Louisville Medicine Volume 67, Issue 12 | Page 37

DOCTORS' LOUNGE Or you could have it and never even know. While we are connected, I either make everyone walk up and down a flight of steps twice very quickly or walk 100 feet total very fast. I can hear how easily or heavily they breathe. This is to teach them the breathing stress test. If they can do that fine, no worries. I insist that they do this twice a day, every day, when they take their temperatures. I impress upon them very strongly that if they suddenly get only halfway through and gasp for breath, that’s bad news. It means they are in serious trouble from COVID-19 and they should get to the ER, as fast as possible—they need oxygen, doctors and nurses. They should leave now if suddenly short of breath. Having lived through the plague of AIDS, where we could save no one at all for too many years, I am grateful that for many people, ICU care can work. But it will take decades for us to recover from the white-hot anger and grief of losing so many patients, so fast, at life-threatening risk to our frontline medics, police, firefighters Photo design by Jennifer Postlethwait. Left to right: Dr. Mary Barry, Jen- nifer Lucas, Jennifer Postlethwait, Dr. Michael Needleman, Kim Guthrie. else within sight or sound. (If you are the patient video chatting with your own doctor or NP – check out where in your house it’s best to be seen from. You can always arrange a mountain of used Kleenex to make your point.) and all emergency and hospital personnel. We have lost some of the best among us and will lose many more. The federal government has lied to us, obstructed us, outbid us and failed us at every turn. Thanks be for Gov. Beshear and the other leaders in this country who have leapt into the breach. Thanks be for the enormous corps of volunteers, medical and otherwise, who have manned the bar- ricades against this evil invader. I hope to join you all daily for @BeerwithBeshear, so long as this lasts. Be careful out there, people. Dr. Barry is working at various Norton CMA offices as a “float/fill-in” only position. She is a clinical associate professor at the University of Louisville School of Medicine, Department of Medicine. So far the majority of calls and video visits have been about respiratory issues. I make a point of asking everyone if they have questions for me about COVID-19 (they all do). I teach them all what to watch for: that you can go from wonderful one day to terribly ill the next day, or you can just gradually feel worse and worse. You should watch for coughing, fever over 99, loss of your normal appetite. You should watch for changes in how things taste or smell. You should watch for burning or tightness in the chest. You should watch for new nausea. You should study your eyes in the mirror: are they reddish? Do they look wrong in some way? You should watch for loose stool, hivey rashes or pinpoint red rashes, and headaches that are new and different. You should watch for feeling utterly overcome with exhaustion just from standing up. You should watch for brain fog, for trouble paying attention or keeping track. You should watch for shaking chills, high fever and sweats, and wracking body aches. You might just have a runny nose or, as the patients say, “congestion.” MAY 2020 35