Namaste, and all that…

A couple of weeks ago, I made the somewhat premature, and possibly ill-advised, decision to book myself onto a yoga class, and I have to admit that, all things considered, it was quite an odd thing to do taking into account that I am currently unable to even manage the most basic of asanas well. I remain puzzled about what on earth was going through my mind at this particular point in time, but as with the majority of my ‘decisions’ of late, I had a fair level of reassurance that I would most likely bail at the last minute anyway – ‘unreliable’ has become my middle name over the past few years. I’d even gone as far as to phone the teacher beforehand to warn her of my various physical limitations, perhaps in the hope that she would refuse her consent to me attending because I could turn out to be the biggest liability she’d ever had to deal with; however, no joy there either, and she suggested I came along to give it a whirl. Meanwhile, my head was busy reassuring itself that I still had numerous reasons for not showing up: waking up and getting up on time is still quite a major achievement for me, swiftly followed by the level of pain and stiffness first thing, whether the pills kick in on time, and when they do whether I’ll be too wasted to do anything much at all. And even if I managed all of the above, I would presumably have raging anxiety levels which would make it impossible for me to go somewhere I’d never been before and be surrounded by complete strangers. So, I slept well that night, safe in the knowledge that I had numerous genuine reasons and lame excuses already in place, and assumed I simply wouldn’t manage it which would probably be the best outcome for all involved.

Yoga is interesting stuff, and I’ve practised it intermittently for many years. I should, perhaps, add here that I’ve never felt the physical / psychological / spiritual/ transformational uplift which many yogis / yoginis apparently do experience, but in the past my relatively brief periods of doing yoga regularly have produced positive physical and psychological results. I first tried it during late pregnancy, and found it helped with respiration, relaxation and flexibility. I tried it again a few years later, having discovered that I would need to wait many years before my knee replacement surgery could be performed so to try to retain as much flexion within my leg as possible in the meantime, and then again a respectable period of time after surgery. And finally, I drifted back into it a few years ago, during a more frantic search for some level of reassurance that my body wasn’t escalating wildly out of control, before having to admit that actually it was and I needed more surgery. It seems that there has always been some benefit in my practising yoga on a regular basis, so why do I never stick at it? If memory serves correctly, it is a combination of things – firstly, and perhaps inevitably, the changing levels of mobility and pain due to my arthritic condition; secondly, my psychological issues with depression and the accompanying lethargy, lack of motivation and decreased energy levels are hardly conducive to such practices; and finally, dare I say that perhaps it’s my personality which is at odds with it, my impatience and my lifelong inability to stick at anything for very long before flitting off and diving into my next fad?

Anyone who has ever tried yoga will probably tell you that it’s hard work – really bloody hard work. Yes, it all looks very lovely and a bit freaky, but just because no-one ever leaves a class with a scarlet sweating face and gasping for breath doesn’t mean that it isn’t a major body work-out. Again, this is what puzzled me about why I booked myself onto a class – surely, after all the aches and pains of the past few months, why would I want to put my body through something like this?! I guess the answer lies in the fact that I am so totally sick of doctors, surgeons, hospitals, physios, and all things clinical. I think the answer is that I realised that I needed to do more to get my body working better, to build more stamina, to strengthen core muscles etc but also that what I wanted was something which was interesting, nurturing, and was more holistic than the traditional post-surgery recuperation strategies. One of the purposes of this blog has always been to consider a more humane perception of the physical and psychological impact of arthritic conditions and treatments, and how clinical approaches to recuperation are limited simply to physiological expertise rather than a more supportive and holistic approach.

So, did I actually get myself to the class? Yes! Much to my amazement, I did manage to get myself there, and have attended a further two since then, although it would be fair to say that one was far more suitable than the other. I even managed to complete some of the asanas with varying degrees of success, and am now trying out various local classes to find something which works best for me at the present time and with my current physical limitations. It’s tough and I feel absolutely battered for a couple of days afterwards, but I have learnt a lot about the current condition of my body and its limitations. I have also learnt something rather curious about my psychological state of mind. As often happens with me, my anticipation of how I will respond to any given circumstance or situation is not necessarily correct, and this is precisely what happened with the first yoga class; I expected to be too shy / nervous / anxious to attend, but actually the opposite happened. As I have said previously, I don’t really do ‘anxiety’ or if I do it’s usually a specific situation, most often if I have to go somewhere I don’t know and where I don’t know anyone. The first yoga class had all the elements I avoid like the plague whenever possible, however, I did manage this with relative ease, most likely because the state of my depression is, at present, in the “couldn’t care less about anything” phase; it was by exploiting this which enabled me to get there and do that thing. I’ve figured that this is actually something really useful to be aware of, and if I genuinely don’t care, whatever happens or if something goes badly pear-shaped, it won’t bother me because it doesn’t actually matter. It’s empowering, although for all the wrong reasons, but is progress of sorts I think.

My habitual hunt for interesting images today produced the pic above – yes, it’s unusual for a yoga photo, and thankfully, no effortless flexibility or smugness here. The image in itself spoke volumes to me about my own shortcomings regarding yoga practice, but the article is also worth a read. Rage Yoga, if you haven’t heard of it before, is the complete antithesis of the usual practice of yoga, and I’m both ashamed and possibly proud to say that maybe this is a type of yoga that I should consider and start tweaking my practice to accommodate a lot more swearing and regular beer breaks?

So, tomorrow I will be back again at my local, very calm and polite class – forcing my body to do stuff it really would rather not given the choice, channelling my anger and frustration into asanas, and trying not to swear out loud. To any yogis and yoginis out there who might be reading this, “Namaste”. And to anyone else who happens to practise Rage Yoga, “Namaste, Motherfu*kers!”

You are not alone!

alone I don’t know about anyone else, but I find the world to be an incessantly noisy place. And it isn’t just the usual suspects such as the internet, social media, mobile phones and generic media, but people too seem to have become extremely noisy over the past decade or so, almost like they are no longer capable of dealing with stillness or, worse still, silence. I really enjoy both stillness and silence, I enjoy being alone, I am entirely comfortable in my own space, and can easily spend long periods of time alone, quite comfortable in my own company, so much so that I actually prefer it a lot of the time. However, I am not immune to everything and there is one area of my life where I feel a desperate lack of interaction and a need for something to change.

One of the problems which I, and many others, experience as the result of having a long-term health condition is one of feeling alone, and I suspect that this feeling is common to many other problematic health issues; the feeling of isolation, the unfair assumption that those closest to us will probably have no idea how we really feel because we always try to make it sound less of a problem than it really is, and the realisation that no matter how sensible, logical and practical their responses and reassurances intended to counteract our negative mindsets may be, we can never quite accept what they are saying because it feels like they “just don’t get” the extent of the tedium and frustration of dealing with chronic conditions.

Feeling alone with a challenging health condition is an uncomfortable place to be, and in previous posts I have written briefly about this, and the reasons behind why I feel this way. The fact that, statistically, 8.75 million people in the UK sought treatment for osteoarthritis last year reveals how alarmingly common the condition actually is, and there will be many others who have either not sought medical help or are perhaps yet to realise that the source of their pain is actually an arthritic condition. So bearing these statistics in mind, how and why could I possibly feel a sense of isolation when, I am most likely surrounded by people with the same condition?

In the vast majority of cases, osteoarthritis is an age-related condition; put bluntly, the older you are, the more likely you are to develop it because as your body ages, your joints become worn and consequently osteoarthritis sets in. Anyone and everyone can develop the condition, and as we age most people will experience arthritic symptoms to a greater or lesser degree. That being said, herein lies my first problem regarding the isolation which the condition brings. I developed osteoarthritis in my mid-teens, and throughout the many years of dealing with it, I have not been surrounded by people who have any experience of the condition or have needed to have surgery. In fact, until very recently, I had never met anyone else even remotely around my age who had first hand experience of it. I would imagine that by the time most of us reach retirement age, a common topic of conversation is dealing with various aches and pains, some of which could be the result of arthritis developing in the joints, and I would anticipate that having even one friend who shares similar health issues to yourself can help not only with reassurance, but also reduce the levels of psychological isolation which can occur. Over the years, I have come to realise that I would really appreciate knowing someone else who has some personal knowledge and experience of the condition and/or surgery, and feel that this situation could have the potential to reduce the feeling of isolation which I experience on a regular basis, which is most often triggered by a symptom of the condition reappearing or suddenly becoming a new and noticeable problem.

More recently, this situation changed when, a couple of weeks ago, I was at the hospital for a physio appointment. This particular hospital is a private provider who relieve the NHS of the huge demand for joint replacements for NHS patients, a demand which the NHS cannot meet due to lack of funding, beds, staffing, etc. Although it is a small hospital, it is a significant local provider for many joint replacement surgical procedures, and as such, it would be fair to say that their average punter is in their golden years. In fact, during this particular visit, I was reminded of this before I’d even reached the building by overhearing an elderly couple in the car park saying “Oh yes, this is where Mavis got her shoulder done!” The Waiting Room is usually filled with patients of retirement age, but on this particular day there was a woman who looked about my age, and didn’t hesitate to introduce herself and talk to me, which was something which was extremely welcome for both of us I think. This rather lovely lady told me that she was in her mid-fifties and had just had a knee replacement. She was slim, intelligent, with an athletic physique, looked extremely fit and healthy, and was clearly as delighted as I was to find someone of a similar age in the Waiting Room, so it was impossible to resist chatting to one another; in fact, I would have loved to have had more time with her. Also, I have recently heard about a ‘friend of a friend’, who I don’t know personally, who had a knee replacement a couple of years ago. So, rather strangely, in recent weeks I have discovered that there are other people of my age around – I always knew there would be, it was just odd that I never came across them before. Rather disappointingly, my chat with the lady in the waiting room was very brief since we both got shuffled off into different areas for our respective appointments, and the ‘friend of a friend’ is just someone I hear about rather than have any contact with. But, the fact remains that these people are around, which makes me feel slightly less freaky, but I still have the isolation issue to deal with.

My other grouch relates to the widely acclaimed ‘success rates’ of these surgical procedures, which I have always found to be extremely unhelpful. It is invariably more difficult to be the voice of the supposed minority and openly disagree with something which is greatly lauded publicly by saying “I’m sorry, but that hasn’t been my experience of this.” As I have stated in previous posts, I greatly appreciate that these surgical procedures have resulted in my having improved mobility, less pain and a much improved quality of life, however, they are not a perfect solution and some problems do persist. Interestingly, I have also been told by medical professionals that there are more problems with this type of surgery with ‘younger’ patients, ‘younger’ being a term applied to anyone below around 60 years old; the issue which is most evident is that ‘younger’ patients experience more pain, simply because their nervous systems are ‘healthier’, being more sensitive and responsive than those in patients who are of the anticipated age for this type of surgery. More interesting still is the fact that the individuals mentioned above, who are both in their mid-fifties, are currently experiencing problems with their new joint. The lady who I spoke to in the hospital waiting room was experiencing oedema within her knee joint and had limited flexion which was a cause for concern some weeks post-surgery. She had also been informed that there are more problems undertaking these procedures with ‘younger patients’ and she, understandably, felt very disappointed with the current outcome of her surgery. The ‘friend of a friend’ is also experiencing difficulties some two years after surgery, is possibly experiencing nerve pain within the joint, and has recently been back to see the consultant again to try to resolve this. Rather ironically, and disappointingly perhaps, he had decided to go ahead with the surgery after hearing how successful his friend’s knee replacement procedure had been. What I do find interesting in the midst of all this is what happens when you start to voice your own concerns, niggles or even general dissatisfaction with the outcome, and it is certainly enlightening when people who previously claim that the procedure solved all and every problem start to consider whether this is really the case.

Knee replacement surgery in particular is notorious for being painful and a difficult procedure to perform; more to the point, the joint will NEVER function like a natural knee because it is beyond the capabilities of the mechanical joint to do so, so any claim that it is ‘as good as’ is frankly deluded. Knee replacement procedures are considered to be a success when the joint can be bent with ease to 90 degrees – any additional flexion is a bonus, but is not anticipated as a surgical outcome. Additionally, it is accepted by patients and professionals alike that it is extremely painful to kneel on a knee joint replacement – it feels not dissimilar to what you would expect from kneeling on knife blades, so is highly avoidable. However, as time goes on, the pain dissipates slowly, and I noticed that after about 6 years I could actually kneel on the joint again, presumably because the soft tissue had grown back and the joint was bedded in fully. Furthermore, some level of nerve damage is anticipated during most types of surgery – personally I have a couple of numb spots within my knee joint, presumably the result of very minor nerve damage, but this is not a problem to me. However, significant nerve damage can also occur, is extremely painful, is difficult to diagnose where the problem is coming from with much accuracy, and although steroid injections can help to ease this type of pain, they cannot be used where metalwork is present, and therefore are inappropriate for use within the same area as a joint replacement.

It’s complex and frustrating stuff indeed, and I would even dare to suggest that people who wax lyrical in wonderment at their new joint replacement are deluding themselves a little. I’ve had three joint replacements over the past decade, with vastly differing results. The first, a rare type of knee replacement, brought with it an extremely protracted recovery period alongside a host of relatively minor setbacks, before finally being what I would describe as ‘ok, but not brilliant’. The second, a hip replacement and therefore a much simpler joint, procedure and faster recovery period, was relatively straightforward, and ‘it’s pretty good’, is certainly a vast improvement on the knee experience and the joint itself is a whole lot more co-operative. And finally, the second hip replacement, which is ‘totally amazing’; yes, I’m slightly ashamed to say that I gush about this one because it’s been a transformative experience. Maybe I got lucky third time round, but I suspect it was more the case of it being on the side of my body which has less arthritic deterioration and greater muscular strength, and also that this surgery seems to have resolved a lot of pain and mobility issues by actually realigning my skeleton correctly, something which the previous surgeries failed to achieve. But in spite of all this, I remain aware that it is a mechanical joint and that is how it feels.

So, I guess it’s fair to say that I’ve experienced a range of outcomes from these procedures, and even the outcome of the most successful cannot honestly be compared to how my body felt before the onset of arthritis and joint deterioration. When I confessed to the nice-lady-in-the-waiting-room that sometimes I felt I could cheerfully punch people when they harped on about how bloody marvellous their new joint replacement was, I wasn’t joking. I fully expected her to end our conversation abruptly, disown me and sit elsewhere, but she didn’t, and really took me by surprise by quietly confessing that she felt exactly the same. So could it be the case that despite our apparently genteel outward appearances, lurking beneath lie two angry and aggressive women who just want to floor anyone who doesn’t share their own experience of this? Or is it more a case of feeling hugely frustrated with problematic surgical outcomes and the subsequent incumbent responses, which appear to be nothing more than a people-pleasing exercise which meets the required expectations regarding purported miraculous surgical procedures? Surely it would be more beneficial to patients and professionals alike to obtain honest feedback post-surgery, and dispense with the culture of guilt-tripping or challenging anyone who dares to suggest that these procedures cannot yet provide a perfect solution for everyone?

Certainly by talking with this lady and sharing our experiences reassured us both that we were neither hypochondriacs nor attention seekers, and that because we were below the anticipated age for this type of surgery, additional problems were likely to and did arise. However, what felt most important for myself was that I no longer felt I was floating about feeling isolated and a bit of a freak in all this. That sounds horribly selfish so perhaps I should try to clarify the relevance of all this: No, I’m not pleased that either she or the ‘friend of a friend’ have needed to have this type of surgery at a relatively young age, and I’m certainly not pleased to hear that they are both experiencing different problems as a result of those procedures. What I am pleased about is that I have finally met someone of a similar age who has experienced this herself, and that in itself is the much-needed evidence for me that I am not alone. And that, in itself, is massive!

“What did you learn during today’s session?”

Q: “So, what did you learn from today’s session?”

A: Nothing, absolutely nothing. Zilch. Nada. Rien. Nic. An almighty nowt. Sorry.

apathy

I really wish the answer was different. I’ve been thinking about it for a few days now, and I have an official Homework Sheet where I am expected to share my newly gleaned & hopefully positive response(s), which is to be returned by tomorrow. I can’t quite bring myself to answer truthfully so I am struggling to find an acceptable answer which isn’t a downright lie but also not something which might upset or insult the poor bastard who’s delivering this stuff. I see absolutely no point in lying and consequently falling into the trap of people-pleasing, appearing receptive, optimistic, grateful even, but isn’t the whole point to be honest, both with myself and others, and hopefully this is how to pave the way for ‘progress’ of sorts?

Accessing Mental Health Services in the UK is a tricky and lengthy business, and I can only assume that funding (or the shameful lack of it) is the reason for this. Demand is extremely high, at an educated guess I’d say that the need for Mental Health support is probably at epidemic levels these days, and yet it remains elusive, extremely difficult to access, and the process is protracted in the extreme. I have been trying to access Mental Health support for many years now, and after recognising that I’m not coping and my issues aren’t just going to go away if I try ignore them, it has required a relentless and determined effort over the past three years to get this far. I have just been accepted for a seven-week course of ‘group therapy’ relating to living with a Long Term Health Condition, and attended the first session last week.

I can only talk about my own experiences of trying to access NHS Mental Health Services, and have concluded that it is, like many other NHS services, a matter of jumping through hoops and hoping that you don’t get spat out somewhere along the way and find yourself back at the starting line again. I have spent the past few years playing this very unentertaining game, and each time it has gone something like this. It starts with seeing a GP, who expresses concern about, in my case, my relentless low mood. We complete a questionnaire which concludes that I have severe depression, and I am advised to contact the local NHS provider for Mental Health Services. They complete the same questionnaire with me over the phone, conclude that according to the questionnaire I have severe depression so they cannot offer me any support (the service is designed to support individuals with mild to moderate depression) so send me back to my GP. My GP offers anti-depressants, which I refuse. I explain my reasons for being unwilling to take anti-depressants and request some kind of talking therapy or CBT, but am told that these services can only be authorised by the Mental Health Service, who have just spat me out. So I am cut loose and left to my own devices yet again until the next time.

During a more recent trip to my GP we discussed this problem yet again, and I was advised that in order to access these services, I would need to lie. We figured that if I could produce a score which defined me as having mild or moderate depression, presumably I would then be able to access the Service. The trick would be to score as highly as possible but try to get it within the range of ‘moderate depression’ without spilling over into ‘severe’, but try not to lie so much that the score came up as ‘mild’ since I would be treated as less of a priority than a ‘moderate’ score. Bizarre stuff indeed. In my own humble opinion, this was hardly the best starting point for accessing a service, but had to admit that it seemed to be the only way. I dislike lying and deceit of any kind, I am not a good liar and find it hard to provide or maintain describing a situation which really isn’t true. So, when the Service contacted me to complete the damned questionnaire yet again, I quickly decided that being brutally honest would be the best way forward. I confessed to my conversation with my GP about lying in order to access the Service, my reasons for not wanting to do that, and also explained that I felt the scoring on the questionnaire didn’t take enough into consideration – for example, physical conditions. I made clear that because I have a painful, long-term physical condition, this hugely impacts on what I am able to do or any activities which I choose to do, and at that time I would most often choose to do nothing, not because of my mental health but because it was either too painful or physically impossible. However, the scoring on the questionnaire would flag this level of inactivity and hermit-like existence as a symptom of depression rather than an issue relating to physical disability. I also have a long-term and complex history of mental health issues, which were discussed during this phone call and, as usual, was flagged as being of concern – partly because of the duration of my problems, but also because previous interventions had not provided an acceptable outcome. I also felt it important to mention that I did not agree with the outcome of the questionnaire, that it would most likely classify me as ‘severe’, and having experienced severe depression I am absolutely convinced that I am not experiencing that level at present, and have not experienced that for many years. So, having got all that out of the way, we completed the questionnaire and, as anticipated, the score came up as ‘severe’. However, the nurse I spoke to was amazing and did accept the ideas and concerns which I had put to her, and accepted that other factors were providing a distorted score – in fact, we were both very aware that if I did have severe depression, I wouldn’t have even been able to manage such a long and complex conversation with her. So, rather than shoot myself in the foot again, it seemed that being honest had paid off and I was accepted into accessing the Service – huzzah!

A couple of weeks later, I received a letter inviting me to join a group therapy course aimed at supporting people with long-term health conditions. The blurb sounded good, I was excited, but had to decline due to up-coming surgery but asked that I be put on the next course of this kind. The course started last week, and I was excited – at last I’d managed to access the Service, had high hopes that it would be a beneficial thing to do, and was interested in meeting other people who were experiencing similar issues and hoping to exchange a few ideas about coping mechanisms. The reality was that I found it disappointing, but perhaps this is always the case when you finally manage to access something which has previously been denied to you?

So, returning to the original question: “What did you learn in today’s session?”

That the Mental Health provider need to urgently up their game regarding accessibility for individuals with physical health conditions. The session was provided for 12 people in a small room. Half of the room had four tables which were not used, except to provide a space for a small projector (which could have easily been place on one table, and the others moved out of the way or stacked in a corner to make more space for the attendees). The other half of the room contained three rows of chairs, with four chairs in each row, with little space to manoeuvre between; roughly six of the attendees used walking aids (sticks, wheel walkers etc) and a few others had mobility issues, so a little elementary arithmetic will tell you that only four chairs had ease of access. There was NO consideration taken regarding accessibility for people with mobility issues, which is ironic considering who the session was aimed at and that the provider had information regarding our various health issues and accessibility needs in advance.
There were three staff members in the room – the main presenter, a student who assisted with the presentation, and another student who was observing. Was this really necessary considering the space constraints?
There was no opportunity provided to ‘meet’ other participants. The main presenter, a CBT therapist, introduced himself and the students, and the rest of us sat in rows next to complete strangers for the duration of the session. I only got to see the faces of the people sitting on either side of me, the backs of the heads of the people in the row in front, and I have absolutely no idea who was sitting behind me. The presenter seemed a little disconcerted that everyone was reluctant to speak or contribute, but why would we considering that we were in a room full of strangers? I totally get the ‘but people have depression and anxiety issues so wouldn’t want to introduce themselves in front of everyone’ argument, but in my previous life as a teacher, I am very aware that introductions and ice-breakers are really beneficial thing to do and create a positive ambiance in the room, which then facilitates a better learning environment. Activities like this are priceless, and there are loads of options which even the shyest person can participate in.
The ‘presenter’ had absolutely no idea how to provide an engaging presentation. The content of the session was a Powerpoint presentation – the slides were dull, the content was obvious, and it all felt rather patronising. It seemed to be a case of ‘stating the bloody obvious’. There was certainly scope to add our own ideas and contributions but either no-one had much to say, or felt too intimidated to speak. Again, with my teacher’s head attached, there were a couple of opportunities to get us to do some of the work, maybe working in pairs or as a small group, or maybe scribbling ideas on post-it notes – instead of putting it all on a slide and read it out to us, why not ask us what we thought or felt or had experienced? This would provide the added bonus of getting us to communicate with each other and breaking the ice a bit. I wasn’t the only one who felt the presentation element was poor. At the break, I did actually manage to speak to someone! A nice lady who said she thought that the presentation was poor, as was the room layout – she had done presentations professionally too, so we had a bit of a winge about it between us.
That the provider urgently needs more money! The projector needed a new bulb – apparently their other projector did too. Ours was producing a pink screen, so it was difficult to read the mundane content. The other projector, somewhere else in the building, was producing blue light. I thought this to be pretty embarrassing – to be unprepared in this way is bad enough, but for neither machine to be working correctly is pretty piss poor. Also, of course, light and contrast of light with text is extremely important for many health conditions, not just eye complaints but for other conditions such as dyslexia too. Again, no consideration for accessibility for participants.
You provided a really sloppy presentation and set up. In addition to all of the above, I should add that the projector (despite the surplus to requirements four tables) was shining on a wall and part way across the frame of a whiteboard – couldn’t it have been moved to be either on the wall or on the whiteboard, not somewhere vaguely in between where the text distorted? or could you not manage to use the Smartboard which was on the other wall, which could have solved all the problems listed above? Your two students would know how to use one, even if you don’t…

All this is curious stuff indeed. I have heard many and varied tales about this particular provider, some good, some not so good, so I guess my first experience of them is in the ‘not so good’ category so far, which is a shame because there is no other NHS alternative and I don’t have the money to pay for private services. Listing the above short-comings might seem petty, but the fact that there so many of them did contribute considerably to my thoughts following the session, and clearly for several days afterwards; if I’m brutally honest, I really don’t want to go back for even one more session, let alone another six! As with most things in life, if part of it is good or positive, it enables you to overlook the lesser quality stuff and, to some extent, major cock-ups too. But having had poor presentation skills, poor room set-up, lack of accessibility, mundane patronising content, and even the damned projector light bulb being on its way out, I’m finding it hard to find anything good to say about it all. I know for sure that if, as a teacher, I’d been observed doing a presentation like that and committing even one of the deadly sins listed above, I’d be out on my arse before lunchtime. Ok, this guy isn’t a teacher, he’s a therapist, but clearly the ability to provide effective presentations has become part of his job, and therefore he really needs to up his game. Accessibility isn’t rocket science, and requires nothing more than common sense, a bit of foresight, and some empathy – it costs nothing to set up a room for people with accessibility difficulties, just a few minutes of your time, and your audience will recognise this instantly and appreciate your efforts.

Apparently, this provider has been rolling out this course nationally across the UK, and it will be reviewed some time in the near future based on the opinions of the participants and the impact it has had on our lives. In order to assess this with regard to quality, impact and the inevitable ‘value for money’, we will also being given questionnaires to complete each week so our responses can be assessed, analysed, etc and a decision will be made regarding whether the financial cost justifies the outcomes. Right now, I’d say probably not, but then again, I may change my mind as the course progresses, if I can persuade myself to keep attending.

It’s a difficult one. The accompanying blurb sounded very good, and it seemed that it might be a good option to try and a step in the right direction, but the reality is that this session was horribly disappointing, stress-inducing, and uncomfortable, physically and socially. In the meantime, I guess I have to keep attending, I need to complete their paperwork each week, and try desperately to find something positive to say about it to keep the funding coming in, so that the service can be provided for others in the future. However, I’m still stuck with my homework:

Q: “What did you learn in today’s session?”

A: That I really don’t want to come back here again. Sorry.