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Category Archives: Anecdotes…little stories

YOU CAN SAVE A LIFE

 

Cardiac arrest As part of our obligation as a doctor we have to have annual update cardiopulmonary resuscitation training and this also applies to the whole practice team.

We have found over the past few years that it makes sense to have sessions which include a cross-section of staff and even opening it up to patients that want to participate aswell as the the young adults of staff.

A report of a rare miraculously saving of a life 

On December 23rd 2017 Dr Livingston was cosily at home recharging her batteries after a very busy surgery watching “Love Actually” with her daughter and her boyfriend when there was a loud frantic knock at the door. It was the  nextdoor neighbour she was totally beside herself. Her husband had collapsed.

Dr Livingston knew he had heart problems so she immediately went into ‘doctor mode’ She instructed the 2 teenagers ( her daughter had attended CPR training ago but her boyfriend had never attended any training) to bring their phones  ( not usually far from there sides, anyway!) Her daughter who remembered that there was a pocket mask strapped to the stairs in the hall had the presence of mind to grab that as well and the team hurriedly followed the neighbour to the house.  Sure enough the husband was sited against a wall in a collapsed state. Immediate assessment demonstrated he was unrousable, not breathing and with no pulse. He had had a cardiac arrest.

The team managed to drag him onto the kitchen floor. Instantly  the learnt procedure was put into action, and Dr Livingston allocated instructions to her team- the boyfriend called 999 and was communicating with the ambulance service ,very calmly listening and responding appropriately to their questions.

Meanwhile, Dr Livingston had immediately started CPR (basic life support with my daughter). Her daughter maintained good airway and Dr Livingston commenced chest compressions. She commented how exhausting it was and infact had not performed  this for many years in a ‘real situation’ and then only in a hospital situation. Her daughter astutely observed that her mother was getting tired and then took over cardiac compressions. Before the ambulance arrived a police car arrived with a defibrillator. Although she had had training on this but she had never actually used and automated external defibrillator. They followed the spoken voice instructions it gave them.

After about 3 shocks the A.E.D said in a clear voice ‘movement detected’. The team paused in shear amazement ‘It was incredible,’ commented Dr Livingston.

Subsequently, two ambulance crews arrived and they took over and when he seemed stable the patient was transferred to Ealing Hospital. On arrival at hospital the Glasgow coma scale was used to assess the severity of brain injury and prognosis. The initial Glasgow Coma Scale provides a score in the range 3-15; patients with scores of 3-8 are usually said to be in a coma, remarkably his was 15.

This was a true miracle, as it is reported that of cardiac arrests in a hospital set up only 7% of people survive this man not only lived to tell the tale but survived his near-death experience without any damage to his heart muscle or his brain, an outcome extremely rarely seen following an out-of-hospital cardiac arrest.

When Dr Livingston and myself discussed this, I felt empowered to blog about this and Dr Livingston felt it was paramount to share her story with other GP’s by posting on a closed facebook page called Resilient GPs. Usually she would get 1 or 2 responses  but on this occasion had over 700 !!

Many GP’s after reading the account  decided to open up their basic life support training to the staff’s teenagers and family and purchase pocket masks and keep them at home and in the car. Dr Livingston will be advocating to all staff and both her daughters to put a pocket mask in their  cars.

Moreover, the practice would be prepared to offer hosting CPR courses at the surgery for anyone interested or facilitate where a course could be done. 

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When the team  got back home after lots of cups of tea Dr Livingston asked her daughter how she was feeling and was she upset by it?

She admitted it was scary but even though it was 2 years since she had attended the course she said the thing she particularly remembered the trainer saying, 

‘If you dont do anything they will die so you may as well try. Even if just do chest compression that will help. That is what everyone needs to know- have a go !!’

 Dr Livingston felt immensely proud of these teenagers , who not only immediately jumped into action without thinking  but ‘saved a life’.

Well done – an absolute game – changer. 

A week after this there was routine practice training update. The first time with the new practice defibrillator. The trainer simulated a cardiac arrest, which was brilliant, but completely forgot the practices had it’s own device.!!

The most important thing if some one has a cardiac arrest is to fibrillate as soon as possible

A few days later Dr Livingston  passed the gentleman’s son in the street and asked how his father was feeling. He replied, ” he seems fine but that his ribs were aching a lot” he was virtually totally unaware of the magnitude of what had happened and not only had he survived but that his life had been restored without brain injury.

As days went by it gradually it registered this man’s life had been saved by a team that was confident and empowered to act quickly and efficiently and then the team were showered with gifts!

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You could easily learn this skill and be a potential life-saver.

The British Heart Foundation are determined to transform the UK into a Nation of Lifesavers: a country where everyone knows how to save a life.

https://www.bhf.org.uk/heart-health/how-to-save-a-life

Also you could inform the surgery that you wish to participate in training and when enough people have signed up they will arrange a session.

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SPRING IS HERE – START OF NEW LIFE

Since I started this blog each year I have had the chance to make and record some fascinating observations. The first year it was a family of ducklings that hatched and were led by their mother to the river and the challenges of surviving nature and its dangers Alas this year the mother reappeared but she didn’t  establish a nest and I have not spotted any ducklings.

Last year I obseved a family of bluetits which nested in a jug and all fledglings hatched and happily flew into the outside World. This year the tits have nested in the nesting box fixed to a tree and the parents have been happily flitting back and forth and seem very contented  with their new home.

This year after watching a pair of busy redstarts it became apparent that they had decided to build a nest in the eaves of the covered terrace. Redstarts are immediately identifiable by their bright orange-red tails, which they often quiver. Breeding males look smart, with slate grey upper parts, black faces and wings, and an orange rump and chest. Females, like the one I photographed on her nest and young are duller. Redstarts ‘bob’ in a very robin-like manner, but spend little time at ground level. They are commonly seen in Wales, but usually around London but if you are in Europe or travelling outside London  look out for them  as they are charming little birds with a sweet song. They were thought to be in the thrush family but are now thought to be part of the old world flycatcher family and are cousins to robins and nightingales. Infact  name start comes from the Old English word fot tail, steort. According to the RSPB  The redstart is included on the Amber List as a species with unfavourable conservation status in Europe where it is declining, which made me feel happy to be providing a home for this family.

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Then to my delight while the the mother had briefly left the nest I took a sneaky peep in the nest and discovered that the fledglings were beginning to hatch and I was able to take a short video to share:-

 

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FLORENCE NIGHTIGALE AND WILD GARLIC

Last weekend I decided to take advantage of the sun and go for a stroll down the tow path past Kew to Richmond. It was a glorious afternoon  and one of the thrills at this time of year is gathering willd garlic which grows in  abundance on the towpath. The rich slightly acidic clay soil is perfect for this delicacy and nibbling the leaves and white flowers on the way home gets your mouth in shape for a simple supper of gently simmered wild garlic added to pasta tossed in a good quality olive oil  and sprinkled with Parmesan or blue cheese. Alternatively, it can be a good substitute for Basil to make a tasty pesto.

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Allium ursinum or ramsoms often grow alongside bluebells in deciduous woodlands with moist soils, preferring slightly acidic conditions. It flowers before deciduous trees leaf in the spring, filling the air with their characteristic garlic-like scent. The flower stem is triangular in cross-section and the leaves are broadly lanceolate similar to those of the lily of the valley. Check first by gently rubbing the leaves in your hands an d smelling the characteristic smell.

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When I visited Jekka’s Herb farm near Bristol it was during our discussion about herbs that she told me that Florence Nightingale used to mix this with English white wine to make a concoction and use it as an antiseptic on the wards.

Hence, with  its antibacterial, antibiotic, antiseptic and anti … well, just about everything, properties, it makes sense to pack as much into your diet as you can. The headline health benefit of garlic is its effectiveness in reducing blood pressure and, hence, heart disease and the risk of stroke. Although all garlic has this property, wild garlic has the greatest effect on lowering blood pressure.

Jekka Mcvicar for those who don’t know has a know established reputation of being a herb guru but describes herself as an organic herb grower.  She cultivates more than 500 varieties of herbs and has written an excellent illustrated book discussing the culinary and medical use of herbs aswell as an acclaimed cookbook. She shows at Chelsea Flower Show and has been visited by well known chefs such as Raymond Blanc, Jamie Oliver and Heston Blumenthal. Her big claim to fame is that she played and sang at the first Glastonbury in 1970 which impressed my daughter on our last visit. With credentials like those, visiting her at her farm near Bristol where you can listen to one of her talks , browse her herbs now in raised beds and termed a Herbetum and more importantly  have chance to purchase some potted herbs is something I enjoy immensely and thoroughly recommend to keen gardeners. I have to say I make a point of visiting the farm at least once a year.

http://www.jekkasherbfarm.com

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GO THROUGH THE STAGES OF LOSS WITH THIS GIRAFFE

Candace also passed on this video as she found it helpful in describing the feelings she has gone through. It illustrates what anyone goes through when experiencing loss, albeit a serious illness, a bereavement or even the break up of a partnership. I am sure many people will identify with this giraffe and perhaps be able to raise a smile at the end!

 

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WE ARE MORE THAN OUR DISEASE

Several months ago I wrote a blog promoting a book written by one of our patients ‘Prescription for Disaster’ by Candace Lafleur It is a very personal report of what a disease can do to someone, but the way Candace deals with it, is amazing. She shows us that even in the worst conditions like hers, life is worth living and how you can keep on laughing. Reading it makes one laugh from the belly and cry from the heart as it has that underlining sadness that we as doctors are aware of when treating patients with chronic illnesses but her attitude inspires us as doctors to be hopeful and inspired.

She also made this video to emphasise the importance of attitude when dealing with a chronic illness and admits to all the normal emotions besides laughter. She would like to think by showing others how she has hung on to her personal hopes and aspirations and achieved success in her life with the disease she has not allowed it to dominate and prevent achievement.

 

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FREE NHS HEALTH CHECKS

Ealing Borough has one of the highest uptakes of free NHS Health Checks in the country. That means residents are reducing their risk of developing heart disease, stroke, diabetes and kidney disease.

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If you are aged between 40 – 74years old , have not had a health check in the last five years and have not already been diagnosed with certain conditions you will  be invited for a Free NHS  Health Check. The checks only take 20 minutes and hopefully will give  you peace of mind and good advice on staying well.

Even if you feel perfectly well and lead a healthy life style it is worth having it. Some conditions do not have early symptoms. It is estimated that 850,000 people are unaware that they have type 2 diabetes. I remember when I first joined the practise on simple urine screening I picked up 19 asymptomatic diabetics in 6 months including a 19 year old young man.

We as GP’s are increasingly aware that people need to be educated as to what is a healthy weight, the safe levels of alcohol aswell as the importance or regular exercise. If after discussing your results you are found to be at risk of getting one of these diseases your healthcare professional can offer support to help lower the risks.

For more information visit   www.nhs.uk/nhshealthcheck

 

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Prescription for disaster

When I was handed this book by Candace Lafleur I wasn’t quite sure what to expect. We are so used to hearing the negative aspects of the NHS that as doctors we dread to hear let alone read comments from patients. But as I read this book I laughed and I cried but was moved by her gratitude to the NHS. As an NHS doctor I recognised so many of the scenarios and it is patients like Candace that inspire us, humble us and help us to cope with the sadness and despair it can sometimes bring.
Thank you, Candace for this ‘good read’

This is not a book about a disease itself, nor does it have any ‘woe is me’ or forced epiphanies on the meaning of life and health. It’s a book about sobbing student nurses wielding sharp needles, falling hospital elevators, having to be surgically removed from your own sweater for an X-ray and support group brawls. About getting my whole family pulled off into a cement bunker at British customs for being more radioactive than a truck full of Russian nails. It’s about sneaking nachos into the hospital at seven in the morning and making sweet, sweet love to the back of a parked taxi while having a stroke. This is a book about laughing and joyfully embracing the bizarre and the truly funny side of being ridiculously, incurably diseased. So sit back, take a hit of your oxygen tank and get ready to laugh at the funny side of falling apart. At the very least you’ll never look at a bed pan or an IV pole the same way again.

She writes as a patient suffering from a rare disease called Sarcoidosis (pronounced SAR-COY-DOE-SIS) is an inflammatory disease that can affect almost any organ in the body. This causes an increase in immunity. It causes a persons immune system to overreact when fighting an infection, (or imaginary infection). This then creates inflammation which then results in it damaging the persons own body tissue.

The classic feature of Sarcoidosis is the formation of Granulomas. These are microscopic clumps of inflammatory cells that group together. When too many of them form in a body organ they can interfere with how that organ functions on a day to day basis..
Little is known about who is susceptible to this disease and what causes it.
To read more about this condition refer to
http://www.sa-uk.org/What%20is%20Sarcoidosis.htm
or
http://www.stopsarcoidosis.org

Candace is part of an international forum which she highly recommends and finds it supportive, informative and can even share her humour with other people with Sarcoidosis. To join click on the following link
https://www.inspire.com/groups/stop-sarcoidosis/

 

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FLEDGLINGS ARE ALMOST READY TO FLEE THE NEST IN THE JUG

For the past 2 weeks everyday I have had a peep in the jug to watch the progress of these tiny creatures and from a distance observe the dutifully parents flying back and forth with food.


Even their ‘cheep,cheep’ sounds different!

 

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NEXT FAMILY OF JUG FLEDGLINGS GROWING FAST AT 9 DAYS OLD

These second clutch of birds rare growing fast -feathers just appearing. Hungry mouths wait their mother to arrive with food. A slight tap on the jug and they prepare themselves to be fed by there parents.

 

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I THOUGHT THE JUG WAS FREE BUT NEW ARRIVALS!!

I THOUGHT THE JUG WAS FREE BUT NEW ARRIVALS!!