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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💊 Examples: Sodium cromolyn, ketotifen, vit C, quercetin, luteolin
🧪 Main mechanism: Unlike antihistamines, which block the histamine receptor as their primary mechanism of action, mast cell stabilisers help prevent mast cells from spewing out their contents ("degranulation")
In MCAS, this degranulation is inappropriate, with mast cells reacting to benign triggers such as foods, air pressure, or scents (among many other things). Therefore, stabilising mast cells can help with some histamine issues...
Mast cell activation syndrome (#MCAS) & histamine intolerance are common features for many #longcovid & #PostVac patients. 🧵on antihistamines which are commonly used in MCAS & histamine intolerance. (I will do another post on mast cell stabilisers) lc-sc.co.uk/bodily-systems…
There are different types of antihistamines with different actions, but they all block a histamine receptor so histamine can no longer attach to the receptor & cause chaos. I.e. antihistamines do not stop histamine production, they just stop histamine from working properly
🧪 Main mechanism: These work by blocking the H1 receptor, which has roles in hypersensitive reactions (e.g. wheezing, itching, coughing, blood pressure dropping)...
As #microclots are a common part of #longcovid #PostVac chat, different treatments are also a common talking point.
Some treatments do not work exactly as people realise though. A quick rundown of the main mechanisms of different clot-targeting therapies... 🧵
#teamclots
Direct oral anticoagulants (DOACs):
💊 Examples: Apixaban, rivaroxaban
🧪 Main mechanism: These work by blocking part of the clotting cascade.
❌ A common misconception is DOACs *break down* blood clots, when actually their main role is to help prevent clot formation.
In theory, what this means in terms of microclots is that our body will naturally break down the (micro)clots and the DOAC will help stop any new ones (re-)forming.
I think when #chronicillness patients notice new symptoms, people think we are being dramatic.
But really what we are noticing is new malfunctions with unknown consequences, and we're getting a reminder of just how broken we are.
To give an analogy... 🧵
#medtwitter
I have had REALLY shit cars before, and one car that would keep going no matter how broken it was (i.e. a really good car).
With the good car, when a new thing happened (the engine light came on, it made a weird noise, or whatever) i knew i had nothing to worry about
The car never seemed to stop chugging along so new little problems didnt worry me. I could largely ignore them and get them checked out in my own damn time
"A variety of symptoms, including thunderclap headache, focal deficits & movement disorders, can occur after SARS-CoV-2 vaccination, & an (re)activation of the immune system is suggested as [a] cause"link.springer.com/article/10.100…