Long Covid Diaries: yes the glass is more than half full.

Regular readers may be amused by this new (somewhat breezy and short) draft handbook chapter, “What to do when you encounter Funky Causes in the (historical) Wild.” Abstract: the chapter explains how the rise of the Mechanical philosophy during the seventeenth century contributed to the transformation of the traditional, Aristotelian schema of four causes into the dominance of efficient causation as the paradigmatic cause by the time of David Hume. The chapter simultaneously shows that the mechanical philosophy also gave rise to a number of problems internal to it, as diagnosed by Newton and Newtonian natural philosophers, that facilitated more careful analysis of the nature of causation.

It’s time for another long covid diary entry. (For my official "covid diaries" see here; here; here; here; here; here; here; here; here; here; here;  here; here; here;  here; here; here; here; here; here; here; here; here; here; here; here; here; here; here;  here;  here; here; here; here; here; here; here; here; here; here;  here; here; here; here; here; here; and here.) As usual it’s a mixed bag.

So, to recap the main remaining long-term effect of my long covid is the onset of migraine when I am socially overstimulated or cognitively multitasking, and when I have lack of sleep. (Undoubtedly stress is a contributing factor.) I have been getting botox shots in my neck every 12 weeks to combat this. The second full 12 week cycle ended today, and so I got a new round of shots which need to be spaced three months apart.

The good news is that in both cycles the botox has, once it starts working. an immensely positive effect. So much so that when it works, I barely notice any long covid effects at all. The only real effect is that if I am overstimulated during the day I wake up every ninety minutes during the night.

Unfortunately, the effect of botox has waned each time after about 6-7 weeks, and so the second half of the cycle is much more challenging (depending on my schedule). During the summer I barely noticed the problem because when I am doing research I don’t have any side effects. But during the teaching year — which coincides with a lot more work related obligations — it turns out that I cannot control my schedule fully. So both in September and during the last few weeks, I would have migraines about twice a week. (I take anti-inflammatory meds then.)

This past semester I taught three courses, two of which new. And I had to guest lecture in another course (which included helping create and grade a partial exam). Unfortunately, one of the new courses turned out to have a lot of administrative complications, and so it was a lot of extra work. The good news is that compared to two years ago — when a fifth of the present work-load made me collapse — and a year ago (when I decided to go on unpaid research leave) I am immeasurably improved. Really night and day.

The really bad news is that my department has been unable to control my work-load within normal contract hours, despite the fact that I returned from nearly two years sick leave. (We work with highly developed bean-counting system to make sure we all stay more or less in contract and divide the work roughly evenly.) I alerted various people about this (including head of HR who also admitted the problem), but the university and department are so used to pushing over-hours onto employees they find it incredibly difficult to undo the habit. (In admin speak: our processes are fragile and often rely on nodes who lack the experience and resources to make the process work.)

My own department chair was, in fact, most pro-active to help me solve the problem (he postponed a mandatory training course), but people lower in the chain of command will not cut you slack because everyone is overworked. It’s really one of the bad side-effects of working in an underfunded state system. It’s also exhausting to constantly have to police one’s boundaries and to remind people of agreements that they were (or were not) party to knowing that they are now stuck with a problem that is hard to solve. If it keeps recurring I may have to ask my union to advocate on my behalf. But next semester the work load is much lower, so the real proof will be planning for next Fall. It would be nice to work in a better funded system.

People with chronic disease or hidden disability will be familiar with the problem I am noting in the previous paragraphs. I have a similarly exhausting saga trying to get insurance coverage for my botox. Both in the Netherlands and UK, botox is recognized as a therapy against migraine. But it is rationed, as a last resort after other meds are tried. My new Dutch neurologist didn’t even pretend that I should attempt to use the meds that are required by protocol; she strongly discouraged them in virtue of their side effects. She did send me to a very good physical therapist who is teaching me exercises that may be able to prevent triggering of migraine. (Will report back on that next year.)

I don’t want to end on our sour note. I have a pretty great life again. I now know that about 75% of the time I need not worry about migraine or long covid symptoms at all. It’s only during the depth of teaching year that I risk getting triggered regularly. That is I can prevent the migraines if my schedule allows it, and I know how to treat them such that they don’t interfere much with my quality of life or work. Most important: when they occur I know there is no need to panic.

In fact, for the first time since I have had covid and long covid my symptoms have been unchanged for an extended period, and they are clearly much much milder than they were in 2021 or 2022. I have adored my undergraduate teaching and research; and I also enjoyed participating again more fully in the life of the department and the discipline. I gave a number of keynote lectures this year, and I have accepted invitations elsewhere. More important: I can do lovely things with family and friends without much cognitive fatigue or concern it may set on out of the blue.

On that note, this is to announce my customary winter blogging break. I’ll be going off the grid with my family. I hope to read a lot of books, and enjoy the sunny outdoors. To my loyal readers thank you so much for your continued interest (and words of encouragements). To my paying subscribers, please let me know if you want me to tackle any topics or issues in the new year. Happy holidays.