A medical fast

Waking up again under an overcast sky today after a fairly good night's sleep, although uneasy, conscious of the need to prepare myself when it would be time to get going for my fasting blood test at St David's Hospital, wondering how to manage taking the morning medication I'm meant to take with food to prevent it distressing my stomach. I drank a pint of water with my blood pressure pill and took a banana and black bread with me to consume after the blood test. It worked out fine thankfully. A 61 bus arrived in Romilly Road as I reached the bus stop, so I reached the phlebotomy clinic shortly after nine, and was fourteenth in a blood taking queue which moved quite quickly. I returned on another 61 bus and got home at ten. 

Clare's study group was arriving at the same time, and I was confined to the kitchen to finish breaking my fast. By then the meds were causing their usual brain slowdown. I finished my letter of complaint to HMRC, and printed a couple of pictures of the account information required to confirm my identity and ownership of my tax account while Clare was cooking lunch after the group departed. I took the letter to the Post Office to send recorded delivery, to be on the safe side.

Clare had booked us both appointments for toenail cutting after lunch at Step Podiatry near the Cowbridge Road Co-op. It's only the second time I've ever had this done to me. Although I can still bend down and cut my own toes. I worry about a blood pressure surge making an effort while bending so low and causing a nose bleed courtesy of the clot dispersal meds. The lesions in my nose are healing but they are fragile. The longer I can go, without subjecting them to unnecessary additional pressure, the better. The first session cost me fifty quid. The touch screen card reader threw an error message first go. I think it may be due to a sensitive touch screen not responding to my aged fingers, less able to transmit heat or relay a microscopic electrostatic charge to the screen. Kath told us how Anto's fingers couldn't be detected by an electronic fingerprint reader at an airport immigration control gate. Digitizing everything possible for the sake of speed and efficiency is a recipe for disaster in my opinion.

As sunset drew near, time to take out the recycling bags, it started to rain, turning a routine chore into an annoying damp one. It rained for the rest of the evening, so I paced up and down indoors to complete my daily step goal after supper. Then I spent the rest of the evening preparing the Daily Office text for the feast of the Annunciation and writing a reflection about the mystery.

No statin to take before bed tonight. After today's blood test I switch to month's regimen of alternate days with a blood test at the end to assess the impact on my blood cholesterol level. Having inadvertently done a practice switch a few weeks ago, I'm hoping that the same alleviation of toxic symptoms will occur again. It's been terrible to live with this 'toxic head' for the past  six months unabated.

Locked out

Another inadequate night's sleep. Another overcast day. Kath was up early, not just getting ready to return to Kenilworth, but contacting the HMRC and waiting half an hour to reach the help line to try and sort out my tax account lock-out. She's a skilful negotiator and advocate, and was able to engage with the official in question after being given the run around by the direct messaging 'bot'. We were unable to reinstate the account however, as we were asked for account history details which are locked into my tax account. 

One stumbling block was the date and amount of a tax rebate for which I received a cheque. I had no means of determining the details from HMRC emails received. I found the email of my first on-line tax submission receipt, but no confirmation of exactly when I registered to pay tax on-line. Nothing in my tax file papers. So no account reinstatement. I felt helpless, out of control of my life, and had a prolonged panic attack. I found the relevant cheque stub for the tax refund a couple of hours later among my pension documents. It left me feeling terrible. I needed an hour's walk before lunch to calm myself and went out again at sunset in another effort to clear my befuddled head.

Owain helped me with a draft letter of complaint to HMRC technical support giving them the information needed to sort out the issue, hopefully. I'll post a printed copy of this to their team tomorrow. It will take a while to resolve, and in the meanwhile I will download a copy of the tax declaration form which I fill in,  print and send. There's another month before the submission due date in case the issue isn't fixed.

I had a phone call just before five from Sil the Clinical Pharmacist, to clarify the procedure for monitoring the statin dosage change with a couple of blood tests. Sil is Greek named after St Silouan a Russian hermit saint who lived on Mount Athos in the early 20th century. I told him that I knew Silouan's famous saying was 'Keep thy soul in hell and despair not.' I think he may have been a bit bemused by that in the middle of a medical scientific conversation. I couldn't resist it.

Clare went out to the Canna Capella choir practice after an early supper. While I had the house to myself, I finished recording and editing audio for next week's Morning Prayer video, and uploaded it to YouTube. Iran has announced that the country's new Supreme Leader will be the son of the assassinated Khameni. The Israelis will target him as they did his father. He is also a hard liner admired by the Revolutionary Guard Corps. 

America's destruction of Iran's military capacity continues unabated. So does retaliation on the Emirates and Saudi Arabia, both of which have settled for defensive action rather than escalating conflict. Iran's allies are striking strategically at desalination plants and oil production facilities Attacks on Cyprus, Turkey and Azerbaijan are an effort to widen the conflict and increase regional chaos. This will affect tourism and expat communities, creating uncertainty. ir will destabilise the Gulf States economically, even if American military action succeeds in keeping the Straights of Hormuz safe from random attacks on shipping. Russia is now supplying military intelligence to Iran. Ukraine's experience and expertise in drone warfare is being recruited to defend Gulf States from attacks. Trump's heavy handedness in waging war with no clear strategy for what it can achieve or how it will end, despite his rambling rhetoric, makes everything more chaotic and risks igniting World War Three. Heaven help us. 

What a frightful day it's been. Can't stay awake much longer.

Endangered world

I paid a heavy price for eating a spaghetti bolognaise takeaway supper last night. Four hours sleep lost, not from indigestion, but emptying my bladder. I felt terrible when I got up. Kath helped me to make the on-line payment of my outstanding tax bill, which I had been worrying about while awake in the night. I still have to tackle the problem of logging in to my tax account to make this year's declaration. The whole system is about to change as HMRC is pushing everyone to use a third party accountancy app linked to one's tax account. Part of their 'Make tax digital' campaign. It's going to cost tax payers to use the app and create a lot of problems for small businesses and self employed people. I don't yet know how it will affect pensioners, but I sense trouble ahead.

Clare and Kath went to the St David's Hotel spa after breakfast. I went to church, suffering from such a bad night's sleep. I felt tired and stressed out after the service, skipped the coffee and chat, and returned straight home to recover in bed. As Clare and Kath were still out, having a drink and a snack after their spa session, I thought I should prepare the veg for lunch and lay the table. I got in a muddle about cooking paella for lunch, not realising until they got back that they wanted to have a cooked meal later in the day. I gave up in despair and went back to bed again. I slept for a while, had a snack lunch of mackerel fillets and leftover sweet potato chips from last night's takeaway supper, then went for a walk in Llandaff Fields to clear my head.

Clare made a fish pie for supper. I didn't do much for the rest of the day, feeling drained of energy after last night. We watched the first episode of another series of 'The Capture' after supper, about deep fake video, and the politics of national security, with relentless fast paced sound track reflecting the anxiety of the theme, and a whistle blowing female police whistle blower threatened and endangered by a false evidence conspiracy. I found it contrived, melodramatic, a mix of police action thriller and improbable hi-tec sci-fi. Improbable, but maybe not impossible. 

Meanwhile, in the real world the US and Israel continue to batter Iran, and Iran's allies react in ways that are likely to spread the conflict further. There are protests in America and Europe against the illegality of Trump's declaration of war without clear aims, regardless of consequences. His popularity rating at home has slumped. International leaders are expressing concern about the danger of this developing into World War Three.

More new trees

Overcast and cold again today. I slept well enough, and woke up clear headed and sharp but the combined effect of the meds had their usual ill effect as the morning continued. Clare cooked buckwheat pancakes for breakfast, then I went out and walked in Llandaff Fields for almost an hour to clear my head with no success. I noticed that half a dozen new saplings had been planted along the avenue of chestnut trees since yesterday, identifiable by fresh soil around the base that hadn't yet dried out. Two large old chestnut trees on the avenue have been felled because of storms last autumn. The transition to smaller climate resilient trees continues apace, and will eventually provide more shaded areas to benefit park users.

The Iranian president apologised to neighbouring Gulf States for attacks on them, and says Iran would not attack them unless attacked first. The Shi'a hard line Revolutionary Guard Corps promises to continue to defend itself, determined to go down fighting. Although its frequency of attacks is further reduced, they haven't stopped. Dubai Airport was closed again for a while this morning by a drone attack. The president of Iran is more moderate, implying he is open to negotiating an end to hostilities but may be over-ruled by hard liners among the elite leadership.

Trump is determined to pursue a destructive course with no idea of what the eventual outcome may be, if his variable public utterances are anything to go by.  He demands 'unconditional surrender'. If the regime capitulates, or does collapse and Iran becomes ungovernable, civil war may follow.  Trump seems to think he and his cronies can manage a situation in which America is regarded with hatred not only for its malign influence but also for the deaths of over a thousand people, in addition to the supreme leader and his team. Subjugation of people willing to interpret fighting to the death as a heroic triumph is not a path to peace. 

Military escorts for tankers using the Straights of Hormuz won't necessarily ensure the flow of gas and oil exports will continue. One tanker in transit has been hit by a drone today. Oil production was shut down as storage capacity filled up. The price of oil is rising, and this will have a big impact on the global economy. Putin is in contact with Iranian leaders. Who knows what mischief he is getting up to?  Russia, hit by oil export sanctions depriving its economy of revenue to wage war with, will benefit from oil price rises from the cargoes which get through the blockade.

Kath arrived to spend the weekend with us after lunch. We walked in the park and had a take-away supper from Stefanos. I didn't fancy eating out as it's often noisy with an overlay of Italian muzak combining to make it hard to talk at the table with my concentration impaired by the drugs. The portions were generous, and more enjoyable for sitting in the peace and quiet of home. We spent the rest of the evening chatting until bed time.

Keeping account of my day

A cold dry cloudy day after an inadequate night of sleep. The impact of taking a statin before going to bed wasn't quite as intense after taking my blood pressure pill. I suppose this is because it's been in my system for nine hours. The effect when I took the meds after a couple of hours apart from each other was worse. Even so, getting myself going requires mental effort more than physical. To my shame, remembering to say the Daily Office gets relegated down the priority list until I'm sure I can cope with everything else I need to do. And it can sometimes be at midday.

The war against Iran is costing thousands of lives. Its military assets are being devastated by American and Israeli attacks, but the rhetoric of resistance continues. Though the frequency of retaliatory strikes of all kinds is diminished, attacks continue across the Middle East wherever Iran has allies. The element of uncertainty persists. It's now safe enough for repatriation flights to take place for thousands of expats and visitors caught in places under attack. The first flight out was delayed 'for technical reasons', unexplained until today.  Not aircraft being unready but crew 'out of hours'. There's a safe flying time limit for pilots as there is for truck drivers. It's bound to happen if regular schedules are upended by cancellations and delay or aircraft not being in the right place when needed. It was like that during covid as I remember, trying to return from Ibiza via Barcelona to London.

I needed to talk to the clinical pharmacologist about the change of medication frequency and blood tests he proposed, having realised that the timing plan in his letter wasn't going to work. The letter he sent didn't take into account a ten day delay from writing to reception. Results of tests ordered wouldn't be available the day of my next consultation. I phoned the UHW switchboard and reached the Clinical Pharmacology unit secretary without a long delay. I explained the problem I'd uncovered, and received a sympathetic hearing. The pharmacologist in question was on leave but I was promised a call back after the weekend, to revise the arrangement proposed, and clarify whether or not it was meant to be a fasting blood test.

Clare went shopping in town this morning. I walked in Llandaff Fields for an hour to try and clear my 'toxic head' but with little success. Then I cooked veg for lunch, with pork sausages for me and veggie ones for Clare which I left her to cook when she got home, as I wasn't sure how she wanted them done. 

I slept for nearly an hour after eating and then completed writing a rather difficult Reflection on a passage for Hebrews about sacrifice - the sacrifice of praise, and obedience to God's will. Then I went out for another walk under an overcast sky making it seem nearer to sunset than it actually was. I forgot to take my Fitbit off charge before I left, so I used the phone pedometer app to count the distance covered when the Fitbit wasn't logging my steps. A small exercise in mental arithmetic, to counteract slow memory and wandering concentration, and tell me when my daily step goal was achieved, regardless of whether it's recorded by the Fitbit app or not. Making an active effort to walk and think seems essential to me at the moment, when the drugs I'm obliged to take are impairing my cognition and confidence, leading to occasional confusion and panic attacks. 

Remembering the day and its detail is an important exercise to keep me grounded in reality and not in my imagination. No matter how miserable life can be, given this awful drug haze, it's good for mental and spiritual health to remind myself of how much I have to give thanks for by the end of each day.

Panic

Last night I forgot to take the statin I'm supposed to take every other day, so I took it when I woke up this morning. After taking my blood pressure pill the light headed effect was worse than it was on previous days and it was not easy to think straight and get on with the day. In the post, a couple of copies of report letters sent to the GP surgery by the Advanced Clinical Pharmacist, who discussed medication with me last week, plus a couple of blood sample mail bags for me to take to St David's hospital for blood tests on separate days next week. All well and good, but I felt I needed to query an instruction with the Pharmacist.

I went to St David's hospital after breakfast to find out how I could contact him. I thought I took the letters with me, and panicked when I arrived there to present the contents of the letter with my query and couldn't find one of them. I'd left it at home inadvertently. I wanted to know about making an appointment, and how to go about it, and I wanted to check I had understood what I was meant to do, given that I'd already reduced the frequency of taking the statins. The instruction read as if I was still meant to be on the daily dose for the first blood test, and then reduce it for the second. Very confusing. The staff member who dealt with me was unhelpful, and unconcerned that I was in a state because I thought I'd lost a letter. I still don't know how I can contact the Pharmacist as it's not clear from the letters received whose team he belongs to and how he can be contacted. I walked home disconcerted, my leg muscles stiff and reluctant to relax, due to the statin.

The other letter for me in the post was from HMRC, stating that I had an unpaid tax demand from last year's tax return as the system was unable to take the amount owing via the tax coding, perhaps I don't earn enough taxable income to cover the amount outstanding. I set about paying my due through the HMRC website, only to find that accessing my account has become more complex than before with extra layers of security for registration for a Government Gateway account. This is where I came unstuck. I don't know why. Not understanding how to proceed put me into panic mode for a second time in the day, the stress pushed up my blood pressure and my nose started to bleed, so the tax bill is still unpaid. Owain was helpful, and referred me to a live support line for help to get the job done. With slow memory and a swimming head trashing my concentration,  I find it so distressing if I don't understand or lose my way in a complex process.

Clare had an eye appointment this morning in UHW followed by a post hip replacement check-up down the Bay. I started preparing vegetables for lunch when I got home, and didn't notice veggie sausages waiting to be cooked in the fridge. Instead, I took a couple of haddock fillets out of the freezer and thawed them. It took far too long, but that didn't matter, as Clare hadn't arrived home. I left a plate of cooked veg on top of the steamer pan, and the uncooked haddock stayed in the fridge to continue thawing. A rather chaotic way to serve lunch, made worse by the chaos in my head from low blood sugar and fatigue. It was late afternoon when I went out for another walk to clear my head and calm down before supper. At least it wasn't raining and it was neither cold nor windy.

In the evening news, Britain is sending fighter jets to Qatar, and HMS Dragon to Cyprus to help defend against Iranian missile and drone attacks. Britain is being criticised for its poor military contribution in any case. Years of under-investment in the UK's armed forces is exposed by its inadequate response to this current crisis. The Prime Minister continues to field criticism about Britain's cautious response to taking military action. 

Trump chose to initiate a conflict with Iran. The US Congress debated whether to endorse the President's action. The vote was in Trump's favour. Just. Starmer dared question the legality of acting without a formal declaration of war, but if attacked, military action in defence of Britain's interests can be taken. There has to be an agreed understanding of war aims above and beyond defence, to justify a commitment to armed conflict. It's not clear what Trump's war aims are. He seems to be making it up as he goes along. Enough to confuse allies and adversaries alike. The Iranian elite is about to anoint Khamenei's son to succeed him as Supreme Leader. Trump says he wants to pick Iran's new leader. It's laughable but also sinister. Israel is still attacking Hezbollah in Lebanon, as well as joining America in destroying Iran's ability to defend itself or attack, and thousands are dead as a result.

The drone factor

Clear blue sky and a bit warmer when I woke up to post the Morning Prayer YouTube link to WhatsApp at eight. I slept quite well, but not well enough to spare me the light headedness the medication causes.

American and Israeli forces continue to pound Iran in a huge effort to degrade its ability to wage or or defend itself. Iran continues to retaliate against Gulf Arab states. An Iranian warship has been sunk by an American submarine in the Indian Ocean with at least 80 people killed out of a crew of 180 and about fifty missing. Twenty Iranian naval vessels have been sunk so far and a naval headquarters destroyed according to an American official, with the aim of making the Straits of Hormuz safe for oil tankers. It remains to be seen if the threat to sea traffic from ballistic missiles and drones can be eliminated. Reports are suggesting however, that the frequency of drone attacks is reducing as stock piles rapidly diminish. Drone launch facilities and storage bunkers in Iran have been destroyed, but Shahed drones are now manufactured in Russia as well as Iran, for use against Ukraine, but if any of them are being fed back into the Iranian conflict it could have unforeseen consequences in further widening of the theatre of war

The maritime transport industry is very risk averse, and insurance premiums increase accordingly in these conditions. Thousands of visitors are stuck in Gulf cities under attack, waiting for repatriation flights, uncertain when it will be safe to return home, within the region or further afield. Dubai is a major intercontinental air transport hub, so there are people from all over the world as well as aircraft and crew stuck there. Iran's capacity to destroy enemies may be severely depleted, but its ability to disrupt global travel networks in the meanwhile can have a big economic impact on top of the rising cost of oil and gas. 

Meanwhile Israeli forces are attacking Hezbollah bases in Lebanon, attempting to eliminate the threat on its border, displacing hundreds of civilians. It's still not certain how or when this conflict will end. Iran and its jihadi allies, no matter how hard they are hit, will go down fighting, inflicting as much damage as possible on their foes, encouraged by the promise of reward in Paradise. Iranians may want to see the end of Islamic clerical rule in their country, but toppling the regime with excessive force and bloodshed won't end the hatred many Iranians feel towards America, any more than it did among many Iraqi Arabs after the the toppling of Saddam Hussein.

Talking of insurance, I had a notification from Staysure stating that my multi-trip travel insurance with the company will be renewed automatically in a month's time. I don't ever recall agreeing to an option that will if not acted upon, debit my account with another annual premium. I visited my online account to view the policy and engaged with the site's chat bot to terminate the policy not renew it. The bot wanted to know the reason, which I thought was rather impudent. Its reaction to my information light response was to propose alternative policy options. I had to insist I no longer needed anything and eventually received an email confirming that I had opted out of automatic policy renewal. First the bot asked if I had any claim outstanding to be settled. At that point it struck me I didn't need to cancel a policy about to finish. All I had to do was opt out of automatic renewal. Commercial legal language is a foreign tongue to me.

I went to the Eucharist at St Catherine's with seven others. Clare was shopping in town, so I cooked a savoury veg dish with black beans for lunch. I slept in my chair for three quarters of an hour afterwards, then walked for an hour in Llandaff Fields as the sun was setting. Clare went out to sing at a Canton Chorus rehearsal, as she fancied trying a more musically demanding repertoire. 

Finally I got around to looking at material provided by Kath and Owain to fashion a formal complaint to TalkTalk about the way I was treated by TalkTalk over the account switchover. Getting to grips with this has been difficult with my thinking and responses affected by the medication. I must be improving a little to face up to making the effort. I still don't cope well with additional stress of any kind. I had a long chat with Owain on the phone. He's in good spirits at the moment, enjoying his work and being part of a HMRC communications team that works well and does satisfyingly useful stuff.