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Join the #hpm Tweet Chat This Week in a Research Initiative with the Brain Cancer Quality of Life Collaborative
The Pallimed community is invited to participate in the #hpm Tweet Chat this week which help inform and shape a comparative effectiveness research proposal being designed by the Brain Cancer Quality of Life Collaborative, an initiative led by a team of patients, care partners, advocates, neuro-oncologists, and palliative care professionals.The #hpm Tweet Chat is this Wednesday, April 25th, 6-7p PST/9-10p ET.Topics for the chatare available here, in the #hpm chat ’s blog post,How might we introduce palliative care to people with complex neurological conditions, by Liz Salmi and Bethany Kwan, PhD, ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - April 22, 2018 Category: Palliative Care Tags: #hpm brain cancer btsm tweetchat twitter Source Type: blogs
Are You Crippled by the Fear of Leaving No Legacy Behind?
Often the biggest existential distress that we carry is the idea that no-one will remember us when we are gone — initially we know that our friends and family will hold who we are, but after a generation, these people are likely gone too. At the end of life, the pressure to leave an unquestionably relevant legacy can be crippling for people, particularly for young people. When coupled with the limited energy that people have when they are unwell, the very nature of what people expect to achieve in the world shrinks, and the really important pieces come into focus.
When time is seen to be limited, every moment can ta...
Source: World of Psychology - April 3, 2018 Category: Psychiatry & Psychology Authors: Psych Central Staff Tags: Aging Brain Blogger Publishers Success & Achievement death dying Existential Dilemma Fear Legacy Mortality Source Type: blogs
Doctors Discuss Future of Medicine on eMedicoz: India's First Medical Education Centric Mobile app
Note by Dr Sumer Sethi Recently we launched our unique medical education centric app for young Doctors calledeMedicoz. On this in addition to routine discussions Doctors also discuss various aspects of the profession. In a recent discussion series young Doctors brainstormed and tried crystal balling the future of the medicine and technology. It is wonderful to hear their thoughts on future. It is for certain future looks really happening for medical profession, computers and machine learning will re- invent the way we practice medicine. Targeted therapy is another important area, 3D printing , understanding the value ...
Source: Sumer's Radiology Site - April 2, 2018 Category: Radiology Authors: Sumer Sethi Source Type: blogs
Sometimes death is not an option
At 69, Bob appeared to be a broken man. He left the hospital the day before and returned to the emergency department (ED) because he wasn’t “acting right.” Bob became upset when a second injection to his abdomen burned, and family members were angry that the discharge instructions did not explain this.
After four years of receiving treatment for metastatic colon cancer, Bob had reached the breaking point of persecution, but did his vigilant family understand he was dying?
After the physician assistant’s evaluation, I stepped into the room to make my own assessment. Family members appeared to be watchdogs — four o...
Source: Kevin, M.D. - Medical Weblog - March 23, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/kevin-haselhorst" rel="tag" > Kevin Haselhorst, MD < /a > Tags: Physician Hospital-Based Medicine Palliative Care Source Type: blogs
Uncontrollable itching – the denouement
The emergency department ordered a CT scan that showed a dilated common bile duct, no pancreatic masses, a mass in the duct – stone versus other.
Twelve hours after admission, he developed a temperature of 101 and a repeat CBC showed an elevated WBC with left shift.
Therefore, GI did an ERCP the next day – revealing a large gallstone – not easily removable. The placed a stent and drained pus.
So this man had painless jaundice from a common duct stone.
As an intern in 1976 I had a patient with ascending cholangitis. His internist told me that he had pancreatic cancer, but had declined surgery. In 197...
Source: DB's Medical Rants - March 21, 2018 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
A physician sees end-of-life care through a religious lens
In my second year of residency, I was on the hematology/oncology service where we were taking care of a pleasant lady in her 80s who was admitted with pancreatic cancer. It was apparent that the disease had spread rapidly, and when we discussed her at rounds, we knew that she likely had a few months to live, at best. We also knew, however, that there were life-extending treatment options we could provide. When we walked into her room and presented these to her, she was attentive and listened respectfully, and she ultimately decided not to pursue any more treatment.
What struck me was how content she was with the decision a...
Source: Kevin, M.D. - Medical Weblog - February 22, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/chiduzie-madubata" rel="tag" > Chiduzie Madubata, MD < /a > Tags: Physician Hospital-Based Medicine Palliative Care Source Type: blogs
The miscalculated fear of an opioid crisis in Haiti
Opioids are an essential class of drugs used in pain management. In recent years, complex mechanisms pertaining to their abusive use have prompted a deadly crisis which is unfolding in the United States. The U.S. Centers for Disease Control and Prevention stated that 91 Americans lose their lives daily due to an overdose of opioid drugs. This public health crisis has inspired much apprehension even among Haitian diaspora in the United States. Although needed painkillers are notably lacking in developing countries, the fear of a similar path has led a high-profile personality to advise against their use in Haiti. Indeed, he...
Source: Kevin, M.D. - Medical Weblog - February 20, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/kenny-moise" rel="tag" > Kenny Moise, MD < /a > Tags: Policy Pain Management Primary Care Source Type: blogs
You don ’t know what your patient’s end-of-life wishes are
As I walked in the room, I noticed it immediately: Norman was worse. The recurrent invasive cancer in his neck was impairing the drainage of fluid from his face making it difficult for him to turn his head, and it had progressed overnight. Despite his alarming appearance, he seemed calm.
There were no more cancer-specific treatment options: the surgeons had declined to operate again; he had received maximum dose radiation; and the risks of chemotherapy outweighed any potential benefits. His pain required doses of opioids high enough that he often fell asleep in the middle of conversations. Because of his tracheostomy, Norm...
Source: Kevin, M.D. - Medical Weblog - February 16, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/lauge-sokol-hessner" rel="tag" > Lauge Sokol-Hessner, MD < /a > Tags: Physician Hospital-Based Medicine Palliative Care Source Type: blogs
What ’s love got to do with it: lessons from a dying physician
They came from all corners of the globe to bid him farewell. He looked cachetic, his frail form interrupted by swelling in his abdomen and legs, a result of end-stage pancreatic cancer. It was Dr. Yeat’s last week in the hospital before being transferred to a nearby hospice. He was now on morphine, and despite severe fatigue and difficulty breathing, he always managed a smile.
Some of his visitors were former colleagues; others were friends, previous medical trainees, and mentees. Amidst moments of laughter, crying, and sober reflection, each recounted one anecdote after another of their encounters with Dr. Yeat at som...
Source: Kevin, M.D. - Medical Weblog - February 14, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/charles-a-odonkor" rel="tag" > Charles A. Odonkor, MD < /a > Tags: Physician Hospital-Based Medicine Oncology/Hematology Source Type: blogs
Proposed Medicare Changes to Limit Opioid Prescribing
by Chad KollasOn February 1, 2018, the Centers for Medicare& Medicaid Services (CMS)published its Advance Notice of Methodological Changes for Calendar Year 2019. Included in these proposed rules were several directives intended to reduce" Opioid Overutilization ” (see p. 202), including formal adoption of the “90 morphine milligram equivalent (MME) threshold cited in the CDC Guideline, which was developed by experts as the level that prescribers should generally avoid reaching with their patients (p. 203). ” CMS proposed “adding additional flags for high-risk beneficiaries who use ‘potentiator’ drugs (such...
Source: Pallimed: A Hospice and Palliative Medicine Blog - February 4, 2018 Category: Palliative Care Tags: CMS health policy kollas medicare opioids Source Type: blogs
Fight Aging! Newsletter, February 5th 2018
In this study, we tested the hypothesis that Gbp1 plays a role in regulating immunometabolism and senescence of macrophages. We found that Gbp1 was mainly expressed in macrophages, but not adipocytes in response to IFNγ/LPS stimulation; Gbp1 expression was significantly decreased in inguinal white adipose tissue (iWAT) of high-fat diet (HFD)-fed and aged mice. We also observed that downregulation of Gbp1 in macrophages resulted in M1 polarization and impairment of mitochondrial respiratory function possibly via disrupting mitophagy activity. Moreover, macrophages with downregulated Gbp1 displayed dampened glycolysis and e...
Source: Fight Aging! - February 4, 2018 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
An Impromptu Group Conversation With Women in Hospice and Palliative Medicine
Collectively written by Allison Jordan, Katie Harmoney, SarahScott Dietz, Jeanette Ross, Emily Hahn, Meredith MacMartin, Christian Sinclair, Rachel ThienprayoonWaking up today February 3rd, I (Christian) saw a discussion on our Facebook private messages for the Pallimed page about what we should post for National Women Physician Day (which is held on February 3rd the birthday of Elizabeth Blackwell, the birthday of the first US woman physician.) Jeanette hadfound the 2016 Pallimed post written by Meredith MacMartin and we posted that, but then I thought it would be great to write some fresh content on this new celebration....
Source: Pallimed: A Hospice and Palliative Medicine Blog - February 3, 2018 Category: Palliative Care Tags: dietz hahn harmoney macmartin ross sincliar The profession thienprayoon women Source Type: blogs
