Has she tried prokinetic agents to stimulate gut motility like metoclopramide, domperidone, prucalopride, and tried SNRI's to help the pain in the gut?
Anyway, ask about those with your specialist if you haven't tried them.
Can you give LT metoclopramide or domperidone, I thought it was contraindicated. The only 'safe' one I know is erythromycin, until you get C.Diff.
To be fair, with the amount of work Doctors have to do, not only while on duty but also with further studies/exams etc to get to higher positions and up to date, who wouldn't want to get paid well for it? That is something I also think is weird in NHS, how for example nurses can climb the ladder so quick without hardly any need for further training/studies while as a Doctor you got some pretty damn heavy exams coming at you.
Exams we pay for
Contracts should have had compulsory overtime implemented so a&e cover is provided without having to haggle with locums, so basically its covered under normal contracts. This is probably what should be done with every new recruit moving forward, which I think they tried to do recently when we had those protests from the junior doctors. Doctors are they doctors "to save lives"? If I remember right the union leader resigned after that ashamed that the negotiated deal was still turned down.
By the way its all too easy to shoot down what I am saying but you welcome to come up with something alternative, or is it the case you think there is nothing to be done and you would simply keep everything as it is?
When I was a trainee I worked 46-48 hours a week +5 hours more CPD and portfolio, frequently losing 3-4 hours staying late We also had manditory teaching which was on a wednesday 1pm-5pm fortnightly. While I was on my 12 week A&E rotation I worked exactly 3 weeks 8-4, the rest were evenings and nights (4-12, 8-8, 2-10 etc). It meant I came to teaching 1pm-5pm during nights sometimes because the education department were completely out of touch. I did roughly 55-60 hours a week. I got £2200 a month for this pleasure, I rarely got to spend it though.
How the **** are you going to make me do more compulsory overtime? How many more hours can i do safely?
I'm a locum now, night and day difference, I get to go on holiday with my loved ones, my pay is 75% more and I can pay for useful training courses (ATLS £750 after tax). I work 48 hours a week and get paid for 45 as I get these magical 30-45 minute breaks deducted I don't take.
During the winter I remember literally hanging bags of Augmentin and fluid on borderline-septic patients in the A&E waiting room. The NHS cannot cope with the large volume of complex elderly patients who require great care and skill when treating.