I am working with a young mom on the west coast with a clear progression of symptoms that looks like EDS associated with a childbirth injury due to an errant epidural. Throughout, her male physicians have gaslighted her, attributing tangible symptoms to psychiatric illness.
Rather than letting the data inform a diagnostic process, their theory is to deny, deflect the tangible persistent symptoms that are interrupting her daily life.
This is physician failure to adopt an appropriate diagnostic model, not patient failure.
Siloed care fails complexity.
Complex comorbidies are FAILED by siloes of care.
Acute care relies on approaches that tackle simple problems.
Complex comorbidities require 3D, integrated approaches to tackle what amounts to wicked problems.
Acute care approaches FAIL complex care problems.
@AmerMedicalAssn
HEDS, Bell's Palsy, CSF leak, gastroparesis, saddle anesthesia, cauda equina, POTS, bowel/bladder incontinence, persistent pain. While distressing, these symptoms do NOT originate in psychiatric illness.

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More from @tal7291

9 Jul
Every loss counts.
Every sigle denial of life-giving care denied counts.
#HealthCareIsAHumanRight
Read 5 tweets
8 Jul
Five undervaccinated clusters put the entire United States at risk

cnn.com/2021/07/08/hea…
'The five clusters are in parts of eight states, starting in the east in GA and stretching west to TX and north to so MO. The clusters also nclude parts of AL, AR, LA, OK and #Tennessee, and are made up of mostly smaller counties but also cities...'
Vaccination rates (2 jabs) in @GovBillLee's targeted travel cities. All of these metro areas are surrounded by county rates that are far lower.
vaccinetracking.us
Shelby Co (Memphis) 34%
Davidson Co Nashville) 46%
Hamilton Co (Chattanooga) 41%
Knox Co (Knoxville) 44.6%
Read 4 tweets
14 May
Let's not park our personal brains at the door.
If you're vaccinated and in an indoor area, but you don't know the status of folks around you, it's perfectly okay to use a mask - maybe even desirable.
If you are indoors with folks for whom you know the status (+/-) just think.
Helpful discussion about vaccines right here
At home COVID19 test kits-are they reliable?
wdsu.com/article/rossen…
Read 4 tweets
12 May
So there's thus thing called a gas pipeline which is operated with digital software that should have been upgraded years ago and regularly maintained but somehow infrastructure hasn't been a funding priority.
Now the pipeline (that everyone knew was vulnerable) has been hacked by criminals and the fix that should have been in long ago has to be built as a workaround.
And 1000 gas stations are drained because folks are hoarding gas and now you're mad cause you can't fill your tank.
Read 7 tweets
12 May
What HBO’s ‘Crime of the Century’ Doesn’t Tell You disq.us/t/3wuapcq
We do what we can. Shamefully, no benefit will accrue to patients from the marketing of this litigation - no better understanding of pain, its' victims, the history of attempts to treat the sickest of all, no improvements to access, no breakthroughs.
Patients in pain are also victims of this HBO Feature, hapless conduits for gaslighting and revisionist history absent of balanced fact finding and presentation. The film makers don't even pretend that the public good will be served.
Read 4 tweets
10 Nov 20
1/
Community physicians...
Do you know how to code your medical records to support complex chronic care cases?
Do you know how to assess for Palliative (not hospice) care?
effectivehealthcare.ahrq.gov/products/palli…
2/ effectivehealthcare.ahrq.gov/products/palli…

Palliative care: Care that provides relief from pain and other symptoms, supports quality of life, and is focused on patients with serious advanced illness and their families.
3/
National Consensus Guidelines Domains for Quality Palliative Care
1. Structure/Process of care (e.g., continuity, communication)
2. Physical Aspects of Care (e.g., pain, dyspnea)
3. Psychological and Psychiatric Aspects of Care
4. Social Aspects of Care (including caregiving)
Read 9 tweets

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