TobyGeriMed+Music

@TobyGerisMusic

Consultant Geriatrics, Adelaide. UK trained. Rural uni course coordinator &Dr. Passionate re med education, welfare of docs/pts; rugby, cricket, rock singing ☀️

Adelaide, Australia
Vrijeme pridruživanja: veljača 2018.

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  1. Prikvačeni tweet
    13. kol 2018.

    Does anyone else think this sign on the wards is asking a bit too much of our inpatients with advanced cognitive impairment? 😉

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  2. proslijedio/la je Tweet
    30. sij

    🇦🇺 delirium conference in Brisbane this September! Calling all delirium researchers and clinicians And Brissie locals, please spread the word

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  3. proslijedio/la je Tweet
    24. sij
    Odgovor korisnicima i sljedećem broju korisnika:

    Absolutely!! The utility of disease taxonomy (diagnosis) rests in the prediction of natural history (prognosis) and response to therapeutic interventions (treatment). Knowledge of prognosis can be as important as treatment response.

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  4. proslijedio/la je Tweet
    24. sij
    Odgovor korisnicima i sljedećem broju korisnika:

    I would propose that it is one of the most important parts of our job. Check out my video first patients with a new diagnosis

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  5. 24. sij

    Does anyone else share the same sentiments, or otherwise, about value in diagnosis even when disease is incurable? Great to hear all views

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  6. 24. sij

    5) Formal diagnosis also helps society mediate risk. Quite rightly we can't question people's autonomous decision making 'capacity' without first establishing irreversible cognitive damage. A formal diagnosis allows us to keep incapacitated pts &the public safe from accidents ☀️

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  7. 24. sij

    4) teaching others about a diagnosis also helps mobilise input from (amenable) family & services to prevent foreseeable crises. We know medication mishaps when pts are left alone (eg accidental overdoses) trigger LOADS of admissions. This risk lowers if family are aware & step-in

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  8. 24. sij

    3) Formal diagnosis also helps us to preemptively avoid iatrogenesis. Examples: we can deliberately avoid anticholinergics in Alzheimer's (AD), avoid metoclopramide in PD or Lewy Body, or avoid anticoagulants (if able) in AD when it's complicated by cerebral amyloid angiopathy..

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  9. 24. sij

    (2) ...Firstly it affords crucial prognostication. Nobody thinks withholding a diagnosis of terminal cancer or CJD is fair... we all want to be able to know our futures. Equally if the natural history can be known/predicted, hosp admissions are less frequent and less lengthy.

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  10. 24. sij

    (1) Reflection in clinic today: there's real value in the formal diagnosis of neurodegenerative dementia (as a syndrome + specifying the underlying causal disease). This is despite the common assertion "it won't change management". But incurability doesn't mean it's invaluable...

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  11. proslijedio/la je Tweet
    22. sij

    "People are just as wonderful as sunsets if you let them be. When I look at a sunset, I don't find myself saying, "Soften the orange a bit on the right hand corner." I don't try to control a sunset. I watch with awe as it unfolds" Carl R. Rogers

    , , i još njih 3
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  12. 15. sij

    Doc friends (non-Geris): to what extent do you feel that managing growing numbers of v.frail, challenging 'geriatric' cases, contribute (if at all) to slow attritional , or moral injury? A little overall? A lot?

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  13. proslijedio/la je Tweet
    13. sij

    “Would you choose medicine again?”. My heart breaks to say it but I no longer recognise the reality of today’s NHS from the NHS of 10-15 years ago. It’s no wonder many have hung up their stethoscopes for good

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  14. proslijedio/la je Tweet
    13. sij
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  15. 9. sij

    Standing outside on a very warm night in Adelaide with a very strong smell of smoke in the air, no stars to see (although there are no clouds), and an eerie redness to the moon that has just emerged 🙁

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  16. 7. sij

    Mild smoke haze on a hot cloudless summer's day obscuring the horizon north of the Adelaide Oval, & across Adelaide more widely, presumably blowing in from the tragic fires in Kangaroo Island 😔

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  17. proslijedio/la je Tweet
    2. sij

    Such an important article in our current healthcare, political and social environment. Be the voice that makes a change

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  18. proslijedio/la je Tweet
    28. pro 2019.

    Not all heroes wear capes 😭❤ A koala suffering from soaring temperatures and dehydration in Southern Australia approaches cyclists for water 💔 Australia is buring!

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  19. proslijedio/la je Tweet

    An incredible photo. A lone hero standing beside a koala, watching the fire take hold in the Adelaide Hills.

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  20. proslijedio/la je Tweet

    How lovely is this 💓 Local massage therapists Jasmine & Julie in Balhannah are offering free neck & shoulder messages to all volunteers helping with the South Australian fires 🙌

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  21. 23. pro 2019.

    Contemporary Christmas... "Dashing through the smoke, in an air-conditioned sleigh" 🎅

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