Some good news

Multiple COVID+ patients at our institution were extubated over the last several days, including some elderly with comorbid conditions. One in particular was doing very poorly initially with ARDS. Didn’t think was going to make it - now extubated and doing well.

Just wanted to share a few “wins” with the board given the constant barrage of gloomy news.

And no I don’t have a link


Have a good day, everyone

 

[scott in nashville]

Multiple COVID+ patients at our institution were extubated over the last several days, including some elderly with comorbid conditions. One in particular was doing very poorly initially with ARDS. Didn’t think was going to make it - now extubated and doing well.

Just wanted to share a few “wins” with the board given the constant barrage of gloomy news.

And no I don’t have a link


Have a good day, everyone

I'd be interested in your take on the malaria compound and its effectiveness. If this is another political rathole you'd rather not endure, I understand

 

I'd be interested in your take on the malaria compound and its effectiveness. If this is another political rathole you'd rather not endure, I understand

not enough evidence in my opinion for me to say we should use in all cases - we need to pump the breaks a bit. Randomized controlled trials are needed (which people are being enrolled into right now), before we can give the green light safely. In medicine history, there are numerous examples of drugs showing promise in small sample sizes only to either not shown to have benefit when applied to a larger sample or demonstrated to be harmful. So we have to be careful here.

Other thing is we have to be mindful of is that plaquenil is among the medications used for patients with lupus. Using it to treat a condition in which the evidence for its benefit is scant, may/will take away from use against diseases that we know the drug has clinical value.

 

[dbjork6317]

Multiple COVID+ patients at our institution were extubated over the last several days, including some elderly with comorbid conditions. One in particular was doing very poorly initially with ARDS. Didn’t think was going to make it - now extubated and doing well.

Just wanted to share a few “wins” with the board given the constant barrage of gloomy news.

And no I don’t have a link


Have a good day, everyone

I DON’T SEE THIS ON FACEBOOK SO YOU MUST BE LYING MF123, IF THAT IS YOUR REAL USER NAME.

Thanks for the update! It is good to hear some positives, “Doctor.”

 

[johnhugh]

OP can you post a link and PDF scans of these people’s medical records so I can be sure you aren’t spreading hysteria? Thanks

 

I DON’T SEE THIS ON FACEBOOK SO YOU MUST BE LYING MF123, IF THAT IS YOUR REAL USER NAME.

Thanks for the update! It is good to hear some positives, “Doctor.”

Hahah!

 

OP can you post a link and PDF scans of these people’s medical records so I can be sure you aren’t spreading hysteria? Thanks

!!!

 

[CouldBeDabo]

Multiple COVID+ patients at our institution were extubated over the last several days, including some elderly with comorbid conditions. One in particular was doing very poorly initially with ARDS. Didn’t think was going to make it - now extubated and doing well.

Just wanted to share a few “wins” with the board given the constant barrage of gloomy news.

And no I don’t have a link


Have a good day, everyone

Good stuff op. Very encouraging

 

[Tigerswag91]

@MF123 Keep fighting the good fight man! Guys like yourself are a beacon of light shining in these dark times. You da man!!!

 

[Smiling_Tiger]

Hey @MF123

Are you seeing a shortage of sedatives? I read an article this morning that said all the people being put on ventilators is causing a shortage of sedatives as well.

 

[mind-mend]

Thank you! I need some good news!

 

[vatiger1]

Multiple COVID+ patients at our institution were extubated over the last several days, including some elderly with comorbid conditions. One in particular was doing very poorly initially with ARDS. Didn’t think was going to make it - now extubated and doing well.

Just wanted to share a few “wins” with the board given the constant barrage of gloomy news.

And no I don’t have a link


Have a good day, everyone

That's awesome @MF123 and thanks for sharing. Can you help this dummy out, so these patients were given the anti-malaria drug? Anything else given also in connection with it?

On a side note, My daughter is doing great and thanks for your help there. She is totally free of seizures now including absence ones.

She's been on Ethosuximide 250mg Twice a day and no side effects either.

 

Hey @MF123

Are you seeing a shortage of sedatives? I read an article this morning that said all the people being put on ventilators is causing a shortage of sedatives as well.

I haven’t seen that personally - but my opinion may not represent what’s going on in other ICUs or other cases. Hard to say. I’d think that may be the case in nyc - but perhaps in most other places I’d imagine no given elective procedures are basically cancelled

 

[Kelbo]

OP can you post a link and PDF scans of these people’s medical records so I can be sure you aren’t spreading hysteria? Thanks

Would've been humerous, but fell short of making sense.

Kudos for trying.

 

[dbowers2008]

Multiple COVID+ patients at our institution were extubated over the last several days, including some elderly with comorbid conditions. One in particular was doing very poorly initially with ARDS. Didn’t think was going to make it - now extubated and doing well.

Just wanted to share a few “wins” with the board given the constant barrage of gloomy news.

And no I don’t have a link


Have a good day, everyone

Thank you sir! You’re one of the real heroes!

 

That's awesome @MF123 and thanks for sharing. Can you help this dummy out, so these patients were given the anti-malaria drug? Anything else given also in connection with it?

On a side note, My daughter is doing great and thanks for your help there. She is totally free of seizures now including absence ones.

She's been on Ethosuximide 250mg Twice a day and no side effects either.

hey man - really great news about your daughter. Truly. I’m 31 and don’t have kids at the moment, but I can only imagine what you were going through as a parent. It was my pleasure in helping facilitate any kind of help.

Regarding your question - I can’t go into too much detail about treatments etc. I’ll post more on the malaria drug (plaquenil) being used in other studies - I read a lot of the papers already, and yeah the data isn’t there to support it’s widespread use.
Most of the data is from in vitro studies - not in actual human beings.
There are some small studies used in humans but again there are issues with the data. I’ll
Give you this paper as an example - which has been cited by some - https://www.medrxiv.org/content/10.1101/2020.03.22.20040758v2


-Treatment arms, sample size, endpoints are all different on clinical trials registration website
- Although claims to be blinded placebo-controlled trial this is not described in manuscript
- All patients received the standard treatment (oxygen therapy, antiviral agents, antibacterial agents, and immunoglobulin, with or without corticosteroids) but no further information given
- Only moderate disease (not hypoxic), so not generalizable to hospitalized hypoxic patients
- Definition of fever different than US definition
- Did not report on what baseline temperatures were, use ofantipyretic agents
- Time from onset of symptoms to randomization not listed
- Timing of progression not defined
- Appears no deaths, not clearly stated
- Almost no demographic, comorbidity data given, so cannot assess if groups are similar at baseline. Only sex and age listed

I’ve read the other papers, and issues with the studies are peppered everywhere. Point is that there are a lot of issues with these studies, and most of them - I believe all actual - excluded the sickest patients.

other drugs are being more readily used

 

[MBTiger23]

not enough evidence in my opinion for me to say we should use in all cases - we need to pump the breaks a bit. Randomized controlled trials are needed (which people are being enrolled into right now), before we can give the green light safely. In medicine history, there are numerous examples of drugs showing promise in small sample sizes only to either not shown to have benefit when applied to a larger sample or demonstrated to be harmful. So we have to be careful here.

Other thing is we have to be mindful of is that plaquenil is among the medications used for patients with lupus. Using it to treat a condition in which the evidence for its benefit is scant, may/will take away from use against diseases that we know the drug has clinical value.

Curious if the patient that you thought was lost took plaquenil?

 

Curious if the patient that you thought was lost took plaquenil?

As I detailed above, we need to stop with the plaquenil obsession for now. Most of the studies are looking at preventing infection and disease manifestation

 

Thank you sir! You’re one of the real heroes!

Appreciate the kind words, but I feel sheepish when someone calls me that. Just doing what any other person in my shoes would do. Nothing extraordinary

 

[PAWrocka]

Awesome news!!!!!!

F CHINA!!!!!!!!!

 

[jmh9713]

Multiple COVID+ patients at our institution were extubated over the last several days, including some elderly with comorbid conditions. One in particular was doing very poorly initially with ARDS. Didn’t think was going to make it - now extubated and doing well.

Just wanted to share a few “wins” with the board given the constant barrage of gloomy news.

And no I don’t have a link


Have a good day, everyone

The human race is winning every day vs Covid 19. We are currently winning 99-1 at this time.

Keep the pedal to the floor and lets get to 99.5-.5 when the clock hits 0

 

[Larry_Williams]

Thank you for posting. It’s greatly appreciated!

 

[Cleopatrick2001]

Hey @MF123

Are you seeing a shortage of sedatives? I read an article this morning that said all the people being put on ventilators is causing a shortage of sedatives as well.

My wife works for a major pharmaceutical distribution company and everytime I over hear her conference calls, they mention a shortage of Propofol. There are others but this is the one that is running the lowest and in greatest demand.

 

The human race is winning every day vs Covid 19. We are currently winning 99-1 at this time.

Keep the pedal to the floor and lets get to 99.5-.5 when the clock hits 0

For sure. Everyone is on the same team

 

[nmerritt11]

Hearing lots of positives as well. But also hearing 24 positive cases in one smaller assisted living in NC and they are ramping up and getting hospice company ready in case they can’t handle it

 

[tigerich]

Thanks for the update. Need some good news!

 

Hearing lots of positives as well. But also hearing 24 positive cases in one smaller assisted living in NC and they are ramping up and getting hospice company ready in case they can’t handle it

There are some really terrible situations and more gloomy stories but chose not to share Bc we need some positive in here for a change , ha

 

[CU91ENGR]

Hearing lots of positives as well. But also hearing 24 positive cases in one smaller assisted living in NC and they are ramping up and getting hospice company ready in case they can’t handle it

So far today the numbers are looking slightly better, which is a relief. The outlier, though, is the state of GA where 100 people have died today from Covid-19. Yesterday, GA had 10 deaths...big jump for some reason.

 

[neely73]

not enough evidence in my opinion for me to say we should use in all cases - we need to pump the breaks a bit. Randomized controlled trials are needed (which people are being enrolled into right now), before we can give the green light safely. In medicine history, there are numerous examples of drugs showing promise in small sample sizes only to either not shown to have benefit when applied to a larger sample or demonstrated to be harmful. So we have to be careful here.

Other thing is we have to be mindful of is that plaquenil is among the medications used for patients with lupus. Using it to treat a condition in which the evidence for its benefit is scant, may/will take away from use against diseases that we know the drug has clinical value.

Thats some great positive news....
Thanks for sharing..

Have heard that in New York they have given this to about 4,000 patients. A lot of rumblings coming out is that they are doing this as a last step prior to having to put them on a ventilator?? Assuming this because they have seen many go through what you mentioned and it not work??

 

[Baloney_Pony]

not enough evidence in my opinion for me to say we should use in all cases - we need to pump the breaks a bit. Randomized controlled trials are needed (which people are being enrolled into right now), before we can give the green light safely. In medicine history, there are numerous examples of drugs showing promise in small sample sizes only to either not shown to have benefit when applied to a larger sample or demonstrated to be harmful. So we have to be careful here.

Other thing is we have to be mindful of is that plaquenil is among the medications used for patients with lupus. Using it to treat a condition in which the evidence for its benefit is scant, may/will take away from use against diseases that we know the drug has clinical value.

Either you are:

mistaken and/or don't understand the evidence
or
giving the correct medical opinion that we can't use these drugs for treatment right away

I would like to understand why these drugs are being touted by the President as being so promising. Everyone wants the cure to come yesterday, but if it's truly not ready then why confuse people? Or does he know something the medical community does not (classified info, perhaps)?

 

Thats some great positive news....
Thanks for sharing..

Have heard that in New York they have given this to about 4,000 patients. A lot of rumblings coming out is that they are doing this as a last step prior to having to put them on a ventilator?? Assuming this because they have seen many go through what you mentioned and it not work??

I don’t think hydroxychloroquine works, and many people believe that as well. It’s added because in these cases you just do what u can in the rare case that that medication helps in some way.
Telling or implying that it’s a promising drugs is very misleading in my opinion.
The French study that people always point to is a damn joke.

 

[OrangeRegalia]

OP, you are a light through all of this. Thank you.

 

Either you are:

mistaken and/or don't understand the evidence
or
giving the correct medical opinion that we can't use these drugs for treatment right away

I would like to understand why these drugs are being touted by the President as being so promising. Everyone wants the cure to come yesterday, but if it's truly not ready then why confuse people? Or does he know something the medical community does not (classified info, perhaps)?

I do understand the evidence - I know how to appraise papers. I’ve read a lot of papers and published as well. And if you want a serious break down of the issues with these trials, I’ll do that. But curious - what study would u point to that supports its use ? Point to the paper with the most evidence supporting its use.

There’s no “classified” information. All of the data is published - you can read the papers yourself. Although I don’t know how anyone can read the studies using plaquenil for COVID19 and not come away literally laughing out loud. If that’s the level of “evidence” that the general public Is okay with to say that a drug is effective and support its use, I’ll pack it in and do something else. Not worth it anymore

 

[Jonada]

Multiple COVID+ patients at our institution were extubated over the last several days, including some elderly with comorbid conditions. One in particular was doing very poorly initially with ARDS. Didn’t think was going to make it - now extubated and doing well.

Just wanted to share a few “wins” with the board given the constant barrage of gloomy news.

And no I don’t have a link


Have a good day, everyone

Keep fighting the good fight. Thanks for sharing.

 

[dandeman330]

So far today the numbers are looking slightly better, which is a relief. The outlier, though, is the state of GA where 100 people have died today from Covid-19. Yesterday, GA had 10 deaths...big jump for some reason.

Could be reporting lags. For example here in KY, the state reported 54 new cases and Jefferson County(Louisville) reported 59 new cases. Weekends probably skew the numbers.

 

[neely73]

I don’t think hydroxychloroquine works, and many people believe that as well. It’s added because in these cases you just do what u can in the rare case that that medication helps in some way.
Telling or implying that it’s a promising drugs is very misleading in my opinion.
The French study that people always point to is a damn joke.

You know what you mention is kind of like saying, using as a last resort. Getting put on a ventilator, is a lot of times signaling, thats all they can do to keep you alive.

Thanks for sharing your thoughts

 

[Smiling_Tiger]

I would like to understand why these drugs are being touted by the President as being so promising.

It might be because he has a financial stake in the company that makes Plaquenil and several Trump advisors have a significant stake in Novartis. It’s always about the money

 

[Baloney_Pony]

I do understand the evidence - I know how to appraise papers. I’ve read a lot of papers and published as well. And if you want a serious break down of the issues with these trials, I’ll do that. But curious - what study would u point to that supports its use ? Point to the paper with the most evidence supporting its use.

There’s no “classified” information. All of the data is published - you can read the papers yourself. Although I don’t know how anyone can read the studies using plaquenil for COVID19 and not come away literally laughing out loud. If that’s the level of “evidence” that the general public Is okay with to say that a drug is effective and support its use, I’ll pack it in and do something else. Not worth it anymore

I'm really trying to not be political, which is why I posed the question the way I did. I believe that you, an actual doctor, can read the fine print on what we know so far and come away knowing we aren't close to giving those meds the nod.
I guess I don't understand why these meds are brought up by the President over and over if you and the rest of the medical community thinks they aren't close to being a cure.

 

[Tmassen1]

It might be because he has a financial stake in the company that makes Plaquenil and several Trump advisors have a significant stake in Novartis. It’s always about the money

https://finance.yahoo.com/m/f50244df-0b7a-3c22-bb98-c88377c761bd/trump’s-personal-stake-in-the.html

 

[Schema]

I guess I don't understand why these meds are brought up by the President over and over if you and the rest of the medical community thinks they aren't close to being a cure.

I had an opinion on this and I'm proud of myself for backspacing it away and replacing it with this. Thanks for sharing the positive information OP. I hope everyone is staying safe.