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#went to a pediatrician for 5+ years for stomach issues and was on a medicine for 3+ of those years that sucked the calcium from my bones
feralnumberfive · 1 year
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Good morning to every organ in my body except my stomach. Get your shit together
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This is a story that came into my mind. It's 5 years after graduation. Hope you guys like it. I am not able to post it at one go there is a limit.
I will post it in parts.
Always
Part 1
Are you sure he is guilty? The chief asked
Yes,
Han Joon Hwi replied
This was a complicated case taking up months to wind up.
A big shot actors involvement in drug cartel.
After Submitting the reports and the evidence to his chief, Prosecutor Joon Hwi walked towards his cabin
He is sure that the arrest warrant will be easily issued based on all the evidence he has found.
His phone chimed with a message, it was Kang Sol
Where are you?
Are you free?
He smiled,
Yes,
Where are you? he typed back
Hankuk Hospital.
Why,
he asked worriedly.
Getting flashbacks of their uni days when Kang Sol was known to forget to take care of herself while studying.
I came to meet Mi-ja unnie And Seung-jae oppa
Can you come here she asked
Yes I will be there in 15 mins
He reached the hospital in 10 min
Where are you he typed
Come at the ob-gyn department
Sure
he said not minding as Seung hung had rejoined the pediatrician department after his permanent expulsion from law school
The ob-gyn department was filled with expectant mothers and some, anxious excited and frightened parents .
He imagined himself some years down the line sitting in the same place with Kang Sol..
One day he said to himself.
There he saw Kang Sol conversing with a pregnant lady sitting on the bench.
Looking beautiful like always ,he said and swooped in and stole a kiss .
Kang Sol eyes flashed through varied emotions surprised, excitement a bit frighted, anxious and then contentment.
Joon Hai was confused by her reaction.
He made a note to ask her about it.
5 hours before
It's was a day off . Kang Sol reminded herself again and again. He had decided to rest today
She had fainted at the study hall twice this week .
Joon hwi had forced her to take an off today, threating her with severe concequences if she didn’t take time off today.
She rolled her eyes at that, tempted to contradict him just to enjoy his so called consequences she smirked . At the thought itself
She looked at herself in the mirror,
its been 6 years since she graduated law school she never thought that among all of her bach mates she kang sol A will be the one continuing her studies to become a judge .
Only after finishing 2 years at the judicial training institute she would be considered as a judge in south korea right now she was in her last semester Her exams were over and she was awaiting her results
Now she was working on her paper which sumarissed to 20 percent of her final grade she had 2 month to submit it.
But she couldn’t slag of as this paper was a huge deciding factor in her results.
As she will be cross questioned in front of the panel of professors on this paper.
What to do she thought ,
Each of her friends were busy in their own lives.
Even if Joon hwi had denied first he joined the prosecutors office a year after their graduation.
Seo was at prosecutors office too but posted in different city.
Kang Sol B had found a knack for teaching.
So she was now working as an assistant professor. Ye-Suel and Bok vi were human rights lawyers and we're currently not in the country.
She checked the time,
her mother was at work and Kang byeul was at Cram school.
So she decided to vist the hospital and get some vitamins for her fainting .
And visit Seung jae Oppa as well .
Ater listing out her aliments to the doctor she was waiting for the doctor to prescribe her medicine, he gave her a pregnancy kit and asked her to take the test.
While taking the test numerous thoughts passed through Sols mind
.
it can't be true we always use protection
We are not ready
Are we ready?
3 mins passed
And the kit showed 2 lines
You should visit the ob-gyn department to for confirmation the doctor said,.
She was in trans, there was no way she would do this without Joon hwi at her side she didn’t tell him the main reason and just asked him to come to herr …
Her mind was completely blank
Waiting in the line, waiting for Joon hwi
And then he came into front of her and just like that various doubts filled hermind,
I love him,
What if I am really pregnant?
Will he love the baby ?
What if he dosen't want the baby ?
What if he leaves me just like my bio father did?
Will I be alone?
No even then I will have my baby with me I will survive. He resolved in her mind
Joon Hwi is not my like my father.
He loves me I can see it in his eyes, she thought locking their eyes together.
Did you meet noona and hyung , he asked
No not yet.
Hyung is busy.
His surgery unexpectedly extended.
Let's meet noona together , after her shift Sol said
You didn’t study did you, Hwi asked
Nope she answered
Are you well Joon hai asked concerned
She dogged the question , and turning towards him said
I want to tell you something
Just then Her name was called.
Having no time to explain him anything Sol just showed the pregnancy kit that was in her pocket into his hand.
She couldn't let him go inside without any indication.
Wait what, joon Hwi said
Sol didn’t bother to answer his question she dragged him in the doctors cabin
So lets check , when was your last period as the doctor started asking question Jon hwi mind started calculating up till her last period,
As a second round judicial exam reliasition dawned upon him soon enough.
Congrats the doctor said it looks like you ar pregnant ,
Let's do a small check up for the baby.
When he looked beside him he saw that Sol was not at her seat .
Doctor had directed her at the bed
Sol was lying on the bed with the monitor scanning her stomach and soon the baby's heart beats boomed in the roon
Congrats the baby is of 7 weeks its preety early so take care .
The doctor asked them to visit in 4 weeks.
And they both walked out of the cabin.
Joon hwi are you alright. Sol called him, he didn't answer.
Joon Hai was panicking inside his mind
What if I am a shitty father
What if I break the baby trust
I don’t want the baby to be fatherless
What will happen if something happens to me
Doses kang sol want this baby
They sat in the car and went to their apartment in complete silence.
Sol wasa bit scared, were her fears coming true she wondered.
Han Joon Hwi she screamed as they entered their apartment.
Whole ride Joon Hwi had not uttered a single word she was on the verge of eruption her anger was out of bounds.
If he is going to walk out it is better that he did right now at this very moment , she decided her shoulders square redy to confront him.
Her shout brought him out of the stupor
Why are you crying he asked paincked sol hadn’t realized that she was crying her anger had turned her to tears just imagining the betrays from the her loved one
Don’t cry its not good for the baby
Why are you crying
Are you craving something
I will bring it , what do you want .
Why why are you standing , sit. He said his voice concerned and his eyes not leaving her stomach.
Sol was confused seeing his contradicting behavious.
He ws acting aloof a moment ago, then why is he concerned now.
Her anger rosed again.
But the Joon Hwis next words melted her heart.
Thank you he said with tears in his eyes Thank you soo much.
I love you he said Frequently kissing all over her face.
After all misunderstandings were cleared sol smacked him right in the head.
What was that for.
foe making me think that you dont want us
Joon hwi was hurt when she even inplied that she thought that he wanted to walk out on her and their baby
I love you I cant even think of leaving you , he said with sincerity in his eyes.
I am sorry for thinking about that. She apologized.
Joon Hai betrated himself he knew that at times His Sol was very Self conscious and she had some fears.
This episode must have reminded him of her father who left her mother as soon as he knew that she was pregnant.
Why did you take so much time to reply if youu were not having second thoughts she asked him.
Oh I was thinking about various things
Shifting to a bigger house,
Changing our diet not that you are pregnant we can't survive just on ramen ,
Adjusting our jobs for the baby,
Getting Marriage certificate
Baby names ,
Baby clothes etc.
You were thinking about all this Sol asked surprised,but it's too soon we have time. She said.
Baby the months will pass in a jiffy we should start moving and arranging everything for the baby after your paper.
19 notes · View notes
stephenmccull · 4 years
Text
Why Doctors Keep Monitoring Kids Who Recover From Mysterious COVID-Linked Illness
Israel Shippy doesn’t remember much about having COVID-19 — or the unusual auto-immune disease it triggered — other than being groggy and uncomfortable for a bunch of days. He’s a 5-year-old, and would much rather talk about cartoons, or the ideas for inventions that constantly pop into his head.
“Hold your horses, I think I know what I’m gonna make,” he said, holding up a finger in the middle of a conversation. “I’m gonna make something that lights up and attaches to things with glue, so if you don’t have a flashlight, you can just use it!”
In New York, at least 237 kids, including Israel, appear to have Multisystem Inflammatory Syndrome in Children, or MIS-C. And state officials continue to track the syndrome, but the Centers for Disease Control and Prevention did not respond to repeated requests for information on how many children nationwide have been diagnosed so far with MIS-C.
A study published June 29 in the New England Journal of Medicine reported on 186 patients in 26 states who had been diagnosed with MIS-C. A researcher writing in the same issue added reports from other countries, finding that about 1,000 children worldwide have been diagnosed with MIS-C.
Tracking the Long-Term Health Effects of MIS-C
Israel is friendly and energetic, but he’s also really good at sitting still. During a recent checkup at Children’s Hospital at Montefiore, in the Bronx, he had no complaints about all the stickers and wires a health aide attached to him for an EKG. And when Dr. Marc Foca, an infectious disease specialist, came by to listen to his heart and lungs, and prod his abdomen, Israel barely seemed to notice.
There were still some tests pending, but overall, Foca said, “Israel looks like a totally healthy 5-year-old.”
“Stay safe!” Israel called out, as Foca left. It’s his new signoff, instead of goodbye. His mother, Janelle Moholland, explained Israel came up with it himself.
And she’s also hoping that after a harrowing couple of weeks in early May, Israel himself will “stay safe.”
That’s why they’ve been returning to Montefiore for the periodic checkups, even though Israel seems to have recovered fully from both COVID-19 and MIS-C.
MIS-C is relatively rare, and it apparently responds well to treatment, but it is new enough — and mysterious enough — that doctors here want to make sure the children who recover don’t experience any related health complications in the future.
“We’ve seen these kids get really sick, and get better and recover and go home, yet we don’t know what the long-term outcomes are,” said Dr. Nadine Choueiter, a pediatric cardiologist at Montefiore. “So that’s why we will be seeing them.”
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When Israel first got sick at the end of April, his illness didn’t exactly look like COVID-19. He had persistent high fevers, with his temperature reaching 104 degrees — but no problems breathing. He wasn’t eating. He was barely drinking. He wasn’t using the bathroom. He had abdominal pains. His eyes were red.
They went to the emergency room a couple of times and visited an urgent care center, but the doctors sent them home without testing him for the coronavirus. Moholland, 29, said she felt powerless.
“There was nothing I could do but make him comfortable,” she said. “I literally had to just trust in a higher power and just hope that He would come through for us. It taught me a lot about patience and faith.”
As Israel grew sicker, and they still had no answers, Moholland grew frustrated. “I wish his pediatrician and [the emergency room and urgent care staff] had done what they were supposed to do and given him a test” when Israel first got sick, Moholland said. “What harm would it have done? He suffered for about 10 or 11 days that could have been avoided.”
In a later interview, she talked with NPR about how COVID-19 has disproportionately affected the African American community, due to a combination of underlying health conditions and lack of access to good health care. She said she felt she, too, had fallen victim to those disparities.
“It affects me, personally, because I am African American, but you just never know,” she said. “It’s hard. We’re living in uncertain times — very uncertain times.”
Finally, Children’s Hospital at Montefiore admitted Israel — and the test she’d been trying to get for days confirmed he had the virus.
“I was literally in tears, like begging them not to discharge me because I knew he was not fine,” she recalled.
Israel was in shock, and by the time he got to the hospital, doctors were on the lookout for MIS-C, so they recognized his symptoms — which were distinct from most people with COVID-19.
Doctors gave Israel fluids and intravenous immune globulin, a substance obtained from donated human plasma, which is used to treat deficiencies in the immune system.
Immune globulin has been effective in children like Israel because MIS-C appears to be caused by an immune overreaction to the initial coronavirus infection, according to Choueiter, the Montefiore pediatric cardiologist.
“The immune system starts attacking the body itself, including the arteries of the heart,” she said.
In some MIS-C cases — though not Israel’s — the attack occurs in the coronary arteries, inflaming and dilating them. That also happens in a different syndrome affecting children, Kawasaki disease. About 5% of Kawasaki patients experience aneurysms — which can fatally rupture blood vessels — after the initial condition subsides.
Choueiter and her colleagues want to make sure MIS-C patients don’t face similar risks. So far, they’re cautiously optimistic.
“We have not seen any new decrease in heart function or any new coronary artery dilations,” she said. “When we check their blood, their inflammatory markers are back to normal. For the parents, the child is back to baseline, and it’s as if this illness is a nightmare that’s long gone.”
For a Pennsylvania Teen, the MIS-C Diagnosis Came Much Later
Not every child who develops MIS-C tests positive for the coronavirus, though many will test positive for antibodies to the coronavirus, indicating they had been infected previously. That was the case with Andrew Lis, a boy from Pennsylvania who was the first MIS-C patient seen at the Nemours/Alfred I. duPont Hospital for Children in Wilmington, Delaware.
Andrew had been a healthy 14-year-old before he got sick. He and his twin brother love sports and video games. He said the first symptom was a bad headache. He developed a fever the next day, then constipation and intense stomach pain.
“It was terrible,” Andrew said. “It was unbearable. I couldn’t really move a lot.”
His mother, Ingrid Lis, said they were thinking appendicitis, not coronavirus, at first. In fact, she hesitated to take Andrew to the hospital, for fear of exposing him to the virus. But after Andrew stopped eating because of his headache and stomach discomfort, “I knew I couldn’t keep him home anymore,” Lis said.
Andrew was admitted to the hospital April 12, but that was before reports of the mysterious syndrome had started trickling out of Europe.
Over about five days in the pediatric intensive care unit, Andrew’s condition deteriorated rapidly, as doctors struggled to figure out what was wrong. Puzzled, they tried treatments for scarlet fever, strep throat and toxic shock syndrome. Andrew’s body broke out in rashes, then his heart began failing and he was put on a ventilator. Andrew’s father, Ed Lis, said doctors told the family to brace for the worst: “We’ve got a healthy kid who a few days ago was just having these sort of strange symptoms. And now they’re telling us that we could lose him.”
Though Andrew’s symptoms were atypical for Kawasaki disease, doctors decided to give him the standard treatment for that condition — administering intravenous immune globulin, the same treatment Israel Shippy received.
“Within the 24 hours of the infusion, he was a different person,” Ingrid Lis said. Andrew was removed from the ventilator, and his appetite eventually returned. “That’s when we knew that we had turned that corner.”
It wasn’t until after Andrew’s discharge that his doctors learned about MIS-C from colleagues in Europe. They recommended the whole family be tested for antibodies to the coronavirus. Although Andrew tested positive, the rest of the family — both parents, Andrew’s twin brother and two older siblings — all tested negative. Andrew’s mother is still not sure how he was exposed since the family had been observing a strict lockdown since mid-March. Both she and her husband were working remotely from home, and she says they all wore masks and were conscientious about hand-washing when they ventured out for groceries. She thinks Andrew must have been exposed at least a month before his illness began.
And she’s puzzled why the rest of her close-knit family wasn’t infected as well. “We are a Latino family,” Ingrid Lis said. “We are very used to being together, clustering in the same room.” Even when Andrew was sick, she says, all six of them huddled in his bedroom to comfort him.
Meanwhile, Andrew has made a quick recovery. Not long after his discharge in April, he turned 15 and resumed an exercise routine involving running, pushups and situps. A few weeks later, an echocardiogram showed Andrew’s heart was “perfect,” Ed Lis said. Still, doctors have asked Andrew to follow up with a cardiologist every three months.
An Eye on the Long-Term Effects
The medical team at Montefiore is tracking the 40 children they have already treated and discharged. With kids showing few symptoms in the immediate aftermath, Chouetier hopes the long-term trajectory after MIS-C will be similar to what happens after Kawasaki disease.
“Usually children who have had coronary artery dilations [from Kawasaki disease] that have resolved within the first six weeks of the illness do well long-term,” said Choueiter, who runs the Kawasaki disease program at Montefiore.
The Montefiore team is asking patients affected by MIS-C to return for a checkup one week after discharge, then after one month, three months, six months and a year. They will be evaluated by pediatric cardiologists, hematologists, rheumatologists and infectious disease specialists.
Montefiore and other children’s hospitals around the country are sharing information. Choueiter wants to establish an even longer-term monitoring program for MIS-C, comparable to registries that exist for other diseases.
Moholland is glad the hospital is being vigilant.
“The uncertainty of not knowing whether it could come back in his future is a little unsettling,” she said. “But I am hopeful.”
This story is part of a partnership that includes WNYC, NPR and Kaiser Health News.
Why Doctors Keep Monitoring Kids Who Recover From Mysterious COVID-Linked Illness published first on https://smartdrinkingweb.weebly.com/
0 notes
gordonwilliamsweb · 4 years
Text
Why Doctors Keep Monitoring Kids Who Recover From Mysterious COVID-Linked Illness
Israel Shippy doesn’t remember much about having COVID-19 — or the unusual auto-immune disease it triggered — other than being groggy and uncomfortable for a bunch of days. He’s a 5-year-old, and would much rather talk about cartoons, or the ideas for inventions that constantly pop into his head.
“Hold your horses, I think I know what I’m gonna make,” he said, holding up a finger in the middle of a conversation. “I’m gonna make something that lights up and attaches to things with glue, so if you don’t have a flashlight, you can just use it!”
In New York, at least 237 kids, including Israel, appear to have Multisystem Inflammatory Syndrome in Children, or MIS-C. And state officials continue to track the syndrome, but the Centers for Disease Control and Prevention did not respond to repeated requests for information on how many children nationwide have been diagnosed so far with MIS-C.
A study published June 29 in the New England Journal of Medicine reported on 186 patients in 26 states who had been diagnosed with MIS-C. A researcher writing in the same issue added reports from other countries, finding that about 1,000 children worldwide have been diagnosed with MIS-C.
Tracking the Long-Term Health Effects of MIS-C
Israel is friendly and energetic, but he’s also really good at sitting still. During a recent checkup at Children’s Hospital at Montefiore, in the Bronx, he had no complaints about all the stickers and wires a health aide attached to him for an EKG. And when Dr. Marc Foca, an infectious disease specialist, came by to listen to his heart and lungs, and prod his abdomen, Israel barely seemed to notice.
There were still some tests pending, but overall, Foca said, “Israel looks like a totally healthy 5-year-old.”
“Stay safe!” Israel called out, as Foca left. It’s his new signoff, instead of goodbye. His mother, Janelle Moholland, explained Israel came up with it himself.
And she’s also hoping that after a harrowing couple of weeks in early May, Israel himself will “stay safe.”
That’s why they’ve been returning to Montefiore for the periodic checkups, even though Israel seems to have recovered fully from both COVID-19 and MIS-C.
MIS-C is relatively rare, and it apparently responds well to treatment, but it is new enough — and mysterious enough — that doctors here want to make sure the children who recover don’t experience any related health complications in the future.
“We’ve seen these kids get really sick, and get better and recover and go home, yet we don’t know what the long-term outcomes are,” said Dr. Nadine Choueiter, a pediatric cardiologist at Montefiore. “So that’s why we will be seeing them.”
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Subscribe to KHN’s free Morning Briefing.
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Please confirm your email address below:
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When Israel first got sick at the end of April, his illness didn’t exactly look like COVID-19. He had persistent high fevers, with his temperature reaching 104 degrees — but no problems breathing. He wasn’t eating. He was barely drinking. He wasn’t using the bathroom. He had abdominal pains. His eyes were red.
They went to the emergency room a couple of times and visited an urgent care center, but the doctors sent them home without testing him for the coronavirus. Moholland, 29, said she felt powerless.
“There was nothing I could do but make him comfortable,” she said. “I literally had to just trust in a higher power and just hope that He would come through for us. It taught me a lot about patience and faith.”
As Israel grew sicker, and they still had no answers, Moholland grew frustrated. “I wish his pediatrician and [the emergency room and urgent care staff] had done what they were supposed to do and given him a test” when Israel first got sick, Moholland said. “What harm would it have done? He suffered for about 10 or 11 days that could have been avoided.”
In a later interview, she talked with NPR about how COVID-19 has disproportionately affected the African American community, due to a combination of underlying health conditions and lack of access to good health care. She said she felt she, too, had fallen victim to those disparities.
“It affects me, personally, because I am African American, but you just never know,” she said. “It’s hard. We’re living in uncertain times — very uncertain times.”
Finally, Children’s Hospital at Montefiore admitted Israel — and the test she’d been trying to get for days confirmed he had the virus.
“I was literally in tears, like begging them not to discharge me because I knew he was not fine,” she recalled.
Israel was in shock, and by the time he got to the hospital, doctors were on the lookout for MIS-C, so they recognized his symptoms — which were distinct from most people with COVID-19.
Doctors gave Israel fluids and intravenous immune globulin, a substance obtained from donated human plasma, which is used to treat deficiencies in the immune system.
Immune globulin has been effective in children like Israel because MIS-C appears to be caused by an immune overreaction to the initial coronavirus infection, according to Choueiter, the Montefiore pediatric cardiologist.
“The immune system starts attacking the body itself, including the arteries of the heart,” she said.
In some MIS-C cases — though not Israel’s — the attack occurs in the coronary arteries, inflaming and dilating them. That also happens in a different syndrome affecting children, Kawasaki disease. About 5% of Kawasaki patients experience aneurysms — which can fatally rupture blood vessels — after the initial condition subsides.
Choueiter and her colleagues want to make sure MIS-C patients don’t face similar risks. So far, they’re cautiously optimistic.
“We have not seen any new decrease in heart function or any new coronary artery dilations,” she said. “When we check their blood, their inflammatory markers are back to normal. For the parents, the child is back to baseline, and it’s as if this illness is a nightmare that’s long gone.”
For a Pennsylvania Teen, the MIS-C Diagnosis Came Much Later
Not every child who develops MIS-C tests positive for the coronavirus, though many will test positive for antibodies to the coronavirus, indicating they had been infected previously. That was the case with Andrew Lis, a boy from Pennsylvania who was the first MIS-C patient seen at the Nemours/Alfred I. duPont Hospital for Children in Wilmington, Delaware.
Andrew had been a healthy 14-year-old before he got sick. He and his twin brother love sports and video games. He said the first symptom was a bad headache. He developed a fever the next day, then constipation and intense stomach pain.
“It was terrible,” Andrew said. “It was unbearable. I couldn’t really move a lot.”
His mother, Ingrid Lis, said they were thinking appendicitis, not coronavirus, at first. In fact, she hesitated to take Andrew to the hospital, for fear of exposing him to the virus. But after Andrew stopped eating because of his headache and stomach discomfort, “I knew I couldn’t keep him home anymore,” Lis said.
Andrew was admitted to the hospital April 12, but that was before reports of the mysterious syndrome had started trickling out of Europe.
Over about five days in the pediatric intensive care unit, Andrew’s condition deteriorated rapidly, as doctors struggled to figure out what was wrong. Puzzled, they tried treatments for scarlet fever, strep throat and toxic shock syndrome. Andrew’s body broke out in rashes, then his heart began failing and he was put on a ventilator. Andrew’s father, Ed Lis, said doctors told the family to brace for the worst: “We’ve got a healthy kid who a few days ago was just having these sort of strange symptoms. And now they’re telling us that we could lose him.”
Though Andrew’s symptoms were atypical for Kawasaki disease, doctors decided to give him the standard treatment for that condition — administering intravenous immune globulin, the same treatment Israel Shippy received.
“Within the 24 hours of the infusion, he was a different person,” Ingrid Lis said. Andrew was removed from the ventilator, and his appetite eventually returned. “That’s when we knew that we had turned that corner.”
It wasn’t until after Andrew’s discharge that his doctors learned about MIS-C from colleagues in Europe. They recommended the whole family be tested for antibodies to the coronavirus. Although Andrew tested positive, the rest of the family — both parents, Andrew’s twin brother and two older siblings — all tested negative. Andrew’s mother is still not sure how he was exposed since the family had been observing a strict lockdown since mid-March. Both she and her husband were working remotely from home, and she says they all wore masks and were conscientious about hand-washing when they ventured out for groceries. She thinks Andrew must have been exposed at least a month before his illness began.
And she’s puzzled why the rest of her close-knit family wasn’t infected as well. “We are a Latino family,” Ingrid Lis said. “We are very used to being together, clustering in the same room.” Even when Andrew was sick, she says, all six of them huddled in his bedroom to comfort him.
Meanwhile, Andrew has made a quick recovery. Not long after his discharge in April, he turned 15 and resumed an exercise routine involving running, pushups and situps. A few weeks later, an echocardiogram showed Andrew’s heart was “perfect,” Ed Lis said. Still, doctors have asked Andrew to follow up with a cardiologist every three months.
An Eye on the Long-Term Effects
The medical team at Montefiore is tracking the 40 children they have already treated and discharged. With kids showing few symptoms in the immediate aftermath, Chouetier hopes the long-term trajectory after MIS-C will be similar to what happens after Kawasaki disease.
“Usually children who have had coronary artery dilations [from Kawasaki disease] that have resolved within the first six weeks of the illness do well long-term,” said Choueiter, who runs the Kawasaki disease program at Montefiore.
The Montefiore team is asking patients affected by MIS-C to return for a checkup one week after discharge, then after one month, three months, six months and a year. They will be evaluated by pediatric cardiologists, hematologists, rheumatologists and infectious disease specialists.
Montefiore and other children’s hospitals around the country are sharing information. Choueiter wants to establish an even longer-term monitoring program for MIS-C, comparable to registries that exist for other diseases.
Moholland is glad the hospital is being vigilant.
“The uncertainty of not knowing whether it could come back in his future is a little unsettling,” she said. “But I am hopeful.”
This story is part of a partnership that includes WNYC, NPR and Kaiser Health News.
Why Doctors Keep Monitoring Kids Who Recover From Mysterious COVID-Linked Illness published first on https://nootropicspowdersupplier.tumblr.com/
0 notes
dinafbrownil · 4 years
Text
Why Doctors Keep Monitoring Kids Who Recover From Mysterious COVID-Linked Illness
Israel Shippy doesn’t remember much about having COVID-19 — or the unusual auto-immune disease it triggered — other than being groggy and uncomfortable for a bunch of days. He’s a 5-year-old, and would much rather talk about cartoons, or the ideas for inventions that constantly pop into his head.
“Hold your horses, I think I know what I’m gonna make,” he said, holding up a finger in the middle of a conversation. “I’m gonna make something that lights up and attaches to things with glue, so if you don’t have a flashlight, you can just use it!”
In New York, at least 237 kids, including Israel, appear to have Multisystem Inflammatory Syndrome in Children, or MIS-C. And state officials continue to track the syndrome, but the Centers for Disease Control and Prevention did not respond to repeated requests for information on how many children nationwide have been diagnosed so far with MIS-C.
A study published June 29 in the New England Journal of Medicine reported on 186 patients in 26 states who had been diagnosed with MIS-C. A researcher writing in the same issue added reports from other countries, finding that about 1,000 children worldwide have been diagnosed with MIS-C.
Tracking the Long-Term Health Effects of MIS-C
Israel is friendly and energetic, but he’s also really good at sitting still. During a recent checkup at Children’s Hospital at Montefiore, in the Bronx, he had no complaints about all the stickers and wires a health aide attached to him for an EKG. And when Dr. Marc Foca, an infectious disease specialist, came by to listen to his heart and lungs, and prod his abdomen, Israel barely seemed to notice.
There were still some tests pending, but overall, Foca said, “Israel looks like a totally healthy 5-year-old.”
“Stay safe!” Israel called out, as Foca left. It’s his new signoff, instead of goodbye. His mother, Janelle Moholland, explained Israel came up with it himself.
And she’s also hoping that after a harrowing couple of weeks in early May, Israel himself will “stay safe.”
That’s why they’ve been returning to Montefiore for the periodic checkups, even though Israel seems to have recovered fully from both COVID-19 and MIS-C.
MIS-C is relatively rare, and it apparently responds well to treatment, but it is new enough — and mysterious enough — that doctors here want to make sure the children who recover don’t experience any related health complications in the future.
“We’ve seen these kids get really sick, and get better and recover and go home, yet we don’t know what the long-term outcomes are,” said Dr. Nadine Choueiter, a pediatric cardiologist at Montefiore. “So that’s why we will be seeing them.”
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Subscribe to KHN’s free Morning Briefing.
Sign Up
Please confirm your email address below:
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When Israel first got sick at the end of April, his illness didn’t exactly look like COVID-19. He had persistent high fevers, with his temperature reaching 104 degrees — but no problems breathing. He wasn’t eating. He was barely drinking. He wasn’t using the bathroom. He had abdominal pains. His eyes were red.
They went to the emergency room a couple of times and visited an urgent care center, but the doctors sent them home without testing him for the coronavirus. Moholland, 29, said she felt powerless.
“There was nothing I could do but make him comfortable,” she said. “I literally had to just trust in a higher power and just hope that He would come through for us. It taught me a lot about patience and faith.”
As Israel grew sicker, and they still had no answers, Moholland grew frustrated. “I wish his pediatrician and [the emergency room and urgent care staff] had done what they were supposed to do and given him a test” when Israel first got sick, Moholland said. “What harm would it have done? He suffered for about 10 or 11 days that could have been avoided.”
In a later interview, she talked with NPR about how COVID-19 has disproportionately affected the African American community, due to a combination of underlying health conditions and lack of access to good health care. She said she felt she, too, had fallen victim to those disparities.
“It affects me, personally, because I am African American, but you just never know,” she said. “It’s hard. We’re living in uncertain times — very uncertain times.”
Finally, Children’s Hospital at Montefiore admitted Israel — and the test she’d been trying to get for days confirmed he had the virus.
“I was literally in tears, like begging them not to discharge me because I knew he was not fine,” she recalled.
Israel was in shock, and by the time he got to the hospital, doctors were on the lookout for MIS-C, so they recognized his symptoms — which were distinct from most people with COVID-19.
Doctors gave Israel fluids and intravenous immune globulin, a substance obtained from donated human plasma, which is used to treat deficiencies in the immune system.
Immune globulin has been effective in children like Israel because MIS-C appears to be caused by an immune overreaction to the initial coronavirus infection, according to Choueiter, the Montefiore pediatric cardiologist.
“The immune system starts attacking the body itself, including the arteries of the heart,” she said.
In some MIS-C cases — though not Israel’s — the attack occurs in the coronary arteries, inflaming and dilating them. That also happens in a different syndrome affecting children, Kawasaki disease. About 5% of Kawasaki patients experience aneurysms — which can fatally rupture blood vessels — after the initial condition subsides.
Choueiter and her colleagues want to make sure MIS-C patients don’t face similar risks. So far, they’re cautiously optimistic.
“We have not seen any new decrease in heart function or any new coronary artery dilations,” she said. “When we check their blood, their inflammatory markers are back to normal. For the parents, the child is back to baseline, and it’s as if this illness is a nightmare that’s long gone.”
For a Pennsylvania Teen, the MIS-C Diagnosis Came Much Later
Not every child who develops MIS-C tests positive for the coronavirus, though many will test positive for antibodies to the coronavirus, indicating they had been infected previously. That was the case with Andrew Lis, a boy from Pennsylvania who was the first MIS-C patient seen at the Nemours/Alfred I. duPont Hospital for Children in Wilmington, Delaware.
Andrew had been a healthy 14-year-old before he got sick. He and his twin brother love sports and video games. He said the first symptom was a bad headache. He developed a fever the next day, then constipation and intense stomach pain.
“It was terrible,” Andrew said. “It was unbearable. I couldn’t really move a lot.”
His mother, Ingrid Lis, said they were thinking appendicitis, not coronavirus, at first. In fact, she hesitated to take Andrew to the hospital, for fear of exposing him to the virus. But after Andrew stopped eating because of his headache and stomach discomfort, “I knew I couldn’t keep him home anymore,” Lis said.
Andrew was admitted to the hospital April 12, but that was before reports of the mysterious syndrome had started trickling out of Europe.
Over about five days in the pediatric intensive care unit, Andrew’s condition deteriorated rapidly, as doctors struggled to figure out what was wrong. Puzzled, they tried treatments for scarlet fever, strep throat and toxic shock syndrome. Andrew’s body broke out in rashes, then his heart began failing and he was put on a ventilator. Andrew’s father, Ed Lis, said doctors told the family to brace for the worst: “We’ve got a healthy kid who a few days ago was just having these sort of strange symptoms. And now they’re telling us that we could lose him.”
Though Andrew’s symptoms were atypical for Kawasaki disease, doctors decided to give him the standard treatment for that condition — administering intravenous immune globulin, the same treatment Israel Shippy received.
“Within the 24 hours of the infusion, he was a different person,” Ingrid Lis said. Andrew was removed from the ventilator, and his appetite eventually returned. “That’s when we knew that we had turned that corner.”
It wasn’t until after Andrew’s discharge that his doctors learned about MIS-C from colleagues in Europe. They recommended the whole family be tested for antibodies to the coronavirus. Although Andrew tested positive, the rest of the family — both parents, Andrew’s twin brother and two older siblings — all tested negative. Andrew’s mother is still not sure how he was exposed since the family had been observing a strict lockdown since mid-March. Both she and her husband were working remotely from home, and she says they all wore masks and were conscientious about hand-washing when they ventured out for groceries. She thinks Andrew must have been exposed at least a month before his illness began.
And she’s puzzled why the rest of her close-knit family wasn’t infected as well. “We are a Latino family,” Ingrid Lis said. “We are very used to being together, clustering in the same room.” Even when Andrew was sick, she says, all six of them huddled in his bedroom to comfort him.
Meanwhile, Andrew has made a quick recovery. Not long after his discharge in April, he turned 15 and resumed an exercise routine involving running, pushups and situps. A few weeks later, an echocardiogram showed Andrew’s heart was “perfect,” Ed Lis said. Still, doctors have asked Andrew to follow up with a cardiologist every three months.
An Eye on the Long-Term Effects
The medical team at Montefiore is tracking the 40 children they have already treated and discharged. With kids showing few symptoms in the immediate aftermath, Chouetier hopes the long-term trajectory after MIS-C will be similar to what happens after Kawasaki disease.
“Usually children who have had coronary artery dilations [from Kawasaki disease] that have resolved within the first six weeks of the illness do well long-term,” said Choueiter, who runs the Kawasaki disease program at Montefiore.
The Montefiore team is asking patients affected by MIS-C to return for a checkup one week after discharge, then after one month, three months, six months and a year. They will be evaluated by pediatric cardiologists, hematologists, rheumatologists and infectious disease specialists.
Montefiore and other children’s hospitals around the country are sharing information. Choueiter wants to establish an even longer-term monitoring program for MIS-C, comparable to registries that exist for other diseases.
Moholland is glad the hospital is being vigilant.
“The uncertainty of not knowing whether it could come back in his future is a little unsettling,” she said. “But I am hopeful.”
This story is part of a partnership that includes WNYC, NPR and Kaiser Health News.
from Updates By Dina https://khn.org/news/why-doctors-keep-monitoring-kids-who-recover-from-mysterious-covid-linked-illness/
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ivfclinicsinindia · 4 years
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Best IVF &  Gynecologist In India | Best IVF Center in Delhi | OVO Health
Best IVF Center in Delhi 
In vitro treatment (IVF) is a procedure of preparation where an egg is combined with sperm outside the body, in vitro ("in glass"). The procedure involves monitoring and stimulating a lady's ovulatory procedure, removing an ovum or ova (egg or eggs) from the lady's ovaries and letting sperm treat them in a fluid in a research center. After the prepared egg (zygote) experiences incipient organism culture for 2–6 days, it is embedded in the equivalent or another lady's uterus, with the intention of establishing an effective pregnancy.IVF is a kind of helped conceptive innovation utilized for infertility treatment and gestational surrogacy. A prepared egg might be embedded into a surrogate's uterus, and the resulting kid is hereditarily random to the surrogate. A few nations have restricted or generally control the accessibility of IVF treatment, giving ascent to richness the travel industry. Limitations on the accessibility of IVF include expenses and age, in request for a lady to convey a sound pregnancy to term. IVF is commonly not utilized until less invasive or costly choices have fizzled or been determined far-fetched to work.In 1978 Louise Brown was the principal kid effectively brought into the world after her mom got IVF treatment. Darker was conceived because of normal cycle IVF, where no incitement was made. The methodology occurred at Dr Kershaw's Cottage Hospital (presently Dr Kershaw's Hospice) in Royton, Oldham, England. Robert G. Edwards was granted the Nobel Prize in Physiology or Medicine in 2010. The physiologist co-built up the treatment together with Patrick Steptoe and embryologist Jean Purdy yet the last two were not qualified for thought as they had kicked the bucket and the Nobel Prize isn't granted after death. 
Surrogacy Center in Noida 
Surrogacy is a course of action, frequently upheld by a lawful understanding, whereby a lady (the surrogate mother) consents to tolerate a youngster for someone else or people, who will end up being the kid's parent(s) after birth.People may look for a surrogacy plan when pregnancy is restoratively outlandish, when pregnancy dangers are unreasonably risky for the intended mother, or when a single man or a male couple wish to have a kid. Surrogacy is viewed as one of many helped conceptive technologies.In surrogacy courses of action, money related pay might possibly be involved. Receiving cash for the course of action is known as business surrogacy. The lawfulness and cost of surrogacy fluctuates broadly between locales, once in a while resulting in dangerous international or interstate surrogacy courses of action. Couples seeking a surrogacy game plan in a nation where it is restricted once in a while travel to a ward that grants it. In certain nations, surrogacy is just lawful if cash doesn't trade hands. (See surrogacy laws by nation and ripeness tourism.)Where business surrogacy is lawful, couples may utilize the assistance of an outsider office to aid the procedure of surrogacy by finding a surrogate and arranging a surrogacy contract with her. These offices frequently screen surrogates' mental and other therapeutic tests to guarantee the best possibility of solid incubation and conveyance. They additionally as a rule encourage every single lawful issue concerning the intended guardians and the surrogate. 
Best IVF Specialist in Gurgaon 
The initial phase in IVF is taking ripeness prescriptions for a while to enable your ovaries to deliver a few eggs that are experienced and prepared for treatment. This is called ovulation induction. You may get customary ultrasounds or blood tests to gauge your hormone levels and monitor your egg production.Once your ovaries have delivered enough full grown eggs, your primary care physician expels the eggs from your body (this is called egg recovery). Egg recovery is a minor surgery that is done at your primary care physician's office or at a ripeness clinic.You'll get medicine to assist you with being loose and open to during the technique. Using a ultrasound to see inside your body, the specialist puts a thin, empty cylinder through your vagina and into the ovary and follicles that hold your eggs. The needle is associated with a suction gadget that tenderly hauls the eggs out of each follicle.In a lab, your eggs are blended in with sperm cells from your accomplice or a benefactor — this is called insemination. The eggs and sperm are put away together in an exceptional container, and preparation occurs. For sperm that have lower motility (don't swim too), they might be injected straightforwardly into the eggs to advance treatment. As the phones in the treated eggs separate and become undeveloped organisms, individuals who work at the lab screen the progress.About 3-5 days after the egg recovery, at least 1 incipient organisms are placed into your uterus (this is called incipient organism move). The specialist slides a thin cylinder through your cervix into your uterus, and inserts the incipient organism straightforwardly into your uterus through the cylinder. 
Gynecologist Hospital In Faridabad 
The Kahun Gynecological Papyrus, dated to around 1800 BC, manages ladies' wellbeing — gynecological ailments, fruitfulness, pregnancy, contraception, and so on. The content is partitioned into thirty-four segments, each area dealing with a particular issue and containing finding and treatment; no anticipation is recommended. Medications are non careful, comprising applying medicines to the influenced body part or swallowing them. The belly is on occasion observed as the wellspring of complaints manifesting themselves in other body parts.The Hippocratic Corpus contains a few gynecological treatises dating to the fifth/fourth hundreds of years BC. Aristotle is another solid hotspot for restorative writings from the fourth century BC with his portrayals of science principally found in History of Animals, Parts of Animals, Generation of Animals. The gynecological treatise Gynaikeia by Soranus of Ephesus (first/second century AD) is surviving (together with a sixth century Latin reword by Muscio, a doctor of a similar school). He was the main agent of the school of doctors known as the "Methodists".J. Marion Sims is generally viewed as the dad of current gynecology. Presently reprimanded for his practices, Sims built up a portion of his methods by operating on slaves, a considerable lot of whom were not given anaesthesia.[4][5] Sims performed medical procedures on 12 subjugated ladies in his hand crafted lawn hospital for a long time. While performing these medical procedures he invited men doctors and understudies to watch invasive and painful techniques while the ladies were uncovered. On one of the ladies, named Anarcha, he performed 30 medical procedures without anesthesia.[6] Due to having such a large number of oppressed ladies, he would turn starting with one then onto the next, continuously trying to consummate the fix of their fistulas. Doctors and understudies lost interest in assisting Sims through the span of his patio practice, and he enlisted other subjugated ladies, who were healing from their own medical procedures, to help him. In 1855 Sims went on to establish the Woman's Hospital in New York, the principal hospital explicitly for female issue. 
Gynecologist in Chembur 
In certain nations, ladies should initially observe a general professional (GP; otherwise called a family expert (FP)) before seeing a gynecologist. On the off chance that their condition requires training, information, surgery, or gear inaccessible to the GP, the patient is then alluded to a gynecologist. In the United States, be that as it may, law and numerous medical coverage plans enable gynecologists to give essential consideration notwithstanding parts of their own claim to fame. With this choice accessible, a few ladies select to see a gynecological specialist for non-gynecological issues without another doctor's referral.As in the entirety of medicine, the main instruments of conclusion are clinical history and examination. Gynecological examination is very intimate, more so than a routine physical test. It likewise requires one of a kind instrumentation, for example, the speculum. The speculum comprises of two hinged edges of inward metal or plastic which are utilized to withdraw the tissues of the vagina and grant examination of the cervix, the lower some portion of the uterus situated within the upper segment of the vagina. Gynecologists regularly do a bimanual examination (one hand on the stomach area and a couple of fingers in the vagina) to palpate the cervix, uterus, ovaries and hard pelvis. It isn't phenomenal to do a rectovaginal examination for complete assessment of the pelvis, especially if any suspicious masses are valued. Male gynecologists may have a female chaperone for their examination. An abdominal or vaginal ultrasound can be utilized to affirm any irregularities acknowledged with the bimanual examination or when indicated by the patient's history. 
Best Gynecologist in Kolkata Female 
Going to see a gynecologist — a specialist who centers around ladies' conceptive wellbeing — implies you're taking obligation regarding your body in new manners. It very well may be extremely exciting to realize you're making certain all is going admirably with adolescence, your regenerative framework, and more.Keep in mind that different specialists likewise can help with gynecological issues. For instance, a juvenile medicine specialist, family specialist, or pediatrician can respond to questions and might have the option to examine your vagina, too.A gynecologist is a restorative specialist that represents considerable authority in ladies' conceptive frameworks. Separate specialists that represent considerable authority in treating ladies have existed for quite a long time, and these old specialists are the progenitors of the present gynecological specialists and analysts. Gynecologists are frequently at the cutting edge of discussions over ladies' wellbeing and medicinal services. While a general doctor might have the option to pinpoint and treat minor ladies' medical problems, the master opinions of gynecologists are totally important with regards to certain parts of ladies' wellbeing.
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thegloober · 6 years
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A pediatrician finds her “why”
Last Friday, as I sat finishing up notes on the last of my almost 30 physicals (this number is never any surprise for us pediatricians this time of the year, it’s back to school week, so every Thomason, Dickinson, and Harrison is lining up for sports physicals and regular physicals and all sorts of clearance and medication forms that need to be filled out and turned in “yesterday.”) I took a deep breath and exhaled, my mind filled with the events of the day. As is customary, my beloved patients often postpone their physicals all summer, in search of sandy beaches and clear blue vacation skies, so it’s usually a mad rush the first week of school.
I found myself reflecting on the patients I had seen that day as I often do at the end of my day. Most of them were mundane well-baby and well-child checkups, nothing really of note, a few of them had minor issues to clear up before returning to play … but one of them stood out clearly like a lily in a field of carnations … a 16-year-old we shall call “Maya.” I have met Maya only a couple of times in the past, and I have known her to be a troubled teen, plagued with depression and anguish, never really smiling, not much eye contact, not much of an effect — just sad. I have tried to manage her depression the best I can with counseling in the office and referral for proper psychotherapy. My good friend and child psychiatrist sees her regularly and has placed her on an appropriate dose of antidepressants. And she reportedly goes to counseling regularly, all with little or no change in her mood.
She came in that day in the company of her mother and her older 17-year-old sister. I sensed something wrong right away, but I continued my usual intros and salutations. Her mom could not stop fidgeting, with the characteristic continuous knee shaking. Her sister’s face was buried in her mobile device for pretty much the duration of the visit, except when I inquired about her. It turned out her sister was also to be seen that day.
Both mother and child proceeded to explain to me that her sister needed to be seen for “stomach problems” that only happen at her high school, stemming from her “unique eating habits,” and her lunchtime not being fixed at a particular time of the school day. This apparently never happens at home or during the holidays or vacation, when she reportedly “has her own eating schedule.” She wanted a note from me to the school nurse authorizing her to eat her lunch at the exact time she wanted, or she would develop abdominal cramps, nausea, and headaches and “get so sick” she would end up being sent home from school. This storyline and request struck me as bizarre, I recognized a familiar thread of possible anxiety in her sister, and maybe some codependency in her mom, but I digress.
Maya, on the other hand, wore a thick black sweatshirt and jogging pants. Mind you, it is 105 degrees outdoors in San Antonio in July!
I somehow am a magnet for depressed and suicidal teens, and Maya was no different. She made absolutely no attempt to engage with me, no eye contact, shoulders drooped over, melancholic and flat affected. She appeared pale, ashen and sullen with dark circles around her eyes; she simply looked like she could use a long-warm-heart-filled-hug. During the physical exam, she hesitated to take off her sweatshirt, but I insisted, eventually, her mother ordered her to do so. She did so very reluctantly and immediately pronated both forearms. I gently supinated them, and to my horror, it revealed numerous, clearly visible, freshly carved cuts all over her forearms, extending from her wrists all the way to her elbows, on her left and right forearms respectively. I said nothing, gently turned them back to her preferred position, completed her examination, and walked back to my seat.
I then calmly asked her mom about Maya’s depression, and how her cutting behavior was fairing. She hurriedly replied, “Oh, a lot better, she is receiving counseling, and has not cut in two years.” Two years!? I thought to myself, more like two days. Her response immediately made me stop typing on my laptop EMR, I looked up at her, made sure my words came out clearly and as gently as my rapidly beating heart could muster, as I said, “No ma’am, I am afraid, but I have to tell you that Maya has fresh cuts on her forearms and wrists, that are probably not more than two days old.”
The rest of the visit was a bit awkward. Her mom asked to see the cuts, Maya vehemently refused, and an uneasy silence set in after I explained to mom that, she would probably do better waiting until they got home to approach her alone in her bedroom. Meanwhile, we should probably revisit her counseling sessions, and explore the possibility of an in-house facility if possible, especially since her self-completed PHQ-9 score that day was a total of zero.
I write this story today to remind myself of my “why.” To urge each one of us doctors to remember our “why.” Never lose sight of the reason you went into medicine, no matter what. We are a special breed, a unique set of like-minded individuals who choose service to humanity above all. We choose to make a difference in our patients’ lives regardless of all the administrative, legislative, personal and sometimes insurmountable difficulties we face daily in the field. I was reminded that day of my reason for leaving my beloved 9 to 5 job to follow a passion of fighting to end teen depression and teen suicide. I was reminded to follow my heart and believe in my dream. I was reminded to stay the course, because, for every Maya in my office, there are a hundred or even a thousand more out there, so, I must go forth.
“The harvest is plenty, the laborers, few …” – Luke 10:2.
Uchenna Umeh is a pediatrician and can be reached at Teen Alive and on Facebook and YouTube.
Image credit: Shutterstock.com
Source: https://bloghyped.com/a-pediatrician-finds-her-why/
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blockheadbrands · 6 years
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Revenue Hit Predicted for California’s Medical Cannabis Market
The Associated Press by way of Leafly Reports:
LOS ANGELES (AP) — When Elias Zaldivar was an 18-year-old college freshman and decided he was in the market for marijuana, he knew just how to get it, and it didn’t involve canvassing the corridors of his campus in search of that stoned-out dude who sold pot from his dorm room. Instead, he went straight to a doctor.
On a busy Hollywood street, Zaldivar quickly located a clinic specializing in medicinal marijuana referrals. He video-conferenced with a doctor from the waiting room and, following their 10-minute chat, a receptionist handed him an official-looking letter with an embossed gold seal that allowed him to buy medical cannabis at any California dispensary.
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Zaldivar, now a 21-year-old mixed martial arts coach, has renewed his medical marijuana recommendation each year since, always using the same health claim. He still chuckles while recalling what he explained to the doctor to get him to issue him that first prescription: “I told him I had anxiety.”
In the two decades since California became the first state to allow cannabis for medicinal use, it’s been an open secret that pretty much anyone who wants marijuana at just about any time can find a doctor who will recommend it for almost any reason.
Technically, the doctor doesn’t provide a prescription but a “letter of recommendation,” because it’s illegal for a physician to prescribe a substance banned by the federal government, no matter what state law says.
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Once that recommendation is secured, a person can also apply for a state-issued medical marijuana card that, although not required, is more convenient to carry to a dispensary and, in the eyes of some holders, gets them taken more seriously as people who need cannabis to stay healthy.
Although some doctors who take the examination process seriously charge far more, the fees at most of the in-and-out-the-door-in-10-minutes places is about $40.
“You really have physicians following two paths here.”
Dr. David Bearman
Now, with recreational marijuana set to become legal Monday in California for anyone 21 and over, some people will be tossing their state-issued cards.
Revenue from the sale of medical marijuana is expected to drop from an estimated $2 billion in 2016 to about $1.4 billion next year, according to a study published this year by the University of California Agricultural Issues Center. At the same time, according to the study, the legal sale of recreational marijuana should bring in more than $5 billion as recreational cannabis captures about 62 percent of sales, while the black market retains about 30 percent.
Already Zaldivar and others say they see the market forces at work. In the months leading up to legal recreational cannabis sales, they’ve noticed many of the heavily guarded medical dispensaries they frequent are letting them stroll in without their state-issued IDs.
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What Is a Medical Marijuana Card?
“As they’ve gotten closer and closer to being legalized, they are not even asking for the recommendation letters anymore,” said 22-year-old Adam Salcido, who works for a company that helps put on popular events like Hempfest and Cannabis Cup. He got his medical marijuana card to treat stomach problems he said he’s suffered since childhood, and plans to keep it for now.
Like Salcido, many people do use marijuana to treat serious medical problems.
“Some physicians, like myself, who see mostly very ill patients — such as those with epilepsy, cancer and other serious conditions — will likely not see a drop-off as we are involved in managing the cannabis treatment, not only providing a letter for access,” said Dr. Bonni Goldstein, a pediatrician who began treating both children and adults with cannabis 10 years ago after she saw its medical benefits.
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One age group caught between medical and recreational marijuana are those 18 to 20. Medical is legal for anyone 18 and older, so some in that range are likely to continue providing fictitious health conditions so they can get a state medical card and “legally” buy cannabis.
There also could be a financial incentive for some to seek a medical card even if they don’t have a health problem because medical marijuana will be taxed at a lower rate than recreational marijuana. However, for a casual user, the cost and effort needed to get the card probably won’t be worth the savings.
But as the movement away from dispensaries continues, and as some dispensaries simply morph into full-service stores, selling things like candy bars, cannabis-infused wine, pre-rolled joints for the on-the-go crowd, and munchies for the stoned set, some physicians say it’s likely to put the squeeze on those doctors who have grown accustomed to just skyping their patient-physician consultations and emailing their prescriptions, er, recommendations.
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“You really have physicians following two paths here. On one path are those physicians who continue to practice quality medicine, and on the other are those who just see this as a way of making a lot of money,” said Dr. David Bearman, who has been prescribing medicinal marijuana almost since California legalized it in 1996.
He was inspired in part to co-found the American Academy of Cannabinoid Medicine to separate doctors like himself from the guy he saw put a girl in a bikini outside his clinic with a sign announcing medical marijuana cards were available there for only $39.99.
“This is why the legalization of cannabis for recreational use is so important,” said Goldstein, who like Bearman consults with patients face-to-face for an hour or more and only after they’ve provided medical records proving they have a serious condition she believes cannabis can help alleviate.
“Let the medical patients be medical,” she added, “and let the recreational users use it recreationally.”
TO READ MORE OF THIS ARTICLE ON LEAFLY, CLICK HERE.
https://www.leafly.com/news/politics/revenue-hit-predicted-for-californias-medical-cannabis-market
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