In my advanced CKD clinic, this is a common clinical encounter: Mr. Jones is 83 and has chronic kidney failure with a low eGFR. He’s not eligible for a transplant.

Nausea in POTS Severe daily nausea in POTS is a worrying symptom. Why? It can set up a vicious cycle of decline. Nausea limits oral intake, which worsens POTS, which is driving the nausea in the first place. Nausea in POTS is one of the most poorly managed

It is called 'pacing' but the ultimate message buried in this concept is 'do not crash' (try and stay at an activity and arousal level that does not trigger PEM). We all want to believe that we will be different and we can push through. In this condition it is about doing the

Several attacks of abdominal pain and diarrhoea in POTS. I see a lot of POTs writing about severe abdominal attacks with severe pain that can go on for hours or days. Can be severe enough to cause vomiting sweating and syncope. The aetiology of these attacks

🤰 Manage hypertension in pregnancy The BMJ

📚 Delighted & honoured that THE STORY OF A HEART is this week's BBC Radio 4 Book of the Week, read by me. 🌞 11.45am daily from Mon 9 Sept 🦉 Repeated for night owls 12.30am 🫀 The remarkable story of a boy, a girl & the heart they share #OrganDonation

Update! - Pathophysiology of physical activity-induced post-exertional malaise ( PEM) in post-COVID condition and ME/CFS ( #MECFS ) 🚨#PEM #LongCovid 👇 1. Reduced Systemic Oxygen Extraction: 👉Decreased oxygen extraction and oxidative phosphorylation capacity during physical

We all know the axiom that hypomagnesemia causes refractory hypokalemia. Let's understand the interplay between the two from molecular, cellular to clinical aspects. Wishing that at the end of this thread, we have a better understanding of S. Magnesium A 🧵

When is reflux not reflux? Acid reflux in POTS and MCAS pts is often poorly treated, bc no one ever stops to ask the question “why does my pt have reflux?” Reflux seems like a pretty easy symptom to manage. Yet so often it is not managed well.

'Dear doctor, you can help people with ME by reading the new NICE guidelines, making treatment plans and supporting us'. nice.org.uk/guidance/ng206

Faecal loading vs Constipation vs Defecatory dysfunction I talk a lot about faecal loading, and confuse a lot of people. Faecal loading is NOT constipation. Faecal loading is the presence of HARD faeces in the colon. The fluid entering the colon from the

It is less than 3 motions a wk or difficulty passing a motion. Pts use constipation to describe 1/ infrequent motions 2/ hard motions 3/ difficult to pass motions. You need to clarify what a pt means by constipation in order to know what u r treating.

Sabrina Poirier (On Hiatus) I see it’s gain weight in caloric deficit and lose weight in caloric excess. Can switch from one to the other. It is those pesky MC. I just don’t know how they are doing it. The gut hormones released in these conditions are abnormal. But very little to know research.