Deep Breath In

It has been estimated that 10% of people who get covid-19 are still experiencing symptoms over 10 weeks later, and the common symptoms of long covid include fatigue, breathlessness, chest pain and ‘brain fog’. In this week’s episode, we discuss the challenges of assessing long covid symptoms, especially chest pain, in primary care. As we still don’t know enough about the trajectory of the disease,...

Thanks to an incredible scientific effort, vaccines for COVID-19 have arrived in the UK and GPs, and other primary care health professionals, are now being faced with the monumental challenge of vaccinating high volumes of patients in a matter of days, whilst maintaining a COVID-safe environment, and fielding the myriad questions and concerns patients may have around the vaccine. In this week’s ep...

In this end-of-year podcast from Deep Breath In, we're bringing you a light hearted look back at 2020, and trying to remember some of the non-covid-19 medicine that has crossed our desks. This festive quiz features the deep breath in gang, as well as Cat Chatfield from the Wellbeing podcast, and Helen Macdonald from our Talk Evidence podcasts. Reading list; Thyroid disease assessment and managemen...

Old habits die hard, and never does the saying seem more apt than at this time of the year, when many of us start thinking about our New Year’s resolutions, and try to adopt a “new year, new me” mentality, in order to make positive changes to our health. As GPs, discussions around lowering alcohol consumption, smoking cessation, and becoming more active are commonplace in our consultations. Howeve...

GP consultations with patients about sleep problems can go in several directions – could they be a symptom of depression? Financial worries? Sleep apnoea? Is poor sleep merely a condition of modern life? Sleep is a key component of our wellbeing, and talking to a patient about their sleep patterns and habits can be a great window into their life. For optimal sleep health, it is important to follow...

When someone, either an adult or child, has problem swallowing pills or capsules, there are some options open to help. In this podcast, a pharmacist and a psychologist join us to talk about liquid formulations, how to disguise the taste of medicine mixed with food, and some techniques that can be used to help with swallowing a whole pill. Deonne Dersch-Mills is the clinical practice leader for pha...

A lump in the throat is a classic GP presentation, but one that often causes a lot of worry. Many people are struggling with high levels of anxiety anyway at the moment, and this may manifest physical symptoms, such as fatigue, insomnia and dysphagia. In this week’s episode, we discuss how to differentiate between causes of a lump in the throat: is my patient experiencing laryngopharyngeal reflux,...

Personality disorder is often referred to as the “Cinderella” diagnosis of mental health. Around 1 in 20 people is estimated to have a personality disorder, and it is a neglected and under-resourced area of our healthcare system. In this week’s episode, we discuss the stigma surrounding personality disorder, which can often manifest itself in high levels of anxiety for both patients and GPs, when...

Persistent coughing in children is always a challenge, both for parents trying to describe and measure the cough, and for doctors making a diagnosis. In the current climate, this is all the more difficult, seeing as a continual cough is one of the major symptoms of COVID-19. UK Government guidance advises that anyone with a persistent cough should get a coronavirus test. But with the reopening of...

With the annual flu season looming, GPs are anticipating a frenzy of vaccinations, perhaps more so than ever this year. As so many 'flu and respiratory viruses circulate every year, and as the 'flu vaccine is for one strain of influenza only, is the vaccine worth getting, and what are the risks associated with vaccinating vs. not vaccinating? In this week’s episode, we discuss the high vaccine upt...

Sometimes, in Deep Breath In, we only get a chance to include a brief bit of a much longer conversation with our guests. In these Deep Breaths, we're going to bring you some of those more in depth conversations. This is long conversation with Stephanie DiGiorgio, GP and expert on obesity, who had a lot of advice on how GPs can really help their patients lose weight. She talks about having non-stig...

Fatphobia has been described as society’s last ‘ism’. Whilst our understanding of weight and health has changed over time, there is still a stigma towards people who are overweight or obese, and an assumption that they must be unhealthy, and unhealthy by choice. However, the correlation between weight and health may not be as clear cut as our societal biases would lead us to believe, and, therefor...

Contraceptive pill check-up appointments used to be simple and straightforward for GPs, and frequently felt like a welcome reprieve from more complex consultations. However, there’s often more to them these days, especially given the rise in tailored regimens, with more and more women moving away from the standard of 21 pills followed by a 7-day break. In this week’s episode, we discuss common mis...

Sometimes, in Deep Breath In, we only get a chance to include a brief bit of a much longer conversation with our guests. In these Deep Breaths, we're going to bring you some of those more in depth conversations. This first one is with philosopher and author Tom Chatfield (he literally wrote the book on critical thinking) and explained to me the ways in which the heuristics we use in our everyday t...

Interest in vitamin D, and it’s association with a range of health outcomes continues - at least if the regular flurry of papers on the subject that are submitted to The BMJ are anything to go by, and with Covid-19, interest has piqued again. GPs are regularly asked to prescribe it, and to test for deficiencies. Low levels of vitamin D are associated with a large number of health outcomes, but, gi...

In light of the publication of the Independent Medicines and Medical Devices Safety Review (the Cumberlege report) in early July, which assessed the use of vaginal mesh, sodium valproate and Primodos and their associated under-acknowledged complications, this week we discuss trust between patients and doctors, and how that relationship of trust can break down when patients feel that their concerns...

The signs and symptoms of racism have long permeated our society, and are embedded in our clinical practice and medical education. Recent events in the US, including the murder of George Floyd, have brought the Black Lives Matter movement to the fore of public consciousness, and have sparked outrage and protests in countries around the world. COVID-19 has exposed the inequalities in our healthcare...

The relaxation of the COVID-19 lockdown regulations is raising a lot of questions, both for doctors and for patients. This week, we discuss how the lack of clarity and coherence in public health messages over the past few months has caused anxiety and confusion for our patients, especially those who have been told to shield. We talk about GPs tailoring shielding advice to suit the individuals they...

In this week’s episode, our focus is on what the post-COVID world of general practice might look like. The pandemic has exposed the inequalities in our social and healthcare systems, but has also given GPs some much-needed headspace to reflect on changes to make going forward. Will we be able to turn general practice off and on again, like a faulty computer? Will we just drift back to the status q...

For GPs, testing patients is their “bread and butter”. This week, we discuss the “better safe than sorry” attitude towards testing, which is so common among doctors – are we guilty of over-testing purely out of force of habit, or are we worried about missing something vital, and therefore find reassurance in doing them? How should we interpret test results, and how do these results affect the way...

With COVID-19 still ongoing, and at the forefront of the minds of doctors, patients and members of the public alike, difficult conversations are taking place - GPs are encouraged to talk about death with those who might not be ready to discuss it, and families are losing loved ones without being able to say goodbye. In this episode, we also look at survivor guilt, the range of emotions that grievi...

In this week’s episode, we discuss bystander guilt, convergence, brain hacks and “how you can sneeze on someone’s brain from anywhere in the world”. How can GPs cope with the myriad worries around treating patients during the current pandemic, both on the frontline and in general practice? How do we recognise and break unhelpful anxious behaviour habits and stop fixating on the news? Our guests:
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A new podcast from The BMJ, to help GP's feel more connected, heard, and supported. Subscribe on; Apple podcasts - https://bit.ly/applepodsDBI Spotify - https://bit.ly/spotifyDBI Google podcasts - https://bit.ly/googlepodsDBI In our first episode, we discuss the highs and lows of video consultations, and how coronavirus has altered the landscape of business as usual for GPs. How will this change a...

A new podcast from The BMJ, to help GP's feel more connected, heard, and supported. Subscribe on; Apple podcasts - https://bit.ly/applepodsDBI Spotify - https://bit.ly/spotifyDBI Google podcasts - https://bit.ly/googlepodsDBI This week, our topic is fear: we try to get a better understanding of fear, how it affects all of us as clinicians for better or for worse, and the impact that fear has on th...

“Deep breath in…and out. Again, deep breath in…and out.” We tune in to patients’ breath sounds, seeking confirmation of a diagnosis - one more supporting piece of evidence to reassure anxious patients or to narrow the differential. But since the SARS-CoV-2 pandemic arrived, saying “deep breath in” has been replaced by the need to take one ourselves: before opening the morning news, before venturin...