WHAT...... I have to learn a whole new language here????

The best thing about moving from England to America was that eventhough I had to deal with a whole new culture at least I didn't have to learn a new language (just deal with the accent thing)..... or so I thought.
For the last two years before I left England, while I was studying for my A Levels I was also taking an evening class in British Sign Language (BSL). I had taken a couple of courses and I was qualified as a trainer for the subject. 
Unfortunately, in America they use American sign language (ASL). I thought that maybe I could just adapt a few things here and there and try to learn it. So during my associates degree I took a class in American sign language. Wrong move!!! It was completely different. For one thing, Americans use just one hand to sign while British sign language incorporates both hands. Everything was completely different. The alphabet. Words. Everything. It was insane. I did not think that it would be so different. Since I've never been too skilled with my hands, and with the confusion of British sign language, I decided to drop that class. I can still recall the alphabet in both languages and some key terms so if I were to encounter a deaf person which I have often in my field I can communicate with them. I'm still waiting to meet someone in America that is from England and I can use my BSL skills on them so they don't get too rusty.
That just goes to show.... even in two places where English is spoken, there can be language differences.

Feeling Healthy?

I grew up with the NHS - its what I was used to. I knew that going to the doctor meant waiting ages and an appointment in the morning usually meant I'd be taking the whole day off of school. I suffered from recurrent throat infections (pharyngitis for my medical followers) and was told I needed to have my tonsils out. I was put on the waiting list and it took approximately 3 years for my tonsillectomy to take place. I waited 5-10 years to have skin graft surgery for my arm. Well of course, some would say (and I would agree), these weren't life-threatening operations (surgeries), were they?

The NHS was really all I knew until I moved to America 12 years ago. In America you had to have health insurance unless you wanted to pay exorbitant amounts of money to see a doctor, get an x-ray, blood work etc. You can purchase health insurance on your own which can cost approximately $200 a month (about 150 pounds) but that doesn't always include co-existing conditions that a person may already have at the time of purchasing this insurance, such as diabetes, asthma etc. So basically - group insurance is the best way to go. You pay a small fee monthly and you get good benefits (usually) but you have to either be employed, in school, or somehow get a group insurance. Does it sound easy? Not to me, it doesn't.

Anyway by having health insurance in America - it doesn't guarantee anything. You still have to pay a co-pay to see the doctor and a higher co-pay to see specialists. Also, you pay co-pays on medication. You better hope the medication you are prescribed is a generic, or else either the insurance won't cover it, or you'll be responsible for paying over $200 for a medication monthly.

Health insurance is very complicated because it depends on the type you have etc. I did a whole certification class on it but I won't bore you with the details. Which is better - the NHS or having this health insurance? I don't know.

People in America who are employed but not fortunate enough to have health insurance sometimes cannot get health insurance on their own and therefore they are left with little choices. Do they go to the doctor and risk the huge fees? Or do they risk not going and having something really wrong with them? During my clinicals at the ER, we saw plenty of patients without insurance who came to the ER with minimal issues because they didn't have health insurance and its easier for them to go to the emergency room then to a regular doctor because they can just refuse to pay the hospital and let the bills pile up. But what about those people who have chest pain but don't want to go to the ER because they are worried about the cost involved? What about these people? Its tough. Health care providers cannot be there to assess the risk before the patients even come to the hospital or clinic. We cannot force people to come in if we don't know what is going on. Its a hard battle.

But is the NHS so pretty. Not always. I know many people who don't get the testing they need, or the care they deserve because they are receiving NHS care. True - they have a choice, they can go private - but not everyone can do that. A friend I know has diabetes. She is being prescribed Metformin which is one of the cheapest medications available. Unfortunately, she is not doing too good with the medication due to the common GI side effects experienced with this medication. She has been told by her doctor that this is the only medication available to her. Why is this? There are many many medications available for diabetes. Does she have other risk factors, kidney disease, blood disorders etc. No. The reason she is being told this is because metformin is the cheapest drug available and therefore NHS are pushing this medication as being the only drug available because it is cost effective. But is this fair. I don't think so. I don't think a patient who is obviously having side effects which are very common to this particular medication should have to continue this medication and not get a choice to change.

I know that in my experience when patients taking Metformin experienced a side effect we would recommend another because pts who have side effects are usually left likely to be compliant with the medication anyway. So -we switch to another class of medication. But then the patient makes up the cost involved. The patient is responsible for it. So what's the difference? What is better?

I don't know. I can't judge what is better until I have lived a life of both and experienced much more than I have. The way I see it is that both have their own issues and both have their pros and cons. The primary goal of health care regardless should still be to serve the sick and help those that need it and I think that goal needs to be recognized and be more aware of. I just hope that I can adopt that goal when I start working as a PA.

Technology is killing my sleep

So, of course there are difference and there are also similarities between the place I was born (England) and the place I currently reside (America). Technology is the topic I am referring to today. No matter where you live in the world, technology is advancing at an astonishing rate. It seems as if countries are competing with each other over who can bring out the newest software, programs, and hardware. I've always felt that England has been a step above, in terms of bringing out the newest things, most unique, and appealing to the public. This doesn't just refer to technology but also fashion. Fashion usually comes to the UK before it comes to the US, well in my opinion only. but fashion will be another blog entry I am sure.
But back to technology and my sleep issues. I feel like technology is advancing so much and who can help but try to keep up with it. When the i phone first came out, I never thought I would be one of those people that got absorbed in it. But I was. With defense to myself, my purchase came about due to my schooling as a physician assistant and the programs were definitely helpful both in school and during clinicals, not to mention the communication devices and the games.

I remember back in London - almost 12 years ago, all I had was a mobile phone which had text messaging and those free voicemails you could do to other people's phones. My best friend and I would resort to sending each other voicemails, and I remember late at night since my parent's room was right next door I would pull the covers above my head and whisper so that no-one could hear me. But now.... what a difference. Kids under ten have cell phones or mobile phones which have cameras, videos, messaging, and browsing capabilities. Wouldn't it have been awesome to have this as a child?

The other day I woke up in the middle of the night. I wondered what time it was, so I clicked the bottom on my i phone and as I saw the time I also saw I had a new e-mail. Cool. I couldn't go back to sleep without checking my e-mail. And then of course maybe reply too. And then, wait what's that - a facebook notification. Let me quickly check that before going back to bed. Oh cool - someone just replied to my status. Let me reply to that too. And look someone IM'ed me. And if you're like me, even if you're asleep because I have friends and family in my time zone and another time zone, its easy to like technology take you away from your sleep and occupy you with what is right there waiting for you. So what's the difference? Well technology. Its different everywhere. Do I love it? Yes I do.

I think you're getting pulled over

So speeding is a problem no matter where you live, but the way that it is dealt with is different.
I did take driving lessons in London, although since I was about to move, I never ended up taking my driving test there. For those of you who don't know - London has speed cameras. Most people know where these cameras are located, but over the years the volume of cameras have increased, and now they have gone so far as to use these cameras to enforce people not going into the bus lanes etc. These cameras are everywhere.

But people are smart. I've heard stories about people who try to fight the tickets they get when the camera takes a picture of a 'car' being in the bus lane or going over the speed limit. People say 'well it wasn't me driving.' This excuse usually works, although I think that police or whoever it is that is in charge of these cameras are going to get smarter and actually be able to figure out who is actually driving and get that on film.
I was talking to a good friend of mine and we were discussing that the use of the cameras is almost becoming like a big brother thing... where they know where u are. For example, a wife who suspects her husband of cheating may want to get hold of these cameras to show that her husband is regularly passing a 'certain road' where he visits his lover daily. How far will we go with these cameras? Also... is it right that we are being watched when we aren't doing anything wrong? The cameras are there in case someone is breaking the law, but when we are not, is it fair to be watched?

In America, well Florida specifically, police cars hide around corners, or dark areas and observe cars for speeding. They have camera-like devices that they can hold up to cars to observe for speeding.Once they see a car speeding, they turn on their lights and chase that car down. Its quite a traumatic process. Suddenly you are driving and then in your rear view mirror you see a police car with their flashing lights on and sometimes sound too and you have to pull over as soon as you can. Its hard to know sometimes if they are trying to pull you over or just trying to get to someone else because they are behind you and flashing their lights so its sometimes hard to tell, so if in doubt just pull over anyway.

I remember when I had just passed my test and I got pulled over. I was so scared. I was just under 18 years old and I was a new driver and new to the United States. It turned out I was pulled over because my tag wasn't fixed the way it had to be (which wasn't my fault by the way). The cop was nice to me and told me to go to the car store and get it taken care of. But honestly, just being pulled over, even if you don't think you have done something wrong really gets your sympathetic nervous system riled up.

One benefit to being pulled over as opposed to being caught by a camera is that you can 'talk' out of a ticket. I was on my way back from my first overnight ER shift at 3am. I admit I was half-falling asleep and was driving without thinking. The roads were new to me and I honestly did not realize that I was in a road work area. I was going 53 mph and because of the road works the speed limit was 40 mph. I do not even remember passing by the police car on my way. But suddenly in the empty road I see a police car flashing their lights with sirens behind me. I am sure they are pulling me over because there is hardly any one else on the road. I quickly look to pull over somewhere, but there are road works and so its kind of hard to pull over in a convenient place so I pull over to the next turning lane. So I stop the car and put the wndow down and wait. I'm wearing scrubs since I just got out of the ER. The cop tells me that I was doing 53 in a 40 mph road work area. I apologize. He asked me where I just came from and I tell him. He asked for my license and I ask him if I can locate it from my glove pocket nearby. And he says yes. Basically long story short, he lectures me for a bit about driving safely, and especially about how since this is a road work area, and if the work men were about I could be fine up to $200 etc. etc. I apologize again. And then he lets me go.
I don't know the formula for them letting a person go. Whether it depends on what you are dressed like, what you say, how you act, or what kind of day they are having, not to mention if it is the end of the month and they have a quota to fill. But regardless I got off - and I'm glad.

But they are starting to bring cameras in especially in Orlando at the traffic lights to monitor whether people jump a red light. And that brings the same questions about people being monitored and watched also.

Most important thing to know is in England police officers are Bobbys and in America they are Cops.
Well.. alas there u go... it doesn't matter where you are... someone is always watching.

Sneezing

It really doesn't matter what you call it, whether it is sneezing because of hayfever (UK) or because of allergies (USA) its still sneezing, and very annoying.
I'm not sure where my hayfever (allergies) was worse. But I remember in England always sneezing and onestly my hayfever was out of control and I just thought that sniffing and sneezing was something that I was always going to have. I tried nose sprays and some weird liquid med (can't remember the name) because at that age I couldn't swallow tablets yet.
So when we moved to America, my asthma was better and so I thought my allergies would be too... ha ha. Florida is the worst for allergies. Who knows what I'm allergic to, I never did the actual allergy test, but probably mold, spores, dust, dander, and all that nice stuff. So one day while at the doc office I happenned to mention my ever-increasing sneezing and they looked in my nose and down my throat and said 'you have allergies'. Duh.. i could have told you that. Well anyway they gave me Allegra D which is the best. It helped to control my sneezing and led to me getting sick much less. Although my health insurance won't cover Allegra D any more but that's another story... and another blog...!

But whether I'm here in America or in London I still have my allergies/and hayfever.

Chocolate...... Twirl, dairy milk, flake... yum

I'm not really into chocolate that much... but you know what they say.. when you can't get access to something, that's when you miss it the most. I was used to stopping at a newsagents and grabbing a chocolate bar when I went somewhere or picking one up at Tesco by the till.

There is something about that Cadburys chocolate which is so delicious and sweet. No offense to the Hershey chocolate here and those that love it... but it does not compare. It is probably because I am so used to Cadbury's chocolate that it just tastes so good to me.. so now when I visit England I pick up a whole bunch of chocolate and of course I store it in my fridge for months on end...

Where's the drive-thru

When I arrived in London, my cousin and I were both starving so we were looking for a nearby place to eat. Relatively fast and easy. She wanted to find a drive-thru McDonalds so we could eat and run.... I was puzzled... aren't all the McDonalds and all the fast food places drive-thru? No, she said. In fact many of them aren't.
Hmmmmm.... that's strange. And we actually had to drive almost 45 minutes from Heathrow airport just to find a McDonalds.
In America there are drive-thru restaurants everywhere. There are McDonalds within ten minutes of each other literally. Some roads even have multiple McDonalds on one road... yes strange I know. And almost 99.99999999% of all fast food places (whether it is McDonalds, Taco Bell, KFC, Burger Kind etc... all have drive thrus). It is the America way. We eat and run. We drive thru and run lol.

Speaking of food though... the portion sizes in America are much bigger than in England and interestingly enough the price of food is cheaper in America than in England. I was with a good friend at a restaurant and we ordered dessert. And I was surprised that I was able to finish the dessert portion because it was actually smaller than the portion we are given in America which usually is enough for three people to share (certainly not something I could have by myself).

So why is this? Why do we have so much fast food in America? Why do we have an abundance of drive-thrus? And why is it so much more cheaper to eat out in America??