New Blog

Its been 7 months now since the Coast to Coast; a lot has happened and a lot has changed and I’m now half way through my first year at university training to be a nurse. My lungs however, remain as crap as ever but with the Coast to Coast having been and gone, this blog has become somewhat redundant. I don’t really want to stop blogging though and as long as there are people interested enough to read, I will continue to post. With all the changes that have happened recently, it’s only right my blog changes too. I’ll still be sharing my experiences of Brittle Asthma but also those of being a student nurse and the parts where the two aspects of my life cross so I’ll now be posting to Blood, Sweat and Nebulisers – A student nurse with brittle asthma. I’m hoping my new blog will be just as much of a success as this one has been and to everyone who continues to read my rambling anecdotes – thank you! 🙂

( https://bloodsweatandnebulisers.wordpress.com/ )

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The highs and lows of the coast to coast

It seems very weird to think that after 15 months of thinking about and planning the coast to coast walk, it is now over. The walk had been my main focus since leaving university 16 months ago and to be honest, it kept me sane. It was something to work for and something so totally different and out of my comfort zone.

I didn’t find it easy by any stretch of the imagination but in a strange way, I miss it now. I miss sleeping in a tent and water tasting of plastic, I miss the smell of the gas burner and being woken up by sheep! I miss the simplicity of it all, the little, silly things. I met some wonderful people along the way, most of whom were also doing the Coast to Coast for a variety of different reasons. I met Cara when I first arrived in St Bees and bumped into her here and there at various places on the route. She had flown all the way from Canada to do the Coast to Coast, it was her first time in England and she was going solo – I have a huge amount of respect for that woman! Naturally, our routes differed in small but significant ways so we weren’t following each other and I didn’t see her again after Richmond which is just over half way but I’d love to know how she got on in the second half and when she made it to Robin Hood’s Bay. Cara wasn’t the only person I met; there were several people who had come from Australia to tackle the walk and I also met an ex sergeant as I passed through Marske who made me an absolutely cracking cup of tea! What I loved more than anything was that whilst lots of people were walking the same (or similar) route, they all had their own stories to tell, their own reasons for doing it and their own challenges to overcome. The route may have been the same but the walk was very different for each and every one of us.

I went with the impression that food was going to be an issue and that I’d almost permanently be hungry but that couldn’t have been further from the truth! In true British style, pubs, cafes and tea rooms graced the route and provided a welcome break various points. It’s amazing how much more I appreciated food after a day’s walking…In fact, I’m fairly certain 90% of my photos are of my various meals and that the walk was actually just one massive pub crawl!

Full english takeaway, anyone?!


The weather became my nemesis during the walk; whilst there were some lovely days that left me more tanned than a week in France (I wish), there were also an awful lot of wet days. There were days when the waterproofs went on then off and then back on again, there were days when water seeped into my bag despite the best efforts of the waterproof cover and there were days when the rain just made me feel bloody miserable! However, despite my lungs kicking up a fuss at the mist on Blakey Moor in North Yorkshire, they coped fairly well with the rest of the damp air and for that reason alone, I am incredibly happy.

The Coast to Coast has been an absolutely incredible experience, not all of it was pleasant but I learnt a lot (cheesy but true!) and I wouldn’t think twice about doing it all again tomorrow. That aside, the most important aspect was fundraising for Asthma UK and I am very pleased to say that I have currently raised £350 with some more still to come in. So a HUGE thank you to everyone who sponsored me, you’re the people who make the real difference, I just do the walking!

  

The sun did shine…once or twice

Between Markse and Richmond

Home to wonderful tea rooms!

Told you it was a pub crawl…

North York Moors

A view worth the climb

Only in Yorkshire would this be found at the bottom of a pint glass!

 

1 day to go!

I should have left for St Bees yesterday but for several reasons, each as frustrating as the next, I’ve had to postpone until Thursday. But it’s not the end of the world, I’m less likely to forget something now!

I winced slightly as I looked up the weather forecast for the Lake District for the next few day. I don’t really know why I looked; it’s rarely accurate and there’s little I can do about it anyway but needless to say, I think the waterproofs are going to be well used! The rest of my kit looks a little like this:

 
It consists of: a tent, sleeping bag, sleeping mat, maps, clothes, cooking stove, mug, first aid kit, torch, my phone and copious quantities of food! That’s just a very general overview and when written down, it doesn’t seem like a great deal but trying to fit it all into my rucksack is a whole different story.

I’m going to be heavily dependent on local shops for food purely because I don’t have the room to carry enough food for nearly 3 weeks and what I can carry is hardly packed with nutrients; pot pasta and a digestive biscuit anyone? I have a feeling that I’m going to be sick of the sight of pot pasta by the end of the 3 weeks but it’s small and light and after a day’s walking, I doubt I’ll complain…and I would NEVER complain about biscuits!

I joked not that long ago about medication making up a large proportion of the weight in my rucksack and I wasn’t far wrong! But there’s not much I can do about it, that’s just the way it has to be. I spoke to my asthma nurse a few weeks ago to discuss how much and of what medication I should be taking and I drew up a list of those it would be advisable to take, some of which I take all the time, some I’ll be taking prophylactically and some are ‘just in case’. Providing they keep me breathing, I can live with the extra weight.

So that’s it: kit, food and drugs all sorted. Now I’m left with the mammoth task of packing it all into the rucksack which I have a feeling is going to be easier said than done. My train tickets are arriving in the post today (or they better be!) and my train to St Bees where I start the Coast to Coast leaves at 7am tomorrow morning getting me there at shortly after 1:30pm

I’ve been planning this for months and now the day has come, I can’t decide whether I’m more nervous or excited, definitely a mixture of both. The most important thing is raising as much money as possible for Asthma UK and I’d love to arrive at Robin Hood’s bay in 3 weeks’ time to find I’d hit my target of £500 – So please donate whatever you can, it really will make a huge difference! Thank you!!

🙂

A crisis of confidence

Up until now, I’ve been plodding along with practice walks, route planning and asthma blogging and it’s been going swimmingly, if I do say so myself. In fact, I’ve been doing that for so long now that I seem to have forgotten what it was all in aid of until this week when it hit me like a freak train – oh shit, I am actually doing this. I am actually going to walk the width of Britain.

I’ve been playing out all sorts of horrible scenarios in my mind: What if I get totally lost and end up wandering in the middle of nowhere with no idea where I am or where I’m going? What if my lungs freak out in the middle of the Lake District, miles away from civilisation never mind a hospital? What if I’ve just been kidding myself into thinking I can do this?

At the moment, I feel like such a fraud. I have absolutely no idea what I’m doing and yet I’m about to cross the country as though I am an experienced hiker with nothing more than my mind and some OS maps for help. I can’t even read maps all that well! – That’s not strictly true but getting from one side of the country to the other is entirely dependent on my ability to read maps accurately, my faith in which is now dwindling and I am beginning to wish I’d done D of E!

I do however, have the help of this trusty little book which is full of hints and tips for the places where I am most likely to get lost!  

I was also very quick to go over the maps and plot alternative (and slightly easier) routes should the weather decide to turn inclement – in true British summer style! So I should – and I say this very hesitantly – be fine. That’s what I keep telling myself anyway: everything will be fine and with that in mind, I’m trying not to panic about everything that could go horribly wrong. I am determined to enjoy the Coast to Coast. After all, there’s a lot to be enjoyed in those 200 miles.

Everything will be fine…everything will be fine…everything will be fine….

Dear Mr Hunt

No 24 hour NHS eh? Forgive my ignorance Mr Hunt but surely the very nature of the NHS makes it a 24 hour service. I may be totally wrong of course. I don’t profess to be an expert in the workings of the NHS because I’m not. I don’t know how many doctors opt out of working weekends and I don’t know how many patients die because there are no doctors on duty. What I do know however, is that there has never been a time where I’ve had to wait all weekend to see a doctor about my asthma. I’ve never spent all night wheezing in A&E because there are no doctors to see me. I may not share your extensive knowledge about the NHS Mr Hunt but I am an expert at being a patient and I have experienced every aspect of your so called ‘9-5’ NHS. So let me tell you a little story:

It’s 7:30pm on Friday night and I’m in A&E because I am a brittle asthmatic whose lungs are once again failing. Within 10 minutes of arriving, I am in the resuscitation room with three doctors; one is putting another cannula in my arm to run intravenous steroids through, a consultant is taking an arterial blood gas from my wrist and another doctor is on the phone requesting an immediate assessment from the medical registrar and intensive care consultant.

Both arrive 2 minutes later, listen to my chest, look at my blood results and decide I need to be in intensive care but may need to be intubated and ventilated before I am moved. Yet another consultant comes to see me. Her name is Natasha and she is an anaesthetic consultant from intensive care. She assesses my airway and decides it is safe to move me from A&E to intensive care without putting me on a ventilator. A bed is available and I am moved immediately.

Once in intensive care, Natasha puts an arterial line into my wrist to monitor the level of oxygen and C02 in my blood. She stays and observes me, along with the nurses, until at 11:30pm when breathing finally becomes a little easier and she hands me over into the care of the night doctor who then continues Natasha’s care into the early hours of the morning. 7am Saturday morning and Natasha is back to check up on me along with an intensive care and respiratory registrar. They continue to observe me throughout the weekend until I am well enough to be discharged from the intensive care unit.

Now I don’t know about you Mr Hunt, but I cannot find a single moment in that story when I was left without the care of a doctor, whether it be a registrar or consultant. You said doctors need to stop opting out of working weekends and work more in order to provide 24 hour care. Well I disagree. If Natasha worked any more that weekend then she wouldn’t have slept and Mr Hunt, I highly doubt you could leave work at midnight and be back in for 7am.

Mr Hunt, I am only 20 years old and yet my asthma has already nearly cost me my life more times than I care to think. My survival is a testament to the hard work of the doctors who are there 24 hours a day, 7 days a week despite what you say. They work their backsides off and yet still you say it’s not good enough. One day Mr Hunt, it could be your life in their hands. They would no doubt save it, just as they did mine and so many others before but I wonder what you would think of their work then.

You say we don’t have a 24 hour NHS but I think you’re wrong. In fact, I know you’re wrong. It may not be a perfect system but if we didn’t have an NHS that operated 24 hours a day, I would never have made it to my 20th birthday. It is as simple as that.

Thank You!

Just a quick update to say a massive ‘thank you’ to the kind stranger who sponsored me £20 – there was no name left so I can’t thank you in person but who and wherever you are, I just wanted you to know that your sponsorship really is greatly appreciated!

🙂

Training #4: Route Planning

It is now only 5 weeks to go until I set off to walk across the country so I am very relieved to be able to say that I have finished planning the route! The route comprises a mixture of the original path described by Alfred Wainwright and my own detours which allows me to end up near a suitable camping spot each day. The route is around 200 miles and covers 8 OS maps and providing all goes according to plan, should take me just over 2 weeks to complete with 12 days of walking, averaging 17 miles a day (with several much needed rest days in between!)

 

The route starts on the west coast of England in St Bees and heads inland where it passes through the Lake District and then the Yorkshire Dales and the North York Moors in the east before finishing at Robin Hood’s Bay on the east coast of the country. Walking west to east opposed to the other way around is the traditional way to walk the coast to coast but it will also allow me to take full advantage of the prevailing winds. Some of the most demanding terrain is in the west too with Kidsty Pike being the highest point standing at 2560ft on the eastern side of the Lake District – tackling it early on is deemed a wise idea!

The very first part of the coast to coast walk


With the route finished, all that leaves me to do now is finalise my kit, do some more walking and hope and pray my lungs hold themselves together – 5 weeks and counting!

🙂

Hello Sunshine

The positively tropical weather we’ve all enjoyed over the past few days has been the perfect excuse for barbecues, beach trips and sadly, an abundance of socks and sandals in Tesco. The hot summer days are however punctuated with an extortionately high pollen count which causes runny noses and itchy eyes in a lot of people. For asthmatics, the combination of high temperatures and a high pollen, ozone and mould level mean that even the nicest of summer days can wreak havoc with the supposedly simple task of breathing.

Hello sunshine

The effect high pollen, ozone and mould levels have on the airways differ from person to person. For some, there will be very little effect whereas for others, such high levels of pollutants in the atmosphere can trigger a life threatening asthma attack. It all depends on how allergic someone is to the different pollutants. The effect of high temperatures on asthma is not so well understood but it is thought that breathing in hot air causes the constriction of airways, leading to asthma symptoms.

For some, the cold weather has more of an effect that the hot. The cold, damp air associated with the winter months can cause the airways to go into spasm and leave people feeling tight chested and wheezy. Chest infections are often most prevalent in the winter months too which makes breathing harder for people with healthy lungs but for asthmatics, chest infections are to put it bluntly, an absolute bugger and have been the cause of several of my hospital admissions!

Thunderstorms can also cause asthma symptoms, particularly in younger people and children – it sounds strange but I promise it’s true! The reason for this is not that well understood but one potential explanation is that the humid conditions associated with a thunderstorm break up the pollen and mould particles which are whipped up into the air by the wind making it easier for them to enter the smaller airways where they cause more damage.

There is no ‘perfect’ type of weather for asthmatics, everyone is different. A week ago, I would have said that it’s only really the winter weather that bothers me; the cold and damp air usually indicates an imminent need for oral steroids and most of my hospital admissions are between October and March. That said, the combination of heat and pollen  over the past few days have sent my peak flows plummeting. But whilst I manage to avoid another hospital admission, I shall continue to enjoy barbecues and summer evenings without any complaint!

Intensive Care, Asthma and A Levels

Only last week I had been about to press the ‘publish’ button on a new post entitled ‘8 weeks and counting’ – it was about to be the first time in over a year that I had been 2 months without a hospital admission. But it wasn’t to be. Instead, I ended up in intensive care 3 days before my A Level’s started with an arterial line in, aminophylline, potassium and magnesium infusions running, back to back salbutamol and ipratropium nebulisers and donning full cardiac monitoring. Not quite the exam preparation I had in mind.

In such a situation, you’d think a few exams (which aren’t strictly necessary) would be the last thing on my mind but they were the only thing on my mind. The prospect of having to give up a years’ worth of hard work for a stay in intensive care was quite literally sole destroying. Yes, I know health comes first and I know it’s better to be alive and breathing than have an A grade but there’s just something about the sadistic timing of it all that made me want to say ‘stuff you lungs, exams are coming first’

I’m lucky in the respect that I tend to bounce back pretty quickly from a flare up but that said, intensive care to home in under 72 hours was probably expecting a bit much. Some would say it was admirable determination, some would say pure stupidity but whilst I was alive and breathing, I was absolutely adamant I would be in that exam hall and it is an undeniable miracle that I was.

When I first broached the issue of getting an early discharge, I was met with the usual ‘absolutely not’ response and understandably so. Medically, I wasn’t as well as I could be but does that necessarily mean I shouldn’t be discharged? Technically speaking, I was only dependent on medication I could administer at home and my peak flows were considerably better than they had been so whilst I knew it might be a struggle, I knew I could manage.

I am so grateful to Natasha, the ICU anaesthetist. She actually acknowledged that at that moment in time, exams were the most important thing for me and providing I didn’t do anything stupid, she thought I would probably be ok to go with the caveat that I returned immediately if I started to feel unwell again. It’s lovely to be treated by a doctor who sees everything that’s going on rather than just the logistics of your condition. So I want to say ‘thank you’; thank you Natasha for not just saving my life, but saving my grades too.

I can’t say that ICU is an environment particularly conducive to exam preparation. Asthma aside, revision is hardly aided by the extreme stress and lack of sleep. I’m exhausted and ready for a week of sleep but I survived it…ICU and exams so it’s not that bad.

To wheeze or not to wheeze

That horrible, high pitched whistling is probably one of the most well- known symptoms of asthma. Some people are unaware of their wheeze because without a stethoscope, it’s inaudible. On the other hand, wheezing can be distinct enough to be heard on the other side of the room.

Wheezing is caused by restricted airways (think of breathing through a straw) so it is usually only present during a flare up. But what if there is no wheeze? What if you’re struggling for breath, have low peak flows and are coughing but have no wheeze? Does that mean it’s not asthma? Well, no it doesn’t. Symptoms of asthma are different in everyone and not everybody wheezes, even during a bad patch. The problem is, wheezing is such a stereotypical symptom that its absence makes many people doubt the diagnosis of asthma. Instead, people without a wheeze often have their symptoms put down to hay fever, anxiety or it is implied their symptoms are purely factious when that simply isn’t the case. The end result is incorrect treatment or even worse, no treatment at all. Then it’s back to square one.

Another danger of brushing off shortness of breath as being ‘nothing to worry about’ due to the absence of a wheeze is the risk of it being due to something called ‘silent chest’. Silent chest is a symptom of life threatening asthma and it’s just about as bad as it gets. It does what it says on the tin really: the chest is silent, no wheezing, no breath sounds, no air movement at all. How could that ever be dismissed as ‘nothing to worry about’, I hear you say? Unfortunately it happens more often than I care to imagine. Even at that life threatening stage, many people don’t appear stressed which can be due to a plethora of reasons: they’ve been there before and know how to handle it, they don’t appreciate the severity of the situation or it could simply be that appearing stressed or anxious uses too much precious energy. So without close examination, life threatening asthma isn’t always immediately recognised because there is nothing to see or hear.

The point I’m trying to make is “don’t judge a book by its cover” or perhaps it would be more appropriate to say “don’t judge a patient just on their symptoms.” Ignoring breathing difficulties because there is no wheeze can kill. It is as simple and terrifying as that. The absence of a wheeze may be unusual to many but may be perfectly normal for others. From my experience, asthmatics tend to know their own symptoms better than anyone else so if they tell you they don’t wheeze, don’t just fob them off as being a time waster, listen to them and help them because it could well save their life.