🧵 ⭐️ let’s talk about exercise, post-exertional malaise and #MECFS ⭐️ Have you ever told your fatigued patient they are deconditioned and need to exercise? There have been some very eloquent studies that demonstrate why patients have been saying exercise makes them worse..1/

Mika Martikainen Please do not spread this garbage masquerading as science. Tilt table tests are a miserable experience for anyone with an orthostatic disorder. These patients had POTS for up to 18 years, of course they had some anticipatory anxiety about being tilted again.

OK, let's just start with ASSOCIATION IS NOT CAUSATION. Now I don't need to waste my time reading the abstract never mind whatever bullsh*t "conclusions" were reached in this so-called trial. Once more for the hard of understanding: #POTS is not caused by fear of standing up.

Yesterday, in a 5 minute phone call, I was fired by interim DA Brooke Jenkins. I was one of 16 people fired over the phone, all without cause. I’m not a manager. I’m not a chief. I was fired because I believe in criminal justice reform.

Today I was tutted at when parking in a disabled space. I had all these tubes hidden under my clothes, so I looked like a young, healthy person. But in reality, I still have a disability, despite choosing to hide my tubes. Friendly reminder that most disabilities are invisible!

The picture comes together, HPA axis issues, pre-load failure, POTs for some, raised immune markers, SIBO-gut dysbiosis f-s, reactive HHV/Epstein Bar virus, reduced cortisol, inflammatory markers up, cell death proteins rasied, the picture of ME/CFS and LongCovid.

Twitter Hiatus and going to be coming and going due to work 😭

My appeal to folks who sell items from their home businesses: pls incl an allergy statement! Esp for hard to clean items or fabrics. I always hesitate bc I worry abt pet dander etc. I’ve asked sellers sometimes & they’ve said ya that’ll prob be an issue & others it’s fine.

If a patient shows measurable "fear" about a medical procedure where they have past experience with discomfort or worsening of symptoms (e.g. a skin punch biopsy) does that mean the health condition is due to a fear response? Do we use CBT to manage skin cancer now? #Subtweet

Interesting podcast with some reflections on #medicalmisogyny and gaslighting. Worth a listen #MedTwitter

They're getting rid of plastic straws this year in Canada. So I ordered enough plastic straws to last 10+ years and share with friends in need.

Telling someone who is chronically ill that suffers from extreme fatigue to exercise is kind of like telling a car without gas to drive. Energy has to come from somewhere.

Email sent to students explaining I'm clinically vulnerable. I would appreciate anyone who could wear a mask. Lecture arrives: Not a single student in a mask. Me: Did my emails about the module get to everyone? Students: Yes. Hard to describe my feelings right now.

To add to this: I put a pile of KF94s on the front desk, reiterated I was clinically vulnerable, and said they were free to take and keep. (Cost me £130 from US.) No one took one.

Hi Jeff Wise. Thanks for an interesting article in New York Magazine. What a great premise; to suggest #LongCovid is a condition that rhymes with #MECFS. We totally agree on that. Not everyone with #LongCovid has #MECFS of course, but enough do that the analogy has some intellectual merit.

In a moment of crisis like this, with suffering all around us (much of it invisible still), scientists, journalists, & editors have a responsibility to think deeply about how report on emerging science. As a person with #longcovid, I want more answers too. This is not the way.

It's a big problem when journalists write articles that distort the science in order to present the biased views of a group with predetermined views. Even worse when the journalists dismiss all legitimate criticism as hostile rantings.