A New Level of Fatigue? Get Your Bloods Checked!

 

Image From Google Image Search: IndiaMart

Those of us used to living with Pots and EDS will know that fatigue (sometimes extreme) comes as part and parcel of these conditions. However in the last year and a half to 2 years I had developed a new level of fatigue that had just crippled me! I pretty much needed to sleep most of the day. I got up, had a shower, eat breakfast and by the time 4 hours had passed, my body was crying out for bed again. Every 4 hours or so I would need to sleep at least 2 hours and this continued throughout the day until I went to bed at night, it got so bad that my husband was beginning to miss me as I was always in bed!

I had my meds reviewed, I was on a new diet which had helped my gut related symptoms hugely but nothing I tried would help my fatigue.

I decided to get my bloods checked in July this year and promptly found out that I had anemia. My vitamin B12, Folate and Vitamin D3 were all very low and contributing to my major fatigue and related symptoms.

My doctor put me on a regime of B12 injections, once a week for 5 weeks then once every 3 months there after to maintain my levels. She put me on D3 liquid supplements and also on Folate tablets once a day for the next 6 months or so.

After my 5th injection which is due the next time I go in, they will do more bloods to see how my levels are doing and we can maintain accordingly after that.

What are the symptoms of Vitamin B12 Deficiency?

“Vitamin B12 is needed by all cells of the body in order to allow them to multiply. A shortage of vitamin B12 mainly affects red blood cells, because millions need be made every minute. A lack of red blood cells can lead to anaemia. The common symptoms of anaemia are tiredness, shortness of breath and palpitations.

There is also a type of B12 deficiency anaemia caused by lack of intrinsic factor. This is called pernicious anaemia. A shortage of intrinsic factor means that B12 cannot be absorbed properly. Pernicious anaemia has the same symptoms as anaemia, including tiredness, shortness of breath and fatigue. Other symptoms of anaemia can include:

• soreness of the tongue,
• loss of weight,
• pale skin, often with a lemon tint,
• intermittent diarrhoea,
• menstrual problems, and
• poor resistance to infections.

If the deficiency goes on too long, the nervous system is liable to be affected, causing:

• tingling of the fingers and toes,
• muscle weakness,
• staggering,
• tenderness in the calves, and
• confusion.”
• – HSE.ie/b12deficiency

 

What are the causes of Vitamin B12 Deficiency?

” The immune system normally makes antibodies to attack bacteria and viruses. Pernicious anaemia is caused by an autoimmune disease, which causes the immune system to make antibodies against other parts of your body. In pernicious anaemia, antibodies are formed that attack the stomach lining and damage the cells that produce intrinsic factor. This stops intrinsic factor from attaching to B12, and so the vitamin cannot be absorbed into your body.

Another cause is where the bowel cannot absorb the vitamin B12 because it has been damaged by disease (e.g. Crohn’s disease) or shortened by surgery (usually to treat bowel disease). If the bowel has been shortened by surgery, these problems can contribute to a condition known as short bowel syndrome. Short bowel syndrome is a group of problems affecting people who have had half or more of their small intestine removed. Common symptoms are diarrhoea, cramping and heartburn. Some people become malnourished because their remaining small intestine is unable to absorb enough water, vitamins, and other nutrients from food.

Occasionally, some people who follow a vegan diet may become deficient in B12. This is because B12 is not found in vegetable foods (such as fruit, vegetables and grains). ” – HSE.ie/b12causes

 

So have the injections and supplements helped so far?

I definitely found the vitamin B12 injections and the D3 especially were really good initially as they would give me an initial burst of energy for a day or two but recently I haven’t found them as great, but, I am sleeping less now which is great, however, I still need a lot of sleep throughout the day.

Now I get up in the morning and can stay up until evening time around 6 or 7 pm where I have to go to sleep for about 2 hours or I simply wont feel refreshed enough to get up before 2 hours. Then I get up at around 8 pm and can stay up until we go to bed for the night. Sometimes I may need another nap in the evening but usually I just go to bed for a nap now just once in the evening which is a huge improvement and has given me more of a life back.

So, no it’s not a cure by any means, but I believe if I didn’t get my bloods checked at the time that I did, I would still be sleeping my brains out all day so my simple advice to you is, if symptoms change and you notice a new level of fatigue that you haven’t experienced before then there surely is something causing that, don’t just automatically put it down to your EDS or Pots or regular diagnosis, if it’s new get it checked out and I would recommend getting your bloods checked. At least they are something that can be fixed and managed and may play a huge role in your level of fatigue.

Just be aware, explain to your doctor what is happening with you and ask for bloods to cover anything that may impact fatigue as I was told that Vitamin B12 and D3 bloods need to be checked for separately to regular bloods. So just for you to be aware of that 🙂

Best of luck,
Lette 🙂 (Fainting Goat)

 

Woo! Shortlisted for The V By Very Blog Awards Ireland 2017

I am delighted to announce that I just got an email from V by Very Blog Awards Ireland 2017 and Irish Dysautonomia Awareness, this humble bloggie, has made the Shortlist for 2017.

We are now onto the next round ‘The Finalists’ where the blog will be judged on:

• How engaging, entertaining and informative is your writing?

• How consistent is your blog? Is every nook and cranny taken care of?

• How do you compare to other blogs? What makes you unique and stand out?

   

I just want to take this opportunity to firstly thank everyone who put the blog forward in the first place and also thank you to the judges who deemed the blog good enough to make it this far this year, I am delighted.

Thank you all once again and here’s to the next round!

 

Lette (The Fainting Goat)

 

 

 

Saturday Submissions – With Denis Murphy – Parkinson’s Disease and Self Expression

Parkinson’s Disease and Self Expression.

Hi, my name is Denis Murphy and I’m from Cork city. I am currently living in a little village in county Sligo.
A major turning point in my life came in 2007 when, at the age of 48,
I was diagnosed with early stages of Parkinson’s Disease.

I would like to share some of my thoughts, feelings and emotions with you as I believe by sharing, we can better understand what we are going through,
which often seems like a lonely struggle.
It can also bring a better understanding to our family, friends and loved ones.

We can get caught up in our own worries and forget that our disease or condition not
only affects our own lives but those around us and they often feel as frustrated and
confused as we do.
I am very lucky to have such an understanding wife.
She has had M.S for over thirty years so she has great patience,
empathy and understanding through her own experiences.

As anyone who suffers from Parkinson’s Disease,or has a family member who does,
will know and understand that it brings about drastic changes, both physically and mentally.
It can be very difficult for people with Parkinson’s to
express their emotions, feelings and
to cope with their loss of power and independence.

One of the many physical conditions is called “The MASK “.
This is when the face muscles become stiff and rigid and expressionless.
The eyes appear to lose their sparkle and the mouth seems to be
permanently in a “sad” position. To the outside world this appears as if the person with Parkinson’s Disease
( or PWPD for short) is uninterested, bored and
apathetic. But behind this stern facade lies a sea of feelings and emotions.

Another symptom of Parkinson’s is a problem with vocal expression.
The voice becomes weak and we lose our strength and with
this we begin to lose confidence in ourselves.
We find it more difficult to express our opinions
and ideas in public as we struggle to be heard.
So between difficulties with facial and vocal expression
we can withdraw into ourselves and stifle our emotions.
All the more need for an outlet to express these
emotions, feelings and fears.

So many PWPD find this through art, be it painting or crafts or writing.
While Parkinson’s Disease severely restricts our physical and mental activities,
there is one advantage.
Whether it is the disease itself or the side effects of the medication
but it seems to stimulate the creative areas of the mind.
So it is only in the last two years I have begun
to compose and express my feelings through my poetry.

The main themes of my poems are about coping with Parkinson’s Disease
or any disability and the fears and hopes and also about our
relationship with Nature and with ourselves.

So enough about me, I hope that you will enjoy the
rantings and ravings of a mad Corkman and that my words may
stimulate your mind and make you think about life,
changes, and above all, appreciate this wonderful
gift we have been given.

–  c/ Denis Murphy 23 April 2017. 

_______________________________________________

 Background information on the poem – A Parky in the Pub

This is the first poem I ever wrote about Parkinson’s. So it was an important step for me
in revealing my personal feelings and exposing my emotions publicly.
I used humour to write about a serious subject.
I do not like the term “Parky” but in this case it’s just a play on the word party.

______________________________________________

A Parky in the Pub

I’ll head down to the pub for a drink and the craíc
Sure I’ll be dead long enough on the flat of my back
So I make my way down to my local bar
On the other side of town for a chat and a jar
Some sit alone, some sit together
Talk of the match or of the weather
And after a pint or two
I need to visit the loo
So I shuffle and stagger around tables and chairs
Aware of the glances, the pity and stares
Through the noise and the clatter
The gossip and the chatter
I make my way back to my friends and my table
Slow progress but thank God I’m still able
The lads at the bar exchange advice and opinions
To the world’s problems and all their solutions
While the girls at the table share secrets and giggle
And walk pass the lads with a sway and a wiggle
The winking and nudging, the secret half glances
Some of the lads even fancy their chances
The smutty jokes and clinking glasses
The lad’s loud laughter like braying asses
As they drown out the music like crows in the nest
It’s time to go home for some peace and some rest
So I say my goodbyes in words and mumbles
And make my way home in staggers and stumbles.
The journey home seems twice as long
But I’m on the right road not gone wrong
Two steps forward one step to the side
Steady as she goes watch that stride
Left foot right foot no downward glance
Sure I might yet get to star in River Dance
– c Denis Murphy Aug 2015

______________________________________________________

Thanks so much to Denis for todays Saturday Submissions post. Be sure to check out Denis’ own blog and make a connection. I love the poem and the play on words here to show the symptoms of Parkinson’s akin to those of being drunk. How do you feel about his poetry, does it resonate with you? Be sure to leave some feedback for Denis and share the love! 🙂

——— Wanna Be Part of Saturday Submissions?———-

All you have to do is tell us a little about yourself and write a blog post (Any word count) in relation to your chronic illness, or how a relation/friend/patient with an illness affects or interacts with you, etc. all welcome!

You can include photos (preferably your own, if found online be sure to add links to where you found them)

Be sure to add links to your social media accounts so people can link back to you OR You can write it anonymously if you like just be sure to put your details in the email so I can respond to you personally 

You can send your submissions to: irishpotsies@gmail.com

Doing a dry run test for London!

So yesterday and today I have been doing a dry run for London, meaning I have to try and stay up for at least 11 hours straight, without bad symptoms kicking in, to be able for my flights and trip to London on May 13th. Sounds easy right?… yeah! I am having trouble and I still have 3 hours to go today!! I usually last about 4 to 5 hours up before bad symptoms and desperate fatigue get in the way and I need to rest in bed again so I need to be able to do this to go on the trip.

The itinerary starts for the trip on May the 13th at getting up at 5am to check in on time and fly out for the 7:30am flight to London, then I have to make it to London and to the specialists appointment at 12:30pm and wont be at the hotel until at least 4pm, so that is 11 hours from getting up at 5am! Then and only then will I be able to rest for the first time on the trip. To anybody else this would be simple but not for me.

I got up at 9 yesterday and made it to 8pm last night, then watched The Expanse and then passed out cold in bed for a couple of hours, I really needed the sleep and symptoms had kicked in pretty bad throughout the day. I simply do not have the stamina and health like I did the first time I went to London so I decided to do another dry run of it today. I got out of bed at 10am this morning and I have to make it to 9pm tonight and I have to say I am finding it tough!

I have the tickets bought for the trip and I really don’t want to have to change or cancel them so I have to be safely able to do this without bad sickness and symptoms getting in the way.

If I do this successfully, Ill let you know, but, I am finding it hard and may have to change the itinerary around a little to be better able to compensate my physical needs, but hopefully that wont need to happen.

Here’s to the next 3 hours, let’s do this!!! (I hope!!)

Lette xxx – (Fainting Goat!)

Looking for Guest Bloggers Please!

 

Hi folks,

I am still on the lookout for guest posters for this little bloggie, I would appreciate hearing back from anyone with or in contact with a chronic illness. Patients, Partners, Family, Friends, Carers, Therapists, Doctors, anyone who would like to take part. If you know of anyone who might like to, please share this with them, thank you!

It can be completely anonymous or open, whichever you prefer, please just follow the steps below to take part and I really look forward to hearing from you 🙂

Also, a very BIG Thank You to those who have submitted something already, I hugely appreciate the efforts, thank you 🙂

——— Wanna Be Part of Guest Blog Submissions?———-

All you have to do is tell us a little about yourself and write a blog post (Any Wordcount) in relation to your chronic illness, or how a relation/friend/patient with an illness affects or interacts with you, etc. all welcome!

You can include photos (preferably your own, if found online be sure to add links to where you found them)

Be sure to add links to your social media accounts so people can link back to you OR You can write it anonymously if you like just be sure to put your details in the email so I can respond to you personally 

You can send your submissions to: irishpotsies@gmail.com

 

 

–

Lette 🙂

Ambulance Time Once Again!

On August tenth we had to call an ambulance yet again!
I had been in bed for weeks at that stage nursing a savage pain on the right side of my abdomen. This wasn’t the first time it has happened, and probably wont be the last! It got to a stage where I was trying to manage the pain myself at home, trying to avoid going into hospital, but I had to face facts and call it as it got too bad to manage on our own this time.

The Ambulance arrived promptly and began to tend to me. They were a crew of two, Male and female, and were excellent. Friendly, Professional, funny easing the mood when needed and seemed to take a genuine interest in what both Keith and I had to say and contribute.

Unlike the last few ambulance calls, this visit from them wasn’t rushed. It was calm, sedate and gave us time to properly prepare to go into A&E. While they took their time trying to locate a vein on my foot, Keith ran upstairs to the computer, got ready and printed off an A4 sheet with simple information on it about me and my condition, highlighting the main issues I present with, medication I am on and what would be needed when first admitted like fluids, Pain control and Catheterisation, etc.

The reason for this sheet was because through previous experience we have found to be constantly repeating ourselves while giving out my information to different people and yet only parts of the overall story get heard by all different people and nobody has the full story! This time we  said we would try getting this sheet in as a common denominator of information in my files so that everyone will be literally be on the same page regarding my care and see what happens. It was worth a try at least.

After getting a vein in my foot and administering some morphine for pain relief, we were eventually ready to go to the hospital and the ambulance crew were brilliant with everything as well as taking on the information sheet, which they said they thought it was a fantastic idea and wished more people were that organised!

We quickly made it to the hospital, after getting more Morphine on the Ambulance, I was brought straight into the A&E main area, Thankfully I wasn’t rushed into Resus at any stage this time, it was calm and sedate and a far better visit this time round.

I was delighted to hear back from the Female paramedic that she passed on the sheet Keith had given her, to the triage nurse and that the nurse also commented on what a good idea it was to have all the main things highlighted on one page where everyone can see it. She said she would put it in my file so that all the doctors would see it too. So far so good for our little A4 sheet!

While waiting around for a short while, waiting on the triage nurse to find a place to put me as it was busy in A&E that day, The Paramedics were chatting to me and told me they knew some student and new paramedics who were doing papers based on me for some exam that was due the next week! Morto! I found it funny that they would pick me based on my rare or under diagnosed EDS condition or as I like to call it, ‘my awkwardness!’ :p

I once again had terrible trouble getting veins in me, doctor after nurse after doctor tried and failed and it started getting really sore. The vein the Ambulance crew had gotten was already failing just a few hours after it was put in, my foot swelled up  and they were worried as they really wanted to administer fluids and iv meds so they wanted a vein soon. Throughout the following week while in the hospital, this continued. a vein would be gotten and it would fail almost immediately until in the end the anaesthetics team had to be called and they had no trouble getting a vein and thankfully now a note has been put in my file to say that only anaesthetics are to place a cannula on me and no one else, so hopefully all the prodding and poking will come to an end now.

After spending no more 24hours in A&E this time around, I was admitted to the surgical ward. While in the A&E I had all the usual tests, xrays, scopes, exams, the usual trouble of about 50 different doctors trying to get a vein after a brief moment of being cocky and saying something like, “Oh I’m good at this, don’t you worry”, or,”Oh really? Bad veins, huh? well, I like a challenge!” and then just end up being unsuccessful anyway! That always provides me with a giggle especially towards the cocky ones who think I wont post a problem, cha! Say that to me after 20 mins of trying hopelessly! :p Being admitted after 24hours was quick though, considering that I have often had to wait over 46hours before.

I always like being admitted to the surgical ward. Not only does everything seem to be more up to date and cleaner, but Compared to the medical wards, The mood on the ward is generally brighter both from the staff and the patients. The Nurses seem to genuinely care, are not as dismissive as others I have encountered on the medical wards. They get upset when you get upset, they don’t like to see you in pain or discomfort and as much as they are able, they won’t keep you in pain for long and will treat you asap when they are asked to, a lot of the time, they don’t even need to be asked, they will notice themselves and will get you what you need to help ease your discomfort. Also, the electric beds are well cool! :p

I saw My Surgical team the next morning bright and early and they took the situation serious when they saw I had lost over 3.5 stone with the nausea, vomiting and general pain and discomfort I have been having with my gut issues.

As well  as my pain team to cover my Occipital and Sacroilliac joint Nerve Blocks which were due once again, They called in a dietician, a tissue viability nurse to talk about any difficulties I may be having with the chair, thankfully theres nothing serious going on there but she wanted to refer me to a Dermatologist for a small bit of irritation caused by the chair that was easily sorted with some long term antibiotics (starting with an 8 week course and if it needs to continue after that it could go up to 16 weeks), will just have to wait and see how it works. Then they wanted to get a serious OT assessment for me as my own local OT never properly assessed me for manual chair or a bed, given my situation, these are the two basic things my surgical team wanted to be covered while I was admitted.

The Dietician was concerned for my weight loss compared to my height and prescribed a high fiber, high calorie diet as well as Fortisip Calorie drinks to take twice a day along with my usual daily food intake to help at least maintain my current weight if not try to increase it. Sshe also prescribed a new tummy med to take with the other ones I am on to try and help with the nausea and vomiting as well as to try and increase appetite. So I have now started these and I was thinking of doing quick video reviews of the different drink flavours on offer, if you are interested that is! Let me know and I will do it if you like 🙂

Throughout there was non stop testing to find out what was causing the pain in the right side. Xrays, Ultrasounds, CAT and MRI scans, Scopes, blood tests, you name it, it was done.

In the Ultrasound Room!

One outcome is that they have ruled out any Gallbladder issues. There definitely seems to be Sphincter of Oddi, Severe Gut Dysmotility and Neurogenic Bladder Dysfunction problems, as well as a large and painful Lymph node on the inside of my right hip which is causing a lot of pain too and is currently under investigation, all these are contributing to the pain as well as the Ehlers Danlos Pain itself, but they have ruled out Gallbladder and Appendix issues, which is good!

I had 2 major cardiac events while I was in, though I had been battling low Bp all week, these events were the opposite, they came out of nowhere in the middle of the night, they were raging high bp and very fast heartrate, the ecg showed some abnormalities but thankfully they didn’t stay long (about 2 or 3 hours) and after they administered some medication to lower my bp and hr, I seemed to return to my regular low bp self, they were scary though as the pain in my chest when it happened was frightening and I was soaked through with a tempreture. The nurses seemed concerned as Long story  events came out of nowhere. Thankfully though after a few hours I returned to normal and could get some sleep.

Long story short, I got to see everyone that was called for me except OT. The final team was the pain team with the good professor who loves to give injections and this time was no different! He administered my usual Occipital and Sacroiliac joint nerve blocks under ultrasound which he did at my ward bed, he had a little portable ultrasound machine or at least that’s what it looked like and he went for it there and then. The pain team in conjunction with the anestetic team said that I may have chronic piritonitis ( information or even tearing of the abdominal lining that holds your organs) this is still being investigated and will continue as an outpatient appointment along with all the other teams I had to meet while I was in.

The surgical team try everything they can and they are so good to want to learn but they still are not sure exactly what is causing the severe pain and weight loss. I had mentioned to them about a Gastroenterologist specialist in Cork university hospital who is very well up on EDS and speaks regularly as well as trained under Prof Aziz over in London whom I hope to see as soon as i am able to travel. They said go to see him, just to see if he can help and my surgical team said they would be delighted to consult with both him and Aziz going forward as they are of the mind that more on the overall team to help me then the better!

In the meantime my team wanted to bring my case up at an EGM (emergency general meeting) where the head consultants and specialists of a department get together and discus special cases at a count table meeting so that other people’s views and suggestions can be taken on board, then once they have news they  will call me for a new outpatient appointment or send me for further tests if required.

 Unfortunately the OT never turned up and there were questions as to wether she would turn up anyway as she usually only sees Stroke and Neurology patients so my surgical team along with the head nurse on the ward rang her boss as well as had to write a letter in order to argue the case as to why they felt I was a special enough case for her to make an exception and come and see me, alas I was left waiting all over the weekend just to see her and she never turned up so my team decided to send me home at this stage with some new meds and a ton of outpatient appointments and they would follow up with her to get me a much needed appointment as my local OT isn’t really doing what she is supposed to do. 

In the meantime I have made a new appointment to see that Gastro specialist in Cork, his name is Akbar and I have heard great things so I really hope he can help. That appointment is on the 20th of this month (September) and of course I’ll fill you in on how that and any subsequent appointments go.

For now, I’ll just chill and try to recover 🙂

Thank you as always for taking the time to read.

Lette ( the fainting goat!)

Finalist of The Littlewoods Ireland Blog Awards 2016

I am delighted and so proud to announce that I just found out that The Irish Dysautonomia Awareness Blog here has made it as a Finalist in The Littlewoods Ireland Blog Awards 2016 under the Health & Wellbeing Category! 😀

I never imagined we would even make it to the Shortlist when we did, but to make it as a Finalist? I can’t tell you how excited I am about this, and I have YOU, yes, all of you reading this, to Thank for making it this far.

This Blog is all about raising awareness of these under diagnosed conditions, and having people check out the blog for judging means that even just a few fresh eyes will see the blog and may learn something new that day about a condition they may have never heard of before, if that alone is all that is achieved from this then I am absolutely thrilled. I can’t believe we have made it this far, I am so happy! 😀

Thank you all!! ❤

From here, this Finalist List will now be judged by a panel of Pro Judges (Those who know the industry well) and no open voting this time. That final list then will be the ones that go through to the awards to possibly win.

I am utterly thrilled we have come this far and even if we don’t go any further, I couldn’t be happier with the outcome so far. 🙂

Also, I would like to take this opportunity to extend a massive congrats to Catherine Colbert of The Cripple Baby Blog, she also made it as a finalist and Blogs in the same category about Dysautonomia and related issues too! Nice one Lady! 😀

And of course, congrats to everyone who has made it this far in the Awards!

Once more, I can’t thank you all enough for your votes and support, fingers crossed this may go further, but if not, I think we did good! 😉

Cheers, I’ll keep you all updated as I find out more, Thank you so much for reading,

Lette (Fainting Goat)

Shortlisted? – Was Not Expecting That!

WOW!! So in the last week a lot has happened.

I was admitted to hospital on Wednesday the 10th after a few weeks in bed, nursing a savage pain in the right side of my Abdominal area. I was released yesterday after a really productive week in! I will do a separate blog post highlighting what happened, but this post is about something most unexpected to me! 😀

I am delighted to announce that on Tuesday the 16th of August, I got an email to say that Irish Dysautonomia Awareness, had made it through to the Shortlist of the Littlewoods Ireland Blog Awards 2016! 😀 YEAY!

Public Vote:

So now the voting begins and this is where I beg for your votes! –  Well it begun on the 17th and runs until the 23rd but I have missed out on a few days because of the hospital stay.

The public vote opens at the Shortlist stage, and accounts for 20% of your mark (80% comes from peer judging).

If you would be ever so kind as to click on the image below and hit the Vote Button, just be aware It will open in a new window or tab. I would be eternally grateful! 😀 It will ask to verify your vote with giving an email or signing in with Facebook, this only takes a few seconds, so thank you so much in advance.

Please Click Through Here To Vote

Remember, this is not about winning, and completely without trying to sound humble I don’t expect to get anywhere further, but to raise awareness of this condition through opening this blog up to even just a few more people, would be fantastic for all of us. Thank you!

Lette – Fainting Goat =)

A to Z of Ehlers Danlos Syndrome: A is for Autism

The A to Z of Ehlers Danlos Syndrome!
A great idea to highlight and spread awareness of EDS during May, EDS Awareness Month.

Sharing from the wonderful ‘Autistic Zebra‘ 🙂

Please be sure and click through to any other sites I may reblog, throw them some friendly support 😊💜

Stronger Together – The International Future of EDS

Ehlers-Danlos Society Youtube Video Published on Feb 1, 2016

Lara Bloom Eds introduces the new The Ehlers-Danlos Society previously (EDNF.org) and talks about the upcoming New York EDS Symposium, the first meeting of medical and patient experts in this area for over 20 years! Hopefully it will bring international change for the better for those of us with EDS. Thanks for all your hard work Lara and the Ehlers Danlos Society.