Question for Dr. Marcus, or any other pulmonologists. I just got an "interesting consult" 59 yo male a couple months post COVID late March, was intubated late March, intubated x 14 days, self-extubated, and has been having SOB since then. He was on CPAP before, says he lost about 40 - 50 pounds post COVID but is still 5'4" and 215#. Pulmonologist scoped him and he has a large granuloma on the left immediately below the posterior aspect of the cord, and another granuloma vs just granulation tissue midline subglottic. Easy enough, but the kicker is that he has extensive tracheomalacia with dynamic collapse extending even into the mainstem bronchi. Pulmonologist sent me a video and it's really impressive. I am a Lolpoor and technologically challenged, not sure I would even know how to post the video.
Question for you is, do you think the tracheomalacia has anything to do with his COVID-19, or just years of being a big, fat fatty McFatface as we say here? He, consistent with his self-extubation, has discontinued his CPAP because he thinks he is "cured" after he lost weight. I can try to post some photos later when I get back to the office and have some time. He's on insulin, a statin, Losartan, Metformin, and - daily prednisone. He says he cannot come off of his prednisone without getting short of breath (which, of course, is exacerbating his diabetes). Ugh.
Question for you is, do you think the tracheomalacia has anything to do with his COVID-19, or just years of being a big, fat fatty McFatface as we say here? He, consistent with his self-extubation, has discontinued his CPAP because he thinks he is "cured" after he lost weight. I can try to post some photos later when I get back to the office and have some time. He's on insulin, a statin, Losartan, Metformin, and - daily prednisone. He says he cannot come off of his prednisone without getting short of breath (which, of course, is exacerbating his diabetes). Ugh.
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