health · Just for fun

Why You Should Always Find Out Your Surgeon’s Birthday

Today is my birthday! How old am I? Fortunately that’s not relevant to this blog post. Because today, we’re going to be talking about the most important birthday you need to add to your calendar. And, hard though it is to believe – it’s not my birthday… It’s your surgeon’s. Because a study in the British Medical Journal (BMJ) has found that patients who underwent surgery on the surgeon’s birthday exhibited higher mortality than patients who underwent surgery on other days.

Wait, what?

Yes, that’s correct. Your surgeon is more likely to kill you if they’re operating on you on their birthday. How’s that for a crazy fact – and a completely inappropriate topic for a light-hearted celebratory birthday blog post? In my defense, the study was published as part of the British Medical Journal’s fun and festive Christmas edition, so I’m not the only one completely misjudging the suitability of the topic for light entertainment.

It’s my surgeon’s birthday. How worried should I be?

The study looked at almost a million surgical procedures performed by 47,489 surgeons, and found that mortality rates were 6.9% on surgeon’s birthdays, compared to 5.6% on other days. That’s a pretty noticeable difference – but there are, of course, a few “buts”…

The study looked at 17 common emergency surgical procedures, performed on patients aged 65 – 99, at US hospitals from 2011 – 2014. The fact that these were emergency procedures performed on older people means the expected mortality rate for the first 30 days after surgery was already quite high. Unless you’re a 65+ year old undergoing a common medical emergency, even if it is your surgeon’s birthday, you’ve probably not got a 6.9% chance of dying. Good news for anyone getting an ingrowing toenail removed (or having pituitary surgery).

Additionally, apparently it’s actually comparable to the kind of increase in death rates that is seen at other times – including Christmas, New Year and weekends. So that’s… not at all reassuring, actually, now I think of it.

Why does it happen?

Well, the study was observational, meaning that the authors couldn’t establish the reasons behind the ‘birthday effect’ they observed, or exclude the impact of other, unmeasured factors. But they suggested a number of factors that could be at play:

  • Surgeons rushing to complete procedures on their birthday if they have plans to celebrate later on.
  • More distractions from birthday phone messages or conversations with team members, which could lead to more errors.
  • Surgeons being less likely to check up on patients following surgery, if they are busy with birthday plans.

They all sound totally plausible, although I’ve also thought of a few of my own that the researchers somehow missed:

  • Surgical staff suffering from a sugar rush and subsequent drop in blood sugars after eating birthday cake, impairing surgical performance.
  • One or two evil surgeons intentionally killing patients as part of some kind of sick annual birthday ritual. It’s probably a whole conspiracy, guys. I wouldn’t be surprised if it turned out Bill Gates was involved.

How reliable is the study?

I’m not a statistician, so I’ll leave that question to more experienced maths jockeys. I will say, however, that the letters section of the British Medical Journal website contains a number of letters on the topic from some very disgruntled surgeons, and is well worth a read. To quote one letter from neurosurgeon Steven A. Reid: “One wonders about the intrusion of errors on the part of statisticians on their birthdays — I’m certain the outcome isn’t as dramatic. More speeding tickets perhaps?”

And in conclusion…

Well, I’m not a surgeon, but you’ll be glad to hear I’ve booked my birthday off work anyway. You can’t be too careful, right? And if you’re reading this while in the office, well… play it safe and go read about my experience of transsphenoidal pituitary surgery rather than doing any more of that dangerous work stuff…

health · pituitary · top tips

Top Tips For Having Transsphenoidal Pituitary Surgery

Now, I fully recognise that this is a bit of a niche blog post, one which is principally going to be of interest to anyone about to have pituitary surgery. But hey! Pituitary tumors are actually surprisingly common, so there’s a lot of people out there who might be awaiting surgery. Maybe one of them is your, dear reader.

And before going into hospital for your transsphenoidal pituitary surgery, you will be anxious. You will have questions. However, I should note that many of your questions will already have been answered on legitimate medical sites elsewhere on the internet. So instead of regurgitating the same old advice (“Don’t sneeze after surgery or your brain will shoot out of your nose”, “Warning: after they’ve drilled through your head, it may be a little sore”), I have decided I will go down a different route, and write down the more obscure things that I wish I’d known before heading into hospital for transsphenoidal pituitary surgery…

Top Tips For Having Pituitary Surgery

Let me present my top tips for people about to have pituitary surgery:

1. Shave your inside elbows.

“She’s gone mad,” I hear you cry. “She’s raving. It was probably the brain surgery that did it.” In fact, this is an entirely logical step, because of all the blood tests you’ll undergo after your pituitary surgery; you’re basically going to be a human pincushion for a couple of days as the doctors seek to keep a very close watch on various hormone levels. And I mean VERY ClOSE. Both times I’ve had pituitary surgery, I’ve had blood tests every two hours for the first twelve hours after waking up, and then they gradually reduce in frequency… But not fast enough. You will literally be woken up through the night for blood tests in hospital.

This means that the post-blood-test strip of tape and cotton wool that the phlebotomist sticks over your inside elbow is going to get ripped off repeatedly, and then stuck back on. And then ripped off again, along with much of your arm hair. After the sixth time this happens in one day, you’ll be wishing you had taken my advice and shaved your inside elbows. I did this for my second surgery (having learned this lesson the hard way after my first pituitary surgery) and it made all those bloody blood tests just a little bit easier.

2. Drink enough.

If this seems obvious to you, then presumably you’re a normal person who gets thirsty when you haven’t drunk sufficient amounts of water to keep yourself hydrated. However, I am an odd sort of person and I only really notice I’m thirsty when it’s hot or I’ve done exercise (or, for some reason, when I’m pregnant!). Otherwise, I can go for hours and hours without drinking and not even notice; even back when I was a teeny child, my mum would tell me off for not drinking enough.

This was slightly problematic in hospital. Because of the risk of surgery damaging your pituitary gland and causing a condition called diabetes insipidus, your fluid balance is monitored carefully. If they believe you’re becoming dehydrated, they will put you on a drip. This is rubbish. Therefore, drink lots of water. And if you don’t like water, keep a supply of tastier drinks at hand. And by “tastier drinks”, I mean Ribena.

3. Always eat the custard first.

Hospital food gets a bad rep. The food at my hospital was pretty tasty really, and there was a good selection. But for some obscure reason, the dessert was often served before the main. If you waited for your main meal to rock up before eating dessert (like any normal person would), your custard would congeal disconcertingly by the time you got to it.
So remember: you’ve just had brain surgery. Screw societal norms regarding the “correct” order in which to eat sweet or savory comestibles. Don’t let that custard go to waste!

4. Make your visitors play musical chairs.

Again, this may initially seem nonsensical. But I was fortunate enough to have a fair few visitors in hospital after each pituitary surgery (thank you guys!), which was lovely. However, for the most part they sat in the same chair on the left-hand side of my bed. Consequently, by the end of my stay in hospital I had done my neck in, from continually turning my head to the left. It was pretty painful and entirely my own fault. Make them alternate sides. I did for my second surgery and it was much easier on the neck.

5. Get wheeled out in a wheelchair.

Because a) you’ll be feeling rubbish and won’t want to walk, and b) it’s fun!

6. Steroids + morphine = surprisingly fun.

After waking up from my first surgery, initially I felt rubbish. It was very, very painful. Fortunately, the nurse at hand quickly gave me some morphine. By the time I was properly awake, I was pain-free, wired, and weirdly delighted that the nurse had the same first name as my mum. They took me out of the post-surgical care room and up to the main neurosurgical ward, and about half an hour after I woke up I was already texting various members of my friends and family and talking nineteen to the dozen about how unusually chirpy I felt.

7. Play your “brain surgery” card.

I regret not doing this more, in retrospect. When you’ve had brain surgery, you should be able to really milk that fact for all it’s worth. I have no doubt that there are hours of fun to be had in pretending not to recognise household objects, friends, family, political systems and/or branches of philosophy.

I remember speaking to one friend a few weeks after my first brain surgery, and I mentioned that I was always forgetting where I’d left my books. She gave me a sorrowful look and whispered, “Is that because of the surgery?”It was disappointing to have to confess to her that no, I have in fact always been that stupid.

8. Get a free pill slicer. They are awesome.

After pituitary surgery, you’ll be put on steroid replacement medication in case the neurosurgeon accidentally removed your body’s ability to make its own steroid hormone when required. Said pills can be broken into different-sized chunks so you can take, for example, a whole dose in the morning, half a pill at lunch, and the other half in the early afternoon. When I left hospital, I obviously looked too pathetic even to break a tiny pill in two, because they provided me with a pill slicer. You put the pill in, shut the lid, and SHAZAM! A razorblade hidden inside will slice that bad boy in twain.

I managed to lose my pill slicer after a couple of months, and I was pretty cut up about it. …Geddit? Cut up?

Your top tips for having pituitary surgery

Have you had transsphenoidal pituitary surgery? Do you have any top tips you think I’ve missed? Let me know in the comments!

baking · food · gluten free · recipes

Gluten-Free Portuguese Custard Tarts (Pasteis De Nata) Recipe

A few years ago, my husband and I went on holiday to Lisbon in Portugal, and we fell in love with pasteis de nata, the amazing Portuguese custard tarts. Made with a buttery puff pastry and Portuguese custard, they are just delicious. When we got back home, we even found a bakery in our home town that specialised in making pasteis de nata – and we were so happy to be able to continue enjoying them.

But when my husband was diagnosed with gluten intolerance, they just became yet another yummy treat that he couldn’t have. Until now! Using shop-bought gluten free puff pastry, I have succeeded in making gluten-free pasteis de nata that are delicious and taste really authentic. Read on to find out how!

gluten free portuguese custard tarts pasteis de nata recipe the sickly mama

Gluten-free Portuguese Custard Tarts Recipe

Ingredients for gluten-free Portuguese custard tarts:

To make these Portuguese custard tarts, you will need:

  • 1 packet pre-made gluten free puff pastry (you could use shortcrust, but puff pastry is more authentic)
  • 125g golden caster sugar
  • 80ml water
  • 1 cinnamon stick
  • 1 tsp vanilla essence
  • Lemon rind (a few pieces is fine, you don’t need the whole lemon!)
  • 2 egg yolks and one whole egg
  • 25g cornflour
  • 150ml milk
portuguese custard tarts with strawberries and tea the sickly mama blog

How to make your gluten-free pasteis de nata:

1. First prep that pastry! Unroll your puff pastry to remove the baking paper from the roll. Then re-roll it so you end up with a sausage of pastry (yep! I know it seems counter-intuitive, but this is most similar to how real pasteis de nata are made in Portugal). Cut the sausage into sections about 1cm – 1.5cm thick. You should end up with about 12 of these.

2. For each of the pastry pieces, turn them sideways, and place them between two pieces of baking paper. Then roll them out with a rolling pin until you end up with thin discs of pastry about the size of your cupcake tray holes. Pop them into the cupcake tray.

3. Pre-heat the oven to 220 degrees C.

4. Next, make your custard! Proper Portuguese custard is made with a sugar syrup infused with cinammon and lemon rind. To do this, heat the water, sugar, lemon rind and cinnamon stick in a pan. You want to dissolve the sugar into the water and get the mixture hot, but not boiling.

5. Meanwhile, whisk the cornflour into the eggs. Heat the milk until it is warm but not boiling, and slowly pour over the egg and flour mixture, whisking as you go. Add the vanilla essence.

6. Remove the cinnamon stick and lemon rind from your sugar syrup (carefully!). Pour the sugar syrup slowly over your eggs, milk and flour mixture, whisking constantly to form a runny custard.

6. Pour the custard into your pastry cases until they’re about three quarters full (see picture below).

gluten free portuguese custard tarts ready for baking pasteis de nata belem the sickly mama blog

7. Bake in the pre-heated oven for about 15 minutes, until golden on top.

8. Cool on a wire cooling rack. While the tarts are cooling, you can optionally sprinkle them with a mix of sugar and ground cinnamon, to really bring out the flavour. And voila! Your tarts are ready.

fresh from the oven portuguese custard tarts pasteis de nata belem the sickly mama blog cooling rack

Tips and tricks for your gluten free pasteis de nata:

The instructions at step 2 might sound like a peculiar way to treat puff pastry! But they’re actually a reasonably close approximation of the way that pastel de nata pastry cases are made in Portugal. So don’t worry that your pastry will be ruined!

These gluten-free Portuguese custard tarts are definitely best on the day they’re made. They’ll keep overnight in the fridge, but much longer and you risk the pastry becoming very sad and soggy, which no one wants. In my household though, they rarely last that long!

More gluten-free recipes…

Looking for more recipes for tasty gluten-free treats? Why not check out our recipes page, or try baking these delicious gluten free pumpkin muffins?

gluten free portuguese custard tarts with strawberries pasteis de nata belem the sickly mama blog tea
food · gluten free · reviews

Love, Corn Review – New Gluten-Free Snacks

I regularly blog about gluten free baking and share my favourite recipes. But today I’m sharing my review of a yummy new gluten-free snack I was kindly gifted to try out – Love, Corn – and including a code for 20% off your next order. Read on to find out more!

Two bags of Love,Corn gluten free snacks one is sea salt flavour and one is smoked barbecue flavour sitting on a wall with flowers

What is Love, Corn?

It’s a crunchy new savoury snack made from corn kernels – think roasted, un-popped popcorn. Not only are they gluten-free, but they’re also vegan, verified kosher, and non-genetically modified. There are four different Love, Corn flavours – sea salt, smoked barbecue, salt and vinegar, and habanero chilli – and the website says they’re a perfect swap for crisps, pretzels and crackers. But is that true? As a complete crisp addict, I was initially sceptical – and while I waited for my Love, Corn to arrive, I decided to find out more about the history of these new corn kernel snacks…

What’s the history of corn kernel snacks?

Roasted corn kernels are also sometimes known as corn nuts in the United States, as cancha in Peru or kikos in Spain. Although I’ve not come across this before as a snack in the UK, the corn kernel or corn nut apparently has a long and interesting history. Native Americans used to create a snack called ‘parched corn‘, by drying and roasting corn kernels. This created a lightweight but nutritionally dense food that could easily be stored or carried, and either eaten whole or ground into flour. Parched corn was such a great foodstuff that European settlers who arrived in the Americas quickly started making it too.

Years later, in 1936, an enterprising California resident named Albert Holloway started rehydrating the corn kernels before roasting them, to make them bigger and more delicious. He then discovered a giant type of corn from Peru called cusco gigante, and once he’d managed to start importing it, the business really took off. Holloway had originally (and somewhat inexplicably) named his product ‘Olin’s Brown Jug Toasted Corn’ but later (presumably after learning a little more about marketing) changed it to the much snappier Corn Nuts. And corn nuts have been a popular snack in the USA ever since.

Love, Corn: The Review

Having tried all four flavours, I can confirm they’re pretty awesome – much lighter and crunchier than you might expect. I think my favourite Love, Corn flavour is the barbecue, while my husband loved the spicy habanero chilli – but honestly they’re all delicious, and I was particularly impressed how they managed to get a real vinegary tang in the salt and vinegar corn. Much like popcorn, these corn nuts are really more-ish – once you start munching a few, you just keep going! Obviously the fact that they’re gluten-free is also a real bonus for us as a family.

Apparently Holloway originally created corn nuts to sell to tavern owners as a great snack to pair with beer, and that’s definitely also still true! We’ve been enjoying munching on our Love, Corn corn nuts with a cheeky beer in the evenings, while watching the last of this season’s football (just as well really, because Arsenal’s performances have not really given us much to enjoy in and of themselves…)

Something else I really like is that unlike crisps, Love, Corn doesn’t get crushed to pieces if you squash the bag… When we’re travelling, space is usually at a premium thanks to all the bits and pieces you have to cart around when you have a toddler, so it’s nice to have a delicious snack that you can just shove in a bag and not worry about it being ruined in transit.

Where to get your Love, Corn

Well, first off, if you haven’t tried corn nuts before, you can get a free sample pack of all four Love, Corn flavours and all you have to pay is £1.99 shipping. Just head to this link: www.lovecorn.com/sample and follow the instructions. Alternatively, you can get 20% off your entire order if you follow this link to the website and enter the code ‘CRUNCH20’.

Four bags of Love, Corn gluten free snacks in smoked bbq, sea salt, habanero chilli and salt and vinegar flavour with corn nuts spilling out of one packet