Ehsan Navabi

[Ehsan Navabi @ENavabi]

@KRakszawski So sorry for your loss brother. My thoughts and prayers with you and your family.

[Ehsan Navabi @ENavabi]

Obviously nothing against other specialties, I don't think it is fair to patient that I review their dermatology or rheumatology... Meds. Likewise, at least it would have been fair that a GI provider would deny my appeal. Neither patient nor doctors will win by insurance games.

[Ehsan Navabi @ENavabi]

Received a denial letter for changing the frequency of treatment for my Crohn's patient. This was denied after multiple appeals by me, after careful review by pathologist and dermatologist!!!
Good job insurance company!

[Ehsan Navabi @ENavabi]

@AtoosaRabiee @BMoshiree @RezaEmaminia @MSharifpourMD @arghavan_salles Happy Nowrooz

[Ehsan Navabi @ENavabi]

@ShimaghavimiMD @KrugCleveland @kennethernest @novakkerri @ibddoctor @SchairerIBDMD @BowelUltrasound Because courses are not easily accessible in major cities.
3 training modules, but mostly only once or twice a year and only held at one city.

[Ehsan Navabi @ENavabi]

@KofiClarkeMD @JonathanStineMD @DrJazFaust @klkrok @jenmarankimd @ZebaHussainiMD @EStonesiferMD @PennStateGIM @PennStHershey @PennStIMchiefs @PennStateGME I was lucky to have great mentors.

[Ehsan Navabi @ENavabi]

@JonathanStineMD @PennStHershey @klkrok @DrJazFaust @EStonesiferMD @KofiClarkeMD @PennStGastroHep He is one of the greatest of all time.

[Ehsan Navabi @ENavabi]

@JonathanStineMD @PennStGastroHep @KofiClarkeMD @jenmarankimd @klkrok @AndrewTinsley19 @MeetaDesaiMD Thanks. It was so great to see you as well.

[Ehsan Navabi @ENavabi]

@janusfilms Can't imagine how people were much smarter 40 years ago. I am not sure if people can digest this masterpiece now.
But imagine that this was a TV series of a time.

[Ehsan Navabi @ENavabi]

@davidcinema A Pure Formality

[Ehsan Navabi @ENavabi]

@criterionchannl 1.Le huitieme jour 2. Una Pura Formalita

[Ehsan Navabi @ENavabi]

You will be missed maestro Shajarian.
#شجریان

[Ehsan Navabi @ENavabi]

@dr_sheykh دادا، حداقل بزار تو مردنمون بریم یه جای با صفا. زنده مانی ما که همش تو هویزه بود!!!

[Ehsan Navabi @ENavabi]

@KofiClarkeMD @JonathanStineMD I am so proud that you were all part of my life. Great team work

[Ehsan Navabi @ENavabi]

@mcallister_md Thanks. This is really helpful.

[Ehsan Navabi @ENavabi]

@DoctorVig @mcallister_md Exactly, that was my point. But for someone who is dying on ventilator, it is very hard to avoid scoping.

[Ehsan Navabi @ENavabi]

Many #COVID19 patient present with acute anemia with minimal #GIbleed and many of them are thrombocytopenic! When to decide for intervention?! I wonder if this anemia is just marrow suppression and by scoping patients, would increase the risk of exposure for staff! Thoughts???

[Ehsan Navabi @ENavabi]

@DoctorVig @mcallister_md The main issue is, if it is not the GIB as a cause for hemodynamic changes, then is there any value to scope?
For non COVID we may scope just to answer the cause for shock, but for COVID patients it is not an easy decision.

[Ehsan Navabi @ENavabi]

@DoctorVig @mcallister_md They all have elevated D-Dimer and interestingly high ferritin. Small bump in INR but thrombocytopenic. I agree this is thrombosis, marrow suppression and coag issues. Some studies so far show the same.

[Ehsan Navabi @ENavabi]

@DoctorVig @mcallister_md Yes, we are only scoping in the OR or at bedside for ICU patients.
But it is very interesting. Had 2 patients today who had 6-7 gr drop in Hb from baseline, but only had very minimal bleeding sign. For now will monitor since stable. But MICU patient on pressor are challenging!

[Ehsan Navabi @ENavabi]

@mcallister_md Thanks buddy, I had at least 4 inpatient consults this weekend with same presentation. Very tough to decide when to scope. Specially ICU patients on pressor and vent. Would like to exclude hemorrhagic shock but very high risk procedure, while there is minimal bleeding.
Stay safe!