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Welcome to tryingmypatients.co.uk! I write an blog about life as a paramedic. I have an extremely diverse following and have over 4000 followers on Twitter and a large Facebook following through a number of pages. 

My website itself attracts in excess of 75,000 monthly hits, averaging 1000 unique hits a day. I'd love to have you advertise on my website and open up your business to my followers.

I will mention each advertiser on my Twitter and Facebook accounts on a weekly basis and all adverts will be rotated so they don't get missed. 

Feel free to contact me on diagnosislob@gmail.com if you have any questions! 

Loof forward to hearing from you,

Ella x

The Fresh Prince

"24 year old male, intoxicated, fallen down stairs"

As I'm feeling full of song, the next bit, you'll have to read as if you were singing along to the FULL version of Will Smith's 'Fresh Prince of Bel Air'! You all know how it goes!

Jazzy Jeff.......hit it!

Now this is the story all about how 

A man got drunk, and fell right down 

And I'd like to take a minute just sit right there 

I'll tell you how he ended up with some vom in his hair

On a busy Friday night, tired and dazed

In an ambulance, where I spend most of my days 

Driving fast, bandaging, responding to the calls, 

And picking up grannies when they accidentally fall 

When a couple of guys, they were up to no good 

Started drinking shots in my neighbourhood 

They had one to many then went to get some air 

But instead went for a tumble, after tripping on a stair

He fell to bottom, hit his head on the way

His friend standing idly, not knowing what to say

He pointed and laughed and said "Now you gone and done it",

But his friend looking bloodied said, "I think I'm gonna vomit!"

Look at the blood, this is really bad.

We're gonna need an Ambo and his mum's gonna be mad

I hope it's not serious, we were having a good night?

Hmmmmmmm. He might be alright.

But wait, he's looking greener, nauseous and all that,

I think he's gonna blow, I'd best take off his hat!

Yep, there we go,

He vommed all on the stair

I hope they're prepared for the vom in his hair.

Well, the vomming continued and then he passed out,

There was a bouncer looking on and was yellin' to get out.

"I ain't after no trouble,

man, just drank too much beer!"

He then sprang to meet the ambo, like lightin', disappeared.

He waited for a while and when it came near the 

Friend stepped into road and yelled "Quick over here"

If anything I could say that this job was rare 

But I thought nah, it's Friday, there's drunks everywhere!

I pulled up to the club about seven or eight 

And I yelled to the para "You better put some gloves on!" 

Looked at my crew mate, we were finally there

Staring at a bloke with some vom in his hair

Somehow, he was caked in the stuff. It was as if he'd been rolling around in it like a pig in the mud. Not only was it on him though, it was on the stairs, the floor, the walls and everything else near by! He was also lying right outside the vile smelling toilets of the club and it took some serious shouting on my behalf to get the bouncer to stop allowing people to clamber over us.

He had a very nasty head injury so it was impossible to know if it was the injury or the alcohol that had caused the vomiting. Either way, we'd have to treat for the worst. We couldn't accurately assess his neck because of the alcohol and the distracting injury so he needed a full immobilisation. I can assure you, no matter how careful you are, when there is that much vomit, it is impossible to avoid. After a few minutes of trying to escape it you make peace with the fact that you're just going to get vom on your garms! (Sorry, I still think I'm a rapper!)

We asked for a second crew to assist and when they arrived we got him collared, boarded and strapped.  We carried him out to the ambulance where he promptly vomited again. This time we had to hold the spinal board on its side with him strapped to it to stop him choking. It really is a glamorous job! The journey to hospital was equally lush, avoiding the trickling trails of puke and steady showers of projectile, whilst standing up and wresting with a spinal board with a 17 stone man strapped to it. Eventually we arrived at hospital. The back of the ambulance looked and smelled like a cesspit. And I didn't look......or smell much different.

Living the dream!

2013

"29 year old female, talking to imaginary friends in a make believe world"

I read a blog today by the wonderful @Eliza_Do_Lots, author of MommaTwo. The post 'Internet Isn't Real Life' really riled me! OK, admittedly, that doesn't take much, but this subject has been the cause of a number of argument in 'real life' so I thought it was time to have my say. You can go read her blog first, but the question being asked, is, are friendships made online any less 'real' than ones formed by meeting in person?

When I get home from work, to unwind, I stick the telly on, sit on the sofa with my laptop or iPad and may write a blog. Or, I may chat to people on Twitter on my phone or whatever. There are so many social networks out there, I use 3 or 4, others use more, others use less. Through twitter, I have made some very real friends. Friends I can confide in, friends I can laugh with and friends I now meet up with. Unfortunately, it's a very big world and it isn't necessarily easy to travel the length of the country for a coffee. It also isn't very cost effective to get on a plane and travel to Australia or Canada to have a chin wag. Does that make these people I consider friends any less so?

If my housemate is to be believed I am a 'sad act'. A 'loser'. I just spend my time speaking to my 'pathetic imaginary friends' or 'tapping away on my stupid blog'. How unsociable of me. I should instead be sitting watching golf, in silence, like he does. He, the 35 year old, single man with only one serious relationship in his past who comes home drunk most nights and only plays golf all weekend. Yes. I'm a sad act! Sad for meeting new people. Sad for having interesting conversations and debates. Sad for not spending money down the pub every night. I love how sad I am! The only reason he is there is because I can't afford a place big enough for me and my boy without his rent!

How do you know most of your 'real life' friends? Did you meet them at school? Where you were put into a class and friendships were then formed? Or do they come from work? Where you happened to work in the same place and attended social events leaving you being friendly with many but very few you'd share your intimate secrets with. Or do they come from friends of friends or chance meetings in public places?! How open are any of you to a stranger striking up a conversation? If train journeys are anything to go by i'd say not very! People don't really meet new people any more. How many of your 'real life' friends have you known less than two years? I bet most, if not all of you are struggling to fill one hand!

Online friendships can be very real. They are formed on common interests and good conversations without the prejudice and snap judgment face to face encounters can be full of. They grow slowly without forever trying to undo that first impression that a face to face encounter has left. They are real. It is 2013 for gods sake, why can't people be friends with who they want and when they want without being judged. I consider some of the people have met, and am yet to meet, through social networking as some of my best friends. They are no less real than someone I went to school with. To belittle these friendships as 'not real life' is like throwing an insult at a friend standing next me. I won't put up with it and I will instantly alienate myself from the person judging me and them.

The people who question these friendships and mock the online world are the same people who laughed at online dating ten years ago. Now online dating is the norm and more relationships are formed by the internet than down the pub, where bravado is in constant supply. It's also the same people who probably make all their calls on their landline, haven't upgraded their mobile since the Nokia 5110 and look up numbers in the phone book. Get with the times people because us losers online (the majority of the population now) are laughing at you.

Rant over. Thank you @Eliza_Do_Lots (2013 real life friend i've never met) for inspiring the rant.

Open Sesame!

"64 year old female, chest pain"

I was actually dreaming! What I was dreaming I can't remember but I'd managed to fall into a deep sleep whilst sat at hospital. It had only been 10 minutes but when I was eventually roused by the squealing of the radio, I jumped out of my skin thinking I was late for work! Clearly I wasn't, and the reality of sleep and living merging into one being had occurred. It's bad enough that I seem to be at work all the time, or recovering from it, but the fact it's in most of my dreams, means it sometimes feels like never really escape!

Anyway, that aside, by the time I was compos mentis, we were flying through the empty city streets. The only advantage of 4am is that the roads are empty. Other than that, 4am has no redeeming features. None. Zero. Zilch. Nada. Nil. Nothing. Zip. Diddly Squad. We were called to 34 St John's Avenue (obviously NOT the real road) and after squinting to see the numbers we found number 34 which was the corner property. We grabbed our stuff and headed over to the front door. 

The house was in complete darkness, which seemed odd, but similarly wouldn't be the first time that someone has phoned an ambulance and been sat in darkness! I gave the doorbell a ring and listened as the noise resonated through the large Edwardian hallway. There was no sign of life so I gave the door a good knock. Again, nothing! What followed was a frustrated combination of door knocking, bell ringing and shouting thoroughly the letter box! The neighbours must have loved us!

We called up control and requested they gave the patient a ring back. A few moments later we were informed that it was a mobile phone that was now switched off and that they would have to treat the call as a 'collapsed behind closed doors'. Oh deep joy! That ominous feeling of having to venture into the unknown again! We were told that the police were on way so in the mean time we continued with shouting and knocking and generally making a racket! Sue me!

Within minutes our brothers and sisters in blue arrived! We explained what the situation was and after an attempt by them to shout through the door, one stepped back and booted the door open! He kicked it so hard that a) the impact against the wall shattered the glass and b) the door flew off it's hinges! Good effect! They went in ahead of us and began the room by room search. I sheepishly followed behind them! Empty. Empty. Empty. Empty! No patient and no sign of a recent patient! All looking rather disappointed and confused, we went outside. Clearly the noise of smashing glass and flying doors eventually woken the neighbours. Standing on the pavement was a woman in her dressing gown.

"What are you doing?!"

"We were called here because the lady is unwell apparently."

"Not here, the family are on holiday for 2 weeks! You sure you have the correct house?!"

"Yes, 34 St John's Avenue is where the call came from."

"This is 34 St John's Road, 34 St John's Avenue is the first house round the corner, they are always getting the two mixed up!"

I stood motionless, gulped, paused a second while the faint hope of the ground opening up and swallowing me whole came and went, and turned to the coppers.

"Smooth" he said to me laughing and shaking his head at the same time!

"I'm SO sorry!"

"It's OK, we'll just sit here for hours in the cold waiting for the locksmith to come and replace the door."

"I'm SO sorry!"

"You better go to the patient! Do you need directions and a map or will you be OK?!"

Yet again, I leave myself open to a merciless grilling and much banter from the police! You live and learn. As the saying goes 'Check the address twice, kick the door in once'. OK, that wasn't an actual saying, I just made it up, but it is now a saying I follow religiously!

By the way, patient was fine, in fact, she wondered what all the commotion was outside!

Grey Areas

”67 year old male, ? overdose, acting aggressively”

Despite the offer of police assistance we declined and said we'd be happy to investigate first and then request police only if necessary. I felt that with 3 of us on hand we should be able to manage by ourselves! As I've written about previously, it saddens me to attend suicidal elderly patients. They are given anti-depressants and sedatives like smarties. It almost feels like they are given them just to shut them up. Rather than address the cause, let's just make them sleep more, eh?!

We pulled up outside and were met by the patients daughter. She told us that he didn't know we were coming and that he wouldn't be remotely pleased to see us! Regardless of health problems I really wish people wouldn't do this! It makes our job infinitely harder and sets us off on an uphill battle from the get go! I understand why people do it, the emotional tug of loved ones is hard to ignore, it just makes them much harder to treat when we do arrive.

Sure enough, we were greeted with a steam of expletives. Reading between the lines, I think the essence of what he was saying was "Go Away". I am, of course, paraphrasing! He was indeed confused and overly aggressive, nothing like the way he appeared in all his photos. Apparently, he had taken an overdose of pretty much everything he had. We weren't sure exactly how much and of what, but he did need medical help, that was for sure. His family had rung the GP, but the minute they said 'overdose', the GP rightly called us.

At this juncture, where a patient is refusing treatment, but is, in our opinion, in need of help and may lack the capacity to refuse, we would assess him under the Mental Capacity Act (2005) to determine whether he has the capacity to refuse. It involves a form and some questions. The upshot is, the patient needs to be able to explain a rational and reasoned decision and withhold information given to him. If he fails, in our opinion, them we have the right to treat him against his will. It is a crude tool that is often mis-used but in a patients own home, is all we have available to us, short of the GP arranging a mental health assessment and a sectioning. That, doesn't happen quickly, by any stretch of the imagination!

Now, all I've just said, we did. We assessed his capacity, for what he had done. Every question we asked him he replied something like:

"Fuck off, get out of my house, you're not taking me to prison."

I didn't take it personally, clearly something was going on. There was a twist however. Under normal circumstances I wouldn't have thought twice about taking him to hospital for treatment. The issue was that he was a palliative care patient with weeks to live.

Is it morally right to force someone to have treatment in hospital when they want to die at home? There was a DNR in place and this mental deterioration was likely due to the cancer. Surely his previous wishes of non-treatment should be adhered to?! That said, we weren't here for his cancer or even his mental deterioration, we were here for the overdose and that was something that could be treated without conflicting with the wishes of the DNR. Yet again, we were stuck in a grey area, a mine field of mental health uncertainty! I certainly wasn't comfortable with putting him through the distress of being physically forced into going to hospital. And the likelihood was, if we had to take him, then it would be the police who would have to physically drag him out screaming. It isn't how I'd want my friends and family to remember me. 

We decided to call the GP back. Luckily, after eventually bypassing the GP reception security and interrogation I was put through to the locum doctor. She didn't know the patient and it would have been very easy for her to pass the buck and be of little help. Instead, she was excellent. She agreed hospital was not the right place and offered to come out and assess him. Due to his aggression and refusal of treatment, even at home, we requested police. This wasn't necessarily a police job, it was health related, and even though mental health is a huge part of police work, this still wasn't really their remit, but we felt their presence was necessary for the safety of us and the GP. Within half an hour, everyone was there, and with the assistance of the police, he got assessed by the GP. 

She decided that based on what he had possibly taken, he could stay at home. She offered to come back later and check on him and if further treatment was required she would call us back or arrange a home assessment. We thanked her, thanked the police, and we all left.

THIS is how healthcare in the NHS should work. THIS is how mental health should be treated and THIS is how the police should be used with regards to mental health. An outcome that is in the best interests of the patient. An outcome which is as least restrictive as possible and utilising the police when they are needed and not because the words 'mental health' appear. The NHS can work, inter-professional working can work and work very well. There is no need for us to stretch each others resources when it isn't appropriate. The patient got the best and most appropriate treatment, taking into account his physical and mental well being. Perhaps if other areas of the NHS can see things like this as a model for GP led treatment then things will start to improve.