WesElyMD Profile picture
Mar 21 14 tweets 6 min read
1/🧵 Wanna learn from a 61-year love affair? ❤️

They met at a drive-in burger joint in Memphis. Elvis blaring.

He peered into a car of 6 teenage girls & saw her.

💭 “That’s the most beautiful girl I’ve ever seen.”

They’ve been madly in love ever since.

(Pics & story w perm)
2/ Pain feeds pain, but love & gratefulness starve pain…

Mr. M came into the ICU w sepsis & shortness of breath.

We placed him on life support to help reduce his suffering. The disease proved too much.

Fortunately, sadness & despair took a back seat to what happened next…
3/ In 1961, the night they met, the teens went to a bowling alley.

She didn’t have permission, so she walked home.

He found the girls & asked, where’s your friend who was sitting in the back seat?

He couldn’t get his mind off her smile…
4/ So he went to her house & knocked on the door.

“Doctor, he told me, ‘you’re the most special girl I’ve ever met.’”

A year later they were married.

He became an engineer & they had 3 children.

A life full of hard work & blessings, until COVID. Isolation took its toll.
5/ “It is not your love that sustains the marriage, but from now on, the marriage that sustains your love." Bonhoeffer

As he got sick, she arranged an ambulance & has been at his bedside ever since.
 
Mrs. M whispered to me, “Our hearts are sewn together, Doctor.”
6/ Mrs. M called the gas company to pay their bill (old school 😌)…

A total stranger over the phone listened to their story and got 30 office mates together to sign a card & pack them a bag of mints that read, “You 2 were MINT to be together in forever & ever.”

She cried.
7/ As it became clear he wasn’t improving & didn’t want more life support, we removed the ventilator and adjusted his meds to keep him comfortable.

I asked, “What matters most to you, Sir? I’d like to grant you 3 wishes.”

(a la Dr. Deborah Cook’s data - bit.ly/3Jlg0HN
8/ “Doctor, what matters most to me is (1) to be with my family and (2) have all of us drink a beer together (3) sharing stories. Those are my golden ticket wishes.”
 
So our ICU team set out to make it happen…like we did recently for Mrs F👇
9/ Through the night, she sat at his side, never once dozing off.

I was mesmerized as stories spilled out about their marriage, parenting, and hardships that forged their bond.

He talked as well, until he couldn’t any more.

She kept whispering to him…
10/ Always tell others what you need them to know.

Every moment counts.

These two people modeled for me what it means truly to be present for another.

She explained, “I gained weight in age, but he always said I was the most beautiful person he’d ever seen…”
11/ “Doctor, I’m not a special or fancy person. I’m simple, But to him, I’m everything. And to me, that’s all that matters.”
 
They made a promise, a covenant, and they kept it.

What makes such a marriage?
12/ “All the things that make marriage a success are in their nature undramatic things, the silent growth of an instinctive confidence, the common wounds and victories, the accumulation of customs and courtesies, the rich maturing of old jokes and retold stories.” GKC
13/ I see in them something beyond riches.

Their love far exceeds anything one can earn on paper.

Over a lifetime, they have trained for & won an Olympic medal of love.

It was our privilege to serve…to provide his 3 wishes.

Uplift others.

Provide #Mercy & #Humanism.
14/fin
“I do not wish you joy without sorrow,
nor endless days without healing dark,
nor brilliant sun without restful shadows.

I do wish you love, strength, & wisdom
I wish you songs & also blessed silence
& God's sweet peace when every day is done.”

~Dorothy McDonald

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More from @WesElyMD

Mar 16
1/🧵🎥 “It’s a very bad disease. It can be overcome.”
 
My #COVID patient tearfully speaks of his BIG DECISION on the ventilator.

This soldier & leukemia survivor made it through 3 weeks on a ventilator. How?
 
Video shown w his permission “to help others find hope, Doc.”
#Hope
2/ This immunocompromised man was in massive viral septic shock from COVID.

Huge doses of vasopressors.

Gargantuan levels of O2 & vent pressure to save his life.

Lungs, Kidneys, Heart and Brain all failed.
3/ His wife was there with him daily.

We put up pictures of his kids and pets.

We talked to him about the things he loved every day (even when sedated and seemingly unable to hear us).

Somewhere in all of that, he made a silent decision…
Read 8 tweets
Mar 11
1/🧵 Let’s learn about Ace inh-induced angioedema
 
His lips & tongue swelled up hours after taking a blood pressure med he’d been on 10 years - lisinopril.

📍What’s the treatment?
📍Is it an allergy?
📍What’s a common thought error?

(Pic w Perm - trigger warning tweets 2 & 4)
2/ Angioedema is potentially life-threatening
 
It’s very scary to see the tongue & lips swelling up so much and the airway compromised.

The patients are watched in the ICU so that intubation and even tracheostomy can occur emergently if required.

What’s the Dz Mechanism?
3/ Is ACE-inh induced Angioedema an allergy?
 
NO! It’s not an IGE mediated allergic reaction.

💥 Pro Tip:
People can get angioedema from allergies, but they would be very itchy, and my patient was not itching at all.

That's because it's mediated by a buildup of bradykinin.
Read 11 tweets
Mar 10
1/🧵 Let’s talk Long COVID:

I’m grouping several important & interesting articles about the reality of #LongCOVID.

By studying brain fluid, viral persistence & MRIs, we’re building our understanding of the “how” & “why” of this devastating malady.

A train is coming, read on…
2/ Cerebrospinal Fluid Offers Clues to #BrainFog

Most pts w new “thinking problems” after mild #COVID had abnormalities in fluid from lumbar punctures (image); controls did not.

Delayed #LongCOVID was common in younger people who thought they were safe.

bit.ly/3pS0JWN
3/ Believing those with #LongCOVID complaints is our 1st basic show of support!

“If people tell us they have new thinking & memory issues, I think we should believe them rather than require that they meet certain severity criteria.”
Dr. Apple UCSF

bit.ly/3sUNczF
Read 16 tweets
Mar 9
1/🧵 A sister & two brothers were born into a wonderful family. They led an exciting life. 4 months ago, 2 of them died young of #COVID, unprotected. The surviving sibling decided to get Vaxxed but stopped after 1 shot & is now on ventilator (CT scan) w COVID pneumonia. Read on…
2/ A teaching Point: This CT scan shows “holes” in his lung (red lines above & arrows👇) surrounded by white pneumonia.

The holes are previously damaged lung from smoking.

Millions in society, victims of misinformation, remain unprotected & the vaccine could save their lives.
3/ Let’s all do our part to teach others.

When polio hit, almost everyone wanted to be vaccinated despite the disclosed risk of getting polio from the live attenuated vaccine.

This vaccine is even safer and yet the untruths spewed by many have tainted our uptake.
Read 4 tweets
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 28
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
Read 16 tweets

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