What's the scoop on Madonna?

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miacomet

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Heard she was tubed in the unit, septic, expected to recover. Any more info?
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Apollyon said:
I don't know anything, except the picture attached to the article on MSN.com made her look not like her. Kinda puffy, and rounder face. I don't know if that is current, or a stock photo.
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I think that’s just what she looks like now.

Like most medical things in public articles, it doesn’t make a bunch of sense.
 
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Apollyon said:
I don't know anything, except the picture attached to the article on MSN.com made her look not like her. Kinda puffy, and rounder face. I don't know if that is current, or a stock photo.
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That's not related to illness (well, not physical illness anyway). She's had a bunch of plastic surgery and that has been the outcome. I don't know if the photo is super recent, but that's more or less what she looked like the last time I saw a photo of her in the news a year or so ago.
 
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“Found unresponsive” makes me think accidental overdose and they are just making up the bacterial infection as the cause, or she also aspirated or also had a questionable UTI and they are ignoring the real reason she went unresponsive.

I can’t remember the last time I had an otherwise healthy individual come in unresponsive to the ER from septic shock and required intubation. Nursing home patients? Sure, all the time, that would be a rare presentation of sepsis for an otherwise healthy individual.
 
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Oh, I've seen it with severe pneumonia.
 
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WilcoWorld said:
Oh, I've seen it with severe pneumonia.
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Pneumonia in a healthy individual requiring mechanical ventilation, sure, although not that common. Maybe see it once or twice a year outside of the COVID years. A healthy individual with pneumonia coming in completely unresponsive, I don’t know if I’ve ever seen. Generally they are showing up to an ER much sooner than that.
 
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These people have access to physicians for anything at anytime. There’s about a 0% chance a bacterial infection would go untreated in someone of that status to get to the point she’s at. There’s something else going on. Found unresponsive in a celebrity is usually an overdose or unintentional polypharmacy more often than not.
 
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Friends. Not cool to diagnose by MSNBC click bait article. Even on an anonymous forum.
 
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JacobMcCandles said:
These people have access to physicians for anything at anytime. There’s about a 0% chance a bacterial infection would go untreated in someone of that status to get to the point she’s at. There’s something else going on. Found unresponsive in a celebrity is usually an overdose or unintentional polypharmacy more often than not.
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I find that VIPs (and mine are generally “they gave 3M$ to the hospital charity gala”, which is awesome, but not like “madonna”) tend to end up receiving different care than other people. So if what we do for other people is based on evidence or even just experience of it working … then idk what the VIPs get but it’s not that. I feel like they are often allowed to direct their care more than other people are, but unless they are physicians it’s probably not a good idea for them to have any directing role. And insurance wouldn’t be an issue so it’s not like you’d have to go to a BC physician or get prior auth before doing something. I could see a VIP getting totally mismanaged care of a simple condition like pneumonia until it declared itself.
 
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CoolDoc1729 said:
I find that VIPs (and mine are generally “they gave 3M$ to the hospital charity gala”, which is awesome, but not like “madonna”) tend to end up receiving different care than other people. So if what we do for other people is based on evidence or even just experience of it working … then idk what the VIPs get but it’s not that. I feel like they are often allowed to direct their care more than other people are, but unless they are physicians it’s probably not a good idea for them to have any directing role. And insurance wouldn’t be an issue so it’s not like you’d have to go to a BC physician or get prior auth before doing something. I could see a VIP getting totally mismanaged care of a simple condition like pneumonia until it declared itself.
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In my experience, VIPs typically get overtested and get unnecessary meds leading to suboptimal care.
 
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In my experience (and my experience with Madonna-level VIPs, VIPs who aren't really VIPS, donor VIPs etc is fairly considerable) the true VIPs are often fairly humble and easy going. They have expertise in their field, they assume you have expertise in yours. They know they can get what they want anytime, and so they aren't terribly aggressive or demanding. It's the low-level donor VIPs and their ilk that can be a real pain.
 
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miacomet said:
In my experience (and my experience with Madonna-level VIPs, VIPs who aren't really VIPS, donor VIPs etc is fairly considerable) the true VIPs are often fairly humble and easy going. They have expertise in their field, they assume you have expertise in yours. They know they can get what they want anytime, and so they aren't terribly aggressive or demanding. It's the low-level donor VIPs and their ilk that can be a real pain.
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I’m definitely not saying she asked for anything different. It’s just what they tend to end up with. What they are offered may be different despite them being real live humans like the rest of us lol

Agree re the low level donor VIPs. We have now developed a new VIP class : distant relative of one of the nurses with urgent care appropriate complaint that therefore jumps the septic 90yo in the wr for a room 🤦🏻‍♀️
 
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Even if the VIP doesn't expect anything special, often there's pressure from admin to give them special treatment... as if we don't already do the best we possibly can for everyone who enters the ED. I always found that insulting, whether it comes from the VIP or from admin... like they think I'm not doing my best all the time anyway.
 
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bky3c said:
Even if the VIP doesn't expect anything special, often there's pressure from admin to give them special treatment... as if we don't already do the best we possibly can for everyone who enters the ED. I always found that insulting, whether it comes from the VIP or from admin... like they think I'm not doing my best all the time anyway.
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Agree 100% on this. Like we used to give VIP care to everyone, then it got busy, we did our best, then the admin pressure became crazy.

Once again glad I quit and I'm no longer doing much EM, but I feel like an idiot.
 
CoolDoc1729 said:
I find that VIPs (and mine are generally “they gave 3M$ to the hospital charity gala”, which is awesome, but not like “madonna”) tend to end up receiving different care than other people. So if what we do for other people is based on evidence or even just experience of it working … then idk what the VIPs get but it’s not that. I feel like they are often allowed to direct their care more than other people are, but unless they are physicians it’s probably not a good idea for them to have any directing role. And insurance wouldn’t be an issue so it’s not like you’d have to go to a BC physician or get prior auth before doing something. I could see a VIP getting totally mismanaged care of a simple condition like pneumonia until it declared itself.
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If you're aiming for the best possible outcome for every patient, treating someone differently than that means the chance of a suboptimal outcome is automatically higher. Unnecessary tests pick up nothingburger imaging findings that lead to more invasive tests and longer length of stays which increases the risk of iatrogenic and nosocomial injury. Docs that have no relevent experience in the patient's disease or are 20yrs behind current standards start inserting themselves into the decision making.

From an ED standpoint, the best thing to do is get the VIP upstairs as soon as possible so that the c-suite stops hassling your staff. Barring that, figure out how to tactfully make whichever c-suite figure comes down the VIP's official babysitter and remind them that it's their job to keep this donor happy and it's your job to keep them alive.
 
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Pneumonia, Intubation, discharge in a few days. Yeah, where is this bridge someone is selling?
 
emergentmd said:
Pneumonia, Intubation, discharge in a few days. Yeah, where is this bridge someone is selling?
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Ha, I mean I’m sure the chest X-ray after intubation read was “mild opacification at the lung bases, atelectasis versus mild airspace disease.”

Definitely not the heroin.
 
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Not following this much but
1. Septic shock, ICU, intubated, discharged in 48 hrs
2. Narcan used to treat septic shock

Sounds classic standard of care. Where is this bridge I am supposed to buy?
 
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Several thoughts:

1 - The source for the naloxone info was a gossip rag, so some skepticism is warranted.
2 - Narcan has been studied for sepsis...but the results did not support its use.
3 - People get narcan for the wrong reasons, as @wareagle726 mentioned above.
4 - IMO, It's uncouth for doctors to speculate about people's medical misadventures.

None of the above really matters since Madonna has very publicly said "I like opioids" "I need a drip of something" and named an album MDNA.
 
Too much speculation on both sides. Any medical information obtained by the media is usually at least 50% incorrect and I can’t think of a single scenario where what’s been reported makes sense. When was the last time someone was intubated and kept in a hospital for 2 days from heroin OD after being revived with narcan. (I’ve been at this for a decade now and have literally intubated one opioid overdose for non-cardiogenic pulmonary edema which I suspect was from excess narcan use. They were fine and discharged within 24 hours).

Ok fine that’s the only story that even remotely makes sense but odds of that are as likely as pneumonia going through a rapid 48 hour course.
 
Rendar5 said:
Too much speculation on both sides. Any medical information obtained by the media is usually at least 50% incorrect and I can’t think of a single scenario where what’s been reported makes sense. When was the last time someone was intubated and kept in a hospital for 2 days from heroin OD after being revived with narcan. (I’ve been at this for a decade now and have literally intubated one opioid overdose for non-cardiogenic pulmonary edema which I suspect was from excess narcan use. They were fine and discharged within 24 hours).

Ok fine that’s the only story that even remotely makes sense but odds of that are as likely as pneumonia going through a rapid 48 hour course.
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Seen it countless times with polypharmacy overdoses. Intubated overnight, remains too sedated to extubate in the morning, so the ICU team waits until the next morning to extubate.
 
There's an episode of black mirror where a star has an issue, and her managers give a completely different reason to the media for the hospitalization.

Some people are saying Madonna wasn't selling enough tickets for her new show.
 
Late to the party, but as a recovered heroin addict I'm gonna go out on a limb and say I'm 99.9% certain Madonna is taking some form of opiates. It's the colour of her eyes in some of the videos she uploaded to her Instagram, or whatever she uses, that's pinging it for me. Not sure if this is a well known thing, but eye colour can change when you're pinned. I don't mean someone's eyes literally change to a whole 'nother colour, but there is often a sort of lightening effect to their normal eye colour, sort of like a dull haze over the iris. It's usually a dead give away when you see that, especially combined with pin prick pupils. Seriously, next time a junkie comes into the ER, take note of how their eyes look beyond just the obvious pupil thing.
 
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