Plaquenil

kmmd · « **Reply #120 on:** 1 Apr 2020, 02:18 pm »

Last night I cared for a patient that tested positive 8 days ago. He was worsening while self quarantining and presented quite ill. He had a fever, a fast heart heart rate, fast breathing but most striking was a low oxygen saturation. His chest X-ray was clear 8 days ago, but he had bilateral pneumonia on his X-ray last night. I called ID who recommended to give plaquenil in addition to antibiotics. The dosing is as follows: 400mg every twelve hours for 2 doses followed by 8 doses of 200mg twice daily. I am hopeful, but I will see.

This morning I am a mixed bag, but I am thankful for the brave nurse that did everything for my patient. As I signed out to my colleague, who is two years out of training, he offered to take any of my shifts that I wanted to give up to protect me. As I walked out of the pod, I thanked him and said that I am fine. I told him that I love medicine and will continue to care for all for as long as I can. I drove home sobbing thinking about my Emergency colleagues in NY and what they are experiencing. I have not been able to sleep and woke up after 4 hours.

Please stay safe all. This is serious.

Tomy2Tone · « **Reply #121 on:** 1 Apr 2020, 02:54 pm »

Thanks for sharing kmmd and I pray that your patient will make a recovery. Thank you for all that you do and continue to do. I've seen a lot of courageous men and women in the healthcare field doing all that they can and pray that they remain strong and resilient. It reminds of those that serve in the Armed Forces who suffer pain in doing what they do but it would pain them even more if they could not help and be involved. God speed to you and your family.

rollo · « **Reply #122 on:** 1 Apr 2020, 03:01 pm »

Quote from: Tomy2Tone on 1 Apr 2020, 02:54 pm

Thanks for sharing kmmd and I pray that your patient will make a recovery. Thank you for all that you do and continue to do. I've seen a lot of courageous men and women in the healthcare field doing all that they can and pray that they remain strong and resilient. It reminds of those that serve in the Armed Forces who suffer pain in doing what they do but it would pain them even more if they could not help and be involved. God speed to you and your family.

+1. So appreciated. Pray all works out.

charles

I.Greyhound Fan · « **Reply #123 on:** 1 Apr 2020, 03:10 pm »

Quote from: kmmd on 1 Apr 2020, 02:18 pm

Last night I cared for a patient that tested positive 8 days ago. He was worsening while self quarantining and presented quite ill. He had a fever, a fast heart heart rate, fast breathing but most striking was a low oxygen saturation. His chest X-ray was clear 8 days ago, but he had bilateral pneumonia on his X-ray last night. I called ID who recommended to give plaquenil in addition to antibiotics. The dosing is as follows: 400mg every twelve hours for 2 doses followed by 8 doses of 200mg twice daily. I am hopeful, but I will see.

This morning I am a mixed bag, but I am thankful for the brave nurse that did everything for my patient. As I signed out to my colleague, who is two years out of training, he offered to take any of my shifts that I wanted to give up to protect me. As I walked out of the pod, I thanked him and said that I am fine. I told him that I love medicine and will continue to care for all for as long as I can. I drove home sobbing thinking about my Emergency colleagues in NY and what they are experiencing. I have not been able to sleep and woke up after 4 hours.

Please stay safe all. This is serious.

I am right there with you KMMD. My thoughts go out to NY every day. I grew up in Brooklyn. I worry about all healthcare personnel and all my friends and family that are in healthcare every day. I have a son that works in the hospital as a nursing assistant gathering hours to apply to PA school and my daughter is an RN BSN working in a surgery center. I have contemplated retiring after 34 years in EM but I like taking care of patients and was planning on working at least part time until age 70. Now I am not so sure as I worry about bringing the virus home to my wife.

charmerci · « **Reply #124 on:** 1 Apr 2020, 03:18 pm »

Thanks for being there for people, KMMD, you are definitely appreciated for all your efforts in this difficult time.

I.Greyhound Fan · « **Reply #125 on:** 1 Apr 2020, 03:54 pm »

This guy, his family and employees are hero's-

https://www.nbcnews.com/video/helmet-may-aid-as-alternative-amid-ventilator-crisis-81468997734?cid=referral_taboolafeed

Rusty Jefferson · « **Reply #126 on:** 1 Apr 2020, 06:12 pm »

Quote from: I.Greyhound Fan on 1 Apr 2020, 03:54 pm

This guy, his family and employees are hero's-

I could not agree more. Absolutely selfless, unlike the middlemen still hoarding n95 masks.

charmerci · « **Reply #127 on:** 1 Apr 2020, 06:33 pm »

Some good news
https://scitechdaily.com/mit-posts-free-plans-online-for-an-emergency-ventilator-that-can-be-built-for-100/?fbclid=IwAR0k4fOE9eKmz4_ej8f6khpmTtOhc7lUar-RubB0E1RbTL0J2NxBEjsfTqQ

S Clark · « **Reply #128 on:** 1 Apr 2020, 10:52 pm »

The MIT ventilator is cheap, but is it being ramped up into production? This is where the War Production Act should be in full swing ... A Federal response is desperately needed.

jhm731 · « **Reply #129 on:** 2 Apr 2020, 12:12 am »

Quote from: Rusty Jefferson on 1 Apr 2020, 06:12 pm

I could not agree more. Absolutely selfless, unlike the middlemen still hoarding n95 masks.

It's not just n95 hording middlemen:

https://apple.news/AjwqN_3fERN6B0_2o9Em50A

kmmd · « **Reply #130 on:** 2 Apr 2020, 08:29 pm »

Sadly, my patient was intubated last night and is on a ventilator.

Scroof Neachy · « **Reply #131 on:** 12 Apr 2020, 02:26 am »

Is Plaquenil a name of an audio product? Sounds like it’s a drug of some sort.

ctviggen · « **Reply #132 on:** 12 Apr 2020, 10:15 am »

It's a brand name for Hydroxychloroquine , the drug being touted by President Trump. The studies I've seen on it and covid-19 are mixed.

In China, they also tried TCM (traditional chinese medicine), some of which seemed to work (hard to tell...). Very high doses of intravenous vitamin C, for instance. See this, which is a translation of discussion of their protocols:

https://hopefulgeranium.blogspot.com/2020/03/the-official-covid-19-protocol-from.html

I.Greyhound Fan · « **Reply #133 on:** 12 Apr 2020, 12:11 pm »

I admitted a COVID patient to the hospital last week with a temp of 104.9 and low oxygen saturations (pulse oximeter). The patient had been ill for 10 days. He left the hospital on home oxygen after 6 days in the hospital. The patient had diarrhea the whole time.

Letitroll98 · « **Reply #134 on:** 12 Apr 2020, 01:07 pm »

Quote from: kmmd on 2 Apr 2020, 08:29 pm

Sadly, my patient was intubated last night and is on a ventilator.

I'm so sorry for him and his family, as well as you and your medical team. As I understand it that's the last step and not many come off the ventilator successfully, and if they do there can be serious lung damage. I'm not at all qualified, just what I'm hearing. On the other side of it I couldn't be prouder and more grateful to our medical professionals like yourself. Folks like you saved my life and I'll be eternally grateful as I am inspired by your dedication.

Photon46 · « **Reply #135 on:** 12 Apr 2020, 01:28 pm »

For anyone interested, I have found the South China Morning Post (Hong Kong based) to be an interesting source for news about Covid-19 research. Jack Ma (owner of the SCMP) and the editors have a major commitment to the Trust Project, a group of journalists across the world trying to maintain standards of integrity and honesty. Today's edition has a good read about the issues and hurdles the world faces in the race to develop a vaccine. There is another article in today's edition about research into the virus' ability to attack T-cells in some patients in a manner similar to AIDS.

https://www.scmp.com/week-asia/health-environment/article/3079375/coronavirus-why-theres-no-quick-fix-covid-19-vaccine

https://www.scmp.com/news/china/society/article/3079443/coronavirus-could-target-immune-system-targeting-protective

Bob2 · « **Reply #136 on:** 12 Apr 2020, 01:35 pm »

" On the other side of it I couldn't be prouder and more grateful to our medical professionals like yourself. "

+1

kmmd · « **Reply #137 on:** 12 Apr 2020, 02:49 pm »

Quote from: Letitroll98 on 12 Apr 2020, 01:07 pm

I'm so sorry for him and his family, as well as you and your medical team. As I understand it that's the last step and not many come off the ventilator successfully, and if they do there can be serious lung damage. I'm not at all qualified, just what I'm hearing. On the other side of it I couldn't be prouder and more grateful to our medical professionals like yourself. Folks like you saved my life and I'll be eternally grateful as I am inspired by your dedication.

Thank you Letitroll and Bob.

Yes I believe that the statistics show that 80% of patients with coronavirus placed on the ventilator ultimately die.

Well, I'd like update all of you regarding my patient. He IS (not was) 62y/o and has a history of hypertension. He was intubated 24 hours after presentation due to a low oxygen level on room air. He walked in and was speaking in complete sentences as we say. He was in no distress whatsoever. He was on the ventilator for 7 days and was extubated. He was sent home 2 days ago after a 10-day hospital stay!

Since then I admitted a 30y/o woman without any medical problems who has COVID. She presented with a fever and fast heart rate a second time in 3 days. She was known to be positive. She did not have a low oxygen level when I cared for her. She was admitted and discharged home after 4 days.

Both patients received ceftriaxone, zithromax and Plaquenil. Therefore it is hard to say if Plaquenil by itself helped these patients to get well. The good thing is that they were not harmed by it.

Time to go to bed. I just got home from an overnight shift. I just wanted to share these positive outcomes especially on Easter Sunday.

Be well all!

Tomy2Tone · « **Reply #138 on:** 12 Apr 2020, 02:51 pm »

Thanks for sharing kmmd! We all need some positive news!

Wind Chaser · « **Reply #139 on:** 12 Apr 2020, 04:45 pm »

Has anyone tried nebulized ionic or colloidal silver? The worst side effect is supposedly Argyria where the skin can eventually turn blue - but only if the silver builds up in your body over a long period of time. A couple of deep breaths are not likely to cause that to happen.