Dan

Dan

Audioholic Chief
Thanks Dan, you are close to the very front lines on this. Please keep us updated as time permits. Please feel free to PM me if you think that is warranted and don't want to information for general consumption.
Thanks TLS. I am hoping they will let me work at home at least some since I am nearly sixty and diabetic so I won't be quite as close. Our vice chair of operations is also in charge of safety and is taking this very seriously fortunately. We are prepared to convert the post anesthesia area to an extra ICU if needed using the OR ventilators. Certain ED rooms can be used as ICU as well in a pinch. But if it hits the fan we are in as much trouble as anywhere.
 
NINaudio

NINaudio

Audioholic Samurai
For those who like pictures here is a typical CT of these patients. This seems to be the characteristic pattern but it is similar to other viral pneumonias and entities like eosinophilic pneumonia.

View attachment 34666
Any chance you could post a normal lung CT for comparison?
 
Dan

Dan

Audioholic Chief
The ground glass (whiter) areas on the periphery of the lung are typical but also seen in other viral disease, drug and allergic reactions and collagen vascular diseases (like Wegener;s and Lupus) so you can't make the diagnosis from CT or x ray. The value of CT is for when things go really south and there is bacterial superinfection (these are the respirator patients trying to die) to see bacterial pneumonia and empyema.
 
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Swerd

Swerd

Audioholic Warlord
Thanks Dan!
For those who want to see these two images together, here is the first one that illustrates typical viral pneumonia, what Dan calls "the ground glass (whiter) areas on the periphery of the lung".
1584291976762.png


And here is the normal lung without those foggy looking "ground glass" areas.
1584292137747.png
 
Ponzio

Ponzio

Audioholic Samurai
What a mess! DHS is creating COVID19 incubation areas in US airports in customs lines:

Great! ... not. I guess that's where my nephew is right now, coming back from Czechoslovakia, from a school trip (Penn State).

I still can't believe they let him go two weeks ago, when I warned them it was a bad idea.
 
Kvn_Walker

Kvn_Walker

Audioholic Field Marshall
The ground glass (whiter) areas on the periphery of the lung are typical but also seen in other viral disease, drug and allergic reactions and collagen vascular diseases (like Wegener;s and Lupus) so you can't make the diagnosis from CT or x ray. The value of CT is for when things go really south and there is bacterial superinfection (these are the respirator patients trying to die) to see bacterial pneumonia and empyema.
My best half is in Xray and has friends in CT (obviously) and she said the CT of normal pneumonia looks "cloudy" while that of a CV patient looks like shards of glass.

The people who got tested at her hospital last week... their tests got flubbed first time around (mainly due to inexperience with this). They are seeing a 4 day turnaround right now, so there won't be definite results until tomorrow and Wednesday respectively, but based on the scans they are both highly likely to test positive.
 
Dan

Dan

Audioholic Chief
My best half is in Xray and has friends in CT (obviously) and she said the CT of normal pneumonia looks "cloudy" while that of a CV patient looks like shards of glass.

The people who got tested at her hospital last week... their tests got flubbed first time around (mainly due to inexperience with this). They are seeing a 4 day turnaround right now, so there won't be definite results until tomorrow and Wednesday respectively, but based on the scans they are both highly likely to test positive.

I would say that bacterial pneumonia is usually much whiter but doesn't have to be. I think your wife's friends morphed ground glass (like in those chemistry flask stoppers) into shards of glass. Here is a typical bacterial pneumonia:

1584296555469.png


Often but not always they are in one place. The viral type is usually multifocal. I may have seen a new corona case on CT today at a hospital in Baltimore. The ED doc wasn't even suspecting corona but they are now. That puts the CT out of commission for hours for cleaning and it is perhaps the most critical diagnostic device in the hospital.
 
gene

gene

Audioholics Master Chief
Administrator
I, and I think all of us, really appreciate you detailing your experiences with this illness. A report of a case is really crucial. I tend to believe you are a pretty run of the mill case for this illness. I know the press were a bit of a "pest" but you provided a very useful public service. I feel, and severely hope you are now at the end of this and that your wife remains free of it.

You are now moving on to become one of those very precious 'rods in the nuclear reactor' I was talking about. Unfortunately these are only bought the hard way at present, instead of just a prick in the arm!

As I'm sure you realize the curse of this whole thing, is that though serious and critical cases are way in the minority. However, whatever the actual number they are numerous enough they are the face and fear of this pandemic. It is undeniable that there are enough of these cases to overwhelm costly, scarce and highly sophisticated ICU resources, in beds, personal and software. That is the essence and core of the problem.

Our governor in Minnesota is going to speak at 10:00 AM this morning. An inventory has been done of Minnesota medical facilities and it shows the issue I'm talking about.

We have a total of 450 ventilators in the Twin Cities metro it has been announced today. The population of Twin Cities Metro is 3.28 million. So that is a ventilator for every 0.014 percent of the population. So you see why we have to really slow this down. So you can see the rush to build ventilators. I hope the measures I spoke of last night will be successful. I really hope it is, but I think I can be forgiven for have considerable reservations about the practicality. At this time the metro only has 5.7% of its ICU beds open. So like other jurisdictions around the world somehow and someway more ICU beds have to be created, equipped and staffed pretty much immediately. How, I have no idea.

Now under serious consideration in the UK is self isolation of everyone over 70 for four months. Yes, four months. There is rational logic here as that age group are by far the most likely to need ICU care. As I have stated I am 73 years old with multiple risk factors for being in the severe and fatal column. My wife and I have been drawing back and just going out for groceries at non peak times. I have to go to the Mayo Clinic tomorrow. They have developed their own test. They have been screening patients and so far have come up with no positives, so I think I am reasonably safe to go.

Once we know there is community spread in the metro, I think my wife and I will begin self isolation.

Unfortunately our latest case in Minnesota is a teenager with a travel history. All non essential travel needs to be cut out now, and should have been done sooner in my view.

Anyhow enough of our problems, and again many thanks for putting a human face on this pandemic. Your recovery will boost the morale on all on this site.

While you have time on your hands please contribute often.

One thing we have in common are great AV rooms. I'm really blessed and fortunate as I have three great systems.

Lastly a site like this is likely to be a great way to avoid the worst of social isolation for those who choose, or have to have to self isolate. Your idea of a Steam Vent thread, will prove during this time to have been a stroke of brilliance, and an asset that could never have been imagined until now.
Thanks man. The biggest struggle remaining now is just getting over the chest congestion and dealing with the isolation. That's been pretty rough since my wife is having a hard time managing the house and cooking by herself. Hopefully I will be cleared soon.
 
GO-NAD!

GO-NAD!

Audioholic Spartan
Well, it had to happen at some point. Nova Scotia is the last province to report a COVID-19 infection in the country. Out of about 450 tests, so far, we now have 3 positive results. All of them had traveled outside the country - USA, Australia and Europe - so none were related.
 
Darenwh

Darenwh

Audioholic
I and my wife are well provisioned for riding this out for a while. We only have a few weeks of TP but it’s turning into spring here so leaves should soon be in abundance :rolleyes:. Either that or there is always mail order cleaning supplies. Everybody stay safe. I’ll be working from home for the foreseeable future and passing time with the video collection.
 
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