Next talk at #hapc21! Controlling the dyspnea-anxiety cycle.
Remember that dyspnea is very common. Not just in COPD but in other diagnoses, and not just in hospice patients but in the ICU and other settings as well. #hapc21
The complicated and vicious cycle of breathlessness. #hapc21
Patients often feel ashamed: "if only I could get over my anxiety..." It's important to validate that anxiety is the normal response to breathlessness. #hapc21
Non-pharmacologic approaches to breathlessness. #hapc21
Behavioral strategies can help, and palliative care teams can learn to use them with patients. Here are some main messages the speakers discuss with their patients. #hapc21
Back to the vicious cycle between breathlessness and dyspnea. Unfortunately, behaviors that give patients short term relief can have long term negative effects (eg avoiding activity). #hapc21
This is a recurring #hapc theme! We've already heard today that what is unseen or unheard can't be healed. Inviting patients to tell their stories of breathlessness and anxiety is the first step to healing. #hapc21
It's helpful to focus on one approach to anxiety and breathlessness at a time (ie don't try to do it all at once!).

Pro tip: have a collection of one step resources that you can click on and within a minute be exploring with the patient. #hapc21
Guide to teaching self-management of the dyspnea-anxiety cycle. #hapc21
Don't forget the value of pulmomary rehab for putting it all together. #hapc21
It will surprise no one that breaking the dyspnea - anxiety cycle is a team sport! Seek out collaborations with others. #hapc21
Final takeaway: find one aspect of breaking the dyspnea-anxiety cycle and learn more about it so that you can apply it to your patients. Here are some resources to get us started! #hapc21

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More from @Top_Gundersen

18 Feb
Time for a master class in pruritus! #hapc21
Thanks to pruritus presenters @AMehtaMD, @mlmcpherson, Eric Prommer, Mellar Davis, Kathryn Walker. #hapc21
Pruritus definition: Note that chronic pruritus is itching that lasts 6 weeks or longer (this is different than chronic pain). #hapc21
Read 14 tweets
18 Feb
Diving into a difficult topic at #hapc21. Dr. Horowitz is starting with his mother, who had dementia and was considering voluntarily stopping eating and drinking (VSED).
Key points about the key clinical considerations around VSED: note that life should be unacceptable and IRREVERSIBLY difficult. This can't be an impulsive decision. #hapc21.
Psychiatric considerations are important too. There is an important difference between the wish to die vs. the wish to "not live like this" when considering VSED. #hapc21
Read 10 tweets
18 Feb
#hapc21 day #2's plenary is starting! Thank you @questmd @RonitElk @palliator for sharing your wisdom.
.@questmd shares her story. #hapc21
Thank you @questmd for such a heartfelt reflection. Such a complex story of oppression, mistrust, compassion, and hope. #hapc21.
Read 9 tweets
17 Feb
You don't have to be a SEXpert to validate your patients' feelings around their sexuality!

1st take home point from #hapc21's session on "Setting SEXpectations with Patients and Families." @SexANDDeathPos @PalCareErin @CaitlynMooreNP @PCMagicMo
Remember: sex is more than intercourse. #hapc21 Image
The circles of sexuality. #hapc21 Image
Read 9 tweets

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