Actions have consequences

In general I am usually responsible lupie, but yesterday was not one of those days.

I had a exam,classes, then I had to head to London. I left home(university dorm) at 8.40am, was out ALL day , and got home to my mum's home at 10pm.

This morning I got to go to the Royal College of Surgeons, it was really nice.If you ever come down to London and feel geeky, you can check out the Hunterian Museum.

I was supposed to meet a friend, but he cancelled, and I was mentally rejoicing I can imagine the neurones in my limbic system dancing like the plant.

I love my friends,but by noon, I felt like I had done 7 rounds in a boxing ring. I could have cancelled, but I always feel guilty about cancelling for health reasons. I am young, I am supposed to be healthy, and I would rather not let people down.

But now I am so exhausted, and all my joints ache, and I dont think I will be walking anywhere. So I am watching TV, making the most of it,since I do not have TV at university.

I knew this would, happen and I did it anyway. The way I see it is I enjoyed being busy and doing lots of stuff, and it was worth the resulting aches and pains. I can't complain about being achey, because it is self inflicted.

The small print: Dont worry I know neurones don't dance.

Back to Learning

So....I did actually get some food.Eating rael food makes such a good difference to my mood and energy levels.

I feel like a real student now.Well that sentence is ridiculous, but I am now settled in, studying, going to lectures and doing all the other student stuff.

Its also freshers week, so I have been able to collect alot of freebies.Mainly pens and chocolate, I have to say that standards of freebies have dropped since I was a fresher. I did get some free syringe pens though



In other news I have been feeling really tired, (going to bed as soon as I get home from lectures). I hope that I am just tired and not getting ill, or about to have a lupus flare up. I can not fit illness into my schedule!

Next week is medic freshers week(freshers week for medics). As I am on the committee for several societies I need to harass the freshers to make them sign up.

I think joining the societies I am a member of is worthwhile(I mean why else would I be on the committee???) Dear Freshers....sign up to what you are intrested in, most people sign up to things they never end up doing.But watch you budget and dont pay silly amounts to join societies you wont benefit from.

The morning after

Click here if you want to read part 1.

I was really out of it on Wednesday,so I will start at the bit I remember. The doctor who discharged me,taught me last year.He said I could go home ,but he recommended I get home quickly so I can have a shower and a snack before placement.


Walk of shame moment
Traditional the walk of shame is coming home in the same clothes you wore the night before,which I managed to do.This was at 6 am so the shuttle was not running,and I didn't have money so I had to walk home in the rain.It only took 40min but I got soaked and I got a blister.I let myself into my flat and thankfully all my flatmates where sleeping.I like my flatmates but I was not ready to face them until I figured out what they knew.

The shower
I had a shower and discovered some evidence.

• 2 ECG dots-this suggests I had a ECG for some reason or other,
• 1 cotton wool and sticky tape thing points to the idea that I had a blood test.
• 1 pink cannula in my wrist.This was rather disturbing,had I escaped hospital or did I get discharged with a cannula in plain sight??

I pulled the cannula out gently and nothing to bad happened,(no blood came gushing out) it was just weirdly slippery and uncomfortable.

Warm water is so comforting,I immediately felt more like myself after the my shower.

Back to hospital
I considered calling in sick,but realised

A-I don't particularly want to get a sick note from my GP

B-being absent will give people more time to gossip about what they think happened.

C- according to my schedule I would be in a MDT team meeting,so no patient contact at all.

I couldn't find my ID badge so I couldn't get the shuttle.So I had this bizarre idea that I could jog into placement.

Retrieving my ID badge
I had to go back to A&E to see if they had my ID badge since its always in my pockets somewhere.Thankfully it was 8 am by now and the shift had changed.I decided the best thing to do is to play it cool...so I went to the desk and said,hi I am a medical student and I was wondering if I left my badge here.The nurse looked around found it and thankfully gave it to me without asking any questions.She complained about the night staff being so lazy and disorganised because they put it in the patients lost and found stuff. I felt so guilty.

MDT meeting
These are so boring but I was grateful to be away from patients.As a medical student I did not have to say anything so I could let my mind drift.Well until my name was briefly mentioned.(mini heart attack moment)I had no idea I was under the care of the haematology team.It was  brief 'x presented in A&E we are awaiting more details'.

I am attached to the stomach cancer people,but they have MDTs on days we are not at placement,so my colleagues and I got sent to watch the haematologists do their stuff.

I think it passed over the other med students heads,thankfully I never use my first name at uni,so they might have failed to make the connection.

One of the doctors did notice,and asked me to wait behind.They said they where pleased to see me looking so well,and getting on with my life since I was last admitted.But they also insisted I go home and rest if I was up all night.

Home again.
2pm. I got the shuttle back this time and just slept till about 10. I woke up apologised to half my contact list for sending texts I don't remember. I also deleted all my messages,so I have no idea what I said to anyone.I also looked through the photos and did a quick blog post.

The picture above was sent to me by my friend.I also managed to send my phone back to factory settings,deleting texts

Ambulances and Paramedics

Yesterday I got to ride in an ambulance,unfortunately I don't remember much about it.

The picked me up for my uni dorm, as my flatmates have told me.I also got a call from the residence office telling me this.

I mixed up my medicines and ended up unconscious (according to the nurses).

So I think paramedics are pretty amazing because
1. Most importantly...I am still alive
2. They some how figured out name age and profession (I would love to know how they figured out i was a medical student, I don't normally tell anyone I study medicine)
3.I some how ended up in hospital with my phone and house keys.(Thank you sooo much, it was very thoughtful who ever did it)

To all the paramedics out there,thank you for doing the job you do,saving lives is the most important bit,but its all the little things that count too.

Now I have a few questions, and some will probably never be answered.

1.Was I unconscious through out?
2.Why is my phone full of pictures of oxygen tanks and black boots attached to green trousers.(I hope I was not acting silly.)
3. Why on earth have I got ECG sticky pads stuck to me, who done it,when did it happen,and why?
4.What if I was being ridiculous, and the paramedics remember me, since I walk past one ambulance station each day on the way to uni, and i walk through A&E to get to the ward I have placement on.
5.Who called an ambulance?
6.Should I still shadow the paramedics as part of my course, of should I stay well away and shadow the police.

Still around, drowning in revision

I am still studying.

Before I was casually studying,dipping into revision here and there, and doing a bit each night.

Now my life only consists of lectures sleep and revision.It is not as bad as it sounds,since turning it into a habit it has become oddly satisfying.

The amount of stuff I have to know is scary. I really wish I was studying a course with modules, instead I have a long 4 hour exam ,on everything I have learnt since being at medschool.

This is what my typical revision day looks like.

6am- wake up
6am-7am-Get ready for the day(pray,read bible,breakfast,shower,dress)
7am-8.40am-Revise
8.40am-9.00am-walk to uni
9.00am-5.00pm-Lectures/placement( I try to do my homework during the breaks between lectures)
4.00pm-5.00pm-Walk home from uni/I go to the gym for if I finish lectures before 5pm
5.00pm-7.00pm-Sleep,I have been getting home from class exhausted(In capable of using a microwave exhausted)
7.00pm-8.00pm-Lunch(I know its technically dinner time,but this is when I get around to having lunch
8.00pm-12.00pm-Study
12.00pm-1.00am- Snack, then get distracted by youtube/tidy up my room
1.00am-2.00am-Silly hour* exhaustion takes over, so I try to stay awake by talking through my notes with different accents.
2.00am-crawl into bed, only to dream about transport channels, or renal disease risk factors.

That is a typical exam period day for my medic friends.I am exhausted, tired and likely to burst into tears for no reason at all.

But....

I would rather be stressed whilst studying medicine, than doing anything else.

My next post will be about why I wanted to study medicine,I think I need to remind myself why I am torturing myself.

Mitigating Circumstances

My tutor thinks I should fill out a mitigating circumstances form. My initial thoughts are as follows:

1.I might have had a bad term,but lupus is part of my life.
I am training ti be a doctor,I will always have lupus.When I begin to work as a doctor can I use my condition as an excuse for underperformance? Probably not,so why should I use it now

2.Did I really miss that much stuff?
Exams have not yet happened,how could she think I am at risk of failing? Eeeek!!! am I destined to fail??

3.It would be nice to have a back up plan.
If I fail,at least I wont automatically be kicked out of medical school.I have worked really hard to get this far so I should do everything in my power to protect my place at medical school.I didn't ask to be ill,so I sorta deserve a break.

I can choose if I want to apply for mitigating circumstances,however at the end of the day it is up to the university to decide if I should get them.

I appreciate having the choice,even if it brings problems of its own.I do not really know what to do at the moment,so if you have any thoughts please post them in the comments section.

The Fear

Its exam time and I am terrified.

My medical school has one end of year exam that determines weather or not we will graduate with honours. I have been studying my little socks off. Despite trying my best  still  feel woefully unprepared.

I think I have some perfectionistic tendencies,so just passing is not enough.I want a high grade. The problem is in medicine,every one is smart, so the high grades go to the ultra hard workers,or the super smart mutants.

I am neither of these, then there is the small minor detail that I missed a fair chunck of last term.


Thankfully there is a sensible part to my brain that says



This is what I find useful
1. Get out of your house/dorm.
Go to a library. The distraction of home comforts won’t be there and it will get you into a working mindset.  Also it’s nice to go home to relax, and have a change of scene,before doing more work.I get really bored and unmotivated if I stay in one place for too long

2. Study with a buddy
A problem shared is a problem halved.One of the best ways to understand things is to discuss them with a friend.I personally only like to study with 2-3 people,but you may like larger groups. Nominate someone to direct the conversation so as not to go off topic,  you will find it is a great way of sharing information and filling gaps in your knowledge.

3. Think of the future/the past.
Imagine yourself in your dream job. The next phase of your life is going to be so much fun, you just need to get these exams done and dusted.If the future seems so far away,just think of how far you have come,if you got this far,surely you can go a bit further.

4.Study Hard
Use your study leave for the biggest ‘cramathon’ of your life. Don’t give up so close to the end. Keep re-reading notes and practising exam questions. Some of it will stick in your brain eventually. You’ll also feel more confident going into the exams than if you hadn't looked at anything the two weeks before.

Thanks for reading to the end of this post,here is a video to drive the point home

You know your a medical student when..

1.Your grandmother thinks you are addicted to porn because watch anatomy videos in darkness,with the curtains drawn, and rush to turn them off when someone enters the room

2.Holidays no longer exist,

3.Sling shots in toy stores remind you of antibodies

4.Your mother asks you where something is and you respond with....distal to the fridge,and superior to the table

5.Dreaming you are a red blood cell traveling from, the heart to you little finger, is normal

6.You struggle to smalltalk with your friends of friends but have no trouble asking a total stranger about their bowel habits.

7.Staying in bed till 7.30am is a luxury

8.You have been drawing sections on your abdomen,and you actualy get ill and have to see a real doctor,who finds at least 4 mistakes

9.During exam time, washing up is a low priority,so cereal is eaten in a mug 

10.The post man comes to the door and you automatically say "Hello, would you mind confirming,your name date of birth and the first line of your address"

Medicine is consuming my life,but I am enjoying it

Coming to terms with my own mortality

This post is about my faith...if are not a very religious person, feel free to skip this.

The drugs I was taking to manage the side my lupus completely destroyed my platelets. Platelets are essential for forming blood clots, I was bruising easily, I damaged a few blood vessels in my eye and felt poorly.Doctors said that I could die,and it was a good time to call my family.

These are my thoughts from around that time.I wrote them down to make sense ,but its never been the right time to share it.I was reminded of this post when my platelet count fell again,my counts are low,but being managed.


I spent hours studying for an anatomy spot test,I watched all the videos,spent extra time in the dissection room,wrote notes and done it again.I teach Sunday school,volunteer with homeless people and refugees,and I have a part time job saving money to enable me to work on mercy ships once I qualify.What is the point? I have lived my entire life striving to do what is right, trying to learn, trying to be more Christ like. And for what! 

 Now it will all be wasted, my skills will never be used. I have so much left to give and it kills me that I can't deliver. I have never been content just being, I want to be doing. But maybe that is the lesson that God has been trying to teach me my whole life. 

I need to be a Human Being not a Human Doing. Maybe, the only lesson He has been trying to teach me is that He loves me and wants to be and rest in Him. I am dispensable. God's will and His plan will prevail regardless because His power is made perfect in our weakness. Being human means I am not content with being weak, it bothers me that I cant sit up for long amounts of time,or see properly.I am not enjoying this ,but I will try to accept it.

Why can''t I be a part of the vision to come; I feel so robbed, so let down, so cheated. I don't know what is happening and  it hurts intensely. But then, it all comes back to towing that line of tension of trust and submission, despite the outcome. Faith and hope comes from knowing that God has saved us for eternity; not from death in this life. If there is one thing that would bring joy to my heart, it would be to know that this simple truth has been engraved on your heart also. There is only one God; in all situations, turn towards Him.


Its Easter holidays,my platelet counts are low again,but this time I am not as bothered,I seem to be filled with serenity.Getting better would be great,but if my condition deteriorates then my views are the same as they where before.

Fainting

I rarely faint, but since I was unwell I had my first few medical school related faints.Before this year I have never fainted in medical school!

I am one of the least squeamish people around, The more blood there is more interested I become. Being squeamish is not a reason not to study medicine. It might make anatomy and surgery more challenging but it is nothing that can't be overcome.

The first time I fainted was in anatomy.I would not recommend fainting in front of 90+ class mates. When I recovered, I was initially disorientated, but mainly embarrassed. No one mentioned anything after the fact. so my year group is:
a) very professional
b)embarrassed on behalf of me

The second time I fainted was when I stood up to leave the lecture theatre, I managed to get as far as down the stairs, and as soon as I reached the front, i fainted in full view of everyone. My lecturer was so nice, she bought me hot chocolate and sat with me for half an hour. It took me half an hour to convince her I was well enough to be left alone.

When I fainted after the lecture, none of my friends came to check on me.I know I go on about trying to appear strong, but its polite to check on your friend if they faint. I cried(I was ill and feeling overs sensitive) because this was the final straw.

So, now I have said all that , i suppose I should tell you how to avoid fainting.

1. Add sugar.
Its so important to keep your blood glucose levels up. All ways have breakfast, or you will only have yourself to blame if you faint whilst a nurse is inserting a cannula. Eat a small snack before going to gross anatomy. If the thought of anatomy makes your appetite vanish, at least force your self to eat a few jelly beans.

2.Stay well hydrated
Dehydration lowers blood volume slightly. Reduced blood volume leads to a decrease in blood pressure. Low blood pressure makes you more likely to faint. So please stay well hydrated.

3.Don't let blood pool in your legs
Standing still can make you faint, (ever seen soldiers fainting on parade).If you have to stand still for a long time ,tense calves, thighs and buttocks (in that order). This will get  blood flowing around and it can help a bit. 

If none of that has worked..


4.Leave,escape the situation
If something is upsetting you, turn around or close you eyes,sometimes ecaping the situation is all you need to do.
If possible leave the area, get some fresh air, or try to sit down.No one has time to babysit the medical student so if your in theatre or in dissection, move away from the tables ans sharp edges.

                                                                                                                                                                 

Try not to faint, but if you do its not the end of the world

How to get the most out of Primary Care Placements

I spent 10 weeks in a small GP practise. Primary Care is not something I would like to go into, but in medical school you sometimes have to do things that do not interest you.

1. Do a bit of research before hand.
Find out the demographics of the catchment area. All patients are individuals, but I fell I benefited greatly by finding out the following
-Age distribution-The place I was located was a popular retirement area,and there for most of the patients I saw where over 65.
-What culture is most prevalent- Different cultures have different attitudes to health care,and you may need to be aware of this if
-Location-being late for appointments is never cool. My placement was in the middle of nowhere with only hourly buses. Even the patients had difficulty getting to their practise, so they would only come to the surgery if very ill, and returning to collect prescriptions was a no-no

2.Plan how to achieve the learning outcomes
At my medical school we have books that need to be signed off. If the doctor you are shadowing is not used to having medical students you may need to tell them this.Some doctors like signing things off as they are completed, whilst others prefer to sign things off on the last day Unless its stated in your book, always ask.As a student you must take responsibility for your learning.

3.Try to make what ever you are doing relevant to your studies.
As you progress with your course the ability to link things together will be invaluable.Taking endless blood pressures day in and day out can get boring and tedious. To make it slightly more bearable, I decided to teach myself about the drugs used to treat blood pressure.This tied in with my pharmacology module.
Last year on the wards, I took an interest in patient nutrition as it tied in with my module on human nutrition.

4.Ask all the time
Most people want to help you learn. If you want to know more about something just ask a staff member when they don't seem to busy.
Sometimes doctors forget how little students know, so they give incomplete instructions.If you do not understand what to do it is better to ask a question,than to make a mistake

5. Try to reflect regularly during your placement.
I know reflection is a word that medical students are not fond of. I used to think reflection is a waste of time, but I now find it very valuable.For the foreseeable future reflective writing will be part of life, so you may as well get used to it.
What you write does not have to be detailed, its more important that you do something.  If you notice something that could have been better, or you witness someone doing something really well, try to write 150 words or more about it.

January Term

I don't usually like snails, but I find the shells very interesting.

What I find interesting about it is the intricate spiral pattern.

I don't like  hate going round in circles. lately is seems like I've already faced a particular trial and now I'm back here again. I suppose some people have looked at the snail and immediately thought of its less than pleasant slime, i saw something different today.

With every rotation the shell shines and glimmers a little different each time.
With every rotation the shell shines and glimmers a little different each time.  Perhaps the same can be said for the events of this life - even though I have been here before there will be something new, something beautiful, to see amongst the disgusting slime.


My lupus for most of the part is silent, but when I do have a flare its near impossible to ignore. My lovely doctors  treated me with some rather strong drugs and as a result I suffered from severe Thrombocytopenia*. I did not pay attention to the details because I was too tired and achey.  but from a patients point of view it went something like

Doctor:Your body is attacking you and your organs could fail, you need to take these drugs
Doctor: Things are improving go home and take it easy
Doctor: You have no platelets, and your white blood cells are low, it could be a medicine side effect or you have cancer
Doctor: I hereby sentence you to 18 months of monitoring and lumbar punctures.

As scary as it was being in hospital gave me time to reflect. I guess what I realised was that each trial or difficulty I have faced has built up my faith so that I can look back and know that if God has got me through A B and C, which have increased in intensity, in the past then He will get me through X Y and Z in the future.  But, it does make me wonder if this could be building up to a bigger test of faith!  (eeek!)

I was in hospital for  13 days and spent the rest of the time at home feeling miserable and exhausted. Studying medicine does have its advantages though, I was able to escape the ward and attend lectures because it was close enough.

Now, before you think I am an ultra committed medschool gunner/geek, STOP!! Hospital wards are boring, and staying there for any length of time would drive even the calmest person up the wall. Pride also played a part, I do everything in my power to avoid people noticing I am ill. Showing vulnerability  but skipping too many classes in my medical school is not the best idea. 

*Thrombocytopenia=low platelet count. Having to few platelets affects your blood's ability to clot

This past term has been very difficult, hence why I have not bloged at all. I am sorry I am on vacation now, so I will use this time to catch up with my blog posts.

Grades in medical school

Hi,Sorry for the really long break between posts.It was a very hectic start of the academic year.

To all future medics,I would like to say CONGRATULATIONS on getting into medical school.

Its fair to say that most all students that get into medical school will be used to getting good grades.

But its impossible to be the best all the time.Remember to become a doctor you need to PASS every test. A grades are great but they are not a necessity

I choose to defy expectations

This week (9 September-15 September) is National Invisible Chronic Illness Awareness Week. in honour of this I have chosen to write about being a medical student with lupus.

I don't usually tell people in real life that I have lupus,mainly because I don't want sympathy and other times its because i am avoiding insensitive comments.Insensitive comments are part of life, but I find the ones where people tell me what they expect me to do to be the most frustrating.

Here are a few things that have actually been said to me,and my replies.

How can you be a doctor? Shouldn't you have let someone more able take your place at medical school after all you can't offer that much?
 My medical school is aware that I have SLE, they believe in me and they are very supportive. Most of the time I am healthy and fit,but occasionally I do take time off. I realise that I may contribute less working days over my life, but I have lots to offer.Maybe having lupus means I will be able to show much more empathy to my patients

Oh, you have lupus? I know someone that died at 30(insert other really young age here) are ready to die?
Yes, i do have lupus.I am 20,I do not intend to die at any point in the near future,besides treatments have improved, and some people are more severely affected than others.
I am not delusional,and I do not think I am immortal,but I am not at deaths door.Please realise that I am probably more aware of my prognosis than you are.

You have lupus, its ok if you hand your work in late people will understand.
Maybe they will understand, but having lupus is not an excuse to be lazy.I will try my best in everything I do. So far ,i have never handed in a piece of uni work in late,and I don't intend to unless it is absolutely necessary. I can compete with non lupies, and I will.

Being ill must be really tough, you must hate talking about it,it must be so hard for you!
I neither like nor dislike talking about my illness.I don't mind answering questions, I would rather answer questions than have people tip-toe-ing around me unnecessarily.I want to raise awareness of invisible illnesses ,if talking about myself helps, then I don't mind doing it.

Please don't put me in a box. Everyone with an invisible illness is different, get to know them individually,before you decide what is expected from them

Sometimes I will exceed expectations, and thats great.

Other times I will fail to meet them,and whilst I am sorry.I have come to realise that I can only try my best,but i am not a super hero,I have limitations and I can not be perfect.

I CHOOSE TO TRY MY BEST AT EVERYTHING.

That question...

What are you studying?

Some of you may love to be asked this question,you may see it as a chance to show off ,or you may be proud of your achievement.(if your a male fresher you may even use it to pick up girls)

I personally despise this question. Its on the same level as other awkward questions such as are you pregnant or fat and when are you getting married.

Reasons I dont like this question

5.Its un-pc to say, "oh you soooo stupid"
I am not an arrogant person, but inevitably you get aunts,uncles, people at church, and even people in Tesco asking what do you study,and it goes something like this
Great Aunt Glenda: so what are you studyingMe: MedicineGreat Aunt Glenda: Ohhh you must be soooo smart.
Yes,med students are smart, but there is no need to act shocked. And how do you respond to that? If you say yes,it could be rude.Choosing to reply with 'not really' prolongs the conversation.And you most definitely can not say "oh you're so stupid" in the exact tone they used

4. Expectations
For some reason I am still surprised I actually got into medical school.I am surrounded by at least 100 other smart or hardworking people.Since starting med school,i have actually had to work and put effort into staying at the top of the class. I don't want people expecting anything from me incase I fall short of their expectations

3. I am a medical student not a doctor
Inevitably someone is going to have a medical problem,and they will ask what I suggest as a treatment.I am a student not a qualified doctor,its highly likely I can't even diagnose your problem.When I become a doctor I suppose this will become a more frequent occurrence.*sigh*

2.The questions
People just love to ask questions.Now before you think I am a grumpy grouch old woman, normally I welcome questions and love answering them. Some questions I get however are blegh. Eg:

• So do you want to be a nurse?
   Doctors study medicine,nurses study nursing
• Can you should speak to my son/daughter I want them to be a doctor?
  If your son/daughter wants to know what med school is like they can talk to me.Harassing teens and forcing them to consider medicine is not cool.Studying medicine is hard at times,if you do not have a desire to be a doctor you will suffer
• So do you want to be a doctor?
  Seriously??

1. IT IS NOBODIES BUSINESS
I hope this does not come across as rude or arrogant,but if it was relevant to your life you wouldnt need to ask. I am shy,I hate drawing attention to myself .Saying you are studying medicine puts you in the metaphorical spotlight.

In some cultures parents dream of their kids growing up and becomeing doctors or lawyers. So when you actually get into medical school you become " the girl that studies medicine"

One of my best friends a fellow medical student also sews,she was wearing a dress she made.When someone found out she had made it their reaction was  " *gasp* But don't you study medicine?"

Studying medicine and having a life are not mutually exclusive things. Medical school is a huge part of my life,but its not all of my life.I had a life before medical school, I still have hobbies, interests and a name!!

So from this point forward if any one asks....I study something science-y

Resolutions for the New Academic Year

Beginning a New Year...


September is the time students a new academic year. Some may be brand new freshers,others returning students.

I sit in my room contemplating what to write in my brand new academic planner, (its lego,because I adore lego blocks)the first day of another new school year, whilst sipping my mocha. The year is off to an auspicious start: I’ve set my alarm sufficiently early to allow for quiet prayer time and reflection before getting dressed and packing my bag.



My backpack hangs behind my my door ready to be filled with folders,and textbooks. The pencils are sharpened to a deadly point with not a single eraser chewed off yet, fountain pens are cleaned and filled with new ink cartriges. Summer clothes have been folded and packed away, allowing me to easily select uni outfits. I feel ready – at least for the first day of class.

In my quiet time, I contemplate how to make this the best academic year ever. I face the logistical challenge of living off campus. Student life has pampered me and the idea of living more than 10 minutes walk away from my lectures seems like a great hardship.

In my own life, I find great value in setting and actively pursuing resolutions, defined goals, to achieve desired results. I don’t wait for 31 December to set resolutions – it can happen at the start of a new academic year, the beginning of a month, or even at the start of a season.

My hopes for the school year remain the same year after year. I hope this will be a year filled with spiritual and academic growth, and fun times with friends.

My new academic year resolutions are:

1.Be organised to ensure I get to class on time
2.Maintain my A average
3.Exercise  regularly (studies have shown that exercise improves cognitive function)
4.Try to get a research placement,or some extra GP shadowing next summer( will need to start emailing people ASAP )

What is Lupus

If you watch house,you will probably have heard about lupus.This is a chance to find out a bit about it.

I hope you guys don't mind. I am a med student so things could get a bit sciencey.

What Is Lupus?

Lupus is a chronic autoimmune disease where the body's immune system becomes hyperactive ³and attacks normal, healthy tissue. This results in symptoms such as inflammation, swelling, and damage to joints, skin, kidneys, blood, the heart, and lungs.³

Systemic Lupus Erythematosus(SLE) affects about 5 in 10000⁴ people in the UK.

What Causes Systemic Lupus Erythematosus?

At present the cause of lupus is unknown.Researchers have identified a number of  mutations⁶ in the genes

The immune system defends the body against infection. Viruses and bacteria trigger an immune response.

In people with lupus, B cells stay in the body longer than normal. This is thought to be the result  excessive amounts of B-lymphocyte stimulator present in the body. These are called autoreactive B cells, autoreactive B cells react against the body . The autoreactive B cells produce autoantibodies. Unlike normal antibodies, which react against foreign invaders, the autoantibodies attack the body. This results in inflammation of body tissue.( red box figure 2)

Figure2: Top Left - Antibodies in a  normal person. Bottom right-Antibodies in a lupus sufferer.

 Risk Factors

 A persons chance of developing lupus are increased by certain factors.

Estrogen levels: Lupus is more common in female(figure3) than males. In addition to this almost all women

develop lupus whilst they are childbearing age³

Race-lupus is more common in Black and Asian people

Family history: Approximately 10% of people with lupus have a family member with lupus

Major stress or infection: In people who are  genetically  predisposed to get lupus, extreme stress or an infection may trigger onset of the disease

These risk factors are out of peoples control, and it is not possible to reduce the risk of getting lupus.

 Symptoms

How is Lupus Diagnosed

Systemic Lupus Erythematous is difficult to diagnose. This is because symptoms of SLE are sometimes similar to several other conditions, most of which are more common than SLE. Lupus patients often suffer unpredictable bouts of the disease (flares) followed by periods of 

remission ,further complicating diagnoses.

If SLE is suspected, a doctor will run the following blood tests

· Anti-nuclear antibody test

· Anti-DNA antibody test

· Complement level test

Prognosis

SLE is incurable, but available treatments enable sufferers to lead a high quality life⁷

In the 1950s, most people diagnosed with SLE lived less than 5 years.¹² Death within 5 years, of diagnosis is due to organ failure or overwhelming infections.⁷

Now over 90% now survive for more than 10 years after diagnosis.¹² Many  sufferers live relatively asymptomaticly.³  and 60-75% can expect to live a normal lifespan.

Prognosis is worse for men and children than for women.³ If symptoms first present  after  60, the disease runs a more benign course.

While there are no known root causes or cure, the 

progress of recent discoveries and treatments in development is encouraging. Scientists hope that with this 

information effective treatments can be made to prevent the disease.

 References

1  

1.       Lupus Foundation USA.Malar Rash.Lupus Foundation 2009
http://www.howdoyougetlupus.com/lupus-malar-rash-symptoms

2.       GlaxoSmithKline.Lupus Facts.GSK 20012
http://www.benlysta.com/benlysta-information/lupus-facts.html

3.       Lahita RG.Systemic lupus erythematosus. London : Elsevier, 2004

4.       NHS.Lupus.NHS,2012
http://www.nhs.uk/Conditions/Lupus/Pages/Causes.aspx

5.       Lupus UK.Image of Lupus Symptoms.Lupus Uk,2009
http://www.lupusuk.org.uk/

6.       Kamboh MI, Wang X, Kao AH, Barmada MM, Clarke A, Ramsey-Goldman R, Manzi S, Demirci FY. Genome-wide association study of antiphospholipid antibodies.Autoimmune Dis. 2013;2013:76

7.       Wallace DJ. The lupus book : a guide for patients and their families. Oxford : Oxford University Press, 2009.

8.       Frieri M. Mechanisms of disease for the clinician: systemic lupus erythematosus. Ann Allergy Asthma Immunol. 2013 Apr;110(4):228-32

9.       Tortora GJ, Derrickson B. Essentials of anatomy and physiology. 13th ed., Asia. John Wiley & Sons, c2011

10.   Al Arfaj AS, Khalil N.Clinical and immunological manifestations in 624 SLE patients in Saudi Arabia Lupus . 2009 18: 465-473

11.   Kan HJ, Song X, Johnson BH, Bechtel B, O'Sullivan D, Molta CT. Healthcare utilization and costs of systemic lupus erythematosus in Medicaid. Biomed Res Int. 2013;. Epub ahead of print  

12.   Arthritis UK.What is Lupus. Arthritis UK.2010
http://www.arthritisresearchuk.org/arthritis-information/conditions/lupus/what-is-lupus.aspx

Rosario C, Seguro L, Vasconcelos C, Shoenfeld Y. Is there a cure for systemic lupus erythematosus? Lupus. 2013;22:417-21. 

Study Tips

University not only about parties,there is that other thing called studying. Medical School is intense,there is a lot of work required,therefore its important to stay on top of it all.

There is no magic set of instructions to ensure perfect grades.Each person is unique and some things may not work for everyone.

Here is a list of my top 10 study tips.

10. Set mini deadlines or use a to do list.
Break each task into small achievable chunks.Its easier to accomplish lots of small tasks compared to a single big one. With small goals you can also ensure you are on track to achieve the bigger goals
A list reduce the chances of you forgetting to do something.Crossing things of to-do lists is soooo satisfying.


9. Draw mind maps and diagrams
Mind maps are the marmite of studying,you either love them or hate them
I personally only use them during revision time.Mind Maps help me see how various concepts and ideas relate to each other.I found that my course was delivered in such a way that the information given seemed really out of context,so there was no way I could have used mind maps in the beginning. Diagrams are great at all times, they are certainly a nice change from reading text. Print out diagram stick them on doors mirrors,draw your own,or try labeling a blank diagram.


8.Aim to Study a little bit everyday

Every little bit helps.I know from experience that there will be some days when you can not be bothered to study or 101 things are happening at once and you just don't have time to study. Do something,even if its just going over that mornings notes, or making a vocab list.


7.Coloured pens or highlighters
Studies have shown that use of colour can improve memories.I personally love my colored pens and highlighters. Write your notes in colour or highlight key ideas.


6.Be prepared when attending lectures
Doing this will dramaticaly reduce your work load.Before going to a lecture ensure you are ready to learn, try not to be hungry or thirsty.In the lecture listen to whats going on,and do not be distracted by friends. If you are going to drag yourself out of bed for that 8am lecture,you may as well get the most out of it.
Repeat after me: Lectures are for learning, revision is for recapping stuff you have already learnt.


5.Post-it notes
Use post-it notes to summarise things.They are tiny so you can not get too wordy. If have lots of ideas stick to one key idea per post-it note.
Post-it notes are great for revision games
Example:   1.Copy facts onto one color
                 2.Stick these onto a wall.
                 3. Using a different colour try and re-create as many post-it notes as possible,and keep                                    trying to beat your personal best

4.Frequent breaks

As you study your attention span decreases meaning you will become less productive.This means it will take much longer to do every thing.Take breaks after 40 min of studying, go for a walk,stretch, have a snack or tidy your room.
Warning: Don't spend more time having a break than you do studying

3.Periodically review what you have learnt
This is especially important if you are studying a degree like medicine.The sheer volume of information means it will be difficult to rely on cramming for exams alone.
I choose to go over my notes quickly at the end of each week before filing them.Its fairly simple, the more often you review stuff the more you remember.


2.If stuck go find an expert
There is no shame is asking your lecturers for clarification.Send them and email or ask them after class.If you are shy ask your friends if they can explain it for you.
When it comes to essay writing read a book about how to correctly write an essay

1.Stay motivated.
Above all other things keep your eye on your goal.Think of all the great rewards studying will bring.
When desperate:

Introduction

Hey Guys

I am a medical student and this is my blog.
At this point I am not exactly sure what I will talk about,but it is most likely to be about

1.Medical School-Studying medicine is all consuming, unsurprisingly it takes up ALOT of my time. I love is and this is what I have always wanted to do.Hopefully my account won't be boring or scare you away from studying medicine.

2.Arts and crafts- I knit, sew,and create jewelry. When I was much much younger I used to blog about this,so  my creations might make an appearance on this blog.

3.My life-Lets not forget that other thing called life. I have a family,friends, no pets. You will find out a bit more about my life as this blog progresses.