Whitfield Lewis, MD ๐ฆ๐ฌ๐บ๐ธ
@whitfieldlewis6
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Clinical Assistant Professor at UPMC Altoona. Vascular Neurologist. Tweets and views are my own. Tweets are for educational purposes, not for medical advice.
Hollidaysburg, PA
Joined September 2015
๐ง Insulin Resistance of the Brain?.Yes, you heard that rightโyour brain can become insulin resistant. Could this be why you're struggling with your weight?. Letโs upgrade the conversation around energy balance. ๐งต๐. Some folks still think weight gain is just algebra:. Calories.
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This year marks the 10th anniversary of my wifeโs fatherโs passing โ Hon. Dr. Thomas Mark Turay. His work in Sierra Leone uplifted an entire village, advancing education, human rights, and community development. He died of a myocardial infarction while driving to the nearest.
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๐ง Know your orbital anatomy. Letโs break it down into 3 compartments. But firstโwhat are we looking at?. ๐ Axial T2-weighted MRI of the brain.๐ผ๏ธ First image = annotated | Second = raw.Follow along ๐.1. Eyeball (Globe / Ocular Space).Includes:. Cornea & sclera: most anterior,
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Letโs go! Orbital anatomy ๐ง ๐๏ธ. Starting with the extraocular muscles โ the ones responsible for moving the eye. Each is innervated by a specific cranial nerve. Hint: Remember the med school mnemonic?. SO4, LR6, and the rest are 3. Can you guess the muscles highlighted by the
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๐ง This is a 35-year-old male who presents with a generalized tonic-clonic convulsion (grand mal seizure). ๐ธ MRI Brain was done and is shown below. โWhat is the likely etiology of his seizure?.๐ง What is this โpopcornโ lesion evident on T1 and T2?.๐๐๏ธ Note the minimal, if
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Two biggest levers for metabolic health?.1.Extend the fasted window.2.Prioritize nutrient-dense foods. Having a treat once every 2 months for nostalgia isnโt the issue. Itโs what you do consistently that defines your health. Hereโs the protocol ๐งต. โธป. 1.Fasting window:.Extend.
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JOIN US IN 25 MINS. Here are my final thoughts before the Twitter Space meet-up. THREAD: The Dietary LipidโHeart Hypothesis Was Born from Confusion, Not Causality ๐งต. ๐น The idea that saturated fat causes heart disease was never built on strong data. It emerged during a time
Set a reminder for my upcoming Come join @whitfieldlewis6 @JonEntine @camjenglish & me for a follow up of last weekโs Space! . Tomorrow at 11 am CST๐๐ฝ.
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Took a short hiatus from the gym, ~ 1 month. Time to get BACK to basics.
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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 medicationsโ 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 Iโve observed: low potassium, dehydration. 2.
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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,.
@whitfieldlewis6 @diydatascience @Rainmaker1973 Thank you for the insight, Dr. Lewis. You're correctโintermittent 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.
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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
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See my transverse myelitis overview below ๐๐.
Transverse Myelitis ๐งต. Letโs refresh. Myelo = spinal cord. -itis = inflammation.So, transverse myelitis = inflammation of the spinal cord. Letโs talk about what that really means. ๐
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This is a case of post-infectious transverse myelitis. ๐ง The patient had COVID 3 weeks ago, then suddenly developed spinal cord inflammation. Why?. Molecular mimicry โ the virus shares similarities with spinal cord antigens, triggering an immune attack on the cord itself. The.
๐จ Clinical Case: Post-COVID Paraparesis. A 53-year-old man presents with 2 days of lower extremity weakness. โ
Recent COVID (3 weeks ago).โ
Normal vitals, labs, and CSF.โ
Normal brain MRI.MRI spine shown below ๐ . Whatโs the diagnosis? Whatโs your next step? See next comment
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RT @threadreaderapp: @drcm22 @whitfieldlewis6 @drcm22 Salam, please find the unroll here: Talk to you soon. ๐ค.
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@whitfieldlewis6: Transverse Myelitis ๐งต Letโs refresh. Myelo = spinal cord -itis = inflammation So, transverse myelitis = inflammation of the spinal cord. Letโs talk about what that really means. ๐...
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See explanation below ๐ ๐.
๐ FOLLOW-UP CASE: THE HALO SIGN. The โhalo signโ on temporal artery ultrasound isnโt just a pretty ringโitโs a life- and vision-saving clue. ๐ What does the evidence say?. A 2021 meta-analysis (Sebastian et al., Rheumatol Adv Pract) found:. Sensitivity: 67%. Specificity: 95%.
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Halo sign โ an underappreciated but powerful clue for giant cell arteritis. ๐ If you see it on temporal artery ultrasound:.โ Start steroids immediately.โ Donโt wait for ESR or CRP. Delay = vision loss. Explanation below ๐ ๐ .
๐ FOLLOW-UP CASE: THE HALO SIGN. The โhalo signโ on temporal artery ultrasound isnโt just a pretty ringโitโs a life- and vision-saving clue. ๐ What does the evidence say?. A 2021 meta-analysis (Sebastian et al., Rheumatol Adv Pract) found:. Sensitivity: 67%. Specificity: 95%.
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Transverse Myelitis ๐งต. Letโs refresh. Myelo = spinal cord. -itis = inflammation.So, transverse myelitis = inflammation of the spinal cord. Letโs talk about what that really means. ๐
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