OT jlb321- ECMO Study. Fully functioning and living at home does NOT

Discussion in 'Husker Board' started by dinglefritz, Jul 7, 2020.

  1. dinglefritz

    dinglefritz College Football Hall of Fame
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    mean that you have a MINOR comorbidity. For heaven's sake, a friend of mine who just survived COVID is a brittle diabetic, in his 60s, has end stage renal disease, is obese and then found out he had cancer while he was in the ICU. He was still working at a strenuous job and "living at home". Your definition of "MINOR" comorbidities needs to be re-examined. .

    That thread was NOT really off topic given the relevance to college football being played this fall. Not sure why the board police decided to end it.
     
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  2. jlb321

    jlb321 Recruiting Coordinator
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    your friend wouldn’t have been placed on ECMO for COVID related respiratory failure


    Only 2% with chronic renal insufficiency on ECMO
    Mean age 48
    Mean weight 91kg (200 lbs)
    Short term survival - 55%
     
    2 jlb321, Jul 7, 2020
    Last edited: Jul 7, 2020
  3. dinglefritz

    dinglefritz College Football Hall of Fame
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    My point is that you equated living at home and fully functional as not having a serious comorbidity. Given his cancer diagnosis he likely wouldn't have been placed on ECMO but I think the parameters of that are much looser than what you think.

    You better actually read the link you posted. 43% of the patients were obese and 25% had diabetes. 9% had asthma. There were several other comorbidities listed. Why do you keep digging up things to try to misinform people?
     
  4. jlb321

    jlb321 Recruiting Coordinator
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    The comorbidites are mild to be considered- these are people who anyone would consider healthy



    and I’m not “digging” up stats - I/we have access to every single case entered into that data base

    life expectancy aside from the acute illness has to be estimated as decades not just years

    I know EXACTLY what the parameters are
    I’m done debating this ECMO question -
     
    4 jlb321, Jul 7, 2020
    Last edited: Jul 7, 2020
  5. dinglefritz

    dinglefritz College Football Hall of Fame
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    So you're a nurse working for an insurance company then? You're right I haven't. My spouse does. We discuss generalities of cases fairly frequently. Look, I'm not trying to be an ass but why didn't you read your own link? The people in this study clearly had some major comorbidities which invalidate your claim. Good night.
     
  6. jlb321

    jlb321 Recruiting Coordinator
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    I’m not a nurse in an insurance company

    where does it say MAJOR comordities?

    48 yo taking an oral med for DM2 and weighing 200 lbs doesn’t qualify as having major comorbities

    life expectancy aside from the acute illness has to generally be estimated in decades to proceed with ECMO
     
    6 jlb321, Jul 7, 2020
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  7. dinglefritz

    dinglefritz College Football Hall of Fame
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    You're using the mean (roughly average) age and weight of the study participant to arrive at age 48 and 200lbs. Good Lord man. Just stop. For COVID diabetes, obesity, asthma are ALL serious comorbidities. I thought you were done with this. Read your links before you post the damned things.
     
    7 dinglefritz, Jul 7, 2020
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  8. jlb321

    jlb321 Recruiting Coordinator
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    good enough - you mentioned, I believe, that you have asthma. I’ll mark you down as not deserving of advanced therapies if you happen to get sick

    and the mean is not “roughly the average” - it is specifically used to minimize outliers that the average does not - take a stats course
     
  9. dinglefritz

    dinglefritz College Football Hall of Fame
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    but yet 9% of the people in the link you posted who got ECMO in fact had asthma.......
     
  10. jlb321

    jlb321 Recruiting Coordinator
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    yes - asthma in that they occasionally use an inhaler

    not on systemic steroids - not repeatedly in the ER or hospital

    do you think mild intermittent asthma is the same as someone with severe persistent?

    do you think someone who is on a single oral agent for diabetes with an a1c of 6 is the same as someone taking insulin with an a1c of 10?
     
  11. dinglefritz

    dinglefritz College Football Hall of Fame
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    Your study doesn't specify those parameters. Just stop man. Your misinformation and trolling is getting old.
     
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  12. jlb321

    jlb321 Recruiting Coordinator
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    it isn’t a study it is a registry - and you have to have access to the registry to see those parameters
     
  13. dinglefritz

    dinglefritz College Football Hall of Fame
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    So spill your guts then. Why do you have "access to those parameters"? Sorry but I don't believe you. The link you posted does NOT specify the criteria you're now suggesting and there's no way ALL of the patients with the listed comorbidities all had the specific problems you list even if ONE of them did. You got caught. Admit your error and move on.
     
  14. jlb321

    jlb321 Recruiting Coordinator
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    So one patient would invalidate all the data

    im out on this discussion

    you are the guy sitting back in coach telling everyone the pilot is flying the plane wrong
     
    14 jlb321, Jul 7, 2020
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  15. Nebraska_Reality

    Nebraska_Reality Redshirt Freshman
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    "I can say that we are not seeing ANY people under the age of 50 being hospitalized and the ones over 50 have all had comorbidities."

    First off, I'm not trying to be a smart a** or anything. I'm honestly looking for some clarification.

    70% of all Americans are overweight to obese. Around 48% of all Americans have hypertension. 10% are diabetic. About 8% are asthmatic.

    For starters, it seems to me that an awful lot of Americans have a comorbidity of some kind. Given this, I don't think it's a stretch to say that a majority of people over age 50 have some kind of comorbidity.

    When you say that "we are not seeing ANY people under the age of 50 being hospitalized...", do you mean at your hospital? In Nebraska? In general, anywhere? If it's the latter two, I don't buy that for a second.

    There was a 41 year-old Broadway actor that died from C19 a couple of days ago. No known underlying conditions. Looked pretty healthy. He had suffered a couple of mini-strokes, had one leg amputated below the knee due to blood clots, and was facing double-lung transplant in the near future if he had survived. I find it hard to believe that he was never hospitalized.

    Again...not trying to be difficult...just looking for clarification.
     
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  16. Crazyhole

    Crazyhole Sophomore
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  17. dinglefritz

    dinglefritz College Football Hall of Fame
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    First, there's a HUGE difference between being overweight and morbidly obese. That extra 25 pounds is not going to be a death sentence for the average man. Second, IF there's that many people walking around with serious comorbidites which are so horribly dangerous, shouldn't our CFR be MUCH higher? In one study I read from back in I think April, 97% of all deaths in a hard hit area in Italy were in people with KNOWN serious comorbidities. They didn't consider being elderly a comorbidity.

    I'm not in Nebraska and I'm talking multiple hospitals across an area. The only deaths we've had so far (that I know of) have been people over 60 with serious health issues and a few less than that also with serious comorbidities with diabetes being the worst. The Dr.s and nurses I talk to share what's happening in their experience and the state releases some statistical information regarding ages etc. Our local hospital is getting referrals from other facilities with less room in their ICUs so they can keep a reasonable number of beds available.

    We only know what the family has chosen to DISCLOSE about the Broadway actor's previous health history. We can't confirm his situation unless they release all of his medical records. According to a Dr. I trust, there's a whole lot of misdirection going on about the medical history of some COVID victims People have agendas.
     
    17 dinglefritz, Jul 7, 2020
    Last edited: Jul 7, 2020
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  18. dinglefritz

    dinglefritz College Football Hall of Fame
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    It isn't ONE guy. It's over half of the patients in the registry you linked. Over HALF had comorbidities and yet you sold it as them having NO comorbidities. You're expert at trolling.
     
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  19. jlb321

    jlb321 Recruiting Coordinator
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    please point out where I ever said they had NO comorbidities ... you are willing to discount anyone who might die because they might be on 1 prescription med
     
  20. dinglefritz

    dinglefritz College Football Hall of Fame
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    OK. You got me on that one. You didn't say "no comorbidites". You said "VERY MINOR COMORBIDITES". However the comorbidities listed in the registry you linked are in fact the MOST deadly comorbidites leading to death from COVID. They are NOT minor when it comes to COVID. You know that but yet for some reason you chose to minimize it. Agenda?
     
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  21. jlb321

    jlb321 Recruiting Coordinator
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    That is exactly why this is serious ... people with minor comorbidities are at increased risk

    I guess I am not as easily able as you are to “minimize” or dismiss the death of someone who is relatively young and otherwise healthy who might simply be on a single blood pressure medicine or a single diabetes pill.

    don’t talk to me about agendas - when you come on here and post that “we haven’t seen ANY patients hospitalized under 50”

    I showed you a registry with the sickest of the sick, getting the maximal medical and mechanical support humanly possible with a mean age of 48

    I can’t imagine making a statement that we haven’t seen anyone under 50 hospitalized. Your connections, if any, to the medical field must be extremely shallow to put out a statement like that
     
    21 jlb321, Jul 7, 2020
    Last edited: Jul 7, 2020
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  22. Nebraska_Reality

    Nebraska_Reality Redshirt Freshman
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    OK....thanks...although about half of the people overweight/obese category are considered obese.

    I know that you're not my doctor....but, as a guy who is carrying around a fair amount of weight over what he should, but is lowering his BP (high end of normal) and cholesterol (now in normal range) through meds, diet, and exercise, passed a stress test last August with flying colors, and hasn't had a bad cold in about 4 years (I'm in a line of work where I think my immune system is pretty well built up), how concerned should I be?
     
  23. ATLsker

    ATLsker Walk On
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    Lol I'm over this guy. We're supposed to trust whatever he says because he talks to a few doctors and people in the medical field. But we're not supposed to trust the epidemiologists or any datasets that aren't in his specific area. And he won't even provide the data for his area! (Hint.. he doesn't have it)
     
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  24. dinglefritz

    dinglefritz College Football Hall of Fame
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    No the point you made was that people with "minor" comorbidities weren't going to get ECMO so this news of the high fatality rate for patients with a mean age of 48 proved that COVID was deadly for young people without comorbidities. YOU called diabetes, obesity and asthma "minor" comorbidites. That simply is not true for this virus and fact over HALF of the people who got ECMO in that registry did have those things.
     
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  25. dinglefritz

    dinglefritz College Football Hall of Fame
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    Look at the CDC's data then. They've got exactly 28 people who have died from COVID between the ages of 10-29 that they don't have a report of any comorbidities. They wouldn't be able to prove that they didn't have a comorbidity but that is what was reported to them by everything from nurse practiioners to pulmonologists. If that information were put to a reliability test it would fail. Even IF NONE of the Dr.s clicking icons on their computer screen failed to click the right spot, 28 people out of what the CDC recently estimated to now likely be over 30 million cases including their asymptomatic or non-tested cases. Roughly 130 thousand deaths with 28 deaths in that age range with supposedly no associated comorbidity. Statistically, the risk of COVID for a healthy 18 to 25 year old is virtually zero.

    I'm relaying what I hear on a daily basis from a boarded pulmonologist taking care of multiple hospitalized COVID patients and who gets daily updates from the CDC. For multiple reasons, I don't disclose my identity or exact location on this board. If you don't like it put me on ignore.
     
    25 dinglefritz, Jul 7, 2020
    Last edited: Jul 7, 2020
  26. dinglefritz

    dinglefritz College Football Hall of Fame
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    Keep working at it man and stay healthy. I assume everybody I meet has it. The odds are that if you would get COVID you would do fine.
     
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  27. jlb321

    jlb321 Recruiting Coordinator
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    Again where did I say people with minor comorbidities don’t get ECMO. In fact I said in order to be considered for ecmo one's comorbidities have to be only minor

    And please show me where I made the statement or implied that young patients with COVID have a high mortality.

    Comorbidites aren’t graded on a sliding scale based on which particular acute disease you may or may not have. Stage 1 renal disease or NYHA class 1 heart failure don't become stage 3 or 4 just because you have a virus. They are minor/mild comorbidites - the severity classification doesn't change based on whether you present with a bacterial pneumonia, pulmonary embolism, urinary tract infection, COVID-19, or a broken arm. -
     
    27 jlb321, Jul 7, 2020
    Last edited: Jul 8, 2020
  28. dinglefritz

    dinglefritz College Football Hall of Fame
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    Longer answer this time. I am NOT an MD but I "know" one very well. The number one comoibidity that seems to lead to death with this deal is diabetes. Obviously people who are obese also have a higher rate of diabetes. You're doing the right thing trying to shed some extra pounds and by exercising. As I've posted several times, my friend who weighs roughly 270 at 5'10", has insulin dependent diabetes, is in his 60s and has renal failure beat this thing. Unfortunately they diagnosed a cancer while he was in the hospital which is going to kill him. Right now, my pulmonologist "friend" says that the only people they have dying from this have very serious comorbidities. That's just the experience in our area. Almost all of the victims have been nursing home patients in their 80s. The vast majority of COVID positive people haven't even required hospitalization.
     
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  29. Nebraska_Reality

    Nebraska_Reality Redshirt Freshman
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    Trying to be out in the sun more....walking the bank much more on my fishing excursions....doing some things outside the house that needed attention (which required a hedge trimmer and a chainsaw...fun stuff). Haven't been brave enough to head to the Y as of yet. I do wear a mask at the grocery store. We have a sizable farm and home store.....I do wear it in if there are many cars in the parking lot.
     
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  30. Charlie Marlow

    Charlie Marlow Assistant Head Coach
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    Stay to walking outdoors, etc. I cancelled my gym membership. It's one of the highest risk areas. Even swimming which sucks for me.
     
  31. dinglefritz

    dinglefritz College Football Hall of Fame
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    Personally I wouldn't go to the Y if you can get some aerobic work outside. If you're that worried about getting the virus wear the mask in the store no matter how many cars are there. You never know who is going to get in your space. A brisk walk for 20-30 minutes a day is a great way to git er done
     
  32. RaisingArizona

    RaisingArizona Walk On
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    My employee’s mother who is 74 and diabetic (I don’t know how advanced) was put on a ventilator about a week ago. She initially took a turn for the worse and the family was preparing to lose her. She was given convalescent plasma and dexamethasone (they were unable to get her Remdisivir) and was off the ventilator within four days. She was discharged today.

    I still happen to be in the camp that this is a very serious and dangerous disease but I do think they are getting better at treating patients and that is making a very real difference in high risk groups.

    In my completely novice opinion the big threat remains how damn contagious this is and what happens when healthcare systems get overrun.

    That’s why getting more Remdisivir produced will be of such consequence. Shortening hospital stays and freeing up ICU capacity may have far more life saving effect that some initially realized when the “men-ish” data was initially released.
     
    32 RaisingArizona, Jul 7, 2020
    Last edited: Jul 7, 2020
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  33. dinglefritz

    dinglefritz College Football Hall of Fame
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    Right now, there is no shortage of ICU capacity in spite of some of the alarmist social media rants by some Dr.s in urban areas. Hospitals have very good plans in place for caring for patients and some are getting transferred out to other facilities to keep space open for new emergent admissions. The ER doc in Houston who made national headlines that got so much attention was quickly shot down by the head of that hospital system who pointed out how much unused capacity they had.
     
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  34. RaisingArizona

    RaisingArizona Walk On
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    That may be true for larger cities. I’m not sure that it is but I’m not enough of an authority to argue otherwise. I do know that some smaller cities and their county as a whole are having issues. Pima county (Tucson) for instance has 11 open ICU beds for a population of 1m people.
     
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  35. dinglefritz

    dinglefritz College Football Hall of Fame
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    The large Hispanic communities are getting slammed. They tend to have VERY large family gatherings at just about every holiday or family event. It doesn't surprise me that Tuscon is having problems meeting the hospitalization needs.

    Every hospital I've read about though while they have a finite number of true ICU beds, also has a contingency plan to utilize other areas of the hospitals. In our area there's a fair amount of transferring patients to hospitals with more unused capacity. What most people don't understand is that most hospitals have a large amount of unused rooms right now where they can potentially turn an entire floor or wing in to an isolation ward for COVID patients not needing mechanical ventilation. Staffing and observation is more difficult in those situations but it can be done. Our local hospital just this past year had shut down an entire floor largely because so many procedures are done now on a same day basis instead of requiring over night stays.

    Somebody can correct me if I'm wrong, but one of my sons has been working in Omaha and has some clients doing large projects in a couple of hospitals. He says they have made adjustments to their facilities to control air flow etc to accommodate COVID patients if need be. It doesn't sound like Tuscon did enough to get ready for this deal. Hospital administration makes a big difference in the ability to deal with situations like this.
     
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  36. RaisingArizona

    RaisingArizona Walk On
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    Pima county has two Native American reservations as well and that’s another hard hit demographic. Tucson is also a popular retirement community of course. I believe that the average age of those infected In Arizona has skewed young though so I’m not sure how much that plays a role. I’m sure it does to some extent at least.
     
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  37. shocksker

    shocksker Walk On
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    Not very. I have had covid, early. Not that bad. My sister in law, stage 4 triple neg breast cancer had it during chemo, barely sick. My 65 year old mother in law had it, cold.like symptoms and never sought medical care...... no problems. All of my family has been tested for antibodies and all have them. Nobody ever even contemplated hospital. I worked through it as I was sick in Mid Feb and had no idea about corona. Its not as deadly as the media would have you think. If you didn't get a flu shot and never worried about it, stop worrying about corona. If you felt compelled to take a flu shot for fear of dying from the flu then stay home avoid public.
     
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  38. dinglefritz

    dinglefritz College Football Hall of Fame
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    The reservations in Nebraska and the Dakotas have gotten clobbered as well. Winnebago has had quite a few deaths.
     
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  39. RaisingArizona

    RaisingArizona Walk On
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    Don’t want to get political but the pandemic has clearly exposed some grave inequalities the most severe of which IMO are the Native American tribes. Oddly enough that’s underrepresented in this social justice movement.
     
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  40. dinglefritz

    dinglefritz College Football Hall of Fame
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    Native Americans in our area are suffering from COVID because of diabetes, heart disease and obesity. That has nothing to do with inequality. They get referred immediately and get some of the best medical care in the country at no cost to them in our area. That doesn't save your life though when you've got the kinds of largely self induced health problems that some of them do. I think it was the Pine Ridge Reservation in South Dakota who just removed their tribal chairman for trying to enforce a mask wearing rule.

    I have a Native American acquaintance who says we need to quit providing food to the reservations. She says they NEED to work to provide for their families in order to change what is going on there. Roof over their head yes. Food no. I thought it seemed really harsh but that's her view on what's wrong. Another friend who grew up on the rez says that they routinely sold their government commodity food stuffs to get money for liquor and gasoline.
     
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