25 August 2005

We are up in Canberra again because Tim has a 10 day workshop in here. It's hard to keep my diary updated while we are away. It's even harder to keep up with all my exercises when I'm not in Melbourne because I miss out on my usual physios and personal trainings. I was talking to Prema about this last time and she agreed that I have a rather busy weekly schedule in Melbourne - two physio sessions at Epworth, one private physio session at home, two to three sessions of personal trainings, one massage session, one hydro session. It's pretty much like a full time job for me. In fact, Tim has said this before - rehab is my full time job now. If I consider rehab as my full time job, I must have used up my four weeks annual leave for the year already. I remember when I was still at MECRS, before I had to go away for a week or so, I asked Fiona if she knows a good physio in Canberra so I would not miss out too much while I'm away. She used to tell me it's ok to have a break just like when you work, you get four weeks annual leave. I have been away a few times already since the start of this calendar year. I haven't counted the number of working days I have been away but if I add them all up, I probably have use up all my leave for the year already.

Going away has its advatages though. I remember it was because we were here in Canberra that Tim took me to a fitness equipment shop to hire an exercise bike for me. He thought it would be good for me if only I know how to work very hard (I think he and Gavin seem to have the same attitude). I remember the first time I was on the bike, i could only do 5 minutes and my leg got very tired. I had to gradually increase the time and the intensity. After one week's of exercise bike, Judy, my massage therapist, said it was the first time she felt my leg was improving because she was a bit concerned that after treating me for a while, there was not much change in the leg and the bike started to make some difference. I really don't know what the staff at MECRS were thinking. I remember asking Jane, my physio at MECRS when I was an in patient, about what exercises i should do. She told me the best exercises i can do is walking. I know many neuro specialists would probably the best exercise to do for performing certain task is actually practising that certain task, like Carr & Shepard would have said. However, in my case, back then, I could hardly walk and by practising walking I was merely reinforcing bad habits. My gluts was weak (still is) so I would stick out my butt when my weight is on the left. My hamstring was and still is weak so I could not bend my knee. In order to take a step with my left leg, I was circumducting my left leg to compensate for the weakness in the muscles. What I really needed was strength training to fix up the muscle weakness. I hate to think what I would be like had I stayed at MECRS and have not gone to Epworth. The whole time I was an in patient there, they never bothered to put me on an exercise bike or any fitness equipment. I know they would argue that I was not mobile enough to go on such equipments. At Epworth, I notice that they put patients on exercise bikes from a very early stage. Some patients could barely stand and they put them on those recumbent bikes. The contrast in attitude is just enormous.

I had phsio at Epworth on the Monday morning before we left for Canberra. I know Neil has always taken great interests in my progress and he and Rosemary are concerned that while my leg is improving, my arm has not been. Neil has asked me many times to ask Gavin if he knows an arm specialist. It's pretty hard to ask him that when he has been working on my arm over the last few sessions. He has been getting me to do some strengthening exercises with weights. On Monday, I was working on my triceps again. When I finished my usual ones, he asked Tracy to set me up to do some pushups. I told Gavin that when I first went to Epworth, I was hoping for a full recovery but now I think I'm going to get a 120% recovery since I couldn't do pushups before. He said for people who are motivated, he only needs to show them what to do. I took this as a positive comment since he never mentioned anything negative like don't expect 100% recovery and craps like that.

On Monday afternoon, I had personal training with Mary. I think Mary is getting a bit better these days. She is constantly modifying the exercises for me to make sure that they are not too easy for me and has started to push me a it harder than before.

19 August 2005

I had a physio session at the Epworth this morning. The painter is still in the house so I couldn’t get out of the house fast enough. I really hate the smell of the paint. I like going to my physio sessions a bit earlier because it means I have a bit more time to finish my usual exercises even before my session starts.
When I got to the physio treatment room, I was surprised to find it so crowded. I guess it’s probably because I was half an hour early. I was going to do some walking practice but couldn’t find a spare mirror so Gavin told me to lie on my back (or what the physio would call supine) on a physio bed and he’d get me to do some arm exercises. He went away to get me some dumbells and showed me what I had to do. It’s something that will work on my triceps. He knows I had problem with the pushups he asked me to do last time so he said I can work on my triceps today. He showed me a few exercises for triceps and left me there to do them on my own. Today he wanted me to do four sets of tens. After a few sets, my tricep on my left arm was so sore that I had to support my arm with my right hand. Gavin said I could give my tricep a bit of rest while I do some other exercises so he showed me another one to do with the dumbbell. This is the one I lie in ‘supine’, hold the dumbbell in the left hand, start with lifting the left arm up straight and bring it to the side. He has given me this to do before and I looked up on the internet about this – I found a website for body builders and it tells you all the exercises you can do for different muscle groups, I know this exercise is aimed at the pecs. I have learnt a lot about the human bodies these days. Tim thought it was really funny that I told him over dinner that I thought it’s strange that my peroneal muscles hurt after doing the dorsiflexion exercises because I thought it’s the tib ante that does the dorsiflexion and inversion and peroneal does the inversion. Tim looked at me and was laughing. I asked him why he was laughing and he said two years ago I didn’t know what tib ante or peroneal were and I certainly wouldn’t know what dorsiflexion is. I guess it has been interesting to learn new things. I’m of the opinion now that you can’t just rely on the experts and you should always find out for yourself. The only way I can do this is to take interests in my rehab and learn as much as I can.

It’s actually a good feeling when I know what I’m doing and what muscles I’m working on. Gavin also got me to do some shoulder flexion and abduction exercises. He didn’t actually use the technical terms but I know what they are anyway. While I was doing my exercises,Gavin and another physio were helping Gary to walk. Gary appeared to be a little bit tired because he was struggling to get out of his wheelchair. I wonder if his right side is affected because I noticed that the control of his electric wheelchair is on the left side and also Gavin was instructing the other physio to hold his right knee straight when he puts weight on it. At first, I thought he had the same problem I had before – hyperextension in the knee. This was around July/August last year, after a few weeks at MECRS, althought I couldn’t walk back then, I found that whenever I stood up and put weight on my left leg, the knee tend to hyperextend. Of course, back then I didn’t know it’s the first sign of atrophy in the quads. I remember complaining to Jane, the phsio at MECRS, but she didn’t think it’s serious. When I looked at Gary again, I realised that when he put his weight on his right, his knee didn’t hyperextend, it actually buckled and the physio was holding it so it doesn’t flex too much. I must say I find it interesting to watch Gavin treating other patients because it gives me a chance to see other people’s problems and their treatment. I didn’t know that spinal injury can affect one side of the body before but it obviously can.

After I finished with all the arm/shoulder exercises, Gavin said I could continue with my usual dorsiflexion exercises against the wall. While I was doing that, he came over and put his hand on my leg to feel if I'm activating the muscles. He said my dorsiflexion is getting stronger now. He then taped my ankle. I told him that I think my inversion seemed to have gotten worse since I came back. He couldn't tell but I told him about when I went swimming in my hydro session I couldn't control to stop the inversion this time but two weeks ago I could. He told me there's no point in wondering what causes that because he thinks my arm is getting stronger and I'm walking a lot faster and I'm making progress. Maybe he is right. I noticed he taped my ankle differently today and I asked him about it. He said he didn't tape my foot in dorsiflexion and he just wants to try it and see if it affects my walking. He asked to walk around. It didn't seem to feel too different. He seemed pretty happy with the result. He pointed out to me that I should check it in the mirror because he noticed that althought he didn't tape my foot in dorsiflexion, he could see the sole of my shoe when I walk and this means I'm starting to be able to dorsiflex when I walk and instead of using my toes, I'm starting to use my heel. He seemed pretty excited by the progress but of course, being an accountant, I didn't show as much excitement. When I first came to Epworth, I was hoping for a full recovery but now I'm starting to get a feeling that I'm probably going to get 120% recovery.

18 August 2005 - part 2

Episod 2 – continued from yesterday

Gavin put the guy who was picking his nose last time in front of the walking rails. The woman with the pram walked up to him and kissed him. I wonder if that’s their kid in the pram because they both looked so young. When I was wondering about the kid, the woman said to the kid : ‘do you see Daddy there?’ That answered my question. I just thought it’s a bit strange that he didn’t want to pick up the kid or give him a cuddle and she didn’t do anything about it either. I remember when I was at the hospital, every time Lillian came to visit I would always want to hold her even when I only had one functional arm.

This probably made me look like I was slacking off on my exercises but I can assure you that I wasn’t. I was doing my dorsiflexion exercises against the wall while watching a ‘life drama’ on display. The woman then asked Gavin about the wheelchair. I think she’s probably making plans for when he goes home. Gavin asked her if there is a step to get in their house and she said yes. He told her it would be better for them to get a light wheelchair so it’s easier for him to get in the house. He is in an electric wheelchair at the moment and Gavin said it’s much harder to get it in the house. I was very tempted to tell them that you can actually hire a ramp for about $20 per week so it’s easier to get the wheelchair in the house. I remember Danika, the OT from MECRS organised a ramp for me on my first home visit since the operation and it worked quite well. I didn’t say anything because I felt it’s really not my place to say anything. Gavin also told her that it’s better for him to sit in a chair with high back so he doesn’t get a bad posture. As they were talking, I noticed that he was slouching and Gavin told him that if he sits like that all the time, he is stuffed. Again, I felt like telling them about my chair – when I first came home, I had the same problem and at the time my shoulder was really hurting so I needed a chair with arm rest. Tim took me to L& R, a shop that sells a lot of rehab stuff, and I tried on many chairs with arm rest and finally picked one. It’s the best purchase because when I first came home I spent a lot of time in that chair. I was not very mobile at the time and spent a lot of time in that chair during the day doing the upper limb exercises set by Neil and Rosemary. Again, I felt like telling that woman about my chair but I was worried that Gavin may be a bit offended. I know I wouldn’t feel too comfortable if my client is telling another client of mine about some tax strategies right in front of me if I just advised that client about something.

I guess I just felt really sorry for them. It must have been hard for her having to look after the baby and her husband. When I look at her, somehow I don’t feel as hard done by. I also think that in a way I'm lucky to have Danika as my OT because she had thought about a lot of the issues I would have when I go home so when I go home I have all the things I might need - a very compact wheeldchair that can be easily folded up and put in the boot, a kitchen trolley, a shower stool and most importantly, a personal response system - an alarm system that's connected to the phone so if something happens to me I can press the alarm (a pendant that I can wear like a necklace) and call for help. I don't know whether this guy has an OT to look after all these and I'm not sure how it operates at Epworth. Gavin is a good physio but when it comes to the preparation for going home, it's probably better handled by an OT. I remember when I was first admitted to MECRS, I always thought OT sessions were just a waste of time because I felt they were always teaching me doing things by compensating and not helping me to recover. I can now appreciate why they do that. It took me a while to get the movement in my left arm and hand back and if I had to wait for their recovery, someone else would have to shower and dress me and cook and feed me. What they were doing is to teach me to do things by compensating so I can at least be independent. It's not easy to understand it at the time but now when I look back I can see the big picture.

I had an appointment with my massage therapist, Judy, this morning. I missed her for two weeks – the first week was when she had an operation to remove a gall stone and the second week was when we were in Canberra. She noticed the change as well. We both don’t know what happened but my ankle inversion seemed to have gotten worse. I told her that I first noticed that when I went to hydro on Tuesday. I always try a bit of swimming after my exerices during my hydro session and on Tuesday, I noticed that my ankle was inverting a lot more and I couldn’t actually relax it to stop the inversion. I had this problem before but a few weeks ago I was actually able to stop the inversion by relaxing the muscles. I don’t know what has changed and Judy doesn’t know either but it’s definitely something I have to keep my eyes on.

18 August 2005

No diary entry for a while because we were away in Canberra last week. I feel a bit de-conditioned when I got back. I don’t know why that’s the case because I did quite a bit of walking with my mother-in-law, Helen, when I was there. Maybe it’s the lack of weight training at a gym and also the absence of remedial massage for two weeks.

I had a pretty busy week so far –on Monday I had physio in the morning and personal training in the afternoon, on Tuesday, hydro in the morning and personal training in the afternoon, yesterday I had physio at Epworth in the morning and physio with Prema in the afternoon. I was really struggling on Monday morning at physio. The exercises that wouldn’t normally tire me out seem to be so hard and tiring.

After two sessions of physio and two consecutive days of personal training I think I’m feeling a bit better. Gavin started to work on my arm and shoulder a bit before I went to Canberra. He put me on this machine and gets me to do pull ups and push ups. Tracey said the push ups will work my triceps and the pull ups work on my pec and latissimus dorsi (some back muscle). It’s a very hard exercise to do. I told Gavin that I don’t think I could do pull ups or push ups before my surgery anyway. Of course, he doesn’t care whether I could do it before or not, he wants me to be able to do it now! This is what Neil would call a 120% recovery! I told Mary about the exercise and she thought it might be a bit hard for me to do it bilaterally so she used a gym equipment (I can never remember what those things are called) to get me to work on my left side only. She said once I built up the strength on my left side, she’ll get me to use the equipment that I use at Epworth so I can do it bilaterally because otherwise my right side will do most of the work. I think she is actually getting better these days because I found that she would actually think about my problems and try out new exercises for me. I don’t know if it’s because I’m a bit de-conditioned because on Monday and Tuesday I actually felt she was pushing me a bit harder than before. Another thing I noticed is that my arm and shoulder actually felt better after some weight training. I actually find it a bit addictive that I can’t wait for my next session.

When I went to my physio session on Monday, I was surprised to see how much progress Gary has made. He is the loud mouth who has spinal injury. He is not a bad person but because he never shut up and he looked like one of my old boss in the previous accounting firm I worked for, I don’t like him very much. Before I went away, Gavin used to set up a couple of physio beds so Gary could hold on the the edge of the bed for support while Gavin put his foot in place when getting him to walk. It’s a bit like when I first started to learn walking again at MECRS. I was surprised to see that Gary is able to walk with the help of Gavin and another physio. I don’t want to be mean but somehow I felt he is not very deserving of this speedy improvement because I know how little he worked. I know it’s a bitchy thing to say but I think his lips worked more than his legs. While he has improved while I was away, I felt I have regressed. It’s a depressing feeling – a bit like when you trained so hard but was eliminated in the first round (of ballroom dancing competition).

I always thought I was hard done by until I saw this guy at Epworth on Wednesday. I recognise him from a few weeks ago – he was the guy who picked his nose while waiting for the porter to collect him. He is looking so much better when I saw him on Wednesday. He can actually walk with Gavin’s support now. When I was doing my dorsiflexion exercise against the wall, a woman walked in with a pram. The kid is holding a teddy bear and has a dummy stuck in his mouth. I presume he is younger than Lillian since he still sucks on a dummy. I have no idea when do they stop sucking on dummies since Lillian never had one. The woman looks quite young, I don’t know if that’s her kid or if she is just a nanny and is looking after someone else’s kid. (TO BE CONTINUED)... DUE TO THE SMELL OF THE PAINT I WILL HAVE TO FINISH THIS ANOTHER TIME(the painter is still here - after about 1 1/2 weeks)

4 August 2005

I had personal training with Mary this morning. I think just as well I made an appointment to have a session because it looked so miserable outside and I didn’t feel like get out of bed.

It was still raining when I left the house so I had to use an umbrella. It’s probaby the first time I had to do this in heavy rain. It certainly made walking to the gym more challenging. It was even more tricky when crossing the roads. I had to make sure I don’t stand too close to the road or I might get splashed when a car drives past too quickly.

It was still a bit early when I got to the gym so I decided to warm up with some ellipticals before my session. The personal training gym is separate from the general gym so I decided to stay in the personal training area because it’s not as crowded. After about five minutes, my left leg started to get a bit tired and I could really feel the muscles working in the glutes and the quads. I was very tempted to stop but then I thought I should just push on until Mary turns up. Mike, Mary’s boss, came up to me and said Mary just called and she’s running a bit late. Well, I guess this just means I have to stay on the elliptical for a bit longer. I think Tim would be happy to see that I was breaking out in sweats. He always thinks if I’m not sweaty that means I haven’t worked hard enough. I didn’t bring a towel with me because there was never any need in the past but today the sweat was dripped down my face.

I have been on the elliptical for about 10 minutes when Mary turned up. I didn’t tell her that my leg was tired because I was worried that she might just let me do easy stuff today. I told her that Gavin and Prema said there is some gym equipment to work on the hamstrings and I would like to try that. I think I might have been a bit harsh on her in the past because when she set me up on the equipment, I realised that it’s too hard for me and no matter how hard I try I couldn’t lift up the 5kg weight which is the bear minimum. She said she was trying to get me do some strenghthening exercises first so my muscles would be strong enough to use the equipment. She suggested that we go back to the personal training gym and use the cable so she can set up the equipment in such a way to help me work on my hamstrings.

After my session, Neil walked me home. We talked about getting some expert help with my upper limb and he was pushing me to do something about it. He found out for me from Guy Zito, his physio and also a lecturer in physio at Melbourne uni, the name of a physio who specialises in upper limb. When I looked at the address, I realised that it’s the same place where Lisa, a physio from MECRS, works on Fridays. I don’t really like Lisa because she treated me quite badly when I was an in patient there. I remember there was one occasion that my physio Jane didn’t show up and left someone with pen and paper and a test question for me. This happened after Tim complained that they hadn’t done anything about my arm. Jane asked me to write down all the things I have learnt from physio sessions about my arm. I couldn’t write any because she didn’t do much for my arm and there was nothing to write about. I burst out in tears because I thought it was wasting my valuable treatment time. Lisa came over and wheeled me into an office and told me off. Those words will always be branded in my memory because it was quite a traumatic experience for me. I remember her saying that it’s my fault that I don’t remember things because I had a brain injury and I shouldn’t blame Jane for not doing anthing about my arm. She was basically saying that it’s not Jane didn’t do anything about my arm – she has done somethig but I don’t remember. I cannot believe that she had the nerve to tell me that. I don’t think I want to see her again. I’m quite happy to see Dale, the social worker and Kerry and Jacqui, the OTs, but I have no intension of seeing anyone else at that place. Tim thinks I shouldn’t forget the good things they have done for me but all I can remember is how they put me down and treated me like morons. If I ever have any doubt on myself or my ability it is because of their doings. It’s for the same reason I haven’t contacted this upper limb person – I wonder what she is like if she and Lisa work at the same place. Both Jane and Lisa thought it would take me 2 to 3 years to drink a cup of tea with my left hand. I know we can all laugh at that now.

There is another person I told Tim and Neil about who specialises in upper limb. Her name is Kim Miller and she is based at Melbourne Uni. I found out from her website that she is currently doing her PhD on upper limb. I told Neil that she may be a better person to contact because she will be very up to date with all the latest techniques. I also told Neil that when I looked up (on the internet) on this High Level Mobility Assessment Tool Gavin used for my tests yesterday, I found out that Kim is presenting a paper at the APA (Aust Physiotherapy Association) conference on upper limb. I think Gavin is really an expert on the legs and Kim could be really an expert on the arms. Neil said he would call Kim for me because otherwise I just won’t do anything about it.

3 August 2005

I almost couldn’t get out of bed this morning. I’m a little bit concerned that I have been feeling quite tired lately. Every time I feel a bit unwell I start to worry because I don’t know if it’s related to the brains or something else. I can’t remember all the symptoms I had prior to my operation. All I remember were the terrible headaches and dizziness that accompanied the headaches.

I went to my usual physio session at Epworth this morning. When I got there, Tracy was at the physio treatment room. She set up a mirror for me to start on my walking practice. She said Gavin wants to do some tests today. I think I’m still a bit tired from all the walk we did on Sunday when we went to Healsville Sanctuary because my legs were getting a bit tired after a few laps of walking. Tracy was going to start on the tests but she realised we had to wait for Gavin when I asked her if I should wear my ankle brace. She said we had to wait for Gavin because he wants to tape my ankle before I start on the tests.

Gavin came in after I’ve done a few more laps of walking. When he was taping my ankle, he told me that many of the tests I probably can’t do yet but it doesn’t matter because at least he can measure the improvement over time. When Tracy set me up outdoors I noticed that she had a sheet of paper and I think it says ‘high level mobility assessment tool (HiMAT)’ or something like that. I think it’s something that Gavin did in his PhD. I remember I did some Google search on him when John Olver mentioned that he is doing his PhD and is an expert on running. That’s when I first found out about this assessment tool.

The first test was the 10 m walk. Tracy let me practice a couple of times before the real test. A few months ago they did the test and it took me 30 seconds but this time only 9 seconds. I was quite surprised by the improvement. I think all the works in personal trainig, walks to the gym and trying to cross Royal Parade before the light changes probably helped. The next test was also 10 m walk but walking backwards. I still find this quite difficult due to weakness in the hamstrings and hip extensors.

Tracy then told me the next few tests would be harder. First one was running. I couldn’t really run but I tried my best anyway. She then ask me to skip. I did’t know how to do it so she demonstrated. I tried but it was very difficult without the walking rails. Gavin came out to see how we were doing and he told Tracy to skip the skipping if it’s too hard for me. I was quite happy on his decision.

The next one was timing on going up and down the stairs without holding on to the rails or even lightly touching the rails. I know I can do this going up but so far I haven’t done it without any support going downstairs before so this would be the first time I’m doing it. Tracy let me practice this a few times before she started timing me. I know I can definitely go up without any support but coming down Gavin always let me have some light support so when I found out that I can do it without support I was quite surprised. When I was going down the stairs during the test I lost my balance and touched the rails for support so I had to start again. I didn’t check my time on the stairs because Gavin hasn’t done this test previously simply because I couldn’t do it when I first went there in March.

The last test on the list is bounding. Again, Gavin had to demonstrate what I have to do. This is a bit like the jumping practice I have been doing in the walking rails except this one I’m aiming for distance, not height. The test is even harder when it’s done in the middle of the hallway so I have absoultely nothing to hold on to. I asked Gavin if it’s ok for me to do this in the walking rails because I’m too scared of falling over. He said I could go and practice this for a while in the walking rails but the actual test has to be done in the hallway. I went back to the walking rails and started on my practice. Gary was in the room as well but I was too busy practising so I didn’t really hear what he was saying. He had someone there with him today.

After a while, I thought I was ready to do the test. At first, I thought Tracy was going to time me but I realised later that she’s going to measure the distance with a tape measurer. She let me try a few times and I realised that I can only do it when I’m pusing off through my right leg but not the left leg. She said she’ll measure on the right leg first and she’ll pick the best three out of five. When I got to the last one, she noticed that my distance is improving so she told me to continue doing it and she’ll get the best result. I think the furthest I did was 89 cm.

The tests took about one hour to complete so there was no time to do anything else. Gavin said when he first tested on me in February, there were many things I couldn’t do and my score was 6 out of 54 and this time I scored 18 out of 54. I have to find out more about how the score works but it looks like I have improved a lot over the last 5 months.

2 August 2005

I went to MECRS this morning for my usual self help group hydro. I was the first one to arrive this morning. After paying, I went to put my bag and shoes in the change room like last time. By the time I got in the pool, there was already someone in there. I see her every week but I don’t know her name. I said hello to her politely but didn’t expect to continue chatting. She was pretty chatty and I didn’t want to be rude but I was a bit anxious in getting my exercises done and have a bit of swim as well. It turned out that we both go to the same church, St Carthages. I wished I had spoken to her earlier because I also found out that her granddaughter, Charlotte, goes to the same childcare and is in the same class with Lillian. It’s such a small world! Now I know her name is Margo but I won’t see her in hydro anymore because next week is her last week there and we are going to Canberra next week so I won’t be going to my hydro next week.

In the afternoon, I went to my personal training at the Melbourne uni gym. I was a bit early for my session so I did some exercise on an elliptical. These days, I try to get there a bit earlier so I can work on the elliptical a bit before the session so I don’t waste time doing it during my session. Maybe it’s my accountant nature coming out again but I always find that I don’t get my full one hour session so I thought I can probably make it up by doing some exercises beforehand. Mary has her usual client at 1 pm so my session is straight after hers. I have met this woman last time and I didn’t know what to say to her when she asked me today if Mary works me hard as well. I felt like telling her if she thinks Mary is pushy, wait till she meets Gavin. But then again, she is only here for exercises, not rehablitation. She said to me that maybe Mary is not as pushy to me because I’m not as fat. I don’t think that’s the case though.

We worked mainly on the legs today. We went through the same exercises as last week with some slight variations. When Mary put me on the leg press I was on last week, my leg just didn’t work today. Maybe my leg still hasn’t recovered from the long walk we did in Healsville on Sunday, I couldn’t push at all. Mary thought the leg press is probably too hard for me so she put me on a smaller one. I tried it and found it a bit easier. She said it might be better for me to work on the smaller leg press and she’ll increase the weight every week. I’m not sure if this is enough for me but I guess I have to see how I go over the next few weeks. When my session finished, I looked at the clock and noticed that my session was a bit short again. My session didn’t start right on time because the previous session was not finished so I didn’t start till about 2.05 p.m. When I finished, it was about 2.55 p.m. I don’t want to be petty but my accountant nature tells me I got short changed again. I mentioned this to Tim last time and he thinks it’s not really a problem if I get a 55 minutes session instead of 1 hour session. That’s one way of looking at it but if every session is shorten by 5 minutes, you actually loose one full hour over 12 sessions. I hate to think what my clients in the accounting firm would say if I bill them for one hour of consultation but only spent 50 minutes with them in a meeting.