Article from BJM: Post-COVID and primary care physician perspective

Posted by cynthia14 @cynthia14, Oct 1, 2022

I found this article in The British Medical Journal extremely helpful, especially the flow chart that primary care doctors can use to understand and guide post-COVID sufferers through treatment for our various symptoms. If interested, please go to https://bit.ly/bmj-long2

Interested in more discussions like this? Go to the Post-COVID Recovery & COVID-19 Support Group.

I'm a very analytical person (74 Years old) being an engineer managing Engineering, Procurement and Construction Projects in excess of $1 Billion so I like to understand what is going on at all times and have had this affliction with my health for ages. Yet when I tested positive for Covid in early May 2022 and continued to test positive for 4 weeks (Caught Covid after two vaccines and two boosters) and the symptoms never went away - Now in my 6th month and hopefully finding a few answers and potential treatments for my diseases on my own - with very little help from my doctors. Every time I talk to a doctor it seems they are dismissing me while telling me they have no clue to what they need to do at the same time. "lets wait 4 months and see what happens - then 6 months and so on. I feel like I'm talking to my insurance agent - not my doctor.

We are now three years into covid and the medical industry is either dumb or seriously dismissive.
My biggest concern (I have all of the Covid symptoms except for a fever) is the intense pain in my replaced hip after 20 years of caution not to let it get infected - taking antibiotics before any dentist looks in my mouth - yet with long covid forget everything the medical industry told me - it will go away on its on in 8, no 10 ....months.

REPLY
@lbyrd02

I'm a very analytical person (74 Years old) being an engineer managing Engineering, Procurement and Construction Projects in excess of $1 Billion so I like to understand what is going on at all times and have had this affliction with my health for ages. Yet when I tested positive for Covid in early May 2022 and continued to test positive for 4 weeks (Caught Covid after two vaccines and two boosters) and the symptoms never went away - Now in my 6th month and hopefully finding a few answers and potential treatments for my diseases on my own - with very little help from my doctors. Every time I talk to a doctor it seems they are dismissing me while telling me they have no clue to what they need to do at the same time. "lets wait 4 months and see what happens - then 6 months and so on. I feel like I'm talking to my insurance agent - not my doctor.

We are now three years into covid and the medical industry is either dumb or seriously dismissive.
My biggest concern (I have all of the Covid symptoms except for a fever) is the intense pain in my replaced hip after 20 years of caution not to let it get infected - taking antibiotics before any dentist looks in my mouth - yet with long covid forget everything the medical industry told me - it will go away on its on in 8, no 10 ....months.

Jump to this post

Respectful recommendation, read the British Medical Journal article as advised by Cynthia14. This is a very excellent summary of my own experience as Practioner during the height of the Covid-19 pandemic. Most likely you may be somewhat disappointed, because presently there is NO Precise cause of PACS (post acute Covid syndrome). One big hurdle has been over come. Recognition, has been established in the US, Great Britain and on their countries. Some governments are beginning to fund(give money) scientist to investigate this disease(entity). However, I believe we are in the very early stages in this process.
The single most frequent recurring themes that are reported in this support group is “Frustration”. This should not be construed as a criticism and in fact is to be expected. I am very frustrated, even in the face of years of medical practice and scientific training (MD PhD).
The second most common feeling can be described in one word: Dismissal.
A major cause of “dismissal “ is conveyed by some Practitioners and occurs because there no known or precise answer to all of the symptoms reported by each patient in our group. We simply do not have an answer for every disease process known to humankind. Many will encounter “dismissal”, but do not give up, sharing of information is key to science and for this I am thankful to read each and every ones experience.

REPLY

Understand I'm at the top of my profession and I got there by not assessing blame, looking for solutions and most of all not doing nothing. Any positive response is better than "Wait and See".

I know there is "presently there is NO Precise cause of PACS (post acute Covid syndrome)." -I beg to differ as there is a cause - Covid. What drives me up the wall is using the legalese of "Precise" in your quote to mitigate blame. We know what causes it - what the profession can't do is differentiate between the new covid infection and the preexisting conditions. I've had gastric problems since 2006 it took 15 years to figure out (Upper Intestine Diverticulosis) only to find there is no cure. The reason the diagnostic took so long is our national problems with acid reflux doesn't warrant a CT Scan in our medical - insurance environment. The same thing is happening with long covid - too many people that control the medical industry do not want to know the cause - if they did, we would have better screening, testing and sampling being done on individuals with long covid. We know what it looks like, we think we know where it migrates to and how it gets there, so why not use those tools that got us this far to diagnose the millions of long covid patients (Electron Microscopes, CT Scans, MRI scans, nuclear scans, blood samples for micro clots, protiens....) The excuse of "presently there is NO Precise cause of PACS (post acute Covid syndrome)." to do nothing is something I would expect from Trump or Biden or the insurance industry - those people that don't want you to know - not the medical profession. If someone told me that the foundation on this high-rise was sinking and they would rather wait to see if it was natural cause or poor engineered fill - I'd fire them in a heartbeat. You find out what the problem is you fix it then you worry about the cost and blame. No one has asked me for a feces sample, a blood sample to check for covid indicators, or one of the scans (my favorite) a nuclear scan - the one most likely to identify inflammation in the body - they simply reply with the "no precise" which is a financial response - not a medical process.

I'm more convinced than ever we need a single payer plan to remove the insurance virus in our system.

REPLY

Thank you for your response. What nuclear scan would you like to have done?
Frustrating, for sure and then some. Perhaps a referral to a “Long Covid” specialist/clinic would be a place to start.

REPLY
@lbyrd02

Understand I'm at the top of my profession and I got there by not assessing blame, looking for solutions and most of all not doing nothing. Any positive response is better than "Wait and See".

I know there is "presently there is NO Precise cause of PACS (post acute Covid syndrome)." -I beg to differ as there is a cause - Covid. What drives me up the wall is using the legalese of "Precise" in your quote to mitigate blame. We know what causes it - what the profession can't do is differentiate between the new covid infection and the preexisting conditions. I've had gastric problems since 2006 it took 15 years to figure out (Upper Intestine Diverticulosis) only to find there is no cure. The reason the diagnostic took so long is our national problems with acid reflux doesn't warrant a CT Scan in our medical - insurance environment. The same thing is happening with long covid - too many people that control the medical industry do not want to know the cause - if they did, we would have better screening, testing and sampling being done on individuals with long covid. We know what it looks like, we think we know where it migrates to and how it gets there, so why not use those tools that got us this far to diagnose the millions of long covid patients (Electron Microscopes, CT Scans, MRI scans, nuclear scans, blood samples for micro clots, protiens....) The excuse of "presently there is NO Precise cause of PACS (post acute Covid syndrome)." to do nothing is something I would expect from Trump or Biden or the insurance industry - those people that don't want you to know - not the medical profession. If someone told me that the foundation on this high-rise was sinking and they would rather wait to see if it was natural cause or poor engineered fill - I'd fire them in a heartbeat. You find out what the problem is you fix it then you worry about the cost and blame. No one has asked me for a feces sample, a blood sample to check for covid indicators, or one of the scans (my favorite) a nuclear scan - the one most likely to identify inflammation in the body - they simply reply with the "no precise" which is a financial response - not a medical process.

I'm more convinced than ever we need a single payer plan to remove the insurance virus in our system.

Jump to this post

Yes yes yes. Thank you for putting some of my feelings into perfectly phrased words. I too have pre-Covid medical issues that have been dismissed. Try being fat, female, over fifty and with a decades long history of mental healthcare. I have an M.A. and mad research skills. I read medical journals NOT social media junk info.
I’m post Covid for a couple weeks, something is wrong with my lungs and not a single scan. I am missing work. I hope my appointment tomorrow will lead to some kind of scan. I will insist as gently as possible so that I don’t make the doctor feel afraid I’m a crazy patient he doesn’t want on his service….sigh.

REPLY
@docron

Thank you for your response. What nuclear scan would you like to have done?
Frustrating, for sure and then some. Perhaps a referral to a “Long Covid” specialist/clinic would be a place to start.

Jump to this post

Doc - Ron - I hope you're not a doctor, but to fill you in, If you were going through the pain I have experienced over the last seven months, you wouldn't suggest a Long Covid Clinic to me. I have tried to get into studies but live just too far from NY City or Boston, Or my Covid infection has been longer than 6 weeks .... As far as the Long Covid Clinics, they don't want you unless your Primary Care Physician refers you and I've found a reluctance among that group to write referrals. Ignoring the patients is not the appropriate first step and denying access to the clinics is even worse. Sure I'm 74 years old and wasting medical care on an old fart like me seems financially unwise but as one professional to another - I paid for the highest level of my insurance for over 55 years and I don't expect to be short changed in my last 10 to 15 years and even with my Covid Brain Fog, I'm still smart enough to realize that my current doctors do not have my interest but rather the insurance companies profit at heart.

REPLY
@gertibird

Yes yes yes. Thank you for putting some of my feelings into perfectly phrased words. I too have pre-Covid medical issues that have been dismissed. Try being fat, female, over fifty and with a decades long history of mental healthcare. I have an M.A. and mad research skills. I read medical journals NOT social media junk info.
I’m post Covid for a couple weeks, something is wrong with my lungs and not a single scan. I am missing work. I hope my appointment tomorrow will lead to some kind of scan. I will insist as gently as possible so that I don’t make the doctor feel afraid I’m a crazy patient he doesn’t want on his service….sigh.

Jump to this post

Ask a couple of poignant questions.
1 - Is there anything preventing him/her from providing the appropriate care?
2 - Who would he/she be his/her first choice to further investigate your complaints of lung issues if they were in your condition?
Understand it's going to take months to get into see someone, but you have to push to get treatment now days as there is definitely hesitancy to even investigate Long Covid symptoms.

REPLY
Please sign in or register to post a reply.