Discover and read the best of Twitter Threads about #AmazingGrady

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#AmazingGrady, Day 5

I was presented a patient with structural heart disease. Nonischemic HFpEF, to be exact.

PND. Orthopnea. S3 on exam. Reported some intermittent palpitations but EKG NSR, some LVH w/strain.

Admitting diagnosis: Acute decompensated HF

So far, so good.
Work rounds the next day:

Diuresis is going well. Responding to loop diuretics. And shout out to hydralazine for the double whammy of BP control + afterload reduction.

“Oh. But she had palpitations again. And on tele she was in atrial fibrillation.”

Hmm. Ok.
By the time I examined the patient, the heart rate was regular again.

Intern: “She’d been taking her meds and watching her salt intake. Maybe Afib is why she decompensated.”
Me: “We know the patient to have structural heart disease. So it all makes sense.”

And that was it.
Read 13 tweets
#AmazingGrady, Day 1

From the ICU to the step-down unit. From the step-down unit to the floor. Things were getting better. You were getting better.


But then the confusion came.

"My mama wasn't like this!" Your daughter was emphatic.

Your daughter was right.
We reconciled the meds. The astute med student even cross checked your list with the Beers Criteria list since you're an elder.

Vitals were fine.
No sneaky hypothermia.
Or a sucker punch UTI even.


"Now they got her tied down!" Your daughter shook her head.
The team had a good schema for delirium. I agreed with everything they'd already started to explore. And since your daughter was vehement about you never having cognitive issues, it wasn't fair to even think for five seconds that this was your "new baseline."

Read 10 tweets
#AmazingGrady, Day 15

Stepped onto the E elevators on a Saturday morning, joining a young man who looked like me. We gave each other a nod.

Him: “Morning, doc. What floor?”
Me: “Good morning, friend. 10, thanks.”
Him: *pushes 10*
Me: “Preciate you.”

*ride in silence*

Him: “Hey doc? Where you from?”
Me: “Me? I’m from California.”
Him: “No, I meant like, where you FROM FROM.”


Usually this kind of thing feels like a microaggression. But this young brother could easily blend into my own family. I decided not to overthink it.
Me: “Umm. Born in Compton. Raised in Inglewood.” *holds up hand gesture* “West syeeeeeed.”


Him: *squints eyes* “But where your peoples from?”
Me: “Alabama.”
Him: “Alabama? I was thinking you was something else.”
Me: “I say we’re all ’something else.’ ”

Read 9 tweets
#AmazingGrady, Day 10

Me: "Hey there. Just came back to check on you."
Him: "Lawd. Did you come back to bug me about that pill some more?"
Me: "You mean the PrEP? Nah. Well. I mean, I do want you to take it. But I legit came to check on you."
Him: "Mmmm hmmmm."

Him: "You a dog on a bone, you know that?"
Me: "Me?"
Him: "Yeah, YOU. But for real. . .I'm pretty low key. I don't need that pill. I ain't out like that, feel me?"


Him: "What?"
Me: *shrugs*
Him: "Why you so pressed for me to take this pill?"
Me: "Because. I care about you."


Me: "So--tell me again why you aren't feeling it?"
Him: "I don't want nobody experimenting on me. Or using me to get paid."
Me: " Tell me what you mean by that."
Him: "Look. I ain't even out like that. So I'm good." *turns up TV*
Read 14 tweets

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