Is God real? It’s something a lot of people struggle with.. that’s for sure. Millions around the world struggle to sleep at night trying to answer that question. I know this rapper does for sure… it’s what inspired me to write this post.
Well, unless he, or she, other they show their face, I don’t think we’ll ever know the answer to that. Those who believe in him don’t have solid evidence to back him, rather they use faith. But that’s enough.
From a science perspective… there’s no evidence for him existing. He was most likely a notion created by a father whose child had asked “why does the sun rise and set Papa?” to which he replied with a folk tale, or a story, and somehow it all got out of hand form there. Philosophers suggest we humans invented the notion of god not only to give reason to the world around
us, but to get over the guilt of subjugating animals to our control, by making us somehow superior to them all. But that’s no definitive answer…
So do I believe she/it/they/he exists? Well, for a long time I did. Then when I questioned why there was so much suffering in the world, and why I, of all people, had been put through so much it myself, I didn’t. Today, I’d have to say, I dunno.
Many question if he does exist. But I think something everyone mistakenly tries to do is humanise Him.
The very definition of God places him above humanity… a being so entire, so encompassing, so all-knowing that he reigns above us all. So why do we pretend to know what He or She or They want of us?If he does exist… what’s his agenda? Why create us in the first place? Are we an experiment for him? Some weird play thing? If he sees us all as his children, and cares about us… why doesn’t he intervene and help us?
Maybe he doesn’t want to… he wants us to sort it out. But surely – he can make the world a better place.considering the suffering millions, scratch that, billions are going through. If he does care for us, why is there still so much pain and misery in the world? Well, if he is indeed real, and does indeed care and want the best of us as his children, or for life as it is on Earth, how would he achieve that? God is all knowing, he probably possess an IQ over 300 and can understand the huge and far-reaching implications of any changes you make in the world. I mean you can’t make one groups wishes come true without affecting someone else… If you were God and you loved everyone equally..who would you help out first? Who would you let go by?
If you think about it, why should he care about you or I as individuals, when millions suffer elsewhere? How can he make changes which help everyone? Well – maybe it’s just too hard for him to
intervene… maybe he’s trusting us to figure it out… who knows?In the end, we’re basically left with what he’s apparently trying to tell us… through his teachings and scriptures – which, may I point out, humans have written themselves in what we like to call
religion. I think something people get overly carried away with though is a literal interpretation of these words of God, these religious scriptures. Whether or not they were actually God’s/the Gods’ own words, or whether they were created by humans, I think they were said to try and create some sort of order in the world. Back a few thousand years ago when all people had was an instinct to survive, tempered solely by the love and care of mother and family; emotions required, probably even created as an evolutionary response over the years to raise such resource intensive, demanding children, religion may have been required to form societies. Some sort of belief system which established basic moral principles is probably what allowed us to form such large, complex, interconnected social groups whilst still maintaining a sense of individuality.
Years ago, religion and its scriptures were the dominating way in which order was achieved in society. And it worked. For centuries. Using the primal instincts of fear, the instilled order and values
into humanity. Sin, break one of the ten commandments, commit adultery, or eat the meat of a cow and you shall be punished with eternal damnation, stoning
unto death or with misfortune later in life; the concept we know as karma. But many argue that today, we don’t need it. With judicial systems in place, at least a general concept of what is right and wrong being displayed by most individuals, and with concepts of human rights, freedoms and values becoming widely accepted, religion could be viewed as obsolete. And many are coming around to that way of thinking. The rapid growth of atheism and agnosticism over the years is evidence of that.
But still many adhere to the old ways of religion. I’m not here to argue that that’s bad. Many great, wonderful things come from it. Islam purports that a proportion of all earnings be donated to the needy, many missionaries and charities had been started, and are continually funded, by churches, temples and mosques the world over, and millions derive strength, values and a sense of purpose from religion. I myself, despite not being convinced there is a God (partly because there’s no proof, partly because I question why he’d bring harm to millions, including children, including me), have sat down and prayed with other patients and their families. And I prayed earnestly, wanting to believe it’d help them get better. Many have prayed for me during my battle with cancer, my mother the most fervent of them all; she still goes to the temple every week, asking her Gods to keep me alive and healthy. None of the friends I prayed for made it, but they, or their families all gained strength from it, as do millions around the world. But it’s when the words from scripture are taken literally and used or twisted to obstruct the freedoms of others, to acquire financial or political power or to incite violence against others… that it’s wrong. We see it happening throughout history, and it continues to this day, from the harsh right-wing religious based fundamentalism leading to oppression and terrorism the world over, to the 70 odd year siege of a nation of people justified by having had that land proclaimed theirs in religious texts written thousands of years ago.
But that issue is not what I’m focussing on here.
Instead I’m talking about how people choose to view religion. Too long, too many have been too focused on the literal observance of religious texts and scriptures; the following of rituals, traditions and the literal interpretation of God’s words as orders, outlining what we can or can’t do in life.
What if I told you those scriptures, the
stories, the traditions, the restrictions were supposed to be metaphors. That religion was a tool used to educate and teach people back in the days where knowledge of how the world worked and why we should be good, kind people wasn’t as prevalent and easily accessible as it is today.
I’m sure many reading this would think that’s an outrageous thing to say… But I mean, that statement wouldn’t seem too crazy if you were to look at it as if you were an alien who’d
never been exposed to the goings on of humans on Earth. If you think about it, the stories told religious texts are not dissimilar to the tales we tell our children, to warn them of what not to do, to teach them the difference between right and wrong, to give them moral guidelines to how they should live their lives. They aren’t actual stories of what happened, or people to follow and revere, or a list of dos and don’ts, that you must believe in, adhere to or follow to be a true believer. They’re trying to teach us lessons on how we, as people, should live.
Wouldn’t that make more sense than some of the impossible things they talk about?
So are those stories, the messages
of the scriptures, useless today? I don’t think they are. All religions, in some way or another, try and propose a system or a way in which to create a world that works. And all of them, at their very core, preach the same message. To treat others as you would like to be treated yourself, to live life peacefully, with some meaning and restraint and to try and help those around
you.They say it, sometimes plain as day, but what if the stories, the examples they gave had deeper meanings than just strict rules to adhere by or things to do to live forever? What if the Gods were just telling us to be good?Well, all the major religions do just that.
Christianity does it through the concepts of Grace, the ultimate sacrifice made by Jesus and through various passages in the Bible telling others to care for others and to be dignified, respectful people. It’s well documented and widely known and here are a few phrases that show it. http://www.openbible.info/topics/being_a_man . In Islam, the very concept of Jihad is not the external struggle it’s been twisted as by extremists and Western media alike, against Kafirs (whose very meaning has been shifted from those who oppress their right to practice Islam to that of a “non-believer” or infidel), but a much harder, internal one of being a good man. A man who”treats his wife well,” who does not opt to “cursing others”, who “desires for his brother that which he desires for himself”, who “looks to those inferior to him”, who is grateful for what he has and isn’t jealous or spiteful or angry. http://www.islamondemand.com/true_teachings.html
Hinduism’s basic tenets outlined in the Gita are to (1) Accept that we live and we die and live our life without deluding ourselves of this one fact. Instead of fearing it, use it to temper the other 3 and make your life meaningful. (2) To do your duty in life. (3) To be responsible for your actions and (4) To leave this world in a better state than which you found it; all of which leads to better people. So are the rituals, the mantras, the celebrations and this focus on the literal interpretation of God’s words bad? No, not necessarily. They give those who don’t know better, or those unable or unwilling to read the texts critically, direction, some purpose in life. They instill unto us a sense of discipline.
But an over-focus on the literal interpretation of scriptures, the condemnation or judgement against those outside their religion, or even those inside them who aren’t “as devout” (such as that suffered by Sikhs who cut their hair, Muslim ladies who don’t wear a Burqa or Christians who don’t attend church), is unfruitful, and can, at its worst, be harmful. The holy texts are written there. It’s up to make the most of it. And right now, I don’t think we’re doing that. If religious preachers, leaders or figureheads were, in general, more focused on creating better people, rather than better followers, they’d not only be creating a more devout, satisfied following, but a better world too.In the absence, or lack of this focus by those leaders though – it comes unto us to choose how we take religion. Don’t just conform to the idea that it’s something that defines what one can or can’t do in life, but think about it critically, and, whether you believe in God or not, use its teachings to live a better life as a better person. If you do believe in him, in the end, God’s the one who gave you a brain, and intuition. It’d be a sin to not use it to try and decipher the true
meanings behind his words, and live life in the way that he wants us to; with consideration for others. If you don’t believe in him, it doesn’t mean you can’t learn from “His” teachings. Take the good, dismiss the bad, and use it to become a better person. Why not? In the end, it brings the only satisfaction that can’t be taken away from you, or made to seem hollow; the satisfaction of
helping others. So am I religious? Well, by the definition I gave above, I must be. I know many choose to lean on the concept of a God, or a supreme being looking over them for a sense of comfort, to give them assurance in hard times and purpose in life. Me, after everything I’ve been through, lots of thinking about death and what our purpose is, I’ve come to believe in myself. When it comes to religion though, I choose instead to focus on trying to be the perfect man he wants me to be, by doing what I reckon he’s trying to teach me. I don’t do it to please him or because I believe I should do it to be religious… but rather because helping others, putting a smile on someone’s face and making the world a better place is simply the best, most rewarding thing you can do in life. It’s the best way of staying happy. Unlike any other form of happiness; money, fame, power, women (or men, whatever floats your boat), that smile, that feeling of making someone’s life easier or better can never be taken away from you; it will never seem a hollow, or meaningless both in life and when you’re on your deathbed. Hell, if all we are is just a bunch of chemicals interacting with each-other in a series of odd arrangements, and there is no god or purpose in life… we, as humans, who are doomed to have minds that think too much; too deeply, have to make it all seem worthwhile by giving ourselves some sense of purpose. If we’re here, and then we’re gone, that purpose may just be to live life doing anything to be as happy as possible. But what better, more sustainable way of getting that dopamine flowing is there than helping others?
Instead of believing that doing good will lead me to Heaven, I choose to try and make the world we live in a Heaven… not just for me, my family or my country, but for the 7billion + people who live on it… or failing that, as much of it as I can.
The only way I can’t be happy in life is if all my efforts seem fruitless… If all my efforts are not accomplishing anything, or not helping enough people. And despite the happiness I’ve brought many so far through my writing, speaking and actions, sometimes it does seem I haven’t made much of a difference… that my efforts are fruitless… that there’s no real reason to live.
When that happens though – I talk about it with others. My family, friends, I catch up with someone I’ve helped in the past. I remember that getting to help 1 individual person get past their fear of treatment, their depressive mood, their shyness, helping 1 friend or stranger achieve a goal they’ve wanted for years or simply getting to put a smile on 1 person’s face is beautiful. It’s what keeps me going. And I’m glad this blog has been able to help me do that. I hope it, and other things I plan on doing, help me keep doing it. God (or whatever) Bless.
This post is from the archives – my old blog where I go into detail a lot more – explaining an old treatment I had, called Extracorporeal photopheresis! Enjoy words from old me guys! Full details on how this fascinating treatment, and my experiences of it, are below (about halfway down!).
I’m starting a new therapy soon, called “extracorporeal photopheresis”, where they take huge amounts of my blood and expose it to UV light. It’s being done to to treat my Graft Versus Host Disease, a side effect of my stem cell donor’s cells being transplanted into me (caused by his immune system, which was put into me, thinking my skin, organs and body are foreign), which is why my skin is so scarred and I have slightly abnormal organ functioning.
It’s shown remarkable results. Nearly every patient with Graft Versus Host Disease (GVHD), be it acute or chronic, has shown not just improvement, but complete remission of skin hardening and scarring. It has good rates of resolving other organs affected by GVHD too, and the treatment itself has minimal side effects. Here’s a great little video on how it works.
A very good, easy to understand video on how it works!
But it still sucks that I have to do this.
Mainly ’cause I’ve had to have a catheter put into me. A plastic line, inserted into my jugular vein by tunneling through my chest, with 2 access points, or “pumps” hanging out. And though I know it feels normal after a week or so, it has already made me miss so many things.
The fact that I’ll be stuck in hospital, 5 hours at a time, two, or three days a week for the next 4 – 6 months, and that I won’t being allowed out in the sun for a day week this entire summer (due to exposure to UV light, manipulated in this procedure) makes it worse.
The fact that I missed out on attending the World Cancer Congress, where 8,000 leading researchers, doctors and health charity and organisations were going to discuss the latest developments in cancer research around the world torments me.
But the thing that gets me most, is that, yet again, I have to start all over again.
The whole year of exercise and work put into me getting back to my old self, culminating in me finishing a 200km bike ride… all poured down the drain.
A talk I gave to open that bike ride.
You’d think I’d be used to it now. I mean it’s happened so many times, right?
But every time it happens… it feels as if I’m being worn down, and each time it happens, I’m that much closer to giving up.
Despite me having such great support, despite my doctors’ assurances that I can still do some things, despite me having gone through this so many times before, I, like every other cancer patient, HATE that this thing STILL affects me SO. DAMN. MUCH.
It feels like I’ll never get back to my old self.
It feels like it’ll never end…
And for so many… it never does.
But in the end, when I take a step back and think about it… I still know that I have a choice in all this.
I still know that though this sucks… I wouldn’t be getting this if they didn’t think it’d help. And when I take that step back and look at the big picture; the fact that this treatment may just stop my steroids, my cramping and the constant itching in my skin… I realise that in truth, I should be celebrating this.
When I look at why I’m most put down by everything cancer’s done to me; that these constant treatments and these side effects are stopping me from being the old me… I get angry.
Because though I’m sick of the effects cancer has on my life… I’m sicker of the fact that I keep making myself feel bad because of it.
I REFUSEto lament that I’m limited to a “new normal” after cancer. Because the ill effects of cancer, they don’t define me… they shouldn’t make me detestmyself…
The fact that I still manage to function, that I still manage to find reasons to smile despite all this, and that somehow, despite all this, I’m STILL able to learn from this should be something to PROUD of.
Yeah, this, and other treatments, may physically stop me from doing things in the future.
But it won’t stop me from being me.
Indeed, when I think about it, this may just be the golden opportunity, the extra few hours in my day that’ll allow me to focus on other, more important things.
Writing my books. Learning more about cancer, depression and global inequity that I may help more people in the long run. And just being happy for being me, instead of what I can do.
I’m gonna make the most of this. And I hope this helps you make the most of yourselves too…
********************************************************************************** This bit is for patients or medical students, or those interested in this treatment I’m going through and learning more about extracorporeal photopheresis.
What is Extracorporeal Photopheresis? And how does it work?
Well, basically what happens is they take blood out of your body (hence “extra” – or out of, “corporeal” body) and put it through a machine that exposes the blood to UV light (hence photopheresis – “photo” being the UV light and “esis” being blood put through a machine or filter).
The same video as above, but it’s a really good summary, which is why I’ve linked it.
They need good access to some large veins to get a lot of blood through the machine and gain maximum benefits from the therapy, which is why they usually make sure people have VasCaths or other catheters in to ensure access to veins before doing it. Though some people have good enough veins to do it without it, often, due to the sheer number of times they need to access it, they can start to fail half-way through, and the tunneled (under the skin) ‘Vascath’ port ends up being the less painful, less intrusive option.).
(by the way – while you’re reading this, be sure to subscribe to my email list if you wanna keep hearing about my journey and other cool stuff in medicine!).
The whole process works by killing off T-cells, a type of immune cell which finds things that may endanger the body and attacks them, and activates the immune system, that have been activated and are on the attack or that are abnormal. These cells are responsible for graft versus host disease, an autoimmune process that’s often felt by bone marrow transplant patients. It occurs because the donor’s bone marrow stem cells (bone marrow contains haematopoeic (blood) stem cells, which produce white cells, which are a huge part of your immune system) is slightly different to your own cells. Even though you are tissue matched to your donor, there will always be slight differences between you and someone else, hence the T-cells attack your body thinking it’s a foreign particle of some kind, even though it’s not.
UV light, in combination with psoralen (8-mop or methoxypsoralen), a medication which sensitizes your cells to UV light, has been shown to kill mainly activated or abnormal T cells. The ones that are attacking you or causing you problem, fits this bill. You’re essentially given the medication, and then a procedure where blood is collected from one arm and put back into another (or through the port), with your immune cells separated out. These immune cells are exposed to UV light (inside these very expensive, specialised machines) and then injected into your body.
The blood from your entire body doesn’t pass through the UV-light machine though. It’d be very hard to ensure it all does. So there must be a systemic mechanism of its working here too – a way for the 10% of your blood that is passed through the machine, to cause an effect on the rest of your immune cells.
The activated or weird T-cells aren’t just all killed off, the treatment has to somehow cause the stopping of the production, or else the killing off of the immune cells causing the graft versus host disease.
And though it’s not set in stone, or observable right now, this is how we think it works (remember, there’s a disclaimer on the side of this here for a reason! Always ask your doctors if something is right for you!)
The T-cells that are “killed off” by UV light induce apoptosis, or self destruction, of the cell. And when these dying T cells reenter the body, they are taken up by macrophages and dendrites and other “antigen-presenting” or immune system stimulating cells, that likely cause your good immune cells to recognise the bad ones as foreign. This causes an immune response when self-reactive T cells are produced, and continues to get better over time as your body forms immunological memory cells which stop graft-versus-host-disease cells from coming back. This is combined with other likely factors in play as well.
So that’s how it works.
How effective is it?
In patients who have failed steroid and other immunosuppressing therapies in reducing chronic GVHD, ECP was remarkably effective. Rates of 80% – 100% cessation of skin GVHD are noted. With those with other forms of GVHD, like liver, gut and eye GVHD, high rates (70% and up) were noted in those who started it early after GVHD had set in (about half a year after it had started). However, lower rates of success in other organs were seen in those started later (1.5years median), and lung GVHD seems to have low rates of response to it in one study, though others suggest a decent rate. These studies were done on those with severe, uncontrollable chronic GVHD, might I add, so success rates may be slightly better.
And many of the studies done on this are rudimentary. There are different protocols with different measures of effectiveness. But the best sources for this (the ones I got my data from) are below: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3766348/ http://www.ncbi.nlm.nih.gov/pubmed/25025011
So what does it involve for the patient?
Well, first off, there are many protocols around the world for this, as stated above, and so the length and time involved varies.
In my case, I’ll end up getting 25 treatments of this, usually 2 per week (so around 3 – 4 months), plus any extra time I may need to show full response. I know at MD Andrerson, one of the world’s largest blood cancer centres, that they usually continue treatment for 6 months.
In most cases, it takes about 4 – 6 treatments (nurses say 2 – 3 months usually) for the effects to start showing.
Before you start, you put in the VasCath or other means of venous access. As I said above, you can avoid this, but it’s not recommended.
Each actual treatment will take about 3 – 4 hours on the machine. It is a long time, and the machine can be a little noisy, and there may be small side effects such as a mild fever, slightly lowered blood pressure or cramping, but these usually die down after the first few treatments. Blood will be taken from your VasCath and pushed through the machine, and pumped back into you simultaneously. I’ll update this while I’m having it to let you know any other thigns you may feel.
And after it, because you take a medication called psoralen, which sensitizes your body to UV light, you’re required to stay out of the sun (or wear large covering clothing) and to wear sunglasses for 24 hours after each treatment (the glasses, they recommend, to do it inside) to protect you from burning and lasting eye damage.
So I’ve had a lot of treatments now! I’m just updating this. How has the overall treatment worked?
Well! It’s no miracle “overnight” cure . But when I started, the skin around my joints had started to stiffen up and become inelastic. This changed that, and now, I can move them freely again (if it wasn’t for a few random, open wounds that just started up for some reason). My skin is still scarred, as you may have gathered if you follow the Facebook Page for this blog but it’s less scarred over my body, and it is starting to reduce in severity, slowly.
35 treatments took around half a year for me. The first 25 – they happened weekly, with 2 a week. But then it got spaced out to fortnightly/monthly. There was an issue for the funding for me in my nation (Australia) – after 25 of the treatments, you only get 2 treatments monthly from then on. In other nations, they like to “wean you off it” and give 2 treatments fortnightly for 3 – 6 months and then go to monthly treatments, reviewing you all the while. We ended up getting it anyway, but around treatment 15 – 25 is where I noticed most of the improvements.
There has also been a downward trend in my liver enzyme counts, possibly due to the GVHD too. The cramps (my other major GVHD symptom) haven’t dissapeared since commencing – I’ve actually noticed they, and the other signs of GVHD (skin darkening/itching) that I could feel, seemed to “flare up” the day or two after treatment – which my doctor said often happens. So don’t be alarmed (but do tell your doctors nonetheless! If it’s flaring up, it could be a sign of something else entirely) if that seems to be happening to you too. But the cramps I have are happening within the nerves supplying the muscles (this happens for many GVHD patients actually – if you, or one of your patients are experiencing this – you may want to get an EMG done to see if that’s the case. Treatment post this is limited though), which can take a few months to a few years to repair themselves. So it may be a while before I see any positive impacts of that too.
According to the nurses/doctors running this (it’s a newish/less documented therapy, so I know it’s hard to find info regarding it) – my GVHD is MUCH less severe than other people who are on this therapy. And others who couldn’t walk without a walking aid, or couldn’t eat things easily (bending the arm was hard/painful to do) have been helped immencely because of it!
Tis is just a “just in case warning” but a few months ago, I started seeing these red dots in my eye’s vision (you couldn’t see it if you looked at my eyes, but I could), about 3 days after an ECP treatment, just before I slept. And within a few days a “central retinal venous occlusion” had been seen, blocking blood supply to the eye, and causing my left eye to become blind.
Last week, as of June 2015, it happened in my right eye too. Luckily, for some reason, the occlusion cleared up, or wasn’t as severe (I drank a lot of water this time after seeing it – that may have helped) and I’ve still got vision there.
The doctors aren’t sure what’s caused it – it can happen to anyone really, and they’ve ruled out all the major causes. But dehydration can sometimes cause it apparently, and the eye doctors said the ECP treatment may possibly have exacerbated that.
It’s just a “just in case” warning, because they’re not certain of it, it’s the only cause that they can’t rule out sort of thing (it hasn’t been documented with ECP either this issue), but just in case – for Sam to avoid anything like this – make sure you drink LOTS of water, the night before, the morning/arvo of, and even during the treatment.
But don’t be afraid – I was likely a 1/1000 patient who that happened to, and there’s only a tiny chance that ECP has actually caused it too – indeed, there’s no proof. It’s just a theory. But it’s better to be safe than sorry, and drinking a good amount of water before and after the treatment is recommended anyway, so why not?
And also because it leaves you the option to keep hittin dat 😉
Valentine’s is a hard day for some. Not only are beta males like us forced to watch on, desolately, as billions share their perfect love lives on social media, we’re also subjected to this shit.
It’s seems like every zoo, and every viral news site in the world have come together to form the ultimate clickholes of clickholes this year around. I was mildly annoyed by this, so, as is my God Given Right as a MILLENIAL – I put in hours (10 minutes) of work to stop this shit. Sign the Change.org to stop this shameless attempt to generate website hits, and be sure to click this link to watch each of these photos in slideshow mode to artificially inflate the views this page gets before this leaves your news cycle.
If you hate shameless self promotion and clickbait, be sure to check out my upcoming free e-book on how what I did to beat cancer can be used to help you with anything in life, guaranteed (and by guaranteed, I mean it may work – but I’m committed to testing the psychological, neurobiological, learning and motivation science behind this with my app – which powers and automates medical research – Centered Around You.)
If you actually wanna make a difference, donate a mosquito net, one of the most cost effective way to save lives and billions in lost revenue according to GiveWell – which I’m sure you can name after that bloodsucking #$*!# ex of yours too.
It was funny the first 100 times… Ok… I’ll be honest… It’s still quite funny. I’m just doing this for teh views lel.
Shameless promo: Follow me on Facebook – or on insta/twitter @nikhilautar . If you wanna help make my startup a success – www.GoFundMe.com/gettosleepeasy
I recently went on CoffeZilla’s podcast today, and outlined a few experiences I had with dodgy MLMers and alternative clinics who advertise on Facebook, netting them millions, and Facebook tens to hundreds of thousands. Here’s a bunch of evidence and screenshots of other conversations I’ve had with scammers/MLM grifters. It’s REALLY sad to see.
For those who don’t know me… My name is Nikhil. I’m a medical researcher, medical student, and ex cancer patient.
I’ve been on both sides of the medical bed in my role as a patient, future doctor, and have also been in the background too – working on, and advocating for medical research. Again, in both my capacities as a professional AND a ‘consumer.’
I know what it’s like to be desperate. I know how crappy doctors can be when considering you as a COMPLETE patient, and person – and why and how complimentary medicine DOES make a difference. Indeed – a massage therapist, and dietician have changed my life. I’m on COQ10, Fish oil and am involved in other complimentary medicine too. Indeed – UpToDate, a tool pretty much every doctor uses every day to guide treatment actually recommends these two as first line therapy for lipid and cholesterol control.
But I also know the importance of medical science. I also know numerous friends who’ve been turned away from options which gave them a chance, and ended up dying. And in this post, you’ll read a story of HOW I MYSELF WAS ALMOST CONNED into trying Sodium Bicarbonate instead of real medicine when I’d relapsed, and given a 10% chance of surviving, and why we need to PROSECUTE PEOPLE WHO SPREAD MISINFORMATION FOR PROFIT – OR WITHOUT DISCLAIMERS (Click here to lend your voice to the the Change.Org campaign now)
Alternative medicine can be amazing. Many, if not most medical therapies DID come from nature, and knowledge of traditional medicine. And I’d say the majority of naturopaths, massage therapists and yoga teachers only encourage you to be more healthy, mindful individuals.
A video from my series – Medical Factz – that outlines the ridiculous “Cancer is a Fungus, and sodium bicarbonate is the cure” theory that started from fraud, and ended in jailtime for manslaughter, and millions of others being deceived.
Recently, Facebook took action after a natural birth Facebook Group urged an endangered patient to not seek medical treatment at a hospital. The baby passed away.
Right: Another pernicious danger seen often in Facebook groups… Toby is a juice advocate who sells juicing guides and products. He has no clue what cystic fibrosis is. Yet he is still trying to scam them to make a few Dollars. It’s sickening. Vertex is a pharmaceutical company who’s creating treatment for CF, by the way.
The picture below outlines a scam I almost fell for. When I’d relapsed, I was given a less than 10% chance of surviving. Palliative care was suggested as an option for me. A second bone marrow transplant was a long-shot, but the only curative option.
At this time, a family friend put my family in contact with a researcher and scientist named Dr J, who promised to have a cure for me.
I was desperate. Willing to try anything. But luckily, I also had a year of medical knowledge under my belt.
We went in to see ‘Dr’ J one day at his apartment. He went into this theory of how sodium bicarbonate could cure cancer. One common, popular alternative therapy promoted by many, is the idea that “cancer thrives in acid, and therefore making yourself more alkaline will cure it”. He also purported another common alternative therapy – that “cancer loves, and is fueled by glucose, therefore low-sugar diets will cure it.” The former is largely known to be false. Cancers, due to their rapid, anaerobic metabolism of energy emit large amounts of lactic acid which PRODUCE an acidic environment. Not the other way around. And in any case – ‘alkaline diets’ or alkaline water will only result in less acidic urine, and slightly more alkaline saliva (not associated with alkaline blood). Your body’s buffer systems keep your blood’s pH in a 0.1 window. Even 0.01 higher or lower than normal ranges result in medical emergency. There’s no way for alkalinity to make it TO the cancer.
When I asked him about how you could make tumor sites more alkaline… he had no response. And when I asked him a basic metabolism question any 1st year student in any health degree would understand (‘if cancer feeds off glucose… your body will produce glucose from elsewhere by breaking down fats and protein if need be. Why wouldn’t the cancer just keep using that glucose preferrentially?)… he again, couldn’t answer me.
He showed me a few case studies from decades ago of 1 or 2 people who seemed to have had tumours regress after trying sodium bicarbonate. But even then I’d been reading on spontaneous regressions, and even then, I knew that if only a few case studies could be produced in the decades since we had this ‘common knowledge’ of how to cure cancer… then it was unlikely to be representative, or statistically significant. And after all this, he turned his attention towards my parents and started his sales pitch on why “Amway vitamins” could cure me. Again, no clear linkages as to why his vitamins were better (or why vitamins could cure cancer for that matter) were made. I later found out that Amway is a company with a pyramid-scheme model, designed to make money through the perpetual, impossible, addition of members who go on to onsell product, and earn commissions on all members they bring into the program. “Dr” J was probably locked in this trap himself.
John Oliver, in his brilliant style, breaks down the fraud that is the many mutli-level marketing companies that exist worldwide.
Family and friends pressured me down his pathway. They said it couldn’t hurt. They told me to believe in him. They took me to a seminar where he waxed on and on, and brought up people with chronic conditions cured by his miracle therapies (when likely, their changed lifestyle habits were the real fix), where he wanted me to speak, to endorse his treatments.
I didn’t.
If he, a scientist working at the University of Sydney, couldn’t answer the questions of a 1st year medical student, why should I believe him?
It’s likely because of that drug, and hundreds of thousands of hours of work from scientists, and doctors around the world, that I’m still here today.
Yet, if I hadn’t had the knowledge I did, “Dr” J above could have killed me.
If you’re in a similar position – but don’t have medical training, please, PLEASE do a simple search on ClinicalTrials.Gov and/or your national clinical trial database for options. When I was looking up my own therapy – it helped me see trends of new therapies and backed my case to my doctor to get me the drug I needed. It’s simple to use – I’ve suggested it to numerous patients who’ve found second options and benefited from REAL SCIENCE through this. Please – try this first!
So why does this happen? Isn’t it illegal?
Consumer law protection exists for this kind of stuff. Yet misinformation like the above is rife within the multi-billion dollar alternative medical industry. You can’t sell TVs or Fridges based off false statements and claims. But somehow, it’s OK to gamble with other peoples’ lives, in health.
Why? Well, I’m not a lawyer. I’d love to hear from any medical malpractice lawyers out there who’d like to offer their own perspectives. But one major issue is that legislation against this kind of thing, around the world often lacks teeth.
This great article discussing the UK’s Consumer Protection from Unfair Trading Regulations 2008 in regards to alternative medicine –goes into some of the issues. Interpretations of the law are often not as clear as their intentions, in the eyes of lawyers and judges. Though it seemingly is clear that the defendent, not accuser, has to prove the claims they make are true, in practice, it often is up to the accuser to prove something’s false. Proving a negative is very difficult. And in a field where not much research is done… this becomes tougher. In addition, a lot of the time, enforcement isn’t followed up on laws. The Competition and Consumer Act 2010 (Australia), and numerous precedents and investigations done by the FTC also mark many of these practices as illegal.
Yet millions get away with this. Indeed, social media and fake news is a big proponent of this too. There are thousands of influencers with millions of followers making millions of dollars pedaling misleading, and often dangerous misinformation. Wellness is a half a trillion dollar, largely unregulated industry. Chinese Medicine, which I tried, were found to have 127 different types of fungal contaminants in just 15 herbal mixes. And innocuously, there are thousands, maybe hundreds of thousands, advocating for unproven therapies in Facebook groups – turning people away from real therapies – sometimes profiting, sometimes spreading misinformation. People and groups like this, I see everyday in cancer groups where I talk and interact with other patients.
And often, this stuff goes unchecked on social media. Not just from unscrupulous people like Toby (pictured above), but also from “Influencers,” and “Wellness Gurus and Coaches” who post deliberately misleading posts to millions of followers to sell their own products, or that of other, often unproven, wellness therapies.
Things like this seem innocuous. But it literally kills millions every year. It scams people, many of whom are already under heavy financial strain following intense treatments, of tens of thousands. It’s taken the lives of at least 2 close friends who had other, better options still available to them, and likely many more people I’ve known too.
Alternative and complimentary medicine can be amazing. The fact that practitioners actually sit down, and take the time to listen to you as a whole person is a big reason why it’s so popular. There are many massage therapists, yoga instructors, aromatherapists, dietitians and naturopaths out there who do know their stuff, work with doctors, abide by laws – and they help DO help millions. I benefit from many of the above.
But it’s when they do things like this that they become dangerous.
I believe we need to crack down on this industry, and the crooks who lead millions astray every year. We need to #MakeAlternativesGreatAgain – and when people make false health claims – we need to #LockEmUp – for the good of society – if they make unfounded health claims. If you agree – check out this change.org campaign I’m running soon.
1) IF YOU MAKE CLAIMS PERTAINING TO HEALTH – claiming a therapy WILL cure or fix a condition, or encourage others to try such therapies, without any evidence to back up your claims, without inserting disclaimers or saying “May” – YOU SHOULD BE CULPABLE, AND YOU SHOULD GO TO JAIL if your advice ends up harming someone.
2) – If you profit from the sales, in any way, of products with purported health benefits, YOU SHOULD HAVE TO MAKE THAT CLEAR, and it SHOULD BE YOUR RESPONSIBILITY, to check the validity of those health claims.
I’ll even go so far as to say:
3) If you share misinformation, without any reasonable scientific or other evidence behind it, and it ends up harming someone – YOU SHOULD BE PROSECUTED AS WELL.
If not… scumbags like these will continue to exist, and prosper off the suffering of good people. Check out the Change.org campaign I’ve made and add your voice to this campaign for science and reason.
Bell Gibson fraudulently made millions after faking that she cured brain cancer with diet and alternative therapies. Millions of dollars escaped fines. But how many she led astray of real options will probably never be known. Full article here. She joins other fitness and wellness ‘experts,’ such as Sarah Stevenson who’ve falsely claimed they’d beaten a cancer which spontaneously regresses in over 1/4 people due to diet and wellness alone, and then gone on to fraudulently provide wellness coaching sessions, for $300 per 50 minutes (rates doctors who’ve studied for decades don’t charge).
There are numerous examples of scumbags like this out there. You may well already be following them. If you are, and you don’t see links to journals, or any kind of evidence which backs up their claim – do me a favour. Unfollow them. And if they say something which you feel may be harmful to society – tag me, @nikhilautar, or use the #LockEmUp to help bring them down.
What I’m doing about it.
I’ll be running this campaign soon, this is one thing. But my Startup – Centered Around You – actually aims to be the first app of its kind to not just provide evidence based wellness advice – but TEST IT TOO. A combination of machine learning, my own passion for research, and inputs from world leading clinicians, researchers, and coders/designers, advised by CEOs, senior VPs and heads of national operations of international and ASX listed firms advise us. We won Australian Student Startup of the Year not long ago. Along with numerous other prizes (we made the finals of the Global Impact Challenge, won NSW Student Startup of the Year in a separate competition, and have received numerous other grants and rewards for our work).
Our medical devices will also make life safer and easier for elderly and disabled patients. We are testing with some of Australia’s largest nursing home chains in the near future.
And our products have also generated interest and pre-sales from people interested in getting a better night’s sleep too!
Check out www.GetToSleepEasy and CAroundYou.com for more information.
I’m always here to talk. You can reach me (I am incredibly busy, but strive to read all my emails) at info [at [ nikhilautar.com – or via this contact form.
Wanna report a dodgy influencer who may be breaking the law?
Could it help? Possibly – early studies have shown some improvement. Almost no cures. It it generally well tolerated. But toxicities have also been noted. I’ve been in a desperate position before… There are many options MUCH higher on my list of things I’d try if things got more dire.
Cancer patients who take alternative treatments are more l
Some alternative treatments also reduce the efficacy of treatments or prom0te tumour growth! For example, antioxidants may actually cause cancers to grow once established by reducing cancer-killing, toxic reactive oxidative species (ROS). Some drugs which mediate tumour cell death through inducing more ROS’s will also be less effective if you’re on a high antioxidant diet.
Wanna report a dodgy influencer who may be breaking the law?
So recently, a I was linked this article by many people. It’s been all over my Facebook feed, and I’ve been told to read it by many.
It’s really well done and articulates the challenges of hospital well. On both the doctor’s and patient’s side. It goes into the powerlessness patients feel, the confusion they face in hospitals, and the struggle of being a junior doctor in a system that’s pushed to its limits, and seems not to care. It features some really amazing artwork, and is told in the form of a cartoon, that really does capture your eye. As much as I may seem like I’m bagging on it now… it really is well done, and I highly recommend you give it a read.
But regarding the “novel” realisation that being a patient sucks…
A) No Shit.
Every 2 months a ‘profound’ article comes out after a doctor enters ED or faces his own health challenge and suddenly realizes – “holy crap I was treated like shit,” and i slapmy head. Hard (it’s probably why my memory sucks so much)…
You see it all the time in your patient’s eyes. It doesn’t take huge amounts of ’emotional intelligence’ to see that. You get used to it and start thinking “that’s just how it has to be.” and you are, quite reasonably, tired yourself, and often unable to do anything.
B) Where you can, instead of clapping your hands and crying ‘amen,’ go do something about it.
Take it from someone who knows… the tiny, little things which HARDLY takes time out of your day make a HUGE difference. When someone asks for pain meds, and they need it, chart it asap. And tell them, or get your nurses to tell them if it’s gonna take time, and explain why if it is going to take a while. “I haven’t got time right now, but I’m gonna try my best to get it to you asap” reduces suffering 90% compared to just being left hanging. Believe me, it does. Same goes for if you’re late, generally, in a clinic, or whatever.
Ask patients if they understand what you said when you chat to them, and if they have any questions. It’s not wasting time. It ensures that they buy into your treatment plan and comply with recovery, and they’ll trust you, divulge everything, and give better histories. If you’re too busy, let them know that you’ll get around to it when you can or to ask the nurses when they’re around next.
Asking about those little things like work, if they’re okay to get home, how they get their medications, is, for similar reasons, not a waste of time. And, importantly, they make you feel cared for.
The tiny things – greeting people warmly. Asking how they’ve been, talking about things important to them as you walk to your consult room… they are HUGE. My haematologist does that. There’s a reason why I drive, or take a train 1-1.5 hours each way to see him.
Because I feel CARED FOR.
That feeling is EVERYTHING. It’s your most powerful tool as a healer.
From someone who’s gone through enormous amounts of physical agony… trust me that I know what I’m talking about when I say that psychological/ emotional agony is 100x worse. And you ALWAYS have the power to change that. No matter what.
I get it. It feels hard to keep giving. Day in and day out, when you work such a stressful job and face failure on a constant basis… when you’re depressed and when everything feels even harder to do than normal… giving back becomes even harder. It seems futile. For many reasons – we doctors don’t take it as seriously as we should. Just going on and telling yourself you can’t do much is how we cope with it. But that’s the biggest trap of depression. Though playing the victim and focusing on the things that stop you is easier at the time, it really makes you feel shitter in the long run.
In truth though, doing the right thing – going “that extra mile”… it’s really as hard as it seems. The little things make just as much of a difference as huge, epic gestures. And ultimately, you being the good person I know 99% of doctors are underneath, wherever you can, helps YOU too. It reminds you why you got into this. It reminds you that you DO and CAN make a difference.
It isn’t that hard to do. And, like with anything in life, making the decision to give back where possible becomes habitual too. It becomes your norm. So anyone reading this… next time you’re out there… go that ‘extra’ foot or two. I guarantee you. It’s worth it.
This was a talk I did for the Australian Indian Medical Graduate Association’s annual general meeting a few years ago. I was quite raw… I’d just come from the funeral of an old friend and fellow medical student who’d taken his own life. I hope it helps those of you struggling out there, wondering, “what’s the point?” realise, that you can and always do make a difference.
I wrote this up for a friend recently. And as some of you who follow me know, I’m writing a book about my experiences through cancer, and the science behind the mentality which kept me going. But I realised recently that I hadn’t written up what I wished I did have when I was suffering most from chronic pain… A step-by-step guide which showed HOW you could beat this back.
The thing is – when you have something like chronic pain… everyone around you has suggestions. Eeryone suddenly becomes an expert. When you’re already so drained, physically and emotionally, from the condition itself – being told about miracle cures and being sold things that ‘WILL CURE IT ALL’ is not only heartbreaking, when you find measure after measure fails, but also depressing, in and of itself.
So I’m telling you straight up – this isn’t a miracle cure. I still have issues dealing with the sleep and fatigue I get from this chronic pain/cramping/fibromyalgic-like condition that I have. I still do get frustrated by how it limits me, fatigue wise, at times (though I can ignore the fatigue as well, I know it’s healthy to respond to REAL signs it needs rest).
With this mental process, I still feel pain sometimes. But my suffering because of pain has decreased almost completely.
But the great thing about this is… It wasn’t even hard. It didn’t require an ounce or bravery/courage or willpower. It did take time. But to this day, I can, and do ignore pain as it comes on, automatically, 6 years on. Without effort, or an ounce of courage or “strength” that I frankly couldn’t muster back then. Almost no-one who’s faced real pain can.
I hope it helps you get to a point where you can ignore the pain, and reduce the depression pain brings too.
The Process. How To Ignore Chronic Pain.
It took a few weeks to get there. But key key to this is that I had a long term goal in mind – of becoming a person whose mind would automatically ignore the pain when it came on.
I knew I could do this because I was on duloxetine – an antidepressant – for a while 2 years ago, which helped me, despite it not actually stopping the cramps which were responsible for my pain. While I was on it… the pain still happened. But it didn’t affect me . This powerful evidence of me knowing it worked – of me being able to ignore pain – in the past, really helped get through my head that I could indeed accomplish this. That I COULD ignore chronic pain, which really helped me believe I could do it.
Here’s the thing though – YOU have proof of yourself ignoring pain too. Because all duloxetine is, is an antidepressant. It causes neurochemicals in your brain to make you feel happy, or happier than before.
YOU – when you’ve been happy, when you’re doing something fun, do the exact same thing. You HAVE ignored pain in the past. And that’s HUGE.
In the first few days (and it really only takes a few days to a week, max) of adapting this mindset, that belief, that KNOWLEDGE I had, and do beat back pain, is what motivated me to keep going through this process, which creates, and solidifies neural circuits in your brain, that help you ignore chronic pain. Automatically.
I also read about neuroplasticity in general (the science of habit formation in particular), and the effects of positive reinforcement (not ‘omg you’re the best!!!’ positive, but rather you Telling yourself when you’re right, to help affirm how you did something) on strengthening mesolimbic reward pathways. These mesolimbic pathways have numerous effects that makes a thought process or behaviour (and hence, easier to maintain) – from our amygdala (emotional centre), to the pre-frontal cortex (planning and attention centre), to our hippocampus (a vital part of memory).
But in the end – all you need to know is that when neurons Wire Together – they Fire Together. By firing off the same thought processes (which are ultimately a bunch of electrical signals) over and over – your neurons become more sensitive to being activated the same way. And they physically transform to have stronger connections. And as electricity goes down the path of least resistance, in time, this becomes the automatic way your brain deals with something!
By understanding everything I could about neuroplasticity, learning and motivation science, and combining my findings, I figured out how I could hack this process, through positive reinforcement (again NOT reaffirmations, but through constantly reminding yourself HOW you thought through something!)- so you could do it again.
Ultimately, this makes the journey to get to a stage where neuroplasticity would change my reaction to pain, easier. Below, I go into this process, step by step, in a manner that could help you out too! Here’s a video on it if you’re interested in the science. But really… underneath it all… it also just makes sense.
I talk more about this, and referencing hundreds of articles which helped me ‘hack my brain’ in my book – which is free! Just click there.
The 4 Steps to Make Ignoring Pain your Norm.
These steps I keep talking about are not only simple and replicable, but they make adapting this mindset, and making it your normal way of dealing with pain, easy too! What I do is I:
1) Take a step back and look at the pain I was facing – when it was worst, when it was best etc. I figured that out, and I wrote it all down.
2) I saw that I could, and did ignore pain when I was feeling happy, when I was on that antidepressant (it didn’t reduce the cramps themselves, but did help me ignore them). You don’t have to stop the pain at the source – you often can’t do that. When you are able to attach less importance to a burst of pain and suffering though – you don’t feel it. I LATCH onto that.
3) I know now that I can, I do ignore pain sometimes… I saw that “As antidepressants caused me to ignore, and not be affected by pain, let’s focus on getting the same chemicals going on inside me to ensure I’m not affected by it!
By (a) Distracting myself! When you have chronic pain, your attentional centres in your frontal cortex grow visibly (we can see it in scans!) in size. Focusing on pain makes it worse. Do the opposite – distract yourself and focus on something else – and do this a few times in a row… and it starts becoming how you deal with things. and then b) Focusing on something, or doing something that made me happy – like antidepressants do. That makes staying distracted easier. Do it enough times in a row – it becomes a habit.
I knew that process of making this your automatic, normal response, would take only a few weeks – as neuroplasticity causes LITERAL NEURAL CIRCUITS to form in that time.
In this case, of ignoring pain, It only takes 4 – 6 weeks to do this to a point where it lasts FOREVER. But it only takes days to start not having to think, and consciously remind yourself to distract yourself, to start happing automatically.
By doing this – Almost mantra like – Instead of focusing on the pain once it occurred, I told myself “This Pain. All it is, is an aberrant, FAULTY signal that I shouldn’t be attaching significance to,” that “it would be over in seconds – minutes” that “getting annoyed by it, fretting over it happening again was only gonna make it worse (literally as remember – attention makes pain worse!). I told myself that “focusing on something else was more constructive – why not do that instead?”
and
4) I rewarded myself every time I ignored the pain. I told myself it would take time. But I treated it as a long term goal I was working towards. If I allowed myself to be human – to crash, and acknowledge there would be times I’d be unable to ignore pain along the way, I’d be able to get back up when that did happen.
I’d remember that in the long run, if I managed to do this more often than not… I would become someone who could ignore pain automatically.
It wasn’t because I was brave… It wasn’t because I had raw ‘willpower…’ It’s literally basic biology. It was the only way things could go!
After a week, as I got better at distracting myself, and inducing happiness, I even started looking forward to cramps coming on as an opportunity to show myself I could do it! I’d addicted myself to getting better at doing this. I treated it like a game, that I was improving at. I did improve. I was winning.
In less than a month, my reward pathways kicked in and I didn’t have to keep reminding myself to ignore the pain, and talk to a friend, or put on a movie, or do anything again. I only had to think about Tom n Jerry, and I’d be able to smile inside, and change how I responded to the pain.
And the better I got at doing that, the easier it was to distract myself and feel proud that I could. It doesn’t hurt that when you give yourself a long term goal, you release exponentially more dopamine (our happy neurotransmitter), the closer you get to achieving it.
In 5-6 weeks, I didn’t have to tell myself any of this at all. I was automatically ignoring chronic pain when it struck. IT DIDN’T EVEN TAKE WILLPOWER – or me reminding myself of those ‘mantras’-cum-realisations I did in step 1 and 2. Neuroplasticity made this a habit. One I maintain to this day, 6 years later.
Maybe this could help some of you guys out too.
It isn’t perfect. When I cramp these days, I do still feel a jolt of pain, and it does still stop me from doing things as it physically takes a lot more effort to do things when you’ve got other issues like I do.
But I have been able to ignore the pain more often than not. Over 95% of the time.
My psychologist told me “you have to accept the pain”. But doing that was REALLY HARD – accepting that and saying “I may suffer like this all the time…” was impossible for me to just jump straight into. CBT and all that, I mean it could have helped, maybe… but again… that was hard to maintain.
It was the preparation of this mindset – the manipulation of my reward pathways and neuroplasticity – and the knowledge I could change how I deal with pain – that helped me stay on track.
The acknowledgement that it’d take time, and knowing I’d fail and feel crappy some days – but that in the long run, I’d get there – prepared me. When failure did come, when I felt pain overcome me (I knew I inevitably would in my journey), I’d grit my teeth and bear it, but found myself focusing on the long run, and taking solace in that I would get there. I didn’t have to be this ‘brave, strong dude who had to ignore everything.’ By not having to be that guy, and by knowing how my brain worked, and that if I just walked myself through this more often than not, I didn’t just have faith that I could ignore pain. I KNEW IT.
But ultimately – the thing that helped me most was the realisation that this life can be very long. Why make my suffering worse by lingering on it? Why let it take anything more than me than it should? That is what helped me persist with this and get to this stage I’m at now, where I do ignore pain, as an automatic response, when it comes on.
AND I KNOW YOU CAN DO THIS TOO.
I think it could possibly help some of you. I wrote this out for a friend, and realised I didn’t have a ‘lay-over’, something to help people as I kept working on that full sized book (don’t worry, it’s only going to be 30-40 pages). So I thought I’d share this with you guys too. Again – sign up to my email list (I only email people once a month or so, don’t worry), and you’ll know when that books’s finally out. I’m gonna try and make it free too!
I know how much is sucked being told “It’s all in your head” when I was really in the dumps because of all this, that’s why I don’t wanna kid you, and wanna let you know that it’s not perfect. You can ignore fatigue as well, I’ve found, but my recent health run-ins made me realise that ignoring legitimate signs your body is suffering (pain is not a good sign of this) is not exactly healthy.
But I hope my getting there can help some of you. Feel free to hit me up if you wanna talk it through – info at nikhilautar.com will give you a good chance of reaching me (I’m getting extraordinarily busy though – so this can’t be guaranteed). I’m also decently active on my Facebook page and have a startup – Bheem Health – I run (I got NSW Young Australian of the Year for this!) and Knia Maps – the Google Maps for Accessibility!) which I’m always working on.
Let me know your thoughts – good or bad (Please… ROAST ME if you hate this post. I wanna make sure what I’m saying helps the most people possible. I won’t mind at all if you completely hate this).
More about my pain condition –
So I’m an ex leukaemia patient, current graft versus host disease sufferer and get chronic cramps. This is sort of common post transplant, but doctors aren’t too sure about what it is, how it happens, and have no clue about treating it in general. You can read more about my journey here.
Since writing this article, I’ve actually managed to fix my condition! My cramps affect me 95% less. I found a combo of drugs that work for it and am publishing it in medical journals. I hope that this reminds you, that, for some of you… there is hope yet.
During my time in hospital, and the months, years now of near isolation afterwards, my mum was the heart and head of my whole treatment. Keeping me safe, making sure I was comfortable and never alone, coordinating EVERYTHING that came with the cancer treatment, all while working, completing her MBA and keeping the house in order too (I still don’t know how she did it)… all those things.
But if she was the heart, Dad was the soul of my cancer “battle”. He kept me smiling, organized surprises and events, just him being the larrikin, the easy going person he is made my life that much easier.
The best thing he used to do though (and still does to this day) – was his jokes.
But a joke is wasted, if not told. And though he delivers those jokes with the best of them (even jokes I’ve heard thousands of times, I don’t mind hearing again when he tells them)… he sends us these crackers that he “makes up on his own” all the time. So without further ado, I’ll throw in his best ones, so hopefully you too can laugh no matter what too.
Sign up to my email newsletter to get it free! (Don’t worry, I don’t spam you, and you get it as soon as you sign up!) [email-subscribers namefield=”YES” desc=”” group=”Public”]
Facebook Banter
Dad and I have a hate-hate relationship on Facebook. Whenever we get the chance, we take cheap shots on eachother. And I mean whenever… Once he hacked my Facebook and shared all the dirty pictures he could. Let’s just say I had a week of explaining to do… plus a few friendships tainted…
But this one was gold.
It was plastering day at med school the other week, andmy tutorial happened to be on April Fool’s day. A GOLDEN opportunity to freak out my parents, right???
Wrong. Because as I posted this.. he snuck in with this gem.
I’m not even mad… Mr Autar… take a bow. But I’d watch out for next time if I were you…
I mean c’mon, his comment got more likes than my pic. I COULDA BEEN DYING GUYS!!!!!
A company, feeling it was time for a shakeup, hired a new CEO. The new boss was determined to rid the company of all slackers.
On a tour of the facilities, the CEO noticed a guy leaning against a wall and idly picking his teeth. The room was full of workers and he wanted to let them know that he meant business. He asked the guy,
“How much money do you make a week?”
A little surprised, the young man looked at him and said, “I make a little over $400 dollars a week, why?
The CEO said,”Wait right here.”
He walked back to his office, came back in two minutes, and handed the guy $1,600 in cash and said, “Here’s four weeks’ pay. Now GET OUT and don’t come back.”
Feeling pretty good about himself the CEO looked around the room and asked,
“Does anyone want to tell me what that goof-ball did here?”
From across the room a voice said,
“Sure – he was the Pizza delivery guy from Domino’s and was just waiting to collect the money!”
Marriage Training
Son: Dad, I want to get married.
Father: First, tell me you’re sorry.
Son: For what?
Father: Say sorry.
Son: But for what ? What did I do?
Father: Just say sorry.
Son: But…what have i done wrong ?
Father: Say sorry!
Son: WHY?
Father: Say sorry!!
Son: Please, just tell me why?
Father: Say sorry!!!
Son: OK, Dad…i’m sorry!
Father: There ! You’re finished training. When you learn to say sorry for no reason at all, then you’re ready to get married!
Here comes the Bride
A young man excitedly tells his mother he’s fallen in love and that he is going to get married.
He says, “Just for fun, Ma, I’m going to bring over 3 girls and you try and guess which one I’m going to marry.”
The mother agrees.
The next day, he brings three women into the house and sits them down on the couch and they chat for a while. He then says, “Okay Ma, guess which one I’m going to marry.”
She immediately replies, “The one on the right.”
“That’s amazing, Ma. You’re right. How did you know?”
The mother replies, “I don’t like her.”
Report Card
Father: Why did you get such a low score in that exam?
Son: Absence.
Father: You were absent on the day of the exam?
Son: No but the boy who sits next to me was!
I feel sheepish for sharing this one…
After a talking sheepdog gets all the sheep in the pen, he reports back to the farmer: “All 40 accounted for.”
“But I only have 36 sheep,” says the farmer.
“I know,” says the sheepdog. “But I rounded them up.”
Polly want a WHAT?”!?!!
A man went to a pet shop looking to buy a parrot. The shop had several parrots but one was priced much lower than the others. When the man asked why one was so much cheaper than the others, the pet shop owner assured the man that he did not want the cheaper one because it had a very foul mouth.
“I’ve tried everything, but I can’t get him to stop cussing”, he explained.
Eager to save some money, the man bought the parrot, sure he could teach the bird not to cuss. He too tried everything to stop the parrot’s foul mouth.
Finally, in frustration, he put the bird in the freezer to cool off. After a few minutes, he opened the freezer to find the parrot with a totally changed attitude.
“Please, I’ll NEVER cuss again! Please let me out! By the way, what did the chicken do?”
You can’t teach common sense
An uneducated father with his educated son went on a camping trip. They set up their tent and fell asleep. Some hours later, the father woke up his son.
Father: Look up to the sky and tell me what you see.
Son: I see millions of stars…
Father: And what does that tell you?
Son: Astronomically, it tells me that, there are millions of galaxies and planets out there!
Father slaps the son hard on his hand and says, “Idiot, someone has stolen our tent!”
Trolling the bro
It’s just so fun to do! The poor soul has to suffer SO MUCH of our crap. This here below is why he has trust issues.
The ol’ rancher.
A rancher was minding his own business when an FBI agent came up up to him and said, “We got a tip that you may be growing illegal drugs on the premises. Do you mind if I take a look around?”
The old rancher replied, “That’s fine, you shouldn’t go over there though.” As he pointed at one of his fields.
The FBI agent snapped at him, “I’m am a federal agent! I can go wherever I want!” With that he pulled out his badge and shoved it into the ranchers face.
The rancher shrugged this off and continued with his daily chores. About 15 minutes later he heard a loud scream from the field he had pointed out earlier. All of a sudden he could see the FBI agent sprinting towards him with a large bull on his heels.
The rancher rushed to the fence and yelled, “HEY HEY!!”, tugging his shirt, “SHOW HIM YOUR BADGE!”
The glass is always half full.
This poor man is facing surgery on both his feet because of severe wounds. The doctor has warned him that he cannot tell how bad the damage is until he gets him in the operating room and he has prepared the man for the worst.
After surgery, the man is slowly waking up and he sees the surgeon approaching his bed. The doc looks at him and says, “I have good news news and I have bad news – which would you like first?”
The man nervously responds, “Give me the bad news first.” The doc says, “I had to take both your feet”
“Oh my, what could possibly be the good news?” says the man.
“The guy in the bed next to you wants to buy your slippers!”
I’m gonna keep updating this with more laughs and videos of some stuff he’s done too! Not to mention the post with the dirtier jokes he’s shared with me in another post soon… So make sure you subscribe here, like Musings of a Med Student Patient on Facebook, check out my YouTube and all the other funny posts on this blog (look under the “Humour in Hospital” section) and hopefully, dad can keep you guys smiling too =]
Needles are a part of medicine. Unfortunately, despite having been discovered centuries ago, there is still no more elegant way of accessing your blood than stabbing a pointy thing through your skin – especially since Theranos turned out to be a huge bust ). An interesting story of how a startup that raised $9billion promising to avoid having to prick skin when taking bloods failed because… it wasn’t possible (meanwhile, my social enterprise just cheered winning a $10,000 grant. We’ll get there. Soon).
So I guess, as a future doctor, it becomes my duty to be the best I can be in this aspect. God knows it’ll be a major part of my training and (at least) the first five years of my career. May as well be good at it… if not for the sake of the poor beings I’ll be stabbing, for my own pride. After been cannulated at least a hundred times… you’d hope I’d have gotten at least decent in it…
This list below is a bunch of tips that I’ve picked up over my time in hospital as a patient from the best phlebotomists in the business – and the worst. It won’t go through the absolute basics – I’m sure you can find those in medical text books or handouts and the like – but rather those tips you won’t see in textbooks. Here’s the absolute basics – with nice pictures too if for reference! In future posts – I’ll go into things like subcutaneous injections and local anaesthesia as well – as I gain more experience with them.
You can help out by posting a comment about any awesome tips that can help that I may have missed – and by sharing it – with other medical students, doctors, nurses,
blood collectors and even patients. Discuss it below, put in some of your best and worst experiences with canulations, sub-cuts and blood taking – and I’ll definitely put any good tips I missed into the post. I’ve also got in touch with an old friend who’s working in a path lab, and she’s let me know of some further insights into how blood taking methodology can alter results, and, more importantly, how to reduce those alterations! Doctors take these results as gospel truth – but it’s important to note – alterations can happen and results can and do vary depending on how it’s collected.
A health-sector filled with good injectors will mean a health-sector filled with happier patients – not to mention one more open to giving blood, joining the bone marrow donor registry and picking up diseases before they become serious! AND a population of patients with more accurate results! So it’s in everyone’s best interest to share their experiences and share it with their peers!
THE TIPS:
First off – ALWAYS check the necessity of using a needle in the first place. In many wards, patients commonly have central lines, Hickman lines and other such things which negate the necessity for cannulas and blood tests – and they’re being used more and more. In my own case, nurses would always take bloods from my central line in the morning and I’d only need cannulas if I needed contrast for CTs, or some form of sedation (both of which can’t be injected into a central line). Majority of my blood tests, aside from cultures, were done through the line as well.
Though central lines and other such non-invasive (well, at least not after they’re put in) measures are being used more and more in hospitals, you will still have to resort to cannulation and venipuncture more often than not. And if you have the opportunity to have it done under ultrasound guidance – DO SO!
But without further ado – here
are my best tips:
Preparing yourself:
Before cannulating, ask the patient (or check in their files) if any blood needs to be taken that day. It’ll save them another jab which is always appreciated!
1. Make sure you have the correct basic equipment. Often forgotten examples include:
I. – An empty syringe – when taking blood it provides more suction than regular vacuum tubes so it can often draw blood where regular vacuum tubes can’t.
The syringe should only be used though if the vacuum tubes can’t. From the lab’s perspective, too much suction causes haemolysis (destruction of red blood cells) which can alter results. If that syringe is needed, pull back slowly, allow the blood to pull itself back through the vacuum effect, to reduce the chances of spurious results.
A saline syringe to flush canulas. It should be already attached to the bung/cap of cannula. This saves on the pain of having to manually pull and twist the cannula an extra time when you first flush it (often, that’s the bit that hurts the most). Nexiva canulas, which I’ll talk about below, eliminates this need.
A tourniquet to raise venous pressure and hence allow blood to flow. Failing that a blood pressure cuff works fine too and is actually superior as you can set the pressure to be above venous pressure (20 – 30mmHG) yet below arterial pressure too (100 – ish mmHG) to ensure blood pooling without undue risk of hypoxia/ischemia to the hand.
Gauze or cotton balls. A must – I’d keep a few ready and one placed below, or a bluey (or some other, disposable sheet) if possible where you’re about to inject. Blood inside cannula dressings can be an infection risk, and if you miss you should be ready to clamp down on it straight away. Bloody sheets/pillows are never fun.
More than one strip of alcohol wipes, in case you need more cleaning or if you’re checking a few injection sites. It’s not fun being left, anxious and alone in a room, waiting to get stabbed while a nurse or doctor runs outside looking for extra wipes.
Gloves and other requirements for sterility. In many areas, cannulation is becoming a fully sterile procedure, and many wards/units are clamping down on “cutting the tip off the end of a glove” for infection reasons, so being able to cannulate with goves will become more and more important. Try and do them with gloves on.
Correct needles, of course. A butterfly is always best for the patient for blood taking purposes, on the patient end. They’re generally fine to use when you only require small samples.
Although smaller needles are nicer for the patient – they can alter blood results (very fast flow through the needle can cause haemolysis too!) slightly, and slow down the drawing of blood, making it more likely veins can collapse. Too large though, and it’ll not only be more painful, but also more easy to miss. Getting the right balance is key!
Remember you will need to choose the best one for the job – depending on how much blood needed, how big or small the veins look, or, in cannulas, at what rate medication/fluids will be pushed through.
A small, yet short, plastic tube addition to the bung is also recommended. It will reduce pain for the patient from having to twist the cannula every time to flush it or when connecting new medications. Simply attach this to the end of the cannula and the nurses who administer medications through that cannula/port will no longer need to directly touch the injection site (reducing the need to move or twist it; thus reducing pain for the patient, as well as the infection risk).
Rightmost tube is an example of what I’m talking about. Attach this to the bung and nurses and patients will find it easier and less painful to flush/access the cannula.
IX Tape to hold down any such additions as in the above as well as to secure the IV tubes.
THE NEXIVA CANNULA.
This new-ish type of cannula, pictured underneath, has a section of tubing already attached so you will not have to come in contact with the blood at any point or touch the cannula once inserted.
What makes it the best cannula to use is its basic function. The needle in this cannula is inserted the same way as a regular cannula – with your forefinger placed on the soft tab in the middle (the wings supported by middle finger and thumb). As you withdraw the needle itself though, you need not pinch the vein down proximal to injection site as blood enters the tube meaning you will not come into contact with the blood or have any blood spurting everywhere. After you insert you see initial flashback, followed by a second flash which is where you stop threading it. The amazing thing about this is the needle itself. When you remove it, simple pull back on the tab at the end and it pulls out with a cap on the tip – so needle sticks are COMPLETELY eliminated making it MUCH SAFER for the injector.
Nexiva cannula pictured above. See sources below for more info. Notice the needle itself can be pulled out with a cap on it (grey part).
2. Make sure you gather all the correct equipment and keep it on a tray/trolley on your non-injecting hand’s side. This will ensure that you can reach all equipment easily without it getting in your way.
3. Try to be seated comfortably or, at worst, be kneeling, rather than bending over a patient. Unfortunately you may have to spend a while looking for a site to cannulate or injecting properly and hence a sitting down position with the patient high in the bed/seat (so you don’t have to bend over) is best.
Preparing the
Patient:
Often ignored, but vitally important is the patient’s own preparation. But luckily there are ways you can help out, even if you just inform your patient so they know better for next time:
1. Try and get the patient to be properly hydrated before cannulating/taking blood. The more fluid and blood in you, the more likely it is to pool up in your veins, where you’re trying to go. Also, increasing turgor of the skin allows for easier injection.
My arms 20minutes before and after drinking two glasses of water (obviously not – but in reality it does make a huge difference – one reason why I think doing blood rounds in wards just after patients wake up isn’t too smart even though it’s easier for doctor’s rounds.)
2. Ask the patient if they’ve got any preferences based on previous experiences – especially if they have been cannulated often. I guess that some patients who have only had a few may not be experts on the matter, but at the same time I feel doctors in particular who cannulate me will often go for veins that I have insisted simply do not work (some god complex – “what would you know, you’re just a patient” mentality) and, more often than not, they’ll fail. I MEAN C’MON! I’ve had at least one hundred by now – and many patients are in the same boat, so if they have had a few before and it isn’t contraindicated – do listen to them.
3. In order to make palpating the veins easy – place a heat pack over the arm/area which is most promising. It causes vasodilatation as blood attempts to cool itself by pooling to the surface in your veins and hence makes palpating and cannulating easier.
If a heat pack isn’t available, fill a glove with hot water and place it on desired spotor run a towel under hot water. I picked up this little trick once in the ward where they didn’t have a heat pack so there will always be a way to do this =]
4.
Talking to the patient is VERY effective in reassuring patients and will reduce occurrences of syncope and also reduce vasoconstriction due to anxiety and the fight-or-flight response. Anxiety will also mean faster blood return to the heart, meaning less blood in veins to draw blood/cannulate easily. A two way dialogue will be best for this. Seeming confident will also reduce a patient’s anxiety, and hence make you more likely to get it right the first time. So even if you’re not that confident, act like you are – putting on a false bravado about your skills will not only help your patient, but also you as you won’t hesitate and miss by accident.
5. If veins seem hard to spot or palpate, place the arm you wish to cannulate below heart level with a tourniquet on it before resting it up in a position to inject. This will increase blood pooling to the veins due to gravity and the tourniquet will further the pooling effect.
6. Don’t forget to ask if they have any conditions which will make this hard/messy – eg) blood thinners, low platelets etc. and plan for it by having the appropriate gear with you.
Choosing/readying your site:
1. TAKE YOUR TIME AND DON’T BE AFRAID TO PASS IT ON TO SOMEONE MORE EXPERIENCED IF YOU’RE NOT CONFIDENT. Too often I’ve seen doctors/nurses rush in to cannulate and miss and end up spending twice as long looking for another vein (often only to miss again)!
2. When looking for veins, always try and rely on your sense of touch first. Seeing veins is always a good hint of where to go, but a vein should feel soft and spring back – even more so when the tourniquet is placed above it and other preparation measures are applied – and often sight can be deceptive as less suitable, superficial veins will seem more appealing.
3. For regular venipuncture, the cubital fossa is often a good place to look first. Care must be taken not to inject the brachial artery, but the veins are often large and always closer to the surface. However, for cannulation, the forearm, the dorsum of the hand and a vein on the radial border of the distal part of the forearm are more promising (although the wrist veins are usually small, painful and restrict movement). The cubital fossa is more susceptible to kinks and having the cannula tissue/extravasate, as patients move around at the elbow a lot, . People underestimate the pointiness of the actual plastic cannula and don’t realise that it can penetrate the vein from inside if it moves around too much! Unfortunately, in emergency wards, they often attack this vein unnecessarily for cannulation because it’s easier to get. In my eyes – it shouldn’t happen if a patient is being sent up to a ward or observed – only reserved for “get the cannula in or die” situations.
4. There are deceptive muscles and tendons in your hands that will feel like veins. So get the patient to flex a few times if you’re trying to differentiate between a vein and muscle.
5. Forked veins seem to roll less but remember – they often have valves by the bifurctication. So instead of going in at the bifurctication, go slightly proximal to it (in order to avoid valve yet still get a vein that is less likely to roll)
6. Place the tourniquet about 20cm proximal to a promising site. Too far will not ensure enough pooling and too close may just constrict your entry point. It is generally considered safe to have a tourniquet on for five minutes maximum before ischemia becomes an issue – though I wouldn’t risk getting too close to that time, and wouldn’t tighten it too much.
7. Look for already straight veins. Pulling the vein straightwon’t do anything when choosing a sight or when injecting, as it will revert to its original position.
8. Valves can be tricky. However, they are palpate-able as small dips as you pass along a vein. Avoid these at all costs as they are very hard to navigate out of and cannulate/venipuncture.
Remember valves are there to stop blood flowing away from the heart in veins. Therefore – if you palpate one on a promising vein, inject to the proximal side of it so you aren’t stuck behind the structure.
9. Tap the vein gently in order to vasodilate the veins. Doing so will cause slight stress in the vein to release NO which is a vasodilator as well as histamine from mast cells which have the same effect. Rubbing gently has a similar effect and is actually more effective on cubital fossa veins.
10. When sterilising the skin with alco-wipes, allow at least 30 seconds for it to air dry. Not only will it allow more bacteria to be properly dealt with, it’ll mean the stuff won’t sting if it gets pushed into the vein. Fanning or blowing it will only increase chances of infection and cause the alcohol pool up in areas, potentially increasing the stinging as you inject.
11. Place the patient’s hand on a pillow or a stable yet soft object in a comfortable position as you are about to inject both for comfort and ease of access for you. Don’t forget to have a bluey or piece of gauze underneath where you’re entering for cannulas!
Going In – keeping the patient calm and getting it right:
You’ve picked your spot and have it fully prepared. Now all you’ve gotta do is get in there.
1. To stop vein from rolling away, pull the skin and muscles a few centimetres from the vein taut. Do not attempt to straighten the vein
overtly, as, as I’ve mentioned before, it will retract to its usual state as you inject anyway, causing tissuing and more pain.
2. Distraction therapy is helpful. Not only can you talk to a patient as it is about to go, I’d suggest getting them to look away. The natural fight-or-flight response will quicken heart rate, even subconsciously, and cause less blood to pool in the veins you’re aiming for. Other methods include getting them to focus on doing other things like wiggling their toes or tapping on a table (not your rest table of course) to get their mind off it.
With kids in particular, this is vitally important. You cannot lie to them about the pain, as it may lead to involuntary jerks or movement as you inject, but getting their mind off it will definitely help. Again, the trusty glove can be blown up and have a smiley face drawn on it to make it look like a spiky-haired friend. Definitely will cheer up the kids =]
3.
Hold the patient’s arm firmly with your non-injecting hand, as involuntary jerks are common and can disrupt the procedure. Also be sure to watch for any signs of syncope.
4. As you inject, the best angle, in my experience (and that of the best jabbers I’ve talked to) is anywhere between 10 and 30 degrees. Also, a quick jab as you pass through the skin is most effective in reducing pain – although taking it slow after you hit the vein wall is essential. You don’t want to jab through the other side.
5. Don’t forget to point the bevel up towards you!
6. Local lidocaine, a weak anaesthetic, is also an effective way to stop pain. But only if you can master injecting it into the dermis (level of skin just under the surface) rather than into the vein. A small jab into the dermis only 1 or 2mm into the skin followed by a slight push of only one or two drops should be enough to make the cannulation almost painless. This is usually more useful in larger gauge cannulas or on difficult-to-cannulate patients, and, like any local, you should give it time to take effect before penetrating the skin again for the cannulation.
7. Don’t feel you have to inject from right above the vein! Pressure directly on top of the vein can often cause elastic veins to roll more, so going at an angle and entering the vein under the skin rather than going straight above it can help.
8. Once you are inside, and you see a flash of blood, go a few millimetres deeper in order to ensure that the cannula is genuinely inside the lumen of the vein
and not just the needle tip. Has happened to me a few times where they removed the needle too soon and just ended up being a bloodier-than-usual miss.
As you can see in the picture above, the cannula may give a
false impression of being inside the lumen when only the needle point/bevel end is. Going
only a little deeper will ensure the cannula is properly inside. Using a nexiva cannula while withdrawing (requires a bit of practice) the needle removes this necessity.
9. If you do not see the flash of blood, do not immediately remove the needle. Attempt, with consideration for the patient (as it can be painful) to withdraw the needle a few millimetres
in case you went to deep. The needle may be resting on the opposite vein wall, so doing this will ensure quicker blood flow into the needle during venipuncture in particular. Palpate around the needle to see where the vein is and where you should go if you need to adjust it further. Though painful, in my experience, and from what nurses and doctors have told me, “digging around” for the vein after you’ve missed is less torturous than having the needle reinserted elsewhere.
10. If you do happen to miss, you should have a piece of gauze/a bluey underneath your spot so blood spurting should be fine. Remove the needle and cannula as usual and immediately
press down to prevent bruising from blood seeping into tissue.
11. If you have missed, try the other hand, or choose a spot that is proximal to the elbow on the arm as it will not be impacted by the miss further down on the vein as severely.
12. When taking blood, remember to keep the vacuum tube ready to insert into the suction cap. If that doesn’t work use the empty syringe instead to pull out blood. As it has a more powerful vacuum, it can often produce results where the vacuum tube cannot – though care should be taken to make sure you don’t end up pumping air into the vein. Remember, you should always try to take blood from a cannula if it’s required as patients like me will definitely appreciate not having to get stabbed twice. Do not do it after flushing cannula though as it will heamodilute the blood sample thus distorting results.
12. TAKE THE TORNIQUET OFF AS SOON AS BLOOD IS BEING DRAWN! It’s OK to leave it on prior to a patients’ blood being taken, but too long can alter results slightly. Ideally, it should be removed/loosened as soon as blood starts being drawn.
13. Flush after placing cap on needle. As you are placing the cap, pinch the vein a few centimetres proximal to injection site to stop blood from spurting out.
POST CANNULATION
1. Try and put a small tube that extends beyond the cap of the cannula and tape it down along the length of the forearm/arm. This ensures that the patient will not have to have the cannula twisted every time it is accessed and hence reduces chance of kinking and extravascation inside the vein too.
As seen above – there is a small tube attached to the cannula which the nurse is flushing the cannula with. This avoids having to twist and move the actual cannula when using the cannula.
2. When required, or if delays are occurring during blood collection for whatever reason, keep already collected tubes moving (turn them from facing up to down rapidly 5 times) to reduce the chances of the blood clotting too early and distorting coagulation results.
3. Anchoring the cannula. The most powerful anchor on a cannula I’ve seen and had done on me was to place a strip of tape underneath the cannula, perpendicular to the direction of the cannula with the stick side facing up. Criss-cross the tape around the insertion site, making a “bow” shape (see picture below). Place your usual, preferably transparent dressing over the cannula as you usually do and finish by placing a strip of tape again perpendicular to the cannula direction, but this time toward the cap to anchor it firmly. Although you may not see the injection site, most problems arise from the cannula slipping out rather than an infection near the entry site (which can be seen through this anchor anyway) so a good anchor like this IS necessary.
That’s right… admire my impressive paint skills.
4. Give the patient a “sock” to place over the cannula. Can be easily created from a cotton ribbed stockinette (easily findable in any medical store-room) by cutting a decent length of it out, enough to cover cannula and portion of forearm, and making a small slit on the side where you can feed the patients thumb through. This will protect the cannulation site and stop
unnecessary kinking and pain on the patient’s end too. Having just had a cannula tissue due to the dressing pulling back today, I realise doubly how important this is now!
Removing the needle:
1. Again, keep a piece of gauze ready as you remove the cannula/butterfly/syringe.
2. Immediately after removing it, press down hard on the insertion site. This will reduce bruising significantly post removal as the major cause for bruising in this procedure is allowing blood to seep into the tissue and hence bruise the area. Ask the patient to hold it down for two minutes after removal of cannula.
3. A very good tip is to tie a tourniquet around the insertion site very tightly (around a piece of gauze/the dressing of course). This causes any bleeding to stop rapidly and will significantly reduce bruising and bleeding.
So these are the best tips I’ve picked up over years of being cannulated by the pros!
Remember – share this with other patients, med/nursing students and doctors and anyone else who may be interested and share your experiences/own tips by commenting below! If I see really good ones – I’ll definitely add them to the post. It’s all about improving the experience for the patient so don’t be ashamed or shy to do so!
It’s your personality, your spirit, it’s every aspect on how you view the
world.
It’s you.
It’s no surprise, therefore, that when your mind gets affected by something and you lose control of yourself, it is often a torturous, traumatic experience.
During my treatment, I had a brush with that.
I developed an allergy to a drug I’d been taking for a long time for some reason or another that gave me PRES (Posterior Reversible Encephalopathy Syndrome) – a
very rare, but luckily, reversible condition, that sends people down into a staggering path of seizures, altered personalities, nausea and hallucinations.
Those 2 weeks I was being treated for it 2 of the worst in
my life.
But looking back I am able to see past that and not let it affect me. It wasn’t easy to do so. It took some time, but today I can look back and draw from my experience in a positive manner.
I hope what you’re about to read can help others do the same.
The scariest part of my condition was definitely the hallucinations. How real your mind can make impossible situations seem and the weird sort of links you see in the world when you’re out of your mind can be just plain frightening. But the fact that they are the projections of your inner soul – your inner person – allows yourself to see who you REALLY are deep inside. I was lucky enough to come out of it good…
But not everyone would be as lucky as me, or able to see their way past a mental illness and come out the other end like I had. And their trials aren’t limited to extreme things like hallucinations. Things like trauma and depression people face on a day to day basis are even harder to see out of sometimes because it becomes a part of someone. Some of the things
I experienced and saw really makes me sympathise with anyone who has to face that struggle every day of their life.
And unfortunately, millions of people do.
Here are a few of the most powerful, moving hallucinations I
had. For anyone who’s ever gone through anything similar to this or anyone who
may be going through a severe issue such as this, I really hope that this helps you get past your experiences and
encourage you to talk to someone about your fears and concerns (that someone can be me) and find a way
to move past them.
Time travelling
You guys remember the whole Mayan Calender – “The world is gonna end!” – Armagedon sort of event that was predicted to happen on December 21 2012 right?
Well, I experienced it all a few days before you all…
Let me explain.
During my time with PRES, I was obsessed with the idea of time. I don’t know why but things like the clock and the time display on the
computer terrified me. If I glanced at a clock face in that time, the hands would change directions every now and then, they’d sometimes grow a tail and even flip around, and twist and move in different directions.
One day, I was on my laptop. It was the 12/12/12 andapproaching 12am, midnight. My mind in its state, shifted it to 21 though and as time ticked over – I entered Judgement Day 8 days before everyone else.
I was panicking – I knew about the whole Mayan Calendar thing and in my confused, delirious state, really thought that the world was going to end. I started clutching at the straps restraining me, struggling to sit up to look through a window at the sky that wasn’t even there in the Intensive Care Unit, and see what was happening to the world.
Well, oddly enough nothing happened. Not even through the day. But I lived a full day – more than a week in advance – all in my head. I actually lived it – experienced everything from the taste of the breakfast muffin dad got me that morning to the feel of a fan cooling my face to even seeing and talking to visitors who never actually came – all in my head!
Even more amazing – I envisaged a whole day’s worth of international cricket (a sport we Aussies love to watch) playing on the TV the whole day. Australia had a great days play so looking back at it now, it’s made me realise how much pride I have for my country. I even watched a YouTube music video of a “newly released” song by Eminem, Kanye West and Hopsin all in my head. I looked it up a few months afterwards when I was thinking back to this particular hallucination and realised that I had, in the span of 3:45 minutes,
made up A WHOLE SONG – chord progressions, beat, lyrics and all WITH music video to match in my head.
That in itself is amazing!
But the next day when I woke up and saw that it was actually the 14th of December – I was shocked. The whole time I was hallucinating, I didn’t even know I was. I had lucid moments where I was myself for a few minutes a day but I don’t remember those. So naturally I panicked as I believed that I’d just travelled through time. I lashed out at doctors, nurses, my family – accusing them of making up my whole disease and forcing me through useless treatments, asking questions they couldn’t answer like why the windows were open when there weren’t any in the ICU anyway in my confusion.
It was my family who got me through it all – who grounded me every time – sometimes even playing along with hallucinations and withstanding the tempers and tantrums that came with them. What I was going through was hard enough – but I can’t even imagine having to watch someone you love go through all that pain. My brother in particular had to focus on this AND his final years’ exams too – how he managed to do as well as he did still astounds me! They kept me laughing, kept me as sane as possible – something I can never be grateful enough for.
Something that I now realise countless carers and supporters do for people with mental illnesses every day of their lives!
Kill me.
It started off a normal day. I had just started losing my hair again after chemotherapy actually and in my almost deranged state – was scared out my mind by visions of floating strands of hair entering my central line – an exaggeration of how germophobic I get when my immune system gets killed off from chemo.
Footage of me having a hallucination. I was seeing hairs everywhere, and my oxygen prongs was acting as a shield, protecting me from them. It was super trippy.
In any case, my doctor came into the room and I had a sudden vision. The light shifted and it was as if all those hair particles were emitting from HIM and coming to almost attack me.
The scary thing was the sense of doom I got from it. I connected his presence with the reason for me being attacked and infected by all the bugs I was getting sick and I found myself shouting at him to get out of the room.
What I did next I can’t even believe. I reached for my central line and was seriously contemplating pulling it out. It wouldn’t be lethal if I had done it, but I had just been overwhelmed by my circumstance and had made the conclusion that the hairs were going to cause an infection and kill me.
I wanted out.
Nurses came running in and I was asking about euthanasia and if they could do it for me. To be asked that question by someone who only days before had been smiling and genuinely
happy must’ve been terrifying – but as usual, they did their job well and grabbed the doctors. I suspect I was also put on suicide watch or something like that too.
What I did later that night though horrifies me to this day.
I was suddenly pulled out of my reverie before I started sleeping and saw small chunks of hair entering my central line again.
I grabbed my mother’s hair and screamed at her, “KILL
ME NOW! BEFORE THEY DO!” I pointed at my line again, urging her to see the clogged up chunks of possibly lethal shavings running into my veins.
“PLEASE!”
To be asked that by someone you love is horrifying. The way she managed to calm me down with the help of the nurses and remain smiling in front of me astounds me to this day. I can never thank her enough for all she’s done for me – but that one night in particular stands out from the hundreds she spent running back and forth from home to hospital, 45 minutes away, cooking and preparing meals all the time and sleeping on a too-small couch in that dreary hospital room for months on end.
It made me really appreciate the support I had behind me and it made the horrifying experience just bearable for me. Her support, her courage, is why I can write this today without being affected by it.
And there will always be someone who can do that for you in your time of need – whether it be someone, like my amazing mother in my case, in your family, a friend or partner, me even (feel free to comment your own experiences anonymously below) or best of all – a professional. Do not feel ashamed or weak to do so. In truth, if you take a step back and ask yourself why you shouldn’t talk about it – you’ll see it’s only an excuse to not get better and taking that first step and confiding in someone is actually the most courageous thing you can do.
Though the first two may seem otherwise, not all of my hallucinations were dreary, dark things with little hope. In fact, most, though scary or confusing at the time, are actually quite funny looking back at them now and there are a few that I as exalting, inspirational revelations rather than something to feel down about. Hopefully by reading about this one you can
see that any issues you may have – any trials you may face in your future – can ALWAYS be seen in another, more positive way.
The Most Amazing Hour Of My Life
This one started not too long after the last one.
A few days prior to this particular hallucination, I’d had an episode of cortical blindness – a weird kind of blindness where your mind refuses to register images that you see
but you’re still able to walk around without falling over things and are still otherwise aware of your environment For some reason I was suffering from extremely blurred vision for the days after that too.
It was 7:30pm on Sunday night – and my favorite show was about to come on – “Extreme Fishing Adventures with Robson Green.” My elder cousin – a really good friend of mine – had come in to sit down and chat and I hadn’t seen him in weeks so I was glad to have him there. Dad was there too – he wouldn’t miss that show unless he absolutely had to!
But for some reason, I was getting a really weird vibe from them both. The way they’d look at each-other every now and then with solemn looks and then turn away when I caught them looking made me think something was afoot. And I was getting an odd feeling in my chest – a little tightening maybe – that was bugging me.
The episode began with the these song playing and it was like a veil being lifted away from my eyes for the first time in years. The blurriness, the weird flashes of light that kept coming up and annoying me as I tried to see things shifted in an instant and I could see perfectly again. Everything was well defined and clear as if a group of electricians had come in and with
pit-stop-team efficiency changed my television to the most high-tech, advanced HD possible and left without me noticing.
I exclaimed “This is amazing!” and Dad and Manik, my cousin, looked over questioningly, with slight, almost knowing smiles on their faces.
“What’s up?” asked Manik.
“I can see everything… better than I have before. The TV, all the posters in the room – I can see people’s faces on the street!”
“That’s good man,” he said, calmly.
“Yeah, it’s cool isn’t it,” said Dad.
I was a little confused at their lack of excitement at the sudden reversal of my symptoms, but the show that was on was so beatific I soon found myself entranced by it. One of my greatest hobbies in life – fishing – was being displayed in the most perfect way possible. The host, Robson Green was sitting at a spot not too dissimilar to one of my favourite places of all time, a little lake surrounded by trees and sand and wading out to mid-ankle level and casting at fish he could see and – more importantly – catching them too.
My conversation with my cousin was one of the funniest and one of the best I’d had ever, as we relived all our old experiences of playing basketball together, of holidays we’d gone on years in the past and laced it with exaggerated, mostly made up references of our conquests and the prowess we displayedin dealing with the fairer sex.
As the show ended, everything became even more surreal than
before.
Breathing was getting harder – but not painfully so – just requiring a little more effort than usual.
“How are you feeling,” asked Dad, concern showing clearly on his face.
“I dunno but I’m feeling a little slow I guess, but it’s probably me just a little tired. How good was that show?”
“Yeah it was good wasn’t it,” he agreed,”Your timer’s getting low, might wanna buzz the nurse in soon.”
Sure enough, my medication pump started beeping and in a few minutes the nurse came in, checked my medications and put on the 5 minute, post medication flush, nodding at my father and Manik as she left the room. I gazed at them questioningly but was distracted again by the show.
It was as if everything had shifted. Robson – the host of
the show – talked and it was as if he was talking directly to me.
“The end is near. And it will go off with a bang.”
he pronounced, gently caressing a little trout he’d just pulled in. “Don’t
worry – don’t be afraid – it won’t be hard, in fact, it will be beautiful. I
present to you Extreme Fishing, the Movie.”
A sense of finality came over me. But it was peaceful – soothed by the smiles of my father and cousin and made happy by the montage of scenes of his upcoming movie playing in the background.
I was starting to get a little scared and glanced anxiously at the timer on the pump as it ticked down closer to 0.
I thought I was going to die.
“Don’t worry, Nikhil,” assured Dad. “It’ll all be over soon. And it won’t hurt”
Robson’s voice called out, breaking the little silence,
“It will not be sad, it’ll be over quickly. And it’s coming soon.”
“Dad, what’s happening? Why are you guys acting so weird.”
The pump started beeping.
“Don’t worry, Nikhil. Press the silence button. Trust me – you’ll be fine.”
I glanced over him and at Manik tentatively. I looked at my pump again and the time was out. I suddenly realised they must’ve rigged the “Silence Buzzer” button to release a medication that would end it all peacefully.
I glanced at them, tearing up a little. But they glanced back, solemn looks on their faces, and nodded for me to continue.
I looked back to the button and slowly extended my finger outward. It would all be over soon. I could feel it. But I wasn’t scared.
I trusted them and knew they’d know best of what was to come. Though I was shaking, tears streaming down my face, I slowly found it in myself to extend that finger and closed my eyes as I pressed the button, leaving us in silence.
I waited – knowing it would take a while for the medication to take effect.
After a few minutes, however, I opened my eyes, and blinked
a few times.
Nothing had happened. I turned my head back toward my cousin and father to my right and saw them beaming at me – grins stretched across their faces and eyes shining tears.
“What happened?” asked Dad, struggling to hold back a smile.
“I don’t know… Why did you do that to me? I was so scared…”
“Why do you think you’re going to die! Son, you’ve made
it. You’re fine!” he said, choking back a sob.
I sit here now, crying in joy as I write this, and am still astounded by that one moment of pure joy, of pure ecstasy that my mind had made me experience.
Can you imagine the utter joy that experience brings me?
It let me know that deep down, in the core fibres of my being, my inner soul – I was so sure, so CERTAIN I would be fine, that I wouldbe happy – despite all my struggles and pain, despite being told I had only a 10 – 20% of surviving twice and despite all the doubts I had along my journey. That I could envision something so uplifting, so motivating, so beautiful in a time where I was at the lowest in my life amazes me. And I thank my experiences, the attitude I’d developed with the help of my family, doctors, nurses and friends and myself
every day for allowing me to experience such a thing in my life.
*****
Your mind is a power thing.
And when something about it goes wrong, it can be a harrowing, life changing experience.
I am lucky enough to be able to have a healthy mind now (though I’m sure my brother would dispute this claim) and am so much more aware and sympathetic of the struggles people face on a daily basis in their battle with mental illnesses.
It affects a lot of us – depression will hit 1/2 people during their lifetime, dementia and Alzheimer’s are on the rise along with many other mental disorders and people face trauma and struggle to deal with pain every day of their lives.
I hope that my story of my own experience can help you to see that it isn’t something you should be ashamed about, or something that has to take you down. Give it time, do talk to someone about your problems – if possible a professional – and I hope that you do get better.
I know that each and every one of you can have all the happiness in the world.
All you’ve gotta do is give it some time and you’ll realise
that YOU have the power to control how you feel.
My life changed a few years ago when I was told, “Nikhil, the good news is you’re 17 and you have leukemia, but the bad news is you’re 17… and you have leukemia.”
Then I asked him the one question every cancer patient dreads: “What are my chances?” He looked at me, sighed and said, “10-20 percent that you’ll live the next five years.”
Somehow, I got through that.
But it did get close. Quite a few times actually. And now that I’m a medical student and cancer researcher, I can appreciate just how close “close” actually was.
During my treatment, I suffered from many infections and falls, a few pressure sores, and a deep vein thrombosis (clot). Three of these four things could have killed me. One (those pressure sores) stayed with me for nearly two years, and even stopped me from swimming and washing my back.
The thing is, these things are common complications seen in hospitals:
Pneumonias (depending on the type and treatment) can affect 70 percent of cancer patients.
Falls will seriously injure nearly 1/10 people over 65 admitted to a hospital.
Deep vein thromboses affect up to 20 percent of those who are immobile, and will kill 15 percent of those who have them dislodged.
And pressure sores affect seven percent of those who enter hospitals (with nearly 1/4 in ICUs).
Each of these problems cost literally tens of billions to hospital settings, just in America alone! And most of these are unnecessary. Even one that often isn’t for cancer patients (pneumonias) can be reduced.
How? By simply sitting up. That simple act can reduce the severity and time spent in the hospital by 35 percent — more than two days in the hospital on average.
But although they’re recommended by physicians and have surgical guidelines around the world, and although I knew in the middle of chemo that any infection could kill me, I still couldn’t find it in me at my sickest and tiredest state to walk those few meters to my hospital bed.
And even though patients are told to exercise (or at least move their legs around to prevent dangerous clots where they happen most), and nurses are told to move patients around to prevent pressure sores, and patients are encouraged to wait for nurses’ assistance to get up when particularly weak, or at risk of falls… right now hundreds of thousands are falling through the cracks.
I knew I had to do something about it. I’d lost too many friends to these preventable issues myself. And I saw a perfect way to do so — by changing something that hasn’t really been changed in decades.
The hospital bed.
I’ve created a version of the hospital bed that will reduce, perhaps even eliminate, the incidence of all of these! How? Well, I explain in this video.
The features on our beds not only make lives more comfortable for patients, or those who are being cared for at nursing homes or homes, but they also save lives.
The inclining ability of the legs will increase blood flow to vital organs in times of shock. The decline feature, when combined with the incline of the head, will make this a chair that encourages patients to sit up much more effectively than any distant hospital bed could. Hence, reducing the rates and severities of infections.
The massage prongs will stop blood from pooling around the legs, which will reduce rates of blood clots. The contouring features and weight sensors will reduce tissue pressures where they’re highest, thus reducing pressure sores. And many features, such as the slide out rails, embedded charging ports, intuitive IV pole placement and a bed pan chamber, will reduce the need to get up for those who shouldn’t.
But we’re not only creating this. We’ve also got provisional patents on an adjusting wedge pillow — something that’ll help millions with lung or back conditions, acid reflux, or those wanting to lounge in bed more comfortably.
I think the best thing about this is that instead of the profits going to my back pocket, I’ll be giving away all of the profits we can towards charity, research and ensuring manual, affordable versions of this get to nations who need hospital beds the most. Personally, I feel relieving pain and putting a smile on someone’s face is so much more fulfilling than money could ever be.
We’re already partnering with Engineers Without Borders to create a version of this bed that can be produced cheaply, and close to source!
Plus, this is something that’ll save hospital systems money and lives.
The thing is, for a project this big to become a reality, we’re gonna need lots of help, so feel free to donate or buy some products that’ll help you Get To Sleep Easy (we also have some pretty cool merchandise, too.) You can also follow our journey through our email list, on Facebook , Twitter or Instagram.
And watch out for a pretty hilarious campaign we’ll be releasing next week called #GiveMeAWedgie. We’ve got a bunch of people ready to help share that out, so join us!
I hope this can help as many people out there as possible. I decided to study medicine because I knew I could make an impact on peoples’ lives. I’m working on some interesting immunotherapy cancer research because I saw you could save potentially thousands of people at a time… if you discovered something awesome.
And something like this could save millions of lives, and do so continuously and sustainably, for years to come.
I hope what I’ve said convinces you to help make this vision a reality.
Nikhil Autar was diagnosed with acute myeloid leukemia at 17 and given a 10-20 percent chance of surviving. Despite that, he made it into a medical degree at 18, and is currently doing medical research and running his social enterprise, Get To Sleep Easy. You can find him here or at his blog, Musings of a Med Student Patient.
