I haven't forgotten this blog! - Dad Appreciation Post and Update

Warning: this post talks about Cancer.

I promise I haven't forgotten this blog. I've just been busy with one thing after another and it kept getting put off, and the more I put it off the harder it became to sit down and catch up. But today's the day to get back on track!

So, my last blog was on the 18th March, but I haven't updated you guys properly for some time, but I want to do a Dad appreciation post and update as he's really got back to his normal self much more since March, we know a bit more now, and I feel strong enough to talk about it openly.

In an earlier blog post I mentioned that a few days before Christmas we found out my Dad has an incurable cancer. I feel like it's time to talk about that properly.

The primary tumour is in the bowel, with two mets on the liver, and numerous mets on the lungs.
He had a major surgery, laparotomy and stoma formation, came home from hospital just after New Year, and we celebrated Christmas with him properly at home, although he opened his presents in HDU.

He's on quite a few medications to help with his stoma, pain, iron and magnesium levels, and build up drinks to help replace the 30kg of weight he lost before they found out what was wrong with him.
He has since had two admissions in February for stoma blockages, and one trip to A&E for a stoma prolapse.

His chemotherapy started on 7th March. He has a three week cycle, two drugs on day one, one drug on day eight, and one drug on day fifteen. He doesn't have a break between cycles. Chemotherapy means more tablets for steroids and antisickness.

His review CT scan in May and appointment with the oncologist revealed that his cancer antigen (CEA) levels are decreasing, his primary bowel tumour has shrunk, and the original liver mets have shrunk, but a few more small liver and lung mets have appeared, and they're concerned about the liver ones in case they continue to grow or more appear.

We're limited to three authorised types of chemotherapy so we're continuing with the same treatment for another three months for now with a further CT scan at the end of the three months.

In himself, he's improved drastically since leaving the hospital, his recovery from surgery was good, and although he initially needed oramorph almost every day, he's only had to use his oramorph once since March, and that was after walking around all day almost non-stop. He's got himself a new little car which has given him his independence back, and he can take himself off out for the day, and take his dog with him too if he wants to.

We're working through his bucket list fairly quickly, as we don't have a real prognosis yet, and I doubt we ever will, but we know that if chemotherapy doesn't work he could have less than a year, and we're already almost half way through the year so we're making sure to pack plenty in, just in case.

Here's a few of his adventures so far this year:

His Cousin's Wedding:

Dinner in Bella Italia (he loved that lasagne!):

Easter Egg Hunt:

He bought me a special stethoscope:

Fishing trip, wearing his new Hogwarts hat:

Platform 9 3/4:

And with his girls:

We've just taken him to Comic Con this weekend.

And the Emirates Cable Car:

Coming up, so far he's got:
June - Download Festival and Fathers' Day.
July - A family holiday to do a "secret" activity which he doesn't know about yet.
August - Reading Festival.
September - Warner Brothers Studio Tour and nine days in London with my Sister.
October is empty so far, but I doubt it will stay that way!
November - Celebrate Halloween and Bonfire Night while I'm home for a weekend from uni, and celebrate his 55th birthday.
December - Star Wars themed Christmas.

Plenty for him to look forward to and hopefully keep him strong.

Obviously, I'm nervous about leaving him to go to uni, and I don't drive yet so visiting home is a five hour train journey each time. But he's doing so well in himself, and is so positive about life as he says he doesn't want to waste his limited time moping about it and losing even more time. He's thrown himself into life headfirst, and is enjoying himself. All of this makes it easier for me to cope. And we'll face the inevitable when it arrives.

On the medicine side of things there's not a lot to report at the moment. I've applied for my student finance, packing is well underway, and I've been buying the "essentials" (read: so much stationary!).

In non Dad related life update: I'm off to Japan on 18th June for three weeks with my brother, and so I'll likely post a bunch of pictures of that when I get back.

I'll try to update this blog when I can over this hectic summer. Once I'm settled in at uni I'd like to attempt to get this blog back on track, weekly on Monday mornings.

Sorry for a post full of mixed sad and happy things, but such is life.
Thanks for reading.
Katherine

I've been to London... Let's talk about Plague

I've been to London this weekend, to a concert, but I also visited the Museum of London.

This museum has a small display area about the Plague, which was an influential part of the history of London. The microbe which causes Plague was one of the first to be studied by early microbiologists, and so I thought today I would do a quick blog about it with a few pictures from the display.

Microbe - Bacterium

Name - Yersinia pestis 

Transmission - Flea saliva (bite), inhalation, ingestion, direct contact

Incubation period - 3 - 7 days

Symptoms - non-specific flu like symptoms, sudden onset chills, fever, headache, diarrhoea, muscle ache, weakness, nausea and vomiting, swelling of lymph nodes

Three commonest forms - Bubonic, septicaemic, pneumonic

Bubonic - most common, bacteria replicate in the lymph nodes causing them to become very large and swollen, most commonly in the groin, although the armpits and neck are also affected

Septicaemic - usually no evidence of lymph node involvement, bacteria spread to the blood and cause septic shock, bleeding may occur from skin and mucous membranes and internally, symptoms can appear on the day and death can occur within 24 hours

Pneumonic - least common of the three but most dangerous, mortality and contagibility is very high, lung infection can be primary, or secondary to bubonic, can spread directly between humans, can progress rapidly to septicaemia, incubation period 2 hours - 4 days

Other types of plague - currently classified by WHO include, cellulocutaneous, meningeal, pharyngeal, abortive, asymptomatic, and pestis minor


Most famous outbreak - Black Death - 14th Century

The Year 1348
A ship arrived in England, possibly in either Bristol or Dorset, carrying the bubonic plague microbe, either in the people on the ship, or in the fleas of the rats on the ship. By November, 30,000 of the 70,000 people who lived in London were dead. Over the following three years between 30-40% of the population of England had succumbed to the disease and died.

Other notable outbreaks
There have been a number of outbreaks throughout history, across the world, but another particularly notable outbreak in London was between 1665 - 1666, and this was the last major epidemic in England.

Plague today
Between 2010 - 2015 the WHO noted 3248 cases were reported worldwide with 584 deaths.
The three most endemic countries are the Democratic Republic of the Congo, Madagascar and Peru.
The most recent outbreak was between August - November 2017 in Madagascar with 2348 confirmed/suspected/probable cases, and 202 deaths

Treatment - antibiotics and supportive therapy are effective if the diagnosis is made in time

Prevention - surveillance plays a big part so people can be informed to take measures against flea bites and avoid touching animal carcasses. People are advised to always avoid contact with infected body fluids and tissues

Vaccinnation - there is a vaccination available but it is not recommended except for high risk groups, and as it's effectiveness has never been measured precisely, exposed persons should be treated regardless of vaccination history

If you would like to see more blogs like this about different diseases or illnesses please let me know in the comments.
Thanks for reading.
Katherine

Sources:
https://patient.info/doctor/plague
http://www.who.int/mediacentre/factsheets/fs267/en/
http://www.who.int/csr/don/27-november-2017-plague-madagascar/en/
https://www.cdc.gov/mmwr/preview/mmwrhtml/00041848.htm
The Open University textbook, Empire of the Microbes, Charles Cockell and Audrey Brown

Pictures taken by me at the Museum of London on Sunday 18th March 2018

Design Plans for my University Room

I recently saw this picture, I think on Facebook (I'm sorry I didn't note where), of a room full of calm, clean colours, and nature.

It got me thinking about my university room and I decided I would set a theme of green and white, with greys and browns, in the hope that I could create a space which would feel peaceful and tranquil, so I could focus and relax. And so, the following mood board was born.

All items featured were found on wilko.com

These items are not necessarily the exact things I will buy but they are to give me an idea of what I want. I have priced it all up just to see what kind of expense I'm looking at, and I can get all of it (plus a few items not pictured, and some items multiple times) plus home delivery for easily less than £300. This might seem like a lot for a student to pay out to decorate their room but, as I am a mature student I am working and earning and so can afford to decorate a little bit nicer, and all of these items can continue on with me into my student housing and beyond. 

You'll be able to see how my room turns out to be decorated when I move to halls in September.

I hope you don't mind the slightly different post this week, but I do want this blog to cover my whole journey and that includes some things that are not directly related to applications or study.

Thanks for reading,

Katherine

Accommodation Decisions

Students at Brighton and Sussex Medical School can choose to live on the University of Sussex campus or the University of Brighton, Falmer Campus. On each campus all of the medical students are housed together so either in Lewes Court or Paddock Field. There are a number of differences to consider.

Lewes Court - University of Sussex
When I went for my interview this is the accommodation we were shown.

Map from Google Maps (04.03.18)

Pros
Lewes Court is just under a 15 minute walk to the BSMS teaching building. It is close to the library and amenities like shops and a cash point.

Cons
Not all of Lewes Court is en-suite. Some of the flats have a shared bathroom between 6 bedrooms.

Paddock Field - University of Brighton, Falmer Campus

Map from Google Maps (04.03.18)

Pros
All of the flats in Paddock Field have en-suite bathrooms. There is the option for catering, the restaurant is only 3 minutes walk from the accommodation, and provides a varied menu for breakfast and dinner 5 days a week. On this campus you can also get free off-peak gym membership.

Cons
Slightly further to walk to the teaching building but still only just over 15 minutes. I'm unsure if the closest shops/cash point are on the University of Sussex campus or if there are some closer.

Personal Choice
I initially preferred the layout of the bedrooms in Lewes Court, particularly the style of desk supplied, but have settled on applying for Paddock Fields for two reasons. Firstly, because all of the rooms are en-suite, and secondly, because I would like to apply for the option of catering. Catering will just make my first year that little bit easier while I am adjusting to living away from home and trying to cope with my Dad being terminally ill while I have to focus on my degree. I am looking forward to cooking at the weekends though and thinking about healthy packed lunches.

Thanks for reading,
Katherine

Offers And Accepting

There's probably not a huge amount I can say about this topic, but I'm going to go ahead and say it anyway.

When I went for my interview at Brighton and Sussex Medical School we were told in the presentation/talk prior to our interviews that approximately 5% of people will receive their offer of a place on the same day. We were also told that those people would be the ones who scored full marks at every station. Everybody else would receive their offers sometime before May.

Now, I hadn't exactly made the best first impression when I arrived at BSMS as I'd forgotten to bring my qualification certificates with me, but what I did have was a letter from a doctor who I work with, who looks after my Father, stating that I had just found out he had an incurable cancer, literally two weeks before my interview, and hence, I wasn't as well prepared as I would have liked to have been, and probably wasn't in the best frame of mind either. I showed this letter to the admissions team, who were sympathetic and supportive, and informed the interviewers before I went in.

These circumstances meant that, while in the long term I wanted a place to study medicine, in the short term I didn't care very much about whether I received an offer this year. It made me strangely relaxed about my interview. I had bigger things in my life to worry about than if those five people liked me that day. In a way I think it turned out to be beneficial to my interview as I usually get very nervous and don't interview very well, but on that day I couldn't bring myself to even worry enough to be nervous, I just hoped I would get through the day without crying in front of people.

I did making it through the day without crying, just. I had a couple of wobbles but no tears. One of the interviewers told me he was sorry to hear about my Father, which was kind but not what I needed to hear mid-interview, but I still somehow managed to keep it together.

After the interview, I went back to the train station to wait for my train home. I even fell asleep in the waiting room, as I was emotionally and mentally exhausted. It's a good job I had remembered to put my phone back onto loud as it woke me from my sleep. It was a call from the admissions team, they asked me how my interview went and if I was okay, and I was thinking this is a kind courtesy call because of my Dad, but then they informed me that I had done really well and they were going to offer me a place, and that I could call my Dad and tell him. I was in shock. I rang my family immediately to let them know and my Dad told me straight away he wanted me to accept the place, even though I would be further away than I would like while he battles this illness, he was adamant that he wanted to see me live out my dreams, and not put my life on hold for him. It almost broke my heart, and it almost breaks my heart all over again typing it now. But I was incredibly thankful for his support, and even that he made the decision for me. I wouldn't have been able to leave him without his blessing.

While I was shocked and thankful for the place, I did have some doubts about my performance. Even though I had felt comfortable in my interview and I had felt I had answered most questions fully, I didn't think I had done that well, and I questioned for a few moments if it was a sympathy place because of my Dad. But my friends, family, and medical colleagues soon put me right, I wouldn't have been offered the place if I wasn't good enough, and I shouldn't ever put myself down.

I had to wait for the offer to be made official on UCAS but as soon as it was I cancelled the other interview I had been offered, withdrew from the other applications I was still waiting to hear from, and, along with my Father, I clicked the button to accept it straight away. Some people feel I was a bit rash about it, but it had been my top choice out of the universities I had applied to and it was an unconditional offer, so I didn't see the pointing in waiting, travelling to other interviews, and putting myself through more stress at a bad time.

So, I had accepted my place. Now it's time to wait for the rest of the offers to be sent out before I can sort accommodation and finance, forward my certificates and vaccination history, and get my DBS check done.

Thanks for reading.
Katherine

On The Interview Day

I mentioned this at the beginning of the previous blog but let me remind you that I will not be discussing any of the real questions I had to answer as candidates are sworn to secrecy about this. This is something the university takes very seriously. If you are found to have disclosed the nature of any of the questions you can have your offer of a place withdrawn, even if you have already accepted it.

Essential notes
Make some essential notes, bullet points, of the things you find hard to remember or are very important and take them with you to read on the way there and before you go in. Having something practical to read will likely also help to calm your nerves.

Be punctual
Make sure you plan your travel so that you will arrive on time. If you have a long way to travel consider staying somewhere local the night before. Do not plan to arrive at the very last minute or any delay will make you late for your interview.

When you arrive
Register your arrival, there will be people to greet you, likely student volunteers. You may be required to show your qualification certificates at this stage, if you already have them. You will be shown where to wait. Stay calm and read your notes. Eat something small and not too sugary, and remember to stay hydrated.

Information talks and campus tours
You may be given a short talk about your university and what to expect in your interview and you may be taken on a campus tour. This tour could be optional or compulsory. Especially if your tour is before your interview try to use this time to actually look around and ask questions. Could you imagine yourself living and studying here? Which halls would you like to live in? Are amenities conveniently located? What is transport like? Are there lots of societies and clubs to choose from?

In the interview
I had a mini-station interview so that's the only set up I can talk about. This set up is good because you move to a new station every few minutes and start fresh so if you feel like you've messed up one station it's easier to move on and not let it affect the rest of your interview. You get a minute between stations to have a breather and a drink. This set up is also very similar to the OSCE style of exams you will do as a medical student if you get a place so it is good practice.

First impressions
At each station you will have to make your first impression again so remember to smile, introduce yourself and shake hands with your interviewer.

Answering the questions
When you are answering the questions you need to consider the following:

• Am I answering the question they have asked me, not the question I want to answer?
• What skills or attributes are they looking for with this question?
• Where have I shown these?
• Where have I observed these?
• What have I learned?
• How could I use these as a student or doctor?
• The length of your answer.
• The structure of your answer.
• The vocabulary you use.

Remember

Your interviewers are there to help you answer the questions. If they can give you a hint or guide you then they will. If they do this it does not mean you are doing badly.

Your interviewer may cut you off in the middle of a sentence. This could be because what you are saying is not relevant, or you have already said what they want to hear and they want to move on. They may also come back to a question if they feel you have not answered it as well as you could.

Your interviewer may be very cheerful or very serious, this is not a reflection on you or how well or badly you might be doing, they are told to act that way. 

Remember to thank your interviewer and shake their hand as you leave their station.

And remember to relax. You will either receive an offer or you won't, but getting worked up about it won't help you to answer the questions to the best of your ability. 

Good Luck!
Thanks for reading.
Katherine

Preparation For Medicine Interviews

Let me make one thing clear before I begin, I will not be discussing any of the real questions I had to answer as candidates are sworn to secrecy about this. This is something the university takes very seriously. If you are found to have disclosed the nature of any of the questions you can have your offer of a place withdrawn, even if you have already accepted it.

But what I am going to do is tell you what topics I read up on to prepare for my interview.

About me
In this section be prepared to talk about something you're passionate about. Also think of 3 or so words you would use to describe yourself.

Why medicine?
In this section prepare to answer the big question "Why do you want to be a doctor?" Think about your motivation. Do you enjoy science? Do you enjoy helping people? What about leadership or problem solving? Has anybody influenced your decision to apply for medicine, and why? Think about why medicine instead of nursing. Nurses can specialise, prescribe and lead a team. So, why medicine?

What makes a good doctor?
Think about some traits and attributes of a good doctor, both academic and non-academic.

Attributes of a doctor
For the following attributes think about an example of a time where you have shown it and an example of a time where you have observed it.

• Empathy
• Conflict Resolution
• Communication Skills
• Dealing With Stress
• Leadership
• Teamwork
• Resilience
• Limitations and Weakest Attributes

Changes in medicine

Think about a topic that interests you, and a topic you've read about or heard about recently. Think about the most important development in the last ten years, and the most interesting one.

Changes in NHS

Think about the biggest challenges of the NHS at the moment, look up NHS hot topics. Think about an issue you've read about or heard about recently. Think about the most important or interesting development in the last ten years. Also consider if there was one thing you could change about the NHS what would it be and how would you implement the change. 

Make sure you look up the NHS core values, the NHS constitution, the NHS seven principles and the 6 Cs of NHS values.

Think about the NHS five year forward view and the Wanless report. 

Make sure you know who the following are and what they do:

• DOH - Department of Health
• GMC - General Medical Council
• CQC - Care Quality Commissioning 
• NICE - National Institute of Clinical Excellence
• CCG - Clinical Commissioning Groups
• STP - Sustainability and Transformation Partnerships
• BMA - British Medical Association
• BMJ - British Medical Journal

Ethics, confidentiality and other notes

Look up the four pillars of ethics and use them when you answer every ethical question, and remember to give balanced arguments. 

Look up the eight principles of confidentiality and make sure you understand the meaning and importance of these.

Look up the stages of breaking bad news, you may be asked to do this in your interview. They do not expect it to be perfect, you will learn how to do this properly later but they are looking to see if you would have the ability to do this. 

Look up how to assess competency in adults and children, how to resolve conflict, and what makes a good leader.

Your university

Remember you might be asked why you specifically want to go to that university, so remember to research the university and be prepared to convince them that's where you want to go.

Thanks for reading.
Katherine