Medical Professionals Information and Advice

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King Stannis

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My Friends,

We are blessed to have all manner of people on RCF. Amongst them we have a number of doctors and psychologists.

I have asked a few of these professionals to contribute to a thread. Note, they are not Infectious Disease specialists, however, their MDs give them a better understanding of what is going on than the layperson.

@Zeus69 and @Pioneer10 are your MDs,

Moreover, this chaotic time has caused a great deal of anxiety as well as the loneliness of social distancing. @Hydroponic3385 has agreed to contribute in that regard.

Thank you, gentlemen!

There will be no political debate in this thread. This is strictly for medical questions and answers.
 

King Stannis

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@Hydroponic3385 has posted these very helpful links on mental health:



24/7 Crisis / Support Resources


  • Crisis Text Line: text HOME to 741741
  • National Suicide Prevention Life Line: 800-273-TALK (8255)
  • If you or a loved one is having a difficult time coping with the outbreak, SAMHSA has a Disaster Distress Helpline with trained counselors: 800-985-5990 or text TalkWithUs to 66746
Resources for Connecting with Mental Health Providers

Many mental health providers across the country will be offering phone/video services for clients during the pandemic. If you are currently / previously connected with a therapist in your area, we suggest contacting them

  • Use Psychology Today's Find a Therapist feature (https://www.psychologytoday.com/us) to search for therapists in your area.
  • Contact your insurance provider for a list of providers in your network.
  • Contact your primary care physician for therapist recommendations.
  • Betterhelp is a national teletherapy counseling website available 24/7 at a cost for subscription. More information can be found at https://www.betterhelp.com/
Ways to Cope with the Stress, Anxiety, Uncertainty, Anger and Grief

Other Tips for Mental and Physical Wellness

Staying healthy during this time is central to the mission of reducing the spread of COVID-19. As such, it is important to remember that your immune system is significantly affected by diet, stress, sleep, and exercise. While practicing quarantine guidelines, it is very beneficial to keep your body moving and your mind focused, to boost your immune system and reduce stress. Socialize virtually, through online group games and apps. Keep your mind focused by listening to podcasts, videos, and audiobooks, many of which are free at this time. Stay in touch with your friends and family. Take the time to learn a new skill, hobby, or brush up on skills you previously wanted to learn but didn't, due to time restrictions. Learning the practice of mindfulness and present-moment presence can really reduce stress, anxiety, quiet racing thoughts, and help you have better quality sleep.

Listed below are apps and services that are being offered free of charge during pandemic quarantine:

Apps

Peloton

Down dog

Amazon Prime

  • If you have Amazon Prime, login, access prime video, and search for workout videos included with prime
Nike training club app

7-minute workout

You Tube

Gyms Streaming Free Classes

Blink Fitness is hosting Facebook Live sessions weekdays at 8 a.m. ET. The fitness chain will host virtual workouts, give tips to stay motivated and answer fitness questions from the comments.

Orangetheory is sharing a new 30-minute workout video each day, featuring some of its most popular coaches from around the world. According to the fitness center, the workouts don't require any special equipment, but may feature everyday household items. Orangetheory's first at-home workout was designed to help alleviate stress and elevate your mood.

Gold's Gym is offering a variety of digital workouts for free through the end of May. Its app offers over 600 audio and video workouts.

Planet Fitness is live streaming "Work-Ins" at 7 p.m. ET every day on Facebook. The company said its trainers, and occasionally surprise celebrity guests, will lead the 20-minute workouts, which are free for everyone.

All Crunch Fitness members, regardless of membership tier, will now have free access to the Crunch Liveplatform, which offers over 100 workouts that can be streamed on phones, tablets or TVs. The app has a variety of workouts, including dance, yoga and kickboxing.

Life Time announced Thursday "Classes on Demand," a way for members and non-members across the country to stream cardio, strength and yoga classes for free. New classes are added every day and include kickboxing, barre, guided meditations and more.

305 Fitness is offering cardio dance live streams twice a day on YouTube. The sessions are held at 12 p.m. and 6 p.m. ET, and are hosted by the founder of the studio, Sadie Kurzban.

Barry's Bootcamp is hosting 20-minute body-weight workouts live on Instagram for free. On Tuesday, its 9 a.m.

CorePower Yoga is offering free access to a limited collection of online yoga and meditation classes while studios are closed.

Facebook

Homegrown Yoga (https://www.facebook.com/homegrownyogaky/ )

 

Zeus69

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Tho I agree with @BMAN above - if I find or am sent a link that I feel is pertinent/informative, I’ll post it here instead of sprinkling it among the various other ongoing threads.
 

inliner311

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Does this stuff have any side-effects?
Just note that this is used for long term management of Lupas and rheumatoid arthritis. While they also use it for a prophylactic (prevent you from getting) for malaria, which some people take for years if they are in a region with a high risk of malaria. So the dosage and the length of use is completely different than what they would use for coronavirus.

I've read the dosage they have used but can the professionals chime in on how much more risky or safer the possible higher dosage but much shorter duration might have?

"Side Effects
Nausea, stomach cramps, loss of appetite, diarrhea, dizziness, or headache may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: arm/leg/back pain, slow heartbeat, symptoms of heart failure (such as shortness of breath, swelling ankles/feet, unusual tiredness, unusual/sudden weight gain), hair loss/color change, mental/mood changes (e.g., anxiety, depression, rare thoughts of suicide, hallucinations), ringing in the ears/hearing loss, worsening of skin conditions (e.g., psoriasis), severe stomach/abdominal pain, severe nausea/vomiting, easy bleeding/bruising, signs of infection (e.g., fever, persistent sore throat), dark urine, yellowing eyes/skin.

This medication may rarely cause low blood sugar (hypoglycemia). Tell your doctor right away if you develop symptoms of low blood sugar, such as sudden sweating, shaking, hunger, blurred vision, dizziness, or tingling hands/feet. If you have diabetes, be sure to check your blood sugars regularly. Your doctor may need to adjust your diabetes medication.

This medication may rarely cause serious (sometimes permanent) eye problems or muscle/nerve damage, especially if you take it for a long time. Get medical help right away if you have any very serious side effects, including: sensitivity to light, vision changes (e.g., blurred vision, seeing light flashes/streaks/halos, missing/blacked-out areas of vision), muscle weakness, numbness/tingling/pain of the arms/legs.

Get medical help right away if you have any very serious side effects, including: chest pain, fast/irregular heartbeat, severe dizziness, fainting, seizures.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing."

 
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inliner311

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Convalescent plasma could be a short term solution if they prove it to be effective. The downside is they will have to wait for significant group of people to get better before they can implement it. They also have to get those people to donate plasma. You can only give plasma every 28 day. They don't know how long antibodies will stay in a person's blood, it could be months or years. Plasma has a life of 36 months when frozen.

Is there anything I'm missing here that should be pointed out? Realistically how many people will one person's plasma donation help?

 
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Zeus69

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Does this stuff have any side-effects?
Plaquenil is also used to treat patients with Sjogren’s syndrome for their dry eye and dry mouth…. These patients may take 400 mg or more a day for 5, 10, 15 years. Most have moderate measurable improvement for dry eye/dry mouth. That improvement has to be weighed against the long term toxicity. And for some folks it’s worth it while for others it is questionable. If there is any suggestion of any kind of retina (macula) damage, cessation of the drug is usually recommended because it’s not "life and death to take it but preserving sight is critical”.

The prophylactic dose of plaquenil is lower than that mentioned above, and the therapeutic dose for someone who is positive with COVID-19 is not much greater than above, and then only for a burst of duration.
 

Zeus69

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COVID-19 is an RNA virus. Plaquenil’s effectiveness likely stems from its mechanism of action as an “ionophore” for zinc ions…meaning they help “shuttle” zinc into (infected) cells, where zinc then blocks “RNA-dependant replicase” (enzyme) from reproducing viral proteins (slowing the rampant spread of a person's viral load).
 

inliner311

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COVID-19 is an RNA virus. Plaquenil’s effectiveness likely stems from its mechanism of action as an “ionophore” for zinc ions…meaning they help “shuttle” zinc into (infected) cells, where zinc then blocks “RNA-dependant replicase” (enzyme) from reproducing viral proteins (slowing the rampant spread of a person's viral load).
Can you explain the difference between doctors using drugs off label vs on a compassionate bases? I have heard doctors using Hydroxychloroquine in both ways. I heard that if a doctor uses it on a compassionate bases that the patient's info has to be released so it helps with research.
 

Zeus69

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Can you explain the difference between doctors using drugs off label vs on a compassionate bases? I have heard doctors using Hydroxychloroquine in both ways. I heard that if a doctor uses it on a compassionate bases that the patient's info has to be released so it helps with research.
Not redirecting you, since you can obviously "search" on your own, but these links sum things up well...


 

inliner311

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Not redirecting you, since you can obviously "search" on your own, but these links sum things up well...


Thanks. Just to be clear here so when people are saying Hydroxychloroquine is being used on a compassionate bases, are they misspeaking and the patients are just getting it off label? It's not an experimental drug and is FDA approved. I know remdesivir is experimental and is being use on a compassionate bases.

Or is there some gray area and the CDC and FDA wants doctors to use all these FDA approved drugs on a compassionate bases when it involves coronavirus so the data can be released to help research?
 

Zeus69

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Thanks. Just to be clear here so when people are saying Hydroxychloroquine is being used on a compassionate bases, are they misspeaking and the patients are just getting it off label? It's not an experimental drug and is FDA approved. I know remdesivir is experimental and is being use on a compassionate bases.

Or is there some gray area and the CDC and FDA wants doctors to use all these FDA approved drugs on a compassionate bases when it involves coronavirus so the data can be released to help research?
My understanding is Hydroxychloroquine use for COVID-19 would be considered “off label“.

Here’s a table of drugs FDA approved for specific conditions, as well as their “off label” uses.

951A9306-54D5-4850-89E0-54DA85614009.jpeg
 

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