It’s ok to not be ok.

This past week has been really tough. Asthma is one of those conditions that is on a spectrum. Going from those with the mildest of asthma to those with the most severe and life threatening asthma you get everyone across the board and you can not pick out the one person with mild and the one person with severe asthma. You can’t see asthma, sometimes you can hear it depending on how wheezy you are!!!

Recovery from this last hiccup has taken a lot longer than I ever anticipated. It was not the worst of attacks but equally was not the mildest either. I was only in hospital for a week yet it has taken me a good 3 weeks to get back on my feet and still Im not there yet.

I have been so fortunate this time to have the support of my consultant. When I say support I mean that should I have issues he has said so many times that I just need to call his secretary and she will get him to call me back or the resp reg on call to give me a call. Having that support is so reassuring to me it makes life that little bit easier. Also being seen in clinic every month (which is a faff but won’t be forever) and then on top of that I am at the ward once a month too for my mepolizumab injection with the asthma nurse specialists so if I have any issues I can ask them too.

As much support as there is they cannot speed up the recovery process and help with the everyday symptoms that just take time. The never ending fatigue that no matter how much you rest it just doesn’t go away (Thanks to prednisolone contributing to that), and no it doesn’t help by getting a good night sleep. It is a fatigue that is unlike no other- a fatigue that having a nap won’t fix, it is a feeling where your whole body feels double its weight, you are not tired and sleeping doesn’t help, but you just cant do anything. Until you have experienced it (which I hope you won’t) you have no idea what it is like. This is the really hard bit. Fatigue you cant see, and asthma you cant see.

Keeping your mind motivated is really hard when your body is preventing you from doing what you love. This is the challenge I keep facing. This time of year its all about Christmas, Christmas Parties, going out with friends, shopping and enjoying the festive period, but I feel like I am sitting watching the world go by and seeing photos of people enjoying themselves but I haven’t been able to join them. Just going to the shops to get the messages is hard enough leaving me exhausted.

One big thing that I am really finding hard and one friend who is also on biologic therapy said this can be a side effect is speed of recovery as well as joint and muscle weakness. Speed of recovery has been slow but as I keep trying to tell myself slow and steady wins the race- but truthfully its getting really wearing now. The other thing is the joint and muscles weakness. I always have some weakness after being in hospital as for most of it I am bed bound and not able to get up due to the inability to breath and also the number of IV lines I have which are often in my feet making walking a challenge. Building up slowly isn’t helping. The only way I can describe it is having DOMS (delayed onset muscle soreness) but having DOMS that won’t go away. Normally lasting 48 hours this has been 2 weeks now and my quads feel like they are ripping in half every time I go to sit down or stand up, occasionally jerking as I walk too, stairs are an interesting experience- thankfully I have a lift in my building so can avoid the stairs!!!

I am desperate to get back to work and my consultant knows this. I see him tomorrow to hopefully get the ok. I know it will be tough going back to work but I need something to mentally challenge me. I having been doing bits and pieces of research and evaluation of research conferences too. Evaluation forms I find are so hit or miss especially when there has been positive or negative things that you want to acknowledge etc- there is never the room and I end up putting a covering letter along with the form.

This whole recovery process and hospital admission this time has taught me a lot. The main thing I guess I have finally accepted is that it is ok to not be ok. It is ok to ask for help and admit when you are defeated. Over the years I have been made to see a psychologist to help me deal with life with severe asthma. You could say I was a bit resistant to it initially. I think it was the stigma I associated with it. I felt that if I was seeing a psychologist then something was wrong with me mentally and actually my problems were psychological rather than physical. I think I made this assumption because I was young (this was over 12 years ago) and at the time there was really not much openness about mental health and it really was stigmatised. In more recent years as my asthma has impacted my life in ways I never thought it would and prevented me doing more than I ever thought I have been so thankfully to have access to a psychologist  who I can see regularly and help deal with the restrictive aspects of living with such severe asthma. What I have found though is that I have focused so much on adapting life to cope with my asthma and the majority has been on pacing. I didn’t realise that a major area which we never worked on or spoke about was the severe life threatening attack that comes out the blue much like this last one was, and also the trauma after it. It has almost felt like a mild version of post traumatic stress because even at clinic last week I got this huge sense of fear when I saw those windows of the ICU again.

So tomorrow I have a variety of different appointments all at different hospitals. The morning I have the asthma nurse specialists for my mepolizumab injection and review with my consultant, then the eye pavilion to have tests done on my eye that has lost its peripheral vision and then over to the royal infirmary to see the psychologist and will go up to see work and discuss coming back.

I hope that getting back to work and routine will maybe improve the fatigue I have and give me a purpose to my day again.

Cleaning products and lung health

Reading the BBC news online I came across an article about cleaning products and lung health. A study carried out in Norway found that using a micro fibre cloth and water was suitable for most purposes rather than the products full of chemicals which advertise themselves as killing 99.9% of all bacteria etc.

Cleaning particularly house work is something that has to be done in all homes, offices, public places etc. There is no getting away from it unless you prefer to be in an area which is not cleaned. Not many people enjoy cleaning and it is a chore rather than a hobby or enjoyable past time (forgive me as I know there are some people who do enjoy cleaning and find it therapeutic) with needs to be done. Many will leave it as long as they can possibly get away with before they get the mop, bucket and all the different cleaning products out to make everything sparkle and smell nice while removing the limescale, grease, dust etc from surfaces.

The reason I am writing about this is because for some people like myself cleaning and cleaning products can be life threatening causing acute breathing difficulties and allergic reactions. A study highlighting that water and micro fibre clothes are just as good as Mr Muscle, Cif, Cilit Bang and all the other products which you end up buying which all have a different job to do in the house is fantastic and could potentially remove a massive risk to my health.

You wouldn’t think that cleaning products could cause such big issues. You may be thinking that of course some products particularly those containing bleach will set my asthma off and why am I making a whole blog post dedicated to cleaning products. Well for me other than the strong chemicals posing a risk to my asthma most cleaning products also contain salicylic acid which I am very allergic to.

At home it is ok and I can avoid things that pose a risk by just not using them and finding alternatives. I am in control of what is and what is not used to clean my flat (whether I am doing it or my Mum) so I can eliminate as many risks as possible. However out with my safe haven of home, there are cleaning products everywhere- work, restaurants shops, hospitals etc. I do not know what is being used or what has been used on the objects I touch however with this new evidence suggesting that there is not always a need for chemical products, there is some hope that places may adopt this and change their cleaning regime to water and microfibre clothes.

For those who are not allergic and don’t have difficulties with their breathing must think what am I going on about and why am I making a big deal. Well cleaning products have been life threatening. Once I was not aware that my nebuliser mask had been cleaned by a member of staff on the ward when I had been admitted to hospital. They thought they were being helpful and even the staff member admitted she had assumed you cant be that allergic to even mild cleaning products and she thought it was mainly food stuffs. The result of the clean nebuliser mask was this:

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This photo I took after I had been given oral and IV anti histamine, IV steroids, a number of back to back nebulisers and about 4 hours after the initial reaction. You can clearly see were the nebuliser was on my face and where I have reacted to whatever it was cleaned with and the residual cleaning product left behind.

In hospitals it becomes even trickier to try and avoid cleaning products and many of them seem very toxic given some of the bugs they need to kill to prevent the spread of infection and increasing the number of people having to stay in hospital longer because they have not been able to recover from their initial illness due to developing another illness from exposure to bacteria. I would never expect the NHS or hospitals to change their cleaning regimes as the infection control teams will have assessed the best possible way to ensure the wards are kept clean and safe. Having said that the products used to achieve this do pose a really big threat to me and have resulted as fair few times in me staying longer in hospital due to having an allergic reaction to some sort of cleaning product being used. It has once been such a bad reaction when I was in hospital that I had to be moved to the critical care unit to be stabilised.

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Above is the remains of an allergic reaction. I think this was a good 8-9 hours after the reaction. I was in hospital due to a chest infection which had my asthma worse. I had narrowly avoided going to critical care when I was admitted but did have to be in a monitored bed and attached to all the machines. This meant I wasn’t allowed up to the toilet and had to use a commode- which I used but when I stood back up to get back into bed I felt awful. My skin was burning, itchier than hundreds of midge bites, my heart rate jumped up to 180 ish and breathing was very difficult. Thankfully the respiratory team had just arrived to review me anyway when I had this reaction. The Dr’s were looking at the monitor as my heart was going mad, and my oxygen saturations dropping but the respiratory nurse specialist who was also with them was talking to me from the end of the bed. She said she could just see the bright red rash spread before her eyes and soon I was scarlet all over with parts of it blotchy. Again I was given everything to treat it and quickly moved to the critical care unit. It turned out the commode I had used was cleaned with some other product rather than the normal one so the contact of it on my skin was enough to spark a reaction.

There have been other situation where cleaning products have caused a reaction for example my youngest brother gave me a hug once but the washing powder he used I met have been sensitive to as where bare skin touched his jumper I had a blotchy reaction which looked very bizarre- almost like a golfers tan except the tan was red inflamed irritated skin and not a nice bronze colour.

From this you can see that for me cleaning products pose a huge risk but not predominantly from an asthma point of view but an allergy side. Of course the allergic reaction in turn sets my asthma off due to the irritation to my airways from the chemical etc etc. It would be fantastic if more studies were done which further proved that chemical based cleaning products are not required and water with a micro fibre cloth is just as good.

This would make the risks to many not just myself but other who have allergies or asthma which is triggered by strong smells from cleaning products or the chemicals themselves much less and mean that we are able to preserve our lung function and lung health by not exposing them to harmful triggers. Until the time comes and chemical based products which cause me harm are less widely available I have my own way to try and protect myself. I have a vogmask which many other brittle asthmatics, ILD or CF patients recommended to me. This mask has a filter to can protect me from inhaling the chemicals which could cause a reaction. This won’t eliminate all the risk as there is still the risk from contact. This is the vogmask which can be bought online. I do feel pretty self conscious in it just now if I wear it in public but I am sure as I get used to it and reap the benefits from it then I won’t notice it so much.

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Happy Birthday NHS

Today 69 years ago the NHS was created. A vision of the government and Clement Attlee which would provide a unified health service available to all. The campaign and implementation was spearheaded by Nye Bevan who can be quoted saying:

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I really do owe everything to the NHS and it is scary to see how the Conservative party are really making some difficult choices and actions which are really putting stress on the NHS which is a health service already on its knees.

It is a huge compliment to Scotland whose health service is by no means perfect but reading tweets this morning which said the Scottish system should be the road map for the health service in England, with that being said in newspapers headlines were slating the Scottish health services and hospital due to the number of beds being blocks and operations being cancelled. Its tough to see as I am both a service user of the NHS and employed by the NHS. I have also had experience of the NHS in England and there are huge differences which could be down to those who run the systems- the Scottish Government and British Government.

As an employee of the NHS I must say it is a fantastic organisation to work for. I have been very fortunate in my treatment by the NHS, I have a pension with them, receive a wage and have the support of colleagues but it is so hard to sit back and watch as wards are under staffed with not enough nurses, drs, domestics, care assistants and everyone is run off their feet all the time trying to cater for the needs of everyone else but not able to take the time out they need. NHS nurses have been subject to a 1% pay cap (along with other professions) which has crippled a lot of nurses who have families, mortgages and just trying to cover their bills. The 1% cap being lifted would make a huge difference because it would not only makes nurses lives more comfortable but it would be their effort recognised and help them feel valued in what they are doing.

As a user of the NHS and dependent on the NHS I really value them. I have gone from growing up in Scotland where because I was in school and under 18 I got free prescriptions so didnt need to rely on anyone for my medications and inhalers. I was guaranteed to get them no matter what. I then went to living in England being self sufficient and having to budget to include my growing medication list. At the time the cost of a prescription was £7.20 per item. It has gone up a huge amount now but this was about 10 years ago. I was on a huge number of medications and often needed multiple prescriptions of certain medications. It became a budgeting nightmare. I was fortunate that I was able to buy a pre-payment certificate so for £110 every year I was able to get all my prescriptions covered with it. Now living in Scotland prescription charges were scrapped which for me has been a real benefit as I have so many medications and currently have 32 regular items on my repeat prescription which is the medication I need every day. While free prescriptions for me are great I can imagine them being abused for some people who will go to the GP for something and get a prescription rather than spending the money themselves. A number of medications which people get on prescription could be things which can be bought over the counter but because they are free on script they go for that option putting more stress on the GP system.

I have also had some outstanding care from a variety of medical professionals. All hospitals across the UK have been great. The care I can’t fault especially when I was in hospital in Winchester and having my consultant from Southampton driving up after he finished work to review me as we were struggling to get control of my asthma. It is things like this that stick in your head and you won’t ever forget. Its also nursing care too. I can remember being in the resp ward Shawford Ward after coming out of ICU but finding it hard to breathe but being too terrified to go back to intensive care, but a nurse from ICU came to sit with me and go through why I didnt want to go back and reassured me it would be ok. She didnt have to do that but she did and it made a difference. It too sticks in my mind and when looking at the prospect of going to ICU I do think about that time. Not all hospital experiences are good and there are times when you do have bad nursing or bad medical care but its going to happen when services are stretched to the point of breaking.

It is scary to think that we really could be facing a time without the NHS. Im not sure how I would survive without them. They have been there to pick up the pieces when my asthma has kicked off. Looking at some numbers a night in ICU costs £2000 approx. I spent 4 nights earlier this year. I wouldn’t be able to afford that if the NHS is privatised. £500 approx for a night stay in hospital. I was in hospital for 3 weeks earlier this year. I would need over 1/2 a years salary to cover my hospital stays not including the added extras like x rays, bloods, IVs, drugs, food to name but a few.

I owe my life to the NHS as do so many other people but with so many people abusing the NHS and going to hospital for a sore tummy or headache, or cut finger when not needed is crippling the service. As a nurse I can’t say to people why did you bother going to the hospital because this could have been dealt with at home, we have to smile and provide the care we would give to other patients and hope their Dr will discharge them when required so the bed can be opened up for someone who really needs it. I often question going into hospital and calling an ambulance. If I can I will drive myself to hospital but am often told I was stupid for doing that and should have called an ambulance because people who were a lot less in need would call them but I feel if I am able to get myself there thats what I should be doing and if I can deal with my asthma at home then I should and do all I can to stay at home so to ease the burden on the stretched heath service.

Please stop and think if you do need the GP, or hospital or prescription. The NHS is on its knees but as a country we wouldn’t be able to survive with it and healthcare would not be accessible to all as it is now.

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How do you get used to to living in a state of instability?

You don’t….

I like my life to be quite ordered. I like to know what I’m doing day to day, week to week. Many think I am stuck in my ways but I like routine. Routine gets me through, it means I know where I am. Recently I have found my asthma has been not to bad but the last month I would say it has been teetering on a knife edge. Never quite knowing when things are going to tip but desperately hanging on.

It is that very difficult period where your just sort of suffering. The nights are long and a little frightening as my asthma always gets worse at night. I finish work at four and have often been in bed by 6 using my nebulisers but just exhausted from getting myself through the day without getting sent home or worse ending up in A&E. Part of me wants to just hold my hands up and admit defeat but I can’t. I have to keep going.

If I am honest I feel alone just now. I sort of feel like I am on my own with this horrible condition even though I know Im not. I have lost a lot of my vital support networks which I didnt realise I heavily relied on even when my breathing is good. Matters out with my control have meant that to protect myself I cannot show true self or leave myself vulnerable to others, in doing this I am protecting myself but I am also isolating myself and I hate this. I loved being part of the support groups being able to help others and receive help and support myself too.

I really hate asthma just now and how little it is understood.

If only it could go away or a cure could be found soon. I try to be strong but today I can’t be. Today I want to hide in my flat and curl up in bed.

One of the other things I hope that by just not doing anything this weekend is that I still have a massive fear of going to A&E again. The fear of not being listened to is still fresh in my mind and that resulted in me going to intensive care because a nurse thought he new best, I was young and was not that bad. I hate to think what would have happened had I not had my own nebuliser with me and had I not know my own chest. I mean even with my own actions I couldn’t stop myself ending up in intensive care and this really terrifies me. I fear that I will end up being looked after by the same nurse again, it may be an irrational fear and the chances are slim but it is still there in my mind at was was already a scary time and it was just made worse. As a result there has been times when I may have had to go to hospital but did because I just stayed at home and would do back to back nebs- maybe more than I should have but the fear was paralysing and I can’t explain that fear to anyone.

I have to look at the positives though. I have had the most amazing summer doing things I never thought I would have. I made some awesome friends and played more lacrosse than I could have dreamt of so while I don’t feel great I can sit and look at the photos and memories of the summer and smile knowing that with hard work I will be able to do this again!!

Inhalers in Schools

Last year the law changed which allowed schools to keep inhalers for emergencies in school much like an epicene etc. Until then an asthmatic child had to have their own individual named and prescribed inhaler which was carried on their person or kept under lock and key- something which is not useful in an emergency situation when treating an asthma attack is time critical. The sooner the attack it treated the less risk of adverse effects happening and potential hospitalisation.

I must be honest and did not think much about the inhalers in schools law being changed mainly because I have left school but also because this was never an issue for me at school. I was fortunate that I had great support with my asthma in school. I was at boarding school and kept my inhalers on me, or in my dorm room or the teacher had it during games. If I had an attack I would go to the school Medical Centre to be seen and would see a Dr if needed. The support I had was second to none. My housemistress even drove behind the ambulance I was being taken in to hospital in the middle of the night. I was never alone with my asthma and that really made what could have been terrifying experiences a little less so.

But as I said I didnt think much about inhalers in schools until I returned to my old school and saw this…

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I was amazed that they had an asthma station. I remember the support I had a school but never though of St L’s to be forward thinking and have something like this. In my day my school jacket was a cloak with house colours in the hood (all very Harry Potter- but it was the warmest thing around) so we were really not with the times until I was in my last year and we got sports jackets- this was ground breaking for us!!

I recently emailed school and had a lovely email back from the school nurse who was not there when I was at school but she was the one who implemented the station and put a policy in place as well as getting a list of pupils whose parents consented to them being given the emergency inhaler by a member of staff. The initiative to implement this is great. I really hope more schools can get emergency asthma stations put in place as it could make a real difference to pupils with asthma.

More schools need to follow suit but I understand how hard it can be to put something like this in place and maintain. If we could develop a blue print which could be rolled out across schools so they would not need to establish their own way of implementing and maintaining might mean more schools sign up to become asthma friendly rather than rely on pupils who will not always remember to bring their inhaler to school with them.

I hope the work done by the nurse at St L’s keeps going and others can to be as forwarding thinking and get an emergency asthma station!

Signs vs Symptoms

After my last post about pulse oximeters and oxygen saturations some of the comments were interesting and not surprising.

One of the most common things you hear when having an asthma attack is “your sats are fine your ok”.

As a nurse your trained to look at signs first and then symptoms but often we look at the signs and judge a patient by them rather than the whole picture. Which as a patient I know is so frustrating. Especially with asthma you feel so awful as not only you cannot breathe but you are scared and tired and often being told your fine is really hard to hear and can make you feel worse as you have altered judgement due to the situation so it will often make you think they won’t do anything to help your breathing.

I wonder if there is a way we can communicate with nurses and doctors to say that we know our sats may be fine but that doesn’t mean I don’t feel absolutely awful, scared and would like something to help alleviate that. I am wondering about using a cue card type of thing which we could show to the nurses and Drs when they are telling us that our oxygen sats are fine and we are ok. During this time speaking is very difficult so a cue card might be easier to communicate our feelings just so they can understand. I have found that once nurses and Drs understand how I feel they are more sensitive about what they say to you. There are many more ways in which you can be told your sats are fine and are ok without the patient ending up feeling terrified or over reacting afterwards.

Some examples might be:

I know you are really struggling but a good thing is that your oxygen levels are good just now but we will keep an eye on them.

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We will give you some medication to help with your breathing and make it easier. Your observations look ok just now but we will keep an eye on them while your chest settles and breathing becomes a bit easier.

This is just an example of what I thought could be said but I am sure there are many more ways it could be said.

As a nurse looking after patients and trying to get help from them I have found it hard to get them help when you can tell by looking at them something is not right but their clinical signs are all ok. When you call for help from a Dr you will go through a series of questions many of which are about signs a patient is displaying not what your gut feeling is and that they just don’t look right. Often by the time their signs match your gut feeling the patient is much sicker than before.

It is a real balance between not over reacting and acting as needed. In a way I am privileged as I have seen it from both ways. I am both a patient and a nurse and hope that my experiences as a patient reflect how I conduct myself as a nurse.

23 days on….. and its only got worse!

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Smokers need to imagine what it is like to fight for your life, to work so hard to get that tiny bit of breath in to supply oxygen to your brain and body. They need to experience this. They need to fast forward 10, 15, 20 years and try taking those precious breaths which they won’t be able to due to all the damage from smoking for many many years. They will soon have to fight for each breath. Only there fight will never get better. Their obstruction will not be reversible it will be permanent, there cough will not go away, the chronic chest infections won’t get better with antibiotics they will be stuck in a downward spiral as their airways get smaller and smaller due to inflammation and obstruction. They will rely on Drs and Nurses to fight to make them better. They will need the help of social services and be left gasping for breath just getting out of bed or standing up. This will all be due to the years of smoking cigarettes. The feeling they will feel are the feelings they make me feel every time I have to pass someone who is smoking. They don’t give a second  thought about it. They think I am over reacting about the effect the smoke has one me. They will comment about it being a free country and they can smoke when and where they want without thought of the damage it does to others. They will expect the health service to look after them and some of the people they have made ill will have to be looking after the people who smoked.

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The day that you fight for your breathe and fight for your life will be the day when you experience exactly what many asthmatics feel like when exposed to smoke.

Back on the first of April I questioned wether or not the NHS going smoke free was a big April Fool. Its the 23rd April and it appears that the NHS are not going smoke free even though they say they are. Rules are made to be broken but this new rule seems to be the easiest one to break of all.

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I and many of my asthmatic friends would be the first ones to stand up and rejoice that hospital sites are meant to be smoke free. It would mean so much more than not having to wonder how many times you will need to use your inhaler from taking your first step into hospital grounds to getting inside the door. It would mean no longer having to walk the long way round to find a door not many use to enter the hospital avoiding smokers hovering outside, it would mean being able to do your job or attend appointments without being worse than you were when you left your own house. The list is never ending for the benefits of not smoking.

There are no benefits to smoking what so ever but occasionally when I am very frustrated and having trouble to breathe, part of me wishes I had smoked. If I had smoked there would be a physical reason why my lungs don’t work as they should and why I need inhalers, nebulisers and tablets to keep my lungs working. This only comes into my mind when I am sitting awake in the small hours of the morning using my nebuliser wishing there was a cause for all this illness which just now I don’t have.

This is why I can not believe what I am about to say. Never in my wildest dreams would I ever dreamt that I would be in favour of revoking the rule and allow people to smoke on site again. I am stunned I would even consider thinking such a thing, but the reality is I would prefer it. I hate part of myself for this as I know what it feels like not to be able to breathe and I watch powerless as strangers choose to inflict damage and give themselves a future of pain and suffering.

Why do I want this?

Since the ban on smoking on hospital sites it feels like there has been an epidemic of people smoking on the hospital site and they are everywhere. Around every corner there will be someone puffing on a fag. It has made getting from the carpark to inside the building a logistical nightmare trying to find doorways which are not clouded in a plume of smoke.

At least before there were smoking shelters which were used pretty well and for those who did not use the smoking shelters there were the hot spots where you could find a group gathered. You knew the areas to avoid but now it feels like there is no where to hide from people smoking.

The biggest irritation is that no one is patrolling and enforcing the ban. No one is picking people up on smoking and god forbid you take it upon yourself to suggest people did not smoke the looks and comments you got were not worth it.

As a worker on an NHS site I despair on many occasions. There are rules for everything and it begs the question why are some enforced and some not. For example parking. You are quizzed about why you are trying to get into a carpark on arrival at the barrier and if it not for a reason that is approved by the car park people you don’t get in. As a community worker based in the hospital I have to take a lot of stock out to patients which can be very heavy. The solution is that it is dropped down stairs and I then bring the car round. The number of times a warden has come to tell me my bumper is over the yellow hashed lines or I am in the wrong place is astonishing. Half the time I spend arguing with them about being allowed to park to pick up stock I would have been away far quicker had they not caused an issue. I would have been creating less of an obstruction. My issue is that there are people enforcing rules which are doing no damage at all and not preventing someone getting treatment or anything being detrimental to someones health yet a ban is in place to stop people smoking on NHS sites and there is no one to enforce it.

It is disgusting that they can get away with this. I am sure if I went (wearing a mask and protection) and sprayed air freshener or a substance with an unpleasant smell all the smokers would be up in arms about someone spraying something yet they have no issue making others breathe their smoke in when it could damage their health.

I was so annoyed last nigh about it as I suffered a bit of an asthma attack- nothing major on my way home from work as I was rushing to get my haircut, I wrote to Asthma UK, Asthma UK Scotland, ASH and also my local MSP about how the smoking ban on NHS sites has almost caused a bigger problem than smoking was before. At least before you knew were people were and could avoid areas. It was not ideal but it worked. Now previous “safe spots” are a hazard making an already slightly problematic task nigh on impossible. I decided to take action and will await my responses. It may not come do anything but for myself I feel better for expressing how I feel and doing a small part to try and make life better for myself and others who suffer at the hands of those who are selfish and smoke.

I feel so passionately about this subject more so than any others because it effects my ability to carry out the care I need to give my patients to ensure they have the best quality of life they can possibly have.

My whinge is over sort of!! Had a pretty awful day at work and it has left me questioning why I bother killing myself to do  the best job I can. Pushing myself is making my life very restricted. I love my job and I love my job so much that I am prepared to sacrifice some of my free time to rest and recover from hard days at work. But today I really wondered why I bother. Many more days like that its not going to be worth it as I really can’t afford to sacrifice any more of my social time to allow myself to rest and get better and stronger for the next day ahead. I have a lovely weekend planned as it is my Stepmums 60th so we are all going out for a family and friends lunch on saturday and then I have golf on Sunday before more golf next weekend!