Chris Orlando MD, MPH

Asst Prof of clinical neurology at @KeckMedUSC. Trained at @UofUmedicine and @utneurology. Research focus - SDOH and disparities in MS. Views my own. he/him/his

[Chris Orlando MD, MPH @OrlandoMDMPH]

Proud to have contributed to this important work.

And shout-out to my wife who helped us design that figure!

[Neurology Journal @GreenJournal]

Person-Centered Social Determinants and Neighborhood-Level Deprivation Associated With Disability in Hispanic People With Multiple Sclerosis: https://t.co/XnbvAdmT6n

#NeuroTwitter #MS

[Deadric T. Williams @doc_thoughts]

1/3 Race is not merely a characteristic OF an individual; race reflects individuals' experiences WITHIN a society. Given that race is socio-politically and historically constructed via racism, race cannot exist independently from racism.

[Alvin Christian @_AlvinChristian]

Running that first regression and seeing null results after waiting six months for data

[Chris Orlando MD, MPH @OrlandoMDMPH]

On a med student rotation an attending remarked how nice it was to have two cows on the team. The other student and I were sitting in front of the computers on wheels so when he pointed I thought he was talking about us. I was very confused.

[Wayne @Toaster_Pastry]

I call this a COW (computer on wheels). But they want me to call it a WOW (workstation on wheels) because, you know, Liberals.

[Kay M. Dingwell🍁🩺🏳️‍🌈 @CanadianKayMD]

My applications to med school, including interviews, cost ~10% of my family income that year.

I almost had to decline my acceptance when an unplanned expense came up & I didn’t have the $1000 deposit.

Medical training selects for privilege & too few schools are addressing this.

[Drew Scanlon @drewscanlon]

Hi Internet! I'm Drew and THIS IS MY FACE.

If this GIF has ever brought you joy in the past, I humbly ask you to consider making a donation to the National MS Society. It would mean a lot to me and to those I know affected by the disease!

Donate at https://t.co/cHLs9sKqix

[Walker👨‍🦽🇬🇧🇺🇸 @moorlandTony]

Good morning

[Chris Orlando MD, MPH @OrlandoMDMPH]

@Brandon_Beaber Well, that's horrifying.

[Chris Orlando MD, MPH @OrlandoMDMPH]

Interesting thread!

Intravascular lymphoma affecting the CNS isn't super common, but I feel like we reliably see it 1-2 times per year. Important to be at least a little familiar with as a neurologist.

[Tony Breu @tony_breu]

1/7 - The Mystery

A patient presents with fever and confusion. After multiple weeks without a diagnosis, an astute clinician suggests a random skin biopsy.

The patient has no rash or dermatologic symptoms. And yet, the biopsy reveals the diagnosis.

🤔What is the condition?

[Nico Gagelmann @NicoGagelmann]

A classic of immunology for beginners...

[Chris Orlando MD, MPH @OrlandoMDMPH]

We appealed this decision and clearly explained that the refusal of coverage was placing the patient at risk of additional neurologic injury and was inconsistent with the standard of care.

Despite this, our appeal was denied. Shame on @AnthemBCBS

[Chris Orlando MD, MPH @OrlandoMDMPH]

Hey @AnthemBCBS

Why are you trying to require us to give less than the standard of care?

I have a patient that has failed low efficacy DMT for MS in the past, and yet you are requiring another trial of a less efficacious agent before allowing us to do high efficacy therapy.

[Chris Orlando MD, MPH @OrlandoMDMPH]

@DGlaucomflecken a share to boost reach of this would be much appreciated!

[Chris Orlando MD, MPH @OrlandoMDMPH]

Hey @AnthemBCBS

Why are you trying to require us to give less than the standard of care?

I have a patient that has failed low efficacy DMT for MS in the past, and yet you are requiring another trial of a less efficacious agent before allowing us to do high efficacy therapy.

[Chris Orlando MD, MPH @OrlandoMDMPH]

P2P conversation today was not helpful. Deeply upsetting that adhering to step therapy policy is apparently more important to you than preventing neurologic disability.

[Chris Orlando MD, MPH @OrlandoMDMPH]

@Elena2456h @AnthemBCBS @drhansonspores Please don't try to co-opt this post to promote treatments that are not evidence based. Please delete your comment.

[Chris Orlando MD, MPH @OrlandoMDMPH]

@Housoup @doctorORbust I trained at UT Houston. All of their Neuromuscular folks are great. Kazim Sheikh, Suur Biliciler, Thy Nguyen, and a couple others.

[D. King, MD @doctorORbust]

I think it’s weird when a patient is sent to for supposed fibromyalgia and fatigue and I’m the first to send an iron and ferritin. Her ferritin was 7. I was like, do you like eating ice? She devours it.

Please send Fe + ferritin and remember fibromyalgia is a Dx of exclusion.

[Chris Orlando MD, MPH @OrlandoMDMPH]

@doctorORbust So many women suffer debilitating effects of treatable conditions because nobody takes them seriously enough to send even basic workup. I see it in patients ultimately diagnosed with MS, and in situations where the neurologist is somehow the one to find severe iron deficiency.

[Chris Orlando MD, MPH @OrlandoMDMPH]

@doctorORbust Had a similar situation recently where we were the first to really investigate symptoms which uncovered severe iron deficiency anemia from AUB and ultimately endometrial cancer.