Friday 29 July 2011

The Letter

It
Sits behind the old clock,
An elegant timepiece,
A retirement gift
That declares its existence
As it chimes on the hour,
Breaking the silence, the quiet denial.

It,
The letter,
Has sat there for decades,
Yellowed with age
From time and tobacco,
Its envelope hiding – no,
Refusing its contents.

The words
No longer read
Are fading
As are memories,
Memories of him,
Their first born, their angel,
Who proudly,
For King and for Country
Donned the colours of war.

He will return one day,
Of that they are certain.
He will walk through the front door,
Older and wiser,
Matured by the terror,
The conflict of battle;
He will battle no more.

They will embrace him,
Their first born,
Tears streaming down faces,
Hearts full of elation
And they will glance at the letter,
The Missing In Action,
In quiet jubilation
And breaking the silence
Will declare
“We knew you’d come home!”

Anna :o]

With thanks to the good folk at Theme Thursday  for the inspiration

Monday 25 July 2011

Tubby, Or Not Tubby: Fat Is The Question

About the NHS

"Since its launch in 1948, the NHS has grown to become the world's largest publicly funded health service.  It is also one of the most *efficient, most egalitarian and most comprehensive.  *(Erm, this can't be right – thinking of the present Health and Social Care Bill and the reasoning behind it?)

The NHS was born out of a long-held ideal that good healthcare should be available to all, regardless of wealth.   That principle remains at its core.   With the exception of charges for some prescriptions and optical and dental services, the NHS remains free at the point of use for anyone who is resident in the UK.  That is currently more than 60m people.  It covers everything from antenatal screening and routine treatment for coughs and colds to open heart surgery, accident and emergency treatment and end-of-life care."

The above can be read at NHS Choices.

Of course good healthcare is no longer available to all – some excluded from elective surgery in specific health care trusts (e.g. Kent, North Yorkshire) as they are smokers or/and are obese.  It is true that all surgery involves risk and this risk is said to be increased in those who smoke or are obese.

Research would suggest that smokers have a higher incidence of postoperative lung problems caused by increased mucous production and decreased ability to clear it.  A smoker's blood is less oxygenated (through inhalation of carbon monoxide and nicotine) and blood flow to the wound is reduced, increasing healing time and the risk of infection.  Giving up the weed a few weeks before surgery does appear to be beneficial.      (On a personal note and as a smoker I can state that my habit has never appeared to have a detrimental effect after surgery – but maybe I am lucky?)

The obese - research here shows that surgery is more complicated in that incisions have to be deeper and  surgery takes longer and is therefore more expensive.  Post operative complications centred round longer healing time – due to a decreased blood supply to the wound and an increased risk of nosocomial (hospital acquired) infection, particularly surgical site infection and that morbidity – not mortality – is increased after surgery.

However, and this is a big however – no pun intended – research here and here show that "… withholding surgery based on the BMI is not justified" and "The regressive attitude towards general surgery in obese patients is no longer justified."

Interestingly, if you read here you will see that bariatric surgery on those with a BMI of 30 or more "appears to be a clinically effective and cost-effective for moderately to severely obese people compared with non-surgical interventions."  This will be a poser for some NHS trusts then – can't have surgery with a BMI above thirty – so you lose a little weight and then no longer qualify for bariatric surgery!  How frustrating that will be!

If you read this article in Pulse you will read that (some) GPs have decided that it is okay for those who are obese and/or smoke to be discriminated against and are backing NHS Hertfordshire to block same denormalised, stigmatised individuals from elective surgery unless certain conditions are met.   So the right to healthcare is no longer available to all and this principle (no longer) remains at its core then?

You will see from the comments in the above mentioned article that all GPs do not condone the rise and rise of the 'Health Police' and indeed this criminalisation of the obese and the smoker is not new.   Poor GPs will also get it in the neck regarding (none) referrals for other newly specified (none) treatments as PCTs add more procedures to the list of 'low clinical priority.'  These measures are of course implemented in cost cutting exercises as trusts need to tighten their financial belts. 

If you visit here - Page 16 (pdf), you will see the Croydon list of low priority treatments.  I find it a little worrying as without one of those specified procedures – I am a 100% certain that I would have been 'on the sick' for over twelve years as I certainly, certainly would have had a greatly reduced quality of life.  It is a sure bet that those folk that made up this little list have never experienced some of these conditions.

So there you have it folks – the NHS is being slowly privatised – believe me it is (!) – and patients are already being selected out of the assurance of 'good healthcare … (being) available to all' and the 'core principle' is no longer the core principle and as you were warned here, there and everywhere in blogland, GP mags and indeed The Guardian the NHS as we knew it is slowly but surely becoming a distant memory.

You were warned…

I wonder why sports injuries aren't excluded from treatment…? 

Competing interests:  I smoke and am overweight although not obese and I just love my imperfect NHS.

Anna :o]

Thursday 14 July 2011

Six Hour Anger Resolution Session = Cure?

The Institute of Meridian Psychotherapy
She sits
With time wrapped                                                                    
Round her wrist
To count the seconds, minutes
Of the six hour session. 
Above her, displayed
The (achieved online) certificate
Of her profession;
Anger Resolution Therapist,
The therapist who amateurishly
Probes the minds of those
Who come to her for frank confession.

They confess to her unbounded rage
And hope that she through therapy
Their smouldering anger will assuage.
But she plays with her online learned
Anger shafting mumbo jumbo;
(Her self perceived psychology diploma)
Her self importance well unearned
She talks of Freud's oral, anal stages
Mechanisms of repression, thought regression
Goals achieved and thought suppression
And all the other dangerous 'knowledge'
Gleaned from the spurious pages
Littering the path to her
Worthless online paper.

They come to her, her lab rats,
In hope that she might be the one
To set them free from their injurious rages
That bleeds red into their tumultuous lives
Of battered husbands, battered wives,
Lost hopes, lost jobs, lost dreams, lost friends.

And as she plays her dangerous game
Tearing their minds to raw emotion,
She has this ridiculous, egotistic notion
That her therapy will set them free
While the whole disaster descends
Into some horrific exposure of sorely damaged souls,
She sees this as success and realised goals;
Insensitive to the damaged reeked she seeks not closure
And blind, she is not the least bit curious
Why her 'clients' leave without grateful thanks
But with raped emotions and darkly furious.

This post was inspired by Maffick Mondays prompt – Anger management classes – and as usual I let the prompt take me where it wanted.  I researched anger management classes and was not surprised that anyone in the USA (sorry USA) could become an anger management therapist – however I was surprised that this applied to the UK too.

Sites will suggest that courses are aimed at professionals – but then add that anyone with a personal interest in anger management can take the online course too.  Professional or not – I would worry re any so called qualification earned on distance learning.

One of the sites I visited was the UK College of Holistic Training and for £225 and a recommended training period of three months or less – you will receive (I'm quite sure you will) a Diploma in Anger Management, be accredited with The Institute of Meridian Psychotherapy and the world will then become your counselling oyster.  All this on line – no face to face with a real person; no checks to see if you are able to deal with the can of worms you might open up, are psychologically suited to the task in hand, nothing.

Counselling, if carried out by amateurs is a dangerous thing and indeed those who are professionally qualified, really professionally qualified, may not possess necessary skills, can become complacent, fail to recognise opened wounds and thus do not close them.  People are left damaged by the very thing intended to aid them.

Some years ago I attended a course in bereavement counselling – discussing death poses no problems for me and I wanted to help those who were 'stuck' in the bereavement process.
The course consisted of ten one hour sessions and at the end I would be a bereavement counsellor.  I never became one as the course worried me, all of it screamed at me that I would be playing with peoples minds as there was no clear instruction, no learning of potential pitfalls or the wounds that I might open up and the skills, the knowledge base for closure.  The course consisted of mere role play and an awareness of bereavement stages and to me that was not good enough.  Although several of us raised this concern – it was never addressed.  So does it still continue?

The poem itself may be a gross exaggeration of the potential for damage, damage of those unfortunate souls who enter, eyes open, to therapy, but unknowing that their therapist may be an individual who completed an on-line diploma course and have absolutely no idea of the dangerous games they are playing with peoples lives – but it may not be.

Anna :o]

Tuesday 12 July 2011

Zest for Life

People of Chilmark  Thomas Hart Benton
Fresh faced,
Exuberant,
Energised;
Barefoot,
Dipping toes
Into the sea of life;
Riding high on the
Crest of a wave.

Youthful
Rough and tumble;
Happy chaos;
Bodies touch bodies,
Minds touch minds,
Vitalised,
Existing for the moment.

Without Tess's great Magpie prompt I would have never known of Thomas Hart Benton -
What a wonderful artist!

Anna :o]

Wednesday 6 July 2011

The Eyes of the Beholder

Wheat Field with Rising Sun, Vincent Van Gogh, 1889
Van Gogh
Creates his inner vision
As colours twist like cotton yarn
On waiting canvas.

Yet I ask the question,
If untitled
Would I see a field of wheat? 
And if not,
Would there be cries of Philistine
Or acceptance of my point of view?

Are piles of bricks
And unmade beds
And pickled sheep
Art?
Or merely pickled sheep
And unmade beds
And piles of bricks?

And do we like sheep
Follow the art worlds
Pretentious few,
Who (with inflated egos
View us - the great unwashed
With deep disdain)
Decide and define
Contemporary art?

And in doing so
Elevate the status
Of the mediocre,
The untalented
To that of undeserving 'masters;'
While the gifted
Gather dust
As some old masterpiece
Lost in time in
Forgotten garrets?

Anna :o]

With thanks to Tess at Magpie Tales for the inspiration.

Friday 1 July 2011

Steak and chips in a smoke-free pub - the myth of "clean air" and a person's "right" to it.

This guest post is from one of my wonderful sons.  I mentioned to him that the BMA's latest proclamations that smoking should be banned in cars, that minimum alcohol pricing will eradicate alcoholism and that the banning of certain fats in foods would turn us all into perfect physical specimens were to be the themes in upcoming posts.  He told me that he had responded in the comments section of The Telegraph to the thoughts of an anti-smoking zealot whose foaming mouth was in danger of choking him.  Below is a slightly amended version of same.  Michael will respond as and when possible to any observations you may have on his post.

Ever since reading about the proposed outdoor smoking ban near the fresh air zone that is car-gridlocked Milton Keynes, I have been very disturbed by the rabid psychosis of today's anti-smokers as seen on online newspapers' readers' comments.

Let me make one thing clear - non-smokers and anti-smokers are two different beasts. My friends, virtually all of whom are non-smokers, are tolerant, friendly and interested in other people. They realise we live in a polluted world and make the best of it. They see me first, not the ciggie in my mouth.

The anti-smoker however is intolerant of anyone else's joy which s/he does not understand. The anti-smoker seems to believe that the bubble of the atmosphere within 5 metres of their nose is actually their property and not a shared space. The anti-smoker sees the ciggie in my mouth first and does not believe that a human being worthy of respect is attached to it.

On the Telegraph website, a poster named "Cyphre" was advocating physical violence against smokers. Of course, this is just his mouth shooting off on the internet - it is doubtful he would ever do such a thing in the real world. It makes me wonder what part of his psyche and his need to be heard makes him preach that which he would be too scared to practice?

He then states "The air is naturally clean of harmful tobacco smoke so anyone smoking is knowingly polluting the air."

All human activity pollutes the air. The fumes coming from a smoke-free pub's kitchen are full of all types of nasty carcinogens that are inhaled by all the unsuspecting victims of the murderous landlord. According to the Global Alliance for Clean Cookstoves, cooking smoke is estimated to shorten the lives of 1.9 million people a year.

It's worse than that though. Cleaning solvents contains such lethal dangers as naptha, which cause dangers to the eyes, skin, liver, kidney and more. When the oven is on, the cooking process releases those into the atmosphere as well.

The air fresheners the landlord's cleaner uses contain carcinogens, volatile organic compounds and known toxins such as phthalate esters in their formulas. In 2008, Anne Steinemann of the University of Washington published a study of top-selling air fresheners and laundry products. She found that all products tested gave off chemicals regulated as toxic or hazardous under federal laws, including carcinogens with no safe exposure level, but none of these chemicals were listed on any of the product labels or Material Safety Data Sheets. Chemicals included acetone, the active ingredient in paint thinner and nail-polish remover; chloromethane, a neurotoxicant and respiratory toxicant; and acetaldehyde and 1,4-dioxane, both carcinogens.

To prepare the meat you'll be eating at your smokefree pub, a whole global industry is involved in cutting down trees and replacing them with plains. Whilst I personally believe that the AGM case is wildly overstated (just like passive smoking), livestock release countless thousands of tonnes of stinky, smelly farts into the atmosphere. This may be matched by other pollutant gasses involved in their rearing, slaughtering, butchery and distribution.

On the subject of farting, you might gently and discretely lift a buttock cheek to squeeze out a fart out in your smoke-free pub. However, because you can't see it doesn't mean the mortal dangers aren't there, you selfish murderer. The primary constituents of flatulence are the non-odorous gases nitrogen (ingested), carbon dioxide (produced by aerobic microbes or ingested), and hydrogen (produced by some microbes and consumed by others), as well as lesser amounts of oxygen (ingested) and methane (produced by anaerobic microbes). Odors result from trace amounts of other components (often sulphur containing). The gas released during a flatus event frequently has a foul odour which mainly results from low molecular weight fatty acids such as butyric acid (rancid butter smell) and reduced sulfur compounds such as hydrogen sulfide (rotten egg smell) and carbonyl sulfide that are the result of protein breakdown.

Your demand to be able to sit in your smoke-free pub at anytime explains the existence of the on-demand electricity and gas industries. By their very nature, they have to release countless tons of pollutants into the air to suit your desire to sit down and have your steak and chips.

Of course, you and the other patrons have had to pollute the air by travelling to your smoke-free pub of choice. This probably involved a vehicle using internal combustion, whether a taxi, bus or car. This can be hardly considered essential transport - you are making it for selfish reasons.

Traffic pollution "contributes to thousands of deaths a year caused by pneumonia, research suggested yesterday." The researcher, Professor George Knox said the annual death toll caused by air pollution was comparable to that caused by the London smog of 1952, which killed 4,000 people.

Cyphre should stop flapping your gums and talking such lunacy. Everything anyone does affects someone else - the question is to what degree.

Passive smoking studies are flimsy and nonsensical. The latest gem suggests that passive smoke are more dangerous than traffic fumes. It's a wonder why so many people committing suicide chose traffic fumes through a hose rather than just having a ciggy in a car.

I gave up smoking after 18 years. I smoked the grand total of 160,000 cigarettes in that time - at least. If I can survive that, you can survive a brief whiff of cigarette smoke.

Otherwise, I'll expect to see you on the streets demanding the immediate banning of farting, air fresheners, commercial kitchens, the internal combustion engine, meat consumption and power generation. The reason? I can denormalise you and stigmatise you because the flawed studies of biased interest groups say I can.
 
Michael Entferrier (Guest Poster)