POLYANALGESIC TITRATION FOR OPIOID-REFRACTORY PAIN
In pall care, conventional approach is serial monotherapy
Non-opioid analgesics one at a time
If partial response, add a 2nd; no response, switch to 2nd.
But this takes time. Here we describe an alternative approach
spcare.bmj.com/content/earl...
After cross-country skiing yesterday, today we're trying bobsleigh - it's scary, but fun!
#glasgow #penguins #bobsleigh #winterolympics #kelvinwalkway
My wife, my sister-in-law, and me with an absolutely not fake robot cat that says clem bot on the top. It’s a bit like K-9 from doctor who but a cat. We all look very pleased with ourselves.
Smashed the record time of an escape room today and looked cute doing it!
Very impressed by letter in @theguardian.com from @jamescsanderson.bsky.social. We can’t talk about hospices without talking about inequalities in access to hospice care in less affluent areas and communities.
www.theguardian.com/society/2025...
Glorious!
“My colleague was using the terminology (terminal restlessness). . . And I said, ‘‘Have we done a rectal examination? Have we done a bladder scan? . . . The colleague got back to me – even though he’d been urinating he had a bladder of 1000 mls. So they’ve put a catheter in.’
#delirium
This is an awful & to me genuinely shocking, story. It’s not that Jay was let down by the safeguarding *system*, tho of course that’s never acceptable, it’s the personal role played in the failure by the Bishop of Leicester, which raises serious questions of judgement
www.bbc.co.uk/news/article...
It’s #PrideMonth & we’re sharing our resource ‘It’s more than rainbows in receptions’ - Working with LGBTQ+ People in Palliative and End of Life Care.
Inclusive and accessible #PEoLC care should be a right - not a privilege
Illustration:@casshm.bsky.social
www.nobarriershere.org/wp-content/u...
Incredibly important report by the commission on palliative care released by parliament today.
I implore you all to read and I hope the government will take action to finally end the inequity in palliative care provision across the uk
palliativecarecommission.uk
I was on French Exchange when John Paul II died and my friend's exchange's pet rabbit also died, leading her mother to utter the immortal words <Le pape est mort, le lapin est mort, tout le monde est mort.>
It's not that the Cardinals are in seclusion. It's just that the Vatican only has Eduroam.
I enjoyed spending a fabulous evening last week with the Small Voice Podcast team recording this conversation around how to cross the (apparent) divide between science and the Church.
Thank you @cloudylemonade.bsky.social, Darren and all. 👍🙂
www.smallvoice.org.uk/sv-podcast-s...
🚨 Outrage as 20 police officers break into Westminster Quaker Meeting House and arrest six. 🚨
This shocking violation of a place of worship is a direct result of crackdowns on protest and dissent - freedom of speech, assembly and democracy are at risk.🕊️
👉 www.quaker.org.uk/news-and-eve...
Enjoy Clare. I’ve also stayed to hang out with my mum for a few days
"Words like racism don't go well in our fundraising departments"
Dr Gurpreet Gupta & Professor Max Watson hold space to explore anti-racism & allyship in PEOLC
#PCC2025
This editorial is more important than ever. Please read it and consider your response
journals.sagepub.com/doi/full/10....
On a green background is a light green speech bubble that contains the following text: I didn't think of what I did as whistleblowing. I just though, "Well, that's my job. I'm a clinical lead and I can see that we're not providing the right care". In the bottom left corner of the image is a small green logo that says "patient safety learning, the hub".
🆕Retired consultant @doctorcaldwell.bsky.social speaks to @helenh49.bsky.social and Peter Duffy about how raising patient safety concerns led to his decision to retire early and how NHS culture has changed during his 40 year career.
Link: www.pslhub.org/learn/cultur...
Amen
Can sadly believe this.
Bro was recommended physio for back pain. The self referral system was a very long series of automated questions via telephone which ultimately stressed him out so much we didn’t end up doing it.
Four good letters the Guardian but imo the most important is by Prof Allan House whose expertise (alongside other psychiatrists) seems to have been ignored because it was inconvenient. What does this say about the commitment of the bill’s proponents to safety? t.co/q7DRJjSDpe
Important review on domestic abuse in the context of life limiting illness.
Relevant to assisted dying debate.
Summary below.
onlinelibrary.wiley.com/doi/10.1155/...
That would really put me off as I think it says something about their allyship…
I know! So excited!
Fun fact: most people don’t die of pip-taz deficiency, and it is allowable to die without a trial of it.
This is like watching an infinite number of monkeys trying to type Shakespeare. #thetraitors
Meanwhile over on Twitter, someone's making tea in an air fryer.
It's like the last days of Rome.
Just out - call for evidence for committee stage of Terminally Ill Adults (End of Life) Bill. Submissions requested “as soon as possible”.
Assisted dying / assisted suicide
www.parliament.uk/business/new...
A round teak mid-century dining table with very cool chairs that have been recovered in dark red velvet.
Our new to us dining table arrived today. It’s our first since the fire in 2013 and my first that isn’t glass and chrome with leather chairs (chosen by my mother). I’m already looking forward to dinner!
The disabled community lost a powerful activist in Lisa Egan last week. She showed a lot of us how to ‘be disabled’ & mentored us in #DisabilityRights activism. If I’ve ever done anything to try to change things for disabled people, it was because of Lisa. Short thread linking to some of her work:
First page of article. Fairytale type pic of Princess leaning over dead or sleeping Prince. Facing death and grief: revolution needed Despite growing public interest in death, support for end-of-life care and bereavement remains inadequate. We urgently need a revolution: a community centred, public health approach to the social processes of dying and mourning, backed by properly funded palliative care, writes Lucy Selman.
Pic of man in bed in hospital. Sample of text: In the UK around 90% of dying people would benefit from palliative care, but 25% don't get it. Demand is set to rise 25% over the next 25 years as lifespans increase and health conditions grow more complex, yet the sector is already critically underfunded. Just a third of UK hospice funding comes from the state, with the remaining £1bn raised annually through charity shops, fundraising events, and donation. This funding gap sends a clear message: care for dying people is less valued than aggressive treatments and high tech medical advances. (It's surely no coincidence that 9 in 10 of the clinical and care workforce in UK hospices are women, reflecting a long history of "women's work" being undervalued.)
Pic of someone being cared for and having their hair brushed. Sample of text: Clinicians too have a critical role in reshaping attitudes and so must build their own death and grief literacy. By discussing end-of-life care openly and challenging common misconceptions, they can model acceptance of dying, build trust, and show the public that it is safe to ask questions and voice doubts and fears. Care must be emotionally aware, culturally sensitive, compassionate, and person centred-and this must be reflected in clinical education. Clinical leaders must acknowledge the emotional weight of dealing with death and grief and offer support, encouraging sharing, peer support, and remembrance. By making space for grief and vulnerability in professional life we nurture the human side of being a clinician.
“Facing death differently: revolutionising our approach to death and grief”.
A really important piece here from @lucyselman.bsky.social in the @bmj.com.
I’ll try to pick out some highlights in a🧵, but actually I’d recommend reading the whole article.
Link here:
www.bmj.com/content/387/...