The problem is the combo meds containing codeine, many of which are available OTC. A helpful first step would be for pharmacies to take these risky agents off display in the pharmacy.
The government has failed in its goal pf protecting the NHS
Worth remembering also that "going private" is not currently a viable option with the private hospitals seeing their seres to NHS and private clinics cancelled.
Perhaps it would work, to put in the post a DIY ward round and count that as compete the day it's posted: given that's how the government counts C-19 tests.
I do not agree that prostate cancer commonly metastasises to brain. The relevant cancers are breast bronchus kidney melanoma & thyroid.
Worth remembering that some sort of mass lesion, usually benign, is found by chance in abut a quarter of heathy people on MRI brain scan.
Idgaf, I agree that"focal neurology' is vague, it is however common medical parlance. You could argue that all neurology is focal.
"Subtle personality change" is similarly difficult. Hard to disentangle organic personality change, from the non-specific effects of illness.
The chances of obtaining a diagnostic test appears to be highest for white males, particularly politicians or members of the Royal Family: not egalitarian.
Thank you Dr Gerada this is reassuring as I begin my self-isolation for pyrexia and profound malaise.
"Boris the Spider is a song by The Who from 1966, a golden age before the birth of BJ the PM.
Endee77, the present government is an exercise in futility.
Mental capacity is about disability or impairment, not about diagnosis.
For example two people have a diagnsosis of dementia, one has mental capacity, the other does not.
Therefore the government's position is incorrect.
I agree with what you say about the NHS however I think there were more than two ancient kingdoms. Wessex, Mercia, East Anglia & Northumbria spring to mind, from my reading of Bernard Cornwell's books.
"The third most common adult-onset neurodegenerative condition in the UK"? I think you have overlooked progressive MS.
This is a big problem. I propose that firstly that it is mandatory to warn patients of the risk of chance findings on imaging at the time the test is ordered; and secondly that responsibility for addressing incidental findings rests with the doctor who ordered the imaging.
I can see why primary care colleagues are unwilling to pick up the pieces after useless health screening scans; but it is also a problem for neurology secondary care as increasing brain and spine MRI is ordered in primary care and incidentaloma then triggers referral. It would be helpful if NICE summarised the risk of incidentalomas and recommended appropriate management.
Dr Copperfield, I have worked in Essex for only 26 years and I still haven't worked out who you are but when I do I would like to shake your hand.
How long? "since I was younger"; "when the doctor referred me"
Has it changed over time? "I have good days and bad days"
How often does it happen? "there's no pattern to it"; is it hourly, daily, weekly, or monthly? "yes"; "it's all the time, you know, it comes and goes"; "My symptoms last 2-3 days and happen many times a week"; "it's at least twice a month"; and at most? "I just told you, at least twice a month"
Any treatment? "no... just tablets" which ones? "little white ones with a line across" or "tried everything but nothing works"; how long did you take the treatment "I completed the course"
Is there illness in the family?"no"; are your parents alive and well "no, they're dead"; I'm sorry, what happened? "Oh, nothing serious"
It's like a playing "Just a Minute" only here the rules are to speak for as long as possible without communicating any information. Though as a general rule, the vaguer the history the less likely a serious cause.
If the pain clinics initiated the opiates/opioids (and gabapentinoids) it is their responsibility to help patients come off those drugs.
This is really helpful. I am a neurologist. Every day at least one patient asks about therapeutic cannabis or cannabinoid(s). My answer is inevitably: no. The hard part is explaining why, and getting that out of the way, to leave time for more constructive discussion.
CQC see QC?
Anonymouse3, Omnopom [sic] sounds like too many brits in Oz.
Seriously though, there is a world of difference between "prescribable" (some cannabinoids are currently prescribable as they have been for years) and "NHS funded" which they are not. So no NHS prescribing. I imagine the cases in the press have been IFRs (for which we all know the CCG default response). Many of my MS patients would like to try cannabinoids but the data, notwithstanding some optimistic anecdotes, is not exactly convincing, hence no NICE approval.
Matt the app?
DecorumEst you would not believe the number of people who come unaccompanied to secondary care clinics for ?dementia. I like to think that they forgot that their excellent GP emphasised the importance of attending with a witness.