I've become a proper, grown-up, midwife!

Yesterday was my first ever day at work as a fully independent midwife. I was fairly nervous before I started given that I haven't done any midwifery since Ghana (although I still think what I saw was less 'midwifery' and more 'forcibly tearing babies out of vaginas'), but as soon as I started it all came back to me. Everyone I worked with was incredibly helpful and friendly, and I don't think it'll take long to settle in. I'm still loving living in Nottingham, and I can't believe the difference a year has made to my life. Grateful doesn't cover it.

Love Emily x

Graduation day

Last week I graduated from my training course, with a first class degree. This time last year I wanted to be able to walk across the stage by myself. That stopped being a challenge in February, so I upped the difficulty and aimed for doing it whilst wearing high heels. I managed it, even if they were sturdy and sensible, with a strap so I could keep them on.

For the seriously interested, you can watch the ceremony here - although I recommend saving an hour of your life and skipping to 35 minutes in!

Life is going really well in the Midlands. My house is great fun, if not what my mum expected. It's sort of a cross between Fresh Meat and Men Behaving Badly, but when living with 4 blokes gets a bit grating Abbie is always up for a drink - so I can't complain at all! I start my 'induction' stuff this week at Queens, and I'm sure once they've taught me to manually handle fires safely I'll remember how to be a midwife. That's the plan.

Love Emily x

Settling back down in the UK

It feels so much longer than a week ago that I returned to the UK. I had a shower before I boarded the plane which got rid of the layer of dirt which could have plausibly been a tan, and now everyone at home is laughing at the 7 new freckles I've gained after a month in Africa. I've got used to the crap weather again, and have a new appreciation for health and safety, bureaucracy, and tarmac on roads.

I've found myself a place to live in Nottingham, and I'll be moving up at the weekend. I'm getting a bit nervous about this working as a midwife thing, but if Ghana taught me anything it's: you can be downright negligent and abusive to a mother and her baby, but I didn't actually see anyone die, so if I go to QMC with good intentions and try my hardest then it might all be okay.

I've had a little look at the reader statistics of this blog, and it's crazy. There's a good chunk of people who come via a Facebook link I've posted, but equally as many are now coming directly via the URL, or stumbling on it via Google. I've got regular readers in the UK, Ireland, Spain, Portugal, Turkey, Romania, Croatia, USA, Canada, Argentina and New Zealand - along with hits from France, Ghana, Sri Lanka, and Czech Republic, but I know people who are/were out there which explains it. 

Love Emily x

P.s. I met Archie Brunton on Tuesday... if he's not an expert in African folklore by the time he's 4 I'll be seriously annoyed!

1 Year On

Today has been exactly 1 year since I ended up in A&E. It's been slightly longer since I started getting excruciating headaches; the first signs of what was about to happen next. They were so intense that I couldn't move, talk or breathe whilst they were happening. They'd only last 30 seconds or so, but it took every bit of energy I had trying to stay conscious for those half minutes. I meant to mention them to my neurologist at a routine review I had the week before I started hallucinating, but I forgot. Thinking back, I forgot lots of things in the days before the infection properly took hold - the best example was just not turning up at a hugely important IT training session for the eHospital system Addenbrooke's rolled out in Autumn 2014. Something so significant just didn't stick in my mind. My back and neck were very painful, but I'd been moving house so I put it down to a muscle strain. There were also early behaviour changes; relatively harmless situations would make me a tearful mess.

So much has changed in this year, but in many other ways most things are still the same. Being ill is still my default thought and, as you can probably tell from the above paragraph, I'm still coming up with new "what if?" and "why not?" scenarios on a daily basis. But also, when I think of being in hospital and the months of recovery afterwards, I'm only able to recall 'false memories' of things which I have a photo or blog post about - and even then it feels like I'm thinking of someone else. It's possible the heavy doses of opiates and anti-convulsants I took/take has something to do with this, but I think it's far more likely to do with the avoidance and disassociation strategies commonly used by people with PTSD. Without doubt, admitting the dangerous state of my mental health and getting appropriate help for this was significantly harder than all aspects of my physical recovery. Although I no longer feel constantly at risk or on edge, I still have to make a conscious effort to keep my mind occupied at all times to stop it wandering back to an unhappy place. 

I've been fortunate enough to be able to choose which areas I work in as a HCA, and I've been drawn towards neuro departments. In some ways this has given me a lot of closure, but seeing the specialist NCCU (neuro critical care unit) and neuro re-hab at Addenbrooke's also made me angry that I wasn't able to be treated and recover there. The more my neurologist in Cambridge (I was his patient before all of this kicked off) explains what my scans and LP results mean the more my anger towards Kettering grows. I was mismanaged from the start: I should never have sat in the waiting room at A&E (I honestly think the triage nurse thought I was drunk), it shouldn't have taken 20 hours to have a brain CT, I should have been told about the hydrocephalus before I forced their hand by threatening to self-discharge, and I shouldn't have found out I had transverse myelitis by reading the 'diagnosis' section of my discharge letter. In Northamptonshire neuro-rehab was neuro-rehab: it was the same unit whether you'd had a car crash, a stroke, a disability present from birth, or an acute illness like I did. At Addenbrooke's (as it's the regional major trauma centre for the East of England) there are separate units for each of these areas, so I would have been 'living' with other people of a similar age and starting point. It's easy to say "I would have chosen that option" now I know I've completed my training and it's not a decision I have to confront again, but I honestly think I would have given it far greater thought had the Addenbrooke's option been there. 

My 25th birthday happened between my illness and now. It seems 25 is the magic age where you stop being 'young, free and single' in the eyes of friends and relatives and edge into 'potential spinster' territory, so casual enquires about my love life are regularly slipped into conversation. I started 2015 in an extremely unhappy state for all sorts of reasons, but over the course of the year I've changed lots of things and now I really do love my life. I don't think a relationship would create any additional happiness, and nor do I think 'the one' is currently in my life. I think meeting someone new would re-trigger anxiety about explaining my health and history: trying to balance conveying how much meningitis messed me up vs not making my health a factor in destroying another relationship. I think I'm years, not months, away from being able to trust another person to not leave me when I'm at my lowest - and that's fine.

But, positives, because there are plenty. Looking back at what I've achieved in 2015 so far is quite satisfying. I walked out of a wheelchair, and got rid of my walking stick. I admitted - to myself and those close to me - that psychologically I was breaking down, and got the right help to get me back on track. I've qualified as a midwife. I've earned myself a first class BSc. I worked abroad. I trucked across Africa. I've moved to a new city. I've made myself a complete and happy person. I'm very grateful for all of these opportunities, and I'm overwhelmingly glad I put the hard work into getting better to enjoy them all.

Love Emily x

Leaving Joburg

I've finished my journey around Africa, and now I'm sitting in the departure lounge at Joburg airport, ready to board my Heathrow-bound plane. It has been a fantastic month. 

I struggled with Ghana in the first week. The hospital wasn't what I had expected at all, and my presence there felt pointless. The staff had no interest in changing their practice based on anything I suggested to them, and all I learned from them was how not to do things. The Work the World house also wasn't quite what I expected, but that was far easier to adapt to, and contained some great people. Possibly the prospect of cold showers wouldn't have been so irritating if I hadn't come back to the house from a day of watching dangerous and dispassionate midwifery at Kwesimintsim. But after accepting I wasn't going to change anything about Ghanaian healthcare, and instead making small differences to individual women when I was working, it became a lot easier to detach myself from the awful things I saw staff do to women most days. Other aspects of Ghana were brilliant: the people I lived with, the day we went to Lower Dixcove and health screened the residents, meeting a village Chief, choosing fabric to make clothes with, surviving marketplaces, learning to hand-wash clothes, Busua beach, Hotel Fespa (only with hindsight...), Cape Coast Castle, crocodile stroking, catching tro-tros, Kakum canopy walk, trying Ghanaian food, learning some Fante, the friendliness of most of the people, and the 'personality quirks' of some of the others! 

For the rest of the trip the good times are almost too many to list. Collecting dozens of new stamps in my passport, exploring the Cradle of Humankind, caving in the Sterkfontein Caves, seeing Victoria Falls from both sides, and above, camping in some beautiful places, seeing hundreds of animals in their natural environment and living according to nature, driving on some stunning mountain roads, seeing the stars with no light pollution obscuring the view, trying all kinds of African food, trying all kinds of African alcohol and (apparently legal) 'traditional herbs', doing stupidly reckless things, having a bash at dancing with a tribe, trucking across the Kalahari Desert,, meeting people from all over the world, and mastering the art of walking in fli flops with numb feet. I crossed Victoria Falls, a safari, and seeing an underground lake off my bucket list (plus saving a life in Ghana, I guess), and sowed the seed for more adventures over the next few years to complete some more.

There are also little things which I'm proud of doing. The flights to Ghana were the first I've ever taken on my own. 10 months ago I couldn't stand up, but now I've just got myself across Africa and back. I had extremely good medical insurance so the moment my legs started hurting, new parts of my body started going numb, or Crohn's relapsed I could have called it a day and either got to a hospital, or gone home on medical grounds. But I didn't, and that takes a hell of a lot of willpower when the alternative is having the shits at a campsite in Zambia. I think biggest of all, after leaving Ghana no-one really knew about my medical history. It was all on a form somewhere at Acacia head office, and I think our driver knew one of us had a bit of a history, but I don't think he knew it was me - and even if he did, he didn't treat me any differently. I loved being able to take part in everything I wanted to, with no-one asking "are you limping?", or "are you sure you can do that?", or "do you think that drink is a good idea?", or "have you remembered your drugs?", or "have you missed an injection?", or "let me see your pupils", or "do you need any help with that?", or "are you getting an aura?", or "you're slurring your words, you must be smashed!", or "do you think you need to go to a hospital?". Having travellers tummy was left at that, and the only person who had 'this is actually a Crohn's relapse' or 'could this be a trigger for another autoimmune attack?' at the back of their mind was me. It was so good to feel normal for a few weeks.

A key part of my safari was camping. As a child I loved camping holidays, and I loved animals, and combining the 2 meant an unbeatable trip. I loved the sense of feeling self-sufficient, and so connected to the environment around me. Also, I love trucking. At first I saw it as a necessary evil for a safari spanning several countries, but now I've been converted. The feeling of sitting there with other like minded people, knocking back beers, swapping travelling stories, playing cards and glancing out of the window to catch a view of whichever desert, mountain or animal you're passing is hard to beat. After the first couple of days of the 2nd leg I felt so light and carefree, a feeling which I hadn't noticed was missing until I felt it again. As much as I love my job, it was the first time in 3 years that I was able to not think about it, and that was refreshing. 

Eating meat is a luxury in Africa, and after the first week of my trip I opted for temporary vegetarianism in view of the 'meat from miscellaneous origin' which seemed to be an ingredient of most meals. After 3 weeks of being a vegetarian I'm not missing meat nearly as much as I thought I would, and I'm toying with the idea of making this a long term choice. Ever since watching Babe (in 1996) I've refused to eat sausages, but having had iron deficiency anaemia for most of my life I've always thought, or been told, removing red meat from my diet, would be a recipe for malnutrition. Since being in Africa, I've seen first hand that meat isn't just produced from a storeroom of a supermarket; it's the goat or chicken I was stroking a couple of hours earlier. For the past few years I've only bought cosmetics and toiletries from companies which are against animal testing, so perhaps becoming vegetarian is the next step of this hippy spiral. On a sort of related side note, I also try not to buy Nestle products - but it's really surprising how difficult that was to stick to in Africa... I thought here would be the first place to boycott! 

I'll be very sad to board BA0054 and leave this wonderful continent behind, but necking champagne in the departure lounge is taking the edge off it, and I'm already making plans to return next year.

Love Emily x 

Kruger National Park day 2

Today we packed up camp and left Kruger NP (where we've been for the past couple of days) to leave for Joburg. It was very much a camp of two halves: one of us who chose to make a proper night of our last evening on safari, and the other made of those who were annoyed at being woken up by this. We started the evening off by having a liquid dinner, and watching a song and dance performance by a local Zulu tribe. It was great, and they started dragging us up and making us dance with them. It was one of the funniest things I've seen all trip. 

After this some of us headed for a bar, and when our driver/leader ushered us into a circle and whispered "what happens at the bar stays at the bar" I knew it was going to be a good one. Alcohol is crazily cheap in South Africa - even cheaper than in Ghana. I was paying R18 per drink: in my mind I thought 1 rand was roughly equivalent to 1 pound so I started off slowly, but after I got told R18 is about 87p I thought it'd be rude not to take advantage of this opportunity.

Round after round later, the bar staff were obviously getting irritated by us and called last orders 5 times (over 2 hours) before chucking those of us still standing out. The final 7 got back to the truck and carried on. And on. And on. Between us there were 3 Brits, 1 Zimbabwean, 1 Aussie, 1 Irish and 1 person from Luxembourg. It's amazing what alcohol and this melting pot of cultures can lead to: we had a bash at river dancing, the benefits of polygamy were laid bare, we observed in-truck acrobatics, played Dobble, and learned all there is to know about tax avoidance. At 3am, after we'd trashed the truck and completely drained the battery by pumping music out of the speakers, I did the conscientious thing and collected up the metal mugs we'd been drinking from, along with all the other tin crockery we'd been using. Getting on and off this truck is hard enough completely sober in daylight, so drunk me at 3am didn't stand a chance. I fell from the steps, bringing an entire steel dinner set crashing down with me, and provided the final straw for everyone else on the campsite. I think the annoyed people were expecting a degree of sympathy and mediation from our driver/leader; instead they got something along the lines of "shut up, we're drinking".

The sensible thing to do at this point was go to bed. That is far easier said than done when there are 10 identical tents and you've got to remember which one is yours, without resorting to trial and error, and then get into the right one without making your co-camper want to smother you with a pillow. It took a few goes but somehow we managed it, and were up at 6am to take down our tents and load the truck - still absolutely hammered, and feeling the wrath of lots of sleep deprived onlookers. They were seriously unimpressed when the truck needed jump-starting.

The rest of today will be spent driving through the mountains from Hazyview to Johannesburg. We had an 8am McDonalds stop, and the survivors from last night are about to bed down at the back of the truck.

Love (from a dog rough) Emily x

Kruger National Park day 1

I spent all of today on a game drive in Kreuger National Park. Our driver told us how many square miles this park covers but I forgot... the point is, it's big! When I say "all day" I mean all day - we started out at 5:45am. The company I went with have walkie talkies in each of their trucks, so if one driver spots something interesting they can let all of the others know. The downside to this is lots of vehicles rock up at one place (+ other drivers who happened to be passing by) and scare the animal(s) away.

Within a couple of hours I had seen the Big 5 (lion, leopard, rhino, elephant and buffalo) and over the rest of the day I saw giraffes, zebras, hippos (in and out of the water), crocodiles, kuda, waterbuck, springbok, eagles, wildebeest, hyena, and lots more animals I'm too tired to remember the name of. Seeing these animals in their natural habitat was awesome, and is something on my bucket list which I've been able to complete.

It's been a great day,

Love Emily x