BC HEALTH
Saved by @CodyyyGardner

I tweeted yesterday about clinical engineering and the vital role they play and had a reminder about all the other incredible staff in the NHS that no one ever hears about and so to try and change that

NHS Covid unsung heroes list

 Perfusionists - magicians. From the crucial role they play in cardiac surgery to the unbelievable role they have in providing ECMO (using the machine below) to the sickest covid-19 patients. Barely anyone knows about them but they are an incredible profession.
Estates - built new high dependency and intensive care areas almost overnight in hospitals up and down the country. They make what often seems impossible happen and we would not be able to treat as many patients without them and their vital work.
Laboratory scientists - I dread to think how many samples they receive and process each day but we absolutely cannot care for patients without them and their technical skills. Their workload has soared and they are working consistently flat out.
Porters - the backbone of the hospital. The transferring patients, running samples, getting blood, making the impossible happen staff that simply keep the hospital running.
Cleaners and domestic staff - how can you not appreciate the essential work they do in keeping patients and staff safe? They are the absolute frontline in preventing spread of infections and do the most crucial of roles.
Ward clerks and administrative staff - the NHS would collapse without their organisation. Trying to organise anything in the NHS can feel a little bit like herding cats but they navigate systems and make stuff happen.
Mortuary workers - the past months have been hellish for them but they continue to do their job with kindness and the upmost respect for the deceased patients they are caring, and it definitely is care.
Switchboard staff - directing calls, putting out emergency calls, dealing with such a higher workload now families sadly can’t visit in many areas. They are a vital part of getting teams to emergencies across the hospital.
Catering staff - bringers of food and cups of tea and so often kind words and compassion to patients who are sadly isolated from their loved ones.
Pharmacists - from checking patients drugs and interactions to advising on medications and complex regimens to dispensing and making up incredibly complex infusions - a core part of the team yet hugely under recognised for the vital work they do
Play specialists - supporting children through all sorts of procedures and operations with skill, kindness and laughter. A crucial part of the paediatric team and always the most consistent supply of bubbles in any hospital!
I am going to kick myself as I remember other groups and will add to this thread but if others want to kick me and remind me please do!!
But most of all thank you all for the incredible jobs you do!!
Speech and language therapists - improve the quality of life for the patients that need them day in day out. Assessing swallow, advising on diet, supporting removal of tracheostomies, improving speech....a complex and varied role that has a huge impact for patients.
Radiographers - from X-rays to CT scans to MRIs to ultrasound and every modality in between - performing huge numbers of investigations that guide the care of patients and they have been working tirelessly throughout this pandemic. We couldn’t do without them.
Physiotherapists - the role they play in the rehabilitation of patients is mind blowing - from providing chest physio and weaning plans in ITU to helping patients mobilise and gain strength to helping patients go home to their loved ones. Just astonishing
Occupational therapists - supporting patients in a huge number of varied ways to live their lives and improve the quality of that. Their expert assessments, treatment plans and use of different equipment can be truly life changing after illness or injury.
Informatics - using data and making it meaningful to guide clinical and operational decision making. The insight their work gives is extraordinary and supports all sort of the healthcare system and yet they go often so unnoticed
IT - I apologise to them for every time I have managed to lock myself out of a system but they do so much more than that. Building new systems, installing new hardware, making sure we can do our jobs by providing expertise across a huge number of areas.
Procurement - their role in ensuring we all have access to PPE cannot be downplayed but they do so much more that goes unseen to make sure staff and patients have the resources and equipment needed. Staggering given how much stuff we use daily!!
Told you all I needed help and please keep the suggestions coming!!
ODPs - now in my defence I tweet about my love for them regularly but I will add it here again because could not do my job without them. When an ODP ever says “have you thought about....” or hands you a bit of equipment it is always a godsend.

#loveyourODP
Phlebotomists - masters of the dark art of getting blood samples from the patient with even the trickiest of veins (and I include myself in that so sorry!).
Vascular access team - literal life savers when it comes to patients with tricky access or the need for longer term lines such as PICC lines. Learn a huge amount from them every time I am fortunate enough to see them out in a line.
Dieticians - their knowledge bank is incredible and what they do makes a huge amount of difference to how patients recover from illness. From advising patients through to incredibly complex decisions around TPN - just amazing!
And yes - hospital volunteers play an absolutely wonderful role and the support they give can never be underestimated. A huge huge thank you for the time and dedication you all bring and for making the NHS just that but more special through what you do each day!
Clinical engineering and medical physics - currently at a hospital which has 24/7 clinical engineering on site and my respect for the incredible work they do has never been higher. Sorting out the myriad of clinical equipment, medical gases and everything inbetween.
Turns out it is really hard to compile such a list when at home and desperately trying to think of everyone to add!!
Medical librarians - providing expert support in identifying new literature to support patient care and whizzes at finding invaluable clinical information to help teams care for patients. Especially vital when we were dealing with a virus we knew barely anything about!
Medical education teams - almost overnight putting on courses and finding resources to support staff who were redeployed, their role in training staff can never be overlooked.
Security staff - personally a huge thanks for helping every time I have needed them but keeping us all safe day in day out - thank you doesn’t seem enough
Research teams - trials change practice and improve patient care and we have seen just how vital that is during this pandemic. Research is one of the most important things we can all be part of to improve the care for patients now and in the future.
Apologies to any groups not included and that doesn’t mean you aren’t hugely valued but hope this thread has given a flavour of the huge variety of those working in the NHS. So often hear about doctors and nurses but hope this opens people’s eyes to other amazing varied roles!
Other teams include HR, payroll, finance teams, and because @DavidKovar1 will never forgive me if I forgot - our amazing managerial teams - honestly we couldn’t do our clinical jobs without each of these roles and it is one of the joys of the NHS that I do get to work with them
And a huge special thanks to all those supporting patients and their relatives, perfect example are psychologists and chaplains have played an absolutely vital role and whose importance can never be overlooked.

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Why do B12 and folate deficiencies lead to HUGE red blood cells?

And, if the issue is DNA synthesis, why are red blood cells (which don't have DNA) the key cell line affected?

For answers, we'll have to go back a few billion years.


2/
RNA came first. Then, ~3-4 billion years ago, DNA emerged.

Among their differences:
🔹RNA contains uracil
🔹DNA contains thymine

But why does DNA contains thymine (T) instead of uracil (U)?

https://t.co/XlxT6cLLXg


3/
🔑Cytosine (C) can undergo spontaneous deamination to uracil (U).

In the RNA world, this meant that U could appear intensionally or unintentionally. This is clearly problematic. How can you repair RNA when you can't tell if something is an error?

https://t.co/bIZGviHBUc


4/
DNA's use of T instead of U means that spontaneous C → U deamination can be corrected without worry that an intentional U is being removed.

DNA requires greater stability than RNA so the transition to a thymine-based structure was beneficial.

https://t.co/bIZGviHBUc


5/
Let's return to megaloblastic anemia secondary to B12 or folate deficiency.

When either is severely deficient deoxythymidine monophosphate (dTMP*) production is hindered. With less dTMP, DNA synthesis is abnormal.

[*Note: thymine is the base in dTMP]

https://t.co/AnDUtKkbZh
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More stem cells = lower chance of cancer

Fasting is also a viable option for increasing your stem cells.

You could do a 24 hour fast once a week.

Or go extreme like my business partner @taylinsimmonds

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what's funny about this is that nothing about it new

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the point Lasch makes towards the end is that all of these books are grasping towards something that neither therapy or politics fully covers, even if both are obviously relevant.

but first, he does a tour through the books. he encounters people who believe all character traits are a product of "propaganda" and "conditioning" that can be fixed with therapy or therapy-like processes, and people who think therapy is a distraction from politics
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