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.

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.

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

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

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.

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. 

New Flatmates and Chronic Illness

Freshers week is almost upon us.Many people like with long term conditions such as epilepsy,allergies,diabetes, etc.I personally have lupus, and several food allergies resulting in anaphylaxis.

If you decide to live away from home its highly likely that you will have flatmates, deciding what to tell them about your health can be difficult for some. Medical conditions are a highly personal thing, that you wouldn't want to share with just anybody.

I personally tell my flatmates exactly what I am allergic to ,this is important for my safety and it just makes things simpler later on. I didn't tell them the first time I met them but they definitely knew I had food allergies after a week.

It was not a formal chat,it just randomly came up in conversation,and my flatmates didn't find it weird at all.If you have a medical condition that could result in you requiring assistance in an emergency( diabetes,allergies etc) you should definitely let your flatmates know.

This brings us onto emergency contact details, who to phone if you get ill. My G.P said that this would be a good idea, because if you get ill you don't have to worry about contacting your parents.

 I did not because:
1.lived and will live on campus, assuming I got ill enough to be incapable of phoning my parents, I would be in hospital or on my way to hospital. There is no way this can happen without the accommodation staff getting involved, the accommodation staff have my parents contact details.
2.I have a medic alert bracelet that has all my incase of emergency contact details, if i am ill in the presence of my flatmates they will have access to my wrists
3. Uni students are notorious for their juvenile pranks, the last thing I need is my flatmates ringing my parents in the middle of the night as a joke.

Long term conditions and Mental Health

There is less of a need to tell others about these,but bear in mind that you will be living with the same people for at least a year, they will notice stuff.

If you tell them from the beginning it will get rid of any awkward moments before they happen. Your flatmates can also be more accommodating and helpful if they know.

If you say nothing they could wonder what's wrong with you but be too shy to ask ,resulting in them reaching misinformed decisions.

I chose not to tell my flatmates,because I did not want to be treated differently.When they asked questions I answered them honestly and it all worked out well.

Please post about your experiences or thoughts in the comments bellow.I would love to hear from you