Archive for November, 2009

In the ideal world…

Posted on November 23, 2009. Filed under: Benign, Journal from behind the desk... |

A patient came in today complaining of having a sore throat, runny nose and feeling awful… 

Aaarg- tichoooooooooo!

I assessed him and advised him that he appeared to have a virus…not an uncommon occurence, but the fact he told me he was feeling awful sort of amused me, then started my brain ticking…(oh no!!)

Why do viruses have to make us feel awful?  I appreciate this microscopic life forms need to reproduce and spread from person to person to keep their existence, and as annoying as this is, it is basically the same as any other life form on the planet, so good luck to it. If the survival of their species is the only reason colds and other viruses exist, would it make evolutionary sense to encourage the host (AKA us!) to stop trying to get rid of them?

Surely if viruses evolved to make us (the host) feel good it would become a happy symbiotic relationship, a bit like the bird that eats the annoying bugs off the hippos back, leaving the hippo less irritated and the bird fed (only the poor bug loses out!)

3 birds on his back…Sounds like being married with two daughters to me!

Why can’t we have airborne viruses that make us feel energised and full of the joys of spring with a euphoric bounce in our step?  If this was the case then people would want viruses, we would feel great when we had them and the virus would be encouraged to thrive.  Sure you’d have some virus abusers, trying to get a viral fix all the time, but perhaps it’d cut down on drug abuse.  See now I’ve ruined this idea with a vision of slutty dressed girls going up to greasy old men in clubs, and slyly whispering in their ear…”Eh mate, fancy a virus?  20 quid???”

There is a down side to every nice thought…what’s that expression…Every silver lining has a cloud?

My original nice thought was this…

Pt: “Good morning Max!  I’ve had a virus and I think it’s gone to my chest”

Max: “So what symptoms did you have and when did they start?”

Pt: “Well before the weekend I started with a tickle in my throat, really made me giggle and feel happy, then I think I had a raised temperature because I felt like someone was giving me a nice warm hug all day, but over the last few days my chest has been tickly as well.  I’m sure it’s just a virus, but would you mind listening to my lungs and check?”

Max after throughly examining the patient: “Your chest is as clear as a bell, it must just be an Upper resp-giggle-tory infection. The bad news is it’ll be cleared up in a few days”.

Ahhhh….how nice….

Max!! Max!!! STOP dreaming….my nose is streaming!

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H1N1…to jab or not to jab…that is the question?

Posted on November 16, 2009. Filed under: Apply topically |

It’s crunch time…the H1N1 jabs are here.

We were one of the last places to receive the first batch. Patients and staff are approaching me, asking whether they should have one or not.   My instinct is to shirk the issue and hide under my couch, but alas I can not do that.

Everyone asks me all the questions, and I can give the answers to all but one….”Are you going to have the jab?”  So lets answer that now….

I virtually hang out with a few conspiracy theorists who tell me that the jab is a government ploy, or that the jab itself has been rushed through the testing stage. I know the 1976 jabs were blamed for neuro problems including Guillain Barre, see below…

but convincing evidence is difficult to find.   The coincidence factor is always a concern.

Every year I hear : “I had my flu jab, and the next day…<add any random common presenting feature here>…my hair turned blue!

I argue with myself….I’m perfectly healthy (physically, mental health is debatable….I mean I blog therefore I must be a tad nutty!)

So why should I have the jab??? Well….

In 1991 I did a research project looking at the effect of the Measles, Mumps and Rubella vaccine (MMR) and specifically looking at the WHO target of complete UK eradication of the three childhood diseases.  My research found that indeed the three nasties would be eradicated by the year 2000 as planned…. it didn’t happen of course as some twit Andrew Wakefield in 1998 decided the vaccine caused autism… which was later disproved ad nauseum, none-the-less the damage was done and the diseases were not eradicated. So I am quite pro- immunisation and aware of the detrimental effects of negative press.

The H1N1 vaccines are much the same as any other flu jab, just one aspect of it has changed, surely the risks must be fairly minimal.

Perhaps a microbiologist opinion might be worth having….

Then I argue back with myself… It’s just another upper respiratory tract infection, mild flu symptoms in the vast majority of cases, why bother getting stabbed.

Then the good angel appears on the other shoulder…if I get piggy flu and feel just a bit sick, I can still pass the bugs on to someone else who may not cope with it as well, that may be an immune suppressed patient or one of my precious kids, and that wins the case.

I get the jab and I get some brain altering weird extra head growing side effect…well that is rotten luck. Cash in on the critical illness cover, pay the mortgage off.

I don’t get the jab, I pass the bugs to my nearest and dearest and they get really ill… and it’s my fault, the mortgage doesn’t get paid off early.

Yes I’m a cynical nurse, but I’m a dad first.

…and “Yes” Deborah, that’s just a government ploy to get us all jabbed, but it’s a good one!

and “No” Sister, you don’t have to make any jokes about just having a small prick, my sleeve is up, just get on with it!

OW!

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It is better to give than to receive!

Posted on November 5, 2009. Filed under: Journal from behind the desk... |

I consider myself spiritual, but not particularly religious… Lets leave it at that… but today I shall start by quoting the bible….

Here goes….

In everything I did, I showed you that by this kind of hard work we must help the weak, remembering the words the Lord Jesus himself said: ‘It is more blessed to give than to receive.’

Acts 20:35

Wow!!! I feel better for that!

Anyhoooo, where am I going with this.  I’m definitely a “giver” at work.

I give to my patients my time, my experience and expertise, handsome good looks and a listening ear…as shown in the following picture…

But sometimes on the battle front of primary care, it is the patient that gives and I who receive.  The things I receive are not flower or chocolates, but health care battle wounds….

Patients give me….

Urine samples in bottles not designed to have urine samples in them. Some make patients appear diabetic when they are not (you really mustn’t put wee in honey pots!) and others in pots that seem to be specifically designed to ensure the contents goes anywhere but on the urinalysis stick.  (Yes! I am writing this post with someone elses urine on my trousers!)

Flying microscopic bugs. Debatably when you sneeze the bugs and grubs that come out along with all that forced air travel at 100mph. Coughs are less speedy, but probably more germ ridden….please don’t aim them at me, and as I have said before the Peak flow meter is not a germ pea shooter, face away from me.

Flying macroscopic bugs: Tic’s and flea’s and head lice! No thanks. I believe you, you really don’t need to get any closer!

Pus.  OK it’s not your fault, but your abscess just erupted…(all the following have happened to me and I feel a little poetic…)

I squeezed your big juicy spot 

Messily it erupted like it oughta.

See that gunk and watch it fly.

Nearly hit the picture by my daughter.

Pus now dripping down my tie,

across my keyboard and into my water,

and somehow just missed my eye!

So, as you can see my job is give and take. It’s a war zone and I stand up and take my place to fight, but if you could keep the above “gifts” to yourself….and bring me some chocolate I’d appreciate it. 

This post was slightly motivated by getting wee on my trousers and slightly by NYCRN’s new blog “Pee and Sympathy” and his Nurse manifesto.

All this talk of war zones in humour at this time of year, lets not forget the real heros…

Poppy Appeal 2009 poster - For their sake, wear a poppy

I have a battle just trying not to lose my poppy, still it’s for a good cause so I’ll just have to buy another!

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