WesElyMD Profile picture
Feb 28 16 tweets 11 min read
1/🧵 Are you happy?

My brother w #DownSyndrome is teaching me tons of life lessons.

In medicine & in life, I make big decisions based on guesstimates of other’s Quality of Life #QOL.

I often GET IT WRONG!
 
What do adults w #disability teach me about TRUTH?

Can I learn? Image
2/🎥 How do we “calculate” someone’s #QOL?
 
#Confession: I get it all wrong when I impose MY judgment onto THEIR life.
 
Greg, my 57 y/o brother-in-law with Down Syndrome, has a better QOL than I do.

Why?

Digest this…read on…
 
#DownSyndromeLove
3/ My working definition of QOL is “the ability to give & receive love.”

REREAD THAT👆

Greg understands the Law of the Gift: Treasures GROW when we give them away.

It’s the opposite of hoarding.

Yet, giving ourselves to others can be SCARY. Greg ponders deeply these emotions. Image
4/ As Greg’s new “dad,” I have watched a pattern in his life.

Every day, Greg starts out afraid. He says, “Wesley, I scared.”

We talk about why & then we slow down & take life one moment at a time…

For Greg it’s very important NOT to jump ahead or skip steps.

#TheLuckyFew Image
5/ Yesterday, while eating waffles, Greg saw me making his lunch. I was being efficient. Greg threw a fit.

It totally messed him up because it meant I was rushing to the next thing without enjoying the present moment.

He NEEDS to absorb EVERY portion of NOW. Why?

#UpSyndrome Image
6/🎥 When Greg can relish exactly where he is & what he’s doing, all is right in the world.
 
Dancing to THIS song.
Eating THIS donut.
Petting THIS dog.
Looking at THIS snow.
Telling ME he loves me.
 
For Greg, this is what he wants in life. NOW matters most.
 
#DifferentNotLess
7/🎥 In contrast, what do I do?
 
While steamy waffles are on my plate, I worry about a meeting or a challenging person I’ll see in 3 hours. I review data I need for a patient’s #COVID treatment.
 
I cheat NOW of JOY.

Instead Greg finds #Hope in belief…watch👇
 
#T21 #MedLasso
8/ Back to #QualityOfLife.
 
If QOL is the ability to give and receive love, then Greg is teaching me a #MasterClass.
 
I am at the foot of Picasso‼️
 
So what about his fear at the start of each day?
 
What can I learn from him about FEAR?
 
#FindYourTribe ImageImage
9/ He starts out anxious…but day after day, I watch what happens.
 
As he takes each moment for what it is, and only for that, his day unfolds with beauty & #grace.
 
He dances at the YMCA. He makes some art. He hugs a friend. He jokes with others to make them laugh. Image
10/ The most beautiful lesson of all comes from the pure love I witness between Greg & his sister, my wife. There’s a love of complete giving.

Reckless abandon.

They show me that I can tumble into offering myself to another and gain immeasurable riches: the law of the gift! 🎁 Image
11/ Do you know about the “QOL Gap”?

Data show that if someone’s “expected vs actual” QOL are close, there’s a narrow QOL Gap, & they are happy. If they EXPECT something different than they get (large gap), they’re unhappy. It’s all about expectations.

bit.ly/3BRZ48w ImageImage
12/ Resentment come from unmet expectations.
 
Greg & “philosopher” Michael J. Fox (severe Parkinson’s) @realmikefox teach me that happiness increases if I ⬆️ my acceptance and ⬇️ my expectations.
 
Fox: “Gratitude makes optimism sustainable. Keep striving for gratefulness.” Image
13/ This last point is proving helpful in #LongCOVID.
 
Using ACT – Acceptance & Commitment Therapy - we are all learning how to maintain a NARROW QOL GAP, maximize gratefulness, and boost happiness while we wait for more science & answers.
 
LINK: bit.ly/3pkJblL
14/ Greg’s ability to accept life on life’s terms is remarkable. 🔑

Acceptance is the answer to so many problems. When I’m disturbed, it’s usually because I find a person, place, thing, or situation unacceptable. I can find no serenity until I accept.

Greg models this.
15/ What’s the Gold of Greg's MasterClass?
 
Happiness is not “all or none.”

I’ll dive into the deeps of personal change & do the work to increase my capacity to give & receive love…increasing my quality of life through acceptance of what is.

Taking life on life’s terms.
16/fin
When I pick up Greg @FriendsLifeNash, as we’re driving home, he invariably gets a little quiet…thinks…and says to me, “Wesley, I had a good day today. D’ya wanna go on a honeymoon?”
 
And I realize, “Greg, you and I, in this moment…we ARE on a honeymoon!”
 
#Cherish Image

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More from @WesElyMD

Mar 3
1/🧵 WAKE UP - #COVID is a Ball & Chain for heart disease & stroke.
 
This 154,000 pt study & others solidify COVID as a PREDICTOR of a variety of CardioVascular Dzs.
 
Translation: #LongCOVID pts suffer heart attacks, strokes & much more.
 
#Vaccinate!
 
go.nature.com/3pxKjmi
2/ SHOCKER: Amazing work scientifically. Every med student is taught to gauge Cardiovascular risk history: Smoking, Obesity, HTN, Cholesterol, Family History…

Add COVID to the list. Solid data from @NatureMedicine of US Veterans used >11M contemporary + historical controls!
3/ Main figure shows both hazard ratios & excess burden per 1,000 persons of highlighted types of problems like strokes, V Tach & #POTS, myocarditis, heart attacks, heart failure & blood clots in 154,000 people 30 days after COVID vs. 5,637,647 contemporary controls.
Read 13 tweets
Feb 21
1/🧵 Paul Farmer has died.

It is so heartbreaking 💔. Let us collectively mourn his passing - one of the greatest #PublicHealth figures in the history of Medicine.

His @PIH is a tribute to a kinder gentler way to love each other.

More…
2/ Dr. Farmer started his vocation of #SocialJustice by serving the beautiful people of Haiti, the world’s 1st Black republic. He looked in their eyes & saw their needs…HIV, malaria, Tb, hunger, poverty, neglect.

In response he took action…

(paintings below by my daughter)
3/ Paul Farmer is the central figure in Kidder’s 📚 “Mountains Beyond Mountains.” If you haven’t read it, order now.

Through his drive and insights we learned to say “Yes” to bringing modern medicine to the most remote settings of human life on Earth 🌍
Read 6 tweets
Feb 21
1/🧵 Why is COVID hospitalization like 2X sticks of dynamite 🧨?
 
A thread on the ICU portion… #PICS + #LongCOVID.
 
Prevent this w 3 steps:
📌Avoid #COVID by Vax & Mask
📌Avoid severe COVID by Paxlovid & Monoclonal Ab
📌👇 read here about PICS & how to reduce injury in the ICU
2/ Here’s what you must know if you get too sick & land in an ICU.

History Lesson 📝
In the past, too many decisions in #CriticalCare were guided by fear. We oversedated patients for too long out of worry they might self-extubate & pull off restraints.

That’s happening again 🤮
3/ We kept patients immobilized due to an overly conservative approach to fall prevention that precluded us from attempting to walk them early. We kept families away from patients, treating loved ones as visitors rather than members of the healing plan.

That’s happening again.
Read 10 tweets
Feb 15
1/🧵 Seeing Differently in #COVID ICU Care 👁

The world tells me “stuff” & “freedom ” bring happiness, yet neither suffice or satisfy.

If I reject chances to serve my suffering patients, I am left bereft.

Merciful care brings healing & provides joy all around.

What is #Mercy?
2/ My working definition of mercy is my willingness to dive into the chaos of another person’s life & provide lifting & healing.

Often as an ICU physician I do the former but not the latter.

That is, I dive into their #chaos without admitting I don’t know what’s right for them.
3/…but without performing actions that lead to lifting and healing of my patient’s spirit & mind, what I’m doing is dispensing false mercy.

eg, If in #COVID, I make the lungs 🫁 my whole goal, sedate & depersonalize someone for too long, I beget new diseases.

#PICS #LongCovid
Read 5 tweets
Feb 14
1/🧵 #WISDOM of Wine, Coffee & Chocolate. 🍷 🍫 ☕️
 
Millions love morning coffee or curling up w DARK chocolate & wine
 
What’s the #SCIENCE?

All 3 in moderation are safe…
 
This thread will focus on WINE! Let’s explore actual SCIENCE…
2/ This infographic shows the putative benefits – weight & BP control, diabetes & stroke prevention. But what do actual data say about this?
 
bit.ly/3LqvKug
3/ Wine has antioxidants and flavonoids that might reduce cardiac disease.
bit.ly/3LtmGEG
 
Resveratrol from grapes inhibits initiation, promotion, and progression of cancer.
bit.ly/34RZpeK
Read 14 tweets
Feb 10
1/🧵🎥 Politicians & Media are sending messages to take down #COVID protections.

In US it’s premature. Why?

📍>50% adults are NOT protected w #Booster
📍>75% of kids 5-11 are NOT fully #Vaccinated
📍Feb 8th >3,000 died
📍>17,000 dead in past week
📍>60,000 💀 January

Thoughts?
2/ Last week I had moments where I thought, “It really is sad that society has to keep masking up & those poor kids in school haven’t seen people smile in so long.”

THEN…I thought about how dangerous it is for #CovidKids who get #longCovid to have to live that way.

And…
3/ People continue to contract #Covid from children who skate through #Omicron initially while adults spend 3 weeks in ICU & die.

Denmark 🇩🇰 Israel 🇮🇱 South Africa 🇿🇦 will be safer faster.

US 🇺🇸 will lag behind by YEARS.

Messaging about an end to the pandemic is premature!
Read 6 tweets

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