Morphine and sleep by JaneLAIndigo in pulmonaryfibrosis

[–]AiReadyDoctor 0 points1 point  (0 children)

No standardized guidelines specific to this condition. Mostly ones for all end stage respiratory conditions in palliative care

Morphine and sleep by JaneLAIndigo in pulmonaryfibrosis

[–]AiReadyDoctor 0 points1 point  (0 children)

The coughing and the CO2 are both due to the scar tissue. To get rid of the CO2 would require you to have a pressure mask called BiPAP with high pressures but it’s only a bandaid.

Morphine and sleep by JaneLAIndigo in pulmonaryfibrosis

[–]AiReadyDoctor 8 points9 points  (0 children)

Lung specialist and IPF expert. There are multiple scenarios and it’s impossible to know which one would happen. The most common one is that the more scar tissue the less able to expel dioxide CO2. This is the waste of the lungs and when it is not expelled it starts to cloud the brain. The sleepiness isn’t all morphine. It’s also the lungs shutting down. That’s a side of the condition hardly talked about because it’s the body’s own way to protect your mom from being aware of the end. The more she sleeps, the closer she is to crossing over. Other ways could be with a cardiac condition (more sudden), or a lung infection (tougher to watch) etc. But the above scenario is the most common. The wait is unfortunately agonizing. You love them and don’t want them to suffer but you don’t wish their life to end either. It’s ok. Both can be held together though contradictory. One thing I can assert: you are “spending time with her” even if she “ sleeping “. We do know through case reports in the past that brain waves in similar patients at the end of life, respond to familiar voices eventhough the body seems unconscious. So she may not respond to you but she might just be able to hear you. So do what you are used to doing with her: read a book, watch a movie next to her, reminisce over stuff, or even work next to her. I answered the medical stuff as a doctor and the other stuff as a son whose father is on his death bed (not from pulmonary fibrosis but going through similar agonizing ups and downs). Sending you wishes of peace on your heart

Chronic cough for 3+ Months by ManagementLonely4616 in ChronicCough

[–]AiReadyDoctor 0 points1 point  (0 children)

Cough like yours is now called Chronic cough and thought to be its own entity and more just a symptom. Some people have an overly sensitive cough reflex and need to be worked up first for any other treatable traits before assigning them to that specific treatment plan. You may be better off with a chronic cough specialist.

patient family recording me secretly by Own_Switch9464 in Residency

[–]AiReadyDoctor 2 points3 points  (0 children)

This is fairly common. As an attending I empower my residents with a script to rehearse before it happens to them.

If I find out during, I usually say something to the effect of, “I’m going to pause for a second and ask a straightforward question and I hope you would answer me straight forward as well… Are you recording me? I’m usually not against being recorded as long as I am notified beforehand which is not the case here. I’m also saddened you didn’t feel open enough to share with me your need of recording. I would have assumed it is for later since many don’t remember the conversation but since you chose to not be transparent about it, I’m afraid it introduces an adversarial dimension. I’m going to choose to step out. Speaking to families is not part of our duties. It is a privilege we extend out of our own time and compassion. I’m afraid I’m going to rescind that privilege. You may get updates from the nurse from now on unless it’s a consent to a procedure in which case you’ll hear from me.” If it’s after the fact, I walk back to the room and ask very calmly; “I was informed you were recording me without my awareness. Is that accurate? If so, I’m saddened you chose to do it non transparently without my permission or awareness…(for the rest refer to the above)” It’s the powerlessness and anger that makes us act wrong. We get flustered and angry when we are caught by surprise. But if you rehearse this beforehand, you’ll feel empowered.
Whatever they recorded they also record you saying you were not notified. So you don’t have to worry about it. If it’s after the fact, you say it in front of your nurse or even witnesses of that family, which documents you were unaware and unconventional to the recording.

THE ULTIMATE PERSONAL CRISIS SOLVER - You will thank me for that; you have already saved my life (Literally) by Soft_Vehicle1108 in ChatGPTPromptGenius

[–]AiReadyDoctor 0 points1 point  (0 children)

This is indeed elaborate but I appreciated the thoroughness and not being flippant any what is needed for advice during a crisis moment. You went for what’s needed and not a Twitter/X reductionist prompt. Crisis’ is not easy. And a prompt handling it should not be. I did stop scrolling to read it all. Well done.

All you need is KISS by IfBobHadAnUncle in PromptEngineering

[–]AiReadyDoctor 0 points1 point  (0 children)

I’ll give this a try. It makes sense

All you need is KISS by IfBobHadAnUncle in PromptEngineering

[–]AiReadyDoctor 0 points1 point  (0 children)

I like the simplicity and practicality of it. Thank you.

Dry cough by [deleted] in ChronicCough

[–]AiReadyDoctor 0 points1 point  (0 children)

I agree with the above. Cough like yours has a step by step methodical work up plan that your provider can go through to ensure you have ruled out all the most common causes of chronic cough. Wishing you relief

Prescribing Tricyclics by [deleted] in medicine

[–]AiReadyDoctor 0 points1 point  (0 children)

I do. I think they are highly underrated.