Two Patients

Patient One

• 18 Year Old Male.
• No Medical History, Normally very healthy.
• Very fit and active.
• Presented to A&E with acute abdominal pain.
• Diagnosed with appendicitis with immediate risk put on the next mornings surgical list.
• Patients family are hypochondriacs and overly dramatic panic mongers.
• Patient goes into theatres for a perfectly routine procedure.

Patient Two

• 87 Year Old Male.
• Repeated relapses of cancer over the last 20 years.
• Chronic Obstructive Pulmonary Disease.
• Not very active and in pretty rough shape at the best of times.
• Patient admitted with increasing Shortness of breath due to infection.
• Infection not responding to antibiotics.
• Deterioration indicates that patient meets the criteria for the liverpool care pathway(will be dead within 72 hours).
• Very upbeat, has had a hard life and accepts everything that is happening.
  

I have treated patients similar to both of these although neither of these patients is exactly like any one patient I have treated. Now heres the challenge for any of you poor readers, Tell me what I will find if I go back in three weeks to see these patients. And tell me why I will find what I do.

Sleep

Its 0425.
Every muscle in my body is aching.
I can barely find the energy to sit up in my chair.
My mind has slipped into an energy sparing melancholia.
I should be fast asleep.

But I'm not. I've spent the last five hours staring at my bedroom ceiling, unable to sleep despite the new depths of fatigue I am currently exploring. I've been back in lectures for a while. Thus the lack of posts, I havent had anything of worth to blog about. Given how exhausted I've been when on placement I decided to take some time off working as a bank carer as well. Finally get some time to just be a student. Unfortunately this is how my body always reacts when I go a prolonged period without work. The lecturers arent challenging(for anyone) at the moment, and despite the fact I am still being very active for some reason I just cant seem to function unless I am working myself to the point of sickness.

In the past I have tried everything through medications, herbal remedies and alcohol (not at the same time) to correct this purpose-deprived insomnia but nothing touches it. So I thought I would throw it out to all you guys, what wierd and wonderful tactics/potions/tricks do you guys use to treat insomnia. Anyone who comes up with something that actually works will earn my undying gratitude.

Mythology: Vampires

Most cultures have superstitions involving beings more or less similar to what we call vampires. In this post I intend to offer a possible medical explanation for these creatures. A condition known as Porferia is caused by a malformation of an enzyme in haem. Haem is a crucial element in our blood and allows our red blood cells to bind to oxygen. The condition can easily be fatal without a treatment, a suppliment of artifical haem. Lets break down the "signs" of vampirism.

Drinking Blood
The folklore states that vampires need to drink blood in order to survive. This is technically a solution for porferia suffers, Ingesting large amounts of human blood would provide the required elements to suppliment low haem levels. However most of the ingested blood would be immediately broken down and unusable in the stomach.

Sensitivity to Sunlight
Three types of porphyria are associated with a sensitivity to light, which can be as extreme as sever sunburn at minor exposure. Most sunscreens are totally non-effective.

Complexion
Most legends suggest that vampires are very pale in complexion. Maybe because the legends state they dont get out much during the day? Most people suffering from porpyria are very pale in complexion as a result of barely functioning red blood cells.

Despite all this there are a few bits where the legends dont match up to the medical condition. As far as medical science is aware porphyria suffers cant fly. Also the legends all seem to give vampires a far eastern european accent. Porphyria is one of surprisingly few condtions that dont seem to effect any ethnic group more or less.

This connection has been suggested in the past by many academics one of the better works was a paper writen by a biochemist named David Dolphin in 1985. These suggestions are deeply contravercial as it adds an additional stigma unto suffers of what is in reality a very natural and saddening condition.