Helloooo Friend!
Hema Here!
Give me a biggg Hi5!
FITNESS TO FLY?
It is easy to guess/ commonsense in most cases.
There are few scenarios can come up in CSA.
Like a patient with SOB and suspected Anaemia/ stable angina/ recent MI, pregnancy, with cast etc.
Patients who CANNOT fly are:
1. Unstable Angina, (Watch for it - can apply if patient to be seen at CP clinic)
2. Decompensated CCF,
3. Uncontrolled Hypertension,
4. Uncontrolled Cardiac Arrhythmias,
5. Severe Valvular Heart Disease,
6. If Haemoglobin < 7.5.
Myocardial Infarction
If Complicated - 4 - 6 weeks.
If Uncomplicated MI - 1 week.
Angioplasty - 5 days.
CABG - 10 days.
CVA - 3 days.
Viscus surgery - 10 days.
Chest surgery - 3 - 4 weeks
Pregnancy if > 28 weeks, need certification.
Single - not more than 36 weeks.
Multiple - not more than 32 weeks.
Ortho Cast
If < 2 hrs flight - can fly after 24 hrs.
For longer duration - can fly after 48 hrs.
Others
Oxygen requirements for COPD, Pneumothorax, etc, etc.
In CSA, when not clear, it is better to say that we would look into and let them know later.
This Guidance will certainly vary,
Sooooooo
Please check the link for other conditions/updates -
http://www.caa.co.uk/docs/923/Fitness%20To%20Fly%20-%20May%202012.pdf
To Your Success,
Hema xoxo.
P.S.
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Helloooo Friend!
Hema Here!
Give me a Biggg Hi5!
Genetic conditions !!
I feel veryyy Scary :- (
This is one of the things we need to brush up just before our BIG day.
But the truth is as GPs we come across them very often.
I still remember...
How thrilled I felt when I saw my first Duchenne patient in my Surgery...
How I panicked to explain the risks for getting Downs Baby...
In CSA, it is important to remember that we are not going to teach the patient ALL about the condition.
But to facilitate their understanding, to explore their concerns, expectations, how it is affecting them etc.
It is important to acknowledge our limitations in the Genetic Knowledge.
To explain using simple terms - Keep It Simple and Clear!
Feel free to pester your Trainer, fellow GPs, Midwife, Nurses etc to get the right words to explain a genetic condition.
Let our patient lead our consultation.
SHOW EMPATHY! BE NATURAL!
I am sure You will certainly do your best with your real patients.
It is Tough on your BIG day!
So Practise, Practise, Practise!
Get the Patients' agenda earlier
Tailor our explanations to their needs.
Guide them to relevant places like genetic counselling, websites etc.
The Genetic conditions for CSA we need to know for CSA according to our GP Curriculum -
In Autosomal Dominant,
1. APKD
2. NF
3. Huntingtons (scary case - different dimensions/angles - Must Practise)
4. Hypercholesterolemia - (case to discuss blood results)
In Autosomal Recessive,
1. Cystic Fibrosis (Mum / Young man/ wife can come and ask about it)
2. Sickle Cell Disease/ TRAIT (Woman can come and ask about prenatal advice)
3. Thalassaemia Disease/ Trait.
4. Haemochromatosis ( relative can ask about their chance of getting HC)
In X linked Recessive,
1. Duchenne
2. Hemophilia A (common case)
In X linked Dominant, one and only case - Fragile X syndrome.
In Chromosomal Abnormalities, You should know about
1.Downs -21 Trisomy
2. Turners - XO
3. Klinefelter - XXY
Down's syndrome
Very Important - It has many angles - prenatal, screening, explaining the risks, diagnosis, Options etc.
Practise, Practise, Practise.
Make your Trainers to show you....
We made our Programme Directors to sit on the Hot Seat...
Believe Me - IT WORKED!
Hearty Thanks to them!
You can see how cautiously they choose their words, tone of their voice, body language, use of silence, hesitancy etc...
Wowwww! Excellent!
I adore my Trainers!
The bitter Truth is -
It cannot be taught by words, from the Books...
You need to OBSERVE and Actively Listen...
Go through the leaflets,
You can get them from
your Practice Midwife, www.patient.co.uk, www.nhs.uk.
They have got videos from patients, families.
It is easy to understand their perspectives.
The MOST important things are
To Show Genuine Empathy.
To Give what they want.
To Acknowledge your knowledge limitation earlier on.
To be Neutral while giving informations...
It is easy to be drifted towards Doctor centred approach easily....
Do not pressurise yourself to make your Patient 'Expert' in Tennnn minutes....
To Your Success,
Hema xoxo.
P.S.
I 'd love to hear from You...
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Hellooo Frienddd!
Hema Here!
Give me a Bigggg Hi 5!!!
I am thinking! about the correct mindset to have for passing CSA :-)
What I learnt from my Personal experience?
You need 2Ps -
Both of the Ps - Strong Psychological and Physical fitness on the BIG day of CSA.
Otherwise, It would cost you a lot.
The Correct Mindset for CSA involves E.U.I....
I can hear you wondering - What is thattt?
E - Education - Realising that You have to learn New skills and to unlearn the wrong ones :-)
U - Understanding - Making sure you understand WHAT you are doing!
I - Implementation - Taking ACTION and Implementing your New Skills - Most trickyyy Bit!
Please Have a Daily Plan - To make it easy to stick to!
Please Enjoy your Weekends!(unless on OOH)
Hooray!!!
Have a Every Day Plan
Concentrate on ONE small thing like exploring Ideas or Concerns or Expectations and stick with it in all patients on that day.
Not all at a same time :-)
Finally -
You will be doing All in <10 minutes.
(where is the stop-watch?)
Believe me!
Wowww!
Observe your Trainer, other GPs, Colleagues to see how they deal it with superb efficiency and Above all, Naturally...
The MOST important thing is to Take Action EVERY day!
The most valuable lessons of all are the ones You teach Yourself.
It takes a PASSION to face a New CHALLENGE.
Remember - It is a Marathon, Not a Sprinter :-)
This isn't kindergarten where you will get a Gold star just for showing up!
The Key to Success - is Taking Consistent Action!
At the End of the GP Training -
Everything. YES...
Everything will be Easy -Peasy!!!
You will be another little Roger Neighbour or Liz Moulton!
( I almost wrote Roger Moore!)
Your Patients Will Love You Forever!
To Your Success,
Hema xoxo.
P.S.
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