Update:
So, the flesh eating bacterium, having done a number on the first leg, is now quite literally ploughing through leg No.2 (I know, I am shocked as you are).
It's probably getting pretty critical now.
What's that you say?
N=2 is just one better than N=1?
(1/6)
Yes, that is strictly true but I don't think you're going to be able to increase sample size much further.
You could add in a trial arm I suppose...
But I do think we have enough to be going on here, you may not (literally), but we do.
2/6
I see your point that leg 2 is not quite so bad as leg 1 but that is just the lag.
You don't agree? I see, you think that leg 2 has acquired some immunity so is fighting back better.
Well, your hope and optimism gladden my cynical heart but I do think-
3/6
Yes, it is your body, and yes these are still your legs (well, soon to be ex-legs), and yes autonomy is very important. I can't argue with any of that.
Perhaps some antibiotics? They do work well on this bacterium.
No? You're concerned about long-term effects?
4/6
Have we done any trials on the long-term effects of giving antibiotics to people? Specifically in cases like yours?
Well no, your case is rather unique, particularly unique.
Yes, I know it seems like we agree on that but trust me, we don't really.
5/6
Ok, let me know once you feel you have enough data.
You're confident this leg will be milder? And what about leg 1? It just needs some time to fight back? Right you are.
You've got a good feeling about this? You can feel it in your bones?
You know, I rather suspect you can.
6/6

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More from @HZiauddeen

15 Dec
🧵 COVID-19 in the UK: We're so fucked

Today UK case numbers set a new pandemic record, a milestone so portentous that, despite having nothing to say and no plan to announce, Boris Johnson had to hold a briefing, even if it was only for the symbolism.
And it was.
1/25
Chris Whitty did his best to inject some vital reality into the briefing and the title of this 🧵 is an homage to his valiant efforts, too little and too late, but at least a true communication of some of the harsh realities we face.
2/25
But the bottom line is the govt is going to continue to do just about enough to defend against the charge that it is doing nothing. A case that it will fight on a technicality.

Btw, for those who might point to Plan B and the booster plan, I offer you this analogy.
3/25
Read 25 tweets
11 Dec
🧵 Research study: Psychotic experiences in borderline personality disorder (BPD)

Psychotic experiences are common in BPD but are under researched and often dismissed. We are looking to better understand these experiences and how they might arise.
tinyurl.com/rnjs8xs7
(1/4)
BPD is associated with a huge amount of suffering and it is one of the most stigmatised psychiatric conditions. For research it is important to use established diagnoses but we are very mindful of the issues with the diagnosis as discussed 👇
(2/4)
The study will involve a brief screening session to determine if you are eligible to take part. If eligible, you will be sent a link to fill out a set of questionnaires and some computer based tasks that will take ~ 1.5 hours. You will be paid £20 for your time.
(3/4)
Read 4 tweets
11 Dec
🧵 The problematic diagnosis of Borderline Personality Disorder (BPD)

BPD (aka EUPD, emotionally unstable PD) is arguably the most stigmatised diagnosis (Dx) in MHservices and in the general hospital.

This 🧵is going to cover some of the problems with this Dx.
(1/51)
Many of the people (predominantly women) given this diagnosis are survivors of complex trauma, who continue to experience recurrent trauma in mental health and physical health services, as well as in other areas of their lives (a frequent & painful legacy of trauma).
(2/51)
Despite this being fairly well known, in reality the trauma and suffering often receive little consideration, and the Dx is heavily stigmatised, leads to frequent dismissal and EXCLUSION from care, and even frank discrimination, with far too many people taking their lives.
(3/51)
Read 55 tweets
4 Dec
🧵On complicated grief: losing someone who should have been close but wasn’t

For those of us who've lost people who should have been loved ones but didn’t really love one,
Who’ve lost parents, siblings, (sometimes children), and spouses, who were uncaring, and abusive.
(1/25)
Grief is the pain of the void left in life where someone used to be.
The void is the great discontinuity, the point where they will no longer be part of the unfolding story of your life, the point where your shared story ends, from when there will be no new memories.
(2/25)
All they were part of, all that they helped in making the world feel better and safer, in making you know you mattered, all of it ends at the void. The enormity of the void is overwhelming, and in the early stages of grief, it can be hard to see a future beyond the void.
(3/25)
Read 25 tweets
4 Dec
RTing this for 2 reasons:
1. I think this is the only way in which we might get a sensible pandemic strategy (I'm not hopeful).
2. The lovely replies from pronoun warriors.

Neither of these is a compelling reason to read this little thread but 1 possibly narrowly beats 2.
1/6
We've learnt a lot about Omicron since I wrote the original thread and none of it is remotely reassuring. In the thread below I wrote about how this is what was expected and predicted especially by people who know about virus and immunology.
2/6
My worry is that a massive change of direction will be required to deal with the combined delta and Omicron pandemics. This is not going to be controlled by minimal interventions and continuing otherwise as before.
3/6
Read 6 tweets
4 Dec
🧵Ostensibly about necrotising fasciitis:

A flesh-eating bacterium is eating through your leg. This is a new experience. You have never seen bits of your leg disappearing like this. And the pain, well that's something else. And the smell, oh boy the smell.
1/8
This is not looking too good but we don't know how it's going to go. Perhaps you should sit & watch carefully to figure out what's going to happen next. What can you infer from the mysterious ways in which the bacterium moves?
2/8
Perhaps it's important to adopt the right attitude, one of caution but not rushing of to action. Perhaps fortitude may cause the bacterium to think again if this is perhaps the wisest strategy to pursue.
Read the entrails carefully (but quickly lest they become your own).
3/8
Read 8 tweets

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