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Tatiana Prowell, MD Profile picture
Tatiana Prowell, MD
@tmprowell
Oncologist serving people w/ #cancer in #MedEd/#bcsm clinic/#regulatory. #ASCO20 Ed Chair. Cofounder @HCWvsHunger. #LongCovid. Team hope/good trouble/go high.💙
7 subscribers
Sep 21 • 7 tweets • 2 min read
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…
Image 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
Sep 5 • 10 tweets • 4 min read
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…
Image 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
Aug 28 • 9 tweets • 2 min read
#MedTwitter #NurseTwitter I have a small but important rant about medical gaslighting. I booked a pharmacy appt for vaccines for myself & my family. This evening when we all went to get them, the pharmacist said to me: “You only booked an appt for yourself, not the others.” 1/ No, I’m sure I booked all of us. I had actually booked a time & when it didn’t let me add others, I had cancelled & rescheduled for an hr later when they could take us all. I explained that to the pharmacist who could SEE the cancellation & rescheduling just as I said, but… /2
Jun 19 • 4 tweets • 1 min read
#MedTwitter

Great to see independent groups demonstrate that passive transfer of IgG from people w/ #longCovid (LC) to mice produces symptoms.

A few reactions:

👉 We need #clinicaltrials of repurposed drugs (& novel agents) to treat autoimmune disease now

BUT… We have GOT to be able to identify patients w/ #longCovid who instead (or also) have persistent #SARSCoV2 &/or other reactivated virus. If we immunosuppress them (w/o treating 🦠), we can inadvertently harm them AND potentially abandon therapy that could help others w/ LC.

2/
Apr 29 • 4 tweets • 2 min read
The postmortem exams of cats who died of #H5N1 #BirdFlu on dairy farms show devastating effects on the heart, lung, eyes, & brain.

‼️Do not consume raw (unpasteurized) dairy products.

#MedTwitter, 👀 at the screenshot. #AvianFlu #IDTwitter

wwwnc.cdc.gov/eid/article/30…
Image Because some are asking me to translate this, the very brief version is that massive inflammation & cell death occurred in heart, lungs, brain, & eyes of cats who drank unpasteurized milk from cows with #H5N1. In all, >50% of cats at that dairy farm died. #MedTwitter #BirdFlu
Apr 23 • 5 tweets • 1 min read
NEW: Prosp study in 225 pts w/ “mild” #COVID19 & future surgery or other procedures. People w/ viral RNA detection in tissue or🩸5.2 times more likely to dev #longCOVID symptoms (OR 5.2, 95% CI 2.6–10.1, p<0·0001). Higher copy #, higher odds. #MedTwitter
thelancet.com/journals/lanin… Months after a positive #COVID19 test, viral RNA was found in 10 diff types of tissue, incl the liver, kidney, stomach, intestine, brain, blood vessel, lung, breast, skin, & thyroid + blood cells, which could explain the wide range of reported #longCovid symptoms. #MedTwitter /2
Mar 22 • 8 tweets • 2 min read
I’ve received 4 major media requests in the 2h since #KateMiddleton announced her #cancer diagnosis. I have declined them all. She has not revealed what type or stage of cancer she has, & any dr, including oncologists such as myself, appearing on the news would be speculating. /1 Image I’ve been asked questions on live broadcasts before that we had agreed were off-limits. I know if I agreed here, I’d be asked to speculate on the type of cancer, type of treatment, how long it might last, what the side effects might be, what her prognosis is. I won’t do it. /2
Mar 6 • 4 tweets • 2 min read
Devastating study in NEJM. Prospective study of 257 patients having carotid artery surgery: micro/nanoplastics (MNP) in 58% of atheromas & those w/ MNP present had 4.5x ⬆️ risk of stroke, heart attack, & death at mean of 34 mos follow-up. #MedTwitter nejm.org/doi/full/10.10… Add this to the list of health concerns about micro/nanoplastics (MNP) in food. For example, this recent thread I wrote expressing concern about how we're seeing more young-onset colon cancer. Unfortunately MNP are already in soil, water, foods, etc. This is a big problem.
Jan 19 • 10 tweets • 3 min read
#MedTwitter, This is an important 🧵 from a bereaved husband’s perspective as a caregiver. I’ve been an oncologist for >20y; all of my patients by definition have a serious illness. So I hadn’t thought much about the power of affirming it. When the #COVID19 #pandemic began… 1/ & we all did more outpatient care via 📱, I had the good fortune of overhearing bits of how my husband (an infectious diseases dr) speaks to his patients. I don’t know them or their diagnoses of course, but I know it’s not all cancer, which everyone agrees is real & serious. /2
Jan 18 • 17 tweets • 6 min read
Sen @BernieSanders opens Senate HELP Committee mtg on #LongCovid stating that 16M in the US are currently living w/ #LongCOVID, a syndrome w/ brain fog, memory loss, language problems, fatigue, & more. “Long COVID can affect anyone…It poses a severe threat to #publichealth.” Image A former endurance athlete Angela Vasquez shares her story of becoming severely disabled after an otherwise mild #COVID19 infection in 2020. She now requires 12 prescription meds. Notes that people w/ #longCovid may be too ill to navigate the disability system. #HELPLongCovid Image
Jan 9 • 8 tweets • 3 min read
Wading into this water bottle debate as a cancer doctor. There has been a striking increase in #coloncancer in people under age 50. When you see an abrupt change like this by generation, it always raises concern for an environmental cause. #MedTwitter cancer.gov/news-events/ca… We don’t know why this is happening, but I think it’s logical to ask what may be spending time sitting in the colon, i.e., things we eat or drink. This rise in #coloncancer is occurring in #Millenials & younger #GenX. Look at the birth years & ages in the screenshot. #crcsm /2 Image
Aug 2, 2023 • 5 tweets • 3 min read
🧵 LOTS of folks with #COVID19 in my text messages this week for the first time in months, & many of my #MedTwitter friends are saying the same. This has happened before every recognized 🇺🇸 surge. Be careful, esp if you are higher risk. All, please 😷 & test if you feel sick. 1/ Some insurers (incl Medicaid) are still covering #COVID19 home rapid tests. If you have rapid tests at home that have expired, check this list before discarding them. Many have had their expiration dates extended: . /2 #MedTwitterfda.gov/medical-device…
May 12, 2023 • 5 tweets • 10 min read
In May 2019, Dr. @rschilsky & I co-chaired the #AAADV19 Workshop Plenary Session "Decentralized #ClinicalTrials: The Future is Now." An incredible group of panelists from academia, industry, govt, & patient #advocacy 👇discussed the rationale, challenges, & opportunities of DCTs. Image No one knew yet that the #COVID19 #pandemic was just around the corner. In Mar 2020, FDA released a guidance on conduct of #clinicaltrials during the pandemic: fda.gov/media/136238/d…, & colleagues wrote about the impact on #OncTwitter trials: ncbi.nlm.nih.gov/pmc/articles/P…. /2
May 12, 2023 • 10 tweets • 5 min read
Students from 🏠 with annual income <$50K were half as likely to be accepted to med school as students with 🏠 annual income >$200K. We all knew this was a problem, but the magnitude is shocking. We all have a role in addressing this, #MedTwitter… /1 Students from lower income 🏠 are at an educational disadvantage that begins well before college. A concrete intervention: volunteer to tutor students. I did this multiple times per month the whole time all 3 of my kids were in elem school. files.eric.ed.gov/fulltext/EJ898… /2
Apr 9, 2023 • 6 tweets • 5 min read
A study from #Brazil finds 1 in 4 adults who had mild #COVID19 demonstrated cognitive deficits. The average age of study participants was 38. See what happened when they were asked to copy a diagram. We are not prepared for this. #MedTwitter #LongCovid brainfacts.org/diseases-and-d… Image Many people are replying “I wouldn’t have been able to copy that drawing accurately even before #COVID19.” This is true. On avg, 5-8% of population are unable to reproduce this. What concerned researchers was that in this study of ppl w/ mild COVID, 25% of them could not.
Jan 18, 2023 • 4 tweets • 1 min read
A survey of 20K people found the most productive people:
👉Set objectives & priorities before beginning to read, write, or plan day
👉Insist on short, focused mtgs & clear, efficient comms
👉Develop consistent strategy to handle 🌊 of msgs/tasks
hbr.org/2019/03/what-m… 2/ A couple interesting observations. Americans work more hours than much of the world but are not more productive. I suspect this is because 🇺🇸 culture values “workaholics,”
so we push through with diminishing returns.
Jan 5, 2023 • 5 tweets • 5 min read
🔥IMPORTANT! #MedTwitter & all workers: the @FTC is proposing to make noncompete clauses illegal. Employers would be prohibited from establishing them & forced to rescind existing ones, incl notifying past employees of the change! 👏👏 @MedicineForward nytimes.com/2023/01/05/bus… ~ 1/5 of US workers are currently under non-compete clauses. They harm workers in many sectors, incl #MedTwitter, e.g., by preventing them from taking a better position w/ another company unless they’re willing to move or travel a long way to work. 2/
Dec 5, 2022 • 7 tweets • 5 min read
🧵This is a VERY brief thread about #HCWvsHunger tonight because this week has been out of control, & I still have to pack to fly to Texas for #SABCS22 on 12/5, which is TOMORROW! A longer thread will follow because I know everyone comes to Twitter for long form, lol.

1/ The last few months worried me. The economy. The numerically & emotionally depleted #MedTwitter colleagues. The very fate of this platform, which has big problems, & also has been an undeniable source of reliable info to the public during this #pandemic & community for us all.
Nov 23, 2022 • 5 tweets • 3 min read
🧵 I did 10 parent teacher conferences yesterday where my kids have an A in the class & I had nothing to discuss. I used the time to tell #TeacherTwitter a few things:
👉I know you risked your own health & life, & your family’s, to come to work in a #pandemic. #ThankYou

/1 👉I know you spent 1.5 yrs teaching our kids virtually, navigating unfamiliar technology, staring at a little dot on your monitor instead of a class full of kids, not knowing if the kids with cameras off were there, wondering about the ones who never connect. #ThankYou

/2
Nov 15, 2022 • 10 tweets • 15 min read
Learned so much in this evening's @AACI_Cancer@ webinar on physician use of social media! Dr. @fumikochino highlighted sev successful research collaborations that began via #SoMe & said that Twitter has helped a lot with the "hustle" all #MedTwitter junior faculty face. Dr. @SyedAAhmad5, who began tweeting during the #pandemic, highlighted opportunities to expand reach of #MedEd via #SoMe. For example, he taught this to #MedStudentTwitter, then realized there was no reason the learning needed to be confined to his operating room. cc @AACI_Cancer
Nov 8, 2022 • 6 tweets • 6 min read
#HoCoMd #Election2022 - I am supporting @DanNewberger & @JackyMcCoyBOE in the non-partisan race for @HCPSS Board of Ed. I have spent a lot of time reading about all of the candidates. McCoy & Newberger, endorsed by @MomsDemand, are committed to ending #GunViolence in our schools. .@JackyMcCoyBOE has been a teacher for decades & is endorsed by our local educators. She has dyslexia & achieved a graduate level-degree so understands what supports make it possible for students with learning differences to be academically successful.
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