Friday, 14 February 2025
Tuesday, 21 January 2025
How our minds and bodies react to bereavement
"Whatever the loss, our mind and body will react to this change. Something or someone that was there before is no longer there. Something or someone we depended on as part of our lives has gone. There has been a change. This can shake our world, and how it does so, will depend on what has happened and what support we have in place to cope.
When we are bereaved, we can feel anxious, sad, angry, shocked, grief-stricken, withdrawn, in disbelief, guilty, sad and in denial – and experience these in no particular order. We can struggle with sleep, concentration, our appetite and making decisions. We can also experience physical pain, such as headaches and muscle pain, as well as less specific bodily reactions that are similar to feelings of anxiety."
https://www.mentalhealth.org.uk/explore-mental-health/articles/change-loss-bereavement
Mental Health Foundation A to Z of mental health problems:
https://www.mentalhealth.org.uk/explore-mental-health/a-z-topics
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Wednesday, 8 January 2025
Wednesday, 1 January 2025
Talking Meds Podcasts
https://open.spotify.com/episode/00vCwf7jHnuknBYWTENJSP
Talking Meds and the PrescQIPP podcast, engaging conversations about medicines-related dilemmas.
Use other methods such as physiotherapy first for patients who are at risk, then if NSAID if needed at the lowest dose for shortest time needed, use Ibuprofen or Naproxen first, use medication to protect the stomach.
In Asthma therapy Bronchodilators alone is not enough, steroid therapy is also needed. If 3 or more Bronchodilator inhaler per year without steroid question that. Ask if they have an Asthma plan.
Multidisciplinary teamworking is important, consultation skills is important (what is important for patients), you should be able to manage risks. We are working with uncertainties.
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Thursday, 12 December 2024
Sleep habits
Remember bed is only for sleep (and sex)
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Friday, 25 October 2024
How to Reset Your Vagus Nerve...This Will Change Your Life! Dr. Mandell
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Friday, 20 September 2024
To improve my consultation skills
Preparing for the consultation : Establishing initial rapport, Establishing the reason for the consultation
Gathering information: Questioning & Listening
Explanation and planning: Providing evidence based advice and information, Discussing options and potential outcomes of
Closing the session: Offering a safety net, Verifying and agreeing a plan
Building the relationship: Demonstrating empathy, Building rapport throughout, Increasing a person's involvement in consultation, Using open body language.
Additional Skills for Person-centred approach: Understanding the person's perspective of their medicines and/or health. Analysing own behaviours during the consultation and identifying areas for change (body language and attitudes towards people). Engaging the person in shared decision making. Working in partnership with the person. Taking a holistic view of the person
Consultations Models:
Calgary-Cambridge: Preparing for the encounter, establishing rapport with the patient, and identifying the reason for the consultation.
Pendleton: a set of guidelines designed to structure the feedback process in a way that encourages learning and improvement.
Neighbour: Five checkpoints of connecting, summarising, handing over, safety netting and housekeeping alongside an awareness of 'minimal cues' (verbal and non-verbal) to help discover the unspoken agenda.
BARD: Using an open question to start the consultation Listening carefully to the patient Using verbal cues like "mmm" and "ok" Using non-verbal cues like a smile or nod the totality of the relationship between the doctor and patient.
Health Coaching Models:
GROW: Goal (what do you want to achieve), Reality (tell me about the current situation), Option ( What could you do differently, what might get you on the way), Way forward (how committed are you? SMART action plan).
4Es: Explore, Empower, Educate, Enable
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Thursday, 5 September 2024
Tuesday, 13 August 2024
Shingles
Paracetamol is the first-line pain management option for shingles, as it is well-tolerated and effective for mild to moderate pain. NSAIDs, like ibuprofen, can be used if paracetamol is insufficient. Opioids and Gabapentinoids are reserved for more severe, refractory pain.
Aciclovir is the first-line antiviral treatment for shingles in immunocompetent individuals aged over 50 years when started within 72 hours of rash onset.
The presence of shingles in the ophthalmic dermatome, even without any symptoms affecting vision, warrants referral for urgent assessment to prevent potential eye complications.
Immunocompromised patients with widespread, disseminated shingles and systemic symptoms require immediate referral to emergency services for intravenous antiviral therapy and close monitoring.
Valaciclovir is the preferred antiviral for immunocompromised patients and can be managed under the NHS Pharmacy First Clinical Pathway, providing the patient is not severely immunosuppressed. The NHS Pharmacy First service PGD for the supply of Valaciclovir in shingles indicates that a person is classed as being ‘severely immunosuppressed’ when taking a dose of Methotrexate of 20mg or above, or where lower doses are taken in combination with other immunosuppressive therapies.
Valaciclovir is the preferred antiviral for patients with adherence concerns, because it has a simpler dosing regimen (three times daily) than aciclovir (five times daily).
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