Paralyzed Breathing and 2 Simple Steps To Be Happy Now

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Kari’s feet on a kayak in Halong Bay, Vietnam. Photo taken 5/16/16.

Several months ago, Gary came to my hospital complaining of weakness. Gary was 72 years old, so weakness was a pretty common complaint in his age population. While lying in bed, Gary told me that this morning he could not move his feet. Since then, the weakness has gotten progressively worse and traveled up both his legs. At presentation, Gary said that he could not even lift either of his arms or legs. I lifted up one of his legs, and let it go. The leg dropped like a dead weight. In addition, Gary said he recently got over a cold. Gary also told me he had a similar illness over ten years ago. He said at the time he was hospitalized for 3 weeks with over 10 days connected to a breathing machine. Essentially, what he had ten years ago was the same as what he had at presentation.

Gary had Guillain-Barré Syndrome.

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The Body Destroying Itself And Creating Your Own Luck

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In the emergency department, I saw a 52-year-old female that was here for a flare up of her systemic lupus erythematosis (SLE). Let’s call her “Lupe.” So Lupe has been in and out of the hospital for the past several years for different reasons. One time it was for severe back pain. Another time was low energy from anemia. The most recent time was for acute lupus nephritis (kidney failure) which required for her to start hemodialysis every other day (hemodialysis is a method of purifying the blood when the kidneys aren’t working properly).

Lupe was here this time for a lot of critical lab values found on her blood work – a poor sign for those with kidney failure.  SLE is a devastating disease, and it can affect almost everything in the body. If kidney failure is one of them, it’s usually a poor prognosis. I felt sorry for Lupe because she was so crippled from this menacing illness.

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Ventricular Tachycardia, Bomber Planes, And Checklists: How To Decrease Cognitive Load To Be More Productive

On my last day on the ICU rotation block, one of the patients went into an irregular heart rhythm called ventricular tachycardia. He was a 60-something year old guy with multiple medical problems and connected to a breathing machine. All of a sudden, he became unresponsive and hypotensive and had a heart rate of 150+ beats per minute. As we all rushed into the room, we systematically ran through the ACLS algorithm. We initially evaluated him, checked for pulses, started CPR, established the  airway, monitored blood pressure, identified the rhythm, and gave a dose of treatment. We repeated the process until the patient was stable. It was efficient, it was effective, and most importantly it was routine. It was a checklist that was used around the world and saved many lives.

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Look Down A Trachea And Succeed With A Growth Mindset

In the ICU, we had to perform a bronchoscopy on a patient to rule out excessive bleeding in the lung. It might have been my attending who was in a good mood or the fact that I was just sitting at the computer responding to WordPress comments, but whatever it was, he asked me to do the bronchoscopy. For those of you who don’t know, a bronchoscopy is a procedure where you take this thin tube with a camera at the end of it to visualize the inside of someone’s airways. The procedure looks like this. Gross, I know. I’m not much of a procedure person, but as I was standing there holding the scope in my hand and looking down this guy’s trachea, I came to a realization. Bronchoscopy is a type of endoscopy, and endoscopy means to look inside.

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Bronchoscopy (Courtesy of WebMD)

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