2019-2020 coronavirus pandemic (Vaccination 2021 Edition)

McElroy

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Somatic disorders are very common. Ailments like chronic fatique syndrome or irritable bowel syndrome could be post-infectious disorders as well. Now for sure those disorders can make your life miserable but if scans show no organic or structural anomalies you aren't being 'gaslighted' by the medical community as is stated in the huff post article. I believe it's what they call a diagnosis of exclusion. Where symptoms can't be explained by an identifiable cause. I believe also half of people who get referred to a specialist get thrown in that bin. I guess it's possible to experience a lot of bothersome symptoms without there being anything medically wrong.
Many people would be surprised how often "no need for further examination and/or tests, stick with basic treatment" is the right call. Then again I'm sure there are doctors that sometimes use it too quickly. And yeah, a huffpost article referencing systemic issues facing minorities seems to be a given. There is always the same problem with articles about people that have got medical treatment: the people who treated them can't legally give their side of the case.

Anyway, the second wave of infections is practically looming around the corner. There was a case in my flatmate's school, but luckily he isn't among the exposed.
 

Agema

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Somatic disorders are very common. Ailments like chronic fatique syndrome or irritable bowel syndrome could be post-infectious disorders as well.
IBS is a real syndrome that can be diagnosed, because there will be evident inflammation observable. By comparison to chronic fatigue syndrome, you may more be referring to forms of "gluten allergy" for which no clear biological cause has been identified.

Now for sure those disorders can make your life miserable but if scans show no organic or structural anomalies you aren't being 'gaslighted' by the medical community as is stated in the huff post article. I believe it's what they call a diagnosis of exclusion. Where symptoms can't be explained by an identifiable cause. I believe also half of people who get referred to a specialist get thrown in that bin. I guess it's possible to experience a lot of bothersome symptoms without there being anything medically wrong.
Yeah. Iif the medical community can't find a problem, what are they supposed to do? They can try out various treatments which may deal with the observed symptoms, and maybe they'll do no good. All the medical community can really do if these don't work is be empathetic, nod their heads, and say "I don't know, go find a psychologist and learn how to live with your problems because there's nothing we can do".

Patients can be frustrated with the fact nothing biological can be found and no treatments can be available, and assume the medics are somehow not respecting them. I have some sympathies here because some medics really do have a certain, unhelpful mindset where if they can't find a recognisable disease, no disease therefore exists (and the patient is making it up).
 
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stroopwafel

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IBS is a real syndrome that can be diagnosed, because there will be evident inflammation observable. By comparison to chronic fatigue syndrome, you may more be referring to forms of "gluten allergy" for which no clear biological cause has been identified.
I think you got IBS mixed up with IBD; inflammatory bowel disease like colitis ulcerosa or Crohn's. IBS is a functional disorder with no inflammation. Otherwise it would no longer be IBS but IBD. From what I read about chronic fatique syndrome it has something do with alterations of grey and white matter volume in parts of the brain though that also could have other reasons(like stress, anxiety, depression etc). Celiac disease(the medically diagnosed gluten allergy) definitely has a biological cause. It's an autoimmune disorder with serious GI symptoms that can also lead to malnutrition due to absorbtion issues caused by inflammation in the small bowel. People who have it can eat like a small piece of white bread and have immediate diarrhea. I think you're confusing that one with ''gluten sensitivity'' that can't be medically diagnosed but people who think they have it complain of same symptoms as the 'post-Covid disorder': nausea, headache, brain fog, joint pain, numbness in legs arms or fingers etc. But it's not the immune system attacking the small intestine like with celiac or have any other identifiable cause so it's again symptoms without underlying pathology.
 

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One really does have to wonder though how many arm chair physicians there are here when the only person with an actual Medical Degree in the discussion posts an article discussing symptoms that we, as physicians, do not always have an answer for and people automatically assume they know or steer the conversation to mental illness or stress or anxiety causing somatic issues rather than it just simply being some other problem we overlooked. It would be a disservice to our patients for us to dismiss their symptoms as somatic and far too many are entirely too quick to jump to that conclusion rather than consider that we simply do not always have the answers yet, but not to give up on being able to help provide people with relief for their symptoms.

First of all, my dizziness and fainting spells have been directly related to my sinus issues that have actually been diagnosed and have been undergoing surgery for in addition to lowered oxygen levels as a result of the severe damage that was done to my lung tissue by a virus. The intermittent reduced amount of oxygen causes a number of symptoms ranging from headaches, organ damage, and interference with brain function. It can interfere with everything from your ability to digest food to being able and body's ability to heal itself. It is not uncommon for patients with lung conditions, that are a result of having a virus like COVID_19 and others, such as asthma, bronchitis, COPD, ect to have a range of other symptoms associated with this that we do not know how to treat well. Often we overlook intermittent problems because it is not always apparent that is what is going on because we have to be able to see what is happening at the time in order to give a proper diagnosis, this, in addition to us still discovering new illnesses and conditions all the time as we are far from " knowing" all the conditions one can actually have yet. I have stated repeatedly that one day I hope we look back on our " modern medicine of today" as barbaric and outdated because there really is so much we do not know or understand yet and are constantly learning. As a physician, we have to understand that we are always learning, no matter how much we think we already know, we are still learning things all the time that constantly surprise us. This is why it is important that if we do not have the answers, it is good to consult with our peers in specialized fields that can offer some insight to problems we do not understand to help us work through whether or not there is something we simply could have overlooked, which is often the case.

Other Rheumatic disorders such as Fibromaylgia can be set off by an injury, viral infection, childbirth, or other illness causes widespread amplified pain shooting throughout the body. While often misdiagnosed and misunderstood, it is actually now believed to be a lifelong prototypic central nervous system disorder where there are disturbances in how the brain processes pain and other sensory information. Fibromaylgia also frequently occurs alongside other painful condtions such as osteoarthritis, rheumatoid arthritis, and systemic immune disorders, such as systemic lupus erythematosus and Sjogren’s syndrome. Neuroimaging has shown us that there are structural, functional, and chemical differences in the central nervous system of Fibromaylgia patients and correlate with pain severity. In severe cases, we have had a great deal of overlap with small fiber neuropathy , skin biopsy demonstrating a reduction in intraepidermal nerve fiber (IENF) density has been present in many of the patients Fibromaylgia tested indicating SFN as well.

The problem with being able to achieve proper diagnosis is the biggest hurdle to patients experiencing these symptoms ,however, as the tests required to even achieve a proper diagnosis are expensive and inaccessible to most people seeking treatment from their primary care physicians and like others here have jumped to dismissive conclusions such as " anxiety" , the same sadly often occurs entirely too often and these suffering these conditions are left misdiagnosed, suffering and untreated entirely too often instead.
 

Buyetyen

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One really does have to wonder though how many arm chair physicians there are here when the only person with an actual Medical Degree in the discussion posts an article discussing symptoms that we, as physicians, do not always have an answer for and people automatically assume they know or steer the conversation to mental illness or stress or anxiety causing somatic issues rather than it just simply being some other problem we overlooked. It would be a disservice to our patients for us to dismiss their symptoms as somatic and far too many are entirely too quick to jump to that conclusion rather than consider that we simply do not always have the answers yet, but not to give up on being able to help provide people with relief for their symptoms.
One of the less-talked-about aspect of the Dunning-Krueger phenomenon is how no one is immune to it, and it's real easy to assume simple answers when you lack more extensive knowledge and context. We also live in a culture that shames deferral to experts and encourages the individual to believe they can be omnicompetent. That correlates the swiftness of an answer with its correctness.

It's like how everyone assumes that things like creative writing, business management and singing are easy and will come naturally to them... right up until the moment they actually try and discover it's more involved than they thought.
 

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IBS is a real syndrome that can be diagnosed, because there will be evident inflammation observable. By comparison to chronic fatigue syndrome, you may more be referring to forms of "gluten allergy" for which no clear biological cause has been identified.



Yeah. Iif the medical community can't find a problem, what are they supposed to do? They can try out various treatments which may deal with the observed symptoms, and maybe they'll do no good. All the medical community can really do if these don't work is be empathetic, nod their heads, and say "I don't know, go find a psychologist and learn how to live with your problems because there's nothing we can do".

Patients can be frustrated with the fact nothing biological can be found and no treatments can be available, and assume the medics are somehow not respecting them. I have some sympathies here because some medics really do have a certain, unhelpful mindset where if they can't find a recognisable disease, no disease therefore exists (and the patient is making it up).
We have options, but often those options are inaccessible to most patients and expensive. It isn't necessarily even that nothing biological can be found, it is the patient does not have access to the resources to be able to do so. For example, Primary care physicians do not do the neuroimaging required to make a proper diagnosis or even are able to gather enough information with the resources they have available to them to be able to send the patient in the proper direction to be able to obtain a referral to the right specialist needed to be able to provide them with the proper diagnosis in the first place and insurance companies and governments do not cover it. Not many have the resources to be able to go to the specialists required to receive an accurate diagnosis at all. Most Primary Care Physicians just try to rule out the most common threats then resort to attempting to treat the patients symptoms to the best of their ability rater than continue t o look for the actual cause. The actual reality here is that the vast majority of these conditions simply just go undiagnosed or misdiagnosed, not that there is no other cause available to be found. It can be extremely expensive to actually find the cause is the primary obstacle and people lack the resources to be able to do so.
 
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lil devils x

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Except I work in the psychiatric field, you know? Besides, you don't need to tell me about the problem of dismissing hard to diagnose somatic symptoms as anxiety and bucking it over to a psychiatric clinic. It happens way too often and has resulted in at least one frequent patient dying because the ER saw their stomach pains and loss of feeling in their legs as an anxiety attack, when it was an ileus that had cut blood flow to the patients lower extremities. There was also the patient admitted for being psychotic, who turned out to have far progressed brain tumors. Just to name a few I've seen myself.

My point, as much as you bothered to miss it, was that after somatic diagnosing has been exhausted without finding any explanation for subjective somatic symptoms, then a psychiatric diagnosis should be considered and a psychiatric evaluation performed by a psychiatrist.
Except we actually know how to diagnose an anxiety attack. When discussing lingering chronic conditions, as addressed in the article, they have already addressed that.

We actually do not really tend to " exhaust" our ability to diagnose these conditions is part of the problem, we just rule out the most common problems then after that, the resources required to achieve a proper diagnosis are expensive and insurers and governments do not cover it well so we just stop looking. That is the reality here more than anything else. The general population does not always have access to the specialists in research in the fields necessary to be able to obtain the diagnosis, and most of the practicing physicians simply lack the ability to do so.
 

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An anxiety attack is simple. A chronic anxiety condition like GAD can be harder, especially if the symptoms are somatoform and/or the patient fail to recognize their anxiety for what it is. Once again: I absolutely support the idea that chronic conditions of uncertain origin should be treated with absolute respect, but at some point you need to widen your differential diagnosis to include psychiatric problems.

Besides, as you'll notice if you read my posts again I was talking to Stroopwafel about CFS and hard to diagnose subjective symptoms in general. Not about the HuffPo article or lingering symptoms after Covid-19 infection.



And that's where Swedish and US healthcare differs dramatically. Over here, with a single player system and public healthcare, it is the norm for GPs to pass anything they feel is out of their league or they suspect might require specialized treatment to a specialized instance for further diagnostic evaluation. That the US healthcare system is in a sorry state should not stop a discussion about what should be best practice.
In the US, we too refer patients to practicing specialists, the issue is even then, the specialists do not even always have access to all of the same resources that say a lead researcher in their field does. We can consult with those researchers, but we do not always have access to what they are using in their research to treat the condition. For example, even in your public system, do they cover new technologies such as stem cell therapies utilizing oxygen chambers, and what steps are required to be taken to receive authorization to do so? Our healthcare systems generally are designed to treat the most common issues and those which are well known and proven, but when we start getting into the less known, and the newly discovered, we run into difficulty receiving access to proper diagnosis and treatment. That is expected, and why these resources are only available to those in research and the extremely wealthy, even in nations with greatly increased access to standard medicine.

For example, when you discuss a condition such as Fibromyalgia, misdiagnosis and misunderstanding in the medical community and treatments are so widely varied due to lack of understanding in the medical community itself. We still have physicians that treat it as psychosomatic, even after we have already proven structural, functional, and chemical differences in patient's Central Nervous Systems. We have many more misdiagnosing other conditions as Fibromyalgia because it was easier for them to stop there to begin to start treating their patients symptoms to provide them with immediate relief rather than keep looking for the true underlying cause, often leading to even more serious conditions being left undiagnosed. Our overall lack of understanding of many conditions result in this happening entirely too frequently in the medical community regardless of whether the healthcare system in the nation is private or public. The reality is it is just our current state of global advancement in medicine, one that I hope the future finds means to better address.

We do the best we can with the tools we have available, the reality is we still need more tools to better assist with this if we hope to improve accuracy in medicine.
 
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stroopwafel

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One really does have to wonder though how many arm chair physicians there are here when the only person with an actual Medical Degree in the discussion posts an article discussing symptoms that we, as physicians, do not always have an answer for and people automatically assume they know or steer the conversation to mental illness or stress or anxiety causing somatic issues rather than it just simply being some other problem we overlooked. It would be a disservice to our patients for us to dismiss their symptoms as somatic and far too many are entirely too quick to jump to that conclusion rather than consider that we simply do not always have the answers yet, but not to give up on being able to help provide people with relief for their symptoms.
Yeah, but why does it have to be one or the other? For example it could be a minor issue that is then seriously aggravated by stress, anxiety, depression etc. If every test shows up negative and symptoms don't get worse you can be sure it's not serious let alone life threatening. Innocent disorders can cause a lot of grief but are no threat to your health. Serious disease most often don't even give symptoms until it's too late, like cancer for example.
 

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Yeah, but why does it have to be one or the other? For example it could be a minor issue that is then seriously aggravated by stress, anxiety, depression etc. If every test shows up negative and symptoms don't get worse you can be sure it's not serious let alone life threatening. Innocent disorders can cause a lot of grief but are no threat to your health. Serious disease most often don't even give symptoms until it's too late, like cancer for example.
Usually anyone with a chronic condition experiences anxiety, depression and stress as a result of their condition. Usually this is treated by treating their actual symptoms and conditions causing the stress in the first place. When you have a physical medical condition causing the stress, the easiest remedy is removing what is actually causing the stress in the first place. This is not the same as someone who experiences excess stress, anxiety and depression without other causes and is not treated the same. The cause is usually the most important factor in determining the best course of treatment. We also do not recommend the same course of treatment for the stress for someone with an incurable or terminal condition as well.
 

Phoenixmgs

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I'm been saying Vitamin D is super important against Covid-19 for months now. The amount of people that were Vitamin D deficient that needed hospitalizations and/or ended up dying were just so staggering it couldn't be ignored. And the surprising part of the trial was that Vitamin D works as a treatment vs something you have prior to getting infected.

And the 1st trial for using Vitamin D as a treatment has resulted in:

Got Vitamin D - 2% required ICU admission, 0 deaths
No Vitamin D - 50% required ICU admission, 2 deaths

 

Eacaraxe

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I gotta be honest, people mistaking being an oblivious asshole for patriotism, and the consequences of one's choices for persecution, far exceeds the scope and scale of the pandemic. It's a problem that's crept slowly for forty years into practically every aspect of American life. Frankly I've been anti-open carry my whole-ass life, but at this point people are acting so buck-wild stupid and obnoxious I'm on the verge of starting to open carry.