If you continue without changing your settings, we’ll assume you’re happy to receive all cookies from the BMA website. Find out more about cookies
When you visit any web site, it may store or retrieve information on your browser, mostly in the form of cookies. This information might be about you, your preferences or your device and is mostly used to make the site work as you expect it to. The information does not usually directly identify you, but it can give you a more personalised web experience.
Because we respect your right to privacy, you can choose not to allow some types of cookies. Click on the different category headings to find out more and change our default settings. However, blocking some types of cookies may impact your experience of the site and the services we are able to offer.
These cookies are necessary for the website to function and cannot be switched off in our systems. They are usually only set in response to actions made by you which amount to a request for services, such as setting your privacy preferences, logging in or filling in forms.
You can set your browser to block or alert you about these cookies, but some parts of the site will not then work. These cookies do not store any personally identifiable information.
These cookies are required
These cookies allow us to know which pages are the most and least popular and see how visitors move around the site. All information we collect is anonymous unless you actively provide personal information to us.
If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance.
These cookies allow a website to remember choices you make (such as your user name, language or the region you're in) and tailor the website to provide enhanced features and content for you.
For example, they can be used to remember certain log-in details, changes you've made to text size, font and other parts of pages that you can customise. They may also be used to provide services you've asked for such as watching a video or commenting on a blog. These cookies may be used to ensure that all our services and communications are relevant to you. The information these cookies collect cannot track your browsing activity on other websites.
Without these cookies, a website cannot remember choices you've previously made or personalise your browsing experience meaning you would have to reset these for every visit. In addition, some functionality may not be available if this category is switched off.
Our websites sometimes integrate with other companies’ sites. For example, we integrate with social networking sites such as Twitter and Facebook, to make it easier for you to share what you have read. These sites place their own cookies on your browser as a result of us including their icons and ‘like’ or ‘share’ buttons on our sites.
I have few principles — I believe in instinct, on principle.
However, when I was a GP, if someone had been to see me three times with the same complaint it was time to get a second opinion.
Another principle is that the people who know the patient best are the relatives.
It was interesting over the last year or so of my mother’s life to be on the other side of the bed, so to speak, trying to walk a fine line between daughter and doctor.
I wanted the most appropriate treatment for Mum but I didn’t want to offend the health professionals who were looking after her.
Not that my parents helped. Mum did a good job of distracting the GP from alternative diagnoses of her worsening back pain with her life-long scoliosis and an otherwise unremarkable plain x-ray until she ended up being admitted urgently with impending spinal-cord compression and wedge fractures of two of her lumbar vertebrae.
She sacked the chiropodist and fell off the toilet seat trying to cut her own toenails.
The GP gave her ibuprofen gel for her painful arm. When I finally got to hear about it on my next visit a couple of weeks later, I figured that for someone on MST, pregabalin, paracetamol and oral ibuprofen, it shouldn’t still be making her shriek when she tried to use it.
I set about persuading people she needed an x-ray. Pathological fracture.
Down the line, Dad was blaming the medication for her memory loss and bizarre behaviour and I was happy to collude with him. I did stop all her meds except the MST with no increase in her pain, so that was good, at any rate.
Then I got an email from him. They had had a night away in a hotel. ‘Really strange this morning,’ he wrote. ‘Mum put her T-shirt on over her fleece, and she hadn’t a clue what to do with her bra.’ Ah shite. Dressing dyspraxia. Can’t blame that on the meds.
The oncologist organised a CT head scan. Normal. See in six weeks.
Things were deteriorating at home. Even Dad, a retired bank manager, was disbelieving of the result. The Macmillan nurse suggested it might be dementia. I pointed out that around a third of brain metastases do not show up on CT.
The night before the next oncology appointment I wrote a list of all her neurological signs and symptoms. If we were playing frontotemporal symptom bingo we would have been yelling ‘House!’
The MRI showed multiple meningeal and posterior fossa metastases. It gave me no pleasure to be right. My regret is that if we had had this result earlier I would have asked for her Herceptin to be stopped sooner.
It had done a good job on the extra-cranial secondaries, but has little effect on the brain.
We spent the last few months of her life with the shell of my mother — a Cambridge graduate, retired teacher and magistrate — and that was the saddest thing.
Becky Hirst is a consultant in palliative medicine in Barnsley
Read the third and final report, reflections and recommendations from the end-of-life care and physician-assisted dying project, and join the discussion on our dedicated community
The article you have shared is really nice and will help the one who will seize information from this . As i have gone through this addprinterwindows10.com/ article seems to be beneficial and advantageous.
This is the full secure and fast device for the window users get the online this add printer use by the USB cable in the wireless forever just get here addprinterwindows10.com/ and save the full setting to according the system forever.
No doubt this leakage can be very dangerous for our cars as well as to our lives. This leakage can lead the car in massive destruction. To have essay help visit dissertationhelp.org.uk I am very glad that you shared this very informative news with us I will forward it with all my friends.
Do participate in the lowes customer satisfaction survey on this website www.homedepotcomsurveys.com/.../ and win $1000 gift card for free.