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Sarah Axelrath MD Profile picture
Sarah Axelrath MD
@DrSarahAxelrath
Addiction medicine & primary care. Sustained by a propriety blend™️ of rage, hope, hospital coffee, #harmreduction, & heavy 🤘(she/hers)
Mar 28, 2022 • 15 tweets • 5 min read
I was talking to a patient recently about her different experiences using heroin vs fentanyl. She’s been using opioids a long time. Too long, by her count.

She explained the difference to me like this (shared with permission):

1/x With heroin, she had a 6-12 hour period after using when she could reliably expect to feel well. She could work, or visit with family. She could get a full night’s sleep and know she had enough left over to get well in the morning. She managed this way for years.

2/x
Jun 11, 2021 • 7 tweets • 2 min read
How I know all you new interns are gonna be ok: a brief story

My first rotation of residency was in the ED. Day 2, I was managing a patient w/ septic shock, persistently hypotensive after the 30cc/kg bolus, on abx but not looking good.

1/x 2/x My resident asked what I wanted to do next for the pt, and I froze. Not a single clue. I think I said something like “I could, uh, call the family and have them come in to say goodbye?”

B/c in that moment, my algorithm for management of septic shock ended after…fluids.
Jun 8, 2021 • 4 tweets • 4 min read
So glad to be part of this video showcasing my incredible @MGH_SUDs addiction medicine fellowship program led by the #GOAT @DrSarahWakeman, in addition to many other fantastic faculty @drjessgray @drlaurakehoe @Dinahlew @DrBenBearnot @markeisenberg16 @ampeckham And although I’m only there part time, I’m also proud to help highlight the important work being done by @BHCHP and AHOPE on the CCiR van, day in and day out, by dedicated providers like @JoeWrightMD @Dinahlew @e8b8r @JessieGaeta @Boston_Mackin and others.
Nov 14, 2020 • 13 tweets • 4 min read
4 years ago tomorrow would have been my 1st #residency interview, at @mghmedres. I know this because 4 years ago today my dad died unexpectedly in Denver while I was in Boston. I cancelled the interview from the tarmac at 6am the day of, and flew home.

It’s a whole 🧵 2/ This will not be a memorial thread about how much I love and miss my dad, although I do and I do. Weirdly, this is a @mghmedres appreciation and #medstudenttwitter celebration thread. Bear with me.
Aug 31, 2020 • 4 tweets • 3 min read
August 31 is International #Overdose Awareness Day. Every year I reflect on all the people we’ve lost, but especially Arielle. Here we are at 18 - careless, happy assholes. She was brilliant, snarky, a talented musician, and she died at age 26 from a poisoned drug supply. Image In the last 2 years of her life, Arielle went to jail, went to rehab, and “got clean.”

Jail didn’t save her.
Rehab didn’t save her.
Abstinence didn’t save her.

#SCS could’ve saved her. #safesupply could’ve saved her.
#MOUD could’ve saved her.
#Naloxone could’ve saved her.