Saturday, April 9, 2016


    In medicine as in any other field we all are product of advertisement. Every one today is concerned about cholesterol , even a 80 years old patient who has end stage lung disease and controlling the cholesterol would make no difference in his shortness of breathing for sure and probably in his survival. But he continues to be given statins and he also spends lot of money for the medicines that I am not sure is going to help. I would like to have someone do a study on these kind of patients who have significant co morbidity or are very old , to see if lowering cholesterol is beneficial or not. But then there is no benefit in doing this study for the pharmaceutical companies. But then there are known killers and we pay no attentions. This is primarily due to media bias. The two most common disease get attention in media are heart disease and breast cancer . But then there is no excitement in Influenza. That is what I am talking today .
    The flu is common and most of the people do not  need or seek treatment and get better. But then physician like me see the sick ones and some get so sick that they are in intensive care unit and even die.
    It was 6-30 pm and I was about finished with my patients and I had couple of notes to be finished . So I was happy . Then I got a call from one of the hospital doctors, asking me if I could see a new patient who was 'sick'. It was a27 years old Hispanic patient who had her first delivery and was found to have low oxygen and so this hospital doctor was asked to see her . In tern he asked me to see her . They had thought about some unusual conditions like amniotic fluid embolism. In this condition at the time of delivery the fluid from the sack enters the mother's blood and gets in lung and causes all sorts of problem . The bad part is that there is no real treatment. So I went to see her . When I saw her she not complaining of shortness of breath or any chest pain. Her respiratory rate was high and her oxygen saturation was low . Her lungs were congested and her chest X-ray was bad . It showed pneumonia . In this young lady who had just delivered a baby , I thought of vomiting and aspiration . But then there was no history of vomiting .She was in ER day before with symptoms of cold or flu and had 'rapid flu test' . It was negative and so she was sent home . Her history was suggestive of flu . So I started her on treatment and called infection specialist. I also transferred her to ICU . I was worried about the pneumonia and flu causing respiratory failure. I was right and she did get worse . There was no embolism. She was in ICU for 4 or 5 days . needed high flow oxygen. But she slowly got better and after in the hospital for 10 days she was sent home.
   So flu almost killed this lady. But with shear luck she got better . Recently I have had 2 more otherwise healthy patients in ICU and needed to be in the hospital foe 12-14 days. I also heard of 35 years old male loosing life due to flu.  

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