Health

Put the Paracetamol DOWN!!

I am still getting a worrying number of people coming to this blog trying to find out how many tablets of paracetamol one would need to swallow in order to overdose.

The answer is that it varies from person to person and depends on a lot of things including your physical state of health, your size and your weight.

Again, I stress if you are feeling suicidal the please talk to a doctor, counsellor or someone else.  Being suicidal doesn’t always result in having to be “sectioned” and talking can help you to get out of that dark place.  If you feel you may have accidentally taken a paracetamol overdose then call your GP or NHS Direct (or NHS 24 in Scotland) to seek professional advice on the matter).

For those planning suicide by a paracetamol overdose then remember it is not quick and it is not painless.   You often die days, weeks, months or even years after the overdose by which time you will almost certainly have changed your mind on dying.  Ironically, given that paracetamol is an analgesic, it can be quite a painful death also.

That’s been another public service broadcast from Ramblings of a Scottish Student.

Health

Schizophrenia and Bipolar Disorder genetically linked

I read an interesting article in the paper at Lunchtime.  The Independent was carrying the headline Unlocked: the secrets of schizophrenia on the front page.

The article detailed the findings of a recent report which suggests that there is a “…remarkable similarity between the genetic faults behind both schizophrenia and manic depression…”  Up until now the two conditions have thought not to be related, but now these findings could lead to new treatments for both conditions.

The “new research shows for the first time that both have a common genetic basis that leads people to develop one or other of the two illnesses.”

Thomas Insel, director of the US National Institute for Mental Health in Bethesda, Maryland, which part-funded the studies said “If some of the same genetic risks underlie schizophrenia and bipolar disorder, perhaps these disorders originate from some common vulnerability in brain development… Of course the big question then is how some people develop schizophrenia and others develop bipolar disorder.”

The full article in the Independent can be read here.

This is some really exciting research in the field of Psychiatry that could revolutionise the way doctors treat both Bipolar Disorder and Schizophrenia, both of which are psychiatric conditions that can ruin the life of those suffering from the conditions.

Health, Religion

Is it right to mix religion and healthcare?

The BBC are asking whether it is right to mix religion and healthcare.  It comes off the back of a story detailing how doctors are demanding that NHS staff be given a right to discuss spiritual issues with patients as well as being allowed to offer to pray for them.

For those who have faith and a religion the spiritual aspect to their life can almost be as important as taking the medication and treatment provided by doctors.  However, should doctors and nurses be involved in that spiritual side?  I’d suggest not.  The chaplaincy systems operated within the NHS are where the spiritual aspect of getting better are rightly concentrated.  Having priests, ministers, pastors, imams (or whatever they are called by the patient) available to come and pray for/with, meditate and talk with patients is a very good idea and can be of great comfort to the patient.  I know that when I was in hospital recently that the visits made by a few of the church elders and one of the pastors was very comforting and helpful.

Doctors, nurses and church leaders are all specialist in their own areas and as such should be left to do the job that they do.  I don’t know about other faiths, but certainly in Christianity one does not choose to become a church leader, but rather is called to be one.  They are specially chosen by God to do the job that they do and this makes them much better equipped to do the job.

I remember reading a story in a book where a junior doctor was telling about the time when he called a priest in for a dying patient who was all on his own.  The patient had indicated in their patient records that they were a catholic.  The patient died that night, but he did not die alone.  The priest sat with him until the end, praying for him and such like.  No doctor or nurse could act in this way – the just don’t have the time!

What I am trying to say is that faith has a place in medicine for those who believe in a God, but to mix them together is not the best idea in the world.  The doctor-patient relationship works because of the distance between doctor and patient, yes there may be a relationship and/or rapport built up over a long period of time, but it is quite different to the sort of relationship you start entering into with prayer.  Prayer is deeply spiritual and I think that the spiritual bond created between doctor and patient were a doctor to pray with a patient would be counter-productive.

Does anyone have any thoughts or opinions?

Health, Personal

Diagnosis

I do apologise for my abrupt and recent absence.  I collapsed on the bus on my way to work on Tuesday morning and have been in hospital.  The good news is that they now know what is wrong with me.  I have been diagnosed with Pseudoseizures (also known as Non-Epileptic Attack Disorder).

Now out of hospital and taking a few days to get back into the swing of things!

Health, Human Rights

Care of the Elderly

I watched Panorama last night which featured an investigation into the care being provided by “care” companies in the homes of elderly people and I was speechless at what I was watching.

This is not the first time that panorama has went undercover in the “care” industry; in the past they have focused on “care” homes.  The problems exposed last night in the programme appear to be endemic across the country and throughout the industry.  This is deeply concerning.

Care plans, which are legal documents and vital to ensure that the person being cared for receives the right care at the right time were missing, incomplete or out-of-date (on some occasions by up to two years).  Details of medication that should be getting taken and when it should be getting taken was not there, including medication such as insulin.  The copies of the care plans which were supposed to be kept at the company’s headquarters were found lying around in cars – and one employee even admitted to throwing information as important and confidential as this out.

People’s visits were getting cut short to the point where no care at all could be administered or were being missed altogether.  This resulted in people lying in their own excrement and urine.

The programme told of a Scottish local authority opening up the bid for a contract to a reverse auction.  Which resulted in a company who was clearly unfit to carry out the standard of care required being awarded a care contract worth more than £2m per year.

I am absolutely disgusted at this and it terrifies me to think that while I sit here typing this blog entry that people are in this situation.  This is abuse and it has to stop.

If you didn’t see the programme it is available on BBC iPlayer for seven days from the date it was broadcast.  The programme was originally broadcast at 21:00 on Thursday 9 April 2009.

Counselling Experiences, Health

Is a paracetamol overdose quick?

In response to the worryingly high number of hits I get from the search terms “is a Paracetamol overdose quick” I thought that I would answer this question in a full blog entry.

The short answer to that question is that where death does occur it is not quick and it can be painful.

The recommended adult single dose of paracetamol is two standard 500 mg tablets. Research shows that the common threshold for liver damage to occur from a single paracetamol overdose is 15g (30 tablets) although standard hospital guidelines allow an extra safety margin and assume liver damage could occur at a single overdose of 24 standard tablets or 150 mg/kg body weight, whichever is the smaller.

The overdose threshold may be lowered in a person taking certain prescription medicines, or a person who is an alcoholic or is seriously undernourished. If the overdose is spread over a period of time the threshold may be higher, as the initial paracetamol dose is effectively metabolised. (The recommended maximum dose in a 24 hour period is 4g or 8 tablets).

There are often no symptoms in the first 24 hours following overdose, although there may be mild nausea and vomiting. In a large overdose liver function deteriorates leading to jaundice, confusion, and loss of consciousness. Death is rare but when it occurs it is due to liver failure.

Treatment of a serious paracetamol overdose is mainly by administration of an antidote which can prevent the toxic effects of the overdose. This must be done early, ideally within 12 hours of the overdose although it can still be beneficial up to 24 hours or even later.

Treatment must be supervised in a hospital. It is important that if a paracetamol overdose is suspected, hospital treatment is sought without delay.

In England and Wales on average approximately 130 deaths per year can be directly attributed to paracetamol alone. In the vast majority of these cases the overdose is deliberate, and these deaths are returned as certain or probable suicides. In a small number of cases the overdose was intentional but the individual’s expectation was not to cause death. Such deaths may be recorded as accidental.