Whitfield Lewis, MD 🇦🇬🇺🇸
@whitfieldlewis6
Clinical Assistant Professor at UPMC Altoona. Vascular Neurologist. Tweets and views are my own. Tweets are for educational purposes, not for medical advice.
Transverse Myelitis 🧵 Let’s refresh. Myelo = spinal cord -itis = inflammation So, transverse myelitis = inflammation of the spinal cord. Let’s talk about what that really means. 👇
Watch out for side effect due to abrupt discontinuation of gabapentin. The side effect being a really significant case of status epilepticus. The same phenomenon happens with abrupt discontinuation of klonopin. You really have to slower wean those drugs off. The most common…
My 3 LEAST favorite medications— especially in over 60s. As a physician for many years, I would never want any relative of mine to take any of these pills: 1. Hydrochlorthiazide (HCTZ) for blood pressure. Most common side effect I’ve observed: low potassium, dehydration. 2.…
In human physiology, there are two opposing metabolic states governed by hormones: the fed state and the fasted state. During the fed state, insulin is high. Three main factors stimulate insulin release: 1.Just thinking about, smelling, or seeing food activates the hypothalamus,…
Thank you for the insight, Dr. Lewis. You're correct—intermittent fasting can indeed benefit type 2 diabetics by improving insulin sensitivity and reducing resistance, per recent studies from the Endocrine Society and NIH (2023-2025). Supervision is key to manage hypoglycemia…
This is sad to watch. Over time, this person will develop "Black lung disease." The medical term is coal workers' pneumoconiosis. Chronic inhalation of coal dust leads to chronic inflammation, progressive scarring (fibrosis), and subsequent death of lung tissue (necrosis). The…
The harsh reality of a coal mine
@drcm22 Salam, please find the unroll here: threadreaderapp.com/thread/1948144… Talk to you soon. 🤖
I should play it safe. Stay quiet. Don’t mess up the algorithm by talking about diet. But I can’t help it. 📱Just got this from a friend: “Down 48 lbs. BP is lower too. Doc still gave me a small dose of meds.” My friend represents the average patient I see in stroke clinic.…
Your immune system constantly surveys your body for cancerous cells. If a cancer cell is detected, your CD8 T cells and Natural Killer cells attack the cancer cell and try to kill it. We all produce cancer cells frequently. Arguably, the first stage of cancer is failure of your…
T cell identifying and destroying a cancer cell, the immune system's role in cancer defence
🔍 FOLLOW-UP CASE: THE HALO SIGN The “halo sign” on temporal artery ultrasound isn’t just a pretty ring—it’s a life- and vision-saving clue. 📊 What does the evidence say? A 2021 meta-analysis (Sebastian et al., Rheumatol Adv Pract) found: Sensitivity: 67% Specificity: 95%…
☕️ Nothing pairs better with your morning coffee than a clinical case that could change how you practice. In case you missed it, my transverse myelitis post is below. Because in neurology, timing is everything—catch it early, treat it fast, or risk irreversible damage. 👇 Read…