4 ms·

My normal deep voice now sounds like Mickey Mouse's and it hurts to swallow. Perhaps a more "low hanging fruit" solution for this problem space would be better

My normal deep voice now sounds like Mickey Mouse's and it hurts to swallow. Perhaps a more "low hanging fruit" solution for this problem space would be better procedures for helping people recover. Doctors routinely prescribe antibiotics. I never had any of them tell me to eat yogurt afterwards to repair what they do to your gut biome. I learned that elsewhere. No doctor ever told me I needed to taper off of steroids. I learned that from a friend. There are a lot of ways modern follow-up care for medicine seems to be pretty bad and this is probably a much easier thing to improve upon than innovating on intubation tubes (which I'm not trying to discourage -- I see no reason we can't do both).

robbiep 6y ago
No doctor is ever going to prescribe steroids that do not end in a tapering dose (necessary for initial durations longer than 5 days). It literally kills and is negligent
- DoreenMichele 6y ago
  I've been on steroids multiple times, for sometimes months at a time. No doctor ever put me on a tapering dose. So whatever they are supposed to do, that's not what I personally experienced.
- peteretep 6y ago
  Plenty of doctors prescribing benzos seemingly unaware of the cessation issues with them
  - robbiep 6y ago
    Very few would be unaware of the consequences... it’s a basic tenet of medicine - after all, along with alcohol withdrawal (and because of similar mechanisms) it’s one of the few withdrawals that can actually kill you (along with steroids). Again that’s terrible practice but more often than not, given the prevelance of Benzo knowledge and specific requests from patients, some people end up giving them away (similarly to antibiotics for viral infections). It’s bad medicine but when GPs have 20 minutes for a consult and patients are more and more demanding... corners are cut when harm is considered minimal (ie regular low level Benzo dosing). For example, probably 20-30% of elderly patients in hospital are on temazepam on arrival. They’re taking 10mg every night. That should never happen, but it does all the time.
- chromatin 6y ago
  While a steroid taper has been practice in medicine for a long time, we have found more recently that it is unnecessary in many cases, with specific exceptional thresholds for total dose in prednisone equivalents or total number of days on steroid. 5 days is no longer dogma, and in some evidence now supports that courses as long as 2 weeks (of reasonable doses I am not talking 1 mg/kg for GVHD or ILD or anything along those lines) may be stopped without taper. Finally, there is emerging data that prolonged tapering may actually worsen outcomes, such as in certain post operative settings.
- teatree 6y ago
  I was prescribed steroid (prednisolone) for 2 years by a licensed, famous doctor. He never told me about its ill effects and he didn't taper the does till mid of second year. It didn't help my Crohns much, just kept it suppressed. I am expecting to die early because of this. So, please don't assume the doctor is always right. Do your due diligence. They are fallible just like us, to be honest, I think they are just engineers working on the human body.
Ovah 6y ago
"I never had any of them tell me to eat yogurt afterwards to repair what they do to your gut biome." At least today 'probiotics' are just like any other health supplement without the proper data to back up regular clinical use. There might come a time where they are regularly prescribed but we are not there.
- DoreenMichele 6y ago
  My comment is advocating that we work on getting there. Your comment only really agrees with mine that this is something we currently don't do. Justifying the practice of not doing it isn't actually a rebuttal to the thought that "It would probably be easier and quicker to do a few studies and come up with some better post op instructions for how to recover than to invent new tubing and get that FDA approved."

robbiep 6y ago

No doctor is ever going to prescribe steroids that do not end in a tapering dose (necessary for initial durations longer than 5 days). It literally kills and is negligent

DoreenMichele 6y ago
I've been on steroids multiple times, for sometimes months at a time. No doctor ever put me on a tapering dose. So whatever they are supposed to do, that's not what I personally experienced.
peteretep 6y ago
Plenty of doctors prescribing benzos seemingly unaware of the cessation issues with them
- robbiep 6y ago
  Very few would be unaware of the consequences... it’s a basic tenet of medicine - after all, along with alcohol withdrawal (and because of similar mechanisms) it’s one of the few withdrawals that can actually kill you (along with steroids). Again that’s terrible practice but more often than not, given the prevelance of Benzo knowledge and specific requests from patients, some people end up giving them away (similarly to antibiotics for viral infections). It’s bad medicine but when GPs have 20 minutes for a consult and patients are more and more demanding... corners are cut when harm is considered minimal (ie regular low level Benzo dosing). For example, probably 20-30% of elderly patients in hospital are on temazepam on arrival. They’re taking 10mg every night. That should never happen, but it does all the time.
chromatin 6y ago
While a steroid taper has been practice in medicine for a long time, we have found more recently that it is unnecessary in many cases, with specific exceptional thresholds for total dose in prednisone equivalents or total number of days on steroid. 5 days is no longer dogma, and in some evidence now supports that courses as long as 2 weeks (of reasonable doses I am not talking 1 mg/kg for GVHD or ILD or anything along those lines) may be stopped without taper. Finally, there is emerging data that prolonged tapering may actually worsen outcomes, such as in certain post operative settings.
teatree 6y ago
I was prescribed steroid (prednisolone) for 2 years by a licensed, famous doctor. He never told me about its ill effects and he didn't taper the does till mid of second year. It didn't help my Crohns much, just kept it suppressed. I am expecting to die early because of this. So, please don't assume the doctor is always right. Do your due diligence. They are fallible just like us, to be honest, I think they are just engineers working on the human body.

Ovah 6y ago

"I never had any of them tell me to eat yogurt afterwards to repair what they do to your gut biome." At least today 'probiotics' are just like any other health supplement without the proper data to back up regular clinical use. There might come a time where they are regularly prescribed but we are not there.

DoreenMichele 6y ago
My comment is advocating that we work on getting there. Your comment only really agrees with mine that this is something we currently don't do. Justifying the practice of not doing it isn't actually a rebuttal to the thought that "It would probably be easier and quicker to do a few studies and come up with some better post op instructions for how to recover than to invent new tubing and get that FDA approved."