WesElyMD Profile picture
Apr 6 4 tweets 3 min read
1/🧵 #LongCovid is REAL & up to 23,000,000 ARE (not “may be”👇) suffering.

Yesterday, @POTUS announced expanded funding.

Becerra told reporters Tuesday. "Millions of Americans may be ⁉️struggling with lingering health effects…”

nbcnews.to/3ramyS3
2/ As part of its efforts, the White House said in a statement that Biden will push to accelerate a $1.5 billion study started last year by the National Institutes of Health to follow 40,000 individuals with and without long Covid to try to better understand the condition.
3/ Biden also proposed spending an additional $25 million on a $50 million study started last year by the Centers for Disease Control and Prevention to understand the risk factors, mechanisms of action and characteristics of long Covid, the White House said.
4/fin
Months after leaving the hospital, millions of #COVID survivors (& some never hospitalized) are on oxygen, unable to go back to work, so fatigued that they’re spending an immense amount of time in bed. This is the new reality - we must dive deep to help.

#LongCOVID #Vaxx

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More from @WesElyMD

Apr 7
1/🧵 You have a COVID ICU patient on benzos who doesn’t respond to needle injection of local anesthetic do to sedatives.
 
What depth of sedation do you consider this? (it was a CME question just now)
2/ The answer is GENERAL ANESTHESIA, which of course makes sense.

If a person is so deep that he/she doesn’t respond to getting stuck by a needle and the pain of lidocaine injection, that is general!

Why am I writing about this? Image
3/ Anyone working in the ICU this past few years of #COVID #PANDEMIC is seeing this depth of sedation on a regular basis.

We had almost gotten rid of this by 2019. Then COVID undid progress.

People now think this is normal for some reason.

It is NOT normal.

It is not OK.
Read 9 tweets
Apr 7
1/🧵 A personal story of misjudgment as a physician.
 
Years ago, when I was a young doctor, I had a patient in the ICU on a ventilator who was doing so poorly, day after day, that I was certain he was going to die.

I confidently told the family he was going to die. Image
2/ The family members all gathered and were extremely distraught. They listened and trusted me.
 
But I was wrong.

#PalliativeCare #EndofLife Image
3/ For many years to come, I received Christmas cards from this man.

It was extremely humbling.
 
Until I learned, this happened many other times in my life as an ICU doctor.

Sometimes I was off by just 2 weeks, sometimes 2 months, and other times by 2 years. Image
Read 8 tweets
Apr 5
1/🧵 Race & Medicine - #COVID

Dark-skinned people who get #COVID, or any disease lowering O2 levels, are more likely vs whites to suffer undetected hypoxemia (missed ⬇️ O2 levels).

Pulse oximeters are affected by skin color & read falsely high in Blacks.

Does it matter?
2/ It matters because undetected hypoxemia tripled the odds of DEATH 💀
 
This study of >128k measurements from 26,000 pts confirmed these inaccuracies that we’ve known about for 30 years.

Black, Asian & Am Indians were all included. #Disparity
 
bit.ly/3KaNAAj
3/ It’s not lost on me that this study comes at a time when we’re trying to get RID of false distinctions of race in medicine.

MYTHS generated by #racism about Blacks having different lung or kidney function are bogus.

But the Pulse Ox must addressed: bit.ly/3uZIrEG
Read 8 tweets
Mar 29
1/🧵Serious question:
Is it ok to CLAMP OFF blood vessels to a human brain to stop cell function & get organs for transplant?

A new procedure does this to ensure no blood reaches a person’s 🧠 as surgeons take organs from freshly ‘dead’ bodies. Discuss.

bit.ly/3tEZhtl
2/ We all want to relieve the suffering when people are dying of failing kidneys, lungs, hearts.

Transplant can be a great solution.

As a transplant physician myself, I directed lung transplantation at #Vanderbilt.

I worry this new approach is a breech of the dead donor rule.
3/ The “dead donor rule” (DDR) says donors must be determined dead according to established legal/medical criteria PRIOR to procurement of vital organs.

What if there are doubts?

Like ongoing neuronal activity?

Can we take it upon ourselves to stop blood flow?

My letter:👇
Read 15 tweets
Mar 28
1/🧵 True Medicine #LongCOVID
 
In #COVID & beyond, TRUE medicine, which is to say true healing ❤️‍🩹,  adapts itself to each suffering patient.
 
It’s the opposite of #gaslighting someone because her disease doesn't “fit” our model when she (eg) fails POTS criteria.

Instead…
2/ Our healing must have the character of MERCY, which means we #doctors & #nurses will bend our love to fit the shape of each suffering patient.

Only then can we lift her up.

It may means admitting we don't know what to do now other than listen more.

#Medtwitter #NurseTwitter
3/ I am drawn in by my patient's weakness, perhaps because I see even greater weakness in myself.
 
The person in front of me needs the help I can provide by mustering #compassion, the same compassion I seek from others for MY foibles, deficits & inabilities.
Read 5 tweets
Mar 21
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…
Read 14 tweets

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