Out of Stock

I’m a bit concerned about the state of my meds. I order these electronically. I mean, it is all done through the NHS, through one of their approved pharmacies’ web sites.

In theory, I fire off an electronic request to the pharmacy, who then contact my doctor’s surgery for an authorisation. All of this is electronic. Lastly, the pharmacy pops my meds in the post, and they arrive through my letterbox a few days later. In terms of timescale, my pharmacy recommend you trigger the request 7-10 days before you want the meds to arrive.

Well, I sent a request last Monday, 21st January, 2 weeks before I’m due to run out. Apparently, this was approved by my doctor’s surgery on 25th January, but it has not yet been dispatched to me. Apparently, some of the items are proving difficult to get hold of. I wonder if this has anything to do with Brexit? Although I note that we are still in the EU for another two months, so right now, absolutely nothing has changed from. say, 10 years ago! All rules and regulations are the same. The pharmacy told me that they are waiting on three meds, one of which is branded Bayer, one from Boehringer Ingelheim (which I presume are both German pharmas), but the third is generic, the only address I can see on my existing packet is Eastbourne, well and trulty in the UK and actually not too far from here.

I’m kinda concerned because the upshot is that next month, I will order 3 weeks in advance, to try and make sure the meds arrive on time. And, maybe I need to stockpile a supply of meds, just in case? A friend of mine published details of a campaign by his local doctors and pharmacists, aimed at discouraging people from stockpiling meds, but really, when the supply chain lets you down, what choice do patients have?

Hot Dog

For the last few days my sugar has been really high. I say “really high” – it was 11 mmol/l (200 mg/dl) this morning. OK, not really high but I’m used to single digits these days.

The culprit? Well, I did get myself a little treat at the weekend. One of those multipacks containing 4 x 4-finger Kit-Kats. That’s English candy, a chocolate and wafer thing. I kind-of think that anything around these days must be internationally available, but I could be wrong.

I had my last one of these bars yesterday. But the whole bar is, like, 50g, I’ve had 50g bars of candy before and it is never even noticeable in my sugar readings. maybe  it’s because I had one the day before too, and the day before that? I’ve observed that after some “bad” foods, it takes my body a good 2 or 3 days to get back to normal sugar levels (not “normal” – average for me).

The other thing I bought at the weekend was a packet of Bratwurst, plus some hot dog rolls to go with them. I had 3 Bratwursts – half the pack – on Sunday for lunch, plus another 2 yesterday for lunch. It is difficult to see the Bratwursts themselves putting my sugar up, although god knows what has been added to them in the factory. but those white bread rolls…

I’m normally very careful with my bread consumption. It is difficult to avoid it completely, especially as I rely on sandwiches for lunch. But usually it is, at least, wholemeal bread. The way it was explained to me, white bread is easier to digest (i.e. your body doesn’t have to do as much work). wholemeal makes your body work a bit harder, so you end up using more energy to digest it, and therefore your sugar goes up less. A bit, anyway. I’ve never looked at this in detail but that’s what I was told by a diabetes nurse and it makes sense.

I can’t imagine white vs. brown makes that much of a difference, so my main “tool” in terms of controlling my sugar is simply to eat as little bread as I can, full stop. So the hot dog buns were a treat, I knew that. Plus, in one of those buns, you’re eating far more bread than you would in, say, a slice of toast. But when I think of my diabetic diet, there are very few foods that I totally ban – most stuff, even chocolate, I just make sure my intake is sufficiently small – a bar per month, say – that I don’t notice it when I test my sugar. But perhaps I just need to think of these rolls as totally off-limits?

As things stand, there is one Bratwurst left and one roll (I started off with 6 of each). I plan to have the last Bratwurst for lunch, but I can’t risk the roll. I’m gonna do that and measure myself again come tea time.

This diabetes – having to worry about this stuff – is a real pita, although I must admit that I do find it fascinating to know that such-and-such a food will do such-and-such to my sugar. I guess I’m lucky in that I can test all this stuff on myself, it is all empirical. A lot of peope can live in ignorance of this, but for me, that knowledge is literally life or death.

I did take a little extra insulin this morning, just when I saw the high reading. I’m out this afternoon so I’ll need to make sure I have my jelly beans with me, just in case. Although I’m in the centre of Salisbury so finding some food or other to put my sugar up a bit shouldn’t be a problem.

Deal or no deal?

Sorry, UK politics again. Our current affairs at the moment seems totally dominated by the question of deal / no deal with the EU. I just wanted to put my thoughts down.

For my money, Day #1 after the referendum, there should have been an announcement that there *would* be a deal with the EU, or, at least, an attempt to strike one come what may. Exactly how much of life was encompassed by this deal would be subject to later negotiation. I’d see the deal having two or three parts.

Part I would be the amount of money the UK needed to hand over in order to honour its existing commitments. For this reason, it might have been better to leave at the end of a budget cycle, which I think is seven years. In theory, that commitment would then be zero, although I expect there must be a few things which span multiple cycles, so would probably be greater. The UK parliament (ultimately) could then argue with the EU about what that actual number was.

Part II would be to settle the things you would do going forward, in every circumstance. There must be several areas like this, where both the EU and UK gain pretty much equally. I’d suggest that something like guaranteeing the healthcare and security of ex-patriots falls into this category. Again there might be a cost, again it is open for barter, but the point is, you remove a lot of uncertainty from the equation.

Part III would be the optional things. Like, “we want unhindered, tariff-free, access to your markets, how much will it cost?” Again, you come up with a number (actually, numeric cost is just one of the factors here), then you decide whether the terms are acceptable or not. In that way, you kind-of cherry pick how the future relationship will look. The EU has said that “there will be no cherry-picking”, but frankly this was a dumb thing to say, especially when they ultimately proposed a deal which included both free trade, and the UK government’s wish to control immigration. If that isn’t cherry picking, what is? But again, the precise numbers tbd. This is where is might get a little contentious, in that you argue whether you want a WTO relationship, or something more. Indeed if you want to ride piggyback onto something like Galileo or the Medicines Agency, it is difficult to see where WTO is relevant – the relationship we have with the EU currently is far wider.

So I think you come up with two numbers. The first is a number (not necessarily an agreed number, but a requested number) just to honour existing commitments and to guarantee some basics going forward.

The second number would take a bit longer to come up with, but would basically be what “the best” relationship would cost going forward. And the UK and EU could each decide what “the best” relationship looks like, or whether the price the other side wants is worth paying. Again I realise a lot of stuff is intertwined so I’m not just talking about money here.

In terms of making (the UK) parliament (and therefore the public) aware of where we are in the process, I think the UK government acts almost as a broker. “The EU wants us to pay £xbn/year for access to y“, and let (the UK) parliament decide whether to agree or not. In that way, you don’t need to rely upon any skill in negotiations – the UK government, or some appointee, simply relays what the EU is asking for, and the UK parliament decides whether this is acceptable or not. And, if the EU asks for £10bn for access to something which the UK parliament judges is only worth £5bn, then the UK walks away and everybody loses. So it is in the EU’s interests to be reasonable. In any case, if all this is made public, then when people say “the EU wants to punish us to stop other countries leaving”, this is something that we can all judge for ourselves. Possibly one reason for trying to obfuscate the process (as I think the UK government has done) is that they wanted a bigger role in the process. But I don’t think, with the highest turnout this century in the 2016 poll, that the people of the UK (and, by implication, parliament) were ever prepared to accept opacity. Plus, of course, this has dogged the UK government all the way.

I must admit I was very surprised when, early on in the negotiations, the sum of £39bn (which the UK would pay to the EU) was mentioned, before any detail was made public. I thought, if this is just the price to honour existing commitments, then we will have another bill, an ongoing cost, to cover the future relationship. But as time has gone on, nobody has talked about this, even to say “this bill is zero”. If the £39bn was intended to cover the cost of the future relationship as well, then how could anybody possibly know that number without also knowing what the details of the future relationship would be?