It’s disheartening to know the only people trained in caring for this disease is my department. It requires specific strategies on the ventilator. So it’s disheartening when we are so overwhelmed that surgeons are being asked to care for medical complexities and then watch them do it wrong, knowing, I can’t help because I’ve got 30 downstairs of my own crashing
I've been advocating wearing masks, and I didn't even vote for Trump. There's a reason doctors and scientists don't run the country - they have zero risk tolerance. They want no cases, and no deaths. The cost of that position is the economy, people's jobs, mental health, etc. The lockdown was absurd. ...and by the way - if you're going to insult me, at least learn some grammar. "You're an idiot", not "your".
The level of arrogance... in the West and especially the United States.... (mostly white men) really believing they understand a virus and how to treat it and prevent it.... better than experts that have spent decades working on these exact scenarios. It is puzzling to me the amount of crap passed around by people that are not scientists and not doctors but are so entitled they believe their person opinion holds more validity. From crap about vitamin C and vitamin D being some wonder cure, to degrading masks and claims that social distancing doesn’t matter.
Somebody needs to be blunt and share the true urgency of the situation. I think this is one fight where you might just want to shut the hell up and say thank you for what you do, and you’ll take his story to heart moving forward.
There’s a reason we should. What happens when the hospitals are full again and everyone goes diversion? The only logical step left is to lockdown to limit spread. You know like every single other country in the world did to prevent this disease. Why are we the only western country left with this disease overwhelming our hospital system. We never said no cases. We said limit cases to manageable levels. We advocated flattening the curve to offset stress on the healthcare infrastructure. This is not manageable. Every ICU is over normal capacity. With no measures being made to stop it. Right now do you feel like you won’t get in a car wreck, food poisoning, have any kind of accident, a heart attack. If you do then good luck finding a way in to the hospital. We’re operating under the STRAC emergency plan. Look it up
I'm glad you're advocating for wearing a mask, your rhetoric is still deadly as you are calling a half-ass lockdown that was opened WAY too soon absurd. I don't give a **** about Trump individually, it's the entire right-wing in this country, do your support Abbott and Patrick? The entire developed world outside of Sweden SERIOUSLY curtailed the virus, and their economies are not looking much worse than ours currently, and ours will take longer to recover because we aren't ****ing dealing with it. You're* a ****ing idiot politically, and the rhetoric you participate in is making this country a shitty place.
The disease itself. I have never been more terrified of a disease. It is so overwhelming that the manifestations are so vast yet physiologically sensible. In essence it is a truly hyper inflammatory virus. So think of every organ in your body and what would happen if intense inflammation went on in it. I will list the cases I have personally seen in my ICU Organ by organ neuro: Ischemic stroke Basilar stroke from endothelitis GBS ( inflammation around spinal cord) cardiac: Cardiac tamponade (rapid filling of the sac around the heart causing collapse) Heart failure Dysrhythmia and bradycardia leading in asystole resp Acute respiratory distress syndrome Mucus plugging gi Abdominal pain/porphyria? pancreatitis Diabetic keto acidosis renal Prerenal failure Possible hemolytic uremic syndrome heme Secondary huh all of these are deadly in their own right but you can see them happening on multiple fronts on one patient even
The respiratory disease itself is terrifying It mainly causes a condition called hypoxemic respiratory failure That I will detail in depth below. one type of hypoxemia in the body is from a lack of cardiac pump. This virus can slow down hear rate(decreasing cardiac flow through lungs), limit effectiveness of your cardiac pump (limiting blood flow through lungs). It can mimic heart attacks as well. It can cause such intense inflammation in the arteries that feed oxygen to your heart muscles. This is essentially a heart attack without a clot.
Secondly it causes hypoxemia by decreasing the carriers of oxygen your red blood cells. it can shear them or sequester them in different parts of your body through the intense inflammation it causes throughout your body. so not only is the pump for oxygenation compromised so is your transport mechanism
Im not going to discount BollaDoc's experience. But like everyone else, he wants to tell everyone what they are doing wrong instead of offering suggestions. Staying home to 'netflix and chill' is not a solution when you can't pay your bills because there is no economy. If you feel like you're a soldier on the front lines, then I suggest you own up to your oath. Otherwise you can stay home and netflix and chill too. Just dont expect to get paid like everyone else you told to do it. There are millions of other people who are making sacrifices and doing the right things. When we opened up, we expected this to happen and this is why we shut down for 3 months ... to prepare for this. And we are as prepared as we can be. Stop hyperfocusing on a few idiots.
This is dumb. His posts talk about overflowing icu patients and the downgrade of care to non Covid patients. This is exactly what flattening the curve intended to prevent. We're several months through this without a containment strategy all while political leaders want to wish this away with no effort and no will to organize. If I were in healthcare, I'd be pissed off for eating the bill of others too. I don't envy the choices they have to make when options and time are limited
Lastly and most importantly it causes hypoxemia by inflaming and infecting your lungs. it enters the airways and lodges itself there. While there it causes sloughing of the air sacs and intense mucus production. So oxygen from the air is limited in passing this to your blood. When it does make it across the mucus the interstitial lining of your lung is fluid ridden and inflamed from the virus. The intersitium can eventually start having fibrotic deposits which make your lung concrete and unable to expand to a given volume. Think of a stiff balloon. Then when it passes the interstitium to the blood there is a higher chance of blood clots from inflammation reducing the amount of oxygen transport. Remember your transport and pump are already compromised from before
@BallaDoc - I am very sorry for all you have been through. I have been doing my best and it has worked with close family and friends, but this board shows how arrogant and dismissive people are in regards to social distancing. Almost like they're so stupid they got intimidated when dealing with an intelligent opinion - http://bbs.clutchfans.net/index.php...idnt-take-social-distancing-seriously.304765/ posters like buck turgidson, pippendagimp in this thread try to blame this on trump, say cops should be disarmed because they have to deal with people resisting arrest and shooting at them every day, kept trying to play it down so they could go to their favorite pubs. These were all liberal posters when the media made it out to be rednecks tlaking about their "freedoms" and "rights". Stupid doesn't have a political affiliation! I think we as Americans just have to accept we have the stupidest common sense population in the world, and I'm sorry the adults (doctors, cops, anyone in a position of skill) have to be the ones suffering.
This combination has led to some of the most insanely low oxygen levels in patients I have ever seen. When I have to incubate them I literally have seconds to get a tube in your mouth around your tongue and then in your vocal cords. Even if I’m a second off and even when the tube is in your oxygen plummets immediately because of the seconds your off non invasive oxygen support. I’ve seen as low as 20.
Tube is in great we win? No now the terrifying events begin. The next 2 weeks I keep you heavily sedated because despite the high levels of support my ventilator gives I cannot increase your oxygen levels to normal ranges. They are so low we have to try to increase the normal lung tissue by flipping you on your stomach and paralyzing you so you do not breathe on your own. We do this because if left yo your own devices your oxygen levels would be so low they would permanently damage your brain kidney and heart. Even then we cannot get the oxygen up to normal levels. We sometimes consider lung bypass but there are only certain number of circuits in a whole city for that.
Had people stayed at home and followed the directives like some of the other nations we could be getting back to work just like those nations. They are doing it safely, but now we have to roll back our reopenings and delay our economy rebound even more. Let's try and do it right this time so we can get our economy back on track eventually.