About the Binscombe Doctor Blog

Welcome to the Binscombe Doctor Blog

Have you ever listened to a health scare on the news, or read about the latest medical break-through in the newspaper, and thought to yourself “I wonder what my doctor thinks about that?” In this high-tech world of ever more complex and fancy tests, new treatments for conditions we didn’t even know we had, and information coming at us from all angles, perhaps there is more need than ever to ask our own doctor what to make of it all. Certainly it is humbling to know that many people still place a high value on their GP’s opinion, and it is with this in mind that this blog has been started.

The blog is written by Martin Brunet, one of the doctors at Binscombe Medical Centre and will give comment on topical or important health-related issues. Sometimes the posts are focused on helping to distill health information for the sake of patients, while others stray into areas of politics and health policy. Each post reflects my particular view – which is often shared by the other doctors, but there is sometimes a healthy difference of opinion between us!

I hope you will enjoy reading it and find it valuable, and I greatly value your comments, which will help me to improve it and keep it relevant. New posts are usually published at a rate of about 2 or 3 a month. If you would like to follow the blog then follow the link. You will be able to register for the site and receive an email once a new post is published. Your email address will not be used for marketing or passed to a third-party for any reason, and you can unsubscribe at any time.

Declarations of Interests

I have no links with the pharmaceutical industry, or other health-related industries, and do not see drug representatives. I do receive income from writing a blog for Pulse magazine, and have occasionally received other fees for writing or speaking for the publishing industry, including Prescriber magazineThe Guardian and The Telegraph

3 thoughts on “About the Binscombe Doctor Blog

  1. I think the Karen Jones article on the blog about the Liverpool Pathway is really a summation of all the best practice that we have been used to at the Binscombe Surgery, and I thank her and would have expected no less. However I am very concerned about hospital / carer or family interaction (I know the RSCH has a good team for this) but particularly the introduction of a plan where food and hydration may be discontinued. Food, yes, whether tube-fed or on a plate, may be logical. But I am very opposed to the removal of hydration before the point of death. Sips or drips, as appropriate, would be my wish.

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    1. Thanks for these really helpful comments, Sheila. I agree with you that the idea of forbidding a person from eating or drinking naturally is very worrying. I think the way this has been described in the press has been one of the grossest distortions of the reporting of the LCP – images of families sectretly giving their loved ones sips of water against doctors’ orders is appalling.

      The LCP is very clear that natural eating and drinking is to be encouraged for as long as possible, so if there have been cases where doctors have forbidden it (and I don’t trust the Mail’s reports here) then it has nothing to do with the LCP and has either been a miscommunication with relatives, or someone going way beyond the purpose of the LCP.

      What the LCP does do is to raise the possibility of the removal of nasogastric food and drips. As you say, stopping NG food makes sense as it is quite natural to lose all desire to eat or sense of hunger when you are very unwell. Drips are usually stopped – but can be continued if it is felt they will do more good than harm. The problem with artificial fluid in the dying is that it often can do harm. As the kidneys stop working the fluid can fail to leave the body, leading to swelling or the build up of fluid on the lungs, which can be quite distressing. Also very unwell people often have very low albumin levels, which is vital to keeping water in the blood stream. With low albumin the fluid can simply pool in the tissues, again leading to swelling.

      So sips and good mouth care should always be done, while drips are a balance of benefits v harms.

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