So - here we are in Tampico, Tamaulipas Mexico. Not a place you'd want to be, as it turns out! I've already talked about the difficulties of getting hold of Glucagon and given my views on the underlying reasons. Living with Diabetes (Type 1 anyway) in this part of Mexico continues to get more problematic. Especially if, as my spouse, you follow the tight control regime using the 24 hour ultra-slow acting analog insulin, Lantus, once a day and the ultra-fast acting analog insulin, NovoRapid (or NovoLog in the States), before every meal. Very few, if any, Mexican Type 1 Diabetics can be on this regime. Why do I say this? Well, read below.
As most Type Ones on the tight control regime know, trying to keep blood sugar levels within the normal person's range of 70-100 mg/dl means frequent hypoglycemic episodes of varying degrees of intensity. In the US that fragility means high additional costs occasioned by the need for treatment from Emergency Services or from third party administered Glucagon or, at less extreme times, from self or assisted dosing with glucose jelly or tablets. Therefore, the problem for diabetics in the US is not the unavailability of the treatments - it is their cost. And that can be prohibitive if or when the diabetic is not covered by health insurance. The lack of government controls on drug pricing alone appears to mean that everyone involved in selling the vital products is out to make a fortune. Nevertheless the paramedical services, Glucagon and glucose jelly are available. Not so readily so once you step outside of the first world (not just the USA!), where if products are on shop shelves this week, they may well not be ever afterwards.
So: here in Mexico, there is the Glucagon Problem and its attendant costly Paramedical-Hospital visit Dextrose replacement Set Up difficulty. Avoiding the high expenses entailed in all but compulsory use of the hospital following the administration of Dextrose solution by paramedics necessarily means avoiding hypos altogether; and that means keeping the Blood Glucose levels higher than is good over the long term. No tight control regimen here!
Now you see, now you don't! About a month ago, the locally made glucose tablets that we had discovered disappeared from the pharmacy shelves of two US chain grocery stores in town. It took us a while to find them and they were more expensive and lower in carbohydrate values than their US counterparts - but they had existed. For about two months. As we bought them during our weekly shopping trips, we watched the numbers of their boxed bottles dwindle away to None-at-All.
As for glucose (dextrose) jelly - Ha Ha!! You must be Joking! (I mentioned its never presence in third world countries in an earlier post.)
Now we have just (almost, nearly...) hit another Block in Living with Diabetes in Mexico. The sudden disappearance from pharmacies (here in Tampico, at least) of NovoRapid (Novolog)! My spouse has just enough left for about 12 days! We had bought a box of cartridges three weeks ago from the closest branch of Mexico's largest chain pharmacy: Benavides. Now they no longer stock the insulin - not in either its cartridge or disposable pen form. We already knew that one of the US chain stores here did not stock either it or Lantus. So we took a taxi over to the other to see if their pharmacy stocked it. There was none readily available, and the best that could be offered was that the pharmacist would find out if it could be got for us!
Living without glucose tablets or jelly or even Glucagon can be and is edgy. But without the insulin - that, my friends, cannot be done.
But why not go back to using regular fast-acting insulin? Surely that would be available. Maybe, maybe not. However, long past experience tells us that that course is no option at all without ready access to Glucagon and glucose jelly. Before his doctor put him on these two insulins, my spouse had frequent comas, most of which I dealt with by using the Glucagon. For the equally frequent near comas, I used the jelly. We cannot go back to the dangers inherent in using regular fast-acting at mealtimes in a country where we do not have access to these two items. And living with high blood glucose levels is not an option, either.
So we wait until Monday, when we go again to the Texas chain store pharmacy to find out whether or not the insulin will be available to us.
Living with Diabetes in the third world is riddled with uncertainties and the vagaries of market capitalism. Quite probably the pharmacies here see no profit - literally - in stocking an insulin that has a market of only one. Let him use another! Let him eat cake!
Saturday, October 25, 2008
Wednesday, October 8, 2008
What follows is derived from my own trials and tribulations, joys and Eureka! moments as both a student historian and as someone researching their own family history. My hope is that what I have learnt from using historical sources can in some way help others also happily absorbed by the past doings and beings of their families. My posts on this subject will concentrate on the difficulties that we all encounter at some point. For many of us, several "walls" arise to block our forward - or backward - progress, some of which seem absolutely impenetrable. I have at least four such blockages along the main lines of my family. The frustrations are real and derive from really existing problems in the sources and in the ways our ancestors lived their lives.
Over the next few posts I intend to examine some of the problems that beset family historical research, particularly as it relates to English and Welsh records (they are the family records with which I am most familiar). However, the issues I raise are surely not restricted to the historical records of these geographical areas. First I want to take an overview of general historical records as they have related to the majority of the population. Then in this post I'll examine the specific information in BMD certificates and its potential unreliability. Next time I'll look at the Censuses.
Where to begin? Well, when it comes to finding written records about most of our ancestors, the best sources available to us come not, unfortunately, directly from their own pens but from those of the Upper and Upper-Middling Classes. Until the latter half of the 19th century in England and Wales, most amongst the Labouring Classes were illiterate, or, at the very least, could not write. Children of both sexes began their labouring lives as early as eight, even after legislation prohibiting it. (The legislation focussed on factories and mills; small and family workshops where many also children worked were hardly affected.) Moreover, there was no system of publicly funded elementary education; and such schools as existed (dames' schools, for instance) were cheap but not free. Labouring families were in a bind: without the income earning labour of their children they could not afford the cost of the schools. So at best many children had only a few months of schooling in which they may or may not have picked up some reading skills before their life of work began. And at many schools in rural areas the children were learning a "trade" such as strawplaiting rather than the rudiments of reading, writing and arithmetic. In the official records of the day, the signatures of our uneducated or semi-educated ancestors were 'X' followed or suprascripted by the registrar's provision of their names. Even where an ancestor has signed his or her name there is little guarantee that that indicates full literacy. As we shall see, the lack of literacy on the part of those whose births, marriages or deaths were being registered or whose existence was being counted in a census affects the records.
As early as the late eighteenth century in Britain, Gentlemen had been making it their business to test the temperature of the populace at large. The French Revolution and its influences on English Republicanism, the growing disturbances in rural areas and small manufacturing areas (often one and the same place) in the forms of Ludd and of Swing, and later, of Chartism, the evolving industrial revolution with attendant developing gender sensibilities among an emergent manufacturing class, all caused the the few with money, power and in authority to be wary of the unwashed multitudes. The first decades of the nineteenth century saw several Parliamentary enquiries into What the Labourers were Up To and What Could Be Done About Them and Their Behaviour. Consequently, Parliamentary Papers provide rich pickings for historians who seek to know not only about how rural workers in, say, Gloucestershire lived, but also what some of them had to say about their work, living conditions and the labour of others. Of course, these sources are hardly unadulterated or unfiltered, if for no other reason than that the vast majority of the labouring classes accents and dialects would have been unintelligible to the visiting investigators. For the family historian these invaluable sources hold little direct evidence on individual people, unless one of your forebears was among those whose interviews were included in a report. Nevertheless, the reports do provide much background colour and depth for the family historian trying to understand how their ancestors lived and worked. Some reports, for example, contain much collateral information on the living and working conditions of certain groups of workers, particularly in the fields of mining, textiles and agriculture.
Many of these Parliamentary Reports are available in bound volumes, held in places like the National Archives, the British Library and its adjunct institutions in other parts of Britain and possibly in major Public Libraries like the one in central Manchester. It may well be possible to borrow individual volumes through InterLibrary Loan, even through a Public Library. I know that members of universities, students and faculty alike, can gain access to such records via this facility. Other reports are available on microfiche or microfilm; for instance, the 1841 Poor Law Commission: Report of the Special Assistant...on the Employment of women and Children in Agriculture is definitely available in university libraries in the USA on microfiche. If you can get hold of them or copies of them - do. They make for truly fascinating and riveting reading.
Most family historians approach their task by looking for and at familiar records: birth, marriage and death certificates. These public records are the essential building blocks for creating a family history. In England and Wales they only go back to the summer of 1837, when Civil Registration began. Before Civil Registration was initiated the only record of individual life and death events was held in Parish Registers and later in Dissenting sect records. Whether Civil , Parish or Non-Conformist register - the records are incomplete as to content and as to event. And the Parish records only reach back as far as the sixteenth century in a few places, not so far back in most.
Let us deal with Civil Registration first because that is where most of us can and should start. In the first decades of its existence, registration of a Birth was not even compulsory until 1875. Nor was it initially the parents job to report but rather the onus was on the local Registrar to seek out the births. Illness, temperament, lack of communication, poor roads - all could influence any given Registrar's ability to fulfil his duties. As for Marriages, if performed by a minister of the Church of England, were registered automatically because he could and did act as a Registrar. Other denominations' ministers could not. Moreover, among the Labouring Classes unofficial marriages continued to take place; these unions were legitimated by custom and community but not by officialdom. Those who married by common law have left no paper trail of their union, inadvertently denying their descendants a vital piece of the family history jigsaw puzzle. Deaths were supposed to be registered, but not all were. Thus Civil Registration records cannot be completely relied on to provide a full picture of a family's birth, marriage and death history - even when all of the information recorded on those that do exist is accurate.
As for what the certificates themselves can tell us, we need to be aware of two categories of error that can and not infrequently do afflict the certificates. The first category of error belongs to the those men (and they were assuredly men and of the middling to upper-middling sorts) who made the original entries and subsequent copies. And the second category derives from the "registrees" themselves: they frequently lied to the registrars about their ages, about their fathers' names and occupations and the addresses they provided were often those of "convenience" (for the purpose of Banns, for instance).
Let's examine the first category. Remember that many of the people registering births and marriages (we'll ignore deaths for the moment) were illiterate or only semi-literate. The registrars and other registry office workers were not; and they were of a higher social class. Their way of speaking - enunciation, accent, dialect - would rarely coincide with that of the local Labouring Classes. Names could be misheard or misunderstood; different officials could hold (and clearly did hold) varying views about how any given name was spelt. The result was a fairly wide variation in name spelling over the years and across the records. The illiterate registrees would have had no idea how their names were spelt; and the registrars would not have consulted them, in any case, assuming that they anyway knew best. This problem only gets compunded for the poor family history researcher! The photocopy of a certificate that we get from the General Register Office is but a copy of a copy of the original registry entry. At each stage the room for error increased. No handwriting is always and to everyone completely legible. And for some names the range of possibilities seems almost infinite: Reeves is one such name! Think about how many ways you could spell it and you'll see what I mean. It has been, and still can be, exceedingly frustrating and at times has led me to yelling robustly at the website I'm using.
The second category is potentially the more serious for the family historian: the lying or misleading that our ancestors engaged in when giving personal information to registrars. Age first, I think. (This problem also plagues the Censuses.) First and foremost, many people did not know exactly when they were born - that literacy thing again! If you were illiterate, you could not even keep a family record in a Bible, if you owned one. Nor could you have read your own birth certificate, should you have had one and should it have survived the travails and shifts of your life. Secondly, during the 19th century our ancestors did not think it a Good Thing when there was a great age difference between a couple. Quite how many years difference constituted a Bad Thing, I don't know, but maybe five or more and certainly ten or above. It really did not seem to matter to our great-grea-grandparents if the woman or man was the older partner; what mattered was how great the age difference. So people raised or lowered their ages to comply with the prevalent social standard. And of course those of minor age marrying without their parents' knowledge raised theirs to avoid legal constraints.
Name and Occupation of fathers only - here was an another opportunity to lie about or improve upon your background. For those who were born out-of-wedlock, and who had no clue about who their fathers were, not infrequently provided him with a name and a death. Others (like one of my great-grandmothers) created for their fathers what was to them a "posher" occupation (for her: "Coachman") than their real ones (in his case: "Iron Foundry Labourer"). I don't know who my great-grandmother was trying to impress, her husband or the registrar, but the result for me was months of futile searching for a Coachman who fitted the other parameters of his existence. Not that she was responsible for my deciding to dig around the back of the family closets!
The Addresses as given on the marriage certificate can also be fairly unreliable, at least as regards actual origins or residence. To be able to marry in a particular church (and in the 19th century that was where most marriages took place and nothing about the belief patterns of our ancestors can or should be construed from this ubiquity of church weddings; most of the lower levels of the English working classes had long been at the very least secular if not actually atheist) meant having to have an address in the church's parish. Some churches, Manchester Cathedral being one, were cheaper places to hold your wedding in than others; but the same rules of "residence" applied. Hence addresses of convenience - a dwelling which could be named as your place of abode for marriage purposes.
Many among the Labouring Classes did not marry by official means, probably for any number of reasons. The commonest reason for most of these marriages was the virtual impossibility of getting divorced. Common Law marriage allowed Labouring couples to engage in serial monogamy without running into legal problems. Not that all official marriages were between two single people - by no means! Bigamous marriages were not unusual in the 19th century, for the same reason that common law marriages were indeed common. Again in my own family, I can point to a (different) great-grandmother, who married three times; the first time officially, the second time unofficially and the third bigamously, her first and only "legal" husband being still alive in another county. (My link to her is through her second, unofficial marriage.)
So - are we to throw up our hands and say: "There is nothing we can trust!" No. For us as family researchers, we must always be wary of accepting at face value what any of the records tell us. But we are not without tools. Here is where learning something of local, social and national history - with all its complexities of gender and hierarchy and ethnicity - will help a lot. Such a broader and deeper understanding of the general histories of our families' pasts will help us to situate our specific ancestors and thus to better comprehend their lives and sometime lies.
Till next time!
Over the next few posts I intend to examine some of the problems that beset family historical research, particularly as it relates to English and Welsh records (they are the family records with which I am most familiar). However, the issues I raise are surely not restricted to the historical records of these geographical areas. First I want to take an overview of general historical records as they have related to the majority of the population. Then in this post I'll examine the specific information in BMD certificates and its potential unreliability. Next time I'll look at the Censuses.
Where to begin? Well, when it comes to finding written records about most of our ancestors, the best sources available to us come not, unfortunately, directly from their own pens but from those of the Upper and Upper-Middling Classes. Until the latter half of the 19th century in England and Wales, most amongst the Labouring Classes were illiterate, or, at the very least, could not write. Children of both sexes began their labouring lives as early as eight, even after legislation prohibiting it. (The legislation focussed on factories and mills; small and family workshops where many also children worked were hardly affected.) Moreover, there was no system of publicly funded elementary education; and such schools as existed (dames' schools, for instance) were cheap but not free. Labouring families were in a bind: without the income earning labour of their children they could not afford the cost of the schools. So at best many children had only a few months of schooling in which they may or may not have picked up some reading skills before their life of work began. And at many schools in rural areas the children were learning a "trade" such as strawplaiting rather than the rudiments of reading, writing and arithmetic. In the official records of the day, the signatures of our uneducated or semi-educated ancestors were 'X' followed or suprascripted by the registrar's provision of their names. Even where an ancestor has signed his or her name there is little guarantee that that indicates full literacy. As we shall see, the lack of literacy on the part of those whose births, marriages or deaths were being registered or whose existence was being counted in a census affects the records.
As early as the late eighteenth century in Britain, Gentlemen had been making it their business to test the temperature of the populace at large. The French Revolution and its influences on English Republicanism, the growing disturbances in rural areas and small manufacturing areas (often one and the same place) in the forms of Ludd and of Swing, and later, of Chartism, the evolving industrial revolution with attendant developing gender sensibilities among an emergent manufacturing class, all caused the the few with money, power and in authority to be wary of the unwashed multitudes. The first decades of the nineteenth century saw several Parliamentary enquiries into What the Labourers were Up To and What Could Be Done About Them and Their Behaviour. Consequently, Parliamentary Papers provide rich pickings for historians who seek to know not only about how rural workers in, say, Gloucestershire lived, but also what some of them had to say about their work, living conditions and the labour of others. Of course, these sources are hardly unadulterated or unfiltered, if for no other reason than that the vast majority of the labouring classes accents and dialects would have been unintelligible to the visiting investigators. For the family historian these invaluable sources hold little direct evidence on individual people, unless one of your forebears was among those whose interviews were included in a report. Nevertheless, the reports do provide much background colour and depth for the family historian trying to understand how their ancestors lived and worked. Some reports, for example, contain much collateral information on the living and working conditions of certain groups of workers, particularly in the fields of mining, textiles and agriculture.
Many of these Parliamentary Reports are available in bound volumes, held in places like the National Archives, the British Library and its adjunct institutions in other parts of Britain and possibly in major Public Libraries like the one in central Manchester. It may well be possible to borrow individual volumes through InterLibrary Loan, even through a Public Library. I know that members of universities, students and faculty alike, can gain access to such records via this facility. Other reports are available on microfiche or microfilm; for instance, the 1841 Poor Law Commission: Report of the Special Assistant...on the Employment of women and Children in Agriculture is definitely available in university libraries in the USA on microfiche. If you can get hold of them or copies of them - do. They make for truly fascinating and riveting reading.
Most family historians approach their task by looking for and at familiar records: birth, marriage and death certificates. These public records are the essential building blocks for creating a family history. In England and Wales they only go back to the summer of 1837, when Civil Registration began. Before Civil Registration was initiated the only record of individual life and death events was held in Parish Registers and later in Dissenting sect records. Whether Civil , Parish or Non-Conformist register - the records are incomplete as to content and as to event. And the Parish records only reach back as far as the sixteenth century in a few places, not so far back in most.
Let us deal with Civil Registration first because that is where most of us can and should start. In the first decades of its existence, registration of a Birth was not even compulsory until 1875. Nor was it initially the parents job to report but rather the onus was on the local Registrar to seek out the births. Illness, temperament, lack of communication, poor roads - all could influence any given Registrar's ability to fulfil his duties. As for Marriages, if performed by a minister of the Church of England, were registered automatically because he could and did act as a Registrar. Other denominations' ministers could not. Moreover, among the Labouring Classes unofficial marriages continued to take place; these unions were legitimated by custom and community but not by officialdom. Those who married by common law have left no paper trail of their union, inadvertently denying their descendants a vital piece of the family history jigsaw puzzle. Deaths were supposed to be registered, but not all were. Thus Civil Registration records cannot be completely relied on to provide a full picture of a family's birth, marriage and death history - even when all of the information recorded on those that do exist is accurate.
As for what the certificates themselves can tell us, we need to be aware of two categories of error that can and not infrequently do afflict the certificates. The first category of error belongs to the those men (and they were assuredly men and of the middling to upper-middling sorts) who made the original entries and subsequent copies. And the second category derives from the "registrees" themselves: they frequently lied to the registrars about their ages, about their fathers' names and occupations and the addresses they provided were often those of "convenience" (for the purpose of Banns, for instance).
Let's examine the first category. Remember that many of the people registering births and marriages (we'll ignore deaths for the moment) were illiterate or only semi-literate. The registrars and other registry office workers were not; and they were of a higher social class. Their way of speaking - enunciation, accent, dialect - would rarely coincide with that of the local Labouring Classes. Names could be misheard or misunderstood; different officials could hold (and clearly did hold) varying views about how any given name was spelt. The result was a fairly wide variation in name spelling over the years and across the records. The illiterate registrees would have had no idea how their names were spelt; and the registrars would not have consulted them, in any case, assuming that they anyway knew best. This problem only gets compunded for the poor family history researcher! The photocopy of a certificate that we get from the General Register Office is but a copy of a copy of the original registry entry. At each stage the room for error increased. No handwriting is always and to everyone completely legible. And for some names the range of possibilities seems almost infinite: Reeves is one such name! Think about how many ways you could spell it and you'll see what I mean. It has been, and still can be, exceedingly frustrating and at times has led me to yelling robustly at the website I'm using.
The second category is potentially the more serious for the family historian: the lying or misleading that our ancestors engaged in when giving personal information to registrars. Age first, I think. (This problem also plagues the Censuses.) First and foremost, many people did not know exactly when they were born - that literacy thing again! If you were illiterate, you could not even keep a family record in a Bible, if you owned one. Nor could you have read your own birth certificate, should you have had one and should it have survived the travails and shifts of your life. Secondly, during the 19th century our ancestors did not think it a Good Thing when there was a great age difference between a couple. Quite how many years difference constituted a Bad Thing, I don't know, but maybe five or more and certainly ten or above. It really did not seem to matter to our great-grea-grandparents if the woman or man was the older partner; what mattered was how great the age difference. So people raised or lowered their ages to comply with the prevalent social standard. And of course those of minor age marrying without their parents' knowledge raised theirs to avoid legal constraints.
Name and Occupation of fathers only - here was an another opportunity to lie about or improve upon your background. For those who were born out-of-wedlock, and who had no clue about who their fathers were, not infrequently provided him with a name and a death. Others (like one of my great-grandmothers) created for their fathers what was to them a "posher" occupation (for her: "Coachman") than their real ones (in his case: "Iron Foundry Labourer"). I don't know who my great-grandmother was trying to impress, her husband or the registrar, but the result for me was months of futile searching for a Coachman who fitted the other parameters of his existence. Not that she was responsible for my deciding to dig around the back of the family closets!
The Addresses as given on the marriage certificate can also be fairly unreliable, at least as regards actual origins or residence. To be able to marry in a particular church (and in the 19th century that was where most marriages took place and nothing about the belief patterns of our ancestors can or should be construed from this ubiquity of church weddings; most of the lower levels of the English working classes had long been at the very least secular if not actually atheist) meant having to have an address in the church's parish. Some churches, Manchester Cathedral being one, were cheaper places to hold your wedding in than others; but the same rules of "residence" applied. Hence addresses of convenience - a dwelling which could be named as your place of abode for marriage purposes.
Many among the Labouring Classes did not marry by official means, probably for any number of reasons. The commonest reason for most of these marriages was the virtual impossibility of getting divorced. Common Law marriage allowed Labouring couples to engage in serial monogamy without running into legal problems. Not that all official marriages were between two single people - by no means! Bigamous marriages were not unusual in the 19th century, for the same reason that common law marriages were indeed common. Again in my own family, I can point to a (different) great-grandmother, who married three times; the first time officially, the second time unofficially and the third bigamously, her first and only "legal" husband being still alive in another county. (My link to her is through her second, unofficial marriage.)
So - are we to throw up our hands and say: "There is nothing we can trust!" No. For us as family researchers, we must always be wary of accepting at face value what any of the records tell us. But we are not without tools. Here is where learning something of local, social and national history - with all its complexities of gender and hierarchy and ethnicity - will help a lot. Such a broader and deeper understanding of the general histories of our families' pasts will help us to situate our specific ancestors and thus to better comprehend their lives and sometime lies.
Till next time!
Tuesday, October 7, 2008
The Travails of Glucagon
As those of you who are living with type one diabetes already know, Glucagon in its emergency kit form is nothing short of a LifeSaver. It allows others, usually nearest and dearest others, to give you that quick fix for a hypoglycemic coma which reduces the need for calling in the emergency services and a trip to hospital. It is cheaper by far for all concerned than either of the former. So you would imagine that a Glucagon kit would be readily available for a reasonable price. You could be wrong on either count, depending on where you lived.
On our summer vacation in California my spouse went into a coma (travelling is frequently dodgy for diabetics). We had brought four kits with us from Turkey because our travel insurance did not cover ordinary chronic disease needs and in California calling out the emergency services is costly. The Glucagon in one kit was not good, so I had to use another from our precious lode. Some time later that week we thought to try to replace at least one of these kits; but what would it cost, leaving aside the cost of seeing a doctor for the necessary prescription? Effectively, we were without insurance for the kit; but I had once checked into the cost of a kit from Eli Lilly and seemed to recall that it was in the region of $130. Exorbitant, yes, but it is a LifeSaver. Imagine our shock-horror to find that without insurance coverage (when it costs about $35) pharmacies were more than willing to think of a number, double it and then charge more! Prices in excess of $300 were quoted at supposedly reputable chain pharmacies. My spouse said no way. We managed throughout the rest of the stay on glucose jelly and hope. We needed at least a couple of Glucagon kits to get us to Mexico, to where we were moving, so did our best to avoid using the rest of the stache.
Before we set out for Mexico we checked into the availability of Glucagon; and we also tried to find out from Walmart whether or not their glucose jelly and tablets were available in their stores with pharmacies. Walmart never responded to our email enquiries (at least here in Tampico Walmart does NOT stock either glucose jelly or its own glucose tablets; nor does it stock its own glucometer and test strips). As for the Glucagon, or Glucagen (Novo Nordisk's brand) we found out that it was available. We felt somewhat more secure.
Within a few days of our arrival in Tampico, Mexico, my spouse had another coma, during the day at work. I was able to give him some glucose jelly, tiny spot by tiny spot rubbed into the inside of his cheek; by the time the ambulance had arrived he could almost communicate. Rather than give him the intravenous dextrose there on the spot, the paramedics carried him on a stretcher to the ambulance and closed the doors, refusing me entry. (There was a doctor there in charge of using the intravenous needle, I suppose.) Normally, my spouse refuses point blank to be taken to hospital, and he was protesting strongly against it this time; but his refusals were ignored. So he, and I, were taken to a private hospital where he was kept hooked up to one fluid or another (more dextrose then saline) for a couple of hours. While waiting agitatedly for our release, we asked about Glucagon. The thought of another episode like this one was not appealing - and would undoubtedly be expensive (his workplace paid this time). Glucagon? Who uses that? Here diabetics, we were informed, are maintained so as not to go into comas! Tight Control regimens do not appear to exist in Mexico.
Undaunted with this news we sought information from Eli Lilly here in Mexico via email. Glucagon is available here - on prescription (unlike syringes which can be bought over the counter) of course. The cost, without insurance? About $68. Of course we have yet to go to a doctor and ask for a prescription. That will be the acid test of its "availability". Private hospitals here clearly have a stake in Glucagon not being readily available. The cost to type one diabetics here may well be much greater over the long term, however. The only way to avoid hypoglycemic comas in type one diabetes is to maintain a higher than optimal blood glucose. With a generally high blood glucose comes the likelihood, if not the certainty, of cardio-vascular disease, kidney disease, ophthalmic ailments and polyneuropathy, with its attendant greater risk of injury induced gangrene. Of course, one avoids the possibility of earlier death by hypoglycemic coma.
In the sum of things, perhaps there is not that much difference between the US and Mexican systems: the making of profit out of illness and disease rather than doing everything to provide a vital service at the least cost to all.
On our summer vacation in California my spouse went into a coma (travelling is frequently dodgy for diabetics). We had brought four kits with us from Turkey because our travel insurance did not cover ordinary chronic disease needs and in California calling out the emergency services is costly. The Glucagon in one kit was not good, so I had to use another from our precious lode. Some time later that week we thought to try to replace at least one of these kits; but what would it cost, leaving aside the cost of seeing a doctor for the necessary prescription? Effectively, we were without insurance for the kit; but I had once checked into the cost of a kit from Eli Lilly and seemed to recall that it was in the region of $130. Exorbitant, yes, but it is a LifeSaver. Imagine our shock-horror to find that without insurance coverage (when it costs about $35) pharmacies were more than willing to think of a number, double it and then charge more! Prices in excess of $300 were quoted at supposedly reputable chain pharmacies. My spouse said no way. We managed throughout the rest of the stay on glucose jelly and hope. We needed at least a couple of Glucagon kits to get us to Mexico, to where we were moving, so did our best to avoid using the rest of the stache.
Before we set out for Mexico we checked into the availability of Glucagon; and we also tried to find out from Walmart whether or not their glucose jelly and tablets were available in their stores with pharmacies. Walmart never responded to our email enquiries (at least here in Tampico Walmart does NOT stock either glucose jelly or its own glucose tablets; nor does it stock its own glucometer and test strips). As for the Glucagon, or Glucagen (Novo Nordisk's brand) we found out that it was available. We felt somewhat more secure.
Within a few days of our arrival in Tampico, Mexico, my spouse had another coma, during the day at work. I was able to give him some glucose jelly, tiny spot by tiny spot rubbed into the inside of his cheek; by the time the ambulance had arrived he could almost communicate. Rather than give him the intravenous dextrose there on the spot, the paramedics carried him on a stretcher to the ambulance and closed the doors, refusing me entry. (There was a doctor there in charge of using the intravenous needle, I suppose.) Normally, my spouse refuses point blank to be taken to hospital, and he was protesting strongly against it this time; but his refusals were ignored. So he, and I, were taken to a private hospital where he was kept hooked up to one fluid or another (more dextrose then saline) for a couple of hours. While waiting agitatedly for our release, we asked about Glucagon. The thought of another episode like this one was not appealing - and would undoubtedly be expensive (his workplace paid this time). Glucagon? Who uses that? Here diabetics, we were informed, are maintained so as not to go into comas! Tight Control regimens do not appear to exist in Mexico.
Undaunted with this news we sought information from Eli Lilly here in Mexico via email. Glucagon is available here - on prescription (unlike syringes which can be bought over the counter) of course. The cost, without insurance? About $68. Of course we have yet to go to a doctor and ask for a prescription. That will be the acid test of its "availability". Private hospitals here clearly have a stake in Glucagon not being readily available. The cost to type one diabetics here may well be much greater over the long term, however. The only way to avoid hypoglycemic comas in type one diabetes is to maintain a higher than optimal blood glucose. With a generally high blood glucose comes the likelihood, if not the certainty, of cardio-vascular disease, kidney disease, ophthalmic ailments and polyneuropathy, with its attendant greater risk of injury induced gangrene. Of course, one avoids the possibility of earlier death by hypoglycemic coma.
In the sum of things, perhaps there is not that much difference between the US and Mexican systems: the making of profit out of illness and disease rather than doing everything to provide a vital service at the least cost to all.
Sunday, October 5, 2008
Family History Research
As anyone surely knows by now, family history research has become big business. Knowing your family's background, where they came from, what they did, "who" they were has immense appeal for millions of people - at least in the first world. In part that is because so many families emigrated from Eurasia to North America and the Antipodes leaving behind forebears and their stock of familial knowledge. In part it derives from some sort of popularized belief that culture is genetically and usually paternally determined; and this sense that we are what our male forebears were no matter where we were born and raised has been well nurtured by the pluralism of the multicultural movement. In part it flows from the desire to understand the intersection between personal histories and public history: what were our ancestors doing at this or that time in history; how were they affected by this or that historical event?
Once upon a time only the rich and titled were able to chart their families' pasts. Now it is within the compass of most us in the first world to learn something about the peoples who made up and made our families. The internet and the ever-growing digitization of public and private records have made possible what today what would have been all but unthinkable ten to fifteen years ago (I'm guessing here!). A treasure trove of archives can be searched with a few clicks of the mouse - and, of course, usually a credit card! The click of the mouse allows everyone to be a historian and a genealogist; and, as tellingly, able to determine their own past.
It is this last reason behind much of family history research - structuring one's own past - with which this blog is concerned. Unfortunately, genealogy does not have too high a reputation among academic historians - and, equally unfortunately, all too frequently for good reason. Reputable genealogists, like other historians, recognize the need to read the records with care and in the knowledge that little in the archives can be taken at face value; that the further back you go the more tenuous the evidential links and so the unreliability of making claims; and that the vast majority of ordinary people left behind little or no evidence of their existence, certainly prior to the late sixteenth century in England. Now that everyone and anyone can be their own genealogist - which is as it should be - the restraints are off!! Everybody seems to claim a Family Crest for at least one line in their background; every other family appears to have a connection to royalty, or the nobility, or even petty aristocracy! There are those who have staked their claim to a genetic link to Charlemagne (not a few) and to sundry Anglo-Saxons, Danes and whatnots. How and where they have been able to find the records that make these connections and how they have been assured of their reliability is, well, beyond me! I suspect that much of the chronologically distant research for these "family trees" was the work of paid researchers who understood what their clients wanted: a claim to their family's historical significance. An understandable wish, but not one that makes for reliable history or genealogy. And a desire that misunderstands the social historical significance of ordinary people's lives in the making of public history.
Let me make my disclosure here: I am by training a historian; I am researching my own family history; and I should like to work as both a historical and genealogical researcher for others. Historical research and writing about the past in the light of what the available evidence does and does not say are my passions. Since leaving university, not having found any other outlet for these twinned passions, I have indulged them through looking into my own family's past. As for so many another, the internet and its ever-growing digitized store of personal historical records have proved a wondrous boon. Best of course would be to do the digging in the repositories themselves; but when you live thousands of miles away from the pertinent ones, the internet's incomplete but burgeoning crop are almost as good. So long as you have the money to pay for viewing the digitized manuscripts.
It is absolutely necessary to check the indexed and transcribed information against the manuscript. You should not trust other people's transcription of documents. However, many appear to do so - perhaps because of the extra cost involved in viewing the ms. Many of the transcribers of, for example, British census records for some of the best known genealogical subscription websites are volunteers. Some of them do not appear to be familiar with 18th and 19th century handwriting styles; nor do many appear have much if any knowledge of British place names. Other transcription or manuscript errors abound. The manuscripts of the British census records as we see them on our computer screens are themselves transcribed copies of the original forms that either the enumerator or the literate householder filled out on the night of the census (more likely the latter filled out the form at some point in time before the night of the census). The original forms were destroyed after their information had been copied down into the census return books, so there is no possibility of double-checking the census books, as we have them, against the original forms.
If all that the family history researcher had to worry about were transcription errors, it would be a simple matter of being willing and able to pay to view the manuscripts either in virtual or tangible formats. If that were all there were to researching the records, it would far far less fascinating than historical research intrinsically is. It is to those other absorbing problems that I shall turn in the next blog - and what they tell us about how we understand our families' pasts and their place in our public histories. And I shall touch on the problems that beset the family historian once the 19th century is left behind for earlier periods.
Once upon a time only the rich and titled were able to chart their families' pasts. Now it is within the compass of most us in the first world to learn something about the peoples who made up and made our families. The internet and the ever-growing digitization of public and private records have made possible what today what would have been all but unthinkable ten to fifteen years ago (I'm guessing here!). A treasure trove of archives can be searched with a few clicks of the mouse - and, of course, usually a credit card! The click of the mouse allows everyone to be a historian and a genealogist; and, as tellingly, able to determine their own past.
It is this last reason behind much of family history research - structuring one's own past - with which this blog is concerned. Unfortunately, genealogy does not have too high a reputation among academic historians - and, equally unfortunately, all too frequently for good reason. Reputable genealogists, like other historians, recognize the need to read the records with care and in the knowledge that little in the archives can be taken at face value; that the further back you go the more tenuous the evidential links and so the unreliability of making claims; and that the vast majority of ordinary people left behind little or no evidence of their existence, certainly prior to the late sixteenth century in England. Now that everyone and anyone can be their own genealogist - which is as it should be - the restraints are off!! Everybody seems to claim a Family Crest for at least one line in their background; every other family appears to have a connection to royalty, or the nobility, or even petty aristocracy! There are those who have staked their claim to a genetic link to Charlemagne (not a few) and to sundry Anglo-Saxons, Danes and whatnots. How and where they have been able to find the records that make these connections and how they have been assured of their reliability is, well, beyond me! I suspect that much of the chronologically distant research for these "family trees" was the work of paid researchers who understood what their clients wanted: a claim to their family's historical significance. An understandable wish, but not one that makes for reliable history or genealogy. And a desire that misunderstands the social historical significance of ordinary people's lives in the making of public history.
Let me make my disclosure here: I am by training a historian; I am researching my own family history; and I should like to work as both a historical and genealogical researcher for others. Historical research and writing about the past in the light of what the available evidence does and does not say are my passions. Since leaving university, not having found any other outlet for these twinned passions, I have indulged them through looking into my own family's past. As for so many another, the internet and its ever-growing digitized store of personal historical records have proved a wondrous boon. Best of course would be to do the digging in the repositories themselves; but when you live thousands of miles away from the pertinent ones, the internet's incomplete but burgeoning crop are almost as good. So long as you have the money to pay for viewing the digitized manuscripts.
It is absolutely necessary to check the indexed and transcribed information against the manuscript. You should not trust other people's transcription of documents. However, many appear to do so - perhaps because of the extra cost involved in viewing the ms. Many of the transcribers of, for example, British census records for some of the best known genealogical subscription websites are volunteers. Some of them do not appear to be familiar with 18th and 19th century handwriting styles; nor do many appear have much if any knowledge of British place names. Other transcription or manuscript errors abound. The manuscripts of the British census records as we see them on our computer screens are themselves transcribed copies of the original forms that either the enumerator or the literate householder filled out on the night of the census (more likely the latter filled out the form at some point in time before the night of the census). The original forms were destroyed after their information had been copied down into the census return books, so there is no possibility of double-checking the census books, as we have them, against the original forms.
If all that the family history researcher had to worry about were transcription errors, it would be a simple matter of being willing and able to pay to view the manuscripts either in virtual or tangible formats. If that were all there were to researching the records, it would far far less fascinating than historical research intrinsically is. It is to those other absorbing problems that I shall turn in the next blog - and what they tell us about how we understand our families' pasts and their place in our public histories. And I shall touch on the problems that beset the family historian once the 19th century is left behind for earlier periods.
Wednesday, January 9, 2008
Living With Diabetes Number One.
I am the partner of a type one Diabetic. We became aware of his disease in early January, 1994, when not only was he urinating every 45 minutes throughout the day and night, but his vision also grew blurry. We were living in Casablanca, Morocco at the time. There one could take oneself off to a Laboratoire and have tests done without the initial step of visiting a doctor. So, off he went, without breakfast and before going to work, to check out our fears. The results of both blood and urine tests were positive for high blood glucose and the presence of ketones, this latter marking the type of diabetes that had developed. The laboratory owner and head chemist, also the husband of the then Principal of the international high school where both my spouse and I worked, advised on an internist. An appointment was made and insulin treatment and diet instituted.
Initially, my spouse was put on animal insulin, but within a few months he was using a fast acting human insulin via an insulin pen for his mealtime doses and a 22-24 hour ultra long-acting human insulin via hypodermic at night for the 'housekeeping' dose. This regimen together with careful attention to diet, though not extending to the exclusion of wine, worked admirably. Little did we know then how much of a honeymoon phase those three years of diabetes in Morocco were. There were no hypoglycemic comas or near comas; boiled sweets satisfied his self-recognized low blood glucose episodes; his blood glucose seemed under control. We had, thankfully, no need of para-medical aid, or of glucose tablets or glucose jelly (anyway unobtainable in Casablanca at the time). (Glucose is something of a misnomer as the vital ingredient is dextrose.)
After six years of life in Morocco, we left in 1997 for Louisville, Kentucky. The first couple of months went smoothly enough, diabetically speaking, as my spouse had taken enough insulin with him to carry him through the initial period in a new place, with new doctors. When trouble arose it came from unanticipated quarters: the insulin and comas.
In the States, the overwhelming majority of insulin used comes from one company, Eli Lilly. Both insulins used by my spouse had been from the major European supplier, Novo-Nordisk. He was able to continue to use his regular fast-acting mealtime insulin by NN without any difficulty, as that was readily available; but the NN ultra long-acting, housekeeping insulin was not. To replace that, his endocrinologist prescribed the longest acting insulin then in Eli Lilly's formulary. None of us, including his doctor, knew that the Novo Nordisk ultra long- acting and the Eli Lilly long-acting did not act similarly, at least in my spouse. While the former achieved a steady state action within 30-60 minutes after injection and stayed in that state for 22-23 hours, the latter peaked and fell over a period of twelve hours. Thus, unbeknownst to us, there was little long-acting housekeeping insulin activity going on during the daytime. The consequence of this was high blood glucose readings from mid morning onwards. His doctor prescribed a medium acting insulin to replace the long acting - with disastrous results: his second coma.
Back in 1994, just two days after we had learnt of his diabetes, I flew off to England to see my father (for the last time as it turned out) who had suffered two heart attacks in as many weeks. The day before I flew back to Casablanca I spent a few hours in Leeds, visiting book shops and generally wandering around soaking up home ground vibrations. At one of the book stores I found and bought an excellent guide for diabetics, written by an endocrinologist. The book was wonderfully explanatory and did not treat its readers as if they were barely literate children. It became our 'bible' on matters diabetic. Among its many important sections was a diagram which illustrated the peaking time and duration of each and every insulin available at the time. From this more detailed diagram, I drew up my own illustrating the working of the insulins that my spouse was using in the States and that did not seem to be controlling his blood glucose levels satisfactorily. This diagram made apparent the shortfall of the available long-acting insulin. To rectify the problem caused by the insulin's shorter working time, he would have to take two smaller doses, each about twelve hours apart. It worked.
Our first coma occurred when we were staying with friends over our first Thanksgiving. We had driven over to Missouri, spending a night in a hotel on the way to reduce the physical strain on him (I can't drive). At two o'clock that first night in Columbia, however, we all got a shock. When my partner's jerking around in bed became obviously more than restlessness and he didn't respond to my questions, I turned on the bedside light and promptly went into panic mode, as I had never seen anyone in a hypoglycemic coma before, with its convulsions, heavy, heavy sweats and autonomic urination. And this was all happening to the man I loved. But at least I remembered enough from my student nurse training (four months before I dropped out) in another lifetime, to make sure that his airway was clear and that he was on his side. Then, I ran out of the bedroom screaming for help, for an ambulance. Our friends called EMS and the minutes waiting for it to arrive seemed like years. Our friends were pure gold and we were so thankful to have their support that first time; without them I do not know what would have happened. There have been many comas and near comas since then, all of them still scary but some scarier than others.
Since that night in 1997, we have tried not to be without a Glucagon kit or glucose jelly. That jelly has saved him from many full-blown comas and when that has been too dangerous to give, then the Glucagon kit has often been the life-saver.
The availability and price of glucose, in jelly or tablet form, is anything but uniform across countries and continents. In the US, glucose tablets are available at many pharmacies. But I have only found glucose jelly, in packs of three at $12 a pack, in one pharmacy chain. In the UK, glucose tablets are readily available in a variety of stores; glucose jelly, also in packs of three but at the staggering price of 11 pounds sterling/pack (!), has to be bought at chemists (equivalent of pharmacies). But there you could on occasion find dextrose energy tubes for 99p each and small tubs of dextrose (used in making certain types of icing for cakes) at a similar price. The drawback to the confectioner's dextrose is its consistency: very stiff and so difficult for the hypo diabetic to swallow. In Germany, the glucose jelly comes in re-sealable tubes, at 1 Euro 76 cents per tube. The glucose tablets are 49 cents a tube in drugstores (two are equivalent to one US glucose tablet) and other dextrose tablets are available in most grocery stores. The US and UK glucose jelly prices are iniquitous; and doubly so given that the tubes in both countries are not re-sealable. Nor are their tubes easy to open for the low blood glucose diabetic, whose hands are likely to be somewhat uncoordinated and greasy with sweat.
But where we now live, glucose jelly is unavailable; and glucose tablets cannot be bought with any regularity or certainty. They were non-existent during our first year here; then they appeared on the shelves of the nearest hypermarket for about six months but have since disappeared again.
This constitutes the first blog on living with diabetes.
Initially, my spouse was put on animal insulin, but within a few months he was using a fast acting human insulin via an insulin pen for his mealtime doses and a 22-24 hour ultra long-acting human insulin via hypodermic at night for the 'housekeeping' dose. This regimen together with careful attention to diet, though not extending to the exclusion of wine, worked admirably. Little did we know then how much of a honeymoon phase those three years of diabetes in Morocco were. There were no hypoglycemic comas or near comas; boiled sweets satisfied his self-recognized low blood glucose episodes; his blood glucose seemed under control. We had, thankfully, no need of para-medical aid, or of glucose tablets or glucose jelly (anyway unobtainable in Casablanca at the time). (Glucose is something of a misnomer as the vital ingredient is dextrose.)
After six years of life in Morocco, we left in 1997 for Louisville, Kentucky. The first couple of months went smoothly enough, diabetically speaking, as my spouse had taken enough insulin with him to carry him through the initial period in a new place, with new doctors. When trouble arose it came from unanticipated quarters: the insulin and comas.
In the States, the overwhelming majority of insulin used comes from one company, Eli Lilly. Both insulins used by my spouse had been from the major European supplier, Novo-Nordisk. He was able to continue to use his regular fast-acting mealtime insulin by NN without any difficulty, as that was readily available; but the NN ultra long-acting, housekeeping insulin was not. To replace that, his endocrinologist prescribed the longest acting insulin then in Eli Lilly's formulary. None of us, including his doctor, knew that the Novo Nordisk ultra long- acting and the Eli Lilly long-acting did not act similarly, at least in my spouse. While the former achieved a steady state action within 30-60 minutes after injection and stayed in that state for 22-23 hours, the latter peaked and fell over a period of twelve hours. Thus, unbeknownst to us, there was little long-acting housekeeping insulin activity going on during the daytime. The consequence of this was high blood glucose readings from mid morning onwards. His doctor prescribed a medium acting insulin to replace the long acting - with disastrous results: his second coma.
Back in 1994, just two days after we had learnt of his diabetes, I flew off to England to see my father (for the last time as it turned out) who had suffered two heart attacks in as many weeks. The day before I flew back to Casablanca I spent a few hours in Leeds, visiting book shops and generally wandering around soaking up home ground vibrations. At one of the book stores I found and bought an excellent guide for diabetics, written by an endocrinologist. The book was wonderfully explanatory and did not treat its readers as if they were barely literate children. It became our 'bible' on matters diabetic. Among its many important sections was a diagram which illustrated the peaking time and duration of each and every insulin available at the time. From this more detailed diagram, I drew up my own illustrating the working of the insulins that my spouse was using in the States and that did not seem to be controlling his blood glucose levels satisfactorily. This diagram made apparent the shortfall of the available long-acting insulin. To rectify the problem caused by the insulin's shorter working time, he would have to take two smaller doses, each about twelve hours apart. It worked.
Our first coma occurred when we were staying with friends over our first Thanksgiving. We had driven over to Missouri, spending a night in a hotel on the way to reduce the physical strain on him (I can't drive). At two o'clock that first night in Columbia, however, we all got a shock. When my partner's jerking around in bed became obviously more than restlessness and he didn't respond to my questions, I turned on the bedside light and promptly went into panic mode, as I had never seen anyone in a hypoglycemic coma before, with its convulsions, heavy, heavy sweats and autonomic urination. And this was all happening to the man I loved. But at least I remembered enough from my student nurse training (four months before I dropped out) in another lifetime, to make sure that his airway was clear and that he was on his side. Then, I ran out of the bedroom screaming for help, for an ambulance. Our friends called EMS and the minutes waiting for it to arrive seemed like years. Our friends were pure gold and we were so thankful to have their support that first time; without them I do not know what would have happened. There have been many comas and near comas since then, all of them still scary but some scarier than others.
Since that night in 1997, we have tried not to be without a Glucagon kit or glucose jelly. That jelly has saved him from many full-blown comas and when that has been too dangerous to give, then the Glucagon kit has often been the life-saver.
The availability and price of glucose, in jelly or tablet form, is anything but uniform across countries and continents. In the US, glucose tablets are available at many pharmacies. But I have only found glucose jelly, in packs of three at $12 a pack, in one pharmacy chain. In the UK, glucose tablets are readily available in a variety of stores; glucose jelly, also in packs of three but at the staggering price of 11 pounds sterling/pack (!), has to be bought at chemists (equivalent of pharmacies). But there you could on occasion find dextrose energy tubes for 99p each and small tubs of dextrose (used in making certain types of icing for cakes) at a similar price. The drawback to the confectioner's dextrose is its consistency: very stiff and so difficult for the hypo diabetic to swallow. In Germany, the glucose jelly comes in re-sealable tubes, at 1 Euro 76 cents per tube. The glucose tablets are 49 cents a tube in drugstores (two are equivalent to one US glucose tablet) and other dextrose tablets are available in most grocery stores. The US and UK glucose jelly prices are iniquitous; and doubly so given that the tubes in both countries are not re-sealable. Nor are their tubes easy to open for the low blood glucose diabetic, whose hands are likely to be somewhat uncoordinated and greasy with sweat.
But where we now live, glucose jelly is unavailable; and glucose tablets cannot be bought with any regularity or certainty. They were non-existent during our first year here; then they appeared on the shelves of the nearest hypermarket for about six months but have since disappeared again.
This constitutes the first blog on living with diabetes.
Thursday, January 3, 2008
Notes from an Outskirt of Ankara and Heidelberg
At last, snow! Not that I particularly like the stuff (it interferes with running once it freezes), but it is desperately needed. Last autumn, our second here, was so very dry, as had been the summer and spring before it. The wild plants flowered early and briefly. Their appearance was too short for some of the local butterflies and doubtless other insects. The wasp and bee populations was greatly diminished from those of the previous year. The European Bee Eaters did not appear as they had in the fall of 2006, so the skies overhead were empty of their flashing colours and whooping calls. The beautiful, blue globe-flowered thistles that in 2006 had flowered continuously and heavily throughout August, September and October, feeding lots of small seed-eating birds like goldfinches, this last year bloomed scantily, with tiny globes. And then by the end of August, all were finished. The fieldfares arrived (it seemed to me) rather late this year (not until early December) and in fewer numbers than last year. The great tits and a couple of pairs of blackbirds arrived around the same time as before; the starlings also returned, but are definitely fewer in number. There are a few grey wagtails that feed around a channelled water course, which in turn feeds a dammed lake. Among the wagtails I have seen a pair of plovers. I haven't been able to do more than recognize their basic shape and habits because I see them only on one of my runs. The lake (or reservoir) shrank by about two metres over the summer and has yet to recover; but it is playing host to some ten ducks and one or two cranes. None of these birds spend time around this lake during the summer months. Or at least they haven't yet.
We spent a few days in Heidelberg over the winter break, courtesy of an old friend. It was a delight to run along the river Neckar, even with the bitter, raw cold that accompanied every day. The wooded hills were rimed with heavy frost and the air over the river was cloudy with condensation. Running along the river allowed me to become re-acquainted with some of the common birds of my youth. On the river were lots of common and black-headed gulls, four or five cormorants - which was a big surprise, so far inland, and a ringed pair of Egyptian Geese, with their sooty eyes and russet pink markings. Beside the river, twittering in the overhanging branches of alders and other trees, were long-tailed tits and a scattering of blue tits. Darting in and around the lower lying bushes was the odd robin and wren. Padding on and pecking at the beds of dead reeds floating by the side of the river were several moorhens and the occasional pigeon. Blackbirds abounded, poking their way through the leaf litter. But the crowning glory of our bird sighting was that of the kingfisher. Twice! The first time skimming over the water close by the river bank, instantly recognizable by its irridescent torquoise back. The second time, the day before we returned home was yet more wonderful. First we saw it once again skimming above the water; then it flew up into and perched on a leafless branch, overhanging the water. There it sat, first frontally, then in profile - displaying all of its colours and contours for a full photo opportunity! (Of course, we had not got the camera!)
We spent a few days in Heidelberg over the winter break, courtesy of an old friend. It was a delight to run along the river Neckar, even with the bitter, raw cold that accompanied every day. The wooded hills were rimed with heavy frost and the air over the river was cloudy with condensation. Running along the river allowed me to become re-acquainted with some of the common birds of my youth. On the river were lots of common and black-headed gulls, four or five cormorants - which was a big surprise, so far inland, and a ringed pair of Egyptian Geese, with their sooty eyes and russet pink markings. Beside the river, twittering in the overhanging branches of alders and other trees, were long-tailed tits and a scattering of blue tits. Darting in and around the lower lying bushes was the odd robin and wren. Padding on and pecking at the beds of dead reeds floating by the side of the river were several moorhens and the occasional pigeon. Blackbirds abounded, poking their way through the leaf litter. But the crowning glory of our bird sighting was that of the kingfisher. Twice! The first time skimming over the water close by the river bank, instantly recognizable by its irridescent torquoise back. The second time, the day before we returned home was yet more wonderful. First we saw it once again skimming above the water; then it flew up into and perched on a leafless branch, overhanging the water. There it sat, first frontally, then in profile - displaying all of its colours and contours for a full photo opportunity! (Of course, we had not got the camera!)
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