News from Australia

NelliePledge said:
Obviously big issue for medical education generally tho
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Yes, it seems so. This doctor did say that she would ask her supervisor about Long Covid.

And, sorry, this is me just venting off-topic, but she looked in my infected ear with an otoscope, that is, she looked in the ear that is clearly leaking pus (with an instrument that goes in the ear canal). And then she said 'I'll just look in your other ear' and went to look, without changing the end of the instrument. And I didn't turn my head, just looked at her and she said something like 'oh, would you like me to put a fresh cover on it', to which I replied, 'yes, that would probably be a good idea'.

Like, never mind post-infection syndromes, we haven't even got germ theory bedded down.
 
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Recent radio segment on ABC Life Matters, featuring ME/CFS patient Sara Gingold, Emerge Australia CEO Anne Wilson, and Associate Professor of Rehabilitation and Human Performance, Mount Sinai Health System, Dr David Putrino. The segment runs for about 20 mins.

https://www.abc.net.au/radionationa...ing-the-spotlight-on-chronic-fatigue/13797106

In the segment, David talks about his clinic using autonomic rehabilitation with Long COVID patients. I did a bit of digging around to find out what this was. It seems that David and his team utilise this approach (which they call autonomic conditioning therapy) with people with long COVID who have pulmonary fibrosis (lung damage). They acknowledge that it may not be suitable for people with long COVID who don’t have PF.

I found an outline of what the program consists of (see screenshot. Sorry my brain couldn’t figure out how to get the image to be embedded in the post!). In short, it’s breathwork and exercise to improve lung function. Good that they are using objective outcome measures to determine the effectiveness of their program (6 and 10 minute walk test, and orthostatic measurements like HR and BP).

Sources:
https://www.health.ny.gov/commissio...y_approaches_long_covid_care/docs/putrino.pdf

https://cdn.who.int/media/docs/defa...-4c92-a685-dd1d59658d4e.pdf?sfvrsn=c0c5e9db_5
 

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Hutan said:
She didn't know what ME/CFS was (I had had to fill out a new patient record of illnesses), but had heard of chronic fatigue syndrome. She had not been taught anything about it, well, nothing she was telling me, and said that she'd never come across anyone with it. She had heard of Long Covid, but not in her training. She didn't know much about it, didn't know anything about its management. This is a new GP, completing her training, and no one has told her to watch out for signs of Long Covid in the patients she sees, or given her any ideas on how to manage it.
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Was she interested in finding out?
 
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Eye movements may be key to chronic fatigue syndrome diagnosis

“What we’re trying to do is generate a unique ME/CFS signature based on characteristic changes to eye movements, a behaviourial signature that is specific to the disorder that can be used to help diagnose it and monitor the effects of any treatments.”

Associate Professor Fielding and her team will develop the clinically useful test using ocular-motor, machine learning and neuroimaging techniques.

“We’re using video-oculography, which is basically high-powered cameras that record the eye movements in response to a set of simple stimuli on the screen.

“People with ME/CFS are typically extremely fatigued – we need something very quick that gives a snapshot of how they’re performing.”​
 
A news article about the establishment of a Long Covid clinic in Canberra:

ACT long-COVID clinic opens as health system prepares for more cases of illness in Canberra

The post-COVID recovery clinic is based in the University of Canberra Hospital at Bruce, and will treat people over the age of 16 who have COVID-19 symptoms more than 12 weeks after they first catch the virus.
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The clinic's staff includes physiotherapists, occupational therapists and social workers.
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According to someone with ME/CFS who has been to this same rehabilitation clinic, they only offer GET for ME/CFS patients. I'm sure it will be similarly useful for those with Long Covid :banghead:

In Adelaide, the RAH has set up a similar clinic:

The Royal Adelaide Hospital has established a Long COVID Clinic to coordinate care for people experiencing continued symptoms.
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Again, it appears to be set up around 'rehabilitation' and involves 'physiotherapy, exercise physiology and mental health teams'.

ETA, according to a few people on social media with friends with Long Covid, doctors here have been using the existing (out of date) Australian ME/CFS guidelines which recommend GET and CBT to guide treatment for Long Covid.
 
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Emerge Australia are doing a pretty good job of highlighting the inadequate support available for people with ME/CFS and, now, Long Covid. I found this article a little disjointed and confused and was annoyed by the emphasis on "fatigue" and "chronic fatigue" (which I'd say reflects on the journalist rather than the message):

Rise of long COVID highlights need for support for people with chronic fatigue syndrome
And as more people are diagnosed with long COVID, with some unable to work or live a normal life for months after getting the virus, advocates say the number of people needing support for post-viral illness is set to skyrocket.
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Recent research from Deakin University estimates between 40,000-325,000 might develop long COVID, which can have similar symptoms to ME-CFS.
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ME-CFS advocates say Australia is lagging behind the rest of the world in evidence-based guidelines for GPs to accurately diagnose patients with post-viral illnesses.
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With the Federal election weeks away, Emerge is also encouraging Australians to email their State of the Nation report to their MPs. There is a template email and a form on their website.
 
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Long COVID clinics likely to be required across the country
https://www1.racgp.org.au/newsgp/clinical/long-covid-clinics-likely-to-be-required-across-th

‘We know from the experience overseas that people were going to get long COVID, and we believe that now we’re playing catch up and it’s important that those clinics get established urgently.’

And, given the breadth of care that is sometimes required for these patients, Dr Willett says it would be ‘prudent’ for authorities to start planning multidisciplinary clinics in jurisdictions where they are not currently established.
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‘You’ve got to have access to different specialists, like respiratory, rheumatology, infectious diseases, cardiology, and general physicians,’ he said.

‘Then you’ve got to have allied health, physios, dietitians, exercise physiology – it’s a very difficult model to fund in a private system.
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He is also hopeful that referrals to the clinics will eventually be expanded to incorporate patients with chronic fatigue syndrome.

‘We know there are plenty of patients with this syndrome who haven’t had COVID but have got the same symptoms,’ Dr Byrne said.

‘It’ll be interesting to see if efforts on data, research and treatment strategies come out that can help our other long-term chronic fatigue patients post-viral infection.’​

Too bad the RACGP has been blocking those efforts for years and played a direct role in the absolute nothingness that exists today in Oz in the form of useless CBT & harmful GET. Where will be the accountability for that? The organization was vehemently hostile to changing from the current failed paradigm.
 
On a non-medical issue, electricity and gas prices are set to soar here by up to five fold or more. I think anyone on limited income needs to be aware of this. Given that the main issues are global, Covid and the Ukraine war, this might apply to many other countries.
 
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