Wow! So it's been about 6 weeks since I wrote anything on here - note: on here - mainly due to a profound lack of connectivity (and the need to prioritise other tasks) and writing offline and never getting around to posting... If I have a chance, I might post some stuff up retrospectively, but don't hold your breath.

And I've discovered how rubbish this site looks to some users: those who use micro$oft Internet Evil (TM) versions 5 or 6 - or probably any others as well. Well, tough, I'm afraid: there are no plans at the moment to fix this, although maybe in the longer term... Meanwhile, I suuggest you use firefox which suffers none of the same problems and is an infinitely more elegant browser.

The anticoagulation protocol used at the Freeman Hospital is based on our experience with Ventricular Assist Devices, which in turn is based upon guidance from the Berlin Heart group.

We place 25u/kg/ml of heparin in a 50 ml syringe with 0.9% saline and then start it at 1ml an hour, checking APTT after 4 hours. The heparin is usually started 8-12 hours after insertion of the VAD.

In other scenarios, all guidance suggests giving an initial bolus of about 75u/kg and then continuing with an infusion rate of 25u/kg/hr. Although this is not what is done for the VADs in the immediate postoperative period, when we have need to (re)start anticoagulation at a later phase, in general, we have either given a small bolus of 25u/kg or none at all and have found that this is sufficient to achieve the desired level of anticoagulation.

travel

• GNER tickets
• nexus

medicine

• Newcastle Hospitals

places to go

other stuff

I go out each night, go for a walk down the public footpath amongst the trees and bushes behind the hospital. If I'm lucky, the stars are out: silhouetted, against the cranes and the lights and the buildings, little glimpses of blackness with a twinkling reminder... Strolling further away, one can see between. The spaces enlarge, the glimpses become expanses and I can fit into vision entire constellations.

Half-a-world-away... REM flickers to the atmosphere. I stood in darkened streets, cool wind blowing, bus ride waiting. I had company: the stars, Orion. Up there, solid, we were together, we shared this journey, this voyage unto shores unknown. Now, half a world away, so much ground covered, so much in between. Petty differences, atmospheric subtleties but the essence is the same. Fighting.

Ahh, so I'm here: arrived. New job, Newcastle. In fact, it's an old castle now, but it replaced an older one: Hadrian's Wall ran (runs) through the town, and it has always been the northernmost guard against the unwieldy heathens to the north, the Scots. The 'new' castle was built following the invasion of the Normans in 1066 - if I remember correctly, about 20 years after that; but then a lot of things seemed to happen about 20 years after that according to my memory, so I could well be confused about that. Anyway. I am here....

Bit of an uncertain arrival. Back in the interview, I'd been asked if I was political. What a question! They went on to clarify... meant more medical politics so I gave the lowdown on my past involvements and how I had struggled for better working conditions but others were only interested in money. 'Others' being both colleagues and management. When asked whether I was supported in these battles I responded something to the effect that I was unanimously supported by my colleagues and senior colleagues; all my problems were to do with the managerial side of the staffing structure. Whoops - apologies to the Human Resources representative in the room! However, since then, she has been the one I've been dealing with - or not. Correspondence from the hospital over the past month has been, to say the least, minimal, and it was unclear what arrangements had been made for my accommodation, although I knew the address.