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Erin C. Sanders, MSN, WHNP-BC (She/Her) Profile picture
@ErinSandersNP
Oct 15, 2022 • 32 tweets • 19 min read • Read on X
A core mission of mine has become deconstructing the false binary fallacy of clinician vs patient that is perpetuated by both sides.

And instead making space for the many clinicians & trainees who are also patients & bring hard earned patient wisdom to their practice & science🧵
2/ Being able to translate patient experience into the language of science, medicine and healthcare, and connect worlds of expertise has tremendous value.

These often painful experiences can enrich the care and wisdom we offer to others.

When you know better, do better ♥️
3/ On ableism and exclusion of disabled clinicians in healthcare:
4/ The rest of this thread, I’m going to link some accounts, books, and articles of clinicians who have been public ally open about also being patients and some lessons they have learned ♥️
5/ First up, my dear friend @RanaAwdish. Rana you are & have been a buoy in an endless sea of uncertainty for so many of us. There is so much power in witnessing & validating pain.

Your book #InShock is essential reading for anyone caring for patients. TY for art, light & hope
6/ (These amazing folks are not in any particular order other than the order of what my brain can recall)

Like Dr. @RanaAwdish, @marklewismd is also a cancer survivor. He is also an oncologist who cares for other patients with cancer. A brilliant clinician with epic dad jokes ♥️
7/ I call @DocZing a golden Zebra. She is an incredible clinician with training in orthopedics and preventive medicine. Alissa built her own practice #PRISM to care for patients with Ehlers Danlos Syndrome #EDS because she has the connective tissue disorder herself. ♥️🦓
8/ @MDaware works as an emergency medicine physician. In January, Seth detailed his journey of navigating our broken systems to get a rare diagnosis of paraneoplastic syndrome. He also plays the guitar & has a hilariously dry sense of humor.
9/ @RuhoyMD is one of those shooting star type of people. Ilene is a brilliant neurologist, an unrelenting medical detective, a fierce advocate, & an all around amazing human. She is also a cancer survivor & sees daily how our system fails patients. ♥️
10/ @Twitter's favorite ophthalmologist, @DGlaucomflecken, is also a survivor of cardiac arrest & cancer x 2. Will has spread laughter & joy during a horrific pandemic. I also appreciate his open stance against insurance companies unfettered corruption.
11/ @drjessigold has been such an incredible advocate for mental health, especially for healthcare professionals during the pandemic. Jessi has also been vulnerable about the stigma that comes with these diagnoses & the use of medications that can help.
12/ Dr. @Craig_A_Spencer survived Ebola infection & then fought #COVID on the frontlines in New York. When patients started talking about #LongCOVID, he was one of the few physicians who openly believed them and talked about his own long recovery journey.
13/ .@ShawnteJamesMD is joy personified. She is a pediatrician who cares for babies and delights @Twitter with stories of their adorableness. Dr. James is also an cancer survivor and shared her experience here for us:
14/ Dr. @Adamhill1212 is a pediatrician specializing in oncology and palliative care. As he details in his book, #LongWalkOutOfTheWoods, Adam is also in recovery from substance use disorder, depression & suicidal ideation. Your vulnerability is STRENGTH ♥️
15/ Both Dr. @rocketgirlmd (internal medicine) and Dr. Paul Kalanithi (neurosurgery) shared the story of navigating Paul's terminal lung cancer diagnosis during their medical training in the book #WhenBreathBecomesAir. It is an *incredible* read ♥️
16/ .@DrJenGunter is an OB/GYN and a fierce advocate for women's health and women's rights. Jen had a very complicated triplet pregnancy and lost one of her babies at 22 weeks. Her 2 other sons were born at 26 weeks & after their birth she became septic.
17/ .@jfitzgeraldMD is a female pelvic medicine reconstructive surgeon and OB/GYN rock star.

"I knew that if I was my own patient I would say, "just get an ultrasound!"--so I did, and I found a 7cm ovarian mass." (thankfully a benign Cystadenomafibroma)
18/ Dr. @arghavan_salles is a minimally invasive and bariatric surgeon and a thoughtful speaker in recognizing bias.

"Even those of us who love to control everything in our lives must surrender to the reality that we cannot control fertility."

19/ Dr. @DianaCejasMD is a pediatric neurologist. She was diagnosed with cancer in residency (a malignant carotid body paraganglioma) and shortly after suffered from a stroke.

Hear her story here:
20/ I am so grateful for @drannamvaldez because for as ableist as medicine is, nursing as a profession is almost worse 😞. Anna is a professor, and scholar and also has several autoimmune disorders, including Lupus. She is kind and compassionate and a powerful force for change ♥️
21/ And then there is me. November will be 3 years since I first got sick. It has been an odyssey and it’s not over. I keep collecting diagnoses like rare coins. I need a rollator & a cane to ambulate and my health has deteriorated to the point that I’m mostly house bound. 😔
22/ I still hold on to the hope that I will get better. It’s been incredibly healing to find others here who *get it*.

I know there are many more out there and it’s not always safe to disclose disability.

But I plan to keep adding to this thread as a reminder that we are human.
23/ In August, @DrDevikaB is a pediatrician and a former acting CA surgeon general shared her diagnosis of bipolar disorder.
24/ @dgurdasani1 has not only been an incredible voice of reason during the #COVID pandemic, she is trained in internal medicine and genetic epidemiology. She also has the autoimmune disease, ulcerative colitis.
25/ @AmyTanMD is trained in family medicine and palliative care. She almost died in a car accident and broke her spine in 4 places. She survived but has ongoing disability and pain.
26/ Dr. @jbullockruns is a research fellow in nephrology. He also published an incredibly genuine and honest account of his personal struggle with mental health as a physician in @NEJM. I am so grateful that you are here and that you have shared your story with all of us ♥️
27/ Dr. @annabonkhoff is now a research fellow in vascular neurology, But while she was a medical student she suffered from stroke and arterial dissection and underwent a thrombectomy. She wrote about her experience here on @Twitter & in this interview:

brainandlife.org/articles/docto…
28/ Dr. @AG_EM33 is dual trained in emergency medicine and critical care medicine. She also underwent a heart transplant for familial dilated cardiomyopathy that worsened after a viral infection in the middle of residency. She is amazing ♥️

29/ I love this thread so much, so I'm going to keep adding more brilliant patient-clinicians to it because it makes my heart happy. ♥️
30/ Dr. @MVGutierrezMD is trained as a physiatrist, she serves as Professor & Chair of the Department of Rehabilitation Medicine. She also has #LongCOVID. Despite her illness, she created a Post-COVID Recovery Clinic & is a fierce advocate for patients.
31/ Dr. @calirunnerdoc is a board-certified cardiologist, as well as Chief Medical Officer & Founding Director of a non-profit called Blooming Magnolia. She helps to research, advocate & support patients w/ #LongCOVID; tenacious patients just like her ♥️
@threadreaderapp please unroll, not sure how long this bird site is going to last 💔

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More from @ErinSandersNP

Erin C. Sanders, MSN, WHNP-BC (She/Her) Profile picture
Nov 12
Just so we are clear, this perspective is deeply ableist, unquestionably organized abandonment, and optimizes passive eugenics. Disabled lives are more important than your comfort. When we say you’re cosplaying revolution, this is what we mean. You don’t leave comrades to die.
And you don’t actively contribute to spreading infection & disease and fail to protect the same people you are in alleged community with. That’s what colonizers and white supremacists do. That’s why I say that disease is a weapon of empire. Masks coming off in more ways than one.
So once again, for the people just joining…disease does the dirty work of empire and it is a well utilized tool to facilitate both eugenics and genocide at home and abroad. So if you are able to, #MaskUpComrade
Read 4 tweets
Erin C. Sanders, MSN, WHNP-BC (She/Her) Profile picture
Oct 26
I can’t stop thinking about this. We were sold a future that isn’t going to exist. Still from video shown in quote tweet below. Shows a man speaking at a podium in front of slides. Showing temperatures in human history and the projection to the year 2100 (76 years from now). He says “in my view it is impossible to survive that sort of change. That’s beyond human physiology.”
Governments doing nothing but facilitating mass death and disablement while hoarding resources that are only worsening the problem makes more sense to me now.
2100 is only 76 years from now. That’s less than a human lifetime. All the things you think matter now really don’t.
Read 5 tweets
Erin C. Sanders, MSN, WHNP-BC (She/Her) Profile picture
Sep 30
Yes. You need an actual gas mask. Chlorine gas was used in WW1 by the Germans as chemical warfare. It can be very damaging, especially to the lungs. You need to check that your filters are specifically approved for Chlorine gas.

kumc.edu/school-of-medi… x.com/funnygenderman…
Per @3M:

. 3m.com/3M/en_US/respi…Screenshot from 3M website. “• Filtration efficiency. Filters will be rated 95, 99 or 100. This means when used properly, they are capable of filtering at least 95%, 99% or 99.97% of airborne particles. For PAPR filters, there is single particulate filtration classification referred to as HEPA or HE. High Efficiency Particulate Air or HEPA filters provide at least 99.97% filtration for all particulates. For gas and vapor cartridges, NIOSH has a color-coding system to help you identify the correct equipment for your specific hazard. For example some common colors are: • Organic vapors from...
@3M You can buy them on @Amazon or any hardware store @HomeDepot @Lowes @TrueValue. They look like this: Screenshot from Amazon.com “Visit the 3M Store 4.8 stars (10,154) reviews 3M P100 Respirator Cartridge/Filter 60923, 1 Pair, Helps Protect Against Organic Vapors, Acid Gases, and Particulates #1 Best Seller in Respirator Cartridges & Filters 4K+ bought in past month ЗМ Science. Applied to Life.™ Organic vapour/acid gas P100 Particulate Filter NIOSH-approved for: - Certain organic vapours - Chlorine - Hydrogen chloride - Sulfur dioxide - Hydrogen sulfide - Hydrogen fluoride - Particulates Has image of top and side of pink and yellow cartridges that work for acid gas.
Screenshot from Amazon.com Visit the 3M Store 4.7 stars (2,069) reviews 3M Respirator Cartridge 6003, 1 Pair, Helps Protect Against Organic Vapors or Acid Gases 100+ bought in past month ЗМ Science. Applied to Life.™ NIOSH-approved for: - Certain organic vapours - Chlorine - Hydrogen chloride - Sulfur dioxide or Hydrogen sulfide or Hydrogen fluoride Has image of top and side of yellow cartridges that work for acid gas. Model: 6003/0747 Style: Organic Vapor Acid Gas
Screenshot from Amazon.com Visit the 3M Store 4.7 stars (2,069) reviews 3M Respirator Cartridge 6003, 1 Pair, Helps Protect Against Organic Vapors or Acid Gases 100+ bought in past month Image of half face respirator with yellow cartridges one in place and one in front of the mask. Model: 6003/0747 Style: Organic Vapor Acid Gas
Screenshot from Amazon.com Visit the 3M Store 4.8 stars (10,154) reviews 3M P100 Respirator Cartridge/Filter 60923, 1 Pair, Helps Protect Against Organic Vapors, Acid Gases, and Particulates #1 Best Seller in Respirator Cartridges & Filters 4K+ bought in past month ЗМ Science. Applied to Life. 3M™ Half Facepiece Reusable Respirator 6000 Series 3M™ Half Facepiece Reusable Respirator 6500 Series 3M™ Half Facepiece Reusable Respirator 7500 Series 3M™ Full Facepiece Reusable Respirator 6000 Series 3M™ Ultimate FX Full Facepiece Reusable Respirator FF-400 Series 3M'™ Full Facepiece...
Read 11 tweets
Erin C. Sanders, MSN, WHNP-BC (She/Her) Profile picture
Jul 25
I see as a collective we need to reflect on the fact that passive eugenics (we won’t help you survive and will make conditions unsurvivable) is much more palatable to the public than the active eugenics Trump alludes to here. Although both methods result in dead disabled people.
Negative eugenics deselects for people that society doesn’t want to survive. It can be active or passive. Our COVID policies are examples of both active and passive negative eugenics. Who lives. Who dies. Who is protected or not (The poor, elderly, young, disabled, Black & brown)
And that’s not even bringing up the unhoused, undocumented, or incarcerated. Many folks couldn’t outright kill a person but are perfectly ok with a society that does nothing to protect them or keep them alive. And this is what COVID has put in SHARP relief for so many of us.
Read 4 tweets
Erin C. Sanders, MSN, WHNP-BC (She/Her) Profile picture
Apr 23
Most dermatologists do not recommend using Neosporin d/t risk of allergic contact dermatitis. Declared the Contact Allergen of the Year for 2010 by the American Contact Dermatitis Society (ACDS). Can cause secondary dermatosis known as autosensitization.
ncbi.nlm.nih.gov/pmc/articles/P…

Screenshot tweet “Prof. Akiko Iwasaki @VirusesImmunity.•1h More than half of the human volunteers who applied Neosporin into their noses showed robust antiviral gene expression (interferon-stimulated genes) measured by nasal brush, compared to placebo controls. We believe we can Increase efficacy with higher neomycin doses. (8/)”
Screenshot tweet: “Prof. Akiko Iwasaki @VirusesImmunity OK, but does this work in humans? Collaborating with @DelaCruzMed, we ran a small randomized, double-blind, placebo-controlled trial involving healthy human volunteers, who applied OTC Neosporin (containing neomycin) (n=12) or placebo (vaseline) (n=7) twice daily into their noses with cotton swabs. (7/)”
Derms recommend polysporin instead because it doesn’t contain neomycin, just polymixin & bacitracin. Would also be curious what infectious disease physicians think of prolonged use of topical antibiotics in an era of increasing antimicrobial resistance & antibiotic stewardship…
This is particularly a concern for people who have altered immune systems, autoimmunity or issues with allergies already like with MCAS.

Just my clinical opinion.
Read 9 tweets
Erin C. Sanders, MSN, WHNP-BC (She/Her) Profile picture
Apr 12
The biology of neurotypical (allistic) brains is towards maximal efficiency. Microglia literally prune redundant synapses to strengthen neural connections. This works differently in autistic folks who have many more dendritic spines & less pruning🧵
Paper: nature.com/articles/nn.27…

Screenshot of line graph showing synapse formation over time with “Dendritic spine number” on y-axis and age/life phase on x-axis. Autistic Spectrum Disorder (ASD) is in magenta. Normal is in black. Schizophrenia (SZ) is in green. And Alzheimer’s disease (AD) is in Navy. Birth is marked as a vertical dashed line. Childhood is shown in light pink. Adolescence is in light green. Adulthood is light blue. Across all disease states dendritic spine formation and synapse formation increase rapidly after birth. With ASD extending the highest. This is followed by a rapid decline during adolescence ...
2/ These brains function differently. Many folks have superior pattern recognition. It’s not fully understood why. Some areas of the brain have shown more connectivity, some less. Many variables at play and lack of diagnosis especially in underrepresented groups are significant.
3/ Some literature cites higher incidence of neurodegenerative diseases in Autistic people but with the known diagnostic and representation issues, as well as how much we don’t understand about the brain, I’m not sure how much of that can be extrapolated to an entire population.
Read 12 tweets

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