🏴Thank you to @Fionasstalker & @BBCScotland for covering #LongCovid so well
🏴Interviewing the right experts
🏴Highlighting the fact that #pwLC in Scotland are struggling to obtain care and treatment.
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This is the very real danger we are facing in the 🇬🇧 with clinical care.
#LC is being seen as persistent & is going to be integrated with chronic pain & other unexplainable 'persistent symptoms'. 🧵/1
The problem is there's real issues in chronic pain clinical practice. It follows a problematic biopsychosocial approach of 'central sensitisation'. Which essentially means there's no 'real' physical cause. /2
It's a dubious theory & often comes with significant patient trauma. With little actual investigation. It's likely alot of pain comes from mechanisms we don't yet understand that aren't on a visible level. /3
🌟Major Step Forward 🌟
Long Covid DEFINITION 🧵
5️⃣ Main Points
👉ATTRIBUTION TO INFECTION
-yet no labs needed
👉ONSET & DURATION
-3 months yet can be cont. or delayed
👉 SYMPTOMS
-1 or more organ system but no limits
👉EQUITY
-anyone!
👉FUNCTIONAL IMPAIRMENT
-can be profound.
🌟Key Takeaways🌟
👉Legitimate Disease State
-that's in black and white folks)
👉#POTS #MECFS #MCAS are pathophysiologic mechanisms of #LC
👉#LC is an IACC - Infection Associated Chronic Condition
👉 Designed for max. impact & distribution /2
This is an interesting phenomena. It can affect attitude, advocacy priorities and nomenclature.
It's especially present in the area of illnesses that carry taboo or disbelief in the medical world.
There are different advocacy styles - which is great /1 🧵
Yet if an org can't
🛸 clearly define, say, interact or state issues that affects patients
-that are part of the discrimination against them
-that affects their quality of life and illness
-that are unjust
Then Houston, we have a problem - we have advocacy alienation /2
This can take many forms:
🛸Some won't say or have much to do with ME
🛸Some won't speak out about injustice
🛸Some avoid the severe or contentious, difficult issues
Why is this? It's curious. There might be a number of reasons: /3
Those who have Long Covid, ME or chronic illness often experience a "double obscurity" (a quote from Margaret Atwood).
There is the obscurity of the illness and then the obscurity of societies inability to understand the illness. /1
Susan Sontag in her famous quote from 'Illness as Metaphor' captures this experience.
It's as if we enter into a different Kingdom, even if people can see us in plain view. We are other, it, a reminder that life can be unfair, painful and cruel. /2
It is as if we hold a social contagion, a bad luck that needs to be avoided. No wonder history has its sin eaters and scapegoats.
🧵After the NHS #LongCvd conference we can see a peculiar split in view:
1️⃣ NHS clinicians & researchers - think they are empathetic, giving a good service, dealing with psychological needs. Researchers still invested in psychosocial & activity intervention.
more... 👇 /1
2️⃣ #LongCvd patients often feel neglected, have a poor experience of clinics, emphasis on the psychological is leading to an increase in social services referrals, poor knowledge & gaslighting in primary care. At risk through lack of masking. /2
3️⃣ How do we bridge this gap? There still seems a lack of engagement with the severe, very severe & ME from the NHS. This is crucial. What is from good intentions is leading to a difficult patient experience. /3
📝This is the agenda from the NHS #LongCvd conference
It was filmed and will be online (H/T @JCeoltaSmith)
🙄Concern: why on earth is each hub allowed to wing it in woo wonderland?
🕵️♀️Where is the standardised investigations & treatment for POTS/ME/Microclots - that incl severe?
🤔The majority of the conference seems to be on therapies 4 rehab. But how do people access rehab if the underlying pathology isn't treated?
🤔Kind of freaking out the CYP section was led by lead from SW Hub Bath lead fatigue service - Crawley territory
🤔'Post Covid' Society - nomenclature concern - it was called Long Covid to avoid implying Cvd was over in LC
It's why post-acute is used
🤔What's the future system to treat LC and post viral illness. Are we all going to fatigue clinics?!