iramurphy

Points well taken. The reason for stopping elective surgeries was to preserve PPE’s and medications necessary for intubation. If we reach a time when we have adequate supplies and meds, I would strongly recommend resuming all necessary medical procedures. We never stopped seeing patients in our clinic,? but we see patients by appointment only and screen for potential Covid patients at time of appointment. . They are all screened at the door including temperature screening, when they get to the clinic. Anyone with upper respiratory illness/fever etc is diverted to a designated area at our clinic/hospital facility 15 min away. We are all screened daily for fever or respiratory/flu symptoms at the door before we come in to the clinic. Patients are probably safer coming to the clinic compared to Walmart or grocery store. There is no reason for patients to neglect their health. They should keep their routine appointments for physicals, chronic illnesses and be seen for acute care problems. We do virtual visits and verbal visits for those who don’t want to come in. That doesn’t guarantee no risk, but it minimizes risk. For the patients you refer to, it is probably riskier to neglect their routine chronic care follow up. I would also reopen dental offices. Neglected dental care can lead to other health care issues. Dentists and their assistants have gowned, gloved, worn masks and shields long before Covid. If they screen like we do it should minimize risk.

So we have one pseudo-intellectual who disguises his limited knowledge by attempting to chase some poor souls to their “google dictionary “ to see what he is talking about. Other than the political bend, there seems to be nothing of substance. Reminds me of the Harvard geek who was put in his place by a janitor (albeit a bright one) for regurgitating other people thoughts and ideas in the movie Good Will Hunting. At one time there was an exchange of information and thoughts from medical people dealing with the crisis directly. There were discussions and comments from folks who have lost friends or loved ones, or folks suffering, both economically and socially, as a result of this pandemic. The blame game can wait and their will be plenty of blame to go around. If anyone doesn’t think multiple federal and state administrations, both political parties, world, federal, state, county, and city health departments, government health care providers, private health care providers as well as individual citizens mustn’t assume their share of the responsibility, then you need get get your head out of the sand. To dismiss the need for precautions whether it be social distancing, stay at home orders, masks, testing etc would be a mistake. At the same time to dismiss the suffering of those that have lost their jobs, face financial difficulties or financial disaster, and social isolation would also be a mistake. Regardless of what the Trump administration decides or your state government administration decides there will be risk involved. Testing is important but testing negative this week doesn’t mean much for next week. Antibody testing may indicate immunity but we aren’t sure yet. The medical community is still in the trial and error mode with different hospitals/institutions forming conflicting opinions with regards to same or similar treatments. Same with our government leaders. In the meantime, as people start to return to work, take precautions such as masks, hand washing, social distancing and resist the temptation to gather in groups for social events without being careful. There are too many people and families facing financial collapse to disregard their plight. At the same time returning work and other normal activities will involve the risk of spreading the infection. Reasonable arguments on both sides and because we aren’t the decision makers we need to focus on best practice. In addition to the recommended precautions accept the personal responsibility to get healthy.

We can assume that in some, but it is a new virus only months old so how do we know what the long lasting effects will be at this time??

Right on cue.

I will let Keikla answer for herself, but I believe across the country most providers use it early in the disease. We still are getting mixed reports as to the efficacy, but from what I have gathered if used it should be used early.

Thanks for your updates. I tried to address the issue with our clinic administrators and I doubt they had a clue why I was asking. It was clear they didn’t like questions and the answer was a brisk “it’s in the protocol”. Of course I can’t find the protocol but the information you have shared is invaluable. Thanks and thanks for your heroic and exhausting work. You and your colleagues are saving lives and giving comfort to so many whose families can’t be there. God bless and God speed.

I suppose. Most of those folks live in their Grandma’s basement cuz their Mom kicked them out and Grandma loves to cook and wanted someone to talk to.

Who gives a rat’s behind? Kid has great feet, great frame, great athlete. No one offered Shobert out of HS either. Great career at Wisconsin now playing in NFL. Joe Haeg didn’t get offers either. Had great career at NDSU now playing in NFL. What the hell is your point?

I raised the issue with our hospital CEO today. Over 90% of my patients age 80 or older have indicated they wish to be DNR. Unfortunately most haven’t filled out the forms so unless the ER docs or hospitalist read my notes they don’t ask. We all assume patients are full code unless we have documentation to direct us otherwise. The elderly patients have indicated they don’t wish to be intubated but often family members talk them into being full code. I am reviewing the patients code status every day now with regard to COVID-19. Thanks for the info.

Does your hospital have access to Leronlimab? Shows promise against HIV. It will be hot topic over next few days. Have you seen anyone use corticosteroids? Have you many (if any ) patients requiring ventilators recover? Thanks for you great work and thanks for sharing. I’m passing the comments of your experience up our chain of command. Greatly appreciated. Hang in there and take care of yourself.

When patients are diagnosed, this is a reportable disease. The patient with Covid-19 is interviewed and a list of contacts is collected and the contacts are contacted. Absolutely no reason for public to get names. It would be a HIPPA violation.

Source?

That is a common but unproven belief. Great way to accomplish dreams is to stay in hs play your other sports and graduate with classmates. Plenty of time for juniors after hs. On the other hand maybe the U of Mn studies, Mayo studies, Dr. Andrews out of Birmingham are all wrong. Dr Mike Stuart whose sons played in the NHL was Chairman of Sports Med at Mayo when these were the studies discussed and recommendations made at the annual Mayo Sports Med Conferences on multiple years. What it takes are parents who support what’s best for their student athletes not what self proclaimed experts think is best for their bantam , hockey, elite hockey, hs hockey etc. Gopher Asst Coach Garret Raboin was multiple sport athlete for a mediocre Detroit Lakes team. He and another hockey player were star RB’s on the FB team who helped lead DL to a 4th State Championship their Sr. Year. He then played 3 years of Junior hockey and got a late scholarship at St. Cloud St. He was an All WCHA defenseman , team Captain, Academic All American, and a professional career in Europe for a few years. Kids who are multiple sport athletes in hs tend to have a higher “upside” than those who played only one sport. Hakstol used to tell kids to stay out for FB or soccer in the fall. How many “top prospects “ who only played hockey never seemed to develop at the college level after juniors. Too many kids are told from a very young age they have to focus on one sport if they want to play in college. It works for many but studies show they have more injuries and peak earlier. It isn’t just hockey. It’s tough to stay the course but that’s what the evidence says. Multiple sport athletes can still hone their favorite sport skills in the off season and play their favorite sport in the summer or part of the off season but playing one sport year round isn’t good for kids.

Maybe not a mistake if referring to bowel movements.

They are. So far so good. We have designated our clinic as a “clean” clinic. Respiratory infection cases are directed to another of our clinics 12 miles away. We are no longer testing at our clinic. Sanford health and the Mayo Clinic are now doing our own testing which improved turn around time. We are staring virtual visits next week in addition to the patisserie in clinic. Seems simple compared to the great work you and your colleagues are doing. Stay strong and stay safe.

The epicenter. No reason for any of us in Northern Mn to feel sorry for ourselves. My daughter and family are hunkered down in Mamaronek. Take care of yourself and thanks for what you are doing.

Hang in there

Where in NY are you?

I would hope when we get through this, the Ohio State Board of Medical Examiners reviews the providers who did this. This is egregious. Worse than hoarding TP.

I would think reasonable to try in known cases. We will have the crazy TP hoarders crawling out of their bomb shelters demanding prescriptions “just in case”. It should be saved for hospitalized patients until we gather more information. Keep us posted on your experience.

3 sport HS athlete who got into the weight room. Good example for kids who want to play college hockey. Studies show the kids who play one sport year round have more injuries and peak earlier.

I believe the rest of the story is that that department was combined with 2 others in a cost cutting efficiency move to improve collaboration and efficiency. Some said it accomplished that. So the Pandemic and Bioterrism group is still around. I’m not defending Trump no condemning him. There are scientists and medical experts advising this administration and have been. The other misinformation passed on by some is the claim that the US refused test kits. The WHO didn’t offer. I’m not sure I understand the need for some to assign blame in the middle of a crisis. I’ve seen these people while preparing to go into combat as we learned of deficiencies and lack of supplies and equipment. I’ve seen them as an emergency room physician dealing with mass casualties. Those folks become part of the problem rather than part of the solution. Sometimes you want them to understand they need to get the hell out of the way and let others do their job as best we can. There will be time later to point fingers and assign blame. There will be plenty of blame to go around. When the time comes we can reflect on what we did to help or we can talk to other like minded folks about how we whined and criticized every step of the way. Which group do we want to associate with? Stay healthy.

The plight of the lady and her husband is because their clinic and hospital failed her and her husband. The lack of test kits is no excuse to not know what to do.

I’m not an anti-Trump guy. I have reviewed these reports and they were discussed yesterday and today via the Mayo webcast by hundreds of physicians from around the country. When able most of us will be willing to use these meds in combination but if we are wrong, we could cause harm and the anti-Trump lawyer guy would probably want to file class action lawsuit.

I didn’t say he was right or wrong. I’m not a fan of the media. I have to deal with facts. The hydroxychloroquine combo looks promising. We will learn more day by day.