COVID-19 vaccines: medical concerns and recommendations

[ccmdfd]

It's really shitty to say, but sometimes with hospitals you have to advocate for yourself. You should not have to, but it's a sad truth.

You know it is sad to say, but it is true.


Years ago I was hearing of a growing movement where people would hire “advocate physicians” (almost certainly not the correct title but we will use it for the purposes of this post).



This advocate would have full access to the patient’s EMR, would be able to call and/or meet with any and all of the care team, consultants, etc. They would then be able to summarize all of their findings into a clear and coherent message to the family. They also would express the family’s concerns in a way that made sure that the physicians knew what was up. They would point out conflicts; Hey! The Nephrologist just ordered 6 liters of IV fluids and the Pulmonologist just ordered 400mg Lasix IV, let’s get it together here and figure out which way we want the fluids to go!!!



Can’t say that I’ve seen anyplace adopt this just yet. Don’t know if anyone of our experts have seen it at their institutions.



cc

[HeavyDuty]

You know it is sad to say, but it is true.


Years ago I was hearing of a growing movement where people would hire “advocate physicians” (almost certainly not the correct title but we will use it for the purposes of this post).



This advocate would have full access to the patient’s EMR, would be able to call and/or meet with any and all of the care team, consultants, etc. They would then be able to summarize all of their findings into a clear and coherent message to the family. They also would express the family’s concerns in a way that made sure that the physicians knew what was up. They would point out conflicts; Hey! The Nephrologist just ordered 6 liters of IV fluids and the Pulmonologist just ordered 400mg Lasix IV, let’s get it together here and figure out which way we want the fluids to go!!!



Can’t say that I’ve seen anyplace adopt this just yet. Don’t know if anyone of our experts have seen it at their institutions.



cc

That’s pretty much the role I had to take with my wife. My medical knowledge was limited - as a former EMT my scope of practice was nonexistent - but I’m a project manager and analyst, so I was able to organize, summarize and advocate for her. Plus I got pretty damn good at dealing with day to day care, her case was so complex it required constant coordination. I was at the hospital every morning until after rounds, and again after work until bedtime - most of the day on weekends, too. She was a frequent flyer for years, generally inpatient for three weeks, home for six - rinse, repeat. Managing medical care is hugely complex, and I think the idea of a licensed advocate is good for some cases.

[98z28]

https://m.theepochtimes.com/almost-h...9_4200820.html

"Nearly half of the patients currently in New York hospitals with COVID-19 were admitted for reasons other than the disease, the state said on Jan. 7.

Forty-three percent of the 11,548 hospitalized patients didn’t have COVID-19 listed as one of the reasons for admission, Gov. Kathy Hochul’s office said.

Hochul, a Democrat, told a press conference that she wanted to drill down on the hospitalization numbers to see how many patients are actually being treated for COVID-19 versus merely having the disease,...."

So when you show up with a broken leg but test positive, asymptomatic or not, without vaccine you go on that chart even though you're not there for covid

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Something else worth noting is that this is data from Seattle and New York. Two places with very high vaccination rates. They are not exactly safe havens for tinfoil hat wearing Trumpers (not that I’m lumping all non-vaccinated into that category, either). Who is it left unvaccinated in those areas? I’d bet a couple PF dollars a significant chunk are people who cannot be vaccinated for health reasons or are otherwise quite unhealthy (homeless/mentally ill). In other words, people one would expect to have more negative COVID outcomes independent of vaccination status.

I am in no way suggesting that the benefits of vaccination are made up. The fact that vaccination appears to reduce severe disease looks as settled as anything can be with data (though I’d bet a couple more PF dollars that we’ve only begun understanding the risks of the vaccines). I’m just saying that there are many reasons that otherwise healthy people should not to use this particular data to make decisions.

[4RNR]

Something else worth noting is that this is data from Seattle and New York. Two places with very high vaccination rates. They are not exactly safe havens for tinfoil hat wearing Trumpers (not that I’m lumping all non-vaccinated into that category, either). Who is it left unvaccinated in those areas? I’d bet a couple PF dollars a significant chunk are people who cannot be vaccinated for health reasons or are otherwise quite unhealthy (homeless/mentally ill). In other words, people one would expect to have more negative COVID outcomes independent of vaccination status.

I am in no way suggesting that the benefits of vaccination are made up. The fact that vaccination appears to reduce severe disease looks as settled as anything can be with data (though I’d bet a couple more PF dollars that we’ve only begun understanding the risks of the vaccines). I’m just saying that there are many reasons that otherwise healthy people should not to use this particular data to make decisions.

The best data I could find with a quick search say 17% not vaccinated and 9.5% partially. But with the ever changing definition of "vaccinated" I don't know if partially means just one dose out of two or no booster or both.

With vaccinated/not vaccinated it's easy. Yes or no but partially vaccinated is a sliding scale. Yesterday one is vaccinated and tomorrow they no longer are.

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[4RNR]

Talking to my dad yesterday he mentioned a coworker having issues.

She's in her early 40s, apparently very healthy. A life long gym rat. Religiously 6 days a week, 2 times a day, before and after work. She's never had health issues, fully vaccinated. When vaccines were available for everyone she went out right away and got hers. So not someone who's hesitant. On Monday after work she went to get her booster, Tuesday evening she felt like something was wrong and went to the hospital. Blood work showed possible blood clots but MRI (or whatever the scan thing is) didn't show any presence of clots however it was discovered that her heart was enlarged. She now has an appointment with a cardiologist.

He also mentioned an acquaintance of his who possibly had a much much worse reaction but I'm going to hold off posting about it until my dad can clear up some info.

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[Dog Guy]

4RNR, here's a totally not supported by data but just sort of wondering sort of thought: with that much gym work, I wonder if she was overtrained and had chronic low grade inflammation tendencies that set her up for a poor outcome for anything new that spiked the inflammatory response?

[peterb]

That’s pretty much the role I had to take with my wife. My medical knowledge was limited - as a former EMT my scope of practice was nonexistent - but I’m a project manager and analyst, so I was able to organize, summarize and advocate for her. Plus I got pretty damn good at dealing with day to day care, her case was so complex it required constant coordination. I was at the hospital every morning until after rounds, and again after work until bedtime - most of the day on weekends, too. She was a frequent flyer for years, generally inpatient for three weeks, home for six - rinse, repeat. Managing medical care is hugely complex, and I think the idea of a licensed advocate is good for some cases.

https://www.amazon.com/dp/0738712248...roduct_details
The “Hospital Stay Handbook”. I just got a copy. Haven’t really dug into it yet but looks like it might be useful.

[45dotACP]

Talking to my dad yesterday he mentioned a coworker having issues.

She's in her early 40s, apparently very healthy. A life long gym rat. Religiously 6 days a week, 2 times a day, before and after work. She's never had health issues, fully vaccinated. When vaccines were available for everyone she went out right away and got hers. So not someone who's hesitant. On Monday after work she went to get her booster, Tuesday evening she felt like something was wrong and went to the hospital. Blood work showed possible blood clots but MRI (or whatever the scan thing is) didn't show any presence of clots however it was discovered that her heart was enlarged. She now has an appointment with a cardiologist.

He also mentioned an acquaintance of his who possibly had a much much worse reaction but I'm going to hold off posting about it until my dad can clear up some info.

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If you're going to present a case study it helps to be precise.

What blood work? D-dimer? CRP? Ferritin levels? CBC or a BMP? Can you define this "enlarged heart?" RV hypertrophy or LV? Did you mean a CT angiogram or was it a cardiac MRI? Was a TTE also performed? Do you have an estimated election fraction? Wall motion abnormalities? Does your Dad have a detailed H&P of this woman? What type of exercise? More heavy on cardio in a way that might explain hypertrophic cardiomyopathy (seen in athletic individuals who train heavily)? If not, does he suspect she has any existing cardiac history, valvular dysfunction, or defects? Does he have the medical understanding to concisely detail it to you in a scientifically relevant way?

I have a coworker who experienced myocarditis post vaccine. Athletic female in their 30s, frequently lifts weights (appr. 3-4x weekly) They presented with palpitations and lower extremity swelling following a booster shot, had a 2D echo and 12 lead ECG indicating myocarditis, had to wear a Holter for a week and had to take it easy. Said individual will follow up for a series of Echocardiograms to verify correct function of the heart, though most recent EF was reported to be normal.

It's my hope that your father's friend's coworker recovers, but your third hand anecdote is not data and your friend of a friend is a poor case study without relevant diagnostics, H&P or clinical perspective, so it's basically useless.

Also, with all due respect, unless you have the technical or educational background to understand precisely what is or has transpired, then there is a high likelihood of you incorrectly transmitting useless, false or incorrect anecdotes that were likely incorrectly passed to you by another layperson without background knowledge of the above mentioned case study.

No offense dude, but the plural of anecdote isn't data, and your case study is lacking in the relevant data that may exclude or include the booster shot as a cause for your father's colleague's problem.

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[45dotACP]

4RNR, here's a totally not supported by data but just sort of wondering sort of thought: with that much gym work, I wonder if she was overtrained and had chronic low grade inflammation tendencies that set her up for a poor outcome for anything new that spiked the inflammatory response?

"Athletes heart" is a real actual thing. Left ventricular hypertrophy of athletes who train regularly can sometimes require an array of clinical diagnostics to exclude some type of pathological hypertrophy.

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[4RNR]

If you're going to present a case study it helps to be precise.

What blood work? D-dimer? CRP? Ferritin levels? CBC or a BMP? Can you define this "enlarged heart?" RV hypertrophy or LV? Did you mean a CT angiogram or was it a cardiac MRI? Was a TTE also performed? Do you have an estimated election fraction? Wall motion abnormalities? Does your Dad have a detailed H&P of this woman? What type of exercise? More heavy on cardio in a way that might explain hypertrophic cardiomyopathy (seen in athletic individuals who train heavily)? If not, does he suspect she has any existing cardiac history, valvular dysfunction, or defects? Does he have the medical understanding to concisely detail it to you in a scientifically relevant way?

I have a coworker who experienced myocarditis post vaccine. Athletic female in their 30s, frequently lifts weights (appr. 3-4x weekly) They presented with palpitations and lower extremity swelling following a booster shot, had a 2D echo and 12 lead ECG indicating myocarditis, had to wear a Holter for a week and had to take it easy. Said individual will follow up for a series of Echocardiograms to verify correct function of the heart, though most recent EF was reported to be normal.

It's my hope that your father's friend's coworker recovers, but your third hand anecdote is not data and your friend of a friend is a poor case study without relevant diagnostics, H&P or clinical perspective, so it's basically useless.

Also, with all due respect, unless you have the technical or educational background to understand precisely what is or has transpired, then there is a high likelihood of you incorrectly transmitting useless, false or incorrect anecdotes that were likely incorrectly passed to you by another layperson without background knowledge of the above mentioned case study.

No offense dude, but the plural of anecdote isn't data, and your case study is lacking in the relevant data that may exclude or include the booster shot as a cause for your father's colleague's problem.

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That's great when you're in the medical field but no one I know talks like that or can give that detailed info. And I don't think she's passing out pamphlets oh how everything went step by step.
I get blood work done every so often I can tell you the results but I have no clue what was actually done, which specific tests were run and how much blood was needed per test. Doctor checks off a bunch of things I can't pronounce and wouldn't understand, maybe things like D-dimer and CRP, and later I hand it to the phlebotomist.

This is how most people talk.... I went to the doctor, they did some tests, I have XYZ.

Since this was done in the ER I'm guessing they didn't go over what specific blood tests they were going to run. They probably just took the blood and did their thing.

Thats how my dad explained it to me. Shes more into cardio than lifting weights. Sure it could be anything and everything and could be nothing but the symptoms presented within 24hr after the booster. Maybe the symptoms would have presented at that moment anyway.

His friend is a different case

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