Into the system…

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Phased Return…

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So last week, I finally met up with the HR manager to discuss Dr Occy Health’s latest report and we have agreed that I can begin a very slow phased return.

I am starting with 2 hours a week on Tuesdays and Thursdays. I will be doing this for the next few weeks until I see Dr Occy Health again in December, when we will review again. All being well we will add a few more hours to each day and eventually extra days until I am back full-time, but I have been told to expect this process to take many months. I have no idea if I will be able to cope with going back at all, but it is time to try. It has to be a case of seeing how it goes and hoping that the transition is smooth.

It’s more than two weeks since I saw Dr Occy Health and our discussion about how I may go about a return to work. He seemed reluctant to try and push me into anything more than I was already doing (the occasional short visit), but I asked about formalising something more and he agreed I could begin with a slow phased return. He set some guidelines, but said I would need to arrange the details with HR, rather than him prescribe anything more definite.

The guidelines suggested that I am restricted to a maximum of 15% of normal hours at first. I didn’t ask him if he meant contractual hours or realistic ones, but I suspect he meant the former. It would mean quite a big difference – my contractual working week was 37.5 hours, but realistically I did anything upwards of 50 hours. I don’t think I will be allowed to do those sort of hours again though. Essentially I am restricted to a maximum of 5 and a half hours, which I guess seems reasonable, although of course I am only doing 4 at first. I don’t know how long this restriction is meant to last – the first week, first fortnight, first month? It looks like it will be at least the first month though and possibly even until the new year.

He suggested I start my working day during late morning, which suits me fine. I am usually at my most stable in the middle of the day and I am not used to early starts any more, so it makes sense for me to try and work when my mood is best. It also gives me the chance to take the dog out and get anything else that needs to be done beforehand.

Whereas over the summer my mood was consistently on the low end of normal and hardly ever changed, since the slow decline in my mood during late September and the subsequent increase in Reboxetine, my mood has been fluctuating a lot more. I am having good days and bad days, rather than lots of okayish ones and my mood is varying during the day too. Over the past month, my mood has been largely following the classic depressive cycle of feeling worst in the morning and mood improving throughout the day. I am waking up feeling pretty depressed each morning, but by lunchtime I am usually feeling okay. By evening, I am often feeling agitated or edgy, which is also not conducive to work either, so not leaving work until too late in the day is probably wise. Occasionally I’ve had a day that has gone the other way around or the morning depression has lingered long past lunchtime, some days are just crap all round, other days are absolutely fine. On the whole, I think the increase in Reboxetine has brought my average mood up again, but I am less comfortable with the instability that has come with it. I don’t know how I am going to feel from one day to the next and I find it harder to plan what I’m going to do, because one day I will be able to get loads done and the next I can’t face getting up. My mood isn’t really getting to the extremes, but it’s wobbly enough to be problematic.

Alongside the fluctuating mood, is also a fluctuating, but omnipresent level of anxiety. Most of the time I don’t even know what I’m anxious about, but I just feel the physical presence of anxiety lurking in my chest and a niggling worry about something in my brain. Sometimes that physical presence is a lot more than just a niggle and I feel physically sick, my heart keeps skipping a bit and I feel dizzy and shaky. I am getting a lot of nightmares too. Often I don’t know why this is happening. Sometimes the cause makes itself very clear and I can’t stop thinking about it no matter how much I try. There are plenty of worries about work, how it affects my benefits and finances, my tummy troubles, medication, diagnosis stuff and other stupid things like “what am I going to knit next?” floating around, but they shouldn’t be enough to prompt the level of panic I’ve been experiencing.

I don’t really know where this anxiety is all coming from, because until fairly recently I’ve not had much of a problem with it. I am usually pretty good at managing my worries and very rarely have I experienced the physical symptoms of them. Anxiety was always tagged alongside my list of diagnoses and I was often sent to “Anxiety Management” at The Priory, but I think that mainly came out of an assumption that all depression comes with anxiety and not because I actually experienced it. I can use those anxiety management skills and rationalise my worries and thoughts, but I don’t seem to be able to beat away the physical results. I have been taking Propranolol for months and that is supposedly meant to reduce agitation and anxiety, but I don’t know if it does much good. Reboxetine is known to increase anxiety, so it could just be that, but I am loathe to attribute everything to the damn drug.

Anyway, we shall see how I go with my working hours. I think if I stick to the middle of the day I will be okay. I don’t think there is anything stopping me going in a bit earlier or later if I want so if needs be I can do that, but I think it’s important I try and stick to a routine and get used to going to work at a specific time. I don’t know what will happen when I need to increase my hours or which end of the day it would be better to add to, but we will come to that when it happens. Having a routine and going in at regular times is one of the things I am going to need to adjust to. I’m not sure I’m up to doing stuff whenever I have to, rather than just when I feel up to it. When I’ve had chores I really need to do and am having a bad day it can make things a whole lot worse, so I hope I can manage.

Another guideline suggested that whatever I do is non-client facing. This is pretty important to me at the moment, because I can’t deal with the stress and responsibility that goes with working directly for the client. I am having to remember how to communicate in the world of business and not the world of mental health services or just with my friends. I think it is going to take some getting used to. I don’t know what to write in work-related emails or how to talk to people any more, so I’d rather keep my communication with others down to a minimum until I get used to it. At least if I make an idiot of myself with a colleague it’s not going to get me fired, but say or do something stupid with a client and I could be in trouble.

This is actually something that upset me during the HR meeting. The HR manager said she was worried about how I am going to cope interacting with others in the workplace. She remarked that observing me at the community meeting I went to the other week, she was worried that I was too honest and open with people and she is worried that my openness will shock people. She said she doesn’t want me to stand out too much or give people the wrong impression. I don’t think I said anything other than that I’d been off work for a couple of years due to illness, but I am currently in the process of returning to work. I didn’t elaborate on what kind of illness I’d experienced. I only said that because we were asked when we joined the company and what client we were working with at the start of the meeting. If I didn’t explain that I’d been off for a while, it would look like I’d been passed over for promotion a couple of times and that I wasn’t chargeable to a project, which I think would have been more embarrassing.

I’m not ashamed of the fact I’ve been ill and don’t see why I should hide it from people. I didn’t mention mental illness, but even if I did, it shouldn’t be a problem. I’m sure nobody would be telling me not to tell people that I’d been off work if it had been cancer or a heart attack keeping me away, so why do I have to hide it because I’ve been off for mental illness? I don’t intend on telling everyone the whys and wherefores, but questions are going to be asked or assumptions made unless I say something. You can’t just ignore two years of my career that have just disappeared. The gap in my company CV and in my client history is plain for everyone to see and the fact I’m still at my current level over 3 years after joining, also points to some kind of problem. I don’t see what is wrong about being honest about the fact I’ve been on long-term sick leave. I don’t know what else I’m meant to say. I have no intentions of lying or deliberately hiding the truth.

She said I should treat it like starting a new job and I should remember that I will be meeting new people all the time and they don’t know my history, so I should feel no reason to tell them. I understand this and agree, but the problem is that there will be plenty of times that my absence will be obvious. My company start date and level is on my people profile and my CV is on the system for anyone to see. The question of what client I am working on or have worked on in the past is going to come up. People I have worked with in the past will see me and ask where I’ve been. People will see me arriving and leaving the office at strange times, only working for a few hours and doing pointless tasks. I can’t hide things forever and I see no reason why I should, especially as I don’t have to worry about HR finding out, resulting in me losing my job. HR know the whole grizzly story, so there is no reason to hide. I will have to be honest with whoever I work with next, because I will be working reduced hours.

I was really quite upset by this comment and it took a lot to bite back the tears that were threatening. I knew I couldn’t break down at that point, because she would never think me well enough if that happened. I really would look like an overly emotional mental person if I burst into tears in her office and it would confirm all of her worst fears, so I did my best to maintain my composure. She thinks that I’m not able to act professionally and deal with people’s reactions and of course her comments do feed my own fears and anxiety. I am scared about what I will say, but I have thought about it a lot and see no option but to be honest. If they aren’t happy with that, then it is their problem, not mine. I know I am going to have to get used to this kind of thing, but it hit a nerve. I worry I will be faced with this dilemma for the rest of my life.

I’d asked Dr Occy Health if he thought I should or could go to the all-day community event and Christmas party in London. I’d like to go because I have missed out on the last couple of years and the meetings are usually interesting. I think it would be a good opportunity to find out what is happening in the company at the moment and the party should be fun too! I was a bit worried about the fact I will be travelling down to London on my own and it may be a bit much, but I think I will be okay. Dr Occy Health agreed that it would probably be good for me and said he would put a comment supporting my attendance on his report.

HR Manager was less keen on the idea. She was worried about me travelling to London on my own and is worried that I won’t cope with meeting everyone. She seemed worried about how it will look if I manage to attend a whole day event and a party, yet I’m only able to work four hours a week normally. People may judge me for it. They may, but it is a bit different spending a day listening to someone else talk than actually having to do proper work and very few of them will know I’m working reduced hours anyway. We have agreed to take a call on it next week, so we shall see what she says. I don’t know what is the right decision, but I’d like to go if I can.

I can’t remember what the other guidelines said. I think they probably mentioned local working and having a local manager, but I’m not sure. There was a note about me being protected by the DDA and the fact that these could be considered “reasonable adjustments”. Finally it was noted that I should be reviewed by Dr Occy Health in early December.

I hope I can manage. I have survived my visits so far, but I think it will get harder when I have to tackle some proper work. I have run out of initial tasks now, but HR Manager talked about the possibility of me doing some work for her. There’s a project she is considering that is related to something I did on a previous role, so I may be able to help with that, but I don’t know yet. I’m just waiting to see what she suggests.

At the moment it is a bit frustrating. I feel weird when I arrive at work so late and have to leave so early. I worry what everyone thinks of me. I generally feel okay whilst I am working, but I struggle either side of it. Strangely, one of the weirdest things is wearing smart clothes again. I am not used to it.

I wish I could fast forward to being back properly, but sadly that is not an option. I have been off work for nearly two and a half years though and I know it is going to take a lot of adjusting to go back. Dr Occy Health keeps reminding me of this and I think as far as he’s concerned, it’s a miracle that I’m trying to go back at all. This is somewhat disheartening, but I know the statistics and he must see enough people that never make it. I hope I can be one of the lucky few.

Anyway, I must stop writing now. I always finish blog posts like this, but I never get the chance to say everything that I am thinking at once. I have been writing this on and off for days anyway, so it’s time I posted.

Written by intothesystem

Tuesday, 16th November 2010 at 6:35 pm

29 Responses

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  1. When I switched from working on a ward to an office, I found the smart clothes and itchy scratchy office trousers strange too. Now I quite like wearing smarter clothes, I definitely carry myself differently. On the other hand, there’s nothing quite like jimmie jams and a hot water bottle at the end of the day (I’m 28 going on 108).

    HR Manager? Hmm. I’m with you on this one. It’s all very well to try to follow her starting-a-new-role advice but you’ve pointed out a few flaws in that plan. I’m of the opinion that “I’ve been unwell and am gradually returning to work” is the best plan. It may help to stop those gossipy conversations by the water cooler about why you’re projectless and so forth.

    Good luck with the continued return. Please keep us posted, intothesystem :)


    Tuesday, 16th November 2010 at 7:11 pm

    • I used to prefer wearing smarter clothes. Our office is officially smart-casual, but I tended to stick to the smart side of things, because it was just easier to know you were within acceptable boundaries. The client I was at last was pretty formal, so I wore a suit there and I actually preferred that. I always felt more confident when I was dressed smarter.

      I am not used to it at the moment though. I can barely walk in my heels – I was never comfortable in heels, but now it’s impossible.

      Plus I have the hazard of the dog to avoid now I’m home, so I have to try and change for work at the last minute and change again the second I get home.

      We shall see what happens with telling people. I hope there won’t be too many gossipy conversations in the office as not many people know me. It’s pretty anonymous and people come and go all the time, but there will be other occasions – mainly social ones, where it may be more uncomfortable.

      Thanks LF. xx


      Wednesday, 17th November 2010 at 12:49 pm

  2. First of all congratulations on your return to work – that’s great news. I hope HR give you all the support you need.
    How long have you been on the reboxetine? I’ve just started and seem to be experiencing similar problems to you – and if you don’t mind me asking how do you find Lamotrigine? I need to introduce a mood stabiliser but have been hesitant after bad experiences with quetiapine and abilify –

    Sorry for all the questions


    Tuesday, 16th November 2010 at 7:16 pm

    • I’ve been on the Reboxetine since late Jan/early Feb, but I started on a very tiny dose. I only recently increased to 8mg, which is meant to be the standard therapeutic dose! <- is a post about Reboxetine. There are some interesting comments too.

      I never used to know if the Lamotrigine helped or not, but when I stopped taking it this time last year I got worse very quickly, so it must have been. I have definitely been more stable whilst I've been on it, although it doesn't do much to alleviate my depression. The Reboxetine has been the only thing to touch that side of things. One good thing for Lamotrigine is there have barely been any side effects at all. I certainly couldn't attribute any specifically to it.


      Wednesday, 17th November 2010 at 12:56 pm

  3. Hope the phased return goes well, it seems like a positive step forward.

    Take care,


    Tuesday, 16th November 2010 at 7:56 pm

  4. This is really interesting. Like you and LF I’m not happy about HR Manager, in fact I’m left wondering who she’s really talking about. Well I’m not really, it’s herself isn’t it? I don’t know her, of course, but clearly she sees mental illness as something to be ashamed of and denied, even lied about. Her suggestions wouldn’t work for reasons you’ve already stated.

    Anyone who has a problem about your mental health, well it’s their problem isn’t it, not yours? There are risks in this strategy but, let’s face it, there are are risks in crossing the road if a big bus with ‘intothesystem’ or ‘Bristol Michael’ on it hoves into view.

    Blowing from this post is a refreshing gust of good, fresh air. Your experiences I think have helped you to develop as a person and it shows in what you write and in the way you write about it. At a meeting I was at many moons ago, R D Laing, who was one of the billed speakers, said: “It is no good fortune to go mad but if you do happen to do so then you may as well use the experience to your own advantage”.

    ‘Tis a small world. Reading this, before I got to the comments, I thought, “LittleFeet would have something useful to say about the returning to work strategy”. Having got to the comments, here she is! So you listen to her, in fact listen to each other perhaps?

    Bristol Michael

    Tuesday, 16th November 2010 at 9:22 pm

    • I’ve been a corporate employee for the past twelve years. Much of what is expected of us is to suppress personal information generally. Women – young and old – dye their hair so that nobody can see whether they have grey hair or not. Our co-workers are not our friends. We put on a bit of a uniform when we go to work; clients and colleagues alike find life easier when they can interact with us as a supplier or customer rather than as a person.

      While people – including HR – can be quite silly, it’s also possible to accept the input. If HR is being silly, maybe someone else will be silly too. Maybe HR knows something about silly people.

      It might be sufficient to keep the information sharing to an absolute minimum. This means not the minimum required to make sense, but the minimum required to demonstrate you heard the question. “I’m only in on Tuesdays.” “I was off.” Direct questions can be handled with “That’s so personal it couldn’t possibly interest you.”

      And then changing the subject back to the task at hand.

      On the other hand, perhaps it’s not possible. If you need to feel seen as a whole human being and not just the occupier of a position, you won’t be comfortable maintaining that wall of mystery.

      Alison Cummins

      Tuesday, 16th November 2010 at 10:10 pm

      • *If you need to feel seen as a whole human being..wall of mystery.*


        Bristol Michael

        Wednesday, 17th November 2010 at 12:00 am

        • A whole human being on benefits or a wall of mystery on £40k a year?

          Hmm, hard choice.


          Wednesday, 17th November 2010 at 11:46 am

      • Hi Alison,

        I think you are right that the corporate environment can be almost cold in the way that people maintain a professional distance, but that isn’t universal acros business. Usually with clients or senior management, a professional distance would be the norm, but less so with contemporaries. I do have friends from work and there is a strong social aspect to our company, especially due to the large number of young graduates. Many people form similar relationships to the ones they would at uni or elsewhere.

        There is also a very open equality and diversity agenda within the company. Most LGBT staff are out and proud, with an active community and leadership support. There are special groups and training sessions for women and there are groups focussing on ethnicity, religion, parenting and disability. I know other colleagues from the disabilities group who have been open about their mental health and as far as I’m aware this has not had a negative impact.

        I am going to try to keep information to a minimum. When customer services were saying that they can’t reserve me a hot desk for just two hours unless I will be in by 9.30am. I just said that I’m only working for 2 hours at the moment and I am only in from lunchtime. I am not sure what they thought of this, but it seemed sufficient at the time.

        I am not sure about a wall of mystery. Mystery only invites gossip and I would prefer to be more open and avoid that. I think it should be possible to be a whole human being, as well as being professional and I hope I can get the balance right.


        Wednesday, 17th November 2010 at 1:32 pm

    • HR Manager hasn’t seemed too uncomfortable when I’ve told her the truth of the extent of my illness. Work know what has happened to me and have extensive notes about it, which is kinda unsettling, but I think I can trust them to keep them confidential. My old HR Reps knew when I was in hospital and why I’d been admitted. They helped me get further funding from the company health insurance whilst I was being treated at The Priory and knew I was having ECT, so they know I’ve been pretty ill. Although HR know all that stuff though, it doesn’t mean I’m going to tell anyone else. Maybe that is what she worries about?

      When I mentioned being in hospital, she did ask “so what was *that* like?” and something in her voice told me there was a tinge of discomfort there and a kinda morbid curiosity to know what the loony bin is like. I do sense she is not entirely comfortable with my mental-ness, but I think she is also well versed in disability awareness and knows she shouldn’t be.

      I am pretty honest in general about my mental health. Most people in my life know what has happened. Some know more than others, but I have not hidden the fact I have been depressed or even that I’ve tried to kill myself and been in the loony bin. Generally my (sometimes brutal) honesty has been well received and I have noticed that people will themselves open up about experiencing depression or knowing people that have if you make it clear that it’s okay to do so.

      That said, I know that it is different in professional situations and I think I know where to draw the line. I do have a few friends at work that know and HR obviously do, but I’m not going to tell the whole office what has happened. I’m disappointed that she wasn’t sure if to trust me on that.


      Wednesday, 17th November 2010 at 1:16 pm

  5. In your position I think I too would be open about the fact I’d been ill and off sick, without going into more details… two and a half years is quite a lot to try to hide!

    I hope you do get to go to the party. I would think being present at social events would make it much easier for you to integrate back with your colleagues.

    Good luck with it all!


    Residual Craziness

    Wednesday, 17th November 2010 at 9:55 am

    • Thanks Res.

      I hope I get to go to the party as well. I think it probably will be quite scary, but I need to get over that hurdle sooner rather than later. It will be a long day and probably pretty tiring, especially with the travelling, but I will have a weekend to recover and I don’t have to rush down the evening before either – I can take my time. If I was struggling during the day, I’m sure I could take some time out anyway and no one would notice. I know other people that have had to duck out of past events for a conference call or whatever and no one else noticed or cared.

      Networking is an important aspect of our work too and I think it could be hard to get on with the job if I miss out on those opportunities. I know so few people now, I’d like to have the chance to meet everyone. People don’t tend to talk to each other in the office unless they have to, so social events and meetings are the only chance to get to know people.

      I will probably talk to my shrink about it on Monday when I see her. She may have some thoughts. We shall see what HR say anyway.

      Thanks. x


      Wednesday, 17th November 2010 at 1:44 pm

  6. Well done for making steps and I hope it all goes well for you. I don’t think you were revealing too much and I would have done the same. You shouldn’t have to hide anything. If other people are ignorant it’s their problem.
    Do take care not to do too much though


    Wednesday, 17th November 2010 at 12:46 pm

    • Thanks la-reve.

      I am trying not to take on too much. Dr Occy Health, work and everyone else is aware that I have a tendency to over-work and be a workaholic, so they are monitoring that closely. I will get told off if I spend more hours in work than agreed, although the temptation is still there. I find it hard to stop when I get started. I am being good at the moment though.


      Wednesday, 17th November 2010 at 1:50 pm

  7. ITS, glad you got your phased return, its something to work towards just remember one day at a time x

    Ms Leftie

    Thursday, 18th November 2010 at 3:42 pm

  8. […] the System is going back to work on a phased return: So last week, I finally met up with the HR manager to discuss Dr Occy Health’s latest report and […]

  9. Hiya I enjoyed reading your blog and found that I could relate to some of your feelings,it’s hard to believe ur nt alone when u feel so low and get others to understand who don’t quite suffer from such difficulties. Hope u feel better.


    Tuesday, 23rd November 2010 at 2:05 pm

    • Thanks. I am feeling a lot better than I was when most of my blog has been written. I hope you feel better too.


      Tuesday, 7th December 2010 at 8:29 pm

  10. I hope it’s all going well xx

    Ruby Tuesday

    Thursday, 25th November 2010 at 12:47 pm

    • Thanks Ruby. Surviving. Have had a post half-drafted updating on how it is going, but not got around to finishing it yet.


      Tuesday, 7th December 2010 at 8:30 pm

  11. Hi

    Called by cos I was wondering how life was going with you. Well done you!

    Firstly, a big well done for starting phased return to work. I send you masses of wishes for it to go well.

    Second, the HR person sounds like she has a problem with mental illness. Sounds like she needs some training/education! Your approach regarding what you say to folk etc sounds just fine to me. I too struggle to see what the alternative is apart from attempting to cover things up. I think going down that route would just be high stress, feed into lower self esteem, and re-inforce stigma. Just don’t go there. Imo your way is definitely the way to go.

    Thirdly, I think you mentioned about carrying this ‘problem’ with you throughout your career i.e. the 2-3 years that needs explanation. Time moves on and things fade into the distance. You will get to the stage where it will not show up on a cv, truly. That might be hard to believe now, but in a few years time it will become less and less significant. Also in a few years time, it will be evidence of a huge success in your life, of adversity overcome / lived with.

    Take care. I am thinking of you. Email me if there is any way in which I might be able to help.



    Saturday, 27th November 2010 at 3:55 pm

    • Hi Di,

      Lovely to hear from you. I miss your contact on twitter, but still trying to stay away for the time being.

      I hope you are right about the CV. I guess I have to take comfort in the fact I am young and many grads don’t even find a job in their first few years after finishing work. It is difficult at the moment because it is too obvious to ignore, but I do hope with time it will fade. I just need to get some work in during the meantime to try and push it down a bit! Easier said than done, but we shall see. At least my employer are generally supportive and they will have to find me something to do, even if no manager wants me on their project!

      Thinking of you too. Take care xx


      Tuesday, 7th December 2010 at 8:27 pm

  12. Hi intothesystem, I have been reading for a while, and wanted to say good luck.
    I have been off work for about 6 months now, and am just going back to voluntary work for a few hours per week, so I can relate.
    Don’t feel bad about ‘only’ going in for 2 hours, even that is an achievement. Try not to worry about what your colleagues think.
    (On that, I would go with just saying you’ve been off sick – it makes it obvious you don’t want to talk further. Then *ask them something about themselves* – everyone likes talking about themselves, so they’ll like you, and you get to avoid disclosing things you’d rather not).
    Don’t pressure yourself too hard to be ‘productive’ either. It’s as important to get back into the routine of going to work, workplace behaviours and so on.
    Hmm, I’m probably telling you stuff you already know, and have rambled on enough. Again, good luck.


    Wednesday, 1st December 2010 at 11:40 am

    • Thanks. Always good to finally “meet” my lurkers. I know there are a few out there!

      I hope you get on okay in your voluntary work and that if you want it to be, it can be a stepping stone to a “proper” job. (not to imply that voluntary work isn’t real work, more just that it would be nice to be paid I guess?)

      Take care x


      Tuesday, 7th December 2010 at 9:19 pm

      • Hi! I hope you’re doing OK with the return, and generally.
        Yes I’m hoping the voluntary work will get me a paid job. Don’t worry, I know what you meant by a ‘proper’ job. It certainly would be nice to be paid – I’m currently existing on benefits which as you know is not easy.
        Take care too. x


        Wednesday, 8th December 2010 at 8:00 pm

        • Aye. I’m lucky in that I’m not surviving purely on benefit – I have an insurance payment from work, but even with that we’re not exactly rolling in cash. Our rent is more than the benefit payment alone!

          Owning a dog is not exactly cheap either, although I kinda consider my DLA payment as going towards that as she’s very therapeutic. Gets me out the house on walks, offers good hugs and comes to check I’m okay when I am upset.

          I’m doing okay. I went to the work all-day thingy and party on Friday and have been struggling a bit since. Think it wiped me out a little. Hoping it will pick up again soon as I settle back down to a routine.


          Thursday, 9th December 2010 at 11:03 am

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