PEARLS Ambassador

While at #HealtheVoices19 Rick Guidotti gave the key note speech. I had never heard of him or the work he was doing but as soon as he started to speak I was in awe. He spoke with such passion and exuded positivity. It is no surprise that he is the man behind Positive Exposure a movement which celebrates the beauty of human diversity. Just because you may look different, or sound different you can still be celebrated for being you. Positive Exposure embraces everyone.

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Being able to speak with Rick and then have my photo taken with him was amazing and then being able to continue the conversation over email once I was back home has just emphasised to me the passion Rick has for the work he does.

One of the Projects he has within Positive Exposure is the PEARLS Project and I am delighted to be a PEARLS ambassador and part of a platform made up of other like minded people who are empowered to be advocates and use their voice to make a change. The other advantage with the PEARLS Platform is that it is a safe online blogging platform where all ambassadors can see what each other post and feel safe doing so.

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I am really proud to be part of such an amazing network and can’t wait to see what happens going forward.

 

#MentalHealthAwarenessWeek2019 Acceptance

In my first post for #MentalHealthAwarenessWeek2019 I looked at dealing with being in denial. Wether that denial be of your physical health or your mental health, I am sure it is something we have all done. Tried to brush things off and say I’m fine. But what does saying fine really mean. To me now saying “fine” says a lot more that it means. To me when someone says they are fine it means they don’t know how to explain how they feel, or they don’t want to admit how they feel, or they don’t know how they feel. This happened just tonight speaking to a friend whose response to my how are you? was Im fine when clearly they were not.

I think we all just jump to I’m fine because we think it will not lead to anymore questions and we can move on to a different topic. Why do I think this? I used to be that person and still am sometimes. I would think if I said I was fine then I would be left alone to get on with things and could feel rubbish with out anybody pestering me. When I first started seeing a psychologist we spent a session talking about “Im fine” and why we use it. It was interesting to explore it further. It caused me a lot of pain as it brought up thoughts I didnt want to deal with, and made me realise my situation but now I look back and see I needed it otherwise I would still be telling people I am fine when I am falling apart.

Exploring the I’m fine became a lot more. It helped me accept my health. It helped me move out of a denial phase where I wanted to pretend to everyone I was ok. I didnt want to be the weak one who struggled to breathe or could work like everyone else. I didnt want a condition that can be considered by many as “just asthma” to rule my life and dictate it so if I didnt knowledge it to other people then everyone was happy as larry. All this did was hurt me more as no one else was getting more unwell or lonely because of my asthma and my health it was only me I was punishing.

Opening up and being able to explain how you feel is hard. I started off by trying to verbalise it but I found doing word clusters easier. I had 3 sheets of paper and each one contained a word: asthma, physically, and mentally. I also had coloured pens where I then wrote down how each word made me feel right there and then in one colour, in another colour I wrote down how i have felt in the past and then in a third colour I wrote down how I wanted to feel about the words.

This task made me accept my health both physically and mentally. It made me acknowledge that asthma is not just a physical condition but impacts you mentally as well. By treating each part in isolation I was never going to be able to really get to where I want to go. One each sheet of paper I had the same words particularly with where I wanted to be in the future. I had a common goal across everything and this is when I realised that to achieve that goal I need to look at every aspect of my health and how my condition is effecting me.

I found also that by doing this task I accept my health. I was able to see where I was and where I wanted to go. Rather than focusing on the here and now I was able to set goals for the future both short and long term. Goals which are achievable but also including some that are going to push me because you don’t want to make life too easy. Doing this meant I evaluated myself there and then, how I was feeling, what I needed to do to keep me stable or what I needed to do to change the situation I was in if it was a bad day. Accepting that you can have bad days is a big part of this but to accept bad days I found I need to have strategies on how to fix these bad days. It was not about looking for a fix such as a cure but looking at things that can still be done and achieved despite you not feeling well. For me a big part of not feeling well was feeling like I was failing. If I was not well enough to work or when i cut my hours cut down I found myself sitting at home thinking I should be at work just now but am not because of my lungs. Accepting that this is where I was at that point and doing something to change it even though I am not able to change my lungs I can change what my brain is doing. For me that is being involved in research. No matter how unwell I feel I will always be able to be involved in research.

One of the other big things about moving from denial to acceptance is evaluating yourself. You are going to have days where you slip back into the Im fine I don’t want to talk about things from time to time but if you can reflect back on why you felt like that. It might be that it was the people you were around you at the time and you did not want to share your feelings with them. This is ok. Everything has to be done in your own pace. Some people maybe able to reflect on themselves and feel they can shout from the rooftops about their condition and how it makes them feel where others cant tell a sole. Everyone is different and everyone has their own way of dealing with it.

I would be really interested to hear about how others found self acceptance of their health when they had previously been in denial about anything being wrong with them. I am always intrigued as to what skills others utilise to help them.

The above is just my experience. It might not be right for anyone else, but I found this is how I got my head around things and accepting how my asthma is impacting on life and how I felt about my asthma, the impact it has on my physical and mental health too.

One thing I want to get across this week is that a physical health condition is not isolated to just the physical body, and a mental health condition is not just associated with your mental state. They all over lap with each other and to truly get the best management for you everything needs to be looked at not just the condition in isolation.

#MentalHealthAwarenessWeek2019

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This week is mental health awareness week. It officially started yesterday but it was a mega busy day so did not manage to get anything up here although did schedule an instagram live for 7pm tonight @just_TUX for anyone that wants to join. Mental health has always been a bit of a taboo subject and not spoken about but why shouldnt it be. It is as organic as any other disease. It can be diagnosed and treated with medication just like a physical condition is so why is it so taboo. I think it is because it affects behaviour and you should supposedly be able to control behaviours. Not wanting to belittle mental health symptoms but with physical health you cant control a coughing fit in asthma just like you might not be able to stop repetitive activity in someone that has OCD. It comes on out with your control so what is different.

My blog had touched on mental health and how it has impacted my life but I have not explored it in more detail. Living with a chronic physical health condition the Dr’s focus on the physical side of things, the medications and the numbers they don’t tend to spend a lot of time asking about how you are managing mentally. It almost feels like it is out their remit. They are there to treat the asthma exacerbation and get you physically better but it is not until something major happens that they then maybe just maybe take your mental health into consideration.

Today I want to focus on denial, I have spent so long in denial for both my physical health and my mental health. I am getting better at speaking about my mental health but still not very good at it! I can write when I choose too and feel able to publish it here.

For me I have gone through a bit of a rollercoaster with my mental health. Having had such severe asthma for so long and being in denial about how much it was impacting on my life. I wanted everyone to see I was fine, I was pushing my body and my mind to the limit but so many thought it was just asthma or others thought it was just asthma that was bad because I was assumed to be a irresponsible student. I maybe was not always as responsible as I could have been but reflecting back a lot of that I think is me being in denial about how bad my asthma was and how much it was dictating and destroying my life. I often wonder now if I have some input from psychology then how would things have been different.

I have constantly been in and out of hospital with my asthma, from being rushed in with blues and twos to the resuscitation room, even being life flighted from one hospital to another over in Canada, countless intensive care admissions, 4 month long hospital admissions, central lines, blood gases, arterial lines, bed bound, tethered to machines just to live but until 8 years ago I never had any mental health input. Then I had 2 sessions with a psychologist but I cant say it did anything but then 4 years ago I was forced to go to see a psychologist but it has taken a while for it to really be impactful and make a difference to me.

I look back on it now and wonder if I had had psychological input would my health be any different from what it is now. It might not be but I am sure I would have been able to deal with my health and the experiences of it a lot better. In saying this I am not sure wether I would have been in the right frame of mind to accept the help to try and understand my condition. My way of dealing with things was to pretend it didn’t bother me or when dealing with hospital I trained myself to forget about what happened in the hospital. It was the only thing I knew how to manage it. The experiences you go through as a young adult who cant breathe is so humiliating, when you cant go to the toilet yourself or be left alone because your breathing is so bad and your blood pressure plummets it is easiest just to blank it out and forget about it. This I think did not do me any favours. I still find myself relapsing back to those ways as I just cant deal with what’s happening and not feeling strong enough to process it all. It is a work in progress and always will be to try as I try to balance the psychological aspects of living with a physical health condition.

Some aspects of my life I think I am still in denial about my health and how it really effects me. I hope others can read this and know it is normal to be in denial, it is normal to not want to acknowledge how unwell you are or that you’re not having a good day. Its ok to not be ok and its ok to ask for help. Even if you don’t want to talk there are other outlets- I will tell you now punching things are not the way to go about it and only end up with broken bones in your hand so writing I would say is one of the best options. No one has to see it if you don’t want or even just one person that you feel close to or even distant too. Everyone can find an outlet.

Everyone will feel in denial at some point with their health and sometimes we relapse not denial but it is ok. There is help out there. We cannot all be perfect all the time but know that we can come out the denial when we just find the best way that suits us and we are ready to accept our body, our health and our mind.

Out of negative situations there is positives, its just about looking at life in a different way.

International Nurses Day

The birthday of Florence Nightingale it is only natural that this is also international nurses day given she was the founder of modern nursing as we know it.

When I left school I was the last person anyone would have thought would be a nurse. All I did was sport, all I talked about was sport. I was sport and it was all I had. A series of events happened in life and I had to rethink my career and I somehow ended up doing nursing and I could not be happier!!! I had so much fun doing my training and then got a job in an area I never thought I would end up but being a renal nurse is pretty special and I don’t think any other area you will get the same relationship between nurses, patients, Drs and families.

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This photo was taken just after we passed our final OSCE’s in 3rd year!!!

I miss putting on my cornflower blue uniform everyday. I loved being a nurse and will be back as a nurse when my lungs get better. Being a nurse is hard work, busy, never time for a rest and you never know what will happen next but seeing the improvements in patients is the best feeling you can have. Even if it is the little things like sitting chatting to them or helping them with a wash and getting their own clothes on, it is so rewarding. For me it is even more special as I have been on the receiving end of nursing care so many times and the nurses that take that extra bit of time to just do that little something means so much to me.

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This uniform means so much to so many. For me it gives me a purpose. While not being in renal this year I keep my uniform out so on days when I am feeling dejected and thinking about what I should be doing had my health not stopped me, it is there reminding me what I am aiming to get back to. My life as a nurse is not over, it is temporarily on hold, while I focus on research and getting my health better so I can go back to doing what I love with a body that can cope and the energy to give it my all.

I also owe my life to nurses. Having asthma like I do and requiring hospital treatment, admissions and appointments I come across a lot of nurses. The nurses have made sure I am alright, helped me wash when I am too weak to do it myself, helped me go to the toilet when just moving from the bed to commode is too much for my lungs, even just holding my hand when I am finding the situation terrifying because every breath is a fight and requires more energy than I can muster. The presence of a nurse just being there adds this security so I know I am ok.

When you live with a chronic condition which lands you in hospital fairly often you end up getting to know the staff in the wards. For me it is the respiratory ward. I always end up going to the same one now particularly since moving consultants. I also have to go to the respiratory ward once a month for my mepolizumab injection which is given to me by the asthma nurse specialists who take such care and will always answer questions I have or even just reassure me that I have done the right thing. One draw back which when I am not in hospital it is not a draw back is that the nurses now know me well. They will not hold back when they know I need pushed and just to buck up a bit. They will tell me to stop being stupid or stop being grumpy etc, at the time I hate them for it but I know they are doing it for my own good otherwise I would wallow in self-pity until I snapped myself out of it. Equally those nurses know when I am not doing well and am struggling, because they know me they know when something is up.

In NHS Lothian there is an awards night which celebrates the work of different people across the trust. Not only nurses, but Dr’s auxillaries, domestics anyone. The shortlist has just been released and it was fantastic to see one of the nurses from Ward 54 (the respiratory ward I attend) is up for Nurse of the year. I am thrilled as he is super. I have known him for a number of years, he is always so caring and takes time with his patients even when he has 101 things to do you never feel like you are being rushed, he gives you the time you need. He also always speak to your relatives and takes an interest which is really special. Nurses just now are stretched beyond belief, moral is low and nurses are required to do more and more jobs than before but with this nurse you would never guess. I really hope he does win the nurse of the year as he is so genuine and acts the same way to all his patients.

I want to thank all the nurses who have looked after me and worked with me. If it was not for them I would not be here.

Welcome Ghillie

I can’t believe I have not posted about Ghillie. For the longest time I have wanted to get a dog. I had cocker spaniels as a kid and my grandparents always had dogs and rescue dogs. While working I always thought I would never be able to have a dog as it would just not be fair and I was not one for wanting to either leave the dog at home and someone else walk them or leave them in the car or crate etc. I have read a lot and met a few people who have service dogs and spoken about the various different things they can do. My consultant had also mentioned them as well and he supported me which is great.

Now that I am not working in the hospital and mainly doing research and public speaking plus some writing it seemed like the perfect time to investigate further and see how the best way to get a dog which would then be trained to be a service dog. I feel very strongly that everyone likes to train their dog in their own way. Some charities you get matched with a dog who is pre-trained which is great but I want to have that bond so opted to get a puppy myself, train it and go through the kennel club obedience tests before going on to start working towards assistance training.

A lot of research went into choosing the right breed and breeder. Having had cocker spaniels when I was younger I knew I would be fine with them as they never caused me any issue. I have been lucky with dogs as one the whole I am good with them except the ones that malt all the time. So I thought about a cocker and found some breeders but doing my research I learnt that the nose on a poodle is far more sensitive than of a cocker so it was recommended for my need that a cockapoo would be the best cross breed as it would have the nose  and scent attributes of a poodle but then also the work and gun dog ethic of a cocker.

I sourced a breeder, did some background, went out to see the breeder armed with questions and was surprised when he too was armed with questions for me. I guess because he wants to make sure the puppy goes to the right place. As soon as I met the breeder I knew it was a good fit and he was the right one. I just hoped he thought the same about me! Thankfully he did.

When it came to choosing the pup I stood in the area and let the puppy come to me. This wee guy was the one that came to me so I decided to go with him. Next came the name. He ended up being called Ghillie after a text message was miss read. I had a few others but Ghillie just sort of stuck. I like it and also there is a link to the breeder as he is a ghillie!

This is him at 2 weeks old.

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At weeks old he got to come home with me to start his new life with me. I feel a little bit like a crazy dog lady as keep posting photos but at a time in my life where things have not been that great he has been the much needed distraction and companion. It has been less than 2 weeks but he has had such a big impact already and not just for me but also my mum and youngest brother too as well as nephew and sister in law.

The day I picked him up to bring him home.

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The first week has been busy and hard work but it will pay off in the long run. I have discovered how clever he is. We are doing a lot of house training. Not many hiccups although we have had a few times when it is like he has forgotten everything he has been taught but I think it is more because he gets distracted and hyper excited about anything and everything.

Having Ghillie at home is like a breath of fresh air. He is so dependent on me for everything that it gives me a real purpose and not waste away my days. I cant wait for him to be able to go outside so he can explore the world, see the beach and go up north. He is a little monkey as well and knows when he has been caught doing something he shouldn’t he gives me those puppy dog eyes that butter wouldn’t melt.

Below are a few more photos of him. So many people were asking for photos and asking about how he will become a service dog, I have created an instagram account called @ghillieservicepup where you can see photos but I will also post about his training and becoming my service dog as well as my companion.

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Parking is not the only issue at the RIE

In the press today and on social media there is a lot of energy being focused on the Royal Infirmary in Edinburgh and its issue with parking. Ever since I have worked at the RIE there has always been an issue with parking. There has never been enough parking for the number of staff let alone patients or visitors.

This summer the new Sick Kids hospital is moving out to the RIE site as well as DCN. Now the new departments have been built on one of the previous car parks and there has been no replacement car parks being put in place.

There is up roar about this especially as staff have to pay to park. You can apply for a permit which costs £25 a month but these are now in short supply and to qualify for a permit you need to meet certain criteria. I remember when I was applying for my permit first off having a blue disabled parking badge did not move me up the line I still had to wait. I did eventually get a permit and was able to get a permit for a car park close to the hospital because of my blue badge but this to me is almost a waste of time because the welfare of the people working there is not addressed or prioritised.

For me and many others one of the biggest issues at the Royal Infirmary in Edinburgh is the smoking issue. There was a supposed smoking ban on NHS Lothian sites but what it seems to have done is nothing more than encourage people to smoke right outside the hospital doors. I remember just after the smoking ban came in I was working a night shift and halfway through hand over I had to get taken to A&E due to an asthma attack as a direct result of making my way into the hospital from my car. Sadly this was not the only occasion this occurred. There have been at least 6 occurrences where me getting from my car in the car park to the front door have resulted in me being exposed to people smoking where they should not be and ending up requiring hospital treatment and sometimes needing to go to intensive care.

Just now I am on a career break focusing on research but I am very concerned about going back to work next year. I will need to reapply for my permit but also if I don’t have a permit I will need to either pay for parking which is not always guaranteed, or risk getting public transport which could put my life at risk. I worry that will my hard work this year to get my health better be then set backwards by the risks that are involved in just getting into the hospital.

I have tried to speak to anyone who will listen about the smoking issue which is particularly bad at the Royal Infirmary but it seems to fall on deaf ears. The really shocking thing is that an area which is probably the worst for the number of people smoking is right below the respiratory ward and not even that is doing anything to get the smokers moved. I am not against people smoking- it is their choice if they want to end up giving themselves COPD and a self inflicted breathing condition but I am against them inflicting others to their bad habit. I didnt do anything to cause my lungs to get like this they are just like that so I do not expect to have them deteriorate as a direct consequence of someone breaking the law and smoking where they should not be working.

The most shocking bit about it is that the Royal Infirmary in Edinburgh are happy to patrol the car parks and put tickets on cars which are parked in the wrong place but turn a blind eye to people smoking. I tell you a car parked in the wrong place does a lot less harm than people smoking.

When it comes to April 2020 I will need to think about wether it is worth the risk  to come back to work if the smoking issue is not addressed.

It is a sorry state of affairs when healthcare workers are questioning wether they continue in the career or where they are working because there is not adequate provision to support them.

 

My HealtheVoices19 experience!

Last night I was catching up on reading some blogs and came across one that was written by one of the other people who attended HealtheVoices (HeV) who opened her blog post with my exact thoughts. She had been drafting and redrafting posts about her experiences of HealtheVoices and not knowing quite how to write it. She came down to the point of just getting it out and putting it down in a post. So this is what I am going to do as well because like her I have been going over how to write my experience and then rewriting it and never being happy or knowing quite how to word it.

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So here goes…

Leaving the UK to go to Dallas was a mix of nerves and excitement. The lead up to the HeV event was so positive and the support from everyone was there right from the start so I was feeling at ease but also felt a little is this really going to be like this once I am there too. A small hiccup at the airport but I was soon at the hotel and getting ready to settle in.

There was no real plans for the Thursday night. There was dinner but it was a buffet and you could just go down and eat when you wanted. I am never very good at these things and went downstairs several times with the intention of going in to the dinner room but I kept bottling it so would head back up to my room. I was too nervous, and tired because I was still on UK time and had been up for about 24 hours at this point, but I needed to get over jet lag so I could enjoy the conference without crashing, so I forced myself to go in and join a table. I am so glad I did go down. The slight awkwardness of plating my food and all the time thinking which table should I ask to sit at, who won’t mind if I join them, there was 101 things flying through my head but actually some of those who I had my first meal with in Dallas are also the ones I had my last lunch with as well. I did have that bit of security with me at dinner though- I had my name badge/lable/neck thing so anyone I met knew my name, knew I was speaking but also knew that it was my first time attending the conference.

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When I have attended conferences in the past I have felt at ease, and with each conference I attend and speak at I feel more confident but this was different. When I have spoken at conferences I have been there and what I am speaking about is my specialist interest and my experience, I tended to be the patient giving my opinion of essentially being an expert patient. This was a different ball game. Everyone there was like me, we are all experts at living with our own conditions and doing our own thing to raise the profile and difficulties we face trying to live a functional life.

I have never really thought of the work I do with asthma as advocacy, I actually didn’t like the word advocacy but attending HeV I came away feeling that maybe it was and I was an asthma advocate. People often ask me what drives me to do what I do, how do I come up with content, ideas etc. I never really know how to answer because I have never thought about why I do these things. I just do it because I hope that by sharing my story maybe people or even just one person might be able to take something from it and their experience will be a bit easier.

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It sounds cliche but after my initial nerves everyone was so welcoming at the meeting. Wether you were a first timer or had been at all the HeV meetings in the past everyone was on the same level- we were all there for one reason. Everyone there is motivated to help make a change. There was a variety of people who have had a condition all their life, then some with conditions that vary, go into remission or are cured from it but through their experience they are sharing knowledge gained, experiences which were good or bad.

I still really am struggling to put into words all my emotions from the meeting but I think the photos speak for themselves.

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So where do I go from here??

I have a few projects that I would like to pursue the most pressing one is to try and get rid of all the stock images media outlets are using which are subconsciously promoting poor inhaler technique. Almost every day I see a photo being used on a media article which shows a child or adult using a MDI (metered dose inhaler) with no spacer and even though there is no spacer the technique is not good either. In the UK there is an inherent problem with asthma management and self management resulting in high death levels from asthma attacks which can be prevented. One of these preventions is correct inhaler technique.

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And a last disclaimer:

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