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Yep, my wife and I were both down at the same time for weeks. Life was pretty miserable.
What's new where you live?
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I very much appreciate and welcome your advice Kevin! Not drinking and won’t be. As far as walking around, I am staying a little active, even though I’m tired. My new chicks need taken care of and my hens do too. I also feed the geese on our small lake. Been taking my dog out too. Animals keep even sick people from being too relaxed.
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I think I would have sent your husband, since your guesthouse hadn't been contaminated yet. Just let your hunny know he will need to disinfect the house. All sheets, towels, wash rags, maybe even curtains in rooms that you have been in washed. All counters, floors, nicknacks and even furniture. . . Maybe I'm paranoid but I would do everything in the rooms you had been in.
Hi again. Just to clarify my qualifications for espousing my opinions. I am a physician with about 40 yr experience in critical care medicine. surgery and anesthesiology. I have worked in 5 countries in 4 continents. Regarding the possibility of neurological complications of Covid-19, it is a possibility especially if some patients develop encephalitis from the virus. I speak from personal experience here having survived an episode of viral encephalitis about 12 yr ago.
It is too soon to know whether there will be secondary complications from this infection. I haven’t read that neurological presentations are typical. Rather, a picture of respiratory failure, multi organ failure and septic shock. But I haven’t personally treated any of those patients.
Most of my research has been in the field of managing acute respiratory failure and the effects of different ventilator designs on pulmonary function.
I have also set up a Facebook Service for providing tele medicine for anyone who is interested.
It is too soon to know whether there will be secondary complications from this infection. I haven’t read that neurological presentations are typical. Rather, a picture of respiratory failure, multi organ failure and septic shock. But I haven’t personally treated any of those patients.
Most of my research has been in the field of managing acute respiratory failure and the effects of different ventilator designs on pulmonary function.
I have also set up a Facebook Service for providing tele medicine for anyone who is interested.
I wanted the guesthouse. He thought the same as you. LOL. He Lysoled, sprayed counters and washed the bedding and cleaned bath rooms. Probably all for nothing because I will be surprised if I haven’t already given it to him...unfortunately.
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Well I am glad it got done. . . not sure my hunny would have.
My guy is a clean freak.
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Count your blessings
!! If it was up to my hunny the house would never get dusted. . .
Yep 2 of my adult kids are in the cabin for 14 days at the least since they are both coming from hot zones. Both are well thus far. Both coming from large cities and work tech jobs that can be worked from home. Both also single.
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Thanks for the insight.
But dust is part of my decor!Count your blessings
I heard that there is a drastic shortage of ventilators, and this raised a question about a possibly helpful stopgap.
I worked in EMS as a paramedic (and Field Training Officer) for almost 12 years, and we used to use an awful machine that we called a 'Thumper'.
It was a pneumatic-powered CPR device that also worked as a kind of crude ventilator to keep the patient oxygenated through the ET tube. We sometimes used an end-tidal CO2 monitor in combination with this.
I'm sure that these devices have been retired ages ago, but I imagine that they're sitting in mothballs somewhere.
It seems like it would be a simple matter to disable the pneumatic piston component of the device that did chest compressions, and just keep the ventilator part. If fittings have to modified, I imagine it could run on air as well as pure O2 if respiratory alkalosis is a concern.
These devices were crude, but it seems to me that this simplicity would be a benefit for one nurse and/or respiratory therapist who has to manage 50 patients in an epidemic.
I'm only suggesting this as an alternative to letting people die from lack of equipment, and I don't pretend that this device is--in any way--ideal.
Is there a respository somewhere of mothballed medical devices . . . like the military storing guns from WWII in cosmoline for decades on end?
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Patients need oxygen, not air pressure. The ventilators have been causing damage.
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You need to keep the lungs constantly inflated using low tidal volume to prevent damage to the lungs by the ventilator. I'm sure schpier can provide more specifics.
Pure oxygen used excessively over a long period of time can also cause problems.
In the old days of EMS, everybody got tons of oxygen** . . . even COPD patients, which--as paramedics--meant little to us because we have the patient for 20 minutes before we run and get another one, but nurses get bent out of shape from giving a COPD* patient high-flow oxygen, because these patients' impulse to breathe comes from the 'carbonic drive'.
It's beyond the scope of a forum post to go into detail about what this is, but it means that too much 02 interferes with the body chemistry in a way that makes these patients stop breathing. The process usually takes a long time, so it wasn't a concern to a medic, but--at the same time--a big concern to a nurse who may have a patient for 12 hours, so you see the source of the traditional "nurse vs. medic" conflict in this issue.
Now, we have devices (like a "pulse oximeter") that constantly measures the oxygenation of the blood, and 02 can be adjusted according to what's needed.
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* COPD is Chronic Obstructive Pulmonary Disease, and includes asthma, emphysema, chronic bronchitis, and cystic fibrosis.
** There was an oddball exception to giving patients O2. In the 1970s, the CIA sprayed an herbicide called Paraquat on marijuana fields in Mexico. If you smoked weed contaminated with Paraquat . . . you could die, and giving pure, high-flow O2 to a paraquat patient, could kill them faster. I, personally, have never treated a paraquat patient, so I'm only parroting our medical director's priorities on this issue.
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Count your blessings
Oh I count them every day! His mother trained him early! LOL.
You took the words out of my mouth Urbanprep. Wishing all of our members and families a full health and full recoveries if affected!! God bless and heal you all. Gary
Homeless meth-heads everywhere breaking into shrouded/locked power outlets outside of buildings to charge their phones. Light rail trains still running with very limited passengers. Downtown Sacramento is completely dead, but for some utility workers, but the suburbs and rich neighborhoods are bustling with families biking and people walking their dogs. 99% of the people outside right now are white.
Hopefully, as suggested by the news media, there seems to be a decrease in the numbers of patients needing mechanical ventilation. Nevertheless, there continues to be a shortage of the devices. A few points from my perspective:
The lungs of patients suffering from Covid19 pneumonia/pneumonitis are “stiff” ( layman term). Compare trying to inflate a nice elastic balloon vs a stiff plastic coke bottle.
Moreover, the diseased lung stiffness ( low pulmonary compliance ) is distributed in a patchy pattern, mostly in the peripheral areas. The stiff, diseased areas, require a higher pressure to inflate than the areas of the lung that are not diseased and which are more effective in gas transfer than the diseased parts.
So attempts to apply a high inflation pressure to the whole lung at one time, will place the less diseased area at risk of bursting - since those areas are elastic and susceptible to overinflation ( a balloon popping ).
That is called barotrauma, a well known, critical complication of mechanical ventilation.
To minimize the risk, modern ventilators control for the highest inflation pressure ( peak inspiratory pressure), the lowest pressure ( end- expiratory pressure) and mean/ average airway pressure.
Additionally, since diseased areas of the lung require more time for gas exchange ( both oxygen-in and carbon dioxide- out ) the timing of inflation/inspiration and deflation/expiration must be controlled very carefully.
There are many terms for all those features and controls leading to many names for different types/ patterns of mechanical ventilation, but the essential considerations are as outlined.
Suffice to say that blindly squeezing a rubber bag and forcing oxygen into a very sick patient with very diseased lungs is an obvious setup for disaster.
Lovely morning here in north Georgia! My hubby is going to go to the grocery soon to see if there r is any bacon and pork. From the sounds of things that meat might be hard to find soon. Wishing we could raise a pig!
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Thank you for clarifying.
I imagine that this barotrauma can cause a tension pneumothorax, subcutaneous emphysema, and maybe an air embolism?
I guess this rules out my idea of using old thumpers as a stopgap ventilator.
Thank you again.
It is perfect outside today. I got some yard work done early and now am relaxing for a few. I need to run an errand in just a bit here too. It’s just too nice of a day to spend it inside.
Glad to hear you are enjoying this beautiful day Brent! Go out. Feel the freedom! And be safe!!
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To put it in Pulmonology for Dummies terms , the tidal volume is the difference between inflation and deflation volumes in the lungs. If the deflation volume is too low (which to healthy people would be "normal deflation volume") the alveoli collapse in critical COVID-19 patients. Then you have to inflate them again. Because they are stiff, it requires too much pressure to reinflate them and that damages the lungs.
, the tidal volume is the difference between inflation and deflation volumes in the lungs. If the deflation volume is too low (which to healthy people would be "normal deflation volume") the alveoli collapse in critical COVID-19 patients. Then you have to inflate them again. Because they are stiff, it requires too much pressure to reinflate them and that damages the lungs.
It's beautiful today here too. I'm going to enjoy the fresh air for a little bit before I have to go in to the office.
It's a little cool here still but sunny. Mid forties. I did get out and pick up sticks under the trees from the wind. Baking bread and such inside this afternoon and laundry. Just like a normal day Covid-19 or not
Freeze warning so I would imagine I will lose part of my peaches and plums but we shall see. Down to 30 tomorrow night. One of my sons is in Colorado right now and said that he is looking at a couple inches of snow. I guess stimulus checks are out for some. He said his was in his account this morning.It's a little cool here still but sunny. Mid forties. I did get out and pick up sticks under the trees from the wind. Baking bread and such inside this afternoon and laundry. Just like a normal day Covid-19 or not
DD you always write the most pleasant things. I truly enjoy reading them! Happy to hear some of the money is being distributed to folks.
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It's a gorgeous day here too. . .a little too cold when I got home from work this morning so took a nap to let it warm up outside . Think it was low 40s maybe. Hunny has been working on getting an electric line out to the red barn digging a deep trench right thru the walkways in my garden. I helped him thread the cables thru the conduit and under the house. Hoping the project gets done by today so I can water the garden. When my part was done being his helper I started building raised beds out of cinder block extending it off the porch steps. When the trench to the barn gets filled in I will bring the pavers we have stacked up there and some wooden mulch to put down in the walk areas. We have some concrete boulders that I am thinking of using but would like to paint them. Also going to put the pepper plants that I over wintered in that area and just leave them in the pots. The cinder blocks will get strawberry plants planted. It a leftover day for dinner. . . Got a big pan of lasagna ready to go.
. Think it was low 40s maybe. Hunny has been working on getting an electric line out to the red barn digging a deep trench right thru the walkways in my garden. I helped him thread the cables thru the conduit and under the house. Hoping the project gets done by today so I can water the garden. When my part was done being his helper I started building raised beds out of cinder block extending it off the porch steps. When the trench to the barn gets filled in I will bring the pavers we have stacked up there and some wooden mulch to put down in the walk areas. We have some concrete boulders that I am thinking of using but would like to paint them. Also going to put the pepper plants that I over wintered in that area and just leave them in the pots. The cinder blocks will get strawberry plants planted. It a leftover day for dinner. . . Got a big pan of lasagna ready to go.
I made a big batch of chili with spaghetti noodles and corn on the Cobb on the side. Figured this cool spell was the last chance for a pot of chili. (Although I’ll eat it anytime of the year). I actually took a nap mid day and as soon as I’m done with eating this chili I will go back out to work some more. Life is at a slower pace now but I seem to be doing more physical work than ever....
