A Patient is just as responsible as their Doctor

The Patient’s Duty:

–       Know how to communicate effectively with medical staff.

Rudeness will not aid or speed up your care, and there is no 100% success rate for any Doctor, a diagnosis can change based on further tests or second opinion. You are as much responsible for your own body and health as your Doctor is, they will do their job in aiding your health, but you should do the same.

–       Know your rights.

I, as have many others, have experienced problems with Doctors who are reluctant to make referrals or give prescriptions, and instead of having a “better safe than sorry” attitude have an “it’s probably not that” attitude. Well, would you rather a suspicious lump shown up in an ultrasound not be tested further because it “probably” isn’t cancer, would save some funding and the GP’s precious time?

No, it is better to test again to get a clearer picture and confirm that it is definitely rather than “probably” not cancer. The most recent story pertaining to this issue was this article about a lady whose husband could have been diagnosed with Alzheimer’s much sooner. The Daily Mail is awful of course, but I found the story interesting.

This BMJ article ‘A horse or a zebra?’ describes a medical student who diagnosed himself correctly, but was told by the GP that this diagnosis was unlikely and would not refer him for testing. This is why sometimes insisting, and knowing your rights, can help you reach a positive outcome quicker, you have to stand up for your health.

Prevention is always better than cure, the funding used on tests to aid early diagnosis, vaccinations, and necessary prescriptions save money in the long-term, and can result in less long-term or chronic conditions that require lifelong medications or treatments.

–       Know when to call NHS Direct instead of an ambulance or going to A&E.

I have heard laughable stories of

Depressed elderly man reacts to music from his era

The video above is really touching, it doesn’t give all the facts about him or where he’s from and why he’s in the nursing home, but his reaction to music is undeniable. This acts as a reminder of the power of the brain, how stimulus through sense of sound can awaken neurological pathways that have remained dormant.

It vaguely reminded me of a film I like, The Music Never Stopped.

Related articles

• original Man In Nursing Home Reacts To Hearing Music From His Era – YouTube (chimac.net)
• Elderly, unresponsive man in a nursing home is transformed by music (boingboing.net)
• Music & Memory (saintleoinkblot.com)
• Video Proves The Power Of Music: Dementia Patient Loves His Cab Calloway (towleroad.com)
• Why In Home Care is More Beneficial Than a Nursing Home (dave-lucas.blogspot.com)
• An old man’s reaction to hearing “his” music (lifebegins45.wordpress.com)

Mind over matter, can thinking kill you?

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Having just read this Guardian article, ‘The nocebo effect’, I’m reminded of how powerful the human brain is. Neurology is my special interest, and the ways that our psychology can interact with our physiology. We all know that stress does not just affect our minds, the way we think or act, but can physically manifest and even shorten your life (good old telomeres!). “Chill out, you’ll live longer” springs to mind. But can a patient affect the course of their treatment just with their mind?

I’m not talking about magic or supernatural powers. I’m referring to the way emotions and attitudes can affect the chemicals released by the brain, emotions after all are just that. A person with depression can be suffering a simple chemical imbalance; perhaps they are not releasing enough serotonin and can be given a tangible remedy. But a person with a state of mind leading to physical symptoms, this is perhaps more difficult to solve, and highlights the need for positivity and better mental health care in the UK.

Take the scenario of a woman suffering a ‘phantom pregnancy’ whereby the abdomen swells, appetite increases, breasts are tender or even lactating. Or an injured solider who still feels pain or an itch which cannot be scratched in the legs he no longer has. These cases exist in no small number, and phantom symptoms are no less real to the patient than those which are visibly proven, yet they are induced solely by the power of the mind. The mind exists only in the brain, and the brain communicates all vital messages to the rest of the body, even the slightest brain damage can have a huge impact on motion, speech, and personality.

Consider what your mind can do when applied to an actual physical condition, can thinking positively really aid your recovery and is thinking negatively detrimental? I believe so to an extent. For example placebos, be they ethically sound or not, undeniably have a positive effect for some people (be it an illusion or not). Countless studies back this up. But can you create your own placebo; can you trick your body into healing faster?

A very interesting topic relating to neurology is pain, which exists in the brain (ironic considering the brain itself feels no pain!). An interesting study I read a while back by the University of Nottingham is discussed in this video: Mind tricks may help arthritic pain

Would you give change to a homeless drug-addict?

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There is a fine line between logic and emotion, and quite often one defies the other. Logic told me the man would use the money he collected to buy more heroin, and that therefore it was wrong, and would be enabling him. But the other part of me knew there was a very slim chance he would at least spend some of it on a hot drink, or something useful, and that I would feel guilty if I just walked past impassively. I knew he was a drug addict from his eyes, his skeletal appearance, the marks, when you’ve seen it all before you know the signs.

I’m not “soft” in a sunshine-and-rainbows, crying at rom-coms, Mother Teresa type way. But I always put myself in another person’s shoes, allowing me to empathise and weigh this with logic. I never just walk past and ignore a homeless person begging for change, or even a charity fundraiser standing neglected with their hopeful bucket, I always give change even if it’s just a little. Does this say something about what kind of a Doctor I will make? I don’t know, but it says something for the way I balance logic with emotion.

In my opinion it is wrong to assume that all homeless people begging for change are drug addicts, and therefore morally wrong to deny them change solely on that basis. Furthermore if they are a drug addict, why are they any less deserving of loose change? As distasteful as it is to enable them, or make any contribution to the grotesque drug business (where someone is always profiting, and others are always losing; their lives, their bodies, their minds or their homes), the beggar has no control over their addiction, and could die from the cold-turkey withdrawal.

Of course, giving them help would be better than giving them change; establishments exist to help drug addicts and homeless people, there are soup kitchens, shelters, Methadone programmes. But nothing is perfect, just as there is no perfect way to handle the scenario laid out in this post, do you:

– Walk past and ignore

– Give them change without knowing whether they are a drug addict or not

– Give them change knowing they are a drug addict (Are the above options doing indirect harm or good?)

– Offer friendly advice about programmes that could benefit them. (Or is this intrusive?)

– Offer to buy food for them rather than give them change (I’ve heard stories of people doing this when they suspect that the money they give would be spent on drugs, therefore this acts as a sort of test, but is this morally sound or not?)

The truth is there is no definite universally applicable right or wrong, it’s all down to the individual. But I find ethics very interesting, and the way empathetic impulses or emotions can lead to views being solidified as law, that is why the law is always changing, particularly medical laws, think about euthanasia, how new cases affect our human rights.

NHS: Let Them Eat Cake! [Latest Health News in Brief]

NHS Reform. The NHS has its flaws but if you privatise it you are essentially minimising patient care but maximising corporate competition. This belittles the principles of Medicine and healthcare, making it all about profit, money and marketing, rather than caring for people. The only people who win in a Privatised and essentially fragmented NHS are the companies that compete for a stand in Healthcare, whose products and service are not the best but cost the private sector less.

Privatising the NHS is essentially saying “Let them eat cake!” In Marie Antoinette’s world, sure, let the patients eat cake when what they really need is quality healthcare.

I agree with assisted suicide; euthanasia is the kindest gift to offer someone who is in the most extreme circumstance, without any quality of life, and with great suffering. Zürich has voted similarly: click to see news story.

Social networking has become more than just social, it is used in Medical schools, some of which in the UK give out smart-phones to students so that they can carry digital textbooks. There are many pros, but I wonder about the cons; for example, will it deter students from being intuitive or self-sufficient if they rely upon a mobile device for the answers to a correct dosage, will it bias the diagnostic process?

Twitter ‘vital’ link to patients, say doctors in Japan: Click   

Lines between plastic surgery and beauty treatments are diminished, but what by? I believe it is the easier access to cosmetic surgeries and procedures which make them less taboo, more easily attainable and therefore more likely that someone will be inclined towards them (the sheep effect; everyone else is doing it so why not you?). Click here for details.

Obese pregnant women are being given Metformin, usually for diabetics, to reduce the risk of obesity in their babies.

Casualty fan saves baby’s life with skills learned from show:http://tinyurl.com/5ux23q4

Monkey HIV vaccine ‘effective’ I really hope this can give us some insight into a way to cure human HIV victims, and yes I say victims because no one chooses to have HIV/AIDs, however they contract it. I remain dubious, because many ‘cures’, or proposed ones, have been and gone. I’m just glad the research continues, and we’ve gotten so far with extending the lives of HIV victims, delaying full AIDs.

Doctors want a decision on the NHS, but the wrong choice could cause further disarray. Personally I am opposed to the NHS reform, but I wanted to hear the other side of the argument so I went to the Royal Society of Medicine debate; arguments for the reform revolved around increased efficiency, quality of products and care, as well as time management. However, I’m doubtful of that, increased corporate competition will commodify health, and prioritise profit over care.

How Superbugs attack; The research carried out at BMC Systems Biology discovered genes responsible for MRSA‘s grown resistance to the Methicillin antibiotic. As a type of Staphylococcus aureus, it is of interest to my upcoming lab project, where I will measure the rate of growth in bacterial resistance. A toxin taken from the skin of a bullfrog has proven effective in destroying MRSA.

Living with a terminal illness

Image by squishband via Flickr

I’ve been meaning to write about this for a while. Mr Anonymous has an inoperable tumour in the right hemisphere of his brain, which means the left side of his body is mostly paralysed. His condition is neurologically complex, to the extent that he could die either any minute, or live for a few more years. Either way, it’s terminal, and the suspense is what depresses him most.

I’ve come to understand how his mind state can differ drastically from one day to the next, because of the conflicting emotions. Sometimes he begs me to pray for him to die, to get it over and done with. Other times he pleads, stating that he is not ready to die yet, and asks what is on the other side; would his wife and children be there. He asks me this despite his Atheist standpoint because, let’s all be honest please, in the face of death you never know how you will feel.

Being bedbound makes him feel useless, so I bring him round poetry and stories sometimes, and this cool device one wears on their hand to exercise it (his functional right hand). I love that he remembers my name, Ruth, even when he forgets some of the other Carers names. I feel we have a genuine friendship, he even agreed to be my guardian angel, which made me laugh because he says: “Guardian angels are the ones who move people up lists and grant wishes, because they seem so serene and wise that no one notices what they’re getting away with.”

It makes me sad that he has deteriorated in the time I’ve known him; he was able to walk slightly, now we use the electric hoist to move him. I feel sorry for his wife because she is going through the same hell that he is, she doesn’t rest enough, is never truly at ease but is always affectionate and polite despite her pain.

“There’s always one happy day, even when the rest are bleak and numbered.” – He said this to me this evening when we put him to bed. He said this is the happiest day he has had since being diagnosed, and that seeing us Carers visit is what makes his day everyday. Well, he made my day just by smiling so freely.

This is why I want to be a Doctor, to see that same smile on the faces of patients and go to sleep at night knowing I have truly helped another person. Being a Carer is helping others of course, but being a Doctor would mean so much more than just making someone comfortable; I could actually help cure them, find a solution, connect with them and their families in such a way that would minimise the pain, even if I am only in their acquaintance briefly. I know I am capable of this, and Mr Anonymous has reminded me of this regularly, he always says he can see me being a marvelous Doctor. I hope he is right, that I can make it someday. And I wish him and his family well, they deserve to be happy.

“You’d make an excellent Doctor”

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Received the nicest compliment today from one of the elderly people I care for, they said there’s something special about me and that I’d make an excellent Doctor.

Also…at the Hospital I volunteer at I found out I’ve been assigned to the Surgical Ward! Very beneficial, especially because I dream of being a surgeon some day.

EX2512exza

Call an ambulance

Apologies to people I am subscribed to, and those in my blogroll, I simply haven’t had any time to read as much or comment lately, let alone write any lengthy posts for my own blog.

What’s my excuse? As well as the huge dissertation article, separate project, double modules at university, commuting to London, and continuous research in my “spare time”, I also work as a carer. The timetable has filled up this week, I’m no longer under mentoring.

Ms Anonymous, a new care receiver I met today, seemed well and able, apart from having a poor memory (I had to remind her each time she asked what time lunch was, and that she had already had breakfast). But, as I and another girl (who does not work for the same care branch as I) were preparing lunch, we heard an almighty crash. We ran to Ms Anonymous’ bedroom to find her crumpled on the floor. She had tried getting out of bed unassisted, and tripped on her Zimmer frame.

We had to call an ambulance fast, because she said she thinks she had broken her leg. We couldn’t take risks, especially seeing as she had a hip replacement recently, and was hospitalized a long time with an infection also. I made sure we kept her still, but comfortable with pillows, and called her son as well.

The ambulance arrived to pick her up, and I hope she will be alright once out of hospital. That’s all I will write for now, it’s important to keep track of these things. Am heading out later for an evening appointment with a different care receiver, hopefully they are faring well, it’s a shame when bad things happen.

Image via Wikipedia

On a brighter note, I saw a very cute cat today who kept me company when I was waiting out in the cold.

Life as a Care Giver

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Firstly, I haven’t been doing this long. But I spent the past few months completing my training, with certificates in First Aid, Health & Safety, Movement & Handling etc. Then I began my mentoring, so I am still not “flying solo”, but I learn from watching/helping the people whom have been carers for much longer.

Today I felt choked up, it was my first time at Mrs Anonymous’s house (Patient confidentiality of course). She has Multiple Sclerosis, and paralysis on one side, meaning she is wheelchair bound and can only use one arm. Not to mention the fact she is 90-something years old, with severe arthritis that curls her toes and fingers into gnarled roots. The discomfort she is constantly in is little eased by medications and prescription creams.

She lives completely alone, with no pets. Pays for her own care, rather than accepting benefits, so perhaps she had a wealthy past. The radio is her friend once we serve her meal and say goodbye, leaving a cup of Earl Grey in the microwave for her like she instructs. She is meticulous, extremely specific in what she wants, even where you place her hairbrush, because this is the only control or power she has left. It’s heartbreaking. Reminds me of my grandmother somewhat, which was the main reason I wanted to do senior care, except my grandmother has Alzheimer’s, and this lady, Mrs Anonymous, seems mentally sharp despite the M.S. But isn’t that the worst part? To be mentally alert but trapped in a crippled body, like a butterfly with broken wings.

Why am I writing this post? I guess I just wanted to give you a glimpse into what caring is really about, and would ask anyone whose grandparents are still alive, to please visit them, take care of them. No one should have to be alone like Mrs Anonymous.

Medical Education Online

 

Image via CrunchBase

 

One more old snippet from my LiveJournal:

• Apr. 5th, 2010 at 8:06 PM

Interesting medical essays HTML:

Effects of Internet Use on Health and Depression: A Longitudinal Study:

http://www.jmir.org/2010/1/e6/HTML

Learning in a Virtual World: Experience With Using Second Life for Medical Education:

http://www.jmir.org/2010/1/e1/HTML

Aloe can help survival during severe blood loss?

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Just found one of my older LiveJournal posts, it was just a DRAFT of thoughts:

Jan. 16th, 2010 at 6:41 PM

• en.wikipedia.org/wiki/Tachycardia Tachycardia – can incidentally be caused by hypothyroidism, it mentions blood loss and all main causes though.

Aloe can help survival during severe blood loss?
www.nationalreviewofmedicine.com/issue/2004_09_15/clinical11_16.html

I initially searched into this mainly because I was wondering whether panic/increased heart rate sped up blood flow (and therefore blood loss), (and therefore one’s demise), OR, does the quickened blood flow aid the situation, seeing as the heart’s natural response to blood loss is to speed up and release adrenaline as a reaction to lower available oxygen and/or volume of blood itself. Does speeding up of heart rate and blood flow enable the remaining oxygen to be distributed in a way that attempts to simulate the regular amounts.

It is mentioned that aloe increases circulation, and the rats that were injected with it during severe blood loss lived longer than rats that were injected with regular saline. However, the improved circulatory function does pose the risk of obstructing coagulation. Therefore aloe could be useful to prolong a patient’s life, whilst further treatment/aid/procedures are taken to stem the blood flow, or a transfusion is made.

So, is the natural rush of adrenaline, which is automatic in the situation of severe blood loss, helpful? Or is it an inevitable symptom, induced by hemorrhagic shock, which essentially speeds up one’s demise?

Heightened heart rate and blood flow BUT lower blood pressure.

Heightened blood flow but lower oxygen and blood volume.

If the heart slowed dramatically rather than speeding dramatically once heavy blood loss is induced, the lowered blood pressure would have an intensified impact…therefore it could be theorised that the over-compensation the heart makes in speeding faster is an attempt to normalise the body and pump oxygen to the parts that need it most.

HOWEVER, with wounds, such as those on major arteries, like the jugular, the heavier blood flow would result in a quicker death.

(Original post can be seen here: LiveJournal)

£92.40 for charity in just one day

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Well, I counted up all the coins and notes I collected on Monday, plus some of my own donation fund, and it adds up to £92.40. Which is absolutely amazing for one day of fundraising on my own. There was another £25 people already donated online, which means I’ve exceeded the £100 target.

Here is why I’m doing it:

Harlequin-type ichthyosis is the most severe form of congenital ichthyosis. Swelling to the eyes, ears, and other appendages, mean that the babies born with this skin disease have difficulty seeing, breathing, or even moving.

The texture of the skin means it cannot bend where soft skin usually can, it’s cracked texture is agonising and means the babies are prone not only to infection from the bleeding exposed cracks, but from hypothermia also.

Medication such as Isotrex, which improves their quality of life, are essential. But with your help, further treatments can be found, and you will be contributing to the life-time care that Harlequin sufferers require.

Please click here for more info: http://www.justgiving.com/RNoakes

I can’t update, fear of failure :(

Image by Spitefully via Flickr

Not properly anyway. Until Monday’s disastrous clinical aptitude exam is over. I’m not expecting to pass because it was years ago that I had to do any maths, and even with these past couple of months revision, the time limits in the exam are the real problem.

I can do the calculations, I’m not thick, but with 1 minute per 4 questions, I need more time to prepare.

Really nervous about Monday, but all I can do is keep studying like I have been. UKCAT just isn’t my thing, give me a proper medical exam and I would do better, or a complex analytical essay. I’ve done more challenging things than this before, but it’s sometimes the “simple” but very time-limited things like this that get to me.

The thing that lets me down is the panic when it comes to time limits and maths. I came out of school years ago with a very good grade, but even so, I still feel hopeless.

Multiple personalities and Shelter

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[contains mild spoilers]

It’s nearly 4am and I can honestly say I haven’t been this spooked by a film in a long time. I just watched Shelter (2010), directed by Måns Mårlind and Björn Stein. And written by Michael Cooney.

Julianne Moore, whom I adore, plays a forensic psychiatrist whose patient (Jonathan Rhys Meyers) has multiple personality disorder…or so she thinks.

The fact that each of his multiple ‘personalities’ are that of actual murder victims, causes her to question herself. An inward battle between science and religion reigns as she tears through experimentation and research, finding nothing that makes sense to her.

What starts out as a psychological thriller becomes supernatural horror, which was quite interesting as it works as both. Some people complained about the ‘switch’, but in actuality there was no transition needed; it was always evident that this was more than just a man with multiple identities. Maybe some people are just a little slow in the brain tank. The filmmakers even showed the supernatural darkness very early on in the plot, leaving no doubt in anyone’s mind other than Julianne Moore herself.

I was impressed with Jonathan Rhys Meyers’s handling of the multiple roles, especially when he had to behave as a little girl crying after her wounded mother. He had the hardest task of balancing the many characters that made his part.

The film had a subtle style which never intruded on the plot; every voice over or scene transition was smooth, and the music haunting in all the places it needed to be. I did wonder why only the spine was fully changed when each of Meyers’s identities switched, whereas everything else was left the same, but I guess that doesn’t need to be explained. The convenient thing about supernatural genres is that they minimise the need to explain what is synonymously unexplainable, or without reason.

8/10 is a very fair rating I think. But I wonder if maybe I was only so jumpy during because I am sleep deprived, and alone in a cold dark house.

Rate my review on imdb.com: click here

Doctors and dentists with HIV/AIDs

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It’s something I’ve looked into before, but I found an interesting article tonight:

Click here to see

I have deep sympathy for anyone that contracts the disease, but particularly those who simply could not prevent it; rape victims, babies born with it, etc. What makes matters more complex is when someone within Healthcare has this disease. As stated in the article I linked, there are regulations on declaring positive test results, and prohibitions when it comes to surgeries, sutures, and any situation that may pose a risk of transmission.

In short, it is not legal to fire a doctor or dentist for having HIV or AIDs, but their career is effectively over nonetheless. What a terrible thing for them, to have gone through so much schooling and hardship only to be brought down by a disease. In any other walk of life they may continue relatively as normal; because improved medication generally means a higher quality of life, and the delay of full-blown AIDs stemming from testing HIV positive.

But it is necessary, for others safety, that transmission risks are minimised. I must admit I would prefer to be treated by a doctor or dentist whom was not HIV positive, and it would be nothing against the person. A disease shouldn’t dehumanise anyone. I just know that if I were HIV positive I would never want to risk infecting others, and would certainly never want anyone to infect me either.

The best thing anyone can do is protect others, ourselves, and encourage the progression of medical research.

End of my boring rant.