👏 By the way I need to give credit where credit is due. The design of this poll was helped greatly by the aid of two Twitter gurus: @nickmmark and @laxswamy. Thank you both! 👏
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Look how my patient’s right leg flails around. This is INVOLUNTARY. He’s trying to stop but his brain is doing this against his will. It is “hemiballismus” & was caused by a fungus deep inside his brain. Read🧵
Link: bit.ly/3ixnWcx
2/ He was having these movements day & night. Unable to sleep. We admitted him to our ICU and realized the fungus Cryptococcus was causing a brain infection called meningitis. He had no underlying immune diseases or other health problems.
Another 🎥, all shown w his permission
3/ His MRI showed 2 pockets of infection on both sides of his brain in a place called the basal ganglia, which controls movement. This area had to heal for him to rest and be at peace again.
🎥👇This man is suffering a form of longCovid wrought by complications of his ICU illness. He’s a clear example of the most severe form of #longCovid, also known as #PICS, for “post intensive care syndrome”…
2/ There are vastly different ways Covid will affect people over future months & years. Do we split those into multiple diseases or lump them into 1 big syndrome (w subgroups) to grab millions of people & help grow advocacy & gain footing?
3/ #PICS is mainly encompassed by cognitive difficulties, an acquired dementia called ADRD (#Alzheimers Disease & Related-Dementias), as well as #PTSD and depression PLUS profound muscle and nerve disease called ICU-AW (ICU Acquired Weakness).
1/🧵Is my LIFE WORTH MORE than yours if I get #VACCINATED & you don’t? Or if I’m a COVID nurse?
ECMO is advanced life support in short supply that can save lives in extreme #Covid19.
Q 1 of 4:
If a #DeltaVariant surge creates too much demand…WHO GETS MY LAST ECMO MACHINE?
2/ How about essential worker status?
Q 2 of 4: Two #Covid19 patients are admitted on the same day & the virus has destroyed their lungs equally. You only have 8 ECMO machines & 7 are already in use. If forced to choose, WHO DO YOU PRIORITIZE?
3/ THE TWIST:
Q 3 or 4: Two #Covid19 patients are admitted on the same day & the virus has destroyed their lungs equally. You only have 8 ECMO machines & 7 are in use. If forced to choose, WHO DO YOU PRIORITIZE?
When I combine intensive care w palliative care as an ICU doc, I’m delivering PRIMARY palliative care. I often consult a board-certified palliativist for additional help, & this is SPECIALTY palliative care. Today… #medtwitter
2/ Today the most complicated thing I did in the ICU were NOT bronchoscopy or restarting a heart. It was helping people navigate these massive life choices, often shifting the treatment ladder we are climbing from the wall of cure to the wall of comfort. To me it’s the best…
3/ To me, primary #PalliativeCare is the most nuanced and critically important part of my vocation as an Intensivist. Just as the Winter gets you to a mountains 🏔, but Summer keeps you there, Palliative Care is not what brought me to the ICU but it definitely keeps me here.
1/🧵 I’m surrounded by an #AntiVaxxer govt now willing to hurt kids!
👎 My home state of #Tennessee made the BONEHEADED decision to halt outreach to kids on ALL #Vaccination, NOT just #COVID19. I’ve lived here since 1997. I’m embarrassed, angry & sad.
2/ Our Department of Health is halting “all adolescent vaccine outreach for ALL diseases.” What? So we aren’t going to protect our precious kids against Tetanus, Pertussis, Diphtheria, Rotavirus, H flu, hepatitis, pneumonia, meningitis, HPV (which leads to cancer)?
3/ GONE are Postcards to teens to remind them to get a second #COVID#Vaccine shot...but adults still get the postcards. Why? “Potential solicitation to a minor.” WHAT? No, this is called #PublicHealth.
Why should adults get promotions toward #wellness and not kids?