Haider Warraich
speaker
683 appearances
3 recordings
1 series
first heard Oct 2020
last heard Dec 2021
Haider Warraich’s voice in public audio — every appearance, attributed to the second.
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Appearances
I might start crying during the middle of the song, but I really wanted to see and get to hear Alex take on it.
Unbelievable.
I mean, I, I do joke that sometimes the best diuresis is through tears and I, and certainly it's, this is quite potent.
Thank you, Alex.
This is really moving.
And thank you for sharing that story.
And I've thought a lot about palliative inotropes, and I feel like especially when it comes to more advanced forms of heart failure, this question comes up all the time.
As you've already outlined some of the challenges that we face with regards to having someone on palliative inotropes, one being that very few hospice agencies will even consider
covered this therapy.
So in essence, the moment you make this decision, what you're doing is you're limiting, you might be limiting someone's options for care quite drastically.
I am a heart failure doctor.
I am obsessed with right heart cath numbers, hemodynamics, et cetera.
But when it comes to palliative inotropes, I take all of that out of the picture and I really focus on them as I would any other palliative care therapy.
like morphine or diuretics, is the benefit that someone's feeling, a quality of life benefit that someone's experiencing, does that outweigh whatever sort of risks or hassles that might come with the therapy?
And so the burden of proof is really on inotropes to demonstrate, are they helping that patient or not feel better?
Not just improve their numbers, not just improve their cardiac index, so to speak, but is it providing a functional benefit?
And I would say that that proportion is quite small, especially in patients who are more advanced.
Before I think about a palliative inotrope, the first thing I want to do is I want to talk to the patient and I want to explain to them what inotropes do.
And the one thing that we know that they don't do is that they do not increase survival.
And I think that's a really, really important thing because
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