Pallmedpro
@pallmedpro.bsky.social
Lucy, Jonathan and Rosanna are three Palliative Care consultants who make up Pallmedpro - an educational partnership who help palliative medicine doctors prepare for exams. Follow for questions, overlooked facts, and evidence-based CPD in palliative care.
Breathlessness steals more than air — it steals agency. Currow & Johnson (2020) argue opioids, used well, can give it back. Start low, titrate slow, monitor closely. This is symptom control with purpose, not palliation by default.
September 3, 2025 at 9:51 AM
Breathlessness steals more than air — it steals agency. Currow & Johnson (2020) argue opioids, used well, can give it back. Start low, titrate slow, monitor closely. This is symptom control with purpose, not palliation by default.
Still hesitating over morphine for breathlessness? The evidence is stronger than many think. Currow & Johnson’s review dismantles myths, clarifies dosing, and reframes risk. Worth a re‑read before your next MDT. spcare.bmj.com/content/10/3...
Opioids for breathlessness: a narrative review
Chronic breathlessness is a disabling and distressing condition for which there is a growing evidence base for a range of interventions. Non-pharmacological interventions are the mainstay of managemen...
spcare.bmj.com
September 3, 2025 at 9:51 AM
Still hesitating over morphine for breathlessness? The evidence is stronger than many think. Currow & Johnson’s review dismantles myths, clarifies dosing, and reframes risk. Worth a re‑read before your next MDT. spcare.bmj.com/content/10/3...
🤔 MCA 2005 and Scotland’s AWI diverge on capacity assessment, scope of proxy authority, and how we justify decisions. Know the ground rules before you cross them. A clear overview from the Mental Welfare Commission: www.mwcscot.org.uk/adults-incap...
www.mwcscot.org.uk
August 28, 2025 at 5:29 PM
🤔 MCA 2005 and Scotland’s AWI diverge on capacity assessment, scope of proxy authority, and how we justify decisions. Know the ground rules before you cross them. A clear overview from the Mental Welfare Commission: www.mwcscot.org.uk/adults-incap...
⚖️ Same patient scenario, different nation, different paperwork. MCA 2005 gives LPAs broad health/welfare powers if capacity is lost. Scotland’s AWI splits decision‑making: welfare powers via guardianship/intervention orders, and healthcare decisions through statutory authority for clinicians.
August 28, 2025 at 5:29 PM
⚖️ Same patient scenario, different nation, different paperwork. MCA 2005 gives LPAs broad health/welfare powers if capacity is lost. Scotland’s AWI splits decision‑making: welfare powers via guardianship/intervention orders, and healthcare decisions through statutory authority for clinicians.
Fallon et al.’s 2018 randomised trial found oral ketamine no different to placebo in cancer-related neuropathic pain, but wondered if there could still be a role for it in cases where central sensitisation was observed (a population not specifically selected for) pmc.ncbi.nlm.nih.gov/articles/PMC...
Oral Ketamine vs Placebo in Patients With Cancer-Related Neuropathic Pain: A Randomized Clinical Trial
This multicenter randomized clinical trial compares oral ketamine with placebo for treating neuropathic pain in patients with cancer.
pmc.ncbi.nlm.nih.gov
August 17, 2025 at 10:03 AM
Fallon et al.’s 2018 randomised trial found oral ketamine no different to placebo in cancer-related neuropathic pain, but wondered if there could still be a role for it in cases where central sensitisation was observed (a population not specifically selected for) pmc.ncbi.nlm.nih.gov/articles/PMC...
The Dual Process Model of Grief:
Laughed during grief then felt guilty? Don’t. The Dual Process Model says we shift between loss-oriented coping (feeling, remembering) and restoration-oriented coping (adapting, rebuilding). This back-and-forth prevents burnout. Joy and sorrow can walk together
Laughed during grief then felt guilty? Don’t. The Dual Process Model says we shift between loss-oriented coping (feeling, remembering) and restoration-oriented coping (adapting, rebuilding). This back-and-forth prevents burnout. Joy and sorrow can walk together
August 14, 2025 at 9:20 AM
The Dual Process Model of Grief:
Laughed during grief then felt guilty? Don’t. The Dual Process Model says we shift between loss-oriented coping (feeling, remembering) and restoration-oriented coping (adapting, rebuilding). This back-and-forth prevents burnout. Joy and sorrow can walk together
Laughed during grief then felt guilty? Don’t. The Dual Process Model says we shift between loss-oriented coping (feeling, remembering) and restoration-oriented coping (adapting, rebuilding). This back-and-forth prevents burnout. Joy and sorrow can walk together
Worden’s Tasks of Mourning:
Grief isn’t just a wave to ride — it’s work. Worden’s 4 tasks: accept the loss, process the pain, adjust to life without them, and keep a lasting connection while moving forward. It’s not “getting over” someone — it’s living with love and loss in the same heart.
Grief isn’t just a wave to ride — it’s work. Worden’s 4 tasks: accept the loss, process the pain, adjust to life without them, and keep a lasting connection while moving forward. It’s not “getting over” someone — it’s living with love and loss in the same heart.
August 14, 2025 at 9:20 AM
Worden’s Tasks of Mourning:
Grief isn’t just a wave to ride — it’s work. Worden’s 4 tasks: accept the loss, process the pain, adjust to life without them, and keep a lasting connection while moving forward. It’s not “getting over” someone — it’s living with love and loss in the same heart.
Grief isn’t just a wave to ride — it’s work. Worden’s 4 tasks: accept the loss, process the pain, adjust to life without them, and keep a lasting connection while moving forward. It’s not “getting over” someone — it’s living with love and loss in the same heart.
(4/4) Fix Opioid-Induced Constipation by tackling the cause: laxatives to soften stool and get things moving, with a low threshold for adding NICE-approved PAMORAs (like naloxegol) that block opioids in the gut but leave pain relief intact.
August 10, 2025 at 10:41 AM
(4/4) Fix Opioid-Induced Constipation by tackling the cause: laxatives to soften stool and get things moving, with a low threshold for adding NICE-approved PAMORAs (like naloxegol) that block opioids in the gut but leave pain relief intact.
(3/4) So what helps Opioid-Induced Constipation? More fibre? More water? Helpful to a point – but if opioids have drained water from the stool, fibre just bulks it up. And extra drinks don’t magically get that water into the colon. This is a different pathology which needs a different approach…
August 10, 2025 at 10:41 AM
(3/4) So what helps Opioid-Induced Constipation? More fibre? More water? Helpful to a point – but if opioids have drained water from the stool, fibre just bulks it up. And extra drinks don’t magically get that water into the colon. This is a different pathology which needs a different approach…
(2/4) Opioid-induced constipation hits from 3 angles: slower gut muscles, more water pulled out of stool, and weaker “time to go” signals. Fibre and fluids often can’t fight all 3.
August 10, 2025 at 10:41 AM
(2/4) Opioid-induced constipation hits from 3 angles: slower gut muscles, more water pulled out of stool, and weaker “time to go” signals. Fibre and fluids often can’t fight all 3.