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drdagly's profile
Darren Markland
Darren Markland
Darren Markland
@drdagly

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Darren Markland

@drdagly

Intensive care doc, nephrologist, bamboo bike frame builder, active transportation advocate, barista bike rider and general humanist. I own my tweets.

Edmonton
Joined July 2007

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    1. Darren Markland‏ @drdagly 30 Sep 2021

      In the non ECMO pathway, we take it day by day. Our job is to protect the vulnerable patient from other things. Blood clots, bacterial infections, skin break down, kidney failure, malnutrition while we wait for the lungs to heal. It can take weeks.

      6 replies . 375 retweets 3,988 likes
      Show this thread
    2. Darren Markland‏ @drdagly 30 Sep 2021

      Ok, now take a deep breath, all the way. Trust me. Just do it. Now hold it. That’s your new starting point. I want you to take your next breath from there. And your next. Don’t cheat. Pretty anxiety provoking, right?

      37 replies . 476 retweets 4,477 likes
      Show this thread
    3. Darren Markland‏ @drdagly 30 Sep 2021

      To keep people with this lung disease (it’s call ARDS) from ripping their lungs apart we need to sedate them very heavily. Sometimes even paralyze them. It can make people incredibly weak, but there are no other options.

      10 replies . 388 retweets 3,917 likes
      Show this thread
    4. Darren Markland‏ @drdagly 30 Sep 2021

      No for weeks we wait. Waiting for the lungs to heal. To relax. There is no clear way to predict who will get better and when. It’s an unclear pathway dictated by genetics and immunity. It’s heralded by the ventilators silence as it can relax and not push the air so hard.

      3 replies . 325 retweets 3,819 likes
      Show this thread
    5. Darren Markland‏ @drdagly 30 Sep 2021

      At that point we can start to wake our patients up. There emergence is often dramatic, like coming up from deep water. We need to be gentle. Too much struggling and we can lose all of our gains.

      3 replies . 296 retweets 3,623 likes
      Show this thread
    6. Darren Markland‏ @drdagly 30 Sep 2021

      I’ve seen some get better quickly. They act like good old bacterial pneumonia. Others take longer. We talk to families about tracheostomies and long term ventilation. They make progress but they will have long term complications from their journey.

      5 replies . 325 retweets 3,632 likes
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    7. Darren Markland‏ @drdagly 30 Sep 2021

      There is however a subset. They seem to improve initially, but despite everything we do they deteriorate after a week on the ventilator. No matter what we do their lungs get stiffer and stiffer. Instead of healing, their lungs are replaced be scar tissue.

      19 replies . 402 retweets 3,822 likes
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    8. Darren Markland‏ @drdagly 30 Sep 2021

      We search for hidden infections, scan them for blood clots, look for strange drug reactions and autoimmune disease. Over the ensuing weeks, their hearts start to fail from the tremendous work of pushing blood through fibrous lungs.

      7 replies . 344 retweets 3,725 likes
      Show this thread
    9. Darren Markland‏ @drdagly 30 Sep 2021

      Deprived of blood the kidneys fail first. Dialysis will keep them going forward a while longer, but without lung transplantation the heart eventually stops. Often we sit down with families before these final things happen to let them know the path their loved ones are on.

      11 replies . 365 retweets 3,775 likes
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    10. Darren Markland‏ @drdagly 30 Sep 2021

      We seek out there values and goals. We let them know what we can accomplish and what we can’t. It’s often choosing between the lesser of two evils, and often I am conflicted about putting people in such difficult positions.

      4 replies . 276 retweets 3,615 likes
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      Darren Markland‏ @drdagly 30 Sep 2021

      The journey of dying in the ICU from #COVID19 takes on average about a 6 weeks. I have seen what that does to families. Despite our resources and technology we can do little but support our patients and their families through the process waiting for them to heal.

      9:35 am - 30 Sep 2021
      • 755 Retweets
      • 4,858 Likes
      • Lori cownden DCG Deb🐝 G #StandWithUkraine!🇺🇦 Jeanne Cerff soy boy kendall roy Angelica Marciano VOTE💙4rKidsFuture 🌊🌻 sherry kennedy hickman SalomeAlexx
      38 replies . 755 retweets 4,858 likes
        1. Darren Markland‏ @drdagly 30 Sep 2021

          And though most who read this thread know that vaccination can prevent almost all of this, it is why those of us in healthcare struggle knowing this is now preventable. It’s a thought that torments us through every day of those 6 weeks.

          419 replies . 1,332 retweets 12,418 likes
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        1. MSW abortion is health care‏ @MSW_researcher 30 Sep 2021
          Replying to @drdagly

          Thanks for this Darren. It is so important that you and the others are putting this out there. When pt/families don't believe what I tell them I am seeing, I am sending them to your timelines to read for themselves. It is critical and I think it helps the skeptics see.

          0 replies . 3 retweets 28 likes
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        1. Angelina Eberly‏ @motherofjacks 30 Sep 2021
          Replying to @drdagly

          Thank you. My MIL died from COVID 1/19/21. She had treatment up to the point of being put on a ventilator - which she refused. She died fairly peacefully within a few hours and was able to see and interact with her family up until then just as she wished.

          0 replies . 0 retweets 27 likes
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        2. Mario Arias Jr.‏ @MissedFlush 30 Sep 2021
          Replying to @drdagly

          Are you seeing that people with autoimmune diseases have worse outcomes? I've got granulomas in my lungs from neurosarcoidosis and I figure I'm 100% dead if I get covid.

          3 replies . 0 retweets 7 likes
        3. Lia_MedicalMama‏ @Lia_MedicalMama 30 Sep 2021
          Replying to @MissedFlush @drdagly

          You are in a scary place indeed. 💔 My medical little (9) has permanent scars in his lungs from repeated pneumonias for the first 7 years (he's a very complex lil Dude). He and I are both on Biologics as well but he THANKFULLY receives IVIG monthly so that he gets an immune boost

          0 replies . 0 retweets 6 likes
        4. End of conversation
        1. Elysa Darling‏ @ElysaDarling 30 Sep 2021
          Replying to @drdagly

          Thank you for your service, your compassion, and for sharing this trajectory with us. More Albertans need to know what's going on behind ICU walls. It's more than just beds...

          0 replies . 0 retweets 2 likes
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        1. Frances Duffy‏ @fduffy23 30 Sep 2021
          Replying to @drdagly

          I have been following you since this pandemic began. You are knowledgeable compassionate and an excellent communicator. I wish your entire post could be published in the Herald and Sun and any other Alberta paper! So many, like myself vaccinated or not need to read this!

          1 reply . 0 retweets 15 likes
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        1. Ms. Jiminy  🇺🇦 Slava Ukraini  🇺🇦 Russia Defeated‏ @JiminySpeaks 30 Sep 2021
          Replying to @drdagly

          Perhaps music therapy, through headphones, could help some people, at certain stages of Covid in ICU, who are declining, to start to recover instead. It helps stress levels, which if reduced, could boost the body's ability to heal the lungs.https://ebn.bmj.com/content/7/4/103 

          0 replies . 0 retweets 1 like
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        1. peaceandlove 🆘 🌊‏ @yoshiandpeanut 30 Sep 2021
          Replying to @drdagly

          I don’t think people realize covid is not a peaceful death, there’s suffering involved. The struggle of trying to live is hard, you can’t get on a bedside commode without feeling like you’re suffocating. And then if you take a turn for the worse- just breathing is all consuming.

          0 replies . 0 retweets 2 likes
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        1. Lena Lotte‏ @Lenalotte 30 Sep 2021
          Replying to @drdagly

          I am in awe of the work of yourself and all health professionals working to save Covid patients. When I had it in March 2020, I was lucky enough to keep myself out of the ICU, I came close. I know how scared a person gets, and how hard it is on their families. Thank you all.

          0 replies . 0 retweets 6 likes
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