Category Archives: Practice

Self-care: Is it selfish?

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Did you work over the holiday break?

Unlike many times in the past – this year I didn’t work a shift on Christmas Eve; or Christmas day, or even New Years. I spent this time with my family. And I turned off my electronic gadgets (well, for the most part)!

I spent quiet time reading. How refreshing it was to have no agenda, and nothing that just had to be done. The only trouble was that, somehow, this felt quite indulgent.

After all, we are trained to care for others – but perhaps not so enlightened on the art of self-care. Is it selfish? Or does genuine care for others perhaps start with yourself? Continue reading →

Centre for Palliative Care – lecture on palliative sedation by A. Prof Jenny Philip

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The Centre for Palliative Care in Melbourne runs a series of Hot Topics lectures for the field. They have kindly published videos of their recent talks, which we would like to share with you.

The Palliverse team are going to start a collection of resources in free open access medical and nursing education (#FOAMed and #FOANed) relative to Palliative Care, and here’s the first addition to the collection.

A.Prof Jenny Philip is a wonderful speaker and takes us on a journey through the controversial issue of palliative sedation. Starting with definition (variable) and incidence (also variable), she describes for us some European guidelines on palliative sedation and then guides a panel of experienced palliative care professionals through three cases exploring issues in palliative sedation.

goo.gl/pAm3Y2

Palace of Care/I think therefore I am? – Special Edition: Palliative Care Mission of Mercy – #getjakbak

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Hi everyone this is a last minute fundraising plea to everyone as private citizens.

I am organising for our non-resident patient “Jak” to return back to the Islands. (Real name changed.)

Jak is a 44 year old man with a large abdominal mass found to be cancer with spinal cord compression + lung mets, intra-abdominal abscess resistant to IV Ertapenem – causing fluctuating levels of sepsis.

Has been trying to get back to the Islands for the past month, but hampered by critical illness.

He has stabilized at present and we have one shot at getting him back tomorrow morning at 0915. He can travel if escorted by a doctor. The most discounted fee for a doctor I could negotiate was $3800, which the family could not afford.

I have volunteered my services to look after him on the flight to help Jak get back.

The family with the help of the local Pasifika Community, have fundraised $7400 of the required $10720. They need $NZ3320 by 5pm today in order for Jak to get back home. i.e. in 1.5 hours have received pledges of $720 so far. 1536hrs

So close but yet so far…

Please forward this email on to your own teams and networks.

Every bit pledged will count. I will consider all pledges of assistance.

For those interested in following the journey I will attempt to live tweet/blog it through Twitter:  @palliverse #getjakbak and www.palliverse.com

Thank you for your consideration,

James

1550hrs – $1320
1557hrs – $1520
1611hrs – $1790
1613hrs – $1990

Just need $1330 to grant this young man his dying wish of going home to his family. We can do this team!

1617hrs – $2190
1620hrs – $2210

Only $1110 to go to #getjakbak

1629hrs – $2260
1630hrs – $2425
1631hrs – $2475
1630hrs – $2775
1634hrs – $2925

Only need another $395. Well done team!

1640hrs – $3005
1642hrs – $3085
1642hrs – $3150
1655hrs – $3350
1700hrs – $3400

Thank you everyone we have done it! Any extra funds raised will go towards payment of hospital fees.

Thank you for helping your fellow man. I am proud of you all!

James

Homelessness in palliative care

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Thanks to Michael Bramwell, from Melbourne City Mission, for the following slides:

Homelessness in palliative care

Sonia learns a new word and hopes to impress her colleagues

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It’s always a great pleasure to learn a new word and I had such a pleasure this week with “analgesia dolorosa”. In fact, two new terms as it’s also known as analgesia algera.

A pain specialist colleague (thanks C) used the term in reference to a patient who had presented with chest wall numbness and such severe nipple pain on light touch that he has difficulty wearing shirts. He went on to be diagnosed with a metastatic malignancy infitrating his thoracic vertebrae.

So, analgesia dolorosa is different from hyperalgesia which is an increased pain sensation from a normally painful stimulus, and I guess a variation on allodynia which is pain from a normally non painful stimulus.

 

Drop it in to a ward round near you and amaze your colleagues!

 

Sonia

Decision Assist project grants

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Decision Assist is seeking applications from eligible organisations for enabling grants to support projects that aim to implement linkage strategies that have the potential to improve the quality of end-of-life care for older people in residential and community settings.

Applications close September 12. More information can be found here.

 

New Palliative Care Resource

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We’ve seen this new, free, online palliative care education resource developed by the folk at Centre for Palliative Care in Victoria. It’s targeted towards health professionals from a variety of clinical settings who have an interest in caring for patients and their families living with a life-threatening illness or who wish to find out more about palliative care.
 

Diabetes management at the end of life

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Diabetes management in palliative care is often tricky. Trying to optimise quality of life, and finding a balance between the burden of diabetes treatment (such as checking blood sugars, diabetic diet and medication side effects) and the sequelae of uncontrolled blood sugars (like unpleasant symptoms and infections) is difficult. As a patient’s weight, diet, metabolism and organ function change, the risk of hypoglycaemia (low blood sugar) increases. Adding further difficulty is that patients with chronic diabetes have often spent years being told that they need to keep strict control of their blood sugars, in order to avoid the awful long-term consequences of poorly-controlled diabetes. It can be difficult to convince patients, their families and carers blood sugar control can be relaxed in the palliative care setting. Continue reading →

“Sonia’s sign” – conjunctivitis as a novel indicator of the terminal phase?

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Generations of junior medical staff had internally rolled their eyes when I voiced my theory about conjunctivitis meaning that the patient would die soon, then been astounded by my prognostic skills when the patient deteriorated into the terminal phase. It was time to put my reputation where my mouth was and do a prospective audit. Did diagnosis and treatment of conjunctivitis in the inpatient palliative care setting mean that the patient had a very poor prognosis? Continue reading →