Harriet Carroll: Long Covid Scientific Consultancy

@angryhacademic

#LongCovid Scientific Consultant PhD Nutrition & Metabolism Hon Research Fellow, Lund Uni Posts: nutrition ▪ health ▪ all-things-science ▪ activism ▪ fun facts ▪ #PostVac Donations: Facebook:

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Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· 27d

As you can see in the graph, the neat little story above does not pan out: AVP increases quite dramatically by 90 minutes without much change in osmolality In fact, AVP & osmolality predictably correlated well (r = 0.94) but only until the 90 minute mark (after which r = 0.71)

Graph showing vasopressin and osmolality responses over time. At 60 minutes neither vasopressin nor osmolality have really changed. at 90 minutes vasopressin is significantly increased, but osmolality has not really changed. at 120 minutes vasopressin is a bit higher than at 90 minutes and osmolality has also increased

With the caption:

F ig u r e 2 . Time course of plasma osmolality (close
circles) and plasma AVP concentration (open circles)
after administration of the salt load. Note that no difference was observed in plasma osmolality 90 min
after the salt load, whereas plasma AVP increased
significantly from the initial value. Each point represents the mean ± standard error of the mean for six
subjects. *p < 0.01 and **p < 0.001

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· 29d

Fun fact: we secrete some cholesterol through our skin, and in some cases (e.g. if blood levels get too high) the fatty deposits can be visible 👇🏻 pubmed.ncbi.nlm.nih.gov/4430879/ www.ncbi.nlm.nih.gov/books/NBK562... www.sciencedirect.com/science/arti... www.sciencealert.com/mans-carnivo...

A Caucasian hand with yellow-y orange deposits along the creases such as in the joint folds

Image: https://jamanetwork.com/journals/jamacardiology/article-abstract/2828915

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jul 11

Reminder to medical professionals to consider whether a patient is actually difficult or whether they are distressed & desperate for help A sort of Hanlon's razor for medicine, if you will: Never attribute to malice that which is adequately explained by unmet medical needs

Drake meme:
Top panel, Drake looking away mildly horrified with caption reading: difficult patient

Bottom panel, drake smiling approvingly with caption reading: desperate patient

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jul 11

Five years of heartsink patients in general practice (1988) www.bmj.com/content/bmj/... "While heartsink patients often have serious medical problems, they are a disparate group of individuals whose only common thread seems to be the distress they cause their doctor and the practice"

There are patients in every practice who give the doctor and staff a feeling of "heartsink" every time they consult. They evoke an overwhelming mixture of exasperation, defeat, and sometimes plain dislike that causes the heart to sink when they consult. Ellis, a general practitioner, coined the phrase "dysphoria" to define "the feelings felt in the pit of your stomach when their names are seen on the morning's appointment list."' Groves, a psychiatrist, used the term "hateful patient" and defined four stereotypes: dependent clingers, entitled demanders, manipulative help rejectors, and self destructive deniers.'

The problem-It became apparent to me in my first year in the practice that there was a group of patients who were causing stress to the practice. These patients seemed to be dissatisfied with the services provided, placed many demands on the practice, and were often frequent attenders with seemingly endless complaints. This group of patients caused a feeling of "heartsink" in staff in the practice which was often borne with resignation but occasionally led to pejorative remarks being made. With the help of my partner and the receptionist I compiled a list of such patients or families. I reviewed their case notes and summarised each family's reasons for consulting and outlined their present management.

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jul 9

I was asked to be a guest editor (again). And I think academics need to start normalising responses like mine 👇 We live under capitalism, which means money is exchanged for goods and services. I don't know why so many academics are content (keen, even) to be exploited

Screenshot of an email reading:
Dear Dr [retracted],

Thank you for this invitation. Please correct me if I am wrong, but I am assuming - in line with usual exploitative academic practices - this is an unpaid role despite Frontiers bringing in estimated revenues of over $300 million.

As I value my labour at > $0 I will unfortunately have to turn down this opportunity. If my landlord, supermarkets, and energy companies change their policy to accept "experience" and "opportunity" as payment, I will gladly get back in touch to discuss. Alternatively, if you value my labour, experience, and time, my hourly rate is (very reasonably) GBP75/hour.

Kind regards,
Harriet

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jul 8

So far nothing unexpected! But then they measured things I rarely see in the modern hydration literature... NEUROTRANSMITTERS: Urine excretion: ⚡️ Dopamine and noradrenaline increased 🥵 Adrenaline decreased

Graph showing urinary excretion of noradrenaline, dopamine and adrenaline.
NOR and DOP both increased during dry fasting, and then decreased to baseline levels once the dry fast was broken. ADR decreased during dry fasting then returned to baseline once the fast was broken.

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jul 8

I agree with Tara's experience that the team are very lovely face to face, & they did expedite my appointment which was appreciated. But this same team ignored my emails telling them I'd been haemorrhaging, and keep telling me now that post-hysterectomy bleeding is normal

“Dr. Saraswat and specialist nurse Lorna are clinicians who listen even when time is against them. As a patient, they restored my confidence, gave me hope and showed me what truly compassionate, patient-centred medicine looks like,” Tara added.

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jul 8

This is the consultant who left me to rot for ~7 months, virtually unable to work & refused monitoring against NICE guidelines until my endometrioma ruptured requiring surgery and a blood transfusion: dontbelievehype.co.uk/life-of-a-sc...

Consultant gynaecologist Lucky Saraswat has led the introduction of ‘My Endo, My Way’ events to help broaden access to support for those concerned about endometriosis, as well as launching a helpline to provide ongoing support to those in her care living with the condition. She explained: “Everybody's experience of endometriosis is different and there are lots of myths out there about the condition so it’s important services help to dispel those myths and offer a personalised approach. Events have been really popular so far and clinicians who have attended have also given us feedback about how helpful these are.”

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jul 7

Fibroids are non-cancerous tumours that can cause all kinds of shit fuckery: cks.nice.org.uk/topics/fibro... 80 % of women are growing tumours and no one seems to give a shit 🙃

SpongeBob with his hands spread apart and a rainbow connecting them, with the caption reading "medical misogyny yay"

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jul 7

Let alone the frank injustice of "treating" a neuroimmune vascular disease with something that has little long term data, and potential risks

Basically I'm salty for several, sometimes conflicting, reasons:

There are no long term data for the safety or efficacy of high salt intake in POTS, despite several known or potential risks in the both the general and other populations
These risks are rarely, if ever, discussed with patients, i.e. lack of informed consent
Proper testing is rarely done to inform treatment protocols
Salt is uncritically thrown at POTS patients, even by non-specialists
When POTSies are put on salt, proper monitoring is rarely done (e.g. even the basics of regular electrolyte and blood pressure checks, or autonomic testing to see if it is actually helping)
Equally, other GPs withhold salt tablet prescriptions as if they are some deathly highly restricted poison (those same GPs often seem more than happy to hand out opioids and antidepressants like candy)
In the face of a vascular neuroimmune disorder, one of our most popular treatment suggestions is "salt" 🫠 LOL

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jul 6

Fun fact: emperor penguins seem to practice keeping their egg safely balanced on their feet and tucking it into their brood pouch...using a snowball ⛄😻 www.bbcearth.com/news/penguin... www.naturepl.com/pictures/PDF... Watch: youtu.be/q7qECra-c_Q?...

Two emperor penguins. One has a snowball rested on its feet, both are looking down lovingly at the snowball

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jul 2

Fun fact: you can apparently sex turkeys 🦃 according to the shape of their poop 💩: females ♀️ are more curly 🍦 whereas males ♂️ are longer, sometimes a bit J shaped 🌶️ www.jstor.org/stable/3797445 www.discovermagazine.com/turd-tales-d...

Black and white image of 9 poops. 5 are small curly blobs, and 2 are long and 2 are J shaped. The figure caption reads:

FIG. 1. The five droppings left of center are those
of female turkeys; the remaining four are male.

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jun 30

Fun fact: some ants "farm" plant seeds to eat, whilst others plant seeds in nest material in trees to provide structural stability for their nest, known as an ant garden 👇🏻 www.pnas.org/doi/10.1073/... www.asian-myrmecology.org/doi/10.20362... www.tandfonline.com/doi/abs/10.1...

An ant garden attached to a tree branch. It looks like a splotch of dried mud

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jun 29

How it far too often feels like doctors make medical decisions 👇🏻

A white male doctor asking a white female doctor: what differentials have you ruled out?

The female doctor replies: Too thin; too fat; history of depression, anxiety, or drug abuse; female/AFAB, or menopause; Black; colourful dyed hair; piercings; tattoos; wearing jogging bottoms; sounds lower class; sounds too educated. What have I missed? I'm worried I will actually have to run tests

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jun 24

Write your name with images from space science.nasa.gov/specials/you...

Dr smash with each letter written using an image from space that kind of looks like the letter

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jun 23

Struggling with the heat? Get Dr Smash's Dysautonomia while stocks last! 🙃🫠

Struggling with the heat? Introducing...

DR SMASH'S DYSAUTONOMIA!

...plunging your body towards hypothermia regardless of the temperature!

Image of a thermometer reading 35.4 °C (95.72 °F)

Buy now for the low low cost of life ruining chronic illness!

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jun 23

According to NASA, a shave lasts longer if done within an hour or waking 😆 ntrs.nasa.gov/api/citation...

Whether this shift of fluid produces an increase in intravascular
volume or not depends upon how rapidly fluid is regained from some
areas and lost to others. It is at least theoretically possible that
fluid is lost more rapidly than it is gained, with a reduction of
intravascular volume. I do not think this happens and expect there
may be a very slight expansion of intravascular volume which, coupled
with the blood from leg veins, may result in a small fluid loss via
the Gauer-Henry scheme (increased atrial pressure and diuresis), or
some other mechanism. However, remember that tissue fluid shifts
occur under one-g without undue diuresis.
morning and eys are puffy, and a shave lasts longer if made an hour
or so after arising.
Legs are smaller in the the morning and eyes are puffy, and a shave lasts longer if made an hour or so after arising

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jun 22

Fun fact: when spotted skunks feel threatened, before they spray, they aggressively stomp around doing a little handstand 🦨🤸🏻‍♀️ dwr.virginia.gov/blog/underst... news.okstate.edu/magazines/ag... Watch them on this (rather strange) BBC clip: youtu.be/WTQc-WEb5h8?...

A spotted skunk - which is a black skunk with shit spots across its body, a black tail with white feathery bushy hairs coming off it, standing on its two front paws with its back legs in the air

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jun 21

Whenever i hear about the Buy, Borrow, Die strategy of how billionaires can have little cash but massive loans to fund their lifestyle, this is what i think of:

A black stickman talking to a blue stickman. The black on says: hi, id like to take out a loan please. The blue one says: hmm it seems here your income is very low

The black stickman has a pile of rocks next to it and says: oh dont worry about that. I have these rocks. LOADS of rocks, in fact.
Blue stickman replies: im not sure how this is relevant. We cant spend rocks

Black stickman says: yes but my friends—who also have loads of rocks—GUARANTEE they will pay EXCELLENT money for these particular rocks. Blue stickman says: oh! Well why didnt you sat so! Heres an outrageously large loan with low interest rates, enjoy!

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jun 19

Delighted to have recently helped Aisling get some direction on possible causes of her ongoing symptoms that she can explore with her medical team. If you want to discuss long COVID, post-vaccine syndrome, or sister diseases, you can book here: lc-sc.co.uk/book-an-appo...

5 star review reading:
The best appointment I have paid for in my Long Covid journey (6+ years).

I cannot recommend Harriet’s information and guidance highly enough. So informative; and accessible to a non-scientist like me. Her session has given me avenues to explore regarding conditions/treatments that I wasn’t aware of and/or had the confidence to know how to explore with medics before now. Her report was detailed, evidence-based (with citations) and very helpful for understanding what next steps to take. Highly recommended!

~Aisling

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jun 16

Kevin Deans elected as LabMed President Elect labmed.org.uk/our-resource... Super excited that @deanskevin.bsky.social has been elected president-to-be at LabMed. He promises better patient involvement 👇🏻 and, for a change, i don't think this is an empty promise

On his election, Kevin said:

"I approach this role with a deep awareness of the responsibility that will fall on me to continue the work of those who have gone before me. I share the Association's values of innovation, inclusivity and environmental sustainability, and I am passionate about increasing patient and public involvement in healthcare - an area I would like to see LabMed develop further.

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jun 15

Doctors sometimes refuse tests claiming it fuels patient anxiety. But what if ambiguous results with symptoms they can't piece together actually fuels their own anxiety 🤔 I hereby term this Diagnostic Anxiety Transference Syndrome. Treatment is CBT, exercise, & weight loss 🤪

Jim from the office meme. Top panel shows him pointing at a white board reading: the doctor didn't run tests because it will fuel YOUR anxiety, or...

Bottom panel shows Jim looking smug with the whiteboard reading: the doctor didn't run tests becUse not understanding the results will fuel THEIR anxiety

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jun 10

Vitamin C Function in the Brain: Vital Role of the Ascorbate Transporter pmc.ncbi.nlm.nih.gov/articles/PMC... Another overview on neurolo health, including how it is preferentially preserved in nerves during deficiency. I particularly liked this picture showing how it is distributed 👇🏻

Schematic showing various organs/tissues and their vitamin C content:
Plasma: 40-60 uM
Red blood cells: 40-60 uM
Muscle: 0.4 mM
Adrenal: 4-10 mM
Liver: 0.8-1 mM
Cerebrospinal fluid: 200-400 uM
Brain: 2-10 mM

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jun 9

CBT that pain away 🔥

A doctor talking to a patient who is on fire, saying "remember that pain is just in the brain"

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jun 9

I've lived in Aberdeen for 7 years now and every year i re-fall in love with the spring and summer sky at night. 3am here 👇🏻😻

A block of flats with the sky behind them - starting a red-orange, then fading into yellow and pale sky blue. Stunning!

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jun 8

It was an absolute pleasure working with Lesley and I'm delighted she found the service so helpful!

5 star review reading:
Harriet's expertise and depth of knowledge are impressive, as is her dedication to helping clients disentangle complex health conditions.

Her written report was a real gem—thorough, grounded in the latest research, with evidence-based information on testing and treatment options. It gave me a clear pathway to pursue with my doctors, as well as practical strategies for self-management.

An excellent service that I would highly recommend!

~Lesley

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jun 6

Fun fact: some fish like the hatchetfish 👇🏻 produce blue light on their belly to match light coming in above. This—alongside their silvery skin—helps them camouflage from predators below pubmed.ncbi.nlm.nih.gov/33726451/ pmc.ncbi.nlm.nih.gov/articles/PMC... www.montereybayaquarium.org/animals-the-...

A hatchetfish in a humans hand. Its about a quarter the size of the palm, is very flat, with dark iridescent silver-y metallic looking skin with transaprent fins. Its body is quite round and its tail is much thinner.

Image: https://en.wikipedia.org/wiki/Marine_hatchetfish

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jun 3

Fun fact: HD 189733b is an exoplanet ~63 lightyears away. It: 🔵 Is blue! 💦 Has water (vapour) 💫 Orbits it's sun in 2.2 days 🌡️ Is > 1000 °C 🌧️ Rains glass...sideways 🌬️ Due to winds reaching > 4500 mph www.nasa.gov/image-articl... science.nasa.gov/missions/hub... www.esa.int/Science_Expl...

Artist interpretation of the exoplanet HD 189733b. The planet is a royal blue marbled with white

Image: https://esahubble.org/images/heic1312a/

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· Jun 2

Fun fact: melanin - the pigment that makes skin dark - helps protect against ionising radiation (as well as UV radiation). Because of this, typically green frogs around chernobyl seem to have rapidly evolved to be darker onlinelibrary.wiley.com/doi/full/10.... theconversation.com/chernobyl-bl...

5 frogs in a line, viewed from a birdseye view. On the left is a black frog, and on the right is a bright green frog. The three frogs in between are shades of gradually darker green.

Harriet Carroll: Long Covid Scientific Consultancy@angryhacademic· May 28

In the blog below, I hypothesised that low RAAS (e.g. renin, aldosterone) could drive low vasopressin 👇 I've just found this paper from 1970 showing renin and aldosterone infusion can stimulate vasopressin production! (in dogs, anyway) journals.physiology.org/doi/abs/10.1...