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My aunt is in the hospital with covid as of last night. She's 83.

When she went in, she had mild symptoms and low O2 levels, apparently from pneumonia. They immediately admitted her and put her in ICU and put her on O2.

This morning, her O2 levels are steady at 90% on a mask... and they want to intubate her. She is, rightfully, I feel, fighting them on it. Their response is to contact family in an attempt to override her on the decision with the argument of "she could go into cardiac arrest", despite the fact that she is breathing just fine. It's rather infuriating and seems to me that the hospitals are just padding their numbers & billing.

Can one of y'all that are actually working a COVID floor explain why you would intubate someone whose O2 is at 90% and rising?


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Got my own answers.... 90% is LOW, especially for someone on a mask.

These are details that weren't relayed to us.


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Complicated but I will try my best to explain some things.
I am doing this quickly and trying to keep it short so it may not be all encompassing.

Reasons to intubate someone:
They stop breathing (obviously)
They are optimized on noninvasive oxygen and sats are not adequate
They are optimized on oxygen with good sats but struggling and look like they are going to tire out so the decision is made to intubate under a controlled situation rather than waiting for them to stop breathing and have to do it emergently.

As for your aunt, unless she looks like she is struggling to breathe then I would discourage intubation. What we have learned since the start of this pandemic is that with covid pneumonia you can tolerate lower oxygen saturations. Generally we like to keep the oxygen saturation above 93% but with covid patients I am fine with them as low as 88%. This is a struggle because I turn down the patients oxygen because it gets them out of the hospital faster but the respiratory therapist comes by and turns it up. or the nurse moves the patient and the sats drop so they rightfully turn it up but then forget to wean it back down.

The other thing we have learned is that once intubated patients do worse. So we try to wait as long as possible before putting our covid patients on the vent.

So I would say that your aunt is more right than the doctors from the information that you provided.

I don't think the doctors are trying to pad their numbers and billing though. The difference in billing is minuscule is anything at all. I would be more concerned with the quality of doctor that you are dealing with. Sometimes it is just that they have trouble changing from the mantra they have used for decades, other times they just aren't very good. There are good and bad doctors at every hospital including world class institutions like the Cleveland Clinic. More so at hospitals that are "Cleveland Clinic" hospitals but not the main campus. The smaller satellite hospitals that are part of the Cleveland Clinic system but are not actually the Cleveland Clinic. If that makes sense.

Take all this with a grain of salt as I don't know specifics about your aunt's case of anything about her doctors or the hospital she is in. So this information is more guideline than rule.

Hope that helps. Let me know if you need anything clarified. And feel free to PM me if you want.


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90% is low, especially on a mask. But if she is comfortable I wouldn't intubate her. You need to look at the patient and not just the numbers, even though numbers are important.


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Jester #1819347 11/29/20 11:13 AM
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Thanks, Jester!

This is *exactly* the sorts of clarification we don't get, especially if we're not the one talking to the doctors. It's like playing the kid's game 'Telephone' and what gets passed to us is only as good as the understanding of the person relaying it.

My Dad just got his results (he had been over my aunt's house last week); he is also positive, so he & my step mom are doing the self-quarantine thing for a couple weeks. His symptoms are staying really mild, so far, thankfully.


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Sorry to hear about your Aunt. IMO 90 is not that low as long as she is not having trouble breathing. They freaked out at the Cleveland Clinic when I had my first surgery. I run between 90 and 95 almost every time I check mine, and I have never been over 95. After 7 surgery's they now know mine runs low and they don't worry about it.


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Say that reminds me,

Yesterday I was going to make the point, ...

Jax is 1-9, have 4 dbs out for the game, so when the Browns play em,...

Any Wr who drops a ball vs the jaguars, needs CUT, WAIVED, NOT BROUGHT BACK FOR NEXT YEAR. (Cept maybe, .. Higgins has earned some overlook on this but.

What reminded me, is. about 3 minutes ago, we saw Taiwan Taylor drop a pass, a late, hard to get knee high pass at the sideline but,

C'mon, is Taiwan Taylor the best the Browns can do, offer as a roster spot?
Long term?


Can Deshaun Watson play better for the Browns, than Baker Mayfield would have? ... Now the Games count.
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Originally Posted By: PrplPplEater
Got my own answers.... 90% is LOW, especially for someone on a mask.

These are details that weren't relayed to us.


Never had covid, but I've been at that O2 level and as low as 88 a couple times. They did talk about intubating me then and I thought they were nuts. Both times I improved over night on steroids and was discharged the next day. My COPD causes me to live my life at 92%-94%.

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jc

Quote:
In Japan, more people died from suicide last month than from Covid in all of 2020. And women have been impacted most
By Selina [censored], Rebecca Wright and Yoko Wakatsuki, CNN

Updated 6:46 AM ET, Sun November 29, 2020

Tokyo (CNN)Eriko Kobayashi has tried to kill herself four times.

The first time, she was just 22 years old with a full-time job in publishing that didn't pay enough to cover her rent and grocery bills in Tokyo. "I was really poor," said Kobayashi, who spent three days unconscious in hospital after the incident.
Now 43, Kobayashi has written books on her mental health struggles and has a steady job at an NGO. But the coronavirus is bringing back the stress she used to feel.
"My salary was cut, and I cannot see the light at the end of the tunnel," she said. "I constantly feel a sense of crisis that I might fall back into poverty."
Experts have warned that the pandemic could lead to a mental health crisis. Mass unemployment, social isolation, and anxiety are taking their toll on people globally.
In Japan, government statistics show suicide claimed more lives in October than Covid-19 has over the entire year to date. The monthly number of Japanese suicides rose to 2,153 in October, according to Japan's National Police Agency. As of Friday, Japan's total Covid-19 toll was 2,087, the health ministry said.

Japan is one of the few major economies to disclose timely suicide data -- the most recent national data for the US, for example, is from 2018. The Japanese data could give other countries insights into the impact of pandemic measures on mental health, and which groups are the most vulnerable.

"We didn't even have a lockdown, and the impact of Covid is very minimal compared to other countries ... but still we see this big increase in the number of suicides," said Michiko Ueda, an associate professor at Waseda University in Tokyo, and an expert on suicides.

"That suggests other countries might see a similar or even bigger increase in the number of suicides in the future."

Covid's toll on women
Japan has long struggled with one of the highest suicide rates in the world, according to the World Health Organization. In 2016, Japan had a suicide mortality rate of 18.5 per 100,000 people, second only to South Korea in the Western Pacific region and almost triple the annual global average of 10.6 per 100,000 people.


While the reasons for Japan's high suicide rate are complex, long working hours, school pressure, social isolation and a cultural stigma around mental health issues have all been cited as contributing factors.
But for the 10 years leading up to 2019, the number of suicides had been decreasing in Japan, falling to about 20,000 last year, according to the health ministry -- the lowest number since the country's health authorities started keeping records in 1978.

The pandemic appears to have reversed that trend, and the rise in suicides has disproportionately affected women. Although they represent a smaller proportion of total suicides than men, the number of women taking their own lives is increasing. In October, suicides among women in Japan increased almost 83% compared to the same month the previous year. For comparison, male suicides rose almost 22% over the same time period.
There are several potential reasons for this. Women make up a larger percentage of part-time workers in the hotel, food service and retail industries -- where layoffs have been deep. Kobayashi said many of her friends have been laid off. "Japan has been ignoring women," she said. "This is a society where the weakest people are cut off first when something bad happens."

In a global study of more than 10,000 people, conducted by non-profit international aid organization CARE, 27% of women reported increased challenges with mental health during the pandemic, compared to 10% of men.

Compounding those worries about income, women have been dealing with skyrocketing unpaid care burdens, according to the study. For those who keep their jobs, when children are sent home from school or childcare centers, it often falls to mothers to take on those responsibilities, as well as their normal work duties.

Increased anxiety about the health and well-being of children has also put an extra burden on mothers during the pandemic.
Akari, a 35-year-old who did not want to use her real name, said she sought professional help this year when her premature son was hospitalized for six weeks. "I was pretty much worried 24 hours," Akari said. "I didn't have any mental illness history before, but I could see myself really, really anxious all the time."
Her feelings got worse as the pandemic intensified, and she worried her son would get Covid-19.
"I felt there was no hope, I felt like I always thought about the worst-case scenario," she said.

"A Place for You"
In March, Koki Ozora, a 21-year-old university student, started a 24-hour mental health hotline called Anata no Ibasho (A Place for You). He said the hotline, a nonprofit funded by private donations, receives an average of over 200 calls a day, and that the vast majority of callers are women.
"They lost their jobs, and they need to raise their kids, but they didn't have any money," Ozora said. "So, they attempted suicide."
Most of the calls come through the night -- from 10 p.m. to 4 a.m. The nonprofit's 600 volunteers live around the world in different timezones and are awake to answer them. But there aren't enough volunteers to keep up with the volume of messages, Ozora said.

They prioritize the texts that are most urgent -- looking for keywords such as suicide or sexual abuse. He said they respond to 60% of texts within five minutes, and volunteers spend an average of 40 minutes with each person.

Anonymously, over online messaging, people share their deepest struggles. Unlike most mental health hotlines in Japan, which take requests over the phone, Ozora says many people -- especially the younger generation -- are more comfortable asking for help via text.

n April, he said the most common messages were from mothers who were feeling stressed about raising their kids, with some confessing to thoughts of killing their own children. These days, he says messages from women about job losses and financial difficulties are common -- as well as domestic violence.
"I've been accepting messages, like 'I'm being raped by my father' or 'My husband tried to kill me,'" Ozora said. "Women send these kinds of texts almost every day. And it's increasing." He added that the spike in messages is because of the pandemic. Before, there were more places to "escape," like schools, offices or friend's homes.
Pressure on children
Japan is the only G-7 country where suicide is the leading manner of death for young people aged 15 to 39. And suicides among those under 20 had been increasing even before the pandemic, according to health ministry.
As pandemic restrictions take children out of school and social situations, they're dealing with abuse, stressful home lives, and pressures from falling behind on homework, Ozora said. Some children as young as five years old had messaged the hotline, he added.
School closures during the pandemic in the spring have contributed to homework piling up; kids also have less freedom to see friends, which is also contributing to stress, according to Naho Morisaki, of the National Center for Child Health and Development. The center recently conducted an internet survey of more than 8,700 parents and children and found that 75% of Japanese schoolchildren showed signs of stress due to the pandemic.
Morisaki says he thinks there's a big correlation between the anxiety of children and their parents. "The children who are self-injuring themselves have the stress, and then they can't speak out to their family because probably they see that their moms or dads are not able to listen to them."

Stigma of solving the problem
In Japan, there is still a stigma against admitting loneliness and struggle. Ozora said it's common for women and parents to start the conversation with his service with the phrase: "I know it's bad to ask for help, but can I talk?"
Ueda says the "shame" of talking about depression often holds people back.
"It's not something that you talk about in public, you don't talk about it with friends or anything," she said. "(It) could lead to a delay in seeking help, so that's one potential cultural factor that we have in here."

Akari, the mother of the premature baby, agrees. She had previously lived in the US, where she says it seems easier to seek help. "When I lived in America, I knew people who went through therapy, and it's a more common thing to do, but in Japan it's very difficult," she said.
Following the financial crisis in the 1990s, Japan's suicide rate surged to a record high in 2003, when roughly 34,000 people took their own lives. Experts say the shame and anxiety from layoffs, of mostly men at the time, contributed to depression and increased suicide rates. In the early 2000s, the Japanese government accelerated investment and efforts around suicide prevention and survivor support, including passing the Basic Act for Suicide Prevention in 2006 to provide support to those affected by the issue.
But both Ozora and Kobayashi say it has not been nearly enough: reducing the suicide rate requires Japanese society to change.
"It's shameful for others to know your weakness, so you hide everything, hold it in yourself, and endure," Kobayashi said. "We need to create the culture where it's OK to show your weakness and misery."

Celebrity suicides
A succession of Japanese celebrities have taken their lives in recent months. While the Japanese media rarely details the specifics of such deaths -- deliberately not dwelling on method or motive -- the mere reporting on these cases often causes an increase in suicide in the general public, according to experts such as Ueda.
Hana Kimura, a 22-year-old professional wrestler and star of the reality show "Terrace House," died by suicide over the summer, after social media users bombarded her with hateful messages. Hana's mother, Kyoko Kimura, says she was conscious that media reports on her daughter's death may have affected others who were feeling suicidal.

"When Hana died, I asked the police repeatedly not to disclose any concrete situation of her death, but still, I see the reporting of information only the police knew," Kimura said. "It's a chain reaction of grief."

Kimura said the pandemic led her daughter to spend more time reading toxic social media messages, as she was unable to wrestle because of coronavirus restrictions. Kimura is now setting up an NGO called "Remember Hana" to raise awareness about cyberbullying.

"She found her reason to live by fighting as a professional wrestler. It was a big part of her. She was in a really tough situation as she could not wrestle," Kimura said. "The coronavirus pandemic made society more suffocating."

The third wave
In recent weeks, Japan has reported record-high daily Covid-19 cases, as doctors warn of a third wave that could intensify in the winter months. Experts worry that the high suicide rate will get worse as the economic fallout continues.
"We haven't even experienced the full economic consequences of the pandemic," Ueda said. "The pandemic itself can get worse, then maybe there's a semi-lockdown again; if that happens, then the impact can be huge."
Compared with some other nations, Japan's coronavirus restrictions have been relatively relaxed. The country declared a state of emergency but has never imposed a strict lockdown, for example, and its quarantine restrictions for international arrivals have not been as unbending as those in China.

But as cases rise, some worry harsher restrictions will be needed -- and are concerned about how that could affect mental health.
"We didn't even have a lockdown, and the impact of Covid is very minimal compared to other countries ... but still we see this big increase in the number of suicides," Ueda said. "That suggests other countries might see a similar or even bigger increase in the number of suicides in the future."
Despite having to deal with a salary cut and constant financial insecurity, Kobayashi says she is now much better at managing her anxiety. She hopes that by speaking publicly about her fears, more people will do the same and realize they are not alone, before it's too late.
"I come out to the public and say that I have been mentally ill and suffered from depression in the hope that others might be encouraged to speak out," Kobayashi said. "I am 43 now and life starts to get more fun in the middle of my life. So, I feel it's good that I am still alive."


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Counting my blessings and hoping my test comes back positive.

Brother and sister-in-law tested positive and that was my contact. They were able to get a rapid test, I could not. Got tested yesterday and will wait up to five days.

My symptoms started the day after Thanksgiving. By that evening I felt like I got hit by a TRUCK. As I kept telling my wife - it was like my bones actually hurt. Ringing in my ears, massive headaches. Spent three days laying around and taking multiple naps. Never had anything other than a mild fever. I've lost ALL taste and smell. Spent two days having a hard time breathing - that was pretty scary. Did breathing exercises all day yesterday. It's day five and I can actually move around and have a little energy. "Viral load" must not have been very high. Wouldn't wish this on anyone and my case was pretty mild in comparison.


HERE WE GO BROWNIES! HERE WE GO!!
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Not to take away from the current discussion, but those on the front lines (healthcare workers as well as first responders) can take advantage of free coffee from Starbucks for the entire month of December. I believe it's just for a tall hot or iced coffee, but there's no limit how many times you can come in.

Regardless of how you feel about Starbucks or their coffee, this is nice.


There is no level of sucking we haven't seen; in fact, I'm pretty sure we hold the patents on a few levels of sucking NOBODY had seen until the past few years.

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Happy Birthday Fate. Sorry to hear about your illness, hope it's negative and/or you recover quickly and fully.


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Thanks bro!


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Originally Posted By: FATE
Counting my blessings and hoping my test comes back positive.

Brother and sister-in-law tested positive and that was my contact. They were able to get a rapid test, I could not. Got tested yesterday and will wait up to five days.

My symptoms started the day after Thanksgiving. By that evening I felt like I got hit by a TRUCK. As I kept telling my wife - it was like my bones actually hurt. Ringing in my ears, massive headaches. Spent three days laying around and taking multiple naps. Never had anything other than a mild fever. I've lost ALL taste and smell. Spent two days having a hard time breathing - that was pretty scary. Did breathing exercises all day yesterday. It's day five and I can actually move around and have a little energy. "Viral load" must not have been very high. Wouldn't wish this on anyone and my case was pretty mild in comparison.



Happy birthday and hope you feel better soon. thumbsup

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Happy Birthday. Hope you get over it fast.


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Wow. Happy frickin' birthday, huh? Sounds like you're on the mend and I hope you've got a lifetime of antibodies for your effort!


And into the forest I go, to lose my mind and find my soul.
- John Muir

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Happy bday FATE .. hope you stay well


"First down inside the 10. A score here will put us in the Super Bowl. Cooper is far to the left as Njoku settles into the slot. Moore is flanked out wide to the right. Chubb and Ford are split in the backfield as Watson takes the snap ... Here we go."
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Haha. Yes, naturally it would have to be on my birthday. Thanks for all the bday wishes, you guys are awesome!


HERE WE GO BROWNIES! HERE WE GO!!
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Happy birthday, FATE!

Even if you have it, you're not knocked down for the count... that's a pretty good present smile

Get well!


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... there goes Joe Thomas, the best there ever was in this game.

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Man Fate, I hope you manage to recover from this quickly and completely.


Micah 6:8; He has shown you, O mortal, what is good. And what does the Lord require of you? To act justly and to love mercy, and to walk humbly with your God.

John 14:19 Jesus said: Because I live, you also will live.
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More Americans Died from Covid-19 Yesterday than were Killed on 9-11

https://www.msn.com/en-au/news/world/mor...911/ar-BB1bBotR


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One every 30 seconds.


Intoducing for The Cleveland Browns, Quarterback Deshawn "The Predator" Watson. He will also be the one to choose your next head coach.

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More covid deaths than deaths in the Vietnam and korean wars combined. cry


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I guess it must be a little worse than the cold or flu... rolleyes


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My friend just died this afternoon.

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Sorry for your loss, Arch. frown


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Sorry arch.

I hope his family, yourself, and all that are impacted by this are able to find peace.

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Oh man. Sorry to hear that.


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- John Muir

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A family friend died from Covid complications this morning. Not elderly and in good shape before he contracted the virus. Young children and a wife left behind. The hospital I’m working with right now is starting to get overwhelmed.

I’m becoming less and less tolerant of people downplaying this virus or dismissing it altogether. Reasonable people do not behave this way in the midst of something like this pandemic.

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Very sorry to hear that, Arch. May he R.I.P.


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Sorry, Jules. frown . Hope everyone involved is able to find peace and comfort.

Stay safe. Both of my parents work at hospitals in the Cleveland area and I worry about them on a daily basis.

Stuff like this keeps my head on a swivel. Only leaving the house to pick up mail now with trying to keep ourselves safe.

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So sorry to hear that from you guys ... hoping for peace and health


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Sorry for your loss bro. We will keep his family and friends in our prayers


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I'm sorry for your loss jules.


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Wife and 2 kids.....high school and jr. high. Dad/husband/ friend is dead. Today.

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So sorry for what everyone that this crap effects is going through. So much tragic loss. The vaccines can’t come soon enough.
The numbers are getting worse and worse. I’m now being tested twice a week for work.
Stay safe everyone. Hunker down. Keep your circles small. Be diligent about mask wearing and hand hygiene.
There’s a light at the end of this tunnel. Keep focused.


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Sorry to hear that arch. Horrible. So sad for somebody in their prime to be taken by this when it was mostly preventable.


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Sorry to hear this Jules. I'm with you on the losing patience, lost mine a while back. I currently have another houseful of my kids and grandkids on quarantine for close contact. My Grandsons played basketball after school with a kid who was infected. The group of about a dozen who were there have had 7 positive tests. Luckily on day 8 these two have no symptoms.

I will just be glad when the vaccines roll out and we get a handle on this monster.


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damn, I'm so sorry arch frown


Browns is the Browns

... there goes Joe Thomas, the best there ever was in this game.

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