Posted on 04/06/2020 4:27:53 AM PDT by DannyTN
... As more data comes in from China and Italy, as well as Washington state and New York, more cardiac experts are coming to believe the COVID-19 virus can infect the heart muscle. An initial study found cardiac damage in as many as 1 in 5 patients, leading to heart failure and death even among those who show no signs of respiratory distress.
That could change the way doctors and hospitals need to think about patients, particularly in the early stages of illness. It also could open up a second front in the battle against the COVID-19 pandemic, with a need for new precautions in people with preexisting heart problems, new demands for equipment and, ultimately, new treatment plans for damaged hearts among those who survive. ...
(Excerpt) Read more at khn.org ...
You’ve earned being ‘a little tired’...
Doctor, after reading your post, I would not fire you. I would instead seek you out to help me. I withdraw my first post to you. It no longer has any meaning.
You are indeed a hero. A real one. There is nothing at all to forgive.
God bless you and your patients, and God bless America.
Sincerely,
Chris
Any jerk can do heroic things when they aren't scared.
Should you have the honor to treat a Medal of Honor patient, ask them if they were scared when they earned it.
I'm willing to bet you won't find one who wasn't terrified!
And I'm willing to bet they'll tell you the ones who didn't come back were the real heroes.
this drug or combination of drugs is not a cure-all>>>>>>>>>>>>>>>>>>>>>>>
We are far too accustomed to having a “cure all” and have forgotten the pre vaccine paradigm professional application of therapies.
Of course any therapy for Covid 19 is not a cure all. BUT it can be a complete cure IF administered in a timely fashion.
Once the immune system is compromised, it doesn’t really matter what therapy one uses.
Thats why at its very best application hydroxy-chloroquine would be used as prophylaxis.Its a low dosage combined with Zinc vitamin.Its actually the Zinc that brings about the result. The drug makes our cell walls permeable to Zinc ions, which enter and upset the chemistry of the virus.
Most of the cuations about the use of HCQ involve timing, whichi involves a physicians hands on understanding of the nuances of Covid-19 infection symptoms in a patient. The optimum time for treatment is up to 2 days from the spike in temperature up to 104 degrees , which si when the lungs fill with mucus, some doctors compare the reaction as filling the lungs with wet concrete.Thats why only 2% of patients placed on ventilators survive.
Now when people understand that, the whole treatment makes eminent sense. And it means your doctor has to know his way around your body, a somewhat tenuous craft these days in modern medicine.
Here is a perspective from someone who has been on hydroxychloroquine (aka plaquenil) for couple of years for my Rheumatoid Arthritis. In Rheumatoid Arthritis, the immune system goes bananas and attacks various parts of your body instead of protecting your body from invaders. In my case, it attacked my heart. I now have severe heart failure and have had 3 heart surgeries with 2 new artificial heart valves. The hydroxychloroquine and other drugs are used to tamp down the immune system, so the immune system won’t attack you.
It is my understanding that the Covid-19 puts your immune system in hyperdrive, and that the inflammation and damage are actually caused by your own immune system attacking you, not directly by Covid-19, which is why these drugs are effective against Covid-19.
According to my rheumatologist, the hydroxychloroquine won’t keep me from getting Covid-19, but will tend to keep me from getting a severe case. I do hope he is right. He is in the top of his field here in Los Angeles.
Long Island doctor tries new twist on hydroxychloroquine for elderly COVID-19 patients
Doxycycline in this case, cipro is another candidate.
You know the very first thing I said was that SOME and not ALL Dr’s.
Somehow you took this to be an attack on all Dr’s. Are actually claiming there are no physicians who are arrogant and condescending?
Dr’s are perfect humans....right?
You know the very first thing I said was that SOME and not ALL Dr’s.
Somehow you took this to be an attack on all Dr’s. Are actually claiming there are no physicians who are arrogant and condescending?
Dr’s are perfect humans....right?
Reread my post carefully. I think you’ll find we have mostly the same opinion of this. My post is directed at the media...
That people with RA and lupus weren't getting sick was what clued Chinese Doctors into looking at HOCQ.
grey_whiskers wrote:
“
https://www.freerepublic.com/focus/chat/3831993/posts?page=170#170
(This new coronavirus causes its problems by chewing up the heme in red blood cells, releasing the iron into the body. Both the lack of oxygen-carrying capacity, and the iron running amok, cause their own problems. And the body’s adaptive mechanisms to each of them just make things worse.)
I don’t think this mechanism is found in ordinary coronaviruses or pangolin viruses, do you?
= = = = = = =
Also ...
Emilio Martínez @egmartinez951 Cameron Kyle-Sidell, MD, a critical care physician in New York City, has been sounding the alarm urging healthcare professionals to consider that COVID-19 acts less like typical acute respiratory distress syndrome (ARDS) and more like high-altitude pulmonary edema (HAPE). 8 https://twitter.com/egmartinez951/status/1246962186544611334
“
Thanks for finding this; pinging gas_dr.
Yes, I’m aware of that
Well, the tx for HAPE is high positive pressure, the treatment for ARDS is to list barotrauma. Honestly, I think this is a distinction without difference. As for the hemolytic anemia component — I am not seeing that in my patients. It is part of the daily surveillance of any critically ill patient, but we are not seeing higher levels of non binding hemoglobin (met, or carboxylate) in which the redox number is changed to bind or not bind oxygen.
Will keep looking, but not seeing it....
For whats its worth Chris, I would fire myself most days...but thats just my Lutheran upbringing. Thanks for your kind words.
I understand what you are saying, however azitrhomycin has properties that Doxy and quinolones dont have — namely anti-inflammatory and viricidal. So there is likely a synergistic effect between Hydroxy and Azithromycin. All of medicine is the risk reward balance. I have the luxury of continuous cardiac monitoring in the ICU setting so even if someone plants a q on T and enters re-entrant VT or Torsades, I can fix it quickly.
a) different strains of the virus
b) Different stages in disease progression
c) Function of viral load
d) Predisposition (e.g. small sample sets which indicate type O blood is not as susceptible; data which show high A1C is a big risk factor; and the like)
We are not perfect, but we strive to be because mistakes in our business are fatal.
Thanks gas_dr for the review!
Posting a link for an alternate antibiotic
(H/t null and void)
null and void wrote upthread:
“The problem appears to be the Azthromycin. There are other antibiotics that work just as well in people with cardiac issues.
Long Island doctor tries new twist on hydroxychloroquine for elderly COVID-19 patients
Doxycycline in this case, cipro is another candidate.”
http://www.freerepublic.com/focus/f-news/3831643/posts#1
Thanks for what you are doing on the front line.
Get some rest and forget about the Assholes, who hate doctors.
If they really hate doctors, they would have a tattoo on their foreheads or chest saying, “I hate Drs, Rns and every one in the medical profession.”
Then, you can pass them on to their local unlicensed health care bozo and spend your valuable time/energy on someone, who is a human being, not an A$$hole.
“We are not perfect, but we strive to be because mistakes in our business are fatal.”
I read recently that the 3rd leading cause of deaths occurs via medical malpractice.
https://www.cnbc.com/2018/02/22/medical-errors-third-leading-cause-of-death-in-america.html
Doctors do bury their mistakes, don’t they?
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