WesElyMD Profile picture
Jun 30 3 tweets 2 min read
1/🧵🎥 Grateful for Technology
 
As #ALS (Lou Gehrig) patients progress to being unable to speak, they are aided by #EyeControl technology. My pt & his wife agreed to let you watch.

Imagine his bravery

I told him I didn’t understand his suffering but that I would not leave him.
2/ For the video, I speak to her a lot just to deal w short time constraints of Twitter (2 min), but my conversations w him are direct, paced, and open.

I chose not to show the conversation about his life support decisions.

Gut-wrenching, honest, and true.

Send us strength.
3/fin
There is no greater privilege in my days than to enter the lives of my patients and their families. It is unearned.

My working definition of #Mercy is the willingness to dive into their chaos & offer lifting and healing.
 
This is my vocation.
 
What is yours?

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More from @WesElyMD

Jun 27
1/🧵 Hacked on Twitter - what did I learn⁉️

I & other physicians’ @verified @Twitter accts were hacked last week…
 
This “micro-dose” of being silenced reminds me to do all I can to amplify the voice of others.
 
And it made me want to share a few thoughts about this platform…
2/ How did it make me feel?

📍Vulnerable
📍Silenced
📍At the mercy of others
📍Out of control
📍Small

Of course, it’s just social media

But how we handle ourselves here prepares us to fight #Testimonial #Injustice

No one wins if we stifle the voice & truth of another person.
3/ Detachment

I’ve been working on detachment from the lure of worldly things.

When the hackers stole control of my account, my 1st thought was that this was a perfect opportunity for me to practice detachment.

If I’m truly detached, my pulse should remain a calm 46 bpm 😎
Read 11 tweets
Jun 15
1/🧵 Long COVID Brain Science: 🧠

For ~100M suffering 🌎, let’s use data to combat myths & #Misinformation

COVID is biologically dangerous long after virus is gone

#LongCOVID affects our….

📍Olfactory & Limbic Systems
📍 Interferon Autoimmunity
📍PET scans
📍Astrocytes

How? Image
2/ First, Epidemiological comparisons…

FLU vs. COVID

Survivors of viral infxns like #Flu don’t complain of 200 long-term symptoms & ~90% ongoing mood disorders.

#LongCOVID pts do.

Flu kills 0.5M/year vs COVID has killed 10X that (5M) in just 2 years.

bit.ly/3mJTBK4
3/ Consider this:

A study of 150k COVID survivors, hospitalized & not.

COVID survivors had 10-15X ‼️higher risk of considering #suicide at 1 year than 11M control patients.

This is horrifying, yet people still deny #LongCOVID’s importance.

WHY?

bit.ly/3HnHZpB ImageImageImage
Read 27 tweets
Jun 13
1/🧵 95% COVID Immunity⁉️

@JAMA_current data show that in Dec 2021, 95% of US Blood Donors had Immunity from infection or vaccination.🧐
 
Then why do we have record high rates of #Omicron?
 
Does that mean we should have herd immunity?
 
Not so fast…
 
bit.ly/3n2o5HD
2/ First, we make estimates using a combination of the COVID spike Ab & nucleocapsid Ab to determine what proportion of our population is protected at a given time.

ie, either previous infection (nucleocapsid) or vaccination (spike Ab) or combined Infection & vaccination.
3/ But if there was 95% immunity in 2021, how did #Omicron go bonkers infecting so many in 2022?
 
The infection rates reflect #Evolution. The I ntense contagiousness of this variant & enhanced immune escape mutations plus waning protection from previous vaccination & infection.
Read 5 tweets
Jun 8
1/🧵Is Paxlovid Rebound real?👇

Short answer: I say Yes @JAMA_current

It’s when you go from COVID ++ to - to ++ after Treatment.
 
Prior to #Omicron & Pax, rebound seemed rare.
 
We need more data.
 
This article has pearls I want to share…
 
bit.ly/3NZsSEY
2/ 1st “If you’re ++, you must assume you’re infectious to others,” he explained.

“PCR test confirmed his positive rapid Ag test & it was back to jail for Dr. Ho.”
 
Recently, similar cases have been reported & @CDCgov issued a health advisory May 24:
bit.ly/3aDw8Yf
3/ There are just way too many anecdotal cases to ignore.

In recent weeks, prominent physicians in the US including @tmprowell @Bob_Wachter @PeterHotez have all discussed the reality of #PaxlovidRebound.

Yet, @pfizer downplays this & the early papers don’t mention it.
Read 12 tweets
May 25
1/🧵 An exacerbating factor in #LongCOVID is the “Quality of Life (QOL) Gap”🧵👇

…when a person’s expectations about QOL are at odds w their reality.
 
“Covid was over & Long COVID hit my brain, heart & GI.”
 
Let me unpack a study of ICU survivors…
bit.ly/3vp0AMl
2/ Read the thread I attached to the first tweet.

From the cancer literature, we learned about the QOL Gap.

If people appropriately prepare for their “ACTUAL” QOL, there’s a narrow gap and all is well.

If not, #Depression & #Despair too often set in.
3/ This study from Johns Hopkins by @vitaincerta & team adds to our understanding in a way that will apply so well to #COVID ICU survivors.

These are ARDS patients, which is almost always what lands COVID pts in the ICU and later with #PICS.
 
@ChestCritCare
Read 8 tweets
May 2
🧵1/ Here’s your “Big Picture” of COVID & Long COVID for 2022

See my new Figure👇 summarizing #COVID19 Management & Outcomes

Two years in & we have splendid choices.

Stay in peaceful waters of prevention (green) or risk treacherous cliffs of #LongCOVID & Death (red & black)…
2/ Knowledge is Power, and our knowledge has grown dramatically.

Let’s take a look at where we were just 2 years ago - even though it seems like 20 yrs ago.

April 2020: our approach & understanding of COVID looked like this👇.

We didn’t even know about #LongCOVID yet 🤯
3/ Remember, with #LongCOVID, your brain & heart are at stake.

@JohnsHopkinsSPH reports on emerging data: “COVID doesn’t discriminate when it comes to heart problems.”

Anyone affected may develop clots, arrhythmias & strokes >1 yr later.

Link &🧵below
bit.ly/3KzYcbp
Read 23 tweets

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