Barry Notter and the Neglected Tropical Disease

And just like that, I’m back with a new series! This series is super self-serving, wow that sentence had a lot of s’s. Anyway, as I was saying, this current series of posts will maybe benefit me more than you! I’m doing a master’s degree (yay) and I have exams coming up (boo), but I only have one exam (yay) and it’s for one of my favourite topics (yay), International Health. Which is a super vague title, but it basically includes all health issues that may ever be of international concern. I’m gonna use my wee bloggo to revise all the topics I’ve studied this semester, and maybe you’ll learn a little summ-summ in the meantime. Deal!

Okay topic number 1, because I’m a microbiology nerd at heart, is Neglected Tropical Diseases!

There are 18 of these diseases (all infectious) which affect those living in poverty much more than us lucky ones with laptops or iPhones. These 18 diseases regularly infect humans (over 1  billion humans in fact) and are endemic (meaning they are found in and currently causing problems) in 149 countries.

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Examples of (anthropomorphised) NTDs, some of their names are just ludicrous.

Sadly, most of these diseases are treatable and preventable through some pretty simple means.

  1. Controlling the bugs that carry the diseases (eg. mosquitos for malaria)
  2. Improving water sanitation (which would fix cholera)
  3. Delivering drug treatments better (which would make parasites not a problem)
  4. Training healthcare workers (which would help a lot of things)
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Mosquitos suck in all senses of the word.

So why haven’t we fixed these diseases, if the fixes are so simple?

Here’s the problem, most of these diseases make you sick, but probably won’t kill you. So historically, public health specialists have been like “let’s fix the killers first mkay” which is cool and stuff and really good, but that hasn’t helped these neglected tropical diseases which make life a hell of a lot harder. Here’s a statistic, between 15 and 30% of lost productivity is due to neglected tropical diseases (in the countries where it’s a problem). So if we get rid of these diseases, we will not only have more healthy people, but we will have more healthy people able to contribute to society! Not only that, controlling these diseases will reduce child mortality, reduce malnutrition, improve the health of mothers, improve school attendance and education, and reduce disease burden. Overall a big win!

So because it’s so bloody important, the World Health Organisation have a goal to eliminate ten of these NTDs by 2020. Specifically, lymphatic filariasis, trachoma, soil-transmitted helminths, onchocerciasis, schistosomiasis, leprosy, guinea worm, visceral leishmaniasis, Chagas diseases, and human African trypanosomiasis. BLESS YOU. It’s getting there, and even better, because of this initiative, ten pharmaceutical companies have pledged unlimited medication until these illnesses are GONE.

Just briefly, here’s what these diseases do:

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Lots of them look like worms, which made them difficult to artistically interpret, soz

The real difficulty now is how to effectively deliver all these free drugs to the areas than need it, and for long enough that we totally get rid of these diseases. In an ideal world, we will do a few drugs at once, two birds one stones style. It’ll just take time, effort and probably A LOT of money.

So there you go, now you’re a bit more Learned on neglected tropical diseases, and I got some study done! Good one. Stay tuned for the next post which will be about something, I haven’t decided yet k love you byeeeeeeeeeeeeee (Git Lernt.)

 

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Update.

Look, I’ve been busy. Like, really busy. Finishing my Master’s degree (not done yet), working, family commitments etc. has basically meant I’ve let this blog fall to the wayside. And to be honest, I kinda gave up a little bit. I saw less engagement, less interest, and felt like I was wasting my time. I started this blog when I was working, borne out of frustration to do with misinformation in the media. I felt like I made a small difference at times, but recently, I’ve been really disheartened about media coverage of public health matters. I’ve been asking myself, “Why do the public blindly trust media outlets? Why are they so ready to place blame? What difference does it make writing these posts, because I feel like no one is listening?” But I think I need to take a concrete pill and harden up. If I have made a tiny bit of difference in one life by sitting here and writing a blog post, then I’ve succeeded. If I make one person question their prejudices, change their mind, act differently, look after themselves better, I’ve succeeded. If one person makes a decision, changes their behaviour, or offers advice because they remember, “Oh, Tara said something about this in a blog post,” then I’ve succeeded.

One of my professors this year has said that I (and all my classmates) have to act as advocates for public health. If I’ve learnt one thing this year, it’s that public health is a lot more complicated than I initially thought. People have a right to free thought. What I consider correct might not always be correct. Before I did this course, I was thinking in black and white. Now I’m starting to see the grey space in areas I didn’t know it existed.

Public health is hard! But it doesn’t have to be for you. I offer to you, my dear friend, a service. I will analyse the white, the grey, and the black. I will condense, summarise, and collate for you. I will present you with the information, I will give my recommendations, and I will live in hope once again, that I make a difference.

But don’t worry! I’m still gonna be silly! I’m (hopefully still) gonna make you laugh! I will endeavour to keep it short, entertaining, funny and accessible.

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But let’s be honest team. If you’re reading this, you most likely know me. Which means you most likely live within my happy little bubble of liberalism, feminism, and science. But others you know may not. I ask you, if I write something and you think “Man, Aaron really needs to hear that,” or “Gee, Barbara was wondering about that the other day,” or “Damn, Trump needs to get his act together and read Tara’s blog,” then share it! Nothing would please me more than to know my writing has helped a stranger.

Thanks for reading team, I’m looking forward to a new chapter of Getting Learned.

 

Vaccine Action against MMR

Here we are, I’m gonna follow through! We Got Learned about measles, mumps, and rubella last post, now put them all together and add some other bits and pieces, and you get the MMR vaccine!

Not exactly, but lets talk about it anyway. Before we get started, bit o’ background for ya, The Vaccination Investigation Station and Vaccination Frustration due to Misinformation.  My two previous posts on vaccines are general ones, now we can get into the nitty gritty and talk about the MMR vaccine specifically!

So the MMR vaccine is a mixture of three live attenuated viruses, the measles virus, the mumps virus, and the rubella virus.

“LIVE!? YOU WANT TO INJECT MY BABY WITH LIVE VIRUSES?! TARA YOU JUST TOLD ME ABOUT HOW DANGEROUS THESE DISEASES ARE AND NOW YOU WANT TO INJECT THEM INTO MY CHILD!? SECURITY!”, screams Rain, the patchouli-smelling, gluten-free yoga teacher with a new baby who was born while whale sounds were playing.

Yes yes, I know, but we’ve talked about this. There are a bunch of different types of vaccine, the live attenuated ones are the ones that produce the best immunity. The virus is alive but it has been modified so much that it can’t produce disease, but it looks pretty much identical to the dangerous virus, so your immune system can get a real good look at it and ‘know the enemy’ or something profound like that, I can’t remember the actual quote.

Aaaaaaanyway, the first licensed vaccine to prevent measles was in 1963, and measles mumps and rubella got combined in 1971 to create the vaccine we use today. Generally it’s given to babies in two doses, one at about 12 months old, and a second dose at four-five years old.

“TARA, WHY ARE YOU INJECTING MY CHILD WITH LIVE VIRUS TWICE?!”, Rain bellows while burning a bundle of rosemary and waving it in my face.

Chill, Rain. The first dose SHOULD produce enough immunity to last a life time, but in something like 5% of people, it doesn’t quite work. So this second dose just makes absolutely sure that your little baby will never get measles, mumps or rubella ever ever ever.

As with any medical treatment, there may be some minor side effects. MINOR. TINY. It’s like, ow my arm is sore, ooh I’m a little bit hot, maybe a rash, maybe a little bit of joint pain. There is a teeny tiny chance of being allergic to the vaccine and going in to anaphylactic shock, because the viruses are grown inside chicken eggs, so if you have an egg allergy you might react badly to the vaccine.

BUT. If you weigh up the pros and cons of vaccination, it’s generally better to get it so your kid doesn’t die. 🙂

“TARA, IT’S ME AGAIN, RAIN. LISTEN, I GET WHAT YOU’RE SAYING, MMR IS PROBABLY FINE TO GIVE MY CHILD. BUT WHY DOES MY LITTLE BABY LAVENDER NEED IT?! IF EVERYONE ELSE GETS IT THEN THERE WON’T BE ANY OF THE VIRUS AROUND AND LAVENDER WON’T GET MEASLES.”

I have question for you. Ya heard bout herd immunity?

Watch my lame video which should explain why everyone who can get vaccinated, should.

But here is a scary chart.

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That’s from the CDC in the USA. We had an outbreak of measles cases in 2014 because people weren’t getting properly vaccinated. You should do that so these numbers don’t increase.

So that’s the deals, if you have a little spawn, it should get vaccinated against MMR if possible! Thanks for reading team, speak soon okay luv u xox Get Learned!

 

Em Em Argh!

The vaccine that represents all vaccines, Mr. MMR, aka the measles, mumps, rubella vaccine.

You’ve probably only heard about measles out of these three, the others aren’t super well known. Anymore. In this post I’m gonna give you the 411 (is that what the kids say? 411?) on these diseases, so you know what would happen if you (or your children) catch these diseases.

Measles! The most well known and most common of the three, measles is caused by the measles virus. It’s the most deadly, and the one that makes you the most sick. It has an awful progression which goes something like this.

You start with a fever, a really really hot one. Often over 40 °C, which can be super super dangerous by itself. You’ll also have a cough, maybe a runny nose and red eyes. So far sounds just like a cold, right? You’d expect that after two or three days, you’d be better, but not with measles. This is when the virus really starts the party. You’ll start noticing small white spots inside your mouth, and a rash all over your body, which often starts on your face and spreads. Symptoms can last 7-10 days, and complications of these symptoms occur in 30% of cases, including blindness, brain inflammation, pneumonia and diarrhoea. Does not sound like fun. If that were me, I’d be staying at home in bed for those two weeks or so.

measles

But guess what! Measles is a HIGHLY contagious airborne disease, so every cough I let out at home sprays little viruses all over the house, and, if anyone in my house is unvaccinated, there’s a 90% chance they will get measles too.

Measles-global-annual-reported-cases-and-MCV-coverage-1980-2009-WHO0-1024x459

I’ve shown you this graph before! I’ll show you again! This is a graph comparing the number of cases of measles worldwide with percentage of immunisation worldwide over time, since 1980 until 2009. The blue bars represent the number of cases of measles each year worldwide. As you can see, those numbers have dramatically decreased since 1980, and have stayed quite low since about 1995. The blue and red lines are estimating the percentage of people in the world who have been vaccinated against measles. As more people have got vaccinated, we can see the cases have gone down. There is a relationship there.

Mumps! Mumps is not talked about very often because we don’t see many cases of it these days (because of the high uptake of vaccines.) It’s caused by the mumps virus, and symptoms go something like this.

Day 1: I’m feverish, I have sore muscles, a headache and I feel really tired. Maybe I’m coming down with something? Or did I drink too much last night?

Day 2: I feel like, a lump in my throat? Maybe my glands are swollen? I look like I have a double chin 😦

Day 10: Wow I still feel like absolute crap, I look like a bullfrog and I’m still so tired.

mumps

Potentially you could also develop meningitis, pancreatitis, permanent deafness, testicular inflammation and ovarian swelling. Such fun. Also, it’s contagious as fuuuuuuuuuuu, and you’re infectious for like, three weeks, so good luck to anyone around you during that time!

Rubella is also called German measles, just to confuse you. It’s not the same as measles, but it can have similar symptoms. It caused by an infection with the (you guessed it) rubella virus! This is the least dangerous of the three, with about half of the people infected not realising they are sick. It progresses by starting with a rash, which can be itchy. Lymph nodes can get swollen, and you see the classic fever, headache, tiredness sore throat symptoms that come with most viral illnesses. Sometimes you can see joint pain, inflammation, testicular swelling and bleeding problems.

rubella

The real problem with rubella is in pregnant women. If a pregnant woman get infected with rubella during the early stages of their pregnancy, the child can be born with congenital rubella syndrome, or even miscarriage. Symptoms of this congenital rubella syndrome in the baby include eye problems, ear problems, heart and brain problems, which are all bad and should be avoided. Just like the others, it’s spread through the air, and just like the others, it’s SERIOUSLY infectious.

So that’s the low down on measles, mumps, and rubella. Next post I’ll talk about the vaccine, and we can debunk some BUUUUUULLSHIT 😮 Get Learned!

 

Cold ‘n’ Flu who?

It’s coming in to winter here in Ireland, and everyone is getting sick! Coughs and sneezes and gross germs everywhere, and here I am writing a post about all you HYPOCHONDRIACS out there who say you have ‘the flu’ the second you have  lil sniffle. If you had the flu you’d be too sick to even say “I think I have the flu.” So strap on in and let’s Get Learned about the difference between a cold and a flu.

Lemme tell you a story about a flu that went around in 1918, called the Spanish flu. It was estimated that worldwide, 500 million people were infected, and between 3 and 5% of the worlds population DIED. It was a pretty devastating pandemic, and is an example of how awful influenza outbreaks can be.

Spanish Flu
That’s how they laugh in Spain.

Influenza is caused by a virus called the influenza virus (doy – virus names are a lot simpler than bacteria names.) You might have heard of them with some numbers and letters at the start, like H1N1 or H5N2 or something. These refer to two proteins that chill on the outside of the virus called hemagglutinin and neuraminidase. Big words, tiny proteins, all you need to know is that they are identifying features of the virus, like eye colour or hair colour on people. H1N1 influenza virus = blue eyes blond hair Hannah from next door.

Symptoms of influenza virus infection include body aches, headache, fever, runny nose, coughing and tiredness. They can vary in severity from mild to severe, severe being like,  ur dead. Mild being illness for anywhere from a week to two weeks, and generally bed ridden for that whole time.

If you have a flu, you’ll KNOW you have a flu. It’ll be like a combination of having a cold, being hit by a bus and being really really really hungover. Not fun.

The common cold is caused by a bunch of different viruses, called rhinoviruses. I can guarantee if you’re old enough to read this post you will have had at least 10 cases of rhinovirus before, I have about three a year. Symptoms include coughing, sneezing, fever, headache, and a sore throat. We ALL know how this feels, you just wanna be in bed for three or so days, you feel a bit shitty but generally you have to get on with life, right? Maybe you take a couple days off work, order takeaway instead of cooking, get Mum to make you a lemon and honey. Lovely.

People often confuse a cold with the flu because the symptoms can be similar, as we have noted. But they are NOT the same. A flu can be life threatening. A cold is generally non-lethal in most people, exceptions being the very elderly and the immunosuppressed.

rhino virus
Rhinoviruses are polite and generally don’t overstay their welcome.

Sadly, there’s not a lot we can do for either of these illnesses. Some of the more dangerous cases of flu can be treated with anti-virals, but that’s like brink of death type stuff.

The advice your doctor will give you if you have a cold or the flu (rarer) will be as follows. “Rest up, don’t go to work or school. Keep your fluids up, eat if you can and take paracetamol or cold and flu relief that you can buy over the counter at the pharmacy. If you’re still sick in a week or so, get in contact.”

Omg I just saved you 40 bucks! You’re welcome.

So next time you feel a bit shitty and ring in to work to say “I can’t come in, I have the flu,” think again buster. You’ve probably got a cold and a serious case of hypochondria. Get Learned!

To Be Or Not To Be (Immune)

Oh dudes, people keep talking about immunity in my classes, so I want to talk about immunity on my blog! I’m sure you’ve all heard these terms, but I’ma lay it out for you real simple like so that there is no confusion about what it means to be IMMUNE. I might talk about the v word (drama!), we’ll see how we go.

So we already know how the immune system works cos we all read my posts No One Is Immune to My Charms and Immune 2: The Reckoning. Now what does it actually MEAN to be IMMUNE to something? You’ll never get that disease again? It can’t hurt you? If you become immune to everything you are immortal? Read on to learn how to achieve eternal life…

Just jokes, not possible (I think). Being immune to a bug means that your bodies immune system has developed those memory cells we talked about. It sees the disease once (whether it be from an exposure like catching chicken pox from a schoolmate, or from a v word (not vagina)), fights it, and forms memory so that the next time it sees that disease, it can attack it quick smart. Refer to the below EXCELLENT AND ARTISTIC depiction of a memory cell.

MEMORY

However. This is not foolproof. With something like chicken pox, the immune system draws such a good picture of the disease to remember, it will last a lifetime (probably). Those memory cells will hang around in your body for LIFE. This isn’t always the case. With some bugs, the immune system will make SOME memory, but after a few years it might forget (aka delete those memory cells, so there is no quick response when you catch the same disease years later.) In the case of vaccines (oops I said it), you might need boosters. What this means is the first shot will give you some memory, the second shot gives you even better memory, and by the third shot you’ll be immune for life (something like the MMR vaccine).

memory.jpg

Another caveat of creating immunity is that it’s very very very specific to that one bug. Some bugs have different forms, or strains. For example, influenza. I’m gonna talk about the flu vaccine here. In the flu vaccine that is distributed every year, there are a few strains of the virus. The vaccine is developed based on cases of flu seen in the opposite hemisphere in the last flu season. Say for example in New Zealand, there were lots of cases of influenza caused by Virus Susan, Virus Anthony, Virus Donald and Virus Sam. The vaccine for Ireland will be formulated to protect against those strains. But that doesn’t mean that you can’t be infected with Virus Hannah, Virus Miriam, Virus Dan and Virus Voldemort! You weren’t protected against them. And it’s impossible to protect against them all. The flu vaccine does its best to protect again the most common of that flu season.

flu vaccine So there, a quick wee run down of what it means to be immune to something. Next I will talk about the concept of herd immunity, where you immune a whole bunch of cows. Or people. Tune in next week to find out! Love you xoxo GET LEARNED!

Ebol(ya over) virus

Hey ya’ll, it’s ya girl T bout to educate you on up, ooooh shit, you bout to git LEARNED!

Ebola! It’s a pretty hot topic. Most people know it’s a disease in Sub-Saharan Africa, it got in to the US very briefly last year, and everyone LOST THEIR SHIT. But like, why? Let’s dive in and demystify Ebola.

So Ebola’s full name on its birth certificate is Ebola virus disease, or Ebola haemorrhagic fever. But it’s pretty chill just being called Ebola. It’s caused by Ebolaviruses (shocker.) There’s five types of Ebolavirus, four of them cause the disease in humans, one in animals, and they’re each named after the place they were isolated from in Africa. The most common (and most deadly) one is called Zaire ebolavirus, cos it was isolated in… Zaire, or as it’s now known, the Democratic Republic of the Congo.

EBV

FUN FACT TIME: So the Ebolaviruses were named after a river that was near where they were isolated, the Ebola river. BUT the viruses were actually isolated in a place called Yambuku, a wee bit away from the river. So why didn’t they name it Yambukuvirus, or whatever? So the issue is that naming a deadly violent awful illness after a place tends to stigmatise that place. The scientists who named it had seen it happen with Lassa fever, which was named after Lassa in Nigeria, so they decided to call it Ebolavirus instead. If you’re interested in reading more about the discovery of Ebola, there’s a book I HIGHLY recommend called LEVEL 4: Virus Hunters of the CDC, by Joseph B. McCormick M.D and Susan Fischer-Hoch, M.D. It’s literally my favourite book of all time and I can’t read it at night cos I get too excited about viruses and I can’t sleep. Omg I’m literally getting excited just talking about it.

level 4
My goal in life is to write on a form under occupation: Virus Hunter.

Anyway, back to Ebola. So what happens if you get infected with an Ebolavirus? Well, up to 90% chance you’ll die, depending where you contract it. It’s a viral haemorrhagic fever, which means a) you bleed and b) you get a fever. More specifically, you’d start to feel a bit sick 4-21 days after you were exposed. Initial symptoms look something like the flu; fever, sore throat, headaches, muscle aches. That progresses to vomiting and diarrhoea, which progresses to a decrease in kidney and liver function, which progresses to internal and external bleeding, which (most likely at this point) progresses to death. Yeah, Ebola is NOT a nice way to go.

It’s spread through bodily fluids. HOWEVER. That means mostly poop, vomit and blood. Other ~fluids~ like sweat, spit, mucus etc. are unlikely to carry the virus unless the person is SERIOUSLY SERIOUSLY SICK. But look. Unless you are a healthcare worker in Sub-Saharan Africa, or you live with someone who has recently come back from being a healthcare worker in Sub-Saharan Africa, YOU PROBABLY NEVER HAVE TO WORRY ABOUT GETTING EBOLA. It’s only found in Sub-Saharan Africa, and it’s not particularly easy to catch unless you’re handling the body fluids of someone infected.

The problem in Africa is essentially two-fold. First off, the hospitals generally aren’t well resourced, so they struggle to stop the spread of infection from an infected person. Second, places in Africa tend to have different burial methods to us in the developed world. A large part of the burial process is for the family to wash and clean the deceased body before burial. The body which has just died of Ebola. Which is still excreting the Ebola virus. You see how that is a problem? It is estimated that in Guinea, 69% of transmission of the virus during the outbreak was due to this burial transmission. But it’s cultural, so it’s pretty hard to get around.

There’s no vaccine, but it’s being worked on now. (Pst… Ebola was discovered in 1976, and they’re really only making a big effort for vaccination now, in 2016/2017. Man, I wonder if that’s cos there was a scare of Ebola coming to the Western world, and so suddenly all these resources were dedicated to it when before, even though it killed hundreds of people in West Africa, it didn’t matter cos it was a far away threat that had nothing to do with the West. I wonder….)

So there’s the skinny on Ebola. Probably not to be worried about from a “will I get it” perspective, but to be worried about from a “I’m a person with a soul who wants wellbeing for all humans across the world” perspective.

Did you Get Learned? Nice one. Me too. Talk soon babes, ILY 5ever xx

Tara Tara sitting in a tree, I-N-F-E-C-T-I-N-G!

Glandular fever, mononucleosis, the kissing disease, Epstein Barr virus, all different names for the same dumb viral illness that has (apparently) been incubating in me for the last two or so months.

Let’s start with the little, and move up to the big. What is the thing that causes glandular fever?

It’s caused by a little virus called the Epstein Barr virus, also know as herpesvirus 4. WHAT!? OMG!? TARA HAS HERPES!? Yes indeedy kittens and cool cats, the virus that causes glandular fever is a part of the same family that houses the much stigmatised and fairly inoccuous herpes viruses 1 and 2 which can cause genital and oral herpes. Here are some links for you to learn yourself about the herp if you haven’t already; one is written by me, another by my friend Laura Borrowdale over at VICE. Ok, go read them now.

It by me!

It by Laura!

ebv and herp

Read it? Got Learned within Getting Learned? Good. Right, so Epstein Barr virus. It’s a virus! We know, therefore, that it can’t be treated with antibiotics! Cos it’s not alive! It is transferred through saliva and ~genital secretions~ but that second one is way less common. Now here’s a kicker, the virus infects epithelial cells (which are the cells that essentially line all the passageways in the body, like your nose, your lungs, your intestines, and they also make up your skin) and also B cells in the immune system. Oop, here’s another link to a post I wrote about B cells!

Small problem with infecting immune cells; you need immune cells to clear the infection, but the infection is within the immune cells, so like, wtf? This is why glandular fever can last a long time.

Now the Epstein Barr virus is able to do what we in the biz call a latent infection, just like all the other types of herpes virus can do. Lemme break it down for you.

Viruses can be either assassins, or undercover agents. They can be one or the other, and they can have the ability to switch from one to the other. Assassins go in, blow up the cell, and live to die another day. This is called the lytic cycle of virus replication, where they burst the cell they’ve infected. The undercover agents, however, are very sneaky. They go in to the cell and observe the life of the cell, they make friends with it, they hide in plain sight, they are your friends, your neighbours, even your loved ones. Trust no one. TRUST NO ONE. (Soz I got carried away). This is called the latent cycle of virus infection. What happens is the virus infects a cell but just chills in there, incorporates itself into your DNA, lies in wait, so you are constantly infected with it but not necessarily displaying any symptoms. You with me?

lytic latent

Viruses that do this include the herpes virus family, and the HIV virus. So if you get glandular fever, you’re stuck with it for life. It’s not so bad though, your immune system, once it gets the hang of things, will generally keep everything in check.

Even better, most people get exposed to the virus as children, and have very mild symptoms of illness, if any! Ideal. However, if you get exposed as an adult or young adult, symptoms can include fever, sore throat, enlarged lymph nodes in the neck, and chronic fatigue. Generally these symptoms go away within a month, however the tiredness can last for many months. Which is definitely the reason why I’ve been taking so many naps recently. Another issue can be rupture of the spleen (which is a big part of the immune system) and a swollen liver, which I had, and lemme tell you, it hurts like a biiiiiitch. So it’s kinda a mix between chicken pox, herpes, and a really bad flu. Most people will get it at some point, it won’t kill you.

Long story short, no kissing for me for the next wee while.

Much information here, very backstory, Get Learned. Stay tuned ❤

Where have I been?

OMG YOU GUYS I’M SO SORRY I’VE BEEN AWAY FOR SO LONG I’M SORRY LOOK LIFE HAS BEEN CRAZY OKAY I’M SITTING ON A COUCH IN DUBLIN IN MY PJS AND I’M GONNA TELL YOU WHAT’S BEEN HAPPENING SO STRAP ON IN.

So I moved to Ireland. Which is great, I’m here to do a masters degree in International Public Health, which is basically looking at how diseases spread and interact between countries. So that’s fun. I’m really looking forward to it, and hopefully I can share some of the knowledge I gain with you all.

Slight hiccup though. I’ve been feeling a bit off colour for the past wee while, thought I had tonsillitis, thought I had a modified flu. Chalked it all up to stresses of moving and my shitty diabetic immune system, and cracked on. Until last Monday. Dun dun daaaaah!

There is a bit of background info required here, so bear with. Now I’ve talked about ketones before I think, but lets have a quick refresher.

Ketones or ketone bodies are a product that is made in the body when it doesn’t have adequate carbohydrate intake, so the body burns fat instead. Ketones can be a marker of weight loss (the keto diet, heard of it?) as they are produced during starvation. Ketones are also produced during untreated type 1 diabetes, because the body doesn’t have the ability to utilise carbohydrates, so it burns fat instead. Ketones are an issue because they are an acidic molecule. Essentially it’s chucking a whole heap of acid into your blood and changing the pH, which can be very very very dangerous. This state in diabetics is called diabetic ketoacidosis, DKA for short.

Right, now slightly more complex. Because I am super extra and a high maintenance diabetic, I have been taking an off-label drug for the past 7 or so months which makes my diabetes even more controlled than it already was. It’s called dapagliflozin, and it’s an SGLT2 inhibitor. A what?

In your kidneys you have these receptors called SGLT2 receptors. SGLT stands for sodium-glucose co-transporter. Here’s the story. You have extra glucose in your bloodstream for whatever reason that hasn’t been absorbed. The blood gets to the kidneys to be filtered, and these SGLT2 receptors go “hang on, that’s delicious delicious glucose we’re about to pee out. No way.” And they suck the glucose back up, so it stays in the body and isn’t peed out.

Well and good. Now if you stop that happening by inhibiting the receptor, you just pee out any extra glucose in the bloodstream. Ideal for a diabetic, right?? It’s a cool medication, here’s the rub though; a side effect of this medication can be euglycaemic ketoacidosis. Bless you. In English, it means your blood sugar is fine but you have too many ketones in your bloodstream, which is unusual.

Guess what happened on Monday? I tested my ketones, and they were 4.7. (Normally my ketones would be ~0.2). So I was like OH SHIT DAD TAKE ME TO E.D COS IDK WHAT TO DO. And so I went to E.D and they were like OMG WTF WHAT DO WE DO YOUR KETONES ARE DANGEROUSLY HIGH BUT YOUR BLOOD SUGAR IS FINE???? So they gave me a drip and I.V insulin and admitted me and I was like OMG WTF THIS HAS NEVER HAPPENED TO ME BEFORE WTF WHY IS THIS HAPPENING NOW.

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It me and my swollen ass glands

So I was super confused cos I’d been taking this medication for months with no issues so why suddenly was it becoming an issue? I thought maybe there was something wrong with my kidney cos I had a pain in my mid-back area but like idk I’m not a doctor. And the E.D. doctors were like WHAT and the registrars of general medicine were like WHAT and my diabetes doctor was like WHAT and basically everyone was like WHAT. Then the cool doctor from the acute medical assessment unit who was called Nick (Hi, Dr Nick!) gave me a routine exam and felt my neck and was like HMMMMM.

Anyway so overnight I stayed in hospital which sucked, and the nurses were great and I was like OK DOCS MY KETONES ARE DOWN AND STUFF CAN I TAKE BACK CONTROL OF MY INSULIN PLEASE and they were like “yeah ok.”

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This was so uncomfortable omg.

So all hunky dory I’m fine but why did I feel so bad and what made the medication stop working? Well, clever Dr Nick had noticed that my lymph nodes on the left side of my neck were a bit swollen, so he ordered a test for the Epstein-Barr virus, which came back positive.

Epstein-Barr virus, aka, glandular fever. Turns out that tonsillitis and modified flu weren’t tonsillitis or modified flu, but I’d had glandular fever for over two months and didn’t realise. Lol. So I got discharged on Tuesday, I’m off the medication that stopped working, and everything is okay now except for I still have glandular fever and I caught a bit of a cold on the plane which I was on on Wednesday lol.

So that’s the story of how I went to the hospital.

Phew, what a journey! Now you know what’s been going on in my life, I’m gonna write a post about glandular fever next so we’re all up to speed, including me. And hopefully I’ll post more, I’ve missed writing to you all! Stay tuned for the next post, and Get Learned!