fit data to your model [bobologie]

A few weeks ago, I contacted my general (and sport) practitioner for a mild issue with hurting toes, as they were indeed hurting and not only during or after my daily runs (!). Since the beginning of lockdown. I thought he would tell me to contact him later and stop running in the meanwhile but instead he told me to come to his office and after a rather cursory glance at said toes started discussing on a rare occurrence of COVID-19 induced frostbite-like toes. He then ordered a blood test which I took the next morn. Right after my (legit and solitary) one hour run. The results of the test were within the “normal” boundaries, except for the D-dimer test which was above the limit and is usually intended for detecting deep venous thrombosis. (As reported on Wikipedia, “a four-fold increase in the D-Dimer protein is a strong indicator of mortality in those suffering from COVID-19.”) This caused my physician to react quickly by prescribing me a cocktail of anticoagulants, corticosteroids and antibiotics. And another test four days later, incl. one for COVID-19. While anticoagulants made sense wrt to the coagulation issues, the corticosteroids were a surprise as they had been earlier pointed out as a potential aggravating cause for younger patients. Including by the French Ministry of Health. I thus asked my daughter for advice, as she had been triaging potential COVID-19 patients in the emergency room for the past month and she was strongly negative about the treatment, both because of the corticosteroids and of the antibiotics. Treatment that was apparently advocated by my practitioner on his own. I thus waited for the second round of blood tests, which returned a lower D-Dimer level and a negative signal for COVID-19. (In the meanwhile, I had spotted a BMJ paper on the possible impact of extended running on the D-Dimer levels and hence waited till the mid-afternoon to take the test!) While this ended up as a non-story, only made more exciting by the lack of competitive events during the lockdown!, I find it interesting that my doctor, who was most reasonably worried about the rising number of COVID-19 among his patients, leaned towards a viral conclusion with little data, as my month-old return to intensive (daily) running was a more likely explanation for sore toes…

2 Responses to “fit data to your model [bobologie]”

  1. Really glad you are okay, Professor Robert! As to your primary, “when holding a hammer, everything looks like a nail”. Some practitioners have deep knowledge, some don’t.

    Glad you were able to think it through, consult your daughter, and check the BMJ on running.

    I’m a runner, too, but vastly inferior to your skill. I’ve been ill the first third of this year, not with COVID-19, but bacterial pneumonia and then influenza (experienced while on a trip to London, believe it or not). So that has depressed my running, which I very much miss.

    Working back to doing it. But I mention that experience because, well, COVID-19 isn’t the only illness that can get in the way.

    Thanks for relating. Stay safe and well.

    – Jan

    • Thank you Jan. Sorry to hear about your illness. Several of my running mates have met with long-term pneumonial issues, although at the top of their training and abilities. Maybe we train too much… Take care.
      Xi’an

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