Discover and read the best of Twitter Threads about #Palliative
Most recents (11)
"Surviving the COVID-19 #Pandemic: Things I Have Learned (So Far)"
A pandemic mitigation primer geared toward my students.
Full video (40 mins):
vimeo.com/showcase/10115…
Refs in the PPT notes:
psychmike.com/Hoerger_pandem…
Video segments in thread🧵
A pandemic mitigation primer geared toward my students.
Full video (40 mins):
vimeo.com/showcase/10115…
Refs in the PPT notes:
psychmike.com/Hoerger_pandem…
Video segments in thread🧵
1. Introduction
COVID cases and deaths were surging in New Orleans right when I launched a project working with people who are seriously ill.
Thus, I began studying COVID mitigation.
vimeo.com/789390581
COVID cases and deaths were surging in New Orleans right when I launched a project working with people who are seriously ill.
Thus, I began studying COVID mitigation.
vimeo.com/789390581
2. COVID is NOT "A Cold or the Flu"
It is among the most serious illnesses.
COVID has caused life expectancy to plummet. Ppl are getting disabled. 1.5 million Americans can't work. Vascular dysregulation is concerning. Effects are cumulative.
vimeo.com/789392012
It is among the most serious illnesses.
COVID has caused life expectancy to plummet. Ppl are getting disabled. 1.5 million Americans can't work. Vascular dysregulation is concerning. Effects are cumulative.
vimeo.com/789392012
I'll be adding short important points which would hopefully help in remembering certain concepts during #PLAB preparation, to this thread🧵every now and then as I take them out from my scattered notes. Feel free to comment your tips and tricks which would help others, as well 👇
Please don't take any of these as medical advice 😂🙏. Real life stuff is much more nuanced. These are just clinchers for the sake of the exam.
#PLAB
#PLAB
1. Drug contraindications...
-Avoid BAN drugs in Asthma (Beta blockers, aspirin, NSAIDS) &
-DAMN drugs in diarrhoea (Diuretics, ACEIs, Metformin, NSAIDs)
#PLAB
-Avoid BAN drugs in Asthma (Beta blockers, aspirin, NSAIDS) &
-DAMN drugs in diarrhoea (Diuretics, ACEIs, Metformin, NSAIDs)
#PLAB
I’ll now be tweeting from the first of three concurrent sessions today, sitting in on the first Paediatric #PalliativeCare session, chaired by Lisa Cuddeford from the WA Paediatric Palliative Care Service #21OPCC
First presenter is Adjunct. Assoc. Prof. Claire Treadgold @Starlight_star talking about ‘Rosie’s story’. Rosie is a palliative child with chronic kidney disease who was supported by the Starlight Moments program #21OPCC
@Starlight_star Sadly, Rosie died a month ago 😞 Claire says the family are happy to share Rosie's story #21OPCC
People think “Hospice” when they hear #Palliative Care. Neither term understood. Nobody feels comfortable with Death, Dying or Moaning in Pain. No Doctor is Comfortable saying, There’s nothing more we can do. My latest battle #MedicalCannabis is Sort of legal in Virginia.
For me, Cannabis offers a state of less pain and feeling better. Legislators and Doctor Governor @RalphNortham allowed bizarre restrictions like no dispensary near me, 4 plants per Household, no matter size of household, can’t buy it. Can’t have more than 1 ounce.
Now Electronic Vaping products might be outlawed? I recently discovered Delta Effex deltaeffex.com Delta 8 and Delta 10 with Terpenes. The day Cannabis went legal in VA, July 1st 2021, I put down my pipe and picked up my Delta Vapor. Excellent effects! ⬆️ energy ⬇️Pain.
I am a #palliative care doctor.
I am caring for multiple patients dying of #Covid.
When I meet with families, I always ask, “tell me about your loved one- what do they love when they are not sick in the hospital?”
1/
I am caring for multiple patients dying of #Covid.
When I meet with families, I always ask, “tell me about your loved one- what do they love when they are not sick in the hospital?”
1/
I have recently struggled to ballast my own emotions when the response is, “oh, they are so social.”
I hear about the daily breakfasts with friends, the joy of meeting up with loved ones, the “never met a stranger”.
“Just last week we went out for steaks and he was fine.”
2/
I hear about the daily breakfasts with friends, the joy of meeting up with loved ones, the “never met a stranger”.
“Just last week we went out for steaks and he was fine.”
2/
As a clinician who cares for
not only the patient,
not only the family,
but the entire system as a unit of care,
I need to acknowledge the righteous compassion rage that I feel when I hear the story of
Was fine
⬇️
Eating out
⬇️
Got tested, “just in case”
⬇️
Dying.
Dying.
not only the patient,
not only the family,
but the entire system as a unit of care,
I need to acknowledge the righteous compassion rage that I feel when I hear the story of
Was fine
⬇️
Eating out
⬇️
Got tested, “just in case”
⬇️
Dying.
Dying.
🔴 Senate #Republicans have KILLED 400 bills passed by the House, most w/ GOP votes. #Dems need to win 4 seats (3 if #Harris is VP). 6 races are tossups: CO-Gardner, GA-Perdue, IA-Ernst, ME-Collins, MT-Daines, NC-Tillis.
thread: Bills Killed by Senate GOP newsweek.com/mitch-mcconnel…
thread: Bills Killed by Senate GOP newsweek.com/mitch-mcconnel…
🔴 BIPARTISAN Bills PASSED by the House but KILLED by Senate #Republicans:
Climate Action Act
Raise Minimum Wage
Violence vs Women Act
Corporate Transparent Act
Enhanced Background Checks
Gold Star Family Relief Act
Save the Internet Act
Equality Act
Climate Action Act
Raise Minimum Wage
Violence vs Women Act
Corporate Transparent Act
Enhanced Background Checks
Gold Star Family Relief Act
Save the Internet Act
Equality Act
🔴 BIPARTISAN Bills PASSED by the House but KILLED by Senate #Republicans #2
Paycheck Fairness Act
Protect Preexisting Conditions Act
Lower Prescription Drugs Act
Ban Offshore Drilling Act
Invest in Maine Street Act
Lower Prescription Drugs Act #2
#STEM education
Paycheck Fairness Act
Protect Preexisting Conditions Act
Lower Prescription Drugs Act
Ban Offshore Drilling Act
Invest in Maine Street Act
Lower Prescription Drugs Act #2
#STEM education
Did you miss this week's #WASHDriversHangout with @Temple_Oraeki? No worries. Here are the highlights.
A Society is only as healthy as it's most vulnerable member. Access to water in unequal, yet we're all vulnerable @NGRPresident @sanwatforall @ClimateWed
#COVID19 #PTFCOVID19
A Society is only as healthy as it's most vulnerable member. Access to water in unequal, yet we're all vulnerable @NGRPresident @sanwatforall @ClimateWed
#COVID19 #PTFCOVID19
According to @WaterAidNigeria, over 50 million Nigerians lack access to clean water. #handwashing is an impossible task for majority these. @Temple_Oraeki shared some #palliative measures to make water a priority. #WASHDriversHangout #coronavirus #Sdg6 #leavenoonebehind
#Covid_19, especially the emphasis on hand washing, is offering developing countries an opportunity to restore/invest in public water systems. This is a huge project, but NOW is the time to ACT. #EndWaterPoverty #ClaimYourWaterRight #COVID19Response #SDGs #Sdg6 #Water
@magthenomad @RachaelHeitner Differences in Penetration Rates - Teaching Status: Teaching hospitals see an average of 5.2% compared to 6.0% of programs in non-teaching hospitals
@magthenomad @RachaelHeitner Differences in Penetration Rates: Consult Triggers: Hospitals with automatic screening criteria see an average of 6.2% compared to 5.1% for hospitals without it in place
@magthenomad @RachaelHeitner Differences in Penetration Rates - Program Maturity: programs who are three years old or less see an average of 4.4% compared to 5.7% for programs who are four years old or older
Wrote this piece with the help of a great team including @DrKevinHill. Below I'll share some of my thoughts about #opioids and opioid use disorder and how they present in #hpm and #palliative care, plus why we need to do a better job of addressing #addiction at end of life. 1/x
2/x Training in #KY gave me a front row seat to the #opioidcrisis. With an interest in #hpm I kept wondering what would happen to these individuals who developed an OUD and years later were prescribed opioids. How would I keep those patients safe and manage their pain?
3/x I continue to think that our field will struggle in years to come when survivors of the #opioidcrisis age, develop serious illness, and develop pain. Thinking about this, and reading @jeff_deeney article in @TheAtlantic theatlantic.com/health/archive… made me want to do more.
I listen to ~90 #Podcasts on a (semi) regular basis. Let me give you a rundown of ALL of them and why you should listen to some amazing #FOAMed, especially for all the new #EmergencyMedicine interns. #FOAMed #MedEd #medtwitter
First of all, you need a good podcast app. I absolutely love Downcast. Great app, gives you more control over playback, downloading, and allows you to categorize your podcasts into playlists (picture 2). This is where you get to customize your #FOAMed experience! #medtwitter
In no particular order,
- Anesthesia and Critical Care Reviews and Commentary (ACCRAC). Great insight into Crit Care from an anesthesia perspective. Coming from EM, this is great to listen to- much different from my day-to-day! #FOAMed #FOAMcc #CriticalCare
- Anesthesia and Critical Care Reviews and Commentary (ACCRAC). Great insight into Crit Care from an anesthesia perspective. Coming from EM, this is great to listen to- much different from my day-to-day! #FOAMed #FOAMcc #CriticalCare
1/ There’s no debate- #palliativecare doesn’t hasten death, in fact for cancer pts it prolongs life. Even #palliative sedation doesn’t hasten death! The myth that a palliative approach shortens life (e.g. via opioid use) and is “giving up” is something we combat everyday.
2/ These “palliphobias” can lead to delayed symptom management, prognostication and advance care planning- this problem is very dangerous and pervasive, whether the patient wishes to die via #MAID or not. Not at all against #MAID at all but it does differ in intent.
3/ Anecdotally- have had several cases where well-meaning specialists didn’t recognize #palliative needs early. By the time we saw it was too late to request MAID, pt had lost capacity and had suffered greatly. No one had talked about EOL planning before me! #hpm
