CCE Specialities Week 7

Monday

Admin and work day today. I wanted to try and get as much of the presentation list done so I didn’t have as much pressure the rest of the week. Turns out, I didn’t get as much done as I would have liked to but the effort was there!

I also got a bit frustrated in the afternoon as I had tried to book a doctors appointment but with my timetable and the doctors. I literally didn’t have any spare time. I got annoyed. We are constantly told to take care of ourselves, but then also not to miss any teaching time. It feels like I am caught between a rock and a hard place.

Tuesday

Labour shift number 2! Rolled out of bed at 5am, somehow made it to the bus stop and before I knew it, I was back in crocs and blue PJ’s. We were assigned midwives to follow around for the day. My midwife was assigned to a lady who was waiting to go home with her newborn so I wasn’t in line to seeing a baby born. It was OK, this one was cute.

I also got caught by the matrons this day. I wear my hair in two plaits as with it being so thick, ponytails kill by the end of the day. Turns out this isn’t good enough and I had to do some inventive pinning techniques to pin the plaits off my neck. In the afternoon, I noticed one of the rooms was progressing in her labour so I asked the midwife if I could join her. I was with the mum and dad who were both so chilled out and she was even doing her make up whilst the contractions were happening! The wonders of epidurals are incredible.

I also got to experience the delights of labour ward toast, a legend passed down the med school.

It was 6pm by the time it came to push. The midwife included me in preparing for the birth and even got me my own surgical gloves out. I felt so included and important to the team. Soon the baby was making an appearance. I was helping and the midwife grabbed my hands and before I knew it I was supporting the babies head and helped the final few movements before passing baby to mum. I couldn’t believe it, I had just helped deliver a baby !

She was so cute and I even had to hold back a tear or two. I was so amazing to be that included and trusted enough. I also was doing odd jobs for the nurses that day such as doing obs because they were caught with another patients, doing bloods because they were snowed under and generally fetching things from around the ward. I had tried to get the bloods done as my mini-cex but despite normally being OK at taking bloods, I just could not find the vein and the doctor ended up having to step into help. Dam it. I’m going to have to get used to doing things under supervision.

Even though I came out of UH at 9pm (having started at 7pm) and ended up having to us hop home because I missed the last direct bus. I was beaming from each side of my face. I needed this day to remind me why I was putting myself through long days. Im going to finish this course even if it kills me 😀

Wednesday

GP day again. Had to drag myself out of bed with aching legs. I have hyper-extendable knees and I was feeling the stress I had put them through yesterday today. We had the morning off to work on our mini health needs assessment. We had made zero progress by the end of two hours ! We aren’t quite sure what we are meant to be doing and were struggling to pick a topic. In the end we decided to go with alcohol and leave it till next week to sort our project out. aaah procastination, I have missed you dearly.

In the GP session we decided to smash through our assessments. Each block we have to do a mini-cex (history taking, examination, taking bloods etc), Case Based Discussion (talking about a patient and their case) and a Warwick special OSLER (chatting about history, examination, working diagnosis and management plans) in GP and in Hospital leading to six sign off’s overall. We got through our mini-cex and CBD with two patients each. It felt slightly weird as we sat in the comfy seats in the office and I felt as if I was on a TV shown interviewing everyone. However, I got some good feedback, particularly with my patient relationships. Apparently I put people at ease, shame it doesn’t work on myself!

I also managed to handle an entire case by myself as a gent had come in with a chest infection and I did history, exam and treatment (even remembering correct meds as he was allergic to penicillin!). I felt so proud. Maybe, I am making progress!

In the evening I slumped back on my sofa at 6 and when I opened my eyes again it was 8pm, I don’t know how but I had managed 2 hours of sleep on the worlds most uncomfortable sofa. Luckily , I had a quiet day the next day so I could catch up on sleep then.

Thursday

Mostly a day off but I had a T-DOC (a type of mini assessment of our clinical skills). It was oxygen therapy, nebulizers and inhalers. Unfortunately, I had not managed to revise it at all as we couldn’t find the TDOC’s on our web pages. Turns out they were located under medicine block so I spent 15 minutes trying to cram as much info into my head as possible.

My oxygen therapy knowledge is awful but I am happy about the nebulizers and inhalers. Considering the session was two weeks ago and I had only been able to revise 15 minutes before. I was happy with how it went!

Friday

I think the tiredness from Tuesday is still hanging around and woke up dizzy and feeling sick. IT was annoying as I had a community midwife shift but despite waking up at 6am to get there for 8:30, I couldn’t stand up without feeling dizzy. I spent the day just trying to fix myself and catching up on work. I had my family coming up the next day so I was looking forward to them coming with my dog. I needed some bailey therapy.

Saturday

Here he is! My scruff mutt ! And my family of course.

We ended up wandering to Warwick and my mum and grandad were happy to see 1/8th of Warwick castle. At least they are easy to please! We went for food at my grandad’s favourite pub here and bailey took his seat at the top of the table. Where he belongs:

I feel sorry for my dog, he only ever seems to live in Pubs ! They ended up going home after and I was left to my own devices. I decided to give myself the rest of the day off and caught up on Ru Pauls drag race as the new series starts next week!

Sunday

I don’t normally write about Sunday but I got so much done! I hauled myself to the PG hub and finished the presentation list tasks for that week, emailed one of the new incoming newbies back and more importantly COMPLETED MY PLAN FOR SSC2.

I am so excited and it’s in an area I feel I am an expert in, social media. I emailed by supervisor as I have to submit the proposal next week so hopefully she gets back to me. I love it when I have days like this. I feel great when I get to the end of the week and it’s all completed !

A very messy desk for a very productive day

CCE Specialities Week 6

Monday

Morning off today. Not that I did a huge amount with it. We had ABG training in the afternoon which I was looking forward to as we know the ins and outs of ABG’s including how to translate the results (in theory, in practise I’m still second guessing everything) so I was keen to get to grips with the practical side.

A helpful tip for the year below – DON’T WEAR WHITE OR LIGHT CLOTHING . The blood went everywhere. Jacob had the pleasure of fake blood down his light pink chinos whilst my kind clinical partner managed to get blood on his housemate who was stood the opposite side of the table from him. I’ve now seen a dark side to klaudio.

Who would have thought this innocent arm could cause this much chaos?

I headed back home after that night and tried to get an early night. I knew I had to be up at 5 the next day as I had my very first labour shift.

Tuesday

Here it was! My first day on labour ward. I was thankful it had arrived as it mean’t I was in scrubs all day which is like wearing PJ’s to work. I turned up at 7am, got changed and waited. Labour Ward means a lot fo waiting around. I was in Lucina that morning but the ward was eventually closed as there were no patients. The Lucina ward is a ward where low risk births happen. The rooms are beautiful with huge bathtubs, and ceilings with lights in them to simulate the nights sky. All I could keep thinking was how nice it would be to have a bubble bath in there.

I went onto Labour ward with the midwife I was shadowing in the Lucina ward. We ended up in a room with a mum in labour. There was also a student midwife in there. Labour ward is one of the wards where medical students aren’t really the priority in teaching terms. The student midwifes need to supervise births and catch babies for their degree requirements. We are the tourists of the labour ward. However, the lovely student in there took me through the CTG (the machine that produces the funny lines during labour) and how to interpret it. It took me a while but in the end I began to see the lines for the scribbles and slowly understood what was going on. The CTG shows the mothers contractions and the babys heart rate. You’re mainly looking at the heart rate of the baby when you’re monitoring the CTG looking at the rate, accelerations, decelerations and how they correlate with the contractions.

Eventually, mum gave birth to a beautiful baby boy and I was ecstatic, I had just seen my first birth. I stayed to see the newborn checks, see the measurements of the new baby and resist every inch of my fibres to pick him up and give him a cuddle.

I spent the rest of the afternoon doing odd jobs with the midwife. Taking blood, doings obs and even putting the CTG machine on ! I felt a complete part of the team which was great because it made the time fly by and I was enjoying my time of the ward. I left round about 5ish and headed home with a spring in my step. I was pretty exhausted as I had done 10 hours on my feet but felt pretty pleased with how the day had gone.

Wednesday

GP day! I love these days as we get to be as Independent as we can be at this stage and I found I just love talking to patients. I had a good mix of patients that day. Some pain presentations but we later found out they were a heavy drinker (time to deploy the intervention skills I had learnt via an e-module) and I wanted to check how they were doing so I advised them how to slowly decrease the alcohol levels and gave them a two week follow up. I also had a lovely human come with with suspected carpal tunnel. I did the two checks that are drilled into you in first year aaaannnddddd nothing. I asked them to describe the pain and it turned out it was more to do with the radial nerve rather than the median nerve which is normally affected in carpal tunnel. They had been referred to us as the consultants at the hospital as they thought they had carpal tunnel. Med Student 1, Consultants 0.

We also got to stay for the contraceptive clinic in the afternoon. It was interesting and I got to see a implant being put in and taken out. My eyes watered at how much the skin was stretched with the device but thankfully, the lady had been given local anaesthetic so apparently didn’t feel anything! I also got to see (a different one) being taken out as the woman was hoping to get pregnant. So, a nice happy end to the day!

Thursday

Sneaky day off today as the clinic we could go to only allowed one student in and the workshop in the afternoon was part 3/3 and I hadn’t been to the first two due to illness. I decided to catch up on work and go climbing as I hadn’t been since the week before and Im working to build my callouses up so I can climb for longer in less pain #priorities.

Friday

Academic day! I like these as I actually get to see everyone in my year and my friends who I actually begin to miss during the two weeks away. However, I spent more time running around campus than actually seeing others. In the hour we had for lunch I had to go and visit the doctors, return an Amazon package, meet my clinical personal tutor and have a meeting regarding my absences at the beginning of term. Safe to say lectures after were a working lunch. IT was paediatric week so we had lectures on child development with the person who happened to be the lead for paediatrics at UHCW. I managed to grab them at the end of the lecture to talk to them about catching up on the paediatric week I had missed due to the ear infection at the beginning of term. I’m planning on catching up in the last week as I have two weeks of peri-op and even Warwick agreed I can miss some of those to catch up on paediatrics. Turns out it won’t be a problem and I am going to email later on to arrange my visits.

End of the day I spent finally working on my home comforts project. I had ordered 45 new mugs to replace the ones that had gone missing from last term. I had to nail varnish these with WMS to try and stop people taking them away and then find some way to put all the blankets in the box. I lead a very exciting life.

Finally, I got to go home and basically collapse into bed. I had also realized this week that I have 14 more weeks till my glorious week off in May. I can not wait for the glorious dog walks I plan to take my scruff mutt on 🙂

CCE Specialities Week 5

Monday

Psychiatry week! Well, sorta. Warwick scheduled us with a doctor who was on annual leave so we ended up being passed around. We headed for the caludon centre which is the mental health hospital at UHCW for 9am to meet a consultant who had agreed to take us on for the day. We ended up walking back to UHCW to see some patients who were waiting for beds or needed a psychiatric consultation. It was extraordinary to listen to their histories and stories and I could feel my heart breaking for them as they explained why they were at UH. We saw three patients and were extremely grateful to be allowed into the consultation with them as talking about mental health still has a bit of a stigma attached to it and it can be hard to talk. I can’t say much more about the consultations but I came away with a new found appreciation as to how layered mental health can be and it’s not all easily explained away like physical health can often be.

The consultant told us to have the afternoon off and I went back to the medical school to chat with my deputy tutor about how my medication was making me ridiculously tired. I am coming home and struggling to work and practically falling asleep standing up in hospital so I just wanted to chat to her about it. However, there was a bit of agg beforehand so I ended up being a blubbering mess in her office for an hour and a half trying to work through it. Well Done Abbie, Well Done.

In the evening I met with my fellow blogger and med student abi for some hot chocolate and a chance to work through everything that was going on. It was great to have a chat with a good friend and I think the hot chocolate both let us work through everything that was going on that evening. She had just come out of a CBL meeting and I was still working off the back of what was going on earlier that day. I’ve also decided to set up a “hot chocolate therapy” group with another of the medics on campus. I’m looking forward to all the hot chocolate to come !

Tuesday

Day off today. I used it to try to get a doctor’s appointment to sort out my ears. Turns out Im good and healthy, they just seem to like causing me agg. It was nice to have a day off, I used it to catch up on sleep as I was exhausted and get to work on the presentation list for that week. It wasn’t the most productive day, but sometimes that’s ok. I ended up just binge watching TV programmes that evening in an effort to try and switch off from everything going on.

Wednesday

Wednesday we were at GP and IT WAS THE BEST DAY EVER. In the morning I shadowed a GP just sitting in on their consultations and we had so many paeds cases! I was in my element. We had a 6 year old who had an ear infection in which the ear drum looked like it was about to burst. I could relate to them except they were running around and happy as larry. Apparently, kids cope really well with these types of things ! I also got a milestone that consultation, my first GP doodle:

I also got lots of cuddles from them and when they left I felt the happiest I have felt all week. Yup, I think paeds is for me! I also got to see a little 9-month old who had big brown eyes and a head full of hair so that morning was a highlight.

In the afternoon we had our own student lead clinic and I saw my foot patient again and I think just about managed to do a successful consultation. However, it was my second patient whom made the day for me. A mum came in with her three year old and her new baby. I was in paeds heaven. The mum was worried about a rash on her three year old so I got to take their temperature. Turns out mum was a doc herself so this three year old was an expert in this field! Kaludio entertained himself with the baby whilst I examined the toddler with the GP as my rash knowledge is well… non-existent. There wasn’t anything to worry about but I made the toddler a glove balloon anyway, I could not resist.

I came out of that day beaming. After everything that had happened, this day had been amazing and I knew that dropping surgery and going for paeds probably is the best thing for me, even though it was hard to admit it to myself that I was better suited away from the theatre. In the evening I had a pizza catch up with one of my friends who I hadn’t seen in a while. It was nice just to catch up and by the end of the day, I felt the most me I had been in ages.

Thursday

We were summoned to the Caludon centre for 10am and we had some teaching on AKI from an F2. It was really useful especially as although I love the physiology of the kidney, I don’t get on with the diseases associated with them. We also had a skip and hop through addiction, particularly that of alcohol which I could relate to a patient I had seen earlier on in the block so it solidified a lot of the information for me.

In the afternoon we got to sit in on a clinic which had a good turn out rate (something that does not normally happen in psych clinics) and I was able to sit in on patients consultations about their symptoms and medication management. Even though the majority of psych week had been quiet I really enjoyed getting to grips with treatment for certain disorders and was privileged enough to see the “word salad” symptom. It’s incredibly rare to see it and I was incredibly grateful to the patient for letting us sit in on their clinic.

Friday/ Satuday / Sunday

That pretty much summed up the week. We had nothing on friday so I spent the day prepping for teaching the next day. I was teaching the basal ganglia at anatomy day which is one of my favourite aspects of block three. I had nicely set up in a room with my swanky 3 slide powerpoint (as I draw most of my lesson on the whiteboard) and Ollie came and shifted me to a room where the computer nor the powerpoint decided to work. Cheers Mate.

As it was anatomy day, I focused on getting the first years to be able to draw it from memory with the help of some slightly odd mnemonics. I really enjoyed being able to go back to block three and realize that I still had the same passion for Neuroscience as I did before I gave up perusing Neurosurgery. I still find the brain amazing and oddly, I still find Neurosurgery incredible and I will never turn down an opportunity to go and observe. At the end of the morning in my final session I got a hug for my teaching which meant so much to me. I’d gone from thinking about taking a year out of Medicine on Monday, to feeling like I could conquer anything I wanted to after that hug on Saturday. I still am so grateful to be here, yes, some mornings I curse under my breath that my alarm has gone off at 5am because I need to be in for 7am (spoilers for next week) but, then when I get to hospital, I get to see babies being brought into the world, or comfort a patient who’s had to be isolated but has dementia. I keep thinking more and more about when I graduate and become an F1, then an F2 and hopefully one day, a consultant at GOSH (yes I’ve skipped a few steps).

On Sunday I went with my friend Will to IKEA in an effort to have one last plate of meatballs and exercise extreme self-control. The one in Coventry is closing down so we decided to have one last bit of fun. A qoute from Jacob in my year pretty much sums up IKEA after talking about the Corona Virus:

“Coventry can’t have Corona, We’ve already lost IKEA, do they want to hurt us even more?”

Jacob.2020

CCE Specialities Week 4

Monday

Came down with a killer cold over the weekend so I decided to avoid sniffing over pregnant mothers to be and go in later for the clinical skills session at 1pm. I found out that actually I had chosen wisely as the clinic were only letting one student in so 2/3 of the students there got turned away, so I would have gone in early to spend the morning sneezing and feeling sorry for myself.

We had our oxygen clinical skills session in the afternoon essentially looking at what we would give to a patient based on their oxygen needs. Each oxygen delivery system has different flow rates so need to be selected based on the patients needs. We also got to learn about inhaler therapy using different techniques and learnt about equipment to test if the patient is able to use inhalers. This included some weird party blower type things that check the patient has the strength to use some types of inhaler. It was hilarious and we created our own New Year’s Eve in the room. Safe to say we all reverted to about 4 years old at this point. We then moved onto the peak flow instruments and that also turned into a bit of a competition. I was pleasantly surprised by my results, apparently I have the lungs of a 6 foot man….

I guess my classical signing lessons for virtually 4 years of my life payed off. (Yes, I can belt out a phantom song if it takes my fancy).

It felt like a really long afternoon and I was happy to just get back and nurse my cold. However, I had to make a quick stop as I had to pick my new phone up ! A better phone, more data AND a cheaper contract?!?! I was ready to collapse in bed when I got back , and that is exactly what I did (after a helping of my mums chilli).

Tuesday

I had been looking forward to this day as it was my first community midwife shift, this meant babies and lots of them. Well, I thought that, turns out I saw two. Our first stop was a beautiful two-day year old of which it took every fibre not to pick them up and give them a cuddle. I got to help out and take mums temperature and blood pressure which came a little out of the blue so I mentally had to check I could remember how to take a blood pressure (it’s OK, we did remember). It was apparent they had appeared before mum and dad were ready but apparently that’s how all babies arrive. I also got to see a 5 day year old visit where the baby was weighed and the heels pricked. The heel prick test looks for sickle cell, Cystic Fibrosis, congenital hypothyroidism and some inherited metabolic diseases. Amazing considering it’s all done by 5 drops of blood on a bit of paper. This house also had a bird in the corner who kept whistling the Adams family theme tune whilst we were in there providing a comedy element to this check up.

I then got to escape to Costa for 4 hours as the midwife was just doing paper work and I have to say, doing work in a coffee shop made me feel like the Instagram cliché I ultimately am. I hadn’t packed my laptop so I was working all off my phone which was annoying but the antenatal care learning objective is huge and I really needed to get started on it.

Soya Milk …. because I really am that basic (and ya know, IBS).

After wandering round the road system there (it was an industrial park which aren’t really catered for pedestrians) I found my way to the surgery and spent the next couple of hours seeing lots of baby bumps. I got to do the urine dipsticks (a task I can imagine the midwife was more than happy to give me) to check for protein in the urine which is an indicator of pre-eclampsia that can lead to deadly seizures in pregnant mums. Thankfully, all were good. I also got to feel some abdomens for baby and I think I need to keep practising this as I am a bit hesitant about pressing too hard on the mums tums and could only just about feel baby. I also got chatting to the midwife about the channel 4 documentary on mental health that was showing a mum who had gone through serious post-partum psychosis.

It was a pleasantly surprisingly good day and I could see myself working in obs and gyne which was extremely weird as I swore I would never go down this path and for someone who can’t see kids in their future yet, I became extremely broody……

Wednesday

First day of school again! It was our first day in GP which is something we start in phase two. I’m based at a surgery about 40 minutes away from campus which is brilliant as these practises can be flung far from Warwick. I arrived at the surgery at 10am (something which I also loved about them) and we were immediately made to feel so welcome and wanted. Something, I was worried about not happening. I was put in to observe a nurse in the morning and got to see a little one having their first jabs which got us on the topic of anti-vaxers. It’s becoming a sadly growing trend even here in the UK. Vaccines have been shown time and time again to be safe, effective AND LIFE SAVING. Autism does not develop from vaccines. I did not become who I am because my mum decided to save my life from measles, mumps, rubella, polio etc. In fact that paper was retracted exactly 10 years ago this week. Anyway, rant over.

In the afternoon we got to meet our mentor Dr O who would be supervising us through this 7 week block in GP. I expected the first session for us to just be observing her and watching but nope. Immediately we were chucked in front of patients. GULP. It was actually amazing and showed that we’ve reached that stage in medical training where observation isn’t enough for us and we want to get involved with everything that was going on. I really enjoyed it but I need to learn to direct my consultations. I did over-run partly because I was dealing with a condition where I wasn’t sure what I was doing and partly because my patient liked to talk. They were lovely, I just need to be a bit more assertive. In fact, they are coming back next week so I am gong to read up on their condition so I have a better idea of what to do next.

Me and Klaudio left that day feeling accomplished and like we were progressing on our medical careers. I dreaded this clinical learning but you get so much more out of talking to patients and getting involved than a thousand lectures could ever give you. Kaludio mentioned thinking of GP as a career but I am going to need a bit more convincing.

Thursday#

It’s currently 9am and I haven’t slept since Wednesday morning. I was up in A&E all night and basically just went straight to my 8am lecture at the hospital (luckily) but halfway through I had hit the wall and basically called it a day. I was annoyed as I needed the day to get sign offs but I guess luck isn’t on my side today. However, I did make progress in trying to meet my consultant so I guess I got one thing out of today.

Friday

Academic day! A slight lie in and I’m off to the med school for CBL. I have to admit, I get so tired during CBL that it is hard to stay focused. I am also a bit tetchy about CBL at the moment as the learning outcome list is huge and often the points seem leaps and bounds away from the case. However, that’s more my agg. It paediatric week and we got treated to a lecture by one of the lecturers who restored my faith in medicine during AC1. He was Irish and training to become a GP but makes his lecture just interactive and enjoyable.

However, I had to scoot early as I had a GP appointment to talk about my SNRI’s. I don’t think they are working as things had happened that week outside the medical world that had caused me to come crashing to the floor and question everything I thought I knew, I was also still shattered from the Thursday so I wasn’t coping. I had my meds upped in the evening just to see how I am with the side effects so I am going to see how I cope for the next two weeks.

I then high tailed it back to the MTC as my personal tutor had come to Warwick to check in on us. I said that I was just tired and a bit stressed but I was kinda coping, which was true. I still loved my course and I’ll just see how everything goes. It was a quick in and out meeting (plus a quick 5-minute vent to a friend) as I had a THIRD meeting that lunch about my absence at the beginning of term. It was not anything bad, I had done everything the Med School wants us to do but it was just to see how I was doing catching up and if anything else needed to be done. I took the opportunity to mention that sign offs here can only be done by ST3 or higher rule was annoying and seemed excessive for year 2. Other med students (yes, I network!) can be signed off my any grade doctor and band 6 and above nurse so I wondered why Warwick was different. The reason was to prepare us for F1 which I can see the logic, but I am only a second year medical student at this point.

At the end of the meeting it was time to run to lecture as I was slightly late and ended up having a working lunch due to having been in meetings all afternoon. Lectures on academic days are becoming a bit of a cause of chuckle with me. My year isn’t exactly the model year for showing up to lectures but now our lectures are sign in, the lecture theatre is constantly full.

The afternoon lectures looked at paediatric development and I got to chat to the doctor at the end about making up my paeds rotation which I really want to do as it’s not only a sign off but an area of medicine I love. I’ve got two weeks at the end of the block of peri-op that will be a good time to slip two days of paeds in so I am hoping to do it then.

That weekend I also was teaching for Block Three physiology day. I had chosen to do the basal ganglia as it was a part of medicine I loved. It’s the first time it’s been taught at a physiology day so I was keen to split apart the anatomy from how the system functioned as I was also teaching it on anatomy day. I really do love teaching, I know there is going to be Med Ed in my future career and I know in F1 I will be teaching those from KCL and the new Kent and Medway medical schools so I am keen to build up my teaching skills from day one. Here’s to more knowledge imparting on unwilling victims !!