NinjaDoc

33 minutes ago, snot said:

I still don't get it. The number sick vs population. I get closing early, limiting some events but I think we are going to far. It has been a week, so in another week we should see the potential peak, right?

Problem with the disease is healthy people are still functional and most asymptotic to just mild flu like symptoms which could just be mistaken as allergies that are common these times. So just assume all non essential interaction are not worth it, as in you are either receiving it or transmitting it without even knowing. 
 

23 minutes ago, Tonik said:

Not that easy.

We are only testing people that show symptoms. South Korea is testing everyone they can....and they are finding that 30 percent of their cases are young people that have it...but are not showing any symptoms. Those are people that we will never test.

Reminder, Trump was on TV day after day saying we had boatloads of kits and were testing all over the place for the first few weeks of this. It was all a lie, we had no kits. Those people at the first major outbreak in that retirement home in California sat there for a long time without tests. Cleveland didn't start testing until late last week.

He lied, for quite some time about. I was going to vote for him again, just to piss of the liberals. Can't do that now.

China was widely blamed for doing this hush hush job resulting in world spread. We should have learned from them. 
 

then we proceeded to do the same by not believing it and other crap. I think mr trump was taking more information and input from political and economic pundits rather than actual Cdc and health care experts. It was sort of gamble to save the economy vs acting on an unseen threat. It was quite evident from the difference in opinion about this disease right from the podium by mr trump and dr faucci 

On hind sight he should have trusted the scientific world and information that was gathered from around the world. Instead of encouraging and reassuring investors and market should have focused on common people. Er on the side of caution and approached this aggressively from the start and led the fight. Would have had a better outlook when compassion clarity and strength coming from the top. 

better approach would have been mobilizing more fund like what happening right now, keep economy in life line and stop and curb this way earlier. Mike DeWine is doing exactly The right thing. Need extreme approach to start with, 

as they say any measures we take before pandemic appears extreme and afterwards it seems inadequate. 

Many patient who were vulnerable and even more family and bystanders in the elderly age group kept coming to hospital last week with no concern for the disease. When we would advise them to be safe avoid contacts and stuff they would tell me it’s all a hoax and i was wondering where is such a View point developing. All I see was panic and more panic in social media. I don’t have tv hence don’t know what actual media says. Then One of the Doc in forefront of the fight bought this clip up in discussion and I couldn’t believe it. Worst part is just a random search shows avg age of Fox News audience is 64-65 / a major chunk above 80 that’s even worse. 😑

I do understand these days it’s all opinion channel and there are no news channel. That’s why I don’t even have tv and waste time on it. People just want to watch what they want to see and hear. There is no gathering info and analysis by individual, just spoon fed vitriol and hate 24x7 from either side.  All over the world same deal. it’s propaganda spreading and political mind altering from left or right happening on a daily basis. But when it comes to actual science there should be no excuse for this kind of approach and attitude. a hard truth based on science and facts which affects all of humanity shouldn’t be altered like this.  Media shouldn’t be the judge of what’s right and wrong about science as it evolves. This right here was a massive disservice to the US. 

1 hour ago, 2talltim said:

Yea I was on Eliquis for two years before the doc told me to switch to the asprin. Pain in my leg is also gone now after i returned to active duty and got back on the asprin. But about that bug I had. I have to add i have never in my life felt shortness of breath life that before ever. Felt like running up a flight of steps while doing nothing for a period of about a week. 

Me too, this year flu incapacitated me like never before. Almost wanted to get admitted myself. 

All information I say take it with grain of salt as I am purely a kidney guy. (But we are the most common sense / numbers driven field in medicine/ so all my opinion are too rational to be true in medicine. )

 First off if you had a dx of dvt in past/ or active risk of dvt/ the use of or lack of aspirin doesnt play a big role. Aspirin can take an edge off risk if you never had dxed dvt issues or risks but not in a significant way.  Only presence or absence of blood thinners matters/ plus if it was dvt / PE most likely you would have been typing this message from hospital bed during recovery. - we can rule out PE ( I should never say never in medicine I guess) 

then the symptoms, this year flu was bad, common theme seen was despite vaccination people getting hit bad. Even young healthy people. And significant cases of double impact as in one episode recovered some time end of fall winter and another during dec Jan period. Most have been dxed with test proven Inflz para inflz etc but  Recently after corona news started I was also thinking same whtr those rare tests that came back negative was corona which when ever knew. But currently based on the info available, corona is highly contagious and if it was here that early we would have seen a massive influx of cases already and not such spotty rare presentation. 
 

in short that was most likely one of the common viruses running around which was really debilitating this year. Also the sub Acute symptoms like runny nose  continue to run for sometime. 
 

having said that if you have one leg swelling and pain etc make sure you get ultrasound. 

Now the saying goes instead of 14 it might actually be 24 days where you can shed and spread 

As healthcare worker with symptoms she should be tested, Ohio health I believe will fast track such cases,  turn around might be 48hrs. Should get it tested since both the other test is negative 

This is the toughest part of the disease, the symptoms are so broad and common it could be anything. Hopefully she can get tested and it comes out negative. Or may be I should say say comes back positive and you guys are recovering. That’s would be a much better scenario. 
 
 

one of the things i missed out in Ohio, if all the logistics matched up i would have given this a try for sure. cheaper, safer, skill developing and more fun. Cant get any better than this 

On 3/16/2020 at 9:25 AM, NinjaDoc said:

if your sick stay home, could be corona could be just flu, no need to panic. If it gets worse to the point of significant resp distress go to hospital, don’t go to a clinic or urgent care or anything since they will just send you to the hospital anyways. As of now avoid ibuprofen and using left over steroid pack etc confounding information coming out on these so far. 

starting to see the cases trickling in, have a bad feeling of impending trouble at the hospital. 

see young people planning to enjoy the down time, holidays price much lower on stays and travel etc, but some reports coming in shows even-some younger  people getting hit hard even if it’s rare. 

just wanted to highlight this from earlier post just in case it was missed in wall of text. Avoid any nsaids for the time being until more info starts coming in. When flu like symptoms and body ache starts this will be the first line meds we all grab, but as of now hold off. So far tylenol seems to be clear to use.

So far total 4 patient of which 3 have been confirmed. One pending confirmation. 

young healthy confirmed guy just 51yrs is in ICU on vent since last two days. 

treatment has been difficult with no consensus now and people trying different stuff. even those meds are in short supply. 

worst part is lack of protective gear for the healthcare staff. Significant shortage of masks even as of now. 

Shortage of tests and duration to Get result is going to be a bigger problem. As of now high clinical suspicion before approval for test, this means chasing and isolating contacts by test etc going to be difficult. 
 

In short/ as of now patient volume not crazy yet/ But shortage of protective gear/ tests and medicines can be felt already. No way shape or form we will be able to handle the worst case scenario. 
 

as of today we are still not seeing a massive influx etc, this may be promising but also reflects some what isolated area our hospitals are covering. Roughly based on the multiplication time line may be need a week or two before our area is hit hard. Will know soon how real this disease is, how effective the measures taken has been, as in comparing cases keep trickling in vs mass influx vs not much at all seen. 
 

hang tight, continue to follow the recommendations. Hopefully this blows over in few weeks. 

As of today 2 confirmed cases in our facility and one Highly suspected one. This is based on minimal testing of subjects based on clinical suspicion and lack of resources. First case didn’t have travel history no high risk contacts nothing, the suspicious case is younger guy not much risk factors and significant resp distress. 

cuyahoga has the largest reported from Ohio, but probably tested way more esp CCF doing drive by. 
 

if your sick stay home, could be corona could be just flu, no need to panic. If it gets worse to the point of significant resp distress go to hospital, don’t go to a clinic or urgent care or anything since they will just send you to the hospital anyways. As of now avoid ibuprofen and using left over steroid pack etc confounding information coming out on these so far. 

starting to see the cases trickling in, have a bad feeling of impending trouble at the hospital. 
 

Hope you guys are taking this serious. Avoid Social contacts as much as possible. Happy to see people taking this seriously so far, most social networking and media doing its part. 
 

see young people planning to enjoy the down time, holidays price much lower on stays and travel etc, but some reports coming in shows even-some younger  people getting hit hard even if it’s rare. 

The spread will level of, no question about it. Just like any infectious process. Again it’s not the spread we should be worried about. Timing and peak. The spread over months is so much easier to manage than spread over days. That’s why social isolation and hand washing and stuff will help. These are not to defeat the virus but to slow it’s onslaught. 

Not sure how it works, South Korea seemed like their isolation and co tact tracing was top notch.  I know the state in India where I am from the health sector is poor in resource but great in aptitude and skills. News from back home is super fluent work flow and tracing and isolating each and every contact and Building up working Charts. Where I am from I know that scheme work easy due to close relationships/ lot of family friend close support system / knowledge of whereabouts minute to minute. For eg, you can ask a neighbor and he will have most times accurate info where person A is. it’s kind of hard to explain. So these countries with such a social network they probably ahead of the game. We probably will follow the Italian model of spread. 
 

for eg about a week ago Korea had done tracing and testing of nearly 140,000  With a superior kit while we were at test 1500 or so. 

Guys, stay far away from people as much as possible. Follow the social isolation. The reports seems to be right most part, My intuition was wrong, this thing seems as bad as what it’s feared to be. Personal experience from colleagues in some hot spots seems like this is much virulent form. And we just started seeing the tip of the iceberg.  In our practice area we started seeing some positive cases. Not yet horrible scenario of icu filling up etc yet. Hopefully the curve flattens enough for us to deal with it in a timely manner. If the reports turns out to be true , Just a rough guesstimate on worst case scenario is 200 million being affected / 20 million needing hospital/ less than 2 million death/ and less than 1 million hospital beds in USA. If we follow stringent measures advised, we might be able to cut the numbers by a lot , and at least to a point where the 20 million needing hospital can be bought down to 10-15 and spread over time so we can tackle with the 1 million beds we have. 

My brain had to give you guys the alarmist view point the healthcare is adopting to curb this infection. I agree with them just based on the current view point. And continue to follow the hyper precautions . But to be quite honest my heart and personal experience is telling me the virus was here even before the alarms and notoriety. Was seeing cases in hospital which was coming back negative for flu but fit all the bills for bad viral - lung  picture. Some cases even young people getting infected and presenting with caked out lungs. This was even December January period way before alarms went off. If infact that’s the case probably thousands of Ohioans already have it and it still hasn’t resulted in pandemonium. Now that we started testing for it we started finding it. If not we would have charted it as bad case of atypical flu or something. But this is just pure anecdotal personal view point of mine. 

38 minutes ago, Tpoppa said:

I think the government actions like travel bans and limiting gathering sizes are justified.  The point is containment...incremental, half measures would be pointless.

The over-prepared-ness and panic is absolutely causing significant economic collateral damage.   I am not worried about corporate America, it s very likely that the stock market will bounce back.  OTOH, many small businesses (restaurants, bars, shops, barbers, etc ) and people living paycheck to paycheck will not bounce back.  Businesses will be shuttered and houses will be foreclosed over this panic.  That will ripple through our economy for years and have a greater effect than the virus itself.  

Panic and herd mentality over 6 thousanths of a percent will have a lasting impact on large swaths of the population.   

We Panicking about Other people over panicking  is also not going to solve any issues. Yes there will be slow down in every sector but as a nation and majority run by day to day work there is no way to afford shutting it down.  When the choice is between get disease vs starve people would choose get the disease. The disease does not debilitate the Healthy young,  they will if they have to go to work keep going no matter what since alternate option is starving to death. Disease is not going to affect the wealthy old, they will let things keep running. It’s all not going to be sunshine and green grass, it will sure have its impact. Just like anything is this world, this also has pros and cons. Effect lies on the spectrum of good to bad. There are no right answers, to this question of how to solve this,  just answers that linker in grey zone. 
 

China was trying to keep it hush hush and not raise panic etc and go for containment and we are paying the price for that strategy. 

yes panic is bad, its bad whtr its small scale as in small fire in our own home or whtr national lvl pandemic is spreading. Common sense + great judgement +  immediate controlled action + overall good IQ/EQ  is the difference between saving the house or saving the mass of at risk population. Problem is overall its boils down to us being mere humans again. Humans are flawed. We make fun of chicken running around headless or deer jumping righ into the car when panicked not realizing we do the same in a different lvl. 

When looking at bigger picture and statistics, question is >> Is the over reaction justified, may be the simple answer is yes. No body wants their loved ones to be counted among the small numerator no matter how small the number is. As in 1/1000 or 1/100000 doesnt matter if that 1 is your parent or older sibling. 

just like lottery > the difference between who wins a lottery and who will never win a lottery no matter how very very minuscule the chance is that one guy bought it and another didnt. 

lets just hope this blows over just like most other scares we been seeing. More than likely it will, I would rather be happy people are over prepared than under prepared. All essential services will keep going, its not going to be a world war scenario, streets not going to be empty, people not going to starve and die, people who really have to work and whose work is essential will keep working until they are sick.  A volatile thing like Stock market is not at all a judgement, viable marker or good measuring stick of humanities response to call for survival. It will bounce back in due course. Just like master card says , hand soap 1000$, toilet tissues 2000$ .. saving family from some fake, hyped up, simple flu ... priceless. 

1 hour ago, SpecialEd said:

And just how is this disease deadlier than the flu as some assert? I don't get it.

When you have flu like thingy your nose sinuses close up right? Few squirts Of spray few sneezes and back to breathing better. 
 

now Imagine the same inflammation spreading all the way to the major and minute airways in the lungs and plugging up everything. And No way to clear it up and clean up and imagine how breathing is going to be. 

The disease per se is less understood, the epidemiology is evolving. No one knows for sure what’s happening and all are talking in terms of percentage numbers which are evolving. So far the only few information glimpses we got point towards, high R0 number ( very infective) and mortality high among fragile elderly. It may be true may not be true. The only thing we are asked to do is shake less, mingle less, wash hands and sacrifice few basketball games and such.  And if your sick stay home or really really sick come to hospital and get tested. They haven’t asked us anything like permanent life changing or extraordinary like leave your home burn everything and run away. This might all be just hype and will blow away soon, very good if it’s so. I hate to think of the alternative scenario were it’s infact dangerous disease and we are not prepared or being cautious.

WHO called it a pandemic and we are over here like WHO the fark is that. 

mans regarding Chinese data, if they were more transparent and forthcoming in the first place this could have been curbed way earlier. 

Crap missed it twice in a day now 🤯

Ty @Dizzledan for the update, I was late to the party. Plus notoriously indecisive as always hehe. Very good deal for all those who scored 👍👍

No WiFi in the outdoor shed he is sleeping in now. Hopefully in few days he will reply once he is let back into the house 

4 minutes ago, jacobhawkins said:

Vintage Day race bike, if I ever get a free minute.  Katie made a small human on Monday morning, so I'm one handed for a bit.

Congo Jacob, life and speed perspectives gonna change real soon  

1 hour ago, Tonik said:

Explain what a fellow is please. Just curious, my nut doctor is a fellow.

44 minutes ago, TimTheAzn said:

A Fellowship is the period of medical training, in the United States and Canada, that a physician, dentist, or veterinarian may undertake after completing a specialty training program (residency). During this time (usually more than one year), the physician is known as a Fellow.

Do Dr.'s ever actually finish school Nivin? LOL

Yea as timmy said, going back to school again. I actually completed 2 yrs of fellowship already in Michigan before i moved back to ohio. This can be sort of consider as super fellowship again. Your right Timmy, its life long.  I am not even sure when enough is enough, started med school back in 1999 - since then in some form of way i been involved with studying and training till 2015. At this rate i be dead before i get to earn some from the knowledge i gained  

@durk and things were starting to get really good for us extreme east end folks. With you @Skinny guy plus two more great riders i met around this area thee was always a good mix of people to ride with, plus the tracks close by. Sure going to miss it. 

@snot @Helmutt i forgot to tell you guys, i am not that active in FB but one day saw pics of you guys ripping apart the cross fit thing. Now i realize why you guys not active here and not riding much, good for you guys. I felt inspired and went and joined a local gym lol  Now when ever i am going through insomnia and not sleeping at 3 am i go straight there and have the gym all to myself haha . Yes i know i am at the pinnacle of stupid choices and unhealthy lifestyle after 16 yrs of medical education