Share this page!

Enter URL or ID to Unroll

You can paste full URL like: https://x.com/threadreaderapp/status/1644127596119195649
or just the ID like: 1644127596119195649

How to get URL link on X (Twitter) App

  1. On the Twitter thread, click on or icon on the bottom
  2. Click again on or Share Via icon
  3. Click on Copy Link to Tweet
  4. Paste it above and click "Unroll Thread"!
  5. More info at Twitter Help
Bill Kinkle, RN, EMT-P, CRS Profile picture
@billkinkle
Jun 15, 2022 • 12 tweets • 7 min read • Read on X
Scrolly
A THREAD REMINISCING AND REFOCUSING.

One thing I’ve had the opportunity to do while sitting in this room for the past 2 months is reflect on my past advocacy efforts and refocus on the direction we are going in the future based on my neck injury and hospitalization.
One thing I miss is working in the field as a harm reductionist. Spending time in the encampments, providing #naloxone, sterile syringes, basic wound care etc. was a highlight of my life. ImageImageImage
Testing drugs for my friends…(fake pressed Xanax bars in photo). Image
Making balloon animals to bring out a smile with my friends experiencing homelessness… ImageImage
Bringing buprenorphine to where folks were via telemed in the field.

Article here:

rollingstone.com/culture/cultur… Image
Various advocacy roles whenever we could…
USA Today piece here:

usatoday.com/in-depth/news/…

Inquirer piece here:

inquirer.com/philly/health/… ImageImageImageImage
ImageImageImage
This is Kensington, Philadelphia. I took a bunch of photos of the community to highlight its beauty amid so much negative press and hung these photos in my office to remind my friends that there is hope in the darkness. ImageImageImageImage
More Kensington. ImageImageImage
Our podcast with @sean_fogler
Episodes here:

stitcher.com/podcast/health… Image
I’m fairly certain our focus is going to be more focused on destroying stigma now that I’ve experienced its effects first hand. I think this will allow me to speak from experience and give me credibility.
I’ve tried to raise awareness in real time throughout the past 2 months and I will continue to do so. This work is important and I’m saddened at how deep stigma is embedded in American healthcare. My life is dedicated to changing this.

• • •

Missing some Tweet in this thread? You can try to force a refresh
　

Keep Current with Bill Kinkle, RN, EMT-P, CRS

Bill Kinkle, RN, EMT-P, CRS Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @billkinkle

Bill Kinkle, RN, EMT-P, CRS Profile picture
Jun 21, 2022
Here are a few papers/case reports to support the long thread on bupe induction I tweeted earlier.
pubmed.ncbi.nlm.nih.gov/32650192/

The findings of this study might explain recent reports of difficulty in bupe inductions for persons who use fentanyl, and point to a need to better understand the pharmacokinetics of fentanyl in the context of opioid wd in persons who regularly use fent.
This paper explains the mechanism behind PW and is a nice comparison of some of the various methods of bupe induction.

journals.lww.com/cja/fulltext/2…
Read 8 tweets
Bill Kinkle, RN, EMT-P, CRS Profile picture
Jun 21, 2022
This is an example of why I need to be absolutely vigilant about my care.

I was experiencing a burning sensation and palpitations whenever something is infused through my PICC. Naturally the first thing the physician ordered was a chest x-ray to make sure it hasn’t moved.
The first CXR was ordered for “palpitations.” Interestingly, the radiologist never noted the PICC which made me wonder if the order for “palpitations” directed the method of interpretation.
After the doc called and asked about the PICC an addendum was placed. However, noting the catheter was retracted compared to the previous image on 6/9 confused the PICC team when they showed up because the line is sutures to my arm and the hub is in the same position.
Read 14 tweets
Bill Kinkle, RN, EMT-P, CRS Profile picture
Jun 21, 2022
ON BUPRENORPHINE INDUCTION AND NURSE/PHYSICIAN ADVOCACY (RE:ACUTE PAIN)

Sitting in a room for 2 months with no windows facing the outdoors lends itself to quite a bit of time to observe the subtleties of my interactions with staff.
First, it has been a rare event to get more than 3-5 minutes with any clinician, so you need to hone communication skills akin to speaking with a politician; unfortunately brevity is a necessary skill you must learn to get your needs met.
However, even if you are able to harness the attention of your treating physician or assigned nurse away from their phone or obvious thoughts about the burden of their other patients, there is still the issue of having them actually hear what you are expressing.
Read 73 tweets
Bill Kinkle, RN, EMT-P, CRS Profile picture
Jun 16, 2022
This is an outstanding talk by @dorazepam on Xylazine.



I’ve had the privilege of working with Dr. D’Orazio as a guest speaker and also as a patient after my relapse in 2020. After my wife he was the first person I called for help after relapse.
After listening to his talk I have several thoughts running through my brain. First has to do with my reporting of bradycardia.
I need to dig deeper, but thinking about his piece on imidazoline receptors and how infrequent bradycardia was I’m curious if the bags were cut with another a2 agonist. Bradycardia was specific to a particular “stamp” which I then avoided.
Read 14 tweets
Bill Kinkle, RN, EMT-P, CRS Profile picture
Jun 16, 2022
FAIRLY COMPREHENSIVE XYLAZINE THREAD (including personal experience)

Where there’s fentanyl, there’s xylazine.” ~@dorazepam

Xylazine caused so much destruction in my life:
-Terrible, difficult to treat wounds.
-Serious cardiovascular effects.
-Intense withdrawal syndrome.
Xylazine has been used as a “cutting agent” for years, but over the past 3 years we’ve seen a dramatic uptick in its presence in street sample crescendoing to a staggering presence in almost every street sample collected.
See @NPSDiscovery’s second quarter 2022 report:
npsdiscovery.org/wp-content/upl…
Read 39 tweets
Bill Kinkle, RN, EMT-P, CRS Profile picture
Jun 15, 2022
The nurse caring for me said the overnight medicine physician finally called back and said she doesn’t feel comfortable making any changes to my care so I’ll need to wait till the AM to speak with the other medicine doc. She’s only here for emergencies the nsg supervisor said.
So, a man in moderate iatrogenic withdrawal for >24 hours, threatening to leave which statistically increases my likelihood of fatal overdose significantly isn’t considered emergent.
Moreover, I’m not even worth coming to speak with, think about that. My nurse messaged her and the nsg supervisor contacted her to tell her I want to speak with her, and she responded with a text. When did physicians become such cowards who hide behind text messages?
Read 5 tweets

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us!

Send Email!

:(