1/🧵ICU Burn-Out Prevention in #COVID: a few thoughts
Early on as an ICU Doc, I carried a lot of shame because I realized that even though I sufficed as a technician and possessed the right knowledge, I was NOT doing a good job as a “person” with “people.”
2/ Which is to say, I was only “good” doctor on paper. NOT in real life.
I kept myself at too much of a distance, and I thought my job was to do procedures well and provide the right medicines.
Now I know that was not enough, not by a LONG SHOT.
3/ 📚 I wrote: “That shot of adrenaline from saving a life dissipated once the ventilator was in place…as if we handed over care of our patients to machines while we went off & intubated, sedated & paralyzed the next person...
2/ Brains of COVID-19 patients had some of the same pathological changes seen in Alzheimer's disease, which may explain the memory problems people with long COVID experience....
3/ The study...linked the inflammatory response found in SARS-CoV-2 infection with pathways causing tau hyperphosphorylation typically associated with #Alzheimers. The data also indicated a role for leaky ryanodine receptor 2 (RyR2) in the pathophysiology of SARS-CoV-2 infection.
Would you be upset if you found out that a medical student had done a FULL PELVIC EXAM (or PROSTATE EXAM) under general anesthesia without explicitly telling you beforehand or even afterward?
Is this a violation of your privacy?
Read on…
2/ Would you consider it A FORM OF ASSAULT if you found out that a medical student had done a FULL PELVICE EXAM (or PROSTATE EXAM) under general anesthesia without explicitly telling you beforehand or even afterward?
3/ Apparently, some medical schools are still doing this as a way to teach budding doctors how to examine the human body. Many types of injustice in medicine have occurred over the years, and this represents one of them.
2/ These #LongCOVID pts had NORMAL CT scans but when asked to inhale Xenon, an inert gas, the MRI showed their lungs transferred gases (think oxygen) into the bloodstream abnormally. This is alarming evidence of another weird form of organ damage from COVID not visible on CXR/CT.
3/ Oxford Prof Dr. Gleeson says these patients, who were never in hospital & didn’t have acute severe illness w their COVID19, have been experiencing symptoms for a year after contracting the infection.
2/ This successful trend is especially important given AI/AN communities have been disproportionately affected by Covid-19 and by ongoing discrimination throughout the health care system.
AI/AN communities have worked to protect the health and well-being of their members by…
3/ …adapting community mitigation & vaccination strategies to their diverse cultures.
There are 574 federally recognized tribes located in 35 states. AI/AN lands, which are sovereign territories, extend over 100 million acres, including 44 million acres in Alaska.
This new @JAMA_current study of 246 Dutch pts shows that 3 out of 4 people had physical problems 1 YEAR LATER plus 1 in 4 have #brainfog, depression & anxiety.
2/ The paper is also discussed in @Medscape👇: “Our study shows what an impact ICU admission has on former #COVID19 pts. Even after 1 year, half are tired or experience lack of the energy to fully resume their work," says author Marieke Zegers, PhD
For too long in life, I thought success was about climbing in the 🌎’s eyes…higher, better, farther. My physician wife & I are “new parents” to my 58 y/o brother w #DownSyndrome & he’s giving me all kinds of new understanding of what matters.
2/ When I come home, Greg is usually hiding from me, like you see here. He thinks so beautifully, “How can I make someone else #happy in the small things in life?”
Here he is hiding in plane sight next to our dog Butter. Look at that grin!