@KatyMontgomerie @ElPolloDiabloX @AbigailShrier @chadfelixg Okay, so you haven't read the study in the British Journal of Sports Medicine, you've read a Guardian story about it.

I have now read the study, and I teach critical appraisal as part of my job, so let's dive into it a bit.

Eight years ago, Spencer Cox died of #AIDS. He had access to #antiretroviral therapy, but in his own struggles with #depression and substance use, he stopped taking them. 1/

Spencer left college, dropped out like me in the 80s, and we both found ourselves in @actupny where we joined the Treatment and Data Committee, doing battle with drug companies, the @US_FDA, the @NIH on a quest to save ourselves and our friends from near-certain death. 2/

Now everyone knows what those dark days before the advent of antiretroviral therapy were like. Waves upon waves of dying friends. A government who couldn't care less for the sick and dying. 3/

All this has happened before, and all this will happen again. AIDS. #COVID19. The next pandemic. The fire next time. 4/

And it changes you. Seeing so much death so young. Seeing those in power turn away from the catastrophe, even joke about it (find, listen to the tape of Larry Speakes in Oval Office w Reagan laughing about AIDS). 5/

Can any MP ask the government why early treatment kits to stop viral replication & infection are not made available cheaply & prescription free in pharmacies as they are in India? Is it lives we want to save or is it Big Pharma profits? Because the two are mutually exclusive.

There could even be competing kits, & the decision which to take could be left to doctors & patients, as happens with most medicines. The problem is that there is not one of these kits available cheaply & prescription free anywhere in the West.

Doxycycline, Ivermectin, Azithromycin, Hydroxychloroquine, Zinc, Vitamin D, Vitamin C, omega-3s, all approved as safe drugs decades ago. This is clearly not an issue of safety. It should be left to a doctor's experience & judgement whether they are effective or not, not academia.

A GP could simply state on his website: of all the kits I recommend Kit Z, then Kit Y etc. No need to wait hours for consultations, as soon as the symptoms are clear the self administered treatment begins, and thousands of lives are saved, as well as hospitals remain underwhelmed

There is no need to go to ER or ICU if people can buy early treatment kits from pharmacies. There is no need for any hospital to be overwhelmed. This problem could be resolved in days. There is simply no political will to save lives as it means to go against Big Pharma profits.

Okay, let's start this hypersomnia thread!

[note - I am not looking for unsolicited advice.]

Idiopathic hypersomnia or narcolepsy (not the same, but similar) is very hard to describe to people.

When I say "I slept 10 hours last night and I'm still tired" I'm not bragging. 1/16

For me, the accommodations I need are about time. My body doesn't care what I want to do - when I want to wake up or be asleep. My body wants to wake up at 10-11am, and go to sleep at 3am, always.

Just a one hour shift in my sleep schedule can screw me up for days. 2/16

When I tell people that I'd really "prefer it" if we could meet at 10am or later, it's because getting up before that has consequences for me. Big consequences. Most people won't see them. Sometimes I still give in and say it's fine. It ruins 2-3 of my days, sometimes more. 3/16

Let me explain. When I am required to wake up at 9am, esp. in covid times working from home, my body pays me back for it later.

I'm going to show you ways this happens. I can usually withstand 1 day of waking up early, with some consequences, but 2 days in a row kills me. 4/16

Let's say this graph represents Day 1, the first time I am required to get up early. The y-axis is my level of Sleepiness. Any symptom listed higher up includes that symptom + every other symptom below it. Getting up that early means I can't listen or concentrate all day. 5/16

Anxiety resides in 4 spaces:

1. The space inside you
2. The space between you and another
3. The space between others
4. The space inside another.

A powerful de escalation tools is to first locate the anxiety. Where is it?

Often the answer is 'all 4.' Yikes!

1/

Anxiety is contagious, we spread it and escalate it unless we know how to manage it.

This was perhaps my biggest lesson as a trauma chaplain - the very hard work of not catching someone's anxiety.

2/

When I caught it, I was no good to them. I no longer saw what was going on, I was now 'infected' by my own triggers, assumptions, the story I tell myself. I was all wrapped up in myself.

But when I managed my anxiety, I was able to be calm, aware and fully present to them.

3/

Even in the very worst moment of their lives, even if they had me by the shoulders screaming, 'how could God allow this to happen?'

4/

Incidentally, early in chaplaincy, I thought this was an actual question. Because I was anxious, I was more infected by my need to answer than I was to simply be calm and present with them in their pain.

5/