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So I question the author's understanding of the use of "NOS".

Indeed. It sounds like some sort of junior medical subculture jargon that does not even appreciate what the term is designed for. I have never heard of it used in this sense. It does not even mean non-specific. It just means no more was said. So a crossbill is perfectly well described as a bird, NOS, if in the circumstances it was just called a bird.
 
So the term "NOS" (Not otherwise specified) is not a stand alone term in ICD-10, ICD-10-CM or ICD-10-CA, but a qualifier appearing at the end of a coded-for term, for which there are many examples in ICD-10 and in the national modifications of ICD-10.

So I question the author's understanding of the use of "NOS".
At some point she specifies that she settled on "deconditioning NOS". Which would be consistent with usual thinking about "chronic fatigue" and GET.
 
At some point she specifies that she settled on "deconditioning NOS". Which would be consistent with usual thinking about "chronic fatigue" and GET.


She settled on "deconditioning NOS" or her clinician settled on "deconditioning NOS"?


There is no term "Deconditioning NOS" in ICD-10-CM.

There is a Concept code: 1031000119102 | Physical deconditioning (finding) in SNOMED CT U.S. Edition but no Concept term for "Deconditioning NOS".

Concept code: 1031000119102 | Physical deconditioning (finding) in the U.S. Edition of SNOMED CT is cross mapped to ICD-10-CM's

R68.89 Other general symptoms and signs

There is also (in ICD-10-CM):

R69 Illness, unspecified
Unknown and unspecified cases of morbidity.
 
Sadly, there are lots of people who are continuing to dismiss, reject, disparage, disbelieve and troll anyone who mentions Long Covid, ME, CFS, and PVFS. I found most of the opinions on this thread horrific.



It's a public thread so it is not necessary to have a Twitter account to read it.
 
Sadly, there are lots of people who are continuing to dismiss, reject, disparage, disbelieve and troll anyone who mentions Long Covid, ME, CFS, and PVFS. I found most of the opinions on this thread horrific.
The BBC story that triggered the tweet says:
"We've got no doubt long Covid exists," Prof David Strain, from the University of Exeter, who is already seeing long-Covid patients at his Chronic Fatigue Syndrome clinic, told the BBC.
 
Sadly, there are lots of people who are continuing to dismiss, reject, disparage, disbelieve and troll anyone who mentions Long Covid, ME, CFS, and PVFS. I found most of the opinions on this thread horrific.



It's a public thread so it is not necessary to have a Twitter account to read it.

I find it very telling that it's impossible to tell the "skeptical" MDs from actual trolls, they say the same thing. For the same reasons. With the same arguments.

Very telling.
 
Panel discussion with Avi Nath, along with two MDs who work at Long Covid clinics and a neurologist who would rather this is all chemical imbalance (goes on a bit about serotonin at some point, no idea where he's getting at), or something.



I watched it last night so my memory is fuzzy but:

Doesn't reveal all that much new to people who follow the topic but otherwise a good intro on the overall issue of neurological symptoms following Covid. Also that holy crap is research funding needed because this is still at best 2% of the effort that's needed. Which is more than the usual <1% but still very much unlikely to lead anywhere.

There is some discussion of autopsies, the NIH has performed about two dozens so far. Some of the things they found is that almost no viruses are found in the brain and CSF, and there is only evidence of neuroinflammation in two places: the olfactory nerve and the brain stem. But the evidence for those is pretty bad. Can't remember who said it but they found the olfactory nerve in some patients to be so inflamed that the neural structure has basically been destroyed. But those were in severe acute cases so they could have had encephalitis, or GBS or other more pronounced inflammation.

There is some discussion of research overlapping with ME at about 20-22 minutes, from Dr Navis, as well as at about 28-32 minutes from Nath. Navis mentioned diet modifications and supplements, about working with functional medicine doctors, not very useful but she seems overall capable and understanding, just early days.

Nath does a brief mention of how other viruses are known to cause similar symptoms, how there are many post-viral syndromes with their own features but also clearly shared features.

This is all still very much at square 1. It's sad that research was never allowed to go beyond square 1. That looks very bad in hindsight, considering it was all an ideological choice.
 
Physicians Among COVID Long-Haulers

https://www.medpagetoday.com/infectiousdisease/covid19/89267?trw=no

Months after he first developed COVID-19 symptoms in March, Paul Garner, MD, of Liverpool School of Tropical Medicine in England, still feels the effects of the disease.

Garner, who is also a coordinating editor of the Cochrane Infectious Diseases group, describes ongoing symptoms like "difficulty reading -- this is there all the time. I cannot read much and I cannot negotiate large documents. If someone sends me an email with a block of 800 words in one paragraph, I simply cannot read it."

He also has difficulty finding words. "This gets worse when I am fatigued," Garner told MedPage Today. "I cannot remember words, people. I had an episode of blindness in one eye. I have had very severe headaches, absolutely horrible. Tingling in my arms and legs. Tinnitus. Both slightly less now."
Walter Koroshetz, MD, director of the National Institute of Neurological Disorders and Stroke (NINDS), said it's "clear that, in contrast to influenza, COVID-19 infection can have longer-term effects on many who are affected, whether they have suffered critical illness or cleared the virus while sheltered at home. Whether chronic illness results from COVID-19 infection is currently not known, but this will become more clear over time."

"I am concerned that, as in many other conditions, treatment will be less effective once chronicity has been established," Koroshetz told MedPage Today. "So time is of the essence to help the thousands now coming out of their illness."
Too bad that when he was asked about this in March he said he "hoped" it wouldn't happen, then did nothing to prepare. This is what happen when you make "hope" a plan. Hope is not a strategy.
COVID-19's neurologic symptoms may stem from three possible sources, Koralnik noted: lack of oxygen to the brain due to respiratory problems during infection, direct viral attack on brain cells or nerves, or overreaction of the immune system.

So far, there is no convincing evidence for widespread infection of the brain with the virus, noted Avindra Nath, MD, of NINDS.
Definitely an improvement over "unhelpful illness beliefs", whatever that means.
"Virus has been detected in cerebrospinal fluid and brain of very rare cases, however, there is evidence for widespread glial cell activation which may be related to metabolic dysfunction or to the massive immune activation in the periphery," he wrote in a recent Neurology editorial. "Depending on the predominant underlying pathophysiologic mechanism at play, targeted treatment might be possible."
Until there's more data to help target treatment, doctors need to pay attention to what long COVID patients may be experiencing, he added. "Patients need to be believed," he emphasized. "You need to listen to them to understand the disease. The patients know more than the doctors."
Has been true for decades on this issue, hence why things are currently FUBAR: because nobody listened to us, in fact gleefully bullied over our desperate pleas not to go ahead with the weird ideological stuff. A corollary of this is that patient involvement in the research is critical. It would be great if it could start. Any day now.
 
Panel discussion with Avi Nath, along with two MDs who work at Long Covid clinics and a neurologist who would rather this is all chemical imbalance (goes on a bit about serotonin at some point, no idea where he's getting at), or something.



I watched it last night so my memory is fuzzy but:

Doesn't reveal all that much new to people who follow the topic but otherwise a good intro on the overall issue of neurological symptoms following Covid. Also that holy crap is research funding needed because this is still at best 2% of the effort that's needed. Which is more than the usual <1% but still very much unlikely to lead anywhere.

There is some discussion of autopsies, the NIH has performed about two dozens so far. Some of the things they found is that almost no viruses are found in the brain and CSF, and there is only evidence of neuroinflammation in two places: the olfactory nerve and the brain stem. But the evidence for those is pretty bad. Can't remember who said it but they found the olfactory nerve in some patients to be so inflamed that the neural structure has basically been destroyed. But those were in severe acute cases so they could have had encephalitis, or GBS or other more pronounced inflammation.

There is some discussion of research overlapping with ME at about 20-22 minutes, from Dr Navis, as well as at about 28-32 minutes from Nath. Navis mentioned diet modifications and supplements, about working with functional medicine doctors, not very useful but she seems overall capable and understanding, just early days.

Nath does a brief mention of how other viruses are known to cause similar symptoms, how there are many post-viral syndromes with their own features but also clearly shared features.

This is all still very much at square 1. It's sad that research was never allowed to go beyond square 1. That looks very bad in hindsight, considering it was all an ideological choice.

I found it very interesting in Dr Nath's piece where he mentioned ME/CFS to hear how viruses can affect the brain in different ways and also their different replication patterns. Probably not new to lots of people.

Also great to hear sympathetic and knowledgeable neurologists, though I admit I only listened to the bits you highlighted where ME/CFS was mentioned.
 
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Did they say anything about what they are doing at the LongC clinic? What treatments they're offering and how they take PENE into account?
Not many specifics, that I can remember. There was mention of neurocognitive testing, which can definitely become useful if the right questions can be asked. This was largely about neurological symptoms and it mostly stayed on topic. There is clearly growing concern about it, especially about brain fog, or however it all fits in the various forms or definitions of dementia. Only questions with their own questions, no answers yet.

It seems mostly about support and trying to figure it out. I'm fairly sure there was mention of exercise challenges, but more about observing the effects, especially with shortness of breath, not as treatment.

Crap I watched it last night and barely remember any of it. Fun.
 
Panel discussion with Avi Nath, along with two MDs who work at Long Covid clinics and a neurologist who would rather this is all chemical imbalance (goes on a bit about serotonin at some point, no idea where he's getting at), or something.



I watched it last night so my memory is fuzzy but:

Doesn't reveal all that much new to people who follow the topic but otherwise a good intro on the overall issue of neurological symptoms following Covid. Also that holy crap is research funding needed because this is still at best 2% of the effort that's needed. Which is more than the usual <1% but still very much unlikely to lead anywhere.

There is some discussion of autopsies, the NIH has performed about two dozens so far. Some of the things they found is that almost no viruses are found in the brain and CSF, and there is only evidence of neuroinflammation in two places: the olfactory nerve and the brain stem. But the evidence for those is pretty bad. Can't remember who said it but they found the olfactory nerve in some patients to be so inflamed that the neural structure has basically been destroyed. But those were in severe acute cases so they could have had encephalitis, or GBS or other more pronounced inflammation.

There is some discussion of research overlapping with ME at about 20-22 minutes, from Dr Navis, as well as at about 28-32 minutes from Nath. Navis mentioned diet modifications and supplements, about working with functional medicine doctors, not very useful but she seems overall capable and understanding, just early days.

Nath does a brief mention of how other viruses are known to cause similar symptoms, how there are many post-viral syndromes with their own features but also clearly shared features.

This is all still very much at square 1. It's sad that research was never allowed to go beyond square 1. That looks very bad in hindsight, considering it was all an ideological choice.

I’m obviously a bit slow because until she mentioned functional medicine in this piece, it hadn’t occurred to me that “functional” is used in this context but also in phrases like “functional neurological disorders”. I knew the term “functional medicine”, just forgot the same word is used in different ways.
 
I’m obviously a bit slow because until she mentioned functional medicine in this piece, it hadn’t occurred to me that “functional” is used in this context but also in phrases like “functional neurological disorders”. I knew the term “functional medicine”, just forgot the same word is used in different ways.
functional another word deliberately made ambiguous by the charlatans within the b p s industry .
 
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