08:18 GMT

  To the west the sky looks dark and cloudy, but to the east the cloud is broken enough to let through some nice sunshine. The forecast says the sunshine will improve, although still only sunny spells, just after midday. It will only take the temperature up to 10° C, but depending on the wind, that could feel OK. From 4pm the chance of rain increases, and light rain is shown from 9pm. That may turn to heavy rain by 11pm. It looks like tomorrow may feature rain all day long, although all of it is shown as light rain. Tomorrow afternoon may see 10° C by 2pm, and most of the late afternoon and evening will be the same.

  Yesterday was good and bad - and much of it was bad. I guess the day started fairly good apart from the annoying weight gain. It felt like the sort of day when I would have a shower and go shopping in Tesco. That is exactly what I did, but.......

  I knew from much milder exercise, like walking upstairs, that my chest/heart was in a precarious way. With that in mind I put on a pair of shoes that I knew were not exactly uncomfortable, but somehow stopped me walking very fast. I did my best to walk slowly to Tesco, but not slowly enough. I was barely a third of the way there when my chest started to hurt. It was not the more acute pain of a heart attack, but the dull pain of my heart working too hard to try and make up for the faulty heart valve making it far less efficient.

  I ended up stopping a few times to rest my heart for a minute or two, but decided I would press on. I really wanted to get to Tesco because there was stuff I thought I needed, or at least would be more beneficial to me than slowly emptying out the freezer. It was hard work, but I made it, and grabbed a basket on the way into the store.

  The first place I made a beeline for was where they kept the West Indian style chilli/pepper sauce. I put four small bottles in my basket. Then I headed to the reduced price shelves. I hoped there might be some reduced price sandwiches there. They may not be that good for me, but I felt I wanted some anyway. Sadly there was none there. I did find a reduced price "Tesco Finest" quiche that was still rather expensive after the discount, but it looked nice, and that went into my basket. The best thing there was a Paella, and that was what I had for dinner last night.

  Other stuff I bought as I went around Tesco was more packets of instant noodles. I have good stocks of instant noodles here, but I fancied some different flavours. Then I grabbed a one litre tub of plain vanilla ice cream. I then headed for the frozen vegetables. I hoped I might see some sprouts and bacon, as they have had in there some time in the past, but there was none there yesterday. I did get more of the sweet potato chips because somehow they do seem a bit better for me.

  I was also looking for some roast (or roastable) root vegetables. I had a couple of meals in hospital that included them, and they wwere quite nice. What I found was almost as good - it was roast Mediterranean vegetables. I may have some of them for dinner tonight. My next stop was the drinks aisles. I wanted some more Diet Coke, but I knew it would be taunting danger to try and lug my usual 4 bottles home, and just bought two 2 litre bottles.

  I was concerned that I didn't seem to see any staffed checkouts open, and I had fears I would have to dump my basket, and take a painful walk home empty handed, but fortunately a few checkouts had staff, and very short queues (maybe that is why I thought they were closed). I had bought, after any club card discounts, just over £40 of food, and then had to walk it home.

  I took extra care to take it as easy as I could when I walked home. That included stopping 3 or 4 times to give my heart a minutes rest. I arrived home home with my chest feeling quite heavy, and really looked forward to a sit down, or preferably a lie down. Before that I wanted to put my food away. I then made my way up the stairs to my PC where I would eat my lunch. It was the "Tesco Finest" quiche, and it was not very good. Maybe it might have benefited from being warmed up, but I always think of quiche as being a cold food. The ice cream was very nice, and it was hard to stop after I had eaten my intended small portion.

  After going back down the stairs to put the rest of the ice cream in the fridge, I came back up the stairs. With that I was definitely ready to lie down on my bed, and have a snooze. My memory of it is a bit hazy, but I'm sure it was not a long deep snooze like I hoped for. Even after waking up I could still feel some heaviness of my chest. I got to wondering if I had done some further damage to my heart.

  In my rush to describe my first shopping trip this year, I missed out another important thing. Before I went to Tesco I phoned "Patient Transport" to see about getting some transport to Kings College Hospital for my next TAVI assessment. (The link explains it all). I expected it to be a load of faffing around, but it was very straightforward. The man at the other end asked for my NHS number (which is one piece of information I had in front of me). He looked it up, found my appointment, and from then on it was very straightforward.

   He asked a few simple things like did I need a wheelchair, and would I need a two man team to help me. I said no to both, and a few moments later I was told I would be collected from home at approximately 8.45am, and taken to Kings for my 11.45 am appointment. I have a suspicion it will be a mini bus making several pickups, and that will account for allowing 3 hours to get to the hospital (plus some time to find my way through the hospital).

  I had a very lazy afternoon, and while it was not all snoozing, I may have had another short snooze, or maybe it was a long one (who can tell). With some reading, both from book and internet, it was soon time for dinner. To be honest I did not feel that hungry, and it was just habit that meant I was looking forward to my Paella dinner.

  I have a feeling that my resumption of Mounjaro, and going in at full strength, has started to do what it is alleged to do - put a big curb on appetite by making you feel full for longer after eating. Mounjaro has been wonderful for my blood glucose levels, but previously had no effect on my appetite, and any effect seemed to be to make me feel even more hungry, and actually put on weight.

  I resumed Mounjaro with an injection on Sunday before last. At first I did not notice anything except a great improvement in my blood glucose measurements. Some time, and I am not exactly sure when, I started to notice some nausea when eating. I would eat a meal and feel like I might throw up after - presumably because my stomach had been prevented from emptying as quickly as usual. That is how it is supposed to work as a weight loss treatment.

  One trouble with a stomach full of food is the tendency of it to start to ferment and produce gas, and that can have a similar effect to acid indigestion, and feel like the start of angina. A lot of burping clears the effect to some extent. Last night I was really looking forward to the Paella, but after about half of it it started to feel like I was forcing it down. I should probably have stopped eating at that point, and given the rest to the foxes, but I managed to stuff it all down. That left me feeling uncomfortable, and once again I wondered if I might throw up.

  It is not just the stomach that is delayed in it's emptying. It also slows the emptying of the bowel. It is like, but not quite the same as constipation. I have passed a few "toilet bowl blockers" recently. (Fortunately none have actually blocked the bowl, but there was one man in hospital who semi managed it several times !). As I say, it is similar to constipation, but mostly seems painless. The worst thing is that I fear it interferes with my weight.

  Last night I watched some TV (as usual), but I think it was about 9pm when I felt really tired, and decided to go to bed. I laid in bed, and thought I would never actually get to sleep. An hour or two later I was waking up from the sleep I never thought I would get, needing a pee. After that I think I slept quite well. I do remember one dream, and it seemed to be some sort of regression to childhood...I think.

  I was in a forest in the dream, and it felt rather nice. It is hard to say if I was dreaming I was an adult or a child, but everybody else I saw was a child. Nobody, including me, seemed to be doing anything except for a few younger kids who were running around. I seemed to be quite happy to see the scenery. The only only brief disturbance was the arrival of a sinister looking black car (although it did remind me of a London Taxi). Some of the kids hid from it, and I was never sure why. It looked sinister, but I felt it was no threat to me.

  Like many/most dreams, it never reached any conclusion, and I woke up from it wondering what it was al about. I had actually woken up at around 6am, and maybe that was good practice for Friday when I have to be ready to be picked up for my ride to Hospital. I thought it was too early, and after a visit to the toilet I went back to bed where I seemed to have no difficulty falling asleep again.

  The next time I woke up it did feel like it was time to get up. I made another trip to the toilet where I passed more pee, and a chunky poo. When I weighed myself I found I had lost 900gm - which sounds good, but is still not good enough to get me back on track to a few days previously, and nowhere near enough to get me back to how low my weight was in hospital. Once again, my blood glucose was very good, although not quite as good as the day before. Yesterday's average was 6.1mmol/l, and this morning it was 6.7mmol/l - which is still pretty good.

  My first reading of blood pressure was a bit high this morning. It was 146/51 which my meter describes as "mild hypertension". A few minutes of relaxation and my blood pressure is a much better 126/56. It probably doesn't help that I need a pee, and it would be sensible to have checked my blood pressure after having a pee.

  My plans for today are fairly simple. There is only one important thing to do today, and I shall do it after I've had a snooze and a shower. It is another walk. This time to the pharmacy to (hopefully) pick up a prescription sent to them from the GP pharmacy expert next door. It should consist of all the drugs I am supposed to be taking since the hospital changed everything. I think I am taking the correct combination now, but it would be good to confirm it.

  I might pop into in to the Surgery while I am there to see if I can get an appointment with the diabetic nurse, or maybe even arrange a telephone consultation with her to get my next Mounjaro prescribed. It will be the next strength up, and I think that will be full strength. Whether that will have any special effect is a mystery. Even the low strength versions seemed good enough to get my blood glucose well controlled. Maybe the strength I am on at the moment (and I may only have half a dose left) does seem like it has the potential to modify my appetite if only I can read my body correctly, and act upon it.

  This afternoon will probably be just resting and snoozing. I think that tonight I will try having just roast root vegetables for dinner. That may be healthy for me, but I am pretty sure I will be having ice cream for dessert - although even that has proved to be beneficial for me. I am trying one more beneficial thing - beneficial in a two ways - probably. I am trying to mostly drink plain chilled water today instead of Diet Coke. When cold enough it is as refreshing, but it is, of course, not gassy. If my stomach is not blown up with added gas it may be more comfortable - less burping, and not making me feel like I might throw up when eating. Of course the latter is probably a wanted effect to make me want to eat less....but doesn't seem to work for me.








   2373 words today.