Discover and read the best of Twitter Threads about #sleep

Most recents (5)

Thread. Please read if you have an #infant at home.

So this is a well-kept and potentially deadly secret about an industry that is growing exponentially and has spawned sexy, venture-funded #startups. The industry is #sleep. And the product is the #mattress. #parenting 1/n
Recently, we went #mattress shopping. After many trials (choosing a mattress is crazy stressful!) zeroed in on and placed an order at a prominent brand's store. It was a beautiful #memoryfoam mattress. I was drooling thinking of all the glorious #sleep I'd soon be getting. 2/n
I have had horrible body ache for years now thanks to our old #mattress that was handmade in Mumbai. I was so excited about buying this amazing new mattress that I did what anyone in my place would: obsessively Google memory-foam mattresses. 3/n
Read 14 tweets
I'm not a big #tweetorial person, more a #bitesized learning guy.
But important topic + healthy peer pressure =
Let's talk about #Delirium in the ICU (#DICU)!
For the most part, this is applicable to most patients.

Q: Do you regularly assess for #DICU?
What does delirium look like?
<5% "hyperactive": EASY TO JUDGE these pts
95%: "hypoactive" or mixed: somnolent, not accepting feeds, withdrawn:
EASY TO MISS these pts

What's the big deal?
Vent time 🔼 8d
Hosp LOS 🔼 by 8d
Cognitive impairment at D/C: 50%, long term: 33%
WHAT is delirium:
😣 Altered level of consciousness (hyper/hypoactive) +
🙄 Inattention

With either:
😇 Change in cognition (who, you?, what is life?) OR
🤓 Change in perception

Easy to miss in a patient that isn't "belligerent" or "climbing out of the bed". It can be SUBTLE!
Read 17 tweets
1. thread.

Nice @FrontPediatrics paper providing guidance for docs and #pwME in the diagnosis and management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome #MECFS

#MedEd #MedTwitter #chronicillness #chronicpain #SickNotTired
frontiersin.org/article/10.338…
2. #MECFS is commonly misdiagnosed as a #somatic disorder

#pwME "..have been humiliated or dismissed by other providers, so [doctors] will need to be.. nonjudgmental.. & acknowledge that #MECFS is not a #psychological condition but a real illness"

frontiersin.org/article/10.338…
3. #MECFS symptoms can be diverse, complex, fluctuate and overlap with many other conditions making the diagnosis difficult

This @FrontPediatrics paper lists 33 (!) co-morbidities commonly associated with #MECFS

#MedEd #MedTwitter #pwME #SickNotTired
frontiersin.org/article/10.338…
Read 8 tweets
18 myths & misconceptions of Post-Exertional Malaise #PEM in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome #MECFS

#PEM (aka PENE, "flare" or “crash”) is seriously debilitating symptom caused by exercise

#SickNotWeak #SickNotTired #pwME #chronicillness #medtwitter #MedEd
1. #PEM is just tiredness

No

#pwME experience <pathological> fatigue after #exercise which can be long-lasting and includes debilitating fatigue, flu-like symptoms, cognitive impairment, #sleep disturbance

@PNASNews #MECFS #MyalgicE #MedEd #medtwitter
pnas.org/content/114/6/…
2. #PEM is not a real

No

“there exists no medical condition.. where exertion.. causes #immune/ inflammatory-related symptoms like sore throat, tender lymph nodes, or flu-like feelings, yet 60%.. of.. [#pwME].. reported these symptoms”

@PLOSONE #MECFS
dx.plos.org/10.1371/journa…
Read 20 tweets
thread

Remarkable @bmj_latest @BMJCaseReports report documenting the extreme lengths a bedbound patient went through to get a diagnosis of #POTS, #MCAS, #SIBO and #tachycardia

read her story here

#MedEd #MedTwitter @MayoClinic
casereports.bmj.com/content/2018/b…
2. After suffering for 16 years, seeing 19 docs with repeated misdiagnosis:

Her cardiologist couldnt diagnose #POTS

Her gastroenterologist couldnt diagnose #SIBO

Her immunologist couldnt diagnose #MCAS

Her neurologist referred her to a #psychiatrist!

casereports.bmj.com/content/2018/b…
3. Patient: the "neurologist was out of ideas and suggested I get a psych evaluation, which I declined"

the patient <referred herself> to @MayoClinic

#SickNotWeak #chronicillness #chronicpain #MedEd #medtwitter

casereports.bmj.com/content/2018/b…
Read 10 tweets

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