WesElyMD Profile picture
Dec 9 4 tweets 5 min read
1/🧵 Grasping for help in LC

📍as a #LongCovid patient you admitted on embarking to Turkey for pheresis that
📍this Tx was an UN-established long shot
📍but your life w this syndrome had devolved
📍as a scientist you now found yourself willing
📍while others conduct trials
2/ I see your choices in seeking therapy for #LongCOVID as brave & honest w cautious expectations cognitively & physically.

Most importantly, you’re demonstrating hope & a desire never to give up.

Knowing you, @pamelarbishop, and calling you friend is a gift beyond measure.
3/ For anyone who chides a highly intelligent person for pursuing alternative approaches to solving health problems #medicine scoffs at, seek empathy & read these truth-telling books 📚

@DouthatNYT @meghanor are my teachers…

#LongLyme #MECFS #LongCovid #Fibromyalgia
4/fin
As an academic medical insider, I was taught these diseases are bogus & of the mind.

✔️I silently dissed & carry that shame. No more
✔️Listen & Silent = Same letters
✔️Change my thinking? Deming said it well
✔️We @CIBScenter are leveraging NIH💰to do science & #discover

• • •

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More from @WesElyMD

Dec 7
1/🧵 Micro Clots & Endothelial Dysfunction in Long COVID

Plus new Epidemiology in @JAMA_current some say proves #LongCOVID is a hoax⁉️
 
Truth is…endothelial dysfunction plus inflammation can lead to life-altering brain & body dz.
 
Let’s explore data

Pic H/T @VirusesImmunity
2/ Remember that Vascular flow problems don’t occur in isolation from inflammation.

This new piece by @Jamie_Ducharme balances the discussion well.
 
It’s time for great studies & NOT immediate widespread treatment with blood thinners that might harm.
 
bit.ly/3He2FCj
3/ The urgency is that people are living w what amounts to newly acquired #dementia.
 
This WaPo piece starts w “Haze. Slow. Drunk. Lost.”
 
Our patients are adamant that descriptors like #fatigue & #brainfog don’t do justice to what makes them suicidal.
 
wapo.st/3YbRJLQ
Read 22 tweets
Nov 30
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
Read 5 tweets
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

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