Ortho starts on Monday! Super excited for my first ever placement as a medical student!
[EDIT: Shit, that's tomorrow. I know no anatomy! I will be shot down!]
Erm.... since last posting, I have:
-cried, like, six times.
-bought new undies (matching, for the first time in my life!)
-broken the 'o' button on my laptop to the extent that it requires a small beating to produce each letter.
-bought new trainers, that I don't like, but have no way of returning...
-virtually furnished the new flat (yeh, I mean virtually as in internet-window-shopping, not actually purchasing. Not my job, not my money).
-very nearly dumped my boyfriend.
Ha, that last one was less mundane than the rest. All I will say, for posterity's sake, since I haven't really mentioned it anywhere else, is that he was a twat. He went in a strip club, and then lied about it for six months, to 'protect' me from the truth. Needless to say, I went nuts. Crying, hair pulling (I had trichotillomania as a child, and it's never really left me), hitting lying scum every time he came near me [as an aside, he did wipe my snotty nose and dry my eyes, regardless of the punches he sustained while doing so], and, once I'd calmed down a little, went upstairs to our room and pulled all the cards I'd ever sent him off the walls, and all the photos of the two of us together, and put them, together with every one of my possessions that resides at his, into the drawer under the bed, ready for disposal/collection at a later date.
Sunday 23 August 2009
Sunday 16 August 2009
Bye bye homelessness :)
Lab stuff is finally over. Did some immunophenotyping, and immunfluorescence, but mainly cell culturing and making up and aliquoting media.
Also in the meantime, I have been out for 3 birthdays (18th, 20th, 20th) and a bbq (SEVERE food poisoning from a Quorn sausage :( We are absolving the Taboo (with apple sourz & vodka additions) from all responsibility for subsequent sickiness). Plus a weekend in Reading with my bestest friend from all the way back to the first days of primary school!! Not seen her in 4 years so we had an awesome gossipy catch up :)
Work has been cancelled this week (the perils of casual labour), except for Thursday, so my £300 expected profit has dwindled to... £60. That ain't paying no rent....
...on my new flat which we just bought!!!! I'm not homeless any more!! I'm very excited (a little miffed that this is the flat we viewed in April. We've since made 2 offers on it, and have finally been accepted, conditional to downstairs agreeing to some rather essential maintenance of our kitchen (it's had a disagreement with the main building and is slowly pulling away...) and negotiating a reasonable moving date)!!
Also in the meantime, I have been out for 3 birthdays (18th, 20th, 20th) and a bbq (SEVERE food poisoning from a Quorn sausage :( We are absolving the Taboo (with apple sourz & vodka additions) from all responsibility for subsequent sickiness). Plus a weekend in Reading with my bestest friend from all the way back to the first days of primary school!! Not seen her in 4 years so we had an awesome gossipy catch up :)
Work has been cancelled this week (the perils of casual labour), except for Thursday, so my £300 expected profit has dwindled to... £60. That ain't paying no rent....
...on my new flat which we just bought!!!! I'm not homeless any more!! I'm very excited (a little miffed that this is the flat we viewed in April. We've since made 2 offers on it, and have finally been accepted, conditional to downstairs agreeing to some rather essential maintenance of our kitchen (it's had a disagreement with the main building and is slowly pulling away...) and negotiating a reasonable moving date)!!
Thursday 6 August 2009
Wednesday 5 August 2009
Various. Rambles. Etc.
Expect a shit post - watching Bizarre ER on iPlayer at the same time...
No more exciting trauma stuff... I'm in the local uni's research labs doing stem cell work.
MASSIVE REVELATION: I am not cut out for lab-based research.
Too slow, too imprecise (results wise), no clinical background on any of the patients. In fact, no patients. Wait a second... serious deja vu occuring.
Oh yeah, I did a day in the NHS cyto & molecular genetics labs. 3 years ago. It sucked. It made me realise that I wanted to do medicine, and not just medical sciences.
The same is still true. Give me people. Sick people. And not just their haematomas! That is all I have to say on the matter.
[Although I did get quite attached to 'my' cells today. Even though they were stupid lazy cells and have died instead of proliferating. What happened to standing up for the non-smokers, eh guys?]
In exciting news (honestly), I may have an Ortho placement! Finally got hold of the right admin people (a month after my first attempt), just need to beg several uni-based people to do various documents!
Diary looks busy - 3 birthdays in the next week, plus 2 or 3 more lab days, a trip down to Reading to see my first ever best friend (still goin strong since 4 years old! Oh yeah!), 4 days employment (money money money!!! I have missed you!!), the week in Ortho, Christian festival (downside: camping. Upside: free entry for volunteering), and then the parentals go back to school! Sometime in that period, a house needs to appear....
No more exciting trauma stuff... I'm in the local uni's research labs doing stem cell work.
MASSIVE REVELATION: I am not cut out for lab-based research.
Too slow, too imprecise (results wise), no clinical background on any of the patients. In fact, no patients. Wait a second... serious deja vu occuring.
Oh yeah, I did a day in the NHS cyto & molecular genetics labs. 3 years ago. It sucked. It made me realise that I wanted to do medicine, and not just medical sciences.
The same is still true. Give me people. Sick people. And not just their haematomas! That is all I have to say on the matter.
[Although I did get quite attached to 'my' cells today. Even though they were stupid lazy cells and have died instead of proliferating. What happened to standing up for the non-smokers, eh guys?]
In exciting news (honestly), I may have an Ortho placement! Finally got hold of the right admin people (a month after my first attempt), just need to beg several uni-based people to do various documents!
Diary looks busy - 3 birthdays in the next week, plus 2 or 3 more lab days, a trip down to Reading to see my first ever best friend (still goin strong since 4 years old! Oh yeah!), 4 days employment (money money money!!! I have missed you!!), the week in Ortho, Christian festival (downside: camping. Upside: free entry for volunteering), and then the parentals go back to school! Sometime in that period, a house needs to appear....
Sunday 2 August 2009
BASICS Day 2
Been in a bit of a shock over the last 24 hours as boyf's lil bro has got someone pregnant. That'll be the last time I let him near any of my friends!
In nicer news (as I think the above is going to be 'dealt with', unfortunately), I had another day out with the BASICS doc on Friday.
Still no big gruesome jobs, so we had a fairly quiet day. We were both a little miffed as we came on station at 8am, and the big entrapment-RTC had come in at 6.45am, and we hadn't been alerted. Fairly sure it wouldn't have required any more than a paramedic, but it would have been the most interesting thing to happen all day!
So, in the absence of real work to do, we headed up to the Para training centre and played about with their SimMan. It's the first time I've been allowed on a real mannikin, as our BLS ones are just a head & torso - these ones have eyes and proper airways and moveable limbs and breath sounds and variable heart rhythms and are shockable! OK, I got a little excited.
Basically covered the ALS course in a little under two hours (minus the complicated [and for me, unnecessary] drug bits).
I can now:
-do basic airway opening: head lift & jaw thrust (both ways)
-insert a nasopharyngeal airway
-insert an oropharyngeal airway (in adults and kids)
-insert a laryngeal mask airway (or I-Gel)
-fit and use a bag-valve mask with catheter mount
-intubate, with a laryngoscope and endotracheal tube
-secure all those airways with tape, ties, or a Thomas tube-holder
-remove all those airway adjuncts and tubes
-'burp' a patient to assist intubation (cannot remember exactly what it stands for, but it's to do with lifting the larynx and deviating it to the right to get the structures in the neck to align better for intubation
-determine equal bilat air entry from looking at the chest
-identify V-fib, V-tach and explain when and why we shock
-use the LifePak de-fib (at a cost of £15k each!) to recognise input from paddles or leads, use the advisory/analyse mode or manual mode to charge (to the correct number of joules) and shock
-CANNULATE!!!!
I was pretty proud of that last one. Two pinks into a fake arm, with perfect flashback and no vein puncture on the far side! Just need to wait another year or two til I can do it on a real arm...
We just got out the training centre when we were alerted to a collapse in a well-known food hall on the High Street. When we [finally] got up the High Street (you wouldn't believe how many people can ignore a car with a big DOCTOR sign and flashing lights all over it), there was already a Fast Responder parked up, but when we got out it turned out that he was there for another patient! Not only that, but there was another just round the corner with a third guy!
Our chap was parked in a chair between two checkouts, having gone very hot and faint. Don't recall whether he LOC'd at any point (then again, neither can he!). Pretty bradycardic at 50bpm, with low sats (92%, I think), so we got some highflow o2 on him. The store provided a wheelchair to get him out of the crowds of the checkout area and into a little office so we could get an ECG started. The two first responders from the other incidents were with us by now (thank goodness, seeing as we only carry a very basic 3 lead). 3 lead showed AF and some other abnormalities, so we moved out to the truck (on a stretcher) - amazingly, people still don't move out of your way if you have an occupied stretcher, plus a (very heavy) o2 cylinder and a (equally heavy) Lifepak. Clearly, your organic lunch is far too important.
He was pinking up by the time we got him loaded (with every man and his kid stopping in the middle of the high street to rubberneck), so just popped a line in (pink, how very similar to the CANNULA THAT I PUT IN EARLIER ALL BY MYSELF - ok, I was somewhat itching to have a go. I settled for picking the right gauge, digging out an alco-swab and tegaderm, and setting up a saline flush.), did a 12-lead, and strapped him in for the journey. 12-lead confirmed AF, plus LBBB - turned out he had a previous MI and was under the consultant cardiologist at the hospital anyway. I travelled with the crew for funsies, and met up with Matt at A&E, since the patient was on his o2 cylinder that he wanted to reclaim.
Not long until we got another call - epistaxis in a supermarket carpark (I have no idea what was with all the food-location accidents, but it was damn annoying as it was gone lunchtime!). Raced the ambulance there (they're bigger and more noticable, so traffic moves out the way faster, but we're nippier and everyone thinks we're the cops) and then the two vehicles drove in circles around the car park. Why can't casualties identify themselves?! Wave at us, or something! Either way, it was a case of walking him onto the truck, sticking a vom bowl under his nose, and taking him in. We reckon it'd be an ENT consult (he was losing a fair amount of blood, and it wasn't his first major bleed) and home...
Since we were already parked at the front door, we nipped in for a sandwich. It's got to be the only place in town that you can walk into in ambulance attire and not freak the staff out - the ambulances sit on standby in the carpark almost every day!
Back on station, sat down with a cool drink, halfway through our sandwiches - convulsions. Yay! 13min drive on blues to a manky estate. The occupants are a little surprised to see us - they'd cancelled the ambulance! The wonderful control to mobile technology had let us down again, but as we were there, we insisted on a quick look at our patient. 18YOF with H/O multiple convulsions, under consultant neurologist at the hospital, had been seen by ambu staff multiple times.... for pseudofitting. Grr! Even Matt recognised her, from having climbed five flights to the top floor of the local college when she wanted to get out of participating in a science lesson. I hate attention seekers. Either way, she was absolutely fine when we saw her - a little quiet and resistant to questioning, but obs were all spot on.
Some kind person had put our sandwiches in the fridge to save our lunch getting nicked - yet more proof that the ambu staff are absolute stars!
Finally - RTC! Big leap off the sofa for this one! Battled our way through south town to get out to the bypass, and nearly caused an accident turning across the road to reach scene - someone braked to let us through, and the cars behind were too busy looking at all the blue lights on the roadside to notice the big red ones dead ahead. Needless to say, there was a lot of brake-screeching.
On scene, couple of coppers looking pretty relaxed, one dented [local business] car, and one other car, plus an ambu-truck. Turned out that there was only one patient, who was already in the truck, getting his sore neck checked out. We stuck our heads in to say hello, and on seeing me, our 20-something YOM perks up - "why couldn't I have had her treating me?!" Thank goodness the only female member of the truck team was outside conversing with a cop...
It's one thing battling traffic on blues, but coming back through the same traffic without lights is just hell. Spotted a local first responder in a car park alongside, so slipped off the road to have a chat, and check out his council-sponsored LIVES-liveried estate car! Very impressed! If only my village had a car like that, I'd be able to join! It had some pretty neat tricks of beating the no-blues rules too - white strobes in a lightbox with LIVES across it, that is pretty inconspicious with the lights off, and some orange strobes further back, plus a bright yellow bonnet with the reverse 'EMERGENCY' wording across it (for reading it in mirrors).
And then we sat. On station. With pressure sores developing. And not even the motivation to make a coffee. But there was plenty of shit telly. And the occasional member of ambu staff passing through. And we could speculate as to why two fire trucks, plus two separate cars of fire officers had passed the window in under five minutes, all on blues. That's one lucky cat in a tree. An hour passed. We got very excited at everyone else's radio calls. Ooh, prison! Ooh, old dear fell over! Ooh, swine flu! However, none required our presence. Another hour. "OK, just go til half five and we'll give up". Half five arrives... "we'll drive back to the hospital very slowly and then log off if nothing's happened". Arrive at the hospital... "I'll drive you home, and then log off". Hmm...
As luck would have it, we got to within 1/2 a mile of my front door - 999 CARDIAC/RESPIRATORY ARREST. Oh yesh. Rapid u-turn, blues on, race back down the road into the city, through town (6pm traffic!), down into the rough end, to our one and only horrible drug addled tower block. Erm - we don't have a flat number. The CRU and the truck are there, so I hop into the truck and try to get the computer to spit out the address, to no avail. We phone Control. Much easier.
Bypass the entryphone system (who answers the phone while working on a cardiac arrest?!) by sneaking through a rapidly closing door after two lads. Just in time to meet both crew walking out of the lift, followed by a bloke. Walking after a cardiac arrest? Wow - these guys are good! Actually, no (although they are awesome). Alcoholic C/O abdo pain and peeing blood.
He staggers onto the truck. None of the crew are looking amused.
We have a short chat with the CRU guy about diagnosis of distal radius fractures (I still have no idea if there's a magic test for this - pain on pronation was suggested though), and head off again. My PPE had already been deposited at station, so I was in the spare 'DOCTOR' jacket :D
So that was my time with Matt. A genuinely lovely bloke with a huge passion for pre-hospital care, a great ability to teach, and a wonderful way with patients (and pretty hot for a greying 35yo.... )
I've inquired about joining first responders in uni town, and will be joining BASICS Scotland on a student membership as soon as I have a scottish address :) Now I just need my own mannikin to play with, or all these skills are gonna disappear faster than that nice weather...
In nicer news (as I think the above is going to be 'dealt with', unfortunately), I had another day out with the BASICS doc on Friday.
Still no big gruesome jobs, so we had a fairly quiet day. We were both a little miffed as we came on station at 8am, and the big entrapment-RTC had come in at 6.45am, and we hadn't been alerted. Fairly sure it wouldn't have required any more than a paramedic, but it would have been the most interesting thing to happen all day!
So, in the absence of real work to do, we headed up to the Para training centre and played about with their SimMan. It's the first time I've been allowed on a real mannikin, as our BLS ones are just a head & torso - these ones have eyes and proper airways and moveable limbs and breath sounds and variable heart rhythms and are shockable! OK, I got a little excited.
Basically covered the ALS course in a little under two hours (minus the complicated [and for me, unnecessary] drug bits).
I can now:
-do basic airway opening: head lift & jaw thrust (both ways)
-insert a nasopharyngeal airway
-insert an oropharyngeal airway (in adults and kids)
-insert a laryngeal mask airway (or I-Gel)
-fit and use a bag-valve mask with catheter mount
-intubate, with a laryngoscope and endotracheal tube
-secure all those airways with tape, ties, or a Thomas tube-holder
-remove all those airway adjuncts and tubes
-'burp' a patient to assist intubation (cannot remember exactly what it stands for, but it's to do with lifting the larynx and deviating it to the right to get the structures in the neck to align better for intubation
-determine equal bilat air entry from looking at the chest
-identify V-fib, V-tach and explain when and why we shock
-use the LifePak de-fib (at a cost of £15k each!) to recognise input from paddles or leads, use the advisory/analyse mode or manual mode to charge (to the correct number of joules) and shock
-CANNULATE!!!!
I was pretty proud of that last one. Two pinks into a fake arm, with perfect flashback and no vein puncture on the far side! Just need to wait another year or two til I can do it on a real arm...
We just got out the training centre when we were alerted to a collapse in a well-known food hall on the High Street. When we [finally] got up the High Street (you wouldn't believe how many people can ignore a car with a big DOCTOR sign and flashing lights all over it), there was already a Fast Responder parked up, but when we got out it turned out that he was there for another patient! Not only that, but there was another just round the corner with a third guy!
Our chap was parked in a chair between two checkouts, having gone very hot and faint. Don't recall whether he LOC'd at any point (then again, neither can he!). Pretty bradycardic at 50bpm, with low sats (92%, I think), so we got some highflow o2 on him. The store provided a wheelchair to get him out of the crowds of the checkout area and into a little office so we could get an ECG started. The two first responders from the other incidents were with us by now (thank goodness, seeing as we only carry a very basic 3 lead). 3 lead showed AF and some other abnormalities, so we moved out to the truck (on a stretcher) - amazingly, people still don't move out of your way if you have an occupied stretcher, plus a (very heavy) o2 cylinder and a (equally heavy) Lifepak. Clearly, your organic lunch is far too important.
He was pinking up by the time we got him loaded (with every man and his kid stopping in the middle of the high street to rubberneck), so just popped a line in (pink, how very similar to the CANNULA THAT I PUT IN EARLIER ALL BY MYSELF - ok, I was somewhat itching to have a go. I settled for picking the right gauge, digging out an alco-swab and tegaderm, and setting up a saline flush.), did a 12-lead, and strapped him in for the journey. 12-lead confirmed AF, plus LBBB - turned out he had a previous MI and was under the consultant cardiologist at the hospital anyway. I travelled with the crew for funsies, and met up with Matt at A&E, since the patient was on his o2 cylinder that he wanted to reclaim.
Not long until we got another call - epistaxis in a supermarket carpark (I have no idea what was with all the food-location accidents, but it was damn annoying as it was gone lunchtime!). Raced the ambulance there (they're bigger and more noticable, so traffic moves out the way faster, but we're nippier and everyone thinks we're the cops) and then the two vehicles drove in circles around the car park. Why can't casualties identify themselves?! Wave at us, or something! Either way, it was a case of walking him onto the truck, sticking a vom bowl under his nose, and taking him in. We reckon it'd be an ENT consult (he was losing a fair amount of blood, and it wasn't his first major bleed) and home...
Since we were already parked at the front door, we nipped in for a sandwich. It's got to be the only place in town that you can walk into in ambulance attire and not freak the staff out - the ambulances sit on standby in the carpark almost every day!
Back on station, sat down with a cool drink, halfway through our sandwiches - convulsions. Yay! 13min drive on blues to a manky estate. The occupants are a little surprised to see us - they'd cancelled the ambulance! The wonderful control to mobile technology had let us down again, but as we were there, we insisted on a quick look at our patient. 18YOF with H/O multiple convulsions, under consultant neurologist at the hospital, had been seen by ambu staff multiple times.... for pseudofitting. Grr! Even Matt recognised her, from having climbed five flights to the top floor of the local college when she wanted to get out of participating in a science lesson. I hate attention seekers. Either way, she was absolutely fine when we saw her - a little quiet and resistant to questioning, but obs were all spot on.
Some kind person had put our sandwiches in the fridge to save our lunch getting nicked - yet more proof that the ambu staff are absolute stars!
Finally - RTC! Big leap off the sofa for this one! Battled our way through south town to get out to the bypass, and nearly caused an accident turning across the road to reach scene - someone braked to let us through, and the cars behind were too busy looking at all the blue lights on the roadside to notice the big red ones dead ahead. Needless to say, there was a lot of brake-screeching.
On scene, couple of coppers looking pretty relaxed, one dented [local business] car, and one other car, plus an ambu-truck. Turned out that there was only one patient, who was already in the truck, getting his sore neck checked out. We stuck our heads in to say hello, and on seeing me, our 20-something YOM perks up - "why couldn't I have had her treating me?!" Thank goodness the only female member of the truck team was outside conversing with a cop...
It's one thing battling traffic on blues, but coming back through the same traffic without lights is just hell. Spotted a local first responder in a car park alongside, so slipped off the road to have a chat, and check out his council-sponsored LIVES-liveried estate car! Very impressed! If only my village had a car like that, I'd be able to join! It had some pretty neat tricks of beating the no-blues rules too - white strobes in a lightbox with LIVES across it, that is pretty inconspicious with the lights off, and some orange strobes further back, plus a bright yellow bonnet with the reverse 'EMERGENCY' wording across it (for reading it in mirrors).
And then we sat. On station. With pressure sores developing. And not even the motivation to make a coffee. But there was plenty of shit telly. And the occasional member of ambu staff passing through. And we could speculate as to why two fire trucks, plus two separate cars of fire officers had passed the window in under five minutes, all on blues. That's one lucky cat in a tree. An hour passed. We got very excited at everyone else's radio calls. Ooh, prison! Ooh, old dear fell over! Ooh, swine flu! However, none required our presence. Another hour. "OK, just go til half five and we'll give up". Half five arrives... "we'll drive back to the hospital very slowly and then log off if nothing's happened". Arrive at the hospital... "I'll drive you home, and then log off". Hmm...
As luck would have it, we got to within 1/2 a mile of my front door - 999 CARDIAC/RESPIRATORY ARREST. Oh yesh. Rapid u-turn, blues on, race back down the road into the city, through town (6pm traffic!), down into the rough end, to our one and only horrible drug addled tower block. Erm - we don't have a flat number. The CRU and the truck are there, so I hop into the truck and try to get the computer to spit out the address, to no avail. We phone Control. Much easier.
Bypass the entryphone system (who answers the phone while working on a cardiac arrest?!) by sneaking through a rapidly closing door after two lads. Just in time to meet both crew walking out of the lift, followed by a bloke. Walking after a cardiac arrest? Wow - these guys are good! Actually, no (although they are awesome). Alcoholic C/O abdo pain and peeing blood.
He staggers onto the truck. None of the crew are looking amused.
We have a short chat with the CRU guy about diagnosis of distal radius fractures (I still have no idea if there's a magic test for this - pain on pronation was suggested though), and head off again. My PPE had already been deposited at station, so I was in the spare 'DOCTOR' jacket :D
So that was my time with Matt. A genuinely lovely bloke with a huge passion for pre-hospital care, a great ability to teach, and a wonderful way with patients (and pretty hot for a greying 35yo.... )
I've inquired about joining first responders in uni town, and will be joining BASICS Scotland on a student membership as soon as I have a scottish address :) Now I just need my own mannikin to play with, or all these skills are gonna disappear faster than that nice weather...
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