The NHS Long Term Plan

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No one can have missed the news recently about the NHS Long Term Plan for NHS England. Even those of us not living in England can’t miss it!!! I know I live in Scotland so it does not impact me directly but I am pretty sure the Scottish Government will take on a lot of the plans for the Scottish Health Service that are talked about in the NHS Long Term Plan.

The biggest thing that I have noticed in the news, on social media from news agencies is surrounding smoking and the help that is going to be given to people who smoke that are admitted to hospital. Any time I see anything about the plan this is what I see and it just angers me so much. I know I am not alone either as have spoken to many people who are in a similar position to me with their lungs that are frustrated and angry about it to. For me what it me most was that along with the national news agencies and NHS health boards tweeting about it, my own local health board posted (once again) about how they were going to give smoking cessation help and advice to patients admitted to hospital.

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I know this is a very good step etc and that people who smoke should be offered help to stop however on a daily basis just to get into work I run a gauntlet to try and avoid breathing in any smoke. The NHS made a huge deal about how their sites were to be no smoking sites and that smoking is banned on their sites yet nothing is done to enforce this. They have signs everywhere yet those who smoke just stand by them and light up. Some don’t even wait till they clear the door before they light up. This is not unique to me and the hospital I work in. I regularly see on different forums asthmatics saying they had to go to hospital but just trying to get into the hospital left them in a worse off state than they were when they arrived in the car park etc because of all the smokers they had to pass.

Until you have put up the fight of your life just to get a breath in you cant understand what it is like. It is one thing when you may have been a bit silly and done something stupid which provokes an asthma attack but when you have done nothing other than try and get into work and you end up in intensive care it can leave you feeling really angry and bitter.

What I would love to see and so many would love to see is the smoking ban being enforced or at least a shelter to provide those who smoke a place to go and then leave areas such as the main doors to the hospital as a safe zone. Also when there are the groups of people congregating outside the doors of the hospital- many of whom are patients why are the smoking cessation nurses not down there encouraging them to not smoke or at least smoke in an area which won’t risk killing people.

What is worse is that the main doors to the hospital I work in which are always flanked by people smoking, are over looked by 3 of the four bedded bays in the respiratory ward so during sweltering summer days you cant have the window open because you end up with a room full of seconds hand smoke.

I am not alone in how I feel and what I think which is why I am writing this. I am at a total loss as to what to do because everywhere I try and get the issue addressed cant give me any answers. Is it going to take someone dying from an asthma attack as a direct consequence of people smoking outside hospital doors for action to be taken?? I have got in touch with ASH, Unison, local MP none of whom could give me an answer or willing to take action.

My working hours are 9am to 3:15pm, I have a blue badge due to the severity of my asthma so can park close to the hospital however I have had to start arriving earlier and earlier so I can have the time to wait till the doors are clear of people smoking and then take my chance. This time is different each day but it shouldn’t need to be done. There is then the reverse when it comes to leaving work however I tend to end up just trying to get out and get to my car, once in the safety of my car I can have some nebulisers to alleviate the effects the smoke has had on my lungs. I just wish those who smoke understood what they were doing to others.

It is so hard to see so many struggle. I have read how people feel like turning back and missing their hospital clinic appointments because of people smoking at the doors and the risk this poses to their health. This should never be a choice that someone has to make.

It would be great if others could share this and try and get change to happen.

If the NHS are committed to help people stop smoking, then they need to be down there with those who are smoking not up in offices making plans. Smoke is not just effecting those smoking but also others around them and not only those with lung disease either.

Please lets try and get things changed. I don’t want to risk losing my job (which could be a real possibility) because I have once again ended up in the intensive care unit as a result of people smoking where they should not be smoking.

#stopsmokingonNHSsites

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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Returning to work in a fog of smoke.

I have been back at work now on a phased return and it is going fairly well except for one part. When my chest feels tight I do find it a bit of a struggle to get from the car park to the hospital. The staff car park is the furthest out from the hospital and includes crossing the road that circles the hospital. It is not to far only about 400m probably but when your chest is tight it feels like a marathon.

To compound this staff seem incapable of waiting until they are either in their car or off the hospital site before they light up they cigarette and go on their way. I see them walking out the hospital cigarette and lighter in hand before they are even out the building- it is almost like you can see them itching to light it which they do as soon as they are out the building. It appears that they cannot survive without their nicotine that they don’t have a care for who is around them all they are focused on is lighting up and getting their fix not worrying about the effect they have on others as long as their cravings are satisfied.

I guess I am more sensitive to triggers now than I ever was before because of the attacks I have had since the start of the year- they terrified me and still haunt me. My lungs are still twitchy so any trigger will make me feel tight and wheezy. When I was off sick I longed to go back to work to have a purpose to the day and get back to the job I love but how can I do the job I love when getting into work I can only describe as running the gauntlet not knowing what I am going to have to go through just to get from my car and into safety of the hospital. This really hit me yesterday when I had 3 people in front of me smoking as I left the hospital to get to my car. I had to wait outside in the cold until they had moved far enough away that their smoke had dissipated and was no longer a threat. To me smoke is as much of a threat as a dangerous patient if not worse. You can’t call security for help from someone smoking but you can for a dangerous patient. I don’t mean to trivialise a dangerous patient but to me right now smoke is more of a danger to me than anything else. I don’t want an attack triggered- the fear of another asthma attack like I had grips me so hard I can’t shake it off.

I know you can’t go around dictating what people do but what I have huge difficulties with is that the hospital is meant to be a no smoking zone and there are signs everywhere which are just disregarded and no notice is taken of them. Many of the people I see out smoking are nurses. The same caring compassionate profession that I am in yet they really don’t actually care for those around them. There is nothing worse than being a patient and having a nurse come off their break smelling of smoke and you are sitting in a respiratory ward and could quite easily be set off just by the smoke that is lingering in their hair or on their clothes.

I think my issue that I have trouble accepting is that I did not choose to have my lungs like this. I am trying to do all I can to stay well and achieve what I want to do but I see all these people who choose to smoke and are choosing to do damage to their lungs and other peoples lungs. I do remember once I was subject to one persons smoke which caused me to have an asthma attack and go to hospital- the nurse’s smoke that caused the asthma attack was the nurse who ended up looking after me. I found this really hard.

I have rambled a little bit here but I am just so frustrated that by trying to work and get to work I am risking my own health to get inside the building. I have asked to move carpark to one that is closer so that the gauntlet I have to run is shorter and therefore the potential risk is much less but this is yet to happen and Im not sure if it will happen. It is a very small request but it does make me think what is the point of pushing myself to work when those around don’t want to try and help. To put it bluntly if those who smoke think about those around them and perhaps smoke only where they are meant to they would not effect other people, they would reduce the number of people who end up in hospital and therefore reduce their work load making their life easier.

This is a little bit off the deep end but its how I feel.