Psychosis – Simon says: Psychosis! video

While I was browsing some internet news sites today I came across this truly inspirational video made by a young man who has suffered from psychosis. This video involves three young people who have bravely told their stories and experiences of psychosis from symptoms, to treatment to recovery, and also encompasses two professionals working within early intervention for mental health who explain some of the help given by the NHS within early intervention.

This video really struck me, as although I have researched mental health conditions in the past, and indeed have some good friends who struggle with mental health issues I didn’t really know much about psychosis itself. To be honest all I really knew was from my A2 biology definition; Psychosis: A mental health condition, characterised by an impaired grasp on reality, diminished impulse control and disorder of perception (such as hallucinations).

However, psychosis and psychotic episodes are much more common than many people realise. According to the NHS, in England approximately 1 in every 2,000 people are diagnosed with psychosis every year, and it is estimated that around 1 in 100 people have at least one psychotic episode in their life. Psychosis itself as explained earlier is categorised by two main symptoms; hallucinations, when someone sees, hears, or less commonly smells things that are not really there; and delusions, when someone truly believes things are true that when examined rationally are obviously untrue, such as believing your neighbour has bugged you house in a plot to murder you etc. The most important thing to remember is though that to someone suffering a psychotic episode these hallucinations/delusions are true and are their reality. In the video the young people explain all about how it felt to have psychosis and explain how rational and true they felt that their thoughts were.

Psychosis is often caused by other mental health conditions such as schizophrenia, diagnosed when someone has repeated psychotic episodes, or bipolar disorder, where someone has both extreme depressive stages and extreme high stages (manic).

The link to the video is as follows: https://www.youtube.com/watch?v=GXh9hPzHHi4 it really does open your eyes to the world of mental health and early intervention.

For more information on psychosis or other mental health conditions these are great links:
http://www.nhs.uk/conditions/psychosis/Pages/Introduction.aspx
http://www.mind.org.uk/information-support/types-of-mental-health-problems/psychosis/
https://www.rethink.org/diagnosis-treatment/conditions/psychosis

Disability sports men and women

The coverage if the 2012 paralympics and more recently the winter games have suggested that disabled sports men and women have started to win the battle fir equality. However, I know of several people who still look at these remarkable men and women and feel sorry for them. I can see where they are coming from but surely we should be looking at these people with admiration rather than pity.

Take Rudy Garcis-Tolson for example, an American paralympic swimmer and runner. To begin with, how many other Olympians compete in two very different disciplines? Not many! Rudy is a double leg amputee, yet can still swim 200m IM in 2:35:92 – a time not many of us could match! His determination and dedication shows through his world record in 200m.

Another very famous paralympian is Ellie Simmonds. At 19 Ellie is an OBE, has 3 long-course world records, and 7 short-course world records. The first one she received when she was just short of 15, just the year after she was named BBC young sports personality. It is people like Ellie which inspire the next generation of not only disability swimmers and athletes but “able-bodied” sports people alike!

On a more personal level, a young girl I coach has recently received 2 gold medals and 1 silver medal and the national championships for her particular disability. There are not many kids under 10 who can say they have achieved that! And it is all due to her own hard work and determination!

Overall, although the battle again equality is nearly over, there is still some way to go. But the recognition of disabled athletes and their achievements goes a long way to help this. After all, these are the people those of us fortunate enough to be “able-bodded” should look to for inspiration!

Mental health and the media

In light of recent cases relating to mental health in the media, I thought I would write a blog about mental illness and the impacts it can have. In the UK every year, approximately one in four people will experience a mental health problem. Every seven years a survey is carried out in England to establish the numbers of people suffering with mental health conditions. The latest released in 2009 showed that out of 100 people on average 2.6 will suffer with depressions, 4.7 with anxiety, 9.7 with mixed anxiety and depressions, 2.6 with phobias, 1.2 with panic disorders, 3 with Post traumatic stress disorder (PTSD), 1.3 with Obsessive compulsive disorder (OCD) and 1.6 with Eating disorders. Other surveys have also suggested that over a lifetime 17 in 100 people will have suicidal thoughts and 3 in 100 will self-harm. In is also reported that out of every 100 people 3-5 will have a personality disorder, 1-3 will have bipolar and 1-3 will have schizophrenia.

However, although mental illness is much more common than many of us realise. It is actually nearly 3 times more common than Asthma which affects 1 in 11 children – why is it then that many people do not reveal their mental illness? A survey undertaken by the NHS in 2011 showed that 43% of people would feel uncomfortable talking about their mental health to their employer, and 70% would be comfortable talking about it with friends and family. Although these figures had risen from the previous year, it still demonstrated that many people are still aware of the stigmatism attached to mental health and would not feel comfortable in discussing their mental health and wellbeing.

Although stigmatism is something which plays a big part in people no wishing to reveal their mental illness, denial of the illness also has a part to play. In many mental illnesses the sufferer may not be aware that they have the illness, for example some people with schizophrenia may be of the opinion that it is the people around them who are “crazy” and not listening to them. In this situation is can be very difficult for someone to be diagnosed with having a mental illness as they are unlikely to go to the doctor themselves for treatment. In this case it often falls to friends and/or family to seek professional advice. However, in other situations the sufferer may be aware that they have the condition deep down but do not want to admit it to themselves. Due to the stigmatism and stereotypes attached to mental health, many people feel that having a mental illness is seen as “week” and to acknowledge it themselves can often lead to perceiving one’s self as a “failure”. This however is completely incorrect. Having a mental illness makes you no weaker than someone suffering from a physical condition.

A think another common misconception about mental health is that it is incurable, which is not the case. For many people mental health conditions can be treated with medication, therapy and lifestyle changes, and some people even look back at their time of suffering with a mental illness as being the spark to changing their life for the better. This is something which really fascinates me personally about mental health. A know a couple of people who have suffered/are suffering with mental health conditions, and although they are at a “good” period. They are fully aware of their condition, just as someone who is asthmatic is aware of what can trigger their attacks. They also fully understand that they must continue to use their medication even when they feel that they do not need it. This can often be the danger with mental health conditions, however I think of it like this; if you were asthmatic and hadn’t had a major attack for three months, but you are still taking a daily inhaler in the morning as prescribed by the doctor would you stop? It is the same with a mental health condition.

Overall, I feel that although the view of mental illness has changed dramatically in recent times, there is still more to be done to ensure all those with mental health condition are not stigmatised or stereotyped. In my opinion education is something which can be put to good use in this situation. In my 6th form we have had many talks about mental health and wellbeing from different charities and organisations, and although some may find this a bore, I feel that it is just as important to talk to and educate young adults about mental health as you would about sexual health. After all, we are the future of the country, and looking after your mental health is just as important as looking after your physical health.

For more information and advice about mental health visit http://www.mind.org.uk

Sources:
http://www.mind.org.uk/

Click to access Key_facts_mental_health_080911.pdf

http://www.asthma.org.uk/asthma-facts-and-statistics

Leprosy – not just from biblical times

Many people think of leprosy as being a disease from biblical times. Many people are familiar with the story of Jesus healing the man of leprosy, however it is still around today. It is estimated that one person is diagnosed with leprosy every two minutes, with 228,474 new cases detected in 2010 according to the World Health Organisation.

Leprosy itself is caused by a bacillus, Mycobacterium leprae, closely related to the bacillus which causes TB. Most scientists believe that the disease is spread by droplets of moisture in the air from someone who is infected with the disease, however, it is estimated that 95% of the population have a natural immunity to condition.

The first signs of Leprosy usually start 5 or 10 years after being first exposed to the disease, and usually begin with patches of the skin which look paler than others and/or have nodules on. The disease damages the nerves in the cooler parts of the body, often affecting the nerves near the skins on the hands, feet and face. Although there is currently no vaccine for leprosy, it can be cured with Multi-Drug Therapy (MDT), a course of drugs taken for 6-12 months. Not only does this cure the sufferer but also renders them non-infectious within two weeks of starting the treatment. If treatment is started during the early stages of the disease, there is often no loss of sensation or paralysis. However, if the nerves are damaged it is not possible for feeling and movement to be returned, and so there are an estimated two/three million people living globally with leprosy-related disabilities.

However, aside from the physical effects it is the emotional abuse many sufferers face which is heart breaking. In some countries due to superstitions and myths, fear is associated with leprosy. Traditionally those with the condition would be locked away from society and unable to make contact with family. Although this is no longer necessarily the case, due to the stereotyping of those diagnosed with the disease, people are still rejected by their families and communities and many may lose their jobs and sources of income as a result of the condition.

Yet there are many charities and organisations which are working tirelessly in order to combat the stereotype and raise awareness of leprosy. Recent work by said organisations and health care professionals has reduced the global prevalence of the disease by 90% in the last two decades. However, may believe there is still more to be done. Although leprosy is becoming less and less common it does still exist, and so from my point of view I believe it is important to remember those suffering with the diseases and conditions such as leprosy which are often forgotten by society.

Sources:
http://www.who.int/mediacentre/factsheets/fs101/en/index.html
http://www.bbc.co.uk/news/world-europe-22837704
http://www.who.int/topics/leprosy/en/
http://www.leprosymission.org/what-is-leprosy.html

Use of spine boards in sporting injuries

As a lifeguard we are trained for many different scenarios including spinal injuries. In recent years it has become more common place for spine boards to be present at leisure centres and other sporting events. This has mainly been brought about by an increased understanding of the importance of immobilising someone with a spinal cord injury (SCI) to promote recovery. There has also been more emphasis on training professionals, both directly and indirectly involved with health care, in how to deal with a SCI and the general public as a whole are more educated within this area.

However, even so it is estimated that every 8 hours in the UK someone is told that they will never walk again due to an SCI. Although falls and road traffic make up 41.7% and 36.8% of SPIs respectively, sporting injuries still account for 11.6%, approximately 116 people every year. This is where the use of spine boards is extremely important. With a spinal injury immobilisation is key to ensure that no further damage to the spinal cord is caused.  Although this can simply be done by asking someone not to move and/or keeping their head still, the most effective way to ensure that no further injury is sustained is to use a spine board.

A spine board itself consists of a hard ridged board with straps across which can be tightened and secured to prevent movement. Some spine boards, like many found at swimming pools, have a further strap which comes across the forehead securing in three places, behind the top of the head and then on either side of the head almost in line with the ears, others make use of immobilising blocks which are positioned on either side of the head so the person is not able to move their head.

Within sport however using a spine board does not only immobilise the casualty but also makes it much easier for the emergency services, particularly when transferring to hospital. In my opinion this is one of the most attractive assets of a spine board. Although professionals have to be taught how to effectively use a spine board it is always good practice to have. In particular as is often the case with smaller sporting events or at a swimming pool it is necessary for first aid and treatment to be given by people who may not necessarily be trained health care professionals although they are first aid trained.

One example of this is the use of spine boards in pool rescue. As a lifeguard in the UK as part of the NPLQ (national pool lifeguard qualification) spinal rescue is taught, ensuring all qualified lifeguards are training within spinal rescue. It is also within the qualification to teach rescue with a spine board (the qualification I have) however this is not always possible due to the practicalities of the leisure centre. For many smaller centres, there is deemed to not be a big enough risk in order for there to be a spine board. Same can also apply to small football clubs and/or other sports, particularly at a junior level.

Overall, although the use of spine boards has increased dramatically over recent years there are still many more places which they could be present. However, this can be likened to the use of AEDs (automated external defaulters) which are no present in so many public places and have saved many lives. In order for the spine board to follow suit I feel more people should be aware of the benefits and training to use such devices. In sport in particular this first response care before health care professional can arrive is often critical in promoting recovery and I think with more research and publicity on the issue spinal boards will be present more often in public sporting places.

Sources:

http://www.spinal-research.org/research-matters/spinal-cord-injury/facts-and-figures/

http://www.everyeighthours.com/about-spinal-cord-injury

http://www.spinal.co.uk/page/sci-aware

NPLQ lifeguard qualification

Swine Flu vaccine and Narcolepsy

While watching the One Show on BBC One today, a particular feature on the swine flu vaccine really captured my interest. The report outlined the possibility that the swine flu vaccine could have triggered the chronic sleep condition narcolepsy in a small number of young people.

Narcolepsy is a life-long condition which causes inappropriate and sudden sleep attacks, where the sufferer falls into a deep sleep without warning. Each attack can last for seconds to minutes, often giving the appearance of epileptic seizures.

Before this week the UK Government did not believe that there was sufficient evidence to link the onset of narcolepsy in some cases to the swine flu vaccination. However, the Government is now set to u-turn on this decision, and has accepted that in rare cases the vaccine may trigger narcolepsy.

The vaccine in question, the Pandemrix vaccine, made by GlaxoSmithKline, was given to high risk groups in the UK from October 2009 and March 2010. Although since 2011 the use of the vaccination on people under the age of 20 has been restricted, it is thought that approximately 31million people in Europe received the vaccine.
However, it is still not clear how the vaccine could contribute to narcolepsy. Yet, research by the Health Protection Agency associated the vaccine with a 14-fold increased risk of narcolepsy, equating to approximately 1 case for every 52,000 – 57,000 vaccinations.

The other side of this story however is the compensation available for those affected as a result. Lawyers have estimated that 100 people would be entitled to compensation, which could cost the government anywhere in the region of £1 million.

Yet, for the families affected by the condition, no amount of compensation can ever make up for the change in their lives. Lindsey Foy, features on the One Show whose son Ben developed the condition after having the swine flu vaccine, said “money won’t change everything; it won’t bring my little boy back”. For me personally this really brought it home, and demonstrated the emotions the families have had to go through. However, the hardest part for me was how Lindsey felt such guilt for deciding to have Ben vaccinated.

Another sufferer Chloe Glasson, in an interview with the mail online said “what hurts the most is when people see me in public and I’m starting to fall asleep and they look at me as if I’m drink or have been taking drugs”. This highlights the fact that for her, and so many other families, it is not about the money, but rather the awareness of the condition and the potential cause.

Sources:
http://www.bbc.co.uk/iplayer/tv/bbc_one_london/watchlive
http://www.telegraph.co.uk/health/swine-flu/10322392/Government-set-to-u-turn-over-narcolepsy-link-to-swine-flu-jab.html
http://www.dailymail.co.uk/health/article-2439408/Narcoleptic-schoolgirl-Chloe-Glasson-hopes-swine-flu-vaccine-payout.htm

Ethical dilemma – Enforced sterilisation of those with learning disabilities?

Through my voluntary work, work experience and other experiences I have had the privilege to meet many people with varying degrees of learning disabilities. However, a very difficult topic for a lot of parents with children with learning disabilities; is the idea of sexual relationships, and if parents decide to allow their children to have a sexual relationship this creates the even bigger question of allowing the couple to have of not. As with any ethical topic everybody has different opinions, and I feel that each case has to be looked at individually to determine what would be the “right” opinion.

Many people with learning disabilities are more than capable of making fantastic, loving and caring parents. However, this is often helped by a strong support network of friends and family. The worry for some people however, is not that they wouldn’t necessarily not make good parents, however it is more about the emotional strain it would put on them, and if they could cope with that responsibility and stress.

This was true in the case of a 36 year old man from the Midlands. I found this story from August this year while looking through some archives in the BBC. The details of the case, and the family detailed that the man, although capable of sexual consent, did not have the capacity to make decisions about contraception, and could not be relied upon to use condoms of other birth control methods effectively to prevent pregnancy.

The man had previously had a son born in 2010 with his long term girlfriend, who also has learning difficulties. However, it was said that this had a “profound” effect on the two families. As a result measures were taken to ensure a further pregnancy didn’t occur by keeping the couple apart and ensuring supervision when they were together. This was said to have a severe effect on the man, and he had lost all confidence.

As a result, his family appealed to the court for a forced sterilisation, so he could continue his sexual relationship with his girlfriend, but without the worry of a potential pregnancy. The high court judge ruled that a forced sterilisation would be in his “best interests” and ruled that a vasectomy could take place due to the fact that having another child could cause the man “psychological harm”, as well as allowing him to gain back independence.
However, Beverley Dawkins, of Mencap, said that Britain must not return to the “routine” sterilisation of people with learning disabilities seen in the past.

This is what raises a lot of the questions. In my opinion a vasectomy was the right decision by the high court judge, mainly because of the man’s desire not to have any more children. However, this is not always the case, and in some cases parents of family members may have to act on behalf of the person in question. Although, as with any ethical dilemma, I strongly feel that enforced sterilisation is something which has to be treated differently for every different case, there can be no “overall” rule. However, no matter what I believe that the interests of the person should be at the heart of the decision.

For the full details of the case visit: http://www.bbc.co.uk/news/uk-23721893

Medical Condition of the Week

I have decided to start to write a post about a different medical condition each week. My hope is that there will be something for everyone in these posts, or at least give some information on some less well known Medical conditions. Naturally, I have decided to work in Alphabetical order! (Maybe I should feature OCD in it….)

So on with the Medical Condition of the Week!

Organ Donation – opt in or opt out?

The idea of an opt-out scheme for Organ Donation has been debated for a long time, and never tires of being topical and debatable. However, from December 2015 Wales will be the first UK nation to introduce a system of presumed consent.

Under the new scheme donors will have to “opt-out” online to giving consent for their organs to be donated after death. However, family will still have the right to prevent donations going ahead if they provide evidence that the deceased would not have wanted to donate their organs. Other people exempted from the new regulations are those under 18, those no longer living in Wales, and those who have been judged to not have the mental capacity to
make a decision regarding Organ Donation.

However, as with any medical issue, it is important to look at both sides of the argument regarding an opt-out system to see if the benefits do really outweigh the positives. In Wales there are approximately 250 people on the transplant waiting list at any one time. In 2012/13 33 people died while waiting for a transplant. Although, evidence from other countries have shown that the actual increase in donor numbers is not as large as many would have hoped. It indicates that there would be only an approximate increase of 15 donors a year, leading to approximately 45 extra organs. Yet, any increase is a good increase and the potential 45 lives that could be changed annually are priceless.

Yet, the debate regarding organ donation is one which has been fought hard through the Welsh parliament, and the act of passing this legislation has been deemed as “arguably the most significant piece of legislation passed by the National Assembly for Wales since it acquired full lawmaking powers in 2011.”

However, the question now is; “will the rest of the UK follow suit?”. The current opt-in system in England, although criticized by many, does attract quiet a lot of organ donors. What surprised me personally was the level of young people who are now organ donors, mainly due to the availability to opt-in when applying for a provision driving licence. Yet, many still argue that organ donation is not well publicised and the NHSBT can do more “get the message out there”.

However the launch of the Human Transplantaion (Wales) Act 2013 will also hopefully provide more organs to other UK countries. This is not only through the possible inspiration it will give people in the other UK nations to join the organ donor register, but also the extra organs donated in Wales can be used for transplants anywhere in the UK. In Wales, they are hoping to launch a 2 year campaign to ensure all are aware of the changes due to take place. The level of the success it may have is still unknown – however, if enough people are behind the scheme hopefully it will provide more organs available for transplantation in Wales and the rest of the UK, making a difference to even more lives.

Sources:
BBC news: http://www.bbc.co.uk/news/uk-wales-24032031, Organ donation: Presumed consent to start in December 2015, 10th September 2013
BBC news: http://www.bbc.co.uk/news/uk-wales-politics-23127751, Q&A: Organ donation planned changes in Wales, 1st July 2013

The importance of look at the individual behind the diagnosis

I feel that one of the most important things for a medical professional is looking past the diagnosis and at the patient themselves. I feel very privileged to have met many inspirational individuals through voluntary work and work experience which have taught me to focus on the person, their characteristics, and not the medical condition. It can be very easy to generalise all people with certain medical conditions, for example may people has quizzed my sister why she is diabetic as she isn’t overweight or old!

One of the most striking examples for me is the medical condition cerebral palsy. Cerebral palsy (CP) is a general term which covers a number of neurological conditions which present when a child is young. It is caused by damage to the brain which occurs normally before, during or soon after birth such as a bleed on the brain or abnormal foetal development. CP effects each sufferer differently, and has a range a severities and associated medical conditions, such as epilepsy, scoliosis, learning difficulties, visual and/or hearing impairments, incontinence and drooling.

The five main types of cerebral palsy are as follows:
*Spastic hemiplegia – causes muscle stiffness on one side of the body, sometimes scoliosis is present
*Spastic diplegia – causes muscle stiffness in the legs
*Ataxic cerebral palsy – causes problems with balance and depth perception
Athetoid (dyskinetic) cerebral palsy – causes an increased and decreased muscle tone and problems with speech
*Spastic quadriplegia – the most severe type of cerebral palsy, the child may be unable to walk and/or support their neck, spastic quadriplegia is also often associated with moderate to severe learning difficulties.

However the medical details on the screen or in a textbook cannot tell the full story. They may detail the different possible effects and complications of the condition, but I think until you meet an individual with the condition you can never fully understand the symptoms. I have had the joy of meeting quiet a few young people with cerebral palsy through my voluntary work, and the condition effects each of them very differently. Some may be in a wheelchair, some are not; some are tube fed, some eat general food, some have both! However looking aside for the condition you begin to see the young person for themselves. One young man loves Olly Murs, where as one of the young ladies is a huge fan of One Direction – in particular Harry!

After all, no-one can tell you the full effect of a condition apart from the sufferer or their close friend or family. For me meeting/working with individuals with a certain medical condition allows you to see the “medical diagnosis” in a more personal way, and fully allows you to understand the symptoms and/or effects it can cause. However, more importantly it teaches you the importance of getting to know the person behind the diagnosis – you will be surprised my how much you can learn and benefit from doing so.