Sunday, 26 March 2017

Little Things I've Loved This Week #48

Tulips and sunshine

As I'm typing this, it's definitely beginning to feel a lot more like spring! I hope everyone's had a lovely week. This was my last week working on an orthogeriatric ward - potentially my final ever work on a medical ward as my next jobs are all surgery, psychiatry or A&E. A downside of the week was a broken washing machine - but the upside to this was a good excuse to buy a few more clothes. You know, just in case it took a while to get sorted?! Today I'm home for Mother's Day, treating my mum to a home-cooked dinner (full disclosure - my sister's idea, I'm just lending a hand with the cooking). So for everyone who is doing something for mother's day, I hope it's a good day fo you.

On to the little things I've loved this week:

Bright sunshine streaming through the flat. It was just such an uplifting sight, especially with the tulips blooming on the kitchen counter!

All the compliments from my lovely patients. Orthogeriatrics is an elderly care ward, and I've had some very nice patients to look after this week! From loving my shoes to telling me I've got a kind face and caring voice, it's been a rather ego-boosting week. I'll take that!

Beating my 5km personal best. A couple of years ago when I first started getting back into running, I was almost but not quite getting under the 30-minute mark. I don't actually run and time myself over 5km that often, so I've not been setting any targets but it was great to see how much time I've shaved off - so nearly under 25 minutes now! And considering that was an early morning workout (I'm generally better in the afternoon) and I had no music because my headphones broke, I think there's a lot of scope for further improvement now. Having a goal to beat is definitely going to be a good motivator.

Coconut porridge
Coconut milk in my porridge. This is something I'll be doing again for certain! I had a bit leftover from a dinner recipe, so poured it into the pan with my oats the next morning and it was so deliciously creamy. 

Finding forgotten shoes. When I moved into my flat, I didn't have quite enough space to keep all my shoes in my wardrobe. So I put the rest in the corner of another room and promptly forgot about them. Until this week - it was like revealing a whole new collection of shoes! (My poor, unloved clothes... it was only a few weeks ago I was loving finding a pair of jeans again.)

What have been the highlights of your week? I always love hearing about them!


Thursday, 23 March 2017

Preventing Osteoporosis - What you can be doing now

Milk preventing osteoporosis

I've learned a few things during my time as an orthopaedic junior doctor:

1. I seem to have defied the odds by surviving a childhood of gymnastics and horse riding with no more than just a few bumps and bruises.

2. Walking the dog is apparently a far more dangerous activity than I'd ever fully appreciated.

3. I really, really don't want to break my hip when I'm an old lady.

And it's this last one that has got me thinking. Many of the elderly patients I see have broken their bones after fairly low impact falls, but due to osteoporosis, their bones are much weaker. Hip, wrist and spinal fractures are the most common injuries and can significantly impact on quality of life - leading to reduced mobility, chronic pain and sometimes lengthy hospital stays while they're fixed and healing.

What is osteoporosis?

Osteoporosis is essentially weakening of the bone - there is a loss of bone mass and density which can make the bone much more likely to break under lower forces. It's a common condition and is linked to ageing, but there are also a number of other factors involved.

Osteoporosis can affect people of almost any age, but it is typically associated with the elderly population. Despite this though, it's worth thinking about sooner rather than later!

A key factor is "peak bone mass" - the point at which our bones are as dense as they will get in our lifetime. After this, bone mass starts to decline and bone becomes thinner and weaker - and in individuals at risk, this happens faster. The higher your peak bone mass, the more you can afford to lose as you age.

Typically women achieve 90% of their peak bone mass by the age of 18, and men by the age of 20. Even if your teenage days are behind you though, you've still got until roughly age 30 to fully maximise your peak bone mass!

Yoghurt with fruit

How to prevent osteoporosis

So what can we be doing now to reduce the risk of osteoporosis as we age and hopefully avoid any nasty fractures?

Well, there are some things we simply can't change - getting older, being female and a family history of osteoporosis and fragility fractures. But as with all preventative processes, it's about changing the modifiable risks factors. 


Diet can play a big part in keeping your bones healthy. Key nutrients for bones are calcium and vitamin D. Young people can be at risk of missing out many essential nutrients through restrictive diets - not ideal when you've got a limited window of time to build up bone mass!

Good sources of calcium include dairy products and green leafy vegetables (although apparently not spinach which can interfere with calcium absorption), tofu, soya beans, almonds, dried fruits and any foodstuffs or dairy replacements fortified with calcium. You'll notice from the full list of calcium-rich foods that it's definitely possible to maintain good bone health even with a vegetarian or vegan diet so long as it's varied enough.

Vitamin D can come from oily fish, egg yolk and any foodstuffs fortified with vitamin D. It's also important to get some sunlight - we're just getting to the start of vitamin D season when there's enough UVB in the sunlight and it'll last until September so make the most of it! There are also vitamin D supplements that can be taken during periods when there's not enough sunlight. Vitamin D helps absorb calcium so it's crucial for getting enough calcium in to build good bone mass.

There's also research being carried out to see what impact other nutrients and minerals have on bone strength and osteoporosis, so it's probably wise to be eating a wide and varied diet to make sure you're getting all the goodness you need.

Bowls of porridge


Regular exercise is really important in building up and maintaining your bone strength. The best kinds of exercise to prevent osteoporosis are those that are weight bearing and resistance based. Higher impact sports and activities that involve running and jumping are ideal. Up until about the age of thirty, bone is produced faster than it is lost so you've hopefully still got plenty of time to keep building it up!

Running kit


As if there weren't already enough reasons not to smoke, it's also a risk factor for osteoporosis. It ties in with exercise, but leading an active lifestyle is better than being sedentary, so try to be getting up and about as much as possible!

Combining a balanced, varied diet with regular exercise is also important to maintaining a healthy BMI to reduce the risk of developing osteoporosis - a low BMI is associated with a higher risk.

Excess alcohol intake can also cause weakening of the bones, so keeping your drinking to moderation is good for your bones and avoiding those later life fractures!

Health & Medications

Certain health conditions and medications can put you at higher risk of developing osteoporosis - prolonged use of steroids, inflammatory conditions such as rheumatoid arthritis and inflammatory bowel disease and chronic kidney disease are just a few. If you're at risk, your doctor should be aware of this and prescribing bone-protection medication or be arranging screening as needed - but if you're not sure, then ask.

Where to find out more:

The NHS website is always a good start! - Osteoporosis
The National Osteoporosis Society has plenty of helpful resources and info
It's aimed at doctors, but I like using Patient professional pages for a bit more in-depth information


Sunday, 19 March 2017

Little Things I've Loved This Week #47

Little things I've loved tulips

Hello again everyone! Hope you're all doing well and have had a great week. This week I've been working, then went home for the weekend to look after my favourite little dog. It's been a busy one for me with a bit of travelling around, more time in theatre at work and a weekend blog event! But my busiest weeks are often the best ones and here are just some of the happy moments over the past seven days:

A massive slice of carrot cake just when I needed it. Tuesday was an even busier than usual day at work, and although I was doing my best not to get stressed out I think the nurses recognised just how hard I was having to work to keep on top of everything! So when the sister in charge brought me a huge slice of carrot cake it was the perfect boost - cake and a bit of recognition go a long way. (Perhaps I should add 'eat cake whenever it's offered' to my things I've learned about managing stress at work?!).

Time to chat at work. And in stark contrast to the above point, Wednesday afternoon I got back from the operating theatre to find that nearly all the ward jobs had been done. I've said it many times, but working as a team has been the thing getting me through this tough rotation, so a good forty-five minutes of silly conversation was a highlight of the week!

Trying out a new workout routine. I've been really enjoying slowly incorporating new things into my gym sessions, including a kettlebell workout. What was less enjoyable was following it up with a day in theatre which is a workout in itself for me - I need to keep working on my strength for some of these procedures...

A Krispy Kreme doughnut. Perhaps I should just make this week's post about nice things I've eaten at work? I'm not usually that fussed about Krispy Kremes, I find them too sugary, but one of the anaesthetists had brought in a box for the operating team on Thursday. With all-day operating lists, regular mealtimes can sometimes go a bit haywire - you end up getting lunch inbetween cases rather than fitting the cases around mealtimes. So when our second case finished at just before 2pm and I'd spent a good few hours holding equipment (plus the intense concentration required just to keep everything sterile when you're not used to the operating theatre), a sweet and sticky doughnut made me feel much more human!

A useful careers workshop. As a medical student, I often found careers workshops a bit generic and unhelpful - there was a lot of focus on how to apply to core medical or surgical training not much else. This session though was all about our personal values and attributes - and although it sounds a bit "fluffy" it was right up my street! Lots of self-reflection and some reassurance that my current aim for a career in psychiatry seems to be a good fit.

Attending BlogConLDN on Saturday. This was a fabulous event with some excellent speakers and incredibly generous brands. What was also lovely was how friendly everyone was! I turned up to the event on my own but had no trouble finding other bloggers to chat to and browse the stands with.


What have you been up to this week? I love hearing about other people's happy moments, so do leave me a comment!


Tuesday, 14 March 2017

Caramelised Pear and Walnut Salad - Recipe

Pear and walnut salad with spinach and quinoa

A warm salad: spinach and quinoa topped with sweet pear, crisp walnut pieces and tangy goats cheese, utterly delicious!

Inspired by Chloe (of Nine Grand Student) and her Instagram photo of a fabulous looking warm pear and blue cheese salad, I decided to try out my own version based upon what I had in the kitchen.

It made for a scrumptious salad - warming, filling and full of flavour. Not just that, but also full of goodness with both fruit and greens, protein from the quinoa and plenty of vitamins from the walnuts.

I love pear in a main course - it lends a wonderful sweetness without being overwhelming and it's absolutely delicious warm. What also works well in this dish is the variety of textures - soft pear, crunchy walnuts and smooth cheese. 

It's a quick and easy meal to whip up; if you're just cooking for one it shouldn't take more than about 15 minutes thanks to the small quantity of quinoa to cook up - it'll take a little longer if you're multiplying the portions but it will be worth the wait!

For a lighter dish, perhaps as a starter or light lunch, you could forgo the quinoa but I find it gives a good deal more substance to the meal. 

As always, there are many ways to vary this up - try blue cheese rather than goats cheese, or swap the spinach for rocket. 

Pear walnut and goats cheese warm salad recipe

Caramelised Pear & Walnut Salad (Serves 1)


30g quinoa
2 handfuls of fresh spinach
1 pear, diced
1 handful of chopped walnuts
25g goat's cheese
1/2 tsp caster sugar


Put the quinoa in a small saucepan with 75ml water and bring to the boil. Then reduce the heat and simmer gently, stirring regularly until all the water is absorbed.

Meanwhile, slice the pear into bitesize chunks. Warm a frying pan over a medium heat, then sprinkle the sugar into it. Add the pear and walnuts and cook until the pear is softening and caramelised. 

To cook the spinach, I normally just microwave for 45 seconds, but you can also wilt it in a saucepan or by putting in a colander placed over a pan of steaming water.

Mix the spinach and quinoa together in a bowl, then top with the pear, walnuts and crumble over or add cubes of the goat's cheese.

Dig in!

Pear and Walnut Salad

Homemade pear and walnut warm salad recipe

Pin for later!


Sunday, 12 March 2017

Little Things I've Loved This Week #46

Vase of spring tulips

I like these weeks - just Tuesday to Thursday at work and a nice long weekend. It's so nice to have a couple of extra days free to do whatever I want, and that's exactly what I've been doing. We ended up having to do a bit of shuffling at work this week, so I spent two of my three days covering the elective sugery ward by myself - and let me tell you, it's a world away from the trauma ward! Here are the little things I've been loving the past seven days:

Reviving fresh tulips. Having fresh tulips was also something I loved, so I was really disappointed to get home on Thursday evening and see them all drooping over in the vase before they'd even properly bloomed! I topped up the water, crossed my fingers and headed out to the gym - and it was so satisfying to get home and see them all looking healthy and perky when I got back.

Chocolate yoghurt pots. I bought a stack of Cadbury's fudge and mini-egg chocolate pots in the supermarket this week and I had forgotten how much I like them! A perfect after work pick-me-up!

Photographing the gardens at Basildon Park. It was a beautifully bright and dry day on Monday and staying indoors seemed such a waste when I had the day off. So I ventured out to Basildon Park National Trust property and wandered round the gardens, camera in hand.

Gardens at Basildon Park

Discharge letter compliments. It probably says a lot about the role of a FY1 doctor that my most frequent compliments are on my discharge summary writing and my neat handwriting in the clinical notes - but I'll take what I can get! There was one particular summary I'd put extra effort into the other week, then when I arrived at work on Tuesday morning I was told that the patient had come back to hospital and my discharge summary had been "excellent" and made everything much easier for the doctor admitting them in the night.

A full body massage. Booking a massage the day after finish my oncall week is something I wish I'd started doing sooner! It was the perfect way to melt away the stresses of a long week and left me feeling all nice and relaxed.

Full body massage at spa

Lunch in London. Making the most of a long weekend, I met my mum for lunch on Friday. We went for pizzas at Rossopomodoro in John Lewis. The pizzas were nothing special, but I had a yummy chocolate tiramisu topped with nutella, and a refreshing mandarin soda.

What have you been up to this week?


Tuesday, 7 March 2017

What working as a junior doctor has taught me about managing stress

Stress management at work

It's been over seven months now since I hung my stethoscope around my neck and took those first steps onto the gastroenterology ward, ready to start my new life as a junior doctor. Since then I've survived long days, night shifts, weekends on-call and all manner of tasks faced by doctors every single day. I've learned plenty - from exactly what information I need to hand to call the microbiologists, how to speedily write discharge letters before pharmacy shuts, to which wards will always have a supply of the particular things I want in order to take blood or site a cannula. 

The most important thing I've learned, though? Well, that would be the stress management side of things. 


Sunday, 5 March 2017

Little Things I've Loved This Week (and last week) #45

Hello! I ended up having a quiet weekend at home last week, without my laptop, so I never got round to publishing my Little Things I've Loved post last Sunday. I've also been on-call this weekend, so very nearly didn't get round to this week's either! But I enjoy looking back over the week and sharing the best bits so I decided to combine the last two into a post this evening. Here are a bumper fourteen days of happy moments:

This Week:

As I said, I've been on call every day this week. As on-call weeks go, it hasn't been too bad at all - the majority of the patients have actually been pretty well (aside from their fractures of course) which has meant we've managed to stay on top of all the work and not feel ten steps behind all the time.  

Assisting in trauma theatre. I agreed to start earlier on Friday to help one of the trauma surgeons with his upper limb list. I'm not hugely interested in surgery, but I do still find it kind of fascinating seeing it all up close! I used to enjoy watching it as a medical student, but now I actually get paid to help with surgery and I still can't get over that haha.

Quiet on-call evenings, leaving time for catching up with friends. Stable patients in the day also turned into stable patients overnight! I had very little to do after 5 pm each evening so I had a bit of time sitting around in the ward office - the perfect opportunity to text a few people and catch up.

First creme egg of the year. I used to love these- I still remember buying multiple six-packs of them in my second year of uni. Nowadays I find them better enjoyed in moderation, but still enjoy that first one after not having had one since last Easter!

Listening to Ed Sheeran's new album. I make an effort to wind down in the evenings and so Friday when I got home I stuck this on and just listened to it. Pretty sure there'll be a couple of new favourites from it.

Last Week:

I've spent this week working on an orthogeriatric ward, looking after elderly people after having their hip fractures repaired. Seemingly it's a bit of a love-it-or-hate-it rotation - I personally really enjoy the time I spend there, but some of my other orthopaedics colleagues would much rather do anything else! I've been finishing work on time each day, the hospital hasn't been too pressured this week and none of the patients has been that unwell so it's been a good one! Here are the happy moments from the past week:

Patients asking me how I am. It just makes the ward round feel less formal, less rushed and more like a pleasant conversation. Plus it's usually a good sign that they're doing well! 

Braving new bits of the gym. It's been nearly two months now since I joined and I'm slowly building up my confidence about exploring new parts, different equipment and varied workouts. 

Saturday breakfast and an almond pastry. I don't normally eat pastries for breakfast, but I walked past the bakery section of M&S after the gym on Saturday morning and decided I really wanted one! It was delicious with the rest of my post-workout breakfast in bed.

Finding a forgotten pair of black skinny jeans in the wardrobe. Even better they're still actually black rather than grey. And then I found three good hairbands in the pockets. 

A midweek haircut. I've been meaning to have my hair trimmed for a while, so I made an appointment for after work on Wednesday. Especially nice was the head massage and back massaging chair while having my hair washed - a lovely way to wind down after the day!

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