A special place.

I went to Beacy Head, this is a really magical place, the cliffs are absolutely breath taking and stunning like nothing else. There's such a calm feeling that washes over you, when you stand near the cliff edge, it's almost overwhelming. That place is truely serene. But apparently not all people can cope with that serenity and the quiet, because a lot of suicides happen here. Imagine diving of the cliffs...

The life changing hour.

So I've been slacking a bit with these posts, who would've thought that I'd manage to get some sort of a life, whilst being stuck in this God forsaken small town, but here am I...behind on my posts. I feel like I should continue this more serious roll, I have going on at the moment, so this post will also feature a story about a patient, just like the previous one...

It was a regular day and as always a tad slow in the morning, that was until my man, which is one of my many male patients got the news about him going down the OR (or as the lovely Brits say, theatre) in order to have a LBKA. I imagine your synapses are a bit crowded, as your neurons fire at an accelerated speed in order to solve this rather fancy abbreviation, let me put you out of your misery. LBKA is a left below knee amputation. This is an operation that I haven't seen before, so this was a once in a life time opportunity. My man, aka. P is such a lovely elderly man in his prime at the age of 73. He has a wonderful sense of humor and it's a pleasure to speak with him. He always smiles and sometimes waves at me, if he sees me coming down the hallway. However, due to his serious problem with his leg that causes him tremendous pain, he's often confused, because of the dosage of the pain relieving medication. The doctors made the decision about the amputation a couple of days ago, they even had to fly in specialists from London to see P. 

My man, I think it can be interpreted as wrong, if I keep refering to him as my man, but it just feels right and it's really a bad habbit that has followed me throughout the past three years, when I first enrolled to do this gig. 
So back on track...P is the only one, who makes my heart "flutter", when he shouts "love", "darling" and "dear" after me. He's one of those patients that stick with you...

The reason as to why he's having a LBKA, is him being on a drug called, Warfarin (this one you ought to look up, I won't give it all away!) Apparently this drug leaves some sort of crystals or it crystalizes in the arteries, which ever really, and when the crystals start to clot, then it becomes dangerous. This has caused that an area of P's leg has had limited blood flow with oxygen and the vital nutritions, this has caused ireversable tissue damage, so the leg is no longer viable. P has also got a history of Diabetes, and this doesn't exactly help his situation! So his leg is an ischemic one, that's almost neucrotic and the malleolus is exposed.

He's brought to the OR at around 4pm and an hour later it's all over. Imagine, an amputation sounds like major surgery, and to me it is, but in fact a bowel surgery takes longer. Shocker!
The surgeon begins with the laser, which enables him to cut through all the layers of the dermis. It smells, you can even spot a few "smoke bubbles", it's impossible to decribe what it smells like and even more so to compare it with something else. But it's manageable. The surgeon needn't worry about accidentally cutting something "important", seeing that there's no flow what-so-ever. He continues using the laser for about ½ an hour, even though it felt like longer. Some places he's forced to use the scalpel, which ensures that the laser has done its job. The skin is now loose and the tibia is completely exposed and "raw". It's time for the saw. I imagined it lookind differently than it did, I suppose I pictured it to be more "saw-y" (that's definitely not a word!) It was steel blade that moved in a "saw-y" way. You could see small saw dust particles, as if it had been a log, he'd cut into.
This was a humbling experience (not sure if that's the right word to use, to describe what I felt at that instance!), because it wasn't some random log, the surgeon was in the process of taking a man's ability to walk away from him. After a while the leg is no longer attached to the rest of the body, and the leg is removed by the sterile nurse and layed on a table next to P. Just one hour had passed since the first incision and the leg was now a seperate thing. The surgeon spends a lot of time to sow the skin laps together, and then attaches a drain and a vaccum-pump to relieve the pressure and excess the extra fluid. The stump is dressed with dressing pads and tegaderm. And then I leave him and don't see him until the next day...

The following day P is in pain. A lot of pain! And it's not only because I like him as much as I do, but it hurts me to see him like that. And because of the very heavy dosage of pain relieving medication, he's so confused that he's refusing to take any stronger tablets. 
Of course because I'm fond of him, it affects me a bit more than had it been a who-ever. I put my hand on his shoulder and tried to take his mind of his pain, easier said than done! He's hurting in a place that's no longer there. 
"I know it hurts right now, but it won't hurt forever! I promise it will get better and I know that it doesn't seem like that, but it will!" those were the only comforting words I could muster, I was absolutely no help whatsoever! I just sat with him and tried to keep the tears at bay, almost easier said than done...

-xoxo-

Trauma - like no other.

So this is a post that's unlike the others, this follows my experince of a patient, who suffered cardiac arrest while I was on-call. I've had people dying on me, but I've never seen anything like this before...so bare with me, this post will include plenty of medical jargon.

I was in for a quite day with one of the out reach nurses, J, who's basically a nurse skilled within the critical and ICU (or as it's called in the UK, ITU) field. We started our day with hand-over reports with the anesthesiologists, when suddenly the pages wen't off and a voice practically shouted "cardiac arrest MAU" and then all hell broke loose. Just to keep you with me, the MAU is the Medical Assessment Unit. Then one of the anesthesiologist doctors took of and J signaled for me to join. At first I was a bit confused, I mean, she couldn't have meant for me to actually join in with the cardiac arrest...oh but she did. So there we were, running like crazy for MAU. 

Once we got there, the patient hadn't actually arrested...but that scenario wasn't that far out in the future, so the defibrillation pads were put on the patient just in case. And while that was going on, the patient now arrested and the biotelemetry showed asystole, which rendered the pads useless, so they started pushing Epinephrine and Atropine. However, the patient's major problem was that she was in the process of bleeding out. I kid you not, if I say that the minute I got there, the scene looked like it was taken out of Grey's Anatomy or ER. There was blood everywhere, it looked like there was an Ebola outbreak - the patient bleed from her nose, throat and ears... The anesthesiologist intubated and started ventilating, while simultaneously sucking blood from the intubation tube, while she was concentrating on this, the leader of the Resus team started CPR. The regular staff, including J started hanging units of blood up - the only problem with this was, as fast as they were pouring it into her venflons (and I say this in plural, she had about 4 of them!), just as fast it left her body again. They simply couldn't keep up. However, nobody had called the MHP (Major Hemorrhage Protocol) even though in my oh-so skilled opinion, if this wasn't one of those, I don't know what else would qualify. Just to give you a clear picture of how much she was actually bleeding, the patient had -pre-arrest- gotten three units of blood and her Hgb was still merely 3, we ended up giving a total of 9 units of blood and two units of FFP's to boot. They even considered drilling a hole into the tibia in order to boost the effect of the blood. Her pillow was completely soaked, blood even dripped onto the floor from it - like I said, there was so much blood. There were also much melena, I had never in my life seen that much. The CPR was performed in 6 stages consisting of 2 minute rounds of chest compressions and ventilation. 
The regular staff tried to contact next of kin, they were successful, but I didn't see any relatives until she was transferred into ITU - as you probably can deduce by now, she actually made it. Even though that the doctors decided to end CPR, afterwhich she had no pulse, but then after a few seconds, the pulse came back and they continued trying to save her. 

It was chaos, plain and simple - there were 9 people surrounding the patient, all trying to help to the best of their ability. I mean, some of the doctors started filling out the DNR form in the middle of the process, one of the male nurses forgot to check the blood, before he started pouring it into the patient (a serious lawsuit waiting to happen!). It was like time just stood still.

After what felt like forever, but was more like two hours - the patient was semi-stable and could be moved. However, the doctors had difficulties sorting out their next step, because could she survive an emergency surgery? It was either that or giving the radiologists a chance to see, if they could do some damage control. They upped for the latter and she was transferred to the X-ray ward. I had to suit up for this one, wearing a led skirt and shirt, in order to protect myself from the radiation now blasting through the room. The radiologists went in through the femoral artery and started the embolisation. Safe to say that they were successful and the patient was now transferred into the ITU.

On a semi-finale note, the reason to her almost dying was that, she had had two DU's in the past and this was probably what had caused her to almost bleed out... 

On a final note...I still cannot believe that she made it! I really can't believe it! It really looked grim, when they were doing the chest compressions and you could hear the ribs cracking from all the weight. It was a surreal experience, but one I wouldn't want to be without!
The most shocking part of this was actually that no one seemed to know the name of the patient! It was embarassing to say the least and really undignified to the patient! She wasn't a Jane Doe - she was J.J.

-xoxo-

Cultural shock - understatement of the year.

I've been meaning to write this for quite a while now, so I figured it was time for me to sit my arse down and get down to it and I find it a wee-bit ironic that as I'm sitting here and trying to write this, Bruno Mars' "The Lazy Song" is cheering me on...

As you probably can deduce with those awesome Sherlock Holmes skills of yours, it was quite a cultural shocker coming to the UK. 
I can honestly say that I haven't met nicer and more friendly people than the Brits. It doesn't matter who you approach to ask for directions or whatever, you will be helped. People actually go out of their way to try and help you and that's definitely not something I'm used to. It makes for a nice change, it's just too bad that I've been damaged by my semi-Danish upbringing. I'm way too picky as to whom I'll ask for directions and I'm always suspicious of the people I ask, it's almost like I've decided that they have less honorable intentions as to why they're helping me. I know, paranoid much?! I need to lay of the horror films and stop re-playing the theme from Jaws in my head!

...time for another story from real life...

It was a cold, windy and very rainy afternoon, two girls set out to find the nearest computer and gadget store...*enter dramatic music*
Nah, just kidding. We went looking for one, because Sarah's computer practically went up in flames, so being two girls with little or no flair for computers, we decided to seek the help of computer wizards in a land far far away. Once we entered Curry's PC-World, an employee of the store spotted us and went straight for us. We had literally just entered the store and there he was, all ready to help us. Albeit we did look completely soaked and probably lost, I hadn't imagined that within two seconds a person would drop everything in his hands in order to help us. It turned out that the computer couldn't be salvaged, the guy then spent almost half an hour with us to try and find out, if a Danish computer could be shipped to their store or if we could purchase a Danish keyboard online. That guy went out of his way to try and fix our problem, I'm not that gullible that I don't know that he was also trying to make a sale, but it was still very nice for him to go to some lengths in order to help us. So if the short Asian bloke is reading this - a very big thank you!

So an interesting fact, Brits don't greet by handshake, this gesture is seen as being very business-y, so whenever I greet somebody, I have to keep that in mind. I'm not the biggest people person out there, and I can honestly say, I really dislike touching random people, but I don't feel like I've greeted the person, unless a handshake has been exchanged. This has been difficult for me and I have to admit that I've forgotten this and sometimes this has resulted in many strange looks. I mean, c'mon - you don't know that you won't be doing business with me in the future, and then what? Should I shake you hand after all those years, let's just get that big boy out of the way right now!
What's more interesting and very peculiar, if you were to try to understand the two things in extention to one another, is that Brits stand very close to one another. A distance of 2 feet (oh no! I've been in this country too long, I've forgotten my beloved Metric system!), as I was saying a distance of 0.5 metres is kept between one another, and that's extremly close! I mean, if you were standing any closer, you'd be in my lap! I was told that personal space is very important and it's probably true for most people, but how much personal space can you have within 0.5 metres? So it's all very odd. People don't want to shake your hand, but they want you to stand in their grills - yeah, that totally makes sense!
What's more hilarious is that I can't get it right, I want (well, not want, but you get it) to shake hands, but as soon as someone enters my space, I immediately back up, and I catch myself doing it, I instinctively arch my back away from the person. It's quite the conundrum!

So to all of you, who prefers handshakes and maybe 1 metre of distance (or maybe even 0.75 metres) - it's all good! Unless you're in Britain, then tug away that devilish hand of yours and remember, it's 2.5 feet and not 0.75 metres! ;)

-xoxo-

Let the good times roll...

"It is not our differences that divide us. It is our inability to recognize, accept, and celebrate those differences" - Audre Lorde

I have to agree with Audre Lorde's words, though I wouldn't break out the Dom Perignon just yet. I've done my first two weeks of the internship, and I live to tell about it.

My first day was scary as hell (initially I wanted to insert a curse word, but since I know that my mom is reading this, I won't!). It was just a couple of minutes to 7 am, when I entered the staff room, dressed in my extremely and almost permanently dazzling white shirt and navy blue trousers (yeah, I'm practically a Brit now). There were three other people in the room with me, by the looks of it, two of them were healthcare assistants and the third one was a nurse, a male nurse to boot. Nobody said anything to me, not even responed to my "good morning", which I had belted out, when I entered. It was almost like they didn't acknowledge my presence, so safe to say, I was pretty much ignored for a half hour or so. Then one female nurse turned her attention to me and literally asked me, who I belonged to?! Hm, had I looked like a stray dog? Well, I got the opportunity to select my own master, so I just settled with the one, who'd just semi-insulted me. She is now my mentor or pet owner, which ever floats either of our boats. She is -despite the oh-so bad first impression- actually very nice and so fabulously Scottish...

I need to get back on track, back to the quote. So there are a lot of differences in the approaches to nursing. Let's start with the settings, my ward consists of three bays, which have room for six patients (it's kind of lying, when I say "have room for", because the truth is, there's not much room. Let me just say that if my junk in the trunk was any bigger, I'd get stuck a lot!) There's one side room, which is preferably reserved for isolated patients due to infections. Then there's a desk in the middle of the ward, where there are two computers (they have definitely seen better days!) and to your right you find a table attached to  sink, a tiny refrigerator and a drug cupboard (psssh! It's here all the good stuff is stored!), to your left are all the patient journals. It looks like something from another century, which all makes sense, because apparently the digital age hasn't reached the English hospital wards yet, since EVERYTHING is written by hand. Your first thought must be - "crapola, that's a lot of work", and you wouldn't be wrong, most times the writing isn't illegible, heck I reckon Sanscript is easier to decipher! So at times I have to decline to give drugs to some patients, because I simply cannot read the bloody drug chart! 

This prompt me to tell my mentor about our system and handling of drugs, she didn't seem that impressed by it, almost like she couldn't be bothered, but she did tell me that the reason, they didn't use computers for this, was that it was too expensive! Wow! Too expensive...at the expense of what could be a patient's life!

So everything is basically cramped up as much as possible. The bays are identical, each patient has a bed, a night stand, where the medicine is kept (I know, awful, eh?), a chair and a tiny TV, and to top it of, they also have their own curtain, so they can have some privacy. Needless to say that you cannot achieve much privacy behind a curtain, everything you're told by the doctor on rounds is heard by five other patients, sometimes relatives, nurses and students - way to uphold the patient/doctor confidentiality! 

All in all, they way they handle the medicine and drugs is just an accident waiting to happen...

...a story from real life...

I was to inject a patient with Clexane in the abdomen, I asked for an alcohol swab to clear of the injection spot, to which the nurse replied, that they didn't do that anymore. Incredulously I sighed and said that I had been taught to do that before doing anything that involved needles, she said that she was taught the same procedure, but it wasn't practiced like that anymore. I reluctantly injected the patient with Clexane and told the nurse that next time I will be using the alcohol swabs.

So it's safe to say that I do recognize the differences, however, I'm finding it difficult to accept these differences, and I'm not sure that I'll end up accepting them, but I'll try. I do know, that if I end up breaking out the Dom Perignon, it would be for completely other reasons than celebrating those differences!

-xoxo-

My new home

Welcome to the glamorous life of an exchange student.

Kitchen - at least the microwave is new.

A sink in my room - now that's handy.

The room we dare not speak of, nor enter for that matter.

The loo - if you look closely, you can see the stolen goods.

The bathroom.

The hallway. 

The kitchen in all its glam.

My desk - without a chair.

The tiniest closet ever.

The nightstand.

The not so cozy bed.

The view from my prison cell.

Part of the stolen goods.

The infamous sofa.

The living room.

The living room view.

My first blog post in all its glory.

My first update from this adventure.

Let's see, it's been a week, so far I've managed to cut a dish towel into pieces that can be used as dishcloths (shh! don't tell anyone!), almost got caught for stealing daffodils (so not worth jail time!), cut into an electric wire in order to make it fit my adapter, and the list goes on...

My reasons for choosing to study abroad are countless. I wanted to be on my own in foreign country, I wanted to experience student life as an exchange student, I wanted to learn about a different culture, I wanted to practice my English...as I said countless. After being here a week these reasons still stand, despite being met by a horrific apartment that I'm supposed to call "home", even though I think that the multiple bugs already call it "home".

The tiny apartment that is my home now is really something else entirely. Imagine Gordon Ramsey's Kitchen Nightmares and add a blue sofa covered in suspiscious looking white stains (don't blush, you totally know what I mean!), a carpet looking like something died on it and then evolution did its thing and the abhorrent smell, then you have a pretty clear picture of my new home.
I live across the hospital, where my placement will be. So as far as location in extention to the placement, it's very great. The area I live in houses only hospital staff, so there are plenty of nurses, doctors, porters, etc. around. But I'm -apart from Sarah- the only exchange student, and I have yet to meet someone near my own age range. Apparently Eastbourne is the place for retirement, so I've seen tons of elderly people, maybe even more elderly people in one week than I've ever seen in Denmark. 

But let me just say that I was lucky to get this far. Upon arriving at Gatwick Airport I had to fill out some documentation about my stay here, because of my lack of a European passport. So I was met by this scary-looking dude, who started quizzing me about my stay here, my reasons for coming here and my life back home. Suffice to say that this 3rd degree, or what actually felt like the Spanish Inquisition, got me quite nervous. I mean, the dude could've given me a break, considering he was a foreigner himself - isn't there some sort of code, Foreigners Unite? Anywho, after sweating buckets I got the clear and I was in.

...here are two feel-good-stories about how Sarah and I apparently left our IQ's at home...

Our first breakfast consisted of eggs and the driest bread known to man (I've never felt the need for more saliva, before eating that particular loaf of bread!) We were very excited...that was until we found out that there wasn't any salt or pepper. I cannot begin to say what we were possibly thinking, while we stood in the aisle of Sainsbury's (our new favourite grocery shop!), why would we buy eggs and not buy salt and pepper...that meal made me feel like I was in prison and given the scenary of my new home, it was a definite prison vibe!

In an attempt to make our new home more homely, we decided to buy candles, scented candles none the less,  when we got home, we put the candles on the table and then we just took a minute to stare and acknowledge our  brilliance, until it hit us, that we didn't have any matches or even a lighter...should've taken up smoking! 

Got yourself a good laugh on our behalf? Maybe even pitied us a bit and took comfort in our misery? Yeah, I figured you would, heck I would too!

I start my internship tomorrow, at a surgical ward that deals with general surgery. I'm very stoked to see how it will turn out. The shifts are 12 hours long, that's going to be challenging in more ways than one...hopefully I'll get through the day in one piece!

On a final note, a week in and I don't regret coming here, despite all of the above, but I would recommend going and studying in a bigger city, or you just might end up snatching a sugar daddy!

-xoxo-