Doctor Gambles On Clot-Busting Drug To Save Virus Patients
(further “anecdotal (sic)” proof that the blood is central to CV –
and doctors are being true to the **Oath they take on becoming an MD)
The woman was dying. New York’s Mount Sinai Hospital was about to call her husband and break the news that there was nothing left to try. Then Dr. Hooman Poor took a gamble.
With high-stress, high-stakes decisions, doctors around the world are frantically trying to figure out how COVID-19 is killing their patients so they can attempt new ways to fight back. One growing theory: In the sickest of the sick, little blood clots clog the lungs. Poor couldn’t prove it. The tests required would further endanger his staff, who were already at risk of getting the virus. But the lung specialist saw clues that were “screaming blood clots.” So Poor pulled out a drug best known for treating strokes, and held his breath.
“I said, ‘What do we actually have to lose?’” Poor told The Associated Press. “That’s when I decided to give not just a blood thinner but a blood clot buster.”
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| *Hippocratic Oath of New MDs (see below for Halactic analysis and Revision to this Oath after WWII) |
Exactly what’s going on with blood clots in at least some COVID-19 patients is a mystery.
Chinese doctors were first to sound the alarm. In March, Chinese heart specialists advised the American College of Cardiology to watch for clots and said certain blood tests showing a rise in clot risk might signal which patients were in greatest danger. Other reports suggested the clots can show up all over the body. But were they a cause of deterioration or an effect?
Already, many hospitals are attempting preventive doses of blood thinners to keep clots from forming. There’s huge debate over what kind to try, what dose is safe — the drugs can cause dangerous bleeding — and how soon to start.
In New York, Poor was going a step further with a drug named tPA that doesn’t prevent clots — it breaks them up. It’s an example of how, with no vaccine or approved treatment for the coronavirus, many overwhelmed doctors are following trails of clues to figure out what to try next.
Poor’s 55-year-old patient wasn’t getting enough oxygen even after doctors rolled her onto her stomach for an extreme ventilation technique called “prone positioning.” She was in shock. Other organs were failing fast. Twenty minutes after the injection of tPA, her oxygen levels rose. Poor was elated. But not for long. “She gets better, but then she starts to get worse,” he said. “Most likely we’re breaking up the clot, but she is immediately forming the clot again.”
So he next tried something novel, putting the woman on a low-dose drip of tPA for about 24 hours together with a blood thinner, in hopes of chipping away at existing clots while blocking new ones. To Poor’s dismay, the experimental treatment bought the woman only a few more days of life. A sudden, different complication killed her on Friday. But last weekend, Poor’s team tested the new clot-fighting approach in four additional severely ill patients. One didn’t survive, dying of cardiac arrest from a massive blood clot in his heart.
The rest saw improvement in oxygen levels and shock. As of Friday, three remained on ventilators but were doing better, especially one who had been treated soon after her lungs failed. In a new report, Poor called for urgent study of whether abnormal clotting drives at least some people’s deterioration, even as his own hospital updated treatment advice for its sickest patients.
Others are onto the same lead. Specialists at the University of Colorado and Harvard recently published a similar tPA research call, and cited three additional cases where it was tried as hospitals in Colorado and Massachusetts prepare for a study.
“We’re taking care of extremely ill patients that are dying in front of us, and we can’t get any diagnostic testing,” yet still have to make treatment decisions, said Dr. Steven Pugliese, a lung specialist at the University of Pennsylvania.
- Rambam’s Oath: The eternal providence has appointed me to watch over the life and health of Thy creatures. May the love for my art actuate me at all times; may neither avarice nor miserliness, nor thirst for glory or for a great reputation engage my mind; for the enemies of truth and philanthropy could easily deceive me and make me forgetful of my lofty aim of doing good to Thy children.
- May I never see in the patient anything but a fellow creature in pain.
- Grant me the strength, time and opportunity always to correct what I have acquired, always to extend its domain; for knowledge is immense and the spirit of man can extend indefinitely to enrich itself daily with new requirements. Today he can discover his errors of yesterday and tomorrow he can obtain a new light on what he thinks himself sure of today.
- Oh, God, Thou has appointed me to watch over the life and death of Thy creatures; here am I ready for my vocation and now I turn unto my calling
[…} Poor first noticed oddities as his ICU filled with patients who just weren’t responding to care the way doctors expected. They were on breathing machines after developing ARDS, acute respiratory distress syndrome. It’s an inflammatory form of lung failure that, when caused by other infections, stiffens lungs. . . “I did a case series of five. This does not prove anything,” he cautioned. “Perhaps it brings light to possibilities where further research can delve into what exactly is going on.”
READ ENTIRE AMAZING ARTICLE AT YWNews
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*The Hippocratic Oath in Halacha
**Revision to Hippocratic Oath after WWII:
The Declaration of Geneva,
as currently published by the World Medical Association reads:
"AS A MEMBER OF THE MEDICAL PROFESSION:
I SOLEMNLY PLEDGE to dedicate my life to the service of humanity;
THE HEALTH AND WELL-BEING OF MY PATIENT will be my first consideration;
I WILL RESPECT the autonomy and dignity of my patient;
I WILL MAINTAIN the utmost respect for human life;
I WILL NOT PERMIT considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient;
I WILL RESPECT the secrets that are confided in me, even after the patient has died;
I WILL PRACTICE my profession with conscience and dignity and in accordance with good medical practice;
I WILL FOSTER the honour and noble traditions of the medical profession;
I WILL GIVE to my teachers, colleagues, and students the respect and gratitude that is their due;
I WILL SHARE my medical knowledge for the benefit of the patient and the advancement of healthcare;
I WILL ATTEND TO my own health, well-being, and abilities in order to provide care of the highest standard;
I WILL NOT USE my medical knowledge to violate human rights and civil liberties, even under threat;
I MAKE THESE PROMISES solemnly, freely and upon my honour."
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