DavidStHubbins

The flu is more prevalent during the winter because people congregate inside together during the cold more frequently. Add the major holidays into that and that’s why they push for the vaccine in the fall before the major holidays.

I’d also argue that the reason we’re seeing other respiratory illnesses year round since COVID is because people globally have become a more sedentary, inside-dwelling population since the lockdowns.

"The flu shot primes you for flu, 36% pathogenic priming for COVID & increases non-flu infections like pneumonia 440%."

I don’t know what this statement means. First of all, not sure if they’re referring to non-Covid 19 coronavirus, but if that study they’re citing is from 2012, then that’s before COVID-19 even happened. Also in the statement, there’s a gross misunderstanding of what pneumonia is. Pneumonia is infection of the lungs by any cause (viral, fungal, bacterial, parasitic). So to say that flu shot increases non flu infections like pneumonia is nonsensical. Now let’s say that in those who got the flu shot, the percentage of other infections causing pneumonia went up. Well then the shot is doing its job. It has lowered the number of pneumonias related to flu. But it hasn’t lowered non-flu etiologies of pneumonia, because it’s not supposed to. Now if you said the number of pneumonias from all etiologies in those with the flu shot is higher than those who did not receive the flu shot, then clearly that’s a big deal and should be investigated. But that’s not what he said at least in the quote.
In all fairness, I have not read any of the quoted studies, I’m just pointing out that he needs to be clear if he’s taking a swing at the prevailing medical thought. There are plenty of things to reexamine in the medical literature and plenty of bad research. My hope in supporting him is that we push for real science to be conducted to examine the incongruences and questions of old literature. As a doctor, I have seen plenty of research that is published for resume padding. I think the whole process needs a shakedown. I support RFK doing that. But if he’s going to do that, he needs to be precise in his language, otherwise the medical establishment is just going to poke holes to prove he doesn’t know what he’s talking about. If I’m misunderstanding his quote or this is a product of shortening the argument for tv interviews due to time constraints, then I’ll admit my understanding of what he’s saying is wrong. I’m not saying one way or the other for the flu shot either. If the total number of pneumonias by all etiologies is more in the flu vaccinated population compared to non-vaccinated, then that needs to be studied more closely including controlling for outside variables like other comorbidities and folks more likely to go to the hospital compared to those who refuse to go ( factors which would skew towards vaccinated patients have more pneumonias)

What color is it? Do you use a steroid inhaler or using antibiotics lately?

Highest viral load found in nasopharynx

Decision-making for tracheostomy in COVID patients is not quite the same as in non-COVID patients. We hadn't really established guidelines for this until well into April. Many of our critical care colleagues frequently consult us to sort through this, particularly in LA as many of our patients have social circumstances and comorbidities that make the decision more difficult than trachs prior to the COVID-era. This is just an observational study pointing out some of the commonalities we deal with to help establish a decision-making tree for these difficult decisions. Most journals of our subspecialty use the term Otolaryngology-Head and Neck Surgery rather than ENT.

The algorithm for COVID treatment at UMC New Orleans

I can’t speak for the ED folks who have prescribed it for early infection, but I have not seen it be useful in the ICU setting where I am currently, nor have my colleagues in Nola had much success. For the months of March and April, plaquenil and azithromycin were used regularly in ICU setting.

For the record, the intensivists at UMC have had great success in treating COVID.

Except an oropharyngeal airway doesn’t go into the windpipe. If you insert something down the windpipe (trachea), it would be called an endoTRACHEAL tube. We call that intubating.

In regards to allowing the lungs to expirate, the alveoli (smallest unit of lung tissue involved with CO2 and O2 exchange) only have so much recoil. You’d have to give significant amounts of time to allow appropriate exhalation. This is why you can only bag-mask someone so fast (the EMTs you refer to). If you squeeze the bag too fast, you “stack breaths” as we call it. You can’t do that forever, even if you have an on/off setting for a CPAP that gives several seconds of expiration, you risk not delivering enough oxygen and removing enough CO2 quick enough, which is the whole point of mechanical ventilation via endotracheal tube.

Despite not technically being engineers, there are plenty of doctors who both invent and have been engineers in previous lives. There are also plenty of inventor physicians who were also not engineers at any point.

You have to think of breathing as a spectrum. CPAP/BIPAP is used with certain degrees of respiratory difficulties. The end of the spectrum for respiratory distress/ARDS though is intubation and mechanical ventilation. Last ditch efforts are placing people prone and sometimes the controversial changing of the ratio of time inspirating versus time expirating.

Do you smoke/use tobacco? Did you at some point smoke or use tobacco for a while?

Pain with swallowing? Frequent throat clearing? Change in voice? Cough? Any inner ear pain or an itchiness that just wouldn’t go away?

Save the money and live in metry near Bucktown. Can take 610 in, get off at St Bernard and take the service road to the school. If you have to do CBD, you can take canal or Tulane to Carrollton, take that up to Desaix. Shouldn’t come close to taking 30m either way.

If it’s foggy enough, they’ll block off a lane, lower the speed limit, and have a cop drive through every so often.

quote:

---

my SO who had her SCM cut when she had brain surgery

---

quote:

---

numbness/loss of vision and hearing/drooling and nasal dripping on that side

---

Just a few questions and thoughts. This history of brain tumor and post-surgical development of trigeminal neuralgia is interesting. Where specifically was the tumor located and what type of tumor was it?

I wouldn't imagine the removal of her SCM to cause directly the trigeminal neuralgia but rather that she has had neurosurgery of some unspecified sort. Without really knowing the details of the neurosurgery, I'm curious about the nasal dripping. Does this occur in conjunction with the pain, or is this a more constant issue? Is it only on one side?

Again, without really knowing what they did when they operated previously, it's really hard to say if this is something even medically manageable (including Kratom as medicine) to begin with. Considering her history of neurosurgery, physical irritation of her trigeminal nerve due to post-surgical changes is something that needs to be considered and may only be fixed with more surgical or radiotherapy options.

Point being, it is important to discuss with the neurologist the associations that occur with the pain and those that occur regardless of pain. As you mention, an MRI can help with some answers particularly when compared to her previous. The neurologist may recommend carbamazepine until the MRI can be done or answer found. It's a pretty widely prescribed drug for a variety of diagnoses, and its the drug with the most evidence of helping those with classical TN. That being said, there are a ton of medications used to treat TN. Another issue to be discussed is if she accepts traditional medicine and it doesn't work, how far do you go before the surgical/radiotherapy option is put on the table. As difficult as it may be, she needs to think about what that threshold is.

Good luck with both the appointment and thereafter treatment of your SO's TN.