Maeve Boothby O'Neill - articles about her life, death and inquest

Every hospital in the world has signs and rules about noise: be quiet. It's heavily enforced by staff and with good reasons.

Actually they don't and it isn't in UK hospitals in this century. A member of my family who had a stroke had to listen all night to nurses ten feet away laughing about their relationships without any concern about patients being present. Things were very different forty years ago.
 
The coroner has asked Sarah to move on, as this line of questioning isn’t helpful.

In my opinion, Sarah is trying to draw out what she knows is there, they didn’t help her or Maeve and she knows the subject too well to do it objectively, I’ve seen this many times before, I really feel for her.
 
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SB- When Maeve died did DCC make a referral made to the Safeguarding Adults board?*
SJC - I’m not aware if that took place
Coroner - if it was, I’d have a record of it

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*I think whers there’s concerns and Social Services involved, then the person died, this would normally be referred to Adult Safeguarding Board because a review/investigation may be needed to avoid similar happening, learn any lessons or amend practices.
 
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A “Ms Allan” has spoken a few times (interrupted) and my guess is she is the DCC rep/lawyer

Sean O’Neill now questions SJC

No references to MBP/FIDA/prior to 10 September 21, made by a Tim Jackson (don’t know him?)
 
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It’s finished for the day. Tomorrow will be Sarah Boothby followed by Sean O’Neill. There may be more from Dr Shenton. Friday morning we have a witness ( will it be JH? Helmsley) Friday afternoon will be legal submissions.


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edit - apparently Kate Dixon on Fri
 
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No word from the Observer so i assume they won't be publishing.

Not very happy with myself for sending it off before i could read most of the feedback on here.

So disturbed by everything in this thread. Every patient's worst nightmare. I can't begin to imagine what she went through.

This has to stop.
1. They don’t normally contact you. You need to check the website on Sunday morning to see if it’s been published or not.

2. They probably won’t finalise letters for the Observer until Thursday, so you could send an amended version of your letter today.
 
Instead of looking at literature as to whether 1000 eg cats with (or without) the same thing (which I doubt is possible as the comorbidities etc are different) to 'cite' most can deal with x so that cat reacting like that 'is wrong' or used as an inference towards said cat and 'maybe they are being fussy', manipulating, or 'its in their head' you just find something.
such a good analogy Bobbler

We've just got to get rid of that word "Tired". It's being repeated in the Inquest. "Tired" is the most trivialising word, it leads the general public and some/most medical/health professionals to think that ME 'tiredness' is something they may have experienced, or something close to it. Because of the word. Everyone has experienced tiredness. That word is sabotaging us

This times a million. So sick of seeing a life-destroying disease reduced down to 'tired', 'tiredness', 'fatigue', 'chronic fatigue'. That has GOT to GO. ME will never be taken seriously as long as people think it's 'tiredness', which they of course see as just laziness and therefore to be mocked and laughed at.
AMEN! 'tired'....it is grotesque word to use imho

I saw a dr on reddit say something like 'when i tell myself i'm f'ing tired, it becomes a self fulfilling prophecy'

Its just almost impossible when this is what they think, to get anywhere. And why wouldnt they think it? This is what they're taught, what gets repeated over & over.
I'm not tired, i'm ill

I think maybe the needs of people with ME/CFS need to be explained much more in terms of the actual experience of the patient. The problem IS the symptoms, which include both feeling terrible and blocks to function at a reflex level.

And the management has to pivot on management of the symptoms. Quiet side rooms are not just a kindness to sensitive souls. They are a physiologic necessity.
oh thank you, just thank you a 1000 times thank you, for getting it

Explaining it didn't seem to do any good because it was processed by them in a way that led them to tell me it was normal (when it isn't).
No, ime drs are entirely unable to hear things they are not expecting to hear. It doesnt matter what you say or how you explain it, or how much they seem to be listening. The words somehow get filtered and twisted into something they're familiar with, something they're expecting. Its like in their minds there are 500 boxes and everything thats said gets put into one of them. ME needs a new box.

No disrespect to anyone else, but @Jonathan Edwards is the only Dr i have ever come across who can listen without filtering & morphing whats said into something he's expecting to hear. Its a joy to speak to someone with a kind of 'clean slate', who is actively looking for whats actually said rather than simply assuming whats said will be some version of what he already knows!

Every hospital in the world has signs and rules about noise: be quiet. It's heavily enforced by staff and with good reasons.
Not in the UK they dont! Goodness, they are louder than a building site! and the nurses are the loudest ones, they positively shout when talking to you, even on wards full of sick people, even after you tell them you have a splitting headache. I honestly find nurses to be the loudest people of all. It seems to be cultural, they have one volume & its FULL
 
Reducing (or adding) environmental stimuli is one of the first things to try when helping someone eat. A problem I think can occur with (severe) ME is that the reasoning behind changing the environment is

  • cost effectiveness/low resource
  • avoiding having to use more invasive nutrition treatment (nutrition drinks, tube, parenteral nutrition)
The accomodations someone with severe ME might need could easily not be called «low resource». A typical example fir environmental change is adding or removing a TV-program. And while it is possible to combine changes in the eating environment with more nutritional support the extent of accomodations needed for severe ME is beyond any (example) cases in my dietitian education, and we also are taught about the 30-45 degree angle and being upright after a meal. A (severe) ME patient thus requires much out-of-the-box thinking.

Edit: changed my wording.
 
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I don't follow the question quite.

What I am saying is that health professionals need to face up to the intolerability being undeniable and impossible to overcome, just as a man with a septic knee cannot walk. If the discussion gets sidetracked into whether the mechanism is blockage or faulty thinking then the real problem is never acknowledged. The justification for PEG would not be a 'non-functioning gut' but an impossibility of using it.
Last year when I was put on a NG tube (again before I was diagnosed with gastroparesis and subsequently given a NJ tube), I looked at the French Society of Clinical Nutrition and Metabolism’s algorithm for weight loss and severe malnourishment, which included paths towards enteral and parenteral feeding. I don’t remember that these options required “non-functioning gut” or another biomedical explanation as an eligibility criterion, only that the previous steps recommended by the algorithm must have failed. Is that not the case in the UK too?

That being said, I didn’t tolerate the NG tube and the doctor in charge of my care refused to put me on a NJ tube even though I explained them that I was struggling to digest the feed. And they were adamant about not putting me on TPN — they told me by my bedside that they would do “everything in their power” against it.

Also, in the preliminary hospital report that they wrote when I was discharged, they diagnosed me with “functional digestive disorder” but when I contacted them a few days later to tell them that I had just done a gastric emptying scintigraphy that objectively confirmed my gastroparesis, this term was suddenly nowhere to be seen in the definitive report…
 
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Last year when I was put on a NG tube (again before I was diagnosed with gastroparesis and subsequently given a NJ tube), I looked at the French Society of Clinical Nutrition and Metabolism’s algorithm for weight loss and severe malnourishment, which included paths towards enteral and parenteral feeding. I don’t remember that these options required “non-functioning gut” or another biomedical explanation as an eligibility criterion, only that the previous steps recommended by the algorithm must have failed. Is that not the case in the UK too?
If they follow ESPEN it should be the case.

Though BAPEN write on their site on parenteral nutrition (which says it is to be updated):
"Parenteral nutrition(PN) refers to the provision of nutrients by the intravenous route. In general, PN should only be used when it is not possible to supply nutrition using the GI tract ie when intestinal failure is present."
 
A few new comments from Paul R Keeble
“One of my top concerns…is guidance on nutrition around ME is wrong”
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and some comment on the “hard to follow” social services DCC questioning by Sarah. It seems there is missing info in the records, 2 phone transcripts and an email, which are referred to in other emails, which Sarah is questioning

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Paul Keeble’s summaries of todays witnesses
Dr Fox
Did intake assessment found little physiologically wrong other than phosphate, discharged Maeve with supplement drinks to improve intake. Did not think tube appropriate. Some concerning things in record about psychologisation andBPS


Beth Thompson, Dietician

Lots of “Maeve believes…” used same coached answer about what ME is, showed little knowledge of ME, misinterpreted ME signs and discharged Maeve with supplement drinks well below the necessary intake, can’t understand consequences of NG and failure

Sarah Clark (SJC) DCC Safeguarding Managef

Safeguarding in Jan-Mar and September. [safeguarding Maeve from Sarah] Both closed once information gathered. Was meant to speak on JH’s behalf but didn’t know anything about other safeguarding raised by Maeve and Sarah [about safeguarding Maeve from neglect by DCC]
 
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