Busy week?

I'm on holiday this week. Supposedly a time for doing nothing but sit in front of the computer, checking up on all my favourite blogs. I should be so lucky! It's perfect gardening weather - in Scotland that usually means it's not raining, but actually, the sun is out. Later this week, it's the double birthday. My niece and nephew conveniently decided to have their birthdays on consecutive days. She's going to be five and he'll be eight. So today I was out shopping for birthday stuff.
I've also been down at Mum's teaching her how to use Photoshop. That's the thing, you have a bit of computer savvy, and you're a guru. I was showing her how to use the lighting effects that I just discovered the day before. It always helps to be one step ahead.

After school

I delivered my wee seminar on the complications of retinal surgery today. It seemed to go okay. Mary, the course tutor, told me she and her husband have been reading this blog, and the picture in the preceding post was yucky. I'm glad it's getting such a good reaction.
Well that's my teaching done for the ophthalmic course. Now I've got to cobble together a teaching programme on tonometry for my Knowledge and Skills Framework. That's partly why I wrote that previous post about the different types of tonometers. See, the way they want it to work is that every year you set a target of learning objectives you want to achieve in the year ahead, to justify to the NHS that you're worth paying extra for. This year I had planned the seminar on the retina (done) and the tonometry project (still to do). But Mary asked me to do another seminar, so I've been concentrating on that (one thing at a time is a good philosophy to live by). Now, I've got until the summer to get the tonometry thing up and running.
Oh the joys of educational nursing!

A sight for sore eyes

It's good to get pictures from readers, so here's one sent in by Angela the pharmacist. She was telling me about a book she had (Eyes by Michael Glasspool) with a picture that she found difficult to look at - so she sent me it, and now I can share it with you.

The condition above is probably as bad as it gets for someone with an overactive thyroid. The eyeballs are protruding (exophthalmos). Because of this, movement is restricted (ophthalmoplegia), and there is a lot of fluid retention in the tissues (oedema). This poor chap will be unable to close his eyelids, so his cornea will be permanently exposed to the elements. The tear film will dry and his corneas will be at high risk of abrasion and ulceration. He will require constant lubrication, and reduction of his thyroid production - possibly by thyroidectomy.

Once the thyroid has been dealt with, he will probably require corneal transplants if there is too much damage to his corneas.

A 5000 year old operation?

I've just read that there is an Egyptian papyrus in Berlin that's five thousand years old, which has a description of cataract surgery. At present, I have no way of knowing whether this is true or not, but if true, it would put the origins of ophthalmic surgery four thousand years further back than was first believed.
I would so love to see this papyrus. I'm sure, given enough time and a facsimile copy, I could translate the appropriate passage to see whether they used an extracapsular approach, or the subluxation technique described in an earlier post.
How's that for a project? Combining two of my favourite subjects : hieroglyphics and ophthalmology!

Two new links

Two blogs have just linked to me. I've just added them to my blogroll. Don't call me Joe is a new blog - a very new blog. He only started a couple of weeks ago. And I was the very first person to comment! He seems to have got into the blogging way, so he could be around for some time.
The other is code blog : tales of a nurse. She hosted Change of Shift a few weeks ago, and came up with a limerick for each post! Pure genius! And just have a look at her blogroll! An icon for each link! Pure dead posh, so it is!
I love my one. It makes me want to keep visiting her blog, just to press it.

A touch of the Blobbies

Does anyone remember the Blobbies? It was a children's show from the late seventies with characters called Melody Gwen and Mr Centigrade. That's all I can find out about it on Google. I had this vague memory of a show with a Melody Gwen in it, so I googled her name and found the Blobbies who were some sort of pop group. The page didn't have any pictures to jog my memory. I have a feeling it was a cartoon though.
Although a lot of programmes from my childhood have achieved cult status, many more have fallen off the cultural radar, and this, I fear, is one of them.
BTW the programme had nothing to do with Mr Blobby, that I am sure of. He is one cultural icon I could do with forgetting.

MAARTH : CHAPTER IV

1. At first they knew not what had happened. They had no understanding of His sacrifice.
2. Some rejoiced in His passing. But others grew fearful.
3. And caution prevailed in the councils of the First ones. And likewise the Secondcomers and Thirdcomers too were cautious. And an uneasy truce was between them.
4. The winter came. And with it the sickness. Death claimed the sick in their thousands. First ones, Secondcomers and Thirdcomers alike. For the sickness knew no difference between them.
5. For death had entered the world with His death.
6. After the sickness came strife. And after the strife came more sickness.
7. Those that succumbed neither to strife nor sickness began to know what it is to grow old.
8.But also in the years after His sacrifice, children were born for the first time in the world. And the sound of their laughter was a comfort to ease the sadness of those who yet remained.
9. One by one, as the years passed, each First one, Secondcomer and Thirdcomer died.
10. And then there was not one left who had entered through the Doors of the World.

MAARTH : CHAPTER III

1. And now among the rebels were ones with great knowledge and power, to rival any among the First ones. Their craftsmen created great engines of war. They used blood secrets to breed fell beasts of battle.
2. And He fought with the rebels. He gave them His leadership. His power. His knowledge. And they prevailed against the First ones.
3. One by one the First ones were taken. And the roots of Mount Abnakhos rumbled with their groans.
4. Their palaces were taken. Their chariots were destroyed. And their devices burned.
5. But the last of the First ones, seeing that all was lost, resolved to take action. They gathered all the sources of power into one Source.
6. None could stand against them now. And the war turned in their favour.
7. He knew what they had done. They had used His discoveries. Continued the work He had forsaken. And now they were all powerful. There would never be another rebellion.
8. But even they did not know how far His knowledge now extended.
9. He surrendered Himself to their judgement. As they demanded. And they condemned Him to a thousand years of torment.
10. But before they took Him away He spoke unto them, saying that their immortality was a barrier to being fully of the world. Without death, there was no true life : only endurance. No birth. No renewal. No change. Only stagnation.
11. And He reached into the Source and pulled the power into Himself, Immolating Himself in an instant.
12. And He died.
13. His was the first death.
14. And by His death the veil was torn. First ones, Secondcomers and Thirdcomers became truly part of the world.
15. And the Doors of the World slammed shut.

MAARTH : CHAPTER II

1. There was one in the world of great knowledge. Who understood the energies and workings of the world. And through whose means the First ones obtained the Source of their power.
2. He it was who led the First ones in their struggle against the rebellion. But the victory tasted to Him of bitter gall.
3. He could understand the right of the rebels. And He could see the corruption of the First ones.
4. And He slowly withdrew from their councils. And dwelt apart in His dwelling place on the northern continent. Where He immersed Himself in His studies into the workings of the world.
5. And the Doors of the World remained open. And more people entered the world to serve and worship the First ones.
6. And also through the Doors of the World came other creatures. And they were strange of form. And some malevolent and dark of breeding.
7. The Thirdcomers also wearied of their servitude. And they joined with the remnants of the Secondcomers in rebellion.
8.This time He refused to lead the First ones against the rebellion. And though their power was great, they could not completely subdue the rebels.
9. When peace was obtained, the rebels agreed to serve. But never more were the First ones worshipped in the world.
10. But He remained apart from the conflict. And His standing with the First ones worsened.
11. And when the Thirdcomers, and the remnants of the Secondcomers tired again of their servitude, He joined them in their rebellion.
12. And there was war upon the face of the world.

THE FIRST BOOK OF FOUR GODS

CALLED
MAARTH

CHAPTER I
1. Into the world came the First ones. And they were first because the world had no inhabitants.
2. The First ones named the lands and the oceans. And they named the plants and the animals therein.
3. The First ones took delight in their world. But they had no-one to rule over, for they were all equal.
4. They said: “Let us open the Doors of the World so that we may have people to serve us and worship us.”
5. And so the Doors of the World were opened. And people found their way from their worlds to this world.
6. But the First ones captured all who came through the Doors of the World. And made them serve them and worship them.
7. And in those times there was no death. And no-one grew old or sick. Even those that came through the Doors of the World to serve and worship the First ones. And their time of servitude was unending.
8. It came to pass that the number of Secondcomers surpassed the number of First ones. And they resented their servitude. And there was rebellion in the world against the First ones.
9. But the First ones were all powerful. And they crushed the rebellion. But there was no death in the world so they could not kill the rebels.
10. They chained the rebels. And bound them beneath the roots of Mount Abnakhos. But there were others who evaded capture. And they hid in the secret places of the world.

A real ophthalmological nurse

Mother Jones at Nurse Ratched's Place has tagged me with a meme. It's 'what makes a real nurse?' I'm going to refine it to my specialty, so here's my take on the meme.

What makes a real ophthalmic nurse?

1. You automatically remember to spell ophthalmology with an 'h' after the 'p' and an 'l' before the 'm'.
2. You can hold eyelids open with your ring finger while your thumb and forefinger are squeezing a drop bottle.
3. Your 'yuck' reflex evaporated ten minutes after starting work in an eye ward.
4. You loathe and detest iridologists.
5. You're not too fond of people offering laser corrective surgery either.

Okay, that's it. You only need five statements. I tag Dead Nurse Walking and Intelinurse. Have fun guys.

Mystery of the missing pods

The Royal Infirmary of Edinburgh has a pneumatic tube system for the transportation of laboratory samples and pharmacy orders. These are encased in cylindrical pods which shuttle back and forth through the fabric of the building. Lately, staff have been noticing that the supply of these pods have dwindled. Where once there were a couple of spare pods on the rack, now they need to be borrowed from nearby wards, or failing that, requested from the labs or estates.
Recently, a number of pods were discovered on the roof of the hospital. No-one knows how they got there!
I have a theory.
Considering the number of cock-ups in the building of the hospital, I find it more than credible that a misreading of the architect's blueprints may have resulted in an egress of the tube system opening onto the roof. The missing pods being shunted down this false exit by a miskeying of the destination code, would result in them popping out the pipe and travelling in a parabolic arc over the hospital before landing where they were found. The opening might be some distance away, and thus remains undiscovered and purely conjectural at this stage. Any other theories would be appreciated.

Rock n' Roll n' Resus

Pack your trunk Nelly! Step gaily away Marie! There's a new entry at the top of the CPR charts.
Up until now, practitioners performing resuscitation had a choice of songs to pump people's chests to. They were Nelly the Elephant, and Marie's Wedding. Today, I was informed by our friendly neighbourhood consultant anaesthetist that the tune of choice is now Status Quo's Rockin' all over the World. Apparently it's a bit faster than the other two.
So now, when you are trying to revive someone who's suffered a cardiac arrest, you're going to be in a whole new world of cool as you perform compressions, going, "Here we go and here we go and here we go..." At this point the words subside into a hum because you don't actually know the words to the next bit. And so it continues until you finish with "... Rockin' all over the world!"

Stand and deliver

What's the most expensive postage in Britain? I believe I have a candidate. The Royal Infirmary of Edinburgh portering services are run by Haden. The other day, a colleague sent a prescription to pharmacy. She was told it would cost £36 for it to be delivered to the ward! That's from one end of the building to the other. You could get the same package delivered to the other end of the country for under a pound.
What I don't understand is how Haden calculate that £36 is a fair and equitable rate to charge for one person to carry a small package weighing not much more than a packet of crisps for the ten minutes maximum it takes to walk from one end of the hospital to the other. That works out at a rate of £216 per hour. Nice work if you can get it. I must be in the wrong profession.

Placido out of retirement

In my previous post, On Tonometry, I referred to a black and white disc only found in a cupboard with other obsolete equipment. I must now amend that description. My colleague Debbie, a reader of this blog has informed me that this disc, known as a Placido Disc (no, it's not a CD by one of the three tenors!) is very much still in use. It was required by one of our Ophthalmologists in the clinic the other day, so this fragile, rickety museum piece was carefully removed from its resting place and pressed into service. In appearance, it resembles one of those big cartoon lollipops, with concentric black and white rings (probably liquorice flavoured) It's purpose is to help visualise the curvature of the cornea, by examining the reflection of the white rings. Any astigmatism will show up as a distortion of the rings. The reason the Placido Disc is rarely used now is because we have a tomography machine which will give you a printed map of the cornea, showing you the distortions in a colour-coded diagram.
Still, it's nice to know the old equipment is being used as back-up.

Change of Shift : Key of the Door

Change of Shift is now up at Emergiblog. It's volume one, number twenty-one, so hop over and wish it a happy coming-of-age. Here's the link:
http://www.emergiblog.com/2007/04/change-of-shift-vol-one-number-21.html

Blogger reconnected

I'm back online! I managed to get to B&Q today and got a telephone line extension to replace the one that mysteriously stopped working, cutting me off from the blogosphere. Not a pleasant experience I can assure you. You miss not being able to check things up on the internet when you want to. For the past three days, I've been forced to sit and watch television, then go to bed before midnight! My normal bedtime is round about 1am, with 2am sessions not unheard of. So being in bed at 11:30 was a bit of a culture shock. Mind you, I have been working the last two days, which means getting up at 5:30. I'll be a bit later tonight. I'm definitely an owl. Late nights are no problem at all. My wife, on the other hand is a lark. She has no trouble getting up at the crack of dawn, whereas I refuse to emerge until after 9:00. (on my days off that is - it compensates for the early starts on my days on.)

Blogger interrupted

Disaster! The line connecting my computer to the telephone socket has mysteriously stopped working. Normal service will be disrupted until I can reconnect the machine. I'm using another machine to post this. This is such a pain. And I'm getting withdrawal symptoms. I'll have to do some shopping on Saturday. Hopefully I'll be back with you after that.

Song of the Foolish Ones

BEHOLD.
The world is a plaything.
And the doors of the world are open.
O foolish ones.
You play unheeding of the gathering evil.

They create such marvels.
Great palaces. Golden chariots. Devices wondrous to behold.
O foolish ones.
Your playthings will bring you no comfort.

There is one who seeks knowledge.
And He sets Himself in authority.
O foolish ones.
Beware the one who sets Himself in authority.

He says:
We must know the measure of this world.
Its width. Its height. Its depth.
He sets Himself apart to watch and learn
O foolish ones.
Do not scorn He who has set Himself apart.

He returns to them saying.
I will bind you to this land.
I have its measure.
I have its width. Its height. Its depth.
Its beginning. Its end.
His death tears the veil that separates them from this world.
O foolish ones.
You can never leave this world.

You are bound to it by His death.
And like Him you must also die.
For His is the first death.
By His death all who dwell in this world must die.
And He has dominion over them.
O foolish ones.
See how you have fallen.

Your palaces are hollow shells.
Your chariots are broken.
Your devices are ashes.
O foolish ones
You are dust.

Shaggy Blog 2K

The 451st copy of Shaggy Blog Stories has been sold, bringing the total amount raised for Comic Relief to £2000! Go team!