Yesterday, I had to come face to face with several COVID patients (yes I had an n95 & limited my contact as much as possible)
I admitted one patient with COVID… an older gentleman who had natural immunity from recovered COVID from a year prior, he had come in with mild viral symptoms… he was much less symptomatic compared to his 1st infection…
but now he was more short of breath. His D-dimer was high and he was COVID+, his CTA of the lungs showed bilateral pulmonary embolism…

This is the, it’s nothing new pandemic
Also not new, I received these two simutanoes comments on social media. One said I was recommending the vaccine too aggressively and the other literally written at the same time said I didn’t recommend it enough.
Around the same time a family member who rarely ever talks to me, replies to me questioning how I care for my patients 🤔
I have been asked to help out inpatient in the hospitals… I have countless patients in my clinic sick every day with SERIOUS medical conditions from cancer, sepsis, COVID, to diabetes and heart disease.
I have devoted 20 years of my life to building knowledge, graduating medical school, finishing residency, chief residency, practicing medicine, publishing research articles, creating support groups and apps all to help people get healthier.
While I understand that random social media trolls will come out and attack me based upon their political or ideological beliefs or maybe just to plain mess with me…
But it’s surprising when distant family/friends who show little interest in your life… they feel it’s appropriate to gaslight, ad-hominem, and just plain make up shit to suit some deranged, shameless politically-aligned narrative, based in all-or-none thinking…
It’s superficial. It’s disingenuous.

I give 100% of myself to my patients. If my patients suffer so do I, emotionally and otherwise. This is something selfish people cannot understand.
I spend on average AT LEAST 3 hours with my patients when they first join my practice. To understand who they are, their values and their goals. I spend time to educate them and listen as best as I can, in a way that’s unseen in modern medical practice (the avg MD visit is 7 min)
While everyone on social media is sitting on their couch at home they may want to feel like they “are doing something”… about this pandemic… the reality is that there are real people ACTUALLY doing something about the pandemic.
So take a second, if you have a doctor or nurse, hospital administrator in your family… THANK THEM.

While you were out drinking, smoking, partying, We were studying, so we could serve our families, friends, community and country.
My entire focus has been on the service I can provide to others. My entire purpose is to educate myself as best as possible to deliver the best possible healthcare.
If in the last two years, if you haven’t seen countless COVID patients, if you haven’t actually contributed to medical science in any way… maybe just maybe, say a thank you to people who do every day.
There are some of us who are acting in complete service and find ourselves having the armchair social media mob criticize you for simultaneously doing something TOO MUCH & TOO LITTLE.
Let’s bring nuance back to medicine, discussions and let’s not forget the people in our lives that are serving others… yes thank your waiter, garbage man, nurse, doctor or physician’s assistant, or office manager (least recognized people IMVHO)
Yesterday, I had to come face to face with countless COVID patients. For two years I’ve dealt with this pandemic in hospital and out while publishing research and volunteering time… What exactly did you do?

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More from @DoctorTro

20 Dec 21
🚨 Thread on LDL & low carb🚨

How I approached high LDL in my patients, and how we observed a decrease in LDL of 480mg/dl

About the case-series of 5 patients…

(1/20)
As data supporting low carb diets has proliferated for weight loss, diabetes, seizures and other conditions, patients are now presenting with various issues related to the diet

2/20
For example, while it’s true that consistently a1c, triglycerides, HDL and lpa seem to improve, some patients report some adverse events.

3/20
Read 23 tweets
25 Nov 21
I want to THANK some of my mentors, colleagues and friends/family this thanksgiving

@drericwestman - for being a shining example of a clinical scientist
@davidludwigmd - for being a proponent of science in the face of harsh criticism

/thread 🚨
@bigfatsurprise - for opening my eyes to understanding how poor nutrition policy has effected us all

Dr. Mark Cuccuzella - for showing me that systemic change is possible
@BrianLenzkes - that values and family are more important than material things

@IMWHorvitz - for agreeing to pick up the phone & talk to me about the value of independence in medical practice 5 years ago
Read 5 tweets
23 Nov 21
What I wish I knew as a 350lb doctor?

❌eat all food in moderation
✅Fuck that, eat satiating real food with no limit and then if hungry eat more 🥩🍖🍗🥚🍳🥦🫑🥑🍓🍤

❌eat 5-7 small meals
✅Fuck that, if you aren’t hungry don’t eat & when you are hungry eat real food

/thread
❌breakfast is the most important meal
✅I haven’t eating breakfast in 7 years & I’ve kept 150lbs off

❌eat whole grains
✅this is just a way to get you to eat Kellogg’s & General Mills processed shit food… if they are advertising “fiber” or “whole grains” you are being conned
❌if you want chocolate or ice cream just have a little
✅either don’t have it OR if you need it find a version without sugar, plenty of low carb alternatives out there, takes some of the addictive qualities of the food out (yes and calories)
Read 5 tweets
19 Nov 21
THREAD:

Why I personally never took the influenza vaccine, despite recommending it to many of my higher risk patients...
I was told as a first-year, medical intern that my refusal to take the influenza vaccine was a disgrace.

I want to outline why 10 +years ago I refused the flu shot & haven't taken it since...
Around that time the previous recommendations were for the flu shots to be given to the high-risk and elderly.

After all, the shots were changed annually and there were no high-quality studies definitively showing it improved outcomes in the general population
Read 25 tweets
11 Nov 21
First of all, love @mackinprof work on protein

The love stops there m… THREAD
To equalize diets to some concept of “whatever works” is a lazy approach to obesity. FULL STOP.

Diets work for very specific reasons in certain individuals, not understanding those reasons needs to be states and it wasn’t

What happened instead?
Some koombaya nonsense that the efficacy of diets is based on adherence. Besides that being circular reasoning it again shifts the blame to the disenfranchised people with obesity & not the dumbfucks who portend to be experts
Read 4 tweets
28 Oct 21
I met a person in the gym who went to a bariatric surgeon, was evaluated by a psychotherapist, psychiatrist and then had bariatric surgery.

She lost some weight but gained it all back several years later. No one reached out to her, nobody followed up.

/thread
When I asked her why she thinks it happened, why she gained weight, she said “it’s my fault”

She said “she ate too much, maybe she was emotionally eating”

And this is basically where I lost my shit (keep reading)
They cut out her stomach, forced her to “eat the size of her palm”… they cleared her for surgery and provided no support, no clear vision of what she is up against… but they did collect fact check$

THEY did this to her, SHE WANTED HELP… and yet she says “it’s my fault”
Read 5 tweets

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