Friday, 4 September 2015

Get Ready for a Rant

If you are in any way sensitive, don't like naughty language etc, then stop reading right now.

Background - I work in the oil and gas industry, including working offshore, occasionally as an auditor.  That involves me walking around the platform, accompanied by a person from the operating company, looking at stuff and asking questions. I also carry a digital camera as I take photos of stuff that I see, to use in feedback sessions at the end of the audit. Overall therefore, what I do is actually pretty low on the risk scale.

One of the things that I need to do is every four years, go through a training course on offshore escape and emergency training, involving basic fire fighting, escape from smoke filled buildings, escape from submerged and capsized helicopters etc.  I also need a medical. 

Pre diabetes this was every two years.  In their wisdom Oil and Gas UK have determined that as a T1 diabetic, I need to do this every year.   Rant number 1 - why the fuck, as a well controlled diabetic should I be subject to a full medical on an annual basis when I have two other significant engagements with the medical system in terms of annual reviews as a pump user and with my consultant.  Surely the most effective basis here would be for me to submit my HbA1c information, a letter from my quack and then determine on the basis of that, what my risk as a T1D is, and then decide if I need an annual medical. But what the fuck would I know, I only do it every day.

Get ready for rant number 2

This year, my now annual medical expired on 22nd August, I therefore arranged my appointment with my offshore doctor on 27th July, assuming that would be plenty of time. I arranged it early because, and get ready for yet more pointless bureaucracy, I need every single platform I may visit identified on my medical certificate and the company doctor of every operator needs to give consent for me to go there, and, before I go the medic on the platform needs to give his affirmation that he is happy for me to visit and can deal with potential complications.

You'd have thought with an HbA1C of 42, no history of hypo unawareness and no history of needing assistance to deal with hypos, and a consultant's letter detailing how well I manage the condition (yes, in diabetic terms I'm in the top 10%, sun shining out of my arse etc) I'd have no problem.

Well, 4 weeks down the line and looking to go offshore next week I can tell you, I'm mightily pissed off, to the extent that I'd be happy right now to tell the offshore medical community to go and do things to itself in anatomical terms that only the medical community is likely to understand.
 

Pulling directly from an e-mail sent to me (names redacted to avoid litigation)

Dear Dr XXXX,

 I have had discussions with [operator XXX].  There are some issues to overcome before a decision can be made as the battery operated insulin pump is often not certified as ‘intrinsically safe’

Does the auditing work he is undertaking involve going outdoors i.e. outwith the accommodation area

If his job would involve going out on deck can he forward evidence that the insulin pump is ‘intrinsically safe

 
My response

Essentially the problem is that your company doctor is conflating the medical clearance in terms of is my diabetes controlled and am I a health risk with process safety risks.  They are asking, wrongly in my view, questions about the pump and whether it is intrinsically safe etc which has absolutely no bearing on my ability to manage diabetes as a medical condition.

My view is that control of the ignition risk is an issue for the platform management through ISSOW and other risk control channels. In fact the pump is an IPX8 rated device, so suitable for Zone 2 environments and is powered by one AAA battery, which will not be changed outside the accommodation. We routinely use digital cameras outside the accommodation, with gas detectors, permit to work etc, which is exactly what I have done elsewhere in relation to the pump.

Since I started on the pump I have been to XXX LNG, YYY Tunisia and a handful of other North Sea installations, all under the conditions I describe above.  My view here is that the doctor is overstepping the bounds of both his responsibility and knowledge
 

My real response

What the fuck are you talking about? You are a doctor, not a process safety specialist. Your company employs me because I am a process safety specialist.  Do you have any fucking idea why you are asking that question, or what intrinsically safe actually means?  Do you have any idea of what goes on offshore and the equipment that people take outside the accommodation?  Do you really think, as a process safety specialist I would put myself and others at risk unnecessarily?

Wind your fucking neck in and stick to what you know about.  Am I medically fit to go offshore or not.  Leave questions about managing safety risks to those that know how to do it.

Can you detect that I'm slightly peeved?

End of Rant

 

 

Tuesday, 1 September 2015

Watch This Space


No pun intended there, but an accidental double tagging.

Having gotten fed up of my Garmin 310XT losing its memory, I decided enough was enough, flogged it on flea bay and bought myself the new 920XT instead.  This watch really is the dogs-danglies, taking all the concepts that were introduced in the 310XT, adding a load of new stuff from the Fenix range and ending up with an even better package overall.

Battery life is much better, with a variable tracking option, built in run walk, does swim, bike, run (I’ve tried all three so far) and gym.  Only thing that’s a retrograde step is removing the interaction with gym equipment, but you can’t have everything. The GPS connects much better than the 310XT, even when amongst buildings in Aberdeen.  It’s also a functional, if a bit chunky watch with a very strident alarm.  One of the best things is that unlike the 310XT, you can upload the resulting .FIT files directly to Garmin Connect via the USB charge cradle. Photos will follow once I’ve played with it a bot more.

So far I’ve used it on several runs, including the Bob Graham recce where the altimeter proved to be pretty accurate, and on several bike rides.  Even used it in the pool where it correctly picked up my stroke rate.  And most important, it’s nice to me – at the moment it’s telling me that my VO2max is at the top of the scale, above the 95th centile for someone 20 years younger than me.

The other part of watch this space is the growing trepidation as this year’s silliness arrives quickly – the Riover Ayr Way race, on 19th Sept.  Last long run tomorrow, using the predesigned run/walk feature on the Garmin.  I’ll plan it as 25min run/5 min walk, normally something I try and do to conserve energy through the race and to stop myself going off too hard with the adrenaline at the start.  Planning my drop-bag strategy as well for the 10-mile-ish aid stations that have food as well as water. Not planning on carrying much, some just in case and then concentrated electrolytes.

Pack list is being jotted down as well on my desk pad as things come to mind.  Along with nutritional needs etc.

The third and final part of watch this space?  I’m trying to build myself a website.  I’m getting so many questions and requests for advice on managing diabetes as an athlete that I don’t have time to answer them alongside the day job, which now that I’m on the leadership development plan will only get busier. So, a website, all about me, managing diabetes, a few nice piccies, recipes, link to my blog, a chance to ask me more questions etc.  Pretty basic and will be self-built, but it’s a start.

So, to the final bit of this episode, last long run before the RAW, strictly controlled as 25min run/5 min walk using the function on the Garmin 920XT.  Overall worked very well, 80% off road on the lanes and bridleways around me, flat mainly of course, but then RAW is overall downhill losing about 250m in the 40 miles or so.   

One thing I did find, which is of course relevant for the BGR later is that my calves reacted more to the walking than the running, particularly the outside of the shins – more massage needed there I think.  Overall though 34.5km, no issues at all, legs feel absolutely fine with no discomfort at all on the Monday or Tuesday following.  Pace stayed pretty much the same all through and if sustainable could see me putting in a decent time. The strict run/walk tends to stop me going off too hard and then blowing up later in the race.  All comes down to rest times and pace drop off in the last 10-15 miles.  Touch wood, I’m not carrying any injuries this year, unlike the last two years.

Stats for the run
Total 34.8km / 3h 23:39 / 5:51 pace / AHR 146 /MHR 160

BG in good control all round, with approx. 100g on the run, 30 g before and 20g straight after, so sticking around the 30-40g/hr that I seem to get by with.
 
Details

Splits / Time / Cumulative Time / Distance / Avg Pace / Avg HR / Max HR
1 / 27:49 / 27:49 / 5.00 / 5:34 / 143 /157
2 / 32:05 / 59:55 / 5.00 / 6:25 / 147 / 160
3 / 28:06 / 1:28:01 / 5.00 / 5:37 / 146 / 154
4 / 29:09 / 1:57:09 / 5.00 / 5:50 / 146 / 155
5 / 29:46 / 2:26:55 / 5.00 / 5:57 / 146 / 153
6 / 28:06 / 2:55:01 / 5.00 / 5:37 / 147 / 154
7 / 28:38 / 3:23:39 / 4.80 / 5:58 / 143 / 154

Summary 3:23:39 / 34.80 / 5:51 / 146 / 160