Med student started a thread on vertebral artery dissection ( causing stroke, sometimes severe) after chiropractic manipulationon #MedTwitter and my goodness so many people chiming in with terrible stories. Say no to neck adjustments-I have seen one case and it was tragic.
Headache, neck pain, and later neurological issues-dizziness, sensation symptoms one side face-other side body, balance, vision, swallowing, taste can be affected... lots of stuff can go wrong if your artery lining tears a little.
/2
I’m a hospital based doc not a neurologist and saw this in training, but remember it VERY well because the patient had no symptoms before the adjustment (routine visit apparently) but refused to believe the adjustment caused it when we admitted them. (These can happen from...
/3
Other causes like neck trauma or have no obvious cause but there is an association with neck manipulation) ... and if you have neck pain from this and go for manipulation it becomes hard to tell what’s what...tandfonline.com/doi/full/10.10…

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More from @AntibioticDoc

21 Nov
I found this discussion illuminating and stressful (because it was hard to know even where to start unpacking the somewhat strange takes on the current realities) - I can’t watch it because I can’t watch myself (cringey!!) but I learned a lot...
/1
People really seem hung up on ??misrepresentations of health care capacity (why should your mismanagement make us lock down) rather than
1) it’s all us - health care is people and for all of the people, and uncontrolled COVID 19 hurts people and businesses simultaneously
...
/2
2) the initial health care need projections were for an apocalyptic event and we assumed every able bodied HCW would just do what they could. We didn’t think we’d PLAN for that scenario, keep everything open, and watch it coming.
/3
Read 8 tweets
14 Nov
Apropos of...well, COVID19, I’m sharing a few of my favourite Dr. Who quotes. These are barely a start...

“Of course we should interfere. Always do what you’re good at.” – The Fourth Doctor, Nightmare of Eden (1979)
/1
“Never give up. Never give in.” – The War Doctor, The Day of the Doctor (2013)

“Always try to be nice, but never fail to be kind.” – The Twelfth Doctor, Twice Upon a Time (2017)

“Anybody remotely interesting is mad in some way or another.” – The Seventh Doctor, THSITG (1988)
/2
“There are some corners of the universe which have bred the most terrible things. They must be fought.” – The Second Doctor, The Moonbase (1967)

/3
Read 8 tweets
11 Nov
#COVID19AB
I fear we have lost perspective on the measurable risk of the pandemic for both lives and livelihoods, and while we debate the worst harm, we are losing an opportunity to protect both. This is the worse we've seen so far.
A thread.
@ByMatthewBlack visualizations:
No plateau in hospitalizations, or ICU and we WILL be tight in ICU very soon. Image
Look at the heatmap coming up - more cases in older people, more deaths....although younger adults may still die or have serious complications too. Image
Read 6 tweets
24 Oct
...about COVID numbers.
(Note -I’m often up for a reasonable look at varied viewpoints, and can get along with people that I also violently disagree with. )

The 2 broad takes (with lots in between are

1) Not a big deal calm down girlie

2) holy #%*^ better do better

/1
So for the “no big deal” crowd-
Let’s say case# and percent positivity and hospitalizations are all increasing because of increased testing, or maybe numbers are right but it’s less lethal

(both of those are *very unlikely*)#
/2
First, the “no changes” thought experiment - we do nothing different, ride it out. Heck. Open up more. Infect the healthy - get it over with.
If you are right, everything is fine.
If you are wrong, densely populated areas see overcapacity hospitals excess preventable deaths
/3
Read 6 tweets
22 Oct
So... Alberta COVID-
Record setting new cases is profoundly concerning.

Overall in Alberta so far, 5% of cases hospitalized, 1-2% go to ICU and 1% die. (The improvement in COVID outcomes from the use of dexamethasone would reduces the risk of death by up to 25%.)
/1
Right now the ICU proportion in Edmonton and Calgary is actually high, in the 4-7% range. Very sick people.

Percent positivity is 3.15%
- rate is 4.2% in Edmonton since October 8. Part may be reduction of low likelihood asymptomatic testing

BUT the numbers and % both ⬆️
/2
Scarily:
>30 cases daily in people over the age of 60 and climbing over last days*

The daily case rate NOW is six times higher than it was in April.

The number of new outbreaks over last 10 days (of voluntary restriction) is about the same as previous 10 d (40-45/ 10 d)

/3
Read 12 tweets
8 Oct
Albertans -especially #YEG
It’s time to party like it’s...May 2020.

Yes, that means:
no party and
no big Thanksgiving gatherings and
no nonessential contacts
...because it’s getting real.

COVID-19 +276 cases Edmonton
(+364 in province)
ALWAYS #DistanceHandwashMask
...
/1
Where are cases?
Rough calculations -
In Alberta since June,
over 3/4 of Alberta outbreak related cases are from >8 case clusters- and over half of these “superspreader” events are at workplaces and in private gatherings-parties (with an average of 20-25 cases per outbreak!!) /2
Almost 40% of big outbreak cases are church-community gatherings- (very few but very LARGE outbreaks) while restaurants, conferences contribute ~5% of big outbreaks, and schools have lots of investigations but <2% of superspreader event cases
/3
Read 7 tweets

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