wee update:
had a couple of pretty good weeks which has surprised me. everything in life is tolerable. still worse than before my last relapse, but if life stays like this, i can work around it. tho i usually feel "good" pre-relapse, so hoping it's not the calm before the storm
had TWO dr apps this week: 1. at the nutrition clinic: anaemia has resolved so i can stop iron supps, just got some follow up apps to check my haemoglobin, B12 etc stay stable
2. GP: spoke to advanced nurse practitioner. i was sorta ready to put up a bit of a fight as it was...
to discuss tests & meds recommended by a private dr. she was absolutely lovely tho, & shocked how much ive been suffering
- agreed to D-dimer: if elevated 1 month after anticoagulation ends I may be indicated for longer term anticoagulation as i have a high risk of further clots
- agreed to fludrocortisone (YAY!)
- agreed to increasing famotidine (from 20 to 40 mg/d)
- didn't agree to steroids, but said i can call back if i relapse
- didn't agree to melatonin but not at all shocked by that, esp as we asked for 9 mg!
- agreed to tests for antiphospholipid tests but after discussing with a GP, they werent keen on doing things piecemeal so referred to haematology, should be in 2-3 weeks
bit concerned as ive heard haematology arent up to speed on the type of clotting seen post-vaccine #TeamClots
but hopefully (if i need them) the solution will be something standard (like APS or DASH score)
So overall, very happy with that outcome and glad they were happy to help like this
i'll add also that the nurse COMPLIMENTED me on being a well read & "clearly very intelligent" patient & she REALLY listened to my concerns & explained things well
i cant stress enough how much of a difference medical professionals appreciating patient expertise makes #MedTwitter
simply by listening and explaining her POV compassionately i came away content despite not getting everything i was hoping for. if the practitioner was dismissive, we could have had the VERY SAME OUTCOME but i would feel belittled, angry, and gaslit
but no idea why it's happening (PCR yesterday was negative too)
will see if they calm down, and will discuss with haematology but ideas welcome about wtf my immune system is doing (beyond the possibility that there is some low level infection). in terms of potential immune modulators, im on loratidine, famotidine, ketotifen, statins, aspirin
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POTS not being immediately life threatening i think is one reason (in combination with others) there is little interest in it medically. However, this is a very narrow view of life and death - and not just because it ignores the life ruining impacts of POTS 🧵
But also the fact it *can* impact life and death decisions.
For example: my tachycardia in A&E was very normal for me. "Thats just POTS"...whilst im haemorrhaging internally.
A key marker of a potentially fatal pathology was ignored because of POTS.
🤔 What if i had a cardiologist on my medical team who could advise?
🤔 What if the hospital hadnt left my POTS so poorly controlled?
🤔 What if we funded research for more effective treatments?
Something underappreciated with chronic illness is the amount of things constantly going on *even on better days*.
For example, on a lower symptom day, having a conversation can mean:
🦵🏻 My legs start tingling and internally vibrating
🙌🏻 The numbness in my hands gets worse
🧵
👂🏻 Pulsatile tinnitus gets worse
🫁 Breathing becomes harder
💓 My heart beats faster and i can often feel palpitations
🤢 Nausea kicks up a notch
😵💫 Dizziness gets worse
💪🏻 My muscles twitch and sometimes spasm
👋🏻 I might start tremoring
😨 My energy drains and fatigue sets in
🤯 My head feels "full" (I don't know how to describe this sensation)
👀 It becomes harder to focus my eyes
🗣️ I'm fighting to stop my speech becoming slower and/or quieter
🤔 My concentration and "present-ness" fades
Im glad to see more doctors speak about things like #MECFS #POTS #MCAS #fibromyalgia etc but it also worries me because its seems many have a rather superficial understanding. For example, i quite often hear such doctors speak about MCAS only in terms of histamine
#medtwitter
They talk about the more obvious histamine related symptoms like hives. I heard one dr say one of the "most common" symptoms is dermatographia (skin writing) and im really not sure thats the case (both our samples may be biased though)
Treatments are (as far as I've seen) exclusively spoken about as trigger avoidance and antihistamines.
Similarly ME is described as chronic fatigue (not PEM), and POTS is described as dizziness and fainting
It's #LongCovidAwarenessDay2025 and these are the messages i want different groups to understand:
Medical professionals:
Our best healthcare teams dont have all the answers, nor do they pretend to. Instead, they read the evidence, they listen, they believe, they monitor 🧵
They take risks (with informed consent), they keep accurate notes, they advocate, they wear respirators, they accommodate (e.g. low lighting, allowing us to lie down, or have online appointments and home tests), they care.
Medical professionals (again):
Long COVID is not a complete mystery. The GMC state that you need to work according to best evidence. This requires you to read the evidence and listen to experts. If you did this, you'd know to rule in/out the most obvious at the very least:
Clearly things DO need improving otherwise we wouldnt have the need for a vaccine injury charity to be set up to support patients with vaccine injuries.
We wouldnt be waiting for basic tests/diagnoses, we wouldnt be censored, and we wouldnt be battling VDPS
Some jumbled notes from Evans:
Kept talking about gold standard evidence without appreciating where we can actually do better. Research methods is a dynamic field, the gold standard of today is the poor practice of tomorrow