Does he have the power to release himself from the hospital against doctor’s wishes?
Because I can imagine Trump telling everyone that he’s going to go home tomorrow. I can’t imagine that this is in line with his doctor’s recommendations.
Conley implied the news conferences were as upbeat as they are as so not to disturb the patient (who is undoubtedly watching.) So we may be able to add Trump’s truth-allergy to the list of comorbidities and/or pre-existing conditions.
Well, then there are two options, either he is getting terrible medical advice from physicians throwing the kitchen sink at the problem regardless of whether that sink is actually going to hurt him, or (more likely) he is getting sound medical advice for a patient with more severe disease than they are letting on. The latter option being more consistent with both the recommendations on the drug as well as the statements to the press about the severity of his disease by Mark Meadows.
Neither of us has any facts with which to judge his medical advice. The single fact that they are using the few medicines which may help - earlier than you might wish - does not tell you as much as you think it does.
I think he was banking on being asymptomatic the whole way through.
Lost that bet.
But it does though. It tells me the two options above. Either he is mild and getting a drug that is not intended, recommended or beneficial (and probably harmful) for a patient like himself, or he is not mild and is getting a drug that is intended, recommended and beneficial for a patient like himself.
Going back to the White House doesn’t mean he wouldn’t continue to be treated and isolated. I would assume now he is shedding the virus all over the place and will do so for some time. How long will he remain contagious? A week to ten days?
If Trump does come out of this okey-dokey, I hope Biden isn’t afraid to remind everyone that he was able to benefit from healthcare that most taxpayers aren’t able to access. There have been so many stories of people being turned away from hospitals despite being in poor condition and later dying at home because they don’t have good health coverage. Seems to me that most people have heard of these stories, they personally know someone it happened to, or it has happened to them. So if Trump is tempted to gloat, Biden should be able to knock him back down to reality if he plays this intelligently.
That’s actually a great point.
If he goes back to the WH, will he be in full quarantine mode to protect the WH staff (including general staff, like the butler and kitchen staff). Or will the staff have to look over their shoulders every five minutes to make sure Typhoid Trumpy isn’t spreading contagion in their midst?
It would be better for everyone to keep him at Walter Reed.
Betting Melania doesn’t want him back for co-isolation. He brought a disease home to her. Separated her from her child. Got other people and their families infected. She may be a shallow rich b#*!h but she still has reason enough to be totally pissed off at him and the situation he put her in.
Very difficult to keep a patient in a hospital if they can get up and walk out.
She’s been swallowing his crap for a lot of years. This is just item# 56,345 on the list.
Oh, she can fuck off. She was at his side at many of these events.
As dexamethasone is a steroid, yes, I’d expect it to suppress the immune system so you give it only if the inflammation you need to treat is more of the threat than the immune suppression. But with Trump, who knows? Major national leaders and the wealthy (or perceived wealthy) have been over-medicated in the past, occasionally fatally.
With this administration who the hell knows for sure?
Less than 24 hours in my experience as a patient. Sometimes less than 12. Granted I haven’t taken dex, but I’ve been subjected to a couple others. Dex is also an emergency treatment for life-threatening high-altitude situations, like HACE or HAPE or maybe both. Would have to work pretty quick for that, wouldn’t it?
Yeah, my husband got that in his last days - he was still carrying on a coherent conversation a half an hour before he died.
“Able to sit upright and use a pen” while on dex doesn’t give you any guidance as to how sick a person really is.
There are two ways to leave a hospital. I think most people are assuming one over the other, but again, given this administration who the hell knows for sure?
Here in the US, DO’s are doctors with the same requirements and hands-on training as MD’s. In the US it’s not misleading terminology. Most people are NOT familiar with the history, which, by the way, includes the steady movement towards science and evidence based medicine since the first half of the 20th Century. See this article about osteopathic medicine in the US.
In the US, the difference makes little to no difference so what does it matter? In other places yes, “osteopaths” are a lot different than allopaths.
… and this is a problem… why?
We need practical doctors, and how much research does the average physician do anyway? Certainly for primary care physicians and family doctors there is little to no research of their own.
And allopaths started out with blood-letting, leeches, and “humoral theory” that hadn’t been updated since the days of the Ceasers. Why do you ignore that?
Presumably, yes, Trump would have the same rights to refuse medical treatment as any other adult. Assuming he can ambulate, he could leave AMA.
Excerpt from amboss.com (“a medical student guide”).
Glucocorticoids are a group of drugs with various anti-inflammatory and immunosuppressant as well as metabolic and endocrine effects. These drugs are structurally and pharmacologically similar to the endogenous hormone cortisol.
Glucocorticoids have immediate effects that do not depend on DNA interaction (e.g., vasodilation).
However, they exert their main anti-inflammatory and immunosuppressive actions by binding to glucocorticoid receptors, which, in turn, causes complex changes in gene transcription. These genomic effects only begin to manifest after several hours.
Similarly, glucocorticoids bind to mineralocorticoid receptors, but for most glucocorticoid drugs, high doses are required for a significant mineralocorticoid effect. Systemic glucocorticoids are used for hormone replacement therapy (e.g., in Addison disease), for acute or chronic inflammatory diseases (e.g., rheumatoid arthritis), and for immunosuppression (e.g., after organ transplants). Local glucocorticoids are used to treat conditions like dermatoses, asthma, and anterior uveitis.
Side effects include metabolic and endocrine disturbances, weight gain, skin reactions, hypertension, and psychiatric disorders. Contraindications for systemic glucocorticoids include systemic fungal infections and, in the case of dexamethasone, cerebral malaria. Status asthmaticus is a contraindication for inhalative glucocorticoids. Topical and ophthalmic glucocorticoids are usually contraindicated if there are pre-existing local infections.
The point of the article though is a very good: VIP care is not always the best care. It can be more aggressive when watchful waiting is actually better for the patient. “Experimental” treatment is treatment that has not yet been proven to cause more good than harm. As stated in that article:
As to dexamethasone use, here is what the article provided by @Dr_Paprika concluded:
Bolding mine.
Also this:
So IF Trump was not receiving respiratory support at the point of starting the medicine, then using the medicine might cause more harm than good … but for a VIP they might do it anyway, preferring to err on the side of doing than not doing something that might have helped if the outcome is bad.
Is it possible they are able to set up a part of the White House as a sort of field hospital? I know it already has some medical facilities but might Trump be ordering them to put in an ICU capability and other things so he can return to the White House tomorrow and appear to be in more control? It would be a stupid thing to do I’d guess, but I wonder…
There’s a video on dexamethasone on FiveThirtyEight. A few excerpts:
In very sick patients whose immune systems are overreacting, researchers suspect that dexamehtasone lowers the inflammatory response which otherwise could be life-threatening.
…
It’s really only meant for the most serious cases. After all, dexamethasone suppresses the immune system, and you need your immune system to fight off the disease.
…
Also, doctors still aren’t sure which of dexamethasone’s many functions is most helpful for COVID patients
Reckless endangerment. They knew his policies all right. But actually to expose them to the virus, on purpose and secretly, I’d be phoning my lawyer.