favourite politician. I didn't have the chance to vote for her in the national elections, so I'll settle for voting her onto my tv screen for as long as possible.

How to get ADHD

I always suspected Bambam might have ADHD, or at least, that there was something about his development that  was atypical. Several parents and teachers have praised me on my persistence and success in pursuing a diagnosis and treatment for him. Perhaps I should share some of my experiences here.

When Bambam was a baby, he seemed to find it exceptionally difficult to calm down. He also did not play 'appropriately'. He had toys that stimulate different senses and are meant to elicit different responses, but he would only throw and bang. Since then, I have noticed that other babies can also, for example, investigate and concentrate quietly. Obviously this is normal for any baby and certainly, at this point, there would have been no reason to suspect a problem.

As he grew up to be a toddler and an older child, his speech seemed delayed to me and he continued to find it difficult to play with toys appropriately. Throwing balls and banging hammers is fine. But most children will build with blocks, fit puzzles, draw with pencils, roll marbles down the track. Bambam was, well, like Bambam, or Godzilla. Constantly on a rampage. At home, I soon organised toys and furniture to be safe to drop, throw, and bang into. When out, I developed an iron grip to hold his hand and it still felt like walking a cat.

He couldn't focus on anything, even if he liked doing it (with the notable exception of screen-activities, common in ADHD) I learned to break down instructions to him into very short, very small steps. Not: "get dressed", not even: "put your trousers on", but "pick up your trousers" - pause for execution - "now turn them over with the button to the front" - pause for execution - "now put your one foot into the leg"... etc. If left to himself with this for even a moment, trousers and all other clothes would be flung around the room and hanging from the light fixtures.

I must stress, he did none of this from malice. He was, and is, genuinely incapable of controlling these impulses and focusing on the task at hand. He was often surprised and even saddened by the havoc he caused, like he wasn't really there when it happened.

By this time, I felt we needed a professional opinion. What really got my goat was the difficulty at reaching the right specialists. I mentioned a problem to the health visitor, who told me to go to the GP, who referred me with no result for more than 6 months. When I inquired, it turned out we had missed an appointment with the specialist centre, because they had gotten our address wrong. So the GP had to refer us again. When we were finally seen, we were assessed by a temporary registrar paediatrician, who tried to claim that speech delay was normal in bilingual kids even when I asserted it had been a problem before our household ever became bilingual. They tried to blame his behaviour on the fact that I'd separated from my partner and had re-married and the stresses that entailed. They wrote a little report mentioning impulsiveness and hyperactivity and left it for six months.

Six months later, at the follow-up visit, the entire medical staff at the centre seemed to have been replaced. Lather, rinse, repeat.
They did suggest I attend a parenting class. I know it is part of the support that ADHD children need, but at that point it just felt I was being branded a 'bad' parent. I have trained both as a primary teacher and a childminder and volunteered as a play leader for six years, so it felt very inappropriate. I couldn't even attend the class because I couldn't get childcare for the other kids! I did look up which system they were using, and got myself the book instead, which has proved invaluable: The incredible years. 

After three entirely unproductive visits, we made an official complaint that 2 years of follow-up had yielded absolutely nothing. I pointed out that he had been described as impulsive and hyperactive in each and every report, regardless of other circumstances, and that his behaviour was the same both at home and at school. Within weeks, we actually saw the consultant paediatrician and a child psychologist and soon we also got referred to a psychiatrist who was able to confirm the diagnosis of ADHD. Then we just had a few months to wait for Bambam's sixth birthday to start ADHD medication called Concerta.

The trick to getting this far was to use the internet to interpret symptoms, being careful to discriminate between hysterical misinformation and actually medically relevant data. Then figure out exactly what you want to achieve, check the NICE guidelines http://www.nice.org.uk/CG72 and quote them at your medical professionals until they listen. Do not give in. They try to avoid getting patients 'on their books' because they are understaffed and overworked. Although they are doctors, it's perversely not in their interest to diagnose. But it was in my interest and in Bambam's interest that we found out about his ADHD, because it is perfectly treatable with specialized behaviour management and medication. The earlier it is recognized, the better.

In future posts, I'll go into some parenting tricks I've learned over the years, the benefits of treating with medication, and how to deal with ADHD in school.

Now we can use the bookshelf as Kindle-ing

I got one for my birthday and now Kirk has got one of his own.
The Kindle.

I thought I might miss paper books, but I don't. I really love my Kindle. It's screen is really easy on the eyes and it even works in the sunshine. All my big heavy sci-fi trilogies fit into it, which saves loads on weight and handling. But the best part is, when I run out of book in the middle of the night, I just buy a new one by turning the wifi on and carry on reading without even getting out of bed.

I've read most of Peter F. Hamilton's books now, and for those of you who've read him, you'll see why weight and size would've been an issue. The Kindle is much safer to drop on a co-sleeping baby as you doze off ;-)

More new reads were on the theme of girls who go into alternate realities such as: Alice in Wonderland, The Lion, the Witch, and the Wardrobe, and Coraline.
Am I missing any?

Introductions

Hello and welcome to Why mothers never drink hot tea. In case you were wondering, it's because the tea always goes cold before we have time to drink it.

This blog is for venting my varied and many opinions, and do feel free to comment.

I am a mother of four, and I hereby code-name the brood as follows: Bambam, Pebbles, Eeyore, and Tigger. For my husband, I choose Kirk (he'll be so happy about that).

Enjoy!