🧵📢 It’s been ~1 year that #COVID19 has changed our lives forever.

As an IM physician, GI trainee, educator and human, here are my thoughts/observations. Please indulge me in a 🧵 and join the convo. Would love to hear your take! #GITwitter 1/9
2/9 #COVID19 Coagulopathy: GI bleeding is most common GI consult(excellent talk by @mlatorremd @AmCollegeGastro ) and can be very hard to Tx

⚖️risk of 🩸 vs clot is a multiD approach

Some tips I learned👇
✅Rectal tubes/Fecal Mngt systems: need careful monitoring. >48 hours➡️pressure ulcers➡️rectal bleeding https://bit.ly/2LFvltR 
✅Ensure regular💩: none in 48 hours, ask why?
✅Endoscopy may not always be the answer; conservative mngt may be🗝️ https://bit.ly/3jzFp44 
3/9 NUTRITION, NUTRITION, NUTRITION

‼️🔑in acute illness and healing process.

Many need long term options (feeding tubes) but procedure rooms may be limited.

#IRad, #GI, #Surgery may be able to help so more durable feeding 🚫delayed https://bit.ly/3aX56r8 
4/9 #colorectalcancer screening is NOT elective. There have been delays in diagnosis and treatment. March is #coloncancerawareness month. We can’t let COVID+ #colorectalcancer team up and win!

https://bit.ly/374nygF 
5/9 As always, be mindful of anti-secretory Rx. Whether PPIs and H2RAs truly increase risk for COVID, I’m not sure. But we should always Rx wisely. https://bit.ly/2ZbBSzj 
6/9 Healthcare #Burnout is real. It’s our responsibility to take care of each other. Make a point to check in with yourself+colleagues. https://bit.ly/3q5Otjw 

To the residents out there...you my MVP

@Brown_IM_Chiefs @KellyMcGarry10 @RossHilliard @OslerResidency @sanjayvdesai
7/9 If it wasn't obvious before, #COVID19 has brought health disparities to light: a flaming, burning, supernova of light! WE MUST BE AWARE, LISTEN,TAKE ACTION https://bit.ly/2Z3HU5l 

Shout out to our leaders @drfolamay @LindaNguyenMD @SophieBalzoraMD @DMGrayMD @cnekekez
8/9 Adult learning ( #andragogy) NEEDS social interaction ( #constructivismtheory). Shout out to the giants in education: @DrEllieDS at @TeachersCollege and my brother @JordanDSimons 😊

Now, Insert #SoMed and #GITwitter taking the world by storm!
Virtual GI education has exploded- and it’s here to stay!
⬆️networking
⬆️educational materials
⬆️sharing ideas/experiences

Many thanks to those who have made it possible: @MondayNightIBD @ScopingSundays @GiJournal @ASGEendoscopy @AmCollegeGastro

and to my twitter family 💕
9/9 In summary
✅COVID Coagulopathy= team approach
🔑Nutrition
✅Get screened #colorectalcancer
✅Mindful of PPIs,H2RAs
✅Healthcare disparities = pandemic
✅Burnout is real,👀for each other
✅Virtual education has exploded-and it’s here to stay!

What say you #GITwitter? /Fin
You can follow @DrMalSimons.
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