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morbidity,covid,heart,lung,brain

A Guide to Self Care of (Mild) COVID19

There is guidance published on how to manage moderate to severe cases, but very few blueprints detail what to do with “mild” infection.  The first day, I developed congestion and cough, with a sore throat.  As the day progressed, I started to have chills, low grade fevers, and myalgias.  The postnasal drainage was overwhelming, and when I tried to swallow, it felt like swallowing broken glass.  Isolating in my room, I was left to deal with my symptoms.
mask,covid,people,risk

Freeze Tag

A beloved childhood game I enjoyed was Freeze Tag. Players would run to avoid being tagged by the person who was “It”.  If you were tagged, you had to “freeze” in your spot until someone was brave enough to come un-tag you.  The game ends when everyone is frozen or if people quit. For over 2 years, I have been living in a real-life “Freeze Tag” game and able to dodge COVID19, until now. Sitting in my room symptomatic and frozen in isolation, I ruminated about my patients who had COVID19 and their experiences. I wanted to share with you three stories of three variants.
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Who is Your Glue?

I’ve often talked about the nurses in my clinic as being the glue, the clinic glue, my personal glue. Without them, the day and task would never go as well and just might crash and burn, if not for their steadying influence.

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Best of 2021: Steroid Poker

It began as many cases do: an ill patient, in the ICU, with signs and symptoms across several body systems, yet no clear unifying diagnosis on admission. With things stabilizing, the internal medicine hospital team on which I was serving as hospitalist that week assumed care of the patient. As the case unfolded – pulmonary infiltrates that could be hemorrhagic, renal dysfunction with proteinuria – rheumatic diseases rose in the differential. When serologic studies and other data suggested GPA rather than glomerular basement membrane (GBM) disease or other possibilities such as infection, it seemed the right time to act. And that is when a game of what I call “steroid poker” began.
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Best of 2021: Drug Safety Risk Communication- The 800 lb Gorilla Approach

Discussions on drug safety can be as treacherous as quicksand for the patient and physician. What the physician knows and what the patient perceives may not be in sync.

2020 dead crime scene

Best of 2021: 20,21 Whatever it Takes

Amazingly, we made it through 2020, a most forgettable year.

Life was great in the first 3 months of 2020, and then COVID hit the fan and a pandemic steamroller derailed life as we knew it.

zoom room

Best of 2021: Zoomatology – Present in Absentia

Are you a zoomatologist or a doomsatologist? Zoom has replaced the meeting, the teleconference or the board meeting. If your old meetings were bad, then your replacement zoom meetings will also be bad, if not worse. Largely because you have failed to master the medium. Here are the rules of Zoom.
virus,injection,COVID,vaccine

Best of 2021: My Personal Delta COVID-19 Breakthrough Infection

As many of you are aware, I have written and spoken on COVID-19 extensively over these past 20 months, and just last month wrote about the dangers of the delta variant. In July, things took an unexpected turn when I developed a breakthrough infection with the delta variant.

Selfie car cell telehealth

Best of 2021: Consults in Cars

In this episode of Dialing for Doctors (aka, Tales of Telehell), we consider a growing subset of telehealth seekers connecting from their cars. This has happened several times and it always catches me surprise. While I've had "live" televideo visits with patients walking the dog, waking up in bed, and from the waiting room of another doctor's office, consults in cars is about the nuttiest. What is the patient's role in telehealth?
Couple walking on beach with dog

Redefining Aging

I was thrilled that the American College of Rheumatology put together the Community Aging Hub and multiple sessions to help rheumatologists identify gaps in care for older patients with rheumatic diseases. My friend and colleague, Dr. Una Makris, taught me the 5 M’s of aging that should be assessed in our patients.
poker.jpg

ICYMI: Steroid Poker

It began as many cases do: an ill patient, in the ICU, with signs and symptoms across several body systems, yet no clear unifying diagnosis on admission. With things stabilizing, the internal medicine hospital team on which I was serving as hospitalist that week assumed care of the patient. As the case unfolded – pulmonary infiltrates that could be hemorrhagic, renal dysfunction with proteinuria – rheumatic diseases rose in the differential. When serologic studies and other data suggested GPA rather than glomerular basement membrane (GBM) disease or other possibilities such as infection, it seemed the right time to act. And that is when a game of what I call “steroid poker” began.
ape%20silver-back-707324__180.jpg

ICYMI: Drug Safety Risk Communication- The 800 lb Gorilla Approach

Discussions on drug safety can be as treacherous as quicksand for the patient and physician. What the physician knows and what the patient perceives may not be in sync.

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