mart michmd

Emergency Doc and football mom (!) bearing witness to the US healthcare crisis

[mart michmd @martmd]

Go ‘Gate! Go Max! @maxhurleman @ColgateFB

[Pittsburgh Steelers @steelers]

Heavy on the school spirit today‼️

[mart michmd @martmd]

Agreed!

[Suneel Dhand MD @DrSuneelDhand]

In my opinion, GABAPENTIN (Neurontin) is an awful drug. Does nothing to address the root cause of neuralgia/pain— only knocks out brain receptors.

Here are three very common problems I see, especially in people over 65:

1. Tolerance develops very quickly, so the dose has to escalate (just like a narcotic). Some of the high doses I see in older people, are absolutely insane. Would probably knock a horse out.

2. Altered mental status/sedation. In the hospital, the amount of times we have to stop gabapentin in a patient admitted to hospital (often because of their current illness). Their loved one, often their daughter or son will say— “My goodness, I haven’t seen mom/dad so awake and alert in a long time!”. Well, go figure.

3. Falls. This is a big problem, especially at high doses in older people. Often starts with dizziness and tiredness. One bad fall in a high risk person, and their life is never the same again.

I would never want any loved one of mine on gabapentin, and if it is prescribed because there’s no other alternative— let it be at the lowest possible dose, with an exit strategy (why oh why, do most medications nowadays prescribed by the medical profession, become “forever meds”?!).

[mart michmd @martmd]

You’re missing @maxhurleman !

[Pittsburgh Steelers @steelers]

Our initial 53-man roster ⤵️

[mart michmd @martmd]

Shocking and sad.

[Mark Kaplan @markkaplan20]

I want to show you the most important year in the history of American health.

1977.

For 20 years before that line, obesity in America was stable. 13 to 15 percent. Flat.

In 1977, the McGovern Committee published the first Dietary Goals for the United States. The government told America to cut fat from 40 percent of calories to 30 percent.

America listened. And replaced fat with sugar, refined carbohydrates, and seed oils.

Look at what happened next.

Obesity: 15 percent to 42 percent.
Diabetes: 2.5 percent to 12 percent.

Both lines were flat before 1977. Both lines exploded after.

The government changed the guidelines. Then everything changed.

This is not a coincidence. This is a policy failure measured in millions of lives.

[Kevin Williams @wxbywilliams]

Across the state it's been a lovely sun-filled morning with bright skies and gentle winds. As we near noon, however, we find energy production from wind is 0 (zero) and energy production from solar (lumped in with methane and wood) is <4%. The kicker: we're all paying for this.

[mart michmd @martmd]

@LesserEvilSnack say it isn’t so!!!!

[mart michmd @martmd]

Hero’s! Incredible.

[mart michmd @martmd]

Agreed

[Suneel Dhand MD @DrSuneelDhand]

As a Doctor, here are 5 things I would do if any loved one, especially over the age of 65, was ever admitted to hospital. To make sure they have the BEST possible outcome:

1. Check at least twice on Day 1 and Day 2 that the medical team knows the exact medications and dosages they are taking at home. You wouldn’t believe how often this is wrong (it’s called Medication Reconciliation”)

2. Make sure that the nurses, physios, aides— get my loved one out of bed and moving ASAP as soon as they are recovering from the condition. Muscular deconditioning, or what I call “Sinking In Bed Syndrome” can set in extremely fast, and will turn someone who was fully independent into a completely different person within a few days.

3. Monitor for any change in mental status/increasing confusion. This is very common, can be disastrous and significantly increases risk of complications. Make sure you communicate as assertively as you can to the medical team that your loved one is not themselves. Is it a medication side-effect, dehydration, infection, or something else? It must be investigated ASAP

4. When the time comes for discharge, the follow-up plan must be crystal clear. The ball cannot be dropped on anything. What was the diagnosis, what abnormal tests need primary care follow up (labs/imaging), restrictions (diet, exercise), what specialists need to be seen, and what to do/who to call if any new symptoms occur.

5. Be at the bedside every hour I’m allowed to be there for my loved one. Rotate with other family members if needed. If it was up to me there would be zero visitation restrictions— as long as no other patients are being disturbed.

I like to see a family member in the room of every patient I see on hospital rounds. If they are not there, I get them on speaker phone so they can listen in and ask questions.

Hospitals are very busy places. There are some great dedicated medical staff, but mistakes happen all the time. I’ve worked in dozens of hospitals and it’s always the same.

Be a solid advocate for your loved one and be on the ball. Don’t be intimidated. Speak up. Ask questions.

I really believe the above can save lives.

Do follow me for more practical tips wellbeing and longevity. I wish you and yours luck and the best of health.

[mart michmd @martmd]

This isn’t just about the snow. The number of cloudy days throughout the year is what can really get old. Can’t beat the Finger Lakes for beauty though! #FLX #Rochester

[Colin McCarthy @US_Stormwatch]

Top 10 cities with the worst weather in the United States:

1. Anchorage, AK
2. Syracuse, NY
3. Madison, WI
4. Grand Rapids, MI
5. Rochester, NY
6. Allentown, PA
7. Hartford, CT
8. Pittsburgh, PA
9. Lansing, MI
10. Lincoln, NE

[mart michmd @martmd]

Why all of this “voting vulnerability” called out before T and all of a sudden they go silent and deny there’s a potential problem?!

[mart michmd @martmd]

Crazy Roc, thanks for sharing Canada. 🔥 💨

[mart michmd @martmd]

What a blast! @rocjazzfest @tromboneshorty

[mart michmd @martmd]

@FreddyLA7 Finger Lakes! Go visit Letchworth and Watkins Glen parks and lakefronts. Beautiful!

[mart michmd @martmd]

Just took off from ROC🥺😳🤯. Thx for the standing up for Western NY @alex_fasulo @johnrich @SecRollins

[Michelle Maxwell ™ @MichelleMaxwell]

With everything we are hearing right now about ticks this seems like good information to share.

“Here’s what I’ve learned after more ticks than I care to count.
First, whatever your uncle told you, forget it. No matches. No nail polish. No Vaseline. No soap on a cotton ball. All of those do the same terrible thing, they stress the tick out, and a stressed tick empties its gut back into the bite before letting go. Which, if you think about what that actually means for a second, is literally how Lyme and the rest get transmitted so you’re not speeding up its exit. You’re making it throw up into you.
Fine-tipped tweezers. Grip right where the mouthparts enter the skin, not the body, the head. Pull straight up, steady, no twisting, no jerking. It’ll feel like it’s resisting because it is, the mouthparts are barbed. Just keep the pressure on and it lets go in a few seconds. If a piece breaks off in the skin, leave it alone. Your body pushes splinters out. Digging around with a needle does more damage then the fragment ever would.
Clean it with alcohol or soap. Wash your hands.
Now here’s the part most people skip: don’t flush the tick.
Tape it to an index card. Clear packing tape right over the body, write the date and where on your body it was, and stick the card in a drawer. If you come down with anything weird in the next 30 days, rash, fever, joint pain, that flu-that-isn’t-flu feeling, that tick goes with you to the doctor. Some labs will test the tick itself, which is faster and often more reliable than waiting for antibodies to show up in your own blood. A dated tick taped to a card is one of the most useful things you can hand a doctor who’s trying to figure out what’s wrong with you.
The other thing worth saying out loud: if the tick was engorged when you pulled it, and you can’t swear it was off your body within 24 hours, call your doctor that same day. Don’t wait for a rash. Fewer than three out of four Lyme cases even produce the classic bullseye. A single preventive dose of doxycycline within 72 hours of a deer tick bite cuts the Lyme odds way down, and most docs in tick country will write that prescription without giving you a hard time, especially if you walk in with the tick taped to a card and a clear timeline.”

[Alex Fasulo @alex_fasulo]

How did we get here?

How did we get to a place where New York State just issued a final permit for a designated and ecologically sensitive habitat that our own state's NYS Department of Environmental Conservation has admitted houses 10 of the 11 TOP grassland species of concern?

It's a masterful play in the art of usurping power from the public and storing it inside shadow bureaucratic bodies and "clean energy" propaganda that's designed to benefit foreign corporations.

Here is the timeline of how New York State was able to pull off siting Fort Edward Solar while breaking its own laws in front of the public:

Step 1: the Climate Act was passed in 2019 justifying mass environmental devastation in the name of "saving the climate"

Step 2: ORES was shoved through in a budget bill April 2020 while everyone sheltered at home, creating a shadow agency no one voted for

Step 3: Kathy Hochul stacked the DEC (and APA) with renewable energy salesmen and women, installing Amanda Lefton as the DEC Commissioner to stand down in the face of renewable destruction

Step 4: ORES defers all decision-making to foreign renewable developers, including allowing them to buy and redact the environmental "assessments"

Step 5: ORES takes in a $1,000 fee/MW for each complex, directly profiting from the size/number of projects it sites

Step 6: ORES agrees to issue a final permit to the foreign renewable developers 100% of the time, ensuring they recoup their investments and are able to exchange/sell the permit as many times as they want for 7-years thereafter

Step 7: The solar industrial complex lobbies NYS politicians like Senator Pete Harckham, Michelle Hinchey, and NYS Senator Rachel May to push through environmentally destructive legislation while pretending they care about the environment

Step 8: NYS distributes Environmental Protection Fund (EPF) money to conservation easement nonprofits and environmental advocacy nonprofits with strings attached: "support climate change infrastructure and messaging"

Step 9: Nonprofits like the Grassland Bird Trust withdrew their Appeal one-week before the Fort Edward Solar final permit to receive mitigation money from Boralex, effectively dismantling any perceived "opposition" to big solar and wind

Step 10: Solar conglomerates infiltrate town boards and leadership, paying off elected officials while pressuring landowners at their physicals doorsteps and handing out 40+ page contracts that are impossible to decipher without a law firm

Step 11: Solar conglomerates are actively funding political candidates at the local level in NYS to displace Upstate NYers that have taken public stands against solar complexes

And there you have it.

After the 8-month journey I have been on, this is the timeline. These are the steps. This is the playbook.

If you still believe any of this is for the environment, you and I have nothing in common.

This is coming for every single town and county in New York State and beyond.

It stops with Fort Edward.

[Secretary Brooke Rollins @SecRollins]

Another day, another ridiculous battle to destroy our farmers and their farmland.

New York’s decision to craft their own lax standards for ‘prime farmland’ to fast-track solar developments is a direct attack on American agriculture. In 2020, the exact year they stood up their Office of Renewable Energy Siting, they worked with @Cornell to downgrade soils that were long considered prime. This wasn’t an accident. It was engineered to fast-track solar projects on our best farmland.

For our farmers and ranchers, land is far more than acreage on a map. It is the ground that holds a family’s history. It is a generational heritage and legacy.

Our great ranchers and farmers feed this nation — we cannot allow prime soils to be paved over for unreliable energy that displaces our producers. Farm security is national security. @USDA stands with American agriculture, not green new deal mandates that sacrifice our farmland.

Thanks @johnrich for bringing this to our attention! We are on it.

[F.A. United States Attorney Bill Essayli @USAttyEssayli]

MacArthur Park Update:

Christopher Barret Johnson, a 42-year-old Culver City resident who works for the nonprofit People Assisting the Homeless (PATH), which distributes syringes to drug users at L.A.’s MacArthur Park and elsewhere, was arrested today on a federal criminal complaint charging him with possession with intent to distribute fentanyl.

On May 5, law enforcement pulled Johnson over near MacArthur Park after he abruptly made a U-turn in front of them in his BMW. LAPD officers saw methamphetamine in a plastic baggie in plain view in Johnson’s car. Additional searches of Johnson’s person and his BMW resulted in the seizure of at least 142 grams of fentanyl and nearly 46 grams of methamphetamine.

If convicted, Johnson faces a mandatory minimum sentence of five years in federal prison and a maximum of 40 years.

His initial appearance is expected tomorrow afternoon at the Roybal Federal Building in DTLA.

Residents and businesses in MacArthur Park and elsewhere have long complained about the wisdom of distributing syringes to homeless drug addicts where law-abiding citizens live and work.

They call these policies “harm reduction.” I consider them “harm enabling.” Giving drug-addicted users needles to shoot up meth and fentanyl is never a good idea.

[mart michmd @martmd]

@war24182236 @SharylAttkisson This is heartbreaking and infuriating. The funds allocated disappear and never make it to those Americans that deserve solutions, not to be enabled. @CAgovernor @POTUS @HHSGov