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1 Jun, 7 tweets, 6 min read
1/🧵 AGEISM: Never be discouraged by age AND don’t judge others by age. Chronological age is a bogus constraint in life. I read today of some great examples of iconic people who did crazy cool things after 7 decades of life. See these & realize age is NOT a limitation...
#MedEd
2/ 👏 Major late-life #winners: 👏

• #NelsonMandela, president of SA at 75 y/o
• #Michelangelo started on St. Peter’s at 72
•#GrandmaMoses folk artist sold her 1st painting at 90!
• #ArthurMuir just scaled Mt Everest 🏔 at 75 (pic)
• #JohnGlenn went into space at 77 y/o!
3/ Bonus 😀: German athlete Johanna Quaas at 86 y/o is the world’s oldest gymnast at age 86. She’s a retired P.E. teacher & started in this sport at age 56.

#NoLimits 🧠

bit.ly/3i5wclf
4/ Ageism is flat out wrong. I used to look at pts & focus first on age. I have retooled my mind to avoid this entirely. Each person is unique in her/his physiology. I limit others unfairly by the prejudice of ageism. #DementiaAwareness is key of course. Let’s look...
#MedTwitter
5/ 60-minutes 🎥: the 90+ Study is teaching us so much about aging & raising exciting new questions. Some people have plaques & tangles galore but no dementia. Others vice versa. It’s all about resilience or lack thereof.
 
cbsn.ws/3p3tP3M
6/ That video discussed dementia causes like TDP-43, microinfarcts, and hippocampal sclerosis. Lots beyond Alzheimer’s Disease. We have more questions now than answers. Listen further...🎥
7/ fin 🎥
Luckily, many living w #dementia like Ruthie stay happy, and we want more for them! In our NIH BRAIN-2 study of 🧠s of ICU survivors (after their eventual death) we’ll unravel #PICS & acquired dementia.

Today, I’ll avoid bias & judgment of ageism, how ‘bout choo?

• • •

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More from @WesElyMD

WesElyMD Profile picture
2 Jun
1/ 🧵Wisdom in Medicine
 
What’s going on here? And why it’s key in #COVID19
 
It’s quite simple: we finally had the #wisdom to ask Mr. D the right question! He and his wife encouraged us to use this picture to teach what we learned.
 
#PalliativeCare #MedTwitter #NurseTwitter Image
2/ What we learned was to switch the preposition!
 
Mr. D was a pre-#COVID patient. On this day, he was taken off the vent after a MONTH. The incessant mantra had been, “What’s the matter WITH Mr. D?” He was surprised when we asked, “What matters TO you, Mr. D?”
3/ He has a tracheostomy, as you can see. We insert this airway through the neck to improve #comfort when someone is on a vent well beyond 10 days. He’s more comfortable because he no longer has a tube in his mouth. We used a program called the #A2Fbundle to reduce his #delirium.
Read 13 tweets
WesElyMD Profile picture
31 May
1/🧵The Nightmare of #COVID19 & #LongCOVID
 
Im a doctor who is now spending more & more time daily caring for #LongHaulers (pts w LongCOVID). I just got a TINY dose of what it must feel like to be unheard and unseen…AND I want to apologize to you.
 
#MedTwitter #NurseTwitter
2/ I just keep hearing you say, “Doc, why doesn’t anyone believe me? My friends look at me and think I’m fine, even as I feel further and further adrift. I’m not myself and I can’t tell if I ever will be again. #COVID has ruined my life.”
3/ Yesterday as my plan landed, my phone vibrated. It was the wife of a former ICU #COVID pt, now trached & living on a vent in an LTAC, asking how she can get his new docs to understand & carefully manage her husband’s ongoing #LongCOVID & Post-Intensive Care Syndrome (#PICS).
Read 13 tweets
WesElyMD Profile picture
26 May
1/🧵 Imagine 2 people, madly in love & married 28 years, in an impossible situation, both lives on the line & separated by different hospitals. Then imagine 2 sets of #nurses & #doctors separately determined to overcome ⛰ of obstacles…
(shared w perm)

#MedTwitter #NurseTwitter
2/ Last night this is what happened…

NOTE: the family wants to share their story to offer a glimpse of love ❤️ on all levels

For 3 years, Mark took care of Sharon, his #bride, as she battled breast #cancer. It relentlessly spread to her bones. He never stopped giving.
3/ She could tell he was spent and getting sick himself. “Mark, let’s get you to the doctor!” “Not until you are well, Sharon.” He remained laser focused on her every need. As she became weaker, he took her to get admitted yesterday.

#marriage #life #caregivers
Read 13 tweets
WesElyMD Profile picture
25 May
1/🧵 Lung Scarring in #COVID19 – what’s the deal?
 
I got a birds eye view of #LongCOVID yesterday from my patient who’s still on Oxygen at 8 months. WHY?

Let’s unpack what happens in the 🫁 and why it’s such a life-changing disease is for so many...
 
#MedTwitter #NurseTwitter
2/ 4-months after #COVID, this @JAMA_current study found 51% of N=478 pts had >=1 #LongCOVID symptom that wasn’t there before. 63% of those w CT scans had lung problems, with 1 in 5 showing scarring. What else?...
 
bit.ly/34a29k9
3/ This JAMA study also showed this important array of symptoms that essentially constitute #LongCOVID – 31% gross fatigue, 21% cognitive problems, and 23/18/7% anxiety, depression & PTSD. Their outsides look normal, but they aren’t!
Read 7 tweets
WesElyMD Profile picture
24 May
1/ 🎥 Asymptomatic #COVID = Silent Spreaders
 
This short video from @EricTopol & @Danieloran summarizes key issues about Asymptomatic Spread of #COVID19. Watch & then read the🧵for my unpacking…there is so much at stake!
 
#Pandemic #Vaccinate
2/ In 2020, @danieloran & @EricTopol predicted that up to 40-45% of people infected w #COVID19 were totally asymptomatic, meaning HUGE risk of silently spreading the disease to others. 👁 highlights

Next tweet for the UPDATE...

bit.ly/3yz1QNN

#MedTwitter #NurseTwitter
3/ Now we know ~1 in 3 people infected with #SARSCoV2 remain asymptomatic. This is based on 61 studies & ~1,800,000 pts! Also, of those who test + w/out any symptoms, 75% stay asymptomatic.  This poses a HUGE risk of silent spread to high risk patients.

bit.ly/2SiXQAn
Read 8 tweets
WesElyMD Profile picture
20 May
1/🧵#COVID19 Compassion

Our patient wants to live 3 days to see his grandson graduate. He has #COVID19 pneumonia & is extremely short of breath. He’s chosen NOT to go on a ventilator & is on 100% O2 HiFlow Canula. He’s afraid of tight-fitting a bipap mask.

#PalliativeCare
2/ The intern said, “I never saw a patient whose respiratory rate was twice his oxygen saturation!” Yep, last night his O2 sats dropped to 30% and he was breathing 60 times a minute! By morning he was 85% sat and RR was 28. Better but tenuous.

#TipsForNewDocs #MedStudentTwitter
3/ All of this raises some complicated ethical + treatment questions that I’d like to cover. We addressed this on rounds several times this week & at times it got a bit heated. His #nurse said she noticed herself flushed, mad, and heart rate >130…why?
Read 13 tweets

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