Nothing wrong with MY pituitary, thank you

Just over one year on and I have an appointment with the neurosurgeon to review my latest MRI scan. The last time we looked at what was left after surgery there was too much debris in the void to make meaningful conclusions, although the surgeon was confident that nearly all of the tumour had been removed. This time the MRI was quite clear and we were able to see that only a tiny fraction remained, as was suggested immediately after surgery. The propensity for regrowth is low and it seems very likely that I will never need any further interventions (no Gamma Knife Surgery, for example).

I have spent the last year quite confident that the issue had been dealt with, at least so far as the actual adenoma was concerned, and was slightly surprised to find that a small residue of tension was released at this review. I walked out of the consulting room as if on air suspension, not just knowing intellectually (because my surgeon had told me so, and why should I doubt him) that the lump had gone but having seen the absence with my own eyes.

A further review in 12 months was set up alongside a further check of my visual fields (Goldman Test) and it seems that all we have to do now is keep an eye on hormone levels. Less than a month ago I had an review with the endocrine registrar and subject to a further blood tests and review 2 months from now all seems well.

So, to all intents and purposes, it’s all over. On 28th May 2015 I found out that I had a large pituitary adenoma and started this diary the day after. Today I am declaring it closed. It has been an ‘interesting’ journey, from the despair of those first few days when I thought I was living my last, through the totally avoidable administrative shambles, two postponements while I was at the hospital waiting for surgery, relief at waking up with family around me, delight at the lack of pain following surgery  and then the subsequent recovery and settling down back to life as normal. I know that others have had a much more challenging time than I with this particular problem and am relieved that it was caught before doing any serious irreparable damage to my eyesight or hormone balance. To the people at Biobank who discovered the adenoma incidentally, those of you who have ridden along with me, to those (Suzanne especially) who have held my hand and hugged me when I needed it (not very often, toughie that I am!), who have written notes of support and who have had me in your thoughts and not least to the hugely skilled surgeons I say “Thank You”.

And finally to anyone out there who has found out that they too have such a pituitary adenoma, good luck and remember to ask all those niggling questions you have in your mind for the doctors and nurses will be able to answer them and reassure you.

Retire – to what?

I want to start this piece by thanking Yorkshire Water’s pension scheme and HM Government for creating the conditions that allow me to write the post. Read on…

For many years I have spoken with people looking forward to retiring and for many years I have wondered what the word meant and whether or not I should succumb to thealleged temptations thereof

The first question I have tended to ask those looking forward to retiring is “retiring to what?”. They tend to know what they are retiring from, but the “to what” question is often more challenging. After all, there do seem to be a lot of people in jobs they don’t actively enjoy and I can hardly blame them for wanting to escape – but to what? The question often stumps my clients.

And now it may be stumping me.

Well, for some time friends and colleagues have been asking me if I am retired yet or when I am going to do so – and I have always replied along the lines of “It depends on what you mean by retirement”. After all, I am 66 and drawing both company and state pensions!

One definition of ‘retirement’ that I have used, and the one that seems to make the most sense to me, is the cessation of paid work – the ‘paid’ being important, because digging the garden is work, cooking is work, blogging is work… – and that’s the challenge that I face now. For the first time since I left my employment with Yorkshire Water 17 years ago I have no paid work in my diary. Moreover, I am not very motivated to do much about that. I’m happy to consider anything that comes my way, especially if it is short-term (coaching, training interventions – end of advert), but as we can get by (OK, a bit more than just get by) on my pensions there is not a huge financial incentive.

But the word ‘retirement’ brings baggage with it, as indeed does any word.

There is a folk myth that ‘back in the day’, when ‘men were men’ and physically wore themselves out doing manual labour for 50 years, the average life expectancy after retirement at 65 was around 2 years. (Actually I can’t find much evidence for this, back in the days when the state pension was first introduced  – the first pensions were  paid on 1 January 1909 to around 500,000 people aged 70 or more at the time only one in four people reached the age of 70 and life expectancy at that age was about 9 years.) Current life expectancy at age 65 is ca. 19 years. Now whether this myth is true or not, I can understand that as a piece of baggage it might inhibit some people from making that  jump to retired status – irrational yes but we are not rational beings.

So what other baggage might the word bring with it?

  • Feet up in front of the fire, slippers on, pipe lit, glass of whisky in hand, telly blaring out Eastenders…
  • or perhaps endless days on the golf course, watching cricket (neither a lot of cop in the winter unless you can afford to migrate to sunnier climes for 10 months of the year)…
  • or merrily frittering the day away babysitting those grandchildren who are the offspring of the children you spent so long encouraging to leave home…
  • or (over?) involving yourself in the Parish Council and getting frustrated with its inability to actually make any changes…
  • or ????

My point is that you are going to be ‘doing’ this retirement thing for, typically, 20 years so it might be worth giving the subject of how you spend those 20 years a bit of forethought. No employer is going to drive your day for you with this project and that, it’s up to you and me to find our own way to enjoy ourselves – for what is the point if we are not enjoying ourselves. I have a sign on our fridge that seems relevant here

“I do not intend to creep quietly through life only to arrive safely at death”

So my question to you, and to myself, is “What are you going to do that fills your soul, that you enjoy, that you will get out of bed for, that you will happily spout on about to your friends, that is your passion?”

Well?

Inspirational ripples

 I was wandering around my old files today when I came across this little piece that I wrote yet didn’t publish back in Autumn 2009.

I was thinking about how the little fountain I rested against offered a metaphor for change…

Market day in Tonneins – busy busy, hot hot, dusty dusty; lots of French (and a few English) locals, the usual North Africans, tourists, migrant workers for the plum/corn/sunflower harvests. The ‘ethnics’ all at one end with their brightly patterned and coloured clothing, their spices; the locals sifting through market stalls filling with fleeces and other autumn and winter clothing, picking the sweetest and juiciest tomatoes, melons, the first of the season’s prunes and the last of the haricots verts, jaunes et noirs.

It was an unprepossessing little fountain near the riverside ; no more than a piece of local rock about 6ft wide with a hole drilled through it and six 12” jets of water spurting from the top, splashing on the rock and into the pool around the rock. Still it offered a coolish resting place and the gentle tinkle of water on water. I sat on the surround for a brief rest, the fountain to my back. Drifting into some heat induced trance, I noticed the occasional wet spot appearing and disappearing in front of me, several metres away from the fountain. It’s not raining, no local child with a water pistol, they can’t be travelling so far from the little fountain – what’s going on?

Sherlock Holmes kicked into action – yes they were coming from the fountain after all, very occasional little splashes hitting the rock at just the right angle to reflect them out across the pool so far away as to seem improbable. The pool, and the ripples of the water splashes, had my attention…

As I watched, entranced by the ripples, I noticed that sometimes the surface was relatively calm, at others turbulent with the interactions of several ripples; sometimes small splashes, at others large blobs of water would disturb a great part of the pool – ever changing and always something happening, my attention gripped by the circles of light and dark as the ripples shed their shadows on the pool bottom. Always light after dark, the shadows fading as the ripple spread out across the pool, intersecting ripples throwing up sun-bright spots and night-dark shades.

I am sat focussing on the ripples and their shadows before my eyes, only just now noticing the contents of the pool – what was in the pool, on the bottom, floating on the surface, coming into eyeshot. Bunches of grapes, last night’s coke can, single leaves and leaves formed into mats solid enough to resist the charms of the water splashes, tiny tiny fish, gnarled rocks and smooth pebbles.

Suddenly a tsunami! Now the local boys had started playing in my pool, all the time they had been creeping up and now they struck coming from outside my viewpoint to change the whole pattern of my little ripples.

 

 

Well, I could sit here and philosophise or I could actually go get my pen and paper and record these thoughts – so I do so.

 

Coming back to the fountain I can see nothing, the glare of the sun on the ripples totally bleaches out everything. But as I walk around the pool to my starting place, the glare reduces as the angle of the sun changes until I can finally see all the original detail. It was worth coming back. I sit, I think, I write, I remember that 30 metres away from this mesmeric little pool, perhaps 3 metres across, flows the mighty Garonne River as wide as a bus and as deep as a house; strong enough to sweep away this little piece of rock without even blinking an eye. I notice again the hundreds of people going about their daily business all around whilst I muse on ripples and their metaphorical relationship to organisational change. I move on – if I stay I get damp or sunburned and neither of those is in your writer’s plan…

 

 

 

Inspiration from the most everyday objects – just let your attention flow…

 

 

 

Pay attention to the tiniest detail of your environment…

…to the unexpected…

“…there is something interesting going on here…”

…stick with it, investigate.

 

 

 

 

Never the same yet patterns of similarity

Some actions have little effects, some are more traumatic

 

 

Calm after the storm…just wait…

 

Sometimes you get the occasional really  difficult challenge

 

Don’t get mesmerised by surface noise – look below/through to see the deeper structure and/or what is not changing. Keep your eyes open for what is just out of and coming into view – it may be more important than your current focus; or it may temporarily make your current efforts pointless. Is what you are observing part of the underlying issue or is it an artefact – perhaps of someone else’s fiddling?

 

Take action – thinking never changed a thing, only actions change the world

Observation — Insight

Action — Change

 

Review the challenge from different angles – what may seem impossible with one set of eyes may not be through another.

 

Be aware of the wider world – you might be deeply embedded in your problem, others might not care less!

 

…and when it’s time to go. It’s time to go.

 

 

 

N****rs in the woodpile

Racist or ignorant?A Tory MP was recently recorded using the phrase “Nigger in the woodpile” when speaking about Brexit. She was castigated for use of the term, with the inevitable suggestions of racism. Whilst not condoning the phrase in any way, I want to offer (for the purposes of discussion) another hypothesis – that she is simply ignorant.

Looking at her, she seems to be from a similar generation to mine, brought up in the 50/60s when this phrase, along with “Eeny, meeny, miny, mo…” was in common use and well before ‘we’ started to recognise the implicit (if not occasionally explicit) racism in the use of the ‘N word’. As a child, I happily used the two phrases already mentioned as well as many others we would nowadays regard as ‘beyond the pale’. I was ignorant, not in the colloquially sense it is often used to insult people, but in the literal sense of ‘not knowing’.

Now perhaps by now this woman should have learned about the offensive nature of her words, and perhaps she hasn’t. Maybe she is so isolated from society in general that she isn’t exposed to the issues of racism, or indeed other ‘isms’, that she genuinely does not realise how offensive she has been.

I guess that this plays in to one of the long-argued views about intent. Can one really be guilty in the absence of intent? This principle even is established in UK) law with the phrase “actus reus non facit reum nisi mens sit rea, i.e. “the act is not culpable unless the mind is guilty”. So whilst ignorance of the law is no excuse and will not stop you getting pursued through the courts, the absence of intent will work in your favour.

So was this woman racist or ignorant? What do you think? Do let me know.

Infantile representatives

A few days ago MPs were heard to cheer when a Labour amendment to terminate the 1% cap on public sector pay was defeated. This post is not about the politics of that decision, but the behaviour itself. Behaviour that would and should be challenged in many ‘lesser’ institutions than the Houses of Parliament and which, in my opinion, devalues the House itself.

Politics is currently, like it or not, an adversarial process. I might wish otherwise. Perhaps a more collaborative, consensual, partnership…approach might be desirable (especially in a house with no inbuilt absolute majority) but that seems far away given the current predispositions of most of our politicians. Too many seem to have too much to win/lose, both personally and politically, to want to work with others to seek the best for the  country rather than the best for themselves or their party (which of course has the only correct answers tot he many challenges we face).

I think that thoughts on the adversarial system itself had better wait for another day, with the exception of the unfortunate behaviour that seems to be associated with ‘winning’ – namely this tendency to boorish (my judgement) behaviour towards the losers.

Not only do we have the Commons (OK, just over half of them) cheering when civil servants’ pay is restrained, but listen to almost any Parliamentary Questions (especially PMQs) and  the ‘yah boo’ brigade are out in force on both sides.

Behaviour that would not be acceptable in a school debating society has become the norm in arguably the most important debating chamber in the land.

The House of Commons has got so raucous in recent months that Speaker John Bercow was moved to warn MPs in November that he was receiving “bucketloads” of complaints from the public about their “low-grade, down-market and unnecessary” misbehaviour.

This quotation is from 2013 and despite the best(?) efforts of at least two party leaders little seems to have changed. If Speaker Bercow can unilaterally decide that ties are no longer required to be worn, then what’s stopping him making a rather more significant decision to clamp down on boorish behaviour? Parliament should not be a raucous side-show and a few well-timed remonstrations accompanied by threats of expulsion and/or refusing to accept questions from the relevant MP and/or closing the session would surely make a difference? If the party whips really want to ‘enforce’ the views of their leaders and create a more ordered Parliament then how about them enforcing better behaviour – they are quite happy to reward loyalty or toadying and to punish disloyalty, so perhaps punishing simple bad behaviour might also work.

But of cause, all of this requires MPs as a whole to actually want to improve!

The blame game – and why we should avoid it.

Grenfell TowerMy brother in law is a recently retired airline pilot who has not only been flying planes since he left school 40 years ago but has been training the pilots of tomorrow for some years now. Yesterday we ended up talking about Grenfell, the Challenger disaster, the floods of 2015, drinking water pollution and airline safety. Apparently unrelated subjects one might think; but think again about how those things are investigated and the link becomes clear.

Let me start with a short personal story about drinking water pollution – people ill, huge costs and disruption and a serious possibility of prosecution of the company. My job was to conduct an investigation into the causes of the incident and suggest remedies. I completed my investigations and made my recommendations and presented them to the relevant Directors, leading to a ‘discussion’ with my Managing Director when I refused to put any names into the report or to assign blame to anyone. He wanted somebody to point a finger at, to sack. But would the people who so willingly helped me investigate a very tricky incident have been so helpful had they feared for their jobs? I suspect not.

What about the Xmas 2015 flooding? Well, as Chairman of The Aire Rivers Trust, I have been heavily involved in the aftermath of those floods looking at the causes, effects and future remedies. What has been especially ‘disappointing’ has been the amount of overt and covert politicking (with both lower and upper-case ‘p’) surrounding the whole process. This politicking, much (maybe most) of which as come from elected councillors does little to further the cause and only serves to demoralise the committed officers working on the schemes. Moreover it sows doubt about the accuracy and veracity of the various reports and recommendations, in turn feeding rather than calming the understandable public concern about what happens next time it rains.

Finally the Challenger disaster, which was rigorously investigated and which was ultimately held to be essentially ’caused’ not by the technical failure of a o-ring that had been identified and for which a ‘No launch’ recommendation had been made by the technical experts, but by the managers who decided to over-ride the engineers’ advice in order to protect their company’s position.

The similarity in all of these seems to be a desire by some parties to investigate rigorously, butting up against a wish by others to point the finger, to blame. I will come to Grenfell in a minute, but by now my point may already be coming clear.

For many years, the airline industry has had a ‘no jeopardy’ form of investigation. One which has led to continuous increases in the safety of an already very safe form of transport. The purpose of an investigation should be to establish all of the facts and the inter-relationships between them in order to prevent repetition. For any investigation to be able to establish the true facts of an incident it is necessary that the participants can ‘have their say’ and report their understandings and for the investigators to be able to dig into every detail and nook and cranny without ANY of them prejudicing their career or the possibility of legal action against them.

Will, even can, this happen for the tragic fire at Grenfell Tower? We have Politicians of one ‘colour’ blaming the other, and the other blaming the one; we have debate raging about the Fire Safety Assessments, about the Building Regulations (and who is responsible for enforcing them in the light of them being ‘privatised’); we have some pointing the finger at illegal sub-letting (as if illegal sub-letting justified the occupants to be burned to death), the companies responsible for supplying and then fitting the cladding are covering their legal arses, the officers who commissioned the work will be feeling very uneasy (especially those who encouraged the cost-saving measures that may have resulted in less safe cladding being fitted), we have a local authority absolving itself of responsibility because it was social housing run by a housing association not themselves…add your own complicating elements to the list.

Amidst all this we have at least 76 dead, grieving relatives, annoyed survivors and thousands more in similar accommodations who are not only seeking answers but looking to find fault. We seem to have a natural tendency to want to find someone to blame when accidents occur and that is playing out big-time here. But will that help in the long-term? Even if blame could be allocated, would it bring back the dead, would it sooth the anguish and the fears? And would the prospect of blame being allocated inhibit individuals and corporations from being completely open in their collection and giving of evidence?

When you run into the back of the car in front, it is usually ‘he braked suddenly’ rather than ‘I was going too fast, too close, not looking ahead of the car in front for possible emerging hazards’. When my house floods it is not because I failed to take the many resilience measures that I could have done but ‘because they didn’t build proper flood defences’ or ‘the farmers are causing increased runoff’ or even ‘climate change’ (as if we were not all contributing to the latter). It’s psychologically ‘safer’ to find someone to blame than to accept my own failings.

So back to Grenfell. Will the public inquiry set up a ‘no jeopardy’ process – no, because much of its’ evidence will be held in pubic and so anonymity (an essential part of a no-jeopardy process) cannot be guaranteed. How can this be set up? Sorry but I do not know, what I do however believe is that such a no-blame process is necessary if we are to truly identify and learn the lessons from this tragic event. Maybe just highlighting the issue and asking the question might help someone else to pick up the baton and see what can be learned from the air transport industry’s processes.

Shattering memories – updated

Lefkada deserted village 2One day, while wandering around Lekfada Island (In the Ionian, in case you didn’t know), we came across this deserted village. Houses broken down and looking as if they might have been left in a hurry. We mused about earthquakes, displaced ethnicities, economic disaster etc and it was only  later that we found that the village had been hastily abandoned after a traumatic earthquake some years previously.

Now earthquakes are nothing new in this region and they are caused by three Lefkada deserted village 3tectonic plates which meet in the area of Kefalonia, Ithika and Zakynthos (Zanti). Apparently the plates, which are in constant motion are causing Greece to sink slowly into the Aegean. A major quake centred on nearby Kefalonia in 1953 was felt in Lefkada, but the real damage was likely done by one in Lefkada on August 14, 2003 – 50 years to the week after the 1953 quake.

I find it hard, if not impossible, to imagine such trauma. We regularly hear of earthquakes and other equivalent tragedies on the TV and radio, yet we are inevitably somewhat dissociated and insulated from them. Here I am so many years after the poor people watched and heard and felt as their word tumbled around them, not realising in the instant that they were witnessing the end of their village. The sadness was almost overwhelming, even so may years later.

As we wandered, we found NO evidence of the people who had probably lived here for centuries. Nothing, zip, zilch. Perhaps the odd bit of plastic suggesting that someone was trying, or had been trying, to keep the walls dry (essential if they are not to deteriorate beyond repair). A herd of goats could be heard tingling awaDeserted village in Lefkada following Earthquakes 1y at the far end of the village when we noticed the odd sign of regeneration starting. Was this one old owner returning? Was it the beginning of a complete rebuilding? Who knows? Whatever was happening, it was a sign of hope, a sign that perhaps this centuries-old village was not dead for all time.
Plagia starts to regenerate

UPDATE

Thanks to the wonder of Tripadvisor Forums I have found out more about this village. Firstly, that it is not on Lefkada but actually on the mainland just across the water and is called Palia Plagia. It is sometimes known as Old Plagia because the village has apparently been moved nearer to the coast after the earthquake that caused the devastation in the photos above. Here is a Google map of the location. 

Facebook Friend or Stalker

I love Facebook, it’s free, it’s simple, it allows me to keep in touch with family and friends (both ‘real’ and virtual) wherever they are in the world. Yes, it gets a bit full of adverts occasionally – but I have found a cool Add-In called AdBlockPlus that will block most of them as well as allowing configuration of lots of other potentially irritating features of FB. FB don’t like it and keep trying to get in it’s way, but so far ABP have managed to keep ahead of the programmers employed by Mark Zuckerberg, so give it a go.

So I use FB regularly, it is always on in both my phone and my laptop, I post several times a day and read my ‘Friends’ posts at a similar frequency. I rarely think about the consequences of my posts, having already paid a lot of attention to who I accept as a Friend, who I include in the various audiences allowed to read my posts, what I post etc… I work on the basis that, despite my best efforts, everything I post will probably be available to anyone with sufficient expertise anyway and so avoid posting photos of various bits of genitalia or being gratuitously offensive.

But a recent conversation has got me thinking about those ‘Friends’, one of who has admitted to reading posts but never posting anything themselves. My first, and admittedly rather extreme, thoughts were that this practice is in the same territory as stalking and that I would UnFriend the individual. Clearly it is not stalking, but I’m still very uneasy about someone who sucks stuff in about others’ lives but never gives anything out. How would I respond if a physical friend spent their whole time listening to my conversations, looking at my photos without ever speaking themselves or showing off their own family snaps? How long would I keep accepting that person into my house or inviting them to the pub? Would I question their motives for the apparent friendship? Isn’t friendship about a mutual exchange of information?

One part of me is interested in what lies behind this behaviour, another part thinks that even if I knew, what would I do with that insight and would it make any difference to how I feel?

So what would YOU do in these circumstances and why? I would really value your insights into the situation – please comment below. I promise I will share all comments (unless you specifically ask me not to).

Bursting my bubble

As an experiment and in an attempt to get out of my bubble and seek to understand some of the thinking, I committed myself to reading some of the right-wing media supporting Trump – in particular Brietbart as it seems to be perceived as the source of much of the thinking and supportive comment.
I don’t know if I want to continue.
The bile, the hatred, the racism, the conspiracy theories (one today being that ‘they’ are letting in “TB ridden” refugees so they can infect the true Americans and in turn collapse the country) are overwhelming and horrendously alien to my own mindset and values. Some of it makes the Daily Mail read like pink fluffy liberalism.
I guess that the real worry is that the publishers and many (most?) of their readers truly believe all this stuff, much as the relaitvley uneducated (by which I mean ‘do not really understand how the media works’) left and right in this country believe their own mouthpieces. The Guardian is no more ‘correct’ than the Telegraph.
Having been involved with the media over the years I believe that I do understand how most channels will represent even the most innocent story in a way which suits their agenda. Just think of the headlines and stories written about HS2 (not that HS2 is necessarily an ‘innocent’ story, it’ just a very good example of my point):
  • “Billions invested in UK jobs”
  • “Billions to be wasted on foreign trains”
  • “Trade and industry helped by faster journey times”
  • “Thousands of homes blighted”
  • “Property values near route rocket”
  • “Hedgehogs tunnels to be built”
  • “Lesser Spotted Winklewort habitat under threat”

You buys your paper and you takes your choice. None of the above are ‘wrong’, just different views on the self-same scheme. But unless the promoters of a scheme seek to understand the positions of other stakeholders the chances of accommodation are almost zero.

So it is with Trump, Brexit etc – bile in response to their bile just generates and even stinkier swamp, hatred in response to hatred just sets parties at war with each other, denial of positions closes down any possibility of change. As Stephen Covey said in his “7 Habits of Highly Effective People”, ‘Seek first to understand’. And you can only ever understand if you are willing to risk bursting your own bubble and investigating those things with which you disagree.

My pituitary journey

For those who have not really been following my journey over the last 18 months, this is a summary recorded by Leeds Teaching Hospitals Trust and shown to an internal conference. Watch and learn!