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Cake day: July 2nd, 2023

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  • No, if a patient is declared brain dead, there is usually no sedation given. It shouldn’t be necessary, as the neurons responsible for sensing pain aren’t alive and processing signals, and extra medication like sedation comes with the risk of hemodynamic instability, which is already kind of a headache in brain dead patients as the brain is no longer meditating that (extremely oversimplified). Yes, sedation can be measured (sorta) with a BIS probe, a spectral imaging probe on the forehead that acts like an EEG with fewer probes, but it’s not very useful in brain death as it’s ultimately looking at blood flow, and in brain death, we don’t expect to see blood flow to the brain.

    All of this, of course, assumes that he was declared brain dead, which is a very specific legal term with very specific parameters that vary slightly state by state, which seems unlikely in this situation. He may have been deemed to have a severe neurologic injury with an unlikely prognosis of meaningful recovery, and thus be a planned DCD (declared cardiac death) donation, meaning placed on a minimally assistive ventilatory support and allowed to die once his respiratory drive was so low he died of hypoxic respiratory failure. But the article is long on anecdotes and short on the technical terms physicians would use, so it’s hard to say.






  • I am a doctor, not your doctor.

    First, you need to clean the area with soap and water. It’s hard to say a lot with the way it looks now.

    Second, that looks like a fungal infection. You can treat it OTC with athlete’s foot medications or something for ringworm. I usually say topical terbinafine, which is the generic in a lot of those creams.

    Third, might be less popular, but I’d encourage shaving the area. Hair makes it hard to care for or cleanse wounds. There are slightly higher rates of infection in situations like perioperative infections, but for fine care, it’ll be way easier for you.








  • Went to school with Weston Wamp. His dad was a professional congresscritter, and it was pretty clear all he was ever interested in was politics. Not very bright, not very athletic, but always shaking hands. I doubt he has any real understanding of the situation outside what an advisor told him. He won the Special Olympics of jobs, since he was running as a Republican for local elections in Tennessee. I value his opinion just slightly more than my dogs, as I suspect he knows not to eat his own poop, but he’s basically just a fine combination of nepotism and entitlement and shouldn’t be allowed to counsel people unless it’s on how to make a career without any marketable skills.