Guest Post: Medical Advice From Gavin

Gavin has good advice about the prevention of choking on food, using his many years of experience in the Ambulance Service in London, and New Zealand.

Hi folks, 2 things I feared most when I was in the ambulance service. One was asthma & the other similar was choking. I was the first in NZ to teach the Heimlich manoeuvre & got into trouble for it. I’m pleased to see in the video in the news story courtesy of Wellington Free, they have brought it back.

(This is not the video clip mentioned, just an illustration of the technique-Pete.)

Some advice
Never sneak up on someone while they are eating or give them a fright, such as saying HI by slapping them on the back. Eat small bites of steak and not chewy bits – no need to be polite, spit them out. And don’t forget Oranges. The meat on that is a regular choker as the acid can make you gulp. For children, eating oranges like we did at half time is safest, not peeled or Mandarins are better.

Only advanced paramedics have the equipment & can do cricothyroid punctures, certainly not in rural areas. An off duty doctor would struggle without the right gear but a midwife did it successfully in the Hawkes Bay a few years ago.

https://www.stuff.co.nz/the-press/news/131578891/super-fit-dadoftwo-dies-after-choking-on-steak-at-family-barbecue

Ollie Update

I know many of you like to be informed about what is happening with Ollie. Well, something new has happened. As if our poor dog hasn’t suffered enough in his almost 11 years.

With us both living with full-blown Covid, Julie elected to take Ollie for his walk today. That saved me going out in the freezing rain when I was feeling like death warmed up. On her return, she was concerned. Ollie had tried to poo as usual, but he had trouble passing it, and eventually just started to bleed copiously from his rear end. It didn’t seem to upset him unduly, but naturally worried us and we didn’t want to be faced with an emergency over the Christmas shutdown period.

So Julie rang the Vet and arranged that they would see Ollie under Covid rules, with her wearing a mask. She got an appointment for 4pm. The Vet did the usual examinations, and had an immediate diagnosis. Colitis. Ollie has an inflammation of the colon, caused by the interior version of the frequent exterior skin infections he gets every year.

She managed to put Julie’s mind at rest. It is very common, and easily treated. A prescription of antibiotics, and feed to be changed to small amounts several times a day, instead of one big meal.

Now everyone in this small house has something. Even our beloved pet.

Early Hospital Photographs

Some early photographers were interested in documenting the patients and equipment in hospitals. I found some good examples online.

Babies in incubators. Crystal Palace Hospital London, 1910.

An early form of X-Ray machine being used, 1913.

Lydia Ward for children. Guy’s Hospital, London. 1907

An experimental ECG machine being used for heart tests. National Heart Hospital, London. 1916.

Children outside on a hospital balcony. Salford, Lancashire. 1905. At the time, great emphasis was put on fresh air to aid recovery.

The new operating theatre at Dollis Hill Hospital, London. 1920.

The Canadian Military Convalescent Hospital in Epsom. 1918

The Whirlpool Bath at Manor House Hospital, London. 1920. The man with his leg in the bath is wearing Army hospital uniform, so is likely to still be receiving treatment for injuries sustained in WW1.

The Women and Children’s Hospital in Leeds, Yorkshire around 1916. Once again, they have wheeled the children outside for ‘fresh air’.

President Ward at St Bartholemew’s Hospital in London. 1909.

The Orthopaedic Hospital in Oswestry, Shropshire. 1910. The ward is open to the elements during the day for more of that ‘fresh air’.

Finsen light treatment for Lupus. The London Hospital, 1906.

New Year, Same Ollie

I mentioned recently that Ollie’s fur is not growing back after his recent skin infection. If anything, the fur loss is getting worse.

Then over the weekend, he started to shake his head again, a sure sign of a developing ear infection.

So my first ‘normal’ day after the holiday season involved taking him to the Vet, yet again. I was lucky to get an afternoon appointment, even though the place was heaving with numerous dogs, and cats in baskets.

For some reason, the dogs in the waiting room yesterday were particularly distressed. One small French Buldog was in such a state, it was climbing over its owner’s head to try to get out of a window. A stocky Chow Chow was digging its front legs so hard into the flooring, the frustrated owner had to drag the poor thing into the consulting room by its body harness.

Next to us, a nervous Lurcher bitch spent her waiting time trembling and crying, and an unseen dog in the treatment room at the back howled through whatever process it was enduring. Ollie picked up on all the distress, constantly walking in circles around me.

Eventually, we got in to see the usual Vet. He diagnosed an ear infection in the right ear. I expected him to use the new ‘wonder-gel’ to cure it, but he told me that does not get into the bloodstream, so Ollie would have to have tablets. Back to Prednisilone and Antibiotics for two weeks. He has to go back then, to be checked over.

As if the Christmas season wasn’t expensive enough, that ten minutes and two bottles of tablets cost £126. ($171)

On the plus side, (looking for positives!) the squeaking noise from my car has stopped. Maybe it was just something caught in the wheel? I won’t be able to risk not getting it checked though, but that will have to wait for a while.

Ollie’s Ears (Again)

Just before we went on holiday in September, Ollie had a bad infection in his left ear. I took him to the Vet, and they tried a new gel treatment, administered directly into his ear. It worked so well, he was on the mend within 24 hours, and by the time of the second dose a week later, completely cured.

That was only a month ago, but Ollie started to shake his head again last Wednesday. By Thursday, he was hanging his head to the right, and that ear felt hot. Out on his walk, he started to rub the right ear against anything he could find, followed by frantic shaking of his whole head.

So I arranged to get him to the Vet last Friday, and another dose of the gel was given, into the right ear this time. That evening, he calmed down considerably, and by Saturday afternoon, he was even quite playful.

Next Thursday, I have to take him back for the second dose, as it can only be given by a qualified Vet. This is nothing short of miraculous though, as previous treatment involved 10 days of antibiotic and steroid tablets, which became increasingly difficult to get him to take.

If you have a dog that is prone to ear infections, ask your Vet about this product.
https://www.dechra.co.uk/search/search?q=Osurnia
(I gain nothing from this recommendation, just so you know.)

Thinking Aloud On a Sunday

The Forgotten.

Remember before all we talked about was the Coronavirus? Seems like a long time ago, doesn’t it?

I woke up thinking about a news report I watched on our local news. It featured a lady who had been due to have a life-saving cancer operation, back in March. They had predicted a very good outcome, one that might well give her another ten years of life. Ten more years with her family and friends, ten more years of doing whatever she could; reading, pursuing her hobbies, and enjoying her garden.

But the operation was cancelled, because of the pandemic and the demand for beds in hospitals. The lady understood. A worldwide-pandemic was something new, something huge, and she was just one woman in an obscure English vilage. If her operation had to be delayed, then so be it. Let them deal with the shocking number of cases of Covid-19, and she could have her operation a little bit later on.

Except she didn’t get that operation. And by the time she was eventually called back to see her hospital doctor last week, six months had passed since she had first been told an urgent operation woud save her life. The tumour she has is now inoperable. It has spread too far, and cannot be removed. They have offered her debilitating treatment to shrink the growth, but that will only give her a few more weeks, not those ten years.

Interviewed in her garden, she was upset, but not bitter. She had accepted her raw deal, in the knowledge that people might recover from Covid-19 and go on to live longer, fuller lives. Though she couldn’t help but comment on the fact that she was one of the ‘forgotten’. Cancer patients, heart patients, those crippled and immobilised by hips and knees requiring surgery. First delayed, then cancelled, eventually forgotten.

Nobody reads out their statistics at the government briefing.

Virus Deaths: One Story

I read something on a local newspaper website earlier this week. I went back to get a link to add here, but it has been taken down. Presumably to save the family from more distress.

We are all reading about deaths from the virus, all around the world. As the numbers get bigger, they stop becoming people, and are just numbers. I read that 1,000 people have died fom the virus in the USA. Can you imagine seeing 1,000 dead bodies laid out in a line? I once saw more than 20 bodies at the scene of a train crash. It looked like a lot of bodies. And I was an EMT, so used to seeing such things.

1,000 bodies arranged in a line would stretch almost 3,000 yards. That’s 1.7 miles. That distance would take almost 30 minutes to walk, at a normal pace. Hard to comprehend, I know.

So let’s just think about one person who died because of this virus, and the impact on his family.

A local man in his fifties had a mild heart attack last year. He had a stent procedure to open a coronary artery, was put on blood-thinning drugs, and sent home. He went back to work as normal, and returned home to his wife and two twenty-something children who still lived at the house. Just over a week ago, he woke up with a very high temperature, so stayed off work. The next day he had a very bad cough too. Covid-19 was suspected, and the call was made to the family doctor. That doctor decided to send an ambulance to take the man into the emergency department of the local main hospital.

He had to travel without his wife and family of course. They were not allowed to get close to him as he was taken to the ambulance, so no goodbye kisses. Then because they were in a house where those symptoms were found, they all had to self-isolate. Calling the hospital that night, they were told that he was ‘seriously ill’. The next day, someone called them to tell them he had died.

Imagine that. No goodbyes, no last moments together, no chance to comfort the man she had been married to for thirty years.

The funeral was just 24 hours later, a cremation arranged by a local undertaker. The family was informed that only ten mourners could attend. But as they were self-isolating, they were not allowed to go. Any relatives or friends that might usually have attended did not want to travel during this crisis. So the man was cremated in an empty facility. The undertaker sent a bill, adding that they understood it would be some time before payment could be made. The ashes would be sent to her in due course.

That’s it. Thirty years together comes down to three phone calls, and it’s all over.

Then the everyday problems begin. To get an official death certificate, you have to attend the appropriate department at the Town Hall, with the initial certificate given to you at the hospital. But you are self-isolating, and are not allowed out. Even if they could go out, the office is closed because of the lockdown of workplaces. And you would not be allowed into the hospital to collect their form, as you were too close to someone who died from Covid-19.

Without that death certificate, you cannot access the man’s bank account or savings. Cannot cancel his credit card, or any other payments still going out of his account. You cannot make a claim on his life insurance, sell his car, or do a dozen other things that have crossed your mind will need doing.

On top of your grief, you have to deal with all that stuff too.

Then there is the worry. What about me? What about the chldren? Will we get it now? You can’t seek comfort from relatives and friends either, because you are not allowed out. Anyway, it wouldn’t be a good idea, even if you were.

In the last 24 hours in Spain, 832 people died. Imagine that story above, mutiplied by that figure.

That’s the reality. Are you scared yet? You should be.

Yes still, social media is showing people, mostly young people and teenagers, who think it is funny to spit on food in supermarkets, or rub their saliva over the handles on public transport. Parcel delivery people spitting on parcels that they then hand to a recipient, idiots licking toilet seats, some deliberately touching things in shops then replacing them, and even claiming that Covid-19 is a hoax, and doesn’t exist. Some of those videos have been shared over half a million times, watched by giggling youngsters who think it is all a great joke.

Try telling that to the wife of the man who died near here this week.

Ollie At The Vet (Again)

Ollie had to go to the Vet again today. That’s why I am late posting my serial episode, (for those of you that noticed) and just running late in general. Any break in my fixed routine makes me feel that I lose the rest of the day trying to catch up.

Anyway, Ollie had to have his annual booster injection, and general health check. In addition, I was worried about a sore eye that was troubling him, and the fact that he just cannot seem to stop shedding hair out of season.

Excited to get in the car, he was less impressed after the 12-mile drive deposited him at the hated Vet. Not that he balks at going in, but once inside he shows obvious signs of distress about what may be about to happen. Luckily, there were lots of other dogs there already, so his attention was distracted. Two Golden Retrievers, a young Rottweiler, a barky Labrador, and a nervous Poodle all gave Ollie the eye as he came in, and there was a great deal of mutual sniffing. Only the trembling Poodle made sure to avoid my dog.

He weighed in at thirty kilograms. This is a one kilo increase on last year, and a two-kilo increase on his weight at the age of two. The Vet checked his heart, looked in his ears, and gave him the booster jab. Then he was examined around the eyes, as I talked about the never-ending moulting of fur. He had to have an ‘indicator solution’ dropped into the bad eye, and after a short delay, the colour change (to green) indicated Conjunctivitis. The issue with the fur was diagnosed as yet another yeast infection on the skin, causing the fur to constantly fall out and re-grow.

The treatment will be seven days of eye drops to clear up the right eye. The Vet agreed that we should avoid yet another dose of oral antibiotics and steroids for the skin, but has suggested weekly baths in the special shampoo for the foreseeable future. That in itself is going to be a mission, getting Olie in and out of our small corner bath, and trying to dry him off. I could take him to the groomer every week, but at £32 a time, that option is too expensive.

As he filled out the report on his computer the Vet also discussed Ollie’s age. He will be 8 years old in February. For a Sharpei, that is the human equivalent of 65 years of age, and is why he is slowing down more each month, and sleeping longer. He casually added, “If he sees double figures, I will be happy, but surprised”. I was shocked, and asked him if that was really true. Might Ollie only live for less than two more years? He shrugged. “The oldest one I have ever seen was ten years old. I have never seen one older than that. Too much in-breeding, I’m afraid.”

I paid the £60 bill, and we left. As I was driving home, I wondered if the Vet’s gloomy prediction could be correct.

Life without Ollie in it just doesn’t seem possible.

Ollie goes out in the car


Ollie, when he is ‘not happy’. Tail down, and panting.

Since he started the summer moult, Ollie has been scratching his legs and biting his ‘undercarriage’. These are sure signs of irritation caused by the usual skin infection he gets a few times a year. Rushing through nettles and brambles doesn’t help, nor does standing for long periods up to his neck in the river. That might cool him down, but it allows who knows what in the river to get into his system too.

So I bowed to the inevitable, and booked him in for a Vet appointment today. Then on Wednesday, he went to the groomer to have the loose fur stripped, and a nice bath. He came back looking sleek, and smelling a whole lot better too.

Taking Ollie to the Vet has to be done by car, as it is twelve miles away, in Swaffham. It makes me feel guilty to see how excited he gets to be going for a drive to some exciting new place, when I know where we are actually going. In the familiar car park, he emerges from his place at the back with a worried look. Having spent so much of his life to and from one Vet or another, he recognises the location immediately.

Once through the door, he begins panting and placing his paws on my knees, looking concerned, and turning in circles on his lead. I always try to see the same Vet, but he was doing surgery today, so I had to see a young lady instead. Meanwhile, a nervous Spaniel in the waiting room was whining and crying, which upset Ollie even more. He kept going over to check on the dog, to make sure he was alright.

By the time we were called in to the examination room, Ollie was trying to head for the door. Fortunately, his condition is well-known, so he only had to be weighed, and suffer a brief investigation with an ear-scope. He tolerates Vet treatment very well as a rule, and as long as I am there, they can do more or less anything to him. After a quick once-over, the lady Vet agreed that he should have the usual doses of ear-drops, antibiotics, and steroids for the inflammation and itchiness. When she got up to go and get the medicines, Ollie tried to exit through the closed door, keen to get back out to the car.

Still feeling guilty, I took him straight up to Milennium Wood in North Elmham, where he came across a group of Labradors and Terriers to sniff and play with.

By the time we were heading back to the car, he appeared to have forgotten his distressing trip.

Until the next time.