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Tatiana Prowell, MD

@tmprowell

Oct 3, 2022 • 8 tweets • 11 min read • Read on X

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@gabrieldane

Part 2 of ACP-Medicine Forward series on solutions to #FixPriorAuth happening now w/ amazing lineup! @gabrieldane, co-founder w/ @EricTopol of @MedicineForward, kicks off the mtg w/ comments about urgency of #MedTwitter #advocacy & activism to protect dr-patient relationship.

https://twitter.com/ACPinternists/status/1576905413013946368

@ShikhaJainMD

Dr. @ShikhaJainMD is orienting audience to the amt of time #MedTwitter spends doing prior auth & peer-to-peer calls, in many cases w/ insurance company "peers" w/ no training in the specialty. Some could not even pronounce the tumor type or drug name. #DenialOfCare #FixPriorAuth

@ShikhaJainMD

Dr. @ShikhaJainMD says that she cares for a patient with #cancer whose insurance company only allow 4 CT scans LIFETIME for their #cancer, which prevents her from assessing how well the treatment is working. This is absurd & MUST be fixed. #DenialOfCare #FixPriorAuth #MedTwitter

@MedicineForward

The audience at tonight's @MedicineForward & @ACPinternists mtg to #FixPriorAuth was asked about key drivers for overly burdensome prior auth processes. Payers/insurers (96% of respondents) & PBMs (74%) are overwhelmingly viewed as key culprits (>1 response allowed). #MedTwitter

@DavidPugach

Dr. @DavidPugach on the @MedicineForward @ACPinternists #FixPriorAuth panel is highlighting the ACP's Patients Before Paperwork web page for #MedTwitter & #MedStudentTwitter interested in #advocacy: acponline.org/advocacy/where…

Here is the link to contact your Senator to pass existing legislation that will help to #FixPriorAuth. It takes 1-2 minutes, literally. Stop scrolling, scan below, & do it now! #MedTwitter #MedStudentTwitter #NurseTwitter #OncTwitter #advocacy

@MedicineForward

If those attending the @MedicineForward & @ACPinternists #FixPriorAuth meeting tonight are interested in #advocacy opportunities, the ACP Advocates for Internal Medicine Network can be found here: acponline.org/advocacy/advoc…. #MedTwitter

I just sent email to both of my Senators about this in 2 actual minutes. Action gets things done. Scrolling does not, #MedTwitter. Let’s get this done! Reply with your screenshot. #FixPriorAuth

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More from @tmprowell

Tatiana Prowell, MD

@tmprowell

Jan 4

#MedTwitter
There is a widespread outbreak of #norovirus, a GI virus that causes projectile vomiting & profuse diarrhea usually lasting 24-48 hrs. Wastewater levels nationwide are high. It’s miserable & incredibly contagious. So many friends are texting us SOS, so here’s a 🧵. /1

Norovirus spreads when as few as 10 viral particles get in the mouth. This happens via direct contact (eg, kissing), contaminated food/water, or touching contaminated surfaces (countertop, toy, soiled clothes) then mouth (eg, toddler toys in mouth, eating by hand, nailbiting). /2

#MedTwitter
Given how contagious #norovirus is & how it spreads, it is like a brushfire in close quarters and/or where common items are handled by many. Cruise ships are famous for outbreaks, but also daycares/schools, dorms, dining hall/salad bars, nursing homes, jails, etc. /3

Read 18 tweets

Tatiana Prowell, MD

@tmprowell

Jan 1

🧵 #MedTwitter IMPORTANT
The case of this 🇨🇦 adolescent with #H5N1 #BirdFlu is terrifying. Her only medical history was mild asthma, & symptoms started w/ fever and conjunctivitis. On d5 from symptom onset, she was admitted in respiratory failure, kidney failure, in shock … /1

Despite 3 antivirals (oseltamivir, amantadine, & baloxavir) to which her virus appeared to be susceptible & plasma exchange (three times !!), she spent 2 wks on ECMO and almost 3 wks on a ventilator and was dialysis-dependent. She survived. Let her be a warning, #MedTwitter /2

In an H5N1 outbreak, if even a small % of people get so sick, hospitals are in trouble. If a #H5N1 virus gains ability to spread btwn humans & enters widespread circulation, humanity is in trouble. No amount of #publichealth effort or cost to prep for #BirdFlu is too great. /3

Read 8 tweets

Tatiana Prowell, MD

@tmprowell

Jan 1

#MedTwitter
NEW Analysis of 641K hospital admissions in 3.5y finds ending universal masking & #COVID19 testing was assoc w/ a 25% ⬆️ in hospital-onset resp viral infections (w/ longer stay & ⬆️ mortality) & resumption of universal hospital masking with a 33% ⬇️. #WearAMask /1

#MedTwitter
The ⬇️ in respiratory viral infections w/ universal masking included #COVID19, #influenza, & #RSV: .

We need universal masking in hospitals, especially now when #SARSCoV2, #flu, & #RSV levels are high nationwide based on wastewater testing. /2 ja.ma/3Z5fdn7

#MedTwitter
The study didn’t assess #longCovid (LC) risk but given that preventing #COVID19 is the only reliable way to prevent LC, universal masking in hospital would likely also ⬇️ LC risk. In my opinion, lack of universal masking should be a hospital quality measure. /3

Read 4 tweets

Tatiana Prowell, MD

@tmprowell

Dec 29, 2024

President Jimmy Carter died today at age 100, having lived w/ melanoma that had spread to his brain & liver for >9y. I grew up in GA admiring him, so as an oncologist, I’d like to honor his life by teaching you a bit. #melsm #MedTwitter

First, the ⚠️ signs (ABCDE 👇) & pics

/1

It’s important to know who’s at ⬆️ risk for #melanoma (see 📸 ).

UV exposure (☀️ or tanning bed) is the major risk.

Having 5 sunburns doubles your lifetime risk of melanoma. Age matters. Even ONE blistering sunburn as a kid/teen doubles lifetime risk!

🔑 AVOID BURNS! /2

People with dark skin can also get melanoma (though they are at much lower risk than people with fair skin).

And #melanoma can appear in unusual places including some you might not expect like your nails or even areas that get little or no sun exposure. /3

#melsm #MedTwitter

Read 7 tweets

Tatiana Prowell, MD

@tmprowell

Sep 21, 2024

NEW 📣 Nat’l study in #Sweden: 86% of people on sick leave due to #COVID19 in wave 1 of #pandemic still had symptoms 18m later, esp fatigue, cognition, sleep, movement. Risks higher if hospitalized or female. Vax didn’t exist then.
#MedTwitter #LongCovid

journals.sagepub.com/doi/10.1177/14…

The study also found nearly half of respondents also had problems w/ functioning in daily life 18 mos after they were infected w/ #COVID19. That is #LongCovid. This is a stunning number.

Sweden never had a full lockdown or mask mandate in wave 1. /2

#MedTwitter

With this approach, #COVID19 deaths were noticeably higher in #Sweden than in neighboring countries with more precautions. For example, see this graph from ABC based on a Johns Hopkins analysis of the region. The King said: “I think we have failed.” /3 au.news.yahoo.com/leaders-tragic…

Read 7 tweets

Tatiana Prowell, MD

@tmprowell

Sep 5, 2024

NEW Longest prospective study of #LongCovidKids: 1.3K kids who tested pos for #COVID19 were followed up to 3y. Of note, 89% of cases were “mild” & 9% had no symptoms, & 80% had zero doses of vaccine. Mix of variants, but most were Omicron then Delta. /1 thelancet.com/action/showPdf…

Sadly, 23% of kids had #LongCovid at 3 mos. While #s fell over time, 13% at 6 mos, 8% at 1 yr, 6% at 18 mos, & 7% at 2 yrs still had #LongCovid. This is tragic, both because it means that 1 in 12 kids are still suffering a year later, & most of those remain ill longer term. /2

Adolescents/teens were at MUCH greater risk than age <12, as were those infected by earlier variants. Females & those w/ comorbidities were also at slightly increased risk. Infection w/ orig variant resulted in ⬆️ autoimmune disease. Vaccination reduced risk of #LongCovid. /3

Read 10 tweets

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