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

#MedTwitter
lastly, some weird blood results
in A&E in Dec, my WBC were slightly high. Sort of expected in that situation & werent alarmingly high


Bloods yesterday: they havent changed much, & now my neutrophils are slightly elevated too with slightly low eosinophils
(urea also a bit low in both measures, assuming low protein diet)

No signs of current infection, and as above, my general post-vax symptoms are "good"

maybe immunostimulation is helping me:
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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More from @angryhacademic

Sep 12
My prediction:
1. Once MCAS is properly recognised, we'll find theres also platelet activation syndrome and basophil activation syndrome

2. MCAS, PAS, and BAS will likely be commonly comorbid

3. Significant symptom overlap

4. (Luckily) Treatment overlaps
As an example: many MCAS patients respond very well to aspirin (me 🙋🏻‍♀️). Ofc this is likely in part from blocking prostaglandins, but it also inhibits platelet activation
Platelets and basophils are similar to mast cells in that they are granulocytes - they contain lots of of the same chemicals (mediators) mast cells release, like histamine, & respond to various stimuli. Both platelets and basophils have roles in allergies too
Read 5 tweets
Sep 8
SIADH and hyponatraemia: why does it matter?


This paper is absolute fire 🔥🔥 and some of the core points are 100 % relevant to SO MANY diseases🧵academic.oup.com/ckj/article/2/…
SIADH = syndrome of inappropriate anti-diuretic hormone. In SIADH, patients (usually) have high ADH (also called vasopressin). A problem with this is that patients store too much water which dilutes blood, causing too low blood sodium (hyponatraemia). Worst case = fatal
But much of this paper applied so much more broadly. Some quotes from the paper and general commentary:

Abstract:
"Recent studies show that hyponatraemia is often poorly managed—insufficient diagnostic tests are ordered and patients are undertreated....
Read 34 tweets
Sep 2
When doctors say "i PrAcTicE eViDeNcE-bAsEd MeDiCiNe", what they really mean is...

1. Picking and choosing what evidence they approve of
2. Not even reading the latest guidelines
3. Refusing to read scientific literature (and being pretty shit at understanding it anyway)
4. Psychologising and gaslighting patients instead of admitting they don't know
5. Arguing against and ignoring legitimate experts, which has literally led to deaths,.e.g.:

6. Leaving patients to suffer rather than investigating the cause of their symptomsmanchestereveningnews.co.uk/news/health/on…
7. Flat out making stuff up
8. Calling things they dont understand quackery
9. Being unable to update their knowledge in the face of new evidence
10. Mocking informed patients cos they cant drop their ego enough to consider that maybe—just maybe—patients have done proper research
Read 10 tweets
Jul 13
Another inconsistency in medicine:

Most doctors accept endometriosis is an inflammatory condition even if inflammatory markers are not raised

Yet when i speak to neurology or rheumatology they deny i have any inflammation because my inflammatory markers arent raised
So i simultaneously have an inflammatory condition, yet i dont have any inflammation 🧐
"But ahh☝🏻💡" they might say, "the inflammation in endometriosis can be localised to endometriotic tissue!"

And that is exactly the point - inflammation can be localised! For example, *in* the central nervous system, or around tissues directly being targeted by autoantibodies
Read 6 tweets
Jun 22
Mitochondria Are More Than Powerhouses—They’re the Motherboard of the Cell


Fascinating piece by @MitoPsychoBio. Makes me wonder if the energy problems in ME are related to cristae alignment/mito-mito communication 🤔🧵scientificamerican.com/article/why-mi…
I.e. Picard states that healthy mito help out unhealthy mito, and thats why things like exercise can be good, as it forces everything to work together. But if that communication path is shut off, i would guess adaption to exercise/stress would not be possible
And if mito are not receiving help from their neighbours, then dysfunction proliferates.

So you end up in a state of individual mitochondria doing their own thing (no coherence), unable to adapt, and unable to call their buddies for help
Read 6 tweets
May 28
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?
Read 6 tweets

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