Our DCS man was unfortunately back in the Chamber today. We examined him this morning and there was *some* improvement, but Dr Ahmed asked him the big-money question re: presence of urinary retention (which we should've asked about yesterday, but didn't..)? And he said yes.. = BAD.
He has a spinal thoracic lesion (around T10, the belly button area), which can result in paralysis and/ or paraesthesia from there downwards (so groin, legs, feet).
So he was back in the Chamber for another (4hrs 45mins) USN T6 session today. His friend went in with him (instead of Alice), which I thought it a much better arrangement, since they had much more to chat about and were a bit more at ease with each other.
Bueno.
This is actually a pretty serious case. Dr Ahmed said ~1 in 50 DCS cases are this severe, so we are very lucky to have been able to see one and follow one through.
So he'll be back again tomorrow am and we'll see how he is.
Beach tomorrow am. Hopefully we'll find the one you have to pay for (didn't see it on the way back from the Old Market). Tum tee tum.
Wednesday, March 31, 2010
Day 4: Beach Tips
There are two beaches near us: one public, one paid. Of course, the one you pay for is much nicer (and also does breakfast, NOM).
Dr Ahmed's wife goes with their 15 month-old baby boy (the CUTEST thing you will have ever set your eyes on, tanned skin, big light hazel brown hair with big brown eyes and the most ADORABLE smile) every morning to chillax with other Mummys and babies. It's 5 minutes walk down the road and apparently there are hardly any tourists in the early morning, so since we only start at 10.30am.. Plenty of time to go to the beach in the mornings before work!
Yes that's:- plenty of time to go to the beach before work!
Hell yes.
Dr Ahmed's wife goes with their 15 month-old baby boy (the CUTEST thing you will have ever set your eyes on, tanned skin, big light hazel brown hair with big brown eyes and the most ADORABLE smile) every morning to chillax with other Mummys and babies. It's 5 minutes walk down the road and apparently there are hardly any tourists in the early morning, so since we only start at 10.30am.. Plenty of time to go to the beach in the mornings before work!
Yes that's:- plenty of time to go to the beach before work!
Hell yes.
Tuesday, March 30, 2010
Day 3: Much Much Excitement!!
Today was much more exciting! No bodies, but:-
1) The shower is GREAT.
2) I found the room with t'internet and moved into it.
3) There was a diving accident..!
4) And another elective student arrived. Huzzah!
Dr Ahmed got the call at ~11am and I was down at the Search + Rescue (again) half an hour later, waiting for the boat to get in.
In an almost anti-climatical way (the patient was reported over the radio to be "paralysed"), the boat pulled into the jetty and the patient-to-be *jumped* out of the boat. Then again, I suppose that was good sign = not too severe.
We red-lighted him (the two minutes down the road from the Search + Rescue place) back to the Chamber, took a thorough history and examined him then chucked him in the Chamber for some decompression Rx. With the newly arrived medical elective student (she'd been diving before, so was much less complicated for her to go in the Chamber than me).
They stayed in for 4hrs and 45mins (decompression treatment adhering to the US Navy Decompression Treatment Guidelines, Table 6) with the patient taking air and O2 at timed intervals and Alice taking just air. We are going to see him again tomorrow and see if his symptoms have improved.
SO! The newly arrived elective student is Alice from Nottingham Uni who is here for 6 weeks. I am well happy and excited that I have someone to do stuff/ go to the beach/ plan trips/ travel with. YAY!!
(On a not-so-exciting front, where have all my geckos gone..? I found 2 giant American cockroaches playing dead this morning. Not impressed. I hope my geckos (?gecki) come home soon!!)
1) The shower is GREAT.
2) I found the room with t'internet and moved into it.
3) There was a diving accident..!
4) And another elective student arrived. Huzzah!
Dr Ahmed got the call at ~11am and I was down at the Search + Rescue (again) half an hour later, waiting for the boat to get in.
In an almost anti-climatical way (the patient was reported over the radio to be "paralysed"), the boat pulled into the jetty and the patient-to-be *jumped* out of the boat. Then again, I suppose that was good sign = not too severe.
We red-lighted him (the two minutes down the road from the Search + Rescue place) back to the Chamber, took a thorough history and examined him then chucked him in the Chamber for some decompression Rx. With the newly arrived medical elective student (she'd been diving before, so was much less complicated for her to go in the Chamber than me).
"The Chamber" (not in action).
They stayed in for 4hrs and 45mins (decompression treatment adhering to the US Navy Decompression Treatment Guidelines, Table 6) with the patient taking air and O2 at timed intervals and Alice taking just air. We are going to see him again tomorrow and see if his symptoms have improved.
SO! The newly arrived elective student is Alice from Nottingham Uni who is here for 6 weeks. I am well happy and excited that I have someone to do stuff/ go to the beach/ plan trips/ travel with. YAY!!
(On a not-so-exciting front, where have all my geckos gone..? I found 2 giant American cockroaches playing dead this morning. Not impressed. I hope my geckos (?gecki) come home soon!!)
Day 2: The ?Free Diver Mystery
Having said nothing exciting happened yesterday, in the evening, my supervisor, Dr Adel was called to examine a body the Search + Rescue had found in the water.
It was a bit surreal.
Yes, it was a body. But all the humanly features had gone. We were left with mainly bone (apart from the intestines, which was definitely not a pretty sight).
Dr Adel estimated it had been in the water for ~21 days. The body came with the last remaining bits of Lycra on his R arm and L foot + a long flipper, size 11-12. The ribs were a bit mangled. Dr Adel guesstimated him to be free diver (ie, from the beach), possibly attacked by sharks or maybe a propeller..? But there have been no missing reports lately. So it's a bit of a mystery..
Must dash. Meant to be meeting Dr Adel... Now.
It was a bit surreal.
Yes, it was a body. But all the humanly features had gone. We were left with mainly bone (apart from the intestines, which was definitely not a pretty sight).
Dr Adel estimated it had been in the water for ~21 days. The body came with the last remaining bits of Lycra on his R arm and L foot + a long flipper, size 11-12. The ribs were a bit mangled. Dr Adel guesstimated him to be free diver (ie, from the beach), possibly attacked by sharks or maybe a propeller..? But there have been no missing reports lately. So it's a bit of a mystery..
Must dash. Meant to be meeting Dr Adel... Now.
Re: the War on Mozzies
Mozzies-bites 39 - 2 Prill-kills
So... Itchy.................. *scratch scratch scratch scratch scratch*
GODDAMIT. 50% DEET spray ain't doin' it's job!
Monday, March 29, 2010
Day 2: Diving Medicine
We've had no patients/ tourists who need to be certified medically fit to dive since.. 12pm? And now, I have been left alone in the Centre (or "the Chamber" as they like to call it).
Today, I have seennothing exceedingly exciting. Yet. 2 perforated eardrums (oto-barotrauma) and certified (under supervision, ofc) 3 people medically fit to dive. Out of the 3, one was a doc who suffers from very mild exercise-induced asthma and another was a type I diabetic. Dr Ahmed (my supervisor, Dr Adel's lieutenant) nearly said no to both of them. Who knew diving was so medically dangerous..!
Asthma and DM are both very common and well-recognised in the UK. Most of the time, I feel that they are promoted as diseases which mean can't stop you from doing things. But in reality, it can.
Asthmatics, especially exercise-induced asthmatics (see me), are at especially high risk. When you are diving in the sea (and not your local swimming pool), there is a lot of surface swimming and you may encounter very strong currents, which means you have to swim. A lot. Therefore = a lot of exercise, which (in exercise-induced asthmatics) can lead to severe bronchospasm.
Also, the air pressure in the scuba tanks can be up to ~200 bar (= 3,000 psi), which means it will inflate your end-alveoli. So imagine you are diving along happily, then you hit a strong current and you have to work very hard to get to safety. As a result of this, you suffer some bronchospasm in your small airways. Result? Air-trapping in your end alveoli. Doh. Air trapping ==> popping ==> pneumothorax.
But anyway, this guy who suffered from very mild exercise-induced asthma was also an intensive care SHO (I'm guessing, he was 25), so Dr Ahmed said to him, "As long as you understand the possible consequences," He did, "And you know your own body," He also did, "Then I am happy for you to do the course."
And now, I am cold. They *insist* on having all three air-cons ON at freeze-your-arse-off degrees in this tiny tiny space. I switched 2 of them off while Dr Ahmed was out, mwahaha. He came back, saw a wee kid with a blunt finger trauma in his freeezing room, sat back down in the "main office" and said, "Why is it suddenly warm in here?"
....
Coz I'm cold-blooded..?
Today, I have seen
Asthma and DM are both very common and well-recognised in the UK. Most of the time, I feel that they are promoted as diseases which mean can't stop you from doing things. But in reality, it can.
Asthmatics, especially exercise-induced asthmatics (see me), are at especially high risk. When you are diving in the sea (and not your local swimming pool), there is a lot of surface swimming and you may encounter very strong currents, which means you have to swim. A lot. Therefore = a lot of exercise, which (in exercise-induced asthmatics) can lead to severe bronchospasm.
Also, the air pressure in the scuba tanks can be up to ~200 bar (= 3,000 psi), which means it will inflate your end-alveoli. So imagine you are diving along happily, then you hit a strong current and you have to work very hard to get to safety. As a result of this, you suffer some bronchospasm in your small airways. Result? Air-trapping in your end alveoli. Doh. Air trapping ==> popping ==> pneumothorax.
But anyway, this guy who suffered from very mild exercise-induced asthma was also an intensive care SHO (I'm guessing, he was 25), so Dr Ahmed said to him, "As long as you understand the possible consequences," He did, "And you know your own body," He also did, "Then I am happy for you to do the course."
And now, I am cold. They *insist* on having all three air-cons ON at freeze-your-arse-off degrees in this tiny tiny space. I switched 2 of them off while Dr Ahmed was out, mwahaha. He came back, saw a wee kid with a blunt finger trauma in his freeezing room, sat back down in the "main office" and said, "Why is it suddenly warm in here?"
....
Coz I'm cold-blooded..?
Stitchys.
Some stitchys I did last night, whilst battling the mozzies.
First Impression of Egypt = Rocks + Sand.
The Hyperbaric Medical Centre at Sunrise
More soon (though nothing very exciting..)
Day 1: Passport Control
So. Here I am at the Hyperbaric Medical Centre in Sharm el Sheikh. And connected kinda too, which is a *big thumbs up*.
The trip down (on Saturday) went pretty smoothly, except I somehow managed to get "final call for passenger Lu"-ed on the Manchester-Gatwick flight. Hehe, oops. All I was doing was buying a couple of adapters at WH Smiths..
The 5-hour stop-over in Londres was a barrel of laughs (or not), especially since there was no *whistles McDonald's promo tune*, as Navdeep Gill promised. Hrumph. Had a good old fish 'n' chips instead. NOM. (Then also got fed on the plane, mwahaha.)
And there are lizards in my flat. Ick.
Arrived at Sharm El Sheikh International Airport at ~5am (GMT+1) and had a silly man at immigration:-
I filled out my landing card, as per usual; queued, as per usual; then handed the immigration man my passport + landing card. The immigration man looks at the passport and says, "China?"
Confused, I say, "No, Taiwan."
"Taiwan? No, China."
More forcefully, "Taiwan."
He held my passport up to me and says, "Where Taiwan?" "China," he says, pointing to the Republic of China text on my passport.
"Oh," realising reasoning behind the misunderstanding, "It's the same."
He looks up at me, "China."
Not. China. TAIWAN. Ugh.
Then he decides to go ask one of his chums. Comes back a couple minutes later and waves me along. I put on my best "And my passport?" face. Realising he'd left it with his chum, he retrieves it, returns, then asks, "This real, yes?"
....
"No actually, it's fake," "Yes," I smiled. (As IF I would've said on..????)
Anyway.
I've taken some noice piccys of where I am to reside for the next 8 weeks, so will post them up at some point. Maybe when (if ever) the internet stops being so temperamental..
Arrived at Sharm El Sheikh International Airport at ~5am (GMT+1) and had a silly man at immigration:-
I filled out my landing card, as per usual; queued, as per usual; then handed the immigration man my passport + landing card. The immigration man looks at the passport and says, "China?"
Confused, I say, "No, Taiwan."
"Taiwan? No, China."
More forcefully, "Taiwan."
He held my passport up to me and says, "Where Taiwan?" "China," he says, pointing to the Republic of China text on my passport.
"Oh," realising reasoning behind the misunderstanding, "It's the same."
He looks up at me, "China."
Not. China. TAIWAN. Ugh.
Then he decides to go ask one of his chums. Comes back a couple minutes later and waves me along. I put on my best "And my passport?" face. Realising he'd left it with his chum, he retrieves it, returns, then asks, "This real, yes?"
....
Anyway.
I've taken some noice piccys of where I am to reside for the next 8 weeks, so will post them up at some point. Maybe when (if ever) the internet stops being so temperamental..
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