iramurphy

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.

Um... Then they should be the ones reporting. As of noon today, we have zero results from studies about the use of hydroxychloroquineazithromycin. The reports are anecdotal. Same report from 3 presenters at The Mayo Clinic Clinical Reviews 2020 completed at noon today. We have multiple studies going right now studying the antiviral agent Remdesivir but studies aren’t complete yet. The President isn’t responsible for our problems. When we do an after action review, there will be a long list for people to criticize. The President’s mistake has been to speak on medical issues that he has no knowledge about and must rely on what he is told by others. If I were advising him I would tell him to allow his medical advisors to brief the nation on the medical details including potential helpful medications or vaccines. He can talk about gearing up the nation to produce more of the required medical supplies. Business is his area of expertise.

Let us know what you learn. Good luck.

You are correct in that as of right now we have no studies to support use of hydroxyxhloroquine with or without Azithromycin. We have some isolated, unsubstantiated reports. No one should be prescribing for friends or health care workers anymore than people should hoard TP or PPE. It should be saved for hospitalized patients who have either tested positive or are highly suspicious for COVID-19. I will say exactly what I said before going into combat. This is what we signed up for. Let’s do our job, no complaining, watch out for one another and have each other’s backs. The new standard for community acquired pneumonia was just changed. It’s back to Amoxicillin 1gm tid or Doxycycline 100mg bid x 5d or longer if Sx persist. They don’t need to be hospitalized unless they need oxygen or fluid resuscitation or have other complications. Zosyn isn’t on the list no should it have been with few exceptions. Remdesivir is part of multiple ongoing studies. China as of 2/6, And multiple studies in the US starting 2/21. Hoping for results early May. I would guess if early results are excellent they will ramp up production and start widespread use. Stay safe. Thanks for your work.

Yup. Especially before this spreads. Few cases in this area leaves a window for donations.

I don’t think the significance of testing is overblown at all. It’s a moot point until we have the resources to do so. Give us the ability to test and we can test everyone. Right now we don’t have the capacity to do so, therefore we tell people with milder symptoms to stay home in order to protect others. Data analysis will have to wait until we have the resources to test everyone. In the meantime we deal with patients with the resources we have.

I am doing an online Mayo Webcast so not in clinic today or tomorrow. I attended our briefing yesterday. We were still doing elective surgeries but will likely stop after this week to preserve supplies. Outpatient clinics still open. Discussing designating “clean clinics” for OB visits and patients without symptoms or risks but the problem is you may have it and not know. We tell people with respiratory symptoms to stay home. Adults no longer need to be tested for strep because antibiotics are no longer used in adults. Kids would be cultured. If patients have had flu symptoms more than 72 hours no reason to screen because Tamiflu hasn’t been shown to be efficacious. The Minnesota Department of Health stopped our testing except for travelers, health care workers or NH etc. We tell patients with URI to call before coming to ER, Hospital or clinic. Every employee enters by separate entrance and signs in, answers questionnaire and takes temp. We screen every clinic patient or select hospital visitors at the entrance with interviews and take temp. Most hospital visitors are turned away. As of last night, the Minnesota cases were in Twin Cities 200 miles away. The NDak cases are 70 miles away. We are trying to make sure we have day care for our employees children. We deal with difficult patients who want to be tested “just to be safe”. I’m sure it’s still coming if not here already. Our drive up testing is on hold til MDH eases restrictions. We have test kits but State labs are backed up with testing. State and regions are working to determine resources and how the different organizations will work together. Stay healthy. Thanks for the work you do.