Health for Baby

https://www.scmp.com//mothers-milk-could-help-fight-corona

In 10 years of working as a medicine attending I haven’t posted anything about work. Facebook is my sacred non-work place, where I often post silly, borderline ...inappropriate things. Now it’s different though. The hospitals are limiting the information outflow to very few, if any, journalists (unclear why), while I think the public needs to know much more about what it’s like behind those closed doors, where many people are walking in and many bodies are being carried out. So I’ll write more #CovidChronicles about these past seven days and will continue as long as I can. I got luckier than some of my colleagues. I only had three deaths in 7 days. All three were already on ventilators, elderly with multiple organ failure when I took over I never met them in awake state, but according to charts they all were functional and active people before they got COVID. In pre-COVID era when families were able to visit they often set up pictures on windowsills of what intubated patients were like before they got sick. So you could put a personality on the motionless body in front of you, at least this way you knew more about them than just their age, name, labs and vitals. Now nobody can visit, so there are no pictures, there is no time for long heartfelt conversations with families to know what they were like in their pre-disease life- you have a name, age, vitals, labs, ventilator parameters and one diagnosis for all. I described the two deaths that happened as I walked in on my first day in a previous post, the third one happened the morning after. As the patient was dying we called his daughter. It turned out to be her Birthday that day. It also turned out that her mother passed away from COVID the day prior in another hospital. She asked us to put a phone to his ear, so she could tell him that his wife passed away, because she promised to tell him if something happened to her. We did. I don’t know if he heard her, as he expired as she was talking to him. This couple died within a day of each other from the same disease on their daughter’s Birthday. The rest of the week was just taking care of these patients and discharging them. I discharged a young healthy 37 yo guy who had a pretty difficult course requiring concentrated oxygen and was on a verge of intubation, but made it out. He was luckier than a 32 yo guy who died a week prior on our service. There was a 50 yo healthy gentleman who was in the hospital for three weeks now and was still requiring oxygen. I discharged him home with oxygen as he couldn’t bear being in the hospital anymore. I hope one day he will be able to get off it, but I don’t really know. I discharged a 36 yo lady with COVID pneumonia who developed symptoms several days after she gave birth via a C-section and was now separated from her baby pumping her milk while on oxygen. Discharged a 77 yo lady who felt better, but there was nobody to pick her up as all of her children were too sick at home with COVID and one of them was also in our hospital. There was one patient I was very worried about an older woman who was struggling on a mask. I called critical care to come see her. In the process of discussion with critical care she decided to be DNR/DNI meaning if it gets to the point that she cannot breathe we will not be putting her on a ventilator, but will rather provide her a comfortable death. I was so afraid to make a wrong step with her which would make her worse while trying to help, that I asked that critical care attending a million questions about a million things for her and he patiently answered all of them. Then I asked him "in your experience what are her chances?" He said none. I called her daughter right away and was able to arrange a visit for her. We are so helpless against this disease that it is not a matter of experience, knowledge or skill, but pure luck if you lose or don’t lose a patient. My colleagues who have lost young healthy patients cannot get over it. Even two weeks later they keep thinking out loud what if I did this or what if I did that... It doesn’t leave them it’s not something you just move on from. In American hospitals a code is called overhead when somebody’s heart stops, and a rapid response is called when somebody may be close to their heart stopping. We usually have them once every few days. Now they are called every hour or so I ran into my manager and asked when we could start getting autopsies on patients who die unexpectedly. He said there was no light in sight as there was physically no space in the morgue to perform autopsies we are getting a second refrigerator truck. In all these days I got only one patient who didn’t have COVID. It was a guy who came in with chest pain. He might have been the only non-covid patient on that whole floor. I went to tell him that all his tests came back normal. He asked why was he having chest pain then. I told him I didn’t know, but what I did know was that he needed to RUN from here as fast as his healthy heart let him. And he did. While I was in the room with him I heard a lot of sirens outside. We both came to the window and saw four firetrucks lined up in front of our hospital with all the sirens and lights on and all the firefighters standing outside and applauding in unison underneath our windows I choked with tears. We should applaud them as much as they are applauding us. Some of these days I made it home before seven. I did my usual routine shoes outside the door, stripped at the entrance, put all clothes in a bucket with detergent and went straight into the shower. The 7 pm loud cheers caught me in that shower as I was scrubbing every inch of my body off that virus. I stood there and tried not to cry. I never loved this city more than now. Our politicians and administrators might have failed us, but the people have not. Be healthy everyone.

https://theconversation.com/coronavirus-while-pregnant-or-g

https://youtu.be/9qECJ9YtF4w

MEDIA RELEASE - York Region Public Health is advising individuals about a measles exposure at Vaughan Mills. Individuals who attended this location during the date and time listed in the release may have been exposed. Read more: https://bddy.me/2TIh6lO

Ontario government announces a series of actions to better support families at the critical stages of conception, pregnancy, childbirth and during newborns' first six weeks.