Coronavirus

I have immediate family living in California, Tennessee, and Georgia. These areas of the country, along with many others, are suffering. Cases of Covid-19 are rising. Hospitals and health care providers are overwhelmed. Some patients are unable to receive the care they need. So, for my family’s sake and the sake of others living in hotspot areas, I don’t want to come across as tone-deaf or out of touch, but elsewhere, there is actually some good news about the pandemic.

In mid-November, my home state of Montana was hurting. We converted two additional units in our hospital to negative pressure areas so that patients with Covid-19 could be roomed appropriately. Our overflowing ICU was boarding patients in the post-anesthesia care unit. …

A Healthy New Year

I’m looking forward to a few changes come January 1st, and I suspect I’m not the only one. While many seek to modify their diet each new year, some see the hope of 2021 as the perfect kickstart to a radical departure from the status quo. Among hundreds of dietary regimens, the ketogenic diet has exploded in popularity, but scientists and health experts are only beginning to understand its physiologic impact and how it can be used to treat certain medical conditions.

Recently I had the opportunity to interview Tara Finnerty, a board-certified ketogenic nutrition specialist. …

Coronavirus

I can’t believe the day came this soon. This is not hyperbole: It was a joyful experience to receive this vaccine. There was a buzz and excitement at the hospital. Camera crews descended. Local media reporters interviewed hospital administrators and providers. Even the governor showed up. Why? Because this marks the beginning of the end.

As I waited in line with my colleagues on Tuesday, we shared a feeling that didn’t need to be verbalized, though it often was — the mutual understanding that it was an absolute privilege to receive this vaccine. I can’t express enough how thankful I am for the scientists who developed this, the patients who participated in the clinical trials, the suppliers, the distributors, the administrators, the organizers, the nurses, even the lab mice, even the leaders in our government who made this possible. …

Coronavirus

“There are three kinds of lies: lies, damned lies, and statistics.”
- a quote with no clear origin popularized by Mark Twain

It’s true. Stats can often be manipulated to support a person's agenda. While I make no claim to be void of bias, here’s my honest attempt to paint a picture of the pandemic by applying a heavy dose of my favorite medium, numbers.

Over the past four months at a community teaching hospital in the Northwest, after 275 encounters with 101 hospitalized patients suffering from Covid-19, here’s what the numbers reveal:

66%

As in 66% of the patients I cared for had been previously diagnosed with high blood pressure. Another 43% had diabetes and 23% had obstructive lung disease (e.g. asthma or emphysema/COPD). While 45% of my patients required advanced means of respiratory support such as heated high-flow oxygen (HHF), non-invasive positive pressure ventilation (NIPPV), or mechanical ventilation (MV), this number increased to 61% among those with obstructive lung disease. …

As someone who provides care for those with Covid-19 in a hospital approaching its capacity, I’m constantly on the lookout for safe and effective treatment strategies — anything to help my patients recover faster and get home sooner. With so many therapies being studied, it can be difficult to determine which new piece of data is truly valuable. My attention was caught by a well-constructed clinical trial published November 12 in The Lancet by Phillip Monk, et al. Here’s why I believe it’s so important.

Recent studies have shown a significant portion of individuals who become severely ill from Covid-19 possess antibodies that disable naturally occurring immune proteins called interferons. Instead of targeting invading pathogens, these antibodies, called autoantibodies, act against the body’s own immune system. …

Pandemic & Politics

On October 4th, three professors penned a petition titled the Great Barrington Declaration. Ten days later, in response, the John Snow Memorandum was published in the Lancet. These documents highlight the deep politicization and polarization that has occurred in the U.S. and abroad as a result of the Covid-19 pandemic.

If you want to know the details of these documents, I invite you to take a look for yourself. My over-simplified summary is that Great Barrington (the declaration, not the city in Massachusetts) claims we need to end restrictions on society and open things up because the ‘cure is worse than the disease’ as some have said. Proponents of Great Barrington emphasize the harms that have occurred from lockdowns and the like. …

Coronavirus

Six years ago on a spring day in Indiana, suddenly and without warning, Will had his first seizure. Shortly thereafter, the previously healthy 5-year-old was diagnosed with generalized epilepsy. Despite starting treatment, Will’s epilepsy continued to worsen.

His mother, Sarah Ackerman, recalls, “We tried medicine after medicine, upping the doses and combining it with others only to see his condition drastically decline. He went from having just a few generalized myoclonic seizures to over 100 a day within the first two months. His numbers continually increased as the months went on with no reprieve.”

Will’s epilepsy was preventing him from focusing and learning in kindergarten. Sometimes he had so many seizures in a row that he would pass out. When medical treatments for epilepsy fail, doctors often recommend surgery on the affected part of the brain. However, such a procedure was not offered to Will because his seizures were occurring in multiple areas of the brain rather than one specific location. …