New Orthostatic Intolerance (OI) Video

I've been absent/silent lately here! If you follow me on social media, you know I'm still struggling to recover from COVID, which just made all my ME/CFS symptoms much worse (as you'd expect). Last week was particularly bad, and I spent several days in bed.

But, in between, on the days when I felt a little better, I managed to record, edit, and upload a new video: Orthostatic Intolerance in ME/CFS, long COVID, fibro, Lyme & EDS. You can click the link to watch on YouTube or watch below:

This video is based on my most popular blog post in over 16 years of writing this blog! Year after year, this post that I wrote in 2010 shows up as the one with the most visits. 

Orthostatic Intolerance (OI) is a hot topic on my blog for good reason. It is an integral part of ME/CFS (one study showed that over 97% of us have some form of it), and it is treatable! It can take a bit of trial and error (and patience), but treating OI often brings dramatic results, decreasing all symptoms and improving quality of life. It's been life-changing for my sons and I over the years--got my two sons back to school full-time when they were young and allows me to be active without crashing (usually, without COVID messing things up!).

I also wrote a 2-part article on OI for the ProHealth website. All of my articles (and many others) were taken down when they revamped their website last year, but making the video gave me the motivation to scan my articles and get them back online last week. This two-part series covers:

Part 1: Diagnosing Orthostatic Intolerance

Part 2: Treating Orthostatic Intolerance

These articles are especially good for sharing with your doctor(s), as they are brief, cover the most important points, and include scientific references at the end, in case your doctor wants to look up more information.

Check out the video or read the blog post or articles, if you prefer. If you are sick of being sick and struggling through each day, treating OI is one of the simplest and most effective things you can do to improve your life!

And please let me know if you have any questions, in the comments here or in the comments below the video or on Twitter or my Facebook page.

TV Tuesday: The Handmaid's Tale

One of the best TV shows we've seen in the past six months--perhaps ever--is the The Handmaid's Tale, adapted from Margaret Atwood's modern classic novel (my review at the link). My husband and I both read the novel, and the adaptation is outstanding. It's an accurate recreation of the world and story Atwood created, only expanded and deepened.

Elisabeth Moss stars as June Osborne, who is now known as Offred (Of-Fred, her commander) in this chilling dystopian world known as Gilead. Commander Fred Waterford, played by Joseph Fiennes, runs the household where Offred resides as handmaid. His wife, Serena Waterford (played by Yvonne Strahovski), desperately wants a baby but, like most women in this world, is infertile and must rely on her handmaid. Once a month, in a bizarre and horrifying Ceremony, Mrs. Waterford holds Offred down while her husband "plants his seed" (as it says in the novel). The rest of the upper-crust household is filled out by a Martha servant (played by Amanda Brugel) whose real name was Rita in the before world, and Nick (played by Max Minghella), who works as a driver, bodyguard, and general handyman at the house. In flashbacks, we see that June and the other handmaids were captured during the revolution and spent time in a training center to learn how to be proper handmaids. Her best friend, Moira (played by Samira Wiley) was at the center with June, and flashbacks show June and Moira enjoying their freedom and friendship in the before world. Their particular Training Center was overseen by "Aunt Lydia," played by Ann Dowd, with a disturbing mix of motherly kindness and terrifying cruelty toward "her girls." When she was captured, June was separated from her husband, Luke (played by O-T Fagbenle), and their daughter, Hannah, and June is desperate to find out where Luke and Hannah are. This tightly-controlled world is ruled by religion and uses scripture to justify every aspect of their warped society, even the mandated monthly rape. June and the other handmaids must strictly comply with the rules of society and their households or risk severe punishment, but inside their brains and their hearts, they still yearn for their real families and old lives.

Any description of this show feels inadequate in fully embodying its compelling and powerful story. While adaptations often fall short of the original material, this stunning show has taken Atwood's clever, imaginative, thoughtful novel and not only brought it to life but filled in the details and richness of the story to bring it to new heights. We are now watching season 4 (a fifth one is planned), and the plot has been delightfully twisty and unpredictable, as June's desire and strength to fight back have grown. Most of all, the acting on this show is absolutely outstanding. Moss is, of course, the undisputed star of the show, showing an incredible range of emotions from grief to love to rage and everything in between, but every single actor here shows a stunning complexity in their roles. Serena used to be a modern career woman and must now be the proper, submissive wife. She and Fred actually helped to create this society that she is now trapped in. Like June, Rita must be a silent and passive servant as the Martha of the house, without her own needs or desires. Even Fred, as the powerful head of household, has some complicated feelings about his wife and his handmaid. Taken as a whole, the incredible talent here, in writing and acting, and the breathtaking sets and cinematography combine to provide a powerful viewing experience that grabs hold of you and won't let go. It's one of the best shows we've ever seen, and we are completely hooked.

The Handmaid's Tale is a Hulu original, so it is available there. Episodes and seasons can also be purchased on Amazon. There are currently four seasons, and a fifth one is planned. Our son's student Hulu account runs out this month, so we are rushing to finish season four, but we might have to subscribe ourselves to see the last one when it is released!

The trailer below for Season 1 provides scenes from the show and a bit of background as to how Gilead came to be:

Weekly Inspiration: Let's Get to Know Each Other!

A year ago, I started my YouTube channel, and since then, I have posted 86 videos, with 16 of them being directly about living with chronic illness (the rest are about books and reading). But, it occurred to me that I only talk about chronic illness and books (and same for other YouTubers in both the chronic illness and book worlds) and that it would be fun to get to know each better!

So, I started my own original tag, All About Me (a YouTube tag video provides questions or another framework for people to share their own answers). The idea is to tell my viewers/readers more about myself, beyond the details of my chronic illness or my reading habits. And I am hoping that others will also do the same, so I can learn more about the YouTubers, bloggers, and other patients whose videos, blogs, and comments I enjoy.

Especially in the chronic illness community, the connections I have made online have greatly enriched my life and provided comfort and support when it feels like no one else "gets it."

At its heart, it comes down to this:

We are more than our illnesses.

We are all complex, interesting people! Here's my All About Me video - click the link to watch it on YouTube or you can watch it below.

And, now it's YOUR turn! I'd love to learn more about you, too! Make your own All About Me video or blog post (the questions are listed in the notes below the video on YouTube) or just share something about yourself in the comments below or on my blog's Facebook page or in the wonderful chronic illness Twitter community (I will post this to my own Twitter feed.)

Let's get to know each other better!

It's My 20-Year Illiversary

On March 2, 2002, I woke up feeling awful, exhausted and aching all over, with the worst sore throat I'd ever had, and my life forever split into Before and After. Today, it's been a full 20 years of living in the After and adjusting to life with chronic illness. A lot has happened since then, with lots of ups and downs, though thanks to many effective treatments, I am in much better shape and able to do more now than I was 15-20 years ago. You can read a more story-like summary of our years of illness at the Our Story tab, but here's a detailed summary.

March 2, 2002

Abrupt onset (like 75-80% of patients) of ME/CFS, with flu-like symptoms. Unsure what the initial trigger was, but it could have been my allergy shots, since I had just recently reached the maintenance level. Symptoms came and went in seemingly random patterns (it took a long time to finally see the exertion-crash pattern). 

March 2003

Diagnosis! After a year of getting hundreds of lab tests and seeing dozens of doctors (all of whom said, "I have no idea what's wrong with you"), I went to see our new primary care physician for the first time. She was close to our house, was a woman, and was accepting new patients; otherwise, we chose her somewhat randomly! I showed her my 3-ring binder full of lab results and symptom graphs and pointed out the mysterious ups and downs. 

She said, "I'm pretty sure you have Chronic Fatigue Syndrome. I have a few other patients with it. Would you like to try some treatments?" That sounded like something made-up to me, so I did a little more research, found a CDC website about it, and read a couple of books where I recognized my "mystery illness" for the first time in their pages. 

I went back to her, and she started trying treatments, telling me the first priority was to correct my sleep dysfunction because good quality sleep would improve everything. She was right, of course!

Yes, I know how incredibly lucky I was to find her!!

 

July 2004

While on vacation, my husband and our younger son both got a virus, including a cough that lasted for 6 weeks (with current knowledge, possibly a SARS-type virus?). After that, both of our sons started showing signs of ME/CFS (though we didn't want to believe it) - fatigue, recurring sore throats, and worst of all, crashes after exercise. The older son (who hadn't caught the virus but had been exposed) had more severe symptoms.

 

December 2004

Our older son and I went to western NY state (near my hometown of Rochester) to see Dr. David Bell, a renowned ME/CFS specialist (now retired) and the top pediatric ME/CFS expert in the world at the time. He officially diagnosed our son with ME/CFS (then known often as CFIDS) and confirmed my diagnosis.

Dr. Bell also did an OI standing test of my son in the office. I had read about Orthostatic Intolerance (OI) but didn't think we had it because we never felt dizzy or fainted. Boy, was I wrong! I was stunned by how sick my son got from less than 10 minutes of standing in the doctor's office, as his heart rate went sky-high and his blood pressure plummeted. Dr. Bell explained that I would react the same way but might be too sick to get the two of us home that night!

May 2005

Dr. Bell had introduced us to Dr. Peter Rowe at Johns Hopkins, who specialized in OI, especially in kids with ME/CFS. He couldn't take on any new patients (even back then!) but talked to me by phone and e-mail and spent two hours on the phone with our pediatrician, teaching her all about OI and how to treat it. Our son began taking Florinef (fludrocortisone), which helps the body hold onto more fluids and salt to overcome the low blood volume in ME/CFS. Once he got up to an effective dose (0.2 mg for him at that time), it was like someone had flipped a switch, and he came back to life! By spring 2006, he was back at school full-time, had resumed extracurriculars, like band, and was playing soccer again.

 

2005-2007

Both my son and I continued seeing our primary care doctors, consulting with Dr. Bell and Dr. Rowe, and started seeing Dr. Susan Levine, ME/CFS specialist in NYC. Through all of those doctors, we both corrected sleep dysfunction, treated immune dysfunction and underlying infections, and treated OI (low-dose beta blockers helped a lot). Both of us improved significantly.

 

Spring 2007

Our older son got Lyme disease for the second time. The first time, before ME/CFS, he had been treated and had fully recovered, with no symptoms for over a year, until ME/CFS hit. This time, standard treatment (a month of antibiotics) helped with some new, acute symptoms but his worsened fatigue and other symptoms continued.

That spring, we finally got our younger son officially diagnosed. His symptoms were always milder, and we'd talked to Dr. Bell about him, but since he was only 6 when the boys first got ME/CFS and was still able to function semi-normally, he advised us to wait to diagnose him, saying sometimes younger kids with mild symptoms recover. But by March of 3rd grade, he had missed 35 days of school already, and his principal called us to find out why. With everything she'd learned from Dr. Bell and Dr. Rowe, our own pediatrician ran all the tests to rule out other things and diagnosed him. She also immediately began treating him with Florinef, and he was soon back to living a pretty normal life, other than crashing when exposed to a virus or after extreme exertion. He stayed on Florinef and generally missed 20-30 days of school a year (and had accommodations plans, like his brother), until age 16, when he did indeed recover fully.

August 2008

Sudden onset of knee pain and nausea told me that I, too, had Lyme disease, though my screening tests kept coming back negative. After much arguing (and some tears on my part), my primary care doctor agreed to try a course of doxycycline. My symptoms immediately cleared up, back to my "normal" ME/CFS baseline, and she was convinced! After a few months of treatment, when the symptoms still came back after stopping antibiotics, she said we were beyond her expertise, and we found a Lyme specialist in a neighboring state, who tested me for co-infections (none) and kept treating my Lyme with a varied treatment approach that worked well.

2007-2009

Despite the treatments that had initially helped, our son got gradually worse over a three-year period. He had some odd symptoms his pediatrician couldn't identify, but with the help of a parents' group online, I finally realized his weird rashes were from bartonella, another tick infection. I took him to my Lyme specialist, who discovered he still had Lyme, plus bartonella and babesia, all probably from that initial 2007 bite. More on tick infections, which are common among those with ME/CFS and fibro).

2008-2019

My Lyme symptoms kept returning, and I kept treating for a period of time then stopping, in a never-ending cycle! In 2019, I started seeing the new Lyme specialist our son was seeing (we loved our old one, but this one was closer to home). She suggested some new approaches that helped.

May 2019-present

After finishing college (an arduous process, even with accommodations), our son hit bottom medically. He was very ill, almost homebound and had some new symptoms, including anxiety and severe GI symptoms. He had lost 40 pounds and was vomiting every day and nauseous all the time. That's when he started seeing the new Lyme specialist, along with her partner, a functional medicine specialist. Between the two of them (and lots of testing and new treatments), our son has gradually improved and is doing quite well now. He was able to work 30 hours a week last summer and is now looking for a full-time job, which feels like a miracle!

March 2020-November 2021

Yes, that was the start of the pandemic, but for me, it was also the start of a 22-month-long relapse with no obvious cause. I suspected my Lyme again and went back to the new Lyme specialist, who helped me to once again get my Lyme under control with some new treatments. She also found and treated hypothyroidism. The Lyme flaring up and the worsened immune dysfunction of ME/CFS triggered old viruses to reactivate again, so I went back on antivirals. And, kind of by accident, I discovered that a higher dose of inosine (a super-cheap and over-the-counter immune modulator) on my high-dose weeks also helped. I think all of these factors helped, and by December 2021, I was back to my previous "normal" ME/CFS baseline (keeping up all those treatments).

January 2022-present

Finally feeling pretty good again, I got COVID on January 5 from my father-in-law's nursing home! I am mostly recovered, though energy and stamina are still lower than normal for me. I am slowly getting back (I hope) to my baseline.

Whew, that was supposed to be a quick summary! Nothing with these illnesses is simple, of course. But, that's our story, so far.

How long have you been ill?

Which diagnoses do you have?

What treatments have most helped?

Let me know in the comments below.

Celebrate Mardi Gras - The Easy Way

It's Mardi Gras weekend! We used to live in New Orleans, so this is a major holiday at out house, as you may have heard in my recent video, Celebrate Everything, Big and Small. We usually celebrate on Saturday and again on Tuesday. Before the pandemic, we had an annual party with a few friends (many of whom also lived in New Orleans when we did) on Saturday. Tonight it will be a smaller Zoom gathering, but I have a pot of jambalaya cooking on the stove, a fresh King Cake from a local bakery on the counter, plus we'll pick up some steamed shrimp and trade some jambalaya for bread pudding with some friends! Tuesday, Mardi Gras day, we will finish off the season with our annual tradition of Popeye's at a friend's house (yes, Popeye's is authentic Louisiana food!).

 

Want to join the fun? Here is a collection of ways to celebrate Mardi Gras, New Orleans, and Louisiana today...including food, recipes, travel tips, movies & TV shows, and, of course, some great books! You can also check out my column in Shelf Awareness that features books about and set in New Orleans, Armchair Travel: Destination New Orleans.

 

Great Adult Books Set In/About Louisiana (additional titles in my article linked above):

• The Crowning Glory of Calla Lily Ponder by Rebecca Wells, author of Divine Secrets of the Ya-Ya Sisterhood - I listened to Calla Lily's story on audio and laughed out loud & bawled my eyes out! It takes place in southern Louisiana, with plenty of local color.
• Gumbo Tales: Finding My Place at the New Orleans Table by Sara Roahen - I loved this memoir about the food, history, people, and unique culture of New Orleans.
• Trail of Crumbs: Food, Love, and the Search for Home by Kim Sunée - although this food-focused memoir covers everyplace from Sweden to France to Korea, the author grew up in New Orleans, where the food culture impacted the rest of her life.
  

Middle-Grade and Teen/YA Books Set In/About Louisiana:

• Ruined by Paula Morris - a teen/YA mystery/ghost story set in New Orleans (the perfect setting for a ghost story!)
• The Freedom Maze by Delia Sherman - a compelling middle-grade historical fiction adventure (with a touch of time travel), where a girl from 1960 travels back to 1860 Louisiana
• Zane and the Hurricane by Rodman Philbrick - a middle-grade novel about Hurricane Katrina - powerful and gripping
• Out of the Easy by Ruta Sepetys - most people are familiar with her two YA novels set during WWII (Between Shades of Gray and Salt to the Sea), but this historical novel is set in New Orleans in 1950

Movies & TV Shows

• Chef  - a wonderful, uplifting movie about a family food truck that travels from Miami to LA, with a stop in New Orleans, of course! My favorite movie of the year in 2015.
• NCIS: New Orleans - though it's a crime show, it includes many scenes of New Orleans, mention of local restaurants and landmarks, and other local tidbits, plus some great local music. They usually do a Mardi Gras episode once a season, for extra fun. It's streaming on Paramount Plus (which used to be CBS All Access).
• Treme - we LOVED this HBO show, which we were somehow able to watch on cable at one point. You can see it now streaming on HBO Max or Hulu.
  
• You can also check out some classic movies and modern classics with New Orleans settings, like A Streetcar Named Desire and The Big Easy.
• Or tune in to watch parades and other scenes in New Orleans streaming live (or if you missed the parades, some great video clips) at www.mardigras.com.

One of the locals in Louisiana

Travel
All this talk of Louisiana making you want to visit? I have written articles about visiting New Orleans  and Exploring Cajun Country - check them out and start planning your trip (plenty of food recommendations in both!). I'm certainly ready to go back!

Crawfish!

Eat, Drink, and Be Merry!
Notice that many of the books and movies about Louisiana are focused on FOOD? Yes, Louisiana - and especially New Orleans - is known for its amazing, unique food. This blog post on how to celebrate Mardi Gras includes my own recipes for some classic Louisiana dishes, plus food you can grab locally today and webcams where you can vicariously experience Mardi Gras - there are plenty of suggestions in this post that you can still manage to do between now and Tuesday. Or save it for later if you like - we eat this food all year round. 

NOTE that Zapp's potato chips - which you absolutely MUST try) have been bought out by PA-chip maker Utz, so you don't have to get them by mail-order anymore. We can now find them in local stores like Wawa here in Delaware....though we still ordered a carton of assorted flavors for Mardi Gras! (Cajun Crawtator and Cajun Dill are the best.)

 

Me & my sons, about 10 years ago

 

What To Do If You Get COVID

NOTE: I am not a medical expert. In this blog post, my goal is to share with you my own experiences and those of my family, along with research I have done. As always, check with your doctor before trying anything new.

Shortly after writing my recent post on My Experiences with COVID and ME/CFS, I realized I had left out some of the most important information: what I had done (and what treatments are available) to treat COVID and prevent side effects, severe COVID, or a worsening of my ME/CFS. So, that's what this post will cover.

To clarify, this post is relevant for:

• Anyone who has ME/CFS or long COVID (which is usually ME/CFS)
• Anyone, even without underlying medical conditions, who gets COVID
• Anyone who had COVID and is suffering from lingering symptoms, i.e. long COVID

 

With ME/CFS, Prepare Before You Get COVID

If you have ME/CFS, I'm sure you're aware by now that COVID presents some serious possible effects, beyond those in the general population. Our immune systems don't work normally and we don't fight infections the way we should. Also, as anyone with ME/CFS has probably experienced, just being exposed to even a mild infection, like a cold, can often trigger a long-term worsening of all of our usual symptoms (this is because our immune systems are over-reacting, even after the infection clears up). 

COVID, however, is proving to be an even stronger trigger than most infections. In studies, for most common infections that can trigger ME/CFS to start--like mono/glandular fever, parvovirus, Lyme disease, and others--about 10% of those who get infected do not recover but go on to develop ME/CFS. So far, studies show that between 30-50% of those who get COVID do not fully recover but develop lingering symptoms (that are often ME/CFS). Those numbers are stunning! This failure to recover after the infection clears is what is being called "long COVID" in the media.

So, if you already have ME/CFS and then get COVID, your chances of lingering symptoms and/or a long-term worsening of your underlying disease are quite high.

 

Fully vaccinated in June!

 

For that reason, it makes sense to do everything possible to avoid getting COVID (for everyone because even a very healthy person could develop long COVID), and especially if you already have ME/CFS. That includes getting vaccinated, if you and your doctor decide it is safe for you to do so. That is an entirely different topic that I have already covered here on the blog. Refer to My Experiences with COVID and ME/CFS for links to my three posts on deciding whether to get the vaccine and how to prepare first. I did get the first two vaccines but later tests showed that I did not make many antibodies. In addition to considering vaccines, wear masks (experts now recommend medical/surgical masks or KN-95's). And, of course, it is still wise to avoid crowds or any groups without masks.

Double-masked now

If you have ME/CFS and have not gotten COVID yet, congratulations! Do everything you can now to give yourself a better chance of recovering if you do get it. That includes topics covered in my vaccine prep post, like:

• Improve methylation.
• Treat underlying infections and Normalize your immune system, as much as possible:
• Low-dose naltrexone
• Inosine
• Increase glutathione
• Treat Orthostatic Intolerance (OI).
• Correct sleep dysfunction.
  

In other words, do as much as you can to improve your overall condition, which will improve your life and reduce the chance of a worsening if you get COVID. This post summarizes all of the treatments that have been effective for my sons and I. Many of these treatments in that post and listed above are inexpensive and readily available. Some can even be tried without a doctor, if you don't have a cooperative doctor willing to help you. I am mostly recovered from COVID, after six weeks, except for slightly reduced energy/stamina that are slowly improving. I believe that all of these treatments I did over the previous years to improve my overall condition with ME/CFS helped me to recover more quickly.

 

For Anyone: What To Do If You Get COVID

Whether you have ME/CFS or not, there are some simple things you can do at the first signs of COVID infection to prevent serious complications and/or lingering symptoms (long COVID or a worsening of your ME/CFS). There are also some newer treatments that are available, if you can get access to them. Let's start with those.

Approved, Effective Treatments for COVID

There are now two main types of treatments available for COVID that are meant to be used early in the infection at home and to prevent complications and hospitalization:

• Oral COVID Antivirals (Paxlovid and molnupiravir - see article)
• Monoclonal Antibodies

These treatments are intended for use in those at increased risk for severe illness (that would include those with asthma and other lung conditions, older adults, and yes, those with ME/CFS or other immune issues) and are intended to be used to help prevent hospitalizations. 

The problem? Since the holiday surge, they have been mostly unavailable. The two new antivirals were released around Christmas-time and were immediately sold out everywhere--too much demand and not enough initial supply. While monoclonal antibodies are not that new, they have also been unavailable for most patients recently, with limited supplies being used for those already in hospitals. My 96-year-old father-in-law is in a nursing home, and he and I both got COVID the first week of January. We could not get either of these treatments for either of us, not even through the nursing home! Hopefully, those supply issues will be worked out, as more is manufactured and infection rates drop in the spring. My primary care doctor said the next shipments of the antivirals are expected in March.

Alternative Treatments

With the official, approved treatments unavailable, some doctors have turned to alternatives. See the NIH page on COVID antiviral treatments for details and talk to your doctor:

• Ivermectin - despite all the media controversy, this antiparasitic drug has shown some effectiveness in limited trials in other countries, but there have been no controlled studies proving its effectiveness. Some doctors are prescribing it, but it is also widely unavailable due to increased demand.
• Fluvoxamine - this SSRI (anti-depressant) showed some effectiveness in limiting serious complications in a study in Brazil. My own doctor prescribed a short course for me for 10 days, when we determined that antivirals and monoclonal antibodies were unavailable.

 

At-Home Treatments

With most cases of COVID, primary symptoms include chest congestion, cough, chest tightness, and sometimes sinus congestion and/or shortness of breath (plus severe fatigue). My son and I both had most of that, except for shortness of breath. You want to prevent those symptoms from becoming severe and doing long-term damage to your lungs and heart. These simple over-the-counter or prescription remedies can help to keep sinuses and lungs clear and ease symptoms:

• Mucinex 12-hour Maximum Strength (1200 mg extended-release guaifenesin) - thins mucus to keep it from collecting in sinuses and lungs and becoming infected - we use it often for allergies and colds, to prevent bronchitis and sinus infection, but we took it round-the-clock (every 12 hours) while we had COVID. Get the kind I linked to above, with no other ingredients in it.
  
• For sinus congestion, phenylephrine (mild decongestant, sold as Sudafed PE or decongestant PE) or pseudoephedrine (strong decongestant, often sold as Sudafed or decongestant - can't be sold online because you must show ID at the drugstore). Pseudoephedrine can have some side effects, as it constricts blood vessels (which can actually help OI) and is stimulating, so save it for severe congestion. I take PE daily for allergies but only take pseudoephedrine when I get a bad headache (that vaso-constriction makes it very effective for headaches).
• Throat lozenges/cough drops for cough, sore throat, and throat irritation due to cough. I lost my voice during COVID from the constant coughing, and these were very soothing and allowed me to sleep. Be sure they are SUGAR-FREE or they can worsen yeast overgrowth (which many with ME/CFS have) and make you feel worse. I like Hall's Sugar-Free Lemon Honey or Ricola Sugar-Free Lemon Mint herbal drops (my new favorite), but they come in all kinds of flavors.
• Albuterol inhaler (prescription required) for chest tightness, cough, congestion, or shortness of breath - these require a prescription from your doctor but can provide extra relief (and prevention of serious complications) by dilating (opening up) bronchial pathways. I already had one for bronchitis, and I used it a few times at bedtime so that I could fall asleep without having a coughing fit. If breathing in deeply makes you start coughing, you may need an inhaler.
  
• Ibuprofen or acetaminophen for reducing fever. Ibuprofen will also reduce inflammation. Follow dosing guidelines, especially with acetaminophen, which can damage the liver if you use too much.
  
• AVOID oral steroids or a steroid inhaler, unless your doctor deems them absolutely necessary and then only use for a short period. Steroids suppress the immune system so are not a good idea when fighting an infection or when you have ME/CFS (in which parts of the immune system are already suppressed). They can be used for short periods to decrease inflammation.
• Get an inexpensive Pulse Oximeter to monitor your blood oxygen saturation level. If it dips below 90%, you should call your doctor and/or go to the emergency room.
  
• Watch for signs of secondary bacterial infections, like bronchitis or sinus infection, and treat with antibiotics before they get serious. Although my primary care doctor said they are not seeing a lot of secondary bacterial infections with COVID generally, those with ME/CFS tend to be more susceptible to bacterial infections (our dysfunctional immune systems usually over-react to viruses but under-react to bacteria). Bacterial infections need immediate treatment with antibiotics to prevent them from developing into something even worse, like pneumonia. In my case, since I have a long history of bacterial bronchitis, my doctor started me on Zithromax (antibiotic that works against bronchitis) the first day I woke up with chest congestion and called her--not for COVID (it's a virus) but because my congestion was very likely to develop into bronchitis, given my history. If you suspect a secondary infection, like bronchitis or sinus infection, call your doctor immediately.
• Lots and lots of fluids. You can easily get dehydrated when you are sick, which can make everything worse. Plus, lots of fluids--especially hot herbal tea with a touch of honey in it--can soothe a sore throat. My favorites are Celestial Seasonings Zinger herbal teas.
  
• LISTEN TO YOUR BODY AND REST!! After 20 years with ME/CFS, I thought I knew fatigue, but wow, COVID knocked me out. I mostly slept and ate for 2-3 weeks (and my healthy son was very sick for a week). I am still, six weeks later, needing more sleep at night than usual, have lower energy, and more post-exertional malaise (PEM) than before COVID. All of this is getting better but slowly. Forget about doing anything at all and rest as much as your body needs.

Those are my tips for easing your symptoms when you have COVID and for preventing serious complications or worsening with COVID, based on our own experiences.

What have been YOUR experiences with COVID? What helped you?

Note: This post contains affiliate links. Purchases from these links provide a small commission to me (pennies per purchase), to help offset the time I spend writing for this blog, at no extra cost to you.

 

Movie Monday: Honey Boy

Sometimes I search through the Rotten Tomatoes website, checking out movie ratings for movies we see on our streaming channels. It's always disappointing when you see something that sounds good and then check to find out it had a 30% rating with critics and 20% with viewers! But one movie recently caught my eye because it had an almost-perfect score with critics and viewers alike: Honey Boy, written by and starring Shia LaBeouf (and said to be semi-autobiographical). We both enjoyed this entertaining and moving film about a dysfunctional childhood.

Young Noah Jupe (A Quiet Place) stars as Otis, a twelve-year-old child actor, struggling to make it in Hollywood. He lives with his father, James, an ex-rodeo clown and recovering alcoholic, played by an almost-unrecognizable Shia LaBeouf. The two of them live in a shabby roadside motel, and their closest neighbors are a group of young prostitutes. Otis supports the two of them, which his father both relies on and resents. James is one of the most dysfunctional fathers you've ever seen on screen (which is saying something). Alternating scenes take place in the future when Otis, now 22 and played by Lucas Hedges, has become a Hollywood action star, living a life filled with alcohol, drugs, and women. Driving drunk one night, he gets in a terrible accident and is sent to rehab. There, his therapist, played by the great Laura San Giacomo, tells him he displays all the signs of PTSD, though he insists he's never suffered trauma. Little by little in rehab, he begins to open up and remember his childhood, which is shown to viewers in alternating scenes. 

This is a powerful way to tell the story of a traumatic, difficult childhood, by simultaneously showing his childhood as it happens and also the effects of that childhood on his adult self. The movie was nominated for and won numerous awards, especially for the writing by Shia LaBeouf, directing by first-time director Alma Har'el, and the incredible performance by young Noah Jupe, as a child who desperately needs a parent--and love--and is growing up too fast out of necessity. It's a powerful, moving film, but it's also entertaining. While the viewer grieves for the lost childhood of young Otis, we are also given reason to hope for a better future for grown-up Otis. One can only imagine that writing this film and then playing a version of his own father must have been very emotional and therapeutic for LaBeouf. He certainly provides a very raw and honest story, powerfully told.

Honey Boy is from Amazon Studios and is available on Amazon Prime.

If you--like me--are interested in knowing more about Shia LaBeouf's feelings about bringing his strange childhood to life on the screen and playing his own Dad, check out this excellent interview with Jimmy Kimmel.

 

Weekly Inspiration: Celebrate Everything, Big and Small!

I usually write my Weekly Inspiration posts on the weekends, but I didn't have a chance with our oldest son visiting last weekend. Then I realized, they don't have to be weekend posts! Who couldn't use a little inspiration mid-week? Besides, this one is time-sensitive, with some great reasons to celebrate this week, so here it is!

A big part of our family life has always been celebrations. It's the way I was brought up, and the way we began things with our own two sons. Those traditions became even more important after three of us got sick in 2002-2004! Celebrating the small stuff adds joy to your days, breaks up dull routine (especially this time of year), and gives you something to look forward to (see my post, What Are You Looking Forward To?)--all for minimal effort!

I will reprint this entire section from my book, Finding a New Normal: Living Your Best Life with Chronic Illness, below for you to read.

I also made a fun show-and-tell video on Celebrate Everything, Big and Small!, with lots of great ideas and examples, that you can watch at the link. 

Here's the full section from the book, reprinted:

(Excuse some weird formatting, from cutting and pasting from the e-book, and I added some 2022 dates into the text in [ ].)

Celebrate Everything, Big and Small!

Since becoming ill with ME/CFS in 2002, I have been surprised by how life with chronic illness makes me more aware of the small pleasures all around me. Although our lives are often defined by illness-imposed restrictions, we have found ways to add pleasure and meaning to our everyday life, too. One way is to celebrate all kinds of occasions, big and small.

I came by my love of celebration from my mother. When I was a kid, we celebrated everything, and I loved the atmosphere of joy and festivity. My mom was, and still is, a major party animal, so I learned from the best! When I had children, I knew I wanted to do the same thing for them. After chronic illness entered our lives, these celebrations became even more important, a way of injecting fun into our lives, including (especially) on the bad days. Our kids love our celebration traditions, even now that they’re grown!

Of course, we celebrate the big holidays, though we’ve had to scale back since chronic illness hit. We now focus on certain elements of each holiday that are the most important to us. At Christmas, that’s decorating our tree together and getting together with our oldest friends for a cookie-decorating/Grinch-watching party. (To reserve energy for celebrating, we now buy premade cookie dough.)

We also celebrate all kinds of smaller occasions, which can be even more fun and less stressful than celebrating the big holidays. The dead of winter, after the major holiday season is past and before Easter and spring arrive, can be a dark and depressing time. But there are lots of smaller holidays and occasions to celebrate during that time that can add a bit of brightness to an otherwise dreary winter.

One favorite is Superbowl, the first Sunday in February [Feb. 13 this year]. We’re not big football fans, and our days of attending big Superbowl parties are long past, but we still get into the spirit of the occasion. Every year, we have our favorite game-day foods—simple things, like tortilla chips with salsa and guacamole, mini hot dogs rolled in crescent rolls, and my husband’s famous Buffalo chicken (pieces

of chicken breast sautéed in Buffalo wing sauce). While happily munching on our savory treats, we watch the game and the much-anticipated TV ads.

Mardi Gras (the day before Ash Wednesday [March 1 this year]) is considered a major holiday at our house because my husband and I used to live in New Orleans. Before I got sick, we had an annual Mardi Gras party that grew to 50 to 60 people at its height! A few years into my illness, we realized that we didn’t have to completely give up our Mardi Gras festivities; we just had to scale back. Now, we invite a few close friends over, buy some traditional New Orleans’ food (like king cake from a local bakery), and make a couple of favorite dishes, like red beans and rice and jambalaya. Friends bring food, too. We play New Orleans’ music, enjoy the food and company, and sometimes watch the real Mardi Gras parades online.

This season also brings Valentine’s Day (February 14), another celebration we enjoy each year. We hang up heart decorations, give each other cards and treats, and indulge in a simple (dairy-free) chocolate fondue for dessert. Similarly, we observe St. Patricks’ Day (March 17), by wearing green, hanging up sham- rock decorations, and eating our traditional corned beef and cabbage dinner. It doesn’t matter that we aren’t Irish; we still join in the fun and make it a special day. If you like jokes and pranks, April Fool’s Day (April 1) is a fun one to celebrate. One year, I even celebrated Groundhog Day (February 2) by putting little edible groundhogs made from cookies into my sons’ bowls of oatmeal for breakfast!

You don’t need a holiday on the calendar for an excuse to celebrate. Once or twice a year we have Mexican Night. I make our favorite enchiladas, decorate the table with a colorful serape, and mix up a special orange-mango fizzy drink. We used to celebrate the start of summer by blasting “School’s Out for Summer” as my kids got off the bus and then going with friends to play in a local creek. Of course, there is always a party when we visit their grandma (my mom)!

If you are more severely ill, you may be thinking that you can’t celebrate. Here are small ways to make a day special, with the help of friends or family:

Dress for the holiday, even if it’s just colored or themed pajamas and some whimsical socks or earrings.

Hang up simple decorations near your couch or bed. We have different sets of window clings for each holiday, and I still hang up holiday-themed artwork my sons made in school when they were little.

Listen to music associated with the holiday or special occasion, like Christmas carols, New Orleans’ jazz for Mardi Gras, Irish music for St. Patrick’s Day, and oldies but goodies from your younger years on your birthday.

Watch holiday-themed movies, such as A Christmas Story, Valentine’s Day, Mardi Gras (starring Pat Boone), Ghostbusters (perfect for Halloween!), or Finian’s Rainbow. (A surprising number of results come up when you search for “movies with leprechauns in them.”) Of course, you have to watch Groundhog Day on Groundhog Day—at least twice!

Cuddle with your children or grandchildren (or nieces & nephews), and read holiday-themed books together. If that’s too much for you, let them read to you, listen to audio books, or watch short videos together.

Eat holiday-themed foods—the best part of any celebration! Enlist the help of a friend or family member to prepare the dishes or order in appropriate foods: Chinese take-out on Chinese New Year, corned beef on St. Patrick’s Day, Mexican on Cinco de Mayo.

Watch holiday specials and live events on TV or online, likeparades (Thanksgiving, Fourth of July, Mardi Gras), New Year’s Eve at Times Square, the Oscars, It’s the Great Pumpkin, Charlie Brown!, and more. Almost everything is televised or live-streamed now.

Next time you are having a bad day or week or month (or year), find a reason to celebrate and insert some joy into your life!

My Experiences with COVID and ME/CFS

On January 5 this year, I got COVID. Happy New Year! I got it from my 96-year-old father-in-law's nursing home, where they are still battling an outbreak. He also got it, and so did my 24-year-old son. Somehow, my husband escaped it, even though all three of us had been visiting my father-in-law every day (he broke his hip just before Christmas so had just moved to the care home). I was wearing my mask when I visited, but as a resident, he was not wearing a mask, mine was just fabric, and the day he was diagnosed, I had spent 90 minutes with him, including hugging him and kissing his forehead and feeding him. And this omicron variant is crazy contagious! My son got very sick, with the classic cough, congestion, and fatigue, but he is otherwise healthy (he's the one who had ME/CFS as a kid but recovered fully) and after a week, he was testing negative, feeling a lot better, and back to work. My father-in-law is also doing much better and is out of the COVID ward, though he is still bed-ridden from the broken hip and has moderate dementia. COVID definitely got in the way of physical therapy and his recovery. As for me, I have had ME/CFS for 20 years, so my story is more complicated:

COVID Vaccines in 2021

After much deliberation, consultations with my doctors, and lab tests, I did decide to get the two Moderna vaccines in May and June of 2021. I shared all of my research here, in a series of three blog posts:

ME/CFS and COVID-19 Vaccines - all about the immune dysfunction of ME/CFS, how vaccines work, and how they are likely to affect those with ME/CFS.

COVID Vaccine Experience of ME/CFS Patients - several resources for looking at COVID vaccine experience of those with ME/CFS and some of the data collected at that point, plus our own experiences.

Prep for ME/CFS Patients Getting a COVID Vaccine - where I review treatments I was already on to help normalize the immune system, treatments for MCAS that could help to ease or prevent an allergic reaction to the vaccine, and advice from experts.

I was already doing most of what the experts recommended, plus lots of treatments to normalize my immune system. I think I had a relatively mild response to the vaccine for someone with ME/CFS. It definitely affected me, maybe for several months, but not severely, as I have heard from other patients (most likely because of all the immune treatments I was already taking). You can read more about my own vaccine experiences (and my son's) in that Vaccine Experience post.

 

Getting COVID in January 2022

So, my father-in-law was diagnosed on January 2 (and I spent so much time with him that day because he was much more lethargic than normal and had no appetite). My son's symptoms began the next day, and he tested positive a couple of days later. My own symptoms began on January 5, and I also tested positive a few days later (which shows you just how much it can spread before you even know you have it!).

For the first two weeks, I was very, very sick. I had the typical chest congestion, sinus congestion, and cough. The biggest symptom, though, was complete exhaustion. I've been living with ME/CFS for 20 years and have been through plenty of bad crash days (including many in the early years), but this was fatigue on a whole other level! Some days, I could not stay awake - I just ate and slept.

People with ME/CFS are especially prone to bacterial infections (our dysfunctional immune systems don't fight very well against bacteria), and I had a long history (before immune treatments) of getting bacterial bronchitis, often 4-5 times a year! Knowing this--and luckily, my doctor understands it, too--that first morning when I woke up with my chest tight and a bit of chest congestion, I immediately asked my doctor for Zithromax, an antibiotic that works against bronchitis. As I said, and she agreed, even if it was COVID, the congestion would almost certainly lead to bronchitis for me. I'm so glad I did this! Given my past history, I think it is almost certain, I would have ended up with both COVID and bronchitis, which would have been much harder to recover from.

Gradually and very slowly, I began to see small signs of improvement after two weeks: fewer days of sleeping all day; being able to sort of sit up on the couch, propped on pillows; less congestion. In this past week, I have been able to resume my usual schedule of being productive from the couch or recliner in the morning, taking an after-lunch nap, and getting in another couple of productive hours in the late afternoon. 

Interestingly, it took me longer than my son to finally test negative - about two weeks versus his one.

I am just past three weeks now, and the improvements have continued. I'm not coughing much anymore, though I still have a lot of excess mucus and need a cough drop before nap and bed. My post-exertional malaise (PEM, i.e. crashing after mild exertion) has been much, much worse with COVID but is beginning to improve. I have been managing a slow 15 minute walk after my nap most days, and I was able to go out in public and run a few easy errands this week. (Note that in past years, I have reduced PEM and improved my stamina by treating OI and treating immune dysfunction.)

Out in the world again!

What's Ahead?

In that second week with COVID, when I was still so very sick that I could barely stay awake, I did start to worry that my ME/CFS could stay worse for a very long time, since COVID is a known trigger for ME/CFS (many cases of "long COVID" are ME/CFS). Although my recovery has been slow, I have now this past week seen steady signs of improvement, and I do think I will be able to get back to my "normal" baseline, which I had just returned to in December after a 20-month relapse!

During those dark days, I did a little informal poll on chronic illness Twitter (there's a great community there - find me @livewithmecfs). I just asked people with ME/CFS who got COVID, how long it took them to return to their normal baseline. I didn't add up the results, but some people answered anywhere from a month to nine months, some people said they still weren't back to baseline (after months or years), and just a very few said they were better than before they had COVID! As with everything else with ME/CFS, we are all different!

I do think that all that work I did in the past 20 months to recover from my March 2020 relapse, plus the treatments I had started before that, certainly have helped me. I'll work on a separate post about what I did to recover from that relapse, but in the meantime, you can see a summary of the treatments for ME/CFS that have most helped my son and I.

Please see my follow-up post, What To Do If You Get COVID, for more information on how to treat COVID to prevent serious complications and some other preliminary things you can do, with ME/CFS, to lessen the impact. All of this information is also applicable to those with long-COVID.

What About You?

Please share your own experiences in the Comments (please let me know on Twitter or Facebook if you are unable to leave a comment).

Have you had COVID? How bad was it? Have you recovered back to your normal baseline yet?

Movie Monday: Parasite

As usual, we were searching for a movie Saturday night, something with great ratings that is free on one of the streaming services we get. I noticed that Parasite is now free on Hulu, so I talked my husband into trying it. Neither of us probably would have chosen this Korean movie with subtitles out of the blue, but I knew it had won the Oscar for Best Picture in 2019 (along with a slew of other Oscars that year). We went into it thinking that it was some sort of thriller, maybe about some kind of pathogen or infestation? We were so wrong. This movie kept surprising us (in a good way) and turning into something we never expected. 

Ki Woo is an older teenaged boy, played by Woo-sik Choi, who is at loose ends. He dreams of going to college, but right now, he's stuck in a basement apartment with the rest of his family. His dad, played by Kang-ho Song, is unemployed, though a medal hanging on the wall in a frame indicates he once had a bright future ahead. He seems depressed in the opening scenes. Ki Woo's older sister, Ki Jung (played by So-dam Park), is similarly unemployed, with no future, though she has some artistic talent. And their mother is also unemployed, though she tries to stir her family to earn some money by folding pizza boxes for a local restaurant. One day, Ki Woo is talking with a friend who's in college. He explains that he has an awesome job tutoring a wealthy high school girl in English, and he asks if Ki Woo wants to take over the job while he travels overseas. Though Ki Woo can't afford school right now, he did very well on his exams, including English, so his friend recommends him to the wealthy family. Ki Woo is in awe when he walks up to their huge, modern home, quite a contrast to his own family's basement apartment. They have an enormous fenced-in yard, windows everywhere, and the latest conveniences. He begins tutoring their daughter, Da Hye, and earning more money than he ever has before. When the mother mentions she is looking for an art teacher for her rambunctious younger son, Ki Woo recommends his sister, hiding her identity by saying she is the cousin of a friend at school. And then ... well, you'll never guess what's coming!

That was just the basic set-up from the earliest scenes of the movie because the fun and cleverness of this film come from the twisty surprises around every corner! It's difficult to categorize Parasite, either, because it has so many different moods and pieces. It's very funny, especially in the first half. Later, things turn quite dark, with plenty of tension and suspense, turning into a thriller. And it is also very sad at times. We don't watch many movies with subtitles, but we got used to them--we just discovered we had to finish dinner first and pay attention! We quickly got into the spirit of the movie and went along with its flow. And what a flow it is! We thoroughly enjoyed this ever-surprising movie and recommended it to our son and his girlfriend last night.

Parasite is currently available for free on Hulu or for a small fee on YouTube, Google Play, Apple TV, and VuDu.

Top Ten Blog Posts of 2021

It still seems weird that it's 2022 now, doesn't it?  Sounds like science fiction! Plus I've had COVID for the past three weeks (caught from my father-in-law's nursing home, in spite of all my precautions), so this has not been a typical January for me! I still need to take a look back at my own personal health year, but in the meantime, I thought I'd share the most popular posts on my blog for the past year.

As is pretty typical here on the blog (which I started in 2006), 6 of the Top 10 posts last year were ME/CFS treatment posts. There is just so little information out in the world--and especially in the medical community--about how to effectively treat our disease that anytime I share our treatment successes, there is a lot of interest from patients and caregivers. It's also no surprise that 3 of the Top 10 posts last year were about COVID vaccines and ME/CFS, which is still a hot topic. And the 10th post is just a head-scratcher!

Here are the Top 10 Posts from the blog in 2021, in order from most popular:

1. Heart Rate and Post-Exertional Crashes in ME/CFS - over the past few years, I've seen this topic attract more and more interest from patients, as different kinds of heart rate monitors have become more common. Monitoring heart rate is a great way to quantify your limits, know when you're doing too much, and help to prevent post-exertional crashes. The post includes how and why it works, how to estimate your own limits, and tips on finding the right heart monitor.
2. Opinions and Editorials on the New Name and Criteria - this one is the head-scratcher! It's a post from 2015 that is really not very relevant anymore, yet it continues to attract a lot of visitors. There must be a link to it somewhere that keeps bringing readers to it, though the new name never caught on.
3. Orthostatic Intolerance (OI) and ME/CFS - This post is from 2010, but I still constantly share it with people. OI (POTS is one type) is an integral part of ME/CFS and often a part of fibro, EDS, MS, Lyme, and other diseases. The good news is that treating OI often improves all symptoms and allows you to be more active without crashing, so this post deserves its spot in the Top 3! It's one of several treatments that have quite literally been life-changing for my sons and I.
4. Prep for ME/CFS Patients Getting a COVID Vaccine - This post was actually #3 in a 3-part series (the other two are below and linked at the start of this post), so you might want to read them in order. In this post, I review different kinds of treatments that can help to improve your immune system and reduce the chances of an adverse reaction from any vaccine, including advice from the experts. Note that the treatments in this post will help to improve your overall condition, whether you're preparing for a vaccine or not!
5. ME/CFS and the COVID-19 Vaccines - This was the first post in the 3-part vaccine series, describing the specific kinds of immune dysfunction common in ME/CFS, how vaccines work, and our past experience with other vaccines.
6. Increasing Glutathione in ME/CFS and Related Illnesses - Glutathione is a naturally occurring antioxidant in the human body that people with ME/CFS (and many related illnesses) just don't make enough of. Increasing your glutathione will help with energy, detox, and most importantly, improving immune function. There are many ways to increase glutathione (some that you can try on your own cheaply and without a prescription). Increasing glutathione has greatly improved immune function in my son and I, taking us both from 4-5 bouts of bronchitis a year to maybe once every two years, plus improving our daily ability to function.
   
7. Imunovir and Inosine for Treating ME/CFS - Inosine is another treatment that helps to normalize the immune system and has had a huge positive impact on my son and I, providing massive improvements in all symptoms, our quality of life, and allowing us to be more active without crashing. And in most places, it is available as a supplement, without a prescription, and is cheap!
8. Treating ME/CFS Sleep Dysfunction - This was one of my first treatment posts, and it's still one of the most important! My own primary care doctor, after first diagnosing me with ME/CFS, said, "The first thing we need to do is fix your sleep--that will make everything better!" (Yes, I am very lucky to have found this doctor.) She was right! Correcting sleep dysfunction and getting good quality sleep every night improves all symptoms, in a domino effect (better sleep improves endocrine function, immune function, etc.). By the way, this post is about actually correcting sleep dysfunction and restoring normal, natural sleep, not knocking yourself out with sedatives.
9. COVID Vaccine Experience of ME/CFS Patients - This was the 2nd post in that 3-part series on COVID vaccines, covering patient experience to date, including where you can go to read about others' experiences.
10. The Methylation Cycle: Central to ME/CFS - Another area of treatment that can yield great improvements. Almost everyone with ME/CFS (and many related illnesses) has dysfunctional methylation, and improving it can improve all symptoms and also allow you to try other treatments. If you can't tolerate even small doses of medications and supplements, this is why! Start with methylation--many of the treatments for it are readily available and inexpensive.

That's it! The Top Ten posts from this blog in 2021--and, coincidentally, an excellent outline of simple, inexpensive treatnents that can greatly improve your condition.

Movie Monday: Finch

Saturday night, after two weeks with COVID, I declared a fun night, and my husband and I ordered pizza and wings and watched a movie. We settled on Finch, an original movie on Apple TV starring Tom Hanks that looked appealing to both of us. We had a wonderful feast and thoroughly enjoyed this warm, funny and heartbreaking yet hopeful movie.

Hanks plays Finch, an engineer marooned in a post-apocalyptic world. A solar flare rendered Earth almost uninhabitable, with searing temperatures, soaring radiation levels, and nothing left growing. It's a stark, terrifying landscape, but Finch is holed up in the old tech company where he used to work and is fairly safe. Something of a tech genius, he has not only outfitted his bunker but also developed a protective suit for himself and some rudimentary robots to help him scavenge what he can (though there's not a lot left). Most important, for his mental health, he found a dog who lives with him in the bunker and to whom he is devoted. At the start of the movie, once we see what the outside world is like and what Finch is up against, he puts the finishing touches on his best robot yet: a human-like robot who has been programmed with a "prime directive," to protect the dog. Not a moment too soon because Finch spots a huge storm coming and decides that the three of them will be better off leaving town. They pile into a modified, tank-ified RV and head west out of St. Louis. Finch has always wanted to see the Golden Gate bridge in San Francisco. Their journey is an adventure, with plenty of challenges encountered but also some laughs and tender moments along the way.

This movie is filled with the kind of warmth and humor you expect from Tom Hanks (not to mention his smart, just-learning-about-the-world robot), though there are moments of peril and one very sad part, too. It takes you on an emotional journey along with the characters. Hanks has some experience with starring in a movie where he is practically the only character on-screen, though here, both the dog and the robot have their own fully-developed personalities, so it doesn't feel like he's alone. The challenges they face are often dark and frightening, so there is plenty of action and suspense, though the heart of this movie is ... its heart, and there is plenty of humor along the way. It's really about relationships and about hope. We both enjoyed it very much; it was a perfect Saturday night escape!

Finch is an Apple original, so it is available exclusively on Apple TV.