My visit to Manchester

As I have mentioned in an earlier entry, I went to Manchester last week to join an academic course that would run for 2 days. Known as the Advanced Paediatric Life Support course, or the APLS, this course was organised by the Advanced Life Support Group with the Royal Manchester Children's Hospital and the related trust. The venue was to be their training headquarters (the ManCEL) at the West Point building on Chester Street in central Manchester. I had already booked my rail tickets to Manchester Oxford street, and my hotel bookings on booking.com at the Hotel Ibis Budget at Salford Quays in the Salford area of central Manchester. I will write a review of this hotel in a separate post or on Tripadvisor. 

The hotel

Arriving by train on Sunday evening, I got off a little previous to my stated destination (at Deansgate instead of the Oxford station), and then took a tram to the hotel area. It was a lovely final leg of the journey and I arrived at the hotel reception at a little after seven p.m. The receptionist, a Spanish woman by the name of Carmen, speaking with a Spanish accent, kindly accepted my online booking and offered me a free upgrade to a double bed room (whereas I had booked into a single bed room). I was handed over the card and shown the cafe and the password for the free WiFi and so on. I retired to my room. It was a pleasant place indeed. I have no complaints against it, as it was just GBP 31.5 per night! The room had adequate lighting, a lovely shower stall, a slightly cramped toilet, an extra bed over the double bed where one can have a third guest if needed and pretty clean furniture and stuff. 

How my room looked

In the night, I went to a local restaurant located just opposite the hotel. It is called the Shahi Masala and although it prides itself on calling it an Indian restaurant, it is owned and run by Pakistanis. I had a nahari lamb with tandoori roti - my first taste of authentic Nahari here in the UK. Meeting the floor manager and the waiters was a pleasant experience. I had mini-chats with the manager (Asif) and the waiter (Saqi) and learned that this is the usual practice in the UK. They said they knew many other places in the kingdom which were run by Pakistanis but were referred to as Indian restaurants. 

The wash basin and my own reflection in the full-length
mirror

On the next morning, I woke up early to reach the course venue which is about 2 km away from the hotel. It was an energising walk indeed, but I managed to arrive at the stroke of eight, and was guided to the 8th floor, where the course would be held. There was an initial period of half an hour where they basically allowed the candidates to come in and register, meet each other and have tea, coffee, and so on. WE got underway at half past eight, and the long day of training, interspersed with 2 tea breaks and a lunch break finally got over at half past six in the evening!

I met with and befriended quite a few people, most from Manchester, but quite a few from other places as well, such as Liverpool, Birmingham, North East England, and so on. I was able to befriend some Indian doctors as well, and would like to mention Drs. Rashmi Mehta and Swaroop Roy specially, since they are both, like me, Mumbaikars. However, they have been here in the UK since many years, and it was easy to see how they are already well-assimilated in the system.

In the evening, after my return, I went for a walk, and then to the same restaurant as I had been to the previous night, where I ate a lovely dinner of a gravy chicken vindaloo with pulao.

The next day at the course was as tiring as the first day, but it seemed that I was getting the hang of it and was able to learn more efficiently. The lunch mostly consisted of sandwiches, but there were plenty of them to go around. They did have biscuits with tea, and juices and such, so they looked after us pretty well. At the end of the day, after waiting for nearly an hour and a half, the trainers came out and told us our results. I had passed their evaluation!

One of my new friends, one Dr. Venkat, who is a consultant at a different location in the UK (Huddersfield) gave me a lift in his car, first to the hotel, to pick up my bag, and then, all the way to Salford Crescent railway station, from where I would be able to catch my return train to Blackpool.

In the event, I returned to Blackpool at half past eight, and I went straight to Mr. Basrai's World Foods restaurant, where I had a filling buffet dinner before returning to my room at the hospital. A review of this excellent eating out place is available on my profile at Tripadvisor. I will add the link once it is published there.

Thank you for reading this entry. I really enjoyed writing it. If you like it, won't you let me know, please, through the comments section below. 

A round-up of the past several days

I have been working hard the last week, and hence, have been unable to supply you, dear readers, with any fresh installments. That doesn't mean that I do not have anything to share ... in fact, a lot has been happening! 

At work, I am getting a little more comfortable with the things I do. 

At home, I am busy studying for the upcoming mandatory training course that I will be going for the coming new week. This is at Manchester, and I must clear this course with a certificate. It is called the Advanced Paediatric Life Support (APLS) course.  

On the fitness front, I am progressing really well. So far, I have lost 4.8 kg since I came here to the UK in about 2 months. I have been training at the local gym, but several other factors have also contributed. I walk a lot - in fact, in the last 15 days, I have walked 120.5 km! I know this as I am using a Fitbit wrist-worn device to measure my footsteps. In addition, I am paying attention to my diet, and I am on a new anti-diabetic medicine that actually helps to not just control my diabetes, but also to lose weight. 

Have I been enjoying myself or not? Well, if you think I am not, you are mistaken. On the last Tuesday, the 19th of this month, some of my co-residents and one of the advanced neonatal nurse practitioners and I went to a posh restaurant in town known as Frank & Benny's. We had a marvellous, but expensive dinner. After this, we went to see a movie - The Revenant - starring Leonardo di Caprio - at a multiplex theatre just opposite the restaurant. The theatre is called the Odeon, and it has six screens. It was a lovely experience, and I can certainly say that every minute of the evening was fun. 

In other news, I also got myself a 32" flat-screen TV through Amazon. The hostel room that I live in already has a feed through an external antenna, and the accommodations-in-charge, Ms. Karen McKenna arranged for getting my TV all set-up to receive the signals of all the free channels that can be seen on the TV. I am really discovering a lot of the Kingdom through these shows - but I really love the itv channel for its variety of shows, and the BBC 2 channel for its news coverage of UK events. 

Am I cooking? My friends will remember how I used to make a lot of dishes when I was in Saudi Arabia. Alas, the lack of time, and the ready availability of food in the hospital restaurant as well as the various shops inside it have made me somewhat lazy. I now get ready-to-eat food many times. Especially enjoyable are the pre-cooked ready meals available at the Marks and Spencer's Food shop (M & S), They have foods from several countries of the world, including the many Asian countries, European ones, etc. This has led me to actually discover world cuisine, but the only grouse is that this is pre-packed food, not fresh. Even so, it is quite tasty. 

My own cooking has been simple, though I have made my own breakfast - poha, upma, omelette, boiled eggs, sandwiches, etc. For the main meals, I usually make dal, but I have made vegetables, fish, chicken and lamb as well. The thing is, British food is slowly growing on me, and I am beginning to enjoy its flavours. This means that I now add a little less chilli in my Indian food! 

The end of the month will see a change in the people I work with. Some will get transferred to other hospitals as they have completed their six-month rota in our hospital. Dr. Elisabeta Ene (Letty for short), Dr. Ahsan Ul Haq and Dr. Selma are all slated to leave, as are some of the house officers. It will be a big loss for me, as they have all been not just colleagues, but have also helped me out in adjusting to the British Healthcare system (the NHS). I am really going to miss them. 

And this ends my entry today. Do let me know how you found it. Thank you. 

About how I am getting along at work

In my previous post, I wrote about my efforts to get fit. Today, I am going to share with you what I am doing at work. When I last wrote about this, I did share with you that I was still on a steep learning curve, and that it sometimes got overwhelming. Well, as I write this today, I will confirm that as far as those view-points are concerned, nothing much has altered. However, my acceptance of them has enabled me to try that much harder to overcome the obstacles that I thought initially to be insurmountable.

Yesterday, I was successful in cannulating the vein of a child for the sake of blood collection; today, I was able to do a test known as a lumbar puncture - something that one does to collect the fluid around our brain and spinal cord to check if there is neural infection.This is one test that relatives in India often do not give consent to, but here, in the UK, they are already aware that it is a necessary test to confirm or rule out infection in the coverings of the brain, or the meninges. This is a potentially serious form of neural infection, which can even be lethal if it occurs in a weak or small child.

Then, today afternoon, I trained with one of the advanced neonatal nurse practitioners, Ms. Liz Morrison, in examining well babies on the post-natal ward (where they keep mothers with recently delivered normal babies).

Now, to be honest, it isn't that I have not cannulated veins or done lumbar punctures or examined healthy babies. I have done all those things during my residency training nearly 32 years ago! And, during my years as a consultant, I kept doing those things off and on - but rarely on a daily basis. That led me to being less confident that I could pick up those skills again. Thus far, I have had difficulties in drawing blood samples from children, or in doing their lumbar punctures,  both of which I had done countless numbers of times during my training in the nineteen-eighties. Lack of continuous practice has blunted my experienced hands. There is another aspect to this as well. Techniques and the tools we use to do these collections have also changed. Needles are sharper too. In the UK, parents are allowed, nay, encouraged, to stay in the room with the child during blood collections and cannulations. All these things are unfamiliar to me, and cause me disturbance that comes in the way of my efficient performance. 

Thus, the last few days have really helped me to become a lot more confident and comfortable with the tasks I am expected to perform, May this confidence help me to convince the others on the clinical team, both, my juniors, and my seniors, to have faith and to believe in my capabilities. Amen.

On the positive side, I am very comfortable when I am asked to see patients in the Paediatric Clinic. This is because most of the consultations are of patients who are "cold", i.e., they have no acute emergency requirements. When the consultants are good to me, I get immense opportunity to learn from them. Usually, they are always good, but, at times, especially when there are many patients, the consultants do get a little impatient and flustered. I can understand where that is coming from, so it's fine. I remain patient and abide my chance to go into the consultants' examining rooms and listen to them and their conversations with the patients and their carers. They will also go over the cases I have seen and make course corrections where they find my plan to be in-consonant with the needs of the patient, or, in some way, not in line with what they think is correct. This is an immense learning opportunity and I am quite happy with it.

Any threats to me? Well, if I don't ship up in the next few months, I might get into trouble, but I sure don't think so, as I am an eager learner, and I guess the more I stay on the wards and do my work, the better I will get at my skills.

The 10000 step challenge

The Blackpool Victoria Hospital works to bring funds from many sources. One such source is the Blue Skies Charity Fund which works with the aim to collect funds for the hospital and its large requirement of money throughout the year. The BSCF runs many ongoing programs and periodically unfurls smaller campaigns that help the fund as well as the participants in some way or the other. Recently, it announced a fitness campaign that encourages employees of the hospital as well as anyone else who wishes to participate, to walk 10 thousand steps daily for an entire month. In this case, it happens to be January. 

I joined the campaign wholeheartedly, as I am all out to improve my fitness levels. It then asks participants to try and get others to "join" in the fun by donating money to support your effort. The donated money goes to the fund, and not to you. As part of the effort, therefore, I created a campaign page for myself at THIS site. Do click on the "THIS" to take you to my page. You will see my progress here, and if you wish to, you can donate to the BSCF and indirectly extend your support both to me, and to the fund, which is doing great work for the time it has been around. 

So far, I have been able to achieve my target and even go past it every day. As I could not join on the first of January, I have started the campaign from the 8th of the month. Today is the fifth day of my campaign, and I must say I am surprised at my own stamina in trying to reach, and then go past, the daily goal. 

To enable me to count my daily steps, I first downloaded an app to my phone, but found it cumbersome to carry my phone around everywhere. Also, when my battery ran out, the phone simply stopped counting my steps, as it happened on the second day, To avoid this, I ordered a wrist band that has the capability not only to count my steps, but also to monitor my heart rate, the calories I burn every day, the number of stairs I climb daily and show me the time as well. This device comes from FITBIT, and the MODEL I use cost me about INR 8000. It arrived within 24 hours, and I have been using it since Saturday afternoon. It has been an awesome experience. 

My aim is to cross the monthly target of 310000 steps. This is equivalent to about 215 km, or a little over 7 km a day. So far, it is going well indeed. I have reached over 55000 steps in the nearly 5 days that I am monitoring myself. That is over 35 km. 

I am also gymming, but not six days a week, just thrice a week. The gym evenings are intensive, however, and my personal trainer, who goes by the curious name of Jamie Evill, is a fantastic motivator and trainer. I am completely under his charisma, and so far, he and I have been doing great things at each of my sessions. With my own resolution to walk more, a little better control of my diet, better medicines for my diabetes, and the training at the gym, I have lost 4.5 kg since I came to the UK on the 14th of November 2015. Cheers to that!

The working week that went by

I have been really busy the last five days. As I write this on a Friday evening, I have little in the way of exciting news to share, and yet, there have been things that I feel I must share with you. It is nearing two months since I arrived in the UK. The first month was a month of getting used to the cold weather here, and also awaiting my first salary. In the second month, the salary, thankfully, did arrive, and liberated me to some extent, from living in abject penury the way I was doing earlier. I have been very fortunate to befriend a few people here, such as my immediate co-registrars Dr. Yogesh Kuba, Dr. Evelyn Chia, and Dr. Letty Ene. In addition, I am on good terms with all my house officers - esp. Drs. Chidi Ogiashe, Dr. Joe Stone, Dr. Akwiya, Dr. Fatima Hayat  and Dr. Yassir, among others. Among the consultants, I am still trying to find my way, as they are all extremely good teachers, but each is temperamentally a little different from the others. I have really enjoyed myself with most of them, but I feel that I do need to be a little more efficient if I have to win them over to my side.

The work has been very "different" from the way I used to work both in India and in Saudi Arabia. For one thing, Blackpool is a very busy hospital. It has over 780 beds. The Paediatric department has hundreds of out-patient visitors every month, and they are usually treated and sent back home. Only a small percent are admitted as in-patients. However, as out-patients, they stretch the resources a lot. Each patient needs to be seen by a nurse, then clerked by the house officer, then shown to the registrar or the consultant, then investigated as needed, re-evaluated by the nurses and the doctor before they go back home and so on. Each patient needs to be explained at each stage what is being done to them and then re-informed of the outcome of each of the interventions and/or the results of the blood tests or X-rays done on them. Once they have gone through all of those steps, one needs to write a prescription of the medicines they would need and then they are sent home. All this happens in an area of the ward that is known as the Children's Assessment Unit. In yet another section, the in-patients are being looked after. This is the Children's Ward and it has over 15 beds, and an Adolescent section, with over 7 beds. Next, there is a Neonatal section with a variable number of preterm and sick neonates (infants less than a month old) - usually 10-15 as well. Lastly, the House officers and sometimes the registrars have to "follow up" blood reports or other investigations done on the patients earlier that day. The list is provided to them at each 8 hourly hand over, and they must complete the pending tasks before the next handover is due.

That's not all. We have Paediatric clinics, where one registrar has to go every day to assist one of the consultants. We have a delivery suite where newborns are churned out of their mothers' wombs either naturally, or actively through a Caeserean section. And that finishes the various active areas involving paediatric department duties. When one is in the ward, it is a very busy duty, and I have frequently been unable to find any time for lunch in between. When I am in the Neonatal unit, it's the same. The only way I can feed myself is if I carry my lunch with me, and so far, I have been able to do it very rarely, as there is no time in the mornings to make myself a lunch box! Thus, quite often, I go to the hospital's own restaurant and buy stuff and eat it there before returning to the ward to continue where I left off.

In the evenings, I go to the gym or go for a walk, depending on whether my gym trainer has fixed a session with me or not. Generally, I walk to the gym which is about 1.5 km away, and return walking as well. This enables me to do the gym workouts AND walk about 3 km each day. After I return from the gym, I usually go to the Costa Coffee outlet in the hospital and have a Cappucino and sit in the lobby to read my Whatsapp messages and play a bit of my mobile phone games. By the time I return to my room, which is at about half past eight or even nine p.m., I am tired and simply heat some food for dinner and have it while watching some TV series videos or a movie on my laptop.

That sums up the things I did this week. What is planned for the weekend? Well, I would go to the gym on Saturday, and work in the ward on Sunday ... and that's where I will be ... so, if you are reading this before the weekend runs out, expect to see me on the blog only after 2-4 days at best. Thanks for reading and for your comments, which I will look forward to.

My first solo-trip: A walk in the woods - Monsal Trail - Part 1

On last Friday, the first day of the new year, I woke up with a thought of going somewhere to spend the next few days, as I have no weekend and holiday duties. I searched for nearby places of interest, and came across descriptions of the Peak District National Park in Derbyshire. This region of the UK is located south-east of Manchester, and includes many locations such as Buxton, Ashford-in-the-water, etc. One of its attractions is a trail known by the name Monsal Trail. It is the route of an old railway line that ran from Manchester to London and was used by commuters and cargo trains from 1860 up until 1968. Once modern railway lines were built, the route fell into disuse and was refurbished over the last several decades into a woods walk, some 10 miles long, from Wyedale on the west end to Bakewell into the south-east ... the trail passes through some very picturesque woodlands, from Wyedale to Cheedale, Millers' Dale, Litton, etc, till it reaches Bakewell in the south. For nearly 60-70% of its distance, it follows by the side of the meandering Wye river. 

More famous for visiting during the spring and the summer, the Monsal trail can be accessed throughout the year. To reach there, one has to either start at Wyedale, join it at Miller's Dale, or start from the Bakewell end. I chose to pick up the trail from Miller's Dale, a place that can be reached by a 15-minute bus ride from Buxton. As I was travelling alone, I decided to only do the trail from my starting point to its western end at Wyedale. 

Armed with this information, I booked a hotel room on Friday morning. It would be a single room at Hotel Portland in Buxton (£ 40 per night for B & B). I informed the gentleman that I would reach there by evening. I began my journey by taking a train from the Blackpool North station. I had booked the journey online, so I had to just go to a ticket self-serving machine, insert my debit card for verification, and print out my tickets (£ 26.40 return). I took a York train, got off at Preston, then changed to a Manchester Piccadilly train, and at the latter station, changed to a Buxton train. The entire journey took about three hours, including the two changes. I arrived at Buxton a little before 5 p.m. It was a cold and windy evening, and I had almost no difficulty finding the hotel I was to stay in. It was located on the main road ahead of the Palace Hotel, the Buxton college and a few private residences. The owner, a Mr. Robert ___. recognised me from the phone call I had made earlier. He and I chatted for a while on various issues concerning India and my life in it earlier. I really enjoyed his company. He is around 60, with a wife, two daughters and two grandchildren. He manages the hotel all by himself through the entire day, sleeps in there all the six nights from Monday until Saturday, and only goes home on Sundays, when a friend of his turns up at the hotel to manage it for a day. I guess he gets a helping hand on each morning when he serves a full breakfast for all his guests. I met with the lady who helps him out the next morning. 

I went to my room - No. 31 on the second floor. It was a small but clean room with a double bed, a table, two chairs, a cupboard in the wall, a well-appointed bathroom with a toilet, two side tables and a lamp, and a large window with a view of the town below. 

Portland Hotel

My room

Another view of the room with the table, the TV and the cupboard (white
in colour with two knobs)

I could hardly see anything, as it was already dark. I watched the ITV channel for an hour before I decided to go out for dinner (the hotel does not serve lunch or dinner). There were several restaurants that I looked at before settling for the "Indian Palace" Restaurant on the main market road. 

This was a busy place, and I was quickly led to the upper floor, where I was allotted a table to myself. The waiter, one Mr. Husain, a bearded guy who told me this was a Bangladeshi restaurant in reality (and that he, himself, was a Bangladeshi). Around me were other guests - a six-member party of three Caucasian couples and a three-member Asian party of a couple with their young daughter who spoke to each other in either Hindi or Urdu. I settled in to order. My order was tandoori salmon tikka and chicken vindaloo with chapatis.

Indian Restaurant, Buxton

Upper floor

Salmon fish tikka

Chicken vindaloo with chappati and papad

After dinner, I returned to the hotel and watched some more TV before turning out the lights at midnight. I was looking forward to my outing the next morning ... please click here to go to the next day's description. 

My first solo-trip: A walk in the woods - Monsal Trail - Part 2

Please read the first part of this HERE. 

Waking up at about half past six, I went down with all my luggage and checked out at half past seven. I had the modest breakfast that was served. It consisted of cereals, milk, juice, toast and scrambled egg. Robert was quite busy, so I had no opportunity to speak with him other than to hand over his dues and shake his hand. When I left the hotel, I had not much of a clue on how to go about reaching the trail, although I had all the bus route numbers and stuff from my internet search. On the previous night, I did go to the bus stops mentioned in the flyers I had downloaded, but it did not amount to much "on-the-ground" information. I ventured out to the railway station, and searched for the information on the various tourist boards. Then I walked down the railway road to the other side where the town centre is listed. I had information on five designated bus stops for all major travel into and out of Buxton, but I could not locate these stops for the life of me. I approached a driver within a bus that was halted at one of the stops. He was not really able to guide me, but he did help me by offering me a ride in his bus with no charges, saying that he would leave me at the town centre, where I could look at the various bus stops and find the ones that were relevant.

I finally located my stops, which were stops A and B right opposite the Buxton Town hall. 

Buxton Town Hall

The stairs to the trail

Basically, one can take the following buses to Miller's Dale: 65, 66 and 68. These buses are not run frequently, but return tickets on them are easier on the pocket and are honoured across all three routes, although 65 is run by an operator different from the one that runs the other two buses. Tony was the driver on the 65 that I got from Stop A. The bus took off at 9.30, and on my request, Tony dropped me at Wormhill - one stop before the one that was mentioned on my flyer (which was Angler's Nest). Just behind the stop, I found, on my right, a flight of wooden stairs that led me up to the Monsal Trail. The walk was on!

Information about Monsal trail

How it looked at the start

This trail is about 2 miles from where I climbed up to its western end at Wyedale. It passes by several side trails and bridle paths (which are meant for horse-riders). The main trail can be used by those who are walking, those who are on bicycles and those horse-riding. Being a wet, winter day, I met less than 20 co-travellers in the next 3 hours that I was on the trail. None was on horse-back, around six or eight were walkers, and the rest, on bicycles. It was very quiet and serene. The trees were shorn of leaves, but the floor of the forest was covered with leaves of these trees. I spotted a very few birds, and heard bird calls from the stone hills on my left and a few green hills on my right, but could identify none. I hardly saw any animals, insects or birds and no flowers either. But what was interesting was the lovely view of the hills and prmontories all along the way. On one of the bridleways, I had trouble coming down, as I slipped on the muddy floor three times! I did not hurt myself, and managed to clean my rear in a large receptacle of water that I found at the base of the trail. So, it was okay. A distinguished looking man by the name of Tony was walking in the opposite direction when I met him with his son Scott (19) and his dog Molly (2). He gave me additional information on the old railway lines that ran here between 1860 and 1968. These lines took passengers from Manchester to London and back, and Miller's Dale station was among the most busy ones on this track. I had a chance to see the station at the very end of my walk, just before I reached the bus stop to take a return bus to Buxton. 

One of the side-trails that goes to the top of the kiln

The two main highlights of my trail included visiting an old Lime Kiln and walking through three tunnels. I am posting pictures of my trail walk, as well as those of the kiln and the tunnels. Enjoy these:

And now, on to the third, the most important and enjoyable highlight of the entire walk: the Wye river. It gurgled and flowed in a relentless stream, twisting this way and that, appearing sometimes on my right, and sometimes on my left, as it meandered down its way. 

The Wye river is a small river here, but its force has to be reckoned with! I took several pictures of the river as it flowed below the walking areas. I even shot a few videos of it.  These photos will be posted here too. Just look below. 

Top of the lime-kiln

Inside the kiln

How the kiln was operated 

The lime kiln

Information about the trail itself and how it runs from one end
to the other

Chee tor tunnel # 1

Inside the tunnel. Lights switch off at dusk

Yet another tunnel

And, one more

Selfie ... inside the tunnel

The last overhang, before the trail nears its end

Information about the trail, with new insights

The old Miller's Dale railway station

I went down here and put my hand in the stream ... it was a strong current indeed.

The gushing river

A selfie by the river

The river at the Wyedale end ... this is at the proximal end

And that brings me to the end of this journey. The rest can be told in five lines. I returned to Buxton by two in the afternoon, and my return journey from there to Blackpool was completed in just over 3 hours and ten minutes, which includes the waiting time between changes. On the return journey, there was a transfer by bus from the Piccadilly station to the Victoria station ... and this bus journey was included in my ticket fare. My final ride was from Manchester Victoria to Blackpool North. And then, it was a bus-ride home, but not until after a dinner at a new place I discovered ... Nunzio's ... but more on this in my food-related entries in this blog.

I hope you enjoyed reading this entry! Do enlarge the photos (just click on them) to enjoy them even more. Thank you. Do comment please ...