Can someone explain why this seems like a good idea? Do you wonder if this might be why they are having trouble winning the "Hearts and minds" of the Iraqi people?

Joey (Accordian Guy) found this cool looking film, and like him, I want to have it subtitled now

First off, thanks to everyone who has contacted me over my "exposure", I appreciate it all - even if I haven't personally replied to you (you'll find out why I might not have answered you a bit later in this post...)

I went to Occupational Health on Monday, basically to let them know about my exposure, and that I was on PEP. (If you want to learn more about PEP, click Here). The LAS showed how nice they are by lending me a spare ambulance to drive to my appointment - GPS navigation comes in handy when you don't know where you are going... Occupational Health is South of the river at Kings College Hospital - which is a bit of a trek. "Occy Health" took baseline blood samples, so that would know if there was any effect on my liver/kidneys/white cell count, as well as filling in a couple of forms about my exposure. Then they told me that they would get in contact with the "Donor" to see what his virus load and Hepatitis status was.
Until now I always thought of "Donor" as a "nice" word - heart donors and the like - I never really thought it would happen to include this circumstance.
During the consultation they told me that I'd need blood tests every fortnight for the next month or so, and that my first HIV/Hepatitis status check would be in three months, with an additional one in six months. Should they both be negative then I would be in the clear.
They also told me of the side effects of the retrovirals that I am taking - and seemed surprised that all I was experiencing was similar to a mild hangover...

That was yesterday - today was spent vomiting/sleeping to avoid nausea/and experiencing the joys of explosive diarrhoea.

My station officer called up and asked me how I was - when I told him, he basically told me to take it easy and go back to work when I felt better.

However there was some good news when the occupational health nurse contacted me, and told me that the donor's viral load was low, that there were no resistances to the PEP drugs I'm taking and that in 2002 he was free of Hepatitis. So that has eased my mind somewhat.

Some people have commented that I'm taking it rather well, there are a number of reasons for this - not least that the chances of me becoming HIV+ are less than 1 in 5,000. The other thing is that I can't do anything now to change those odds, apart from continue to take the PEP.

The other side effect of the meds I'm taking are that I'm having a certain "vagueness" - my mind isn't operating on all three cylinders, so if this seems disjointed, I've got an excuse...

There is a fear that every Health-care worker has. Tonight that fear jumped up and slapped me in the face.

Second job of the shift, we were called to "50 year old male - collapsed in street". Normally this is someone who is drunk - but we rushed to the scene anyway, just in case it isn't (we rush to everything it's the only way to be sure you aren't caught out). We reach the scene and see the male laying on the floor talking gibberish. He is bleeding from a cut on his face and possible from his jaw. Bystanders tell us that he "just dropped". He then starts to vomit, and because it's dark we get him on our trolley and into the back of the ambulance.
Our basic assessment finds that he has no muscular tone on his right side, although all his obs are within normal limits. Decided against hanging around - we start transport to hospital. Halfway to hospital he starts to vomit and cough - part of this vomitus/blood flies unerringly across the width of the ambulance...

...right into my open mouth.

Pretty disgusting - but what can you do? The patient then starts to come around - now able to move all limbs and to talk. This is good - it means I'm able to get some history from him. So I get his name, date of birth, address. Then I ask this 50 year old if he is normally fit and well.

"No", he says, "I have AIDS".

Bollocks.

I've never had anything from a patient in my mouth before (apart from the odd chocolate when I was a nurse) - so of course the first time is with a HIV+ patient.

My crewmate looks in the rear view mirror, and _that_ look passes between us. Ambulance people will know what I mean - it's the "Oh shit" look that you give/get when something goes horribly wrong.

We get to the hospital and the patient is looking a lot better, fully orientated, full strength and starting to feel the pain from a probably busted jaw. So I get to hand over to the nurse, which turned into a bit of a comedy moment...

Me:"Patient witnessed collapse, had right-sided hemiparesis, now resolved. Previous history includes AIDS".
Handover Nurse:"Fine"
Charge Nurse:"You can't say that"
Me:"Pardon?"
Charge Nurse:"You can't say AIDS - People will be prejudiced against him"
Me:"Well they shouldn't be, and this is medical stuff. It's a syndrome like any other"
Charge Nurse:"You have to call it something else"
Me:"I don't really care for political correctness - besides I'm a patient as well as I swallowed some of his blood"
Charge Nurse:"Oh...Well lets get you sorted out then"

I then went through the rigmarole of having blood taken, then I asked to be put on PEP, which the Charge nurse agreed I should be put on.

PEP is "Post Exposure Prophylaxis", basically a cocktail of antiretroviral drugs that taken over a four week period will hopefully reduce any live virus to non-infective amounts. Common side effects include...
Nausea, vomiting, headache, diarrhoea, cough, abdominal pain/cramps, muscle pain, tiredness, flu-like symptoms, difficulty in sleeping, rash and (I love this one) flatulence.
Other more uncommon side effects are - Pancreatitis, anaemia, neutropenia, peripheral neuropathy, and other "metabolic effects".

I'm in for a barrel of laughs for these next four weeks...

The Charge nurse looked really sympathetic when he offered me stuff to look after the side effects - He used to work in a HIV clinic so I guess he knows better than me what I'm in for...

Then we talked about rates of infection, which is why I'm feeling kinda relaxed here. HIV is a tough virus to catch (compared to Hepatitis which is the one that worries me) If I were to stab myself with a needle after drawing HIV positive blood I would have a 0.004% chance of catching the virus. Swallowing a bit of blood/vomitus is less risky than that - especially as I have no mouth/stomach ulcers. With the PEP my chances of "seroconverting" are as close to zero as you can get. I knew all this before I set foot in the hospital - which probably explained why I wasn't a quivering wreck.
So far "only" two medical workers have sero-converted after needle-stick injuries. I greatly doubt that I'll be the third.

So "The Plan" is that I go to see occupational health on Monday, and they will advise me on what happens next. I've been told already that I'll have to avoid sexual contact for the next three months (not a hardship - I've managed "no sexual contact" for two years before now), and that I'll probably need to take four weeks off work due to me feeling too ill from the side effects of the anti-retrovirals.

We'll see about that... I don't "do" ill.

Anyway if I do need to take time off it'll give me a chance to read some books I've got sitting on my shelf - and complete "Zelda - Windwaker".

Gotta go now, I feel flatulent already...

"Yankee Blog" posted about Fast Film on this Channel 4 Webpage. It really is something bizarre, and yet entertaining to watch. I can't imagine the amount of work that must have gone into it.

To get in with everyone else on the Blog "scene" I must point out This which is basically a sweary version of the Channel 4 station promotions which was apparently made for cinema, but couldn't get a certificate. Warning - lots of TV/Film people swearing

And finally this article from Paramagic, who I suspect is colour-blind from his blogs colour scheme. But the article does ring surprisingly true.

I found this on "Un-reconstructed Medic", I'm not sure I agree with a lot of what he posts, but this made me giggle.

I was happy. My girlfriend and I had been dating for over a year, and so we decided to get married.

My parents helped us in every way, my friends encouraged me, and my girlfriend? She was a dream! There was only one thing bothering me, very much indeed, and that one thing was her younger sister.

My prospective sister-in-law was twenty years of age, wore tight mini skirts and low cut blouses. She would regularly bend down when near me and I got many a pleasant view of her underwear.

It had to be deliberate. She never did it when she was near anyone else.
One day little sister called and asked me to come over to check the wedding invitations. She was alone when I arrived. She whispered to me that soon I was to be married, and she had feelings and desires for me that she couldn't overcome and didn't really want to overcome.

She told me that she wanted to make love to me just once before I got married and committed my life to her sister. I was in total shock and couldn't say a word.

She said, "I'm going upstairs to my bedroom, and if you want to go ahead with it just come up and get me." I was stunned. I was frozen in shock as I watched her go up the stairs. When she reached the top she pulled down her panties and threw them down the stairs at me.

I stood there for a moment, then turned and went straight to the front door. I opened the door and stepped out of the house. I walked straight towards my car. My future father-in-law was standing outside.

With tears in his eyes he hugged me and said, "We are very happy that you have passed our little test. We couldn't ask for a better man for our daughter. Welcome to the family.


"The moral of this story is:"
"Always keep your condoms in your car."

Normal moaning will be resumed shortly...

For anyone (in the UK) who saw "Nip/Tuck" last night.

I cried - and I'm not ashamed to say it.

I also laughed at the heads...

For those who don't have Sky or Cable, I'd recommend catching it on TV (should it show up on terrestrial) or to buy the first series on DVD assuming they release it over here in the UK.

I can tell what people have searched for on Google in order to reach my site. Some of the stuff is strange, some is interesting and at least one is disturbing. I'm not trying to insult anyone here (except perhaps the last entry) it's just a bit of light-hearted fun.

"conciousness random -ring -music -krishna" - Don't ask me. I want to know why they excluded "ring" and "music".
"1 in 5 men have women's brains" - I'd say one in five men have brains, and leave it at that.
"belle de jour boots" - Given current speculation "Belle" may well wear the same size twelves as I do.
"dangers of prostitution" - Really popular for some reason... some people search for "prostitutes in Newham". Prostitution is in my top five search terms for this page.
"SMELLING WOMENS ARMPITS" - Eh? What? I don't get it...
"haemarroids" - Because I'm one of only 3 Google pages that uses that particular misspelling of hemmaroid, er I mean hemorrhoid (That should get me a few more...)
"Pictures of dead people in random accidents" - Use Rotten.com for that, not me (especially after a Paramedic got the sack for taking "disturbing" photos).
"Medical" - Only three people have come here after searching for "medical" which I think kinda misses the point.
"Paris Hilton and toilet paper" - You make one passing remark about Paris Hilton (who I thought was the hotel, and all sorts of people wander along). And why "toilet paper"?
"psychiatric depression blog" - I know it might not seem it, but I'm normally very happy.
"reality secret" - There is no secret. I can promise you that - and you wouldn't find it here either.
"cingulate gyrus photos" - You want photos of a part of the brain? Why? Still as long as you aren't going out and getting those photos off your next-door neighbour who you buried in the garden.


And rather worryingly...

"9 year old daughter f**k daddy" - More than slightly disturbing...(and those "*"'s were my inclusion)

I've been told that "Womble Porn" should get a few people to this page as well, maybe if I also talk about "Britney Spears" and "fetish" I'll get even more...

I'm single at work at the moment (which means I don't have anyone to work with - and so am sitting on station twiddling my thumbs), so I thought I'd tell you all about the great God ORCON and how he rules the life of every EMT/Paramedic in England. (Also I recently read This which explains the horrifically complicated system in one state of America).

This is really boring - so I'll not be hurt if you don't bother reading any further.

The government likes to give everything targets, from school grades, the waiting time for breast cancer referrals and number of trains on time.
The ambulance service has only one main target to reach, that of ORCON. ORCON was started in 1974 and governs how fast we are expected to respond to "Cat A" calls. (See here for a description of "Cat A")

Essentially for every Cat A call we have to be there within eight minutes.

Simple really.

It doesn't matter what actually happens to the patient - just so long as we get there within eight minutes. For example - If we get to someone who has been dead for two days within eight minutes, that counts as a Success. If we get to a heart attack in nine minutes, provide life saving treatment and ensure that their quality of life is a good as possible, that is a Failure.

For those who don't live in London , lets just say that traffic is often heavy - there are "sleeping policemen" and tiny sideroads. We have 300+ languages spoken in London - which may delay getting the location we are needed at. We are hideously overused and understaffed, we face delays at hospital due to overcrowding and delays on-scene because of the ignorant people we have to attend to.

Doesn't matter - all that matters is that 8 minutes deadline. If we make 75% of all calls in 8 minutes we get more money from the government, which means more staff, vehicles that work etc... If we don't make 75% then we don't get any more money and we continue to struggle. This year it looks like we are going to make it, but only just.

there isn't any reason behind eight minutes being the time we need to get to people - brain death occurs after 4 minutes or so, trauma - while needing to be treated as quickly as possible - has the "Golden hour". The current rumour is that it is how long MP's have to vote when the "division bell" rings in parliment.

Who knows? No-one I have spoken to has any decent answers.

Well, that should be the last of my posts on the boring "day to day" running of the London Ambulance Service.

You may all rejoice now.

Heh - Just came across the "See Me Rot" webpage...erm...oh well...

Yesterday I met up with Pixeldiva who is a fellow London blogger (and as pretty as her picture). We visited The Weather Project which I would recommend anyone in the country going to visit - it finishes on the 29th of March. What we enjoyed the most about it was that the project was being used. Folk were laying on the ground staring up at the mirrored ceiling, making patterns and generally enjoying the ambiance. Pix took some pictures and at one point a giant circle was made on the floor just by a German tourist asking folks if they would mind making a circle. Lo and behold a giant circle was formed, pictures were taken and I was stunned by the whole "ad-hocracy" of it.
Then it was off to Camden for a few drinks where I briefly met Londonmark and D before heading off to watch The Dolz. This four piece were very good although they had to struggle against a rather dodgy sound system. Someone should sign them (and you can get a sample of music Here).
Then to home where my bladder threatened to burst all over the nightbus from the three beers that I'd drunk. I suspect that there are no public toilets between Camden and Barking.

Now I'm just jealous of those people who live in interesting places like Camden.

Picked up an assault yesterday - while sitting in the back of the ambulance he told his 2 year old daughter that, "daddy is gonna fucking kill the people who did this to me", then moaned when the nurse at the hospital told him to moderate his language.

I love this job.

We then went to someone who started hitting his own nose in order to prove that it had been bleeding earlier; and then went to a woman who had a bleeding varicose vein that had stopped bleeding, but wanted to pick at it to prove that it had been bleeding.

Then went to a 14 year old girl who was "fitting" but when we got there was confused and combative - as she was a diabetic we checked her blood sugar, which was low. Being confused is one of the symptoms of a low blood sugar and we normally give them an injection that brings them out of it. So we gave the injection and waited for it to work and receive the grateful thanks of the parents.

But it didn't work.

So we checked the blood sugar, and it had come back up to normal levels - yet the girls condition was unchanged.

So we rather quickly took her into hospital - we haven't been back there yet to find out what had caused her confusion, was it drugs, alcohol, psychiatric problems, CVA or even just a bad nightmare? Once we get back to the hospital which we took her to we will no doubt be able to find out. She didn't have a high temperature, didn't have any medical history besides the diabeties, pupils were normal and responsive, all observations were normal, and was otherwise normal.

We spend a lot of time dealing with things that are simple to cope with - you can fix them almost by rote thinking. But every so often you get a job that throws you. Normally you "wake-up" and deal with it by going back to basics, other jobs just completely confuse you, and this was one of those jobs.