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Confessions of an ICU doctor during COVID

Discussion in 'BBS Hangout: Debate & Discussion' started by BallaDoc, Jul 5, 2020.

  1. BallaDoc

    BallaDoc Member

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    Please feel free to share if anything piqued your interest.
     
  2. Amiga

    Amiga Member

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    Yea.
    Nationally, since it never went down, but plateaued, this is more of a surge of the 1st wave. If there is an actual 2nd wave this fall... on top of this surge...
     
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  3. Two Sandwiches

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    @BallaDoc I hate to keep @ING you...


    Not sure if you're in the Houston area. I'm not. My family is (Magnolia/Tomball) area.


    My grandma tested positive, as I said. She's asymptomatic. My family was helping her right up to her testing positive. My nephew (11) was in close enough contact with no mask. This was two weeks ago. Three days later, he had chills and slept a lot. He's since had a lot of allergy/sinus type symptoms and a sore throat.

    His strep was negative. My sister's convinced he has strep and it was a false negative.

    She says she tried to get him tested but the tests are gone so quick. Does having contact and symptoms move your priority? If so, what does she do?

    He's supposed to be with his dad for the rest of the month, starting tomorrow, and they're going to Florida within the week (she says she can do nothing about this).

    If you're the former moniker I think, you may be in that general area...or at least from there...thanks.
     
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  4. BallaDoc

    BallaDoc Member

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    interesting question. Anecdotally I have seen families coming into the icu I had a 44 year old die while her son an 18 year old was intubated on the bed next to her. I’ve heard stories about everyone at the house having it. Again anecdotally I would imagine that kids should be able to pass this disease to their parents. Why wouldn’t they it’s a respiratory pathogen and we know it can be transmitted in asymptomatic patients. If you’ve had kids you know if one of those rugrats gets a virus at daycare everyone is getting it and so are the parents. However my beliefs on this matter haven’t held true with new data emerging which I will delve into in a little bit.

    First of all the data on children becoming infected from multiple studies across multiple countries show that the rate of infection is much lower in children less than 10. There haven’t been any meta analyses to assess all these trials or if there is inherent bias in these studies but that is what the data states and what I imagine the AAP is basing their statements off of. The thing that has scared me is the spike in cases of Kawasaki’s Something I only saw in med school once but was questioned about multitudes of times. It’s an intense inflammatory response. There was a spike in cases of kids worldwide that led to some papers hypothesizing the incubation period was longer in children. A spike however in this situation was like an increase of 50 cases or so since it is still an incredibly rare disease. I don’t recall the details of those case reports but I remember reading it and saying we had to be more careful with my 2 year old daughter.

    i know the AAPs position at this time is to allow students to go back but if you read their position carefully they’re choosing what they think is the lesser of two evils FOR THe KIDS. Their opinion is that the risk of spread between and disease manifestation in children Is less than the risk of losing more social interaction and education. This disease is all about trading risks. Risk vs. benefit of lockdown. Risk va benefit of stressing infrastructure. Risk va benefit of intubation. Risk vs benefit of reopening. Risk vs benefit of school.

    I have read their position and to me it is clear that they are stating their position with Their focus being on the sole benefit of children. That is their scope of practice and that is what they are choosing to comment on. They haven’t linked the studies that they are making their claims on but They are easily searchable. An opinion editorial exists of one of the contributors thoughts as well. Their examination of the literature data has revealed that children are not super spreaders, less likely to be infectious, and less likely to be the index case of disease. Again if these studies are valid going forward or not only time will tell but that’s the info we have now. The AAP has stated very clearly that adult to adult transmisision between teachers and workers of schools is something they can’t comment on but they do advise temperature screening limiting sick children to home social distancing Limited use of busses block scheduling and mask covering especially for adults.

    from the data it would appear our children are safe and likely will not be the index case or epicenter. But our teachers and educational staff are at increased risk. If they take proper precautions I would imagine they could mitigate risk further. For example no one in my IcU staff has gotten sick yet fingers crossed and we’re literally got our hands in their mouth putting tubes in or on their blood for ivs. So I would imagine if the teaching staff are equipped with adequate ppe and stay their distances they may be able to open.

    sorry if I’m waffling. The literature states it is safe for children but to take care as an adult
     
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  5. BallaDoc

    BallaDoc Member

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    I’m sorry to hear that that is the case. I wish your family the best. I am from near the tomball area but haven’t been back in awhile. From what I’ve heard though we’ve been out of testing supplies and to keep checking in on Harris county’s website for available appointments. I believe symptoms do move you up the list but again would call ahead for scheduled appointments. I think CVs And other standalons have drive through testing That you can call ahead to inquire about but I do not know if the internal validity of these tests are reputable or not.


    I had commented on a previous posterS question about how spread from children to adults in the literature is supposed to be minimal. They found this data in multiple countries. Whether this is true or not remains to be seen.

    if you are still worried about spread things I’ve been doing with no data behind it include frequent hand washing with soap, frequent shampooing of hair, high alcohol content mouthwash, Increased hydration, gargling with salt water, and regular multivitamin.
     
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  6. BallaDoc

    BallaDoc Member

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    not sure if this helps or not but this website has some links for testing.

    https://www.dshs.state.tx.us/corona...rmation about testing,,certain parts of Texas.
     
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  7. mikol13

    mikol13 Protector of the Realm
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    Thank you so much for all of your hard work. I truly feel for you and everyone else that is on the frontlines as well. I cannot even imagine.

    There are too many people I know that feel this is a political hoax and I would love to share some of this with your permission?
     
  8. BallaDoc

    BallaDoc Member

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    feel free to share sir. I doubt it changes anyone’s minds since their idea of reality is firmly rooted in denial. I’d share this instead honestly.

    https://www.google.com/amp/s/www.ks...helmed-with-covid-19-patients/?outputType=amp
     
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  9. mikol13

    mikol13 Protector of the Realm
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    The problem with sharing it is “CNN Reporter”. They will automatically think it’s bogus.

    I have a friend who says pretty much the only reason hospitals are overwhelmed is because so many people were furloughed. How do you feel about that?
     
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  10. BallaDoc

    BallaDoc Member

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    Ahh I forget the general population cannot look up credentials of the doctor themselves who are listed in the video or the credentials of the hospitals. How silly to forget that critical thinking is absent in these stupid ****s.

    I don’t understand his connection between people being furloughed and rising cases? Could you elaborate on that
     
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  11. mikol13

    mikol13 Protector of the Realm
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    Funny, (But not really funny) he just said he’s not buying you being a doc and no doctor talks like you. It’s pretty maddening, he’s dug in with what he believes.

    btw, I absolutely believe you.
     
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  12. CCorn

    CCorn Member

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    Hospitals are only overwhelmed because Soros is paying people to die
     
  13. BallaDoc

    BallaDoc Member

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    Lol What’s it to him. In this country I can be president By being racist Scum and Saying grab people by the p***y.

    What a snowflake b****. Hope he doesn’t have to come into my icu where literally every physician i know is swearing up a storm at the current state of things.

    I probably wouldn’t offer him a tube anyways or access. We are limiting who gets a breathing tube and who doesn’t. Hope You and your loved ones are under 40 with no co morbidities. Good luck non believers
     
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  14. BallaDoc

    BallaDoc Member

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    Also thank you for your belief but that was not my intention. My intention was for people to understand how truly horrifying this disease is to deal with. I don’t care if the majority of you believe me or not but if I can get one person to buy in or one family to listen it will hopefully be paid forward and save people who need to be saved and allow people who need to be cared for more access to me and my supplies.
     
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  15. B-Bob

    B-Bob "94-year-old self-described dreamer"
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    Really appreciate this link.

    For those wanting to share @BallaDoc's story, would recommend including this link. I think he's totally legit, but it's sometimes too easy to discount "I found this anonymous voice on the internet," and often times with good reason. The actual reporting anchors BallaDoc's details pretty well.
     
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  16. BallaDoc

    BallaDoc Member

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  17. BallaDoc

    BallaDoc Member

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    i wish I could provide my credentials and licensing. But sadly my NPI number/Tx license number is linked to my parents home address. Haven’t been able to remove it for years.

    Either way believe me or not doesn’t matter. The whole point is to open peoples eyes and allow for critical thinking.
     
  18. B-Bob

    B-Bob "94-year-old self-described dreamer"
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    Same page. Just know I believe you, Doc. Just trying to help the message have maximum impact as people spread it. Thanks again for that link and for checking in. I'm going to share your story as well. Godspeed with your work, and hopefully people start being more careful.
     
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  19. malakas

    malakas Member

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    First of all...Do you have enough PPE?
    Are number of the staff working in ICU infected? Are they forced to continue working if so or told to go home and isolate?
    (We have seen in Italy, Spain and the UK that younger nurses and doctors were forced to continue working even when sick with mild symptoms)
    Are there many in your icu staff in the risky ages?

    Have you seen better results with dexomethazone? The latest study by WHO said that it can save up to 1/3 patients in ICU.
    What about tocilizumab? Or other antil IL6?they said they can deal with cytocine storms..

    Are the patients of younger age mostly obese or overweight?
    You said thats there is a genetic component and honestly thats obvious at this point..in the UK they have done a huge study that members of BAME (non white) face a higher mortality rate up to 3 times as much as white regardless of age or gender - but they couldnt say if it is because of more chance of infection at first place or if its for genetic factors..whats your opinion? Do you see a higher proportion of non whites in the ICU than expected?

    Good luck!! Talk is cheap but at least know that many people around the world care, support and pray everyday for our doctors and nurses and the war they are waging.
    Heroes.
     
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  20. Two Sandwiches

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    Thank you. I really appreciate it, and what you're doing.


    As I told my sister, a test doesn't really change anything for him. Even if he has it, his symptoms as mild and he'll be fine. My family just needs to be vigilant about distancing, etc., which they are already supposed to be doing because of my grandma.

    The only thing it would change is peace of mind, and also he wouldn't go to live at another household or travel. She says she doesn't think that would stop it because of court ordered visitation, but I think it absolutely would. Either way, it sounds like the system is too overwhelmed.

    Thanks again.


    Also, for anyone doubting anything (that's stupid), but if memory serves me correct (which I think it does?) Balladoc used to use a different moniker here before/during medical school....story is legit...
     
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