Gaming Disorder – Are Video Games Playing You?

Hey guys, it’s Joerel again and today I’m going to be talking – more like arguing actually – about the whole “gaming disorder” which the World Health Organisation (WHO) has officially recognised as a disorder around June of this year. This is going to be a doozy. In any case, let’s go for it.

So, you might be wondering, why did the World Health Organisation consider this as a disorder? Well, on their website, they see gaming disorder as (and I quote straight off the page) “a pattern of gaming behavior (“digital-gaming” or “video-gaming”) characterized by impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences.”[1] Okay, that does not sound so bad, does it? I personally believe that whatever the addiction is, whether it be something as hardcore as drugs and alcoholism or smoking, it should be taken seriously and should be treated as much as possible to return them back into a generally better state than they were before. Gaming can be addictive, and while gaming is quite relaxing and entertaining, too much of anything can kill. Everything should be kept at a reasonable limit (depending on what it is of course – drugs do not count for this), but not limiting the enjoyment one gets from such said pleasure. I know I like to play games on my laptop and on my Nintendo DS, but I know when I had too much. Overall, well played for keeping up with technology.

But, my argument is what they say next: “For gaming disorder to be diagnosed, the behaviour pattern must be of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning and would normally have been evident for at least 12 months.”[1] That seems a bit too vague, kind of like YouTube’s ad revenue policies. To see someone being engulfed in gaming is within perspective. One doctor or psychologist might be able to see one person as a gaming addict while another might not see the same person as addicted to gaming. It is relatively new, because of the recent surge of gaming and so no-one can truly understand who a gaming addict is and who is not. While it may be seen in the near future, it is currently not possible and if it is possible, many may cause misdiagnosis. Dr. Vladimir Poznyak, a member of WHO’s Department of Mental Health and Substance Abuse, which proposed the new diagnosis to WHO’s decision-making body, the World Health Assembly states: “And let me emphasize that this is a clinical condition, and clinical diagnosis can be made only by health professionals which are properly trained to do that.”[2] Like I said previously, that is completely subjective. Also, it irritates me to not know what their training is. What is it? Like, would it not be obvious if someone has a gaming disorder? How would it work? Though there is some opposition from other professionals. For example, Dr. Richard Graham, lead technology addiction specialist at the Nightingale Hospital in London, said: “it is significant because it creates the opportunity for more specialised services. It puts it on the map as something to take seriously.” Though he argues that “it could lead to confused parents whose children are just enthusiastic gamers.”[3] highlighting the main issue when classifying this as an International classification of disease (ICD).

Also, you must consider some other factors. For example, has anyone is the WHO ever considered E-Sports at all when it came to this conclusion? E-Sports is professional gaming and there are stories out there which counter the point of having gaming disorder as a thing. Take example SKT Faker. SKT Faker, a professional League of Legends player, when he was only a teenager, he decided to drop out of high school to continue his love of gaming. He was scouted to be a part of SKT Telecom K and he played ever since for the organisation.[4] Guess what happened to him? He became known as one of the best players in League of Legends (LoL) as well as winning consecutive world titles in the game. The prize money is absurd when it comes to E-Sports. In 2016, the prize pool was $5,070,000 and last year’s being $4,946,969.[8] Faker, his team, and his organisation got both of those prize pool money because they won both years. E-Sports is not a joke. He threw away his education to win even more money than he would have if he continued his education – just by playing games that he was amazing at! While it is not implying people should leave school for a pursuit of professional gaming, if people see potential then they should go for it otherwise it would have been a wasted opportunity. Another example would be TSM Reginald, the owner of Team SoloMid. He placed his faith in LoL and focused on gaming rather than school or university and see him now.[7] Reginald owns one of the most successful franchises in E-Sports. Currently, TSM has investors such as Stephen Curry supporting his team.[9] Even actual athletes are recognising the potential in E-sports because it is as competitive as actual sports. 100 Thieves, a gaming organisation, has a partnership with the unstoppable NBA team Cleveland Cavaliers[6] and the Golden Guardians, another E-sports team, is supported by the Golden States Warriors.[5]

In my opinion, I think that gaming disorder as a classification should be reconsidered or at least put on hold for now. You must think of other factors, ones you don’t even know or think about, and while I commend WHO for trying to adapt to the new technological advances, I believe that they need further research. There are plenty of uprising professional gamers on the rise and the next thing we need is someone saying another person cannot pursue their career because of ‘gaming disorder’. While it is a good thing to consider, I believe personally, more research and proper training (in years, not months or days) should be done to properly assess this issue before they can officially press it as a disorder.

SOURCES:

[1] http://www.who.int/features/qa/gaming-disorder/en/

[2] https://edition.cnn.com/2018/06/18/health/video-game-disorder-who/index.html

[3] https://www.bbc.co.uk/news/technology-42541404

[4] https://www.youtube.com/watch?v=hNQC5GyumQ4 [The Story of SKT Faker]

[5] https://lol.gamepedia.com/Golden_Guardians

[6] https://www.100thieves.com/partners/

[7] https://www.youtube.com/watch?v=zbQsmHQh2gI [The Story of TSM Reginald]

[8] https://www.esportsearnings.com/leagues/190-lol-world-championship

[9] https://www.forbes.com/consent/?toURL=https://www.forbes.com/sites/mattperez/2018/07/24/tsm-raises-37-million-investors-include-stephen-curry-jerry-yang/#282742827f8a

By Joerel Gestopa

Cuts to NHS Procedures

To acknowledge its 70th birthday the NHS cut a total of 17 procedures from its service which have been deemed as unnecessary. Among this list of abolished or highly restricted procedures include snoring surgery, breast reduction, tonsillectomy, and hysterectomy for heavy menstrual bleeding.

It is estimated that this will stop approximately 100,000 operations, saving the NHS £200m. The medical director of NHS England, Steve Powis, insisted to the Times that ‘there is more to be done’ and this is just ‘the first stage’ of discontinuing unmerited and needless treatments.

Personally, I can definitely see reason for these cuts as the £200m saved could contribute towards offering more essential procedures. For example, I am a strong advocate for the introduction of brain scans for patients with migraines. I think that evaluating the effectiveness of each individual treatment provided is of paramount importance so it is ensured that taxpayers’ money is not wasted, but is spent only on evidence-based and necessary treatments.

Despite this, I can sympathise with those who will be affected by these cuts who will either have to turn to alternative or privatised treatments, or they will be forced to live (and potentially suffer with) the ailments for which they pursued a remedy. For example, women who have heavy menstruation will not be provided with hysterectomy (unless circumstances are extreme and fulfill certain restricted conditions). Hysterectomy is a surgical procedure where the cervix and womb are removed, hence stopping menstruation. This would restore confidence in women with heavy menstruation as they no longer have to worry about leakage, pain or feeling uncomfortable. An added bonus of this procedure is the eliminated risk of cervical cancer and hence the abolished necessity of cervical smears. However, this is a major surgery requiring general anaesthetic, so is associated with risks such as postoperative infection. Moreover, the procedure can cause premature menopause, cannot be reversed and may be less suitable than other treatments, for example, hormone therapy. Therefore, there is a strong argument to regard hysterectomy for heavy menstruation as an unnecessary risk with little benefit.

To conclude, I would propose that the cuts made were justified and that further cuts should be made in the future. Nevertheless, I maintain that each case should be considered deeply with an emphasis on ensuring patient care is of the highest possible standard.

By Sophie Maddock

World Hepatitis Day

Did you know last Saturday (28th July) marked World Hepatitis Day? So what is hepatitis? Hepatitis is a viral infection referring to the inflammatory condition of the liver. The liver is really important in carrying out vital functions in the body that affect metabolism, such as production of bile or filtration of toxins. Hepatitis can be fatal because when the liver can no longer functional properly it can lead to bleeding disorders, kidney failure or even death [1]

Although it is caused by a virus there are other possible causes such as certain medications and alcohol. There are five different types of viral hepatitis – A, B, C, D and E [1]

Hepatitis A – spread through contaminated food/ water

Hepatitis B – spread through bodily fluids such as blood or sharing razors

Hepatitis C – it is the most common blood-borne viral infection in the US

Hepatitis D – spread through direct contact with infected blood

Hepatitis E – it is a waterborne disease and found in places with inadequate sanitation

The disease develops slowly so symptoms such as loss of appetite and fatigue may be indistinct at first. [1]

The aim of world hepatitis day is to raise awareness of the 300 or so million people worldwide who are living with the viral hepatitis. That is nearly 4 and a half times the UK population. The problem here is that they are unaware which has a knock on effect. If these people are not given the appropriate care then this virus can spread rapidly from one person to another and continue to affect many more. By raising awareness, we will be helping so much by finding those ‘missing millions’. [2]

A few years ago, due to the lack of awareness and government intervention/ political commitment, the death toll had been continually rising – despite all the treatments and vaccines found. However, a lot has changed in the previous year. Meetings were held between the global hepatitis community to discuss ways of eliminating hepatitis and it was also recognised as being a global development priority. But this is not enough; the governments now want to fully eliminate viral hepatitis and the aim is to do it by 2030. [3]

A message from the WHO Regional Director for Africa, Dr Matshidiso Moeti : ‘I urge all Member States in the African Region to use the World Hepatitis Day campaign as a vital opportunity to step up national efforts on hepatitis and to spur action to implement the strategy on viral hepatitis. I appeal to the general public to seek information about viral hepatitis and services for prevention and treatment from the nearest health facility.’[3]

Around 1.3 million deaths are caused by hepatitis and it is also the cause of two in three liver cancer deaths per year. This makes hepatitis the seventh leading cause of death globally – that is bigger than HIV/AIDS and malaria. By ‘strengthening public awareness and prevention as well as ensuring that everyone living with viral hepatitis has access to safe, affordable and effective care and treatment services’ we can really come together and make a difference.[3] [2]

Remember prevention is better than cure!

(Please visit this website to see how you can get invo

lved: http://www.worldhepatitisday.org/)

By Kashaf I

Bibliography:

[1] https://www.healthline.com/health/hepatitis

[2] http://www.worldhepatitisday.org/

[3] http://www.worldhepatitisday.org/wp-content/uploads/2018/03/WHD20201620Global20Summary20Report_11.pdf

[4] http://www.worldhepatitisday.org/wp-content/uploads/2018/03/WHD20Summary20Report1.pdf

The Journey Ongoing

You may remember how this blog page first began…

‘Medicine and Me’

‘Anatomy of Antonia’

‘The Making of a Medic’

The stories of each of us admins and why we decided that medicine is what we wanted to do. The decision may have been a lifelong wish for some, it may have been an epiphany for others, or it may even be an uncertain one still. There’s such a big difference between a child saying ‘I want to be a doctor!’ compared to ‘I want to do medicine!’ – it takes a certain spark and a certain energy to say ‘I want to do medicine’. Knowing you want to do medicine, is knowing what the course entails, the work you need to put yourself through to get there and knowing what a doctor actually does.

A-levels have been a struggle, not only for me but for everyone. There are many people who want to take medicine but are trying to think of other options to fall onto if they do not get into medicine. I believe that if medicine is your passion – if becoming a doctor is your passion – then do not feel disheartened, lift yourself up, and realise there are many ways to get into medicine.

Recently I went through work experience in my local hospital (Luton & Dunstable Hospital) with the orthopaedic department. I came with a feeling of uncertainty, yet I was excited at the same time. If you can remember my first blog, you’ll know that I am someone who was surrounded by the medical field, I was a weird child who was so interested in medicine that instead of normal online games a child would play, I ‘played’ the edheads surgery simulations! So it was hard for me when I started questioning my abilities and thinking: ‘Will I even get into medical school?’. That thought gives a horrible feeling to someone like me who has had the dream to be a doctor from a young age.

On my first day of work experience, I was surrounded by junior doctors in the wards. One word to summarise that experience: CHAOS. We walked, we ran, we were as fast as could be, rushing through patients, rushing through files, rushing through paperwork… It was a side of being a doctor I didn’t think about. I always saw being a doctor as something where everything you do fulfills you; everything you do makes you feel a sense of satisfaction; everything you do, in spite of all the hard work, pays you back. Not only did I see it as a job where you can help people and create an impact and difference in the world, I also saw it as a job where I could make my parents proud, I could be the child that parents tell everyone about, and not only that, but it’s a job that could make me money so I’m able to give back to my parents and live a good life. Seeing this side, and the stress the junior doctors were in, was a whole other side of being a doctor I had not thought of. Speaking to them almost brought my spirits down! They said that medical school was lovely, but the job itself is difficult. Some of them straight up said ‘DO NOT DO IT!’, some said that it was too hard and stressful, some believed that it just altogether wasn’t worth it. Other than that, there was also advice that I took close to me: being a doctor is something that you need to have true passion for – you can only do it if you really, truly love it; before you go into it, you just need to know that it is what you want for sure. One junior doctor even recommended taking a gap year.

After this hectic first day, I thought to myself: am I cut out to be a doctor? Is this endless stress really what I want? Is being a doctor actually what I thought it would be? I know for a fact that I want to be in the medical field – I want to make an impact on other people’s lives and help the world be a better place. But there are more ways of doing that than becoming a doctor. I contemplated and my mind ran away from medicine. I could be a nurse. I could be a dentist. There are many things out there which give the care-based work that I want to do. I decided, maybe this year, I’ll just apply for biomedical science and nursing, that way I won’t need to take medicine, and if I feel unfulfilled with what I am doing (which I was adamant I wouldn’t, especially that nurses have such a huge, vital role in the care of patients) I could take an accelerated course in medicine in the future. It was either that, or take a gap year to really experience what working in the medical field is like by applying to be a HCA (healthcare assistant) in my local hospital which would also build my personal statement as well as give me time to think and decide what I want to do for the rest of my life!

The next two days of work experience, we worked with on-call doctors, as well as a consultant. They were doing admin work, lots and lots of admin work. Then once they were called, they would head down to A&E and help out. I saw an NOF case (neck of femur). This means that the patient had fractured their neck of femur. We watched a team of paramedics administer a splint for pain relief. The doctor informed us about how the femur would be operated on to fix it, he also showed us the resuscitation forms which were forms to be signed and decide whether or not the patient would want to be resuscitated in case of cardiac arrest. It was an emotional conversation to have with the patient’s family member who was present. The doctor remained professional and understanding at the same time. NOF cases are considered urgent, yet when I was in trauma meetings every morning and doing ward rounds on my third day of work experience, they seemed very common in elderly patients. One of the things we were told by one doctor really stuck to me: ‘to you, it might be something you see every day – a small matter – but to them, it is the biggest, most important thing going on in their lives’. This applied to everything, from something like osteoarthritis (which was literally a case I’d see every day since I was working with the orthopaedic department) to an NOF case. The doctor I worked with on ward round on my third day of work experience explained to us the importance of patient experience. This side of being a doctor was the side that I was interested in: the whole care-based part of being a doctor – getting to know your patients, building a bond and helping to make a difference in their lives. I love to learn, I love the rush from the intensity of the job as a doctor, I would love to be able to use my knowledge, passion, and emotion to make a difference in the lives of many. This side of being a doctor was the sense of fulfillment I truly wanted to get into medicine for. Was I really going to throw away medicine, throw away being a doctor, throw away my biggest dream?

Medicine is a scary thing.

I find myself running back and forth. I’m going to be a doctor. I’m going to be a nurse. I’m going to be a psychologist. I’m going to be a doctor.

During work experience, I was able to really look at myself and ask myself if this was really what I wanted to do. Consultants would tell me that even after finishing medical school, you are constantly learning and learning – you have to keep going for years onwards before you can be a consultant. I thought to myself, ‘will it be worth it?’, ‘is being a doctor what I really want to do?’, ‘am I even capable of becoming a doctor?’.

L&D hospital is a source of inspiration for my biggest goals and aspirations since I was always surrounded by people in the medical field thanks to my mum. I can now proudly say that going through work experience in L&D hospital is also the very reason I know I do not want to give up on becoming a doctor. I will apply to medicine for university. Whether or not I get in is another story. I had the privilege of working with a passionate medical student, he himself went to the same sixth form that I do, and he was also rejected from medicine in the UK. He did not let that stop him. He knew that medicine was his passion. Being a doctor is what he wanted to do. He followed his dreams all the way to Bulgaria. Yes, he gets it all the time: ‘Bulgaria? Why Bulgaria?’. Well, there he was able to get into university to study medicine through an entrance exam. He said that if you are passionate about medicine and it what you want to do, then do it.

There are many routes into medicine, and if you feel like you are not capable, pick yourself up and tell yourself that you are. Medicine comes with hard work and dedication – all you need is your very best. If medicine is truly what you want to do, if being a doctor is truly what you want to do, then do it – reach for it. There are many ways around it. You can take a foundation year. You can take another degree and then an accelerated course in medicine. You can even take a gap year to really think about it!

I asked an orthopaedic registrar for advice on this whole topic, and here is what he said:

‘Hi Antonia

No probs, hope you are well and good luck with your application to medicine. In my A-Levels, although I got 3 As and a B, I wouldn’t worry at all. There are so many routes into medicine and in fact, some routes are exactly the same as getting into medicine right away.  Firstly The requirements are not 3 As. Secondly doing Biomedical sciences first then medicine is perfectly reasonable and in fact maybe better in the long run. Doing Biomedical sciences first will give you a chance to do research and publish which is desirable when it comes to applying for specialty training later on. It also gives you an added degree which also looks good on the CV. Many of my friends have done Biomed first and have done really well!

Extra-curricular things I did and would recommend are volunteering in a care home or nursing home and doing work experience in a hospital. I chose medicine genuinely because I would like to make a difference to people’s lives and because I enjoy the science behind it. It gives me a chance to do humanitarian work as well in poorer countries. Let me know if you need anything else and good luck!

Os’

I know I am not the only one who has had these mixed emotions with medicine. It is a course you have to be sure about, and rightly so! So, it would be unfair for me to be the only one who poured my heart out for the blog page! I asked our other two admins (Bernice Mangundu and Muskaan Jonathan) to say what they had to say about their journey to medicine…

‘The journey to medicine has not been easy. I have had doubts about whether this has been the right path for me. It is. 

There is no other profession quite like medicine. The ability to help save the life of others is a powerful thing. It will not be easy to go into medicine. The job is difficult and the hours are long, however, the positive impact I will make on other people’s lives will be worth the effort. It is a scary thought that the life of others may literally be in my hands but I know I will do everything in my power to ensure that they will be safe hands.  

To be a part of the NHS family will be an honour. I am willing to fight for the NHS. For 70 years they have been helping to save and improve the lives of millions of people. They are a group of hardworking, caring people and I would be proud to a part of them. To lose it would be a tragedy for this country.  

Bernice Mangundu’

‘It has been a difficult journey for me to decide to do medicine. I know how much work it is, but don’t know how it feels to go through that grueling process, so fear of the unknown has made me very conflicted. One minute I want to do medicine, but the next, it scares me so much that I go running in the opposite direction. But if not medicine, then what? I have looked for experience in so many different areas, and none of them have inspired me, moved me and satisfied me as much as medicine. There are days when I ask myself if I am crazy to be signing myself up for such a lifestyle, but then I remember the hope that I will be spreading and the comfort that I might provide for someone who is feeling vulnerable.

Why do you want to do medicine? It is a difficult question to answer: I have so much to say but at the same time, I have nothing to say—it just feels right. Obviously, I can’t say that in my interviews for medical school or in my personal statement. That is when I have too much to say. I just finished writing a first draft of my personal statement, and the process was torturous. I had to cut at least 7 paragraphs which say why medicine is suited to me (trust me, it was like taking a knife to the soul). But no matter how exhausting the process is, all I can do is have faith in myself that in the future, I will make a good enough doctor to make a small, or big difference to someone’s life and make them a happier person.

Muskaan Jonathan’

Well.

This was a LONG post! But it had a whole journey and a half! I still have a long way to go, and who knows! My mind might change again! I doubt it will now, however; taking medicine, being a doctor, making a difference in the world has been my dream from such a young age. I’m not willing to throw it away now, and I am determined to do everything I can so that one day I will be a doctor.

Antonia Marie Jayme

Questioning Confidentiality

Whatever, in connection with my professional service, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret.’- Hippocratic Oath

Doctor-patient confidentiality is arguably one of the most important policies enforced in modern medicine. Doctors in the UK may not disclose information about their patients unless extenuating circumstances would put the patient more at risk than if the information was not disclosed.

However, complex issues arise from this policy.

Consider the following:

Mrs. A is pregnant, with what is supposedly Mr. A’s child. Mrs. A and Mr. A arrive at the clinic to test for a specific gene that causes a rare disease, of which it is known that Mr. A is a carrier of. Upon inspecting the genealogical data collected from the foetus, it comes to light that the child is not M.r A’s.

What should the doctor do?

I am going to pose three arguments to answer this question.

Argument 1

The doctor has no right to disclose the information to Mr. A as it is not the doctor’s place to do so. The couple has come to the clinic to test for the rare gene, not to test for the paternity information. Besides, it would be in the child’s and the family’s best interest not to disclose the information as this could lead to a broken home.

Argument 2

The doctor should disclose the information to Mrs. and Mr. A, as it is both of their information. It is likely that Mr. A would want to know and to withhold the information would be dishonest.

Argument 3

The doctor should tell Mrs. A but not Mr. A. The information belongs to Mrs A only as she is the carrier of the baby. It would most likely be in the best interest of Mrs. A and the child not to tell Mr. A as this could lead to a broken home.

Personally, I would agree with argument 1 as the doctor is being called on to identify the presence of the rare disease gene so it is not their place to step in. However, the two concepts of non-maleficence (do not harm) and beneficence (only do good) can be called in to question.

Would it be more harmful to tell the couple, than not to tell them? Who would it harm?

Alternatively, would it be more beneficial and who would it benefit?

In conclusion, the principle of doctor-patient confidentiality is a complex and ambiguous one. I think that there is an argument for more strict and precise guidelines for doctor’s to follow. However, I believe that the solution should be left for the individual discretion of the doctor, who is very likely to act in what they think is the best interests of all parties involved.

By Sophie Maddock

Happy 70th to the NHS!!!

Last week, our NHS turned 70 years old! This is a huge reason for big celebrations, and we decided to do a little tribute along with the rest of the country. Some of the writers at Medicine on my Mind have written a small piece about what the NHS means to us. We hope you will enjoy reading our messages of gratitude to the NHS, and hope that this serves as a reminder of how privileged we are to have such a noble service available.

What the NHS means to me

Today is the 70th birthday of the NHS. 70 years ago, Beveridge described the National Health Service as providing care “from the cradle to the grave”. Though a simple phrase, the dedication, hard work and billions of lives saved within those lines are astonishing. From grandparent to parent to child, generation to generation, the NHS has provided an amazing gift to all of us. The gift of security in our healthcare, knowing that no matter what happens to any one of us, anything will be done to save our lives, as care is based on the clinical need of a patient, not the ability to pay. What makes the NHS so unique from any other nations health service, is the powerful values that underpin it. Values of inclusivity, compassion and the highest standard of care. Happy birthday, here’s to the next 70 years.

Jenna Philpott, Guest blogger for Medicine on my Mind

Parent

Until before I wanted to become a doctor, I never really gave much proper thought into how much the NHS does. It was just something that I knew was there when anyone needed it. But that is precisely what makes it so special. The NHS is there for whoever needs it, whenever they need it. They are always there—a bit like a parent. They tell us what to do just like a parent might: ‘smoke less’; ‘drink less’; ‘exercise to reduce your risk of cardiovascular inefficiency’. We try to pick fights and find faults in them, question them just like we may do with our parents sometimes: ‘The NHS is a victim of its own success’ or ‘the NHS is failing to meet targets’ or ‘Is the NHS still the “envy of the world”?’. But, they accept us no matter our background or circumstance, just like a parent does. And their hearts only wish the goodwill for us—just like a parent’s. At the end of the day, no matter what we may say, the NHS is an absolute privilege to have access to. Thank you so much to all the staff who make it so special and selflessly give so much of themselves to benefit the rest of us.

Muskaan Jonathan, Admin for Medicine on my Mind

Happy Birthday NHS!

In the 70-year course that this organisation has worked through, I must admit, it is doing well so far.

Now, I was not born in England – I was born in the Philippines and was brought to England around 2006. There are a few things I want to say about my experience with the NHS. I think that it is the light at the end of the tunnel. I believe many of us in the UK truly underestimate or do not appreciate the fact that the NHS provides free (to an extent) services for both adults and children. The NHS is something that I always thought just made sense? You know? Free healthcare?

Seeing other countries and their massively expensive bills for a consultation and surgery, (I’m looking at you America) it pains me to know that there are others who cannot actively seek help to improve themselves, to improve their conditions physically and mentally because of the fees and costs.

The NHS has helped me out so much in the ten years I have been here. I love the free dental care and the service they give, I would not have been able to get my glasses without them and they are improving by now focusing on mental health, which people undermine these days. The people who work there are selfless people who work around the clock to save lives, to comfort others and put their patients above themselves. We should not take these things lightly but rather help to improve.

The NHS is something wonderful and we should appreciate it because I do not know about you readers, but I would much rather get free health care than having to pay for one if the NHS is privatised.

Clement Attlee was the prime minister who helped establish the NHS, and his legacy and ideals give on in the NHS. He knew that change was needed so he delivered. We should support our National Health Service, and not lose this organisation that benefits not just one person, but everyone in the UK.

May the NHS and everyone who works there live on and prosper for many more years to come!

Joerel Gestopa, guest blogger for Medicine on My Mind

NHS Appreciation

NHS has been a vital part of many people’s lives, including mine. Some may even have had NHS since birth! That fact truly calls for a celebration. Imagine you, your child or your mum, anyone, playing a friendly game of football. One thing leads to another and suddenly – SNAP – a broken knee. A bit gruesome to imagine I suppose – but fear not: NHS comes to the rescue! The knee has been fixed, and at what cost? Nothing! Did you know that a surgery for a broken knee/leg can cost the NHS around £5,120? And you get it for free!

The NHS comes with much controversy, especially with the threat of privatisation – but today, let’s really think of all the positives and all of the things we brush off and disregard; things we are ungrateful for.

I admit, I myself have been guilty of debating about whether or not the NHS should be privatised. Yet the honest truth is, if NHS never existed, we may not even be alive! Just look back at UK’S history and why the NHS began! I believe that the NHS is one of the most unique, essential part, not only of UK’S history, but of its people. The wonderful service provided and the hard work being put in is something we truly cannot repay and wherever NHS goes from here, it will always be a part of us.

Antonia Jayme, Admin for Medicine on My Mind

Happy Birthday to our much-loved NHS!

By the writers of Medicine on My Mind

A drink to save my life?! Milk-shaking up the medical world

If you remember, the last post I did was all about sepsis. Well, this week, I happened to stumble upon a very interesting article about a ‘vitamin cocktail that can treat sepsis’! How strange, a simple vitamin cocktail to treat a deadly condition like sepsis, surely there must be more to it?

[1] At the Eastern Virginia Medical School, Paul Marik gave a mix of Vitamin C, Vitamin B1 and a steroid to 47 sepsis patients in 2017. Before using the treatment, 19 of those 47 sepsis patients dies, whereas out of the 47 who got the treatment, all but 4 survived! Unfortunately, this would not qualify as enough evidence to determine that the cocktail is successful.

However, now the time has come to put the cocktail up to bigger tests. The way in which researchers are aiming to do this is by randomly selecting between 500-2000 patients at multiple hospitals, and giving some of them the cocktails, while others are given a placebo for about a year and a half. The researchers will want to answer questions about what the vitamin mixture does to speed up recovery in sepsis patients on life support. If any improvements in mortality are seen, it is likely that the study may be extended.

The main hope with this vitamin cocktail is that it will minimise any injury caused to the vital organs due to sepsis. Therefore, the researchers will be evaluating how well it prevents organ damage as well as how well it reduces death rates. Furthermore, what is so good about the cocktail is the limited risk of side effects. There can be some side effects of having too much Vitamin C. It can throw off measurements of blood sugar, which would mostly be concerning for those in patients who are getting extra glucose in the hospital. Furthermore, people who take a lot of Vitamin C are more likely to develop kidney stones.

However, there are a lot of benefits of getting that extra vitamin C and B1. Vitamin C lowers oxidative stress and inflammation (oxidative stress is an imbalance between the production of free radicals and the ability of the body to counteract or detoxify their harmful effects through neutralization by antioxidants [2], which can trigger inflammation leading to many chronic diseases such as Cancer, Cardiovascular disease and other neurodegenerative diseases like Alzheimer’s and Parkinson’s disease[3]). Vitamin C also helps blood vessels from dilating (widening or expanding) which can help maintain blood pressure. People who suffer from sepsis are usually deficient in vitamins C and B1, so when combined with the steroid hydrocortisone, the effects seem to be boosted. Vitamin C can also improve blood flow to tissues, which is exactly what sepsis patients need so that their cells can be supplied with enough nutrients and oxygen to prevent organ failure.

A vitamin cocktail is not the only thing that seems to be showing some degree of promising results for treating diseases. There was a nutrient milkshake being sold online in the UK which claimed to be able to slow the effects of Alzheimer’s, however, experts said that there was not enough evidence to support these claims. [4]

The milkshake, called Souvenaid, comes in strawberry or vanilla flavour. It contains a combination of fatty acids, vitamins and other nutrients. The milkshake should be taken once daily and the boost of nutrients is supposed to slow down the effects of Alzheimer’s in people with the earliest signs of this type of dementia.

Unfortunately, clinical trials do not show the results to be positive. 311 patients with very early Alzheimer’s or mild cognitive impairment were given a daily drink, but only half of them were given Souvenaid while the other half were given a placebo—a drink with no added nutrients. After two years, the patients were reassessed, but no advantage from the treatment was found. However, the patients who received Souvenaid did have slightly less brain shrinkage on brain scans, which offers some level of promise because it is brain shrinkage in the memory-controlling regions of the brain which is often seen with worsening dementia.

Whether the drinks are successful or not, the concepts have certainly milk-shaken up the medical world!

By Muskaan

Man-GO Do Your Exercise

Exercise should be an important part of our daily lives. Notice that I wrote ‘should be’ instead of ‘is’, for a lot of us do not include it in our daily lives. Exercise ensures that we stay fit and healthy, but it is something that many of us neglect. We make excuses like ‘I’m too tired’ or ‘I’m too busy’ (I have used these excuses too many times). Yet we seem to find the time and energy to scroll through Instagram or watch the new episode of our favourite show. So why can we not find the time to do something that will benefit our health?

Many of us do not exercise every day, let alone achieve our recommended daily exercise. For people in my age group, (5-18-year olds) it is recommended that we exercise for 60 minutes, every day. Many of us don’t even come close to accomplishing this. If you are reading this and are not included in this age range but would like to know your recommended daily exercise, it is available on the NHS website. (1)

We need to exercise. Starting from today. Stop putting it off for tomorrow, for tomorrow never comes. You, me – we all need to stop procrastinating and exercise (so we can eat those extra fries guilt-free).

There are numerous health benefits to exercising regularly. Exercise increases the strength and efficiency of your cardiovascular system, which transports oxygen and nutrients around your body. When your cardiovascular system works better, you will have more stamina and energy life will become easier for you. Muscle strength is also improved as muscles are kept strong by their constant use. Joint, tendons and ligaments are kept flexible which allows for easier movement. Exercise can help you maintain a healthy weight. This is because the more you exercise, the more calories you burn. Brain function is improved as exercise increases blood flow and oxygen levels in the brain. Blood pressure and blood glucose levels are controlled by exercise, thus reducing the risk of heart disease and type 2 diabetes. Physical activity causes you to be more tired, increasing the likelihood of an excellent quality of sleep. Stress and overall wellness are improved by a good quality of sleep. (1)(2)

People who do regular physical activity are found to be at a lower risk of many major illnesses such as heart disease, stroke, type 2 diabetes and some cancers. (1)

Exercise has also even been found to improve mental health, helping with stress, anxiety and depression. This may be due to changes in chemical levels in the brain such as serotonin, endorphins and stress hormones. It may even provide people with a distraction or a way to release stress. (3)

Exercise doesn’t have to be painful. If you don’t like to run, don’t run! It’s not the only form of exercise. Find something you enjoy. There are countless ways to exercise: playing football, biking, weightlifting, hiking, swimming, dancing – absolutely anything. Just do something. Even if you can only spare 20 minutes of your day to exercise, that’s fine. Doing something is better than nothing.

Image result for cute mango

Man-GO exercise

By Bernice Mangundu.

References:

  1. https://www.nhs.uk/live-well/exercise/exercise-health-benefits/
  2. https://www.skillsyouneed.com/ps/exercise.html
  3. https://www.betterhealth.vic.gov.au/health/healthyliving/physical-activity-its-important

 

‘Just before May 8 is Ovar-y…’

Imagine seeing a random post on Facebook, even this blog post right now, it’s about a certain illness, and you have matched up every symptom to your own. A simple repost of a repost that you find on your friend’s account. You immediately worry, and have countless question circling your mind: ‘what if I’m overreacting?’, ‘it might just be another disease; it’s probably not that serious’. Just to be sure, you contact your doctor and get tested. ‘You have clear cell carcinoma’. What does that mean? ‘You have a type of ovarian cancer’.

This is the story of Laura₁.

You see, one of worst things about ovarian cancer is how hard it is to diagnose. There is no screening for ovarian cancer. So as Laura stated: ‘it is vitally important women are aware of the symptoms’. Therefore, today, May 8th 2018, World Ovarian Cancer Day, I am writing to let all of you know about ovarian cancer.

Symptoms

The symptoms of ovarian cancer are crucial to know about as a woman, so if you are going to skim through this blog, a message from me to you is that this section is the most important section.

The main symptoms of ovarian cancer are the same as less serious conditions such PMS (premenstrual syndrome) and IBS (irritable bowel symptoms). This makes it very hard to recognize ovarian cancer, especially during its early stages₂. The four main symptoms of ovarian cancer include₃:

  • persistent stomach pain
  • persistent bloating
  • difficulty eating – loss of appetite
  • needing to urinate more frequently

Occasionally, there can be even more symptoms such as₂:

  • persistent indigestion or nausea
  • pain during sex
  • a change in your bowel habits
  • back pain
  • vaginal bleeding – particularly bleeding after the menopause (if this occurs, contact your GP)
  • feeling tired all the time
  • unintentional weight loss

Ovarian cancer mainly affects women who have been through menopause and can also be caused by genetics, endometriosis and hormone replacement therapy. However, it can also affect younger women due to obesity, smoking or using talcum between your legs (which I do when wearing shorts to prevent thigh rash – I didn’t know it could cause this, learn something new every day!) ₂. The right time to go to a GP is you have been feeling the symptoms for three weeks, or if you notice a change that isn’t normal for you or if you have any of the possible signs and symptoms of cancer – it doesn’t matter if you aren’t sure because if you are having symptoms, it can also be linked to other things (such as IBS and PMS as mentioned earlier)₄.

Diagnosis

As mentioned earlier, there are no screenings for ovarian cancer, however, a series of tests can be carried out.

When visiting your GP, the GP may₅:

  • ask about your symptoms and general health
  • feel your abdominal region for any swelling or lumps
  • carry out an internal examination (where the doctor inserts one or two gloved fingers into your vagina simultaneously pressing down on your tummy (abdomen) with their other hand for any lumps₄)
  • ask if there’s a history of ovarian or breast cancer in your family
  • refer you to phlebotomy for a blood test – this will be sent to a laboratory and checked for a substance called CA125 – a substance produced by ovarian cancer cells.
  • refer you to a specialist for a CT scan or transvaginal screening (putting an ultrasound probe into the vagina in order to get a better picture of the ovaries than an ultrasound over the abdomen₄).

Whilst these tests exist, they can only suggest ovarian cancer but not be sure – for instance, CA125 is also produced during pregnancy and if you have endometriosis or fibroids₅, as well as this, the transvaginal probe can give a clearer picture but it is still hard to tell if there is a cancer on the ovary or a cyst (PCOS). At the moment, there is still research taking place for ovarian cancer screening by a large study called UKCTOCS₄.

Treatment

Treatment for ovarian cancer is usually a combination of both chemotherapy and surgery. The surgery can involve removing both the ovaries and fallopian tubes, a hysterectomy (removal of the womb), and the removal of the omentum (a layer of fatty tissue in the tummy). This can then be followed by chemotherapy or radiotherapy to kill any of the remaining cancer cells, or even before surgery to shrink the cells for easier removal. IN worst case scenario, chemotherapy is used if the cancer returns after treatment.

Summary

Today is World Ovarian Cancer Day. If you have made it this far, you might now know more than what you did before about ovarian cancer, and understand why it is so important to know its symptoms. Laura said in her article that she was so grateful for the Facebook post,

‘Without that it could have been another two or three months before I got diagnosed. It might have been too late then. It can be so aggressive and it can spread so quickly that I think I was so lucky to catch it when I did.’

You never know, you could save a life today too. Simply by sharing this, or telling your friends about it, spread awareness about ovarian cancer!

By Antonia Marie Jayme

https://www.targetovariancancer.org.uk/stories/symptoms-younger-women-ovarian-cancer-awareness-month/lauras-story

https://www.nhs.uk/conditions/ovarian-cancer/symptoms/

http://ovarian.org.uk/ovarian-cancer/what-are-the-symptoms/

http://www.cancerresearchuk.org/about-cancer/ovarian-cancer/getting-diagnosed

https://www.nhs.uk/conditions/ovarian-cancer/diagnosis/

The Little Girl Called Esme

I have recently obsessively begun watching the BBC Two Documentary, Hospital. In a recent episode, a 4-year-old little girl, Esme, was rushed to hospital with a case of sepsis. I watched her parents sit there, hand clasped tightly; nervous as their little child was put into an induced coma, her hands and feet turning a disconcerting purple/black colour. I could only imagine the fear that they would be going through.

The doctor in that episode, Dr Patrick Davies, explained to the camera what was happening to Esme:

“There is a level of sepsis called septic shock and that is when the body starts to divert blood to the most important organs, I mean brain hearts, lungs, kidney that kind of thing. The organs that a body cares about least are fingers and toes and that is why with some patients with extreme septic shock, they will shut down their blood supply to the hands and their feet. So it’s almost a bit of self-sacrifice when the body is in that much trouble.”1

I had heard of sepsis before watching the episode but was never quite sure what it actually was, so the purpose of my article today is to find out more about sepsis.

Sepsis, as defined by The UK Sepsis Trust, is the reaction to an infection in which the body attacks its own organs and tissues.2 It is sometimes confused with blood poisoning or septicaemia—which is what I thought it was—but there is a difference.

With blood poisoning and septicaemia, bacteria (the nasty ones) make their way into our bloodstream, wreaking havoc as they get transported throughout our bodies. However, sepsis is different, as the bacterial infection (as well as albeit less commonly, viral and fungal infections) can cause harm to multiple organs in our body even without entering the bloodstream via septicaemia or blood poisoning.

There is a helpful mnemonic on The UK sepsis trust website, which is used to remember the symptoms of sepsis:

Slurred speech or confusion

Extreme shivering or muscle pain

Passing no urine in a day

Severe breathlessness

It feels like you are going to die

Skin mottled or discoloured 2

Esme’s hands and feet had gone that purple/blackish colour because as Dr Patrick had said, the body had stopped supplying blood to her hands and feet, as it does not care about those organs as much as the vital others such as the brain, lungs, heart, kidney etc. On our symptoms list above, this would be an extreme version of the last S: Skin mottled r discoloured.

There were two main concerns with Esme:

  1. No one knew if her brain would be in a good enough condition. Whilst in the induced coma, there was obviously no way to judge whether she would wake up to be the same girl as before. Her brain could have been starved of oxygen, in which case her neurones would suffer, causing a substantial amount of brain damage.
  2. Some of her digits (fingers or toes) may have had to be amputated due to the lack of blood supply as the body was pushing the blood to her vital organs instead of the fingers and toes.

Later on in the episode, the medical team stabilises Esme and take her life out of danger, fortunately without the need to amputate any digits, but they still didn’t know the condition of her brain. There is not a brain test yet that would have been able to tell the medical team whether Esme would wake up the same girl as before, so the only way they could get a good idea of how her brain was doing, was by waking her up out of her induced coma.

I sat at the edge of my sofa as Dr Patrick gently woke Esme up from her sleep. ‘Oh God, please let her be okay’ I thought to myself, my feelings probably somewhat mirroring those of her parents. If Esme could communicate well, she would be fine. If not, then she would have to spend more time in hospital, 80 miles away from home, as she and her parents would be loaded with information and the emotional rollercoasters of what to do next.

Esme was brought out of her induced coma, and when Dr Patrick asks her

“How are you?”, she answers: quietly but sturdily:

“Good”. A flood of relief washes over Esme’s parents’ faces, and I relax back into the cushiony sofa.

“Are you tired?” the doctor asks, to which she feebly yet affirmatively nods.

“Are you hungry or thirsty?” he asks again

“Thirsty” she replies

“Would you like some food?

“No, thank you… I’m thirsty”

“What would you like to drink?”

“Blackcurrant juice”

The doctor leaves the family in peace, and the nurse comes in, gently lifting Esme and placing her in her mother’s arms, who cradles her like a new-born baby. The small family sit there, tears in their eyes; Esme resting peacefully with her eyes closed. I can only imagine what they might have been imagining. What they went through must have been a horrible experience.

But, it reminds me to be grateful for the wonderful organisation that is the NHS. In another episode of Hospital, a lady describes the NHS as ‘a privilege, not a right’, after her operation is cancelled for the second time, and that made me think: no matter how much we may scrutinise the NHS, they are absolutely incredible. We are lucky to have them.

Watching Hospital has allowed me the honour of witnessing the highs of being a doctor, but it has also shown me a glimpse of the stressful reality that lies ahead of me. To be completely honest, when I think that one day, I will have to make a decision which could change someone’s life (whilst running on sleep deprivation, lack of food and underfunding), it terrifies me, and I want to run in the opposite direction from medicine. But then I see that doctor getting a huge smile from their patient, or that child getting a huge hug from their parent, and I am reminded that yes, it will be tough, but it will all be worth it in the end.

After all, ‘diamonds are formed under pressure, but they are not formed overnight’.

By Muskaan Jonathan

References:

  1. https://www.nuh.nhs.uk/latest-news/four-year-old-esme-fights-sepsis-in-hospital-2637
  2. https://sepsistrust.org/what-is-sepsis/

Other sources:

  • https://www.nhs.uk/conditions/septic-shock/
  • https://www.nhs.uk/conditions/sepsis/
  • You can find out more about the documentary via this link: https://www.bbc.co.uk/programmes/b09xt5yv

 

Stop Disrespecting Your Home

The Earth is our home. A home is meant to be looked after and protected. Yet the Earth is not. We pollute it with harmful gases. Waste is dumped into the sea, killing countless innocent organisms, who fall victim to our actions. Trees are cut down at an alarming rate, the very organisms providing us with oxygen to breath. It is our duty as humans to care and protect it the Earth. We need to protect it for not only ourselves but for future generations. If we continue to mistreat this planet, eventually there will be nothing left to call home.

Global warming and climate change are already having a significant and costly effect on our communities and health. These effects will only continue to intensify unless we all take immediate action and improve the way in which we treat the planet.

The impacts of climate change include rising seas, changes in precipitation, higher temperatures and increases in the frequency and intensity of some extreme weather events. When it comes to heat waves and coastal flooding, the scientific evidence is clear – these extreme weather events are being caused by human-caused scientific events. Other forms of severe weather are also closely linked to climate change, this includes rises in extreme precipitation events in some regions and increasingly severe droughts in others. [1] [2]

The weather we experience, the food we consume, the water we drink and the air in which we breathe, are all affected by climate change, threatening our health. [2]

Climate change is providing longer and hotter summers.This may seem like a great thing but extreme heat can lead to heat stroke and dehydration as well as cardiovascular and respiratory problems. In extreme cases, elevated temperatures can kill, as the body is pushed beyond its limits. [3]

Extreme rainfall and flooding continue to rise in regions with rain or snow, negatively impacting the conditions people are living in. Extreme weather events such as flooding and drought can create challenges for the growth of food. [4] This can leave people without a source of income and/or hungry.

Changes in temperature, precipitation, and extreme events increase the geographic range of diseases spread by vectors, such as mosquitoes, ticks and fleas. This can also lead to the occurrence of illnesses earlier in the year. [4]

Climate change increases the risk of water-related illness due to increases temperature, more frequent heavy rains and the effects of storms. Gastrointestinal illness like diarrhoea, effects on the body’s nervous and respiratory systems, or liver and kidney damage can occur due to the consumption of unsafe water. Climate impacts can affect exposure to waterborne pathogens. Flooding resulting from increases in extreme precipitation may contaminate bodies of water such as beaches, lakes and sources of drinking water. [4] 

The quality of the air in which we breathe is decreasing as it becomes more polluted. This can lead to asthma attacks and other respiratory and cardiovascular health effects. Wildfires, which are increasing in both intensity and frequency, also create harmful air pollutants, which further decreases the quality of air. [4]

The effects of climate change are slowly but surely destroying the planet. And as the planet deteriorates, so does our health. This is due to climate change affecting human health in two main ways: first, by changing the severity and frequency of health problems that are already affected by climate factors; and second, by creating unprecedented health problems or threats in places or times of the year where they have not previously occurred. [4]

Some populations are especially vulnerable to climate health risks due to sensitivities, high likelihood of exposure, low adaptive capacity, or combinations of these factors. People in society who are more likely to be at risk from the effects of climate change are the elderly children, pregnant women and people with disabilities. [4]

People living in developing countries are more vulnerable to climate change’s effects, compared to those living in wealthier countries. This is because they do not have the resources to properly prepare themselves for extreme weather conditions or rebuild their communities after the occurrence of extreme weather events such as hurricanes. This is highly unfair considering that most pollution is created by these wealthier countries but people in developing countries experience climate change’s effects more heavily.

It doesn’t take much for you to help the planet. Little things like recycling more, having quicker showers and switching off light switches when you leave a room can help. If we all do a little bit to save the planet, it will mean a lot. But if we do nothing and continue to disrespect our planet, our future on Earth is at risk.

By Bernice Mangundu.

[1] https://www.ucsusa.org/global-warming/science-and-impacts/impacts/extreme-weather-climate-change.html#.Wt96S4jwbIU

[2] http://www.climatehotmap.org/global-warming-effects/health.html

[3] https://www.scientificamerican.com/article/heat-wave-health/

[4] https://19january2017snapshot.epa.gov/climate-impacts/climate-impacts-human-health_.html