Wednesday, 7 August 2013

Hot weather up North.

The last few weeks have been mildly warm up North for those of the GPs who have been around for a while and have learned how to adapt to a temperate, tropical, desert, savannah, continental or arctic climates over the years. They wear the same clothes with a pair of good quality stout walking shoes that adapts to most seasons which in winter may require the addition of our Yeti friends and some gloves to ensure patient care on an year, all terrain, all weather basis. Bit like our local farmers’ Border collies who are paid less but valued more than our GPs are by the health Secretary Khunta.

So while our doctors, nurses, administrators et al sit in some rooms that at this time of year regularly hit 32 degrees Centigrade in their blouses, trousers/skirts and some in shirts and ties each according to personnel preference the public come in saying it is too hot for them to work, it is too cold for them to work, it is too sticky for them to work, there is too much snow for them to work but the last few hot weeks somehow the team just keep going. Yes the snow today is terrible here up North you are not ill next . . .

So here is a reporter’s eye view of illness up Northshire in the “heatwave” which would be cool temperatures elsewhere in the world for some in the armed forces:

1) Multiple incoming insect bites.

This was our medics’ top “emergency” these past weeks.

It is one of the wonders of either Creationism or Darwin’s theory of evolution that there is a whole breed of different creatures (horse flies, ticks, mosquitos according to our keen expert entomologists) that our doctors’ patients think are desperate enough to feed off their adipose pumped manky tattooed flesh to the point of causing them harm (the patient that is we do not know how the poor alleged biter ever fares in these life threatening encounters dear reader). A few are allergic, a few infected and most could be avoided by allowing the large quantities of adipose tissue the option of being covered up when it is warm. As any surgeon knows when you cut fat people their unexplainable (it wasn’t me) lard invariably gets infected.

Surgeons are educated and try and avoid operating on the obese for surgeons know the consequences of cutting lard something the lardees know nothing about as it is never their fault. Regarding the insects, have you ever seen a fat insect? Well make your own minds up the result of a penetrating wound in fat tissue is the same whether surgically or insect inflicted and it is always a hot weather medical emergency as it may interfere with an unconnected item later called the BBQ which has no connection with lard as it is always outdoors and therefore always healthy.

(Before you start thin people also occasionally get infected insect bites and wound infections but not in such huge numbers as we have been seeing in those not so thin).

2) Sunburn.

Something the doctors report they haven’t seen for a good few years and the excuse of I use a sunbed and can’t understand why I burnt reminds us of multiple sunburn faux pas from the 1980s when sunbeds and associated sunburn were all the rage

Painful yes, worthy of treatment for we have all done it, yes but when in your fifties and well at it (sun bathing that is) while under the influence preventable.

3) Barbeque acquired diarrhoea.

So 18 pints of lager while camping prior to putting the meat on the barby 18 hours after purchasing it from the supermarket while leaving it in the back of the car to defrost overnight in 20+ C temperatures means no way can you have food poisoning. When you in the small hours checked how it was going and pierced the inflated packaging and let the car windows down because you felt the car was too hot and you thought the meat might suffer means that no fly fresh from a nearby dung heap could ever have trodden on it prior to you under cooking it. And can you have a sick note because the boss does not believe your 15th episode of Monday morning diarrhoea this year? No next . . .

4) Gout

Yes several people have seen the docs with severe painful red joints caused by gout. They will have to wait for the blood tests but given overseas experience of sudden onset of painful swollen extremely tender red joints in your feet these might just be gout due to to dehydration although insect bites remain a possibility even though you insist you had your socks on under your sandals even at night for the last 2 weeks.

5) For the classically educated.

This year and the docs suspect it is because it is hot they have seen more and more sun bronzed/reddened flesh than usual and they have noticed more and more blue pigmented flesh which 2000 years ago may have been called woad. Are we being cynical up North but are we seeing what our Roman forebears saw once before and would have considered offensively hostile then?

6) The old chestnuts.

The presence of an international airport nearby means that at this time of year many alleged “medical” emergencies are prefaced by “I am going on holiday in a short time period and need . . .” or “I have just got back with 2 weeks of symptoms and have come straight to see you (because you are free)”.

The docs have had a new one this year from Crystal, your average travel agent whose list of NVQs (Not Very Qualified) qualifications have led Crystal to insist on an emergency appointment for an elderly patient with a highly contagious airbourne and very visible disease to obtain a letter from a doctor to say “they are fit to fly”.

Crystals are the bane of doctors’ lives for while they are happy to relieve their customers (clients) of their money whenever there is a problem they dump and run. Crystals are not bright and Crystal, being NVQ positive, thought a letter saying an elderly patient was “fit to fly” was needed ASAP.

Unfortunately Crystal is thick for Crystal does not know that the ultimate decision as to whether a patient who is self evidently physically fit to fly but also has self evident highly visible highly contagious infection is with 1) the airline and ultimately 2) the captian of the airplane and not with the patient's GP.

Would Crystal insist that Osama Bin Laden got a letter from his doctor to say he was “fit to fly” because you looked a bit dodgy and might get stopped at security? Perhaps Crystal can guess what effect such a letter would have had at a British airport when Osama was alive and whether a similar letter would do the same now in slightly different circumstances?

No doubt we will be seeing a stressed out Crystal in A&E later when after 20 shorts she arrives in A&E for a Friday night detox after a hard week at work (together with those from NHS 111 who will be doing exactly the same as Crystal).

7) Seeing patients in a new light

The recent warm weather has led to our patients raiding their wardrobes for their long hidden summer finery. If ever a country in the world never knew how to dress for warm weather it is Northenshire whose residents can be spotted a mile off in any foreign country. The appearance of vests (string or otherwise), boob tubes, shorts, short skirts, socks and sandels and the like worn by all with a minimum BMI of 50 means we are seeing how obese our patients really are and believe the doctors this is not a pretty sight.

Roll on winter at least you can blame the clothing then not the patients . . .

Praise be to the Party for alerting the population and our doctors as to a heat wave warning level 3 whatever that means for no one medical knows what this means. It makes bugger all difference to those on the frontline they just get on with it in any weather and this is a moderate temperate climate.

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