Persuading your doctor who wants to follow guidelines when you have distinct COVID-19 Symptoms and WANT TO *STAY ALIVE*
Waiting one or two days too long might death or something life-changing such as permanent lung damage (one possible “sequelae” or lingering problem). No one knows yet what the sequelae are of COVID-19 are when one recovers from a bad case of it.
Talking with your doctor who wants to follow guidelines when you have distinct COVID-19 Symptoms and WANT TO *STAY ALIVE*
Your doctor has no real skin the game here but you do—possibly your very life. If your doctor makes the wrong decision, there are no repurcussions for him/her, but you are hit with all consequences. NEVER forget that when consulting a doctor for any medical issue—one of my doctors could not even be bothered to call me back, and I suffered two years of recovery from nerve damage and still have lingering issues.
That said, I believe that the great majority of doctors are hard-working people who care and are doing their very best for you—no question there. And many are heroes by putting themselves at risk in this pandemic—nothing but praise for those on the front lines. But that is NOT the same as being right more than most of the time, or having enough time for every patient. And having to deal with the pressures of dogmatic medical and licensing boards and regulations surely influence medical judgments—doctors are human beings just like you and me and very few can have truly independent judgment (or the time to have one).
So you go to your doctor because you don’t want to die suffocating and drowning in your own lung goop—a godawful horrible death.
Your doctor is supposed to follow guidelines, so s/he may push back on the Trump Pills, indeed is required have a confirmed positive test as per guidelines. But s/he can prescribe the drugs off-label legally, without the test.
This conversation below assumes that you have confirmed COVID-19 symptoms. Trying to get the drug with no symptoms is just not appropriate and would lead to shortages, so don’t do that!
If your doctor suspects that you know less then she/he does you are not likely to succeed, so you MUST be informed enough about this narrow medical situation to be persuasive.
Your doctor CAN give the drugs to you off-label without the test that the guidelines for COVID-19 require. Waiting for the test is the bureaucrat’s choice. Fuck the government and fuck any doctor who wants to play God with my life or yours when it’s the choice of $20 of drugs versus the risk of a horrible death waiting for a 5-day test.
Doctor: yes, you have symptoms of COVID-19.
Patient: so will you be prescribing the hydroxyquinoline and erythromycin (Zithromax) and zinc triple-drug combo that is keeping people from dying?
Doctor: no, that requires you to take the test first and we are not sure it works.
Patient: doctor, look me in the eyes and tell me that if you had these symptoms, or your spouse or family member did, you would wait for the test?
Doctor: [doctor either answers “yes” honestly, or “no” and is lying to your face, no honest doctor is going to say “no”]
Patient: how long does the test take?
Doctor: about 5 days.
Patient: but the disease progresses quickly.
Doctor: well, the guidelines say you have to take the test first.
Patient: so I have a potentially deadly disease that could kill me in 5 days and you can legally prescribe the drugs off-label without a test and I could take a $20 course of drugs that might save my life OR I could take a $1000 test, wait 5 days and maybe die?
Patient: Doctor, you are treating both my body and my mind. And I am going to go fucking insane worrying about this for the next 5 days. You can legally prescribe the drugs right here and now. Or you can demand a test that costs 50 times as much and puts me a huge risk of pain, suffering and death.
Doctor: [doctor can now agree, or demur].
Patient: Doctor, my preferred choice is that you prescribe the drugs for me because you can monitor my whole situation. You and I both know that the risk is low and that the prescribing is the right thing to do. You know that doctors themselves are using it, and that the disease progresses rapidly and could kill me in 5 days. You know that the cost is trivial versus a huge cost for the test.
So here’s the deal: you can prescribe the drugs here and now, or I am going to walk out of here and shop for a doctor that will, or on the black market if necessary. One way or another I am going to walk out of here and be on those drugs by the end of the day.
Doctor: [now looks like an asshole or writes the prescription. Be prepared to find another doctor and try again]
Anon MD writes:
I cant agree more on avoiding social media. Totally useless construct designed to amplify fear. Network news is right behind. Not really, news, just entertainment cloaked as news in order to hook you into staying long enough to watch the commercials and then come back tomorrow and do it again. All of the news channels are pretty much worthless on both the right and left side.
First of all know that I DID NOT HOARD CHLOROQUINE or Hydroxychloroquine for me or my family. I have plenty of patients on the latter, and they need that drug in order to keep their chronic autoimmune diseases at bay. Chloroquine is rarely used anymore because its so toxic and the malaria parasite has developed resistance in most of the world. HCQ is a much safer drug, though still with risks.
If I had COVID I would want to try HCQ myself. The problems are multiple, though. What’s the dose? No one knows. Will it PREVENT infections? No one knows. Will it cure infections? No one knows. Can you get it? Good luck. There has been such a run on the drug by hoarders that multiple states have stepped in to stop their pharmacists from filling Rxs unless they are legitimate Rxs for patients with Lupus, rheumatoid arthritis, etc. And if California doesn’t shut it down too, at the very least they will probably not fill Rxs for the docs themselves or their family members with the same last names, and certainly not in amounts like 500 tablets with unlimited refills for a year.
If you were a patient who walked into my office and wanted a Rx for the drug and you had no clinical findings, I wouldn’t give it to you. But I WOULD give it to someone who met the criteria. But if I wrote the Rx and you couldn’t get it, you’re SOL. I’m not gonna make a special case to an out of state pharmacy or a Canadian pharmacy, etc. You can stand in line with everybody else.
And if I knew that you were some douchebag who had totally ignored the anti-infection recommendations, I would send you to the hospital and let them deal with you but I wouldn’t have much sympathy for you. I have myself, a family and staff that I need to protect from getting infected so we can continue to care for as many people as possible. And the patient being a douchebag will not help their case, at least not in my office.
DIGLLOYD: I am in complete agreement on hoarding and I am not suggesting that doctors are or did hoard it. See COVID-19: Should Doctors and Their Families Get Priority Access to the “Trump Pills”.
As for treating careless patients who endanger themselves or others, I agree with the sentiment—help those first who helped themselves and idiots can get at the end of the line.
A good friend and colleague works in a regional hospital in respiratory ER care. The lack of PPE is putting them and patients at risk. While far from perfect we came up with two ideas that seem to help - using rolls of building Tyek to make gowns or gown covers (48” X 100’ stuff) and using furnace filter material to make mask pre-filters or as the actual mask filter element (dropped in between the layers of a washable cloth mask). The furnace filters can be found with HEPA standards - far out performing cloth masks and relatively cheap (and you are already breathing through them).
My brother is a doctor at ******** (oncology) - the stories are difficult to hear. As he says, it is the doctors and nurses that pay a steep price fighting a plague. I am convinced that a broad portion of the population does not understand the level of discipline necessary to bring Covid to ground. And this is just a baby pandemic. I work for a public institution and the ideas are clearly not on the traditional approved list.
It is not possible to beat on this too hard. You can do great service by doing what you are already doing - get people to not just take it seriously but to act seriously. The world has already changed and it will be a different place going forward. I saw the projections out of Harvard sometime back and the numbers were horrible then. One of the Profs in my Department has a number of students from China - we got quite an earful about what was coming back in January. Anyone in medicine or national security who says the risks were not known was not listening or worse. Months were wasted. It is going to get far worse and very soon.
In today’s medicine Docs do NOT drive the day in the running of a hospital or setting public health policy. Physicians and nurses as a group face high degrees of burn out (approaching 50% by some reports) and that was before Covid. Docs simply do not yet have what they need to bring the fight to this virus.
Here we are bringing nurses and docs out of retirement and we are getting ready to graduate medical classes early with expectation that our front line docs will either get sick or have uncontrolled exposures and will be quarantined.
The virus is relatively fragile - I do not know how much energy is necessary to de-stabilize it. Strong, sustained UV might do it. Nuking it would definitely do it.
Thank you for discussing this on your platform - we need every reliable voice. Your health profile (from what you have shared on-line) and mine are very similar - I know that if I get it I will have a tough time.
DIGLLOYD: it’s terrible that frontline doctors and nurses are getting such a lousy safety deal. I hope that 3M is ramping up their Minnesota factory to 24 X7 and figuring out how to build another one ASAP.
Reusing masks: I wonder why we cannot build a large lead-lined chamber with some deadly radioactive material inside it behind a safety door. Load chamber with palettes of gear. Open baffle for radioactive material... in a few seconds all organic molecules are destroyed. Close baffle, remove gear, job done. Heavily armed team surrounding the area to prevent anyone getting the radioactive material. Basically, heavy duty irradiation with gamma rays as was once proposed for food safety. Maybe high energy XRays would work also.