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Mum’s Story – Mavis Turner 1929 – 2020

Mum aged 8 months and the Challenge Shield – 1930

Mavis Bowers was born prematurely on 26th September 1929, at home in Bull Hill Stafford. She had a twin brother David who only lived for a short while. Mum was ‘smaller than a bag of sugar’ when she was born and for the first weeks of her life had to be washed in olive oil, dressed in doll’s clothes and a small drawer was used as a cot. Her birth wasn’t registered for two months.


When the picture of mum and the challenge shield was taken mum was eight months’ old, & still not able to sit up for herself. The wooden “Challenge Shield” was an engraved silver plaque for “Stafford Infant Welfare Centre’s Annual Competition for infants during their first year”. This began in 1920 and ended in 1948 (the year the NHS was set up). Mothers who won were presented with one small shield which they could keep, and the large ‘Challenge Shield’ which they kept for 12 months. They also pushed the baby in a pram along Stafford’s main street at Stafford Pageant. The silver plaque was made by G & S Ltd.
Mavis’s mother Frances Bowers brought up her three daughters on her own. They lived in Prospect Road, Coton Fields, Stafford.

Mavis in her dad’s arms, with sisters Olive and Joyce


Another picture shows Mum and her older sisters, Olive and Joyce with mum in her dad William Bowers’ arms . Shortly after this my grandad William went into St George’s Hospital, where he remained until he died, about 30 years later. Mum can remember visiting him in the hospital as a young child. She described how there were many doors to unlock and how the attendants (this was before mental health nurses) were very kind to her and her mother.
We now know granddad had some sort of post traumatic illness, although at the time people didn’t talk about it, and it was said he had been ‘gassed in the first world war’. We have now found out that Fabry disease runs in the family (originating on mum’s side). This rare enzyme disorder, which causes limb pain and organ degeneration, has been misdiagnosed as a mental illness in the past. We wonder if that’s what granddad was suffering from.

Frances Jane Bowers – Mavis Turner’s mother

Mavis and her two sisters brought up in poverty by their mum Frances. Mum remembers her childhood as happy and secure. One of mum’s memories was being sent by her mum to fetch dripping from a local hospital. (Dripping is the fat and juices that come off roast meats.) Mum and her sisters had to take a walk across some fields, where they used to be frightened of the horses, and knock at the kitchen door of the hospital. They then gave a penny for a jug to be filled with dripping. Mum also remembered how her mother used to wash and dry the girl’s school clothes every night, as they only had one set of school uniforms.

Mum aged 18 in a dress she made herself.

Mum’s upbringing made her really appreciative of the small things in life and never to take anything for granted.

Mavis and Jim Turner

After leaving school at 14 Mavis started training as a seamstress and later worked at Lotus shoe factory. Mavis Bowers married Jim Turner a chartered electrical engineer, originally from Plymouth, who worked at English Electric in Stafford, and went on to have two sons, Steve and Nick. Mavis enjoyed sewing and, after the children left, worked from home as a seamstress. Mavis and Jim enjoyed travel and visited Europe often when they were older. At the age of 70 Mavis also went to Australia on her own and had the holiday of a lifetime travelling from Melbourne to Townsville in north Queensland, visiting friends of her son Steve who have lived there for 5 years. After 59 years of marriage Jim Turner died in 2012.

Mungo Lakes, New South Wales,Australia – acrylic on canvas -Mavis Turner

Mum took up paintings at age 80 and completed several pictures, some abstract and some from memory. The picture above is of Mungo Lakes, where mum visited when she was in Australia.

Suma Ahenkro Girl’s Education Project, Ghana (2020)

In the latter years of mum’s life she had glaucoma, osteoporosis Parkinson’s disease and heart failure and was unable to leave the house. Despite this mum remained independent and lived on her own, with carers visiting. This continued until a couple of years before she died, when she had a live-in carer.

For the final months of mum’s life she was cared for by Belinda Comfort Damoah. Belinda stayed with mum for six months, throughout the covid-19 epidemic, and is held in high esteem by mum, all the family and friends.

I was able to spend the final 12 weeks of mum’s life helping look after her at home, where she passed away in July 2020.

Belinda has recently spearheaded the formation of the Akwaama Toprefo Female Club (ATOFEC) in Ghana which has the education of young women and the skills training of women as it’s objective.

We collected for this project at mum’s funeral, and the family is proud to be linked with such a worthwhile endeavor. Mum’s picture now hangs on the wall of the schoolroom.




Written by Steve Turner Version dated: 14.12.2020

Revisions: Picture of Bull Hill, Stafford added. 25.01.2021



Thanks to Melanie Williamson, Collections Assistant, Staffordshire Archives and Heritage, Staffordshire County Council for finding the shield and providing pictures and information.
Website: http://www.staffordshire.gov.uk/archives
Facebook: http://www.facebook.com/StaffordshireArchivesandHeritage
Twitter: http://www.twitter.com/@ArchandHeritage


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Making the most of remote consultations – a guide for patients (*rolling blog)

It is increasingly common for clinicians to carry out consultations with patients over the ‘phone or on the internet.

If you have time to prepare for the consultation here are some suggestions. This is part of our patient led clinical education work. The aim being to help all patients / users of health and care services lead on their own care.

In some cases, you may be talking to someone who has never met you, so preparation is key.

Here is some general advice:

Preparation

  1. Write it all down beforehand if you can, as it’s difficult to remember otherwise.
  2. Take some observations if you are able. Temperature blood pressure heart rate other measurements, including your feelings, mood and areas such as sleep & appetite. If the problem is something visible (like a rash for example) send pictures & monitor changes over time.
  3. Tell them how you are different from your norm.
  4. Tell your story of why you are calling, in your own words.
  5. Be honest and remember mental health and physical health are equally important. Inseparable in fact.
  6. Ask if you don’t understand anything.
  7. Don’t be afraid to check that the clinician has followed what you are saying.

It’s important that you are allowed time at the outset to tell your story in your own words, to be able to share your ideas, your concerns and what you are expecting for the consultation. If you are speaking to someone who doesn’t have access to your medical history, they will also go through this with you in detail.

This checklist will help you prepare for the consultation and lead to an agreed plan for what to do next. Think particularly about what you would like to have happen. This is a question you may well be asked.

A screenshot of a cell phone

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Your clinician will also need to refer to your medical history. If they have this to hand they may check that it’s up to date with you. Often they may not have this information and will have to go through your history with you. This is vital in order to ensure you come up with an appropriate and safe plan for your care. Click here for a second short blog on giving a history.

Medicines and treatments (of any kind)

Consultations often involve medicines and treatments. Because of this it’s important that you share details of all medicines and related substances you take, not just those that are prescribed. This includes herbal medicines, over the counter medicines, supplements and anything borrowed or bought over the internet. It’s vital to be honest, as interactions can be very serious, sometimes fatal. Your clinician will not think badly of you if, for example, you don’t take a prescribed medicine or are trying something else. Statistics show that at least 50% of people don’t take their medicines as prescribed. That’s 50% of the whole population with mental or physical illnesses, not just a specific group of people.

Remember a medicine isn’t always the answer, share with the clinician details of non-medicine related treatments and approaches you take, and how well this works.

This chart shows the information you need to share. Very importantly this includes details of any allergies or sensitivities and how these affected you.

What happens next – The plan

Finally, many consultations do not result in a medicine, or specific treatment, being prescribed. Some may result in a medicine or treatment being stopped, changed or reduced. Sometimes it’s a case of ‘watch and wait’. The most important thing is that both the patient and clinicians have agreed on plan, know how to monitor progress and what to do if things change.

What’s important is that:

  1. You have agreed a plan
  2. You know what tests are needed (if any) and they are arranged
  3. You know what referrals have been made and when to expect to have these consultations
  4. You know the signs of improvement or the signs of deteriorations to look for
  5. You have information on the problem and access to more in a format you prefer
  6. You know when & who to contact if things deteriorate
  7. You know the signs to look out for and when to call 999
  8. Everyone involved in your care shares this information

Summarised in the chart below:

*This is a rolling blog. I welcome all suggestions for amendments, deletions and additions from everyone. Please email carerightnow&gmail.com

I am grateful to my friends and colleagues who helped me put together this information.

Steve Turner is a nurse prescriber, now retired, & former Associate Lecturer at Plymouth University. Steve shares health information from the Twitter account @MedicineGovSte


Revision History:

16.02.2024 – Updated contact details & links.

30.06.2022 – Changed to reflect that the author is now retired.

27.04.2020 – added a note about taking and sending pictures (‘Preparation’ point 2.)

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Life in Lockdown: Coronavirus (StAustell Voice 15.04.2020)

I was working up to retirement when Coronavirus hit us. I work on clinical education and service development. I have lived in the St Austell area for 18 years. Some of my work, such as supporting Pharmacies in the North West, was already carried out from home.  Most of my teaching work has now stopped so I have applied to return to #NHS. While I’m waiting to hear back, I’m sharing health information from my Twitter account @MedicineGovSte using hashtags: #TeamPatient #TeamNHS #TeamCOVID19 .

I am also helping coordinate mum’s care. Mum is 90. She lives 300 miles away & is very frail & poorly. Normally my brother & I would go straight to her when she needs us. So this is a really worrying time. Mum has fantastic carers; community support and a great GP. Because mum has multiple long-term conditions and is seen by several different health and care teams, I am finding that the coordination I do for her is vital to ensure that she receives the best care, nothing is duplicated, she receives her medicines and has the right equipment in the home. If any local families have any questions about coordinating care for a loved one please let me know. I’m happy to share some tips. steve@carerightnow.co.uk

I’ve also started a serives of blogs based on our patient led clinical education work. The first one is on telephone consultations: click here to see it.

More than ever now, we love to spend time in our garden. We’re planting vegetables and the garden’s looking better than ever.

Take care #StAustell

Steve Turner is a registered general and mental health nurse prescriber and Managing Director of Care Right Now CIC. http://www.carerightnow.co.uk

First published in the StAustell Voice

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Steve is Head of Medicines and Prescribing for @MedicineGov , Associate Lecturer at Plymouth University  and a former NICE Medicines and Prescribing Programme Associate.

@MedicineGovSte

LinkedIn profile.

info@carerightnow.co.uk

Author: Steve Turner

First published: 16.04.2020 Revised: 27.04.3030

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Managing long term pain. A NICE Key Therapeutic Topic.

Medicines optimisation in long-term pain.

 

‘#jargonbuster ‘Medicines Optimisation’ means getting the medicines right for the individual. This may involve an alternative medicine, an alternative treatment or approach, and / or not taking medicines. The person’s experience, beliefs and what matters to them most should drive this decision, with clinicians providing guidance, advice and education on trusted sources of information, the evidence base and on safety’. (Steve Turner)

 

This is a brief summary relating to a topic in  the 2018 update of Medicines optimisation: key therapeutic topics

To access the pain management topic [KTT21] click here.

The section on medicines optimisation in long term pain contains a huge amount of information, including links to numerous other documents, on an areas critical to patient safety & wellbeing.

Key points:

Opioids

  • There is little evidence that opioids are helpful for long-term pain.
  • Patient safety incidents relating to the unsafe doses of opiates remain a major concern. People develop a ‘tolerance’ to opiate medicines, meaning that higher and higher doses may be needed to deliver the same effect. However this tolerance rapidly goes away when the opiates are stopped, so restarting at the old dose may be fatal.

 

This image is taken from: ‘Opioids Aware: A resource for patients and healthcare professionals to support prescribing of opioid medicines for pain.

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Click on the image to enlarge it.

Link: http://www.rcoa.ac.uk/faculty-of-pain-medicine/opioids-aware

 

‘A review of medicines-related safety incidents involving controlled drugs reported to the NRLS over 7 years found the risk of death with controlled drug incidents was significantly greater than with medication incidents generally (odds ratio 1.48, 95% CI 1.02 to 2.17). Incidents involving overdose of controlled drugs accounted for 89 (70%) of the 128 incidents reporting death or severe harm. Five controlled drugs (morphine, diamorphine, fentanyl, midazolam and oxycodone) were responsible for 113 (88%) of these 128 incidents.’

 

Non-opioid medicines in long-term pain

  • Patients can be prescribed gabapentin or pregabalin for certain types of pain. Both of these medicines can lead to dependence and may be misused or diverted.

#jargonbuster ‘diverted’ = passed on or sold one to someone else.

 

Finally, emotional influences are real:

  • When assessing pain with someone it’s vital that clinicians take all aspects of the person’s life into account, including lifestyle, nutrition, hydration, social and housing factors, safeguarding, sleep and rest, other illnesses, emotional influences and their mental health.

And take a full history of medicines being taken, or recently stopped, including over the counter medicines, internet bought medicines, borrowed medicines and illicit substances.


Overall key points to remember on pain management:

  • Adopt a  holistic patient-centered approach

  • Aim to prevent acute pain becoming chronic pain

  • There is little evidence that opioids are helpful for long-term pain


Related Guidance:

NICE Guidance NG5 Medicines Optimisation

NICE Guidance CG76 Medicines adherence: involving patients in decisions about prescribed medicines and supporting adherence

NICE Guidnace CG173 Neuropathic pain in adults: pharmacological management in non-specialist settings

NICE Guidance NG59 Low back pain and sciatica in over 16s: assessment and management

Opioids Aware: A resource for patients and healthcare professionals to support prescribing of opioid medicines for pain

NICE Guideline NG46 Controlled drugs safe use and management

NICE Guidance CG140 Palliative care for adults: strong opioids for pain relief


 

Steve is a nurse prescriber, Head of Medicines and Prescribing for @MedicineGov , Associate Lecturer at Plymouth University  and NICE Medicines and Prescribing Programme Associate.

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Author: Steve Turner

First published 1/8/2017. Revised and updated 13/12/2018