WesElyMD Profile picture
16 Feb, 7 tweets, 8 min read
1/ Tinkling of Ice: #Alcohol & Me
 
Personal Share: As a 1st year #MedStudent 35 years ago (#MardiGras 1986), I was a cyclic, binge-drinker. It threatened my future as a physician & my personal safety. I draw on these experiences with pts.
 
#medtwitter #tipsfornewdocs #nurses
2/ For me, #recovery meant detaching from harmful zones of behavior. Years of ups & downs. I often share my story w patients when it comes up. I find this builds a powerful connection between us and helps us both. #healing
 
#medstudenttwitter #academictwitter #nursetwitter
3/ I needed to give up, fess up, make amends, and keep up. I stumbled along the way & am thankful to those who supported me & did not judge me.
 
#HOPE = Hang On, Peace Exists
 
#healing #workinprogress #addiction @ASAMorg @AlAnon_WSO @RyanForRecovery
4/fin
In closing, knowing I have gone low, I am not so superior. I recognize my own attributes as unearned gifts. I try to build on these experiences & use them wisely towards the good. One day at a time...
 
#medstudenttwitter #sober #pandemic
Some have admonished me for sharing #recovery & asked why I did:

To open a door to help both us & pts using “story” (as relevant). It helps me tap into #healing strength. That is why I did it. Wont be for everyone & would not help all pts.

@MedHumChat @MedBookClub1
#MedTwitter
I also learned this in #recovery: I have an overdeveloped sense of responsibility for others. Overused assets are liabilities to be shed.

As a #dad I now live the 4 Gs:
Get off my kids backs
Get out of their way
Give them to others
Get on w/ my life

#Parenting #Peace #Healing
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More from @WesElyMD

28 Dec 20
Green Urine: #NEJM
 
....will be seen in #COVID – Why? Massive use of Propofol. While Green Urine is Benign, effects of prolonged over-sedation & immobilization ++ #DELIRIUM are not 😤 Wake them up & get out of bed. Start w/SAT…#A2Fbundle & #PICS

#medtwitter #nursetwitter
1/ re: SATs to avoid over-sedation in #COVID19 pts, Thx @phanton_icu for Protocol Blindness caution & @Nitkjain reminder “Easier said than done.” I’ve been pondering your comments all day & think them ripe for further conversation on #A2Fbundle

#medtwitter #pulmcc #nursetwitter
2/ Remember, protocols like #A2Fbundle are guides & not “1-shoe-fits-all pts.” Correct, we must deviate when needed. However, these 6 principles (ABCDEF) are derived from 35 NEJM, JAMA, Lancet papers +400 others & now >25,000 pts of data. Not chump change.
bit.ly/2JwVA4E
Read 10 tweets
20 Nov 20
Trigger alert 🚨: Hard to stomach but this hits so hard I want to face it. Segregation of Blood🩸by color of skin went on until 1972 & the “1-drop rule” persisted until 1983 in my home state of LA. 😩 👀 labels.
I pledge to fight #racism & lift each person.

#medtwitter #MedEd
1/ Dr. Charles Drew, an African-American surgeon & father of blood banking, perfected techniques that saved countless lives. Yet he was prohibited from donating blood himself over “fear” of his black blood. Read #2 w/ ✍🏻
bit.ly/2IRvJDW
#MedTwitter #MedStudentTwitter
2/ Dr. Drew ✍🏻 this letter of protest because he wasn’t being allowed to🩸: “I think the Army made a grievous mistake, a stupid error in first issuing an order to the effect that blood for the Army should not be received from Negroes. My 3 reasons are...”
Read 7 tweets
8 Oct 20
1/ ICU #diaries for Good #Death:
 
Especially at EOL, ICU #Diary is part of #A2Fbundle. My pt w/ home-hospice told me details recorded in #ICU by #nurse allowed her to decipher cryptic #delirium memories she was struggling with.

bit.ly/36DOtk3

#medtwitter #meded
2/ Then she told me of hours spent reading big-hearted comments others had written in her ICU diary, making her realize how much her life meant to others. It was a priceless gift to her at a critical juncture in what had a time of deep poverty in her life. #PalliativeCare
3/ ICU Diaries give family members at bedside a practical way of helping w/ loved one’s care & can help channel their worries in a focused way.
#criticalcare #pulmcc
Read 7 tweets
5 Oct 20
1/ #COVID19 Journal: New Yorker

Dr. @danielleofri has gifted us w/her #COVID journal. Her beautiful edifying ✍🏻 is a treat for your 🧠 and super instructive about #Pandemic.

👀Excerpt next tweets...

bit.ly/36vddL7

#medtwitter #TipsForNewDocs #tipsforolddocs #MedEd
2/ Dr. @danielleofri writes in NYer:

“On Friday, the magnolia tree next to the #covid tent bursts into riotous blossom despite the chilly weather. Until now, the flowers have been delicate cups of pink and lavender, spaced along the spindly gray branches...”

(She shared pic...)
3/ Dr. Ofri continues...

“Now they’ve abruptly reversed their concavity, spilling open into an unbroken blanket of defiant white.

Normally, the inner workings of the hospital are invisible to doctors and nurses. We show up every day and the patients are there, the beds...”
Read 6 tweets
4 Oct 20
1/ When I play the #criticalcare movie 🎥 of me as an intern or resident back in my head, I see myself as much too robotic 🤖 with my patients, as if plugging in kitchen appliances.

#medtwitter #meded #tipsfornewdocs #medstudenttwitter #nurse #pulmcc #COVID19
2/ The nurse would slip a Foley catheter up his urethra into his bladder. I’d go to the stockroom to get all the materials to slide a plastic endotracheal tube down his trachea to become command-central for his breathing on the ventilator.
3/ Next, I’d methodically place a Swan-Ganz catheter by serial insertion of a needle first, then a wire through the needle, next a dilator over the wire, and finally the catheter itself down into his great vessels and heart. And start the ‘pressors.
Read 6 tweets
30 Sep 20
1/ In #COVID19, we must learn from #BRAIN masters Engel & Romano, who described #DELIRIUM to #DEMENTIA relationship in the 1950s! Here are my TOP 10 CLASSIC quotes from their famous 1959 article:
bit.ly/2SePA1a
 
#medtwitter #meded #tipsfornewdocs #neurology #geriatrics Image
2/ The problem of delirium is far from an academic one. Not only does the presence of #delirium often complicate and render more difficult the treatment of a serious illness, but also it carries the serious possibility of permanent irreversible brain damage.
 
#dementia #COVID
3/ The deficiencies in the education of many physicians ill equip them to recognize any but the most flagrant examples of delirium.
 
#A2Fbundle #tipsforolddocs
Read 12 tweets

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