#MultiSystem

[willowreader]

This discovery has implications for other autoimmune diseases.

[sapphicautistic]

i am having Big Feelings today about how fast my life is burning out and how trying to live at all burns my life out even faster. i hate M.E. and i hate that we don't have any effective treatment yet beyond "don't do things that trigger the neuroimmune response" which when you have my level of M.E. is ANYTHING. like eating, using the bathroom, bathing, much less having conversations and a social life!!

i know i'm closer to sadness when i feel so sick like this but i'm so mad because all i did was write like, a couple tumblr posts and text with a couple people and i feel like i ran a fucking marathon with no training. i'm so so mad and sad and i hate being trapped in this decaying body!!!

[forensicfield]

The Intersection of Forensic Psychology and Mental Health: A Comprehensive Overview

Forensic Psychology is crucial in understanding criminal behavior and providing mental health care in the legal system. Authored by Prashansa Tripathi #forensicpsychology #forensicscience #mentalhealth #forensicstudy #forensicknowledge #crimescene

Continue reading The Intersection of Forensic Psychology and Mental Health: A Comprehensive Overview

[gumjrop]

The Weather

Amid the CDC’s COVID-minimizing and dangerous rollback to isolation guidance, a new Pew Research poll shows that 27% of Americans are very or somewhat concerned that they will get COVID and require hospitalization, and 40% (nearly half) of Americans are very or somewhat concerned that they will unwittingly spread COVID to others. This number rises substantially for low income brackets, and Black, Hispanic, and Asian adults. Concern about hospitalization was highest in adults with a high school education or less. Despite efforts by the CDC, the Biden Administration, and corporate media to downplay the public’s concern about COVID, these numbers show that a substantial proportion of Americans care about protecting one another.

A popular program providing free rapid antigen tests through the USPS ended on March 9, 2024. Despite the limitations of rapid antigen tests, these home tests continue to be a vital way to quickly identify COVID cases, both to prevent further onward spread as well as to identify the need for treatment with Paxlovid. You can use our letter campaign to let your elected officials know we still need free rapid home tests.

COVID wastewater levels are decreasing, with no states registering “Very High” levels as of 3/15/2024. Eight states are currently at “High” and 15 are at “Moderate” levels of SARS-CoV-2 detected in wastewater.

Wastewater levels show a downward trend in the provisional data (gray shaded area) in all regions. The national wastewater levels are overall indicated as “Low.” Lower wastewater activity is an indication of lower overall viral spread, which is certainly a good thing. However, the “Low” designation is not a representation of low risk in our day-to-day lives, and continued masking and multilayered precautions continue to be necessary to protect ourselves and our communities. State and local trends can also provide additional information, where available.

A recent Axios article highlights the expanding broad utility of wastewater testing for COVID and other infectious diseases, as well as the uncertain footing of the funding and infrastructure for this essential surveillance tool. We encourage you to write your elected officials to let them know you want to keep and expand wastewater testing in your area and nationally.

Wins

On March 13, the People’s CDC hosted a press conference to push back on the CDC’s elimination of COVID isolation guidance and demand accountability to the public (watch the video or read the press release). The online publication (pre-proof) of the People’s CDC External Review in the peer-reviewed scientific journal American Journal of Preventive Medicine Focus was also announced, which is an important authoritative resource highlighting both shortcomings of the CDC’s approach and recommendations for a more transparent, effective, and equitable pandemic response going forward. The full External Review report can be found on the People’s CDC website.

March 15 was Long COVID Awareness Day, and Senator Bernie Sanders along with six cosponsors (Tim Kaine, Edward Markey, John Hickenlooper, Tina Smith, Robert Casey, and Tammy Baldwin) introduced Resolution 590 to formally recognize March 15 as Long COVID Awareness Day. You can ask your senators to support this resolution using this letter campaign. Senator Sanders released a video promising legislation to increase funding for Long COVID research and clinical care, as well as emphasizing the importance of prevention, including vaccination and masking. For more info on Long COVID Awareness Day, see the “Long COVID” section below.

When we make our voices heard, whether with the press, with scientific publications, or with elected officials, we win.

Variants

In the CDC’s most recent Nowcast predictions, JN.1 continues to be the most prevalent variant in the United States (86.5%), with a predicted decrease in JN.1 and sublineage JN.1.13 increasing (9.5%).

Vaccines

The CDC has recommended spring boosters for people age 65 and older, at least 4 months after the previous updated dose. As of 3/2/2024, only about 42.4% of adults age 65 and older had gotten an updated vaccine, and many who were vaccinated in the fall may not realize they are eligible for another dose. 

In addition to the spring boosters recommended for people aged 65 and older, immunocompromised people are eligible for more frequent vaccination. The CDC states, “You can self-attest to your moderately or severely immunocompromised status, which means you do not need any documentation of your status to receive COVID-19 vaccines you might be eligible to receive.”

As a reminder, the currently available COVID vaccine formulations (2023-2024, first available in fall 2023) are effective against the JN.1 variant, with about 54% protection against symptomatic disease. For people of all ages, immunity wanes after 6 months, and, although current eligibility is more limited, we continue to support access to vaccination at least every 6 months for all ages.

If you have not received one of the updated COVID vaccines released last Fall, you can use this tool to find local vaccine providers that are Bridge Access Participants. The Bridge program is currently available through December 31, 2024. 

COVID in Kids

In a recent report in the CDC’s MMWR publication, cases of Multisystem Inflammatory Syndrome in Children (MIS-C) in 2023 were highlighted. MIS-C is an inflammatory response to a COVID infection that usually occurs 2-6 weeks following an infection. MIS-C may be serious and can affect the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal tract. Although rates of MIS-C have slowed since 2020-2021, 112 cases were reported in 2023, with 82.1% of those occurring in unvaccinated children. Among cases in vaccinated children, 60% occurred in children who had not received a booster within the last year. As of 3/2/2024, only about 13.5% of eligible children aged 6 months to 17 years have received a 2023-2024 COVID vaccine. More info on Long COVID in kids is presented below under “Long COVID.” 

It is clear that kids need protection from COVID, and current efforts are inadequate. We demand that public health authorities take action to protect our children. You can find more information to support protecting kids in our Urgency of Equity toolkit.

Long COVID

March 15 marked the second annual International Long Covid Awareness Day. Across the globe, Long Covid survivors, their allies, and the community fight for increased research, treatment, and visibility for people living with Long Covid. 

Searching #LongCovidAwarenessDay on most social media platforms will connect you to posts from people all over the world describing their experience navigating their ongoing symptoms while trying to educate others about the barriers they face in seeking accessible and effective treatments.

Up to 5.8 million children in the US may be affected by Long COVID. A recent study published in the journal Pediatrics from the American Academy of Pediatrics shows that vaccination reduces the risk of Long COVID in children by about 40%. 

Take Action

Super Tuesday has come and gone with nominees in most parties now established for races at the local, state, and national level later this year on November 5th.

People’s CDC wants to remind you that regardless of the outcomes of these elections, we must always continue to organize and fight back against the state’s abandonment of science in favor of corporate interests.

We urge you to use and share our letter campaign demanding that elected officials renew and expand programs to provide free Rapid Antigen Tests (RATs). You can also continue to urge elected officials to support maintaining and extending COVID isolation guidance via our letter campaign. Over 13,000 letters have already been sent, and you can use the same template to send follow up letters.

Whether it’s joining a local mutual aid organization or fighting for increased accessibility measures (required masking, improved air quality, and multilayered precautions) in groups you are already part of, your actions can make your communities safer for all people.

[straydogged]

:( it figures, I finally got my shoulder back in place with the help of a supportive pillow and a heat pack to make the muscles relax, and now it feels like it might be slipping out again because I am no longer holding myself up by a pillow.

[helenwhiteart-blog]

Super syndrome: taking a unified approach to all the things

As anyone long reading my posts will know (you just have to read my About section to hear much more on this topic) I have long believed that there is a whole bundle of health symptoms and conditions that very commonly overlap and which I strongly feel are connected; that, in fact, they need to be regarded as parts of a constellation of related things to make any sense of them at all. Finding…

[ecospreadmelbourne]

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[worldwidevoltage]

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[0dotexe]

Hey sorry to bug you but I saw your post in the tag and you’re the only other person I’ve seen on this site with multisystem inflammatory syndrome. I’m having a hard time accessing medical treatment and was wondering if you know of any groups for people dealing with this ?

Hey, you're not a bother at all, questions relating to health are always welcome.

Unfortunately, I'm not entirely sure, mainly because I wouldn't know where to look for that kind of thing (I don't really seek out group support, sorry), but what might help is looking for people who are dealing with long covid and/or seeing doctors who are keeping up to date with long covid research. You'd be surprised of what kind of symptoms can pop up from long covid outside of MIS.

A lot of support also initially depends on where you live. I live in a developing country and there's still not very much research being done about the effects of covid because of other health crises happening in the country. So it all depends on where you live if there's local support for your symptoms. Aside from that, MIS can only really be mitigated (never cured) through diet, rest, and exercise, just like most other chronic conditions.

Anyways, thanks for reaching out. Stay safe and have a good one.

[oysterlifestyle]

[covid-safer-hotties]

Back in early 2020, the news of the strange illness causing terrible pneumonias in China saddened me, but I believed I was safe in Canada. Within weeks, there was a reckoning: thousands were dying on my doorstep, too.

Directors of an independent living residence at the start of the pandemic asked me to become the residence’s COVID-19 advisor. They had no qualified medical staff, despite supporting elderly residents. Back in those early days, anyone with a medical qualification was commandeered to help in any way they could.

Confronted with the task of providing guidance to the nonmedical staff taking care of these residents, I decided to learn everything I could about the pandemic. At that time, about 1,000 papers were being published every month detailing research into every aspect of the coronavirus. Of course, I couldn’t read all of them, but I read as many as I could and built a breadth and depth of evidenced-based knowledge about SARS-CoV-2 and COVID-19. I wrote up the protocols and during my tenure as COVID-19 Advisor for this residence, we kept COVID out.

As a family physician seeing COVID-19 in my practice, I came to recognize that so many of my colleagues and patients had no idea how to keep themselves safe from the coronavirus, nor were they aware of its long-term risks. I saw the need to take action and effect change, which ultimately led me to becoming an advocate for Long COVID awareness.

I started the medical education company Kojala Medical, aiming to provide evidenced-based information about medical issues in a form patients could understand and reliably trust. I wanted a credible, trustworthy site to which I could refer my patients, colleagues, friends and family. We started with a focus on COVID-19 and have now expanded to Long COVID, with the site longcovidtheanswers.com.

I first learned about Long COVID in 2020 through publicity raised by the Body Politic COVID-19 support group, then became more alarmed as I read scientific articles about the disease.

Aside from the official death toll of over 7 million from COVID-19, Long COVID has emerged from the pandemic as the single biggest disaster to afflict humanity, yet very few people who are not sick with Long COVID are aware of it, want to know about it, believe in it, or even acknowledge that it’s happening. Sadly, many in the medical profession fall within that group of non and disbelievers.

This is bizarre, especially because of the impact of the disease. One recent review estimates more than 400 million global cases of Long COVID. I am furious that not enough is being done to alleviate this suffering. The injustice of yet another neglected and marginalized chronic illness that disproportionately affects women.

So, rather than sitting around waiting for ‘someone’ or ‘body’ to do something, I decided to act.

For me, medicine is fundamentally about aiding people to get as well as possible from any sickness they have — and even more importantly, preventing people from getting sick in the first place. In both of these regards, we are failing people with Long COVID dismally.

Long COVID is not the flu, it is a multisystem debilitating infection associated chronic condition. Developing Long COVID can be disabling and life-changing. Recovery remains low — and some manifestations like heart disease, dysautonomia, and myalgic encephalomyelitis (ME) may last a lifetime.

This is a terrifying situation to be in when, as a global community, we have chosen to act as though the pandemic is over and repeatedly expose ourselves to SARS-CoV-2, a grade 3 biohazard, with little to no protection.

As I read more and more research papers about Long COVID and looked at the inaction of global governments and my own profession, I feared that we were sleepwalking into a global mass disabling event unnecessarily, since we have many technologies available to prevent this.

Infection-associated chronic conditions do not have an established medical speciality, and are rarely taught in medical school. With the medical profession disengaged, people with Long COVID have been left to find answers for themselves.

My work aims to build on support groups, which have helped establish caring communities for people with Long COVID, but have also paved the way for us as scientists and medics to change the way we conduct research in a more patient-focused way. Nevertheless, they don’t entirely fulfill the need for evidence-based information about the disease in a readable format for nonmedical individuals.

I saw a huge need for a comprehensive website that would be of use to all people with Long COVID, their caregivers, the scientists researching the disease, and the multidisciplinary team of healthcare professionals that would be needed to rehabilitate them. Our organization believes that Long COVID The Answers meets those requirements.

There is also a pressing need to train medical professionals so that they will acknowledge Long COVID and feel confident about diagnosing and managing it. Inspired by an interview with Dr. Ric Arsenaeau, an expert in managing complex chronic diseases, my team and I created a podcast series: so that medical providers can receive continuing professional development/educational credits from watching this series.

The podcast series features a range of experts, including people with Long COVID, doctors, scientists, educators, and medical clinicians. Some of these experts also serve on our advisory board, overlooking and participating in the project.

Our site aims to raise awareness about the dangers of continuously exposing ourselves to a perilous virus with no thought of what it will cost us and our children.

This will mobilize the people of the world to demand that their leaders properly provide safe spaces for us all to prevent us from ever getting infected in the first place.

We need to mandate our governments to access all the mitigating technologies that we have in our roster, not only vaccination. The best way of managing Long COVID is to prevent people getting infected with SARS-CoV-2 in the first place!

We need national and international indoor clean air acts – to protect us from emerging pathogens.

For people with Long COVID, awareness will bring an educated and mobilized medical profession, governmental resources, financial and sociological support, and money for research — to facilitate treatments and, hopefully, a cure.

These are the main reasons why I jump out of bed in the morning with gusto, focus, and determination, and why I’ve poured all my money and my time into educating people about Long COVID.

Dr. Funmi Okunola is a British Family Physician who lives and works in Vancouver, Canada. She is the President and CEO of Kojala Medical, a digital medical education company behind COVID-19 The Answers and Long COVID The Answers.

[noagskryf]

It also minimises how serious HSD/EDS is. I don't know a lot about HSD, so i won't say anything about it, but even hEDS, the "mildest" form of EDS, is a multisystemic disorder that ranges from mildly to severely disabling. I have hEDS, and i have neurological, joint, immune, gastrointestinal, renal, autonomic, blood, and dermatological complications and symptoms directly caused by hEDS. No, Emily, your hands hurting from texting in a weird position for hours isn't the same as my organs being too hypermobile to function properly.

And that's ignoring the rarer + more severe types of EDS like vEDS, which is actually life threatening, or brittle cornea syndrome, which can cause blindness, or kEDS, which causes severe kyphoscoliosis and can cause breathing and organ issues. There's 10 more types i haven't even mentioned.

To reduce EDS to just hypermobility with chronic pain makes me so angry and i won't ever shut up about it and i will gatekeep it because i've been told by HCPs that EDS is just symptomatic hypermobility. This meant i had a life-threatening complication during surgery last year, which could've been avoided if i had been listened to.

Also it's really shitty to try to diagnose strangers online in general but that would be too tangentical so i'll leave this here

I wish we'd stop telling everyone with hypermobility and chronic pain that they must have EDS or HSD-- up to 57% of people experience generalized joint hypermobility and up to 50% of adults experience chronic pain

both of these things are exceptionally common with huge overlaps. yes, HSD is common. yes, hEDS is fairly common. no, the vast majority of people who have hypermobility and chronic pain do not have either.

it's also worth noting that hEDS and HSD are both diagnoses of exclusion. if someone has not had any testing done for any condition causing chronic pain why are you suggesting to them that they must have one of these two disorders that can only be diagnosed after ruling everything else out?

not everyone has EDS/HSD!!

[gumjrop]

Make your voice heard and ask the CDC to:

Recommend COVID vaccines for all ages and health statuses at least twice a year (spring vaccine access for all) AND

Support more frequent updates to the vaccines, adjusted for the latest variants.

Submit a public comment using our sample language below.

The committee is anticipated to vote on the following topic on day 1 of the meeting (October 23): “Use of additional doses of COVID-19 vaccine in immunocompromised individuals and older adults following an initial dose of 2024–2025 vaccine”

Your comments make a difference. At this committee’s June 2024 meeting, public comments from our community led to the committee’s decision to make fall COVID vaccines available to people of all ages, rather than limiting eligibility to specific risk groups. Please join us in making your voice heard for spring COVID vaccine access for all, and at least twice a year access going forward.

Submit Written Comment

You can also register to give Oral Public Comment at the upcoming online CDC ACIP Meeting October 23-24 at: https://www2.cdc.gov/vaccines/acip/acip_publiccomment.asp 

Submit written comments and/or register to make oral comments at the meeting by Friday October 18 at 11:59pm Eastern Standard Time.

It’s important to submit a personalized comment, which can be brief. Ideas for a personalized comment:

How you, your family, or your community would be impacted by spring vaccine eligibility being restricted to only high risk groups (such as older age or immunocompromised status)

Barriers to vaccination your have faced, particularly if your eligibility was questioned or misinterpreted by a vaccine provider

How out-of-pocket costs are a barrier to getting the latest vaccines

Also feel free to take inspiration from or borrow the language in our sample public comment below.

Step-By-Step Submission Instructions:

Step 1. Go to the Regulations.gov to submit your comment.

Step 2. Type in your comment under the field, “Comment.”

Step 3 (optional). Submit a PDF or Word version of your comment under, “Attach Files.”

Step 4. Select either “Individual” or “Anonymous” depending on if you want to share your personal identifiable information that will be publicly available on the Federal Register.

Step 5. If selecting “Individual,” minimally provide your first and last name. If selecting “Anonymous” you can directly submit the comment without sharing your personal identifiable information. Click “Submit Comment.”

Example Comment:

Docket No. CDC-2024-0072-0001 COVID vaccination at least twice a year (at least every six months) must be recommended for people of all ages, regardless of health status. A restrictive approach to eligibility creates undue barriers for vulnerable people and discourages high risk people from getting needed vaccine boosters. People of all ages, including those who are aged 65 and older or immunocompromised, should have the opportunity to receive another COVID vaccine in the spring of 2025. The vaccine schedule should address waning efficacy in the months following vaccination [1-3] as well as emergence of new SARS-CoV-2 strains by recommending updated vaccination for all ages, at least every six months. Waning efficacy is seen with all COVID vaccine types, and recent research into the biological mechanisms of waning [4] supports that this effect occurs regardless of age or immunocompromised status. Recent vaccination is associated with a lower risk of developing Long COVID following a COVID infection [5] as well as a lower risk of Multisystem Inflammatory Syndrome in children (MIS-C) [6].  The CDC’s clear and unequivocal recommendation of COVID vaccination at least twice a year for all ages will influence recommendations by healthcare providers, and coverage by health insurance. Moreover, it will improve public awareness in people of all ages about the importance of recent vaccination (within the last six months) to provide the best protection as part of a multilayered approach to preventing illness. The CDC must ensure equitable and affordable access to updated vaccines and prevent limited access because of financial constraints or demographics. The CDC’s Bridge vaccine access program ended in August 2024 [7], leaving many uninsured and underinsured adults without COVID vaccine access. We ask you to advocate for free COVID vaccine access for all of us to reduce barriers and hesitation to vaccination. References: 1. Link-Gelles R. Effectiveness of COVID-19 (2023-2024 Formula) vaccines. Presented at: FDA VRBPAC Meeting; June 5, 2024. Accessed June 12, 2024. https://www.fda.gov/media/179140/download 2. Wu N, Joyal-Desmarais K, Vieira AM, et al. COVID-19 boosters versus primary series: update to a living review. The Lancet Respiratory Medicine. 2023;11(10):e87-e88. doi:10.1016/S2213-2600(23)00265-5 3. Menegale F, Manica M, Zardini A, et al. Evaluation of Waning of SARS-CoV-2 Vaccine–Induced Immunity: A Systematic Review and Meta-analysis. JAMA Netw Open. 2023;6(5):e2310650. doi:10.1001/jamanetworkopen.2023.10650 4. Nguyen DC, Hentenaar IT, Morrison-Porter A, et al. SARS-CoV-2-specific plasma cells are not durably established in the bone marrow long-lived compartment after mRNA vaccination. Nat Med. Published online September 27, 2024:1-10. doi:10.1038/s41591-024-03278-y 5. Fang Z, Ahrnsbrak R, Rekito A. Evidence Mounts That About 7% of US Adults Have Had Long COVID. JAMA. Published online June 7, 2024. doi:10.1001/jama.2024.11370 6.  Yousaf AR. Notes from the Field: Surveillance for Multisystem Inflammatory Syndrome in Children — United States, 2023. MMWR Morb Mortal Wkly Rep. 2024;73. doi:10.15585/mmwr.mm7310a2 7. https://www.cdc.gov/vaccines/programs/bridge/index.html 

Full instructions for written and oral comment and meeting information can be found at: https://www.cdc.gov/acip/meetings/

You can also register to give Oral Public Comment at the upcoming online CDC ACIP Meeting October 23-24 at: https://www2.cdc.gov/vaccines/acip/acip_publiccomment.asp 

You must register by October 18 at 11:59pm Eastern Standard Time

CDC’s ACIP meeting information on the Federal Register: https://www.federalregister.gov/documents/2024/09/30/2024-22357/meeting-of-the-advisory-committee-on-immunization-practices 

Full Statement:

Vaccination with the latest updated vaccines continues to be foundational to a multilayered approach to COVID, providing protection against both acute disease and Long COVID. Far too few Americans have received the latest vaccines. As of October 11, 2024, only 11.2% of all adults and 26.7% of adults aged 65 and older had received an updated 2024-2025 COVID vaccine. Data for children were unavailable at the time of this writing (October 15, 2024). COVID vaccination rates continue to lag behind influenza vaccination rates. As of July 27, 2024, only 9% of adults aged 65 and older received the recommended two doses of last year’s 2023-2024 vaccine.

Vaccine efficacy wanes significantly four to six months following vaccination, making updated vaccination important for all people as COVID continues to spread in our communities. Vaccine approaches that restrict access based on age or risk status put all of us at risk and leave those at high risk of severe consequences of COVID infection confused about whether they qualify to receive additional doses. These high risk patients may also face barriers as vaccine providers misunderstand the guidelines. A more frequent vaccination approach providing vaccination at least every six months as well as frequent updates to match current variants is needed to better protect all of us amid year-round COVID spread.

Recent vaccination is associated with a lower risk of developing Long COVID following a COVID infection as well as a lower risk of Multisystem Inflammatory Syndrome in children (MIS-C). Waning efficacy is seen with all COVID vaccine types, and recent research into the biological mechanisms of waning supports that this effect occurs regardless of age or immunocompromised status. 

The CDC’s Bridge Access Program, which previously provided COVID vaccines to uninsured and underinsured adults free of charge, ended in August 2024. The end of this program without replacement coverage puts people at risk, and public health officials must advocate for free vaccine access for all of us, including those who are uninsured and underinsured.

Submitted written comments or registration to make oral comments at the meeting must be received by the CDC no later than October 18 at 11:59pm Eastern Standard Time

[covidsafecosplay]

Article date: October 14, 2024

Summary: A study found people with long COVID symptoms were twice as likely to have lingering SARS-CoV-2 proteins in their blood, suggesting a persistent viral reservoir may drive some ongoing symptoms. Researchers analyzed blood from 706 individuals and found that 43% of those with multisystem long COVID symptoms had viral proteins present months post-infection, compared to 21% of those without symptoms. This discovery hints at potential benefits from antiviral treatments for those with persistent symptoms. However, the study also reveals that not all long COVID cases show persistent viral proteins, indicating other causes may contribute to this complex condition. Key Facts: 43% of individuals with multisystem long COVID symptoms had persistent viral proteins. 21% of those without long COVID symptoms tested positive for viral proteins. Findings suggest long COVID may have multiple causes, possibly including immune dysfunction.

Read the rest.

[phleb0tomist]

hey, it’s severe myalgic encephalomyelitis awareness day. i’m hopeful that things will change. i’m hopeful that people will learn about us.

infographic credit; see more here

please hold us in your heart. ME itself is not rare (it’s over 5x more common than MS), but it’s really rare to find someone who actually knows what severe ME is! ME has been misrepresented as a vague fatigue syndrome. it is not. it’s a complex multisystem illness with a predictable pattern of neuroimmune crashes that come 24-72 hrs after physical or sensory exertion. it can become progressive and fatal. millions of people with severe ME are isolated and neglected by doctors whose knowledge of ME is based on outdated research.

it seems as though long covid can sometimes progress into ME, so cases are increasing, but many of us have had it for decades already. it crushed my life when i was a kid. but i’m still hopeful.

[robot-roadtrip-rants]

hot take, guilliman would actually hate farming. like he'd have a great couple of months but eventually he would get bored and somehow talk all the neighboring farmers into forming an HOA and things would escalate into a multisystem empire from there. i don't think he can help himself