Episode #121: Dr. Alex Truong
Please note: This podcast is intended to provide information and education and is not intended to provide you with a diagnosis or treatment advice. You should consult with a licensed or registered healthcare professional about your individual condition and circumstance.
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In this episode, Dr. Truong shares his journey in medicine and what inspired him to shift his focus from critical care and pulmonology to COVID care. He discusses the impact of long-COVID ranging from physical and mental issues, including trauma and PTSD, that have not been addressed and discussed enough to help us understand and seek healing.
Given that we’re 3+ years since the start of the pandemic, the world is focused on moving on without acknowledging the issues it caused. While nobody desires illness or long COVID symptoms, the healing process begins with recognizing these aspects of our lives and the importance of seeking help to address the loneliness, isolation, and shame that accompany invisible illnesses.
Dr. Truong is a pulmonary and critical care trained physician with 12 years of experience as assistant professor at Emory Midtown Hospital. Since August of 2020, he and Dr. Adviteeya Dixit have been running the Emory Post-COVID clinic where they care for patients with lingering symptoms from their COVID infection.
Dr. Truong’s passion for helping people get the care they deserve and recover from post-COVID physical and mental symptoms is undeniably inspiring. To provide a comprehensive understanding of the topic, he further explores the distinctions between long COVID, active COVID, and other medical diagnoses, as well as avenues for seeking both conventional and alternative medical treatments. Dr. Truong acknowledges the importance of celebrating the fact that we saved more lives than we lost.
“Part of treatment of any invisible illness, whether it is post COVID or PTSD, must be able to address the mental aspect of it; the loneliness, isolation and shame that comes with this diagnosis.”
Reasons To Listen:
Learn about how Dr. Truong got into medicine, the lessons he has learned from his experiences,what inspired his focus shift to COVID care
Understand how to differentiate long COVID from active COVID and other diagnoses and the treatments that have worked best for managing long COVID symptoms
The bright sides of the pandemic that we ought to celebrate and how it created a unified passion that saved billions of lives without the vigorous hate and anger
Get tips on how to manage post-COVID symptoms and mental health issues beyond Western medicine using holistic health approaches
About Dr. Alex Truong
Dr. Alex Truong is a Pulmonary and Critical Care trained physician at Emory Midtown Hospital. He has been practicing medicine for over 19 years and is highly rated in 14 conditions. His top areas of expertise are Neurosarcoidosis, Pulmonary Fibrosis, Emphysema, and Bullae. Dr. Truong's clinical research consists of co-authoring 2 peer-reviewed articles in the past 15 years.
Emory’s Hope Clinic Contact – 404-712-1371
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Harper Spero (00:04):
Made Visible helps people with invisible illnesses feel seen and heard. It provides a platform for people who seem fine but aren't to share their experiences. It also helps to create a new awareness of how we can be sensitive and supportive to those with invisible illnesses.
(00:25):
Please note this podcast is intended to provide information and education and is not intended to provide you with a diagnosis or treatment advice. You should consult with a license or registered healthcare professional about your individual condition and circumstance. Hey guys, welcome to another episode of Made Visible. I'm your host, Harper Spero, and I'm so glad you tuned in. Today's guest is talking about a subject that I don't think is discussed enough long covid or as he refers to it as post covid. Dr. Alex Chung is a pulmonary and critical care trained physician at Emory Midtown Hospital and has been deep in the trenches since the beginning of the pandemic in 2020. Welcome Alex. So happy to have you here today.
Dr. Alex Truong (01:14):
Thanks so much for having me.
Harper Spero (01:16):
So let's start. Tell us who you are, where you're from, and what you do.
Dr. Alex Truong (01:22):
My name is Alex Truong. I am a pulmonary critical care trained physician working here at Emory Midtown Hospital. I'm also one of the co-directors of the Emory Post Covid Clinic, which we've been running since August of 2020,
Harper Spero (01:38):
Which there's a lot to unpack there. So let's start, how did you get into medicine in the first place?
Dr. Alex Truong (01:45):
Wow, that's a big question. My father was a physician, so I think there's obviously a lot of pressure there to kind of follow in his footsteps. Also, being a refugee and growing up in Northern Virginia amongst all the super rich, there was a pressure to get a job that was financially stable and you can always be employed. So I think there was a lot of pressure there. I think initially I had a lot of problems trying to follow my father's path, but after a while going through my master's degree, going through my, a bunch of work in Los Angeles doing epidemiology work, I think I found my own path and I think I've really enjoyed it. So that's how I ended up in medicine.
Harper Spero (02:25):
And how did you decide to go down the path of pulmonology? It was
Dr. Alex Truong (02:29):
Actually critical care that I fell in love with first. I initially started my residency in internal medicine with a primary focus on primary care, hoping that I would do infectious disease. That was actually the plan when I graduated medical school. And my second rotation was the I C U and it was challenging and it was exhausting, but it was also thrilling and interesting and I just fell in love with it, so chased it. Usually with critical care, a lot of residents do pulmonary critical care because they are very compatible with each other. They compliment each other in terms of physiology and management. My first love was critical care and then I learned to love and now am very much in love with pulmonary medicine as well
Harper Spero (03:12):
And so what did your life and career look like right before the pandemic?
Dr. Alex Truong (03:17):
It was interesting. So being a pulmonary, pulmonary critical care physician is not necessarily easy work. It's a lot of stressful moments and a lot of redundancy in how you take care of patients. Crossing ts dotting is, I really love my job. I loved Emory, I loved the patients that was working here. I will say honestly, I was feeling a little bored <laugh> right before the pandemic, you know? And I wasn't looking for something to cure my boredom. I was a little bit in a rut. I was definitely trying to do some publications doing routine work. I think I was, I was bored, I guess.
Harper Spero (03:50):
Yeah, I can't help but laugh about that of like you went from bored to what we talk about next. I mean, I don't wanna say you asked for it, but it sort of sounds like you did.
Dr. Alex Truong (04:01):
So I got a master's degree in epidemiology and that was 98 99. And at that time we had always talked about what the next pandemic would be. We had always thought it was gonna be something similar to flu. I had a lot of training, I was reading a lot of books about the coming plague and the new pandemics and things like that. It's a little bit morbid and it's a little horrible to say. When there was this outbreak that was spreading early 2020, I was like, oh my gosh, this is what I was studying for so many years. This is what I've been thinking about for a while now. Never thought it would manifest this itself in the way it have. It's, it's been interesting. It's been a rollercoaster ride.
Harper Spero (04:39):
That's so wild. So what was the moment that you knew that your focus was no longer going to be your day-to-day boring ish job and all of a sudden your focus would be on Covid?
Dr. Alex Truong (04:53):
I remember questioning whether or not it was gonna be as serious as everyone said it was gonna be. I remember sitting in clinic and one of my colleagues is sitting down the table from me doing work and seeing patients. He was talking about covid and saying, oh my gosh, I think this is real. My friend in Seattle who's also pulmonary critical care has 12 patients on mechanical ventilation for respiratory failure from covid. And I remember sitting at my computer thinking, gosh, I've never taken care of 12 people on the vent from an infection, an infectious process. And so I think that's the first time it started sinking in that it was real. And then when it hit here one of my other colleagues, Dr. Alt, was the CU attending and she is consistently calm, cool, collected, you can throw anything at her and she can take it with amazing amount of grace.
(05:43):
And I went to see her in the ICU and she looked frazzled. There were, I think 18 patients and we have 20 beds that were on mechanical ventilation. And she was looking exhausted and overwhelmed. I remember going to her and saying, Sarah, what can I help you with? And she basically waved her hand over the whole side of the room and and said, these six beds, I need ultrasounds of their heart. I, I need to know whether or not they're having some sort of strain on their heart. And I dot all my p e. And I went through each room and ultrasound everybody and it was shocking.
Harper Spero (06:16):
Yeah, I mean it's interesting to hear the doctor perspective as someone with pulmonary issues and immunocompromised and at such high risk for covid. I think about the fear that I had of being a patient like that, especially in those first few months and really the first year of knowing nothing and trying to piece together what's safe to do and what's not safe to do and ultimately leaning towards safety for everything and doing nothing. So I'm curious to know, when did you realize that you were in it for the long haul? And this wasn't gonna be a few weeks or a month as people potentially thought at the beginning?
Dr. Alex Truong (07:05):
It really hit hard at the end of March, beginning of April. And then it started quieting down and there was this hope that it would continue to quiet down. I don't know if you've ever seen any of the CDC graphics, but peak kind of went down just slightly and then next came a much higher peak. And in the middle of that higher peak working in the icu, I was thinking, no, this is gonna be bad. This is going to be long lasting and it's unfortunately going to kill a lot of people. So that was sobering.
Harper Spero (07:35):
Yeah, and I, and I wonder how you coped with it yourself. I mean we, I interviewed someone on the podcast, Dr. Michelle Chung who's a therapist and she talked about working in New York City and having so many patients that were really concerned throughout the pandemic naturally and going through this process of living through a pandemic and also her being a provider for them, but needing to take care of herself. So I'm wondering how you would say about your own experience, how you took care of yourself, how you stayed healthy if you did, and how you managed the balance of being a doctor and being a person who also could get sick.
Dr. Alex Truong (08:18):
To be honest with you, I don't think I did take care of myself. I think you can go through our I C U and talk to everyone in it. Everybody was worried about getting sick and bringing home to the loved one, not getting sick and being sick themselves. And I think that was a constant fear. And we would trade stories of all the things we did like strip down in the garage or you know, wipe down everything we touch or you know, some of my colleagues not being able to hug their kids right away and having to run in the shower first before they even did that. I think that was a lot of stress. You know, we worked a lot. It was one of those moments where I think you just were drowning in water and you just kept doing the doggy paddle as long as you can to keep yourself afloat.
(09:01):
And you didn't really think about where you are swimming to or what you're swimming from. You just swam. And I think that it also explains why we've lost so many healthcare professionals who got out of the profession because it was just too much. I thank God for my partner Jason, who was able to give me a grounding source, was able to kind of give me a home to come home to that was safe and comfortable and stress free and he took care of dinner and stuff like that. So I'm really grateful for that. I'm really grateful for the fact that, you know, my sisters and my mom didn't get sick through the pandemic so I didn't have to worry about them and I could just focus on what was happening in the icu. I think that what's happened to a lot of us who've gone through it, that we really haven't dealt with it.
(09:48):
And I, I, I feel horrible for saying that I don't, I think there's a huge amount of PTSD is gonna happen and I think that there are definitely moments in the ICU when I still hear that beeping sound of the vent or a certain way the light hits or those yellow isolation gowns and I get flashbacks of 20 20, 20 21. And you know, on top of that there was the horrible drama of what was happening in the I C U and then you left the hospital, you faced all this politicized TV political crap about people saying it wasn't real or people, doctors making up their numbers. It's traumatic enough to, to do what we did in the icu, but it was also another kick in the teeth to come out and just have people second guess what you did with the intent of what you did or whether it was real or minimizing it or whatever the case may be, or spreading room, whatever it was, I didn't care. And it came from everywhere and that was exceedingly hard to deal with. So I mean, I remember I used to be a news junkie, I used to have Facebook, I used to <laugh> do all these social media things. I remember thinking this is way too much. I just, I just can't. And I, you know, I stopped listening to all the, the noise because it was just too much.
Harper Spero (11:05):
I appreciate you sharing all that. And I think, you know, it sounds like self-preservation, you realizing what your capacity was and what you could handle. And I think you're right. It wasn't just about the actual illness and treating the illness and trying to keep people alive and safe, but then it became totally politicized and just so many layers of additional things that were so not helpful to anyone in any way. But I do really think that there is an extreme level of trauma and P T S D that is not being talked about and addressed enough. And again, I refer back to the episode I mentioned number one 17 with Dr. Michelle Chung where we talked about this and I've already in just two since the episode came out getting tons of feedback on it because people are saying this isn't being talked about. Why is nobody addressing this? I mean it's one thing me as a patient who is immunocompromised or anyone out in the world, but what about you? The medical professionals that were on the front lines for the whole time not getting the cure that you deserve. I mean that needs to be addressed for sure. And it really segues into where you're at now with this, which is that you're focused on long covid. How do you determine what's active covid versus long covid versus another diagnosis?
Dr. Alex Truong (12:35):
I think that's the big million dollar question that everybody has right now. I think it's pretty clear to see what active covid looks like. It presents in a certain fashion, lots of fevers, lots of chills. People can have body aches, shortness of breath, cough, things like that. If assuming they follow the textbooks of what an active infection looks like for covid, sometimes this can be a lot more subtle. Sometimes people just have fatigue and headache and then that was their active infection. Usually it's a pretty acute onset. It lasts for about a week to two weeks and then they start feeling better. So usually when we are saying you have active acute covid infection, it has to do with a related exposure, possibly a positive test result and a, a cluster of signs and symptoms that follow a couple weeks after. Now if you have gone over the acute phase and you have lingering or worsening symptoms past four weeks from the active infection, then we diagnose you with post covid syndrome symptoms that usually are present after the infection that were not present prior.
(13:41):
Or if you had symptoms prior such as chronic migraines or muscle or joint pains and they have worsen amp, then that also falls into the category of qualifying as post covid syndrome. Unfortunately, with every single variant there seems to be new symptoms that are added to that list. So that list grows longer and longer and it becomes much more difficult to figure out what is truly related to post covid and what's not. When you talk about the more exotic symptoms like some of the rash we're seeing, some of the weird neurologic tremblings that we're seeing some patients have are passing out for some reason and it's hard to really relate that back. And so I think with research and time will get a better understanding of that with post covid. The patients present in a very consistent fashion. They always talk about the fatigue, they always talk about the brain fog, they always talk about the shortness of breath, they always talk about the joint pains and the muscle aches. On occasion, I'll hear something that doesn't fall into that pattern. And I'll question, is that really related to post covid or is it something else? I will admit in, in the current state of medicine, we're still in the process of trying to figure out how to differentiate post covid versus something else. So I don't have a a, a precise answer there.
Harper Spero (15:02):
Yeah, understandable. You know, it makes me think how quickly the vaccines were rolled out and how people had skepticism of how quickly it happened. And my understanding was every bit of dollars that could be put into the research for funding it from all over the world. Cause it was an international, you know, situation were going into it, unlike other vaccines that we've been waiting for years for cures for other conditions and it happened so quickly because of that, it was a less thorough process or they were like steps that were missed in the process from my understanding. So I'm curious how the research goes that then leads you to some sort of final diagnosis or clear understanding of saying like, yes, this is concrete information to say everyone with long covid has x, y, Z symptoms. I mean I don't, it doesn't sound like you are there yet and it's still being unraveled.
Dr. Alex Truong (16:11):
Yes, I would agree with that. Could I add to what you had said previously about how quickly the vaccine came out? I think one thing that isn't celebrated enough is the fact that for the very few or maybe the first time in human history, all of the best scientists and researchers and everybody who was involved in medicine, science, bench research, clinical research, whatever it was really stopped what they were doing and focused on one thing, right? So you had immunologists, rheumatologists, cardiologists, internal medicine, doctors, psychiatrists, everybody across the board focused on how to manage this pandemic and there was a lot of brain power that went behind that money to help with the vaccine. On top of it, corporations stopped processing anything else and diverted their efforts towards figuring out this PAC vaccine. And I think that's why we should celebrate the fact that for one of the very few times in human history, we as a race came together and addressed one threat to our existence in a unified fashion without the bickering and hate and anger that you normally see. I think we should talk about that a lot more in the public realm. I think that we should celebrate that science produce something rather quickly and it has saved millions if not billions of lives.
Harper Spero (17:33):
I'm really glad you brought that up. I think it's such an important point. And again, similar to the trauma of all of this, we're also not celebrating the, the wins from this experience. I mean, I oftentimes say on the podcast, oh I feel weird saying this, but one of the benefits of the pandemic fill in the blank were certain things that happened in my life that changed in a positive way, but it feels so strange to go, there was good things that came out of this time.
Dr. Alex Truong (18:03):
I think that's the nature of anything. It's not all bad as not all good, don't get me wrong. There were horrible, horrible things that happened with the pandemic. There are horrible scars that have been left behind, but there are some moments that shine bright and I think one of the problems with our mental health state in medicine is that we don't look at those bright moments very often. We don't celebrate those bright moments. We don't say we went from an ICU that cringed at taken care of five to six vented patients to an ICU that can take 20 vented patients and do well. We don't celebrate that. We saved more lives than we lost. And I think we don't celebrate the fact that across the board everybody came together to help these patients. And something as as simple as celebrating our custodial staff, which we're able to clean those rooms, get them turned so we can get another patient in, was something that we didn't do enough of and we didn't go and say thank you for saving this patient's lives by cleaning these rooms. Because I think it's easy to kind of focus on physicians and nurses. Those professionals can't do what they do without respiratory, without custodial, without nutrition, without all the others.
Harper Spero (19:20):
Yeah, I agree with you completely and I think, you know, let's celebrate it here. This is a perfect moment to acknowledge everyone who deserves acknowledgement for their work throughout the pandemic and still, and to your point, it's, it's all levels within a, within an organization, within a hospital because really every one of those roles is so crucial. So what kind of treatments have worked best for managing patients who are dealing with long covid?
Dr. Alex Truong (19:53):
Oh, that's a hard question to answer. I think that we're still struggling to try to figure out what's happening when patients have long covid or post covid syndrome. There's a lot of theories whether it's because of inflammation or persistent viral infection or whether or not it has to do with an autoimmunity, whether their body triggers itself to fight against itself. The holy grail post covid is figuring out what the underlying pathology to all these symptoms are and then if we're hopefully able to treat that underlying pathology, people will get better. We are so far away from that right now but thank God a lot of research is starting to kind of give us a lot more information about how inflammation plays a role. So right now as as we're treating patients, we're actually treating the different symptoms individually. So for an example, the brain fog is one of the things that really debilitates a lot of my patients.
(20:41):
We here at Emory working with neuropsychology specifically Dr. Michelle Hadad have figured out that a lot of their memory issues or brain fog issues are really attention issues and not really dementia or cognitive decline. And I think that when patients say they forget where they put their keys, they forget what they were doing, they can't multitask. They can't concentrate to read a book or watch a movie from beginning to end. It isn't a memory, it's an attention. And so one of the things that we've been successful in is shifting our approach to those patients and treating them like they have a d d or attention deficit disorder. And once we're able to do that, I think those patients actually do a lot better. I use a lot of the non amphetamine based medications to treat, but you can also side with some of the amphetamine based medications.
(21:29):
Both classes of medications have a side effect of being a little bit stimulating. So those patients with the fatigue, which often often associates with the brain fog get a little bit benefit from that. That's been really helpful for the fatigue. Physical therapy has been really helpful and so we've been employing a lot of physical therapists to help build these patients endurance because their problem isn't neuromuscular weakness, they don't need to lift more weights. What they need to do is work on how far they can walk. It's a little bit of a double-edged sword because a lot of these patients also have what's called post exertional malaise. So they push too hard and they will wear out for about three days and they can't do anything. So a physical therapist who is sensitive to the issues of post covid patients can push them to a point where they build their endurance but not push 'em so hard that they fall off that cliff.
(22:18):
We're also finding there's a lot of shortness of breath that's happening in patients that seem to resound well to inhalers. Sometimes they have lung inflammation, they respond well to steroids and then there's a pain syndrome that we're still at the point of struggling to try to figure out how to manage this pain syndrome includes both chronic headaches. I've had a patient who had six or seven months of daily headaches every single day for that long, which I can't imagine patients who have joint pains and muscle, muscle pains, patients who have frequent migraines. There is a sneaking suspicion in me that it's because of nerve hypersensitivity that these patients are so much in pain. So using medications can that help numb down those nerves like gabapentin or Greek. Pregabalin have been able to help kind of mitigate some of their symptoms, but yet we're still at the point where we're trying to figure out exactly how to manage that and what the cause of this pain syndrome is. Unfortunately, some of those medications that help numb down the nerves can cause fatigue, which then in turns makes their fatigue worse, then makes their brain fog worse, then makes them more pain sensitive. So it becomes a kind of balancing
Harper Spero (23:28):
Act. Yeah, I hear that often in the invisible illness community when people have several diagnoses and they're treated for one but then it affects the other one and how do you figure that all out? But when you talked about the headaches, it made me think of a friend of mine who after having covid, was dealing with extreme migraines every day. And I remember saying to her, I'm not one to give advice, especially medical advice because I've been through enough with my own health that I'm not interested in hearing other people's opinions on what to do with my body. But I said to her, I wanna throw this option out to you. I've heard that acupuncture really helps with migraines, especially for long covid. She said, cool, give me your person's name. She had three sessions with her and was completely healed. And so I wonder if you consider slash research slash know about the holistic world as a doctor to consider offering something like that to a patient.
Dr. Alex Truong (24:30):
I think that's one of the other small benefits of post covid is that it's opening up the realm of management to just beyond western medicine. I think a lot of the holistic approaches have helped, you know, patients roll their eyes when I say physical therapy will help you and when they go through it, they do a lot better. In some cases I've used massage therapy and pressure point therapies with these patients to some benefit. I, I haven't used acupuncture yet, mostly because I don't know of an acupuncturist that I can send patients to. You know, in addition to the holistic approach is also addressing the mental health issues because there's a lot that's happening neuropsychologically in these folks that are affecting them. There's definitely true that these patients have more anxiety and depression as reactive disorder to what they're going through the infection and all the lingering symptoms they have.
(25:21):
But it also seems that anxiety and depression rates seem to be higher once you even adjust for those changes. And so covid may be doing something to our brain or neuro chemistries in ways that we don't get appreciate. So making sure that we address their neuropsych issues as importantly as we address their shortness of breath or their joint issues is gonna be very important to us. And I think that's one of the challenges with a pulmonary critical care physician working in this field is that I've had to pool all these resources from my psychiatry friends, my rheumatology friends, my cardiology friends to try to figure out how to manage these patients cuz I can't remember the last time I ordered a antidepressant. But now in this clinic I do it quite often and I'm much more comfortable than I was before.
Harper Spero (26:08):
Yeah and honestly something about that is really, I'm really thrilled to hear because I think one of the challenges in medicine is so often because people have their specialty, they don't look at the full picture. And so most people looking at the full picture and like functional medicine, which people are paying out of pocket a bazillion dollars for and so many people don't have access to. So I think it's interesting that you are looking at the whole picture because you're seeing that it's all connected, but it's so rare to hear about that so many people could get more information and maybe diag be diagnosed with different things sooner if there were doctors who were looking at it all, not just looking at all right, let's do a scan of your lungs cool moving on when maybe there's something ha happening in your brain or in your legs or something of that nature.
Dr. Alex Truong (27:05):
I think it has to do with how we're trained. You know, it's not that we don't wanna take care of the patient in a holistic kind of over big picture kind of way. I think that our training kind of pinpoints our expertise smaller and smaller and we're expecting now at least all of our residents to figure out what they want to do for fellowship and when they do their fellowship, what super specialty they want. And so they become super experts in a very small realm of disease. I think that what that does is, is it allows us to be very comfortable with what we're good at because we don't want to be not good at something. We don't touch the things that we aren't trained in because we don't wanna make a mistake, we don't wanna do something wrong. We don't want to be seen as going outside of our lane in the post covid realm. Unfortunately we have very, very few physicians who are doing this kind of work that leaves it us up to us to try to figure it out and how to take care of all these other issues that are affecting the patients so that they as a human being, as a whole body gets better as opposed to just breathe better. But you still suffer with horrible brain fog and fatigue. Yeah,
Harper Spero (28:15):
That makes a lot of sense. I mean I totally hear where you're coming from of what you're taught and how you're, you know, quote unquote supposed to go into a specialty. It makes sense and there's a reason why people go to experts. It's why I have an infectious disease doctor, an immunologist, a pulmonologist, and they ear each serve a certain purpose and collaborate because one of them knows something more than the other in certain realms. Are you finding that people who are experiencing post covid are people with underlying conditions or that's not even part of the picture?
Dr. Alex Truong (28:50):
Our research would say that patients with underlying conditions are more prone to having post covid issues. However, in my clinic I have a lot of patients who are super healthy not taking any medications and had absolutely no problems whatsoever, have pretty debilitating and lingering symptoms that lasts for quite a while. Sometimes patients who are infected in 2020 still have a lot of issues now. So I don't know where I stand on on that. The one predictable thing about covid is, is it's unpredictable. When I look at somebody I said, oh yeah, you know, they were super, super sick initially and they have all these comorbidities, they're more likely to get post covid issues and then, you know, fast forward six months, they're fine and no problems and then it'll have, you know, 20 something year old triathletes who have no medical problems whatsoever, have very mild initial disease and then have very long lasting symptoms that keep 'em from working, keep 'em from going back to the trails or whatnot. So it's very unpredictable. I think that if we believe the research then the research will argue that increased comorbidities are associated with increased risk for post covid issues. I'm not sure if that cleaned up.
Harper Spero (29:58):
And why do you think it is that hospitals and doctors are not putting an emphasis or focusing on this three plus years in?
Dr. Alex Truong (30:07):
I think that they are, I think they're just super slow about doing so. I think that to be honest, it's not sexy work <laugh>, it isn't heroic work. It is an image of you running with a stethoscope. But I think it's really important work and I think that hospitals and doctors are starting to realize how much is affecting people and how many people have lingering symptoms that are often debilitating. And I think they're starting to shift their resources start starting to shift their focus into it and I think it's becoming much more important now. Is it really late? Yes, they should have focused on this a year or two ago. I totally agree with that. I'm just grateful that they're starting to focus on it at the same time. We have quite a ways to go and I think we definitely need more resources and we need more physicians and we need more physical therapists and psychiatrists and you know, psychologists and neurologists and everybody working on it as a group. And I think hopefully that will change in the future.
Harper Spero (31:08):
I'd like to beg to differ on the heroic front. You can't possibly say to me that it, you are not a hero for doing the work that you're doing. I mean, you may not feel that way, but you deserve that credit. So please, please take that credit. You shared with me that you often feel isolated doing this work because there's so few people doing it. How do you navigate that? I
Dr. Alex Truong (31:32):
Don't know actually. I probably do the same thing I did when 2020 hit and I just suppressed it all. You know, I I I, I went into medicine cuz I wanted to take care of people. I know it's kind of silly but it's very simple. I, I wanna do well by people. I feel bad because there's so many of our patients who come from so far away just to have a hour visit with us and they have been told by other folks that it's in their head or they'll just get over it or whatever the case may be or that they don't know or there's nothing to do. I'm not saying that we have answers for everything and I'm not saying that we work magic, but we're very willing to do something and I think that means a lot to folks. Seeing these patients seeking help makes me feel at the same time significantly less isolated and a lot more isolated, less isolated as a human being.
(32:26):
As someone who takes care of other people, as someone who wants to like ease suffering, it makes me feel a lot more isolated because these four folks are traveling from Mississippi and South Carolina and North Carolina. We had patient from Indiana come to us. I wish that they had more resources. I wish I had more resources to call up somebody and say, Hey what are you doing? I was really lucky cuz I was able to hook up with one of the post covid clinics in Texas and talk to them about how they're approaching things and it kind of gave me a good perspective and refresher on like how I should be approaching things and how I may change how I manage my patients. But even within Emory, there's very, very few of us who are doing this line of work. I wish it was easier for me to be able to pick up a phone call and call up a colleague and say, Hey, I had this difficult case, how would you approach it?
(33:14):
But that doesn't happen. I think I, to go back to your question, I don't think I do deal with it. I think I just keep my nose to the grindstone <laugh> and I just keep working. I keep hoping that I am flexible and, and malleable enough to change with the pandemic with the patients and figure out new approaches and find some things that help and get rid of some things that don't help. I keep working at it and then we see, and then next thing you know it's 2023, 2024 will come and hopefully things will get better.
Harper Spero (33:44):
Yeah. And it's so clear your dedication to your work and when you gave the analogy about like swimming in no direction, I hope that there comes a time where there is a direction that you're swimming towards that you feel like there's an end in sight in some capacity. What have you learned about yourself as a person and as a doctor in these last few years?
Dr. Alex Truong (34:05):
I think I've learned that oddly a lot more resilient and a lot more fragile At the same time. I've learned that I need to allow myself to be human in amongst all this craziness and crap anger and stuff. And that I need to give myself space to be able to do that. I've learned that I can take care of the sickest patients possible sicker than I ever thought I could. And I'm so grateful to my mentors and my fellowship and my residency for training me to be able to, to do this kind of work. I've learned that all of us who go into medicine wrote these medical school statements that were super touchy feely and superfluous and all about wanting to help people and being someone's hero. And I think it's been, I wanna say a decade or two since that's happened with me. I think those things ring true now.
(34:59):
I think what I learned is, is that what I wrote in my medical school essay is it's something that resonates now. And I think at the gist of all, I don't care about being some huge dean of some department or something like that, but I want to be the, a good doctor who takes care of people and who eases suffering. I, what I think I I've learned through the last couple years is instead of being kind of embarrassed that that's why I want to do things I've learned to be proud of. That's like what I want to be and who I want to be and the kind of doctor I want to be. I don't know if that sounds too cheesy. I think that's a important lesson and a humbling lesson that I learned.
Harper Spero (35:34):
I think those are amazing lessons and I'm so glad that you're able to wrap that all up and be able to share that. As you know, this podcast is all about invisible illness and I'd say long covid post covid is certainly in that category. What do you as a doctor want people to know about invisible illness?
Dr. Alex Truong (35:55):
I think the nature of invisible illnesses that you suffer alone and I think that the physical aspect of the illness causes you to suffer, but that loneliness contributes so much to that suffering and I think that part of the treatment of any invisible illness, whether it is post covid or the PTs d from going through Covid, part of that treatment has to be able to address that mental health aspect of it, that loneliness of it, the isolation of it, the the shame of carrying this illness because no one wants to be sick, no one wants to carry this diagnosis or whatever you want to label it. But I think part of the healing process in addition to medicine, therapies, acupuncture and all that has to be addressing that you own that illness, that it is part of you and that you are in some small part, brave and powerful for fighting against it on a daily basis or a weekly basis or whatever it may be. And I think that applies to any kind of illness and some of which we haven't yet named and some of which we haven't yet put voice to and identified and diagnosed. And I want people to know that in some more small way, they are not alone and that their suffering is physical as well as spiritual. And I think that addressing both is gonna be very important in how they heal.
Harper Spero (37:19):
Wow. Thank you so much for sharing your insights and your experience on the show. It really means a lot to me and I appreciate you so much for doing the work that you do and staying dedicated when it's so clear. The world is just trying to move forward and move on and pretend that we didn't experience what we experience. If someone has long covid and they're not getting the proper care from their doctors or the hospital local, local to them, what can they do? How can they get in contact with Emory?
Dr. Alex Truong (37:52):
So I think a good way is to call the Emory call center, call the information line and ask for the call center and ask for a referral to the post covid clinic and that's the best way to get into our clinic.
Harper Spero (38:03):
Awesome. Thank you so much Alex.
Dr. Alex Truong (38:05):
Thank you.
Harper Spero (38:09):
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