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October 2019

Adventure: The Metropolitan City of Wroclaw, Poland

By Adventures, Friends & Family, Thinking, TravelNo Comments

I recently visited Wroclaw in Poland with my brother and his friends for his stag do and his birthday. It was the first time I had met many of my brother’s friends and they are a great bunch of lads. In this post I’ll be discussing my experience of being in Wroclaw.

The first thing to write is that the architecture is aesthetically pleasing. There are many buildings with a Georgian style and many churches that are exquisitely designed. Here is an example of one such church:


A Church in Wroclaw, Poland.

Here are two photos of fountains I took:


Fountain (1).


Fountain (2).

Wroclaw is vibrant, youthful and has an upbeat feel. It is a clean city, only being let down by graffiti that is everywhere. There are plenty of places to eat and drink, with some even having English menus upon request. The cost of living is cheap with roughly 10 slotty (about £2) buying a double vodka and diet coke. I did have difficulties getting zero sugar drinks in a number of places, which was a bit of an issue with me being diabetic.

The only Polish word I managed to learn was Kawa, which means coffee. The main square is huge and has flower market stalls that appear to be open 24/7. I found myself listening to Polish conversations as I walked around and appreciating the beautiful sound of the language. Some Polish spoke English exceptionally well whereas others didn’t speak any English at all. I found the Google Translate App really useful.

Without doubt it is people that make a city. All appeared happy, content and liberal. Polish people had less inhibitions when it came to dancing than we English have. Polish people will quite happily bump into anyone in their way in pubs and clubs. This is normal to the Polish, but being British I found it a little rude.

As Poland is known for being Roman Catholic and as such conservative when it comes to gay people and their rights. I decided to test the waters with a Polish man who I had been talking to and getting on with whilst smoking a cigarette. I came out and asked his views on gay people. He said:

“I don’t care, I don’t give a fuck. That’s your choice. We’re all just friends here.”

He described himself as not being religious, male, heterosexual and was in his mid twenties.

Overall Wroclaw is a beautiful city, with wonderful people and a place that I will be visiting again.

Take care,


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Why the Pharmacology Principle of Administering A Minimum Dose of Medication To Get The Desired Effect is WRONG

By Health2 Comments

In recent years the pharmacological principle of prescribing and administering the minimum dose of medication to get the desired effect has become common place in medicine. Despite not being a Doctor or Nurse Prescriber I have come to believe that this approach is fundamentally wrong. In this post I explain why.


The medication that I take each morning.

Let me explain why the theory and practice has become so popular. It has lots of benefits. It helps prevent patients being overdosed on medications, minimises the likelihood and severity of side effects; can prevent or reduce the risk of patients becoming tolerant to medications and microbes from developing drug resistance (such as antibiotic resistance).

These benefits all sound good, so lets looks at the risks and why I believe the risks outweigh the benefits – put simply why I think this approach is wrong.

The biggest risk is that patients get under-dosed, leaving them in pain or suffering due to Doctors and Nurses being too cautious. Another risk is that Doctors and Nurses are always looking to reduce doses at medication reviews. This could be physically, mentally and emotionally harmful to the patient. Some may argue that pathways are in place to prevent under-dosing and harm. But pathways don’t always account for the complexity of the individual patients.

Here are some examples of when this theory of giving the minimum amount of medication to get the desired effect doesn’t work:

  • A patient brakes their arm and has the bone sticking out. They are understandably in a lot of acute pain. However a pathway, Doctor or Nurse may choose to start them on paracetamol and work up to stronger painkillers. In this case the patient is likely to need Morphine, which is at the top of the pain management pathway. This may result in several hours (or more) of severe pain.
  • A patient with chronic back pain attends a Pain Service for medication review. After the initial assessment, the Doctor or Nurse decides to lower doses of medications despite the patient saying that they’re struggling with the pain. They refer to Physiotherapy – a good decision, but still reduce the doses of medications. This leads to anxiety, possible depression and more physical pain.
  • An elderly patient has a urine infection and type 2 diabetes. After several GP visits due to constantly needing the toilet, she gets antibiotics. However they are of the lowest dose, indicated by a urine infection pathway. The patient has to return to the GP to get a higher dose. During this time her blood sugars are high, leading to even more urination, the risk of dehydration and other associated complications of having a high blood sugar over a prolonged period of time.
  • A patient with mental illness such as bipolar isn’t put on high enough doses of antipsychotics and/or antidepressants. They are given the dose that is as little as possible and it is not increased despite the patient asking for this. This means that the patient has continual relapses and repeated admissions to mental health wards.

I try to avoid writing about things that could cause controversy. But my recent 15 day stay in a mental health ward and experience with community mental health services has left me having being given less than the standard doses advised in the BNF on two mood stabilisers. I believe that standard doses of medications exist for a reason. These are levels of medication that experienced clinicians through research have found to be effective.

I now face an uphill struggle and a battle to get medications I need increasing increased due to this theory. This is why I believe it is fundamentally wrong. Because of the risks of under-dosing and causing harm. I’m sure I’m not the only one affected by this principle, it is no doubt many others across the country and Western world.

Write soon,



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Book Review: This Is Going To Hurt by Adam Kay

By Amazon, Books & Authors, Happiness & Joy, ReviewsNo Comments
This-Is-Going-To-Hurt-Adam-Kay-Book-Cover Comedian Adam Kay hasn’t always been a Comedian. In a former life he was a Doctor in the National Health Service (NHS). At the time he dutifully kept a reflective diary, as he was encouraged to do so as best practice.

In the best-selling This Is Going To Hurt Kay shares this secret junior Doctor diary with the world. As a junior Doctor Kay mainly worked in maternity. Kay tells true stories with a humorous flare. Obviously patient’s details have been changed to ensure anonymity.

In this book Kay is completely honest and because of this honesty it really does tell you what it’s like to be a junior Doctor in the NHS. Along with what it’s really like behind the scenes in the NHS.

Throughout the book there are brilliant footnotes that explain the medical terminology in an easy to understand way.

All of the stories are interesting, made so by Kay’s constant use of humor. Writing humor in a book is difficult, so Kay should be highly commended for pulling this off as well as he did. A couple of the stories were so so funny that I laughed out loud reading the book.

Kay’s diary is dated and at each change of job, he explains his mental state and shares his thoughts around topics including: commenting on Politician’s meddling in the NHS; under funding and under resourcing; the staff often working for nothing because they feel morally obligated and want to do the best for their patients; the NHS relying too much on the goodwill of staff (in all roles) to the point were the goodwill is almost gone and staff morale is non-existent; the sneaking privatization and what it will mean for all; that our expectation of Doctors and Nurses to be super-human are unrealistic.

Kay wraps up the thoroughly enjoyable This Is Going To Hurt by telling the story of a patient that made him decide to leave the medical profession. It is deeply tragic, as is Kay’s loss to the profession. Kay describes receiving a letter after 4 years of quitting from the General Medical Council (GMC) removing him from active registration due to lack of required practice hours. The ending of the book caused me to cry.

This book reminded me that every person has and is their own story. We whom work in the NHS should always remember this, along with the fact that patient’s like to share their stories whether good or bad of contact with NHS services. Staff in the NHS generally work there to make a positive difference to people’s lives. We certainly don’t go into it for the money!

The success of This Is Going To Hurt has led Kay to recently publish a follow up book Twas The Nightshift Before Christmas, in time to be a stocking-filler for Christmas. I just hope that this follow up book has new diary entries in, rather than a reprint of stories from the first.

Review soon,



I aim for posts on this blog to be informative, educational and entertaining. If you have found this post useful or enjoyable, please consider making a contribution by Paypal:

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Blogs of Interest Links Updated

By Technology, The WebNo Comments


Copyright © Antony Simpson, 2019.

I have updated the Blogs of Interest and Websites I Browse sections on the sidebar. This was to remove links to websites that are either offline or websites that haven’t been updated in so long that they may as well be offline.

There’s a question here about why bloggers stop. But I’ll leave that question for another time, maybe when I have the energy to consider the question and write a post.

Take care,


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