Lucy Allen

Terrible view today...

Grateful to @DCHStrust and @JayneDCHS for supporting me through the @NHSLeadership EGA programme 🙏

And relax 😌

Normal service resumes @RobSteelDCHS @JaneGinniver 😘

Final workshop and NHS Leadership Academy Award presentation for Elizabeth Garrett Anderson programme what a journey 🙂 @NHSLeadership

@DrJN_SportsMed I had a similar case a long time ago with a patient who had just being cleared of nasal ca. She was due a 6/52 PET scan and came to me with single leg sciatic pain. I referred her to A+E due to some abnormal symptoms unfortunately mets in spine and brain 😕 and deteriorated

Consent ✅ A very sad case with some important lessons that I recalled whilst writing my book 40s - trying to increase exercise to lose weight Worsening bilateral shin pain, with altered sensation and progressive weakness Pain worse on extension, relieved by flexion – for example, preferred cycling to running / elliptical trainer Admitted ‘off legs’ to my medical unit – lower limb neurological exam very abnormal with patchy deficits Initially treated as Guillain-Barré syndrome with intravenous immunoglobulins but no improvement When I removed their top to do the lumbar puncture, small scar seen on their back (“they removed a lump four years ago, it was a melanoma I think”) CSF looked gelatinous and bloody - protein levels sky high at 12g/l (Froin’s Syndrome) and Red Blood Cell count elevated Sent for histopathology – macrophages seen containing ingested melanin granules (see pathology slide) MRI lumbar spine image (sagittal) with contrast – cauda equina nerve roots infiltrated by tumour and central canal dilated due to obstructed CSF flow Diagnosis – Malignant Meningitis (leptomeningeal carcinomatosis) secondary to disseminated malignant melanoma Rapid deterioration due to brain metastases (CT image) and died several weeks after admission Pearls – Whenever possible, try and expose a patient fully and remove appropriate clothing to observe eg for scars and explore their past medical history; the patient may consider some of their medical history irrelevant Patchy bilateral neurological deficits should always ‘ring the alarm bells’ – as should comments like ‘my legs don’t feel like my own’ Research link – Noake, J - Melanomatous Leptomeningeal Carcinomatosis masquerading as Guillain-Barré Syndrome pubmed.ncbi.nlm.nih.gov/21597563/

Merry Xmas from the hounds

We have both been stuck in the office today. Sid by choice 🌧. Me not so much with literature falling out of my ears!!

Happy AHP day for yesterday! Reminiscing on Babwalds dream team! @DCHStrust @Abbie_Milwain @SuBuckley01

@JacobCollierMP Please visit @thecsp at stand J4 at #LabourConf25 to hear why recovery after illness, injury or with a long-term condition matters 💪 and sign up as a rehab champion for your constituents.

Good luck to everyone receiving their A-level results today! ⭐ Did you know there are more than 350 different roles to choose from in the NHS and not all of them require a degree level education? Search ‘NHS Careers’ to find out more. #ResultsDay25 #WeAreTheNHS

I mean it's ok here in Portugal 🇵🇹 😅🤣 @RobSteelDCHS @JaneGinniver

Forgot to send the obligatory holiday snap in July can highly recommend Albania for the second time @JaneGinniver @RobSteelDCHS off to Portugal this weekend 😅🤭 to avoid uni work

Spectacular view my mum and dad had whilst kayaking at home in Inverie Scotland

Exclusive: ICBs to shrink to 27 clusters ift.tt/ZjGHUxV

The end is insight with the MSC diss proposal due next week, along with business case proposal and portfolio!! #doanapprenticeshipytheyssaid

Critical gaps exist in our understanding about women-specific conditions. This National Women's Health Week, please consider taking part in research to address this. Take part here: bit.ly/42spMCg

@PhysioMACP @thecsp @Physio_Grodes @ACP_physio @LCphysio @UH_PG_Physio @function2fitnes

Love this very timely 👌

Good morning 🙏 🌄