Jill Piggott Profile picture
PhD. Prof of philosophy & lit now disabled by daily migraine. EJI volunteer. Director, Reading Justice prison study group. Director, headsUPmigraine.
Kelly L.⭐⭐ Profile picture Anne Fuqua Profile picture Cathy Kean Profile picture Hikmatullah Khan,FCPS Neurology Profile picture ultraviolet • 🏴🚩☭♿️🏳️‍🌈🌵💜🥄🇧🇬🌒🌕🌘🧜🏽‍♀️ Profile picture 8 added to My Authors
25 Nov 20
#Migraine is a neurological disorder, not a terrible, disabling #headache," expert @DavidDodick explains. #Pain is "just 1 clinical manifestation deriving from a sensory processing disturbance affecting the nervous system" (Morgan, Lancet 2020). /Thread thelancet.com/journals/laneu…
Billie lost her insurance when #migraine disabled her: “There are days I don't see anything except for shapes." Visual warnings are the most commonly recognized auras, but these symptoms are highly variable, both in different patients & on different days for the same patient. 2/
Difficulty speaking or speaking clearly is another common #migraine symptom, either preceding or during an attack.

Poor St. Husband. He watched this clip & said, "Yup, that's you." I spent a lotta years in school to talk like this. 3/
Read 7 tweets
25 Nov 20
A Yale study of 10 patients found 1 dose of #psilocybin can cut #migraine frequency in half for 2 weeks. Each patient did 1 session with placebo, 1 with the drug. People who felt most high got the least migraine relief. /thread newatlas.com/health-wellbei…
The Yale researchers who conducted the small, but 1st of its kind study suggest #migraine patients might benefit from microdoses or sub-hallucinogenic doses of #psilocybin. Understanding how psilocybin prevents migraine might open new pathways for drug development, as well.
I did 2 #migraine clinical trials. I'm glad someone else took this one for the team. I hated Methysergide (Sansert), now discontinued, which was synthesized from lysergic #acid. A 1965 study said Sansert users experienced a "confused feeling of unreality." Tell me about it.
Read 7 tweets
24 Nov 20
“[W]idespread & variable dysfunction of the nervous system…comprises the aberrant brain state of a #migraine attack” (Charles 2017).

Daily/near-daily migraine is continuous migraine. Imaging shows our brains *always* look like brains during an "attack" (Brennan 2018). >thread
Recurrent #migraine & #pain aren't benign. “Long-lasting &/or repetitive pain over years leads to profound functional as well as structural changes in the brain networks" (Brennan).

Ineffective treatment is a leading risk of progression to continuous migraine. #MedicalTwitter
Brennan & Pietrobon's paper "A Systems Neuroscience Approach to #Migraine" (Neuron 2018) is @headsUPmigraine's favorite. I excerpted it for others like me who aren't fluent in #neurochemistry:

Read 4 tweets
23 Nov 20
It's hard to browse #library bookshelves from home. For other homebound readers, NYT best fiction 2009-19 as a thread for non-subscribers. (Your local library might let you read NYT etc on their website.)

Public libraries are my #SacredPlaces. #books nytimes.com/article/top-bo…
2018: ASYMMETRY Lisa Halliday. THE GREAT BELIEVERS Rebecca Makkai. THE PERFECT NANNY Leila Slimani. Translated Sam Taylor. THERE THERE Tommy Orange. WASHINGTON BLACK Esi Edugyan.
Read 12 tweets
22 Nov 20
Holiday shopping from home? Support #Maine #Wabanaki businesses. The Wabanaki are the Maliseet, Passamaquoddy, Penobscot, Mi'kmaq, and Abenki People of the Dawn. #mepolitics #indigenous <thread>

#Passamaquoddy handmade moccasins facebook.com/PassamaquoddyF…
Who doesn't love a little syrup in their stockings? #Passamaquoddy maple syrup from #Maine. passamaquoddymaple.com/?fbclid=IwAR1V…
Meherrin Outpost is owned & operated by a Mi'kmaq (#Maine) & #Mehrrin (NC) couple. They make jewelry & sell a wide range of products from sage & sweetgrass to hand drums and (aw!) baby moccasins. facebook.com/meherrin/
Read 10 tweets
21 Nov 20
Even if they support the #DeathPenalty, most people think that only people who've killed should be killed.

🔴Prosecutors never claimed #DustinHiggs killed anyone, but #Barr has scheduled him to die 5 days before inauguration. Deeply moving video: /thread vimeo.com/194702182
#DustinHiggs was in his early 20s when he drove a shooter from a crime scene. Prosecutors said the shooter "acted alone," but they failed to get the #DeathPenalty. So they accused Higgs of being the mastermind.

The shooter got life w/ no parole. Higgs is to die on 1/15/21.
Jurors did NOT hear mitigating factors that might've led them to choose death in prison by no parole over execution. They didn't know he was 10 when he was his mother's f/t caretaker as she died of breast cancer. Nor did they know he has learning & developmental disabilities.
Read 4 tweets
21 Nov 20
✔️Trump & #Barr are on a #KillingSpree. The official cause of death for executions is homicide.

If there are no more stays, they'll have killed 13 in 7 months compared to 3 in the 222 months since McVeigh's execution in June 2001. | thread
Dept of Justice website: "There is no proof that the #DeathPenalty deters criminals."

Death in prison by no parole (not execution) saves +/-$1 million per case. The capital punishment error rate is 1 in 10: 1 exoneration for every 9 executions. nij.ojp.gov/topics/article…
Chart source: Wikipedia, List of people executed by the US federal government

#Execution schedule 2020-21 & #DeathPenalty information: deathpenaltyinfo.org/executions/upc…
Read 6 tweets
19 Nov 20
@JulieTheCranky 2019 letter from expert/advocates (thank you @StefanKertesz) & signed by 3 former US “drug czars" & 318 additional healthcare professionals asked CDC to restate what's NOT in the Guideline: no dose cap; no call for forced tapers.

CDC did. 1/
@JulieTheCranky @StefanKertesz .@CDCgov Director 4/2019: The “Guideline does not endorse mandated or abrupt dose reduction or discontinuation, as these actions can result in patient harm.” 2/
@JulieTheCranky @StefanKertesz @CDCgov #CDC Director Redfield (4/2019): the Guideline calls for doctors to reduce or stop opioids “only [in bold] when patient harm outweighs patient benefit” & does not include a dosage cap. 3/
Read 9 tweets
19 Nov 20
✔️Fact-checking @CDCgov's telebriefing on the release of the 2016 Guideline (thread) cdc.gov/media/releases…
3/15/2016: CDC Director Frieden said the Guideline would result in “fewer deaths from all sorts of opiates.”

✔️2018: CDC published a paper showing that #opioid overdose deaths go UP as prescriptions go down. CDC has not yet retracted the Guideline.
2) Frieden (3/15/2016): “The prescription overdose epidemic is doctor-driven."

✔️US OD deaths have been "inexorably tracking along an exponential growth curve since at least 1979," a "predictable pattern of growth" that's NOT associated with increases OR decreases in scripts.
Read 5 tweets
19 Nov 20
@LGiles1017 I'll add tweets below with "highlights" from the @CDCgov transcript of their 3/15/2016 telebriefing on the Guideline to save #TeamPain from having to suffer thru the whole thing themselves. cdc.gov/media/releases…
@LGiles1017 @CDCgov 3/15/2016: CDC Director Frieden said the Guideline would result in “fewer deaths from all sorts of opiates.”

✔️ 2018: CDC published a paper showing that #opioid overdose deaths go UP as prescriptions go down. CDC has not yet retracted the Guideline. Image
@LGiles1017 @CDCgov 2) Frieden (3/15/2016): “The prescription overdose epidemic is doctor-driven."

✔️US OD deaths have been "inexorably tracking along an exponential growth curve since at least 1979," a "predictable pattern of growth" that's NOT associated with increases OR decreases in scripts. Image
Read 4 tweets
18 Nov 20
Late in CDC's 2016 Guideline, a table reveals the Agency had no solid evidence for its claim that reducing rx #opioids would reduce ODs without harming people in #pain. In fact, ODs & suicides have spiked in their wake.

Thread: What did CDC know & when did they know it?
In a spring 2016 research paper, the Guideline's authors report that no "rigorous" studies had been conducted on whether dose reductions lower ODs, tho "preliminary results" suggested that high doses are less risky than low doses.

(All references at end of thread.)
CDC conducted its own study using VHA data about vets taking rx opioids. They matched 221 vets who died of OD (some of whom "likely" committed suicide) with 221 vets still living.

They found "dosage was a moderately good ‘predictor’ of opioid overdose death."
Read 21 tweets
18 Nov 20
#Migraine is the most common & disabling brain disease, but @SocialSecurity still doesn't recognize it as potentially disabling, making it much harder for people to qualify for earned benefits.

🔵Bookmarkable Thread! Info about #SSDI & #disability for migraine.
Globally, #migraine is the #1 cause of disease-related #disability for people 10-24 & the 4th cause for people 25-49. Yet @SocialSecurity still doesn't treat it as a potentially disabling disease. ssa.gov/disability/pro… Image
Severe #migraine is profoundly disabling. The World Health Organization uses objective metrics to determine disease burden & ranks severe migraine in the highest category of disability alongside terminal-stage cancer.

Shame on @SocialSecurity. Image
Read 24 tweets
3 Nov 20
2,887 #vets died of #overdose or #suicide after they were taken off #opioids meds by the VA to adhere to guidelines. @StefanKertesz & colleagues found stopping meds increases the risk of death up to 6.8x (study in linked tweet). @headsUPmigraine thanks him for his work.
2,887 #vets died of #OD/suicide after their rx #opioid was stopped in FY2013, only 90 fewer deaths than on 9/11.
Stopping treatment was associated with increased risk of fatal OD/#suicide regardless of the length of treatment (Oliva et al BMJ 2020). 1/3
#Vets whose #opioid med was stopped were 1.67 to 6.77 times more likely to die than those who continued to be treated. Deaths were highest in 1st 3 months after treatment was stopped. 2/3

Oliva, Bowe, Manhapra, Kertesz et al. BMJ 2020. bmj.com/content/368/bm…
Read 4 tweets
2 Nov 20
@ravensspirit68 @funchefchick @NitaGhei @StefanKertesz @AllysonVarley @PainPtFightBack @LelenaPeacock @tal7291 @urbanfatbiker I'm working on a big annotated bibliography of #cpp/rx #opioid research that I'll put online for activists to use. Here are studies I've got on #CPP-associated #suicide. Send me titles & authors for papers I'm missing & I'll add them. I'll link them below.
Tang et al 2006 review: Risk of death by #suicide at least doubled in #ChronicPain patients. Ideation is 3 times more common; lifetime prevalence of about 20%. 8 risks for suicidality in chronic pain were identified, half are physical.
Tang et al: 8 risks for #suicide in #ChronicPain patients: 4 are physical, including type, intensity & duration of pain & sleep-onset insomnia co-occuring with #pain; 4 are psychological. CP is a neurological suicide risk AND a psychological risk.
Read 15 tweets
31 Oct 20
2 dozen senior Trump admin officials fear he'll use gov't power to refuse to leave office or "create favorable terms for negotiating his exit." They worry too about foreign adversaries using the internet to undermine the election. thread> nytimes.com/2020/10/30/opi…
NYT sources: most senior officials w/ Senate-confirmed jobs, regular access to Trump & highest-level briefings; some still serving. Several are currently in Intel, law enforcement, nat'l security & are focused on violent, far-right white supremacy groups encouraged by Trump.
Officials: "in 1st debate, when the president offered one of the most astonishing performances of any leader in modern American history--bullying, ridiculing, manic, boasting, fabricating, relentlessly interrupting & talking over his opponent: that’s really him.... That’s Trump.”
Read 51 tweets
30 Oct 20
Of 133 million w/ preexisting conditions, 54 million will be permanently uninsurable if Trump wins his Supreme Court case & the #ACA is overturned. For others, any gap in coverage, no matter how short, could forever bar them from insurance. <NYT: thread> nytimes.com/article/suprem…
If Trump wins in Court, 165 million Americans will again face annual & lifetime caps for costs, including both those who get their insurance thru work & those who buy it on the exchanges.

Employers will negotiate which conditions, therapies, drugs they'll cover in their plans.
If Trump wins his case, being female will again be considered a preexisting condition; insurers will be free to increase premiums for women.

60 million #Medicare beneficiaries will face changes to medical care and possibly higher premiums.
Read 14 tweets
26 Oct 20
#Kushner wasn't "successful" til he got a WH job. He & #Ivanka owed $1.4 BILLION on their #mortgage til foreign investors prepaid nearly a century in rent. They got a self-serving taxcut into law & raked in $90 mil from undisclosed overseas sources, most Saudi Arabian. >thread
By the time #Jared & #Ivanka became White House Senior Advisers, they were a little late on their #mortgage. The Washington Post reported that by March 1, 2018, they owed $1.4 billion on 666 5th Avenue.

That's a B. >2 washingtonpost.com/politics/jared…
2 months after WashPost reported #Kushner owed $1.4 billion, a company "swooped in & agreed to take a 99-year lease on the building, paying a near-century’s worth of rent upfront." The #Qatar Investment Authority was a leading investor in the company. >3 nytimes.com/2018/05/17/nyr…
Read 12 tweets
26 Oct 20
.@headsUPmigraine spoke w/ a rural #PCP hounded out of the profession by relentless pressure to stop rxing #opioids. She was the only PCP in +100 miles willing to accept patients on opioid therapy. Most were over 70. 2018 #AMA statement shows many share her frustration. >thread
In 2018, #AMA passed a resolution against “misapplication” of the CDC Guideline by “pharmacists, health insurers, pharmacy benefit managers, legislatures, & governmental & private regulatory bodies in ways that prevent or limit patients’ medical access to #opioid analgesia.” 2/
#AMA: "physicians should not be subject to professional discipline, loss of board certification, loss of clinical privileges, criminal prosecution, civil liability, or other penalties or practice limitations solely for prescribing #opioids" above CDC's recommended dose. 3/
Read 13 tweets
24 Oct 20
.@mareasachs The good news is that you're at the peak of #migraine prevalence! Preventive treatment is always important, but especially so in people with childhood onset & women within a decade +/- of peak. n.neurology.org/content/68/5/3… Image
@mareasachs Thanks for your message! I'm rushing off now, but will check back in soon. If you're just starting to learn about #migraine, try @amfmigraine and .... americanmigrainefoundation.org
And check out this great interview by Angie Glaser (@winedarkme), who, like us, also started #migraine very young. She talks with another talented member of the #migraine sisterhood, @AbiStevens_Art. migraineagain.com/migraine-battl…
Read 4 tweets
21 Oct 20
@louisanamom In 2016, CDC said there wasn't good evidence showing reductions in rx #opioids would reduce ODs. Of their study of 221 #vets (who, sadly, have higher rates of OD/suicide), they said, "caution should be taken in drawing causal inferences from this observational study.” 1/
@louisanamom I don't know why CDC's 2016 paper is titled "a detailed exploration into the association of prescribed #opioid dosage & OD deaths" when it admits there were 2 low-quality studies + their "don't assume anything about cause & effect" study! ncbi.nlm.nih.gov/pmc/articles/P…
@louisanamom In 2016, @CDCgov had NO SOLID EVIDENCE about whether rx #opioid reductions & discontinuation would help or hurt. Here's their review of evidence (table 1). Read the column "Limitations."

By 2017, they knew it didn't reduce ODs. 1/ cdc.gov/mmwr/volumes/6…
Read 8 tweets
1 Oct 20
@DrTomFrieden With all due respect, Dr. Frieden, why didn't you follow science when you directed @CDCgov & you learned in 2018 that fatal overdoses went up, not down, following implementation of the 2016 #Opioid Guideline you promoted? ncbi.nlm.nih.gov/pmc/articles/P…
@DrTomFrieden @CDCgov #CDC-funded research in 2018: “declines in these opioid prescribing metrics ... have not been followed by decreases in opioid overdoses. Instead, overdoses due to illegal opioids ... have increased.” Why didn't CDC retract the Guideline when it saw deaths were going UP?
@DrTomFrieden @CDCgov In 2016, #CDC Director Frieden told the press that the risks of rx #opioids would outweigh benefits for "vast majority of patients.” But the Guideline itself said an average 96% of patients had no addiction or non-addictive abuse, misuse, or long use.
Read 15 tweets