Kenneth A. Vatz

Neurologist. CommunityHealth-Chicago Expat Yinzer. @umich At @pennmedicine when Ben Franklin asked if we could keep our Republic. At BlueSky, same user name.

[Kenneth A. Vatz @KenV54]

You know that I do not think that FND is faking. It is a psychological phenomenon. I also think it is overcalled.

Concussions represent neuronal damage. I know that prolonged post concussion syndrome is said to be functional in many cases, and indeed there may often be a functional component, superimposed.

Without the availability of pathological studies, it’s impossible to say how much is organic and how much is functional. Certainly, autopsies of patients with CTE show neuronal damage.

Below is a summary from OpenEvidence supporting your view, although I don’t understand why a single concussion, producing memory and concentration symptoms amounts to a functional etiology, whereas multiple concussions clearly produce organic rather than functional deficits.

———-

Functional Cognitive Disorder (FCD) — Particularly Relevant Post-Concussion
Consortium diagnostic criteria published in 2020 defined FCD as cognitive symptoms with clear evidence of internal inconsistency, not better explained by another disorder. Key positive features include:
• Detailed, specific descriptions of memory failure episodes (in contrast to patients with neurodegenerative disease who tend to minimize or be unaware of deficits)
• Attending consultations alone (patients with dementia typically come with a companion)
• Greater concern about symptoms than those around them
• Discrepancy between reported cognitive impairment and observed occupational/daily functioning
• Abnormal metacognition — describing universal cognitive experiences (e.g., walking into a room and forgetting why) as evidence of severe impairment
• Variable patterns within cognitive testing, with performance validity tests alone being insufficient for diagnosis

[Kenneth A. Vatz @KenV54]

I disagree entirely, and am amazed that you would put post concussion syndrome into the same category as FND, fibromyalgia, etc., or that you would put FND in the same category as fibromyalgia (ME/CFS).

As yet we have no good proof or explanation of the biological mechanisms of the conditions you mentioned, but I tend to agree with many others, including @dysclinic , that these (except FND) will turn out to be neuroimmune in origin.

[Kenneth A. Vatz @KenV54]

Agree.

I’m out of the game now. I and my wife (also a physician) were very lucky not to have been saddled with much debt when we emerged into the medical workplace some 45 to 50 years ago. It would have been unaffordable.

It’s unconscionable what the hospital and private equity and insurance administrators and executives earn in comparison with the physicians who are taking care of the patients. But I guess that’s the way capitalism works.

[Kenneth A. Vatz @KenV54]

@STzorfas @AAPSonline “There are some fantastic headache medications that work with virtually no side effects that I can’t get approved for my patients.”

Like Nurtec?

Obviously, my patients without insurance or Medicaid can’t afford it. In the clinic, Pfizer gives us a very limited supply, gratis.

[Mike Young @micyoung75]

Bari Weiss built her entire public identity on the proposition that cancel culture was destroying American discourse. She wrote about it. She founded a publication around it. She championed the Intellectual Dark Web as brave thinkers being silenced for saying forbidden things.

Scott Pelley said factually true things, without yelling, without cursing, without threatening anyone, in a staff meeting. He said Bilton had slender qualifications. He said Weiss was murdering 60 Minutes. He said these things because they are true and because saying true things in rooms where powerful people prefer comfortable silence is - per Weiss's own stated philosophy - exactly what journalists are supposed to do.

She fired him.

JVL names what this exposes precisely. They never wanted to end cancel culture. They wanted to control it. Some forbidden ideas - the ones MAGA likes - must be protected and platformed. Other ideas - the ones Bari Weiss dislikes - are genuinely verboten. Say them out loud and you lose your job.

The Pentagon press office is now classified. Tim Miller was threatened with FARA for sharing a public news report. Comey is being prosecuted for seashells on a beach. The federal workforce faces proposed NDAs. Pelley was fired for refusing instructions to broadcast unverified assertions and then saying so in a meeting.

The through line is not chaos. It is a consistent, documented project to determine who gets to speak, about what, to whom, and under whose authority. Cancel culture was never the target. It was always the tactic. Weiss just proved it by doing the thing she built her career opposing, the moment she had the power to do it.

[Kenneth A. Vatz @KenV54]

I know a fair number of neurologists, as I’m sure is the case with you as well, and I’ve never run into any neurologist who told me that they had regretted their choice of specialty within medicine.

We (they) are all dismayed by what has happened to the system, as brought about by the economic and administrative changes of the past 20 years. I agree, some of it is due to the ACA, but private equity seems to be driving everything now.

In my own suburban local healthcare system, for my wife’s and my care, and which is owned by private equity, it can take weeks or months to get in to see a medical specialist. I’m thinking of switching to one of the large Chicago university practices, the trade-off being the long drive into the city.

I work in my free clinic with a volunteer internist whose practice is at the University of Chicago, an hour or an hour and a half drive from where I am. But it sounds better than what I am getting in my close-by practice. Specialty care is almost immediately available in the U of C system.

[Kenneth A. Vatz @KenV54]

@STzorfas Yes, very good news.

[Kenneth A. Vatz @KenV54]

@wildswim2 @Sunny_Rae1 @hannahspierMD Huh? I don’t know her, but this year-old YouTube interview is excellent. Please explain. https://t.co/ulNNUVhVH8

[Kenneth A. Vatz @KenV54]

@dysclinic https://t.co/FGFdE032KL

[Kenneth A. Vatz @KenV54]

For @dysclinic to review.

[Corinna Geiger @DrCorinnaGeiger]

Neue Studie (Boston University, 2026): hEDS ist kein Ein-Gen-Defekt. KI-Genomanalyse zeigt Varianten in 3 Systemen – Kollagen, Immunsystem (HLA bei ~75 %!) & Mitochondrien. Das erklärt, warum hEDS so oft mit MCAS & Dysautonomie auftritt. #hEDS #MECFS #MCAS

[Kenneth A. Vatz @KenV54]

@jakovmrc @FndNope I’ve seen some, but most of these patients don’t come to neurologists primarily unless they have neurologic symptoms.

[Kenneth A. Vatz @KenV54]

@SharylAttkisson https://t.co/FeivN2wpv3

[Kenneth A. Vatz @KenV54]

Your husband was harmed by statins because his doctors in this case failed to pick up on the serious side effects that he was having. I am sorry this happened.

Such side effects are rare, albeit, potentially dangerous, and the good that statins do far outweighs their harm.

There is a wealth of evidence supporting the above statements. Check any AI machine you wish. In the next post on this thread, I will link an OpenEvidence search.

[Kenneth A. Vatz @KenV54]

“If they can’t prescribe a pill or inject a substance within that 15 minute doctor visit, they just do nothing…. Even your reply to me wreaks of arrogance and narcissism, ‘total conspiracy theory.’”

This narcissist spends 30 to 60 minutes with each patient, reviews the history and all of the lab studies, discusses everything with the patient, and prescribes medications when medically indicated.

I have posted the evidence previously for the indications of statins in patients who are at risk for cardiovascular and cerebrovascular disease.

[Kenneth A. Vatz @KenV54]

Interesting chart/paper on a putative association between sleep apnea and various psychiatric and/or neurologic conditions. Suggested to me by @nataliezzz3 . Worth a look, but out of my sphere of expertise, except for dementia. https://t.co/wDlQj9g1KY

[Kenneth A. Vatz @KenV54]

@MoOnemouse4444 @Robert_Heitner8 @newstart_2024 Total conspiracy theory.

LDL level is related to MI risk, and statins reduce this risk as both primary and secondary prevention. https://t.co/FeivN2wpv3

[Kenneth A. Vatz @KenV54]

@FreeTheFeSlaves @newstart_2024 I suppose if you take enough blood often enough, you will not die of heart attack, but rather of something else. But the ferritin connection is controversial, to say the least.

https://t.co/o8WEIWiD97