Thread by @WesElyMD

1/🧵🎥 Hard-Won #Wisdom from the wife of a #LongCovid patient >140 days into hospitalization.

You need to hear her 2 messages:
1. “What I can tell you is I’ve never given up #hope. To make it to tomorrow, we have to make it through today first.”

HUMILITY ❤️‍🩹 IS HER MEDICINE

2/ When things are acute, like in this video of her husband when he was 1st in the ICU, we tend to think our task list is all technological. I’m guilty of this. And I’ve caused ⬆️ suffering because of my tunnel vision.

3/🎥 Point #2 from my pts wife:
“He’s not gonna get better next week or next month. #COVID takes a LONG time. Our lives are forever changed. Expect setbacks & be your loved one’s advocate!”

NOW she & he are convinced of the importance of #Vaccination & masking. Learn from them!

4/ She’s graciously sharing some of his complication to give you an idea of a typical long-term COVID pt’s plight:

COVID pneumonia/ARDS,
Septic Shock
A Fib w RVR
Air leaks and Chest tubes
Bleeding
Clotting
Strokes
Blindness
Kidney failure
Deafness
Ongoing severe brain fog 🧠

5/ Everyone must be involved in #Recovery. Family members & loved ones too often get paralyzed by fear of this illness. 😩 You need to remember that even when he’s sedated in a coma, YOUR voice in his ear sends reassurance that he’s not abandoned. You offer hope.

6/ To all the #Doctors and #Nurses also hurting today, I want to remind you of our ICU History because it will anchor you & also serve as a “burnout prevention tool.” 30-40 years ago, we got great at ICU human physiology, but we lost site of the person in the bed.

7/ For EVERYONE who knows a sick #COVID19 patient, it is KEY to understand the full impact of critical illness. This disease CONSUMES a person. The entire person: mind, body, spirit. Without addressing all of these elements in healing, we miss the mark badly.

8/ #DeltaVariant has taken over. Our 4 MICU teams are now 90% COVID again - a TEN FOLD ⬆️ in <2mos. Years ago, when we practiced de-humanized #CriticalCare, we talked about "the septic shock in Room 8" or "the ARDS in Room 12." Let’s not drift back to “the COVID ECMO in room 7.”

9/ Twenty years ago, great at technology of life support, we failed to understand the context of our patient's illness in their life. We also failed to comprehend the potential negative effects of our new therapies. #COVID19 ICU care can become a depersonalization chamber.

9/ Twenty years ago, great at technology of life support, we failed to understand the context of our patient's illness in their life. We also failed to comprehend the potential negative effects of our new therapies. #COVID19 ICU care can become a depersonalization chamber.

10/ 🎥👇 During ICU, pts get new diseases they didn’t have before. Dementia, PTSD, depression, & muscle/nerve disease. This is #PICS or Post-Intensive Care Syndrome. It’s a HUGE part of #LongCOVID for survivors. This pt survived but has a long way to go:

11/ In the 2000s, we witnessed a move in #CriticalCare toward "cookbook" protocolized approach, that at 1st didn’t include deeper consideration of the humanistic side of medicine. Over the past two decades, we changed bedside dialogue with the #A2FBundle.

bit.ly/2YuoRlC

12/ Whether you are family or medical, today & every day please discuss the key elements of the #A2Bundle for all sick #COVID patients. This is a proven path to rehumanization in the ICU – hundreds of papers and >30k pts of data. Less death & More Recovery. What’s the A2F bundle?

13/ A is analgesia…control pain.  B is BOTH stopping sedation & the vent to test readiness. C is Choice of drugs, avoiding benzos. D is Delirium management. E is Early mobility. F is Family!  Do all that & we see less brain fog, more LIFE, and more HOPE!

14/fin
FIRST - get #Vaccinated
SECOND - There is an ENTIRE PERSON in that bed. Not just sick 🫁 or a COVID blood clot. The #Virus has taken so much. Let’s not let it take our humanity, too.

Fight back using the
Re-personalization Chamber. Whole person care!