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#26: Long Covid's Impact on Global Health Equity, with Dr Rachel Hall-Clifford, PhD
Dr Rachel Hall-Clifford is a medical anthropologist and a global health expert who has done extensive field work to improve systemic health inequities around the world. When she developed Long Covid after an infection in 2022, those systemic failures became a personal issue. Dr Hall-Clifford wrote a powerful article on her experience with Long Covid and the role wealthy countries play in the global treatment of this disease. In our conversation, she speaks about her personal struggles and the universal need for Long Covid treatment.
Rachel Hall-Clifford (PhD, MPH, MSc) is Associate Professor in the Center for the Study of Human Health and the Department of Sociology at Emory University. She is a medical anthropologist who applies social science approaches to global health research and implementation. Her research areas include accessible health care for marginalized populations, health systems strengthening in post-genocide contexts, and global health fieldwork ethics. She is author of the new book, Underbelly, focusing on the multivalent power asymmetries in global health. Rachel is also Co-Founder of safe+natal, a perinatal monitoring and care toolkit developed with Guatemalan midwives. Global health was brought home in a new way for Rachel since the covid infection that led to long covid in 2022.
Subscribe for more at LongCovidMD.substack.com, and follow Dr Khan on X @doctor_zeest
In this episode of The Medicine Cabinet series, I explain how Metformin, a drug we often associate with diabetes, helps acute covid and may help Long Covid.
Metformin is an old, relatively inexpensive medication that has many established off-label uses. I explain its mechanisms of action, who it might be right for, and I discuss the recently published COVID OUT research findings that supported metformin's use in acute infection. It reduces hospitalizations, death, and the development of Long Covid.
What does that mean for those of us who already have Long Covid? I share my opinions.
Research Links COVID OUT metformin dose used: 500mg on Day 1, 500mg twice daily on Days 2-5 and 500mg in the AM and 1,000mg in the PM on Days 6-14
In all the years I practiced medicine, I didn't know much about fatigue-related conditions. While I was in the dark, researchers like Todd Davenport, Department Chair of Physical Therapy at the University of the Pacific, shed light on how fatigue affects patients with disease and even those who are healthy. In our interview, Todd shares how he and other physical therapists approach fatigue, how he saw Long Covid coming, and how to find a physical therapist who is right for you.
Follow me on X @doctor_zeest
Find Todd on X @sunsopeningband
Todd E. Davenport, PT, DPT, PhD, MPH TODD DAVENPORT is Professor and Chair in the Department of Physical Therapy at University of the Pacific in Stockton, California. He earned his bachelor’s degrees in psychology and exercise science (sports medicine) from Willamette University in Salem, Oregon, Doctor of Physical Therapy degree from the University of Southern California in Los Angeles, California, Master of Public Health degree from the University of California at Berkeley, California, and Doctor of Philosophy in Health, Exercise, and Sport Sciences from the University of Portsmouth in the United Kingdom. Dr. Davenport is a scientific advisor to the Workwell Foundation and Chair of Long Covid Physio.
Subscribe for more at LongCovidMD.substack.com, and follow Dr Khan on X @doctor_zeest
The incomparable science journalist David Tuller (https://crowdfund.berkeley.edu/project/42302) shares how he dissects and reports on medical research. He made a name for himself contesting the methods used in the PACE trial, a study that claimed to support the use of cognitive behavioral therapy (CBT) and exercise as a treatment for ME/CFS, but has now been debunked. He sees similarities between the approach to ME and now Long Covid. I ask David about the legacy of the PACE trial today, and how we can we trust what we read in scientific journals.
David is an independent science journalist and holds a fellowship at UC Berkeley Center for Global Public Health. His position is entirely funded by donations from the public. Consider supporting his work here: https://crowdfund.berkeley.edu/project/42302
Subscribe for more at LongCovidMD.substack.com, and follow Dr Khan on X @doctor_zeest
#14 The Medicine Cabinet: Paxlovid and Molnupiravir
Welcome to The Medicine Cabinet, a series of episodes where I pull out a pill bottle and explain why it might be used in Long Covid.
Today we're covering the Paxlovid and Molnupiravir, the two antivirals currently FDA approved to treat acute covid infections, and sometimes Long Covid. They are very different drugs, with very different side effect profiles...and they're not for everyone. Learn the basics on the very first episode of the The Medicine Cabinet.
What's in your medicine cabinet? What drug or supplement do you want to learn more about? Email me at LongCovidMD@gmail.com
*The contents of this podcast are for educational purposes only and do not constitute medical advice. Talk to your medical professional before starting any new treatment.*
Season 2 is here! It's also episode #13 so for something spooky, let's talk about getting reinfected with the virus that changed your life forever. Today I discuss how my recent reinfection felt, how reinfection affected my Long Covid symptoms, and how I responded. I'll share how antivirals work, who they work best for, and who shouldn't take them. We'll also peruse the existing literature on reinfection and Long Covid.
How did reinfection affect you? Email me at LongCovidMD@gmail.com
In the final episode of Season 1 I discuss my favorite subject, anesthesiology. I explain how anesthesia works, whether it's an injection at the dentist or general anesthesia for major surgery, and discuss how your experience with anesthesia might change now that you have Long Covid.
Expect a break in episodes while I prepare Season 2. It's going to be bigger, bolder and even more informative. Follow me on X to stay updated.
Links My article about Long Covid for the California Society of Anesthesiologists https://csahq.org/2022/06/13/experiencing-long-covid-as-a-physician-and-a-patient/
Subscribe for more at LongCovidMD.substack.com, and follow Dr Khan on X @doctor_zeest
We doctors are an odd bunch, I will admit, but the medical system is even more odd. It's complicated, it's constricting, and the business of medicine infiltrates the patient-physician relationship. Most doctors are as unhappy about this as you are. Today I explain the constraints doctors work within that directly affect your experience as a patient, and how to work within these constraints to make the most out of your doctor visits.
Links: Why Doctor Visits Are So Short https://www.kevinmd.com/2014/05/10-minutes-doctor.html
Changes in Patient Outcomes Associated With Private Equity Acquisition https://jamanetwork.com/journals/jama/article-abstract/2813379
Some significant news hit the press this week, with significant backlash. Today I explain the news, the backlash, and how I stay up to date on Long Covid without getting swept up in the response. Emotions are important and require energy, so I share my step-by-step approach to processing heavy events without damaging my recovery.
What do you think? Email comments to LongCovidMD@gmail.com
Links
Deep Phenotyping of Post-Infectious Myalgic Encephalomyelitis https://www.nature.com/articles/s41467-024-45107-3
David Tuller, Virology Blog, Interview with Neuroscientist Michael VanElzakker https://virology.ws/2024/02/28/trial-by-error-an-interview-with-neuroscientist-michael-vanelzakker-about-the-just-published-and-long-awaited-nih-study/
Congressional support for Long Covid research influences all of us, but can be hard to understand. I researched so you don't have to, and in this episode I tell you what I've learned.
On January 18, 2024 the US Senate HELP Committee held a hearing "Addressing Long Covid: Advancing Research and Improving Patient Care." I'll explain the who/what/where and why and explain what Long Covid research funding exists today.
Welcome 2024! This is NOT another new years resolution list. Instead, I discuss the priorities I set for myself to support my recovery and make the most of my resources. Some of them require action around the new year, some of them require reflection throughout the year. On this episode, I share 5 of the things I am doing around the New Year to protect my health and continue my recovery from Long Covid.
I want to hear from you! Email me at LongCovidMD@gmail.com
Find me on X @doctor_zeest
Subscribe for more at LongCovidMD.substack.com, and follow Dr Khan on X @doctor_zeest
This podcast, like Long Covid, has a global reach. Whether we see one another or not, we are part of a new community. And this community, while struggling, is pretty amazing. Today I highlight the diverse location of listeners, to remind you that you are not alone in your struggle. Did I give your town a shout-out? Did I miss it?
Subscribe for more at LongCovidMD.substack.com, and follow Dr Khan on X @doctor_zeest
#6: The Latest Long Covid Science - Summary of UCSF Grand Rounds with Ziad al-Aly, Michael Peluso and Akiko Iwasaki
It's easy to feel out of touch with Long Covid science. Recently, three of the most prestigious Long Covid researchers updated a group of prestigious physicians on this very topic. Lucky for us the meeting was recorded and shared. Lucky for you, I've summarized it and translated the medical jargon.
In this episode I summarize the words of Drs Ziad al-Aly, Michael Peluso and Akiko Iwasaki, as they presented their research to a group of physicians at UCSF. The meeting, Internal Medicine Grand Rounds was held on December 14, 2023 and was moderated by department Chair Dr Bob Wachter. The scientists each discuss their groundbreaking Long Covid findings, their current research studies, and their predictions for the future. I did my best to present their work in a way that is accurate and accessible to everyone.
Email me at LongCovidMD@gmail.com
Watch the original meeting on YouTube at: https://www.youtube.com/watch?v=rMt6ZV-hHSE
Subscribe for more at LongCovidMD.substack.com, and follow Dr Khan on X @doctor_zeest
I got sick, on top of being sick. So today we take a side journey to discuss what it takes to bounce back from a crash, and how I deal with the uncertainty of life with Long Covid.
What do you think about when you're sick in bed? Today I'll tell you what I think about, and it's not always fun. I discuss motherhood, how the ghosts of my patients live with me, and how my friends are literally a part of my recovery plan. Grab a cup of tea and get in your feelings with me. I've never gotten so personal.
Email me at LongCovidMD@gmail.com Twitter.com/doctor_zeest
Subscribe for more at LongCovidMD.substack.com, and follow Dr Khan on X @doctor_zeest
#4: Building a Medical Dream Team Part 1: How to Read a Hospital Badge
Today's episode kicks off a series that will help you become an discerning patient. How much do you know about the health professionals taking care of you? Do you really understand the training of different hospital staff? On today's episode, I teach you how to read a hospital badge. I explain the difference between MD and DO, tell you if an APRN is the same thing as a nurse practitioner, and describe what an MA does. I'll also share which health care professionals you probably need but don't know about. Listen to find out!
Email me at LongCovidMD@gmail.com Find me on X @Doctor_Zeest
Disclaimer: While the host is a licensed physician, listening to this podcast does not establish a patient-physician relationship. The contents are the host's opinions and do not constitute medical advice.
Subscribe for more at LongCovidMD.substack.com, and follow Dr Khan on X @doctor_zeest
Today's episode I share the lessons I learned during my medical career that have helped my recovery. It includes an exercise you can do to clarify your symptoms and better communicate with your own doctor.
Find me on Twitter/X @doctor_zeest Email me at LongCovidMD@gmail.com
Subscribe for more at LongCovidMD.substack.com, and follow Dr Khan on X @doctor_zeest
Welcome to the first peak into our podcast, "Long Covid, MD"! I'm Zeest Khan, a board-certified physician who has been sidelined with LongCovid. For 10 years I saved the lives of critically ill patients and now I'm determined to save my own. I'm opening up about my journey and want to share the medical insights that guide my recovery. I'm offering practical tools to help you navigate your medical options and maintain some joy in the face of this confounding disease. Let's go!
Subscribe for more at LongCovidMD.substack.com, and follow Dr Khan on X @doctor_zeest
#23: "Where is the Finish Line?" Courtney Baker, Endurance Athlete with Long Covid
What happens when you go from running ultramarathons to having difficulty walking? Endurance runner Courtney Baker knows the answer too well. Courtney is an endurance athlete who has been navigating long COVID for three and a half years. In our conversation, she shares her experience before and after the pandemic, her ultimate diagnosis with long COVID, and the challenges she faces in managing her symptoms. She emphasizes the importance of finding a supportive community of people who understand what she's going through. Courtney also discusses the athlete mindset and how it can be both helpful and detrimental in approaching healing and recovery. She reflects on the importance of asking for help and finding balance while living with long COVID and shares her journey of learning to prioritize self-care and set boundaries. Courtney emphasizes the value of community and the support of loved ones in navigating the challenges of long COVID and encourages listeners to embrace acceptance and find joy in the midst of their struggles.
How has your personal identity been challenged by your Long Covid symptoms? I've spent a lot of time exploring this question and today I'm sharing what answers have come up for me.
Our identity is connected to the titles we hold, and those titles are attached to values and judgements.
I believe we don't have to lose ourselves when we have chronic illness, even if our world looks drastically different.
How are you navigating challenges to your identity? Email me at longcovidmd@gmail.com
Subscribe for more at LongCovidMD.substack.com, and follow Dr Khan on X @doctor_zeest
In this conversation, Dr Zeest Khan discusses the characteristics of pseudoscience accounts on social media that claim to provide reliable information about Long Covid. She provides a checklist to help identify these unreliable sources, including triggering fear and anxiety, using all or none statements, selling products related to their claims, speaking outside their area of expertise, and using dense and complicated language. Zeest emphasizes the importance of verifying credentials and understanding the capacity in which the person is speaking.
Sources: Dr Andrea Love https://immunologic.substack.com/ How To Spot A Con Artist https://www.michigan.gov/reinventretirement/protection/investment-scams/how-to-spot-a-con-artist
Keywords
long COVID, pseudoscience, social media, reliable sources, checklist, fear and anxiety, all or none statements, selling products, expertise, credentials, complicated language
Subscribe for more at LongCovidMD.substack.com, and follow Dr Khan on X @doctor_zeest
#20: How Do You Love Yourself Through Your Limitations?
I want to be back to my baseline immediately, and I'm getting impatient. But the impatience itself is draining me. How do you show yourself grace? How do you love yourself through your limitations?
Send me your advice. Tell me what keeps you going. Email me at LongCovidMD@gmail.com
Subscribe for more at LongCovidMD.substack.com, and follow Dr Khan on X @doctor_zeest
Check out the new website LongCovidMD.com Email me at LongCovidMD@gmail.com
On this installment of The Medicine Cabinet series, I tackle the use of Low-Dose Naltrexone (LDN) to treat Long Covid symptoms. Naltrexone is a fascinating drug that works one way at high doses and another way at low doses. In low doses, it can be a potent anti-inflammatory, and it may help reverse autoimmune conditions. There's a lot more to it. I explain how LDN works, who should consider it, and obstacles to access. I also share practical tips to dosing that will help you avoid, or at least understand, side effects.
How do we find community when we're energy-limited? Long Covid Moonshot member Ezra Spier helps me answer this question. Ezra is an Oakland, California-based patient researcher, person with Long Covid, and creator of the website Long Covid Studies . He is a member of Long Covid Moonshot and the Patient-Led Research Collaborative. Outside of Long Covid advocacy, Ezra is an independent operations and technology consultant who helps organizations thrive through periods of growth.
We talk about advocacy, leveraging our strengths, and birds!
Links: Longcovidstudies.net Longcovidmoonshot.com The Spoonbill Club https://buttondown.email/edyong209/archive/the-eds-up-birding-for-long-haulers/
Find Ezra Spier https://x.com/ahhrrr
Subscribe for more at LongCovidMD.substack.com, and follow Dr Khan on X @doctor_zeest
#17 "Not All Storms Come To Disrupt Your Life" - KatherineMarie
Today I share an update on my health (all good things) and what I do to recover when I push myself too much, overdo it, and have post-exertional malaise.
Subscribe for more at LongCovidMD.substack.com, and follow Dr Khan on X @doctor_zeest
#28: Occupational Therapy for Long COVID, with Amy Mooney MS OTR/L
Occupational therapist Amy Mooney focuses her practice on people with fatiguing diseases like ME/CFS and Long COVID. She joins me to discuss how occupational therapy can be a valuable addition to your recovery program. Finding ways to engage in our lives, to do the things we want to do, is at the heart of occupational therapy.
Amy shares how she has modified her practice to empower people with fatigue, and suggests ways you can engage with an occupational therapist near you.
Amy Mooney OT4ME.com Amy is a private practice occupational therapist specializing in therapeutic care for individuals with chronic conditions involving Post-Exertional Malaise (PEM) and Post-Exertion Symptom Exacerbation (PESE). With over 25 years of OT experience, her telehealth practice focuses on conditions like Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), Long COVID, and related co-morbid conditions such as dysautonomia, Ehlers-Danlos syndrome, Mast Cell Activation Syndrome, and Fibromyalgia. Amy's “Pacing for PEM” guidelines and therapeutic strategies have been featured in national and international conferences, continuing education programs for medical professionals, and paƟent advocacy webinars. Drawing on her extensive background in diverse seƫtings, including schools, home health, and clinics, Amy brings a comprehensive understanding of paƟent needs to her practice. As a caregiver to a loved one with ME/CFS, she has a deep, personal understanding of the challenges faced by individuals and families in seeking appropriate care. Her approach is rooted in compassion, focusing on symptom management, pacing strategies, and adaptive interventions to enhance the quality of life for her clients. Amy has a bachelor’s degree from Loyola University Chicago, a master’s degree in occupational therapy from Rush University Chicago and is a returned Peace Corp volunteer. Amy calls Chicago home.
Bateman-Horne Center https://batemanhornecenter.org/
Amy on YouTube with SolveME https://www.youtube.com/watch?v=w5Yt0BdeeN8
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Today I'm answering questions from listeners and online friends. We discuss: -How to find a Long COVID doctor -Best(?) meds to use during a COVID infection -Pediatric LongCOVID -Dental work and anesthesia
Leave me a voice note here: https://www.speakpipe.com/msg/s/371091/1/5ftvm7bekf0v0vrj
Support the show here: https://www.amazon.com/hz/wishlist/ls/5EAAQUNVKP3K?ref_=wl_share
In this conversation, Dr Zeest Khan and Visible founder Harry Leeming discuss the innovative use of biometric tracking in managing long COVID and other chronic illnesses. They explore the significance of heart rate variability (HRV), the role of wearable technology, and the importance of pacing in symptom management. The discussion also highlights the impact of the menstrual cycle on health and the resources available through Visible, a company dedicated to improving health outcomes for those with chronic conditions.
MakeVisible.com
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"Why I'm Not Panicking" Substack Long COVID Rundown, November 2024
The United States government is in transition, and the new administration may make dramatic changes that will impact people with Long COVID, among others. In this reading of my November essay for the Long Covid MD Substack, I explain why, because I am concerned, I am not panicking.
Read, subscribe and share: https://longcovidmd.substack.com/p/why-im-not-panicking?r=478j9x
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#33: Long COVID, Grief, and Post-Traumatic Growth - A Conversation with Mental Health Counselor Paige Zuckerman
In this conversation, Dr. Zeest Khan and certified clinical mental health counselor Paige Zuckerman discuss the critical role of therapy for those dealing with chronic illness and Long COVID. They explore the stigma surrounding mental health, the importance of understanding grief and fear in the context of medical loss, and the potential for post-traumatic growth. The discussion also covers the renegotiation of relationships and boundaries, the significance of finding the right therapist, and the concept of allostatic load in managing chronic illness. Ultimately, they emphasize the value of community and support groups in navigating these challenges.
Record a voicemail: https://www.speakpipe.com/LongCovidMD
How is the United States using federal funds to find a cure to Long COVID? Today, with the help of prominent guests, I reflect on the recent RECOVER-TLC workshop, which will influence the direction of Long COVID in the United States. The workshop was hosted by the National Institute of Allergy and Infectious Disease, and included presentations by scientists, clinicians, patients and advocates. It's a really big deal, but don't worry if you missed it. I'm here to catch you up on the major highlights and take-aways.
Thank you to: Jon Douglas https://jondouglas.dev/longhaul Jermaine Greaves https://www.instagram.com/jermainegreaves/ Todd Davenport, PhD https://www.pacific.edu/campus-directory/todd-davenport Alba Azola, MD https://profiles.hopkinsmedicine.org/provider/alba-azola/2707119
Lindsey Port, who lives with severe Long COVID, represents District 55 in the Minnesota State Senate. How does she do it and to what extent can state governments impact the lives of people with chronic illness? In our conversation, Senator Port shares why she insists on disability accommodations, why it was important for her to share her Long COVID story, and why she encourages YOU to share yours.
Senator Port believes that while there are valid reasons for concern as the government undergoes a transition, there are concrete reasons to remain hopeful.
Happy 2025! In this special New Year’s episode of Long COVID MD, Dr. Zeest Khan reflects on an invaluable piece of wisdom from Mr. Rogers: “Look for the helpers.”
Navigating Long COVID is anything but straightforward, but this timeless advice serves as a guiding principle. Dr. Khan breaks it down into three actionable steps to help you identify the assistance you need, avoid detractors, and—perhaps the hardest part—learn to receive help with grace.
Don’t Sleep on Your Power: Senator Lindsey Port on Long COVID Advocacy
Building Solutions with the Long COVID Moonshot Initiative
Follow and Support: Subscribe to stay updated on new episodes and bonus content. Let us know your thoughts, questions, and New Year’s resolutions by emailing us or commenting on Substack!
Subscribe for more at LongCovidMD.substack.com, and follow Dr Khan on X @doctor_zeest
#35: The Autonomic Nervous System in Long COVID, with Dr Alba Azola, MD
In this conversation, Dr. Khan discusses the impact of the autonomic nervous system in Long COVID, with Dr. Alba Azola, Assistant Professor of Physical Medicine and Rehabilitation at Johns Hopkins University. Dr Azola explains the complexities of autonomic dysfunction, particularly focusing on dysautonomia and POTS, and how these conditions affect patients' daily lives. The discussion highlights the importance of a patient-centered approach in rehabilitation and the need for a multidisciplinary team to address the various symptoms and challenges faced by long COVID patients. In this conversation, Drs Azola and Khan delve into the complexities of dysautonomia, particularly in the context of long COVID and mast cell activation syndrome. They discuss the importance of understanding autonomic dysfunction, the role of mast cells in various symptoms, and the need for a collaborative healthcare approach. The conversation emphasizes non-pharmacologic interventions, the significance of tailored exercise programs, and the various medications available to manage symptoms. Ultimately, they highlight the importance of patient empowerment and finding healthcare providers who are willing to listen and collaborate.
Assistant Professor, Departments of Rehabilitation and Physical Medicine and Pediatrics, Johns Hopkins Medical Center. Director of the Long COVID Chronic Fatigue Syndrome Clinic and Co-director of the JH-UTSW Brain Health Program. She is a co-investigator in several NIH, PCORI, and CDC-sponsored studies on Long COVID. As part of the AAPMR PASC collaborative, she has co-authored several guidance statements on managing Long COVID symptoms, including fatigue, dysautonomia, and cardiovascular complications.
Audio engineering by True Media Solutions https://truemediasolutions.ca/
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#39: January Rundown - Improving Executive Function with Speech and Language Pathology
In this episode of Long Covid, MD, Dr. Zeest Khan shares personal updates from January, highlighting recent projects to educate other medical professionals on long COVID. She explains some of the ways long COVID impacts executive function and how she utilizes Speech and Language Pathology to improve cognition. She also reflects on the impact of social media on mental health and the need for community support among those affected by chronic illness.
In this episode of Long COVID, MD, Dr. Zeest Khan shares highlights from her recent Project ECHO webinar, sponsored by the University of Utah and the Bateman Horne Center. Drawing from her personal journey and clinical expertise, she introduces actionable strategies to manage the complex and often overwhelming nature of Long COVID.
In this conversation, Stanford psychologist and behavioral sleep specialist Dr. Hylton Molzof joins Dr Khan to discuss the complexities of sleep. They focus particularly on insomnia in chronic illness, and the role of Cognitive Behavioral Therapy for Insomnia (CBTI). They discuss the physiological stages of sleep, the impact of chronic illness on sleep patterns, and practical strategies for managing sleep-related anxiety. Dr. Molzof emphasizes the importance of adapting CBTI techniques for individuals with chronic conditions, especially in the context of long COVID. The conversation also covers the significance of sleep evaluation and the nuances of sleep restriction as a treatment method.
Find printable worksheets and resources Dr Molzof has shared at https://substack.com/home/post/p-154561158?source=queue&autoPlay=false
Subscribe for more at LongCovidMD.substack.com, and follow Dr Khan on X @doctor_zeest