Tim Murphy

[Tim Murphy @TimMurp62596675]

@jtonline @AddisonsUK Best version of surgical guidance similar to ADSHG but updated and in Dr speak
Guidelines for the management of glucocorticoids during the peri-operative period for patients with adrenal
insufficiency
Anaesthesia 2020, 75, 654–663 doi:10.1111/anae.14963

[Tim Murphy @TimMurp62596675]

@jamesasm @hormone_doc What was the motivation for the study?
What is the history of previous work by authors?
(How) Were models validated?
Do models/modellers have demonstrated validity?

[Tim Murphy @TimMurp62596675]

@juliesharp86 Yes to both. Cold feet most of time. Mild tremors about 50% and violent tremors when low cortisol - it's the first symptom I notice but I'm already slurring words and struggling to communicate. This is not good when dealing with medical professionals who don't expect that in AI!

[Tim Murphy @TimMurp62596675]

@esc4p33 @hormone_doc Check out the @geoallison tweet with picture from Glasgow!!

[Tim Murphy @TimMurp62596675]

@EwanMaule Clearly none of the supporters have a hearing problem. Telephone consultations require my wife to interpret and restate the discussion so I can follow. Hypopit, adrenal infsufficiency, T2DM and other stuff means big issues.

[Tim Murphy @TimMurp62596675]

@britishthyroid @DrPeteTaylor My TSH is suppressed because of pituitary adenoma and is therefore useless for assessment of LT4 dosage. Even the lab notes this in the results but I still get attempts to lower my LT4 every year. Why is the system so badly designed?

[Tim Murphy @TimMurp62596675]

@britishthyroid Systematic review of poorly designed trials doesn't improve the quality of the results.

[Tim Murphy @TimMurp62596675]

@ThyroidAction @britishthyroid @DrPeteTaylor Never have seen a QoL tool.
I have central hypothyroidism so most of the literature is of little relevance but no-one seems willing to consider this.
I suspect political / ideology is what drives the insistence on lT4 monotherapy.

[Tim Murphy @TimMurp62596675]

@britishthyroid @ThyroidAction @DrPeteTaylor I've not looked recently but in the past the quality of studies on the use of T3 appeared to be at best designed to fail. I'm somewhat cynical and suspect the objective was more them specifically targeted to that end.

[Tim Murphy @TimMurp62596675]

@Richard_GP There is no doubt that administration, hotel staff, maintenance and lots of other skills are needed. The issue is rather how many are needed and how much some seem to be paid - such as new managers on more than the PM gets.

[Tim Murphy @TimMurp62596675]

@hormone_doc @j59dd @RCPhysicians @Soc_Endo @ptsafetyNHS @rpharms Still waiting to hear when I might get one, never mentioned by Endocrinologist, GP or Pharmacy.

[Tim Murphy @TimMurp62596675]

@Pituitary_org The hormone replacements are a hassle, hc 3 times a day is not enough! The real issue is that most medics don't believe that you need the steroids etc and half of them believe you can be cured by just stopping.

[Tim Murphy @TimMurp62596675]

@juliesharp86 @DrFrancesRyan I think a real issue in primary care is that the GPs can't cope with complexity. Turn up with low thyroid, get Thyroxine, next patient. Against Oh I don't know and I've got lots of easier things to deal with so ignore and next patient please.

[Tim Murphy @TimMurp62596675]

@esc4p33 @Pituitary_Surg @bnes I had a macro but only about 15mm dia. Resection failed, less than 1/3rd of bulk removed, because of the texture (fibrous) and cavernous sinus invasion. Neither of these risks appeared to be considered.

[Tim Murphy @TimMurp62596675]

@kaz_emalone @tessajlrichards I'm confident no-one would. The issue is that medical professionals appear to have no access to decent microphones and find it difficult to understand that if one has a significant hearing loss then a telephone consult is at best tortuous and at worst utterly pointless.

[Tim Murphy @TimMurp62596675]

@DrGoblin3 @Holly4KJ @brianwinteruk @DrRosemaryL Sorry but you clearly have no empathy for the problems met by patients.

[Tim Murphy @TimMurp62596675]

@fayelesleys @Medic_Mediator That's not right. It will make you want a doughnut (well on 50mg IM 6 hourly for 3 days you need something to look forward to). It also doesn't keep me awake or turn me into a sociopath - myths held dear by medicals!

[Tim Murphy @TimMurp62596675]

@Pituitary_org @RoyalOsteoSoc I'd like to ask about the impact of acromegaly on bone health. Particular interest is bone quality (in 2015 my t-score was -2.3) and osteophyte development. My acromegaly is still active so bone remodelling continues.

[Tim Murphy @TimMurp62596675]

@Karavitaki_Niki @Soc_Endo @BHPComms @IMSR_UoB Could you expand to include functional adenomas - Cushing's, Acromegaly etc seem to be ignored too often