WesElyMD Profile picture
Nov 30 5 tweets 4 min read
1/🧵 COVID Screws up sex & making babies

Face it, this virus invades our lives – even making babies.

The ACE2 receptor is in testicles, ovary, uterus, vagina & placenta

Pregnancy is affected, sperm counts are reduced, impotence occurs.

Updates…
 
bit.ly/3VIEaBc
2/ Pregnant women are wise to be afraid of COVID.

Thankfully, we have new data to show that Omicron causes 75% less critical illness than Delta & 43% less preterm birth. Less still birth.

All this despite Omicron being way more contagoius.

bit.ly/3XJ6FAO
3/ Since early in the pandemic, men have been complaining of impotence.

Now we have more compelling long-term data as far as 1 year out.

N=200 study shows the median number of sperm down by >50% vs. men without Covid.

H/T @DrEricDing
4/fin
There are many reasons to remain vigilant.

Women: higher vaxx rates may explain better Omicron pregnancy data.

Men: your sexual & reproductive health is at risk w COVID.

The best way to stay safe: Don’t Get Infected.
#Vaxx and #Mask indoors.
 
bit.ly/3VIEaBc
5/ Added piece:

This is a nice editorial that appeared with the pregnancy study. The author places things in perspective…
 
Let’s not let our guards down yet…babies and moms will pay a price if we do.
 
bit.ly/3Ung0eu

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More from @WesElyMD

Nov 29
1/ End-of-Life Discussion - Poll

(data from a ~13,000 patient study next tweet)

QUESTION:
Is it OK for doctors to make unilateral decisions to limit life-sustaining therapy (eg, remove a ventilators) without patient/family discussion?
2/ Variable Approach to Limiting Life Sustaining Treatment for ICU Patients
 
N=12,850 patients in ETHICUS-2
 
% “NO DISCUSSION” at EOL was 2% in North America vs 37% in Latin America
 
Culture is so important
 
bit.ly/3iddH0e
3/ Other regions of the world also have huge discrepancies. See Central Europe and Mid-East vs. Asia.
 
Two questions:
Would people agree w the medical teams approach if asked?

Should limited resources globally affect these rates?
Read 5 tweets
Nov 9
1/🧵 Update on Long COVID Prevention‼️

Do meds & vaccines ⬇️ #LongCOVID risk?

1st meet @pamelarbishop, a scientist in forced early retirement due to LC:

“I oscillate between fierce determination to get better & abject horror at the daily destruction of my body."

read on…
2/ A case-control study of 9k unhospitalized COVID pts treated w Paxlovid btwn March & June 2022 versus 47k patients w no antiviral or antibody treatment.

All >= 1 risk factor for hospitalization.

The results are surprising if you think about it.

Why?
bit.ly/3WKmo1V
3/ It’s NOT a randomized trial, so we don’t know why people did or didn’t get Paxlovid.

In practice, we givemeds more aggressively (or want them ourselves) if we’re sicker.

So you might think those who didn’t take Pax would be less sick & do better. That’s not what was found…
Read 19 tweets
Oct 26
1/🧵 Haldol for ICU patients⁉️

📌 Not so fast
📌 Study of N=1000 backs-up our MIND-USA study - full 🧵👇
📌 Haldol doesn’t treat #delirium
📌 Calms pts & can ⬇️ danger
📌 Delirium care is about non-pharm approaches - the Dr. DRE…

bit.ly/3sz27Pe
2/ Dr. DRE = non-pharmacological approaches to #delirium reduction. Hint - it’s Not about adding drugs.

📍Disease remediation
📍Drug Removal
📍Environment (eye glasses, hearing aids, sleep, light, mobilization)
3/ In this thread👇 I unpack our previously published 2018 placebo controlled randomized trial of typical and atypical antipsychotics.

The MIND-USA study & today’s new ACT-ICU RCT are complementary & should make us unsatisfied w ✍🏻 antipsychotics to treat delirium.
Read 6 tweets
Oct 24
1/🧵 Should Doctors be involved in Lethal Injection?

📍We take an oath to heal
📍Yet Prisons hire Docs to end life
📍I wrote this Op-Ed to challenge the system
📍I’d love your thoughts

(next tweet has a screenshot to bypass paywall)

@GovBillLee

bit.ly/3eZdX1Q
2/ There is a pervasive myth that #lethalinjection is a medical procedure, but this couldn’t be more wrong.

This was a falsehood created by someone with no scientific training.

Suffocation…imagine you’re suffocating…feeling like you’re being buried alive…

@SteveCooperEsq
3/ The force you’d exert to breathe would suck water into air sacks of your lungs.

This is what’s seen at autopsy in the lungs of 77% of prisoners after execution by lethal injection.

Pulmonary Edema. Drowning in water.

bit.ly/3SA2BPj
Read 16 tweets
Oct 20
1/🧵What do ICU survivors tell me about PICS…(post intensive care syndrome)⁉️

Former ICU patient: “I’m angry. I’m furious because the doctors who injured me aren’t willing to help me recover.”

Is this fair?

I think so.

Why?

Read on…(perm to share)
2/ I just got off the phone w a patient who has had PICS for 12 years since nearly dying in the ICU. His story is included in #EDDB…he granted permission to share some thoughts today that I think are eye opening…in terms of how poorly we’re doing w Chronic Disease management
3/ people who never had PTSD before critical illness, leave with inexplicable experiences of road rage, rejecting their spouse, acting in ways that are so foreign to them that they don’t recognize themselves.

They also have tremendous problems with lack of self worth because…
Read 7 tweets
Sep 13
1/🧵 Land Mines in Long COVID - @BostonGlobe

Alex was training for 2024 Olympic Trials 🥇

That dream exploded 💣
 
New #LongCOVID science
📌Viral reservoirs at 1 year
📌Cardiac edema at 1 year
📌Dementia at 2 years
📌Hijacked mitochondria

ScreenShot👇
bit.ly/3U77u4r
2/ It’s one thing to concede that Long COVID exists as a societal problem for those w vulnerabilities like advanced age, pre-existing health conditions, or nearly dying in ICU.

What about nationally ranked D-1 long-distance runners⁉️

Paywall so read 🧵
bit.ly/3U77u4r
3/ Alex Schell is 21 & based his life decisions on making the 2024 Olympic trials.
 
“Not only can I not run due to #LongCOVID, I’ve also lost everything I hoped for. Who I envisioned myself to be is a past idea. It’s a monumental loss.” (story w perm)
 
What causes LongCOVID?
Read 22 tweets

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