MEDICAL MATTERS

[Tripps]

Thanks for that Ian - I've been waiting all evening for it, and had just convinced myself that you had been admitted. Well done - sounds all good.

[PanBiker]

Thanks for your concern Dave. Once given clear I took the opportunity of driving down the M6 to collect our Ruby. We had to put that on hold when I had my wobble.

I need to reiterate here that the treatment and handling I received by the TIA clinic was exemplary. The clinical nurse went out of her way to explain everything and the consultant was very thorough in his interpretation of my results, caring in the way his prognosis was delivered, good news first and then dissemination of how he arrived at his findings. As Stanley says the NHS gets knocked enough, I personally can't fault any of my treatment once in the system. The tests and procedures, time and care I have received over my two visits in the last three days would have cost thousands if not for our healthcare at the point of need. It's a bloody good system if given a chance to work properly.

If there is a failing in the current assessment recommendations I would say it is with the 111 service. I can see that it is useful in some situations but because the person at the other end is not a clinician there is no deviation from the script or change of questioning depending on replies given. The crux seems to be to determine whether or not you are having a heart attack. There doesn't seem to be different branches of the script. That of course is why you need an informed listener on the other end which of course cannot be provided due to staffing shortages. I think the systems needs to be refined. A caller is generally 15 - 30 minutes into their golden hour by the time the script will trigger the cavalry.

As a matter of interest I noted our journey time today from Barlick to junction 5 of the M65 which is the take off for Royal Blackburn Hospital. It is two miles further to the hospital a total of 23 miles from Barlick. AA travel guide gives a journey time of 35 minutes. I clocked it today on an off peak holiday day at 45 minutes passing the junction so I reckon the hospital in 50 minutes. All on the motorway apart from 7 miles. Negotiating Colne to get on the motorway from Barlick can take the first 20 minutes of any journey.

Airedale is 14.5 miles away via the Skipton bypass which is the preferred route on the best roads (A59, A629). All A roads but generally a steady speed. No longer than 20 to 25 minutes for the total journey. Jack got me there in the 20 on Saturday without overtaking. Apart from the other reasons I gave for choosing Airedale, it's a no brainer on time and distance. We are fortunate in Barlick that we can elect to go either way, one advantage of being in border country.

[Stanley]

Glad it isn't a TIA. Ear infections are a bugger as my daughters can tell you... Good luck with it.

[Wendyf]

Glad to hear that you are fit and well Ian...will expect to meet you on top of Weets sometime soon!
When Col came out of Airedale after his op he was given contact details, both email and direct phone numbers, for 2 nurse clinicians who specialize in urology and they have been a wonderful help to him through the last few months. Always there to answer questions, get prescriptions and even arranging for the consultant to call for a chat at one point. Great service.

[Tizer]

Wow, that's a detailed report Ian. I can tell you've written many reports in your time! It's a welcome result for you, at least the infection problems are `the devil you know'. And good outcome from the NHS too - our experiences of the medical side are good, it's the management, communications and coordination that lets them down (not to mention shortage of the main ingredient - money).

[PanBiker]

Thanks all and sorry for rambling on somewhat. I document it as I see it as it may be useful for someone else down the line who reads it. I don't mind admitting that it put the jeebers up me. In a way I have had a pretty good MOT and passed. We'll see what my doc says in the New Year.

I may have to miss the next blood donor session though, the medical screening starts to ring bells if you have been hospitalised or have had tests. I have had needles poked into me so I don't think I will be able to donate mid January. I'll be giving back as as soon as the system will let me.

[Stanley]

Not a bad way to enter the New Year Ian.....

[PanBiker]

Indeed Stanley, the heavy cold I inherited (probably at the wedding) looked yesterday as if it was on it's way out but it's back with a vengeance today. Loads of catarrh and coughing spasms are back. I don't have a temperature, sore throat or feel ill with it (apart from the thick head) so its just the tail end having a final fling hopefully. One things for certain, I know there's nothing major wrong with me.

All this hoo ha about the screening process at Heathrow for the Nurse who presented with the symptoms of the Ebola virus the following day. The media will make a story about anything, she was clear when she came into the country and held back for further tests when she said she felt ill. They tested her a further 6 times in a separate screening area before letting her board the Glasgow flight. As a professional clinician returning from the infected area she had her own kit for monitoring her own health as well. Her symptoms did not fully materialise until the following day and she made the call herself as soon as she was aware of her condition. What was the airport supposed to do, keep her until she fell over?

[Tizer]

The news media seem to have got hold of the wrong end of the stick in this ebola incident. Instead of worrying about what happened at Heathrow they should be investigating to see if an effective quarantine period is being used in the African country before the nurses and doctors leave.

[Stanley]

What a sensible suggestion Tiz!

[Tizer]

Thanks. I was annoyed by hearing the head of the NHS saying that quarantine wasn't needed and I can only assume that she meant quarantine on arrival in the UK rather than quarantine before departure from Africa. At least I hope that's what she meant - otherwise we might see more cases arriving here.

[plaques]

The lady in question acted very responsibly by telling the authorities she felt unwell on arrival and asked for her temperature to be taken. Perhaps she suspected that she had contracted Ebola but preferred to be quarantined / treated in the UK rather than in Africa. I know which one I would have chosen. I doubt if we could pass a law that stated British Nationals must be quarantined in a foreign country, perhaps against their will, just because we think they have an infectious disease.

[Tizer]

You have to do so if it's an emergency. These are not ordinary travellers, they're people who've been in very close contact with the ebola victims and should be treated as likely to be carrying the virus until proven by quarantine that they're safe.

[Stanley]

I was doing a very dangerous thing yesterday.... Marvelling at how well I felt considering the mileage. I wish you all good health this year, eat well, the right foods and take moderate exercise! With a bit of luck you will survive!

[Sue]

What is the incubation period Tiz. I don't know much about the epidemiology of the virus apart from its mode of transmission.

[PanBiker]

Made a follow up appointment today with my GP as recommended by the consultant. Found out that my doctor (Dr Brown) retired at the end of the year so all his patients have been taken up by Dr Manzur who can see me on Wednesday. We'll see what he has to say.

[Tizer]

Sue, an incubation period of 2 to 21 days is always quoted and I think this range originally comes from WHO information. However, looking further you can find a qualification to that range; namely that symptoms usually appear in 8-10 days and that the person is not contagious until symptoms appear. By the nature of the disease and the places where it's occurring I would think that very little is definitely known. It's hard to collect meaningful data when people are so busy saving lives, patients are dying so fast after the symptoms appear and much of it is going on away from medical centres. So it's better to err on the safe side.

[PanBiker]

It seems incredulous to me that there is no mechanism in place to isolate returning medical personnel before allowing return to their originating countries. A three week isolation facility surely could be easily set up, after all it would only need to be a holding facility clear of the infected area until or if further symptoms developed. All the medics are trained to monitor themselves so with such a facility in the regime no one should present with symptoms post transit home.

[Stanley]

News to me that Ian Brown has retired... God help us, I am going to have to educate another medic in lipids and nutrition!

[Sue]

2-21 is classic virus of course. So not infectious till the symptoms appear, that is better than mist viruses if you are going to try and control with quarantine. Infection is by contact with body fluids isn't it and not inhalation of droplets.

[Tizer]

Not inhalation of exhaled droplets, but apparently can be caught from droplets of vomit but perhaps that needs the presence of blood. And yes, the fact that the person is not contagious until they show symptoms means quarantine with close monitoring before return to UK should be straightforward.

[PanBiker]

News to me that Ian Brown has retired... God help us, I am going to have to educate another medic in lipids and nutrition!

Ian Brown retired at the end of the year, admin staff have been adding notes in with prescriptions informing his patients that Dr Manzur has taken over his list. If you are not a regular visitor or currently on prescription, which is my situation you would not know. Don't know if a general proclamation will be given at some future date. Dr Manzur was at the practice in 2013 as Registrar and was quite popular according to the practice website. He is now permanent and hopefully raring to go. You intimate above that the doctor may be lacking in some areas, I think I will reserve my judgement of the guy until I have met him.

Barnoldswick Medical Centre

[Pluggy]

It seems incredulous to me that there is no mechanism in place to isolate returning medical personnel before allowing return to their originating countries. A three week isolation facility surely could be easily set up, after all it would only need to be a holding facility clear of the infected area until or if further symptoms developed. All the medics are trained to monitor themselves so with such a facility in the regime no one should present with symptoms post transit home.

Possibly following a case in America where a returning nurse who steadfastly refused to be quarantined for 3 weeks citing civil liberties or something.

http://www.telegraph.co.uk/news/worldne ... order.html

I happened across Dr Browns retirement just before Christmas when the surgery was closed with a note stuck on the door saying they were holding a presentation for him. He's not my doctor (although I've seem him on occasions when my own GP wasn't available) and didn't think much about it.

[PanBiker]

It should be an understood condition of the service regime before signing up.

[Pluggy]

It would depend on how easy it is to get volunteers. Its an extra hurdle if medical professionals have to be cajoled into volunteering.