Thursday, November 22, 2012

All this, and psychic too?

I know I've sung (very loudly and tunefully) the praises of the Greenwich Hospital Community Palliative Care team before, but I think I need to add another verse to that song today.

All of the staff and volunteers who we have encountered have been amazing, and I couldn't possibly wish for better care for Mum than that which she's receiving from the team at Greenwich.

Since entering the care of the Greenwich team, Mum has been seen by five different doctors. Ruth was the first staff specialist that Mum saw in the day clinic, and each appointment we had with Ruth lasted at least an hour, as she talked to us about every aspect of Mum's health and care; especially the ubiquitous issue of pain meds vs bowel meds, and advising me how to balance and tweak these.

Ruth is now in Nepal, working for Médecins Sans Frontières with her husband, so Mum moved into the care of a different staff specialist, Kat. Like Ruth, Kat was in no hurry in the consultation we had with her in the clinic, and when Mum was admitted to Greenwich for symptom management, Kat visited her a number of times during the week and a half she was there. Mum's comments about both Ruth and Kat have always been along the lines of how nice they are and how lucky she is to have them as her doctors.

During her stay as a inpatient, Mum was also seen by two junior doctors, Brigitte, the registrar, and a resident (whose name I can't remember). One or both of them visited Mum every day she was in the hospital, and were also very nice.

Since Mum's discharge from hospital, she is housebound, due to her requirement for oxygen, so now rather than going into the clinic at Greenwich to see the doctor, the doctor has to come to us at home. Enter a new face, Trish, the registrar. Kat was planning to visit Mum during the second week after her discharge, but due to illness of some of the junior doctors, Kat was required to focus on hospital rounds, so asked Trish to visit Mum. Once again, Trish was lovely, and would have spent a good hour here with us, talking through some of the tricky issues Mum's been having with pain in the mornings, and we discussed some possible strategies to deal with that.

A few days later (Tuesday afternoon), Trish rang me to see how we were going with the new strategies (which didn't make much difference), so we talked about some other options for me to try.

When our community nurse came to see Mum today, I told him about the tweakages of Mum's medication dosages and times Trish had suggested to try to manage Mum's morning pain, and that after one or two days, this didn't seem to be working. He suggested I give it another day, and then if no better tomorrow morning, to ring Greenwich to talk some more about other options.

So I wrote in my diary to ring Greenwich tomorrow (not because I'm so busy I need to diarise such tasks, but because my memory for such details is pretty hopeless at the moment). Then this afternoon, the phone rang, and it was Trish, saying that she was returning my call from this morning... except I hadn't called ... but I took advantage of her serendipitous timing (saying that I was planning to call her tomorrow anyway... is she psychic? :-)

One of Mum's issues at the moment is that she is waking up in quite severe pain, and it takes a good two hours for the breakthrough pain medication to kick in. (Once it kicks in, Mum is pain free, but it's that dreadful two hours of unrelenting pain, which is such a horrible way for Mum to start the day). During our phone conversation today Trish mentioned that there is a particular medication that is much faster-acting than the meds Mum is currently on, but this medication is only available to palliative patients on special authority, and is not cheap. I told her cost is not a problem, and anything that would help is worth a try. She asked me about our local pharmacy, and whether they would be able to help us out by getting this medicine in (which of course they will, because they are amazing).

So at the end of our conversation, Trish said she would phone the pharmacy, and arrange to fax through the authority script for this medicine, so that they could get it in, and then to us, as soon as possible.

We are indeed blessed to be so well looked after.


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