‘Why Weed?’

‘Oh wow, it smells so bad in that shop…’

‘You mean like the mary jane?’

‘Yes, like the mary jane.’

‘Imagine in Canada, it’s legal there!’

Just the other  day, my mum and I went to a corner shop near our house just to buy some chocolate for the icing of our chocolate cake. With such innocent intentions (and excitement to eat some chocolate cake), the smell of burnt rubber mixed with skunks and body odour surprised me much more than it should have. Living where I do, the smell of weed surrounds me often, it’s not very pleasant, and it’s something I can never get used to. On the contrary, this time, the foul odour sparked a very interesting conversation between my mum and I in the car!

‘Well, I don’t know, alcohol and smoking is legal too, and they have even worse effects’

‘What are you talking about? Marijuana will mess with your brain! You’ll hallucinate and get addicted’

‘I understand that! But that’s the same for alcohol! And think of how much more physical damage comes with smoking tobacco smoke!’

It is common knowledge for us that the legal recreational drugs (for us who live in the UK) are alcohol and tobacco smoke. Legal highs include ‘substances with stimulant or mood-altering properties whose sale or use is not banned by current legislation regarding the misuse of drugs’[1] such as solvents like deodorant and glue! That’s right, glue can get you high too. Here’s an article about solvent abuse:

https://www.themix.org.uk/drink-and-drugs/drugs-a-z/solvent-abuse-9613.html

Anyway, all I’m trying to get at is that drugs like alcohol and tobacco smoke are legal, but cannabis is not. Why?

There are many types of drugs[2], but the ones that I will be talking about are depressants and stimulants:

Stimulants are best described as the ones that make things speed up. They impact the central nervous system in a way that your heart rate increases, blood pressure increases, reflexes increases. Doctors will prescribe stimulants to people who have asthma as it increases breathing levels by opening up breathing passages. It can also be used to aid in weight loss as they can decrease appetite or help you perform better in sports and exercise. Stimulants include things such as caffeine, all the way to cocaine. If stimulants are overused, then it can lead to symptoms such as paranoia, psychosis, high body temperature, all the way to heart failure.

Depressants are basically the opposite. They also impact the central nervous system, but they do it in a way in which heart rate decreases, blood pressure decreases, and reflexes decrease too. Doctors will prescribe depressants to treat anxiety, insomnia, OCD – mostly medical and mental issues which stops a person from relaxing. If depressants are overused, it can lead to symptoms such as delirium, diabetes, impaired memory, hallucinations all the way to intense addiction leading to death from withdrawal.

Now that we know that, let’s get to comparing alcohol, tobacco smoke and marijuana.

Let’s start with alcohol. Alcohol is classified as a depressant. It’s short term effects include ‘slurred speech, unsteady movement, disturbed perceptions and inability to react quickly’[3]. In spite of this, many people will drink alcohol for its stimulant effects – alcohol will only ever start to have depressant effects when too much is drank. An alcohol overdose leads to a higher pain tolerance, toxicity to the point of vomiting, unconsciousness, even to the point of a coma from severe toxic overdose. After long-term uses of alcohol, there is damage to the liver and the brain – the liver is in charge of removing alcohol from the blood stream because, as I have covered, it is a toxic substance; inevitably, the liver will get damaged – this is cirrhosis[4]. However, in moderation, could alcohol possibly have health benefits?[5] The School of Public Health at Harvard University found that alcohol raises levels of lipoproteins – this is ‘good’ cholesterol associated with greater protection against heart disease. As well as this, the Catholic University of Campobasso reported drinking less than four or two, for men and women respectively, could lengthen your life for reason I don’t understand. Other benefits of alcohol consumption include reducing the chances of developing dementia, prevention from the common cold and lowering the chances of diabetes.

Tobacco contains many different harmful substances, the three worst and most important ones are nicotine, carbon monoxide and tar[6]. Nicotine is highly addictive, it is a stimulant and increases heart rate. Carbon monoxide combines with haemoglobin in red blood cells so they cannot carry as much oxygen so the heart has to beat faster and harder leading to heart disease and potentially stroke. Tar is a carcinogen, tar deposits get stuck in the lung so it cannot perform in the way that it should. We know that tobacco smoke leads to lung cancer due to the carcinogenic tar. So why do people smoke? Nicotine in cigarettes affects the brain so that it becomes reliant and you become addicted – within 10 seconds, the nicotine reaches your brain and makes it release adrenaline creating a buzz of energy. This rush of adrenaline only lasts for a short burst of time and thus the user will want to use it again. This makes it very hard to stop using it and in fact, if one tried to, it would lead to horrible withdrawal symptoms such as depression, insomnia, slower heart rate and more[7]. And this part will be mind-boggling, and I don’t even want to write it, but it needs to be done to make a clear, fair comparison: what are the health benefits of smoking?[8] Smoking decreases the risk of arthritis (according to the study from the university of Adelaide in Australia). Specifically, in the knees; this is due to the fact that arthritis occurs most commonly among the obese and people who regularly exercise – smokers do not tend to fit into these categories as smoking leads to a decreased appetite and people who smoke are less likely to be active due to lung problems. Numerous studies have also identified that smoking lowers the risk of Parkinson’s disease – the reason: unknown! Harvard researchers found that it came after smokers quit. What do you guys think? Could this just be a spurious correlation? Other benefits of smoking include lowering the risk of obesity.

Finally, let’s talk about weed. THC (tetrahydrocannabinol) is the chemical in charge of most of cannabis’ psychological effects[9]. Here’s how it works: when one smokes marijuana, THC passes from the lungs into the bloodstream; the blood carries the chemical to the brain and other organs so they absorb the THC. The THC acts on specific brain cell receptors and over activates parts of the brain that contain the highest number of these receptors leading to the short term effects of altered senses, mood change, impaired movement as well as impaired memory. In higher doses, marijuana causes hallucinations and psychosis[10]. The receptors that THC bind to play a role in normal brain development and function, consequently, if marijuana is used from a younger age(teenage years), it can cause impaired thinking, memory, and learning functions – at the moment, scientists are still studying if these effects are permanent. In addition to this, marijuana usage can lead to breathing problems, increased heart rate, problems with child development, intense nausea and vomiting, as well as hallucinations and paranoia. Simultaneously, it is not a secret that marijuana has many health benefits including treating chronic pain, depression and anxiety, as well as alleviating symptoms of cancer and chemotherapy as a result of cannabinoids slowing down the growth or even killing some types of cancer (they are a safe but not yet completely reliable treatment) [11]. In fact, it is prescribed by doctors around the world to treat conditions such as multiple sclerosis, spinal cord disease, arthritis and so many more![12] Basically, marijuana is used as an alternative to opioid painkillers – why? The quality of life of a patient is a priority for doctors. With chronic pain comes relatively little hope for a cure, but hope for effective management of symptoms that still allow them to live their lives to the fullest. Medical cannabis is chosen as opioids tend to cause drowsiness, lethargy and other symptoms that stop the patient from doing different activities.[13] Not only this, but marijuana is shown to be much safer than opioids, this is due to the fact that cannabis has a much lower risk of overdose and addiction in comparison to opioids, this is because the peak plasma concentration of THC (the amount your body can physically hold) is 100-200ng/ml and it would take a lot of weed to get to that point, you would have to have 80kg in an hour. When THC binds to receptors, there is also a release of a hormone which weakens the THC’s action on the receptors, so overall a negative feedback loop is created [14]

In my opinion, alcohol and tobacco smoke are much worse than marijuana. Doctors will actually prescribe marijuana to help people overcome drug addiction and alcoholism – if marijuana was worse, why would they prescribe it as medication? You don’t see a doctor prescribing alcohol to a person addicted to heroin or a person with chronic pain. So why is alcohol and tobacco smoke legal, but weed isn’t? I think that legalising and allowing more drugs which cause impairment and other bad symptoms is just unnecessary. Alcohol and tobacco smoke already has large, major companies and they were discovered first. This might be a bad analogy, but it’s like guns in America. It’s got more bad effects than good ones, but to just get rid of them completely will be so difficult as there is already many companies for guns etc. but legalising the use of poison bombs because the poison chemical has less potential to kill and some potential to have some benefits to plants or something will not solve the problem of guns! I think that the usage of marijuana as an opioid alternative is fine and would be good if legalised, but marijuana should only be used in an enclosed section of the hospital so as not to pose a threat to illegal recreational use as well as others in the hospital who could potentially be negatively affected (patients with asthma or schizophrenia). However, the biggest reason why I think marijuana is not legal, is because it is still being studied – there needs to be more solid research and evidence with explanation as to why marijuana is beneficial in the way that it is.

What do you guys think?

By Antonia Marie Jayme

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

‘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/

“You’re Such a Retard”

‘Oh, you retard! What did you do that for?’

‘You’re such a retard’

‘How did you manage that, retard’

As a sixteen-year-old, these are phrases I hear so often, not directed at me, but I hear it being said as a joke between friends, or as simple ‘banter’. I hate to be ‘that person’ – you know the one that complains even though its ‘an inside joke’ or ‘friendly banter’ – but I feel that the word ‘retard’ should stop being used and passed around in the way it is. People say it without knowing what it means: without knowing what the word truly entails; the complications that come with the mental issue; and the way in which life is different for someone who is actually ‘retarded’. What makes it worse is that some people use the word knowing what it means – it has just become so normal in our society, when it shouldn’t be! If you think that it isn’t a big deal, it’s just banter after all – think about the people who have intellectual disabilities. It’s gotten so bad that if you google the definition of retard, the oxford dictionary defines, as well as the verb (delay or hold back in terms of progress or development), the noun form of the word is defined as ‘a person who has a mental disability (often used as a general term of abuse)’₁. Imagine having an intellectual disability like autism and therefore not doing well in class with an IQ of below 70 to 75 (whilst the average is 100) making you classify as a ‘retard’ and then people around you saying it like it’s a joke, and it doesn’t affect you, or saying it to other people as a ‘form of abuse’ when they have no clue what it’s like to actually be in your shoes.

Today, mental retardation is known as intellectual disability. The term ‘retard’ has been tainted over the years and this is normal. According to ‘Questia’₂, it began simply being an account of IQ, however as time went along, this was largely abandoned – it is based on the support one needs in different areas in their life such as educational needs, housing, or daily necessities like feeding and bathing. A common misconception is that the disability means they are unable to learn, however, the actual case is that it takes longer for one with the disability to grasp things. Healthline tells us that there are four levels of intellectual disorder: mild, moderate, severe and profound₃. Severe cases are diagnosed at birth but almost all cases are diagnosed before the child turns 18. It is thought that intellectual disability affects only 1% of the population₅.

Intellectual disability roots from before birth, during birth or in early childhood (as stated by the NHS) ₄. Brain development can be affected before birth for a variety of reasons: the child could be a victim of fetal alcohol syndrome if the mother drinks alcohol during pregnancy, they may develop certain genes (e.g. down syndrome), or even malnutrition₂. Brain development can be affected during childbirth for a variety of reasons: it may be that the baby is premature, underweight₂ or complications occurred during birth that stop enough oxygen from getting to the brain (the umbilical cord might wrap around the baby’s neck) ₄. Brain development can be affected during childhood for a variety of reasons: illnesses like meningitis (which Muskaan has written about previously on our blog), encephalitis, or injury during early childhood₂. The most common causes are fetal alcohol syndrome, fragile X syndrome and Down syndrome. Sometimes, the cause remains unknown₂.

In order for a doctor to measure a child’s adaptive behaviors (day to day life skills), they will observe the child’s skills and compare them to other children of the same age₅. Signs to look out for would include₃:

  • Inability to reach intellectual standards
  • Taking more time than other children to learn to talk or walk
  • Inability to understand consequences, right and wrong
  • Behavior inconsistent to the child’s age
  • Lack of curiosity
  • Learning difficulties
  • Difficulty to communicate, take care of themselves or interact with others.

In children with profound and multiple learning disability (PMLD), the child has more than one disability (the most significant being an intellectual disability). These can include seizures, mood disorders (anxiety, autism, etc.), and even problems with sight and hearing₅. Children or adults with PMLD need a carer or carers to help them with everyday life.

Diagnosing the child involves a three-part evaluation₃:

  • Interview with the parents
  • Observations of the child
  • Standard tests (e.g. blood tests, urine tests, imaging tests, EEG) ₅ – they may also go through an intelligence test

This may include visits to a psychologist, speech pathologist, social worker, pediatric neurologist etc.

Some doctors believe that the best way to prevent intellectual disorders are vaccinations. Ensuring a child does not undergo rubella, measles, meningitis etc. can help prevent intellectual disorder. For example, vaccination against Haemophilus influenzae b (Hib), a cause of childhood meningitis, is expected to prevent 6000 cases of mental retardation according to ‘Questia’₂.

In terms of treatment, support is key. NHS offers annual health checks in which a general physical examination takes place and as well as this, a checkup for epilepsy, checks on prescribed medicines, and a review on any other arrangements with physiotherapists or speech therapists (to see more see website 6 in the bibliography) ₆. Treatment cannot just get rid of the disability, but it helps them reach their full potential. Although some may think this is barely treatment, it is the only thing that can be done (other than genetic modification which is a whole new topic in itself). When the child is ready to attend school, it is wise to put in place an Individualised Education Program₃. Schools provide this for free. Some choose to bring their children to special schools, however others choose to do the practice of ‘mainstreaming’ in which the child can attend classes in a standard classroom to help them feel more included and also help the people around them understand their special needs and capabilities₂.

People with intellectual disabilities may be going through a lot – be it the struggles of autism, seizures or simply the struggles of school – yet we still use the word ‘retard’ as a ‘term of abuse’. I believe it is wrong. To think that someone who has an intellectual disability is able to cope with the struggle of learning to get through their everyday life, yet someone like me can complain about school and everything being too hard. To think that someone who has an intellectual disability not only has to go through the struggles of their disability, but also the struggles of being bullied to the point that the ex-medical-term ‘mental retardness’ has simply just become a term of abuse. To think there are people out there who have no idea what it means to call someone a ‘retard’. I believe that is wrong.

By Antonia Jayme

 

https://en.oxforddictionaries.com/definition/retard

https://www.questia.com/library/science-and-technology/health-and-medicine/diseases-and-disorders/mental-retardation

https://www.healthline.com/symptom/mental-retardation#modal-close

https://www.nhs.uk/conditions/learning-disabilities/

https://www.webmd.com/parenting/baby/intellectual-disability-mental-retardation#1

https://www.nhs.uk/conditions/learning-disabilities/annual-health-checks/

‘Lose Some Weight.’

‘She’s so fat! What’s wrong with her thighs? They jiggle like jelly! What’s wrong with her stomach? It’s bigger than her head! What’s wrong with her body? What did she do to get that big!’ she cried as she looked back at the girl staring at her in the mirror.
‘How did I get so big?’

But she wasn’t. She was completely fine. She was a healthy weight. I just wish she could see that. That was the state I was in during year 9. ‘Skinny’ was the only word I wanted to embody and thus began the journey of skipping meals, compulsive exercise and horribly low self-esteem: the journey of anorexia.

Of course, I’m okay now, I’m (definitely) no longer underweight nor skipping meals and have regular amounts of exercise! However, looking back and remembering the thoughts that played in my head and how the journey finally came to a halt, I know there’s a lot of things about anorexia people don’t understand, especially about how to help someone who is affected by it…

What is Anorexia?

Anorexia nervosa is an eating disorder. One who has it strives for the lowest possible weight and has body dysmorphia (they look at themselves in the mirror and see something that they’re not). In order to achieve their goal, the victim will miss meals, eat very little or nothing at all; take medications to reduce their appetite, or even weight loss pills; as well as this they may fall into purging (compulsive exercise, vomiting, fasting). Even once they reach their original goal, it will never be enough. Anorexia is often confused with a similar eating disorder: bulimia – this is an eating disorder in which, rather than limiting calorie intake, the affected will binge eat and then immediately purge in a constant cycle. One other thing to remember is that, whilst this article focuses on anorexia, eating disorders also include binge eating disorder – this leads to obesity rather than loss of weight.

There are many symptoms that come with anorexia. Emotional behaviours that come with anorexia include:

  • not eating properly
  • body dysmorphia
  • obsession with body image
  • loss of focus and interest in things
  • Irritability

However, anorexia nervosa also comes with horrible physical symptoms:

  • brittle hair – which can eventually lead to hair loss
  • lanugo may begin to grow – this is fine body hair that is often referred to as ‘peach fuzz’
  • body temperature drops
  • constipation
  • kidney damage
  • osteoporosis – brittle bones
  • slowed thyroid function – causes an imbalance in hormones – this is bad for both boys and girls as it can affect their fertility as it can cause girls to stop menstruating and boys to have erectile dysfunction

Anorexia nervosa is a mental health condition and it is important to speak to your GP for proper diagnosis.

What to do about someone who has it?

One of the biggest things when trying to help someone with an eating disorder is letting go of all the stereotypical beliefs and myths about anorexia. As someone who experienced it, one of the biggest barriers for improvement and healing were the people around me who made uninformed comments, even if they were trying to help, it simply lowered my self-esteem further.

Common Misconceptions: (https://www.helpguide.org/articles/eating-disorders/helping-someone-with-an-eating-disorder.htm)

‘You can’t be anorexic – you’re not even skinny!
You don’t need to be skinny to be anorexic – usually people of an average weight or who are overweight or of an average weight become anorexic trying to become skinnier.
‘You’re mean to be a man – snap out of it!’
Just because someone is male, it doesn’t mean they can’t have anorexia – anorexia is a mental health issue – all of us have brains and therefore all of us are susceptible to mental health issues!

 

‘You’re so self-absorbed. Get over yourself!’

It isn’t often that vanity leads to eating disorders – the behaviours that come with the disorder tends to become a coping mechanism to deal with something happening in their lives. Even so, they could be so self-conscious due to events in life such as bullying or just simply needing attention and a cry for help that they have been driven to the eating disorder.

 

‘It’s not serious anyway.’

As you saw from all the symptoms I listed earlier, yes, it is very serious. In case you need a reminder: brittle bones, kidney disease, infertility, drop in body temperature and many more.

 

Now that you have that out of the way – communication is key. Find a time where you and the person you are concerned for are free from distractions and in an environment where they feel safe and secure. Once you’ve got the right setting and are comfortable – just speak to them. Explain why it is you feel the way you feel without putting them down. Don’t force them into something they don’t want to do as this can lead to secretive behaviour from the affected person as a way to escape the situation again. Don’t comment on their weight the way you would with other people – you’re speaking to someone who is already obsessed with body image! Telling them ‘you’re not even fat’ can do more damage than good as they may take it the wrong way and think it justifies them staying away from being fat – your being negative about the possibility of them being fat! Rather than doing this, try to ask ‘why are you afraid gaining weight?’. Don’t make them feel ashamed of themselves by putting all the blame on them: ‘why can’t you just eat something’ – tell them that you are worried for them; show them they aren’t alone and that there are people that care for them! If it were as easy as to ‘just eat’, the person wouldn’t be suffering.

Stay patient and supportive for the person you are worried about. What you need is for them to admit they have a problem, to understand that they need help. They need to make themselves to go through treatment (therapy), otherwise it can lead to worse things. They may refuse to listen to what you say, but you have to be there to continue to help and support them so that they can see past their morphed reflection in the mirror.

By Antonia Jayme

This website has a list of websites you can contact for help:

https://www.helpguide.org/articles/eating-disorders/helping-someone-with-an-eating-disorder.htm

 

Links used:

https://www.helpguide.org/articles/eating-disorders/helping-someone-with-an-eating-disorder.htm

https://www.nhs.uk/conditions/anorexia/

https://www.everydayhealth.com/eating-disorders/can-an-eating-disorder-affect-your-fertility.aspx

https://youngminds.org.uk/find-help/conditions/anorexia/

March into Knowledge about DVT

March has begun and thus begins deep vein thrombosis awareness month – and so here I am, raising awareness.
As stated by the NHS website ‘DVT (deep vein thrombosis) is a blood clot that develops within a deep vein in the body, usually in the leg’. If you want to impress your friends you can say ‘deep vein thrombosis is a venous thrombus that develops within a deep vein’. Most commonly, deep vein thrombosis occurs in the deep leg vein, however it can occur elsewhere such as the arms, so forgive me if my focus through this article is mainly on the legs.

If you search up ‘deep vein thrombosis’ on Google images, the photos you will find are of legs but one leg is swollen, red and blotchy. Naturally, this swollen leg comes with pain – tenderness, aching and warmth within the affected leg, and yes, bending it would be difficult and very painful. These are the most common symptoms for a DVT patient. On the other hand, there are cases of DVT where no symptoms are detected at all. Whilst that seems like a good thing (I mean: no pain, why would that be bad?), it’s really not. In my opinion, the fact that some people can have no symptoms at all is extremely worrying. This is because if DVT is left untreated, it can lead to life-threatening complications…

One of the less serious (but don’t get me wrong, still serious) complications of DVT is post-thrombotic syndrome (PTS). This develops in nearly half of all patients who experience DVT. PTS causes chronic leg pain, swelling, redness and ulcers that may be expensive to treat and cause lots of discomfort.
However, the most serious complication happens to those who are left untreated. Around 1 in 10 people with DVT who go untreated develop a pulmonary embolism. A pulmonary embolism is caused when a part of the blood clot from the DVT breaks off from the deep leg vein and enters the bloodstream into a major blood vessel: the arteries in the lungs. This is potentially fatal if the blood clot is large as it can cause the lungs to collapse resulting in heart failure. If you have DVT, the warning signs of a pulmonary embolism include shortness of breath, chest pain (especially when trying to take a deep breath in or when you cough), nausea, a rapid pulse and even coughing up blood.

So what causes DVT? Many, many, many different things. Some people actually inherit a blood-clotting disorder from their family that cause it to be easier for their blood to clot – whilst this isn’t the cause of DVT by itself, it increases the risk for them developing DVT. Another factor that can cause DVT is prolonged lack of movement (e.g. paralysis, bed rest etc.) as muscles need to contract in order to help blood circulate – in the leg, the calf muscle needs to contract. Even simply being pregnant puts you under risk consequently to an increase in pressure in the veins of the pelvis and legs. Other factors include smoking, obesity and age.

Not many people know about DVT – neither did I until I came across it on NHS Choice’ Facebook page. The treatment for DVT is as simple as pills – anticoagulant medicines. The prevention of DVT is as simple as a healthy lifestyle. Yet when people get it and don’t know what DVT is, it could potentially lead to their death. It is important people know about DVT, and now that you do, you know all the symptoms and if it happens to you, seek immediate medical attention before complications occur.

Make sure you spread awareness with me; let all your friends know about DVT.

By Antonia Jayme

Make sure you read the sources from which all my information comes from to learn more about DVT, including its diagnosis:
https://www.webmd.com/lung/tc/pulmonary-embolism-topic-overview
http://circ.ahajournals.org/content/121/8/e217
https://www.nhs.uk/conditions/deep-vein-thrombosis-dvt/
https://www.mayoclinic.org/diseases-conditions/deep-vein-thrombosis/symptoms-causes/syc-20352557

‘I’m so stressed…’

‘I’m so stressed…’
Essay due tomorrow?
Work problems?
Relationship problems?
Whatever it may be, everyone has been stressed.

As a student, I understand the world of stress: I may have an excessively long homework due the next day that I haven’t started, or a meeting with a friend that I haven’t seen in a while – even right now, writing up this blog post that I should be posting before the end of the day! All of these things and more cause me to feel stressed. It makes my heart race, my breathing becomes heavy and my muscles tense. Here’s how it works…

First, an almond shaped group of neurones sitting deep on each side of your brain evaluates the stressful situation at hand (this is called the amygdala and it is responsible for our emotions). Afterwards, the hypothalamus links the neurones and endocrine systems through the secretion of hormones from the pituitary and adrenal glands causing a response…

Our adrenal glands release hormones such as adrenaline, noradrenaline and cortisol -these make us feel the way we do when we’re stressed as it triggers our ‘fight or flight’ mechanism. You may get ‘butterflies’; that feeling in your stomach as if all your intestines are swirling around – that is literally your body slowing down, or even stopping digestion completely to focus all of your energy into ‘fighting’ or ‘running’ from your stressful situation. You may get a headache – this is caused by the muscles in your head, neck and shoulders tightening up. What might shock you is that the hormones released when you’re stressed can actually lead to much worse things than the short term feelings that you get. For example, the liver releases glucose to fuel respiration so we can ‘fight or flight’ in our situation; if you are stressed too often and the stress is caused by something more psychological than physical which doesn’t require you to use the glucose released, it can actually lead to diabetes! In addition to this, the hormones released aren’t good for the heart and can horrifyingly lead to high blood pressure, heart attacks or even stroke.

At the end of this intense system, is the hippocampus, a seahorse shaped structure responsible for emotions and memory formation, and the frontal cortex involved in decision making and executive function – these put the stress cycle to an end.

Honestly, why do we even get stressed? Why does this system exist? Imagine how great a world without stress would be! The thing is, this stress system used to be very useful for us humans: it’s main purpose was for situations such as running away from a predator (or fighting them – if you’re brave!). But now, the system is much less for physical purposes, but much more psychological – this is something I want to stress. Stress is real. Mental illness is real. Just because you’re doing something as simple as meeting an old friend and the collection of feelings that come with stress hit you, doesn’t mean you’re ‘weak’ or ‘whiny’. Stress is a real thing and if you overdo yourself and convince yourself you’re being weak, you can stress yourself out more! If you stress out too often, it can lead to chronic stress; heavy amounts of stress can lead to post traumatic stress disorder, depression, anxiety and cognitive disorders. This is why the way you treat stress is important!

One of the most common ways to treat stress is exercise. When you exercise, your body releases endorphins. These interact with the receptors in the brain to reduce our perception of pain and trigger a positive feeling in the body. Plus, it’s winter, and you know what they say ‘summer bodies are made in winter’! Don’t think this means that you have to exercise for hours on end to get rid of your stress, just half an hour a day is fine!

Another highly recommended way to deal with stress is meditation. I recently read an article by Dr Enikő Zsoldos (psychologist and postdoctoral researcher in the Neurobiology of Ageing group, Department of Psychiatry) about a type of meditation called ‘Mindfulness’, a type of meditation originating from Buddhist traditions (I’ll put the link to the article at the bottom of this article). The aim of meditation is relaxation, self awareness and reach freedom from despair and sorrow. In mindfulness, you sit still and focus on one thing and if a distraction arises, you embrace it without trying to change it – very metaphorical but it is just accepting the present without thinking of the future or past – thus relieving panic and stress.

Stress is such a common problem in our modern world to the point that there are even apps made for the purpose of helping with stress! Whilst I haven’t tried any of these and some of them are still being tested in the NHS, I will leave a link to a list of apps at the end of this. If you’re the type to put all your reminders on your phone, all the important dates etc. then I would try them out!

These things may not work for everyone, it may be that you can’t get into them or feel like you don’t have the time to do these things, and I completely understand. But the most important thing is to try! And also try to have a positive mind about stress, don’t brush it away but think ‘I should focus’, ‘I need to get this done’ – if I was never stressed, I would never finish any of my homework nor complete any of my tasks to a high standard! And have you ever gotten butterflies in your stomach when you see something that makes you happy? Like someone you like or food! We would never get that without the stress response! The ‘fight or flight’ mechanism was made to help us, so we should use it to our advantage!

If nothing seems to work and you can’t deal with the stress alone, know that you don’t need to deal with the stress by yourself! You can tell someone, be it a close friend, or a teacher. For example, students, if you’re stressed because your homework is piling up and you have no idea how to manage your time, tell a trusted teacher. But if you really can’t get yourself out of the cycle of stress, consult your GP.

By Antonia Jayme

Links used:
• How stress works
o https://www.webmd.com/balance/stress-management/ss/slideshow-stress-and-you
• Mindfulness meditation
o https://medium.com/oxford-university/a-mindful-approach-to-the-year-will-your-brain-thank-you-for-it-fda63216c36a
• NHS list of apps to manage and improve health
o https://apps.beta.nhs.uk/?category=Mental+Health

 

Anatomy of Antonia

Who am I?
I am Antonia: sixteen years of age and an aspiring ___.
How does one answer ‘who are you’?
I am Antonia: I’m currently taking A-levels in Newman 6th (biology, chemistry and maths).
Do I need to talk about my hobbies?
I am Antonia: I love to write sing and draw.
Who am I?

As my life progresses, it seems that the definition of ‘Antonia’ changes too. I have come from, primary school, hating maths and being put in the lowest set; to now, somewhat enjoying maths and taking it as an A-level. I have come from wanting to be an artist, an author, a singer – to not knowing what I want at all. As I grow up I learn so many new things that lead to so many new questions.

Looking back at my life, medicine is the one thing that stayed close to me in this growing world, full of questions and uncertainty. I remember wanting to be many things as a young girl, I wasn’t very talented academically, but when it came to art, music and poetry, I was amazing. I felt so at home in this intriguing land of imagination. Soon I realised, my parents would not be very happy with me if I failed all of my SATs at the end of primary school – ‘I should really get better at this’.

So I did: I tried my best, asking my dad for help in maths, finding revision websites such as BBC bitesize, and whilst doing so, I found a set of ‘games’. These did not relate to anything in my curriculum as an eight year old in primary school, they were just so interesting to my little mind. I’d play one game, and I’d play it over and over again, until I memorised every step. This was a game by ‘EdHeads’, namely the knee replacement surgery (fun fact: ever since playing this game, my favourite word is ‘patella’). Before I knew it, I was entranced. I wanted good grades, I wanted to learn, I wanted to achieve. I wanted to be a surgeon.

This began my medical journey.

My grades rose; my ambition grew and my passion for the medical field skyrocketed. And here I am now with 5 As and 5 A*s in GCSEs and currently studying biology, chemistry and maths for A levels.

I still don’t actually know what it is I want to be. I still havent let go of my hobbies such as drawing, singing and writing – simultaneously, my mind still wanders through the vast variety of destinations medicine offers: surgeon, GP, psychiatrist. But one thing I know: I want to be in the medical field.

Who am I?
I am Antonia: sixteen years of age and currently taking A-levels in Newman 6th (biology, chemistry and maths). I love to write sing and draw.

Who do I want to be?
I want to be someone who cares: someone who helps others in times of difficulty, in times of pain, in times of grief. Someone who is able: able to connect, able to deliver, able to achieve.
I want to be someone who makes a difference.

I am Antonia: sixteen years of age and an aspiring medical student.

By Antonia Marie Jayme