2011 04 20 hpm tweetchat transcript
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2011 04 20 hpm tweetchat transcript

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    2011 04 20 hpm tweetchat transcript 2011 04 20 hpm tweetchat transcript Document Transcript

    • #hpmHealthcare Hashtag Twitter Transcript From: Wed Apr 20 17:55:00 PDT 2011 To: Wed Apr 20 19:05:00 PDT 2011 Customize transcript dates and layoutLearn more about #hpm at The Healthcare Hashtag ProjectPracticalWisdom Its almost that time. 4minute count down to tired fingers, wired brain, and collective Wisdom. I cant wait. #HPM Wed Apr 20 17:56:39 PDT 2011PracticalWisdom We want others 2 c us competent, not just nice.RT@doclake Powervs.Warmth applies 2 way #hpm prac. interacts @bedsidehttp://is.gd/OI5cqH #HPM Wed Apr 20 18:00:31 PDT 2011equijada Hi everyone. For the next 6 min, Ill be in #hpm tweetchat. Come join the discussion. #hpm Wed Apr 20 18:01:02 PDT 2011equijada @PracticalWisdom Hi Lisa, good to see you here #hpm Wed Apr 20 18:01:25 PDT 2011PracticalWisdom Interested Pt Educ.RT@DianeEMeier:RT @ctsinclairNews/Research UPDATES: U.S. FDA Releases Long-Awaited Opioid-REMS http://hpm.md/g2AncC #HPM Wed Apr 20 18:01:26 PDT 2011RossJeanette hi @equijada only 6 minutes? #hpm Wed Apr 20 18:01:54 PDT 2011KathyKastner What about the other 54 minutes :)RT @equijada: Hi everyone. For the next 6 min, Ill be in #hpm tweetchat. Come join the discussion. #hpm Wed Apr 20 18:02:02 PDT 2011PracticalWisdom My Pleasure. Thanks for being our Host. RT @equijada: @PracticalWisdom Hi Lisa, good to see you here #HPM Wed Apr 20 18:02:28 PDT 2011equijada @KathyKastner ha, i mean for the next 60 min! #hpm Wed Apr 20 18:02:46 PDT 2011
    • PracticalWisdom @KathyKastner @equijada 54 Fun with our Friends. Brain Candy for All #HPM Wed Apr 20 18:03:01 PDT 2011KathyKastner Wheewh. worried for a mo RT @equijada: @KathyKastner ha, i mean for the next 60 min! #hpm Wed Apr 20 18:03:16 PDT 2011equijada @RossJeanette Hi Jeanette! 60 min...thinking faster than I type. Welcome. Good to see you here #hpm Wed Apr 20 18:03:26 PDT 2011FMDGirl Hi everyone- listening in. Kari- RN/pt advocate #HPM Wed Apr 20 18:04:10 PDT 2011KathyKastner H Lisa ! RT @PracticalWisdom:@equijada 54 Fun with our Friends. Brain Candy for All #HPM Wed Apr 20 18:04:20 PDT 2011equijada @FMDGirl Hi Kari, welcome. #hpm Wed Apr 20 18:04:54 PDT 2011PracticalWisdom @equijada: Hoping our Man from Down Under will join us tonight. The Rascal @Hughstephens. #HPM Wed Apr 20 18:05:14 PDT 2011revdoc Pam Harris MD with Kansas City Hospice; also an ordained minister #hpm Wed Apr 20 18:05:32 PDT 2011SheyontheBay Hello all, glad to see you #hpm Wed Apr 20 18:06:31 PDT 2011equijada @PracticalWisdom will start with t1 in a min or so. Join us @hughstephens. Welcome Pam. Good to see you #hpm Wed Apr 20 18:06:35 PDT 2011revdoc Good to tweet with yall #hpm Wed Apr 20 18:07:09 PDT 2011equijada @SheyontheBay hi, good to see you. long time! #hpm Wed Apr 20 18:07:12 PDT 2011PracticalWisdom @KathyKastner Im always glad to see you. #HPM Wed Apr 20 18:07:34 PDT 2011teaminspire Hi everyone--listening in, looking to learn--John Novack, Inspire (online patient support communities) #HPM Wed Apr 20 18:07:45 PDT 2011
    • hughstephens @PracticalWisdom @equijada still looking for cat :( might not make #hpm Wed Apr 20 18:08:01 PDT 2011equijada t1: Its 420! What is the role of marijuana in patients with life threatening illness? #happy420 #hpm Wed Apr 20 18:08:02 PDT 2011equijada For those not familiar with 420 The True Story Of How April 20 Became Weed Day http://huff.to/hmP832 #hpm Wed Apr 20 18:08:41 PDT 2011equijada 420 (cannabis culture) - Wikipedia, the free encyclopedia http://bit.ly/f5aOqV #hpm Wed Apr 20 18:08:49 PDT 2011SheyontheBay @equijada @SheyontheBay yes, sorry about that - lots going on in life!! ;) #hpm Wed Apr 20 18:08:57 PDT 2011equijada @hughstephens welcome! #hpm Wed Apr 20 18:09:06 PDT 2011revdoc T1--I am actually not very impressed with Marinol for sx control #hpm Wed Apr 20 18:09:12 PDT 2011FMDGirl t1- question dear to my heart- close friend passed away from Fredrich ataxia- not legal, but only think that helped #HPM Wed Apr 20 18:09:41 PDT 2011KathyKastner Clearly I need glasses. I put an e in the middle of sx RT @revdoc: T1--I am actually not very impressed with Marinol for sx control #hpm Wed Apr 20 18:10:19 PDT 2011revdoc Although Marinol does help for the wasting syndrome associated with AIDS #hpm Wed Apr 20 18:10:21 PDT 2011SheyontheBay Dating myself: i remember teaching chemo pts how to smoke a joint, circa 1980!!! #hpm Wed Apr 20 18:10:23 PDT 2011equijada @FMDGirl if you dont mind, can you expand on the experience? what did it help? #hpm Wed Apr 20 18:10:34 PDT 2011equijada I think that data on marinol and marijuana are actually different. Not sure. #hpm Wed Apr 20 18:11:27 PDT 2011revdoc Cant speak to the effect of Marinol on sex... #hpm Wed Apr 20 18:11:43 PDT 2011
    • equijada @SheyontheBay was it helpful? #hpm Wed Apr 20 18:11:46 PDT 2011DianeEMeier RT @doclake: Power poses vs. Warmth poses-good research that applies to the way a #hpm practitioner interacts @ the bedside http://is.gd ... Wed Apr 20 18:11:49 PDT 2011revdoc In Kansas, marijuana is not legal, so we are stuck with Marinol #hpm Wed Apr 20 18:12:13 PDT 2011equijada Cannabis use in palliative care http://bit.ly/huBHGx A nice review #hpm Wed Apr 20 18:12:56 PDT 2011FMDGirl Yes, fredrich ataxia causes spasms- traditional meds did not help- up front with docs about using it, pts should be able use medically #HPM Wed Apr 20 18:13:53 PDT 2011SheyontheBay @equijada@SheyontheBayIf they could get past the criminality it helped, esp w/ nausea.po tabs seemed to get neutralized by gastric jc #hpm Wed Apr 20 18:14:17 PDT 2011equijada @FMDGirl I hear that a lot from patients taking it. #hpm Wed Apr 20 18:14:40 PDT 2011SheyontheBay Wasnt legal in Florida either... We ignored the smell of pot wafting down the corridor #hpm Wed Apr 20 18:15:13 PDT 2011DianeEMeier RT @doclake: The New Old Age: A Mother’s Nighttime Rage http://is.gd/ciHsMe delirium #hpm Wed Apr 20 18:15:24 PDT 2011equijada Its legal in CA (Im in CA). There are so many dispensaries. Many times the pts using dont seem legit. Hard to balance. #hpm Wed Apr 20 18:16:14 PDT 2011RossJeanette thanks for the information on 420. Since marijuana is ilegal in Texas I have no experience w/ this. #hpm Wed Apr 20 18:17:15 PDT 2011FMDGirl Plus- it increases appetite, Dave- my friend wrote a book:http://amzn.to/hYJGVk #HPM Wed Apr 20 18:17:28 PDT 2011drpippa Only anecdotal evidence Has been helpful for folks. Hard to balance legit use vs illicit use. Would prob not feel comfortable rxing #Hpm Wed Apr 20 18:17:36 PDT 2011revdoc SAME ISSUE WITH OTHER PAIN MEDS RT @equijada: Its legal in CA (Im in CA). Many times the pts using dont seem legit. Hard to balance. #hpm Wed Apr 20 18:17:58 PDT 2011
    • drpippa @equijada Nice choice of topic for the day! #Hpm Wed Apr 20 18:18:03 PDT 2011equijada Ive let patients use it. I dont have a problem with it. I do get uncomfortable when they are using pot and oxyfast gets lost. #hpm Wed Apr 20 18:18:32 PDT 2011FMDGirl @equijada How is it different from managing any other chronic patient that is on pain meds? #HPM Wed Apr 20 18:18:40 PDT 2011equijada @FMDGirl thanks for the link. Im going to check it out. #hpm Wed Apr 20 18:19:02 PDT 2011SheyontheBay @equijada Have no idea how it was used or abused in the home. Hospital pts had to provide their own -> no quality control #hpm Wed Apr 20 18:19:04 PDT 2011revdoc FDA proposing REMS on ALL opiates because of issues of abuse or diversion http://hpm.md/g2AncC #hpm #hpm Wed Apr 20 18:19:07 PDT 2011PracticalWisdom Sorry had internet problems Kerri great to see you. #HPM Wed Apr 20 18:19:22 PDT 2011equijada @FMDGirl its not. I have to risk assess just like opioids. #hpm Wed Apr 20 18:19:35 PDT 2011BuddhishMD @NYTimeskrugman Language is so important - it sometimes feels like the world of money and business has completely co-opted our lives. #hpm Wed Apr 20 18:20:13 PDT 2011equijada @FMDGirl I think the main difference is basically legal but in terms of prescribing - same as opoioids #hpm Wed Apr 20 18:20:27 PDT 2011equijada @drpippa ha! thanks. #hpm Wed Apr 20 18:20:49 PDT 2011FMDGirl @equijada pt on ms for cancer- it made him confused and he cut his feeding tube in half without realizing it- thought it was a string #HPM Wed Apr 20 18:20:54 PDT 2011PracticalWisdom RT @drpippa: Only anecdotal evid. Has been helpful 4 folks. Hard 2 balance legi use vsillicit use.Would prob not feel comfortable rxing #HPM Wed Apr 20 18:21:10 PDT 2011PracticalWisdom RT @FMDGirl: @equijadapton ms 4 cancer- made him confused& he cut his feeding tube in 1/2 without realizing it- thought it was a string #HPM
    • Wed Apr 20 18:21:48 PDT 2011equijada @PracticalWisdom @drpippa @AAHPM doesnt have an official stand on marijuana. Interesting discussion in Vancouver #hpm Wed Apr 20 18:22:02 PDT 2011PracticalWisdom Rascal Topic for sure. I knew this would be a good one. RT @drpippa: @equijada Nice choice of topic for the day! #HPM Wed Apr 20 18:22:17 PDT 2011FMDGirl easy to balance legal use, RX from an MD- get from a hospital pharmacy #HPM Wed Apr 20 18:22:27 PDT 2011drpippa Still disappointed i missed it! RT @equijada: @AAHPM doesnt have an official stand on marijuana. Interesting discussion in Vancouver #Hpm Wed Apr 20 18:23:09 PDT 2011equijada RT @FMDGirl: easy to balance legal use, RX from an MD- get from a hospital pharmacy #hpm Wed Apr 20 18:23:20 PDT 2011drpippa RT @FMDGirl: easy to balance legal use, RX from an MD- get from a hospital pharmacy #Hpm Wed Apr 20 18:23:44 PDT 2011equijada Moving on to t2 in a min or so #hpm Wed Apr 20 18:23:52 PDT 2011PracticalWisdom @equijada @drpippa @AAHPM T1: When I taught Pharmacology (Basic) 100 years ago Marijuana was complicated Dep/Stim Sometimes Hallacu? #HPM Wed Apr 20 18:24:01 PDT 2011revdoc RT @FMDGirl: easy to balance legal use, RX from an MD- get from a hospital pharmacy [PEOPLE CAN LIE ABOUT SXS USING LEGAL SOURCES] #hpm Wed Apr 20 18:24:10 PDT 2011hollyby Hi all! I dont rx it. Still a conflict btwn state & federal law. Not worth my DEA license. #hpm Wed Apr 20 18:24:19 PDT 2011RossJeanette @equijada was the MJ discussion in Vancouver a specific session? I bought the Audio recording #hpm Wed Apr 20 18:24:25 PDT 2011PracticalWisdom @PracticalWisdom: Is this still true? complicated? #HPM Wed Apr 20 18:24:52 PDT 2011equijada RT @hollyby: Hi all! I dont rx it. Still a conflict btwn state & federal law. Not worth my DEA license. #hpm Wed Apr 20 18:24:53 PDT 2011
    • FMDGirl I do have a stand I do not use it- I would like to know it is available if I have a terrible stroke, should be MY choice not my states #HPM Wed Apr 20 18:24:57 PDT 2011hollyby Lurking tonight, but wanted to say hello! Hugs to all! #hpm Wed Apr 20 18:25:07 PDT 2011mpf2011 @ctsinclair Have fun. #HPM Wed Apr 20 18:25:08 PDT 2011PracticalWisdom Who wants another Hassle!RT @hollyby: Hi all! I dont rx it. Still a conflict btwn state & federal law. Not worth my DEA license. #HPM Wed Apr 20 18:25:27 PDT 2011ctsinclair RT @drpippa: Only anecdotal evidence Has been helpful for folks. Hard to balance legit use vs illicit use. Would prob not feel comfortable rxing #Hpm Wed Apr 20 18:25:28 PDT 2011equijada @RossJeanette yes, I forget the speakers name. Husband/wife team. Totally supported MJ but data equivocal #hpm Wed Apr 20 18:25:31 PDT 2011KathyKastner RT @FMDGirl: I do have a stand I do not use it- I would like to know it is available if I have a terrible stroke, should be MY choice not my states #HPM Wed Apr 20 18:25:43 PDT 2011mpf2011 RT @hospice_doctor: Aggressive treatment at the end of life, but where is the patient? New blog post: http://hospicedoctor.blogspot.com #palliative #hpm Wed Apr 20 18:25:46 PDT 2011revdoc @ctsinclair Thought you were at concert? #hpm Wed Apr 20 18:26:00 PDT 2011FMDGirl @revdoc @FMDGirl yes-people lie all the time to get narcs- but that should not prevent people who need pain relief from getting it #HPM Wed Apr 20 18:26:46 PDT 2011PracticalWisdom PT Rights!RT @FMDGirl: I do have a stand I do not use it-I would like know its ava.if I a stroke, should be MY choice not my states #HPM Wed Apr 20 18:26:47 PDT 2011PracticalWisdom In the Lobby, Conversation too Good to be left out!RT @revdoc: @ctsinclair Thought you were at concert? #HPM Wed Apr 20 18:27:23 PDT 2011KathyKastner RT @FMDGirl: @revdoc @FMDGirl yes-people lie all the time to get narcs- but that should not prevent people who need pain relief from getting it #HPM Wed Apr 20 18:27:32 PDT 2011equijada t2 via @mpf2011 and @practicalwisdom - how do you communicate and advocate AD when whats said isnt whats done http://bit.ly/eU8wq5 #hpm Wed Apr 20 18:27:42 PDT 2011
    • revdoc @FMDGirl No argument; but having done chronic pain tx for years, it is not as simple as it seems #hpm Wed Apr 20 18:27:59 PDT 2011FMDGirl @PracticalWisdom @FMDGirl EXACTLY Lisa- PT RIGHTS! Your better at this tweeting than me ;) #HPM Wed Apr 20 18:28:00 PDT 2011PracticalWisdom Nope Im older have more insurance.RT @FMDGirl:@PracticalWisdom@FMDGirl EXACTLY Lisa-PT RIGHTS! Your better at this tweeting than me ;) #HPM Wed Apr 20 18:28:52 PDT 2011equijada @mpf2011 @practicalwisdom In this story, pt was "DNR" but her goals and wishes werent exactly known #hpm Wed Apr 20 18:28:53 PDT 2011joshgriffin RT @FMDGirl: @revdoc @FMDGirl yes-people lie all the time to get narcs- but that should not prevent people who need pain relief from getting it #HPM Wed Apr 20 18:29:02 PDT 2011FMDGirl @revdoc @FMDGirl yes, understand it is not easy, but either is living with pain- we must go the extra mile to ensure pt safety #HPM Wed Apr 20 18:29:06 PDT 2011revdoc @FMDGirl Unfortunately, my experience with legislation to promote "safety" is that it makes my life a living hell! #hpm Wed Apr 20 18:30:03 PDT 2011equijada RT @revdoc: @FMDGirl No argument; but having done chronic pain tx for years, it is not as simple as it seems #hpm Wed Apr 20 18:30:19 PDT 2011drpippa T2- I try to get family talking about the person, not the disease. Get an idea of what they were like before. Helps inform #Hpm Wed Apr 20 18:30:54 PDT 2011PracticalWisdom @equijada @mpf2011 @practicalwisdom: Frankly this ink unglued me. Why was her DNR not respected? Where was Clergy/Ethics. #HPM Wed Apr 20 18:30:57 PDT 2011SheyontheBay T2. In 140 characters?really? #hpm Wed Apr 20 18:31:12 PDT 2011revdoc T2 Encourage pt conversation with families, not relying on a piece of paper. Make sure your decision makers KNOW what you want #hpm Wed Apr 20 18:31:18 PDT 2011equijada @SheyontheBay lol #hpm Wed Apr 20 18:31:39 PDT 2011FMDGirl @revdoc @FMDGirl Agreed!!! That is why you have us nurses to do the paper work-
    • FMDGirl @revdoc @FMDGirl Agreed!!! That is why you have us nurses to do the paper work- he he :) #HPM Wed Apr 20 18:31:51 PDT 2011mpf2011 @equijada How was the pt DNR? She had a signed document?? Noted in Notes? #hpm Wed Apr 20 18:31:59 PDT 2011PracticalWisdom T2: If a Pt does everything legally & your desire is not respected What (fill in the Blank) is going on. Seems like ego got in the way #HPM Wed Apr 20 18:32:17 PDT 2011SheyontheBay @equijada ;D #hpm Wed Apr 20 18:32:32 PDT 2011revdoc T2 Encourage pt conv w/ families, not relying on a piece of paper. Make sure your decision makers KNOW what you want B4 they need info #hpm Wed Apr 20 18:32:38 PDT 2011equijada @revdoc It seems when healthcare providers are told to #havethetalk its interpreted as #signthepaper #hpm Wed Apr 20 18:32:41 PDT 2011drpippa RT @revdoc: Encourage pt conversation with families, not relying on a piece of paper. Make sure decision makers KNOW what you want #Hpm Wed Apr 20 18:32:46 PDT 2011PracticalWisdom THey Did RT @revdoc: T2 Encourage pt con. w/ families, not relying on a piece of paper. Make sure your decision makers KNOW what Uwant #HPM Wed Apr 20 18:32:56 PDT 2011FMDGirl t2 question- did not get the link to work- can some one fill me in? #HPM Wed Apr 20 18:33:07 PDT 2011revdoc @FMDGirl @revdoc Unfortunately, I am the housecall doc, so when I show up I AM the IDT! #hpm Wed Apr 20 18:33:09 PDT 2011equijada @mpf2011 it was in her advance directive #hpm Wed Apr 20 18:33:15 PDT 2011PracticalWisdom http://hospicedoctor.blogspot.com/RT @FMDGirl: t2 question- did not get the link to work- can some one fill me in? #HPM Wed Apr 20 18:33:45 PDT 2011KathyKastner Id LOL but its true RT @equijada: @revdoc It seems when healthcare providers are told 2 #havethetalk interpreted as #signthepaper #hpm Wed Apr 20 18:33:46 PDT 2011SheyontheBay Respectingchoices.org. Worksheet to #havethetalk #hpm Wed Apr 20 18:33:48 PDT 2011
    • drpippa So true. RT @equijada: @revdoc It seems when healthcare providers are told to #havethetalk its interpreted as #signthepaper #Hpm Wed Apr 20 18:34:29 PDT 2011mpf2011 RT @equijada: @mpf2011 it was in her advance directive #hpm | Was the pt conscious? Was family disputing it? Wed Apr 20 18:34:42 PDT 2011revdoc T2 Not saying it doesnt happen, but I still think there are more problems not naming DPOA than having AD ignored #hpm Wed Apr 20 18:34:53 PDT 2011RossJeanette T2 bringing the person "in to the room" helps me understand better what makes life meaningful and make care recommendations #hpm Wed Apr 20 18:34:59 PDT 2011equijada @FMDGirl sorry, try this http://bit.ly/eU8wq5 #hpm Wed Apr 20 18:35:10 PDT 2011PracticalWisdom Is this a Legal Doc? Could there be Legal Challenges. RT @equijada: @mpf2011 it was in her advance directive #HPM Wed Apr 20 18:35:19 PDT 2011PracticalWisdom RT @drpippa: So true.RT @equijada: @revdoc It seems when healthcare providers are told to #havethetalk its interpreted as #signthepaper #HPM Wed Apr 20 18:35:37 PDT 2011equijada @FMDGirl in short - an elderly lady was "DNR" but no mentions of goals, wishes. Received aggressive care dialysis etc that didnt work #hpm Wed Apr 20 18:35:55 PDT 2011revdoc As DPOA I did have to bully 4 providers into stopping aggressive care for my father despite my telling them his QOL was unacceptable #hpm Wed Apr 20 18:36:26 PDT 2011equijada @revdoc there is good data that DPOA undergo significant stress and dont follow through thus AD. #hpm Wed Apr 20 18:36:35 PDT 2011equijada @RossJeanette yes, agree. #hpm Wed Apr 20 18:37:36 PDT 2011PracticalWisdom T2: Interesting Quote: How the health care system slants inexorably toward aggressive intervention regardless of the context. #HPM Wed Apr 20 18:37:39 PDT 2011mpf2011 @PracticalWisdom Here is the blog link: http://hospicedoctor.blogspot.com/ #HPM Wed Apr 20 18:37:40 PDT 2011equijada @revdoc tough. You were able to advocate. Most people arent as strong. #hpm Wed Apr 20 18:38:13 PDT 2011
    • PracticalWisdom RT @revdoc:As DPOA I did have 2 bully 4 providers stopping aggressive care 4 my father despite my telling them his QOL was unacceptable #HPM Wed Apr 20 18:38:15 PDT 2011revdoc @PracticalWisdom Yes legal provisions for ADs in all states as well as for recognizing ADs legally enacted from others #hpm Wed Apr 20 18:38:23 PDT 2011FMDGirl @PracticalWisdom @FMDGirl Thanks Lisa! T2- We do take the Humanity out of charting - why dont we include spiritual assessment in chart #HPM Wed Apr 20 18:38:23 PDT 2011RossJeanette T2 sometimes teams pursue certain care b/cause they want to finish what was started eg "need 2 full weeks on vent for pneumonia Rx" #hpm Wed Apr 20 18:38:35 PDT 2011PracticalWisdom @mpf2011: Thanks, I read it think FMDGirl Wanted it. #HPM Wed Apr 20 18:38:54 PDT 2011drpippa Need to address doc side. Why do so many insist that aggressive, curative is only legit model of care? We can model alternatives #Hpm Wed Apr 20 18:38:55 PDT 2011revdoc @equijada @revdoc It was sheer hell. #hpm Wed Apr 20 18:39:12 PDT 2011equijada @FMDGirl @PracticalWisdom agree, well said. #hpm Wed Apr 20 18:39:30 PDT 2011revdoc Stress on DPOA is often because we dont recognize the dying--we need to teach what dying looks like to learners! #hpm Wed Apr 20 18:39:50 PDT 2011PracticalWisdom RT @drpippa: Need 3 address MD side. Why do so many insist aggressive, curative is only legit model of care? We can model alternatives #HPM Wed Apr 20 18:40:01 PDT 2011equijada @drpippa modeling is our best model. #hpm Wed Apr 20 18:40:01 PDT 2011mpf2011 #hpm Unfortunately, even if pts sign an AD, the family hasnt talked to the pt. They dont want to let go despite a "piece of paper." Wed Apr 20 18:40:01 PDT 2011equijada t3 coming up in a min or so. #hpm Wed Apr 20 18:40:20 PDT 2011drpippa RT @revdoc: Stress on DPOA is often because we dont recognize the dying--we need to teach what dying looks like to learners! #Hpm
    • need to teach what dying looks like to learners! #Hpm Wed Apr 20 18:40:23 PDT 2011equijada RT @revdoc: Stress on DPOA is often because we dont recognize the dying--we need to teach what dying looks like to learners! #hpm Wed Apr 20 18:41:04 PDT 2011mpf2011 #hpm So much better if the talk is fully documented (and sometimes taped). Family members present too. Wed Apr 20 18:41:07 PDT 2011drpippa Deep thoughts for a weds. RT @equijada: @drpippa modeling is our best model. #Hpm Wed Apr 20 18:41:10 PDT 2011PracticalWisdom T2: I so Strongly Believe we so need you Pal MDs to gather more Power/Recognition/Understanding to help prevent this from happening. #HPM Wed Apr 20 18:41:27 PDT 2011revdoc Not many families would advocate for aggressive care they cant even spell if docs did not tell them their loved ones needed it #hpm Wed Apr 20 18:41:42 PDT 2011equijada @drpippa lol! Sincerely, Stuart Handy. #hpm Wed Apr 20 18:41:44 PDT 2011KathyKastner Gr8 ideas RT @mpf2011: #hpm So much better if the talk is fully documented (and sometimes taped). Family members present too. Wed Apr 20 18:41:58 PDT 2011KathyKastner RT @revdoc: Stress on DPOA is often because we dont recognize the dying--we need to teach what dying looks like to learners! #hpm Wed Apr 20 18:42:19 PDT 2011mpf2011 @PracticalWisdom When I was an ICU nurse, before becoming an atty, curative tx was the only option. #HPM Wed Apr 20 18:42:30 PDT 2011gailliardadults RT @doclake: The New Old Age: A Mother’s Nighttime Rage http://is.gd/ciHsMe delirium #hpm Wed Apr 20 18:42:36 PDT 2011equijada @KathyKastner @mpf2011 I end up just placing "quotes" in my note and just type out the narrative. #hpm Wed Apr 20 18:42:48 PDT 2011PracticalWisdom RT@KathyKastner:Gr8 ideas RT @mpf2011: #hpmSo much better if talk is fully documented (and sometimes taped). Family members present 2. #HPM Wed Apr 20 18:42:58 PDT 2011KathyKastner RT @mpf2011: #hpm So much better if the talk is fully documented (and sometimes taped). Family members present too.#eldercarechat Wed Apr 20 18:43:11 PDT 2011
    • PracticalWisdom RT @equijada: @KathyKastner @mpf2011 I end up just placing "quotes" in my note and just type out the narrative. #HPM Wed Apr 20 18:43:29 PDT 2011mpf2011 @PracticalWisdom I think docs see Palli as "giving up" which is shown by saying "theres nothing more we can do." Should add "to cure." #HPM Wed Apr 20 18:43:46 PDT 2011equijada t3: How has caring for those in death and dying effected your personal life? I think about this a lot #hpm Wed Apr 20 18:43:56 PDT 2011PracticalWisdom @PracticalWisdom @KathyKastner @mpf2011: Maybe include a section in a persons Facebook Page. #HPM Wed Apr 20 18:44:09 PDT 2011FMDGirl health care providers need more education on process of dying, if they are scared of it- they will practice heroic measures #HPM Wed Apr 20 18:44:42 PDT 2011joshgriffin RT @FMDGirl: health care providers need more education on process of dying, if they are scared of it- they will practice heroic measures #HPM Wed Apr 20 18:45:11 PDT 2011KathyKastner RT @mpf2011: @PracticalWisdom I think docs see Palli as "giving up" which is shown by saying "theres nothing more we can do." Should add "to cure." #HPM Wed Apr 20 18:45:13 PDT 2011equijada RT @FMDGirl: health care providers need more education on process of dying, if they are scared of it-they will practice heroic measures #hpm Wed Apr 20 18:45:16 PDT 2011drpippa T3 - absoultely would not do what I do if it were not for my personal experiences. #Hpm Wed Apr 20 18:45:27 PDT 2011PracticalWisdom @mpf2011 Yes, the Cure sometimes is Enough is Enough. #HPM Wed Apr 20 18:45:28 PDT 2011mpf2011 #hpm Our culture is trained by tv commercials to believe there is a cure (pill) for everything. We dont accept death well as part of life. Wed Apr 20 18:45:35 PDT 2011KathyKastner RT @mpf2011: #hpm Our culture is trained by tv commercials to believe there is a cure (pill) for everything. We dont accept death well as part of life. Wed Apr 20 18:45:52 PDT 2011equijada DITTO! Its changed my life RT @drpippa: T3 - absoultely would not do what I do if it were not for my personal experiences. #hpm Wed Apr 20 18:46:10 PDT 2011 #HPM There is still a lingering fear of litigation, I think. Despite documentation of pt
    • #HPM There is still a lingering fear of litigation, I think. Despite documentation of ptmpf2011 wishes. Wed Apr 20 18:46:20 PDT 2011FMDGirl t3 I am no longer afraid of death or dying #HPM Wed Apr 20 18:46:37 PDT 2011hospiceMTBC t3: (Hi, folks!) Working in #hpm helps me enjoy the moment & go with the flow more in my life. Wed Apr 20 18:47:33 PDT 2011revdoc I elected artificial feed 4 my father s/p ICH, leading to 8.5 yrs of disability, then death from ruptured appy. HPM kept me sane. #hpm Wed Apr 20 18:47:35 PDT 2011equijada t3: Ive seen love in action. It absolutely blows my mind. #hpm Wed Apr 20 18:47:42 PDT 2011KathyKastner RT @Paulflevy: Palli Care on WIHI: Palli Care = Quali Care 21/4,2:- 3PM Eastern TimeGue... http://bit.ly/ggJqEB #hpm Wed Apr 20 18:47:49 PDT 2011revdoc RT @FMDGirl: t3 I am no longer afraid of death or dying. THERE ARE A LOT WORSE THINGS THAN DEAD #hpm Wed Apr 20 18:47:55 PDT 2011FMDGirl Have learned there can be dignity in death #HPM Wed Apr 20 18:47:58 PDT 2011mpf2011 #hpm Plus docs tend to focus on their "body system" so nephro says to family "kidneys are better today" and they hear "pt is better." Wed Apr 20 18:48:05 PDT 2011equijada @hospiceMTBC hi, welcome. I love the moment. #hpm Wed Apr 20 18:48:16 PDT 2011KathyKastner AMEN RT @revdoc: RT @FMDGirl: t3 I am no longer afraid of death or dying. THERE ARE A LOT WORSE THINGS THAN DEAD #hpm Wed Apr 20 18:48:25 PDT 2011PracticalWisdom Seen this so many times. Courage Too!RT @FMDGirl: Have learned there can be dignity in death #HPM Wed Apr 20 18:48:43 PDT 2011PracticalWisdom RT @equijada: t3: Ive seen love in action. It absolutely blows my mind. #HPM Wed Apr 20 18:48:54 PDT 2011FMDGirl @revdoc @FMDGirl you can say that again- why as a society are we so afraid- is because people are afraid of hell? Religion play a part? #HPM Wed Apr 20 18:49:18 PDT 2011
    • equijada t3: Ive learned about my Higher Power #hpm Wed Apr 20 18:49:24 PDT 2011PracticalWisdom RT @equijada: DITTO! Its changed my life RT @drpippa: T3 absoultely would not do what I do if it were not 4 my personal experiences. #HPM Wed Apr 20 18:49:25 PDT 2011revdoc I have seen healings, reconciliation, courage, love--I should PAY to do this work. (But dont tell my boss, I have a mortgage) #hpm Wed Apr 20 18:50:21 PDT 2011PracticalWisdom Accept the things I cannot change Keeps me balanced. RT @equijada: t3: Ive learned about my Higher Power #HPM Wed Apr 20 18:50:27 PDT 2011drpippa Sometimes miracles. RT @equijada: t3: Ive seen love in action. It absolutely blows my mind. #Hpm Wed Apr 20 18:50:38 PDT 2011equijada @FMDGirl @revdoc just finished reading Love Wins by Rob Bell re: hell. Religion has done a disservice #hpm Wed Apr 20 18:50:43 PDT 2011mpf2011 #hpm It is the HPM team that has 2 teach how 2 see pt holistically, rather thn the sum of body systems. LOOK at the pt. not go thru motions. Wed Apr 20 18:50:43 PDT 2011revdoc @FMDGirl Not always, but that can be one aspect. People not grounded in anything besides here and now #hpm Wed Apr 20 18:50:59 PDT 2011revdoc RT @equijada: just finished reading Love Wins by Rob Bell re: hell. Religion has done a disservice [not all of us are like that!] #hpm Wed Apr 20 18:51:36 PDT 2011PracticalWisdom T3: Was a clergy Wife for 13 years. Have seen families in their last moments at Re: worst and best. Learned not to sweat small Stuff #HPM Wed Apr 20 18:51:39 PDT 2011AmandaBinDC RT @ctsinclair: Pain-Topics.org News/Research UPDATES: U.S. FDA Releases Long-Awaited Opioid-REMS http://hpm.md/g2AncC #HPM Wed Apr 20 18:51:49 PDT 2011RossJeanette T3 I feel very priviledged in working with people at a difficult time. It makes my problems seem minor. #hpm Wed Apr 20 18:51:58 PDT 2011KathyKastner RT @equijada: @FMDGirl @revdoc just finished reading Love Wins by Rob Bell re: hell. Religion has done a disservice #hpm Wed Apr 20 18:52:13 PDT 2011 Book Club? RT @equijada: @FMDGirl @revdoc just finished reading Love Wins by
    • Book Club? RT @equijada: @FMDGirl @revdoc just finished reading Love Wins byPracticalWisdom Rob Bell re: hell. Religion has done a disservice #HPM Wed Apr 20 18:52:31 PDT 2011FMDGirl @revdoc @FMDGirl great point- I brought that up because when I was a child I was so scared of death, sunday school...impressionable #HPM Wed Apr 20 18:52:45 PDT 2011PracticalWisdom @equijada @FMDGirl @revdoc: What was the main Lesson? #HPM Wed Apr 20 18:53:02 PDT 2011SheyontheBay @equijada wow.... #hpm Wed Apr 20 18:53:05 PDT 2011hospiceMTBC T3: Denial=suffering, letting go=peace. #hpm Wed Apr 20 18:53:17 PDT 2011FMDGirl @KathyKastner @equijada @FMDGirl @revdoc I will have to read it! #HPM Wed Apr 20 18:53:23 PDT 2011equijada @FMDGirl @revdoc totally. #hpm Wed Apr 20 18:53:41 PDT 2011phlu RT @doclake: Power poses vs. Warmth poses-good research that applies to the way a #hpm practitioner interacts @ the bedside http://is.gd ... Wed Apr 20 18:53:48 PDT 2011PracticalWisdom T3: Learned we can be alive but Dead. #HPM Wed Apr 20 18:54:00 PDT 2011equijada @FMDGirl check it out. History is not tragic, in the end, love wins. #hpm Wed Apr 20 18:54:02 PDT 2011FMDGirl @hospiceMTBC you said it well #HPM Wed Apr 20 18:54:07 PDT 2011PracticalWisdom RT @hospiceMTBC: T3: Denial=suffering, letting go=peace. #HPM Wed Apr 20 18:54:21 PDT 2011revdoc RT @PracticalWisdom: What was the main Lesson? We have only the present: laugh, love, do your best, dont trade today waiting 4 2morro #hpm Wed Apr 20 18:54:52 PDT 2011PracticalWisdom Idea to read book discuss on #HPM later time? RT @FMDGirl: @KathyKastner @equijada @FMDGirl @revdoc I will have to read it! #HPM Wed Apr 20 18:55:00 PDT 2011 RT @hospiceMTBC: T3: Denial=suffering, letting go=peace. #HPM
    • RT @hospiceMTBC: T3: Denial=suffering, letting go=peace. #HPM Wed Apr 20 18:55:02 PDT 2011FMDGirlRossJeanette got to leave now! goodbye nice tweetchat hosting Earl! #hpm Wed Apr 20 18:55:10 PDT 2011equijada @equijada @FMDGirl its this out of this world love I see at the bedside of death (on occasion). #hpm Wed Apr 20 18:55:36 PDT 2011FMDGirl @PracticalWisdom @FMDGirl @KathyKastner @equijada @FMDGirl @revdoc Iam in! #HPM Wed Apr 20 18:55:47 PDT 2011PracticalWisdom Thank you! RT @revdoc: RT @PracticalWisdom: We have only the present:laugh/love/do your best, dont trade 2day waiting 4 2morro #HPM Wed Apr 20 18:55:54 PDT 2011drpippa Love this idea!RT @PracticalWisdom: Idea to read book discuss on #HPM later time? ! #Hpm Wed Apr 20 18:55:57 PDT 2011mpf2011 #HPM Sadly, ppl dont know how hard it is to take away treatment once started. If u cant breathe, pee or eat on your own, u r dying!! Wed Apr 20 18:55:58 PDT 2011equijada Final thoughts and parting words of wisdom...Thanks all. #hpm Wed Apr 20 18:56:02 PDT 2011PracticalWisdom Good Night Thanks RT @RossJeanette: got to leave now! goodbye nice tweetchat hosting Earl! #HPM Wed Apr 20 18:56:07 PDT 2011equijada @RossJeanette good to see you again. Thanks for coming. #hpm Wed Apr 20 18:56:18 PDT 2011FMDGirl forgiveness and acceptance and death comes peacefully #HPM Wed Apr 20 18:56:43 PDT 2011PracticalWisdom @FMDGirl: Lam In? I dont get it? #HPM Wed Apr 20 18:56:46 PDT 2011KathyKastner Too true! RT @mpf2011: #HPM Sadly, ppl dont know how hard it is to take away treatment once started. #eldercarechat Wed Apr 20 18:56:57 PDT 2011PracticalWisdom RT @KathyKastner: Too true! RT @mpf2011: #HPM Sadly, ppl dont know how hard it is to take away treatment once started. #eldercarechat #HPM Wed Apr 20 18:57:27 PDT 2011
    • PracticalWisdom RT @FMDGirl: forgiveness and acceptance and death comes peacefully #HPM Wed Apr 20 18:57:31 PDT 2011FMDGirl @PracticalWisdom @FMDGirl opps- I am in- read the book and chat- pick a date :) #HPM Wed Apr 20 18:57:38 PDT 2011revdoc Thanks for hosting, Earl! #hpm Wed Apr 20 18:57:42 PDT 2011equijada RT @FMDGirl: forgiveness and acceptance and death comes peacefully #hpm Wed Apr 20 18:57:49 PDT 2011PracticalWisdom T3: Im afraid to live in Pain dont think Im afraid to die. #HPM Wed Apr 20 18:57:53 PDT 2011hospiceMTBC Thank you, all, for the work you do & the passion you bring to the bedside. #hpm Wed Apr 20 18:57:55 PDT 2011equijada @revdoc thanks for coming. #hpm Wed Apr 20 18:58:28 PDT 2011PracticalWisdom @hospiceMTBC: Thank you!!!! #HPM Wed Apr 20 18:58:46 PDT 2011FMDGirl RT @hospiceMTBC: Thank you, all, for the work you do & the passion you bring to the bedside. #HPM Wed Apr 20 18:58:51 PDT 2011drpippa @equijada thanks for a night of thought and feeling! Great hosting. #Hpm Wed Apr 20 18:58:55 PDT 2011KathyKastner Final thoughts: thanks Earl @equijada for gr8 hosting. Thanks to all #hpm-ers for the learning. Wed Apr 20 18:59:13 PDT 2011mpf2011 #HPM Thanks everyone. Great chat. Wed Apr 20 18:59:15 PDT 2011equijada @drpippa thanks! hope to catch you next week. happy week to you. #hpm Wed Apr 20 18:59:32 PDT 2011FMDGirl @PracticalWisdom that is why we need to legalize medical marijuana #HPM Wed Apr 20 18:59:41 PDT 2011equijada Good night all. Thanks again! #hpm Wed Apr 20 19:00:06 PDT 2011
    • Wed Apr 20 19:00:06 PDT 2011kathydavisku Catrina Lootens and Marilyn Sampilo sentn in great proposal to SDBP on student school reentry for kids with chronic conditions. #pedpc #hpm Wed Apr 20 19:00:13 PDT 2011KUKidsHP Catrina Lootens and Marilyn Sampilo sent in great proposal to SDBP on student school reentry for kids with chronic conditions. #pedpc #hpm Wed Apr 20 19:00:13 PDT 2011PracticalWisdom So complicated. Im neutral on this 1 but not Pt RightsRT @FMDGirl: @PracticalWisdom that is why we need to legalize medical marijuana #HPM Wed Apr 20 19:00:28 PDT 2011revdoc Goodnight, all! Blessings of Passover and Easter to my Jewish and Christian friends! #hpm Wed Apr 20 19:00:37 PDT 2011amyrnbsn RT @FMDGirl: health care providers need more education on process of dying, if they are scared of it- they will practice heroic measures #HPM Wed Apr 20 19:00:44 PDT 2011FMDGirl Wow! That was the fastest tweet hour ever- you picked all my favorite topics! Thank you everyone for your wisdom. #HPM Wed Apr 20 19:00:49 PDT 2011FMDGirl @revdoc thank you for inspiring words, it was a pleasure to meet you. #HPM Wed Apr 20 19:01:32 PDT 2011revdoc @FMDGirl @revdoc You too! #hpm Wed Apr 20 19:02:07 PDT 2011PracticalWisdom @equijada: Thank you for Hosting tonight. You added your own Flavor/Wisdom. Having different Hosts I think adds a great deal! Thanks #HPM Wed Apr 20 19:02:10 PDT 2011PracticalWisdom AGree 100RT @FMDGirl: Wow! That was the fastest tweet hour ever- you picked all my favorite topics! Thank you everyone for your wisdom. #HPM Wed Apr 20 19:02:23 PDT 2011PracticalWisdom Agree! RT @FMDGirl: @revdoc thank you for inspiring words, it was a pleasure to meet you. #HPM Wed Apr 20 19:02:33 PDT 2011PracticalWisdom @FMDGirl Tonight makes me realize how much Ive missed you. O.K. enough mushy Gooshy from me. My Amazing Friend. #HPM Wed Apr 20 19:03:17 PDT 2011PracticalWisdom Quaker Girl Say Keeping in the LIght! RT @revdoc: Goodnight, all! Blessings of Passover and Easter to my Jewish and Christian friends! #HPM Wed Apr 20 19:04:21 PDT 2011
    • FMDGirl @PracticalWisdom Miss you too! I was so excited when I saw your tweet about #HPM I so happy I follow you! Your awesome Lisa! Wed Apr 20 19:04:40 PDT 2011