Mancunian Monday: Overheard in The Arndale

Girl: (on phone) I can't find it anywhere!..No, I've definitely checked at his..no, he hasn't..no I haven't taken it there…*long pause*…*takes phone away from ear and looks at it*..oh..*puts phone back to ear*..yeah..yeah..I'm er..I'm calling you with it……….

#guessyoufounditthen

Overheard in… a Church

Child: so Jesus was born in a stable?

Lady: yes.

Child: why?

Lady: well, there wasn't any room at any of the houses or inns in the town.

Child: what's an inn?

Lady: it's like a hotel.

Child: did he try Travelodge?

Lady: er I don't think so..

Child: hmm..it is rather horrible, I guess.

#yesthatwouldbewhy

Overheard in… a Classroom

*faint strains of 'Next to Me' by Emeli Sande can be heard*

J: you'll find her, you'll find her under my bed!

#IthinkI'mgoingtoleavenow

My Lungs Hate...

…well, a lot of things.

But today I'm telling you about e-cigs and my lungs.

Don't get me wrong, e-cigs - the things above - are great for so many people. They can really do wonders for people who struggle to quit smoking, and they are better for most people than normal cigarettes.

However, being the definitely-not-normal person that I am, e-cigs are worse for me than normal cigarettes! I know, weird, right?

I don't mean smoking them. I don't smoke, never have and never will, but I don't have to smoke an e-cig in order for my chest and throat to tighten and that cough to start up and that evil little headache..I just have to breathe in the vapour. It is, of course, far worse when I am in close proximity to the person smoking. Only the other day, I was sat on the bus when a guy sat next to me and started to smoke his e-cig. My chest tightened, my cough began, I grabbed my inhaler. My chest kept tightening, my throat felt odd, I tried my inhaler again. The cough worsened, and the headache started up and I felt sick so I tried again. No improvement. I had to do something.

ME: You do realise you aren't allowed those on the bus, right?
HIM: Aren't allowed what?
ME: *gesticulates towards e-cig*
HIM: Yeah.
ME: ..you do realise there are reasons why you aren't allowed those on the bus, right..?
HIM: Like what?
ME: *brings inhaler out of pocket*
HIM: I've opened a window! *takes another puff* *glares at me*

Well, as you can see, that didn't work. Luckily for me, he was talking to his friends and didn't smoke again at least until I had left the bus. It really annoyed me, though. He knew from before that incident that I am asthmatic, and didn't stop even when I was clearly having difficulty. He only opened the window at his friends' suggestion, and to be honest he shouldn't have had it on the bus as it was. However, I am willing to consider for now that he may not have realised the e-cig could be a big trigger for me, and that he genuinely thought that there weren't any important reasons why e-cigs are prohibited on all current forms of public transport in the UK, and truly believed that opening a window would make it all okay.

If, on the other hand, he does it again, then I shall be forced to take action; I would rather be a 'grass' than end up in the emergency department of Royal Blackburn Hospital because I can't breathe. Seriously, lung friends, don't feel afraid to speak out. Asthma attacks can be life-threatening, and even if someone genuinely doesn't realise, it is of paramount importance to educate them while you can still breathe. And if they do realise, then they should not be allowed to get away with it. They could kill someone some day, and they have to know that their actions have consequences.

Now, maybe it sounds crazy to you, but looking at the picture above makes me anxious now. Not just because I think of e-cigs and how badly they set me off, but also because the sight of the vapour reminds me of the sight of it on the bus earlier on in the week and how that made me feel when I inhaled it. It scares me to think of how much worse it could be if it happens again. It scares me how blasé people are about asthma. It scares me that someone had the audacity to smoke one on a bus without even considering how dangerous it could be to those around him. But what really scares me is how little he knew and cared. It's a very real possibility that I could be in the same situation again. A very very very real possibility. And it's terrifying.

Anywho.

I have a theory about the whole 'e-cig/normal cigarette' thing. The particles in e-cig vapour are smaller than those in normal cigarette smoke, meaning they can get deeper into my lungs, through the bronchi and into the bronchioles. Constriction in the bronchi is bad enough but constriction in the bronchioles is worse, so seeing as I am sensitive to e-cig vapour, it sets me off worse than normal smoke does. I don't know, I'm not a scientist yet, but it seems like a decent explanation.

Have any of you had attacks because of e-cig vapour? Do any of you smoke e-cigs with no trouble at all? I'd love to hear from you down in the comments section!

~Liz

We're On Air!

I'm in the Hallé Youth Choir, and back in September we teamed up with the awesome members of the Orchestre Symphonique Kimbanguiste from the DRC to bring the people of Manchester and London (S) a programme of music from Kinshasa DRC, England, Germany and Finland. The orchestras played Sibelius' 'Finlandia', some Berlioz, and a symphony written by some members of the OSK, while the choirs sang some really cool music from KDRC and some George Shearing/Shakespeare stuff, and we joined forces for the stunning finale to Beethoven's 9th Symphony (Ode to Joy). We performed first at the Bridgewater Hall after less than 7 hours' total rehearsal time on everything, and then we went to London's Southbank Centre to perform it all again at the Royal Festival Hall. The BBC followed us around for a few days and then made a documentary, which was aired TODAY on BBC4!

Along with the documentary (which is really good, check it out) the BBC has also posted some full-length clips of pieces that were performed, including the finale to Beethoven's 9th and some of the Kinshasa songs.

This video contains my two top favourite songs from the Kinshasa songs. The first one, Nkolo na biso Yesu (Our Lord Jesus) is beautiful and tender and so almost sad, and makes me teary every time I hear it! The second one was first sung to us when we were in rehearsal and we were told that the choir had a surprise for us..and I just grinned all the way through!

Please take a listen and see how amazing these people are. And us, of course ;)

~Liz

Asthma Review Time!

So..where are my lungs at now?

Well, the prednisolone and antibiotics have just finished and they have worked, so thank goodness for that. The Clenil Modulite has also been doing well and my peak flow has increased significantly (although it isn't great still) and I can breathe better than I have in months.

On the other hand…my reliever inhaler (Ventolin, the important one) has not been that great. That's not Ventolin's fault, that is purely the fault of my body, which doesn't appear to respond to salbutamol (the active ingredient in Ventolin and most blue reliever inhalers) at all, really. I mean, it has had a bit of an effect. When I've been totally desperate, it has been my saviour. In the second week of college, I was in town when I had an asthma attack. I don't know what brought it on, and my chest was really sore and I couldn't find air and I was getting that tell-tale headache, so I pulled my inhaler out and shook it..and the canister flew out of it. I clearly hadn't put it back in properly after marking my last dose on. It rolled into a nearby bus shelter, where there was a small group of people, of whom I knew one. When he had gone, I went into the bus shelter. Guess what. It was gone, of course. I was struggling for air and this headache was getting worse and worse, and I had to almost stagger to Boots down the street and gasp out that I needed an inhaler, and my canister had got stolen or gone missing or something, and they actually made me PAY BEFORE I COULD USE IT. Finally, they gave it to me and I sat down, put it in my spacer and tried to calm myself down and just breathe it in. It worked, enough for me to be able to walk back to college and stress that I wasn't too good, and enough for me to get home and get some rest to try and help my lungs back to normality.

So this time, they've given me Bricanyl (terbutaline) which is supposed to be a good option for people who don't respond to salbutamol enough. Problem? Yes. It only comes in a turbohaler, which is a kind of dry-powder inhaler, which basically means you have to breathe in really hard and really deep and then hold your breath and..oh, it all sounds like hard work! I'm really apprehensive right now. The medication itself might be the think we've been looking for, but dry-powder inhalers? No. I struggle to do all that on a normal day, let alone when I really need it. Currently, my reliever is being used four times a day until my infection is totally under control, so I'm not using it because I'm in desperate need. But what about when that happens? It can't be said when, but it's a certainty that it will.

It's funny, medication. You put all your hope and faith into a little pill or a bit of powder or a mist in the hopes that it'll make a change in your body. You might feel that change, you might not. And you may never know if it is working until you really, really, really need it to. But you do it all anyway, because what else can you do?

Anyway.

As for my spirometry, my lung function has gone up (yay! Go lungs!) although my lung volume has gone down (biatch..) and we are going to continue with the Bricanyl and Clenil Modulite for now until my next review to check that things are still working, and then we may add on a long-acting reliever (such as Serevent) in order to help things along. I need to keep taking my peak flow readings and charting them, and bring in all my inhalers and my spacer and peak flow meter to my next review.

Which is when, I hear you ask? (I don't really. Even if anyone read this blog, I still wouldn't hear them, because there's all this glass and plastic and space and bricks and wood etc. between us so actually, it would be physically impossible for me to hear you..)

It is at 10.00am on 24/12/2014.
That's right, the only date and time available that I could do is on...
...Christmas Eve.

Oh, joy.

~Liz

Mancunian Monday: Overheard in the Park

(This was a few years ago and I can't remember it verbatim, but anyway)
Girl on phone: Yeah..yeah.. I'm just in the park. Yeah, _________ park. Exam? Yeah it's at 5:00. *pause* WHAT?! (looks at phone) OH SH**! OH GOD! HALF AN HOUR AGO?!?! OH SH**!!

#onlyabitlatethen

Mancunian Monday: Overheard on the Train

(4 men at a table, one was on his phone, the others were having a much less censored version of this conversation)

Man 1: that bird last night..

Man 2: what bird last night?

Man 1: ..oh I mean the bird the night before..

Man 3: you were with me then.

Man 1: ..or maybe the night before that..

Man 2: you went home..alone..

Man 1: oh well maybe it was a few weeks ago..

Man 4: (comes off the phone) I thought you told me you were a virgin..?

Man 1: ..er..er..er..nahhhhh you're imagining things..

Man 2: not unlike you, then!

#mightneedsomecreamforthatburn

Autumn is coming to a close

Autumn is coming to a close. Yes, that's a boring topic but hey! I can't always be fun ;)

But you know my favourite part of Winter? Christmas lights. I love them! They twinkle and reflect off all the windows and in the eyes of children and adults and humans and animals and black and white and gay and bi and straight and trans alike. They don't care who you are, they just shine. Put some light in your day.

So how about my worst part of Winter?

Cold and Flu season. And the fact that people cannot seem to differentiate between them. So, how do you know what you've got? How do you know when to stay away from people? And do you know when things aren't as straightforward as they could be?

What is a Cold?

A cold is an infection of the upper respiratory tract, characterised by a sore throat, runny nose and coughing, and a generally slow onset of symptoms over a couple of days. The symptoms are:

- cough

- runny nose

- blocked nose

- tiredness

- sore throat

- sneezing

A cold can be treated for most people with rest, fluids, paracetamol and some good food.

What is Flu?

Flu hits you like a train. All the symptoms may come on at the same time, and you might not get all the symptoms, but if it doesn't hit you suddenly, you're not suffering from flu. The symptoms usually associate with flu are:

- aching bones

- cough

- sneezing a lot

- temperature

- extreme tiredness

- sometimes feeling sick 

- sudden severe sore throat

- headache

- swollen glands (eg in your neck)

Flu is treated with rest, sleep, fluids, and time off from work or school until the worst of the symptoms have died down. Paracetamol can help ease aches and headaches caused by flu, and things like Dequadin or Tyrozets can be used to soothe a sore throat.

What's normal?

Any of the symptoms listed above. The symptoms will go away on their own as the virus is fought off by your immune system.

What precautions can I take?

Everyone can do their bit by washing or sanitising their hands, sneezing or coughing into a tissue or the crook of your elbow and unless you're having more serious problems (see below) then stay away from the doctor's surgery.

Some people choose to get a flu jab which they must pay for at a pharmacy it supermarket. These are safe and given by trained nurses, but aren't necessary unless you fall into one of the risk groups below.

If you:

- work with young children or in a school

- sing for a living

- live with young pets or children

then you should probably pay for a flu shot.

The risk categories, which entitle you to free shots on the NHS, are as follows:

- health care personnel

- those with asthma, COPD, eosinophilic bronchitis or any other chronic lung disease

- cancer patients 

- those with diabetes 

- those on treatments which suppress the immune system 

- babies and very young children

- the elderly 

- pregnant people

If you fit into any of those categories, talk to your doctor or nurse about getting a flu shot.

What is NOT normal?

It depends on who you are sometimes, but the things that are red flags in anyone are:

- coughing up blood

- coughing up thick, yellow/yellow-green sputum (phlegm)

- symptoms that persist for longer than a week

- difficulty breathing

- vomiting after coughing

If you experience any of the above, even if you aren't in a risk category, you should see your doctor as soon as you can. These can all be signs that something other than a cold or flu is causing your symptoms, such as pneumonia (most commonly numbers 1 and 2), other lower respiratory infections, and infections such as bronchiolitis (especially number 1).

If you have asthma, COPD or another lung condition, and you are:

- quite short of breath (as in much more than normal)

- coughing a lot 

- working harder than usual to breathe 

- using your reliever inhaler more than 4 times with no effect 

- having a cough which is accompanied by wheezing

- breathing very fast and having a rapid heart rate

Then you should see your doctor immediately or go to an out-of-hours centre.

However, if you fit into the lung disease category and you:

- are very short of breath

- having a cough accompanied by harsh wheezing 

- have any chest pain, especially if it is worse on breathing in

- have a bluish tint to the skin, dark lips, or pale skin 

- have a cough that won't stop

- cannot speak in full sentences

- have a very fast breathing rate

- are coughing up any kind of thick or yellow or green phlegm

- are not able to relieve your symptoms even after using your reliever 6 times 

then you must call an ambulance, or get to an Emergency Department immediately. You could have a lower respiratory tract infection such as pneumonia which must be treated with antibiotics, or even a pneumothorax (especially number 3) or pleural effusion. You could also be having a severe asthma attack which could be life-threatening if not treated immediately. You may need a course of Prednisolone or another steroid to help you breathe.

If you have a suppressed immune system and you have any cold or flu symptoms, you must go to the ED ASAP as you could have serious complications.

What to expect at the GP

If you are going to see your GP, you should expect to be thoroughly examined with a stethoscope, have your blood pressure and heart rate checked, as well as your oxygen levels (Sats). You may have a blood test ordered to look for infection, or a chest x-ray. 

What NOT to expect at the GP

Don't expect to get antibiotics. Over-prescribing of antibiotics is the reason for MRSA and other treatment-resistant bacteria. These are especially severe in people with suppressed immune systems.

Don't expect that the doctor will prescribe you anything, really. He or she may just advise you on how to keep comfortable and get better soon.

What to expect at the ED

If you have to go to the ED, you should expect a thorough examination with a stethoscope. All of your vitals should be taken regularly, and you can expect to have bloods taken, a cannula inserted and be taken straight to a cubicle. 

If your oxygen levels aren't satisfactory for your age and underlying condition, then you should expect to be given oxygen via a facemask (although a nasal cannula may be used instead).

If you are coughing up phlegm then you may expect to have a chest x-ray taken, although you may not need one. If your doctor does not order a chest x-ray and you are concerned, just ask the doctor if he or she is going to order one. This gives them a chance to tell you why they haven't, or to reconsider their decision.

If you have asthma, you can expect to have your peak flow measured at least twice. You may also be given a nebuliser treatment, although inhalers with spacers have been shown to be just as effective in most patients, and can also be used with a mask for young children and babies or people in distress.

If you are a cancer, HIV or AIDS patient you should be admitted, although thus does not necessarily mean you will have to stay in.

What NOT to expect at the ED

Don't expect that you will be seen first unless you came in by emergency ambulance or you cannot breathe. You must accept that other people may well be in far greater need than you, and EDs have to prioritise patients.

Don't expect that you will be given antibiotics. This is for the same reason as for GPs, and is especially important in hospitals. You may well be given antibiotics, especially if you have asthma or other lung disease, or HIV/AIDS. 

What you should take to the ED

Everyone should take all and any medications they are currently on, including homeopathic medications, creams, ointments, suppositories and herbal remedies. For people with diabetes, it is important to take your diabetes kit, and for people with asthma it is important to take your inhalers with you. If you have a spacer, nebuliser or peak flow meter then you should being those too.

When I go to hospital, even if it is not necessarily to stay, I always take a small bag containing:

- all my medications in a cosmetics pouch

- my phone, iPod and earphones

- deodorant

- a sleeping mask

- a pair of pyjamas

- a spare t-shirt

- toothbrush and toothpaste

- something to do, such as homework, class notes to read, a book, pen and notepad, pencil and sketchpad, small travel game, or iPad

It might be a good idea to take:

- sanitary towels

- wet wipes

- a bit of money

- an extra layer

If you are bringing in a child, either as the patient or with you, then it might be an idea to take:

- small, versatile toys such as a couple of Playmobil or Lego figures, a Barbie doll or an action figure

- colouring books and crayons (taping some crayons onto string and taping that to a book can help prevent losing them)

- picture books or drawing paper

- a camera for children mature enough to understand others' privacy; this can be a way for a child to understand what is happening, and can also give you an idea of their perspective

- a warm blanket

- a bit of food, or money for snacks from vending machines

- any formula milk you are using if applicable

Playmobil are especially good, as you can get hospital-related sets for children who might be scared or worried, or just curious and interested in playing out what is going on. Teddies can have 'breathing treatments' or 'oxygen' and also provide comfort if the child is separated from you or you have to leave your child for a bit.

***

I hope I've given you some good information and remember, if you have any concerns, then seek medical advice. I'm not a doctor or nurse!

Keep safe and keep others safe.

~Liz

Flashback Friday: Overheard in the Hospital 2

Man 1: nachos.

Man 2: what, with cheese?

Man 1: no, just nachos.

Man 2: no sauce?

Man 1: nachos, just nach--

Nurse: how about a side order of 'nil by mouth' with those nachos?

It's just been one of those days...

Here's a song which really captures my mood right now:

It's by a country singer called Brad Paisley, and it's a brilliant and touching song about realising what you've got and how bad things could be. Of course, you have to pity yourself sometimes. Just a little bit, get some 'you' time in. But most of the time, we complain about things that aren't really so significant in the scheme of things.

And every day I listen to this song, as a reminder of how lucky I actually am.

I was lucky, when my aunt was diagnosed with a terminal recurrence of breast cancer a year-and-a-half ago now, that I had the chance to see her for a while before she died.

I was lucky, when my puppy ate 6 ibuprofen AND the foil packaging, that we got him to the vets in time and he didn't suffer any organ damage, or even death.

I was lucky that my appendix was taken out when it was, and the tumour was found before it grew and grew and spread.

I was lucky that my test results came back fine.

I was lucky in the hospital the other night that I wasn't having a severe asthma attack or a life-threatening reaction.

I am so so so so so lucky that I don't have tumours any more as far as we know.

I am lucky to have a MacBook Pro, an iPhone, iPad, iPod, high-quality stage piano, top-range earphones.

I am lucky to have a good education with teachers who respect me and classmates I can work with.

I am lucky that I have a house, and family, and two amazing dogs, and lots of amazing friends.

But above all, I am lucky lucky lucky to be alive right now.

~Liz

ED Doctors and Late-Night Maths

Hmm. So I was given a course of 8 prednisolone tablets every day for 5 days. I was discharged with 28 tablets.

Yeah. Literally nobody spotted that.

The Never-Ending Joy of A&E

Well, last night was fun.

Not.

It all started at about 10:00pm on Tuesday. My normal cough started to become weird. Wheezy, polyphonic, sort of ew. I took 4 puffs of the Ventolin and waited for half an hour.

Nothing.

Took another 4 puffs. Still nothing.

Called 111, answered some questions, including the mainly irrelevant "is there a possibility you could be pregnant?" which I'm sure they even ask 5-year-olds these days.

Then, "based on the information you've given me, I'm going to send an ambulance round to your house."

Woah, hold on, Drastic Danny!

He sent it anyway, and when the two ambulance men came in, they checked my blood pressure - high - and my pulse rate - also high - and my respiratory rate - again, high - and said I needed to go to hospital. This, my friends, was at 11:30pm. On a Tuesday.

Has anyone noticed that trips to the ED for things like pain or breathing etc. always seem to happen at the most inconvenient times possible? Usually, the middle of the night at the end of a very long day.

Anyway, back to the story. I was taken in the ambulance to Royal Blackburn Hospital and put straight into a cubicle. Just a note to people; being put in a cubicle does not necessarily mean you don't have to wait for hours. It still means you have to sit around getting bored out of your mind. You do get triaged straight away if you're brought in by ambulance, but you don't necessarily get priority over, say, a woman in labour or a kid with abdominal pain (been there!), although you are likely to be higher priority than someone who has fractured their wrist, caught themselves a black eye, or been sick a few times. So sorry guys, but priority is priority and if you don't like the fact that someone who is struggling with breathing is being seen before your unusually bad migraine, then you're just going to have to lump it.

When I got in, I was triaged, had bloods taken, a dangly cannula put in the middle of my forearm (seems my weird veins are even weirder now), an ECG done and obs taken. Fun stuff, guys, fun stuff. ECG showed sinus tachycardia, which isn't life-threatening, and obs only really showed the same the paramedics had seen. Eventually, at about 2:30am, I was seen by the doctor, who did a peak flow (best one was at 185-ish) and listened to my chest, asked me loads of questions that I wasn't really awake enough to answer, and told me I had a white blood cell (infection marker) of 16 (normal for my age: ~10) and talked to me about asthma, saying it shouldn't be taken lightly just because it is common, and it's difficult because usually people presenting like I was have a formal, set-in-stone diagnosis of asthma, where I'm just nearing the end of the diagnostic process (based on next week's spirometry) so it's not entirely set in stone, although I probably definitely do have asthma. He told me I should talk to my GP about getting a peak flow meter, and said he thinks I have a respiratory infection and an asthma exacerbation (when asthma gets worse).

The rest is a bit of a blur, but at around 3:30-ish, the doctor came back and said he would give me a short course of prednisolone as well as some clarithromycin, which is an antibiotic. At around 4:00am the nurse came back and gave me a dose of prednisolone along with one antibiotic, and said that she would be back in about 10 minutes to take my obs and peak flow again, to see if the pred was taking effect.

At 4:10-ish, she came back and although in was really tired, we managed to get a half-decent peak flow reading of 200, which is an improvement on my previous one! The doctor came to review me, and although he was originally concerned over the tachycardia (fast heart rate) we assured him this was nothing to do with the presenting problem, and had been going on for a while, so there was no need to keep me in. He brought in the box of prednisolone and the box of clarithromycin, reinforced the idea that asthma was to be taken seriously, and said if I'm ever short of breath or coughing and I take two puffs, four puffs, six and it's still not working, then I absolutely must come in to hospital. He said I have to make an appointment with my GP 24-48 hours after coming to hospital, just to be checked out.

Such fun.

He then discharged me, and my parents and I drove home.

Of course, not before I'd had a chance to nab some BBQ Saucers from the vending machine! They are the only reason I go to Blackburn Hospital at all! ;)

So, with a cracking headache, I got home and crashed in my bed and fell right asleep.

I had the blood tests today that were ordered earlier in the week - again, my veins could not be found, and I had to go to another part of the health centre to have a butterfly cannula put in the back of my hand (ouch) in order to draw the blood. Cheers mum, you've given me your difficult veins! :P

So, GPs tomorrow morning before college (yay), 8 prednisolone and an antibiotic plus my Ventolin and Clenil, and maybe a couple of paracetamol to combat that pred-ache (prednisolone headache) before I go to college.

Once more unto the breach, dear friends, once more.

Although if it were summer, then the beach would be more appropriate than the breach...

~Liz