Torrential rain this morning. Walked in with Helen, raincoats on, pretty grim. Wet feet when I arrived at the hospital, need to get some new shoes as my right toe has a hole in it! Board round, pretty quiet again. Attached myself to surgical ward round, very brief whizz through the surgical inpatients. Black Wednesday today, the first unsupervised day for the F1s! Those of us on the ward round had a teaching session by one of the really nice surgeons on how to administer a chemotherapeutic agent through a catheter to treat bladder cancers, the F1 was taking notes as they'll probably have to do that on their own next time. Must be pretty daunting, being dropped into a job and having to quickly learn the ropes.
After that I went off to theatre to check if the one patient on the list was going ahead; it was so I changed into some scrubs and went in. Scrubbed in for the first time in a while, always good to practice it and go through the motions again. I'm sure after a while it becomes second nature - doing the social wash to the elbows, getting the scrubbing brushes for the nails, few more washes, then pat drying each arm with a towel, putting gown on, asking a nurse politely to do up the back while you get the gloves on. This is always a fun part, takes practice! You have to open up the sterile glove pack using your hands whilst they're still inside the arms of you gown so you don't contaminate. Then pull on the right glove first, battling to get the thumb in, as the cuff of you gown is still at knuckle level at this point. Then left glove goes on, easier as can use your gloved right hand. Then you pull the gloves on tight by pulling the sleeves up your arm, dragging the cuff from knuckle level to mid hand level. After that the final stage is handing a piece of card to one of the people in theatre, doing a 360 twizzle and tying up the gown. Done! Hopefully you remembered to put a face mask on before you started, as once you're gowned up there's no touching anything that's not sterile! That includes itchy faces...
Patient got wheeled in from the anaesthetics room, theatre staff swung into action while the surgeon was scrubbing, preparing the sterile fields, cleaning, adjusting laparoscopy screens. The operation was done using cameras and instruments put into the abdomen via little incisions dotted around. I had the job of holding the camera and trying to follow the surgeons tools, as they were working inside the abdomen, which is inflated with gas so you can see stuff inside. Awesome! Love surgery. Before long the surgeon was finished and time to close up all the holes. The moment I'd been patiently waiting for came when the scrub nurse prepped one of the suturing needles and then asked "Are you suturing or Martin?". Surgeon looked at me, asked if I'd done any, said yes (which I have) and then basically left me to get on with closing up the holes on the patients left hand side! Small things, but such good fun and really great to be able to get involved. The surgeon closed the holes on the other side and just left me to get on with my side. Two small 10mm incisions, and one larger one from the main camera port, about 30mm which I closed with 3 stitches. Tied the sutures down by hand tying, as our gynae consultant last year was very keen on this and made sure we all knew how to do it! Need to have a practice with instrument tying to make that fresh again. So only 5 stitches in total but was brilliant, feels great to be left to your own devices, and be trusted with closing up someone's abdomen. Was nice as well afterwards, as when the scrub nurse was cleaning the sites she said it was very neat - probably just saying it but I'll take it anyway!
I really enjoy surgery, and although I've not got that much experience in theatre the stuff I have done/seen I've really enjoyed. Working with my hands and making definitive interventions is really satisfying - on the flip side though the training is meant to be killer. And you meet all the type A personalities, the surgeons who you probably wouldn't want looking after your mum. Lots to think about.
Back to ward, cannula commotion causing consternation - I'll say no more. Lunch break followed. Back to the doctors office and I tidied up the white boards, cleaning the white spaces and redrawing the separator lines - was accused of 'having problems' when doing this, as I was pretty meticulous, there wasn't much else going on... Shortly after this I left and came back to house to chill. 2 hours of violin practice, bit of TV, pasta dinner, long Skype to Alice. Super chilled evening. Going out cragging tomorrow, weather forecast looking good. Will get some photos!
Wednesday, 7 August 2013
Tuesday, 6 August 2013
Day nine - anaesthetics Tuesday
After yesterdays lie in I was back up at 0720 this morning, swift coffee/porridge (as I start every day) and walked in. The board round was brief, as not many patients were expected during the day and many of the occupants of CAU were expected to be discharged home at some point. It was the F1s final day here, so much cake was consumed and goodbyes said. I attached myself to the surgical ward round, and made myself useful by looking up some bloods for the new F1. After that I headed off to follow the anaesthetist through the days list.
The list was varied, and I had the chance to get hands on with some of the procedures. Slightly embarrasingly however one of the patients needed a particular anaesthetic block doing, where I had the job of pushing the plunger on the syringe whilst the anaesthetist was directing the needle in the sterile field. Unfortunately there was quite a lot of resistance to the injection, and consequently after trying to depress the plunger for a few seconds the plastic tubing on the end promptly shot off due to the pressure build up and I sprayed the contents over everyone... oh dear! Luckily the patient was asleep by this time. No harm done, except to my ego. Could have happened to anyone (...). Lesson learnt: when it's resistant to injection, hold the tubing on the end of the syringe!
The list ran all day, so I got some lunch some time in the early afternoon, and sampled some of the goodbye cakes, which were excellent! Back in theatre I had the opportunity to do more cannulas, bag/mask ventilating and LMA insertions. It was good just to get used to the various tips and tricks, such as drawing up antibiotics (you have to push air into the vial before you can draw up the fluid) and holding various syringe sizes, as I'd never used a 1ml syringe to inject local anaesthetic before. With these sorts of things it only takes being told once and you'll remember it pretty much forever, but it you're never told how to hold it at the start you'll never do it right! Also I never get bored of holding the ventilator bag and feeling the bag fill up and empty with each of the patients breaths - it's amazing.
The only slight disappointment during the day was the one intubation we had turned out to be quite tricky to ventilate, and so the anaesthetist just cracked on and placed the endotracheal tube. I've only done one in the past, so I'd really like to get some more under my belt but obviously only if everythings going OK patient wise. We finished at around 1700 and I walked back to the house with Helen, via tesco to pick up a microwave curry, massively cheating, but given the lack of kitchen facilities at our accomodation I feel it's justified!
Curry, sponge pudding, muffin and hot chocolate later and I was pretty much done for the day, knackered! My legs hadn't been too bad during the day, just felt tired from the previous two days out. I skyped Alice and rang my sister, as it was her birthday today! After a bit of TV and a nap I felt slightly refreshed, so got the violin out again and, under the watchful eye of Helen, ran through a few folk tunes. Every time I play it's getting better, but I still find the bowing pretty difficult, and sometimes get muddled between the bass clef/cello fingering and the treble clef/violin fingering. It'll come with time. Listened to the Bach Partita No 2, played by Hilary Hahn on youtube (https://www.youtube.com/watch?v=NcnbVykOEuY) - amazing, hopefully be able to play some of it one day!
The list was varied, and I had the chance to get hands on with some of the procedures. Slightly embarrasingly however one of the patients needed a particular anaesthetic block doing, where I had the job of pushing the plunger on the syringe whilst the anaesthetist was directing the needle in the sterile field. Unfortunately there was quite a lot of resistance to the injection, and consequently after trying to depress the plunger for a few seconds the plastic tubing on the end promptly shot off due to the pressure build up and I sprayed the contents over everyone... oh dear! Luckily the patient was asleep by this time. No harm done, except to my ego. Could have happened to anyone (...). Lesson learnt: when it's resistant to injection, hold the tubing on the end of the syringe!
The list ran all day, so I got some lunch some time in the early afternoon, and sampled some of the goodbye cakes, which were excellent! Back in theatre I had the opportunity to do more cannulas, bag/mask ventilating and LMA insertions. It was good just to get used to the various tips and tricks, such as drawing up antibiotics (you have to push air into the vial before you can draw up the fluid) and holding various syringe sizes, as I'd never used a 1ml syringe to inject local anaesthetic before. With these sorts of things it only takes being told once and you'll remember it pretty much forever, but it you're never told how to hold it at the start you'll never do it right! Also I never get bored of holding the ventilator bag and feeling the bag fill up and empty with each of the patients breaths - it's amazing.
The only slight disappointment during the day was the one intubation we had turned out to be quite tricky to ventilate, and so the anaesthetist just cracked on and placed the endotracheal tube. I've only done one in the past, so I'd really like to get some more under my belt but obviously only if everythings going OK patient wise. We finished at around 1700 and I walked back to the house with Helen, via tesco to pick up a microwave curry, massively cheating, but given the lack of kitchen facilities at our accomodation I feel it's justified!
Curry, sponge pudding, muffin and hot chocolate later and I was pretty much done for the day, knackered! My legs hadn't been too bad during the day, just felt tired from the previous two days out. I skyped Alice and rang my sister, as it was her birthday today! After a bit of TV and a nap I felt slightly refreshed, so got the violin out again and, under the watchful eye of Helen, ran through a few folk tunes. Every time I play it's getting better, but I still find the bowing pretty difficult, and sometimes get muddled between the bass clef/cello fingering and the treble clef/violin fingering. It'll come with time. Listened to the Bach Partita No 2, played by Hilary Hahn on youtube (https://www.youtube.com/watch?v=NcnbVykOEuY) - amazing, hopefully be able to play some of it one day!
Monday, 5 August 2013
Day eight - Monday
After my run the day before I decided to start the day with a continuation of sleep aka a lie in! Slept in till 0830, a lie in compared to the usual wake up time of 0700. Porridge (not bored of it yet) and coffee then headed into town to try and sort my tax disc. Went to the post office armed with my MOT certificate and insurance details, only to be asked "Where is your V5C?" - Kendal was the answer. "Ah well, you'll have to fill in this extra form and pay £25 extra as you don't have it". Right. I started filling it in, then remembered I'd scanned the V5C and it was on my dropbox. I went back up and asked would they accept it on my phone. 5 minutes later, after an unconnected phone call followed by a successful call to head office and the answer was no, it had to be the paper version. So I was facing either paying £25 extra or getting parents to send it up, recorded delivery, hassle etc. So I rang my folks, decided to just pay the extra. So went back in (third time) and got ready to pay it all. Then the lady behind the desk discovered that they hadn't actually received the tax discs that I needed (Sep 2014) yet, as apparently they were in the post (bum bum chhh) and were due to arrive that afternoon. "Would you be able to pop back in later?"... So frustrating.
So headed to the hospital in a bit of a foul mood. Arrived at 10am to be met with a blank admissions board. It's worth noting at this point that the weather was getting better all the time, with blue skies and white fluffy clouds. Motivation was waning. After moaning about the post office I wandered off to A&E to see some patients. No one waiting in A&E. What is going on? Back to the doctors office on the ward, still not much going on so I headed up to the computers in the Training Centre and looked up tax stuff online. Turns out that I was able to do it all through the DVLA website, with no extra charge and without needing any forms. And the post office is going out of business? Wonder why? It's outrageous that a) they didn't accept my copy of the form b) they were trying to charge me £25 for something that is clearly not needed as shown by DVLA website and c) that even when I decided to pay that they still couldn't provide the service. Rant over.
Back to the doctors office, thinking that if nothing was happening I'd head off. Nothing was happening. But then just to confirm matters one of our lead clinicians came in and told us that as everything had been cancelled we might as well all head off. As if I needed encouragment! On the way out the door at 1300 I caught Tom's eye and asked him if he fancied Aonach Eagach, the famous ridge line scramble on the north side of Glen Coe...
An hour later, at around 1400, Tom and I set off from the Study carpark in Glen Coe, bound for the approach scramble up A' Chailleach. Weather was overcast but dry. The scramble was good at first, rocky outcrops providing brief bits of technical terrain, but we quickly lost the main line and ended up walking up steep grassy ground before popping out just to the east of the summit. I think we unintentionally avoided the main bits of interest on the scramble, but we weren't too fussed as the best was to come, Aonach Eagach!
We quickly reached Am Bodach, at 943m. This was the start of the ridge proper, with a quite technical initial descent before continuing more easily over the ridge towards Meall Dearg. It wasn't too bad, not too exposed and the weather was perfect, overcast so not too hot and not a breath of wind. The three sisters on the south of glencoe were in cloud, but the entire ridge on our side was out. After a steep climb we gained the summit of Meall Dearg and the main part of the ridge was revealed, connecting us to Stob Coire Leith. Superb. Once we started on this section there was no escape route - you either have to continue to the other end or reverse and come back. We committed, and were immediately greeted with much more exposed scrambling that what we had passed previously. The holds were all massive, but the positions were wild! Taking the crest of the ridge as much as possible we were rewarded with fantastic vistas of the surrounding mountains, and also birds eye views of the seldom, if ever, frequented gullies running down the south side of the ridge. It was truly breathtaking!
All too soon we had reached the high point of the ridge, Sgorr nam Fiannaidh at 967m. This signalled the end, and after a few photos looking back at our route we traversed to the top of Clachaig gully before plunging steeply down it's west bank. This was incredibly steep, and in places very loose. As a result it felt like slow going as we were trying to preserve some function in our knees, but even so we lost height incredibly quickly. Handily too the end of the descent spat us out directly opposite the acclaimed Clachaig Inn, the logical venue for our subsequent victory drink! What an awesome route, 5hrs from leaving the car.
Refreshed, although slightly sore, we meandered back to the main road running through Glen Coe, and hitched a life back up to our car with a kind Italian couple who were en route back to Leeds after spending the last few days on Skye. Driving back through the valley I spent most of the time staring out of the window up at Ossian's Cave and the surrounding crags, dreaming of rock routes up their flanks. One day!
Tom dropped me back at the house and after a shower I demolished two baked potatoes with tuna/mayo/sweetcorn. Washed down with sponge pudding and an orange. Amazing last few days; when the weather is good there is nowhere better to be. Here's to the bright spell continuing!
So headed to the hospital in a bit of a foul mood. Arrived at 10am to be met with a blank admissions board. It's worth noting at this point that the weather was getting better all the time, with blue skies and white fluffy clouds. Motivation was waning. After moaning about the post office I wandered off to A&E to see some patients. No one waiting in A&E. What is going on? Back to the doctors office on the ward, still not much going on so I headed up to the computers in the Training Centre and looked up tax stuff online. Turns out that I was able to do it all through the DVLA website, with no extra charge and without needing any forms. And the post office is going out of business? Wonder why? It's outrageous that a) they didn't accept my copy of the form b) they were trying to charge me £25 for something that is clearly not needed as shown by DVLA website and c) that even when I decided to pay that they still couldn't provide the service. Rant over.
Back to the doctors office, thinking that if nothing was happening I'd head off. Nothing was happening. But then just to confirm matters one of our lead clinicians came in and told us that as everything had been cancelled we might as well all head off. As if I needed encouragment! On the way out the door at 1300 I caught Tom's eye and asked him if he fancied Aonach Eagach, the famous ridge line scramble on the north side of Glen Coe...
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| Scramble up A' Chailleach |
An hour later, at around 1400, Tom and I set off from the Study carpark in Glen Coe, bound for the approach scramble up A' Chailleach. Weather was overcast but dry. The scramble was good at first, rocky outcrops providing brief bits of technical terrain, but we quickly lost the main line and ended up walking up steep grassy ground before popping out just to the east of the summit. I think we unintentionally avoided the main bits of interest on the scramble, but we weren't too fussed as the best was to come, Aonach Eagach!
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| Steep scrambling on the ridge! |
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| Looking back over the ground we'd covered - very improbable! |
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| Cheesy summit photo! |
Refreshed, although slightly sore, we meandered back to the main road running through Glen Coe, and hitched a life back up to our car with a kind Italian couple who were en route back to Leeds after spending the last few days on Skye. Driving back through the valley I spent most of the time staring out of the window up at Ossian's Cave and the surrounding crags, dreaming of rock routes up their flanks. One day!
Tom dropped me back at the house and after a shower I demolished two baked potatoes with tuna/mayo/sweetcorn. Washed down with sponge pudding and an orange. Amazing last few days; when the weather is good there is nowhere better to be. Here's to the bright spell continuing!
Day seven - Sunday
Been here a week! Absolutely flown by. Lazy morning, did over an hours violin practice, getting better slowly. Raining initially and still pretty windy. Skype then headed to Morrisons to do some shopping, stocked up for the week. Nipped into Cotswold's too to pick up 2 maps, one of Knoydart and the other a 1:25000 of Glen Coe for the run in the afternoon.
Packed up and house and drove down to South Ballachulish, about 20mins, would have been quicker but stuck behind coach and caravan = 35mph on a 60mph road. Got there eventually anyway! Still pretty cloudy when I set off up Sgorr Dhearg (1024m), leaving the car at 1445. Initially following track in forest, but wanted to go up the ridge on the east, so as soon as popped out of the forest I headed straight up to the ridge, about 300m of really steep scrambling on grass/scree to gain the ridge. South along that to the summit of Sgorr Dhearg, got there 1h15m after setting off, occasional moments of clearing but still in cloud.
Then nipped east to tick off Sgorr Bhan too, before retracing my steps and continuing over to Sgorr Dhonuill (1001m), which I got to 2h7m. Felt good up till there, was in my running kit so had run the level/downhills and fast walked the ups. On top met the only people I saw all day, a couple from Pittsburgh, Pennsylvania. Brief chat to them before continuing on the western side of the horseshoe, which turned out to be really hardwork! No path, and really undulating terrain, energy sapping short descents and climbs, only around 20m ish but my legs were shot! Started to get hungry too, thinking of the sandwidges I'd stashed in the car...
Took just under an hour to get to the last highpoint, the 758m spotheight. From here there were incredible views up Kinlochleven and into Glen Coe, as the cloud had lifted and was now in sunshine. Also a proper birds eye view down onto South Ballachulish! Took lots of photos then commenced the arduous descent down the northern edge of the ridge, incredibly steep in places = tough going. At one point heard a 'mewing' above me, looked up to see a buzzard circling in a thermal about 20m above me. I sat down on the grassy bank and just watched, as the bird circled 4-5 times overhead before disappearing behind the forest canopy. Incredible moment, the beauty of Scotland is staggering.
Got to a fence, followed it west for long enough to start wondering if I'd got the right fence on the map before, just in time, a hut materialised signalling the start of a forest track. From here I ran the whole way to the car, going out with a bang! Kept expecting a farmer in a landrover to start shooting at me with a shotgun for being on their land, as I'd had to jump a padlocked gate to get onto the track. But there was no other way down, it was thick forest, the kind where you really wouldn't want to have the spend the night anywhere near - a bit creepy!
Back to the car and checked the watch, 4h exactly! Bit more than I'd anticipated, my legs were wasted! Drove back in blazing sun, soundtrack of Band of Horses - Everything All The Time seemed very appropriate. There a some moments where you know there's no where else you'd rather be, and driving over the Ballachulish bridge, blazing sun low in the sky to the west, Glen Coe and Kinlochleven to the east, legs aching with Funeral blasting out the stereo - good times!
Back to the house, collapsed out of the drivers seat and crawled into the shower, after which I felt much rejuvenated. There commenced active rehydration and food - pasta/sauce and sandwidges. Met everyone at the Crofters for a pint at 9ish, was good to compare stories from the day. Brett had done a cool walk up Glen Nevis to a waterfall, and Tom had smashed out Curved Ridge on Buchaille Etive Mor. Definitely a route I want to do before I leave. I was filled in on the rest of last night too!
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| On the ridge! Pap of Glencoe behind |
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| Cloudy on the summit... |
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| Two seconds later all is revealed! Spectacular |
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| The route ahead, looking towards Sgurr Dhonuill |
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| Cool ridge in the middle of the horseshoe - potential scramble |
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| The rest of the ridge, my route home, spectacular but hard work! Steep descent at the right hand edge... |
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| Happy but tired! |
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| Incredible weather around 5/6pm; great views up Kinlochleven, Glen Coe on ridge, Ben Nevis is cloud on left |
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| Birds eye view onto South Ballachulish and the start of the brutal descent! |
Got to a fence, followed it west for long enough to start wondering if I'd got the right fence on the map before, just in time, a hut materialised signalling the start of a forest track. From here I ran the whole way to the car, going out with a bang! Kept expecting a farmer in a landrover to start shooting at me with a shotgun for being on their land, as I'd had to jump a padlocked gate to get onto the track. But there was no other way down, it was thick forest, the kind where you really wouldn't want to have the spend the night anywhere near - a bit creepy!
Back to the car and checked the watch, 4h exactly! Bit more than I'd anticipated, my legs were wasted! Drove back in blazing sun, soundtrack of Band of Horses - Everything All The Time seemed very appropriate. There a some moments where you know there's no where else you'd rather be, and driving over the Ballachulish bridge, blazing sun low in the sky to the west, Glen Coe and Kinlochleven to the east, legs aching with Funeral blasting out the stereo - good times!
Back to the house, collapsed out of the drivers seat and crawled into the shower, after which I felt much rejuvenated. There commenced active rehydration and food - pasta/sauce and sandwidges. Met everyone at the Crofters for a pint at 9ish, was good to compare stories from the day. Brett had done a cool walk up Glen Nevis to a waterfall, and Tom had smashed out Curved Ridge on Buchaille Etive Mor. Definitely a route I want to do before I leave. I was filled in on the rest of last night too!
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| Sunset over Loch Linnhe - Fort William on top form |
Sunday, 4 August 2013
Day six - Saturday!
So the first weekend as arrived. After a week of getting up ~0730 I had a lie in this morning, comfortable in the knowledge that once I threw open my curtains it would be raining outside... Scrambled egg (microwaved) and coffee constituted breakfast and I spent a good hour or two perusing my maps/books/the internet looking up potential walks. www.walkhighlands.co.uk is a superb website, giving ideas for routes and mountains, all complete with maps and height profiles - it's awesome! Thinking of doing a two-day trip to Knoydart in a spell of good weather to tick off Sgurr na Ciche and Ladhar Bheinn, two classic munro's. Also looked at my Cuillin map, piecing together a hazy plan to do the ridge on the way up to Lewis. We'll see...
Helen had gone up to Inverness for the day, so I cracked out the violin safe in the knowledge that I wouldn't embarrass myself infront of a bona fide Orkney folk musician! Got on pretty well with it actually, feeling like it's getting a bit easier to read the notes and process them to fingers, and getting a better tone out of the bowing. Disastrous lunch of microwaves pizza followed (I'm not buying pizza again, impossible to cook here even if the microwave claims it's also an oven!) and then I headed into the town to The Crofters to meet Tom, Neil and Brett. Neil's one of the new F1s, and found out he's born in 1990 - found it a bit strange to think he's younger than me but an F1, as up till now I hadn't met anyone younger. Pretty glad I'm not an F1 right now! Had a few drinks then stayed to watch the Celtic game so got food too. I had a lovely steak and ale pie and the game was pretty good, Celtic initially going 0-1 down to a brilliant goal. Was pretty funny watching the reaction in the pub, as the vast majority were supporting Celtic! I was quizzing the others about the extents of the football religions, was interesting to hear. Apparently at Glasgow you're not allowed to wear either a Celtic or Rangers shirt in the gym - crazy! And one Celtic supported in the pub had "I was there when Rangers died, hail hail" on the back of his shirt, I guess a reference to: http://en.wikipedia.org/wiki/Hail_Hail_the_Celts_Are_Here. Also discussing the situation of the Scottish Premier League, in particular the 'split' of the table near the end of the season so that the big clubs play each other more times, but meaning if you were top of the bottom half and won all your games you wouldn't move higher in the table!! Oh Scottish football.
After that headed back briefly before we all made our way up to the hospital later in the evening to catch up with Eleanor and Pippa, the Edinburgh students staying in accomodation there. Forgot that all the shops here shut at 2100... Once we'd arrived we saw all the F1's were packing up their stuff ready to move out! A hall's style drinking followed; cheesy music on laptop, everyone sat on sofa's in accomodation with fire exit stickers everywhere - felt like going back in time! A select few then headed off to sample 'Ossian's' - what looked like a spectacularly bad disco, which in the day is the dining room of a hotel but undergoes a 'transformation' at night. It looked terrible. Needless to say I headed back home!
Helen had gone up to Inverness for the day, so I cracked out the violin safe in the knowledge that I wouldn't embarrass myself infront of a bona fide Orkney folk musician! Got on pretty well with it actually, feeling like it's getting a bit easier to read the notes and process them to fingers, and getting a better tone out of the bowing. Disastrous lunch of microwaves pizza followed (I'm not buying pizza again, impossible to cook here even if the microwave claims it's also an oven!) and then I headed into the town to The Crofters to meet Tom, Neil and Brett. Neil's one of the new F1s, and found out he's born in 1990 - found it a bit strange to think he's younger than me but an F1, as up till now I hadn't met anyone younger. Pretty glad I'm not an F1 right now! Had a few drinks then stayed to watch the Celtic game so got food too. I had a lovely steak and ale pie and the game was pretty good, Celtic initially going 0-1 down to a brilliant goal. Was pretty funny watching the reaction in the pub, as the vast majority were supporting Celtic! I was quizzing the others about the extents of the football religions, was interesting to hear. Apparently at Glasgow you're not allowed to wear either a Celtic or Rangers shirt in the gym - crazy! And one Celtic supported in the pub had "I was there when Rangers died, hail hail" on the back of his shirt, I guess a reference to: http://en.wikipedia.org/wiki/Hail_Hail_the_Celts_Are_Here. Also discussing the situation of the Scottish Premier League, in particular the 'split' of the table near the end of the season so that the big clubs play each other more times, but meaning if you were top of the bottom half and won all your games you wouldn't move higher in the table!! Oh Scottish football.
After that headed back briefly before we all made our way up to the hospital later in the evening to catch up with Eleanor and Pippa, the Edinburgh students staying in accomodation there. Forgot that all the shops here shut at 2100... Once we'd arrived we saw all the F1's were packing up their stuff ready to move out! A hall's style drinking followed; cheesy music on laptop, everyone sat on sofa's in accomodation with fire exit stickers everywhere - felt like going back in time! A select few then headed off to sample 'Ossian's' - what looked like a spectacularly bad disco, which in the day is the dining room of a hotel but undergoes a 'transformation' at night. It looked terrible. Needless to say I headed back home!
Friday, 2 August 2013
Day five
Bit of a slower day today. Started with a board round again, in which I had the opportunity to present the patient I saw yesterday. Went pretty well and didn't get questioned, so I'd call that a success! Quite nerve wracking trying to remember all the clinical details on the spot infront of the entire medical staff of the hospital (albeit not a huge number of people!). Then followed the ward rounds - I joined the medical one today and it was pretty good, saw a few patients and heard some good chest signs. Always nice when the whole group of 7 or 8 people wander to the foot of a patient's bed yet they smile and nod their head specifically at you, as happened when we saw the patient I presented earlier in the morning! Must feel like that with every patient when you're the F1.
Back to the doctors office and the jobs list informed me that my favourite patient needed a blood test. I promptly went and gathered the necessary equipment from the store before collecting the sample. I'm finally getting used to the equipment here - instead of vacutainers they use syringes that are actually themselves the blood bottles. Once they have been filled by pulling out the plunger you can just snap it off and they've turned into blood bottles! Quite neat really but needed a bit of getting used to. Once they were labelled up I took them up to the lab.
Then I saw another patient with some neurological signs - time to crack out the collateral histories, minimental state examination, full cranial nerve and upper/lower motor/sensory exams... Required a quick bit of swotting up from my phone before hand! Good revision though, as these are all things we learnt and were tested on in 3rd year OSCEs, so I know it but it's not very fresh. It's sometimes quite hard to self motivate to do things like this, as the doctors will say "Do you want to see this patient? They need a full neurological exam" and part of you wants to do it as it's a good learning opportunity but the other just can't be bothered as it's effort and you'll probably forget things as it's ages since you've done those examinations and wouldn't it be better to revise it first and then do it properly... Normally the former thought wins though, and it generally goes better than you'd anticipate and you learn way more than just glancing over it later.
Up to the teaching centre for an audit presentation on difficult airway equipment trolleys. There are 2 of these trolleys here, however there's only one fibreoptic scope due to budget restraints. After just 5 days here it's been really noticeable how many times budgets and finances have come into clinical discussions - the pressures of working in the NHS, a massive organisation fighting unlimited demand with limited supply, amplified in an isolated rural location. Lunch and back to the wards. Popped to CT scanner briefly to see a head scan and chat to the radiologists before an impromptu teaching session in the doctors office on the rather esoteric subject of scombroid fish poisoning!
That concluded the week and I headed home in sunshine and blue skies - brilliant I thought, might be able to get out climbing after all. Quick pop into Cotswolds to grab a new drinks bottle and some postcards and back home. No sooner had I arrived back though a torrential monsoon rain shower put paid to those dreams of craggin. After a quick couscous snack I headed over to Calluna, a bunkhouse about five minutes walk from the house where there's a small bouldering wall run by Alan Kimber. I signed the forms and paid for a month's pass (£20) before having a 1h30m session in the wall. It was pretty small and cramped, but surprisingly good once I got into it. Good music on the radio and the place to myself! The training board is a pretty nice angle, maybe 30 degrees? Possibly less. There's a good mixture of holds on it too. After an hour of that I moved onto the campus board, just to do some fingerboarding hangs. Brutal! Really enjoyed the session though, and quite like training on my own anyway so think I might be down there quite a few times more before the placement finishes! And that's my wet evening plans sorted! Dinner consisted of baked potatoes, one with tuna/mayo/sweetcorn, the other with beans/cheese = lovely and hopefully quite nutritious/healthy! Skyped folks, watched a bit of TV and chilled out. Lie in tomorrow, especially as forecast for whole weekend is 'heavy rain'!
Back to the doctors office and the jobs list informed me that my favourite patient needed a blood test. I promptly went and gathered the necessary equipment from the store before collecting the sample. I'm finally getting used to the equipment here - instead of vacutainers they use syringes that are actually themselves the blood bottles. Once they have been filled by pulling out the plunger you can just snap it off and they've turned into blood bottles! Quite neat really but needed a bit of getting used to. Once they were labelled up I took them up to the lab.
Then I saw another patient with some neurological signs - time to crack out the collateral histories, minimental state examination, full cranial nerve and upper/lower motor/sensory exams... Required a quick bit of swotting up from my phone before hand! Good revision though, as these are all things we learnt and were tested on in 3rd year OSCEs, so I know it but it's not very fresh. It's sometimes quite hard to self motivate to do things like this, as the doctors will say "Do you want to see this patient? They need a full neurological exam" and part of you wants to do it as it's a good learning opportunity but the other just can't be bothered as it's effort and you'll probably forget things as it's ages since you've done those examinations and wouldn't it be better to revise it first and then do it properly... Normally the former thought wins though, and it generally goes better than you'd anticipate and you learn way more than just glancing over it later.
Up to the teaching centre for an audit presentation on difficult airway equipment trolleys. There are 2 of these trolleys here, however there's only one fibreoptic scope due to budget restraints. After just 5 days here it's been really noticeable how many times budgets and finances have come into clinical discussions - the pressures of working in the NHS, a massive organisation fighting unlimited demand with limited supply, amplified in an isolated rural location. Lunch and back to the wards. Popped to CT scanner briefly to see a head scan and chat to the radiologists before an impromptu teaching session in the doctors office on the rather esoteric subject of scombroid fish poisoning!
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| The new camelbak bottle, great for car as no spillage! |
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Thursday, 1 August 2013
Day four
Today was a good day! Started off by following an anaesthetist into theatre for the only general anaesthetic on the list. After yesterdays failed attempt it was good to get an actual GA! After a quick grilling in the anaesthetic room from the really nice consultant we met our patient, and I was able to cannulate, manage the airway and insert the laryngeal mask airway - all stuff I've done before on anaesthetic placements but still good fun and good experience to build up. The operation itself was uneventful and the patient was shortly transferred back to recovery. After that I hung around theatre and watched a further operation that I hadn't seen before, mainly out of surgical interest as opposed to the anaesthetic, as this was done only under local anaesthetic injected by the surgeon.
After this it was time for a wee spot of lunch, before checking out the wards and seeing what was going on. It seemed fairly quiet until about 2pm, when a patient came in a bit short of breath. I saw them with the F2, cannulated again and then also did an arterial blood gas (ABG) sample which I was well happy with! I've done a few of these before - basically involves piercing the radial artery in the wrist (where people check for a pulse) with a needle and getting a sample. It's normally quite uncomfortable (/painful!) and although I've done it successfully in the past the last few times I've tried I've missed it. So it was good to get the confidence back up by hitting it straight away! The F2 was awesome, creating a really relaxed environment where I could take my time, relax and concentrate on selecting the right place to try to pierce the artery. Great :)
It slowed down a bit again after that, and after running the bloods up to the lab and writing in the notes it was almost time to head off. On Thursdays there are some 'informal evening tutorials' that take place in the local watering hole (Cobb's), a great opportunity to get to know the doctors who we've only just started working with! The menu included their '3 Peaks Burgers', although I resent the fact that Scafell is the cheapest and least appetising offer... Also discovered that the nearest cinema is in Inverness, over an hour and a halfs drive away, so there goes my wet weather evening plan! I was feeling pretty tired, my muscles aching from my walk yesterday, so I headed back to the house to relax. Pizza dinner in the microwave oven; not the healthiest but quick and easy.
Unfortunately the weather has taken a turn for the worse again, with the next few days looking pretty grim. Sunday might be dry at least, although the rock will probably still be wet. Maybe another scrambling day, we'll see. As for tomorrow in the hospital, routine surgery only happens on Tues/Wed/Thurs, so it will be back to the ward or A&E. Emergency surgery can still happen (if needed), although obviously no predicting when that will be. I'll try and do a night shift or two while I'm here, over the wet days I think! Also some of the weekends could be good to go down as there'll be fewer students but also hopefully more to do and may be more of an actually help to the doctors covering the hospital single handed!
After this it was time for a wee spot of lunch, before checking out the wards and seeing what was going on. It seemed fairly quiet until about 2pm, when a patient came in a bit short of breath. I saw them with the F2, cannulated again and then also did an arterial blood gas (ABG) sample which I was well happy with! I've done a few of these before - basically involves piercing the radial artery in the wrist (where people check for a pulse) with a needle and getting a sample. It's normally quite uncomfortable (/painful!) and although I've done it successfully in the past the last few times I've tried I've missed it. So it was good to get the confidence back up by hitting it straight away! The F2 was awesome, creating a really relaxed environment where I could take my time, relax and concentrate on selecting the right place to try to pierce the artery. Great :)
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| Just cos Ben Nevis is local... |
Unfortunately the weather has taken a turn for the worse again, with the next few days looking pretty grim. Sunday might be dry at least, although the rock will probably still be wet. Maybe another scrambling day, we'll see. As for tomorrow in the hospital, routine surgery only happens on Tues/Wed/Thurs, so it will be back to the ward or A&E. Emergency surgery can still happen (if needed), although obviously no predicting when that will be. I'll try and do a night shift or two while I'm here, over the wet days I think! Also some of the weekends could be good to go down as there'll be fewer students but also hopefully more to do and may be more of an actually help to the doctors covering the hospital single handed!
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