EPQ

I have decided to not continue with my Extended Project, as I feel that I don't have enough time too continue all four subjects to A2 level and still achieve a good standard with my project. I still find the topic of stem cells an incredible subject, and will carry on reading up on it when I have time!

Work Experience - local GP surgery

Today, I spent a few hours with a general practitioner at a surgery nearby. I really enjoyed it, particularly because it was much more varied than I had expected. As well as sitting in on consultations with the "bread and butter" patients, with ongoing colds etc., I went on a visit to see an elderly patient in a care home, and went into a treatment room to watch a vaginal pessary being fitted by the nurse. I found that I learnt a bit more about communicating with a patient: the doctor that I was shadowing helped the patients to understand what was going on with anecdotes, metaphors and Google images. I thought this was very useful, as it allowed the patients to get a better idea of why they were feeling a particular way, and why certain treatments were being suggested. Another thing that caught my interest during the afternoon was when a 50 year old woman came in. She had recently had cataract surgery, and described the process - I found it amazing that the surgeon can completely replace the lens within the eye while the patient is only under local anaesthetic.
I am looking forward to going back to the surgery on Wednesday afternoon, hopefully I will get to see even more interesting things!

The Emporer of all Maladies

A book that one of my teachers had recommended came in the post today, and I've just started it. It's called 'The Emporer of all Maladies', and is about the history of cancer. Written by an American oncologist, it discusses the evolving treatments over time, and begins to question how close we are to "solving one of science's great mysteries". I'm really looking forward to reading it - I am finding it a little easier than other scientific books, as it is written more like a story.

Science Club recruiting

At school today there was a societies fair for years 7 and 8, during which myself and a few other year 13s had a stand for Science Club. It was great fun showing the younger years how science can be exciting, and isn't all about copying down facts from the board. This was even more rewarding when we checked the sign up sheet at the end of the hour, and found that we plenty of interest! Some students couldn't wait to put their names down, and this was great as they obviously had a keen interest in science, however it felt even better when we managed to persuade those who weren't so sure that science was very 'cool' that actually, they would really enjoy the club.

The year 13 Science Team!

I can't wait for the club to start in a couple of weeks, especially as we have a couple of "mad scientist handbooks" to choose experiments from - including a giant bubble big enough to stand in! Watch this space, I might come back next week with charred hair and no eyebrows after what we've got planned...

Open Day

A few weeks ago, I went to an open day, which had a dissection room that inspired me to do Medicine even more. A lecturer gave a small talk and did a little quiz, in which there were three glass cases containing kidneys. However, not one of the kidneys looked alike, in fact it was only the first organ that looked anything like a kidney. I found it incredible that there could be such a huge range of things that could go wrong with one single part of the body. I also learnt that when you do look inside someone, it isn't always going to look like it does in the textbook! One of the specimens was so enormous and filled with air sacs that everyone in the room was sure it was a pair of lungs, however it was where two kidneys had joined together in the first stages of growth and become fused. The kidneys also had hundreds of cysts, making them much larger than normal, giving everyone the impression that they were lungs.

I found the demonstration very interesting, and it has really made me excited to get started!

The body's natural healing mechanisms

My sister recently took part in a charity walk, during which she aquired some blisters on her feet, which got me thinking about how the body is so intricately designed to heal and to prevent further damage. Following the example of blisters, I researched them and found that the liquid contained within them protects the tissue below from further damage. This reminds me of how important it is to take into consideration the body's natural healing process, as often it is cleverer than we think; from simple growth and repair by mitosis, to the specific immune responses of B- and T- lymphocytes. I think it's important to remember that however much technology we develop, much of treatment relies on the body to perform the basis of the healing process.

Horizon: Defeating Cancer

Having seen that it dealt with cancer, my interest was caught and I watched this programme avidly from beginning to end. It showed three brand new and state of the art treatments for different types and stages of cancer, as well as explaining what cancer is, how the treatments are made, and of course what the draw backs of the treatment are. Not all cancer is treatable, but it was amazing to see three more huge steps in the right direction.

One piece was a robotic machine for delivering radiation precisely to the place of the cancer, massively reducing damage to the surrounding tissue. Hundreds of tiny rays were targeted at the tumour, which meant that in order to keep the total radiation level to the tumour the same, the radiation level of each ray could be much smaller. This meant that when it passed through tissue, very little damage occured. Another fantastic aspect of the machine was that it was able to adjust the direction of the ray according to the breathing and movement of the patient, helped by a light sensor. This was particularly good because despite the intricate planning for each move of the robot, the physicists and doctors were unable to plan ahead how the patient's movement on the table would affect the position of the tumour within his body.

Another piece of technology was a machine for robotic surgery. The most fascinating part of this for me was that it enables the surgeon to perform an operation from anywhere in the world! Each tiny movement from his hands is translated into a movement by one of three tools, removing any trace of shaking or tremoring and vastly improving the precision of each cut, of each stitch. A camera, moved by his feet, enabled the surgeon to see what he was doing through an eyepiece, thus enabling him to be working ten feet away from the patient.

The third treatment was a tablet for skin cancer. It was created by looking at the gene patterns in normal, healthy people and those with melanoma skin cancer. They were then able to form a 3D image of the chemical that tells the cell to divide and create a chemical that fitted the gap. This prevented the chemical from working properly and therefore reduced the rate of division of the cells that formed the tumour.

Although all the treatments were incredibly expensive, I believe that it was money well spent, as despite the fact that they are unlikely to be 100% successful, they are huge advances in technology and allow so much hope for the future. This is a very exciting time in the world of medicine!

Enbridge House Care Home

I have spent the last three days at Enbridge House Care Home (http://sitebuilder.yell.com/sb/show.do?id=SB0001503498000050), where I have been shadowing and helping the staff on two afternoon shifts and one morning. This has been a real eye opener into the world of caring, and I have found it extremely interesting.

I helped to take the meals and cups of tea/coffee around to the residents, which gave me the opportunity to talk to them. Currently, I don't spend a lot of time with elderly people, so it took a bit of time to get used to speaking loudly and clearly, as many of them were hard of hearing! However, once I got used to it I found communication a bit easier.

I think some of the patients felt frustrated in the home, despite the excellent care. One lady came into the kitchen while we were having a break in order to ask if she could do anything to help because she was bored. I understand that a similar situation could occur in a hospital, as patients spend a lot of time lying in bed alone. This will probably make it harder to work with them, as when you are frustrated you are less likely to want to cooperate.

The experience at the care home has been really useful. I enjoyed working with the staff, and I feel like I have learnt a lot about dealing with a completely different clientele than the normal children at Mencap, which will be very helpful in the future.

Hungerford surgery work experience

I spent a fantastic afternoon in a nearby general practise surgery last week. Having only been to my local surgery as a patient for little things, I found it really interesting to be watching it from a new angle.

I sat in on a couple of consultations with one of the GPs, then watched the work of a nurse in the asthma clinic. Here, she had patients who needed to be issued with inhalors, who weren't sure how to use their medicine, and who were having an annual check up on their asthma. The nurse running the clinic was very helpful, and got me lots of leaflets and information packs for me to read, which was especially good as I am studying asthma as part of my AS biology course! After spending some time in the asthma clinic and watching a lady have her travel injections, I went back in to sit in on a few more consultations with the GPs.

I think that I have learnt a lot about how to address patients in the right way, depending on their age and what is wrong with them. Having seen a man with dementia suffering from shingles, I also learnt how to deal with medicating different kinds of people. It was not possible to get him to take tablets three times a day, as he did not have a regular carer, so a different method had to be thought of.

Overall, I really enjoyed my time at the surgery, and can't wait to go back again.

Besingstoke hospital work experience: Friday (day 5)

As it was my last day, I felt quite sad as I made my way around the hospital. The patients that I had met during the week were very friendly by smiling at me when they saw me walking past, which made me think how lucky I am to have had this opportunity, and how much I want to be able to show patients a friendly face in the future. In my opinion, being kind and smiley is just as important as physically treating a patient.

Basingstoke hospital work experience: Thursday (day 4)

Today I was lucky enough to transfer a patient to and from the high dependancy unit at the hospital with my mentor. After waiting for a few minutes for him to be ready, we took him out of the unit. However, as soon as we began moving down the corridor, his heart monitor started beeping and flashing red. Luckily the nurse who was accompanying us got it all under control, and he was back to normal within a minute. The urgency of the situation, although dealt with calmly, was really exciting, and has made me look forward to the future even more, when maybe I can deal with these sorts of circumstances.

Later on in the day we had to transfer a patient with MRSA, so as we approached the ward we put on the gloves and aprons supplied. As I didn't know what MRSA was, when I got home I did a bit of research, and found that it is a bacteria that is resistant to beta-lactam anitbiotics, making it very difficult to treat. It is also a particularly problematic issue in hospitals, as most of the patients have weak immune systems, making them a lot more susceptible to the bacterium than the majority of the general public. The symptoms of MRSA begin with small red bumps, sometimes alongside a fever and rash, generally around then nose. As the bacteria take hold, the bumps transform into deep and sore boils containing pus. Most cases of MRSA can be treated, however about a quarter can spread more quickly. These sometimes affect vital organs and cause infection throughout the body, something that can be fatal. Fortunately, the patient that we met was being treated effectively.

Basingstoke hospital work experience: Wednesday (day 3)

This afternoon I met an old man who needed a CT scan, but he thought he was going home: he had packed up his bag and was all ready to leave! Luckily, the nurse managed to latch him onto me so we could persuade him to come down for his scan. I sat and talked with him for about twenty minutes before he was called in, then waited for him to come back out before taking him up to his ward. The experience showed me that patience and a kind smile really help do much, especially when dealing with confused elderly patients. It made me really proud that I had helped a patient to have a more calm and enjoyable experience at the hospital, particularly as he couldn't wait to get home!

Basingstoke hospital work experience: Tuesday (day 2)

Today was a little more exciting, which was good as I had enjoyed my 'breaking in' day, but I was ready for some action! I was allowed to sit and watch a CT scan of the brain of a man from AAU, which was really interesting. I had never seen one before, so it was very helpful to have it explained by one of the staff. The brain is such a complex structure, and never ceases to amaze me, so being able to see a live person's brain being scanned and displayed on a computer screen was very exciting! The new technologies available to the medical profession today are so fascinating, and even more so because they are becoming ever more advanced.

After watching the scan, Brian and I were just about to return this patient to AAU when he turned a funny colour and began shaking drastically. Luckily, a nurse was on hand and hooked home up to an oxygen cylinder in the bay. Throughout the whole episode I felt a need to help and make it better, something that proved to me how much I want to be a doctor. I can't just stand and watch things happen without wanting to help.

Basingstoke hospital work experience: Monday (day 1)

As it was my first day, I spent much of my time getting to know the hospital and my mentor, Brian. I was in the radiology department, portering patients to and from the bed park. The staff were very welcoming, and helped me to get to grips with the job very quickly. As Brian gave me the task of giving the paperwork to the appropriate office (X-ray or CT scanning), I began to understand the different notations on the sheets. This will help me as a student and then as a doctor, as reading the shorthand will come more naturally to me.

I was pleased when by the end of the day I began to feel at home, as I know that a lot of my time in the future will be in a hospital. I felt really happy with the day, but absolutely exhausted, the porters walk miles and miles every day!

"Junior Doctors"

I just watched an episode of 'Junior Doctors', and it really inspired and ignited my desire to be a doctor. Watching the newly graduated doctors find their way around their first shifts made me realise what a hugely superior job it is. Although they struggled a little to begin with, they soon found their feet and began to take part in difficult procedures. The emotions that charged around the hospital with them left me on the edge of my seat, wishing I was there. After watching it, I am determined to get to where they are, and I can't wait! It was the perfect way to prepare me for my work experience portering at Basingstoke Hospital next week.

Assembly participation - understanding what it feels like to have a learning disability or mobility difficulties

Last week I was chosen by my house head to take part in an assembly in order to demonstrate to others what it feels like to have a learning disability or a mobility difficulty. This afternoon, I took part in an obstacle course down the middle of the school hall, however the catch was that the instructions were given to us in Polish. This showed my team and I how difficult communication can be with people who have learning difficulties, as sometimes they just don't understand words in long and complicated sentences as others do. This has made me realise how important actions and gestures are. I also had to attempt to throw a bean bag from a sitting position in a chair into a hoop a considerable distance away. The catch? We were only allowed to use our lower arms, as our elbows were being held to our sides. This helped me to understand more about how frustrating it is to be in such a situation, and this in turn will enable me to be more understanding and sympathetic in my work.

I was then able to put my new skills into practise, as took part in my weekly volunteering session after school. When the children recognise you and choose you as someone to talk to, it is really special, as it shows that you have communicated so well that they want to tell you about everything that is happening in their lives. This, in my opinion, is a fantastic tool, as I understand that it can be particularly difficult to obtain a history from a stubborn patient!

Basingstoke Hospital

Just a quick note to mention that I have organised work experience at Basingstoke Hospital, where I will be following a porter around in order to get an idea of the whole hospital, rather than just one speciality. This will take place over February half term, after an induction afternoon on Thursday. I'm really looking forward to it, as it will be my first experience in a hospital when I'm not the patient!

Mencap

My fourth week at Mencap started off slowly, however this made it all the more amazing and beautiful when the child I was working with began to laugh as I blew bubbles around the room. He was quiet and a little impatient for the first hour or so, but when we went into the craft room and got the bubble blowing bottle out, the change in his behaviour and facial expressions was outstanding. He laughed for nearly hour (while I tried not to swallow any bubble making liquid!), which was really special. For me, I learnt that after a bit of perseverence, there is likely to be something that will make a child smile.
When I'm at Mencap, I feel like I can forget about all my worries, however little or large, and just enjoy the moments spent having fun and helping the children, which just increases my determination to study medicine; there is nothing better than the feeling of making someone happy.

Enbridge House

I went along to Enbridge House (a care home for the elderly) yesterday, as I had expressed an interest in doing work experience there. I learnt what the carers do at the home, and how it is run. It was interesting to hear that they work in conjunction with the local GP surgery, showing how the surgery really integrates into the community, and also how Enbridge House is getting the best for its residents.


I was given a pack with the resources for the NCFE Certificate in Dementia Awareness, which I will be reading through in order to gain a better understanding of how the residents' minds work. The course goes through recognition of dementia, knowledge of the different forms dementia takes, understanding the importance of memory in our behaviour and what we do, learning about 'person-centred care', recognition of 'well being' and 'ill being', compilation of a person's life history, supporting people and maintaining their relationships, communation with people who suffer from dementia and how behaviour can be viewed as a form of communication and caring for these people in a kind and effective way. This will hopefully give me many skills associated with the medical profession of today, for example being able to compile someone's life history could help me to take a history from an unwilling patient in order to create a diagnosis, or recognition of dementia and the symptoms could help me to understand when to change my behaviour and form of communication accordingly.


Hopefully, I will be able to spend a few days observing and learning at Enbridge House over the Easter holidays.

Mencap (2)

Had my second session at Mencap on Friday afternoon, and I really enjoyed it (again!). The time spent there is so fulfilling, and makes you feel so good inside. As it was my second week, I felt a little more accustomed to the centre, so found it easier to get to know the child I was assigned to. As my assigned child's best friend also attends Mencap, I became the volunteer for both of them. We spent some time having a 'tea party' in a little 'house' in the soft play room, where I discovered the amazing feeling when you coax a laugh out of a child with limited speech. It's lovely to know that they want you to be there, and that you're making a difference to how they would have spent that afternoon.

When I leave, I feel like I have just done something really special (albeit very tiring!), and I can't wait until the next week comes around, where I can interact with children who appreciate a friend for the afternoon so much.

Mencap

Yesterday, I spent the afternoon at Mencap, the charity I mentioned in my first post. It was my first time volunteering there, and despite the fact that I'd felt a bit worried and unsure of what to expect before I got there, I felt welcomed in by the staff.
Being with the children was so rewarding; I was given a child to play with, and we spent most of the time in the fantastic soft play room, running around and building towers out of the soft play equipment there. My child was quite outgoing, and made sure I did everything he asked, from holding the tower steady as he jumped on, to pushing it over so he could 'fly' into the ball pit. He was so happy and polite, and this showed me what an amazing job the centre does. It really makes you feel good when you give a child a smile, and they come over to hug you. After he had gone home, I spent the last ten minutes or so with a few other children. By spending time with children who didn't speak very much, I felt I could communicate better using gestures alongside talking, as well as being more able to understand what they wanted. I'm definitely not an expert, but I felt I learned a lot in those three hours, and I will definitely be going back next week!


The charity Mencap supports people of all ages who have learning disabilities. The West Berkshire branch after school club focuses on disabled children and allows them to "play, have fun and socially interact". The link to the website shows just how far it does this: http://www.westberkshiremencap.org/index.htm.




I also found out yesterday that I have been given a language mentee. I will help him to learn his French vocab, and go through the topics he is studying in class. On Monday I plan to introduce myself to him, and organise a weekly lunch time that we can work in. Hopefully this will give me skills in both communication and leadership, but more importantly will give me the feeling that I'm helping someone with such an valuable part of their life, their education.

Research into cramps

At dinner after a long walk recently, mid-sentence I found myself in extreme pain, with which I couldn't move my right calf (unfortunately, I was sat with my legs crossed underneath my chair, meaning it would have been tricky to disentangle them even if the slightest movement wasn't causing agony!). Between shrieks and cries - and a little bit of laughter - my dad diagnosed it as cramp, having had it a few times before. This scene was then followed by frantic treatment of encouraging me to stretch out and move my leg, after all, Sherlock was about to start on BBC1!

This outburst triggered my curiosity, so I decided to try and research into cramps and why they happen, and wrote this report, compiled from a variety of sources, and in my own words:

Cramps

What they are

Cramps are where an already contracted muscle is stimulated to contract further. They range from a few seconds of slight spasming to quarter of an hour of excruciating pain, and can happen either very rarely or, in some cases, every day. The likelihood of getting cramps increases with age, around one third of people over 60 years old, and about a half of those over 80 get regular cramps.

What they are caused by

There are four different types of cramp, the first being true cramp. This is caused by the muscle stimulation nerves becoming hyperexcitable, following an injury to the bone or muscle in that area, exuberant activity (the cramps may occur during the exercise or later), dehydration and body fluid shifts. Tetany cramp is similar to true cramp in its symptoms; however it is where the nerve cells all over the body are stimulated, causing the muscles to spasm all over the body, as opposed to just in one main area. The main cause of this is low levels of magnesium and/or calcium, which results in increased nerve tissue activity. Contractures are when the muscles in one area do not relax and remain cramped for an extended period of time (longer than regular cramps). They are caused by a reduction in ATP in the cells, which then prevents the muscle fibres from relaxing. They can be inherited, they are a symptom of McArdle’s disease, which is a fault within the muscle cells concerning the breakdown of glycogen into glucose (which would then produce ATP). Contractures can also be acquired, through hyperthyroid myopathy, a disease caused by an overactive thyroid. The final type of cramp is the dystonic cramp, in which muscles that are unnecessary for an intended movement are stimulated. These contractions are uncommon, and can be treated with injections of botulism toxin (Botox), which last for several months.

                How they are treated

General treatment of cramps involves treating the underlying condition that causes the cramps. These conditions include unbalanced salt levels, peripheral vascular disease, kidney dialysis and underactive thyroid. However, for immediate pain relief it often helps to stretch out and massage the affected area. On the other hand, there is not much evidence to suggest that this is a good way of preventing further cramps.

References: www.medicinenet.com; news.bbc.co.uk/sport2/hi/health_and_fitness/4275144.stm; www.patient.co.uk > InformationLeaflets

Unfortunately, scientists have not been very helpful, given that there is no certain reason as to why cramps happen!