Category Archives: rural doctor

by

Pediatric autoimmune neuropsychiatric syndrome

Yes, well, PANS rather than PANDAS. PANDAS is just a cooler acronym. Who wants a syndrome named after a kitchen implement? Not me. And probably tuberculosis (my mom’s) was the initial insult and then I was one of those kids who gets Strep A at least yearly. My daughter too, but my son only had Strep A once.

This is actually Pseudoautoimmune. That is, the antibodies that show up to Strep A attack parts of ourselves. It buggers up the acronym so they are not calling in PPANS. Yet. And eventually they will have to drop the Pediatric, so then it’s back to PANS. Oh, well, I can live with a stupid acronym.

My current theory is that the four antibodies that they’ve found so far are an interesting back up crisis system. Either stress or infection can set them off. Once the antibody levels are high, a person gets

1. Either brain fog or some variation of ADHD/OCD/Manic-depressive/TICS/Oppositional Defiance/etc. The brain fog can be labeled depression or memory loss, partly depending on the age of the person.

2. Muscle weirdness: either super strong/super endurance or slow twitch/fast twitch/both muscle dysfunction. With slow and fast twitch muscle dysfunction, theoretically that would be a source of at least some of the chronic fatigue. Chronic fatigue pretty much happens over night and is triggered by one in ten severe infections and/or stress. Though possibly more with Covid-19. The latest estimates are 30% of everyone infected has some form of Long Covid.

3. Anti lysoganglioside. I am still studying lysogangliosides. They lyse ganglions. In theory if this blocks the lysogangliosides, there could be a higher risk of cancer. If the ganglions are lysed more, well, more brain dysfunction and memory loss. I also noticed that I had tremendous muscle pain if I ate the wrong things. This could then be the mechanism for some of the fibromyalgia people.

How to fight this?

It’s not going to be popular in medicine, particularly allopathic, because the main treatments that I can think of are NOT DRUGS.

1. Look for infection and treat it. Penicillin is cheap. High dose if the person doesn’t respond. I don’t look septic when I am near septic: no elevated white blood cell count and no fever. It’s the urine output multiplied by 5, that is, 10 liters instead of 2 liters in 24 hours, that is the clue. This time I did not get to that point and it was milder. Though I need oxygen.

2. Quiet the immune system. Teach the slow breathing that we are using for chronic pain and our anxious people and PTSD veterans. Going from the ramped up hyper crazy sympathetic nervous system state to the quiet relaxed parasympathetic nervous system is a skill that I think anyone can learn. The immune system calms down in the parasympathetic state and antibody levels will drop. The naturopaths want to give tons of pills (that they sell from their clinic or get a kick back from the on line company) for “immune dysfunction” but most of it is crap. Yes, crap. So the naturopaths won’t like this idea either.

3. For the anti lysoganglioside, I’ve treated this by changing my diet. When my antibodies are high, I have to keep my blood sugar as low as possible which means I go keto. As the antibodies come down, I can add foods back in. I am eating everything now except gluten. The gluten is annoying but Things Could Be Worse. Lots worse. This time I figured out that gluten, fructose and sucrose were culprits but not lactose and as I get better rice, potatoes and corn are fine. I dislike soy and always have, except for soy sauce and tamari. Tofu tastes like squishy cardboard to me, yuk. The gluten thing may get better, but since it appears that the baseline of the antibodies rises with each infection/attack, it might not. I will ask for celiac testing in January if I haven’t improved by now. I am not a “bad” celiac who gets terrible symptoms if there is a whiff of gluten. A little doesn’t bother me. French toast two weeks ago brought back the diverticular symptoms and kept hurting for a week. This did motivate me to hold off on gluten. Especially in the holidays and traveling. Again, everyone makes different antibodies, so the food patterns could be highly variable in different people. How very very interesting.

4. Treat the psychiatric stuff. If antibiotics and slow breathing and other parasympathetic exercises don’t help the person, then add the psychiatric drugs. But I’d try the above three first, unless the person is suicidal or threatening others. I am a drug minimalist. Eat food, exercise, have friends, work some, play lots and avoid pills. Including vitamins and supplements.

And that’s the basic plan for treating PANS. The symptoms of Long Haul Covid-19 bear a strong resemblance to my four pneumonias: brain fog or psychiatric problems, shortness of breath, fatigue, muscle pain. Therefore I would try similar treatments which may help some people with Long Haul Covid-19, chronic fatigue and fibromyalgia.

We will see if I make any headway at all.

___________________________________________

For more about PANS/PANDAS: https://home.liebertpub.com/news/revised-treatment-guidelines-released-for-pediatric-acute-onset-neuropsychiatric-syndrome-pans-pandas/2223

by

The Introverted Thinker in New York

The Introverted Thinker is eight. Her mother takes her out of school for a week to go to New York City.

They leave her sister and her father behind.

Her mother complains about the school paperwork. “Never let school get in the way of your children’s education,” she says. “That’s what my father says.”

The IT is not sure what all this means. But she is excited.

They go on an airplane. She gets to sit by the window. She can see the ground and it is squares like a quilt with hills. It is so beautiful! She is amazed, magic!

In New York City they go to the house of an old friend of her mother’s. The old friend is old and wears dresses to the ground and a lot of jewelry. The house is dark and there are many things in it. The IT is told that the things are antiques and she must not touch anything. She walks around carefully in the dark places, looking at all of the strange things while her mother talks to the old friend. They talk about the past and people that she does not know.

Her mother takes her to museums on some days. Some are art museums. The IT is already used to art museums because her mother is an artist. The museum is like an art gallery only much bigger and the ceilings are very high. A lot of the art is very big too.

One museum is different. Natural History, says her mother. There are dinosaur bones. The IT can’t touch them either but they are wonderful. Huge animals from the past that are not here any more! She loves it.

They fly home. First she has to thank the old friend with the house like a museum, only darker. Then they go to the plane. This time there are some clouds so the IT can’t see as much, but she still gets to see the quilt of the land.

She decides that she likes museums and she likes natural history. Especially dinosaurs.

by

Moon

Travelers, be careful, says the moon. Mask up, wash your hands, be kind, be brave. Try not to spread nor acquire new infection. This is a twitchy itchy scratchy moon, saying, “Be careful and have care for others.”

For the Ragtag Daily Prompt: twitch.

by

atmospheric river

The current flooding rivers in the Pacific Northwest (1) now are ascribed to an atmospheric river. Atmospheric rivers are long narrow weather regions that carry enormous amounts of moisture from the tropics in the sky. This sky river carries water vapor and moves with the weather, “carrying an amount of water vapor roughly equivalent to the average flow of water at the mouth of the Mississippi River.”(2) When they make landfall, they can release the water in the form of rain or snow.

They can stall over watersheds and release huge amounts of wind and rain and cause severe flooding. The atmospheric river from Hawaii to the Pacific Northwest is called the “Pineapple Express”. “On average, about 30-50% of annual precipitation on the West Coast occurs in just a few AR events and contributes to the water supply and flooding.”(2) An atmospheric river is approximately 250-375 miles wide.

“Not all atmospheric rivers cause damage; most are weak systems that often provide beneficial rain or snow that is crucial to the water supply.”(2) If it were colder we would have an amazing snow pack right now.

The bomb cyclone that came through a few weeks ago caused much less damage. An atmospheric river does not sound as dramatic, but the drone pictures of houses and cars deep in water (1) tell a different story. There is road and bridge damage and already talk of Thanksgiving travel disrupted.

(1) https://www.accuweather.com/en/winter-weather/pineapple-express-pummels-northwest-british-columbia/1047699

(2) https://www.noaa.gov/stories/what-are-atmospheric-rivers

(3) Meanwhile the Olympic Peninsula still has a section cut off: https://www.peninsuladailynews.com/news/flooded-roadways-cut-off-west-end/

The photographs are of the Sol Duc River, taken by a friend. The river rising and huge amounts of debris being carried down the river. The huge log in the earlier pictures that was on the other side of the river, is gone.

Sol Duc River Tuesday Oct 26, 2021
Sol Duc River Sunday November 7, 2021
Sol Duc River Sunday November 14, 2021

Next is the heading photograph, from Monday, November 15, 2021.

Sol Duc River Monday November 15, 2021. Carrying whole trees downriver.
Rialto Beach with all of the wood washed down the rivers, November 16, 2021.
by

whiskers

For today’s Ragtag Daily Prompt.

The kittens were both two pounds and a bit when I got them. Last Thursday they got their last set of vaccines for a year and they are now both six pounds. They are growing like weeds. My last cat was a small cat. If the stated age was right when I got them, these two are going to be BIG.