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A Radical Change
Published in Stijn Geerinck, Reconstructing Identity After Brain Injury, 2022
The accident left me with an acquired brain injury (ABI). For three months, my skull had to stay open after surgery to give room to my severely injured and swollen brain. At the same time, I suffered from the issues that come with ‘sinking skin flap syndrome’. The gravity of the situation called for an urgent replacement of my bone flap in spite of a hospital bug I had caught and which made surgery particularly risky. Luckily, I came out without further damage. The next step was to install a permanent shunt to drain any superfluous cerebrospinal fluid, which had been heaping up in my ventricles since I fell out of bed. It was supposed to remain there for the rest of my life. Adjusting the shunt, however, proved to be difficult and initially, too much fluid was being drained. As a result, I had to spend the next couple of weeks lying head-down on an inclined bed. To make things worse, I suffered from double pneumonia. My fall from the bed convinced the medical staff to take no further risks and strap me to the bed every single night for four months.
Other Concierge Models
Published in David F. Winter, Service Extraordinaire, 2017
My name is . My husband and I are longtime (probably 15 years) patients of Dr. , MD. In this letter I would like to address issues I have had with the appointment scheduling in the last two weeks and also, in the past. Coming off a cruise on February 26, I became sick with fever, nausea, and congestion on February 28; and my illness progressed. On March 1, I went to an urgent care facility where I was diagnosed with an upper respiratory infection and prescribed Azithromycin. Around 11 p.m. on March 2, I went to an emergency room with breathing problems. Both facilities did blood work, chest x-rays, etc., and told me to follow up with my regular doctor within seven days. I called Dr. office on March 3 and tried to schedule an appointment with an appointment scheduler. She said Dr. didn’t have an opening until March 29 and that they were overrun with sick people. I asked to speak with Dr. ’s nurse; the scheduler refused to let me speak with her. I asked to leave a message with the nurse saying that I was sick, and she had been very good at working me in when I am sick. He refused to let me leave a message. He offered for me to see a nurse practitioner; I emphatically refused that offer. Then, he said he could put me on a cancellation list which I agreed to; but of course, that phone call never came. In the meantime, my illness progressed and on March 4 around midnight, I went back to the emergency department. I was diagnosed with double ear infections on top of everything else. Again, blood work, chest x-rays, etc. were taken; and I was prescribed Augmentin and Promethazine for nausea. I was told to follow up with my regular doctor within seven days—no luck there. I was very sick by March 8, so my daughter took me to a different emergency department. There, I was diagnosed with double pneumonia and was hospitalized for three days. In conjunction with all of my medical issues, I ran a fever with nausea for 10 days. Before I was released from the hospital a case worker met with me and told me to follow up with my regular doctor within seven days. I told him my story with my doctor’s office and of my inability to get an appointment. He said that was unacceptable and that he would call and get me an appointment with my doctor. After playing phone tag all afternoon, he had to leave a message for a return call to me with an appointment with Dr. . When the appointment scheduler finally called me, she said Dr. had no availability. I reminded her of the phone call from the case worker, and he said, “How many days did he say?” I told her seven, she said just a minute and came back with an appointment at 1 p.m. on March 16.
COVID-19: from an acute to chronic disease? Potential long-term health consequences
Published in Critical Reviews in Clinical Laboratory Sciences, 2021
Victoria Higgins, Dorsa Sohaei, Eleftherios P. Diamandis, Ioannis Prassas
In terms of COVID-19, a meta-analysis of 31 articles and approximately 50,000 patients with SARS-CoV-2 reported that 29% of patients developed ARDS, 76% had double pneumonia, 20% had unilateral pneumonia, and 31% reported chest distress [28]. Specific pulmonary abnormalities included ground-glass opacities (70%), irregular lesions (54%), and bronchovascular bundle thickening (40%) [28]. All of 138 hospitalized patients with COVID-19 included in a study by Wang et al. exhibited bilateral involvement of chest computerized tomography (CT) scan [29]. A study of 81 patients with COVID-19 pneumonia found chest CT imaging abnormalities, even in asymptomatic patients [30]. Abnormalities were found to rapidly evolve from focal unilateral to diffuse bilateral ground-glass opacities [30]. Patients who have recovered from COVID-19 may develop irreversible fibrotic interstitial lung disease due to the persistence of chronic inflammation [31], although pulmonary function abnormalities may be reversible with time or treatments. Patients with severe COVID-19 exhibit excessive inflammatory damage due to a failed anti-inflammatory response and, subsequently, excessive proinflammatory cytokines that damage epithelial and endothelial cells of the lung [32]. Importantly, 54% of asymptomatic positive cases from the cruise ship Diamond Princess had lung opacities on CT [33], with a similar prevalence reported in asymptomatic or minimally symptomatic patients in Italy [34]. Without prospective studies, the long-term consequences of COVID-19 on the lungs are not yet confirmed.