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Probation Officers | Federal | The PSR

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Probation Officers Representing The Court:

They Conduct The Presentence Interview,

This is critical – as from it they prepare

Your Presentence Report (PSR),

Which acts as your “referral” to

The Federal Bureau of Prisons for everything

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For a No Obligation Free Consult Call Dr.Blatstein at: 240.888.7778, or through email at: info@PPRSUS.com. Dr. Blatstein answers and personally returns all of his calls.

Probation receives and evaluates pre-sentence investigation requests.

Their Process:

  • 1st they interview you, and then
    • Identify and pursue leads to obtain evidence.
    • Gather and document evidence by interviewing involved parties, obtaining statements, reviewing and analyzing records and files, etc.
    • Gather criminal history, police reports, victim impact statements, criminal complaints, and information and review them prior to the interview with the offender.
    • Conduct offender criminal history checks, warrant inquiries, and driver’s license abstract checks.
    • Compile and maintain history and case records.
    • Inform offenders of their rights, responsibilities, and purposes of the pre-sentence investigation process.
    • Interview offenders are required by the courts to have a pre-sentence investigation completed.
    • Utilize PSI interview guide and the Criminogenic Domains of Criminal History, Education/Employment, Financial, Family/Marital, Accommodation, Leisure/Recreation, Companions, Alcohol/Drug, Emotional/Personal, and Attitude/Orientation.
    • Complete various extensive assessment tools to gauge offender risk and needs.
    • Collect PSI fees.
    • Coordinate investigations with other law enforcement agencies, regulatory agencies, and other relevant entities.
    • Confirm information gathered during the interview.
    • Communicate with the appropriate Department of Corrections and Rehabilitation staff, other state agencies, related organizations, other entities, volunteers, and the public to provide information, referral services, technical advice, and consultation regarding PSI.
    • Communicate with Courts, attorneys, law enforcement, and other agencies involved in a court-ordered pre-sentence investigation.
    • Document interview and investigation.
  • Identify and Inform crime victims of their rights.
    • Assist the victim advocates in coordinating victim requests for offender information; victim issues such as recovery from injury, financial losses, or victim mediation; preparation of victim impact statements and reports; communicate offender progress and victim assistance to various local, state, and federal officials, and to treatment staff.

Prepare The Presentence Report and

Recommend administrative, legal, and/or sentencing action.

  • Present evidence to prosecutors, legal staff, or courts.
  • Prepare and present testimony as required for legal proceedings or administrative hearings.
  • Report offender compliance with the presentence investigation to courts.
  • Summarize information gathered during the investigation and interview into the pre-sentence format.

Make sentencing recommendations

  • based on sentencing guidelines and a thorough analysis of:
  • Ensure the report is distributed according to Applicable Code standards.
  • Monitor programs for compliance with state and federal laws compliance.
  • Gather, compile, and maintain statistics for required and requested reports.
  • Investigate and confirm the information on offender release plans or interstate compact investigations.
  • Maintain working knowledge of the Department of Correction and Rehabilitation (DOCR) programs and community-based programs that are available for offenders.

Note: The duties of probation officers listed above are not intended to be all-inclusive.

Entering The BOP – Verifying The Availability of Your Medications

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Verifying Medication  Availability

Will Go A Long Way To Easing Your Client’s Fears

    • They assume that they will still get medical care on the inside.
    • The assumption may also be that they will also get the same medications that they got on the outside,
    • This will likely be a False assumption.

 

Medication availability (~ 3500 different drugs), falls into 3 categories.

1st) On Formulary -Available:

    • These medications are available for BOP healthcare providers for inmate use.

2nd) Non-Formulary –These require a lengthy Preauthorization Process

    • While they are stocked, these medications are not available and require lengthy pre-authorization.
    • As the BOP Formulary is available online, and should your medication fall into this category, this discussion should occur long before the Presentence Interview for obvious reasons.

3rd) Similar equivalents – Not On Formulary (Not Available)

    • Here, similar or equivalent substitutions are used. After consulting with the current treating physician of record, the defense needs to make appropriate decisions regarding this medical problem before this point and long before the PSI.
      • However, addressing it before the PSR is complete, with the backing of the US Attorney and, finally, the court.
        1. Examples of medication confusion for Cholesterol Control:
          • PCSK9 Inhibitors vs. Statins. Statins are a popular treatment that has been available since the 1980s. PCSK9 inhibitors, on the other hand, are a new type of cholesterol drug. They were approved by the Food and Drug Administration in 2015.

Generics

    • These are the drug of choice for the BOP as they are cheaper than brand-name medications.
    • It may be beneficial to inform your client ahead of time that, while they’ll be taking a generic medication
      • since there are many manufacturers who each produce similar generic drugs
      • these same drugs, while may differ in color, size, and shape;
      • they should be the same
    • Nobody likes surprises, especially if they are entering prison for the first time.

                                                              Generic Lipitor Good Rx

 

Presentence Interview Preparation – Gets Your “Message On The Record”

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Getting The Presentence Interview (PSI) Right

Gets Your “Message On The Record”

The Presentence Interview, and its preparation, long before the interview takes place is likely the pivotal time when the defense team can make a difference in their client’s future. Properly prepared for the presentence interview can at best provide a pathway for the defense to get “their” message on the record.

Abstract

Imprisonment is a frightening experience for your client and their family. Counsel and the defendant’s family together can assuage some of these fears by addressing healthcare and the specialty programs available in Federal Prison before the defendant is in the custody of the Federal Bureau of Prisons (“BOP”) through being properly prepared for their presentence interview,

The Presentence Interview

The Presentence Interview:

  • is done by the Probation Officer (the court’s representative).
  • Following their investigation where they verify your background history,
  • the Probation Officer will take what she/he learned from the presentence interview and draft the official Presentence Report (PSR) along with,
  • making sentencing and placement recommendations to the judge.

 

The Presentence Report (PSR) Importance

The Presentence Report (PSR) also plays a critical role in the Sentencing Guidelines and statutory sentencing considerations, meaning,

  • The judge at sentencing will use it to determine how long you will be incarcerated,
  • The BOP will use it to 1st: place or designate you to a specific facility while matching you according to any needs you may have based on: 
    • security level,
    • prison placement,
    • programming,
    • pre-release, and even
    • medical care.
    • The inmate’s federal prison life depends on that PSR.
  • Should you qualify for Supervised Release,
    • Probation will then get a copy before meeting you in order to get an idea as to whom they are going to supervise over the next several years. 
  • Last, The Presentence Report (PSR) is considered:
    • gospel fact about the defendant.
    • This is because it is often considered the “Inmates Bible”.
    • So you see: It Truly Is The Gift That Keeps On Giving...

One cannot overstate the importance of The Presentence Interview to be properly prepared for – as it impacts The Presentence Report (PSR).

Asking to change the PSR later asks a court to,

  • change positions that it has already adopted as accurate.
  • Even if this can be done – a big if –
  • the amendment process can take years and
  • many billable hours to complete.

Should there be a medical or mental healthcare issue,

  • the PSR drafting process is the time to get it right.
  • An inaccurate PSR can mean a lack of consideration at sentencing and
  • inappropriate or absent care after imprisonment.

For example, if kidney dialysis is necessary,

Everything is important, from osteoarthritis and degenerative joint diseases to food allergies and medically necessary diets.

Activities of Daily Living (ADL)

  • Everything needs to be documented, including:
  • how any maladies would limit “activities of daily living” (“ADL”).
    • Patient-inmates are considered ‘independent’ if they can accomplish their Activities of Daily Living (ADL) – things like dressing, bathing, and eating – on their own.

Medications

Medications must also be identified to estimate which prescription drugs the BOP will make available. It is critical to identify whether given medications are available,

  1. On- Formulary, or
  2. Non-Formulary medication.
    • Understand that the BOP will discourage the use of non-formulary medications
    • They require that they need special approval.
    • More likely, BOP physicians will just switch the inmate’s treatment medications to those that have similar equivalents.
    • Do you know which medications are either available and on-formulary or non-formulary?
    • These issues should be addressed with the court before incarceration because,
      • after incarceration, the court has no real oversight.
      • Letters from the client’s personal physicians should provide documentation about their prescription selection, and
        • reasons why “similar” medicines are not appropriate for individual inmates.
  3. Last, What do you do if you learn that your client’s medication are not available?
    • There are options, but you need:
      • Time
      • The cooperation of the current treating physician

Medical Care

  1. Today the BOP uses a complicated method to convert a person’s medical diagnoses and treatments into a CARE LEVEL Classification. 
    • Classifications range from CARE LEVEL I for the healthiest inmate-patient, to
    • CARE LEVEL IV for gravely ailing inmate-patients who need ‘in-patient’ care. 
  1. Each facility then is identified by both a Security Level and this
  2. CARE LEVEL structure and inmates are then placed accordingly.

Photo Credit: https://pixabay.com

Healthy Steps for Older Adults 2022

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FSA - First step act

FSA, Productive Activities (PA)
Healthy Steps for Older Adults 2022

Program Description Healthy Steps for Older Adults is an evidence-based falls prevention program designed to raise participants’ knowledge and awareness of steps to take to reduce falls and improve health and well-being. The goal of the program is to prevent falls, promote health, and ensure that
older adults remain as independent as possible for as long as possible.
Hours 3
Location(s) All institutions
Needs Addressed Medical/Recreation/Leisure/Fitness
Program Delivery Contractors
Health Services
Recreation
Unit Team
Volunteers

AARP Foundation Finances 50+ (2022)

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FSA - First step act

AARP Foundation Finances 50+ (2022)

Program Description

This program provides financial education and counseling for vulnerable households, particularly adults age 50+.

Older adults face unique challenges in financial planning and weak job prospects. This program will assist the older adult in financial goal setting that translates into positive financial behaviors.
Hours 1.5
Location(s) All BOP Locations
Needs Addressed Finance/Poverty

Schizophrenia in Federal Prison

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Schizophrenia in Federal Prison

 

In federal prison, Schizophrenia is a mix of symptoms that varies from person to person and affects the mind. When severe, people have trouble staying in touch with reality. It’s hard for someone to think clearly, make good judgments, respond emotionally, communicate effectively, understand reality, and behave appropriately. There is no cure, and treatment requires a psychiatrist-guided team approach, which includes a psychologist, social worker, psychiatric nurse, and possibly a case manager to coordinate care.

Anxiety may present as a component, along with Posttraumatic stress disorder, as a symptom of a co-occurring disorder. While Schizophrenia is a serious brain illness, there is no test for it. Diagnosis requires eliminating what it’s not occurring, in order to identify the symptoms that are present.

There are three types of symptoms:

  1. Psychotic symptoms may distort thinking, including hallucinations, delusions (beliefs that are not true), and organizing thoughts.
  2. Negative symptoms: where you’re not able to show emotions – leaving you to present yourself as depressed and withdrawn.
  3. Cognitive symptoms: Trouble making decisions and paying attention.

There is no cure. Different medications may have to be tried to see which are effective because medications affect each person individually. Once you find the medication(s) that work, stay on them daily, keep your doctor’s appointments and follow their recommendations.

Schizophrenia

Changes in behavior;

Includes delusions and hallucinations – which may last a lifetime.

Delusions; False beliefs, not based on reality, such as another person is in love with you, or a major catastrophe is about to occur.

Hallucinations involve seeing or hearing things that don’t exist. They can be in any of the senses, hearing voices is the most common hallucination.

Disorganized thinking and speech may include putting together meaningless words that can’t be understood, sometimes known as word salad. Extremely disorganized or abnormal motor behavior can include resistance to instructions, inappropriate or bizarre posture, a complete lack of response, or useless and excessive movement. All of these behaviors can result in less than optimal interactions between other inmates or with correction staff. The result may be a trip to the hospital or the SHU (isolation), neither is acceptable, and both are preventable.

Negative symptoms can be expressed as, neglecting personal hygiene, appearing to lack emotion, (not; making eye contact, changing facial expressions, or speaking in a monotone), and losing interest in everyday activities, including socially withdrawing.

Treatment is accomplished under the psychiatrist-guided treatment team approach with a case manager coordinating care. The full-team approach may be available in clinics with expertise in schizophrenia treatment. These delusions and hallucinations — may last your lifetime.

First-generation older antipsychotics, introduced in the 1950s – As a class, these provided treatment for acute agitation, bipolar mania, and other psychiatric conditions.

On- Formulary Medications: Haloperidol (Haldol), Perphenazine (Trilafon), Loxapine, Trifluoperazine(Stelazine), and Fluphenazine

Not Available: Flupentixol, Zuclopentixol, Sulpiride, Pimozide, Molindone, Prochlorperazine, Thioridazine, and Thiothixene

Second-generation or atypical antipsychotics,

Some associated side effects; “Schizophrenia in adults, “Bipolar mania and hypomania in adults“,  “Unipolar major depression with psychotic features“,  “Delusional disorder”,   “Brief psychotic disorder”, and  “Treatment of postpartum psychosis”

On Formulary: Clozapine (Clozaril) “Clozapine remains the only antipsychotic that has been FDA-approved for treatment-resistant schizophrenia,” “and it provides effective treatment even when patients do not respond to other second-generation antipsychotics. No existing first- or second-generation antipsychotic is as effective as clozapine monotherapy in treatment-resistant patients. Deanna Kelly, Pharm.D., of the Maryland Psychiatric Research Center (MPRC)” Other Medications: Olanzapine (Zyprexa), and Risperidone (Risperdal).

Medications Non-Formulary: Quetiapine (Seroquel)

Some of the more recent atypical antipsychotics:

Medications Not Available: Asenapine (Saphris), Iloperidone (Fanapt), and Lurasidone (Latuda).

Schizophreniform

Symptoms of schizophreniform

Schizophreniform is a similar disorder that affects how you act, think, relate to others, express emotions, and perceive reality.

Unlike schizophrenia, it lasts one to six months.

A mental condition that can distort the way you:

  • Think.
  • Act.
  • Expresses emotions.
  • Perceive reality.
  • Relate to others.

Medication and Psychotherapy —to help the patient manage everyday problems related to the disorder.

Medications On Formulary: Click here for the article…

Brief psychotic disorder

Involves a sudden, short period of psychotic behavior, often in response to a very stressful event, such as a death in the family. Recovery is often quick — usually less than a month.

The first line of treatment may include atypical antipsychotics.

Medications On Formulary: Click here for the article…

Medications Non-Formulary:   Click here for the article…

For those that have an increased risk of having depression, medications that address this symptom can be an important part of their treatment.

Delusion disorder

The key symptom is having a delusion (a false, fixed belief) involving a real-life situation that could be true but isn’t, such as being followed, being plotted against, or having a disease. The delusion lasts for at least 1 month.

The exact cause is not yet known, but researchers are looking at genetic, biological, environmental, or psychological factors.

A cold, detached manner with the inability to express emotion

  • …has an over-inflated sense of worth, power, knowledge, or identity.
  • Jealous
  • …that someone is spying on them or planning to harm them.
  • …believes that he or she has a physical defect or medical problem.
  • …have two or more of the types of delusions listed above.

Symptoms that are ‘non-bizarre’:

  • An irritable, angry, or low mood
  • Hallucinations

Diagnosis: There are no laboratory tests to yield positive results, they are only good to rule out what it is not.

Treatment:

  • Psychotherapy is primary
  • Conventional antipsychotics

First-generation older antipsychotics, introduced in the 1950s – 

1st Generation, Medications On- Formulary for available medications: Click here for the article…

2nd Generation, Medications On- Formulary for available medications: Click here for the article…

Medications Non-Formulary medications require pre-authorization; click here for the article…

Other types of medications:

  1. Antidepressants might be used to treat depression, which often happens in people with delusional disorder
  2. Psychotherapy can also be helpful, along with medications, as a way to help people better manage and cope with the stresses related to their delusional beliefs and their impact on their lives.
  3. Sedatives and antidepressants might also be used to treat anxiety or mood symptoms if they happen with delusional disorder.
  4. Tranquilizers might be used if the person has a very high level of anxiety or problems sleeping.

Shared psychotic disorder (also called folie à deux)

Here one person in a relationship has a delusion and the other person in the relationship adopts that same delusion.

Diagnosing is difficult, possibly with an MRI.

Treatment: Psychotherapy aims to ease emotional distress, with medication to ease the symptoms of anxiety.

It cannot be prevented, and the key is to diagnose and treat them as soon as possible.

Substance-induced psychotic disorder

Substance-related disorders involve drugs that directly activate the brain’s reward system which typically causes feelings of pleasure.

The classes of drugs include

·       Alcohol

·       Caffeine

·       Cannabis and synthetic cannabinoids

·       Hallucinogens (eg, LSD, phencyclidine, psilocybin)

·       Inhalants (volatile hydrocarbons [eg, paint thinner, certain glues])

·       Opioids (eg, fentanyl, morphine, oxycodone)

·       Sedatives, hypnotics, and anxiolytics (eg, lorazepam, secobarbital)

·       Stimulants (eg, amphetamines, cocaine)

·       Tobacco

·       Other (eg, anabolic steroids)

Treatment/Management

Clinical judgment, with a proper history, creates a safe environment during the withdrawal period. Due to the relative safety of most antidepressants in the setting of depressive symptomatology, and manic episode guidelines, second-generation antipsychotics, such as Quetiapine (Non-Formulary) or Olanzapine (On Formulary), may also be beneficial as they are faster-acting than mood stabilizers.

Psychotic disorder; due to other medical conditions;

Hallucinations, delusions, or other symptoms may happen because of another illness that affects brain function, such as a head injury or brain tumor.

Paraphrenia: symptoms similar to schizophrenia.

It starts late in life in the elderly,

  • Generally has a much better prognosis than other psychotic disorders.
  • Antipsychotic medication can be helpful,
  • Paraphrenia sometimes co-occurs with depression and anxiety

I) BOP Placement Based On Security Level Alone – Without Multiple Medication Needs

The Challenge Program – an EBBR FSA Evidence-based Recidivism Reduction Program for male inmates in Penitentiary (High Security) facilities. Treats those with substance abuse and/or mental illness disorders (psychotic, mood, anxiety, or personality).

II) BOP Placement- With Multiple Medication Needs v Prior Hospitalizations

Here, it depends;

  • the number of types of psychiatric hospitalizations, not related to substance abuse, and
  • the number of multiple diagnoses treated with antipsychotic and/or different psychotropic medications

Influences Mental Healthcare (MH) CARE LEVEL I-IV facility placement.

Sex Offender Programs – Federal Prison

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FSA - First step act

FEDERAL PRISON SEX OFFENDER:

BOP PROGRAMMING WITH 2 LOCATIONS NATIONWIDE

SEX OFFENDER PROGRAM RESIDENTIAL (SOTP-R) is a voluntary program (P5324.10) for Sex Offenders, and those with a history of multiple sexual offenses, re-offense, extensive non-sexual criminal histories, and/or a high level of sexual deviancy or hypersexuality. Inmates ordinarily participate in the program during the remaining 36 to 48 months of their sentence. The duration of the program is 12-18 months. Placement in the SOTP-R is reserved for inmates with more extensive sex offense histories, and cohousing participants permit the implementation of a modified therapeutic community, separate from the general population.

Having only 2 SOTP-R facilities nationwide – before they enter the program, initial placement into a free-standing Federal Prison Camp (FPC), or satellite minimum camp (adjacent to a higher secure facility), if practical, should be part of the court’s calculation.

This is because should an inmate consider acting violently towards your client – most would likely refrain as a single incident would have them transferred behind the wall, to a higher security facility, which they would not want.

Ultimately it just may come down to you knowing your client and the facility recommendation options available during the period before SOTP-R placement. Keep in mind that no matter what the BOP says, this could be a real-life event, therefore having this discussion with your client may prove crucial.

BOP PROGRAMMING WITH 9 LOCATIONS NATIONWIDE

SEX OFFENDER PROGRAM NON-RESIDENTIAL (SOTP-NR), is also a voluntary program (P5324.10) for low to moderate first-time sex offenders with a single history of Internet Sex Crime, intended to identify offenders who are likely to re-offend. Inmates ordinarily participate in the program during the remaining 36-48 months of their sentence. SOTP-NR participants reside in the general population.

Having only 9 facilities nationwide – before they enter the SOTP-NR program, if practical, other than an FPC, or satellite minimum camp, should an inmate act violently towards your client – again, they would most likely refrain, as a single incident would have them transferred behind the wall, to a higher security facility. Otherwise, any other placement could result in a life-threatening sentence.

Consideration may again come down to knowing your client and understanding the facility options available for the period before their SOTP-NR placement.

BOP, 1 LOCATION NATIONWIDE

BUTNER’S COMMITMENT AND TREATMENT PROGRAM FOR SEXUALLY DANGEROUS PERSONS (2022-2023), “This FCI remains a flagship facility and is frequently chosen to pilot new programs such as the Sex Offender Commitment and Treatment Program,” (Page 6).

  • FCI Butner is responsible for the psychological treatment and implementation of behavior management plans, with the coordination of the multidisciplinary treatment teams. Treatment is holistic and multidimensional with the ultimate goal of reducing sexual dangerousness and criminal recidivism potential.
  • FCC Butner has an internship integrated practitioner-scholar model which seeks “the productive interaction of theory and practice in a primarily practice-based approach to inquiry”. The internship component of the Psychology Service strives to meet the training needs of doctoral candidates in applied psychology through supervised experience, didactic programs, and focused scholarship.
  • As there is only 1 location, which appears ‘court ordered’, there should be no other issues regarding inmate threats.

Fore more…

SEX OFFENDER SAFETY IN PRISON- PART OF YOUR SENTENCING CALCULATION

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PPRS - PPRSUS - Physician Presentence Report Service

SEX OFFENDER SAFETY – PART OF YOUR SENTENCING CALCULATION

It is important for the court to consider your client’s, (sex offender) safety, by requesting the court grant initial placement into a Sex Offender Management Program (SOMP), while waiting for your client’s voluntary admittance into a SOTP Program.

Following their interview and investigation, the Probation Officer will draft the official Presentence Report (PSR). Together with preparation, your message stands a better chance of being part of the PSR, and is included “on the record”.

Not being placed into a SOMP, and should an incident occur, could at best result in your client spending the remainder of their sentence in isolation for their protection. Then over time, this may yield a host of mental health phobias, leading to more severe ailments.

The benefit of being proactive as you help your client during their transition into the prison environment safely; cannot be overstated. This is especially significant if the PSR includes the documentation of a mental illness with diagnosis, including the treating physician’s records and testimony.

 

ENSURING THE PHYSICAL SAFETY OF YOUR CLIENT

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Among inmates and convicts, sex offenders are at the bottom of the prison hierarchy and generally, are greeted with hostility.

The BOP, where needed, assigns sex offenders to higher security facilities, which may not be perfect. But this can be especially evident when they’re placed in general population.

Next, when the new sex offender first arrives and meets their new bunkmate, it is not unusual for them to be asked, what did you do?

No matter how they answer, eventually, their roommate or bunkmate Will Find Out! After that, at best, the sex offender is avoided – at worse, they could be robbed, beaten, or even killed. Then he/she may have to spend the rest of their entire sentence in solitary confinement?

Therefore, in your memorandum, safety may dictate placement in either a facility with a Sex Offender Management Program (SOMP) or at minimum, a camp.

For more…

Post-COVID Virus Causes Lingering or Ongoing Symptoms

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PPRS - PPRSUS - Physician Presentence Report Service

The complicated care required for Post-COVID Long-Haulers is likely beyond the mission of most (if not all) prisons, jails, and detention centers.

According to researchers, this is still an active area of investigation. As we are approaching spring/fall 2022/2023, the Post-COVID Pandemic may be becoming an Endemic. Still, with that in mind, treating Post-COVID Long-Haulers and the amount and variety of staff, equipment, finances, and time needed, may just not be available to those incarcerated.

“COVID is a true roller coaster of symptoms and severities, with each new day offering many unknowns.”

 “The difficulty is sorting out long-term consequences,” says Joseph Brennan, a cardiologist at the Yale School of Medicine.

While some patients may fully recover, he and other experts worry others will suffer long-term damage, including lung scarring, heart damage, and neurological and mental health effects.

Long after the fire of a Covid-19 infection, mental and neurological effects can still smolder[1]. ‘Long-Haulers’ after the initial COVID-19 hospitalization: fall into 3 categories (Dr. Sanghavi)

1st) The COVID virus causes lingering or ongoing symptoms, meaning that “ symptoms do not recover completely and are ongoing because of direct cell damage from the virus,”

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2nd) involves chronic ICU hospitalization for weeks. This causes:

  • muscle weakness,
  • cognitive brain dysfunction,
  • psychosocial stress-causing post-traumatic stress disorder (from chronic hospitalization).

3rd) symptoms appearing after recovery. “Interplay with the immune system of a person, and then the impact that both those things have on the body.”

“We are still trying to understand exactly how this interplay between the immune system and inflammatory markers work, but there’s no doubt that that is a group of symptoms because of ramped up immunity or ramped up inflammatory system,” Dr. Sanghavi added.

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Peripheral nerve issues, such as Guillain-Barré Syndrome, can lead to paralysis and respiratory failure.

Post-COVID Stress Disorder is another emerging consequence of the global pandemic.

Although most cases of COVID-19 appear to be mild with a recovery time of a few weeks, health experts are seeing more patients who suffer symptoms for months or get better, and then relapse down the road.

Isolation Is Not the Answer, Precautions for Adults with COVID-19[ii]

For more…

POST – COVID A PHYSICIAN’S JOURNEY

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PPRS - PPRSUS - Physician Presentence Report Service

POST – COVID, A PHYSICIAN’S JOURNEY

Post – COVID a physician’s journey in the summer of 2020 working on both general medical and COVID-positive wards. But by November of that year, the U.K. was in its second wave and second lockdown, with COVID deaths and hospital admissions rising.

“Like being on a treadmill I could not get off”

Being given only basic personal protective equipment (PPE), Dr. Fearnley and her newly graduated doctors were sent onto medical and COVID wards. While on a COVID ward, and after not feeling well, a PCR Test returned positive for COVID, and what comes next follows the phases she went through:

  • “The acute phase lasted 2 weeks – comparable to a case of mild-to-moderate flu.”
  • “As a fit and healthy 35-year-old with no comorbidities, she naively expected to recover quickly,”
  • “By week 3, she still had a lingering fever,”
  • By week 4, Dr. Fearnley wanted to return to work, but being lightheaded and jelly-legged, just made it home.

Thus began the start of her long Post-COVID Long-Hauler (as it was later defined) Journey.

Getting slightly graphic, these attacks “were associated with an unquenchable thirst, with or without an urgent need to open to my bowels, vomiting, or increased shortness of breath. These came in daily cycles lasting up to 14 hours at a time. I would frequently shake through the entire night”.

For more…