High on Life

For the first in a very long time, I genuinely feel high on life. It’s like being drunk but so much better and you know you won’t wake up the next day with a hangover.It’s the best drug in the world and most of all its free.

I felt happiness like this in a long time, and I’ve really missed it.

These are the moments I live for.

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Sitting Ducks

Well, that was certainly an eventful week.

I’ve just spent my first week in a hospital as part of my degree course and was allocated the breat cancer clinic. Needless to say, outpatients isn’t very exciting and there is little going on. Not to mention the fact that obviously in this sort of clinic intimate exposure is required, so patients aren’t exactly thrilled about having medical students staring at them! And then there are obviously the patients recieving a bad diagnosis or other bad news, situations in which it would not be appropriate to have first years standing around.

So the majority of the days were spend sitting at the nurses station reading through leaflets and patient notes. The first time we went to the ward was on our last day! Saw a couple of pre-op patients and then it was off to theatre to watch some real life breast surgery.

The most strange and annoying thing happened in surgery. I was standing watching the procedure when my head went all fuzzy and my vision started to blacken at the edges. This happens to me quite a lot, I have low blood pressure. But it normally happens with a large temperature change like getting out of the bath or posture change like standing up too quickly. It was annoying, because I had to sit down and everyone thought I couldn’t “deal” with the surgery. Seeing as I’d been in over 10 previous surgeries, I thought this unlikely. And those were certainly a lot more bloody and foul smelling than a tiny incision in a breast. Since then I’ve been kinda worried why it happened. And that wasn’t the only time either, it happened several times throughout the day, both during and after the surgery.

I guess I’ll have to ask the doctor about it, something else to add to my never ending list of medical problems. But I have a blood test for vitamin D levels in a week or so, could organise it around the same time as I’ll already be there.

After this week all I can say is thank god it’s the weekend! Most days, I was expected to arrive at the clinic by 8am. Considering the extensive distance and multiple transport changes required to actually get there, this entailed getting up at 5:30am. Let’s just say I’m not a morning person! Most days we finished around 5pm which meant getting home at around 7-8pm depending on how lucky I was between changes. Sometimes you get to the bus stop just as the bus arrives and others time you get there jsut as its leaving so you have to wait 20min!

It was quite an annoying schedule merely because I am a nighttime person. It didn’t matter that I’d only had four hours sleep the night before, at 9-10pm, I tend to wake up and become really active. This makes it quite hard to actually go to bed, considering I need to be asleep by 9:30pm to actually get my full eight hours. So needless to say, I never went to bed in time and suffered the consequences.

This week has been a really good experience for me, and even though there was a lot of sitting around, I loved every second of it. Looking forward to next week now!

Current weight: 8 st 11.5 (123.5 pounds)
Weight lost so far: 12.5 pounds
BMI: 24.1
Weight still to lose: 4.5 pounds by April

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Testing, Testing… One, Two, Three..

I have had a LOT of tests done recently, which let’s say has not bode well for my attendance at my medical lectures. I have recently recieved a letter informing me the need to “discuss” my recent bone densitometry result, which no doubt means it is lower than expected. But this was the test I was least worried about. Sure, if my T-score is low I’m probably gonna be shattering bones all over the place when I’m fifty+, but I’ve got enough to worry about now, let alone things I may well not live long enough to worry about. I do sometimes do the whole “but in twenty year…” worrying, but I have to be brutaly honest with myself. I may well not make it that far, so no use in worrying about it!

I’m already taking Adcal-D3 for my bones, a calcium and vitamin D supplement for those who don’t know, to prevent osteoporosis. Long term, high dose steroid use increases my risk, but apparently what they’ve been giving me so far isn’t enough. It also probably doesn’t help that my drug compliance is absolutely tragic. I’m so forgetful, and when you have to take as many drugs as I do at different times and different doses I just forget. I’ve run out of many of them too, but I’m not a hundred percent sure how to use the repeat presciption thing at the health service and until I run out of any of the “vital” meds, I’m going to continue to avoid it. I also know that most of my meds aren’t even on my repeats with the health service as I recieved them from the hopsital consultant, so I’m kinda hoping either the hospital has told them or they’ll just “believe me”.

I know this sounds pathetic, a medical student who is too scared to go to the health service to find out about repeat prescriptions. But it’s a while away, and I’ve been so busy… and personally I’ve had enough of seeing doctors for a while so I guess it gives me some vague control just to ignore the problem for a while.

It also didn’t help that I recently turned 19, which in the NHS means I no longer recieve free presciptions. It means it’s £7.20 or so a presciption, and as I get at least ten a month, not really a financially smart option to pay as I go. Therefore I had to get the yearly pre-paid certificate for £104, but that only arrived recently. Now I can actually AFFORD to go get my prescriptions.

The other tests I’m waiting on are the ones that keep me up at night. Well, one in particular. I had a nerve conduction study done as I have repeatly experienced paraesthesia, tingingly or “pins and needles”, in my hands. If it gets worse, it could affect my fitness to practise. For those who don’t know, if I am judged no longer fit to practise, I can and will be removed from my medical course, or if it happens after my medical degree, I will loose my medical licence and can no longer work as a doctor. This, needless to say, TERRIFIES me.

It’s unlikely to mean I can no longer continue, I still have feeling in my hands most of the time, and it tends to be worse at night. But my Churg Strauss could permenantly destroy the nerves in my hands, and if that happens I’m pretty sure I wouldn’t be fit to practise. How can I diagnose and treat patients if I have no sensation in my hands? And surgery would be a definate no-no, something I would really like to persue. It would be nothing, just a bit of carpal tunnel. If so, i’m fine, many doctors have carpal tunnel and its just something to keep an eye on. But if it is my Churg Strauss, the damage may well be permanent, and could get worse. And if it’s effecting the nerves in my hands, it will effect elsewhere. And if it gets really bad, I’ll have to consider have cyclophohphamide therapy, a chemotherapy drug, which I really do not want.

I’m also waiting on some biopsies from my colonoscopy, which “looked” normally macroscopically, but still has to be looked at histologically. I’m hoping they find something if I’m honest, these GI symptoms are starting to become annoying, and if they don’t find anything then it’s going to be something I’ll jsut have to “live with”. But I’m hoping they don’t find anything serious… something that they can give me a pill that will magically cure it. Sigh, a girl can dream!

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The Dark Depths of the Colon

I had a colonoscopy last week, that I realise now that I have not discussed. I think all tests I undergo are invaluable experiences for the future, you only know what it’s like when you’ve been there and all that.

When I was 17, I volunteered with a hospital colorectal surgical firm. One of the  joys of this was spending a morning watching colonoscopies being carried out. It was mostly the elderly, as it often is with hospitals, and some were moaning with pain throughout. I thought to myself, come on, how painful can a colonoscopy be?

Very. Not only was I giving sedation referred to as “conscious sedation”, where you are still aware of whats going on around you, but it’s like being very, very drunk, I also had to be giving gas and air because I honestly thought the guy was trying to push the goddamn endoscope through my abdomen. It hurt like hell.

Not to put anyone off, it doesn’t hurt like that for everyone, but some people have “looping” of the bowel, which makes it difficult to pass the camera through and hence, painful. I also found it hilarious, as it was like being absolutely wasted, when I saw what I believed to be the end of the large bowel on the screen and exclaimed, “OMG its the ileocecal valve” in officially the most insane voice ever to be used in a colonoscopy ever. To which the consultant just laughed and asked if I’d “revised” for this. I don’t remember my response, I don’t remember a whole lot of it in fact. Much like a very drunk night out!

When it was over I was glad, they gave me some tea which I then proceeded to vomit everywhere. I then managed to beg for some antiemetics and for my cannula to be removed before I did it myself. I’m very anti-cannulars, they really freak me out. I then got a taxi home and pretty much passed out for a good eight hours.

The procedure itself was by no means the worst part. That was almost the fun part with its drunk like inducing drugs and hysterical laughter. The preparation is the worst.

In order to actually be able to have a camera inserted where the sun don’t shine, you must have the bowels completely empty. To achieve this, I was given the world’s most vile tasting solution ever conceived. And to make matters worse, I had to drink four litres of the stuff within 5 hours. My recommendation for anyone who has to this is simple. Buy some lime juice and a shot glass  and then chase down every sip with some lime. I don’t know if you’re supposed to have lime juice, but at the time I really didn’t care. It was either that or not drink the liquid. And at any rate my bowel was very clear. I was about two litres in when I had finally discovered this technique. After a good old bout of retching, I decided to use the lime juice, but I drank it before each sip. It helped a little, but the real problem was the after taste. Once I’d found the magical solution of a chaser of lime, it was smooth sailing.

The only good thing to say about the prep is that it made me so nauseated that at least I didn’t notice how hungry I was!

All in all, colonoscopies are not the most pleasant of experiences, but still way better than the endoscope I had done on my stomach. When that consultant hands you that consent form asking you if you’d like to be sedated for god sakes say yes. I didn’t and I still have the nightmares.

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Physiological Inadequacy

Today had to have the worst seminar/practical ever devised. The practical only had two objectives, to measure fat and Body Mass Index as well as a practical on lung function. I have never felt so inadequate in my whole life.

In regards to the first practical, we need to weigh ourselves and measure height and then using callipers estimate body fat. Not only am I a measly five feet tall, but I am just above the overweight BMI. As I have bingo wings that look like they belong in KFC, the last thing I need is someone sticking bloody callipers on them. But it also didn’t help that the three people I was doing this practical with were built like TWIGS. Both the girls weighed less than me despite being 4-6 inches taller and then proceeded to complain how fat they were. And the guy was like six and a half foot. I couldn’t have felt shorter or bloody fatter in that moment. Since starting on steroids my weight has ballooned, and the last thing I need is to sit there listening to people who are practically underweight complain about how fat or short they are.

But then to make matters worse, we then had to measure each others lung function. I am a terrible asthmatic, and recently it has been really bad, so you can imagine how shit my scores were, far below the predicted values for my age and height.

So basically all in all I’ve spent the rest of the day pretty down about it. A day spent looking at weight, height and lung function, the three things I am currently depressed about.

I’ve decided when I get back down to a more “reasonable” weight, I’m going clothes shopping and I’m going to spend a ton. I don’t care, I never spend money on clothes, and normally I hate shopping. At five feet tall and not being built like a twig, buying trousers or mid-length skirts is torture. Even petite style trousers are for people around five foot 2, so they are STILL two inches too long. And mid-length skirts that are supposed to be “above the knee” sit far to below my knee to look normal, so I simply can’t buy them. Now I’m huge, most of my clothes don’t fit, but I just can’t face shopping. I have enough trouble finding trousers normally, as most short trousers are designed for skinny people, and before, even though I wasn’t skinny, I was on the thinner side so it wasn’t too bad. Now I’m overweight. It will be IMPOSSIBLE to find clothes that fit. The only trousers I have that really fit lengthwise are from America, their petite clothes are so much better, but now they are too small…

My diet isn’t going well, but considering I’m starting my two week clinical placement next week, it should keep me active, considering it’s a four hour commute as well as 8-12 hour shifts, it won’t leave much time for snacking! Also, I’ve started doing some basic thigh and arm exercises a day as well as a little cardio. It’s not much, but I’m hoping a little, often, will pay off in the long term.

Current weight: 9 stone (126 pounds) (weighed on 8th)
Weight lost so far: 10 pounds
BMI: 24.6
Weight still to lose: 7 pounds by April

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What Sarah Said

For quite a while now, Death Cab for Cutie have been my favourite band, and no other such band has been able to take that title away from them. Not only is it the beauty of the music, but also the depth and meaning to their lyrics. I have a great many memories associated with their music, not only some of the best but some of the worse.

When I lay in hospital one night, alone, scared, in pain and totally unable to sleep. I grabbed my iPod off the table beside my bed, and the first song that happened to play was What Sarah Said by Death Cab for Cutie. For those who do not know of this song, it is about someone in hospital visiting someone who is I suspect dying, and then recalling something a girl named Sarah had told them, “Love is watching someone die”. Because in the end, to be strong enough to smile at someone, to be there for them even though you know they are going to leave you, even if it is through no fault of there own, is a hard thing to do. To stand by a watch someone you love die, takes a great amount of strength.

However, it is the last line of the song, that plays during an instrumental section at the end, that brought me to tears on that hospital bed, that made me think of all those around me and what I stood to lose if I didn’t win this battle:

So who’s going to watch you die?

Because in the end who really loves you enough to be there, to stand by you right til the end.

And it came to me then
That every plan is a tiny prayer to Father Time
As I stared at my shoes in the ICU
That reeked of piss and 409
And I rationed my breaths as I said to myself
That I’d already taken too much today
As each descending peak on the LCD
Took you a little farther away from me
Away from me

Amongst the vending machines and year-old magazines
In a place where we only say goodbye
It stung like a violent wind that our memories depend
On a faulty camera in our minds
But I knew that you were a truth
I would rather lose than to have never lain beside at all
And I looked around at all the eyes on the ground
As the TV entertained itself

‘Cause there’s no comfort in the waiting room
Just nervous paces bracing for bad news
Then the nurse comes around and everyone lifts their head
But I’m thinking of what Sarah said
That love is watching someone die

So who’s going to watch you die
So who’s going to watch you die
So who’s going to watch you die

You can see the music video here (scroll down to the “What Sarah Said” video)

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