Making History

Last June, I was admitted to a specialist unit of an NHS hospital for surgery on my head. I was no stranger to the place having had a major operation there two years previously. Revision surgery was now required as further complications had developed. On this occasion, I was under the care of  a surgeon who specializes in image-guided endoscopic surgery. I was about to undergo an operation which required high precision and carried a significant risk of accidental damage to critical organs. I was also about to make medical history.

I was admitted to the hospital the day before the operation, to be assessed for the complex surgery which lay ahead. My first port of call was to a photographic studio in the basement of the hospital, to have my head photographed from every angle. This was because of my stunning good looks to record the cosmetic defect in my facial profile, due to previous surgery. Next, it was off to the nuclear medicine department to have my head scanned under the supervision of the surgeon. These scans were subsequently used for navigational purposes throughout the technically demanding surgery.

When all the preparations were complete, it was time for a consultation with the surgeon and his team. It was at this stage I learnt that plans were afoot to record my operation for teaching purposes. My history of multiple sinus surgeries* provided the surgical team with an unusual challenge and the operation now planned, had the potential to become a valuable training resource. I had absolutely no hesitation in granting them permission to make me a ‘film star’ for a day. Anything that helps to lessen the risks associated with complex surgery and ultimately, increases patient safety, is to be encouraged.

*For those with an interest in Otorhinolaryngology…

My ENT surgical history includes : A bilateral antrostomy; a Caldwell Luc procedure; multiple endoscopic nasal surgeries; 5 external frontoethmoidectomies; a Riedel’s procedure and a modified endoscopic Lothrop procedure (Draf 111).

My ENT medical history includes recurrent sinus infections, chronic frontal sinus disease, MRSA infection, orbital cellulitis and osteomyelitis.

I also have an inherited connective tissue disorder called Ehlers-Danlos syndrome (EDS) which has added to the complications over the years.

Well, as you can see, I’ve lived to tell the tale. While the signs are encouraging, it’s still too early to know if the latest operation will prove successful in the long run. After what seems like a lifetime of surgery, I feel I’ve earned a place in medical history.

Any guesses what label I’ll be given?

While I’m Away…

I’m off to Nottingham tomorrow for another surgical review.  I last saw the surgeon in June, just 12 days after the 4-hour operation on my head. He was pleased with my progress at that stage and asked me to return again a month later. I never got to that appointment thanks to the development of an unforeseen complication. Before consenting to surgery, I was warned of the dangers of the operation. Osteomyelitis was not on that list but it sure is now! I hope to have more news to share with you when I get back.

I have something for you to ponder on while I’m away. While undergoing prolonged treatment in hospital for the osteomyelitis, it was very noticeable how few Irish nurses were working in the system. It was a large teaching hospital with the usual cohort of trainee nurses on the wards but there were very few fully trained Irish nurses to be seen. The majority of the nurses were recruited from overseas, from the Philippines and India. These nurses were highly trained and  professional except in one regard. While working on the wards, they had a tendency to speak to one another in their native tongue. As a patient, I found this disconcerting as it excluded me from discussions concerning my own care. I wondered if there was a hospital policy requiring staff to speak in English only, while on duty. Do you have any views on this?

A-Z of being a patient

My good friend, Grannymar has been practising her ABC’s on her blog and set her readers a challenge. She said, “Pick not one word for each letter, but three that sit well together”.

I’ve had fun mulling over this task all day. In keeping with the theme of this blog, ‘a patient’s perspective on life‘, I decided to base the alphabet on my summer spent in hospital. Here’s what I came up with…

A-Z of being a patient

A’s for A&E, antibiotics and analgesia.

B is the bacteria, blood pressure and breathing.

C’s for cellulitis, colitis and complications.

D is the diagnosis, doctor and dietician.

E’s for ENT, ECG and ESR.

F is the flare-up, fluids and fasting.

G’s for gargle, gastric and gut.

H is the hospital, hygiene and hypertension.

I’s for investigations, IV’s and injections.

J is the junior doctors, joints (sore) and jelly (and ice-cream).

K’s for kidneys, ketosis and being kind.

L is the light-headed, laughter and longing.

M’s for microbiology, medication and meals.

N is the nurse, needles and nausea.

O’s for osteomyelitis, oxygen and operation (and ouch!).

P is the pulse, PICC line and pain.

Q’s for questions, queasy and quiet.

R is the respiration, rest and results.

S’s for scans (CT), syringes and samples.

T is the temperature, tachycardia and tired.

U’s for ulcer, uncomfortable and unwell.

V is the veins, vision and vital (signs).

W’s for ward, wheelchair and WC.

X is the x-ray, Xysal (antihistamine) and Xanax (for anxiety).

Y’s for yawning, feeling yucky and YES ( in response to) “ready for home”?

Z is the Zoton (antacid), Zestril (ACE inhibitor) and Zimmer frame (not needed yet).

Please Missus, I did my best. Do I pass the test?

Catch It. Bin It. Kill It.

A new health warning has been issued in Ireland. Public information leaflets and posters have been distributed to ports and airports. You have an important role to play in stopping the agenda of privatisation and for-profit medicine. Stop the spread of this pandemic disease now.

Radical health reform, in terms of creating a universal system of healthcare which offers equality and accessibility, is one of the greatest challenges facing Ireland today. Play your part.

Stop the spread of privatisation.

Podcast credit to PoliticalThicko and You Tube.

Catch-22

It’s true what they say. There ain’t no place like home. After four long weeks spent in shared hospital wards, it’s heaven to be back in my own bedroom, in my own bed. No more doctors’ rounds, no more observations taken and no more drips to endure. Peace and quiet at last. I owe a lot of people, a lot of thanks.

Firstly, to the surgical team whom I could not fault. They saw me every day, usually twice a day, throughout those many weeks and my respect for them grew with each passing day. These non-consultant hospital doctors (NCHDs) work incredibly hard and frankly, I don’t know how they stick the conditions they endure. The consultant surgeon is fantastic but he’s just the icing on the cake. The NCHDs are the ones who should really take a bow.

My final diagnosis was osteomyelitis of the frontal bone plus orbital cellulitis following complex surgery on my skull last June. Both conditions had the potential to be life threatening. Prevention and treatment is heavily dependent on antibiotics. I suffer from a form of microscopic colitis called collagenous colitis (CC) which has developed in response to antibiotic treatment for my head over many years. It’s a catch-22 situation. Antibiotics are needed to keep me alive but they also produce side effects which limit treatment. Treatment over the last four weeks, has been a delicate balance of IV drugs and I owe big thanks to the microbiology team at the hospital who devised (and revised) a treatment plan to suit my personal needs. I also owe thanks to the gastroenterology team who came to my rescue when the bottom fell out of my world, quite literally. My overall condition has now stabilised and I’ve been able to return home on oral treatments.

The last few weeks have really made me realise how much my family and friends, and especially my blogging friends, mean to me. It’s been a real privilege to turn on my laptop and know that there is always companionship available. Grannymar was there for me every day on instant messenger and I can’t thank her enough. Lily sent a beautiful bouquet of flowers to brighten up my world. Such a kind gesture! Baino kept me entertained with funny emails and Annb sent gorgeous pics of the West of Ireland, my favourite place. It’s been really fantastic to receive so many supportive emails and comments on my blog. Thank you to one and all

Lastly, but not least, to my husband Jaimie who has stuck by me through thick and thin. I owe him a definite holiday.

Escape

I got out of hospital yesterday between treatments, for a couple of hours at home. Pure heaven! It’s amazing how the simplest pleasures in life really matter when choice is denied. Even the sun shone at the right time.

Thanks to my dear friends Philip (for the lift), Sue (for the catering) and of course, to my dear husband Jaimie for making sure that everything at home was the way I love it the most. I’m not sure who was purring the loudest yesterday – me, Noodle or Doodle (my pusscats)???

Normality does exist, it’s just a matter of getting there and staying there.

Happy and Proud

My son, Robin has designed some software called Decisions for Heroes (D4H), to help emergency services record and analyse their rescue operations and recently he entered it into a competition for start-ups. The competition was held by iQ Content, a Dublin-based internet consultancy, which offered €10,000 of it’s own money for the most interesting technology-based business plan. The competition was launched in March and received 249 entries. The winner was chosen after eight finalists made pitches to judges from Google, Facebook, and Microsoft, as well as indigenous internet firms Daft, Stat-Counter and LouderVoice.

This is Robin’s interview with iQ Content’s Managing Director, Morgan McKeagney…

Robin was the overall winner! The final took place in Dublin last Wednesday evening and news of his win filtered through to me in my hospital bed. It did me more good than any drip ever could.

BTW… if you haven’t already heard… I was discharged from hospital yesterday to continue treatment from home. This development was totally unexpected and the best surprise I’ve had in a long time. I’m one very happy and proud Mama right now.

Me and Matilda

It all started with Geri Atric from Ageing Ungracefully.  Geri wanted to know if I was in a mixed ward in the hospital and thankfully the answer was NO.  I’ve enough problems to cope with here without having strange men in my ‘bedroom’.  Then the bed next to me became vacant yesterday when it’s very pleasant occupant went home and that’s when Grannymar started teasing. She reckoned I might get a HUNK in the next bed.  What can I say?

Having dismissed this hunk in the bed idea, Grannymar suggested that I could always give my drip stand a name as it is by my side night and day. Still teasing, she proposed ‘Derek the Drip’ but I told her I wanted to think carefully about names for my companion.

Well, last night I happen to pop over to visit Baino at Baino’s Banter and there I found an entertertaining post about waltzing Matilda.  That’s it, I shouted! I’ve no need for a hunk in the bed next to me, Matilda keeps me company all the time and we can be seen waltzing down the corridor together. So Matilda is now my newfound friend.

Thanks for the fun folks! And yes, the new occupant of the bed nextdoor, is a delightful addition to the ward.

Fighting MRSA

Hospital cleaners may one day use ionic liquids to clean wards. Scientists at the Queen’s University, Belfast have come up with a new way to kill off bacteria, including the hospital superbug MRSA. In this era of finite resources in our health service, any development which declares war on the superbugs, is to be welcomed.

Many types of bacteria, such as MRSA, exist in colonies that stick to the surfaces of materials. The colonies often form coatings, known as ‘biofilms’, that protect them from antiseptics, disinfectants, and antibiotics. Ionic liquids are up to 250 times better at killing ‘difficult to treat’ biofilms. Ionic liquids are essentially salts which are liquid at around room temperature. The liquid can be sprayed onto a surface where it will kill any existing bacteria. Significantly, the liquid doesn’t evaporate so once it is on a surface, no bacteria can withstand the treatment. It continues to destroy any bacteria that arrive subsequently provided the ionic liquid has not been wiped off. The liquid has low toxicity but has not yet been tested for use in human treatments.

The development was carried out by eight researchers from the Queen’s University Ionic Liquid Laboratories (QUILL) centre, supported by a grant from Invest NI. The research has been published in the journal, Green Chemistry. The Queen’s University group plans to introduce commercial products based on the technology, and is also studying possible uses with humans, eg as hand washes.

The prevalence of superbugs in Irish hospitals is thought to cost the HSE about €200 million a year. Poor cleaning, overcrowding, inadequate facilities, lack of infection control staff, poor management and a lack of accountability have all contributed to unacceptable levels of infection and death within our health system. Almost every year, we hear of a new breakthrough in the war against the superbugs. It remains to be seen if ionic liquids will become the weapon of choice.

Source:  The Irish Times and BBC News Channel (NI).

Save our Health Service

A letter to the editor of the Irish Times, caught my attention the other day as it’s topic was the health service. I was very pleased to find that it’s content confirmed my views about the abuse of out-patient clinic appointments in our public hospitals. The contributor proposed some ideas to solve this problem, measures which would also help to reduce waiting lists and raise funds for hospital services.

The letter was headed “DNA and Hospital Waiting Lists”

“Madam, – Sheila Gorman (February 19th) notes that last year St James’ Hospital had almost 25,000 “DNAs”. As she explains, a “DNA” is someone who did not attend the hospital for their appointment. They did not call to cancel or postpone and so the hospital’s time was lost.

In my own area of Pembroke-Rathmines, St Vincent’s Hospital had 26,878 “DNAs” last year.

Assuming similar figures for hospitals across the country, waiting lists could be cut dramatically by appealing to those who have made medical appointments which they no longer require to cancel their appointment. This would also help to ensure that those most in need of medical attention get it sooner.

In the UK, NHS dentists request a £20 deposit from patients booking an appointment. This is later refunded or discounted from the bill. If the patient does not attend,and fails to cancel in time, the dentist keeps the £20. A similar scheme for our hospitals would either reduce waiting lists by hundreds of thousands or raise millions of euro to provide better services.

Could this be a simple way to improve our own health service for medics and patients alike?”

Source: The Irish Times online.

There are probably lots of reasons why so many public patients do not attend for hospital appointments but I would say prime amongst them, is a lack of respect for our inefficient health service. I’m all for making our present health service more efficient but only if it results in improved patient care. The sooner we get a system of universal health insurance in place, the better.

For anyone interested, world-famous cancer specialist, Professor John Crown will address a Public Meeting in Blanchardstown tomorrow evening. The meeting, hosted by Deputy Joan Burton of the Labour Party, will deal with issues relating to the future of Connolly Hospital, Blanchardstown and will facilitate questions by members of the public.

Where? St. Brigid’s Community Centre, Blanchardstown
When? Thursday 5th March 2009 at 8pm

Prof. Crown will address the meeting on the importance of introducing universal health insurance to put an end to our 2-tier health system.