COVID-19 = dirty bomb.

Hits with a flu like primary blast. Then waves of complications later.

Wife was Covid positive 9/5.
Flu for 10 days.
Diagnosed with PORTAL VEIN THROMBOSIS 10/14.

She followed rules, but still got it.
(Thread RANT 1/)

Pain-Nausea-inability to eat! The portal vein is high price real estate.

Enlarged spleen, bowel edema, liver congestion. 4 days on heparin drip. Interventional radiology determining if they could hep. Hematology looking for coag disorders.

2/

Please wear masks and physically distance. We are still deep in the woods with this pandemic. #COVID19 #3rdsurge

3/

A CALL FOR COORDINATED CARE!

https://abs.twimg.com/emoji/v2/... draggable="false" alt="1️⃣" title="Tastenkappe Ziffer 1" aria-label="Emoji: Tastenkappe Ziffer 1">Communication must occur outside of EMR.
https://abs.twimg.com/emoji/v2/... draggable="false" alt="2️⃣" title="Tastenkappe Ziffer 2" aria-label="Emoji: Tastenkappe Ziffer 2">Different nurses and doctors everyday make for extreme frustration
https://abs.twimg.com/emoji/v2/... draggable="false" alt="3️⃣" title="Tastenkappe Ziffer 3" aria-label="Emoji: Tastenkappe Ziffer 3">Labs, VS checks throughout the night are NOT always necessary. At least do them at the same time, not staggered

4/

WHAT I LEARNED:
https://abs.twimg.com/emoji/v2/... draggable="false" alt="1️⃣" title="Tastenkappe Ziffer 1" aria-label="Emoji: Tastenkappe Ziffer 1">Nurses get the brunt of patient anger when doctors place confusing or delayed orders
https://abs.twimg.com/emoji/v2/... draggable="false" alt="2️⃣" title="Tastenkappe Ziffer 2" aria-label="Emoji: Tastenkappe Ziffer 2">Give patients realistic timelines
https://abs.twimg.com/emoji/v2/... draggable="false" alt="3️⃣" title="Tastenkappe Ziffer 3" aria-label="Emoji: Tastenkappe Ziffer 3">Errors are way more common than we think.
https://abs.twimg.com/emoji/v2/... draggable="false" alt="4️⃣" title="Tastenkappe Ziffer 4" aria-label="Emoji: Tastenkappe Ziffer 4">Sleep is important

5/

ERRORS?

Errors are not always fatal, but may cause long delays and miscommunication. Know why you are seeing the patient! Understand the plan! Talk to the primary team! Document a clear plan. Be on high alert for complications!

6/

Plans?
Something must occur every day that moves the patient forward in their care. Let the patient know what that is. Set clear goals every day.

Imagine the patient waiting in the room for hours...wondering what’s next.

7/

Nutrition, walking, sleep, communication! These are so important to patients.

Don’t forget what is important to the patient.

8/

We can improve our patient experience though

Do what you said you would do! Do it on time! Over-communicate.

FOCUS ON THE PERSON, then the disease.

9/

I am thankful to the doctors and nurses that took care of my wife! I would not get care anywhere else.

Wife is a little better every day.

Doctors make terrible patients.

/END

The CT scan was scary!

Extension into the SMV likely caused her pain.

Portal vein thrombosis popping up in case studies.