Wyldnwoody44

Damn, isn't humility one of the main teachings in many religions? Politics and religion are just topics that invoke some terrible responses, and therefore show an individuals true colors. I think we've seen a lack of humility, a boatload of arrogance, a touch of narcissism and a human that thinks they call the shots. Judgement time will come (if you believe in that kinda thing)

I think the issue is that the quinine is only working in mild to moderate cases, and even then the studies aren't 100% effective. I don't expect any study to be that good, especially when rushed. The mechanism of action of Quinine is somewhat unknown when it comes to augmenting the binding ability and affect on hemoglobin, there is a theory that the quinine can inhibit some processes of RNA replication, but I haven't dove into the specifics of it. We are almost all going rogue on the treatment of this and not awaiting the CDC recommendations, it's actually quite astonishing seeing/hearing from so many hatlcare providers and facilities that have almost no trust for the CDC right now. Whether right or wrong....for the record, I think this is a time to think outside of the box and let cookie cutter medicine fall by the wayside ?

It's quite unique, we're using ferritin levels as well to help guide us. LDH, procalcitonin, ferritin, C reactive protein and sometimes a DDimer (though I hate the test) we also see trends of low lymphocytes counts. It's almost like a flood the bloodstream with oxygen fix without all the positive pressure. The pathophysiology is interesting. Once you dust your brain off I'd love to hear your thoughts ?

Ok back to virus talk and medicine. It's amazing how much it's evolved over the course of a month, the previous thoughts of intubation are now being basically disproven, and there is evidence that intubation in its own right is causing the progressing ARDS. Several different factions and universities are doing many studies and the thought is now that perhaps it's not the lung damage itself or the pneumonia, but the inability for oxygen to Bind to hemoglobin due to iron displacement. The Peep and tidal volume we thought were helpful are the exact opposite in this mechanism of action. Granted, nothing is proven and there are several theories, but the number of theories that go against previous standard of care are pretty telling; and this also would help with the ventilator shortage. Many patients are oxygenating in the 60% with a simple nasal cannula or a hi flow mask and doing OK, we call them the "happy hypoxic". Previous thought has us intubating as soon as they are in the 70's for O2 but that's not the case here. I know this isn't is total layperson talk, but I find the science and theories being it pretty fascinating, and that is the part of Covid that makes my brain tick.

Heading to Saratoga lake tomorrow morning.... My plan is to find the "warmest" day next week and do the 56 mile bike course that the lake placid Ironman utilizes. I'm curious to see where I'm at in training and how far I have to go still (it's probably pretty far).

@Brawndo You selfish bastard, double masking under a face shield.... Think of the children ?? All kidding aside..... Can we just get back to normal soon please? My wanderlust is itching for some adventure, selfish as it may be ?

Blind faith is such a tough concept to grasp..... I've been to churches/temples/monestaries etc of all walks of faith. I have a respect for almost all of them (extremists of each faith being the ones I can't respect) Being a man of "science" makes it even more challenging, I know of many non believers that have converted to one specific religion. Has anyone here been a devout follower of one sect and then made a large change into another religion completely?

Ah that's right, I'm sure it comes down to the dollar at the end of the day.....reimbursement for the hospital still has to partially be a thing there

$$$ More patients admitted, the more money they can bill for. It doesn't hurt that we're a terribly unhealthy country on top of it.

You can sprinkle my toes there ?

If this team makes it that far in the next few years (not holding my breath) and the sabres don't in some way include Rick (a partial game call, day with the cup, something) then I will wash my hands of the organization.

I'm not crunching the numbers, it's not my style, but Ive worked in a large city during a bad "flu" season and we were at catastrophic levels then in terms of supply, personnel and space. I can almost guarantee that the % of people that actually need the hospital is much lower than the actual number that would show up, but I just like in that situation. I'll eat crow in my ash bucket if I end up dead from this, just make sure to partake in spreading the ashes somewhere nice. Also, I'm probably not in the greatest of moods/mental place right now to keep going on this subject, any sense of calm demeanor I usually have is all but gone, reeling it in is rough, hence why I wanted to get away to the woods for a week or so.

Sadly, we are finding that intubation now may be worse that letting the hypoxic fight if off on their own, it's all evolving. I'll say this, a main reason I'm so burnt out at such a young age is because the health care system has been overburdened for quite some time now, it's actually very sad to see. The fact that they act like this is going to collapse the system while the whole process that's been in place is going to collapse the system; I think that's where my big skepticism is at. I wish there was a nice way to fix that, but that is no easy task.

I realize I'm getting a lot of flack in general, my take on this isn't one that others agree with or really appreciate. I feel that working in pandemic areas and having seen much worse is a position that many others haven't been in and it certainly shapes my thoughts a bit; fairly or unfairly. As I've said before, I don't think it's a hoax or fake news, but, again, is each flu season was televised with global deaths and etc, I think the world would shut down every fall.

I have had staff quarantined at home from my main hospital, so it's hit, def not as hard as a big city. No, I don't think a full fledged shutdown was necessary at all, I think the long term consequences of this may end up out weighing the virus itself..... I could see some international travel stopping and NYC being on lock down, but the overreaction is beyond comprehension to me.

If you take NYC out of the equation, generally speaking, then the overall global scale of this is significantly smaller.... Who would've guessed living 3 inches apart from each other would cause issues.... The global mortality rate is still around 1% or so, and it's only getting smaller, I like those odds.

I think this whole thing is ridiculous, but what do I know ?‍♂️ Air Bnb is still listing places, there are private homes that are cabins so I'm thinking of doing that

I'm gonna hole up in a cabin in the andirondacks come Monday for a few days..... I can turn my phone off and hike and cook/take out. Maybe I'll do a little mountain climbing if allowed. I just realized they're fining people with out of state plates and even though I have my medical badge, I'm not essential out of this area, and NY plates will most definitley cause an issue sadly.

Just a daily vent that as this progresses that people are losing their ever loving minds more and more.....Its affecting the staff I work with, and it's sad to see.....and I'm not talking about the virus

I spent all day changing my brakes, calipers, etc...... I wasn't expecting to have to utilize the garage for it ?

Weird random question, I was supposed to be in the Bahamas scuba diving next week, clearly this isn't happening now. I have 16 days off from the hospital and I have an itch to do something. Flying anywhere is a no go; domestically, being from NY sucks as I look like patient zero because of the Fu"ks in NYC. I was thinking of a road trip, many national parks are open still with some modification, no camping etc..... I figure I could drive and stay at hotel or bnb and get take out or cook along the way.... I'm trying to maximize my sightseeing, anyone know of any reccomendations for an area I can get a lot in on a road trip. Bonus if there is a way for me to get some swims in as well.... The ymca being closed is hurting my training

This 3 inches of snow can go F off

@Ogrethat's crazy, I've worked with many GI specialists over the years and I feel like they only take urgent/emergent situations seriously. That's painting a broad brush I realize, but just seems to be the overall feel I've gotten from a large sample size. Colitis for that long? Are they thinking ulcerative colitis? Colitis I would have to imagine would have caused some systemic infection/sepsis but it really varies. I'm glad to hear you are on a treatment plan and hope soon you can enjoy sitting on your ass ?

Man, a lot of grief in here.... I hope all that are affected are pulling through and If anybody needs anything, feel free to reach out to me!

I almost always bring a bag of the snyders pieces with me on most long flights, jalapeño or honey mustard. But those peanut butter filled pretzel nuggets are great as well!