USA: Yale Long Covid clinic - Professor Lisa Sanders

I'm just looking at what is included in the transcript, so maybe not well contextualised.

That's not great.

Does that follow? Probably the same sex ratio occurs in LC as ME. And we haven't previously been having the conversation about ME. The difference now is the shear numbers (female and male) over a compressed timeframe. I suspect even if it were only women being affected by LC we would still be having the conversation.

 

If anyone is offering stellate ganglion block I would keep well away.

 

Why do you say this? I'm asking because it's been suggested in the past by my GP as a possible treatment for my 24/7 headache.

 

I actually just listened to Lisa Sanders's book Every Patient is a Story a couple of weeks ago. For the most part it was a very interesting look at how clinicians diagnose conditions. It was a sort of behind the scenes look at how providers are trained to think, though in some ways the book was also targeting providers by reminding them of what is necessary to correctly diagnose patients such as a proper physical exam. That said, I couldn't help but feel a pang of jealousy that she or the other clinicians mentioned actually seemed to have the time to spend and/or interest in working through diagnosing challenging cases.

There was a whole chapter on Chronic Lyme, which she is skeptical of as a clinical entity, but she also was clear that patients are seriously ill and we don't understand why. I did wince, however, when she went down the "militant Lyme patients who send death threats" road. Yet she didn't dwell on it and didn't use it to dismiss the suffering of patients (though was very dismissive of ILADS). Moreover, the patient in question in that chapter, after being dx with Chronic Lyme and treated with antibiotics for a couple of years that just made her sicker, turned out to have polymyalgia rheumatica. So mostly Sanders's concern was that a Chronic Lyme diagnosis could be used to distract from an underlying treatable condition.

After listening to that book, I'd certainly go see her if I could.

 

Because stellate ganglion block has been around all my medical life as a magic treatment for anything puzzling that there is no other treatment for and as far as I know there has never been good evidence for it being any use in anything.

Another words it has been the paradigm placebo injection used by physicians suffering from furor therapeuticus or a desire to empty wallets. In 1980 I might have taken it seriously. It may possibly be useful for some niche problem or other but I never heard of any good quality trials.

 

Thank you