Monday, 3 July 2017
Portugal and Paris
Last week I got back from a girly holiday with another midwife from work. We started off in Faro, Portugal, before spending a couple of days in Paris. It was a relaxed few days on the beach in Faro which resulted in some incredible sunburn. So sore was my arse that I nearly cried after peeling myself off the plane seat when we landed in Paris. It was nice to vary up my running routes a bit, and the run in Paris was especially great! Why am I running on holiday?, I hear you ask. Well, this year (like all others for the past 5 years) I entered the London Marathon ballot, but I've also promised myself I'll apply for a charity place this year if I don't succeed in the ballot. So far training is going well!
Love Emily x
Thursday, 1 June 2017
Election rant
I originally posted this on Facebook, and it had a surprisingly good reaction so I thought I'd share it here too.
"I'm watching tonight's debate and have heartfelt plea to all who read this: please don't cast a vote for any party willing to endorse this idiot. Look at those weasel eyes and tell me you don't want to poke them?
I work in the NHS. Every day at work I see dedicated and talented midwives, doctors and support staff who women and their families are lucky to have looking after them, but they're getting tired. Real-term pay has consistently shrunk for many years, patient volume and complexity is increasing, and the copious amounts of micropore used to repair the giant cracks in the NHS won't hold for much longer. I think the mood of the NHS can be judged by student midwives: there were 10,990 fewer applicants this year for nursing/midwifery courses than the year previously, which is clearly a consequence of the Tory decision to make them pay tuition fees and strip them of their bursaries. Training was 3 years of HARD work, and the bursary was laughable, but it crucially made me feel like part of the NHS in training instead of a fee-paying undergrad. The impact this had on how I felt about working 36 clinical hours a week for £1.92/hr whilst doing a full-time degree was immense; and I just don't see that look of awe or inspiration on many students faces any more. I find that terrifying.
The NHS has functioned on the goodwill of its staff long before I've been part of it (2012), and that's dwindling. I don't know many NHS workers not experiencing some degree of burnout, which is an inevitable consequence of regularly working emotionally and physically exhausting 12.5 hour shifts without a proper break. The 'efficiency savings' (blatant cuts) just keep on happening, and I've lost count of the number of times I've not had the resources to do my job properly or safely. It seems to be at a tipping point now: proper funding, or destruction.
But, by far, I owe the NHS more than it owes me.
I have a rare condition called autoimmune neutropenia, which means I have a weak immune system and can become extremely unwell from minor infections. This has led to many months of hospital admissions with various life-threatening infections, and the NHS has always pulled me through. In 2014 I had meningitis which led to another extremely rare condition called transverse myelitis, and left me unable to stand up for weeks or walk properly for months: I had months of inpatient and outpatient physiotherapy rehabilitation to help me walk again, and they did such a good job that I bet some of you are reading this and learning about the spinal lesion for the first time! Most recently, antibiotics prescribed for a chest infection (a regular occurrence with neutropenia) triggered anaphylactic shock, and my life was once again saved by NHS nurses and paramedics who jabbed me with adrenaline and steroids before I was even aware I was critically unwell.
Sure, the NHS is far from perfect, and I've been on the receiving end of many a sketchy diagnosis or dubious decision, but all's well that ends well! I've frustratedly been kept waiting for hours too, but I always try to remember that I should be feeling sympathy for, and not jealous of, the other patient who a clinician has decided needs to be prioritised above me. Delays and mistakes are never wilful; usually a result of short staffing, too many patients, or lack of resources.
Most people my age have a far cleaner bill of health than I do and are lucky to have not experienced emergency and critical care as a patient, and might not understand why a well-functioning NHS is so absolutely vital. It is: one day you, or someone you love, will become ill and then you'll realise the immense value of the free (at the point of use) treatment and care you receive, without the need to worry about payment or insurance at an already frightening time.
So I'll hope you'll trust me, as someone who knows the NHS very well, and not use your vote to stick another nail in its coffin."
I work in the NHS. Every day at work I see dedicated and talented midwives, doctors and support staff who women and their families are lucky to have looking after them, but they're getting tired. Real-term pay has consistently shrunk for many years, patient volume and complexity is increasing, and the copious amounts of micropore used to repair the giant cracks in the NHS won't hold for much longer. I think the mood of the NHS can be judged by student midwives: there were 10,990 fewer applicants this year for nursing/midwifery courses than the year previously, which is clearly a consequence of the Tory decision to make them pay tuition fees and strip them of their bursaries. Training was 3 years of HARD work, and the bursary was laughable, but it crucially made me feel like part of the NHS in training instead of a fee-paying undergrad. The impact this had on how I felt about working 36 clinical hours a week for £1.92/hr whilst doing a full-time degree was immense; and I just don't see that look of awe or inspiration on many students faces any more. I find that terrifying.
The NHS has functioned on the goodwill of its staff long before I've been part of it (2012), and that's dwindling. I don't know many NHS workers not experiencing some degree of burnout, which is an inevitable consequence of regularly working emotionally and physically exhausting 12.5 hour shifts without a proper break. The 'efficiency savings' (blatant cuts) just keep on happening, and I've lost count of the number of times I've not had the resources to do my job properly or safely. It seems to be at a tipping point now: proper funding, or destruction.
But, by far, I owe the NHS more than it owes me.
I have a rare condition called autoimmune neutropenia, which means I have a weak immune system and can become extremely unwell from minor infections. This has led to many months of hospital admissions with various life-threatening infections, and the NHS has always pulled me through. In 2014 I had meningitis which led to another extremely rare condition called transverse myelitis, and left me unable to stand up for weeks or walk properly for months: I had months of inpatient and outpatient physiotherapy rehabilitation to help me walk again, and they did such a good job that I bet some of you are reading this and learning about the spinal lesion for the first time! Most recently, antibiotics prescribed for a chest infection (a regular occurrence with neutropenia) triggered anaphylactic shock, and my life was once again saved by NHS nurses and paramedics who jabbed me with adrenaline and steroids before I was even aware I was critically unwell.
Sure, the NHS is far from perfect, and I've been on the receiving end of many a sketchy diagnosis or dubious decision, but all's well that ends well! I've frustratedly been kept waiting for hours too, but I always try to remember that I should be feeling sympathy for, and not jealous of, the other patient who a clinician has decided needs to be prioritised above me. Delays and mistakes are never wilful; usually a result of short staffing, too many patients, or lack of resources.
Most people my age have a far cleaner bill of health than I do and are lucky to have not experienced emergency and critical care as a patient, and might not understand why a well-functioning NHS is so absolutely vital. It is: one day you, or someone you love, will become ill and then you'll realise the immense value of the free (at the point of use) treatment and care you receive, without the need to worry about payment or insurance at an already frightening time.
So I'll hope you'll trust me, as someone who knows the NHS very well, and not use your vote to stick another nail in its coffin."
Monday, 15 May 2017
Anaphylactic shock
I've been fairly quiet so far this year, which I guess is a good thing when the medium is a blog designed to bleat about my various ailments, but I think enough has happened this week to warrant another update!
After returning from Venice I came down with a chest infection. I'm not sure whether Ryanair or Venice canal was the culprit, but on Tuesday afternoon I decided it was too severe to self-treat and dragged myself to my GP who gave me antibiotics. I started the course that evening and felt a bit wheezy and itchy, but not terrible. I came up in a bit of a rash, and also felt incredibly anxious for no clear reason, but went to sleep and woke up feeling okay.
On Wednesday morning I took the 2nd dose of the antibiotics and felt a lot worse. My chest felt a lot tighter, so I went (okay, cycled) to an urgent care centre because I was worried the infection was worsening. I also, inexplicably but adamantly, felt that something awful was about to happen: I'm very used to hospital admissions, and I had an inkling that that might have been the outcome of my appointment, but that wasn't what was worrying me - I just couldn't work out what was. I was triaged by a healthcare assistant and I can remember being really surprised that my temperature was too low rather than too high: I really thought I was septic. My blood pressure was low (but mine always is), and I was slightly tachycardic at 100-110bpm, with a respiration rate in the 60s (a healthy adult should be taking about 10-20 breaths a minute). The healthcare assistant said she was worried, and that I'd be seen next by the GP.
I went back to the waiting room, and saw a nurse in a navy uniform walking past carrying a cup of tea. I'd barely sat down before she saw me, grabbed my upper arm, and pulled the emergency buzzer whilst pushing me into a room. My memories become very hazy from here, but I remember the nurse shouting for an ambulance and the crash trolley. I've been told I then lost consciousness, that my blood pressure and oxygen saturation were unrecordable, and I was given adrenaline followed by hydrocortisone. I was blue lighted to resus at QMC, where treatment for anaphylactic shock continued.
The antibiotic I'd been prescribed was amoxicillin, a penicillin drug, and I'd had as severe an allergic reaction as it's possible to have whilst still being alive to tell the tale. I've taken penicillin numerous times before with no issues, but this time was obviously one time too many. Whilst I appreciate that adrenaline undoubtedly saved my life and is a very useful drug; it's also a bloody horrible drug in terms of side effects! In the hours following it my resting pulse was >130bpm, I was uncontrollably shaking, and I just wanted to rip off my monitoring equipment and go for a run.
I recovered very quickly, and it didn't take me long to get home. The upshot is: I now carry an epipen, and absolutely must not take any penicillin drug - which is an issue as a neutropenic! This means I need to be seen again by haematology to discuss G-CSF a bit more seriously, and also immunology to try to work out what happened!
Summary: it all sounds scary, and it was bit touch and go, but it's all fine now!
Love Emily x
After returning from Venice I came down with a chest infection. I'm not sure whether Ryanair or Venice canal was the culprit, but on Tuesday afternoon I decided it was too severe to self-treat and dragged myself to my GP who gave me antibiotics. I started the course that evening and felt a bit wheezy and itchy, but not terrible. I came up in a bit of a rash, and also felt incredibly anxious for no clear reason, but went to sleep and woke up feeling okay.
On Wednesday morning I took the 2nd dose of the antibiotics and felt a lot worse. My chest felt a lot tighter, so I went (okay, cycled) to an urgent care centre because I was worried the infection was worsening. I also, inexplicably but adamantly, felt that something awful was about to happen: I'm very used to hospital admissions, and I had an inkling that that might have been the outcome of my appointment, but that wasn't what was worrying me - I just couldn't work out what was. I was triaged by a healthcare assistant and I can remember being really surprised that my temperature was too low rather than too high: I really thought I was septic. My blood pressure was low (but mine always is), and I was slightly tachycardic at 100-110bpm, with a respiration rate in the 60s (a healthy adult should be taking about 10-20 breaths a minute). The healthcare assistant said she was worried, and that I'd be seen next by the GP.
I went back to the waiting room, and saw a nurse in a navy uniform walking past carrying a cup of tea. I'd barely sat down before she saw me, grabbed my upper arm, and pulled the emergency buzzer whilst pushing me into a room. My memories become very hazy from here, but I remember the nurse shouting for an ambulance and the crash trolley. I've been told I then lost consciousness, that my blood pressure and oxygen saturation were unrecordable, and I was given adrenaline followed by hydrocortisone. I was blue lighted to resus at QMC, where treatment for anaphylactic shock continued.
The antibiotic I'd been prescribed was amoxicillin, a penicillin drug, and I'd had as severe an allergic reaction as it's possible to have whilst still being alive to tell the tale. I've taken penicillin numerous times before with no issues, but this time was obviously one time too many. Whilst I appreciate that adrenaline undoubtedly saved my life and is a very useful drug; it's also a bloody horrible drug in terms of side effects! In the hours following it my resting pulse was >130bpm, I was uncontrollably shaking, and I just wanted to rip off my monitoring equipment and go for a run.
I recovered very quickly, and it didn't take me long to get home. The upshot is: I now carry an epipen, and absolutely must not take any penicillin drug - which is an issue as a neutropenic! This means I need to be seen again by haematology to discuss G-CSF a bit more seriously, and also immunology to try to work out what happened!
Summary: it all sounds scary, and it was bit touch and go, but it's all fine now!
Love Emily x
Sunday, 7 May 2017
Venice, Italy
Wanting to squeeze one last trip into my mid-20s (I'm 27 now!), I set off to Venice last weekend. We flew from East Midlands to 'Venice Treviso' airport, which is not even slightly close to Venice. Treviso airport was interesting: it was in the arse end of nowhere and smaller than Sywell airfield (probably). We hopped on a bus - which ad-libbed its route and timetable - and (a not inconsiderable time later) arrived in Venice.
The walk from Venice's coach station to our hotel provided the first point of tension in mine and Darryl's relationship: Google maps gave us sound directions but awful GPS tracking, meaning we'd follow directions along a canal, but then the blue dot would dart off and tell us we were hundreds of meters away from where we thought we were, so we'd alter our directions to get back to the route, only for the blue dot to skip back to where it was minutes ago. This happened multiple times, and only would have been mildly annoying, except it was raining, hard, my umbrella had inverted itself, and Darryl was having to pick up a heavy suitcase every 15 metres to go over a bridge.
All's well that ends well, though, and after a shower we were in better moods and ready to explore. Over the next couple of days the weather improved, we found a bar which served some surprisingly decent wine for €1.50 a glass, another one where 800ml was a standard serving of beer, and a pretty good selection of vegetarian and vegan food. We did the obligatory touristy stuff (Rialto bridge, Doge's Palace, St Mark's Bell Tower & Basilica), and ventured out onto the canals and into the lagoon on a kayak. It was the first time Darryl had ever picked up a paddle, and we only hit a few other boats.
Since my last post I've been seen by haematology again, and had another U-turn of opinion, and the decision was made to not start G-CSF treatment. Given that this means I won't need to be thinking about fridge storage for these injections, I've booked a few weeks travelling through India and Nepal in September, with a couple of days stopover in Dubai on the way back. I'll be making my way from Delhi to Kathmandu, via Jaipur, Agra, Orchha, Varanasi, Lumbini, Chitwan and Pokhara. I'll be going through the Himalayas and plan to do hot air ballooning/paragliding/a flight around Everest - can't wait!
Love Emily x
Tuesday, 11 October 2016
Bone marrOW biopsy!
Today I had my bone marrow biopsy, which wasn't pleasant, but was far nicer than I had braced myself for! It seems I'm incredibly sensitive to entonox (nitrous oxide) because I spent the majority of the procedure off my face; entirely unperturbed about a chunk of my hip being surgically removed. I'm feeling pretty sore now - I ironically spent too much thought worrying about the biopsy itself to consider the pain of recovering from it - but it's still nothing compared to transverse myelitis. I've had a lovely Sick Day watching daytime TV, dominating at Monopoly (my opponent owns owns Vine Street), and taking painkillers - so I can't complain.
Love Emily x
Tuesday, 27 September 2016
Bone marrow
Today I saw a haematologist, to try to get to the bottom of my lack of haemoglobin and neutrophils (latest neutrophil count is 0.9, which is actually an improvement!). This consultants opinion directly contrasted the 'it's not a big deal' view of the registrar I saw a few weeks ago: I'm having a bone marrow biopsy next week, with a view to starting G-CSF injections soon after the results are back. I also had some bloods taken which were too specialist to be analysed in Nottingham and are being sent to the National Blood & Transplant labs. The suspected diagnosis is autoimmune neutropenia, which is incredibly rare in adults, but essentially means that I have normally functioning bone marrow which makes neutrophils, but my immune system has mistakenly identified them as harmful and destroys them before they can fight infection - which would explain how I got meningitis. The G-CSF injections (G-CSF stands for granuloycte colony stimulating factor; very confusing since I've used the acronym CSF to mean cerebrospinal fluid so far!) will stimulate bone marrow production of white blood cells in the hope that the rate of production will beat the rate of destruction, and I'll be left with a healthy level. I'll have to give them to myself daily, probably for life. They need to be stored in a fridge, which certainly wasn't available when I was camping in Africa, so I'm very glad I was able to enjoy that experience whilst I was able to. Now, to look forward to the biopsy...
Love Emily x
Saturday, 3 September 2016
1 year qualified
I can't believe it's been a year since I qualified! I feel like I'm starting to get the hang of this 'being a midwife' rhubarb, and I'm still loving it.
Health wise there's been a few blips in the past few months. My neutrophil count (neutrophil = a type of white blood cell responsible for fighting infection) dipped to 0.6 (normal range is 2-8, <1 is the level you'd expect to see in an oncology patient undergoing chemotherapy) and as a result I've regularly been picking up colds, chest infections, ear infections, sore throats, UTIs and keratitis (cornea infections). I've been seeing haematology because of this and the working diagnosis is autoimmune neutropenia: in English, my body is making neutrophils but my immune system destroys them before they become effective. It's a condition which usually affects newborns and infants, but most outgrow it and is therefore incredibly rare in adults. Usually it's pretty benign and is more of a 'quirk' than an issue, but given that it's the probable cause of meningitis and sepsis then the possibility of G-CSF treatment (something I don't fully understand but involves encouraging my bone marrow to produce more white blood cells) has been floated.
Completely incidentally, whilst having blood tests for the neutropenia a fairly dangerously low haemoglobin (Hb) level even for a redhead vegetarian! I was offered a blood transfusion which I accepted, and was admitted to QMC for this, but then it turned out that my GP hadn't cross-matched any blood for me (checking my blood group against what the blood bank has in stock and ordering the right stuff) so it couldn't be done that day, although I was given an IV iron infusion which made me feel AMAZING! I've had a couple more since, and it seems to be keeping on top of things.
Love Emily x
P.s. It's been >1 year seizure free, so this happened:
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