Three Mystery Tools, Two Decomp People & a Council Meeting in the City

I’ve been living in a bit of a bubble the last week or so. I feel utterly exhausted constantly the reason for which I’m not sure if it is because I’m genuinely tired, the b12 tablets are not working or, self-diagnosed, I have some degree of Seasonal Affected Disorder. Just all round I have no energy for much at all, which is proving rather challenging!

Busy doesn’t even really cover it. We are the busiest we have been for a long time. I’m regularly feeling my Fitbit buzz to tell me I’ve hit 10,000 steps well before my working day has ended. Half of that is running lengths of the mortuary at the other hospital to either answer the phone or the doorbell which can be at either end. I try not to miss people so it often involves sprinting.

On Tuesday we had two ‘decomps’ to post-mortem, and myself with the other trainee were tasked with completing them. One was not as bad as the other, by not as bad I mean not as decomposed. There tends to be stages which range from just what seems to be a smell and a change in skin colour, to full on massive changes in the body. I won’t go into masses of detail as always, but I will say that I am rather proud of us coping with the smells that we encountered, plus we received some lovely comments from the pathologist who completed the post-mortem (comments regarding the work, not the bad smells). I do feel I will remember for a long time trying to remove a brain which is effectively mush. It really reminded me of an episode of izombie, you will know what I am talking about if you have ever watched that programme and I highly recommend you do if you haven’t.

Looking fabulous as always in a Tyvek suit and wellington boots. The end outfit is this plus an apron, sleeve protectors, gloves and a face mask.

On Wednesday, I attended a council meeting with the AAPT. It was the first real action I’ve had as Student Representative and I really had a great time. It was fabulous to meet everyone and put faces to names, plus everyone is just really nice and friendly which is only to be expected as a profession known to have a cheery disposition! Lots of things were discussed, and actually it was fantastic to hear about the latest goings on plus particular concerns with our industry. I feel like I have a thirst for knowledge and involvement in these things and I am so lucky to have the opportunity to be a part of the council. I also notably got to meet the organiser of the training course I will be beginning in February and he was really encouraging about working together going forward. I’m super lucky to have the support from my manager and trust in undertaking this venture and I hope this start means I can be involved with the AAPT for a long time.

Yesterday we had no pathologist available so could not do any post mortems, therefore myself and the other trainee cleaned nearly every door and wall in the mortuary in the morning, of which there are loads! Armed with a bucket of cleaning solution and cloths we went round scrubbing down all the surfaces we could. One thing I try to always tell people when they enquire about pursuing a career like mine is that a large part of this job is cleaning. I can’t lie, I’m not the biggest fan of cleaning but I do find that with some music, and/or a colleague to talk to, it’s actually quite a fun part of the job in a weird way.

My manager won an award this week! Congratulations!

This week we had the fabulous news that our manager had won an award he was nominated for in the category of Care and Compassion. We are so proud as a team of him winning this award and also how we work together to provide the care we do. This is largely in relation to the training we provide to nurses and others but also the hard work put in to provide the best care we can. Winning awards like this is great because it highlights the work done in the mortuary that people may not necessarily be aware of or want to think about.

Mystery Tool Number 3- what could they be for?

Today we have our Christmas meal out in the evening which I am looking forward to, and we are also exchanging our Secret Santa gifts. I’ll be sure to let you know what I get. For now, I’ll leave you with Mystery Tool Number 3!! Yes, they are scissors, but why do they have that rounded end and what are they used for? Current or past mortuary workers need not reply thank you! I hope you are all enjoying the festive season and have a good weekend.

MG x

Copenhagen Medical Museum

Copenhagen was the perfect break for November. Laura B and I had planned it for a few months, we reacted to the intense heatwave of the summer by booking a trip to somewhere that would definitely be cold. I spent many a hot summers day dreaming of blankets, scarves and thick socks. I’m a Winter person as well as a cat person it would seem.

Always perfectly happy in the cold!

One thing I had discovered upon researching the sights of the city was that there was an ‘anatomy’ museum or medical museum. I knew nothing about it apart from a glance at the website to find out where exactly it was, because I had to visit no matter what. As it turns out, the medical museum is nestled in a grand looking building next to the more popular Design Museum. The door as you approach is closed, sensible in the climate, but automatically opens as you approach which is not something you expect from a very tall, old looking wooden door. Once inside, the museum is made of wooden floors and steps, the different areas of the museum separated by split levels and short flights of stairs.

I try not to make a habit of taking photographs in toilets…. but this arty display of sharps bins caught my eye while using the facilities!

Fortunately, the people of Copenhagen do generally have everything in Danish or English so we were given an English leaflet guide to take around with us. I had tried my hand at Duolingo before we went but I was hardly fluent. The museums we went to all asked that we left our coats and bags in either a locker or at a cloakroom, something which felt like a very sensible idea and a good way to feel the benefit of your coat upon leaving!

Cool display of pacemaker devices

The first room we entered was a history of psychiatric care and the different approaches. Most notable of this room was the display of a large lockable box with a bed inside which looked mostly terrifying, and the different therapies shown such as electric shock therapy and a really disturbing box of props used for children’s therapy including a creepy mask.

Next we found ourselves in a room with a large glass table which turned out to be a game. After a good ten minutes of trying to Google Translate the Danish, I turned around to find the English version behind me. It was a game of luck, selecting body parts at random each turn via a spinner in the centre of the table. A bit like Anatomical Twister but each body part came with its own disease or trait that added or subtracted years from your life. We both started off at 80, I was taken years for having some mild complaints and died at 76. Laura B was given a great head start and added many years to get life by being a widow! I can’t remember at what age she died but it was at least twenty years on me. I really liked the concept and playing this game, and once we had finished the guide from the front desk came to find us to tell us a tour in English was starting soon if we would like to join. Of course we obliged!

The back wall of the teaching auditorium

The tour took us through the remaining rooms, starting of looking at some early surgical procedures such as trepanning and amputation. We then moved onto the early thoughts of the four humours of the body and how this developed through time to what we know today. This was very interesting, and included a look at the auditorium that was used for early anatomy and surgical demonstrations and lectures, and also a discussion of how the concept of miasma formed and was then forgotten. This is the belief that infections and diseases were carried in the air, which later changed once we understood infection control a lot better!

Dry specimens displaying various pathologies

The final room of our tour took us into a large area packed full of specimen jars like those I’m used to seeing in the Gordon Museum or at Barts Pathology Museum in London. The first cabinet we looked at was packed full of pre-natal and full term babies with various defects and deformities. It turns out this is a collection formed to better understand these problems and find ways of preventing them. The second and third cabinets were full of other specimens showing various pathologies both in dry and wet specimens which was really interesting. I didn’t ask at the time but I think this was a fraction of the teaching collection from the hospital.

Some wet specimens and also the child with Rickets in the lower left corner

One thing I noticed while there was that there were no issues with taking any photographs in this museum. I know from experience of those in London you are not allowed to take photographs, particularly close up of specimens and I would never wish to because I feel it inappropriate especially in the case of babies. I asked our guide Rasmus after our tour had finished if there were any particular laws around display in Denmark, he said there were no laws as such but there were guidelines which allowed display of specimens over 70 years old and there were no issues with photography. He also commented that they had prepared for controversy when the museum opened in regards to the displays but so far none had been received! It was very interesting to see this difference in attitude here and how they chose to display items.

I loved this display but in hindsight I can’t remember exactly what it was!

One final thing, there was a skeleton of a child displaying the effects of a severe vitamin D deficiency. We in the UK know this as Rickets, however in Denmark it was known as the English Disease! Rasmus said he did not know exactly why, however there was a tendency in the early medicine stages of naming illnesses after nations you did not like. As we found out on our boat tour the day before, the English stole the Danish navy at one point so I can see the justification here.

I hope this was interesting, and has tempted you to visit the museum if you ever find yourself in Copenhagen! Link for the museum is here.

MG x

Mystery Tool Number One Revealed- Rib Shears

(Apologies for the delay, this was written on Wednesday waiting on the tarmac and later during take off at Stanstead. A basic introduction to a tool we use, hopefully you will find interesting!)

I said I would write a post on tools starting with the photo at the end of my last post, then I got either another cold or my original one came back with a vengeance and now I find myself on a plane heading for Copenhagen. Life really does take us in some funny directions, this time to the cold land of pastry and schnapps that is Denmark.

Ceiling of the auditorium at the Medical Museion in Copenhagen. More on this in another blog post soon!

However I do also find myself with a little under two hours to kill which seems like a good time to get the article I had planned out of my brain. No one actually guessed what the tool was, well no one who didn’t work or previously work in a mortuary so that doesn’t count! One guess for their similarity to scissors used in fabric cutting with the curved edge underneath to protect the fabric below. That guess made me realise why the bottom of this tool is curved to protect the organs below.

Many different types (and brands!) of rib shears available

The tool in question is a set of rib shears. They do come in many different shapes and sizes, I’ve tried out many different ones and I do have a preference but they all very much work the same way. Rib shears are used to remove the sternum and the area around it, opening up the cavity of the body to access the organs underneath. I’ve been shown that the right way is to remove them from the areas of the ribs made of cartilage, this means the edges left behind from the cut are smooth and do not leave sharp edges to tear your gloves or yourself on. Although you can place a pad or similar over these edges if this happens.

Before using these, we expose the ribcage from the initial incision and ‘loosen’ the clavicles (collar bones) at the top by cutting them free from the attachment to the sternum. Sometimes the clavicles come away easily and pop upwards, other times they can be harder to cut around and this has even snapped the blade of the scalpel I have been using on a couple of occasions. Note, if a blade snaps like this it can be very dangerous so it is important to locate the tip of the blade (probably stuck inside the patient somewhere) and remove it with tweezers or another tool before continuing to work.

The lower ribs cut through easier than the upper ones, and the first rib is the toughest. Sometimes so tough it requires you to rock back and forth a bit to get it to go, I have broken out in a sweat before in all the PPE trying to do this. Once the ‘plate’ consisting of the sternum and ribs sections is cut, we raise the edge from the base and lift while cutting it free from the attachments underneath. I’ve been told this is a common time to accidentally cut yourself and it’s easy to see why. I’ve also been shown how to make a notch between two of the ribs about halfway up while cutting so you can use this to grip better. When I’ve witnessed people come in and watch post-mortems I’ve noticed that they mainly wince at the noise the rib shears make, a loud crunch occasionally when a bone is tough.

The Medezine saw like we use (I’m not being paid to advertise!) with the round blades we use for the cranium and the other ‘fan’ shapes blades.

In really tough cases or other scenarios we can use the bone saw. For example, I recently used the bone saw on the spine to remove the spinal cord from a patient who was donating it for research. We mainly use the bone saw for the skull, but there is another blade you can use to cut through other bones like below.

There you have it, the rib shears! I wanted to start my tool posts with something interesting so I hope this has been a good place to start. If you think I’ve missed anything or have any questions then please let me know by the usual ways, you can see my contact page if you’re not sure.

MG x

Sweet Rose Cottage

I’m not going to lie, it’s been a fairly frustrating week all round. I caught the man flu, which turned out to be close to actual flu in some ways and still has me feeling terrible. On top of that, add some insomnia, anxiety and general joint pain, I think feel close to the classic ‘death warmed up’. She writes during a sneezing fit on the bus.

Wednesday Addams & Antigone Funn inspired generic tired mortuary worker look.

I was in for two days this week and I’m only in work for one next week. I’m then in for the rest of the year, and I’m starting to do some on call type work. In the last two days that went fast, I did some more nurses training in the big auditorium style training room. I get to feel important and stand on a stage with the presentation projected either side of me. For those that have known me a long time, bet you never thought this nervous wreck would stand there confidently and do that!

A selection of stills from the Just Five Minutes More video by Michelle Lancaster at North Tees and Hartlepool NHS Foundation Trust

At the start of the training we play a video made by another NHS trust which demonstrates as well as possible our roles as APTs. It perfectly describes the care we have for our patients and our characters, particularly the ‘cheerful disposition’ we all possess. The link to the video on YouTube is here, Michelle Lancaster who made it and stars in it is someone I have a lot of admiration for and had the pleasure to meet at conference two years in a row, she is a really lovely human being.

There is another line in the video that I’d like to discuss where Michelle mentions the use of the term ‘rose cottage’, describing the phrase as sweet. This hit home upon hearing it yesterday because it sounded so much like the Sweet Rose Cakery where we host our Death Cafe each month, how appropriate and coincidental we found a location named that!

Laura T at the Sweet Rose Cakery

I should explain, the term rose cottage is used by hospital staff to describe either the mortuary, or has further extended to mean a death on the ward either in full form or shortened. The porters use it to ask where the death is, I hear them using our phone to call the ward and ask ‘Do you have a rose cottage?’ or more often it is ‘Do you have a rosie?’. It’s a sweet term indeed, not necessarily one I agree with because I’m fairly certain it’s born of avoiding talking about death, but it’s a tradition that has existed for a long time and I’m sure will continue. I believe other hospitals have other terms they might use, but the Rose Cottage has firmly stuck at ours. Although I believe you can encounter staff who have still yet to hear it and then assume you are asking after a patient called Rose Cottage which would be unfortunate if there was someone with that name!

Have a watch of the video and let me know what you think! Also, as promised I am working on a post about tools starting with the handy device below. Anyone want to take a guess what it’s used for? Mortuary workers past and present need not comment! If you’re Hospital has another term used to mean a death please get in touch also. Have a great weekend everyone.

Mystery tool… what could it be? It’s quite easy (I think!)

MG x

Tools, Organ Blocks & Getting in the Hallowe’en Spirit

Noticeably it’s been getting busier in the mortuary, just like it’s been getting darker and colder in the evenings. We’ve not been short of work at all, while also trying to streamline some processes and make ourselves more efficient. Our manager would like us to get into the habit of working in certain ways that make more sense, for example the tools we need to be in the right places and the right time rather than hunting around for them. I’m all for this, as it makes a lot of sense to not only ensure our work flows a lot better but also make our lives easier! Might take some getting used to though, as I’ve really just got my head around how things are now and in some ways I have to change some habits even if newly formed ones! We also had a delivery of new tools with some exciting additions for me to try when I eviscerate and reconstruct.

You might think the tools we have are quite basic but there’s a lot of different ways to eviscerate. For example, you might like a short handled scalpel while someone else might prefer a long handle to hold. Then there’s different blade types and shapes for the end of that scalpel, there’s pointier ones, curved ones and it really depends on preference. Although I have been told to try them all because you never know when you might need to use a different type, for example if stocks run out of the one you like or you go to work at a different mortuary and they don’t have that one. The rest of the tools are much the same; varying in shape, size and (for want of a better term) ‘pointiness’.

Even down to the needles we use to stitch, they are much bigger than the sewing needle you might use in crafts but they too come in different shapes. At our mortuary we tend to use either an ‘s’ shape one like I prefer because it sits nicely in my hand, or one with a flat part and then a deep bend in it. If people are interested I can do further posts on the tools as I familiarise myself with them! I might well do this anyway as I find if I talk about them I learn more myself.

I’ve had a few chances to have a go at eviscerating over the last few weeks and I’ve got a lot better at the parts I struggled with before. I’ve been trying to get my head around removing the organs in three blocks, the first block is easy and fine but separating the second and third is still flummoxing me a bit. Again, would people like to know more about these blocks and how they are examined? Let me know! I would, of course, warn you if I was to start going into detail about things like that.

https://www.haveringmuseum.org.uk

Outside of work, I had a quiet weekend mostly. Saturday I went to the local museum as they were having a talk on vampires which looked interesting. I couldn’t help noticing that I was the youngest person in the room by about 30 years, but it was enjoyable and amusing in places. It was the first time I had been to the Havering Museum and it’s small but worth a visit if you’re from around this area. After the talk I went to work for a couple of hours to catch up on booking people in. When it’s busy it makes sense to do this so we don’t have lots to do on Monday on top of our other work. Other than that I spent the weekend watching the new Sabrina series on Netflix and a lot of movies. It was a very restful couple of days!

Tuesday 6th November at 7pm!

Upcoming next week is the Upminster Death Cafe which is looking to be very exciting. If you have never been to a Death Cafe before then why not pop along if you can and see what it’s all about? If you’re not local to Upminster then there is certain to be one near you! Try looking at the website and search by postcode. If you think you would like to come or would like to know more, please message or email me and I’m happy to discuss your questions or concerns.

Only a few things I love more than a Snapchat filter and one of them is Hallowe’en

Wednesday is Halloween and I’m looking forward to it a lot! I’ve always loved Halloween, and I have had my decorations up since the start of the month. We get a few neighbourhood kids knock for sweets and then I like to watch a scary movie or two.

That’s it from me at the moment, but if you have any questions or would like to hear more on any of the things I’ve discussed then let me know.

MG x

Body Farms- Yep or Nope?

Would you like to see a Body Farm in the UK? It’s a simple question but one that seems to provoke either a very positive response or a rather negative one. It would seem a lot of people either don’t know what that means or have only a small idea what it would mean if one did exist. Add to that the feelings of disgust at human bodies being left outside to decompose, plus confusion about the legality or morality of such a place existing, it’s not such a simple question at all.

In fact, as I learnt at the weekend, there is no real good reason as to why a Body Farm, or Human Taphonomic Facility, does not exist as yet in the UK. Yesterday I attended my final event of the London Month of the Dead at Brompton Cemetery, a talk titled ‘The Case for a Body Farm in the UK’ presented by Dr. Anna Williams. This talk was a comprehensive one, and the most interesting of those I have attended recently by far.

I guess I should explain what a ‘Body Farm’ or ‘Human Taphonomic Facility’ actually is. In other countries around the world, most prominently in the US, there are insitutions like these. The basic principle is very straightforward and research is conducted into human body decompostion by placing donor bodies in certain situations or conditions and monitoring them for periods of time. The idea behind this being to get a better understanding of not only how bodies decompose but also being able to better interpret decomposed remains. The potential of the research being conducted is fairly endless in the amount of variables that could be examined. The ability to explore different environmental conditions alone is so vast I can’t imagine you could stop thinking of different ideas, let alone when you then combine these possiblities with the huge range of different physical and chemical aspects of the body too either due to lifestyle or other impacting factors.

I would like to specifically mention one of Anna’s comments during the talk that I found fascinating. She explained how it would be interesting to compare the decomposition of a vegetarian versus a vegan and then also versus those of a meat-eater, on the assumption that the different bacteria in the gut due to their diets would have a different affect and alter the decomposition presented! Something seemingly so obvious but I would never have thought of that before. That alone is just one example of how different aspects of lifestyle can affect decomposition.

Personally I would encourage people as a whole to read into this subject matter further if they are interested. As Anna stated, there is no legal reason why such a facility does not exist yet in the UK. In fact the impression she has of the situation is that a lot of people would like to make one, but are waiting for someone else to be the first person to take the leap into the unknown. Most people I speak to are all for this to happen, and the kind of people who attend talks are those who are wanting to learn more because they like the idea it would seem. It would definitely be more interesting to hear from people who have reservations or are completely against this happening.

There is a lot of information online about the existing facilities and also the UK desire to have one. Anna has put together a survey for people to fill out and have an opportunity to have their say which I encourage you fill out. The Twitter handle for this movement is @HTF4UK and there is a blog here. I genuinely want to help this cause and get poeple talking about it. Dr Anna Williams is also on Twitter @bonegella. Huge thank you to Anna for sparking this idea in my head and for a brilliant talk! I have pinned my badge to my coat and willing people to discuss this with me from here on in.

There’s a lack of photos this post so here’s a lovely lion from Brompton Cemetery to make up for it

Apologies for the short post this week and the general lack of posts in the last week or so. Rocks (my cat) is unwell again which has been awful, between that and a busy work week, going into the city for the weekend, plus some other crazy stuff happening I’ve not really had a chance to catch up on much. The next month or so is not promising to calm down although I do have a couple of trips planned where I should be able to chill out and take a step back from the crazy. Keep your eyes peeled for updates but you can also check out my Twitter or Instagram @mortuarygem if you want to see what’s happening. As always, get in touch if you have any questions or comments.

MG x

AAPT Annual Conference London 2018

It’s a most excellent start to any morning when you make a cup of tea only to realise that the milk’s gone off. However I wouldn’t let that ruin or darken my day for I was off early to the AAPT 14th annual conference and this year I had some pretty awesome reasons to be excited.

Cup of tea attempt #2

I arrived at the Holiday Inn Regent’s Park to a crowd of people outside. Some people I recognised, fewer I actually knew and a lot more I had no idea who they were. I’ve been lucky to attend a few AAPT events before including this conference last year, it almost feels like I have a tick-list of people to check off each time to speak to, and this year I got a whole load of new ticks. One thing I will say, the people of the AAPT are always so very friendly and just, well, normal people. I don’t think I’ve ever felt more like I fit with a job I’ve had, good news really when I’m pretty certain I’ve got my dream career.

Got a little beefeater bear to go with my Cardiff dragon

When I got there I saw an open door towards the registration desks so I rushed in to get my lanyard and bag of goodies. A little pre-emptive as I was immediately told they weren’t open yet and to go stand outside! Oops! Outside I stood nervously catching people’s eyes and trying to figure out who was an APT and who was a bog standard hotel patron. The doors opened not long after and I got registered, then walked through to the conference room to grab a seat and dump my coat. Then it was time to grab a cup of tea and settle on in for the morning session.

Trusty notebook bought by Laura D and the conference programme

There was an array of talks in the morning and the afternoon of a very high calibre. I particularly enjoyed a presentation by a member of the air ambulance crew who described East London as being ‘well, yes, a bit stabby’ while discussing the kind of call outs he went to. I’ve seen the kinds of procedures they use on people who have arrived at the mortuary but I’ve never been sure exactly how they are carried out or why, now I know! In the afternoon session there was also a presentation by a Sergeant from the Metropolitan Marine Police who look after the river along with other areas, for example I never knew they did high areas like rooftops too! Her presentation was a brilliant and informative one, largely explaining what happens to people if they end up in the river and how they are found. Her presentation ended on discussing the SS Princess Alice disaster where a passenger paddle steamer was struck and sank in the Thames in 1865. A larger part of my notes from this section includes a direct quote of a description of the water at Woolwich where it sank being ‘fast flowing poo soup’.

Thought you might enjoy my little sketch titled ‘how people float’ drawn from an impression the speaker did on stage, fish was not in demonstration.

It was a fabulous day and I got to meet some wonderful people. Right towards the end I found out that I was going to receive a certificate for my CPD (continual professional development) achievement over the last year with others, which I then spent the last hour worrying about going up the front. Typical of me! The AGM (annual general meeting) after the main conference also had the very exciting announcement that I have been appointed the Student Representative on the Council for the AAPT. This mean some hard work but I’m so looking forward to working with the Council going forward. I guess this is also a good time to announce that, all things going to plan, I will be starting my full training course in February 2019. It’s going to be a very exciting time coming up!

CPD certificate and my mugshot on the council listing!

Sadly I didn’t get to attend the evening event, I had to get home early but I was also a little grateful for other commitments. When your last talk of the day is about boat disasters and pulling bodies out of the Thames, a not very confident swimmer like me would be a little anxious about a party on a riverboat!!

I’d like to take an opportunity to thank the hard working people of the AAPT who put together and awesome conference again this year. I loved every minute and I am very much looking forward to the next one in Edinburgh in 2019!

MG x

Kidneys Are A Bit Awesome. Fact.

I can only apologise for my lack of posts recently, it feels like ages since I’ve posted anything particularly informative other than my regular weekly updates! I have been distracted by my life outside work of vets visits for my poor cat Rockstar who had me worried senseless alongside some other life stuff. I’d love to say I’m on my way back to some kind of normality at some point but who knows!

Obligatory Rockstar photograph, with his little cute bandage!

For now, I’ve got some time so let’s look at one of the body’s most interesting organs (my own point of view) the kidney! I’ve had some of my own kidney issues in life, namely multiple kidney infections including one time in Greece on an Archaeology trip where I ended up urinating in a plastic cup in a doctor’s house and walking past his family watching tv holding it. That time I had pain so bad I vomited and I think possibly hallucinated. Some say kidney pain can be as bad as childbirth, I can’t comment having only experienced one but it was a pretty rough time.

Flashback to archaeologist Gem who always seemed to have sunburn and a kidney infection of some variety

The little kidney is a thing of wonder. You need only one functioning one to live but it has to work. Without that you need dialysis to keep you alive or a full on transplant. On a basic level your kidneys filter your blood and remove out waste alongside fluid which produces urine. The urine travels to your bladder and its removed when you urinate. There’s a highly complex structure of nephrons (the tiny parts that do all the hard work) and a filtration system that works together to do this. They are bean shaped (hence kidney bean!) and look kind of smooth and purple when healthy. Inside they are often a yellow or white. The pathologist removes them from the fat they reside in during a post mortem and has to separate them from a capsule that surround them, often by sliding a finger around them. They sit nearby the adrenal glands that produce necessary hormones, including that lovely stuff called adrenaline.

My drawing of a sectioned kidney in a jar for display

Sometimes the kidneys have cysts on them that can be quite large and burst when removed. These are known as cortical cysts and are generally harmless unless affecting the function of the kidney. I’ve seen quite a few, and a couple go pop. I’ve also seen kidney scarring where the surface is pitted or mottled rather than smooth. Again, scarring can be harmless and is caused by numerous trauma or conditions in the kidney, unless the scarring affects the function. I once asked the pathologist if all my infections would have scarred mine but truth is I wouldn’t know without taking a look, and I’m not that desperate to know.

This week I was lucky to see an example of a horseshoe kidney, where the two kidneys are not separated as normal and are linked at the bottom in a U shape. This can be completely harmless in people and you may have this without even knowing. It can cause some symptoms but there is no known solution. According to Wikipedia it’s a 1 in 600 chance of having this and is more common in men than women. There’s more information and images on Wikipedia.

In some cases, people are born with only one kidney, or only one functional kidney and one kidney that is not functional. In this situation you may, once again, never know you have this. It is possible to never have any problems! I myself know that I don’t have this because I had several scans in my early twenties to find out. Unfortunately I have abnormally short ureters from my kidneys to my bladder that allow infection to travel upwards. Hooray for anatomical abnormality, a slightly sarcastic but there’s no denying they are extremely interesting. The best I can do is ensure I take care of bladder infections or UTIs (urinary tract infections) effectively and drink lots of water. I was also advised to not have baths and avoid citrus or caffeine among other things.

Lastly I’d like to mention kidney transplants. I think the coolest things about transplants are twofold. Firstly, you can donate a kidney while alive and well, and live a normal life after. It’s one of the few things you can give as a living donor. As said above, you only need one functioning kidney to survive. Secondly, they do not remove the non or poorly functioning kidneys of the recipient and they can end up with three or even four kidneys in total. I think someone once even ended up with five (something I think I saw on QI episode once upon a time!). There’s more information on kidney donation on the NHS website.

Aren’t kidneys great? I had a love/hate relationship with mine for a long time but I can only be grateful they do work well most of the time. Give yourself a little pat on the back (pretty much just below your ribs) and thank your kidneys for the hard work they do!

Tomorrow I am off to the AAPT annual conference in London, and I’m very excited! This is how it all began a year ago when I started my career, and I can’t believe how much I’ve progressed in a year. I will write an update shortly after so keep an eye out.

MG x

MG Goes Upstairs to the Lab!

Yesterday I visited the Histology Laboratory at work. Now, before I started working here I had no idea what histology was. Probably a bit ridiculous but I’m a real believer in the fact you don’t know things when you’ve just never come across them before and clearly my path had never crossed anything relating to histology before! For those like me without a clue, histology is the study of looking at tissues in microscopic detail. It’s what happens when a biopsy is taken, for example, and is then studied in detail to determine what is going on.

It is important for me to understand these processes because often during a post mortem histological samples for testing will be requested by the pathologist. They will normally take pieces of organs and place them in pots with formalin (a solution of water and formaldehyde) or in what is known as a block and then into the solution and we will take these samples up to the lab. That is where my knowledge ended, but now I know what happens after and it’s really interesting so I thought I would share!

We take our boxes up to the lab and then leave them on a shelf. In the box are the samples and a form that we have filled out with all the details of the patient and the samples taken. Next, someone from the lab will check that the samples in the box match what is described on the form, any discrepancies and these are sent back to the department to be checked. The guy showing me around says this happens all the time but I’ve never seen any returned to us before- clearly the mortuary is better than other places!!

The samples then move onto another area where they are described in detail and measured, and then placed into blocks if not already. The block is like a small plastic case with a metal lid, and these have holes all over. The blocks are printed with a label saying what they are and an individual number given to each one to identify it. Next, a machine known as a processor is loaded with the blocks. This works to remove any water from the samples, then fill them with a chemical called xylene and then it finally removes the xylene and fills the block with molten wax at 60 degrees centigrade. The processor can work overnight on a 12/13 hour cycle or for shorter or longer if necessary. The blocks come out of this machine with the sample in a block of wax. The blocks can be stored up to 20 years at the hospital.

After this, someone scrapes the sides off of excess wax and the blocks are passed on to another group of people. These people place the wax blocks into another machine called a microtome. The microtome shaves off a slice off the block that is 3 thousandths of a millimetre thick. Teeny tiny. The blocks are held on ice before they go into the machine and then the handle is turned and tiny slices are taken off. A tiny slice is removed and then floated in a bath of water at 50 degrees centigrade which flattens it out and removes any crinkles. The fact it is just below the molten temperature is intentional. A glass slide is placed into the water bath and picks up the tiny slice, and that is what we know as slides! I noticed the microtome we were using had a sticker with Black Widow (member of Marvel’s Avengers) on it and I queried only to be told they have to name them all separately so they know which machine they are referring to!

One more stage is left with the machines and that is to dye the tissue in the slide. You may have seen pictures of cells where they are a real deep purple colour. That is from the dye, were the dye not applied you would really struggle to see anything under the microscope. Slides complete and dyed, they are matched back to the form from the start and then passed on to the consultant to examine and determine a diagnosis. Right before they are passed on a quality check is performed to ensure the slides show what they need to and are of a good quality. It’s a very intensive, thorough and effective process that happens in this lab! There are 21 people who work there and they process work for 12 consultants. The slides are kept for up to 15 years at the hospital for reference in case they need to be looked at again. 34,000 samples go through this lab each year and they are insanely busy from what I could see on my short visit.

I’m hoping to go back and see some more of what happens in the lab, but for now I really fee like the insight I gained was invaluable. You really don’t realise what happens behind the scenes and the work that goes in until you see it for yourself! I hope you found this an interesting as I did and have had a good start to your week!

MG x

Blog at WordPress.com.

Up ↑