NHS is Sh*te when it comes to Specialist Care


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As some have come to realise, from reading my blog, I have issues with my urinary tract. Specifically, I was born with a condition called Bladder Exstrophy. To help with trying to normalise my life the various surgeons over the years have done surgeries – and these surgeries will continue until the day I die – I am okay with this, as this is *MY* normal. I also have a mitrofanoff stoma, which means I don’t have a urethra anymore (it’s been closed off) and I am completely dependant on being to catheterise through my stoma into my neo-bladder (augmented with intestinal tissue as the blasted thing never grew).

So needless to day, I have bladder issues.

Today I went in to get two things accomplished – (1) a cystoscopy & (2) to get my foley changed; the latter of the two was accomplished. Though, the Sister did send off the old catheter for testing as there was some serious calcification of the catheter and something that looks like some bladder tissue (it hurt when the foley was withdrawn, it normally just tickles).

I was asked 2 questions by the Sister (Senior Nurse): (1) since Southampton General Hospital are experimenting with gentamicin bladder washes would I consider it, and (2) have I ever tried taking d-mannose (it’s a probiotic which is good at adhering to UTI bacteria and flushing them out of the system). I nearly laughed, though I know she was serious — the nursing staff are desperate to learn more and I am one of the few patients who is willing to chat about bladder issues.

The reason(s) why I nearly laughed:

(1) gentamicin bladder washes have been advocated for at least 2 decades in North America — why the hell isn’t the NHS clued up on this? My first inkling of this sad lack of knowledge was when I asked for a script for gentamicin 4yrs ago and the GP and surgeon looked at me as if I were completely nuts asking for IV medication. I would expect the GP to be confused, but a Urologist who claims to be a bladder reconstruction specialist not being aware of this was mind-boggling for me. I have been doing these bladder washes for 20yrs now.

(2) d-mannose has also been advocated for a long time in North America – I’ve been taking it for about 10yrs now.

I wouldn’t expect a urologist who specialises in prostates, testicles and all things “male” to be aware of this, but a specialist who knows that people who catheterise on a regular basis are highly prone to urinary tract infections, cystitis, and kidney infections? How the fuck can they not be aware? Do they not read the various medical journals? One of the best research & facilities in the world for Bladder Health is John Hopkins in Baltimore — do none of these UK urologists take the time to learn what is going on outside of the UK? Or are they so arrogant in their belief that they are the best they cannot be bothered?

This just continues to reiterate how shit the NHS can be when in comparison to other countries. Several things need to happen – surgeons need to be knocked off their pedestals … they are not gods/demi-gods, they are highly skilled professionals and well trained, but they are human and they NEED to keep themselves abreast of all medical research & developments. GPs need to learn their place – they are there to handle basic issues such as sore knees, handing out scripts, doing physicals and helping with general health maintenance — again, they are not gods, they need to listen to patients. It’s the god-complex here in the UK which is driving me nuts .. and I believe the nurses at SUHT like me loads because I do question the surgeons (called Consultants in the UK) and refuse to sign anything until I am fully informed.

So my recommendation? Inform yourselves, because the surgeons at SUHT are too full of themselves to actually educate themselves.


NHS Weight Loss vs Slimming World & other fun things

I joined up with Slimming World back in late January of this year, because I wanted to lose weight and feel physically better. I have no delusions that I will ever become a size 8/10, but if I just get my BMI to a more decent level I would be quite happy. I have been steadily working my way towards my goal. And it is a rather modest goal – I am not looking to lose 50kg (though it would be nice) but more manageable expectations.

So I have been merrily doing Slimming World. I am not the most devoted to the plan, I cheat on it, but for the most part I have been sticking to it. Silly things like the “Healthy Extra A” & “Healthy Extra B” (milk & cereal), counting my syns, and making sure I try to stick to the approved food list. For those who remember Weight Watcher’s “Core Program” this is basically it – eat all you want from a particular approved food list. Simple in many ways, as there is no real measuring or weighing.

There are a few things I don’t like about Slimming World and it has nothing to do with the diet per se, but more about the attitude of the Group Leaders and the Group Members. In the first couple of weeks of any given diet a person will tend to lose a lot of weight quickly, but then it tapers off to about 1-2lbs a week. There are people in my group who are aiming for 3-4lbs a week (nearly 2kg a week) and they are doing what SW calls ” Speed Days”. I don’t like these aspects – mostly because people tend to forget that when they were getting chunky (and hence feeling the need for weight loss) they were not piling on 3-5lbs a week, it was usually 0.5lbs one week, 2lbs the next, maybe 0.25lb the next week .. it was gradual so expecting to shift weight quickly is counter-productive — especially since it puts the metabolism into shock.

Now to the part of where the NHS enters into this. When I saw my consultant this past March (consultant is a funny British term used for a specialist doctor/surgeon – like a cardiologist, urologist, obstetrician etc) with regards to my stoma and getting it to work he did a rather thorough cystoscopy under general anaesthetic to see if he could get a catheter in and also to scope out the interior or the bladder. A specialist in bladder reconstructive repair who has performed the Mittrofanoff Procedure multiple times had difficulty getting a catheter into me – and it is due to the pressure on my abdomen from the weight I carry .. so he’s deemed it necessary that I have Gastric By-pass surgery .. except the NHS doesn’t function as quickly as he likes … so I have to go through the whole procedure.

Due to my BMI I have been put onto Tier 3 of the NHS Weight Loss Programme. I am to see a Nutritional Therapist (Registered Dietitian) for 6 months, 6 months of psychological assessment and fitness assessments. Today was my first day with the Nutritional Therapist (Eve) – she doesn’t like Slimming World. After a long conversation this morning it was deemed that my diet is really heavy on the carbs and there are intense highs & lows of sugar levels in my system – which may explain my need to snack in the evening even after I had a meal, especially on something sugary. So what am I suppose to do?:

  • try & have some form of protein in each meal & snack. If I have some fruit for a snack, I should also have some nuts (she recommends almonds)
  • get off the diet drinks – stick to squash or water – the diet drinks are actually counterproductive for weight loss as they trick the brain into thinking that the body is having sugar, it produces insulin and when there isn’t any sugar for the insulin to act against the body craves a huge hit of sugar, which leads to over-eating
  • I am to have one piece of fruit each day, 2 max, the rest of my “5 a day” should be veggies
  • my serving must fit onto a plate with a diameter of no more than 9 inches
  • if I crave an evening snack I am to try having a boiled egg – the egg has a good mix of protein and fats and sugars
  • the goal is food combining
  • I am to continue taking my probiotics
  • if I have potato with my meal, no more than 50g (half a potato), same goes for rice & pasta
  • Mix up my protein intake – it can’t always be chicken. Experiment with chicken, beef, pork, turkey, beans, legumes, duck (occassionally .. it is a fatty meat so should be eaten sparingly) and have at least one vegetarian entree per week
  • wean myself off of muesli
  • DO NOT DO SLIMMING WORLD SPEED DAYS or have a purely Speed Meal .. the meal must be balanced
  • I am to keep track of how my body reacts to everything that I eat – we need to find out what my triggers are, when do I suffer from “brain fog”, when do I feel hungry

So I think I should be able to do this. I have already bought some eggs and some nuts. Tomorrow morning, instead of muesli I shall make myself an omelette – with red pepper, mushrooms and either some bacon lardons or shredded chicken


My Stoma is Freaking Me Out


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There are days in which I actually do wish that my pain would end, with sweet blissful death. But in most cases I am fighting so hard to stay alive that I at times believe I’ll out-live the cockroaches – and we all know that not even a nuclear holocaust can kill those little shits.

I know my health situation isn’t that bad, not really. It’s not like I have a physical disability which affects my mobility, or senses. I can easily move around and function in a relatively normal fashion. But it’s this never ending cycle of Urinary Tract Infections, Urinary Retention, Surgeries, Procedures, spend most of my childhood hopped up on medication, and being able to name my body parts as a young 6yr old – using such words as “penis”, “vagina”, “bladder”, “urethra”, “breast”, “abdomen”, while most of my cohorts used words such as “winky”, “boobies”, “cunt”, “tummy”.

My latest joy in life is an indwelling catheter – or more properly termed a “folley”. I have had this sucker for 23 months now. And it has been irritating the crap out of me. I want to be able to use my stoma – I went through 11hrs of brutal surgery to get the stoma, I better be able to use it. But sadly I can’t. Just this past week I spent a couple days up at UCLH (University College London Hospital) so that the Urology Specialist Nurses could check to see if it is possible for me to catheterise on my own. The nurses had difficulty getting a catheter in, and they do hundreds and if a stoma nurse can’t get a catheter in then there is something to worry about.

Saw my Consultant – or for those of you in North America – Staff Surgeon or Specialist. I will need to return to UCLH for further testing, probably being put under so they can do a thorough investigation of my stoma. Where are the issues? Is it the channel itself? Is it the flap leading into the bladder? Is the channel full of scar tissue? These cannot be investigated easily, so I need to go under a general anaesthetic for this. Oh the joy!

My fear is that I will need further surgery. I was warned when I got my Mitrofanoff back in late 2007, that there’s a 30-40% of further revision being needed. Surgeons can work wonders, but it doesn’t matter how good of a surgeon you have no one can predict how the human body will heal.

Back when I was young I was able to bounce back quite easily from surgery. But my last “big” surgery was brutal. I was on the table for 11hrs and I had 2 departmental chiefs working on me. I was finally wheeled onto the ward but whilst on the ward I fell asleep – because my blood pressured plunged to a very dangerous level, my pulse was thready and my breathing wasn’t that great. So I was in ICU for 5 days while they worked on getting my blood pressure stabilised. Once back on the ward, again, I developed multiple infections – my incision got infected & it was turning grey (which means the tissue is dying) so my incision was opened up in 3 places .. took a year for those holes to be closed. My IVs died, going interstitial and no one could start an IV on me. Infectious Diseases and Urology couldn’t do anything – at one point the Residents were able to get blood from my femeral vein, but the sample was tainted. Finally Infectious Diseases got a PICC installed – which is a surgically inserted copper tube in the vein with 4 ports .. that took 3hrs and it was fucking painful.

After being discharged I discovered I got MRSA – so another 10 days in hospital.

This was not a good recovery for me.

And I dread going through something similar. So when the UCLH Specialist Nurses couldn’t catheterise me I cried, great big heavy sobs. I don’t cry that often, but I felt my world crashing. And due to geography I was all alone.

So I am hoping that I don’t need surgery, but the realist in me knows that I will have surgery. The only things to ponder are – when, where, and how intrusive will the surgery be.


School Holidays, the UK, and Parents

Bearing in mind that I come from a different country, I do find this whole “the government must stop travel companies from gouging parents/families during the school holiday break(s)” rather interesting.

When I was young my parents did, I think twice, take me out of school to go visit my father’s uncle down in the United States (I’m Canadian) and there wasn’t a big deal with regards to that. I believe that to this day there are no such things as fines (like UK parents have) when a child is taken out of school. But … if a child misses too much schooling they either have to go to summer school or repeat the grade. When I was 11yrs old I had major surgery and was off school for 2 months – so that I wouldn’t fall behind and have to go to summer school/repeat the grade, the hospital (Hospital for Sick Children in Toronto) runs a school room for the patients .. so I was able to keep up with my classmates.

My parents never complained about travel companies ripping us off, nor have I heard any of my child-ed friends complain so vehemently that they *must* take a holiday during the school term if they want to save some money. It’s just a given in most countries that the summer months (July & August) are the high season and prices will be higher.

If we take a moment to pause and think there is a reason why the travel companies and the travel industry as a whole charges more during the “high season” – it’s supply & demand. There is a limited supply – planes, hotel rooms, b&bs, Disney Land, Alton Towers etc. There is a limited supply, so it is in essence “supply & demand”. The various companies need to keep these resources available (hotel rooms etc don’t just magically disappear during the low season, there are still overhead costs such as insurance, marketing, salaries etc to pay) so to do so they need to recoup most of their costs and earn an income during those 2-3 glorious months out of the year.

As a childfree woman I have my own views. Because I don’t have children it has been expected that I would not take a holiday during the high season – as that is prime time for the parents. I can live with that. So I end up with the less than ideal times to take a holiday, so in essence to compensate I pay lower costs. Shit timing = lower costs. Parents get great timing = higher costs. There is a balance in essence.

Now I see that there has been a push by British Parents to get the various councils & the national government to legislate fairness to the industry. So the idea is to shift the holidays around so that there is a week off in October or each area has a different timing for this. I do not like this, why? It’s a short-term gain for families .. they will get great prices, for a short while. But then the travel industry will twig, rather quickly, and prices will shoot up again. So the end result is, that peeps like me who have to take shitting times for our holidays are now paying astronomical prices (compared to what they usually are). Aaaaannnd, it will be the exact same argument – I need to take a holiday when it’s cheaper, please Mr Government Minister, put through laws which you have no jurisdiction over, so I can save a few pounds.

I have never heard any of my other friends or acquaintances complain about having to pay more because they have children; it’s considered one of the costs of having children. But in the UK there are at least 1 or 2 articles or opinion pieces in the news media about how the travel industry takes advantage of families. I may sound harsh when I say this – but no one has a human right to splay themselves on a beach in Ibiza or the Maldives. Everyone is entitled to a break, to rest, relax and recuperate .. which I am not denying anyone, but being able to go to Greece for your holidays is not a human right, it’s a priviledge.

So instead of expecting others to subsidise families further, which is what this is, just accept the fact you have children and there are costs involved in rearing them. If the travel industry spreads the costs across the year to even them out people who cannot have the optimum summer holiday (because they don’t have children) are still stuck with the more bleaker months, but are now subsidising those who still get preferential treatment when it comes to booking time off work.

My Least Favourite Time of the Year


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Ever since I’ve moved over to the UK Christmas has not been my favourite time of the year. To be honest, I never really liked it, but it was mostly a bemused attitude towards Christmas-time. Now I just dread it.

What do I miss? Am I missing something? I am missing my family – which right now is just my mother and brother. I miss Kucios. I am used to getting together with family, and family friends, sharing in the 12 meatless dishes, breaking bread, sharing blessings on each other, and reminiscing about loved ones who have passed away. My Christmas was always a quiet and reflective and peaceful time. My parents never showered us with gifts. We did not write letters to Santa either, as there is no Santa Claus in my parents’ traditions – there’s Grandfather Christmas, he wasn’t the kindly fat old man that most kids seem to believe in. I think I was 6yrs old when I had my biggest haul – a batmobile, a barbie and a toy ambulance.

Now I live in the UK and have a new family – my husband’s. It’s a completely different cultural experience for me. As a reminder, my parents are Lithuanian so I grew up with Lithuanian customs and traditions. My husband is English, so I am trying to get used to English/British traditions, but it’s hard. The meal is difficult for me – the focus seems to be eating as much as you can, and then ripping through tonnes of wrapping paper to find something that was originally on your Wish List (that was distributed to the family) anyways, so you have a fair idea of what you’re getting. Part of the joy with my family was that I never knew what I was getting, it was always a surprise .. and was an indication that they thought long & hard as to what they should get you (or at least that is the general idea .. sometimes it was just socks).

For me the evening of December 24th was the magical time. December 25th is a nothing day to me – it’s a day to get together with friends at the local chinese restaurant, have a meal and maybe go see a movie.

So I’ll try and enjoy Christmas, but I am desperately missing my mother and enjoying my own cultural traditions. I believe my ennui in many ways is due to the fact that I don’t really get to celebrate my cultural traditions – I feel stifled in many ways in that regard.


I’m Married! And Still MsBean

I am now married for over 2 months now, to a certain Mr Countrymunkle. But I am not Mrs Countrymunkle, oh no, I am still Ms Bean. In this modern age, now that we are in the 21st Century I don’t need feel the need to define myself as someone’s chattel.


I was asked many times what my new surname would be and in many ways I felt defensive, as if I had to justify keeping my own name – which I have had for over 40yrs. And my attitude was and still is – why should society expect me, the woman, to change her name & identity, defining myself as a “wife” immediately, whilst my husband can still carry on his merry little way with no one the wiser as to what his identity is, unless he discloses that he is in fact married.


So I have been pondering this issue. Why does society expect women to give up their birth name? I found an interesting article on BBC Magazine where the author, Sophie Coulombeau, asks the same question. Having done a year studying British Social History, myself, in university and discussing the concept of marriage in the various social strata, I always believed that the “custom” of the woman changing her name is due to a feudal concept of the woman becoming the property of the man. And my assumptions/beliefs seem to jive with this article, in particular this passage:

British hereditary surnames are only about 1,000 years old. Imported by the French around the time of the Norman Conquest, they stabilised throughout much of English society by the 14th Century .. Married women .. were perceived to have no surname at all, since the Normans had also brought with them the doctrine of coverture, the legal principle that, upon marriage, a woman became her husband’s possession. Her state of namelessness reflected this. In the words of one court in 1340, “when a woman took a husband, she lost every surname except ‘wife of'”.

But, around the turn of the 15th Century, the French doctrine of coverture received a unique English twist. There was another interpretation of coverture available, based on scriptural ideas, which focused not on the husband’s power over his wife but on the unity that marriage gave them.

In the words of the English jurist Henry de Bracton, they became “a single person, because they are one flesh and one blood”. As this idea gained ground, so did the clerical habit of designating a married woman by her husband’s surname. The married woman had formerly been a vassal with no surname at all, but now, in theory, she came to share the surname of her husband as a symbol of their legal and spiritual unity.

However, if there was one person in a marriage, that person was the husband. Married women still could not hold property, vote, or go to law. Legally, at the point of marriage they ceased to exist.

By the early 17th Century, the custom of the woman adopting her husband’s surname was sufficiently entrenched in England that the antiquarian William Camden could write: “Women with us, at their marriage, do change their surnames, and pass into their husbands names, and justly. For they are no more twain, but one flesh.”

Crucially, the custom was also specific to England. Camden noted with disapproval: “And yet in France and the Netherlands, the better sort of women will still retain their own name with their husbands… But I fear husbands will not like this note, for that some of their dames may be ambitiously over-pert and too forward to imitate it.”


I also remember from my studies, that there were several societies that were matrilineal – not matrilineal, not matriarchal. The Egyptians had this concept – the right to rule was through the female line – so if you wanted to be pharaoh you had to marry the Princess; and this is how we get the whole sorry story of brother marrying sister in Egypt, to keep it all in the family.


As well, in several societies a child automatically gets the mother’s surname – so if unmarried the child will automatically get whatever the mother’s surname is unless specifically told otherwise. So this whole giving up one’s name is possibly an extension of needing to “imprint” the husband’s surname on his children – to label them as “his” first and foremost.


Anywho, I ramble on. I, myself, do not feel the need nor desire to give up my identity. I have held my name for this many decades, it is part of who I am. My husband is British and I am the product of two Lithuanian Immigrants, who went through many hardships (running from the Red Army, living under Communist Rule, nearly being sent to a Siberian Gulag). I am proud of my own heritage – and no disrespect to my husband and his family, but I am deeply proud of my heritage, and I feel that a bit of it will die a little if all of a sudden I take on his surname.


Now, if both of us changed our surnames to something completely different I would welcome that – as both of would be making the change in our identities.

It’s Been a Year – So much has happened & not happened


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Wow, can’t believe it’s been over 12 months since I’ve blogged. Where has the time gone?

A few things have happened, both ill and great:

  • got engaged during the New Year, getting married next month – September – to my Munkie.
  • got a cat – his official name is Flip-Flop, but we just call him Flippie. He’s bit of an odd little fellow. If you’re wearing a dressing gown or anything thick & fluffy he assumes your forearm is a lady cat, and he likes to grind himself. He is fixed – so I don’t know where this obsession of his comes from. He meows at us rather forcefully until we are in position.
  • Left my job at the Housing Association – lodged a formal complaint of office bullying, with my manager being the bully. Naturally, HR sided with my manager. Karma can be a bitch, and it is now biting them in the arse – it’s finally coming out that I wasn’t some overly emotional twit, just wish they had realised this before I left them.
  • I’m in a new role, but I don’t like it here very much. I have serious doubts of them being a going concern. The MD likes to pillage the bank account to pay for her children’s techie toys (ipads, imacs, iphones) and for their taxi trips, cos the precious darlings cannot be expected to actually take the train or bus. And her Housekeeper is on our payroll. The company is also in trouble with HMRC & Companies House. I have been working for the past 3 months trying to get the cash in order, and once I think I’ve gotten close, WHAM, I’m back to square one. It’s so bad I don’t actually do any accounting – it’s all the fricken cash collections all the time. I feel like a glorified Cash Receipts Clerk.
  • I have gone out to my first ritual since coming to the UK – Lughnasadh – and it was fun. It was a little low key, but I liked that for my first foray into British Pagan Public Rites. I met some lovely people as well, so hopefully I can actually start forming those friends that I am craving. Still incredibly lonely in that regard.
  • I have a little tumour in my bladder – working on getting that excised. Originally it was to be done on 18/07/15 but the twat who is my urologist decided at the last moment that he wasn’t prepared, as I was too complex a case. So they are trying again, 18/08/15, but with a different urologist – a uro-oncologist – basically a bladder cancer specialist. Is it cancer? Probably is, but I won’t hyperventilate until I know all the results.
  • Saw Yalla & Kerstin this past December, for the Christmas Markets in Germany. I hadn’t seen them in a while, since June 2010, and Munkie had never met them. All he knew was what myself & Ruthie said about them, so naturally he was quite nervous to meet them. I convinced Madam to join us in this excursion and it was great fun. Next week Kerstin & Yalla visit us, so we will be traipsing about looking at flower gardens and other fun sites in the New Forest/South Coast.
  • Now I’m just madly crocheting my wedding bouquet & little table favours.

Being Demoted … sort of

So I have been working in my first permanent job since I moved to the UK. I was so excited to get something, because deep down I crave stability in my career – and temporary roles just make me anxious. So I was excited. And I thought I was doing okay, my monthly meetings with my manager seemed to go very well and she had nothing but praise for me. Then I got sick.

I got sick with sepsis in April. It was a complete fluke, one minute I was okay puttering about in the kitchen, and the next I’m begging Munkie to take me to A&E. Due to some comedy of errors I ended up getting overdosed on morphine and being rushed to ICU. I was off work for 2.5 weeks.

I got back to work and all of a sudden the attitude towards me changes. I’m constantly making errors, not meeting deadlines and not writing my monthly reports correctly. Bearing in mind that I was only off for less than 3 weeks and I have my full mental faculties. I discovered, chatting with a co-worker, that where I work the senior management like to pretend they are supportive of people with health issues & disabilities, but the reality is very different .. he took one sick day a couple years ago and he never heard the end of it. One other co-worker had surgery a couple years ago and she returned to work too early because of pressure from her management.

My manager keeps changing her mind with regards to what she wants in the monthly reports. Telling me that I need to know what the Exec wants to know is useless as I don’t attend Exec Meetings – which I pointed out to her. I’ve looked over what  changes she makes to the reports and other than some wording there is very little difference. She fleshes it out a bit more, but mostly because she is aware of what the Exec is asking about (which I don’t know).

I’ve looked over how the reports were done before she joined the company – there was consistency each month, same schedules, with variance analysis between actuals vs budget vs prior year actuals. I can work with that, that is how I have worked in prior roles .. and that is how most accountants work. But there is something about my manager – she just keeps tinkering, as if she is second guessing what everyone wants … and she wants to prove that she knows best.

She’s managed to suck up to the new Assistant Director. The new director has hardly spent any time with the other managers in the department, but most of her time with mine. The other two managers just roll their eyes and get on with their work. 

Soooooo I have not passed my probationary period. So legally I have been let go, though I have been offered a lower level role with less money. It’s still a decent salary. But it’s galling. My manager and director asked me how I used to produce reports in Canada. I said there was consistency – the requirements were the same – report IT costs, changes in intercompany, cashflows, fixed assets, changes in revenue, and accounting policies. I suggested that it would help if the systems could actually speak to each other. But the rent system doesn’t communicate with the accounting system, there’s a separate HR system, and A/P system .. they all require data dumps into Excel and then uploads into the accounting system. I said it gets much easier when you stop relying on manual labour and actually get decent systems in.

So I have the option of rejecting the offer and leaving at the end of August, or accept and keep job seeking. I am of the opinion I should accept and just keep job seeking. Employers are extremely slow in the UK with the hiring process. So it would be nice to have money coming in whilst job seeking.

I need to speak to Munkie about this, but I think he’ll agree with me.

I do know this much, I want to go back to a corporate environment. My manager said she came from corporate .. I so wanted to snap that it’s been 25yrs since she’s done corporate.

Sepsis, Again


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There are days in which I hate having my mitrofanoff and dream of the days when I didn’t have one. Granted, I was constantly wet, but I never had to be hospitalised when I had a bad UTI.

About a month ago I was puttering about making koldunai at home, whilst Munkie spent a few hours with his brother and nephew in a little park. I then went to catheterise later in the evening and it wouldn’t go in. I tried and tried but it wouldn’t go in. My abdomen and stoma were quite bloody and I was bent over in pain begging Munkie to take me to the hospital.

Thankfully the A&E department took care of me. I was dosed with morphine and the doctors & nurses tried to get a catheter into me. Sadly they couldn’t so I was wheeled into radiology for the urologist, Mr Rees, to use the ultrasound machine to puncture my abdomen and guide a supra-pubic catheter into my bladder (which was also punctured). And yes, I was awake.

I was moved to the urology ward and there was a mixup with regards to how I was to get morphine. They insisted on giving it to me by mouth and I insisted it be through the IV. When I get it orally I don’t feel the effects of the morphine, but it is more effective when via the IV. I was overdosed and ended up in ICU for about a day while my body recovered from a possible morphine overdose.

I spent about 2 weeks in hospital, which is not bad considering how long it took last time to recover. This time round I didn’t vomit blood and go unconscious, with having to require a ventilator to help me breathe.

I blame my latest bout of sepsis on the idiotic GP system here in the UK. The GPs don’t take my bladder issues seriously. And they like to act like demi-gods, who don’t like their judgement being questioned. And don’t even ask me about the receptionists who are the gatekeepers of the GPs. As well this latest bout has shown up how unhelpful my current urologist is. And I mean current as I mean to replace him shortly.

What I did notice when I was on the ward was how militaristic nurses grades are. They wear badges and epaulettes to designate their ranks – staff nurse, ward nurse, sister, matron etc. Plus a similar ranking for HCA – Health Care Assistants. Nurses, at least at Southampton General, take care of 7-8 patients with the help of the HCAs. So it’s a tad difficult to get a handle on the patients and what their particular needs are. As well, there is no assistance given with regards to bed-baths. I was given, everyday, a bowl of warm water with several towelettes and a single towel to dry myself off.

I was taken good care of but there were areas which I saw glaring examples of NHS beaucracy which could easily be handled if there was the political will.

I had good medical attention from the ICU nurses, Mr Rees (as the urologist), Andreas my nurse and the HCAs.

What I badly missed and was disappointed with was the visitors. I had one visitor – Munkie. No one else. Maybe it’s some odd British thing, but no one else visited and I felt the lack. It’s so easy to express good wishes over the interwebs and social media, but in general making an effort is more preferable. I got a couple of get well cards, which was really sweet and I understand why a few people couldn’t make it (taking care of munchkins who could easily disturb other patients or someone with a parent in hospital who is focused on that parent). But in general, if you are reading this, if I am ever in hospital again .. I WANT VISITORS.

British Accountants – you’re all nuts!

I have been exposed to yet another example of differences between how UK accountants function and how Canadian/American accountants function – in the corporate world.

I know I have harped on this a few times – I think – but in North America there’s this funny little law called “Sarbannes-Oxley” – it was put in place after the fiasco that is Enron & WorldCom; a fiasco so large that it shook the investment community and destroyed one of the big audit firms – Arthur Anderson. At heart SOx reminds us all what we studied in “accounting school” – the segregation of duties.

In my funny world of being a Senior Accountant I cannot raise a journal entry unless I have enough evidence – this is generally called either “backup” or “working papers”. Such backup is used to support the justification of putting through a journal entry. So if I have had a verbal conversation with someone, because it was verbal I cannot use it as backup for a journal. So I tend to email the individual asking them to confirm our conversation, so I can use that email as backup.

Last week, whilst completing my balance sheet reconciliations I noted that there is a balance for some investment services which has never been moved to the Income Statement. This should have been moved, so I spoke to our Treasury Manager to confirm that this particular transaction was indeed an investment service charge and where it should be charged to. I then promptly emailed him asking for a confirmation of our conversation. I guess being a foreigner I am not used to the way British accountants function – but I was told off.

I was told that I cannot add layers of bureaucracy, and asking for written confirmation for a verbal discussion is ridiculous.

This is what gets me. I am very mindful of the fact that my transactions could be audited at any given point, so I like to “cover my ass” so that I have the necessary backup in case an auditor asks me why I put through a journal 9-13 months ago. Trying to ask someone else nearly a year after the fact to confirm the conversation is just silly – no one will remember, unless there is something there to trigger the memory – like an email exchange.

Love it or hate it, Sarbannes-Oxley has some very strong benefits. One of those is strict controls, so that stakeholders have confidence in the figures. That the figures are not just all hokum.

I did a CPD on Internal Controls a few months ago, and there are guidelines in the UK which approximate what SOx is trying to achieve. But they are voluntary, and the vast majority of British companies would rather not. They would rather not because it’s too painful and what’s the point.

What does this teach me? There’s no way in hell that I want to invest in a British company, unless they subject themselves to vigorous audit controls.