How to fight Covid at home

[surgblumm]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOW TO FIGHT COVID AT HOME

No one ever talks about how to fight Covid at home. I came down with Covid in November. I went to the hospital, running a fever of 103, a rapid heart beat, and other common symptoms that come with Covid. While I was there they treated me for the high fever, dehydration and pneumonia.

The doctor sent me home to fight Covid with two prescriptions - Azithromycin 250mg & Dexamethason 6mg. When the nurse came in to discharge me, I asked her, "What can I do to help fight this at home?" She said, “Sleep on your stomach at all times with Covid. If you can’t sleep on your stomach because of heath issues sleep on your side. Do not lay on your back no matter what because it smashes your lungs and that will allow fluid to set in.

Set your clock every two hours while sleeping on your stomach, then get out of bed and walk for 15-30 min, no matter how tired or weak that you are. Also move your arms around frequently, it helps to open your lungs. Breathe in thru your nose, and out thru your mouth. This will help build up your lungs, plus help get rid of the Pneumonia or other fluid you may have.

When sitting in a recliner, sit up straight - do not lay back in the recliner, again this will smash your lungs. While watching TV - get up and walk during every commercial.

Eat at least 1 - 2 eggs a day, plus bananas, avocado and asparagus.These are good for Potassium. Drink Pedialyte, Gatorade Zero, Powerade Zero & Water with Electrolytes to prevent you from becoming dehydrated. Do not drink anything cold - have it at room temperature or warm it up. Water with lemon, and little honey, peppermint tea, apple cider are good suggestions for getting in fluids. No milk products, or pork. Vitamin’s D3, C, B, Zinc, Probiotic One-Day are good ideas. Tylenol for fever. Mucinex, or Mucinex DM for drainage, plus helps the cough. Pepcid helps for cramps in your legs. One baby aspirin everyday can help prevent getting a blood clot, which can occur from low activity. "

Drink a smoothie of blueberries, strawberries, bananas, honey, tea and a spoon or two of peanut butter.

We always hear of how Covid takes lives, but there isn't a lot of information out there regarding how to fight Covid. I hope this helps you or someone you know, just as it has helped me.

[ohiovolffemtp]

I'm recommending/prescribing these things for COVID-19 (+) patients I discharge home:

• Dexamethasone 6mg daily for 7 days.  For diabetics I advise them to check their blood sugar daily as the steroids will elevate it.
• A pulse oximeter.  I advised them to wear it while walking through the house at least twice daily and to return to the ED if it reads below 90.
• Anti-tussives if coughing is preventing them from sleeping.  I either recommend Robitussin-DM or prescribe promethazine with dextromethorophan.

Some colleagues in areas where there are no available hospital beds are sending mildly hypoxic patients home with home O2 and strict return guidelines.

[MediMike]

1 hour ago, ohiovolffemtp said:

I'm recommending/prescribing these things for COVID-19 (+) patients I discharge home:

• Dexamethasone 6mg daily for 7 days.  For diabetics I advise them to check their blood sugar daily as the steroids will elevate it.
• A pulse oximeter.  I advised them to wear it while walking through the house at least twice daily and to return to the ED if it reads below 90.
• Anti-tussives if coughing is preventing them from sleeping.  I either recommend Robitussin-DM or prescribe promethazine with dextromethorophan.

Some colleagues in areas where there are no available hospital beds are sending mildly hypoxic patients home with home O2 and strict return guidelines.

Is there a reason you're writing for the dex?

Other than standard recommendations (RAD etc) there's been no evidence showing benefit with a nonsignificant trend towards harm (RECOVERY) in individuals who aren't requiring oxygen.

*This is honest curiosity rather than a judgemental statement *

[surgblumm]

I am a diabetic and the Dex would push my blood sugar to a high of two hundred. I was  sent home with no meds which I thought was irresponsible and am following Tom Rosell's guidance by getting the Robbitussin DM,,  drinking fluids at room temperature and adjusting my diet. Thus far my SpO2 remains at 99% and my temps are 97.3 to 98. BP's are normal and I am trying to get control of my blood sugar again since the hospital used a sliding scale and threw me into a diabetic disaster area.

[Cideous]

I WOULD LIKE TO REQUEST THE MODS LEAVE THIS THREAD OPEN BUT PIN IT TO THE TOP PLEASE.

[MediMike]

3 hours ago, Cideous said:

I WOULD LIKE TO REQUEST THE MODS LEAVE THIS THREAD OPEN BUT PIN IT TO THE TOP PLEASE.

Can I ask why?

This post is full of nonsensical medical advice.

Azithromycin has no place in the treatment of COVID.

There is no evidence that proning at home would do any good, and if you're at the point where you need to prone you need to be monitored inpatient.

None of us would ever advise a patient who is weak or exhausted to get up and exercise, this is dangerous advice.

Why in the name of god would you avoid cold beverages?

Why would you avoid dairy? Why would you avoid pork?

Famotidine for leg cramps? What? Leg cramps are a side effect of famotidine.

This is a piece of internet myth which has been reposted again and again.  

I'm sorry if I come across rude in my reply but we're better than this.

[TheFatMan]

Not to be disrespectful, but this has been shared quite a bit on social media...a lot of it I don't think is very good advice, for example waking up every two hours to walk around? Why? Depriving yourself of sleep is counterproductive. 

Dr. Jess Mason of EM:RAP chimed in as well.

https://kmph.com/news/local/doctor-replies-to-debunks-advice-on-how-to-fight-covid-at-home-social-media-post?fbclid=IwAR03ktX7i4XxL5588tBPRE-xgflJQPBTnB7u3txLl_YjW76gbKrXgar519Y

[ventana]

Yup a lot of not great advice. 
 

buyer be aware. 
 

dex on every patient.  Sorry horrible idea.  Treat each patient, not just checking boxes. 

[surgblumm]

When I posted this I received it from a friend and was still in a Covid fog. Scopes ruled on this and I agree that it is a lot of folk lore and not meant for Covid patients at home. I have been out of the hospital a second time and am doing fluids, rest and checking my temp and SpO2 B.I.D. I have been afebrile for the past four days. Thanks for your honest comments. Bob

[MediMike]

42 minutes ago, surgblumm said:

When I posted this I received it from a friend and was still in a Covid fog. Scopes ruled on this and I agree that it is a lot of folk lore and not meant for Covid patients at home. I have been out of the hospital a second time and am doing fluids, rest and checking my temp and SpO2 B.I.D. I have been afebrile for the past four days. Thanks for your honest comments. Bob

Totally get it man. Glad you are out of the box and trending upwards!

[ohiovolffemtp]

My practice has been to use decadron on an OP basis for folks who are having some respiratory difficulty, eg. wheezing and/or diminished breath sounds but who are not hypoxic either at rest or on walking.  I usually also prescribe a pulse ox and recommending checking while walking around the house BID for outpatients likely to decline.    Hypoxia gets admitted.

What would be downside to having patients "prone", i.e. vary their sleeping/laying positions from side to side vs staying supine on an outpatient basis?

[MediMike]

1 hour ago, ohiovolffemtp said:

My practice has been to use decadron on an OP basis for folks who are having some respiratory difficulty, eg. wheezing and/or diminished breath sounds but who are not hypoxic either at rest or on walking.  I usually also prescribe a pulse ox and recommending checking while walking around the house BID for outpatients likely to decline.    Hypoxia gets admitted.

What would be downside to having patients "prone", i.e. vary their sleeping/laying positions from side to side vs staying supine on an outpatient basis?

Gotcha.  General thought process I've gathered from the literature is those without hypoxia are either a) early enough in the dz process that steroid use will allow more viral replication and progression of the dz or b) simply not going to get bad enough to benefit from the steroids. Guess that's why dex in patients not requiring supplemental oxygen is against ACEP and NIH guidelines in COVID patients.  I'm sure when you factor in the wheezing then it's a different story, what dosing/duration are you using for the non-hypoxic wheezers? Bronchodilators? It's been a while since I've been downstairs but I remember a two day regimen for adults with asthma?

If you're proning due to hypoxia at home then you should likely be admitted.  NEJM had an article with hypoxic patients presenting to the ED with sats in the 80s, and while those sats cranked up within a couple minutes of proning ~35% of them ended up intubated within the hour demonstrating that it is simply a band-aid and while it is a good one in a monitored state if you're bad enough to need it you should probably be hanging out with us.

Caputo ND et al. Early self-proning in awake, non-intubated patients in the emergency department: A single ED's experience during the COVID-19 pandemic. Acad Emerg Med 2020 Apr 22

If you are proning because it's more comfortable for you then whatevs, although I find prone sleepers to be a strange and untrustworthy breed.

[ventana]

MediMike

perfect reply to Ohio

 

Yes we need to follow the knowledge base and simply "creating your own treatment" plan with Dex on almost all patients could be harmful to patients

 

goes back to my talk with students

 

"you and you alone own the scripts you write - please make sure you know exactly what and why you are prescribing...."