Thank you keemstar for providing the world with one of the funniest tweets of all time

Full Transcript at the link; 3-minute listen.

Quote:

By taking biopsies from long COVID patients before and after exercising, scientists in the Netherlands constructed a startling picture of widespread abnormalities in muscle tissue that may explain this severe reaction to physical activity.

Among the most striking findings were clear signs that the cellular power plants, the mitochondria, are compromised and the tissue starved for energy.

"We saw this immediately and it's very profound," says Braeden Charlton, one of the study's authors at Vrije University in Amsterdam.

The tissue samples from long COVID patients also revealed severe muscle damage, a disturbed immune response, and a buildup of microclots.

"This is a very real disease," says Charlton. "We see this at basically every parameter that we measure."

I feel insane seeing stuff like this because this research already exists for Myalgic Encephalomyelitis, a post viral condition caused by multiple types of viral infections that a LOT of people with "Long Covid" meet the diagnostic criteria for.

This article mentions that ME/CFS is a "similar complex condition" but that's DEEPLY underreporting the similarities. The phrase "post exertional malaise" (now researchers are trying to replace it but this article uses that phrase) was INVENTED for ME/CFS. It's the only known condition, before "long covid", that causes these kinds of symptoms after exertion!

It's good to know for sure that it's the same mechanisms at play when the inciting viral infection is Covid and not, for instance, Epstein-Barr or RSV, but half the time it doesn't seem like researchers are making comparisons at all, just reinventing the wheel and acting like "long covid" is a totally new phenomenon with no previous point of comparison. There are literally drugs in human trials to try to treat the mitochondrial dysfunction in ME, this dysfunction is well-established and fairly well understood and I feel insane when ppl report on long covid without mentioning that there is already a named and studied condition that accounts for this subset of symptoms!!

SOME researchers are drawing comparisons but they're largely ME researchers who everyone else is largely cignoring because of the widespread perception that ME is a fake disease for lazy women.

That same perception btw is why "graded exercise therapy" (GET), or exercise gradually increasing in intensity, cwas for years the go-to treatment despite MOUNTAINS of evidence that it makes ME patients sicker. Some end up permanently bedbound and unable to even eat or drink without a feeding tube/IV because the damage is so bad! The GET recommendation was finally changed only in the past few years in the US and the UK, and many doctors hate that they're not allowed to recommend it anymore, because they insist despite the evidence that ME/CFS is psychological and ME patients are just "deconditioned" and too lazy to do anything about it.

Now the same kind of "treatment" is being recommended for long covid patients despite evidence showing exercise is having the same kinds of cellular effects as it does in ME patients. "Taking PEM into account" sounds gentler but I'm deeply concerned about the reinvention of GET for patients who meet all the criteria for an illness that's been shown definitively to become permanently worse with GET. This mitochondrial damage is progressive in ME, and there's no reason to believe patients who meet all the criteria of ME after Covid won't experience the same progression if they force themselves past their energy envelope in such a systematic way.

PEM happens in part (it's complex) because your anaerobic threshold gets dramatically reduced with this mitochondrial damage. Every time you hit that anaerobic threshold, you're injuring your cells more and more. It's deeply worrying that GET is being recommended for long covid patients who meet the criteria for ME when research like this study keeps showing it's the same phenomenon.

If you have Long Covid

for the love of your remaining life

DO NOT LET THEM MAKE YOU DO GRADED EXERCISE THERAPY

I have Long Covid. I recently got in with a cardiologist who used exactly that word—“deconditioned.”

Maybe my resting heart rate spikes to 180 bpm because I’m just “deconditioned.”

She told me many of my problems could be resolved if I “just start exercising.”

I very, very slowly and painstakingly explained (for the third time in just this one appointment) that I am a marine biologist who, prior to having Covid (and then until three months after my infection), maintained a level of daily physical activity that would be impossible for most people. Even with severe Asthma that was sometimes disabling, I lived a more active life than most.

I told her that in July I was hauling in salmon nets by-hand, hiking 10-30 miles a day, commuting on a bike, transporting hundreds of pounds of equipment on-foot in the backcountry, and I’d recently begun training as a free-diver. I was diving in a 7mm cold water wetsuits in difficult currents between small islands with relative ease.

By October, going up and down the stairs could spike my heart rate to 200 bpm and I began experiencing fainting spells for the first time in my life. I tried to dive one day and nearly fainted in the water. I hadn’t even begun a breath-hold. I was just swimming. My diving partners had to rescue me and haul me to shore, where it took me an hour to recover.

It was like night-and-day.

She said, “you could start slow.”

I said, “what exercise is slower than using the stairs? I’ve read that exercise might actually harm me rather than help…”

She finally said, and this is a verbatim quote, “look, many of the women who come in here complaining about tachycardia are whackjobs. But you seem serious. I don’t know much about POTS—which I think you probably have—so I’ll refer you to my colleague.”

I was astounded that she 1. Outright called suffering patients “whackjobs” and 2. That she felt the need to specify that these “whackjobs” were women.

Presumably, men are perfectly sane and to be believed. Not like those silly women.

I could only be relieved that I somehow triggered her bias in a way that made her believe me.

What might have changed that? If I were fat, if I were a person of color, if I simply hadn’t lived such a rigorous lifestyle before that convinced her that now I’m “really” sick.

Until I stated my case, multiple times, this cardiologist I waited months to see simply decided I gave up my entire lifestyle for—what?? Presumably no reason?

She heard, “I’d do anything to be active again,” and her response was, “have you tried being active again?”

And then she gave me dangerous advice. My only saving graces were that I did extensive reading before I saw her and that I matched whatever patient profile she has arbitrarily decided to respect.

Healthcare for people with new and long term dysautonomia and fatigue is a nightmare!

Unfair as it is, you must do your own research and be prepared to self-advocate—tooth and nail. And even then, it may not be enough. But do what you can.

Hello hello, this is the art I made for the @spnangelsanddemons-rb reverse bang. Read the "The fourth archangel" by CathiesCreations. They made my dreams of a Raphael-Jack interaction reality.

Summary:

blood “loss”? well it’s not lost. i know exactly where it went. right over there.

erm achtually

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🩸 🩸🩸

🩸 🩸 🩸

🩸 🩸 🩸🩸🩸

In this big world is there a place for someone as little as me?

Don’t you just hate it when you give in to your lust for blood and you sink your fangs into a robot by mistake?

nothing canon era fic writers could come up with will ever be as cruel as modern au fic writers putting these guys in the most basic modern scenarios. like he was born to live & die by the blade, his story was over before it began. and you made him take the bus and work a 9 to 5 job

lovers, of course, are notoriously frantic epistemologists, second only to paranoiacs (and analysts) as readers of signs and wonders.

adam phillips, on flirtation

SUCCESSION (2018–2023)

I saw a meme about onions tonight and I was so captivated by the beauty of the humble red onion I knew I had to draw one immediately

i love this image not only because of the fact that they thought of it as an idea for a promo photo, decided it was a good idea, and subsequently took it, but also because the angle the photo is taken from means you can see the gilly box

this frame from the fallout tv show is so funny i nearly puked watching it