re: Anti Trump doctor just told me .....

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by tiger91
1) how did you know he was anti Trump (just curious)
2) maybe he’s afraid of liability if it goes awry?

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1) known him nearly 25 years, actually like him pretty much but this response scared me because he seemed so closed off on Hydroxychloroquine helping local patients
2) could be as he’s the hospitalist at our largest local hospital, and his opinion would be considered the hospital position

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“in medicine it’s known to kill people.”

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... So is Tylenol, if given incorrectly.

A doctor who makes that kind of statement has put down his stethoscope, and picked up a pitchfork.

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He’s the hospitalist at our local, fairly large, hospital. He’s a retired military general practitioner and worked as emergency room doc for 10-12 years after military retirement and now hospitalist

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There is a small risk of cardiomyopathy and heart rhythm disturbances with hydroxychloroquine. As medicines go, it’s a relatively safe one and people are on it for years. Just over 75% of the people who experience side effects are on it for over a month. The off label treatments using this are ~ 5 days. It’s a little surprising that someone with this background couldn’t find this information easily.

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I think part of the concern too is that Azithromycin can also can cause QT prolongation and the combination of the two does theoretically carry an increased risk of arrhythmia. So further study to ensure what the appropriate safety profile is compared to the effective dose range is warranted.

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I work in the medical field as a nurse anesthetist and I am exposed to and intubating these patients while taking all the precautions. I was speaking with a physician friend of mine and he said Hydroxchloroquine suppresses the immune system. It’s not to be taken lightly as it prevents the body from identifying and creating antibodies to fight against it. If you are able to survive an infection, you are then susceptible to get re-infected.

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So most of this is mildly incorrect regarding this treatment.

This drug has a couple of different effects, some we found out much later.

First it was an antimalarial. Likely hundreds of thousands of American soldiers took this whole in certain areas over the years.

Secondly is they them found out that is an immunomodulating drug that can be used for treatment of certain auto immune diseases like lupus.

Third, it was found to have some events versus a previous different carona outbreak.

So it was tied against this one.

It appears to work by making it more difficult for the virus to get in and replicate. That is one mechanism if action. The second is it is a mild immunomodulating drug and may help prevent the cytokine storm that leads to the pneumonia/fluid build up in the lungs.

When the op says it may help some, this is my thought. Excerpt I would say it likely helps some.

The situation is almost everyone who gets this survives unless they are really old. So even with no treatment most get better by themselves.

I think this is most beneficial given earlier in the course of the illness. It decreases the amount of people who need hospitalization, and then decreases the percent of hospitalized that need to be intubated and then decreases the amount that die.

Just my thought. And a China position paper said the same thing. I don't trust the Chinese at all but this would appear to make sense.

Anyway, I think everyone over 60 or those with underlying medical problems should get the double treatment as soon as diagnosed. Younger people should get it as soon as they have any issues.

I do know some feel that zinc may help. I'm fine adding that, don't know if it's necessary but perhaps it helps as ace midnight suggested.

So no it's not a cure. It may help people because it's not a definite it will work and you likely would've gotten better without it. But I think it is a potentially useful therapy that at this point is being used in many countries to treat so if a loved one had this who was at risk I would much prefer them to be on this than not.

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but the evidence so far is pretty scant. But at least there is some evidence it could work.

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Early? Yes but isn’t the entire CV-19 scenario early?

The “some evidence” is growing pretty rapidly no? Also, I think I have only heard of the aquarium guy having an adverse reaction. Has there been any real documented adverse reactions?

Seems to me to be a very good thing to try especially when the PT’s at a certain stage.

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He’s a retired military general practitioner

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Strike one.

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He’s the hospitalist

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Strike two.

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worked as emergency room doc for 10-12

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strike 3.

So, he's never had long term interaction with his patients and practiced in the real world. I might be worried to if I read the side effect profile and wanted to spout off some shite to sound smart and didn't have 20 years of patient continuity and seen use of the medicine long, long term in the real world with no significant side effects.

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it’s not any kind of cure but may help some

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Not a doctor but isn't that a self contradictory statement? Helping some is by definition a cure. Doesn't work for everyone but neither do a lot of treatments.

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Then he said “in medicine it’s known to kill people.”

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Too much water has also been known to kill people. It rarely happens, but it has been known to happen.

There's been some debating about how some doctors would prefer it be of last resort at best and alternative options developed, not out of spite for Trump, but because of its dangerous side effects.

I mean it kills people in the sense that amoxicillin kills people. Which is to say an extremely small.perce tage of people have really bad reactions.