Memoirs of France

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I've been editing my French Journal which I kept during our stay there early last year and thought I'd share some of it with you. If you enjoy, then let me know and maybe I'll carry on and finish the job!

  

My dear old Dad used to call it “Sods law” because sometimes things don’t exactly work our as you planned. We had organized a 6 month house swap with a young family near Versailles, France and we foresaw ourselves heading happily for the airport with suitcases packed and ready for off, but that’s when the “toast landed on the floor marmalade-side down” and immediately it didn’t look like we were going to go at all! Out of the blue MJ slipped a disc in her lower back and was flattened by a monstrous pain. Even the tiniest personal “things” led to excruciating pain and I was in the invidious position of being both spouse, Medical Doc and expectant international traveller which made it hard to decide what was the best thing to do! One of the many blessings in our family is that one of our offspring had chosen to follow in the medical profession and is a graduate Doc: it’s just that he lives 2,500kms away in Sydney.

However, thanks to the wonders of modern communication and the help of the local pharmacist he saved the day by organizing appropriate, strong painkillers and steroids which had an almost miraculous effect, allowing us a couple of days later to take wing to Paris, speeded along with the good wishes and prayers of many good folk.

It was, what I could only describe as a smooth flight - not particularly comfortable, and not good at all for sleeping, but because of our apprehensive build up, nothing going wrong was everything going right for us. There were some hiccoughs, one being the sheer size and distances to walk at Dubai, which produced an escalation in pain and accompanying anxiety, but we learned from this and made sure we were prepared for pain in the future. It’s amazing how useless analgesics are when packed in a suitcase that you can’t access: so “message to self” - always carry enough medications to cover you for any long journey, and carry an extra one for good measure!

 Traveling in economy class is always going to be a struggle for tall people, even though the Airlines do their best to maximize comfort, unfortuantely one size does NOT fit all! So for those with known low back pain, take a lumbo-sacral roll with you: they are fairly easy to source from any good Pharmacy, and they’re lightweight and easy to carry.
When you sit in your seat place the roll across the lower part of your back: now the correct position is at the upper part of your pelvis - NOT the lower part of your spine! This is a subtle point, but can make a big difference to your comfort. You locate the correct point (best done before you get on the flight!) by locating the two dimples at the lower part of your “back” where
the spine joins the pelvis

General back care is also vitally important when travelling:
Do NOT carry one huge bag with everything in it. You still have to lift it on and off conveyor belts, tolleys etc and this is a sure way to turn a dream holiday holiday into a nightmare!  Pack you clothes into 2 or 3  smaller, user-friendly cases that are easy to manoeuver.
Keep up exercises to maintian strength in your “core stabilizers”. If you don’t know where to find them, then ask a Physio who does!

Then suddenly we were in Paris! CDG airport cannot be described as one of the more efficient airports in the world. When we arrived it seemed that they must be unloading the luggage piece by piece from the aircraft and then walking with each one from the aircraft to the conveyor belt: and it also seemed that there must have only been a couple of people performing this glacial task. However, others have told me that they thought that CDG operated on “oiled wheels” - so perhaps we just arrived at a bad time! Despite the snail-like progress of the luggage arrival we were amazingly serene about the whole wait: again, if you’re not in pain or watching someone in pain, then life is good.
We were met by a tall Frenchman holding a card with our name emblazoned on it in front of his chest, but he wasn’t looking at us. He was (rightly) distracted by his young female companion who I suspect may have been more than just his navigator
: it was such a “French” moment! They were a lovely couple and delivered us through freeways, tollways and tunnels to our new home in Bailly - pronounced Bi-eeeee). A word on French tunnels: entering into them is like being posted into a letter box. You are warned about the vertical challenge that they represent by a series of suspended balls across the road, which for the newly arrived, causes you to duck as you pass under them as they seemed so low. Then the long shallow slit of a tunnel sucks you in and makes you cower under its lowering roof: definitely not an experience for one of a jet-lagged, claustrophobic nature. But like all things, with time you adjust and eventually we stopped even noticing them.
Our new home was a little gem of a place. We immediately felt very much at home and were amazed at the similarity of tastes that our hosts share: the obvious difference being one of age: their house is relatively new and has all the wonderful features that one would like in such a house and put together with taste and style. The other feature is size. Our down under home is large on a large block and was wonderful for our  .. large family. But now we are two, our french home seems so much more “us”. The bed we slept in can only be described as delicious: and we made the most of catching up on lost sleep until the early hours of Monday morning.

 Flying from East to West is easier on the body clock, but even so, it does take some days to fully adjust. Make sure you try to adapt to the local time ASAP which includes re-setting watches and elctronic gizmos. Try to exercise daily and avoid long naps during the day. Avoid caffeine drinks and alcohol in the evening as they will keep you more awake than ever!

Monday was a day of delicious contrasts: the joy of a lazy breakfast - scrambled eggs with local ham on a freshly bought baguette can only be described as sublime! But then we took a step too far and thought we could navigate French roads, in a foreign language whilst driving on the other side of the road! A feeling of abject panic set in  as, whilst attempting to drive to the local train station we were once again sucked inexorably into the post box tunnel and taken “where you would rather not go” as it says in the Good Book, and ended up in the southern suburbs of Paris! This produced a mixture of claustrophobia not experienced for years and almost tearful frustration for being powerless with no way out. But like most things, this too passed and we returned by another route to our delightful village and comfortable home.

 Message to self:
Always study the maps prior to setting out for the first time in a foreign country - and don’t trust Sat Navs unless you know that they’re up to date too!

“Our” village was wonderful, and the joy we experience as we walk down the street of this scenic village with its aged houses and welcoming inhabitants was balm to a jet lagged soul. Our neighbours introduced themselves - extraordinary, gentle and generous people who made us feel even more at home.
And yet I had a strange dream about my father that night: why I do not know. He was caught up in celebrations and was pushed and fell down several steps and I watched helpless from afar. My brother appeared and as we walked along I burst into tears: “why are you crying” he said? I was unsure at first and then I realized that I wanted to be there for my father in his final suffering and be a gentle presence to him: and I grieved for not being able to do that.*** he was to die suddenly, despite his great age on September 1st 20012.
Why I dreamed that I have no idea, but it stayed with me during the day.
And what a day it’s was. We grasped our courage and took to the car again and headed to a shopping centre 12kms away, although to us it seemed almost like going to another country! But it was not all smooth sailing. In our travels we had to ask a policeman for directions - the GPS having “confused” us - and as we turned to leave, M tripped on a rough surface and almost fell flat on her face. Unfortunately it stirred up her back and her pain troubled her greatly all day although, like most women who have reared 5 children, she did not give in to it.
Talking of ladies in pain, whilst we were at the Pharmacy getting some paracetamol, an elderly lady with porcelain skin around tired eyes was leaving in a staggering sort of way and so I helped her home. She was from Nice originally and we shared stories as we walked down the street. She was young once and knew Nice in the “early” days. Now she is old and falls frequently and lives alone since her husband died. Time can be cruel.

 Staying on your feet.
The aging process is fraught with challenges and one of the biggest is not falling over. At the extremes of life our environment becomes a physical challenge. So stay fit and work on your balance - try standing on one leg whilst brushing your teeth: or walk sideways into the hosue from your car. Do regular
Quads exercises to keep your legs strong and practice “falling” forward from a kneeling position onto a carpeted floor to strengthen the forearms and shoulders should you actually have a fall.

Yet again, the peace and quiet of this house and the real feeling of being at home made for a relaxed and healing evening. Hopping half way around the world meant that we were now eligible to join the “bed by 9 sect” even though we deceived ourselves by saying that we go there to read - within 20 minutes, eyes sting and the call of sleep becomes irresistible. But by midnight I have had 3 hours of deep sleep and I wake for the first time. By 4am I have been in bed for 7 hours and my body tells me to get up, but it is so so dark and I resist for another 90 minutes before I can’t lie there any more. But despite an interrupted nights sleep,  I found myself actually singing when I got up because I was so happy.
But we want to get into our normal morning routine as quickly as possible so it’s cut up oranges and a nice cuppa tea, then check the news on the iPad. Feeling frisky we decide to get up at 6.30 and go for a walk - which proved to be not the greatest idea I ever had as MJs leg gave her a great deal of pain and we limped home for another lie down.
But pain was not going to hold the young lady back and as we had talked of cycling to Versailles,  I prepared the bicycles and the genius of 2 wheels was that M did not have any pain whilst cycling. The relief and happiness that this engendered is hard to describe - tears might lubricate their telling. But we cycled for 2 hours and had the most amazing experience. Even 12 hours later it still seemed unreal that we actually cycled around the “canal” at Versailles with white swans gliding over the cold, grey surface, and the Palace of Versailles in the misty background benignly watching over us.
Back down the forest track and home for lunch followed by a walk to the shops - another less than inspired choice by yours truly as the pain in M’s leg returned with an awful vengeance to remind us that it is only 9 days since she was flattened by a prolapsed disc in her spine. But then it’s amazing what a positive attitude and a beautiful hot bath can do to restore ones spirits, and over tea we talked about living life in the moment and how each of our lives had been modulated by unexpected health issues. Yet again, tears lubricated the moment but they were even more enriching than that hot bath!

Thursday 12th Jan. I have to put in a date every now and then otherwise I lose all sense of time. Each day is different and littered with new experiences and it seems belittling to label it as 08.01.12, but for the purposes of recalling events at a later date, I need all the help I can get.
Today was the second day that I got up and started singing - I even did a quiet pirouette out of sight of M, just in case I came a cropper - and I cannot remember when/if I have ever done that before. Today though was another chance to meet the challenge of French roads! To the untrained, and un-french eye, you get very little warning before an intersection comes up. That, plus the fact that street names appear on maps and Google earth, they don’t seem to appear on the actual street. Major road signs, D3, N4 appear perched atop poles like pigeons but are of a smaller stature, all on roads where speed and narrowness make it imperative to maintain your focus on what is happening in front of you. This can make for extreme anxiety to the novice: especially the elderly novice! But the french motorist is conservative when it comes to the use of the horn. In the past 4 days I have only heard it 3 times - and all of them from an elderly lady who was following me. The amusing thing is that the French klaxon is a bit of a let down. I expected a car horn with a throaty Gaulois sound and yet what you hear is a rather apologetic pre-pubescent peep.
We set ourselves the target of finding the closest station that will take us to Paris and in this we succeeded. The second objective was to find the shopping centre at Versailles and this we did - a great food hall downstairs with those meticulously crafted, mouth-watering patisseries and breads, and for one who is not a meat eater one can only marvel at the displays of our slaughtered bovine friends in the butchers shops.
But M had pain that continues to teach us new things about ourselves. Life is about change, life is about suffering and coping with it. We promote this idea that suffering can be stamped out if we do this or if we do that, and whilst that does give us hope and it does help us recover from one challenge quicker in order to prepare for the next ordeal, suffering is the thing that makes we humans great. M is a fantastic example of that.
The sun came out in the afternoon and we eventually found the Biblioteque open and the charming lady who mobilizes the literature duly sent us off with several books on the history of Bailly - in french of course!
Today was also the first day for a jog in France: M is comfortable on the “velo” and so followed me as I did 2 circuits of the block. It felt good to be back on the road again and it’ll be even better when the two of us can explore new areas together.
With the short days and long nights being distilled with our habit of waking early - around 5.00am in Perth - means that by the time it gets light here we have already been awake for almost 4 hours and it feels more like time for a zizzz than the time of the hunter gatherer! But we enjoy these lovely long lazy starts to the day: why do we make ourselves so busy and then spend all of our lives trying to keep up with our own hectic agendas?
Today - Friday 13th - was a day for a drive to Plaisir again: and yet again, we found our way there perfectly and yet again we came back via a completely different route! Our return was courtesy of Madam Lash - the GPS device - who “came up trumps” this time and delivered us to where we actually wanted to be. We had decided earlier that once a week we’d have lunch out and we booked a table at the local restaurant in Bailly -the Pavillion. This turned out to be an inspired choice! Warm and friendly staff complement the warm and friendly ambience. The menu was varied and our choices provided us with a superb meal topped by the chocolate pudding desert which was, I can only describe as, ball achingly excellent!
It was an amazing lunch and yet again, time seeped soothingly slowly along, perhaps aided by a nice bottle of wine from Gascony. It did however completely blitz the afternoon as our siesta didn’t start until 3.00pm and we awoke to a ringing phone at 4pm. A quick stock up on supplies ie baguette and milk, then home again on the bike as M finds this form of transport the least aggravating for her back/leg.
Tomorrow offers the chance of more adventures and more discoveries, but just the first five days have been a revelation and we are very happy.

Test Driving a Podcast

Tweet This is an experiment to see if my recent Podcast for Puggle FM - a family friendly radio site - can work from my  Blog: fingers crossed

http://pugglefm.com.au/health/head-lice-101-with-dr-duncan-jefferson/

"We are what we eat", but are we also What we Wear?

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Before I start, an apology! First it was a viral infection, then a sinus problem and then a recurrence of a back issue .... plus there was much happening with the development of the Trail I am creating called The Pilgrim Trail here in Perth Australia, and so Blogging went to the back burner!

But today I was reading an article in Medscape which pricked my interest! It was about what Docs wear, and so my blogging juices began to flow again!

In the 19th Century, the Doctor - all male at that time - wore a frock coat and perched a tall black hat on his head to give himself an aura of power and wisdom. In that era, before the times of Anaesthetics and Antibiotics, surgery happened quick and fast because Surgeons were ignorant of what bacteria were, and hygiene and antisepsis were unknown. That's why a Surgeon, who often learned his anatomy by dissecting dead bodies supplied by grave robbers, would walk straight into the Operating "Theatre' from the adjoining room where he had been performing such postmortems.
Wearing the same clothes and frock coat they had worn whilst dissecting the dead bodies, and without washing their hands, they would wipe their blades clean on those self-same coats and began to operate. Such procedures occurred at the speed of light on an often conscious patient who was usually held down by strong restraints! Having finished that surgery, the Surgeon would change his coat and went to see their ward patients in a clean coat!

What the Docs wore then was designed to give them an aura of power and wisdom, neither of which they fully deserved, but then they were trying to do their best with the knowledge they had. Fast forward 150 years and some Doctors still need to project that same aura of power and wisdom, but I suspect that "Change" is happening and it's happening fairly fast too. So have attitudes to dress changed at all? When I began my Intern Year in the UK "last century", we all wore our white coats on the ward and our ties usually gave clues as to which school/college/club you belonged to. We followed our "Consultant" in a small flock and always called him Sir - there were still very few women on the wards in those days! Imagine our amazement when an Aussi Registrar joined us for a ward round wearing SHORTS and NO TIE! But to cap it off, instead of calling the Consultant "Sir", he just said "Morning George, how's it going"? I think that was the time when I thought that I wanted to go to Australia and enjoy some of that open, honest attitude.

These days many Docs still feel that the "White Coat" is still an important part of their uniform. It does have the advantage of providing several extra pockets in which to carry various instruments and IT equipment. but then, they can be carried even more easily in an appropriate case/bag.  In Australia dress code would be described as "Smart Casual", but ties are rarely worn by the menfolk; but as these days over 50% of medical graduates are female, ties are definitely a disappearing part of Medical Haute Couture. In fact, in the UK, ties are banned because they have been shown to carry infection that can be passed onto a patient. (I have to admit to a long period when I wore some very snappy Bow-ties, despite being mistaken for a second hand car salesman and an accountant on a couple of occasions!)

Most female Docs I have worked with followed the rule of "Smart Casual" too and usually followed the principal of "If I can't crawl under a desk in it, I won't wear it" - wise words indeed! Here in Oz, because of the really hot conditions in Rural areas, most guys will wear shorts with an open necked shirt and a wide brimmed hat - which gives a very Antipodean feeling.

But this move toward more Office Attire has come as the Aura of Medical Power has waned and the realization that Health Care is a partnership between the patient, the Doc and the wider medical team and everyone has their important part to play. As we move forward with the increasing role that IT will play in all of our lives with its power to monitor so many functions, and then share that information with other team members, what the Doc wears will have little meaning except for the Doc her/himself. Which is a shame really, because those Frock Coats and ivory topped walking canes were really kool!

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Some real facts on Vaccinations

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It's that time of year again when vaccinations are in the news. Down under in Oz, it's the start of the Flu vaccination "season" whilst up in the northern climes, there is an outbreak of Measles in Wales that is causing great concern because of the recent low vaccination rates amongst infants.

So what is it about vaccinations that seems to scare so many people? Are we starting to believe all those Zombie movies that tell of rogue scientists creating 'orrible vaccines that turn us all into dribbling maniacs?

Point one: Vaccines have become far "smarter" than they were a decade ago. Back in the last Millenia - think the 1990's - although there were fewer diseases covered in a single vaccine such as diptheria  tetanus or measles, the number of antigens that were actually injected into the infant was around several thousand. Today, we might have more diseases covered in each vaccination, but the actual number of antigens with those vaccines is down to 365! Smarter, safer and better targeted.

Point Two: Thimerosal. Many parents have been alarmed by media reports of the rise in Autism Spectrum Disorder and the possible link with Thimerosal, BUT the scientific facts differ radically from the inflammatory headlines screamed from certain Newspaper Headlines. Several large and reliable studies have shown that Thimerosal is not linked to Autism and despite that fact that Thimerosla was removed from vaccines back in 2001, the rate of Autism has continued to increase!

Point Three: I have patients who tell me that each year I give them a Flu shot, they get the flu! The Influenza vaccine doesn't contain any live virus so cannot cause an infection. The vaccine contains certain protein markers from 3 or 4 influenza strains and these are given to stimulate your body's immune system to be prepared for those viruses - should they appear in your community - so that they don't overwhelm it and "give you the flu" before your immune system is able to produce enough killer T cells and wipe them out! But we have to remember that there are approximately 100 influenza viruses continually circulating and mutating around the world and the Flu vaccination will only protect you against the three most likely and most unpleasant of those.

Vaccinations have saved millions of lives and will save millions more: low immunization levels not only put you and your family at risk, they endanger those in your community who are less able to fight off infection - those who are aged, the pregnant and those on chemotherapy. If you have a concern, then ask an expert and don't rely on the headlines in the newspaper or the latest rumour circulating on the web: your health is worth more than that.

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Bowels, Bugs and an unfolding mystery.

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I've written a few blogs on the evolving, largely unexplored, universe that is our very own "Bio-sphere": those Gazillions of bacteria and microscopic organisms that call "yours truly" Home Sweet Home. Just to re-cap on how many there are: if you imagine your body as representing the total number of cells that you call "you", then the area below your left knee represents the number of human cells in your "body" and the rest represents the number of organisms that make up that svelte human being you call you!

But it's in the gloomy recesses of our bowels that mystery unfolds upon mystery. Now it appears that there could be links between what sorts of bacteria are in our bowels and perhaps a gut based immune imbalance that can lead to Diabetes. Then there are theories that certain types of gut bacteria may be linked to why people develop Obesity. Now there are suggestions that bugs in our bowels may feast on the red meat we consume and increase the risks of having a heart attack!

The red meat bit has been around for a long time as vegetarians and vegens have a lower heart attack risk than red meat eaters, and for a long time we have linked the fat in red meat with the increased risk - hence the push for less red meat, make sure it's lean and try to replace it with fish and chicken. But now scientists are saying that there is a chemical in red meat called Carnitine - also found in energy drinks by the way - that might be another link in the Cholesterol/red meat chain. Carnitine is found naturally in red meat and the more you eat then the more Carnitine gets in to your guts. Certain bacteria love the stuff too and create a metabolite (a cute word for chemical) that enhances our body's ability to make cholesterol in the blood stream more likely to stick to the wrong spots!

Yet again, it's early days but my take is that we all eat too much red meat (and urban legend has it that "they" pump our cattle full of antibiotics and chemicals anyway) and that we can get most of our protein and iron needs from other sources. So cut back the red meat to once a week, eat more fish, chicken and all those amazing fresh veggies that are in the supermarkets and stores ( and growing your own is even more fun!) and let those bugs in your bowel get on with the job the good Lord intended for them: and that's to make our lives healthier and happier!

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Questions and courage will help the Kids

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I'm continuing with my theme of how to help young Moms in our communities, because no-one grows up in isolation and we can all play a part - however small - to help lift vulnerable kids out of the mire of despair and give them a chance of making something out of there lives.

Today the CDC reports that 1 in 5 teenage births is a "repeat" and that's a massive challenge for young people to take on and to survive! What that sort of information suggests to me is that it's not just a matter of better birth control - that's vitally important too, but even after decades of information about the pill and condoms only 22% of teenagers used effective methods of contraception - but's it also involves education, literacy, numeracy, parenting skills, having someone they can trust (and for many, that person may not actually be in the community where they currently live), learning the basics of budgeting money, good health information, basic dietary advice to fit their location and their income .. it's a long list and it needs to be accessible to the Mom wherever she is: and that's where the genius of social media may help us play a big part.

Question: Would you be prepared to offer simple, on-line support to a young Mom in your area?

I ask this because it does raise the issue of how much do "I" want to be involved: how can I protect my own identity: what if "they" get to depend on me too much, and "I've got my own problems to contend with"? All of these questions and more need to be asked and some answers found before any website is "switched on": and you, my dear friends, have some of the answers and many of the questions that need to be aired.

But you know what? Despite the tension between our desire to help and our worries about what might be asked of us, none of it compares to the probably life long misery, hurt and destruction that many of these young Moms and their kids face if we people of good will don't at least attempt to do something, however small or seemingly insignificant.

This project will take months/years to get "legs", but I have real faith that eventually something of worth will be created to help those who are most vulnerable. I hope some of you will join me in the journey.

SPREAD THE WORD

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Young Moms - the key to a healthier future

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There are a group of people whom I believe to be the most important people in this world, and they're our young Moms: but to use an Australian colloquial expression, I also think that they're getting the wrong end of the pineapple! They're doing it tough and we need to work out how best to help them during those challenging first 5 years as parents.

The challenge to effect positive change is that "one size" will not fit all: what may work for the affluent parts of San Franciso or Perth, will not work in rural areas of say Africa or India, but the basic principals are the same: education, health and effective mentoring.


I want to start a conversation that leads us to better ways to support our "jeunes Mamans"*, especially those who are single or living in distressed areas, and the internet gives us an opportunity to provide that support.

There are some great educators in cyberspace who can provide culturally appropriate resources for their communities so that literacy and numeracy for young Mums can be improved - and better skilled mothers offers hope for smarter, healthier kids. There is a wealth of information about health issues too - the paradox being that so many in the affluent "west" need information on how to lose weight and yet millions of less affluent "others" needs information on how to provide basic nutrition for themselves and their children: wouldn't it be good for the "Health" of us all if one group could be connected to the other - ? As for mentoring, there must be literally millions of baby boomers with some time on their hands who can provide mentoring for young women in their communities or even those in other communities. Many "grey nomads" already are committed to providing new homes and schools for less well off cultures, perhaps this could be extended to exchanging emails as well?

Another challenge is to have some level of ethics for such an enterprise and here I am impressed by the 12 steps of AA where it's "success" is based on the fact that members need to recognize a "Higher Power", and I believe that for a great number of people this has resonance. There is no doubt that one program will not appeal to everyone, but every woman who is helped to improve their own health and education will have a huge impact on their children and their future life which has great significance for the whole world over time.

I want to start a conversation whereby we can develop a Web Based resource that can be adapted to local needs of each community. What do you think? How can we make a difference? What can we establish that can easily be handed on to the next generation so that we protect the most valuable members in our Communities - our "Madres jovenes"* and their precious children.

*young Moms

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