WesElyMD Profile picture
Feb 8 5 tweets 3 min read
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.”
 
#burnout #nurse Image
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...

P.58 #EveryDeepDrawnBreath Image
4/… “My noble mission of saving lives had turned into a conveyor belt of care.”
 
Have you ever felt like your physician was viewing you in a robotic mindset?

I am sorry for all the times I did this. I wish I could apologize to each patient.

My answer: do better today…
5/fin
The answer is whole person, humanistic care.

This is a burnout prevention program.

Stop 🛑

See each person as an entire magnificent human being…each an entire WORLD 🌎

Cada personal es en mundo. 🎁

Covid only prevents this if I let it. I won’t let it.

Will you? Image

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More from @WesElyMD

Feb 7
1/🧵 #COVID Brain Changes Show Parallels w Alzheimer's Disease
 
Findings may point to potential mechanism for #brainfog in people with #longCOVID

bit.ly/3J8gArA
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....

bit.ly/3sr1S8p
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.
Read 7 tweets
Feb 7
1/🧵 Do you think this is WRONG⁉️
 
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.
 
bit.ly/3Gx4XZv
Read 9 tweets
Feb 2
1/🧵 What is #LongCOVID⁉️
 
A disabling malady from ongoing inflammation, autoimmunity, & potential viral reservoirs (GI, brain?)
 
NEW DATA: The Lungs “light up” on special MRI Scans 3 to 9 months later in patients never hospitalized for COVID.
 
bit.ly/344Oajp
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.
Read 14 tweets
Feb 1
1/🧵 Covid-19 #vaccination in American Indian & Alaska Native (AI/AN): @NEJM

The AI/AN population has the highest 1st dose & full #vaxx rates of any US racial or ethnic group.

This photo of Black Elk should remind us of true #HEROES

link: bit.ly/3KY77og Image
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… Image
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.
Read 8 tweets
Jan 31
1/🧵 How do #COVID patients suffer after the ICU?
 
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.
 
What do we call this?

#LongCOVID #PICS
 
bit.ly/3o4djkT
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
 
wb.md/33U9DeF
3/ I searched this paper for well-known terms like post-intensive care syndrome #PICS, #LongCOVID & even “post-acute sequelae of COVID”#PASC
 
NADA. Zip. Zilch.

Why weren’t these names mentioned? At the very least, these pts’ disabilities are DEFINITELY PICS & underestimated btw
Read 9 tweets
Jan 25
1/🧵 Beauty in simplicity
 
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.

#COVID
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!

#Recovery
3/ Hide and Seek: He taught me that if he can’t see me, I can’t see him!

At first that seems nutty, but in truth, for me to enter “into #relationship” w you, we do need to SEE EACH OTHER, right?

So who’s teaching who here?!
Read 6 tweets

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