Bed shortage crisis

The bed shortage crisis is an ongoing problem causing further stress on the already overburdened NHS. It has reached the point where the NHS is described as the “victim of it’s own success” due to more re-attenders in hospitals .As the number of patients drastically increase and more of the elderly suffer from multi-morbidity, there is an insufficient number of beds to meet the demands in the healthcare sector. This is becoming a serious issue – in April, despite being provided £145 million to aid the NHS only 900 beds were able to be newly provided.The crisis places increased stress on doctors , especially when winter comes around, which may result in more mistakes as there is always an uncertainty of whether there will be enough beds for all patients.

I cannot imagine the situation of this crisis at the moment with the whole pandemic ,which proves to show that escalation beds will be no longer sustainable in the future. However, people turn up to GP’s and local hospitals daily for small problems that can be treated themselves or for some that do not even need treatment;  if these are minimised it will free up the time and space for doctors dealing with patients with life-threatening illnesses. Deaths caused by such delays would totally be unfair and so the wider population need to be made aware of small things that can be done to treat illnesses on minor levels. Most beds are occupied by patients waiting for operations, investigations etc. ,however if this where to happen at other specialist hospitals there would be no time delay. Another comprehensive service would be to provide intravenous antibiotics in the community for the elderly ,leading them to be adequately treated in their homes or nursing homes. Considering that the elderly suffer from illnesses for a longer time and need to be monitored constantly, this is a practical solution, which is also more comfortable for the elderly. I mean having to spend most of your time at the hospital would be quite dismaying.

Many escalation beds are being deployed in order to ease temporary spikes. Patients are seen being housed in corridors , which possible affects confidentiality and privacy as well as good quality of care. For A and E wards the phone triage system has been put in place,which involves patients phoning clinicians to address their problem. The patients with less serious conditions will be referred to GPs with the appropriate amount of advice needed. While, for major cases, appointments are booked immediately through a digital system.Reducing the volume of traffic eases the stress for A and E departments, becomes a solution to the “trolley crisis” (patients are made to wait for their diagnosis and treatment) and overall gives a sustainable apporoach for a decline .

Majority of our problems are being dealt over the phone already, so continuing to use this approach would hugely outweigh the negatives of more staff or clinicians being needed. Therefore the lack of beds in the acute sector of the healthcare provision has improved other aspects of the medical sector . Regarding the current situation the world is in, the only solution for doctors is to work smarter rather than harder.

Living with Parkinson’s disease

Sometimes technology is not always the easiest or most effective solution to problems, as we might think, it may just be a case of thinking of simplistic human-centred solutions. A Tedx talk truly amazed me about how a person’s logical thoughts were put into action to have such a life changing impact on her relative’s life. It surprised me to know that all it needed was a logical approach, as everything has become so technology dependant lately.

Living with Parkinson’s disease (PD) is definitely not easy; more than 10 million people globally are living with this disease. PD occurs when the neurons in the brain break down(die) and stop functioning. These neurons are responsible for the secretion of a chemical known as dopamine. However, this neurological impact results in insufficient dopamine being released, therefore leading to abnormal brain activity and impaired movement etc. As the dopamine levels eventually fall, the symptoms get more and more severe causing so much pain in patients suffering from PD.

I saw in the Tedx talk that a man, who was struggling to even make a turn with one  movement, surprisingly once he had to go down the staircase, actually did so effortlessly like a person without PD. It was quite hard for me to believe at first; the tremors, the slow movements, the pain seen on his face all vanished as soon as he reached the first step. This was due to it being a continuous motion. Following this, a simple idea known as the staircase illusion was created so that walking on flat ground was not as difficult. The staircase illusion involved visually portraying to the man that a staircase was there and once the man walked over this illusion, you would not have told that he was suffering from PD. However, as soon as the illusion was not seen there was an abrupt stop (freezing gait) , which proves that the staircase illusion was in fact effective. This made me question –”Can people diagnosed with PD have their lives changed and improved by visual perceptions such as illusions?”, “So is Parkinson’s something that can be controlled by the power of the brain’s perspective itself?”

Also, a no spill cup was invented so that when drinking tea or coffee in public there would be no embarrassment due to spilling because of the uncontrollable tremors. Every time there is a tremor, the curved cup deflects the liquid back into the cup to prevent spilling. Even though these changes will not cure PD ,it is small tiny steps positively impacting patients to blend into society . The cup had a “normal feel” allowing patients to not be viewed as different. To know that this tiny difference can go a long way in terms of  confidence, how you feel around people and your overall wellbeing gives me a totally different perspective in making a change in people’s life. I’m very curious to find out how a simple idea can sprout into such developments to be beneficial in the medical field and not fully dependant on technology, like it is now.

Tedx talk –  https://www.youtube.com/watch?v=Gg5M3J_FHXY

Mending broken hearts with…..

I took part in the Nottingham summer school, which was a great week to know a bit more about medicine. I have been interested in heart mechanisms so when a talk about “mending broken hearts” was introduced, I went on to researching a bit about this. I found that a fish species known as zebrafish (native to South Asia ) are a significant model in the regenerative biology of hearts and in particular the fixing of “broken hearts”. I know, quite intriguing right?

The zebrafish has characteristics, which makes it a “smart model” for the study of hearts. Zebrafish can repair its damaged heart in a matter of weeks whereas in humans this is very unlikely. The most intriguing characteristic, which is probably also the most important, is that the zebrafish is transparent in its early life cycle. Therefore, researchers are able to see the blood vessels and heart itself grow, which would be fascinating to see I’m sure. Due to their heart being able to develop just 12 hours after birth, the researchers are provided with quick results, making it advantageous for their research. The heart starts out as one long tube and then twists and folds to become the shape we recognise. A consultant cardiologist suggested that switching of particular genes in the zebrafish to identify how blood vessels regrow and repair, will help to identify the genes responsible for the mending of the broken heart. Using the same idea, the possibility of switching the right genes in humans would mean a higher chance of surviving a heart attack ,for example. Zebrafish allow a wide range of genetic manipulation and provided that there are fewer ethical restrictions to mammalian models, they are increasingly being used for research in biology.

To fully regenerate the heart, the zebrafish leaves a temporary scar due to new cardiac muscle cells being formed. Despite having anatomical differences between humans and fish species, the aspect of being vertebrates and having similar cellular structure allow information to be extrapolated by scientists.  Zebrafish embryos that lacked blood circulation, are still supplied with oxygen as they reach all tissues due to passive diffusion as the embryo is so small. This is where for humans this is completely different as the narrowing of arteries due to fatty deposits leads to insufficient blood being supplied. Heart attacks are normally treated with intervention and catheterised procedures, which involves balloon angioplasty and inserting stents to keep narrow arteries open.

Therefore, the introduction of the zebrafish into the development of research to improve “broken hearts” is fascinating. The burden of cardiovascular diseases is staggering and so the developing research into these fish species may be extremely beneficial for future cardiologists!

Robotics in healthcare

The endless challenges of getting accepted into medical school and graduating to become a doctor is something relatable to all doctors. So the introduction of robotics have both pros and cons, considering they will have a shocking influence on the medical sector in the future.

Even though, introducing robotics into hospitals etc. would be very new to both patients and all healthcare staff themselves, they would increase the productivity of doctors. Doctors could save more than half their time in diagnosing, monitoring patients, prescribing medication. This would be especially more helpful due to the overwhelming number of patients in hospitals and GP’s. Surgeries and operations would be less time consuming so majority of the strain and stress doctors experience would be off their shoulders. Considering this situation, this has an immense knock on effect on the whole medical sector. For example, more patients can be treated per day, which means there are an increased number of spaces for patients most in need.

I watched a short clip about robotic surgery, which fascinated me as to how robots can be used in order to perform surgery in a much shorter time. The surgeons use a console to control the robot and handles are used to make movements, which a robot would mirror. Robots can identify hard to reach areas, which are difficult to perform by the human hand. Therefore, there is improved vision, instrumental control and dexterity, which results in less pain for patients and quicker recovery time.

However, many are in doubt whether the development of robotics will lead to decreasing the healthcare roles and jobs. Importantly, it is extremely expensive to use robotics and it is unlikely a robot can replace the basic doctor- patient relationship. The emergence of robotics in healthcare is not new as the in 1999 the da Vinci surgical system which became one of the first robotic-assisted surgical systems to gain clearance. It has been benficial ; for example, one outcome is reducing the number of complications associated with hysterectomy for benign conditions.

Therefore, the fast development which will be seen in the healthcare sector soon will lead to many changes that will hopefully be helpful for doctors to manage complication with patients and the healthcare sector overall.

Privatisation of the NHS

Doctors aim for the best NHS service however, privatisation of the NHS, which became a topical issue, is still quite controversial. There is an issue that privatisation is leading to undermining the NHS core values. Privatisation of the NHS is when the role of the government is reduced and increasing the role of the private sector. I came across this topic and decided to find the pros and cons of it as it could be affecting the NHS hugely in the coming years.

The core values of the NHS are being imapcted , for example, from an article from the “week newsletter” it states that the elderly will experience issues with the continuity of the doctors, which affects the trust and confidence they have. Considering that the NHS prioritises a good doctor-patient relationship, I think it would be unfair for the elderly to experience such issues. This is particularly important, as they may feel distressed that they have to discuss issues with different doctors.  In addition, instead of common medicine becoming more affordable, prices are increasing which puts patients in a further stressful situation.

It is estimated that 7% to 22% of the healthcare budget goes to private providers, so when the NHS is already spending majority of their budget on elderly medicine due to multi-morbidity, I think that gradually there will be a financial struggle.

However, it is also stated that privatised sectors allow patients to choose where they can be treated and also their treatment , which supports autonomy. Also, the NHS is becoming over reliant on private sectors due to their overwhelming number of patients; for example one quarter of NHS knee replacements are performed by private providers. So , even though privatisation can help with the increased demand for the NHS it is starting to impact the core values it holds.

Congenital heart defects

So, I was searching through many articles and videos about cardiovascular diseases and came across this documentary on congenital heart defects (CHD) . CHD are known to be the first birth defect and of which majority of the time the cause is not known. This surprised me, as cardiologists would find it much more difficult than it already is, to know how to diagnose or prevent it in the future.

Congenital heart defects (CHD) is the defect when the heart is underdeveloped, so enough blood is not supplied to the heart muscle, or when the valves have not formed properly when the baby is in the mother’s womb (pre-birth).

The fact that CHD can sometimes be undetected throughout an individual’s whole life is something I found extremely shocking as this defect has a life-changing impact on one’s life. CHD’s can be detected by heart murmurs, where unusual sounds are heard between heartbeats. In infants, this is usually known as an innocent murmur .A symptom when the baby is born is cyanosis (being blue in colour) because of the limited blood flow and this is more subtle in infants of darker and black ethnicities. A pulse oximeter probe is therefore used and in this time period where “black lives matter” is an important topic, it is crucial for everyone to know how to detect these defects in darker minorities.

Fetal intervention is being used to correct forms of CHD before birth and due to the research from the year 2000 onwards, treatments to congenital heart defects are being found. They include heart transplants, surgery and catheter procedures depending on age and severity. During this current pandemic, where deaths are increasingly mounting up I think that the technological advancements to assist with such heart defects are such an advantage.

Start of my journey!

Even though this quarantine has been a tough time, I guess it’s also a new learning experience. However, I had some time to think about why studying medicine is for me. Through an amount of online resources such as a virtual work experience, the fact that medicine requires great responsibility, as we all know, was really emphasised. But this allowed me to gain a deeper insight into what medicine really consisted of. So I guess, this summer holiday is going to be one with a great deal of researching and exploring to do. To be honest, the road to medicine will be a long and bumpy one but with a determined mindset I aim to  complete this journey successfully .

I am interested in cardiovascular diseases and other serious conditions, which are increasingly affecting the society today so expect blogs on related issues!