GSU Brains & Behavior AD / NeuWriteATL / Disability Advocate /•MECFS•/40👇40/ Researcher:“The Long Haul” / *my views*🏳️🌈 B L U E S K Y same handle as above /
Super excited to be working with my friend and colleague, CNN journalist and award winning 🏅 documentary film maker
@r_prior
on his upcoming book “The Long Haul” on
#LongCovid
and the
#patientcentered
revolution shaping policy on
#chronicillness
.
Thanks to
@NeuroWeaverGSU
from coming aboard as a researcher, comrade-in-arms, and major stress reliever on this project. I’m looking forward to many inspired, and inspiring, days ahead in the trenches of fact-checks, footnotes, and cutting edge research. 4
When people say “Getting Covid is inevitable, why not get it over with?” My response is, “death and aging are inevitable too, and look at the lengths we all go to avoid those.”
#LongCovid
#MECFS
Today I sat in as an advocate at a
#Neurologist
appt w/ a friend. W/o skipping a beat, he went into depression causing symptoms 4 women.
For years, I heard about these DRs but fortunately never saw one.
Today I said
“I’m going to stop you right there”
#NoGaslightingOnMyWatch
Today I heard a doctor tell a patient not to feel sorry for themselves as they begged for certain at home accommodations. I said, don’t you get it, this is what it looks like NOT to give up, to fight for their life. This is an act of resistance, not surrender.
#DisabilityRights
If your symptoms are up ticking right now, & you have a neuro disease like
#MECFS
or
#LongCovid
, remember it’s totally normal this time of year as the weather shifts, & the light changes angles.
#TheOctoberSlide
is well documented. Take extra care & rest while ur brain adjusts❤️🩹
🧵An important thread:
At some point, if u are
#Disabled
& dating someone new, no matter how much that person loves u, they may at some point or another receive what I call the *Friends & Family Warning⚠️*… where a friend or family member of theirs warns them not to date u. 1/5
ME/CFS can be compatible with life, but incompatible with living. There’s a saying for the living, if you don’t use it, you lose it. The paradox of
#MECFS
is that if you use it, you will lose it, either temporarily or permanently. It’s the quicksand of the disease world.
@PJPrydderch
Defensive, kinda confused when I told him what I thought was going on. Kept trying to take power and expertise away from the patient. It was… odd and deeply disturbing. Cognitively inflexible.
People with disabilities are whole, dignified, complex, and worthy of love, even when it feels like everyone around us is working out their own sh*t. It’s all projections of internalized fear and pain. You are loved ❤️
5/5
But here’s what they mean
👉“I struggle w/ caretaking & maintaining boundaries, u must struggle too”
👉“I’m terrified of death & I don’t want it close to me or you”
👉“I haven’t done work around ablism & don’t see disabled people as whole individuals“
👉“I don’t trust you” 4/5
@joespfeifer
Yeah. When I stepped out for a moment, he insistently said she was suffering from anxiety because she was wearing a mask. Said Covid isn’t a problem because we now have vaccines. Just bizarre unintelligible nonsense.
The warning to your partner may sound like
👉“are you sure you want date someone who has a disability?” 👉“What if they get sicker?”
👉 “How will you be happy if they can’t do all the things you can do?”
👉“I’m just saying this because I care about you”
3/5
It’s at a times brutal moment when the projections of an insecure and ignorant society are projected on the you, the person you are dating, and the relationship itself. And it’s hard not to internalize it.
2/5
We need to completely rethink how spaces are accessible 4 people w/ brain damage. Hospitals w/ harsh lighting & sounds. Doc offices w/ scents & music. These are low hanging fruit. What would u like to see as we barrel towards a large section of pop w/
#MECFS
&
#LongCovid
? 👇
The chronicity of brain diseases like
#MECFS
&
#LongCovid
bring up so many issues around identity.
Try taking a personality test & you’ll find yourself wondering if you should answer questions from the vantage point of your “old” self or “new” self. And where is the line?
There’s a reason horror movies use the plot-line of gaslighting the main characters as a form of intense anxiety for the audience. It’s because it’s traumatic. Even watching it is stressful for social brains.
#MECFS
#LongCovid
Some docs:
“A virus can’t remain in your system and cause disease or symptoms years later after you “successfully” fight it off. It’s in your head.”
Science:
HIV/AIDS
POLIO
PRIONS
POX/SHINGLES
EPSTEIN BARR
HERPES
LYME
COVID
Hundreds more…
#BelievePatients
#LongCovid
Covid19 didn’t just disable millions, it disproportionately killed disabled people.
My brother, David Weaver, Ph.D., explores this in his new open access paper:
The mortality experience of disabled persons in the US during the COVID-19 pandemic 1/3
The new preprint examining
#LongCovid
biomarkers, by
@VirusesImmunity
&
@PutrinoLab
, points 2 THE usual suspect:
#EpsteinBarrVirus
. We need an antiviral & vaccine. It’s out there running free. How many times does this virus have 2 show up in a lineup before we put it behind bars?
Patient w/
#LongCovid
or
#MECFS
for YEARS 2 fam, friends & doctors:
“I can’t walk. I’m too weak to function or leave house.”
Response: silence
Patient: gets a mobility device like cane/wheelchair.
Response: “OH MY GOD, what on earth is wrong with u?”
The shock is shocking🤦♀️
With
#MECFS
, in order 2 survive, u have to learn to let go.
Not 90%, but 100%.
Completely surrender.
Zero effort, not in thought or movement.
Sometimes for minutes, & for people who are severe, sometimes for years.
U have to learn how to completely give in…without giving up
The balance between the inseparable forces of Effort & Surrender is infinitely more delicate & complex w/
#MECFS
. Everything we’ve been taught about striving & endurance & gain no longer applies. To gain, u must surrender w/ skilled precision. Your life depends on it.
People w/
#MECFS
are warriors. Everyone says people who come back from near death, have immeasurable resilience, a wisdom from the experience. Imagine living that way day in & out, living on that event horizon permanently. There isn’t an English word for that kind of strength.
Molecular blood tests for
#MECFS
are in development.
This is one of the groups doing this kind of biomarker research and it will change the entire game.
Biomedical treatments will change, and EQUALLY important, biosocial treatment of patients will change.
People with ME/CFS can wait years for diagnoses; biomolecular tests are finally in development 👉
This article proudly highlights the groundbreaking work of OMF supported researchers, Ronald W. Davis, PhD, Alain Moreau, PhD, and Maureen Hanson, PhD
Essential to transforming the culture of chronic illness in society will be training & supporting medical professionals, researchers, & science communicators who HAVE complex illnesses like
#MECFS
,
#MCAS
,
#EDS
,
#Lyme
,
#LongCovid
. Their seat at the table will change the game.
It took researchers & patients until NOW 2 find a living biomarker 4
#ParkinsonsDisease
. Only made possible w/ incredible amounts of money & community support.
The economic & societal burden of
#MECFS
cannot be underestimated. We need funding NOW
@NIH
It’s official.
#Covid
infects the brain 🧠 directly. Not surprising at all. I thought it was strange, the folks who’ve been saying there was no chance
#Covid
infected the brain directly 🧐 Also not shocking, it was found in
#brainstem
&
#basalganglia
4/ Importantly, SARS-CoV-2 RNA was detected in the brains of all 6 late cases and across most locations evaluated in the
#brain
in five of these six, including a patient who passed away at day 230. Brain regions in which
#virus
was identified included brainstem and basal ganglia
*Call for
#MECFS
research ideas* PLEASE SHARE
I've been on the NIH
#NINDS
#MECFS
Research Roadmap Working Group this past year, & we have made significant strides in outlining priorities for future research of MECFS.
Many priorities are now open 4 public suggestion & comment👇
Coming down w/
#MECFS
or
#LongCovid
, is like a cutthroat game of musical chairs: whatever u were doing when the music stopped, is exactly where u will stay, frozen & that’s if u r lucky. At best, you’re sitting but the music never plays again. At worst, you’re out of the game
Now imagine what it’s like when your life depends on people believing you. That’s what it’s like to be gaslit by the medical providers. It’s a real life horror flick.
#MECFS
Relationship between Epstein Barr virus
#EBV
& multiple sclerosis
#MS
in living color. 👇 IMO, in the next 20 years, we will learn, this link is not the exception, it’s the rule. Pathogens 🦠 cause
#brain
disease long after the acute infection is over.
#Alzheimers
#HSV
#LongCovid
People with Long Covid &
#MECFS
have elevated glutamate & N-acetyl-aspartate levels in the posterior cingulate cortex compared w/ healthy controls.
I’ve maintained we need to focus on
#glutamate
as a path of symptom intervention.
Read more👇
I say this because I want people to understand the disability of these patients.
There is no chronic fatigue. There is chronic severe brain injury. Over and over. Day after day. We need the kind of funding that matches the disability, not the name.
@NIH
@CDCgov
According to the criteria set for the Glasgow Coma Scale (GCS), patients w/ sometimes moderate, but definitely severe
#MECFS
easily slide into the category for “Severe Head Injury” multiple times per day.
These patients’ rooms at their homes look like ICUs.
#MECFS
#LongCovid
While the NIH has been working toward inclusion of underrepresented groups in the scientific workforce, disabled people have been mostly overlooked in those missions.
Will be closely following the research of Leighton Barnden & his funded research by
@MEResearchUK
looking at the reticular activation system in the brain stem of
#MECFS
patients, using a 7-Tesla MRI. This is definitely a game changer for a biomarker & understanding pathology 👏
🧵 People w/
#MECFS
&/or
#LongCovid
need
#PostExertionalMalaise
- informed wrap-around care. Anything less, & remarkably we are better off outside clinical settings & fending 4 ourselves at home. Here’s what that could look like f/ clinical policy to patient rooms👇
@CDCgov
1/6
Important distinction👇
#LongCovid
isn’t literally long lasting Covid, it’s a new delayed onset distinct disease often found in neuro, cardiovascular & immune systems.Similar to how
#MultipleSclerosis
wouldn’t be considered = to an
#EBV
infection.The 2 are connected but different
I think a lot of people assume
#LongCovid
is a continuation of the acute COVID symptoms, that just take a long time to get over.
In reality it is an often delayed onset of *new* neurological, immunological, cardiovascular, and systemic symptoms.
1/
WEARABLES & DEVICE 🧵
What do you wear or use that helps your chronic illness or disability?
Some of these devices are game-changers.
Let’s say what we love, dislike, or are curious about
Personally I ❤️
#RedLightTherapy
& my 🍎⌚️& I’m curious about
#VieLight
&
#TaoPatch
People w/ disabilities will not have equal access or equity until those same people are invited to the table to help shape policy. A lot of well meaning people will not & truly can not understand the nuisance of accommodations unless people w/ disabilities pull up a seat.
I’m excited & honored to announce a “Science Journalism & Disability” Pop-up Panel & Discussion this coming Tues, Nov 15 @ 5pm.
As we have been sadly reminded this week, how we write abt disability matters.Researcher, sci comm, student, patient, ally, all are welcome. Pls RSVP
🧵 Policy not allowing virtual accommodations as an option for immune compromised or disabled folx b/c other people will take advantage of it, is like saying we shouldn’t have handicap spots for cars, because a non-handicapped person might park there. 1/3
#DisabilityRights
@klmatter
Defensive, kinda confused when I told him what I thought was going on. Kept trying to take power and expertise away from the patient. It was… odd and deeply disturbing. Cognitively inflexible. Unfortunately I had to step out for work and he patronized her repeatedly.
If u have what people consider an invisible disability, coming out of the disability closet can be complex&painful.People r met w/ abandonment&invalidation.Others project their insecurities of vulnerability onto u.Pride happens when we shine a light on shame.
#DisabilityPrideMonth
🧵 I think what confuses a lot of people about how to treat
#MECFS
&
#LongCovid
has to do with their effects on the autonomic nervous system & how this system has inputs from “bottom-up” disease processes & also “top-down” behavior inputs. Keep reading 👇
Deep 🧠 Thoughts on
#MECFS
:
Based on my lived experience & neuro background, I would wager that a large amount of
#MECFS
brain symptoms are not due to lack of energy on excitatory neurons, but lack of energy on inhibitory ones, leading to over-excitation & cell death
Today
@r_prior
& I met w/ 1 of my personal&professional heroes, Stanford geneticist Ron Davis,a pioneer of the
#HumanGenome
project.We discussed
@OpenMedF
studies on
#MECFS
&
#LongCovid
,as we piece together the complex story of post-viral illness in the upcoming book
#TheLongHaul
You’ll have to face questions like, who am I if I don’t behave the same way I used to?
I’m I now an introvert if my nervous system struggles to withstand crowds or am I still the extrovert who couldn’t get enough socialization if I tried?
And how do I make room for the dynamic nature of self?
It’s a lesson in impermanence I haven’t yet learned but I’m trying to explore.
It might take many lifetimes, but in this lifetime, I have an incredibly difficult teacher who requires abundant humility,
#MECFS
For someone who just tested positive for acute
#Covid
infection, other than radical rest & paxlovid…
What are our best practices, one page resources (so it’s not overall complex for folks with limited brain power) and first line med recommendations?
👇 post & share 🙏🏼
At what point, are we becoming new individuals as we accept and embrace our limitations and different abilities?
Am I clinging to old ideas of my self that no longer serve me?
Is this why holding onto our “selves” in buddhism leads to suffering?
@ManvBrain
What you’re coming up against & what you wrote about, the anger, the defensiveness, all of it, is trauma. Medical trauma. These people have been abused beyond what you can imagine, left for dead, & gaslighted. This isn’t the moment to get defensive or gloat.
Honored that our
#LongHaul
book about
#LongCovid
is featured in this month’s
@ScienceMagazine
. The subtitle mentions the empathy found in the pages. Empathy is our sharpest weapon when it comes to complex disease…if we listen closely to the patients, they have the answers
#MECFS
Alien planets are shrouded in hazes that hide clues to their makeup. Lab experiments could help clear the view.
Read this
@NewsfromScience
cover story and more in the latest issue of Science:
2 questions for our community for an upcoming interview w/ a well known medical site
1. What is the main takeaway u would like the public to know about
#LongCovid
2. What tips, other than rest, do u have for someone who is just getting over the infection & still not feeling well?
@thephysicsgirl
1. It’s not just a long bout of Covid or recovering slowly. It’s a distinct vascular/ endothelial/ neuro disease process
2. What is post exertional malaise- possibly hypoxia- reperfusion injury
3. MECFS 👈 important
This week,
@r_prior
& I have the honor of interviewing some big neuroscience / policy people as we research what happens in the brain during
#LongCovid
& how our scientific understanding of post viral illness affects policy and vice versa.
@MBVanElzakker
@NINDSdirector
@NINDSnews
Critical explorations of colloquial terms like “Brain Fog” are a vital practice in science translation.Our brains automatically minimize disabling conditions when the language paints a simple picture. When, in fact, symptoms like
#BrainFog
&
#PEM
r devastating neurological events
🚨I wrote about “brain fog”—one of the most common & disabling symptoms of long COVID (and many other pre-pandemic conditions), and one of the most misunderstood.
Here’s what brain fog actually is, and what it’s like to live with it. 1/
Do I love the city and it’s energy or must I live far away from the noise?
Am I still the risk taker who loved adrenaline or must I measure every ounce risk and maintain the utmost level equanimity in every situation?
Speaking with
@microbeminded2
this week, we discussed how pathogens can easily affect connective tissue. Other tissues are reservoirs, why not connective tissue? It’s not exempt in anyway, maybe we will eventually see, it’s even preferred
#CCI
#MECFS
#LongCovid
#ConnectiveTissue
I have craniocervical instability (CCI). Diagnosed with upright MRI in flexion, extension and rotation. Covid triggered it. This is not new, the surgeon who diagnosed me has seen viruses and other pathogens do this before. Covid is not different.
#MEspine
#CCI
#LongCovid
🧵People w/
#MECFS
need highly specialized care mostly b/c there are many paradoxes when treating the disease. 1 treatment paradox is for the high incidence of medical trauma. There are 3 ways we treat
#PTSD
that are contraindicated in treating the trauma of
#MECFS
patients👇1/4
@ManvBrain
This is NOT the moment to dig your heals in and defend yourself to the entire group of people w/ disabilities. If you are proud of angering disabled patients, take a step back.
Sitting on the ME/CFS NIH working group of council today as a lived experience expert. Today’s webinar is the Immune System. Dr. Nancy Kilmas is talking to us now about the need for clinical trials for things like
#LDN
👏
Our society can’t seem to shake the bogus idea we are imagining symptoms if we can’t see them on our “modern” technology.Even at the end of this
@NPR
, they proclaimed,
#LongCovid
is real,but may be anxiety.That backhanded affirmation reminds me of “hate the sin, love the sinner”
Gathering more info for public facing
#LongCovid
awareness:
• How hard is it rn to get a Long Covid diagnosis?
• Anyone know any stats on length of time it takes on average?
• What are the barriers?
TY to the patients who provide this info. I will amplify your message
#MECFS
The Long Haul project is more than a book about
#LongCovid
.
@r_prior
& I had an exciting meeting w/
@MEActNet
today about how to leverage
#TheLongHaul
into activism & policy to support people living w/ complex diseases like
#LongCovid
&
#MECFS
. Exciting things are in the works…
And it’s fascinating to see which people around you see directly to your authentic self and which cling tightly to your current bodily restrictions.
But the larger more philosophical questions linger…
Doctor’s offices and specialists in these fields should have drive up to door parking when possible, without the use of elevators, stairs.
Office policy should always include tele-health options. Requiring severe MECFS patients to drive is barbaric. 5/6
3/4 🧵
But ignoring the underlying disease input into the system & only changing one input will not be enough for most autonomic dysfunction. It can only move the needle a bit. & 4 people w/ advanced disease coming from the “bottom”, u won’t even touch the autonomic dysfunction
This is unsurprising yet still alarming. In the future, we will figure out infectious agents “set the stage” for many neurological diseases. Death is not the only consequence of Covid. How can we emphasize this enough?
#LongCovid
#Alzheimers
#MECFS
is unique in that less is almost always more. In the clinical setting,we need environments that do not have strong smells, patterns,lights or sounds.Every particle of energy we use 2 process the world subtracts f/ an empty mitochondrial bank.The consequences can b dire 2/6
David argues that “clinical trials & other research should consider including disabled persons as specific study groups as the severity of their underlying health impairments is likely comparable to that of persons of advanced age.” 3/3
Trying out visible + w/ the polar band for the first time. Wow, lots of overexertion notifications when walking or standing.
For those using it, do you go w/ the already determined heart rate limits or choose your own?
If your own, how did you decide on those?
@visible_health
It’s utterly lazy to lump an entire population of
#LongCovid
sufferers in the messy black hole of “this might be anxiety”. It also ignores the shame and guilt that comes with that diagnosis when the implicit message is “you are causing this.” We have to do better.
ME/CFS RELAPSE SERIES:
I’ll be exploring the understudied phenomenon of
#MECFS
relapse 4 the next month. I’m curious abt moderate & severe relapse.
I’ll be asking Qs like:
How does it start?
What’s the difference btw crash & relapse?
How long does it last?
+ Much more
1/2
I’m happy, sad, angry, hopeful… rainbow of emotions as we get nearly half a billion dollars to study
#postviral
Covid. This research will directly impact
#MECFS
patients and our collective knowledge on post viral illness.
#NIH
has awarded nearly $470 million to build a national study population of diverse volunteers & support large-scale studies on
#LongCOVID
. These awards pave the path to gain greater understanding of the long-term effects of
#SARSCOV2
.
#RECOVERcovid
The interactions from clinical providers should be slow and deliberate with the use of low voices. Providers should know that most of these brain injured patients have complex medical trauma and the care should be trauma- informed. 3/6
Finally, and this list is not exhaustive, at home health care providers should extensively understand sensory sensitivities and limitations on talking and walking. 6/6
While at first glance, statements like “the symptoms are real…even if it’s anxiety”, seem affirming, they are just dangerous remnants of stubborn foregone ideas that need to be canceled ASAP if we are to make any progress in understanding pathologies of the brain.
I imagine for pw
#LongCovid
, it can be hard to speak your truth. For millions of people w/
#MECFS
telling our truths meant invalidation,apathy,or worse. But the truth was all we had. Now, we have science. The 2 are the same. “Speak the truth, even if your voice shakes.” -
#MKuhn
I’ve got a family member with new low blood pressure, that needs some help boosting blood volume, but has diabetes.
What are y’all’s favorite
#POTS
salt drinks that aren’t loaded with sugar?
🙏🏼
#NEISVoid
#MECFS
#LongCovid
There needs to be an accurate term for the trauma associated with
#ChronicIllness
because even
#ComplexPostTraumaticStressDisorder
doesn’t describe the ongoing nature. How about Complex Ongoing Traumatic Stress Disorder? After all, there is no “POST”… when you never get better.
“there were 260 000 excess deaths in the United States among current or former disability beneficiaries during the first 22 months of the COVID-19 pandemic. These beneficiaries accounted for 26% of all excess deaths in the United States during this period.” 2/3
🧵 PSA for people w/ disability who live alone. Do not procrastinate planning for emergencies.When my pipes burst recently & I had no water for 2 days,I quickly realized how precariously dependent people w/ disabilities are on not only power & water but also on social safety nets
🧵 2/4
So if you have patients w/ symptoms of autonomic dysregulation or failure, it may be tempting as a psychologist or a person with behavioral training to lean into trying to shift the set point by giving the system input from behavioral adjustments.
When I heard
@stellajyoung
say this in her
@tedxsydney
talk, I knew I had to share it w/ the millions of people dealing w/
#MECFS
&
#LongCovid
who are being told to just change their attitude.
“No amount of smiling at a flight of stairs turns it into a ramp.”
Truth, Stella 🙌
This is a moment for our community to give direct feedback on the direction in which we feel research needs to go. This is a pipeline for shared power and an opportunity to be heard. This is where citizen scientists and patient experts can shine!
#MECFS
@LisaAMcCorkell