Category Archives: Medical

Medical

Adventures in Ageing!

We are always looking for ways to avoid the ravages of time:

Harmony must be the secret… Consonance between all one’s failing powers, coasting home together.

It’s the same with physical fitness – as long as your organs and limbs potter along together at about the same rate of decline, you’ll be in balance, grinding to a gradual halt – but slowly, gracefully. But if one organ gives up, throws in the towel — your heart, or your kidneys, or your liver, your brain or even just your left big toe, on its own –you could be in trouble. As you get older even a dodgy knee or a twisted ankle can let the team down, can slow you down and throw everything out of equilibrium. So use a stick when it’s icy,

or take your spouse’s arm, and be especially careful climbing trees! Because as soon as you can no-longer exercise, everything will clog up and go wrong. If you sit in a chair all day, your legs will swell and to get rid of the oedema you’ll need to pee all night, you won’t sleep properly and you’ll do what I did, and nod off on the loo and fall into a puzzled and indignant heap on the bathroom floor – I didn’t break my hip — but I could have..
Senses dwindle as badly as memory but that has advantages.

Believe me, no-one is immune – my old friends all agree. Dementia seems to be an invention of young people. Ask any old person and, if they are honest, they will tell you it’s just a question of degree and living long enough! So as my friends and I go up and down the stairs looking for our glasses, (woops! They are on my head) — all that exercise helps flush out the clots. Medical science has just worked out that clever old biddies and brainy old codgers (as measured by higher education) can cover up their forgetfulness for years, using the plasticity of their brains — they train themselves to think things in different ways — teaching their brains with games and puzzles and practice. When as time goes on, as it always does, they cannot compensate any more they deteriorate rapidly and everyone says, “How tragic, so sudden and they were so clever.”

We’ve also notice that the bloody-minded amongst us seem to live the longest — control-freaks and unpleasant dictators — that doesn’t bode well.

Standing his ground for 500 years


On the bright side, failing eyesight takes care of wrinkles and facial hair. So I warn you that you will need counselling if you are considering a cataract operation — for the first time you look in the mirror – maybe replace the bulb in the bathroom for one of lower wattage so that you cannot see the ravages so clearly but don’t fall over the scales or you might break another hip.
Failure of hearing protects one from the increasing idiocy of others and one’s increasingly short temper. Most of the nightmares on the Six O’Clock News are subsumed in my inability to concentrate on more than one thing at a time, as I plan our next meal or attempt a crossword (that’s a word puzzle not a verbal missile aimed at my partner – who would only look puzzled because his head is also elsewhere). It’s not that we don’t hear, it’s that we can’t listen anymore, unless our attention is grabbed, but then that helps us understand our grandchildren… For an instant. We find we quite like YouTube! It suits our attention span.

Loss of proprioception (knowing what one’s joints are doing) shields one from reality – I pride myself on my flexibility as I splash about with the other pensioners at my aquarobics class – high kicking, supported by the water. Then, next day, I think I’ll just climb over this fence, catch my foot on the top wire (barbed), lose my balance (also impaired) and fall headfirst into the moist leaf-litter of the woodland on the other side, ripping my trousers. Here I lie, one foot still suspended in the air in the next field, nose in the mud, musing on the muted fragrance that surrounds me, unable, as I am, to truly appreciate the full horror of the rotting fox pooh into which I have just touched down.

That’s how to vault a fence.


It’s all a question of balance – the spirit of adventure versus the weakness of bones – Bill explains as he tries to hoist me out, the way I came – not possible! So, he frees my foot, and rather than attempt a return vault, I head off, trousers flapping, down the hill, to walk the long way home. Ducking, as I go, beneath the low hanging branches which get lower and lower, the more I stoop – it’s weird – like a fairy tale, as I trudge through the bewitched and shape-shifting trees of the dense twilight woodland.

Standard
Medical, Writing

New Book out next month!

I chose this cover picture which shows me in the raw — not at all the way I feel today — the book recounts the reasons why — all the bizarre experiences and formative encounters. The dodgy characters and extraordinary situations proffered by a medical education in the sixties. How the world has changed!

Standard
Humour, Medical

NHS’s famously flexible workforce

When I was a houseman my legs were blebbed and bubbled by the bites of the fleas from the feral cats that lived within the hospital grounds — but things have moved on.

Hospital cats are now more professional — they have come in from the cold, are properly trained and equipped, have regular health checks and probably mandatory immunisations (long before the other staff!)

The thing about cats is that you cannot exclude them if they don’t want to be excluded and some cats just have a vocation! So the NHS works with them, not against them.

Somewhere in Britain, probably everywhere in Britain, Buster here (or a cat like him) guards the confidential waste in the office of the emergency department. He keeps his wits about him as he dissipates the stress of staff, his mouth shut, the perfect confidential mentor and counsellor but as a member of the occupational health psychiatric team, as you can see, he does have his own panic button.

Standard
Humour, Medical, Thoughtful

Padded knickers extending lifespan!

I read somewhere that time accelerates as you age. This is my impression and may be because as you get older you do fewer new, memorable things. Memorable things that you do for the first time populate the time-scape and as you look back, if there aren’t many it seems as if the time has flown by. I don’t suppose it matters much as it’s all just a trick of the memory but it’s good to have things to look back on and one of the reasons I blog.

There was a time I did something new almost every day but that’s not so easy now with all the restrictions. Last week I bought Saville oranges for the first time and yesterday I made marmalade for the first time and got my first sugar burn!

When we are next in Peterborough I am going to have a go on my daughter’s new adult scooter (she uses it to get to work at the hospital avoiding parking and public transport) — it’s manual like the ones we had as kids but bigger — I used to love my scooter! This will require the manufacture of padded knickers — the only proved way to avoid fractured femurs (I should have had them years ago) and I will certainly need them in Kettering when I try the new grown-up motorized scooters that whizz up and down the Headlands with some of the youngest 17 year olds (with driver’s licenses) that I’ve ever seen. Before I can do that I’ll have to get my first i-phone (that’s how you mobilize the scooter) and waylay a school-boy to help me (I’ve done that before).

A friend of mine (I won’t identify him any more specifically — you’ll see why) likes to go to work each day using a different mode of transport, it was easy to begin with, especially as they live on a waterway (that narrows identification down a bit). Car, bicycle, skate board, paddle board, kayak, walking, running along the beach… As time goes on finding new ways gets harder — swimming, sailing… Running over the dunes? (But that’s really just running). Running over the dunes naked! He could do them all again naked even if it does mean going early when it is quiet. So if you knew who it was and where to go you could see him at 5:30 am riding a child’s peddle-cycle, stark naked, along the sea-wall.

Electric Scooters for Rent by Wuestenigel (CC BY 2.0) Object of my desire!

When you see me streaking down the Headlands in nothing but my padded knickers you will know that I too am running out of new things to do.

Standard
Medical, Sheep

The Mystery of the Missing Ears

Our friend Tony told me about the flock of sheep fed on oil-seed rape, when it first became a popular crop in Britain. (It might have been in 1976 that famously hot dry summer.) The sheep gained weight like never before but lost their ears! It was a mystery.

oil seed rape field

Oil seed rape field curtesy of Bayer Crop Science UK  CC BY 2.0

 

Photo-toxicity is something I learned about in another life when a lady gardener showed me the livid, blistered scalds on her arms, as if she had been whipped with a red hot flail. In fact she had been lightly brushed by the cut, sappy ends of giant hog weed, angelica and cow parsley that had taken root and flourished amongst her parsnips that hot summer and which she had been cutting down.

Phototoxic chemicals, which occur in all these plants, increase the reactivity of the skin to ultra-violet and sometimes visible light – they are the opposite of sun screen and can produce the most bizarre patterns of sunburn. You can get them onto your skin directly, like the sap, or be effected by eating them, as with the light sensitivity that can occur with certain drugs.

Bergamot oil is another phototoxic agent, giving a puzzling blistered burn on the neck of a very smart but distressed lady who did no more than spray herself with expensive perfume on a sunny day.

I think that the sheep with the missing ears got such bad sunburn on their ears (their least woolly part) after eating or brushing through oil seed rape that they ultimately lost the tips of their ears– like our lamb here.

SONY DSCTwo of our triplets this year seem to be effected. They are the small ones who have had less milk and, early on, foraged more widely, nibbling in the hedgerow and tasting all sorts of plants at an earlier age than usual, when their hair was thin and their skin sensitive. The bigger one has gained weight but has lost his ears!

 

The little one has done better, now we have worked it out, and she has had treatment and gets my sun screen (factor 20) liberally applied on sunny days!

SONY DSC

Twts (they never have names!) She’s better with antibiotic, steroid and sun-screen

Whatever next?

Standard
Birds, Medical

Survival? Against All the Odds.

I didn’t see the accident — just the blood on the road as I swerved to miss her as she  staggered blindly in my way.  I stopped and the cars behind were already pulling out to overtake me,  I  switched on the hazard warning-lights, jumped out and ran back.

No one else stopped —  they hadn’t seen her — now she lay helpless in the gutter — I had to be quick or there would be another accident.

I could smell her blood, it was on my hands as I tried to hold her — steady her.  She struggled and kicked — there were two huge gashes on her head, I could see the bone, liquid was bubbling from one of her eyes and blood was coming from her nostrils, strangely the cars whizzed past, their drivers oblivious to the drama.

I had nothing with which to do anything.  I ran back to the car and found some carrier bags and the dog’s lead (no first aid kit of course) — anyway there was no time for that.  I tore the bags flat and wrapped her in them, swaddling the little duck like a baby and trussed her up with the dogs lead so that she would not injure herself any more — she calmed.  I lay her in the dark boot of the car wedging her in so she wouldn’t roll about then closed the lid.

Now I could have driven to town, to the vet — yes, she was  (and still is) a duck — a little mallard, hit by a car — well she probably flew into the moving vehicle — she was, is after all, female — but I did not.  I’ve seen the expression on their faces when you present them with a wild thing and I’ve paid the price!

No, I took her home.  My husband groaned and, once again, our wet-room came into it’s own.

?????????????????????????????Trying to walk, she repeatedly toppled over to the right but in the half light of the darkened shower room she settled and sat quietly all that day and all the next.  Nothing ate her.  She moved around a little but would not eat the slugs which I had collected for her and which climbed their slimy way circuitously to the ceiling , nor did she try the bread in water which she spilled, nor the caterpillars that pupated on the tap.

On the third day, she was thin, dehydrated and matted but walked more steadily and looked up at me as if she saw me.   We had to go away to a funeral the next day so first thing in the morning I carried her to our pond and put her down gently by its side.  All the way there she was looking from side to side  as if getting her bearings..  Next thing she topples forward and plop!  She’s in the water, she lowers her head so that the pond water flows into her beak and she takes a long cool drink and paddles off purposefully around the margin  of the pond.

Away to safety.

Away to safety.

On the far side she climbs out onto the bank under the muddy cliff where the water from the spring  runs down in a curtain.  She settles there washed by the tiny waterfall.

Next evening when we return she is still there.  She watches me throw bread on the water then stands up straight and flaps her wings two or three times to test them, shakes herself and settles down again.

Camouflaged.

Camouflaged.

 

Next morning the bread is gone and so is she, flown away or carried off by a fox.  But wait…

What's that?

What’s that?

There she is, sitting near the path, ready for breakfast.

Breakfast!

Breakfast!

We have a friend who is a farmer, when asked if he has to get up a lot in the night for his animals he says, ‘No, God does the night shift.’

?????????????????????????????

 

 

 

Standard
Ecology, Humour, Medical

What you need is a CT scan, 400 Chest X-rays or 1200 packets of Brazil Nuts.

‘What you need is a scan’

‘What, like you have when you are pregnant?’

‘No, a CT scan, computer tomogram — that’s the only way they can really tell what’s going on — but they’ll try to fob you off with painkillers, they always do!’

My friend’s bad knee continued to be discussed in the pub, no one said she ought to lose weight, change her footwear or work on her quads.  Everyone quoted their own experiences, all were unanimous — what she needed was a scan.

That’s equivalent to 8 chest X-rays –okay, probably worth the risk.

But I went to see a gastro-enterologist recently to discuss my mild indigestion during which consultation I mentioned that a relative had died of pancreatic cancer — ‘then you had better have a CT scan!’

He reached for his pad, it was 7.30 pm, I was his last patient, he looked tired.

‘Hang on a minute — what dose of radiation will that involve me in?’

‘About 8 milliSieverts, same as about 400 chest X-rays.’  He said this very quickly, ‘equivalent to sitting at home for three years watching the telly, enjoying the background radiation.’

‘That seems a bit extreme.  I mean having a scan.’

‘Everyone has a CT scan these days, it’s the only way to be sure,’ he said, ‘I don’t mind  — you can have one.  It will almost certainly be negative but then you won’t have to worry.’

But I do worry — 3 years back-ground radiation — that sounds like I’m suddenly 3 years older — three years nearer whatever I do die of.  So I went home to wait for my appointment and looked up one or two things…

Did you know that the average person in Great Britain is exposed to 2.7mSv per year?  This is from radon in the air, radioactivity in the rocks, soil, and plants and manufactured radiation, largely medical.  The radiation in the soil  gets into plants that we eat — you can get 0.005 mSv from one little packet of Brazil nuts (135g).  My CT scan is worth 1200 packets of nuts — there’s a thought.

The background radiation is largely unavoidable and varies a bit according to where you live — radon from the ground in Cornwall gives an annual exposure of 7.8 mSv — so my CT scan is equivalent to a year in Cornwall — that doesn’t sound too bad — unless you live in Cornwall.

Radiation exposure also depends on how high you live, the nearer you are to outer-space, every transatlantic flight you take racks up 0.07 mSv (just over 3 chest x-rays or more than 5 packets of Brazils!)  If you live in Denver, Colorado (mile high city) your background radiation will be twice as much as some other places.

Tobacco  contains Polonium-210 and Lead-210, these are radioactive and become concentrated in he lungs of smokers, the US Environmental Protection Agency quote  that smoking 20 a day gives a radiation exposure equivalent to 300 Chest X-rays or  6mSv/year

Without smoking, the average person in the USA is exposed to 6.2 mSv of radiation per year, more than double the British level (unless you live in Cornwall)  If you look at the different components of these figures, most of the difference is made up by, guess what — medical radiation.

When I first visited the US 20 years ago, I saw a lot that was strange to me — shopping malls, retail parks on the edges of towns with neon signs, ice machines, burger bars and super-sized paper cups, stacks of pancakes with syrup and ice-cream and Tommy Hilfiger clothes  — all are now common-place in Britain.  From jazz and rock-‘n-roll to obesity, what starts in the US comes to us in 15 years or less.

So I guess this trend for scans will continue and I will watch the cancer rates in the US for indications of what is to come here.  In the meantime, I think I might cancel my scan because, do you know, I think I feel better.

Thanks to Panoraia Paraskeva et al for the featured image of a CT scan via Wikimedia (CC-BY-SA-2.0)
Also thanks to Public Health England for the figures for relative doses of radiation.
Standard