The musings of a final year medical student

Saturday, 28 February 2015

Fun fun fun

Had a really great week.

I got my eyes tested as my dad (a GP) and my own GP both suggested this could be causing my headaches. Turns out I am minutely short sighted, so got some new glasses. Hoping they make me look more intelligent. I chose the FCUK 89's, tortoise shell with pink inside.   

This week has been the start of the gastroenterology block, which has been fine, but not as much fun as the respiratory block we have just completed.

I have two friends who have had their birthdays. One friend shares my passion for speaking French so I've really enjoyed trying to make thoughtful presents related to France, and I had a really fun time celebrating my other friend's birthday at Wagamamas in Liverpool. It was the first time I went there, and I had the ebi gyoza (prawn and vegetable dumplings) and the seafood broth, along with carrot and ginger juice. Lovely. 

I also had a massive shopping spree, buying a new pair of navy brogues and then went on to pillage Boots and their 3 for 2 offer.

I had also amassed several coffee vouchers, so went to have a chai latte with my flatmate just after we got some piercings at Bold Street Piercing. I got my conch pierced and my flatmate got her nose done. Very happy, the piercer was absolutely fantastic. I've had quite a few piercings and she was by far the best piercer I have had. 

Bold Street is definitely my favourite part of Liverpool. There's always acoustic guitarists busking, the gradual hill is full of vintage shops, fun cafés and restaurants. Some people say it's the Covent Garden of Liverpool, but I think that's maybe a tad generous. It's still a really nice place and is adjacent to Concert Square, where all the main clubs are found. And at the top of the street is the famous bombed out church (actually called St Luke's church).

In other news, I did end up giving up potatoes, bread, cake and diet coke for lent. The first week was great and I feel so much better and more energetic. I'm now really missing bread and chips. It's hard because whenever I tried to avoid eating bad foods, I would replace it with diet coke, but now that's out it has made me quite grouchy. Glad I am doing it, as it's encouraging me to eat more fruit and veg. Recently I'd been feeling so lethargic all the time and now that's completely gone. Now need to start using that gym membership...

And finally, thought I would share this sign up at the Liverpool Guild. 
"Scouse Dictionary. JARG: adjective. Definition: Anything that isn't genuine. How it's used: 'Goin' down to St John's to get meself some jarg Ray Bans.' "

 J’ai passé d’une vraiment belle semaine.

Ayant reçu des conseils de mon généraliste j’ai fréquenté un ophtalmologue dans l’espoir de résoudre ma souffrance embêtante des migraines. J’ai découvert que je suis myope ; cela veut dire que je vois mal de loin. Alors j’ai acheté des jolies lunettes, avec l’espoir de sembler plus intelligent ! Enfin, j’ai choisi des lunettes de FCUK 89s, écaille de tortue et la couleur rose à l’intérieur.

Cette semaine, on commence l’étude de la gastroentérologie, ça c’est pas mal mais pas aussi agréable que l’étude du système respiratoire que l’on est venu de compléter.

J’ai eu deux copines qui ont eu leurs annivs. Une de mes amies partage ma passion pour l’apprentissage de la langue française, donc c’était épatant d’arranger des cadeaux liés à notre intérêt mutuel. En plus, j’ai sorti pour un bon repas à Wagamamas à Liverpool avec l’autre copine. C’était la première fois que j’y ai visité, j’ai mangé l’ebi gyoza (des boulettes de crevette) suivi par le brouillon de fruits de mer.  Pour boire, j’ai eu le jus de carotte et gingembre.

Je me suis allée fait du shopping, j’ai acheté une nouvelle paire des brogues marines et puis j’ai exploité les soldes à la pharmacie-droguerie Boots.

Ce qui est plus, j’amassais quelques bons de café, il s’ensuit que j’ai bu un latte au thé chai avec mon colocataire avant d’avoir des piercings à Bold Street Piercing. J’ai percé le conch et mon colocataire a percé le nez. La perceuse était fabuleuse est très professionnelle, je lui recommanderais. 

La rue qui s’appelle « Bold Street » est sans doute mon lieu favori à Liverpool. C’est un merveilleux mélange des magasins, plein de culture, plutôt pittoresque. On découvre des musiciens doués et des cafés uniques sur cette colline progressive. Il y a certains qui disent qu’il semble comparable à Covent Garden, mais je dirais pas que oui !  Tout de même c’est beau, c'est proche de Concert Square où se trouve la plupart des boîtes de nuit. Au sommet, on remarque l’église fameuse, St Luke’s Church.

Par ailleurs, j’ai renoncé à manger des pommes, du pain, du gâteau et le coca light pour le prêté. La première semaine a passé bien, je me sens très saine, plein d’énergie. Maintenant, des pommes frites et du pain me manquent énormément. Je trouve ce défi très dur puisque j’étais dans l’habitude de remplacer des aliments malsains avec le coca light. Par conséquent je suis fréquemment de mauvaise humeur !  Mais je suis soulagée qu’il m’encourage à consommer plus des fruits et des légumes.


Tuesday, 17 February 2015

February update

February has been a really good month so far!

Despite a rather irritating combination of tension headaches and migraines, which have stopped me from participating in all my lectures, I have really enjoyed my medical studies this month. We are finishing the respiratory block which I have thoroughly enjoyed. Most of my friends have said they loved musculoskeletal and cardiovascular and hated endocrinology, but I feel the opposite!

I've been managing to really get on top of my anatomy reading and for once felt extremely confident in my two respiratory anatomy sessions. Needless to say, after every 2 hour anatomy session I am always ravenous afterwards. Why does formaldehyde make people hungry?

Okay, just Googled formaldehyde. Did you know it was used to persuade anorexia sufferers to eat? I'm not surprised! Also didn't realise that formaldehyde is just methanal in chemistry speak. Apparently it can be fatally toxic if ingested in large enough quantities.

Anyway, the block has been going really well, and I also had a communication session which went really well, too. We have regular small group sessions where we discuss how we improve our skills in conversing with patients; this sometimes involves an actor joining us, and we watch as each medical student practices carrying out a history. This is by far my favourite part of the course. It's really nice to have a contrast from the monotony of learning biochemical processes and endless latin anatomical vocabulary. It contextualises why we have to learn the course content and literally brings the academic studies alive. I was one of the first volunteers to carry out a history. Prior to the role play, we have no idea what the patient is like or what their condition is. Our job is to extract useful information that we can feedback to a GP before the patient goes into their appointment. I had a great time chatting to a mid-forties ex-smoker who was diagnosed asthma a year previously. It was so much fun! The social aspect of medicine is mainly why I went into it; I love people, understanding their problems, relishing the challenge of trying to win their trust, and the satisfaction of making them feel better, even if all I've done is cheered them up a bit. It makes me really happy. That, in combination with ongoing academic work and the idea of committing to lifelong learning is what makes me love medicine. 

Last Saturday was Valentine's Day, and I had a fantastic time. I got up late, had a lazy brunch and then headed out to central Liverpool and went to Leaf café on Bold Street. I had a lovely lime and coconut cake and a cappuccino; Rob had the same coffee and a cherry bakewell slice which was heavenly! Later on we went to dinner at L'Olivetto, an Italian restaurant which was absolutely amazing and reasonably priced. I had calamari to start followed by linguine in olive oil, chilli and king prawns. Would highly recommend! Neither of us had room for pudding. 

Waking up on Sunday was like waking up from a pleasant dream that you wish you could fall back into again, but somehow you can't, and then you have to get up and get on with the day's tasks. 

Today is Shrove Tuesday, and I have eaten far too many waffles! My halls of residence doesn't have a hob so we couldn't actually make pancakes, but waffles were an excellent alternative. I'm debating giving up Diet Coke, potatoes and bread for lent - maybe that's rather too ambitious. We shall see! 

I also got some good news from back home. I got a letter in the post inviting me to receive an award at my previous sixth form college, thanking me for my contribution to the science department and as the elected STEM ambassador. This involved discussing how we can encourage more students, particularly girls, to go into science-based career fields. We organised several science events and it was really fun to work with my science teachers and local science business representatives. 

Tomorrow is the respiratory block test, and for once I am not shitting myself for an end of block assessment! Medical school is finally feeling more manageable. Having said that, I'm not quite sure how I'm going to have time to revise the previous blocks whilst still learning new course content. Each day already slips away before I realise. 


Monday, 16 February 2015

Interesting article: 5 ways to improve your brain power

This is a great article with good tips as to how you can be more efficient and work better. I definitely agree!

Read the article here.

Tuesday, 10 February 2015

A little party never killed nobody

Last Saturday was the LMSS The Great Gatsby annual ball, held at the Adelphi hotel. It was a crazy, messy, booze-filled fantastic evening.

For my outfit, I chose a maroon embroidered dress from True Decadence, purchased from John Lewis. My black velvet wedge shoes, head piece and jewellery all came from Primark. I also bought a Maybelline SuperStay 24hr lipstick in 575 Always Crimson. My nail polish was Chanel le vernis in Rouge noir


Orthagnathic surgery

I thought today I would talk about something a little different, a subject which I think is worth discussing for others contemplating this operation.

In brief, I have an overbite and it is going to be corrected through surgery this Summer. An overbite can be classed as a facial disfigurement, but I would never say that I had a facial disfigurement because it is not particularly visible from just looking at me. There is a misalignment of the jaws, whereby the lower jaw is more recessed than normal in relation to the upper jaw. It is normal for the lower jaw to be slightly behind the upper, but mine is too recessed. In addition, in my case the actual angle of the jaws is incorrect.

So what does this all mean, and why surgery? 

I began developing an overbite when I was 15, and didn't realise I had one until I got braces just before I turned 16. But what I did notice was that it became more and more uncomfortable to play the flute. For some unknown reason, I could only play a page of music without my chin and jaw feeling so tense that I had to stop playing and wait for everything to relax again. This was incredibly disappointing, because at that time I was about to take my ABRSM grade 6 examination, but the jaw problems took all the fun out of music lessons, so I gave up. An orthodontist later explained to me that the overbite would've been a key factor in that. 

In addition to this, I began to really struggle to eat. I've now become accustomed to my jaw and nobody would particularly notice that I didn't eat in a normal fashion, but it is difficult. It is also really hard to eat with my mouth closed, so it's quite a laboured process to eat without looking rude! 

However, the thing that affects me the most is the difficulty in keeping my mouth closed. Something so automatic in everyone is really tricky. To keep my lips together, there is a lot of tension in my chin which causes dimpling on the skin. I can only really keep my mouth closed for about a minute at a time before it feels too uncomfortable. Although this is not essential, it does make me feel self conscious if I am having a conversation with someone or if I am sat by myself and am not talking, so should be expected to have my mouth closed. 

So, when I began orthodontic treatment, I was offered to undergo orthagnathic surgery to correct the overbite. This involves in my case that an incision on the inside of the mouth is made, breaking of both jaws (for others only one jaw is required to be broken) and they are repositioned and screwed together. This is then followed by a few weeks of liquids-only diet, as elastics are applied vertically across the braces so that you can barely open your mouth. This is done to allow the jaws to heal, which takes approximately 3 months. 

I didn't want to write this post as a 'poor me' rambling, but because there are many people who have considered this procedure, and for obvious reasons it's a really hard decision to make. Will my symptoms go after the procedure? Will it be sore afterwards? How risky is this operation? Is it really worth it?

If you're considering this surgery, I would say that every case is different and your decision should be based solely on yourself. What I mean by this, is to understand what problems your overbite/underbite is giving you, consult your surgeon if these have a likely chance of being eliminated. Just because I have a similar jaw-related problem as you and have decided to go along with the operation doesn't mean you should, too. If your problem is affecting you on a daily basis then I think that's a strong reason to do it. 

In terms of actually having the operation, that's been a little more complicated. You are required to have your braces on for the procedure, as they are used as a guide and this is where the elastics are attached after the operation. I was due to have this done in Summer 2014, however, when my orthodontist moved hospitals there was a lag in the hospital administration, I didn't see my orthodontist for months and so I hadn't completed all the prep work in time for the operation to take place. Prior to the operation, wafers (molds) need to be taken for the surgeon to practice the operation using a model of what your jaw is like to see the exact measurements each jaw is required to move. You need to see a dietician to advise you as to how to eat healthily on a liquid-only diet. You also need to have lab tests and such to prove you're healthy enough to have the operation. It was very disappointing to have missed the operation because I wanted to have my jaw corrected before I came to medical school. I wrote the whole summer off, no holidays or festivals booked because I assumed I  would be recovering in that time. I desperately wanted my braces off before I went to university.

Due to the short holidays of my medical school, the next viable time to operate is this Summer 2015. I am scheduled to have the operation done 2-3 weeks after my term ends on 8th June. Nothing is guaranteed, not even on the day of the procedure, because if a patient enters A&E with a severe maxillo-facial injury requiring surgery, then clearly this is prioritised as it is an emergency. My surgeon and orthodontist seem very optimistic. I have been having appointments alongside medical school and my next one is in April where they're going to see if the wafers previously made still fit, and I will probably see a dietician as well. 

I can't tell you how excited I am for this. I am now 19, I have had braces for almost four years and I cannot wait to see the end of them! It is very frustrating that I still have to wear them even though my orthodontic treatment finished 2 years ago. There is one other medical student in my year with braces, but I expect he'll manage to get rid of his before I do! Now all I hope is that the operation actually happens - with it now being almost a year late, it couldn't happen any sooner. 

Sunday, 1 February 2015

Thought of the day

March Elle 2015, Victoria Coren Mitchell:

If you can't be the cleverest, be the most well-read. If you can't be the most inspired, be the most trustworthy. If you can't be the prettiest, be the most stylish. If you can't be the funniest, be the one that laughs most readily. And if you can't be Ella Fitzgerand, be Lady Gaga.

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