Silly Cartoon Appreciation Post

It’s only a short update I’m afraid today as I feel more obliged to write this than actually have a plan as to what I’m writing! This is possibly the longest unplanned break between blog posts that I’ve had in the whole time I’ve had this blog and it was completely unintentional. However it is a true way of knowing that I’ve just been running myself into the ground recently!

Work has been very eventful, too much going on to even mention it all! I had a huge opportunity to watch something we rarely get to see on Friday that I will write about once I have time to do it justice. One thing I would like to say is that I’ve never been prouder or happier of my team and what we’ve accomplished of late. I really do think we work together really well, and I’m feeling a little confidence boost after some excellent feedback that myself and my colleague, who is the other trainee, received from one of our pathologists. We’re going from strength to strength each week but I think it’s been noticeable in the past month or so just how far we’ve come.

Very appreciative of a bacteriophage chasing a bacteria saying Pew!

I’ll finish with a little note about my revision as it needs to be my main focus for the next two weeks and I’m feeling the pressure now. That as well as finishing my assignments which are in about their third draft and finally with my manager to review. I’ve found in the last day that there are some excellent YouTube videos out there that are right up my street with silly cartoons that I’m certain will help me remember stuff. I just wanted to mention The Amoeba Sisters because I discovered them and they’re awesome. Check them out!

Poor screen photo apologies but find their videos at The Amoeba Sisters

MG x

100 Brains & Counting

In my around 18 months of being a trainee I have now reached my next milestone of 100 brains removed! That means I’ve roughly done slightly less than that in eviscerations I would imagine, as sometimes I have been in the post mortem room and assisted others by just ‘doing the heads’ as we call it. I’m really chuffed that I kept this count and that I’ve got there, it feels good to know. Plus I told the trainee Neuro pathologist who’s been working with us and he said he has done six! I said I just need to get working on what the parts are called now because he puts me to shame naming each and every part, and some bits I really have no idea. I thought it might be a good time to explore the parts of the base of the brain that I’ve learnt so far and what they do.

I don’t think I would ever remember all of that, but here’s an example of how much you could learn!

The brain itself sits in the skull within the meninges, the thick layer outside of the brain but inside the skull is the dura mater. Sometimes this is stuck to the inside of the skull and difficult to remove, other times it can be free. I need to work on getting better at leaving it intact when opening the skull as I often saw through it. I think this is a combination of becoming used to the feeling of the saw but also recognising the differing thickness of skulls. I always think some people must have really heavy heads because the skulls are so thick!

The base of the brain is where the structures that connect to other parts of the body sit. There’s vessels to feed blood to the brain, nerves that shoot off to all the parts of the body too including the spinal cord which is thick and that we disconnect last in order to remove the brain. That’s the bits I know. The only other bit I can name is the rather fancily called Circle of Willis which is a structure of blood vessels at the base of the brain. Sometimes you can identify parts of this that are hard and not working as they should, they are atherosclerotic where there has been a build up in the vessels. It’s taken me a long time to learn how to spell that word, after several times it being spelt letter by letter by the pathologist as I do her notes.

I always think it looks like a little stickman a bit… The Circle of Willis!

The first part of the brain we disconnect as such is the nerves that go to the back of the eyes known as the optic nerves. Once we pull back the front of the brain, just underneath you can see two little white connections that we sever. We work downwards, carefully pulling back the brain and disconnecting the nerves there. The cerebellum, the back of the base of the brain is actually tucked up in a bit more of the dura mater that we have to cut through to remove. Once this is free, we cut down into where the spinal cord has come through, and then can support the top of the brain while scooping out the cerebellum. You then are holding a human brain!

We would, of course, stop at any point if we see anything significant that we might need to note and make the pathologist aware of. This could include any signs of infections, bleeds or other odd things we might not immediately recognise. It takes time to know what is normal and what is not but I’m fairly confident at completing this now.

I hope I’ve explained that fairly well, but if you have any question get in touch, and please bear in mind this is definitely a do not try this at home kind of situation!!

MG x

What’s My Age Again?

As time flies by, I seem to be hurtling towards my 32nd birthday with increasing speed. While I was driving home the other day, What’s My Age Again by Blink 182 came on the radio and it got me thinking. There’s a line ‘Nobody loves you when you’re 23’ and I distinctly remember hearing that line being younger than 23 thinking it was a long way off, now I’m nearly ten years beyond that.

I’m only as old as I feel, and that changes on a daily basis

Age is a funny thing. They say you’re as old as you feel, some days I feel young and incapable of adulthood and others I feel tired and old like I’m beyond my finest years. In 2019, I can expect to live an average of around 84 years as a woman, in comparison in the Victorian era that could have been halved. In the 1200s in the UK I could be expected to already be dead with a life expectancy a little over 31. Only a few decades ago to reach 60 or 70 would seem a fair innings but now we consider this dying young especially with the raising national retirement age. Perspective on life expectancy has changed with many things not restricted to changes in health care, improved living conditions and better awareness of our health.

With all this in mind, it’s still not unusual to see people come into work who are younger than me, or even around my age. I think, for some reason, when I see 1987 on a date of birth it hits home the most. The sad truth is, people die at any age. An average comes with huge outliers in the statistics, those dying in childhood and those living beyond 100. It’s not something we know at all, as much as we don’t know how we will die we have no idea how old we will be. We never know how long is remaining on our lives, and I think wondering about it or knowing for a fact would only drive us insane.

If this has made you think, why not pop along to a Death Cafe? You can find your nearest at DeathCafe.com

My point in writing this was just to say one thing, while we obsess over age and how old we are, it does no good in helping us live our lives to the best they can be. Nothing can be truer of this than when people remind me that I’m in my thirties now so I should be prioritising having children if I want them because my ageing body is only getting worse at conceiving and carrying children as it slowly declines towards middle age. Remember that things just happen when they do. As a control freak I don’t like this, but it serves me much better to think it’s out of my control than to try and do anything about it. What I can control are my emotions around it, and try to not feel negatively regarding the fact.

MG x

Dead Tired, Very Wee Beasties &

I can’t stop yawning, and it happens a lot. I also keep having real moments of ‘I need a nap, right now’ which I think means I’m probably anaemic and iron deficient again as that can happen a lot. I should be better at taking iron tablets but I’m not sadly. I also should be better at taking vitamins. Oh well.

I’ve been catching up on study and trying to learn about fungi and Protozoa. Fungi includes moulds, mushrooms and yeasts while the Protozoa are little things that cause nasty stuff like malaria. I think my main issue with this upcoming exam will be remembering how to spell all the words like prokaryote, eukaryote and peptidoglycan. I just hope I’ve got them correct there or I would look silly!

Ruby and I learning all about viruses too!

All this bacteria and tiny creature talk has meant I think a lot more about the tiny creatures around me. For example, being told there’s insane amounts of microbes in one gram of soil becomes quite worrying when you’re digging a hole in your garden. I’ve started to notice the little things everywhere, including these in a glove box at work I’m sure I’ve seen and ignored every day but not anymore! Being told that microbes are just everywhere, on and inside you even, is enough to just freak you out a tiny bit. It’s a very cool subject but I’ll be glad to not be hyper aware of the things crawling all over my skin and teeth!

You end up seeing the wee beasties EVERYWHERE

In other exciting news, my colleague Courtney thought it might be cool for us to make some YouTube videos explaining some stuff about our jobs and work. She’s working on, and I’m barely contributing towards, the first one currently so if you have any ideas of questions you’d like us to answer get in touch! I think it’s a great idea of how we can explain our work and jobs to a wider audience.

I’ll leave you with my PPE photo from the other week. This is what we wear for standard post mortems in the post mortem room. We have (from top to bottom) a surgical cap, goggles or glasses, surgical gown, apron, oversleeves, gloves and wellington boots. We typically wear this for any routine post mortems. I’d be interested to see what other people wear or if you have any questions so please get in touch!

MG x

Simon Says Study

I briefly mentioned ‘Simon Says Study’ on my Instagram stories yesterday, so I guess I should explain what is going on! I’m fully into studying for my next exam as well as writing my next assignment, and for this one I need a little help. Turns out Microbiology is complicated, and thorough, and quite confusing in some places. I’m very lucky to have a Simon in my life, a friend who is pretty much an expert in that field and who I can say ‘I don’t get this’ to and he can explain to me in one way or another whether that be drawing it out or explaining it in ‘Gemma’ terms. See an example of drawing it out in the image below, by Gemma terms I mean so simple anyone could get it! We arranged to have a study session last night, Simon writing an assignment of his own and me trying to get my head around Gram staining and Bacteriophages. I will crack this and I am ever so grateful to Simon for agreeing to help me!

 

Drawing out lipid membranes and proteins on the back of an envelope and suddenly I get it!

Other than that it’s been what I would like to call a bowel-themed week. Alongside writing an assignment about gut bacteria, I also had a day where I did two eviscerations on people with past procedures on their bowel. What is interesting about this is the fact that wherever you have had surgery in the past, especially in areas like that, you will see adhesions where organs would have normally been free moving. For example, the bowel can usually be moved about easily, it is attached by one side by what is called the mesentery. There is also the peritoneum down there that sits over everything and holds it in place, like a layer of fat that extends downwards and covers it all in an apron-like way. Generally, you can lift the peritoneum and then remove the bowel starting with the duodenum and extending downwards cutting through the mesentery. I hope you’re following me so far! In those that have had surgery or procedures, for example appendix or gall bladder removal, the areas of surgery can scar and form adhesions so areas of bowel become attached to places they would have not been before. Not only is this confusing for following the bowel for removal, but it also can make it much longer process for a trainee. I had to have help with one of the cases this week because I got really confused and knew I needed to stop, I was pleased that the other case actually went really well.

I think some of you may well ask why we remove the bowel. The bowel is examined along with all the other organs and can provide some very useful information. In some cases we even open the bowel, where we cut open the entire organ lengthways and open it out so you can see the membranes inside. The pathologist will look to see if there is any inflammation or conditions affecting the bowel, often this is done by observing a colour change in the tissues. Notably, I have seen a few cases where the bowel has been very dark or even black in places and this is where the bowel tissues have died or become necrotic. If the bowel is damaged this way in life the patient would have to have the sections of the damaged bowel removed which is a common procedure. By removing the bowel at post mortem it also means we can see the organs and structures below such as the kidneys, reproductive organs and bladder. As a trainee it often feels like removing the bowel is a big achievement towards the start of the evisceration and once I mostly mastered it I was quite proud of myself. I hope this was an interesting little insight into the bowel!

 

Are We Ready for Dying Matters last week, Rainbow NHS badge and my trusty hipster Grumpy Cat I have had since I started!

In other news, I am now the proud wearer of a Rainbow NHS badge. Our trust has been giving these out to people who pledge to support the open, inclusive and tolerant NHS, for those who don’t think any barriers should be there for people who identify in any LGBT+ way. When I saw these badges I knew I had to get one because I think they really could make a difference and show people that they don’t need to be scared about being who they are just because they are in a healthcare setting. More information can be found at their Twitter page here.

Hope you all are having a much quicker week than me, and if this applies to you don’t forget to vote today and have a lovely Bank Holiday weekend.

MG x

Dying Matters

What a Dying Matters Awareness Week it has been! I can’t believe my part in it is over and I managed to cram in three Death Cafes which only got bigger and better as the week went on. The first event at King George Hospital was small but a cheery discussion, my favourite part was discussing cryogenics with people who were amazed you could just freeze your head. The second was our regular event and was very well attended with a new face which was really exciting! I love our regulars so much but having new people come and discover what we do is the best. The third event at Queen’s Hospital was standing room only with a lot of pauses while people gathered their thoughts but the discussions were very poignant and important. I thought the fact the language around death was discussed was hugely significant especially to those in the health professions.

Death Cafe at work! Hopefully becoming a regular thing… watch this space!

Alongside these I attended a talk at what I think must be my favourite museum now, The Old Operating Theatre nearby the Guy’s Hospital where I used to work. It was a hilarious talk by Professor Ellis about Royal surgery that I enjoyed so much I didn’t want it to end. I resisted buying all the giant microbe toys while I was there but did cheekily treat myself to a perfect piece of jewellery.

I happen to think I had the best seat in the house at The Old Operating Theatre!

Yesterday I had one of the best Mortuary Insight Visits for staff that I have ever conducted. I felt like people were really engaged and learnt a lot from their time with me. I still love doing these and feel like I get a lot out of them too. My confidence of talking in front of people has grown and grown in recent times thanks to these.

For many reasons, this week has been a challenging one mentally for both me and my fiancé. It seems appropriate to mention that this week also happens to be Mental Health Awareness Week in the UK. Physically invisible illness is what I consider to be something we all are massively improving at being aware of but still has a lot of room for improvement. I see the effects at work, I feel them myself and I worry about them in other people.

People and socialising give me the worst anxiety sometimes, my cats are good at helping with that.

Lastly, I spent yesterday afternoon in absolute wonder at what the human body can do. I was given the opportunity to try and remember the names of all the bones of the skull that once upon a time I could reel off in seconds. Ten years ago, I knew them all and had my own cardboard skeleton I bought and made in my room with all the bones labelled. Yesterday I struggled and was asking everyone what that butterfly shaped bone in the middle of the skull was. I remembered as I was leaving work, it’s the sphenoid. It’s all still in there somewhere.

It kind of looks like a butterfly, if you squint.

I’ll leave you with a photo of the cemetery I see on the staff bus that I vow to visit one day. It’s near the hospital and I’m pretty sure I have family there. Have a great weekend everyone.

MG x

Death. Death. Death.

Well after another trip up to Hartlepool, this time to take an exam and hand in my first assignments, I feel thoroughly ready for some Dying Matters week action!

Happy, feeling positive face!

A brief update, I’m fully stuck into my course now and have met some great people. I have collected some information in my role as AAPT Student Representative and feeling totally positive about the future. Microbiology for Dummies will be firmly by my side for the next two months too, so if we meet expect to see it somewhere looking more and more dog-eared as time passes. It was great to be in Hartlepool, even if it was cold and rainy. The marina is good if you get to ever go there, but the wind whips through the masts of the moored boats and sounds like bats rushing through a cave, even through ear plugs at 2am.

My new friend, Microbiology for Dummies

We got to visit the ‘monkey’ again on his little pedestal and throw some more money at him for good luck. The money goes towards the local hospice, and we now have it in our heads to visit him every time at least once as tradition. Expect many a monkey photo in future!

Good to see you again monkey 🐒

So I want to discuss the word death. I’ve noticed in the last week that through publicising Death Cafe people always seem to ask if it can be called something different. Something less ‘death’. Frankly, I don’t consider the use of the word death inappropriate or insensitive no matter how many times people say it is. I would just like to say, we at one point wouldn’t say cancer. Cancer was a big thing that people avoided. They would say ‘the C word’, or any other way of avoiding actually saying cancer. Cancer is a horrible, truly terrible thing that has impacted my family and nearly every family I know. However, death will happen to everyone. Being opposed to the word death makes no sense to me and not using it is incredibly unhealthy.

I am well aware that a lot of my non-death related friends think I can be a bit much, and it has certainly become an obsession of mine which I’m willing to admit. Perhaps, it is that I have gone in a different unhealthy direction but people do not do themselves any favours by avoiding it completely. I’ll happily discuss this with anyone, anytime. Plus, I will always say death, dead or died in a practical sense. I’m obviously more sensitive around the bereaved but I’m aware of when words work best. In discussing it in general, it’s death!

MG x

Not So Wise Anymore

As you’ve probably seen all over my social media, I had all four of my wisdom teeth out yesterday. My first general anaesthetic, which was genuinely terrifying for me, and my first time at a different hospital than normal. I think I had made it out to be truly awful in my head, so when I woke up from the GA all I did was cry for a solid five minutes while everyone around me tried to figure out why. They were just tears of relief, nothing worse than that! In all honesty, the anaesthetist was so good at her job I don’t remember going under. So once I was awake again they kept telling me to try and sleep more but I was insisting on staying awake and not being tricked again. I am totally fine now apart from the pain, which is manageable with some very strong drugs that are making me mega drowsy.

Puffy face on one side, that was where the nasty cyst was

Wisdom teeth are, in my mind, one of those things they should take out in everyone as early as possible. Along with the appendix, tonsils and anything else people end up needing removed and don’t really need. These little evolutionary hang ups generally don’t do much and just cause problems in the few that have them. Whip them out early and avoid all the nasty things that could happen I say!

My first hospital bed and cannula, achievement unlocked!

The reasons we have wisdom teeth are not entirely clear, but those who have tried to figure it out seem to think it has something to do with our early ancestors diets and processing foods we now no longer eat in abundance. While we opt for softer foods, our ancestors had little choice and would often eat rough food like plants and meats that would require a lot more chewing power. To this end, they also mostly had much larger jaws and muscles around the jaw to assist with this. Now we are left with much smaller jaws, no need for the extra chewing power and generally just some teeth that sit and cause problems in a lot of people. I know several people who have had other teeth removed when children because they’re jaw was small too!

A cute cartoon showing exactly what my lower left molar was doing, only it wasn’t apologetic

My wisdom teeth, or third molars, had a whole range of problems. The upper two had erupted completely, but mostly sideways meaning they not only had a cutting surface pointing directly into my cheek but the other cutting point went into the gum below. The two lower had partially erupted, one more than the other. The one that had half erupted was easier to keep clean and had few problems but one had only just peeled through due to being impacted. When a tooth is impacted it is not facing up like all the other teeth but usually pointing towards the side of the teeth next to it. A combination of the impaction and partial eruption meant I had formed a little cyst which kept filling with pus. They were a mess of ignored for a little bit too long sadly!

I got to rock the delightful hospital socks I see all the time on our deceased patients too!

I believe it’s something like 4 out of 5 third molars that have to be extracted if they appear in the mouth. I did ask the surgeon if I could keep them but he told me it was an infection risk, mostly a lie I believe but I know that a lot of teeth break upon removal and they can’t give you the bits of them. One of those times I wish he’d been honest and not told me a lie to make it sound worse than it is!

These two keeping me company as always

Well I’m full into recovery, got lots of medication and feeling a lot better than I thought. The left hand side of my face is super puffy, I have a sore throat from whatever tubes they shoved down there and I can’t open my mouth very wide at all. Each day it will get better and I will be back to normal service soon I’m sure.

MG x

An Introduction to Dying Matters And The Dying Matters Awareness Week

A year ago or so, Rachel and I were getting excited and nervous about hosting our first Death Cafe. We have come so far since then and I’m so proud of us for approaching our year anniversary! The reason why we decided to host the event in May was to coincide with the Dying Matters Awareness Week 2018. I’m sure I explained at the time what this was but I would like to do so again for all the readers I have gained in the past year.

Dying Matters (www.dyingmatters.org) is an organisation which can only be described at massively death positive. It spans England and Wales, encouraging people to discuss more openly death and dying, alongside all the bits associated. Every year, they host an awareness week where events are held across the countries to highlight the chosen theme of the year. Many organisations such as hospitals, hospices and libraries get involved and host all kinds of events.

For 2019, the theme is Are We Ready? and focuses on the fact we should be talking about death well before we have to or are forced to. We should have made plans well before we die and it’s not something many people know how to do. Hence, this year’s awareness week is the perfect opportunity to get involved and find out more.

I’m pleased to say I’ll be involved in the events at my place of work, hosting my own regular Death Cafe and also helping out at another Death Cafe for another NHS organisation for staff members. At BHRUT there will be two days, Tuesday the 14th at King George Hospital and Thursday 16th at Queen’s Hospital. There will be many stalls with chances to speak to representatives from many places such as funeral directors or hospices and also a Death Cafe between 12.30-13.30 each day. I’m so excited to see what this week will bring and what people will discuss at the events. I’m also attending a few other events myself at other venues which I will update you all on after. It’s set to be a fun, death filled week for me and I can’t wait!

If you are interested in these events or would like to know more please get in touch!

MG x

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