"I Was Wrong": A Surgeon's First-Person Account of His COVID-19 Illness.

A surgeon failed to heed his own misgivings on taking a family vacation cruise. Despite scrupulous hand-washing and antiseptic precautions with anything within reach, he contracts COVID-19. His anxiety increased as his condition became increasingly serious: uncontrollable dry coughing spells, spiking fevers, and his worst symptom, progressive dyspnea and chest pain. From what he knew about the disease, he feared admission to the intensive care unit, a step that portended a significantly worse prognosis. After a week-and-a-half of illness, misery, and fear, he began to improve: first, his fevers diminished, breathing came more easily, and coughing spells occurred less frequently, if still unpredictably. Now with his strength slowly returning, he contemplated returning to work but was frustrated when tests showed he was still shedding active virions. Under quarantine and with time to reflect, he cautions against complacency with regard to the infectiousness of COVID-19. His own denial led to the loss of his health and livelihood. At home but still separated from his wife and children in a basement bedroom, the bittersweet circumstances of his reunion with them is a reminder of the preciousness of life and love of family.

Risk factors associated with acute lower extremity ischemia after coronary revascularization.

Acute lower extremity ischemia (ALEI) is a recognized complication of coronary revascularization that can lead to emergent lower extremity revascularization, amputation, and death. Patients with correctable coronary artery disease have a high incidence of lower extremity arterial occlusive disease (AOD). But, despite the known high correlation between AOD and coronary artery disease, the status of the lower extremity vasculature in patients undergoing coronary revascularization may be overlooked until the lower extremity becomes profoundly ischemic. Data from a retrospective review of 35,000 coronary revascularization procedures identified 55 patients who developed ALEI, subsequent to their cardiac procedures. Risk factors for ALEI included femoral artery instrumentation, previous coronary revascularization, hemodynamic instability, and documented AOD. Means of identifying patients at risk for ALEI are discussed.