Tuesday, 29 June 2010

Celebration time

Sorry for the lack of blogging, I was busy escaping from my house at uni and moving back into the family home for the summer (not sure yet whether the folks are pleased aboout this or not!). STILL 3 days until results come out and I can introduce myself as a second year medical studentI

In the meantime, on Thursday we have a family outing planned to celebrate our 'adopted' homeland at the Canada Day celebrations in London's Trafalgar Square. Nothing like celebrating before results, is there eh!
The timetable for the day is:-
10:30 Canada Day opens:

O'Canada - Canadian Tenors

Ceremonial Drop of the Puck by the Canadian High Commissioner

Hockey: Matches 1-4

Canadian Pavilions Open
11:00 Cine-Club Film: La Grande Seduction

Cooking Demonstration by Chef John Jackson
12:00 Canada on Stage - Eccodek

Cooking Demonstration by Chef John Jackson
12:25 Kwakwaka'wakw First Nations will perform "Tlasala" (Cheif's Dance)
12:35 Kiesza
13:00 David Celia

Cine Club Film: La Grande Seduction

Cooking Demonstration by Chef John Jackson
13:20 Radio Radio
13:45 Hockey: Matches 5-8
14:00 Autograph Signing by Paralympic Medalist: Chantal Petitclerc
15:00 Cine Club Film: La Grande Seduction
15:30 Meet the Mounties

Triviala
16:00 Kwakwaka'wakw First Nations will perform "Tlasala" (Cheif's Dance)
16:30 Hockey: Bronze Final
17:00 Hockey: Gold and Silver Final
17:30

Trafalgar Cup Presentations

17:35 Richie Hawtin: DJ Set

Concert Begins:
18:15 La Patere Rose
18:40 Dan Mangan
19:05 Canadian Tenors
19:40 Hawksley Workman
20:00 Canadian Pavilions Close
20:20 Sarah Harmer
21:10 Jully Black
21:45 Bars and Food Stations Close
22:10 Closing Remarks and O'Canada
22:15 Event Ends

Visit the website here and try to make it if you can. It should be a great day!

Friday, 25 June 2010

A year ago today!

Lancaster - Natural Sciences - class of 2009
Thanks again to all the great people at Lancaster who helped me get where I am now.

Thursday, 24 June 2010

Did the Earth Shake?

Yesterday afternoon a 5.0-magnitude Earthquake shook Canadians in Ontario and Quebec.



Best wishes to all my Canadian friends and family. Particularly those in Ottawa and Toronto.

Read CBC's take on it here.

Wednesday, 23 June 2010

Wow!

Had a long day?


It's nothing compared to the day John Isner and Nicolas Mahut have been having at Wimbledon. They shattered all records for the longest game in grand-slam history. Being forced to give up due to vanishing light after 10 hours of play and tying 59 games all in the 5th set.

But, they'll be back tomorrow to finish what they started.
Read about the match here.

All-in-all a fairly exciting day in sports land.

Edit- on day 3 of the game and after 11 hours of play, Isner won 70:68 in the final set.

Did we make it?

Yup.

But now we face Germany.

Will we make it?


BBC Sport takes a look at the permutations ahead of England's vital match and the equally-important game between the USA and Algeria in Pretoria.

ENGLAND BEAT SLOVENIA, USA DRAW OR LOSE AGAINST ALGERIA

Yup- England win the group.

ENGLAND BEAT SLOVENIA, USA BEAT ALGERIA

Yup- we still go through. Goal difference determines the group winner.

ENGLAND DRAW, USA DRAW

iffy....... goal difference again.

ENGLAND DRAW, USA WIN OR LOSE

Home time.

ENGLAND LOSE

Home time- IF we let them back in the country!

June 23 is .........

Not really sure why this day but it is so......

765 day to go until London 2012

The Organising committee are running an 'open weekend' 23-25 July. It includes hundreds of events across the UK, from sport to art, dance to exhibitions. Find out more here.
The london 2012 venues are also taking shape.


1325 days to go until Sochi 2014


and only 52 days until the first youth olympic games kick off in Singapore.


Also it's now only a 3 horse race for the 2018 Winter Olympics. The final candidate cities are
  • Annecy, France
  • Munich, Germany
  • Pyeongchang, South Korea
I kind of hope korea win it, simply because they've been so close so many times now. Points for effort!

Tuesday, 22 June 2010

Little and Large!

When my mum said she was getting a doppler ultrasound of her legs and asked me if I wanted to come and observe. I imagined a hospital appointment with radiographers and big meaty equipment.



We were both a tad surprised perhaps to find that the doppler in question was more like this.



This gadget confirmed what we already knew- my mother does indeed have blood going to her feet - I could have told them that :-P

Unfortunately it didn't give us much of an answer for why all the fluid wasn't leaving her right foot again........the mystery continues.

Monday, 21 June 2010

Key NHS targets 'to be scrapped'

This came in the news today. Many doctors say some of the NHS targets are a pain in the a** but will the new changes be better or worse for patients?


Key NHS targets are to be scrapped and management costs slashed by nearly half as part of a major shake-up unveiled by the coalition Government.

Health Secretary Andrew Lansley said GPs will no longer need to see patients within 48 hours, while the four-hour maximum A&E waiting time is being relaxed.

Central scrutiny of the 18-week referral to treatment target will also be ended.

Patients' campaigners expressed concern that the reforms could lead to a "free-for-all" where health providers were not held to account.

But Mr Lansley insisted people would still have the right to demand high levels of service.

"I want to free the NHS from bureaucracy and targets that have no clinical justification and move to an NHS which measures its performance on patient outcomes," he said.

"Doctors will be free to focus on the outcomes that matter - providing quality patient care. Patients will still be entitled to rights under the NHS Constitution, and the quality of their experiences and outcomes are what will drive improvements in the future."

Mr Lansley said the changes would help drive down the management bill for Primary Care Trusts and Strategic Health Authorities from its current level of £1.85 billion to £1 billion by 2013-14.

Although NHS spending was set to rise in real terms over the coming years, it was crucial to make "immediate" savings so they could be reinvested in care, he said.

Costs should be cut by £220 million this year, followed by a £350 million fall in 2011/12. By 2013/14 the total reduction will be £850 million.

Article from the press association

Also read from the BBC, here.

Saturday, 19 June 2010

A day early, but.....

To my Dad and all the other great Dads out there.....

Happy Father's Day


PS- the cartoon is no reflection on you - it just made me smile!

Friday, 18 June 2010

All done now :-)

Blink and you miss it - year one of med school is done and dusted.

This was how OSCEs worked out for me

Day 1
1. Anatomy - male reproductive system (questions included- how would you insert a male catheter?- errrrr.....gently? )
2. ECGs (getting better at these - they were double-dutch for a while)
3. Medical research/statistics presentation
4. Anatomy - Knee joint
5. Breast examination (Male examiner: 'Talk to me as if I'm the patient'!)
6. Cardio Examination
7. Infection control (oh yes- it's the hand washing station!)

Day 2 was more of a breeze

1. Anatomy - shoulder joint (I knew something was up when the anatomy professor opened the door before I got to it and said 'Hello- you'll be having me in a minute', closed the door again and left me to quiver in my boots until the bell rang to enter)
2. General exam (yipee!)
3. History taking (yipee!)

Still have to wait a few weeks for results but fingers crossed

Getting used to freedom again- went for a sunny relaxing walk in a country park yesterday - aah :-)

Sunday, 13 June 2010

Photo of the day #2 England 1-USA-1

Bad luck boys- play better next time!

You have to love (or at least have a good giggle at) the American perspective though.



Saturday, 12 June 2010

Photo of the day

(Credit to Daylife.com, not me)

Name and Shame

In an article from the BBC today the 'Best and Worst NHS hospitals were named.

The Consumer watchdog Which? carried out a review of parking policies in the different NHS trusts around the UK and found wide variation in the prices charged and the amount of clamping that takes place. According to Which?, 70% of people have experienced problems with an NHS hospital car park and for nearly half, parking made what can be a very stressful time even worse.

In September last year, former health secretary Andy Burnham announced that hospital car parking charges for in-patients, their families and friends would be scrapped within three years in England. The coalition Government has no current plans to carry this out.



Speaking as a medical student, of the hospitals I visit a days parking can vary from £3 to £10, I'm sure someone is making a tidy profit somewhere. Hopefully the money is going into the trust and improving patient care. You can read the full news story here.

In other news this week.

Unhealthy living 'almost universal' in Scotland (BBC) (CBC)

Thousands of hospital patients dying 'because too few senior staff work weekends' (Telegraph)

A University of Calgary student has taken the University to court saying it violaiolated his constitutional right to freedom of speech when it disciplined him over Facebook comments. (CBC)

The WHO is pleading to increase blood donation in poorer countries (CBC)

Is the sex symbol image damaging nursing? (BBC)

Are GPs up for the challenge posted by the new government? (BBC)

Friday, 11 June 2010

Hockey!

Congrats to the Chicago Blackhawks - 2010 stanley cup champions.



The Blackhawks beat the Philadelphia Flyers in overtime of game 6.
Shame not to see a Canadian team win the cup............

but then again...............

Hockey makes me happy :-)

Thursday, 10 June 2010

Just Good Manners

Thought I was joking when I said we have to chatter away with all our OSCE patients, even the plastic ones?

Think again...



link to the youtube site here

Clean Clean Clean

At first we thought it was almost laughable to have an OSCE station on hand washing. However, Hand Washing is the single most common cause of spread of hospital infections. MRSA and other lovely bugs can live happily on those bits of your hands you miss and be passed from Joe Bloggs in Bed 1 to A. N. Other in Bed 3.



The NHS (and therefore the med-school) hammer into us the correct hand washing technique. Those with a great interest (or a mild form of OCD) can watch this educational NHS film (sorry- embedding wasn't working) and have a play in their own time :-)



The most commonly bits people (including NHS staff!) miss are-
* Thumbs
* Fingertips and Nail Beds
* Back of hands and fingers
* Underneath your rings and watch

Happy Hand Washing!

Tuesday, 8 June 2010

In the heat of the moment....

Preparation for OSCE exams next weeks continues. OSCEs aren't easy as the main thing you have to be is VERY thorough, don't miss steps and cut corners even though 'proper' doctors do so every day.

However once you're in the station and you're own heart is going 10 to the dozen. It's often the simple things we forget.



1) Introduce yourself (full name, why you're there, what you intend to do)

2) Ask the patient's name (and make an attempt to remember and use it!)

3) Check the patient's date of birth.

4) Explain the procedure and get consent (do this even if your 'patient' is a plastic body part)

5) Wash your hands (easy - but also easy to forget!!)

6) Talk through everything like a crazy person, so the examiner knows exactly what your doing and gives you lots of marks.

7) Don't forget to look at the patient and inspect their appearance before you start poking them - do an end-of-bed-o-gram!

8) State extra stuff you would do in a hospital - even if you have no intention of doing them right then!

9) Tell the patient they can get dressed again at the end!

10) Breath :-)

The most breakable gymnast?

I watched the 2009 world championships at the O2 in London. (A trial run of the olympics in 2012) I was lucky to see Ana Porgras of Romania perform in her first senior competition. Very lucky it seems, this girl has a long list of injuries to match her long list of gold medals.



March 2008 - calf muscle tear
January 2009 - torn meniscus
October 2009 - Cracked Ribs
March 2010 - Pulled Left Hamstring
May 2010 - Cracked Fibula

This latest happened during the team final at the European Championships in Birmingham.



Not quite sure on which move the injury happened here, she gets through the whole routine and then has to be carried away from the podium after.



True- the girl just looks breakable! On top of that Ana was back in the gym within a week- working in a cast!

I hope she gets enough time to heal properly and gain some strength. She is a talented gymnast who will do well in the olympics............if she can just get there in one piece!




Monday, 7 June 2010

Just how long DOES it take?

Lets elaborate - just how long does it take to recover from an ACL (Anterior Cruciate ligament) injury?

As promised - this relates to more gymnastics. BBC sport reported this week that British gymnast and recent European champion on Pommel Horse, Daniel Keatings hopes to make an earlier comeback from his ACL injury than expected



"I can't say for definite but I hope to be back in six months," Keatings told BBC Radio Northampton.

"It gives me time to improve pieces like my rings and high bar. I can push my conditioning because I don't have any competitions coming up."

Keatings added: "My knee is going to heal perfectly and it might be even better.

"With the right rehab, it could be a lot stronger than it was before. I had a bad injury in 2006 and I overcame it, so I know what to expect and how to keep positive."

Keatings will miss the World Championships in Rotterdam in October, but is focused on building towards success in the major events leading up to the 2012 Olympics.

Another of my favourite gymnasts - Ivana Hong of the USA tore her ACL at a training camp a few months back and it was instantly desctibed as a 'season ending injury'- this a little over a year after she damaged her ankle, keeping her out of the 2008 olympics.



So this raises the question (in my mind at least) - how quickly can you recover from an ACL injury. The ACL of the knee is a commonly injured ligament in sports. As the unfortunate Rio Ferdinand already showed us this week. The injury often occurs during rotation or landing from a jump, rather than foul play from another athlete!



An ACL tear is often diagnosed by a drawer's sign as shown below. The lower leg moves forward further than it should in relation to the knee. The most common repair of the injury is ACL reconstructive surgery. Particularly in young active people (so... gymnasts then!) or where the knee is unstable.



I got the info below from wiki- please forgive the shameless plagiarism!

The rehabilitation process is the most important part of the surgery. There is a long and rigorous process involved in getting back to one hundred percent. The doctor will start the patient on the rehabilitation program, which is broken down into phases:

Phase 1: This step is called the early rehabilitation phase. This is basically the things that were covered in short term, things to reduce pain and swelling while gaining movement.

Phase 2: This phase covers weeks 3 and 4. At this point the pain should be subsiding and the patient will be ready to try more things that their knee isn’t willing perform. That is why there is a lot of emphasis put on joint protection during this step. The patient will be able to start doing exercises such as mini wall sits and riding stationary bikes. The aim of this is to be able to bend the knee 100 degrees.

Phase 3: This phase is known as the controlled ambulation phase and it covers weeks 4 to 6. At this point the patient will be doing the same exercises from phase 2 plus some more challenging ones. The patient will try to get their knee to bend 130 degrees during this stage. The aim during this period is to focus heavily on improving balance.

Phase 4: This is the moderate protection phase and it covers weeks 6 to 8. In this period the patient will try to obtain full range of motion as well as increase resistance for the workouts.

Phase 5: This is the light activity phase and it covers weeks 8 to 10. This period will place particular emphasis on strengthening exercises with increased concentration on balance and mobility.

Phase 6: This is the return to activity phase and it lasts from week 10 until the target activity level is reached. At this point the patient will be able to start jogging and performing moderately intense agility drills. Somewhere between month 3 and month 6 the surgeon will probably request that the patient perform physical tests so s/he can monitor the activity level. When the doctor feels comfortable with the progress of the patient, s/he will clear that person to resume a fully active lifestyle.

Sunday, 6 June 2010

Introducing Wenlock and Mandeville

Love them or hate them, The olympic and paralympic mascots were introduced recently. Slightly odd-looking one eyed creatures - they (like the original logo) have been slammed by most of the papers. But they're growing on me.



Wenlock (the mascot of the olympic games) is named after the Shropshire town of Much Wenlock, which hosted the Wenlock games in the mid 19th century - an inspiration for the modern olympic movement.

Mandeville is named after Stoke Mandeville Hospital in Bucks (incidentally a few miles from my home) where in the 1940s Dr Ludwig Guttman set up a spinal unit. He came up with the Stoke Mandeville games to inspire the disabled soldiers he treated. They became the forerunner to the modern paralympics.

The organising committee have gone to a lot of effort to give these critters a story. you can watch film about their 'birth' in a steel factory in Bolton, here.




Mind you, they're still not as cuddly as our friends from Vancouver 2010

Volunteers wanted!

My University's temporary job recruiting service recently posted this advert.

Wanted- Simulated Patients for Medical School OSCEs

"As simulated patients for a medical assessment the students will be examining chest, neck, legs etc so you must be prepared to expose body parts for examination. You will be given simple scripts to read from describing symptoms."


Unfortunately I am not eligible to apply for this exciting day out as I will be one of the hapless students being assessed this week on my examination and history skills.

OSCE stands for Objective Structured Clinical Examination. They are used in almost every med school in the country and worldwide. You rotate around a number of 'stations' each usually 5 or 10 minutes long- about the same length as your usual GP appointment.



Usually in each room there is
* One nervous medical student (who doesn't know until they walk in the door what they will be asked to do)
* One mildly bored simulated patient who has had the same procedure done to them all day
* One VERY bored professor who has been marking the nervous students all week.

So - fancy a day out at the medical school? Should be fun!

Dropping like flies!

With the world cup looming in a weeks time I'm starting to realise why the coaches start with a squad of 30 to eventually get 11 men on a football team. Footie players are a clumsy lot!



Shame for ferdinand though- you wait 4 years for a world cup, you get given the Captain's band, you get on the plane and then bum your knee up as soon as you get out there. I'd be grumpy too




Anyways, thats about as much as I know about football. Expect more gymnastics and skating soon!

Back at last!

I've been nagged for a while that my blog is growing cobwebs! The good news however is that we've almost made it through the other side of year 1 of medicine :-). Written papers were done this week (results pending- fingers crossed all-round!) and OSCEs (practical exams) are next week so we get to spend the next week enjoying the sunshine and playing Doctor!