Let's talk honestly about "informed consent."
Someone with decades of training gives someone with none advice usually packed into 1-3 mins. Huge amount is based on trust. Huge potential for bias built in. But also there is no obligation to provide real alternative options.

The #RELAx trial has been published today in @JAMA. It was coordinated by Anna Algera. This thread is to explain the rationale, what we did, the findings and the meaning.
The rationale of #RELAx is based on the following

First, there is NO adequate evidence on the level of PEEP in non-ARDS patients. Most of the studies are old, conducted in post-surgical patients (short-term ventilation), and were not powered to detect differences in patient-centered

Second, despite the absence of evidence, the levels of PEEP used in non-ARDS patients increased over years, from 5 to 7/8 cmH2O, probably as a reflection of studies and practice in ARDS

Third, one IPDM showed that higher levels of PEEP could benefit more severe ARDS patients. However, opposite trends (higher mortality and longer ventilation) were found in mild ARDS with higher PEEP (despite not powered to be statistically

Fourth, most of the weaning protocols include PEEP ≤ 5 cmH2O as a criterion for readiness to wean. Theoretically, a standardized liberal strategy of higher PEEP could delay weaning in some

ECTOPIC PREGNANCY

A woman just lost her life due to ectopic pregnancy!

It's a pregnancy in which the embryo attaches outside the womb. It can be life-threatening.

But we can save lives by helping educate women on our Timelines with this.

THREAD 🧵

In the human body, a fertilized egg hardly survives outside the womb. If allowed to grow, it may damage nearby organs & cause severe blood loss.

The bulk of ectopic pregnancies occur in/along the Fallopian tubes.

Some in the ovaries, cervix or a random location in the abdomen.

The usual symptoms of ectopic pregnancy a woman may experience esp. in early pregnancy are;

* Abdominal pain
* Vaginal bleeding, &
* Amenorrhea (missing your period)

Other pregnancy symptoms like breast fullness & occasional nausea may be there too.

But the common DANGER SIGNS of ectopic pregnancy that may signify rupture are;

🔴 Rigid abdomen

🔴 Severe abdominal pain

🔴 Shoulder tip pain, &

🔴 Signs of shock such as cold hands & feet.

With these signs, immediate medical attention is needed to save the woman's life!

Your chances of having an ectopic pregnancy are higher if you have;

1. Previous ectopic pregnancy

2. STI's like gonorrhea

3. Fertility treatments like IVF*

4. Fallopian tube surgeries

5. Pregnancy while using an Intrauterine Contraceptive Device

6. Smoking history! 🚭

breaking my social media fast, which may or may not exist anymore, to share something i found really really helpful from today's therapy sesh. i figured out why i (we?) have so much trouble celebrating our wins

so ive been in therapy for 100 years. still anxious, but im pretty sure i was born that way so i'll stay that way. still depressed too, which i thought id be cured of by now. aa few sessions ago we talked about what i think a return to health 'should' look like

initially i figured itd look like being the person i was before i got depressed. energetic, not needing pep talks to do shit like go outside, cooking everyday, working out at least 30 mins at least 3 days a week, calling my mom everyday, etc.

that session i realized that im a completely different person than i was before i got depressed. also the world has changed a lot & things are just done differently now. not allowing for those things had me reaching for shit that was impossible.

so i make some concessions but say that i *still* want to be able to do some things that i dont want to do. like i cant just sit on the couch and never move in the name of accepting who i am, which is A Bitch Who Don't Like To Move. i still want to be able to eve if i dont want