The last few weeks have been interesting at work. Most of the time, I've been working with a client who was born with Hydrocephalus and is also epileptic. He has tonic clonic seizures about every week or so, of which I've witnessed a few. He also has trouble with his bowels and so has been on Imodium and Phenytoin (for the seizures) since I started working with him in the Summer.
However, a few weeks ago, his dosage of Phenytoin was increased. While on shift, I noticed he'd become extremely unstable on his feet. He would fall back down after standing up and fall over occasionally - a sign that normally meant he was about to have a seizure. Looking through his communication book, it appeared everyone had noticed the same thing because each day the words "Michael has been very wobbly today" were written. Each time I came on shift and saw him wobbly, I thought he might have a seizure yet he never did. It had also been noticed that Michael hadn't been eating very well.
However, the definitive moment (and one that I'll never forget!) came one night when I was working with him. We were walking down the stairs and Michael dropped something. He attempted to pick it up but, due to his unsteadiness, rolled down the stairs. This deeply embarrassed Michael and so he started showing challenging behaviour (hitting etc). After he'd calmed down however, I checked him for any signs of injury and other than a few scratches he appeared alright. I wrote about the accident several times (in the many different books) and informed night staff and on call, who were to keep an eye on him just to make sure there were no serious injuries.
Over the next few days, similar things happened to Michael, albeit not on the stairs, and he seemed to be losing his appetite. He was taken for a blood test at the hospital and when the results came back the next morning, the levels of Phenytoin were found to be too high and so his dosage was dropped again. Since then, Michael has had further blood tests to ensure the dosage now is now the correct one and hasn't been showing any of the symptoms of the dosage being too high.
Phenytoin is an anti-convulsant, used to treat tonic clonic seizures in epileptic patients by slowing down the impulses in the brain. It can come in tablet, both chewable and non-chewable form and also in suspension (as a liquid). There are many side effects to Phenytoin - some more serious than others. Depression and thoughts of suicide can occur as well as the loss of balance, co-ordination and appetite that Michael displayed, especially when the dosage is too high.
This whole case really brought it home to me the importance of pooling knowledge. Friends and family, or in this case support workers and Michael's key worker, need to monitor medication carefully and let doctors know of anything that seems out of the ordinary.
Sunday, 29 January 2012
Hepatitis B - Need to get that jab!
While working this week, I was bitten on the cheek (not my best experience of work I must say!). The skin was slightly broken and I've been left with a small mark for the rest of the week, but the whole thing reminded me I need to organise my Hep B (Hepatitis B) jab, one that I'm recommended to have seeing as how I work in a house where clients with disabilities live. I decided I'd look into what I was actually being vaccinated against and here's what I found:
Hepatitis B is an infection of the liver (Hepa being Liver, itis meaning inflammation or disease) and is one of multiple strains of the virus that can infect the liver - hence A, B, C etc. Someone becomes infected with the virus when they come into contact with it through someone else's blood or bodily fluids and has not been vaccinated. Because of how it's spread, the virus is predominantly thought to be caught through unprotected sex, but can also be caught by sharing toothbrushes, razors and other objects that are contaminated with blood. Hepatitis is also more common in certain parts of the world, so medical treatment with unsterilised instruments abroad can also result in infection.
So how come I'm recommended to have the vaccination? Well because I work with people with learning disabilities, including in a supported living home, I run the risk of being bitten and scratched at work - which as I said previously I have! Because of this contact, there is a risk of my contracting the virus.
Symptoms of Hepatitis B won't emerge till at least 40 days after exposure to the virus, although a lot of people don't show any symptoms while they have the virus. However, until their body has fought it off, they can still pass it on. The main symptoms include nausea, general flu-like symptoms, jaundice and aches, especially in the upper right side of the body and appetite and weight loss. Normally symptoms don't last longer than a few months, but the infection is said to be chronic if symptoms last longer than 6 months.
So how is it treated? Well those who display symptoms can take PRN medication, such as Ibuprofen or Paracetamol. Codeine may be prescribed by a doctor if the pain is more severe and nausea is generally treated with metoclopramide. Regular blood tests and physical checkups will be required while the patient is displaying symptoms and afterwards to ensure the infection is gone and they don't develop Chronic Hepatitis B. Medication is normally only required for Chronic Hepatitis B to prevent damage to the liver, however not all sufferers of Chronic Hepatitis B need this medication. Chronic Hepatitis can go on to cause liver cancer, fulminant hepatitis B (where the immune system attacks the liver) and cirrhosis (scarring).
For full protection, I'll need 3 jabs in the next 4-6 months - thankfully I'm not scared of needles! My immunity will then be tested a month after the third dose to ensure the vaccination has worked.
Hepatitis B is an infection of the liver (Hepa being Liver, itis meaning inflammation or disease) and is one of multiple strains of the virus that can infect the liver - hence A, B, C etc. Someone becomes infected with the virus when they come into contact with it through someone else's blood or bodily fluids and has not been vaccinated. Because of how it's spread, the virus is predominantly thought to be caught through unprotected sex, but can also be caught by sharing toothbrushes, razors and other objects that are contaminated with blood. Hepatitis is also more common in certain parts of the world, so medical treatment with unsterilised instruments abroad can also result in infection.
So how come I'm recommended to have the vaccination? Well because I work with people with learning disabilities, including in a supported living home, I run the risk of being bitten and scratched at work - which as I said previously I have! Because of this contact, there is a risk of my contracting the virus.
Symptoms of Hepatitis B won't emerge till at least 40 days after exposure to the virus, although a lot of people don't show any symptoms while they have the virus. However, until their body has fought it off, they can still pass it on. The main symptoms include nausea, general flu-like symptoms, jaundice and aches, especially in the upper right side of the body and appetite and weight loss. Normally symptoms don't last longer than a few months, but the infection is said to be chronic if symptoms last longer than 6 months.
So how is it treated? Well those who display symptoms can take PRN medication, such as Ibuprofen or Paracetamol. Codeine may be prescribed by a doctor if the pain is more severe and nausea is generally treated with metoclopramide. Regular blood tests and physical checkups will be required while the patient is displaying symptoms and afterwards to ensure the infection is gone and they don't develop Chronic Hepatitis B. Medication is normally only required for Chronic Hepatitis B to prevent damage to the liver, however not all sufferers of Chronic Hepatitis B need this medication. Chronic Hepatitis can go on to cause liver cancer, fulminant hepatitis B (where the immune system attacks the liver) and cirrhosis (scarring).
For full protection, I'll need 3 jabs in the next 4-6 months - thankfully I'm not scared of needles! My immunity will then be tested a month after the third dose to ensure the vaccination has worked.
Sunday, 22 January 2012
Work Experience - GP Surgery - Dr Harrison
Fortunately, I have been privileged enough to get some valuable work experience in a GP Surgery! I'd arranged to spend a few days in the school holidays shadowing a GP both in clinic and on visits. I had to agree to confidentiality, something which I'm used to in my work with Mencap. We also had to ask patients' permission for me to sit in on their appointments and many of them were happy to have me there, with quite a few of them telling me about their condition and how it affects their day to day life. During my time there, I saw many cases of COPD, Heart Disease, Eczema, colds and Depression, some of which are discussed below:
On the Monday I arrived at the surgery and immediately began shadowing Dr Harrison, who handed me a copy of the "GP Handbook", so I could look up conditions as we saw them. I saw lots of different conditions, ranging from Depression to sports injuries. One patient we saw came in complaining of an aching elbow. He had a history of tendonitis in his elbow, due to weight lifting. It had been recommended that he stop weight training to prevent further damage, but he'd continued. This caused a repetitive strain injury with inflammation around the elbow called medial epicondylitis, also known as "Golfer's Elbow". It was strongly advised that he give up weight lifting for a time to prevent even further damage.
There was one patient who really stood out as a particularly interesting one to me however. We also saw this patient on the Monday and perhaps what first drew my attention to her was the fact she had epilepsy - a condition I'm very used to. It had been caused by a head trauma in childhood, however this was not why she was here. She agreed to have me in the room and her partner spoke to Dr Harrison.
The patient, Mrs Kite, had been suffering from Depression on and off throughout her life, the most recent case being after an incident that occurred at her work where she was attacked and had since been off work. Her partner said she was having trouble motivating herself to do basic tasks, such as get out of bed, prepare food and even eat. She seemed to spend most of her time in bed, simply not doing anything. Mrs Kite said she simply did not feel motivated enough to get up each morning or to look after herself. She was extremely skinny and had suffered severe weight loss recently and had developed a tremor, especially on her left side. This was exaggerated when she elevated her arm or tried to pick objects up. Mrs Kite's partner had also noticed what seemed to be a slight loss of memory, although the patient didn't agree. The patient was prescribed a further course of anti-depressants, which she was recommended to take and see how she felt. It was agreed the patient would then be reviewed in the next few weeks again. However, before the next appointment Mrs Kite was hospitalised due to a sudden deterioration and it was suspected that Mrs Kite had Creutzfeldt-Jakob Disease - known commonly as "Mad Cow Disease" - a fatal condition that's very rare in humans and causes damage to the brain, which can lead to Depression & anxiety disorders, tremors and an inability to speak or look after one's self.
As well as neurological disorders and illnesses, patients came in with infections. One patient had had a C-section to deliver a baby a few weeks before and also has Diabetes and suffered from obesity. Where the stitch in body folds was, an infection and rash had occurred: Intertrigo. A topical antifungal was prescribed by Dr Harrison and all seemed fairly straight forward, if a good example of some of the not-so-appealing parts of medicine!
I accompanied the doctor on visits, one of which was to an old people's home. The patient was in a very vulnerable state and could not talk, move or fulfil basic personal needs such as eating without support. It was known the patient was going to die soon - she was very old and very frail - but as the GP, Dr Harrison had to visit her every 2 weeks, so that if she died, there would be no coroner's report. This gave me a brief insight and opened my eyes to the legalities doctors face.
While shadowing Dr Harrison, I saw some very interesting cases and learnt a lot! As it was my first actual experience in a medical workplace, I wanted to make sure I really wanted to do this for the rest of my life... and I really enjoyed it! Dr Harrison said one of the highlights of being a GP was that you look after the same patients for years - in some cases even 3 generations of the same family! You get to see them grow, something which is tremendously rewarding!
On the Monday I arrived at the surgery and immediately began shadowing Dr Harrison, who handed me a copy of the "GP Handbook", so I could look up conditions as we saw them. I saw lots of different conditions, ranging from Depression to sports injuries. One patient we saw came in complaining of an aching elbow. He had a history of tendonitis in his elbow, due to weight lifting. It had been recommended that he stop weight training to prevent further damage, but he'd continued. This caused a repetitive strain injury with inflammation around the elbow called medial epicondylitis, also known as "Golfer's Elbow". It was strongly advised that he give up weight lifting for a time to prevent even further damage.
There was one patient who really stood out as a particularly interesting one to me however. We also saw this patient on the Monday and perhaps what first drew my attention to her was the fact she had epilepsy - a condition I'm very used to. It had been caused by a head trauma in childhood, however this was not why she was here. She agreed to have me in the room and her partner spoke to Dr Harrison.
The patient, Mrs Kite, had been suffering from Depression on and off throughout her life, the most recent case being after an incident that occurred at her work where she was attacked and had since been off work. Her partner said she was having trouble motivating herself to do basic tasks, such as get out of bed, prepare food and even eat. She seemed to spend most of her time in bed, simply not doing anything. Mrs Kite said she simply did not feel motivated enough to get up each morning or to look after herself. She was extremely skinny and had suffered severe weight loss recently and had developed a tremor, especially on her left side. This was exaggerated when she elevated her arm or tried to pick objects up. Mrs Kite's partner had also noticed what seemed to be a slight loss of memory, although the patient didn't agree. The patient was prescribed a further course of anti-depressants, which she was recommended to take and see how she felt. It was agreed the patient would then be reviewed in the next few weeks again. However, before the next appointment Mrs Kite was hospitalised due to a sudden deterioration and it was suspected that Mrs Kite had Creutzfeldt-Jakob Disease - known commonly as "Mad Cow Disease" - a fatal condition that's very rare in humans and causes damage to the brain, which can lead to Depression & anxiety disorders, tremors and an inability to speak or look after one's self.
As well as neurological disorders and illnesses, patients came in with infections. One patient had had a C-section to deliver a baby a few weeks before and also has Diabetes and suffered from obesity. Where the stitch in body folds was, an infection and rash had occurred: Intertrigo. A topical antifungal was prescribed by Dr Harrison and all seemed fairly straight forward, if a good example of some of the not-so-appealing parts of medicine!
I accompanied the doctor on visits, one of which was to an old people's home. The patient was in a very vulnerable state and could not talk, move or fulfil basic personal needs such as eating without support. It was known the patient was going to die soon - she was very old and very frail - but as the GP, Dr Harrison had to visit her every 2 weeks, so that if she died, there would be no coroner's report. This gave me a brief insight and opened my eyes to the legalities doctors face.
While shadowing Dr Harrison, I saw some very interesting cases and learnt a lot! As it was my first actual experience in a medical workplace, I wanted to make sure I really wanted to do this for the rest of my life... and I really enjoyed it! Dr Harrison said one of the highlights of being a GP was that you look after the same patients for years - in some cases even 3 generations of the same family! You get to see them grow, something which is tremendously rewarding!
Sunday, 15 January 2012
Glue Ear And Eustachian Tube Dysfunction - My Childhood Years!
Yesterday I went to the outpatients clinic for my yearly check-up on my hearing due to a condition I had when I was a lot younger. After 10 years I've been discharged and thought it would be good to find out what actually went on with my right ear when I was younger!
When I was 5, my parents were concerned with my hearing. They'd noticed I seemed to have the TV unusually loud all the time and often had difficulty hearing them calling me/in conversation. After many ear infections, I was referred to an ENT specialist, was diagnosed with Glue Ear in my right ear and have been a regular visitor to the outpatient clinic since!
The eustachian tube is what's responsible for draining mucus and fluid away from your ear and also providing air to your eardrum to equalise pressure in the middle ear. Since mine was faulty, neither of these things could happen. This meant my middle ear filled up with fluid, which was watery at first, but then became thick (hence the name "Glue Ear"). This fluid muffled my hearing, as it stopped the eardrum and the surrounding bones that are necessary for hearing from vibrating. Since my eustachian tube was blocked, the pressure inside my middle ear was less than outside, which sucked my eardrum in. Again, this stopped the eardrum from vibrating, muffling my hearing, and also stretching the eardrum.
Whereas most cases of Glue Ear are caused by a cold and so disappear naturally in a few months, my hearing was persistently muffled. It was decided necessary for surgical intervention, and so in late 2002 , I had a grommet inserted. Grommets are small tubes inserted through the eardrum designed to drain any fluid and also allow air to pass into the middle ear. They are put in under general anaesthetic in an operation that only takes about 15 minutes, which meant I could leave hospital that day. Although normally the grommet falls out naturally due to the eardrum healing in about a year, mine stayed in for nearly 3!
This grommet solved the problem of Glue Ear and fluid build-up, but my Eustachian Tube was still dysfunctional. The remaining problem was the problem of ear pressure. My eardrum was still being sucked into my ear, causing muffled hearing and stretching of the eardrum. This created a pocket, which they wanted to monitor. Ear infections were less common, but still occurred. I was to have 2 appointments a year to outpatients, one of which would also involve a hearing test to monitor my hearing. I was also given the treatment of autoinflation, which involves blowing up a special balloon by your nose in an attempt to push the eardrum out. After a while, this was discontinued and I was told to pop my ears a few times a day.
When I was 10, I had a cold and was in/out of school for about 2 weeks. After 2 weeks of feeling ill/feeling better, I went into school on the Friday, but developed a severe ear ache. After 2 long, extremely painful hours, I was taken home, where I lay in bed screaming. All of a sudden the pain was gone and there was fluid coming out of my ear. I was taken to the GP surgery and was told my eardrum has burst due to the excessive build up of fluid caused by the cold. This obviously meant I couldn't hear in my right ear.
After a few months it healed and I went back to outpatients for my appointment. My eardrum was still being sucked in due to the faulty Eustachian Tube. I still had a pocket that they wanted to monitor, even though I never had another ear infection after that. It looked as though my hearing wasn't going to deteriorate, so my appointments became yearly at the age of 12.
Yesterday, at the age of 16, I saw the original consultant I saw those 10 years ago (appropriate ending!) and after looking at my eardrum and my hearing test results, he concluded that my eustachian tube was now working, as my eardrum was no longer being sucked in. Due to this, he discharged me! However, he advised me there was still a pocket in my eardrum caused by all those years of being sucked into the middle ear that was vulnerable to infection and could mean a deterioration in my hearing.I was told to pop my ears multiple times a day to try to push out the pocket, and that if I was ever to have an ear infection or get concerned with my hearing, I had to come back.
When I was 5, my parents were concerned with my hearing. They'd noticed I seemed to have the TV unusually loud all the time and often had difficulty hearing them calling me/in conversation. After many ear infections, I was referred to an ENT specialist, was diagnosed with Glue Ear in my right ear and have been a regular visitor to the outpatient clinic since!
The eustachian tube is what's responsible for draining mucus and fluid away from your ear and also providing air to your eardrum to equalise pressure in the middle ear. Since mine was faulty, neither of these things could happen. This meant my middle ear filled up with fluid, which was watery at first, but then became thick (hence the name "Glue Ear"). This fluid muffled my hearing, as it stopped the eardrum and the surrounding bones that are necessary for hearing from vibrating. Since my eustachian tube was blocked, the pressure inside my middle ear was less than outside, which sucked my eardrum in. Again, this stopped the eardrum from vibrating, muffling my hearing, and also stretching the eardrum.
Whereas most cases of Glue Ear are caused by a cold and so disappear naturally in a few months, my hearing was persistently muffled. It was decided necessary for surgical intervention, and so in late 2002 , I had a grommet inserted. Grommets are small tubes inserted through the eardrum designed to drain any fluid and also allow air to pass into the middle ear. They are put in under general anaesthetic in an operation that only takes about 15 minutes, which meant I could leave hospital that day. Although normally the grommet falls out naturally due to the eardrum healing in about a year, mine stayed in for nearly 3!
This grommet solved the problem of Glue Ear and fluid build-up, but my Eustachian Tube was still dysfunctional. The remaining problem was the problem of ear pressure. My eardrum was still being sucked into my ear, causing muffled hearing and stretching of the eardrum. This created a pocket, which they wanted to monitor. Ear infections were less common, but still occurred. I was to have 2 appointments a year to outpatients, one of which would also involve a hearing test to monitor my hearing. I was also given the treatment of autoinflation, which involves blowing up a special balloon by your nose in an attempt to push the eardrum out. After a while, this was discontinued and I was told to pop my ears a few times a day.
When I was 10, I had a cold and was in/out of school for about 2 weeks. After 2 weeks of feeling ill/feeling better, I went into school on the Friday, but developed a severe ear ache. After 2 long, extremely painful hours, I was taken home, where I lay in bed screaming. All of a sudden the pain was gone and there was fluid coming out of my ear. I was taken to the GP surgery and was told my eardrum has burst due to the excessive build up of fluid caused by the cold. This obviously meant I couldn't hear in my right ear.
After a few months it healed and I went back to outpatients for my appointment. My eardrum was still being sucked in due to the faulty Eustachian Tube. I still had a pocket that they wanted to monitor, even though I never had another ear infection after that. It looked as though my hearing wasn't going to deteriorate, so my appointments became yearly at the age of 12.
Yesterday, at the age of 16, I saw the original consultant I saw those 10 years ago (appropriate ending!) and after looking at my eardrum and my hearing test results, he concluded that my eustachian tube was now working, as my eardrum was no longer being sucked in. Due to this, he discharged me! However, he advised me there was still a pocket in my eardrum caused by all those years of being sucked into the middle ear that was vulnerable to infection and could mean a deterioration in my hearing.I was told to pop my ears multiple times a day to try to push out the pocket, and that if I was ever to have an ear infection or get concerned with my hearing, I had to come back.
Tuesday, 10 January 2012
Training Courses
Working as a member of staff at West Berkshire Mencap, I have to attend training sessions regularly. Below are a brief summary of the training sessions I have attended and a few things they've taught me.
Buccal Midazolam/Rectal Diazepam & Epilepsy Awareness
In this training sessions we learned when and how to administer these 2 drugs and also basic knowledge about Epilepsy, which is a neurological disorder that causes various types of seizures, such as tonic clonic, myoclonic and absences. Buccal Midazolam and Rectal Diazepam are used to stop convulsions of a seizures, which if prolonged can cause brain damage and severe muscle damage. The people I work with use Buccal Midazolam after 5 minutes of a tonic clonic seizure. So far I've never had to administer either medication.
Medication Theory
This is a training course where after the theory part, you are assessed in your practical skills in administering medicine to clients. In the theory part, we discussed the laws surrounding medication in supported living. The main things I took away from this training were that gloves MUST be worn when handling any medication, even tablets and that we cannot administer any medication, even non-prescribed, PRN (administer when necessary) drugs, such as E45 cream, without written consent from the client's GP, no matter whether the parents have given permission or not.
Something we discussed that had never occurred to me, but I took particular interest in was the issue of chewing tablet medication. Each tablet/capsule has a certain coating, such as enteric or film coated, which affects when the coating is broken down and thus when the medication absorbed into the bloodstream. For example, if a tablet has an enteric coating, which is designed to dissolve in the non-acid conditions in the intestine, it will be broken down in the intestine and absorbed into the body only then. However, if the tablet is chewed or crushed, this leaves a surface of the drug without the coating, meaning it will be absorbed into the body before reaching the intestine, which would affect the medication's effectiveness and duration.
This course gave me direct insight into how medicines must be administered and also how they are designed, such as the coating, in order to fit their purpose.
Safeguarding Children
This was a course I had to do to work with children. It ran through the procedure of reporting suspected child abuse and how to identify it. We looked at famous case studies of child abuse where the result was death of a child, such as "Baby P".
Buccal Midazolam/Rectal Diazepam & Epilepsy Awareness
In this training sessions we learned when and how to administer these 2 drugs and also basic knowledge about Epilepsy, which is a neurological disorder that causes various types of seizures, such as tonic clonic, myoclonic and absences. Buccal Midazolam and Rectal Diazepam are used to stop convulsions of a seizures, which if prolonged can cause brain damage and severe muscle damage. The people I work with use Buccal Midazolam after 5 minutes of a tonic clonic seizure. So far I've never had to administer either medication.
Medication Theory
This is a training course where after the theory part, you are assessed in your practical skills in administering medicine to clients. In the theory part, we discussed the laws surrounding medication in supported living. The main things I took away from this training were that gloves MUST be worn when handling any medication, even tablets and that we cannot administer any medication, even non-prescribed, PRN (administer when necessary) drugs, such as E45 cream, without written consent from the client's GP, no matter whether the parents have given permission or not.
Something we discussed that had never occurred to me, but I took particular interest in was the issue of chewing tablet medication. Each tablet/capsule has a certain coating, such as enteric or film coated, which affects when the coating is broken down and thus when the medication absorbed into the bloodstream. For example, if a tablet has an enteric coating, which is designed to dissolve in the non-acid conditions in the intestine, it will be broken down in the intestine and absorbed into the body only then. However, if the tablet is chewed or crushed, this leaves a surface of the drug without the coating, meaning it will be absorbed into the body before reaching the intestine, which would affect the medication's effectiveness and duration.
This course gave me direct insight into how medicines must be administered and also how they are designed, such as the coating, in order to fit their purpose.
Safeguarding Children
This was a course I had to do to work with children. It ran through the procedure of reporting suspected child abuse and how to identify it. We looked at famous case studies of child abuse where the result was death of a child, such as "Baby P".
West Berkshire Mencap
Since July 2009, I've been volunteering at West Berkshire Mencap for Children's Services. I've regularly attended After School Club, Holiday Playschemes and organised entertainment for Youth Club and Gateway (a club for adults with learning disabilities). The After School Club and Holiday Playscheme sessions involve me being paired 1 to 1 with a child who attends that session. It's my job to make sure that child enjoys themselves! During my time with Children's Services I have had experience with many different conditions, mainly Autism and Down's Syndrome, but also Angelman Syndrome, Cerebral Palsy, Asperger's and also comorbid conditions, such as Autism and William's Syndrome (a genetic development disorder that often causes learning disorders and is strongly characterised by specific facial features) and developmental delays with severe allergies. A few of the conditions I have had experience with are discussed in separate blogs.
In June 2011, I successfully applied for a job at West Berkshire Mencap. This involved paid work with adults and children and more responsibilities, such as handling medication. The most unfamiliar part of the job was providing 1 to 1 care for adults with learning disabilities in supported living, which includes administering medication and assisting with personal care. Many of the clients I support also regularly displayed challenging behaviours.
My work with West Berkshire Mencap has been immensely rewarding! Although extremely challenging at times, my involvement has been one of the best choices I've made. It's given me a huge experience of disabilities, conditions and interaction with people that I definitely didn't have before. I've always been told that Medicine is an extremely rewarding career, but is also very challenging and hard-going at times, which I feel is a parallel to my work with people with learning disabilities. There are times when things aren't so good, but specific positive moments make up for all the negative ones!
In November, my House Head nominated me for the "West Berkshire Junior Citizen of the Year Award" for my contribution to West Berkshire Mencap. I was amazed when he handed me a letter congratulating me on winning the overall award, mainly due to the fact I wasn't even aware that this award existed, let alone that I'd been nominated!
In June 2011, I successfully applied for a job at West Berkshire Mencap. This involved paid work with adults and children and more responsibilities, such as handling medication. The most unfamiliar part of the job was providing 1 to 1 care for adults with learning disabilities in supported living, which includes administering medication and assisting with personal care. Many of the clients I support also regularly displayed challenging behaviours.
My work with West Berkshire Mencap has been immensely rewarding! Although extremely challenging at times, my involvement has been one of the best choices I've made. It's given me a huge experience of disabilities, conditions and interaction with people that I definitely didn't have before. I've always been told that Medicine is an extremely rewarding career, but is also very challenging and hard-going at times, which I feel is a parallel to my work with people with learning disabilities. There are times when things aren't so good, but specific positive moments make up for all the negative ones!
In November, my House Head nominated me for the "West Berkshire Junior Citizen of the Year Award" for my contribution to West Berkshire Mencap. I was amazed when he handed me a letter congratulating me on winning the overall award, mainly due to the fact I wasn't even aware that this award existed, let alone that I'd been nominated!
Monday, 9 January 2012
Angelman Syndrome
After volunteering at West Berkshire Mencap for some time, I've met a variety of conditions that cause learning disabilities, one of which, is Angelman Syndrome:
There's a boy who regularly attends the After School Club and the Holiday Playschemes, called James, who has Angelman Syndrome, a condition which causes severe learning disabilities. Angelman is most commonly caused by a deletion of Chromosome 15, when the deleted gene comes from the in mother. Angelman Syndrome is paired with Prada-Willi Syndrome, which occurs when this deletion is inherited paternally. The gene defect that causes Angelman Syndrome is on UBE3A and can also cause Angelman Syndrome through translocation, as well as deletion/inactivation of this gene.
Angelman was discovered by Dr Harry Angelman. It was previously called "Puppet Syndrome", which came about after Dr Angelman saw an Italian picture of a smiling boy holding a drawing. He believed this also described the jerky, hand-flapping movements many people with Angleman Syndrome display. People with Angelman Syndrome are sometimes referred to as "angels", partly due to the name of the condition, but also partly to do with how they appear much younger than "mainstream" students or adults without Angelman Syndrome.
There are many symptoms of Angelman Syndrome, many of which I have noticed in James. He has severe learning difficulties and has no speech, other than stringing together the 3 noises of "ba", "ga" and "ma". Mental retardation common in Angelman Syndrome, with many people with this condition being able to learn only a few words at best. However, many find other ways of non-verbal communication, such as Makaton an/or PECs. James only communicates by pointing to things, such as at snack time, where he will point to what he wants (often choosing Skips!). James also has an unsteady gait, another common symptom of Angelman Syndrome. James was very late learning to walk and due to this and his lack of balance, he has a buggy which he is often strapped into to go long distances, such as when we went to Thorpe Park. James also appears to be in a very good mood most of the time, which is another common occurence in people with Angelman Syndrome. James' apparent happy demeanour means that he laughs and smiles a lot and also gives lots of people hugs. James also has an obsession with water. This occured to me when we had a day trip out of TVAP, an adventure playground specifically designed for children and adults with learning disabilities. We spent the whole day (5 hours) playing with the water jets, which he appeared to absolutely love. He was giggling and laughing the whole time! this fascination with water is also common in people with Angelman Syndrome, although there is no obvious cause of this.
James also has epilepsy. He takes regular medication for this. He has absences multiple times everyday and these occur more frequently when under certain conditions, such as if he's too hot or cold or hasn't had enough food or drink. An absence is where the person temporarily loses consciousness. They are unaware of this and these types of seizures only last a few seconds normally. Many absences are mistaken for daydreaming, as they have no response while in this seizure. For James, absences are common and result in his head dropping suddenly and his eyelids fluttering. When these seizures happen, we gently stroke James' arm and quietly call his name until we have a response, such as a smile or when he lifts his head. We do things gently to minimise confusion for him when he comes out of the absence. James also suffers rare tonic clonic seizures, and due mainly to this he wears a padded helmet (other than in bed and when in a padded play area) to protect his head in case he has a tonic clonic seizure and falls. Tonic clonic seizures are the ones most commonly associated with epilepsy, and are also called "drop fits" as the person loses control and has full body convulsions. This can often result in injury from falling, or from the convulsions, such as biting their tongue, and sometimes incontinence. Although I have never witnessed James have a tonic clonic seizure, I have witnessed many of his absences.
Working with James has been something that I have immensely enjoyed! It's been extremely rewarding and due to his generally happy demeanour, James is lots of fun to work with! After working with him many times, he's started giving me hugs when he sees me, whether I'm working with him that session or not! It's made me see how rewarding helping people is - something which I wish to continue by studying Medicine.
There's a boy who regularly attends the After School Club and the Holiday Playschemes, called James, who has Angelman Syndrome, a condition which causes severe learning disabilities. Angelman is most commonly caused by a deletion of Chromosome 15, when the deleted gene comes from the in mother. Angelman Syndrome is paired with Prada-Willi Syndrome, which occurs when this deletion is inherited paternally. The gene defect that causes Angelman Syndrome is on UBE3A and can also cause Angelman Syndrome through translocation, as well as deletion/inactivation of this gene.
Angelman was discovered by Dr Harry Angelman. It was previously called "Puppet Syndrome", which came about after Dr Angelman saw an Italian picture of a smiling boy holding a drawing. He believed this also described the jerky, hand-flapping movements many people with Angleman Syndrome display. People with Angelman Syndrome are sometimes referred to as "angels", partly due to the name of the condition, but also partly to do with how they appear much younger than "mainstream" students or adults without Angelman Syndrome.
There are many symptoms of Angelman Syndrome, many of which I have noticed in James. He has severe learning difficulties and has no speech, other than stringing together the 3 noises of "ba", "ga" and "ma". Mental retardation common in Angelman Syndrome, with many people with this condition being able to learn only a few words at best. However, many find other ways of non-verbal communication, such as Makaton an/or PECs. James only communicates by pointing to things, such as at snack time, where he will point to what he wants (often choosing Skips!). James also has an unsteady gait, another common symptom of Angelman Syndrome. James was very late learning to walk and due to this and his lack of balance, he has a buggy which he is often strapped into to go long distances, such as when we went to Thorpe Park. James also appears to be in a very good mood most of the time, which is another common occurence in people with Angelman Syndrome. James' apparent happy demeanour means that he laughs and smiles a lot and also gives lots of people hugs. James also has an obsession with water. This occured to me when we had a day trip out of TVAP, an adventure playground specifically designed for children and adults with learning disabilities. We spent the whole day (5 hours) playing with the water jets, which he appeared to absolutely love. He was giggling and laughing the whole time! this fascination with water is also common in people with Angelman Syndrome, although there is no obvious cause of this.
James also has epilepsy. He takes regular medication for this. He has absences multiple times everyday and these occur more frequently when under certain conditions, such as if he's too hot or cold or hasn't had enough food or drink. An absence is where the person temporarily loses consciousness. They are unaware of this and these types of seizures only last a few seconds normally. Many absences are mistaken for daydreaming, as they have no response while in this seizure. For James, absences are common and result in his head dropping suddenly and his eyelids fluttering. When these seizures happen, we gently stroke James' arm and quietly call his name until we have a response, such as a smile or when he lifts his head. We do things gently to minimise confusion for him when he comes out of the absence. James also suffers rare tonic clonic seizures, and due mainly to this he wears a padded helmet (other than in bed and when in a padded play area) to protect his head in case he has a tonic clonic seizure and falls. Tonic clonic seizures are the ones most commonly associated with epilepsy, and are also called "drop fits" as the person loses control and has full body convulsions. This can often result in injury from falling, or from the convulsions, such as biting their tongue, and sometimes incontinence. Although I have never witnessed James have a tonic clonic seizure, I have witnessed many of his absences.
Working with James has been something that I have immensely enjoyed! It's been extremely rewarding and due to his generally happy demeanour, James is lots of fun to work with! After working with him many times, he's started giving me hugs when he sees me, whether I'm working with him that session or not! It's made me see how rewarding helping people is - something which I wish to continue by studying Medicine.
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