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Inside Health

Charles Bonnet syndrome, Co-proxamol, Meningitis B vaccine, Smart tablets

Inside Health

BBC

Health & Fitness, Science

4.4575 Ratings

🗓️ 23 February 2016

⏱️ 29 minutes

🧾️ Download transcript

Summary

Up to half a million people in the UK could have it, but it's a condition that hardly anybody has heard about: Charles Bonnet Syndrome. It happens to people who are losing their sight through age-related macular degeneration, cataracts, diabetic eye problems or glaucoma. They see vivid and often frightening visual hallucinations and these images are soundless. Judith Potts' mother Esme was in her 90's when she eventually admitted to her daughter that she was seeing frightening images of goblins and Victorian children all around her. Judith had never heard of the condition and as she tells Dr Mark Porter, neither had any of the health professionals taking care of her mother. Shocked that there was so little awareness about something that is so common, she set up an awareness group, Esme's Umbrella. Dr Dominic Ffytche, Clinical Senior Lecturer at King's College London's Institute of Psychiatry and an expert in visual hallucinations, tells Mark that a key area of research is why some people have Charles Bonnet Syndrome and others don't.

Co-proxamol, or Distalgesic as it's better known, was a common drug for mild to moderate pain in the 1990's. But a decade ago, a review by the Medicines and Healthcare Products Regulatory Agency (MHRA) decided that it wasn't a good painkiller and it had very worrying side effects. Its licence was withdrawn and doctors were urged to switch patients onto different medication (although it could still be prescribed on a "named patient" basis). Dr Andrew Green, Chair of the Clinical and Prescribing arm of the GP committee of the British Medical Association tells Mark he's disturbed that nearly ten years after the licence was withdrawn, thousands of patients are still being prescribed co-proxamol at a high cost to the NHS while Bedfordshire GP Dr John Lockley defends continued and careful prescribing for a tiny number of patients who can't get relief from other medication.

In a week in which hundreds of thousands of people have signed a petition calling for more children to receive the Meningitis B vaccine, Dr Margaret McCartney talks to Mark about the tricky decisions involved in planning immunisation programmes.

Traditional bedside paper charts, which record and monitor patients' vital signs, have been replaced in Oxford hospitals with smart PC tablets. Clinical staff enter patients' blood pressure, heart rate and temperature on the tablet and the new "smart" system provides an early warning traffic light system, alerting them if there's a deterioration in the patient's condition. This means clinicians can prioritise care and another major bonus is that the same information is available, at the touch of a button, to medical staff across Oxford's hospitals. The project is called SEND - System for Electronic Notification and Documentation - and it's a collaboration between the University of Oxford and Oxford University Hospitals NHS Foundation Trust. Mark goes to Oxford and with intensive care consultant and SEND Project Leader Dr Peter Watkinson, sees how the new paperless system is working.

Transcript

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0:00.0

Hello, you're about to listen to a BBC podcast, and I'm Ed Gamble, host of another BBC podcast,

0:05.4

The Traitors Uncloaked. But my show is available only on BBC Sounds, just like Ellis and John's

0:10.6

Saturday bonus episodes, the Pop Top Ten podcast with Scott Mills and Ryland, and comedy specials

0:16.2

from the likes of Harriet Kemsley, Susie Ruffel and Rommas Shranger Nathan. However, and maybe I'm biased, it's really all about the traitors uncloked.

0:24.3

So for a whole bunch of exclusive scoops and podcasts, listen only on BBC Sounds.

0:29.4

Hello, thank you for listening to this edition of Inside Health.

0:32.1

I hope you enjoy it.

0:33.7

Coming up in today's program, meningitis B,

0:36.9

and the question that seems to be on lots of parents' lips,

0:40.0

how do I get my child vaccinated? I'll be discussing the unprecedented demand with fellow GP, Margaret McCartney.

0:47.1

Smart tablets. How hospitals in Oxford have swapped the paper chart at the end of the bed for a computerised system

0:53.7

that can help doctors and nurses

0:55.4

spot when a patient is going downhill. And a blast from the past, coproxomol, or distalgesic

1:02.7

as most people will remember it. Why is the NHS still spending millions of pounds on a painkiller

1:08.1

that was withdrawn a decade ago because it was deemed too dangerous.

1:12.6

The big problem with it is that it's very, very good at suppressing your central nervous system.

1:18.6

What that means is if you take too much of it, you stop breathing.

1:21.6

And it's particularly prone to do that if it's taken in combination with other medications as well. Now the one that

1:28.4

most concerned was alcohol, because what was happening is that people were getting distressed or

1:33.3

depressed. They would take perhaps just a handful or so of these tablets, and unfortunately

1:37.7

they were dying from it in quite large numbers. More on coproximal later, but first, Charles

1:43.7

Bonnet syndrome,

...

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