Chronic News Bites: February

Finding the online health and chronic illness news you need is like looking for a needle in a haystack. You don’t have time (or energy) for that, so leave it to us! Every month, our RA columnist Lene Andersen combs through stacks of research, articles, and community conversations to find the information that’s relevant to you. Settle in with your beverage of choice and enjoy the February snack-sized collection of Chronic News Bites, along with Lene’s take on each of the items.

In recent years, fears of opioid overdose have put a choke hold on new prescriptions for people living with chronic pain who have a legitimate need for these drugs. People in this group (including me) are concerned about the lack of effective replacements for opioid medications that previously helped so many with chronic pain live their lives. We’ve wished for a way to identify who can take these medications safely and who may be at risk for addiction. At the end of last year, the U.S. Food and Drug Administration (FDA) approved a new tool that aims to do just that. The test is called Avert and it uses a person’s DNA to assess the risk of addiction in people with acute pain (for example, post-surgery) who may be issued a limited prescription for opioids for up to 30 days.

I’m relieved to see this kind of progress toward identifying people who are at higher risk of addiction, but I have concerns. The new test is intended to be used only in situations of acute pain, but many worry it will also be used off-label for those living with chronic pain. The Pain News Network, a non-profit news service focused on chronic pain, echoes these concerns about this test being expanded, especially after the experience of restrictive opioid guidelines being applied to individuals with chronic pain, regardless of their condition. Plus, one member of the FDA advisory panel voted against the approval, because of its 80% effectiveness rate, which means there can be false positives or false negatives. In my opinion, this test, while potentially helpful, should not be used as an all-or-nothing tool without clinical assessment and judgement in the case of prescriptions for chronic pain.

We speak jokingly about man colds, that is, the way some men act as if they are deathly ill when they get the sniffles, and by ‘we’ I mean the women who manage a household and take care of their sick family while running a fever. But some research indicates men might truly be more severely impacted when infected with a virus.

When it comes to colds, research is thin. In a recent article, the Mayo Clinic reports that estrogen in women’s bodies slows how quickly a cold virus multiplies, which may mean they experience fewer symptoms than men with the same bug. What’s more is that testosterone could nudge fevers higher in men, but research isn’t conclusive on this topic. Overall, there isn’t a notable difference in the way the female and male immune systems react to viruses, the article says. Some of the perceived differences may actually be cultural. For instance, women are socialized to take care of others and put their own needs last and may therefore persevere, even when sick.

With COVID, men may actually feel sicker. A review of studies showed that being male is a risk factor for a worse outcome of COVID. The paper found that men are more likely to catch the virus, had greater ICU admissions, and overall, have worse outcomes than women. In another study on lab animals, researchers found that the ACE2 protein, which plays an important role in protecting organs from high inflammation is associated with the X chromosome, of which females have two and males only one. When exposed to a SARS-CoV-2 infection (the virus causing COVID), the spike protein that we have seen illustrated so often latches onto the ACE2 protein to enter the cell. In male mice, this caused a significant decrease in the protein, while the level remained unchanged in female mice.

For the flu, women may have it worse. Some studies over the last decade seem to indicate women may have a tougher time with influenza. For instance, the Challenge study indicated that men experienced fewer symptoms of the flu than women, by as much as 16%.

Discovering why one gender responds differently to a virus than the other is more than just fun—it can help us understand viruses better, which may lead to research that will result in more effective treatment for all of us.

Tom Scocca had a thriving career and a loving family—what many consider a normal life, and then he started getting mysterious symptoms that changed everything. In an essay for the magazine Intelligencer, Scocca shared his experience of mysterious symptoms that led to a gradual loss of health. This brilliant and heartbreaking story is one that’s all too common. The strange symptoms, the many visits to doctors and specialists, all of whom pronounce you perfectly healthy, the inevitable exploration of stress as the cause of the unexplained, the internalized gaslighting as you wonder if it is all in your head, the endless pokes and prods in the name of finding answers, and the excruciatingly slow journey through the healthcare system. And then, finally, perhaps answers or… maybe not. Scocca’s account illustrates just how difficult it can be to get a diagnosis and how much of the process is about excluding other conditions.

As someone who lives with fibromyalgia, I know firsthand how difficult it can be to achieve any kind of relief from the heightened pain sensitivity of this condition. My rheumatologist has several times shared her disappointment that whereas she could help me go into remission from RA, she had very little in her toolbox for fibromyalgia. Often, it’s a matter of extended trial and error, playing with different remedies to address the many facets of your experience, including pain while resting and what’s called movement-evoked pain or MEP. Some promising news on this front: Researchers investigating the effect of transcutaneous electric nerve stimulation (TENS) on different types of fibromyalgia pain have discovered that this device can be an effective tool. In the study, those who experience MEP reported a 30% decrease in this kind of pain.

If using TENS can help someone get less pain associated with movement, not only might they be able to move more, and thereby experience fewer functional limitations, but reducing this one type of pain may also help decrease their overall level of pain.

Last month, the U.S. Senate took an important first step toward understanding and targeting research toward treatments for long COVID. A committee hearing entitled Addressing Long COVID: Advancing Research and Improving Patient Care offered an opportunity from those living with long COVID and the medical professionals who treat them to explain the details of this chronic condition. A delegation representing an organization called Moonshot for Long Covid also attended as part of their advocacy for $1 billion annual funding to research this often-debilitating condition.

Testifying before government committees and sharing our personal stories with elected representatives is a type of very personal advocacy that may be far more effective than sending someone a document. As someone who lives with chronic illness, I know how difficult it can be for someone to find the energy and resources to advocate, and I salute the delegates for their work.