1 October 2019 (Tuesday) - Nasal Polypectomy

Nasal polyps are growths of abnormal tissue that form in the nose or deeper sinuses. They are usually benign, but larger polyps can block nasal passages causing breathing difficulty and sleep apnoea. It's quite amazing just how much sinus space one has, and how blocked they can become.   

If conservative treatment for nasal polyps is not successful or if polyps are problematical a consultant may recommend a nasal polypectomy. This is (usually) performed under general anaesthetic and takes about 30 minutes. The surgeon will access polyps through the nostrils so there will be no incision. Polyps will be removed using special suction and instruments.
After surgery the nose is packed with dressing to help control any bleeding.
Nasal polypectomy is usually done as a day case however sometimes an overnight stay is necessary.

There is a world of difference between reading these dull dry words and having one's sinuses surgically ravaged...

29 September 2019 (Sunday) - C antigens

Whilst perusing the Blood Bank Interest Group on Facebook I read “If a unit is negative for the C antigen will they also be negative for The CW antigen”. Now this is easy. They might be. They might not.
But in the discussion that followed the question some said yes, some said no, and some agreed with me.

I need to bear in mind that I need to carefully consider my sources of CPD, and not blithely trust everything to be correct…

29 September 2019 (Sunday) - BTLP-TACT Excercise

With a few minutes to spare before the Sunday early shift ended I thought that rather than having a tea break I might do a BTLP-TACT exercise. I’d had a rather difficult shift, I wasn’t feeling on top form (I’d barely slept last night), my car is laying in tatters in the car park (I will be getting the train home and arranging car fixing tomorrow), so if I’m going to get the blood banking wrong I’d like to get it wrong in the simulator… and know that I need to work on separating my mind from my troubles and to concentrate more…

So…I was presented with one case – a seventy-year old female who was vomiting blood. A group and antibody screen was required.
She was A Rh(D) Pos with no antibodies found.

I got the green light… Bearing in mind the stress I was feeling, a more challenging scenario might have been a more valuable exercise. But I’m grateful for the use of the simulator…

27 September 2019 (Friday) - Digital Morphology

The results of the latest digital morphology exercise came out today.
The actual diagnosis was of reactive lymphocytes (a response to EBV infection) but also abnormal red cell morphology reflecting South East Asian Ovalocytosis (SEAO)

I’d noted

CPD Date:
Total Number of Participants:
Case Identifier:
DM 2019-20 1905DM
Consensus of morphological features
Your observations:
Participants who selected this feature (%)
Morphological Feature
Atypical lymphocytes (reactive)
Smear/smudge cells
Concerning the red cells; what condition is most likely responsible for their appearances?
A separate inherited disorder affecting red cells
What diagnosis (or diagnoses) do you think best describes the appearances of this film?
Viral infection ? GF in somneone with hereditary ovalocytosis (?? SE Asian)

I’ve copied and pasted directly (including my spelling mistake), and think I can feel quite justifiably smug about this…

27 September 2019 (Friday) - ASH Update

The American Society of Hematology sent their clinical news update today. You can read it by clicking here. It was a tad dry for me. Very much focused on the clinical aspects rather than the technical aspects.
But it is all useful background material…

26 September 2019 (Thursday) - Anti-D Tutorial

I went to a rather interesting in-house tutorial on anti-D prophylaxis today. Whilst I am aware of how severe HDN due to anti-D can be, I was utterly unaware of how bad it was before the prophylactic program started.
Thousands of fetal deaths a year now reduced to single figures…
And about a quarter of all Rh-Negative women being affected.

All presented in an informal but informative manner, with the opportunity for discussion and questions… I wish I could get more CPD like this…

26 September 2019 (Thursday) - Oncologist Update

The nice people from “The Oncologist” sent their update today. As always it focussed on treatments and clinical matters rather than the more scientific or technical, but background information is always good…

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25 September 2019 (Wednesday) - What's This?

Here’s something else which appeared in the Hematology Interest Group today. The subsequent discussion shows exactly what a dubious source of information this page can be. Whilst the majority opinion is that this is a case of leishmaniasis, one person rudely shouted this suggestion down. Someone else feel the red cells were iffy, another said leukeamia…