Discover and read the best of Twitter Threads about #EDDB
Most recents (9)
1/š§µWhat do ICU survivors tell me about PICSā¦(post intensive care syndrome)āļø
Former ICU patient: āIām angry. Iām furious because the doctors who injured me arenāt willing to help me recover.ā
Is this fair?
I think so.
Why?
Read onā¦(perm to share)
Former ICU patient: āIām angry. Iām furious because the doctors who injured me arenāt willing to help me recover.ā
Is this fair?
I think so.
Why?
Read onā¦(perm to share)
2/ I just got off the phone w a patient who has had PICS for 12 years since nearly dying in the ICU. His story is included in #EDDBā¦he granted permission to share some thoughts today that I think are eye openingā¦in terms of how poorly weāre doing w Chronic Disease management
3/ people who never had PTSD before critical illness, leave with inexplicable experiences of road rage, rejecting their spouse, acting in ways that are so foreign to them that they donāt recognize themselves.
They also have tremendous problems with lack of self worth becauseā¦
They also have tremendous problems with lack of self worth becauseā¦
1/š§µ Land Mines in Long COVID - @BostonGlobe
Alex was training for 2024 Olympic Trials š„
That dream exploded š£
Ā
New #LongCOVID science
šViral reservoirs at 1 year
šCardiac edema at 1 year
šDementia at 2 years
šHijacked mitochondria
ScreenShotš
bit.ly/3U77u4r
Alex was training for 2024 Olympic Trials š„
That dream exploded š£
Ā
New #LongCOVID science
šViral reservoirs at 1 year
šCardiac edema at 1 year
šDementia at 2 years
šHijacked mitochondria
ScreenShotš
bit.ly/3U77u4r
2/ Itās one thing to concede that Long COVID exists as a societal problem for those w vulnerabilities like advanced age, pre-existing health conditions, or nearly dying in ICU.
What about nationally ranked D-1 long-distance runnersāļø
Paywall so read š§µ
bit.ly/3U77u4r
What about nationally ranked D-1 long-distance runnersāļø
Paywall so read š§µ
bit.ly/3U77u4r
3/ Alex Schell is 21 & based his life decisions on making the 2024 Olympic trials.
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āNot only can I not run due to #LongCOVID, Iāve also lost everything I hoped for. Who I envisioned myself to be is a past idea. Itās a monumental loss.ā (story w perm)
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What causes LongCOVID?
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āNot only can I not run due to #LongCOVID, Iāve also lost everything I hoped for. Who I envisioned myself to be is a past idea. Itās a monumental loss.ā (story w perm)
Ā
What causes LongCOVID?
1/š§µ An exacerbating factor in #LongCOVID is the āQuality of Life (QOL) Gapāš§µš
ā¦when a personās expectations about QOL are at odds w their reality.
Ā
āCovid was over & Long COVID hit my brain, heart & GI.ā
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Let me unpack a study of ICU survivorsā¦
bit.ly/3vp0AMl
ā¦when a personās expectations about QOL are at odds w their reality.
Ā
āCovid was over & Long COVID hit my brain, heart & GI.ā
Ā
Let me unpack a study of ICU survivorsā¦
bit.ly/3vp0AMl
2/ Read the thread I attached to the first tweet.
From the cancer literature, we learned about the QOL Gap.
If people appropriately prepare for their āACTUALā QOL, thereās a narrow gap and all is well.
If not, #Depression & #Despair too often set in.
From the cancer literature, we learned about the QOL Gap.
If people appropriately prepare for their āACTUALā QOL, thereās a narrow gap and all is well.
If not, #Depression & #Despair too often set in.
3/ This study from Johns Hopkins by @vitaincerta & team adds to our understanding in a way that will apply so well to #COVID ICU survivors.
These are ARDS patients, which is almost always what lands COVID pts in the ICU and later with #PICS.
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@ChestCritCare
These are ARDS patients, which is almost always what lands COVID pts in the ICU and later with #PICS.
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@ChestCritCare
1/š§µ Why is COVID hospitalization like 2X sticks of dynamite š§Ø?
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A thread on the ICU portionā¦ #PICS + #LongCOVID.
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Prevent this w 3 steps:
šAvoid #COVID by Vax & Mask
šAvoid severe COVID by Paxlovid & Monoclonal Ab
šš read here about PICS & how to reduce injury in the ICU
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A thread on the ICU portionā¦ #PICS + #LongCOVID.
Ā
Prevent this w 3 steps:
šAvoid #COVID by Vax & Mask
šAvoid severe COVID by Paxlovid & Monoclonal Ab
šš read here about PICS & how to reduce injury in the ICU
2/ Hereās what you must know if you get too sick & land in an ICU.
History Lesson š
In the past, too many decisions in #CriticalCare were guided by fear. We oversedated patients for too long out of worry they might self-extubate & pull off restraints.
Thatās happening again š¤®
History Lesson š
In the past, too many decisions in #CriticalCare were guided by fear. We oversedated patients for too long out of worry they might self-extubate & pull off restraints.
Thatās happening again š¤®
3/ We kept patients immobilized due to an overly conservative approach to fall prevention that precluded us from attempting to walk them early. We kept families away from patients, treating loved ones as visitors rather than members of the healing plan.
Thatās happening again.
Thatās happening again.
1/š§µ Seeing Differently in #COVID ICU Care š
The world tells me āstuffā & āfreedom ā bring happiness, yet neither suffice or satisfy.
If I reject chances to serve my suffering patients, I am left bereft.
Merciful care brings healing & provides joy all around.
What is #Mercy?
The world tells me āstuffā & āfreedom ā bring happiness, yet neither suffice or satisfy.
If I reject chances to serve my suffering patients, I am left bereft.
Merciful care brings healing & provides joy all around.
What is #Mercy?
2/ My working definition of mercy is my willingness to dive into the chaos of another personās life & provide lifting & healing.
Often as an ICU physician I do the former but not the latter.
That is, I dive into their #chaos without admitting I donāt know whatās right for them.
Often as an ICU physician I do the former but not the latter.
That is, I dive into their #chaos without admitting I donāt know whatās right for them.
3/ā¦but without performing actions that lead to lifting and healing of my patientās spirit & mind, what Iām doing is dispensing false mercy.
eg, If in #COVID, I make the lungs š« my whole goal, sedate & depersonalize someone for too long, I beget new diseases.
#PICS #LongCovid
eg, If in #COVID, I make the lungs š« my whole goal, sedate & depersonalize someone for too long, I beget new diseases.
#PICS #LongCovid
1/š§µ What is #LongCOVIDāļø
Ā
A disabling malady from ongoing inflammation, autoimmunity, & potential viral reservoirs (GI, brain?)
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NEW DATA: The Lungs ālight upā on special MRI Scans 3 to 9 months later in patients never hospitalized for COVID.
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bit.ly/344Oajp
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A disabling malady from ongoing inflammation, autoimmunity, & potential viral reservoirs (GI, brain?)
Ā
NEW DATA: The Lungs ālight upā on special MRI Scans 3 to 9 months later in patients never hospitalized for COVID.
Ā
bit.ly/344Oajp
2/ These #LongCOVID pts had NORMAL CT scans but when asked to inhale Xenon, an inert gas, the MRI showed their lungs transferred gases (think oxygen) into the bloodstream abnormally. This is alarming evidence of another weird form of organ damage from COVID not visible on CXR/CT.
3/ Oxford Prof Dr. Gleeson says these patients, who were never in hospital & didnāt have acute severe illness w their COVID19, have been experiencing symptoms for a year after contracting the infection.
1/š§µš„ A young mom suffering #COVID. Her husband is scared.
We need to prevent serious long-term complications. Her new normal will likely include PTSD, Dementia, Depression & severe physical disability. (shown w Perm)
Not so āmildā ā”ļø Do you want this?
#vaccinate
#LongCOVID
We need to prevent serious long-term complications. Her new normal will likely include PTSD, Dementia, Depression & severe physical disability. (shown w Perm)
Not so āmildā ā”ļø Do you want this?
#vaccinate
#LongCOVID
2/ what you need to know about ICUs, #PICS and #LongCOVID prevention:
I wrote this @thedailybeast pieceš to help empower you as patients & families. Itāll tell you what you need to know & ask your team for amid the chaos and confusion.
Thereās moreā¦
bit.ly/3DhC6Xe
I wrote this @thedailybeast pieceš to help empower you as patients & families. Itāll tell you what you need to know & ask your team for amid the chaos and confusion.
Thereās moreā¦
bit.ly/3DhC6Xe
3/ This patient on 100% O2 and high-dose propofol & fentanyl did not need both agents. When able, we try to avoid prop & benzos. We stopped Prop, continued Fentanyl & added dexmedetomidine because itās shorter acting & wonāt build up so much in her brain.
This is the #A2Fbundle.
This is the #A2Fbundle.
1/š§µ End-of-Life: Thoughts
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I was explaining to others how the end of my patientsā lives is often such a beautiful experience. They looked back at me with utter confusion. I could tell they thought I was crazy.
Since then, Iāve been thinking of what I should have saidā¦
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I was explaining to others how the end of my patientsā lives is often such a beautiful experience. They looked back at me with utter confusion. I could tell they thought I was crazy.
Since then, Iāve been thinking of what I should have saidā¦
2/ I shouldāve explained that too often in life I feel like I hold on to things I need to let go of. That sometimes I try and force solutions in relationships and all sorts of situations when I simply need to let go.
3/ I watch my patients often try and carry the weight of circumstances way past when itās obvious the burden is too great bear. The only logical solution is to let go of the rock that is drowning them. To let life flow and take its natural course.
1/š§µš„ REFLECTION on Fear & Love ā what connects 9/11 & #COVID19?
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On #Sept11, 2,996 died. 412 were 1st responders running INTO danger.
WIKI: bit.ly/3AiqZN2
WHY did they do this? Listen to my patient Col. Correaš
HINT: it was NOT religion, politics, or patriotism.
Ā
On #Sept11, 2,996 died. 412 were 1st responders running INTO danger.
WIKI: bit.ly/3AiqZN2
WHY did they do this? Listen to my patient Col. Correaš
HINT: it was NOT religion, politics, or patriotism.
2/ When someone around us needs help, the only universally unifying response is #LOVE.
Wells of love (see pics š) must be what we drawn on to achieve success in serving others, whether on 9/11 or in this #Pandemic.
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Pics by Robert Mecea & @marklennihan
Wells of love (see pics š) must be what we drawn on to achieve success in serving others, whether on 9/11 or in this #Pandemic.
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Pics by Robert Mecea & @marklennihan
3/š„ I cared for 9/11 hero Colonel Victor Correa as he died in our @VA hospital years later. His story is told in #EveryDeepDrawnBreath. He carried men out of the Pentagon saving lives. Watch more of his testimonialā¦
