Change is happening in our world at a staggering pace. I watched Brian Cox’s Human Universe last week and marvelled at how far the human race has come in terms of understanding our place in the grand scheme of things. It’s a subject of great debate to decide which period of human evolution has seen the greatest progress but in terms of technological advancement, the last twenty years have moved forward at lightning speed and I’ve been lucky enough to watch it and live it.
In 1994 Oasis and Blur were vying for Number 1, cassette tapes were slowly being replaced by CDs and coincidentally Prof Cox was playing keyboards on D:Ream's Things can only get better. Petrol was fifty-pence a litre, the best selling car in the UK was the Ford Escort and the average house cost £64k. Bizarrely the cost of a pint of milk was 25p – just the same as today. Twenty years ago if someone told you that you were one in a million then there were 5500 humans like you in the world. Today that same comparison means you’re just like 7000 others. The world’s population has grown by more than a quarter in two decades thanks to our ever improving ability to sustain life and cure disease.
I got to thinking about this when my new phone arrived on the day after the good Professor had explained how the advent of writing allowed human knowledge to be recorded, shared, compared and improved. My ingenious new communication device gives me access to seemingly infinite quantities of recorded learning and as such, my understanding grows daily. "Phone" really isn’t a suitable title for something that facilitates all of this.
In 1994 my wonderful parents broke the bank and bought a PC for our home. It was cutting edge and cost £1000 – 2 grand in today’s money. I remember with crystal clarity going to pick it up, such was my excitement. The monitor weighed more than me and the base unit was the size of a small cupboard. The mouse had a ball in it that had to be de-fuzzed every day and Windows 3.1 took half an hour to boot up. Today the device I hold in the palm of my hand cost me £15 (plus a contract) and can process information 1000 times faster than that PC. It has 1000 times more memory and can store 320 times as much data. It’s got a digital camera with a flash and an internet connection that allows me to send the images around the world 5 seconds after they’ve been taken. The modem in the PC would’ve taken an hour to do the same with an intolerable amount of squawking into the bargain – remember that sound? – and cameras cost £4 from SnappySnaps for a disposable.
These numbers blow my mind but not as much as the fact that my new phone has a finger print scanner. A bloody finger print scanner! In 1994 Pierce Brosnan AKA James Bond was only dreaming of finger print scanners and now anyone who nicks my phone will have to chop off my finger to use it. That’s brilliant. I think.
Many technological advances are driven by the human propensity to gather and share information of all types. It’s a wonderful dichotomy that the same space exploration which put satellites into orbit facilitates both a surgeon’s ability to operate on a patient in a different country and your ability to watch TOWIE. Isaac Newton must be fuming.
Although the pace of change in medicine is incredible, there are some things that haven’t changed for years because they’re a matter of simple logistics –getting drugs from the outside to the inside.
After recovering from an infection last week, today I had a new Hickman line inserted – it’s a thin rubber tube which enters a vein in my neck and allows medical staff to infuse chemotherapy and withdraw blood to be tested without the need for needles. Much of the chemotherapy that I will receive is extremely corrosive and needs to be sent into a large vein with fast blood flow to prevent pain and permanent damage. After the chemo and stem cell transplant a sample of my blood will be taken and analysed every day and it’s much easier to take it from the line than from a cannula. It hurts less too. A Hickman facilitates all of this.
The procedure itself takes about half an hour and is relatively simple. After using plenty of local anaesthetic, the person inserting the line first makes a small nick in the external jugular vein (Joke – how do you kill a circus? Go for the juggler. Boom boom!) which sounds risky but because the heart is essentially sucking the blood down towards it, the risk of bleeding is small. They use a guide wire to establish the length of line required and it feels quite odd as the wire is pushed into the vein but it’s not painful.
Next is a process called tunnelling which sounds a bit industrial and is. The line needs to be tunnelled under the skin so that it can secured in the chest and therefore not get pulled out too easily. Using a hollow, medical grade knitting needle, the operant opens up a “track” between the skin and the muscle where the line will sit – imagine stuffing the turkey at Christmas but with less sage & onion and more rubber tube. The line is then passed through the tunneller, the tunneller is removed and the line is fed down the guide wire into the vein. I’ll post a picture when the dressing comes off - I look like a robot with tubes coming out of my chest.
I’ve had 5 lines now and this was certainly the least painful. On the second occasion it was a much larger line and the consultant anaesthetist doing the procedure was a fairly slight man. Most lines go into old people with baggy skin so my young (ish) tough dermis made things a bit tricky. I was heavily sedated but I distinctly remember him saying he’d never had to tunnel through such a magnificently sculpted, Adonis-like pectoral muscle. Stop laughing at the back. In the process of pulling the line upwards towards my neck he lost his grip on the tools and punched me square on the jaw. I must have a glass chin as it all gets a bit blurry after that. In the last few years the NHS has recognised that there are many skilled members of the theatre staff who aren’t Doctors but can become experts in some procedures after extensive tuition. Today the procedure was performed by Nurse Specialist trained in specific procedures to help share the load placed on surgical staff. I didn’t feel a thing apart from the fairly hefty pushing and pulling required to get under my skin. Shared learning for the good of everyone..
Things can and will get better but that’s progress – onwards to the transplant!
If you've recently been diagnosed with Hodgkin lymphoma and have yet to receive treatment you could be eligible to take part in a new clincial trial. Read more here.