Wednesday, 10 July 2013

Which are you most like...?

Ruby + Lottie are running a giveaway at the minute, it's for a Little Us doll.  Kimberley asks which is most like your daughter?

It's interesting to see all the characters of the dolls, as I think Little Miss is a mixture.

She is Chloe.  Everything has to be pink, i'm not sure where she got this from as I hate pink!  Even 'I can cook' on cbeebies is described as 'pink I can cook' in our house (translated: 'i can cook on the go').  She is constantly singing and dancing.  Little Man loves it...he loves playing 'row, row, row, the boat', having 'twinkle, twinkle little star' being sung to him.  But she loves it even more when dancing and singing come together, with 'ring a ring a roses' and 'sleeping bunnies'.

She is Amelia.  She is incredibly cautious, which comes across as shy.  She loves her books and we spend hours reading at home, no bedtime is complete without two stories (and three songs...little miss Chloe!).

She is Ruby.  She is after all a 3 year old, a diva in the making.  She is learning the boundaries, what is good behaviour and what is bad.  And as for being grown up, Little Miss has probably worn more make up in her short life, than I ever have...thanks to granny!

She is Millie.  She can't cope without going outside at least once every day.  She plays will all the boys at nursery, and all I ever hear at home is 'mummy, I count to three, you hide'!  She chooses her clothes of a day, and although she will happily wear dresses and skirts it's all of her own choosing.

So which Little Us doll is she most like?  All of them!  She is a three year old contrary Mary after all!

Friday, 14 June 2013

Listen to me

My daughter often asks me to 'listen to me mummy' or 'talk to me mummy'; often getting it the wrong way around, and expecting me to talk when she asks me to listen, or listen when she asks me to talk.  It's endearing.

What isn't endearing is medical professionals not listening to their patients.

Throughout my pregnancy with Little Man I tried to raise my concerns.  Noone listened.  My medical notes at the GP show this clearly.  I'm described as a GUM nurse, a Health Care Assistant and a Senior Registrar.  I'm none of these.

The registrar I saw the week before Little Man was born didn't listen.  Even when I tried to explain, she tried to look 'big' with her medical student there, and point blank ignored my comments.  I was 32 weeks pregnant.  I'd had multiple episodes of high blood pressure.  I wasn't being monitored properly, but the lovely pregnancy complications unit were looking after me as well as they could (informally).  The latest instructions (after an attendance to the labour ward with raised blood pressure) was to increase the medications if my blood pressure remained high.  My appointment my blood pressure was high.  The response, increase the meds if you're BP is still high next time you're checked, and come back to clinic in 4 weeks.

'4 weeks?!'  My daughter was born before 4 weeks were up.  I asked for a earlier appointment, and was denied.  I explained my reasons, but no, 4 weeks it was.

My medications were increased the next day.  I had my son 10 days later, emergency c-section for pre-eclampsia, at 33+5 weeks.

My consultant listened.  She was shocked, that someone like me had pre-eclampsia again.  There are no obvious reasons why I am at risk of this condition.

Wednesday, 10 October 2012

But yesterday...

Yesterday, he walked to the radiology department.  Yes, he stopped to catch his breath, but he got there, and back.  Yesterday he was talking to his family.  He enjoyed his dinner.  He made his fire.  He had plans to go out with friends.

Today, he's wheeled into the department.  He can hardly catch his breath.  He can't talk.  He can't move his arm or leg.  He lifts his eyes to grab my attention.  He understands.  He moves the other hand, grasps onto the bed side rails.  He's impatient, he's uncomfortable and he's distressed.

In just over 24 hours, his life has changed forever.  That's what a stroke can do.  Take a proud elderly man, and force him into giving up his independence.  Stop him taking his medications which help his heart failure, make him breathless.

I read somewhere once, the question, 'would you prefer to have a form of cancer, or a stroke, a motor neurone disease?'.  The answer slightly surprised me, the reply was cancer, and today I see entirely why.  That man didn't want to live like this.  He told his family that.  He wanted to die at home.  His wishes will no longer be upheld.  But I certainly hope his passing is comfortable and dignified.

Tuesday, 9 October 2012

Blog neglect

Life has changed.  And in trying to fathom it out I've had to neglect my blog.

In the last two months, I've turned into not only a fully qualified doctor, but also a patient.  I am pregnant again.  And whilst that is reason for celebration, there's a great deal of trepidation.

I've had many miscarriages in the past.  It's something I don't dwell on, but it's something that in the early weeks of pregnancy is always in the back of the mind.  It's a human thing.

We weren't trying for a baby, it is a lovely surprise, however that has led to complications.  I didn't know my dates, I knew when my last period couldn't have been after, but not when before that date.  I booked a '12' week scan.  Going along, they dated me at 9 1/2 weeks.  That was at least 3 weeks back.  Not too problematic, until you realise that I therefore had a positive pregnancy urine test at 2 days post-conception.  It's just not possible.

The sonographer didn't understand.
The consultant's 'team' member didn't understand.
Noone understands.

The implications in my mind are that a baby which is dated incorrectly could be left to go post-dates too far, putting it and myself in grave danger.  That a baby who is not dated correctly is therefore already small, and it was my daughter being small that saved both our lives - got us into the system of seeing consultants and being carefully monitored.

So now I am a walking pharmacy, ad-cal d3, aspirin, folic acid and for good measure ferrous sulphate.  Except I'm not a good patient.  Ad-cal d3 and folic acid make me feel sick, really really sick.  So i've not really managed to get them down my throat.  I'm constipated enough to not want to take the ferrous sulphate.  And I just don't want to be on tablets, so haven't started the aspirin yet.

I suspect the roots of this are deeply held, and that no health care professional, doctor or midwife, will even ask any question relevant to find out this.

You see, I am now terrified of pregnancy.  Almost phobic.  The thought of getting 'fat' makes me nauseous.  The thought of getting pre-eclampsia again terrifies me.  But equally the thought of not getting it, and having a 'normal' sized baby also terrifies me.  My daughter was 'perfect', how can a big 'normal' baby be any better than that?  I don't know how to care for a new born.  I know how to care for an incubator baby, and a 3 week old, but not a new born.

I don't want to have choices about giving birth.  I'm still affected by my c-section.  I still feel the need to explain why, and how ill I was; how there was no choice in the matter.  I don't need to feel the guilt that my body can look after one baby, but not my first born.

Sunday, 1 July 2012

'Can he have some night sedatives, please doctor?'

Many of our patients request night sedation, hospitals are noisy places, the lights are left on, and it's difficult to sleep when the patient next to you is snoring like a trooper.  But this request wasn't from the patient.  It was from the nursing staff.

You see, the patient was old.  He was wondering.  He didn't want his bed.  He wanted to sit in the chair between two other patients.  He'd woken another patient, and demanded that 'she' get out of bed.  That man wasn't confused, he wanted to stay in bed and sleep.

The nursing staff stated he was aggressive.

I walked to the ward, late at night, dreading a demanding patient.

I found a lovely gentleman, quite happy, easily led back to his bed space.  Did he want a cup of tea, 'oh yes', said he.  Into the kitchen, a quick cup of tea made, cooled down with plenty of milk.  Gratefully recieved, he started to drink.

Off I toddled through the hospital.  BEEP BEEP, my bleep rang out.

'Doctor, you must sedate him, he's keeping the other patients awake, Mr Smith is now sitting at our nursing station refusing to get into bed as he's keeping him up.'

I explain that I can't sedate one patient for another's comfort, that I can't sedation would increase this patients risk of falls, of head injury, of broken hips, and that it's just not ethically correct.  It's not good enough.  I suggest moving him into the nursing station area, where won't bother the patients in the bay, where the nurses can keep a close eye on him and reduce the risk of him falling.  'He is aggressive and won't let us move him', i'm told.

Back to the ward I march.  This is a care of the elderly ward, they should be able to cope with this.  The patient is perfectly amiable, he walks with me, he sits on a chair in the front area.  I collect his chair, a foot stool, a blanket.  I tuck him up.

Off I wonder, down to the next patient.  I hear no more about this man overnight.  Sometimes it's the simplest answers which work the best.

Sunday, 3 June 2012

Young hospital visitors

Childrens art work adorns her bedside table.  Photos of grandchildren beam down on her.  She's stuck within herself, but mention the pictures and her eyes light up.  It's a way to talk to her, to get her to open up.

We often have young visitors to the hospital, they liven up the area, and bring some of our patients 'to life'.  I love seeing them, although probably because at heart I wish to be a paediatrician.

One thing I feel we all have a duty to, is to look after these wee visitors.  A pen and piece of paper to a bored looking 6 year old.  A glass of water to a hot and tired toddler.  A kind word to a pre-teen.  A smile.  These are our patients of the future, and it's their experiences of the hospital as a visitor, that will as much as anything affect their access to services later in life.

Nothing spelt this out more to me than a recent visiting time.  A warm, quiet afternoon, no reason to suspect what came next.  Sat at the nursing station, the emergency buzzer sounded.  Two nurses run past to the location.  Unusually, this was a real call.  The wheels swung into motion.  The crash trolley wheeled to the patients bedside.  An emergency call out to the 'crash team'.  Screens protect the scene, a security officer stands.  Staff hurrying, scurrying, running.  Fetching equipment, information.  More staff arriving.

Stood at the nursing station gathering information, I noticed the little girl opposite, suddenly I see the scene through her eyes.  Scared.  Not understanding what was happening, but realising something big was.  Her relatives not reassuring, not knowing the little girl had noticed, not understanding what they were seeing.

I realised that what I was doing for the patient may or may not have the effect I wanted, but what I could do was have a massive impact on what that little girl took away with her.  I slowed my step.  I relaxed my shoulders, the expression on my face.  I smiled.  Things which made seconds in difference to me and the patient, but had the ability to have a much greater impact on the little girl and other relatives on the ward.

A short while later, the team drift away.  Two members of staff walk past, one with tears slowly running down her face.  A shake of the head.  Again the atmosphere changes.  I continue on with jobs, walking the corridor multiple times.

'Thank you' says her mum.  'Here's your pen, thank you'.


We're on ward round, and I look across to my colleague.  She's playing with her phone.  I then realise she's not texting or reading a text, but is playing a game.  'Oh', she says, 'I'm just sending my Sims to work, I forgot to do it before'.  A senior is talking to a patient, a sober moment, when his phone rings, 'I just need to get this' he says and slips out of the curtained area.

Moments which seem to happen day in and day out.

Mobile phones and technology are intruding on our everyday life, but how far should this be allowed to happen during working hours?  Should we be able to answer phones and messages?  Should we be allowed to play simple games, Sims, farm style games?  Should we be allowed to check emails, surf the internet, 'Facebook', or any one of the things which technology now allows us to do?

I feel I need my phone.  Sure, Little Miss's nursery have my bleep number, they can contact me through that.  But what if they forget which hospital I'm at?  What my bleep number is?  They are also more likely to start by contacting my phone.  For them, what if I'm not at work that day?  They're not to know that any day I have off I take Little Miss out of nursery and we have fun.  So I feel it's an easy line to my daughter.  To allow nursery to contact me, and for me not to worry about her whilst I'm at work.  It's my security

Anyone else who phones gets a very few tearse words, stating that I'm at work, and it's inappropriate for me to talk!  If it's that urgent they'll call back, leave a message or send a text.

As I've mentioned, I've recently discovered that I can use the internet on my phone.  It's a revelation!  But anything I need during working hours can be found using the work computers and internet.  And, maybe that's the crux of my problem with my colleague playing Sims at work.  Maybe I just don't understand it.  Maybe it just doesn't hold the same influence over how I start my day, how I need to spend my time.  And for that, I'm proud.