How autoimmune disease works

Hello there. Hi. Hi to everybody who has a chronic illness, chronic pain, fatigue. Hello if you're not feeling great right now. If you're stuck in bed, stuck at home. If you're sick and tired of feeling ill, so am I. It's really nice to have you here. It's really nice just to be in company. I've got some really interesting stuff to tell you today. Basically how the immune system works. Which is really fascinating. Like it's just such an amazing thing. The immune system. And it's really interesting specifically to people with autoimmune diseases. I have an autoimmune disease. It's called axial spondyloarthritis, and I'm sure a. Lot of you. Who are listening do. Too, but I bet most of you do. Turns out most chronic illness is caused by autoimmune disease. So to find out how the immune system works. And and then find out how it can go wrong. That's really interesting to anybody with an autoimmune disease because it tells us about what's going on inside our bodies. Why? We feel like we feel. And I find that knowing these things helps me put perspective. On my disease, on everything that I'm going through, it helps me feel more empowered. It just I think it's just a very good thing for anybody who's going through these kinds of things to do is just to learn about what it is and how it works. So that's what we're going to do today. We're going to start just by understanding some basics about how the immune system works. And I'll say it it, it's really fascinating stuff. And I'm trying to. Do it in kind of simple terms, you know, simplifying it a lot, but enough to give us. Some detail to really understand what's happening. So that's going to be the main. Topic for today. Just before we get to that, just a quick app update. So for anybody who's using my symptom diary app, chronic insights, I've been working this week on an updated look. So that's going to be coming soon. I'm not sure how long it's gonna take me to do, but I'm basically adding a little bit of an update to just how the buttons look. I'm changing a few things around just to make it a bit slicker, a bit easier to use, so that's gonna be coming soon. Because I thought I I better do that before I do the tutorials which I I've got planned because a few of you have asked for tutorials about how to use the 3D feature to how do you record pain on on the 3D model, how do you record vinyls? How do you? Add fitness trackers, the diary, and all sorts of other things because it is quite complicated out and you know there's lots of features I've been working on for a very long time. I think tutorials would would help a lot. Some videos just showing you how to use everything, but I thought if I do the tutorials and then update the look of the app. I'm gonna have to redo the tutorials again cause it'll look different, so I decided I I better do this first. It's something I've had planned for a while and do that first. Hopefully it'll take me where a week to. Do and then I can start on the tutorials and then all the features that I, I. Talked about last week. So how are you? How are you doing? I hope you're doing OK, but if you're not, you're in company. You don't have to pretend with being, you know that you're feeling good, that you're OK. I I completely understand what you're going through. If you're not feeling very well, if you're achy, if you're sore, if you're tired. I know what it's like. I've got a. A sort of a family reunion coming up next week, which? I wasn't gonna go to originally because it's it's quite a long way away for me to travel. And that that just really puts me off travelling. I hate travelling because. Or driving or waiting. You know, anything that takes a long time. It's just it's just really, I just hate it, especially if it involves plains or something like that. And it's for a week, which is a really long time for me to be away from, you know, my hot water bottles and my. And you know, my comfy bed and, you know, all the things that I've got in my home just to help. Help me through flare ups and aches and pains and. And to the prospect of going away is just it's actually kind of scary, you know? It frightens me, it it stresses me out. Do you know what I mean? I bet you do too. If if you have a chronicle in this, just things like this, it's. Hard. It's really hard. But what I've I think what I've decided to do is compromise and just go for a couple of days. So at least I get to. I get to see my brother and my sister-in-law and my nephews and spend a little bit of time with them. But I'm not going to stay the whole week because I just. I just can't. I I I can't. Like social interactions. For a whole week, which just totally destroy me, it would totally. Wipe me out. Because I I I just know from experience. And I've arranged a a train ticket so that at least I can just sit on the. Train and hopefully it'll be. Things crossed and reasonably look journey. But it's kind of it's kind of. Stressing me out but. I think I think I should do it cause I do miss out on quite a lot of stuff to do with my family because of my illness, but I've decided that this is one thing that I'm I'm going to try and do. So I'll let you know how it goes. I've been. Been going through my Instagram this morning just looking for looking for something funny to make me laugh and I did find one. I did find a good post. This starts with. A comment and there's a there's a. There's an image underneath, so the comment is to a new friend. So what is? Fibromyalgia sort of new friend is asking what is fibromyalgia? And you you answer. Well, it's a bit like. A merry go round and the friend says AH. And you and you. I'm not finished. I'm not finished. And there's a picture. Of a merry go round that's. On fire. I just thought I just thought that was really funny. Ohh, because you know I I think. I think humour is actually a really helpful thing. UM. You know, for us with chronic illness, it just helps to lap sometimes because if you don't laugh, you're gonna cry sometimes. So you. I just thought. I thought that was a really good one. So OK, I think let's get to. Let's get to our topic. The immune system let's let's learn a little bit about how it works. So the the I mean there are over there isn't an exact count but there are over 80 autoimmune diseases according to you know some sources some people say over 100. And the reason is you know, some things we're not sure if they're an autoimmune disease or not, like fibromyalgia is possibly an autoimmune disease, but we're not sure yet. And so why are there so many? Well, they're all basically different ways that the immune system can go wrong. And the immune system. It's a wonderful. It's amazing. It's an. Incredibly complicated thing. It's a really, really. Intricate mechanism that basically protects us from disease. And but because it's so complicated, it's like this amazing machine with like, a a million working parts. When you have. A machine with a million working parts. That's a million. Different things that can go wrong, right? And that that's basically the the problem with the immune system, it it it's so complicated. And so if this little part you mean system immune system goes wrong, it's called Ms. It causes Ms if this part goes wrong, it causes rheumatoid arthritis. If that part goes wrong, it causes lupus, or it causes axial spondyloarthritis. Or it causes an allergy or it causes IBS. You know, there's so there's all these different. Ways that it can go wrong and each one causes a different chronic illness and. And again, the the the estimates vary, but something like between 5 and 10%, some people say even 15% of people worldwide have an autoimmune disease. It's a huge number of people. And 80% roughly again like estimates vary. Some people think 80%. Is women with autoimmune diseases and only 10% in men. And it's it's it's unclear why that is. Some people think it's it's to do with genetic differences between men and women. Sometimes some people think it's to do with hormones. But basically it it it is a lot more common in women than men, and that's another probably another reason why a lot more women than men have chronic pain because most chronic illness, sorry, most immune autoimmune conditions cause chronic pain. And fatigue. So what's going on with all these? I mean conditions. So to understand that we need to understand or what is the immune system? What does it do when it's healthy? So we we all know basically what the immune system does. It protects us from microorganisms that can harm us. So a microorganism can. Well, they, well, they're generally the scientific term is. A pathogen. It's a microorganism that can harm us, is called a pathogen. And that's from the Greek pathos means suffering. And the the old French. UM. Sort of. Genesis for producing. So it's it's something that produces suffering patho pathogen. So there are all sorts of different kinds of pathogens and. There's, depending on who you ask, this maybe four or five or six main different types of pathogen. Who one of them is bacteria. So bacteria are simple single cells which don't have a nucleus, and a nucleus is just it's a little. It's a little pocket inside the cell, the little envelope that contains. The genome, which is just a fancy word for the DNA, it's the DNA. For the bacteria. So a bacteria. So a bacteria doesn't have a nucleus, so that's what basically defines bacteria and that's and. And then you've also got fungi. So they're more complex than bacteria because they can be more than one cell. You've got protozoa, which is. It's a lot like a bacteria, but they're larger and they do have a nucleus. And then again, it sort of depends on who you ask, like how they're categorised, you, you, you could also include parasites which are which are more complex living organisms which live inside another another Organism. And then maybe you could add in these weird things called. Helmets and these little worm type things and. And maybe other things as well, like simple proteins, but but basically there's there's lots of different kinds of pathogen. But one haven't talked about. So far, and it's a big one, there's viruses. So by now in you know 20. 23 we. All we all know a little bit more than. We probably used. To about viruses, right? Yeah. Uh. So coronavirus was obviously. A really big one. So we all really hate by ourselves too, we. But actually they're fascinating organisms because. They're actually, they're pretty. Much the only. Thing, the only thing on this whole planet that is is living, which isn't made-up of cells. They literally just. Basically, they're just a piece of DNA or sometimes RNA. So RNA is it. It's very similar to DNA, but whereas DNA is like this double stranded molecule, you might see that picture of this double. Helix. There's sort of two spirals, the intertwined well. RNA is just one. It's like it's 1 strand and it's usually used to transmit. Patterns of genetic information from one place to another. But a virus is basically it's either a little bit of DNA or. It's a little bit of RNA. That's wrapped in this coat of protein. And that's it. That's all there is to it. That that's there's no cell. All. There's no like cell machinery and bits and pieces that like bacteria have and proso have. They all have these little complicated bits and pieces to them. Viruses. Just a bit of DNA. With some protein around it. So what? How does that work? I couldn't believe this. When I when I, you know, read about viruses and. And what they. Are so how do they? How do they survive? How do they reproduce? How do they do anything well? Everything else on the planet means cells because they contain all these bits and other bits and pieces, because those are the things that they're like, bits of equipment that are needed to produce more cells to to reproduce. Viruses get around this problem. They don't need all this extra stuff because what they do is they invade other cells and take over that machinery and use it for their own purposes. So it's really sneaky. It's really clever, and it's really sneaky. That's what they do. They, they, they take over all ourselves. So one one thing, you know, we're talking a lot about viruses and things that can harm us. One thing that I haven't mentioned that it is it's really important to recognise, especially if you're a bit you know. A bit sort of. What's the word for, you know, afraid of? Microorganisms. There's a word for it. I just. I can't think of it right now. But one one good thing to recognise is that most. Viruses, most bacteria and fungi and pros are most of the pathogens out there cause us no harm at all. In fact, we need these microorganisms. We couldn't live without them. We've coexisted with them for millions of years. They they, they they are part of how we've evolved, they actually they help us. For example, bacteria you've heard of good bacteria. We hear this a lot, you know, with, like, probiotics and stuff. That's that's because we need bacteria in our digestive system. In the gut, they help us digest food and and help us with all sorts of things. And there's even evidence is more and more evidence that viruses are also actually very helpful to us. Obviously, some viruses are very harmful, but other viruses help us. You know, how we've just said that. Viruses take over other cells well. Bacteria are other cells. Right. So it's possible that a virus can in theory help us to destroy harmful bacteria. And there's, you know, there's there's who be some researchers reading from 2019, I think it was. There's this research group in Finland and they they were demonstrating this, that, that, that viruses can actually help to fight harmful bacteria. So the point is that there are. Billions. There are literally billions of different microorganisms, and it's only a tiny proportion of things that are actually harmful for us. Only a tiny proportion of microorganisms are pathogens. So I mean, I'm actually gonna. Probably do a whole episode on the microbio you know about these good bacteria that that help us. So that's 1/2 of the stage. I'm just setting the stage here. There's the. These are the characters. Those are the bodies. What about the goodies? The goodies of the story, the heroes of the story? Who are they? OK, let's introduce them. So if we. Think about the. Human body they the the human body is made-up of cells too. Skin bone, the heart, the lungs, your little finger. This is all made-up of cells of all sorts, of different kinds. And they're. They're there's like. 30 trillion cells in the average adult human body 30 trillion. They're divided into like 2 about 200 different types of cell, all sorts of different shapes and sizes. And they all do different things. They all do different jobs. So how in the world does the immune system in amongst all of these 30 trillion cells in the human body, all different kinds do different things? How does the immune system pick out? These very specific pathogens, amongst everything else. If you think about it, that is a really amazing thing. That's a really hard thing. How does that work? How does that happen? The fundamental thing to understand about. How the immune system works and how autoimmune diseases come about is to understand how the immune system does this, targeting how it picks out pathogens amongst everything else. Because when it goes wrong. The thing that basically goes wrong. Is this is this targeting mechanism? When the immune. System accidentally starts targeting and attacking ourselves our our bodies. Instead of the pathogens. So let's understand a little bit more about cells. So cells are basically they, you know, they're these containers that make up. Our bodies and and everything else in our body. And they they have these walls that that they're contained by, they're called the cell wall. And on the cell wall. There are proteins. There are bits, bits of protein. And proteins are fascinating things are protein is it's a. Type of molecule. And the molecule is just a collection of atoms joined together. But proteins, they're really, really large molecules. They're very, very complicated things. So to put this into perspective, take water. So water is a molecule that we actually know very well and and we we we we generally know what it is it's. H2O. So it's two hydrogen atoms and one oxygen atom. So in total it's 3 atoms H2O. And sugar or glucose? That's that's 24 atoms. SO6, carbon atoms. There's 12 hydrogen atoms and six oxygen atoms. Alright, proteins. Look at those numbers. 3 atoms, 24 amps and they say. Hold my beer. That's not a molecule. This is a molecule. All right, proteins can be thousands of atoms. They can be 10s of thousands. They can be. Hundreds of thousands of atoms in one protein molecule. It's it's just mind blowing. And it makes them. Really fascinating cause to look at. They have these amazing structures. They're made-up of, so they're made-up of these building blocks called amino acids, an amino acid. It it's just a name for. A bunch of oxygen and hydrogen and nitrogen and carbon and sulphur atoms all joined together into these little building blocks, and there's about 20 different kinds of of amino acids in the human body. And what makes amino acids really create is they are like sort of Lego bricks. They can be combined together into loads of different combinations, almost like an infinite number of different combinations. And so you can take a bunch of amino acids and join them together into a certain combination and. That gives you. Approached him. And when you see these these protein shapes, they, they they fold over each other, they spiral, they form sheets and repeating patterns and then they fall back on themselves and and then they join with other chains and just create these fascinating. Shapes and there's almost there's this infinite variations of different shapes that are possible. And each different shape results in a different behaviour in the bodies at a different protein. Even a very. Tiny change in the sequence of amino acid building blocks can completely change the protein and what it does into something completely different. So an example, if you want to Google One a good example to look up is a protein called HLAB 27 and that's the it's personally quite sort of relevant to me because it's a protein that. It is actually, it turns out there very significant in my autoimmune disease axial spondyloarthritis. It turns out that it. It plays a very important role, we think, and now probably do a whole different episode, but it's a really good example. If you just want to search for for. One go to. Google type in HLA B27 and hit images and you'll see what I'm talking about. These these are amazing structures. So what has all this got to do with the immune system? Well, it turns out that these these shapes, these proteins, they're found on the surface of cells and on the surface of viruses. And it turns out they can be incredibly useful for the immune system to determine what is a pathogen. And what isn't a pathogen based on these very specific shapes? These proteins, because only in certain configurations and shapes. Of proteins and amino acids are found on pathogens and only certain shapes are found on things in the human body. And so that's the thing that we can use to differentiate between what part of our body and what's a harmful thing that's invading us. And this is basically what the immune system does. It looks for certain shapes. And so there's a name for these. Shapes that are on the surface of cells, they're called antigens. So that comes from the Greek anti meaning against and again Gen meaning to to produce or to cause. So an antigen is a thing which causes the immune system to start fighting a pathogen. Just one little side note, antigens are not always proteins, but the vast majority of them are. But just to simplify things, we're just going to talk about. Proteins. There are antigens. So how does the mean system recognise these antigens? That's where a cast of good characters comes in. So the immune system heroes, and there's there's a whole posse of them. There's there's a there's a bunch. Of really great heroes, and I'm only gonna talk about maybe a couple of them. There were loads and loads of different kinds. But again, just to simplify things, I don't understand it all. I only I've only read up about, you know, parts that I could get my head around. So it's important just to be aware that this is a bit of a simplification. But we'll talk about one category of goodies called lymphocytes. And so they're called lymphocytes because they're found in the lymph, which is the, it's a fluid that flows around our bodies in it. To transport lots of stuff to our tissues and organs and back again through lymph vessels and lymph nodes. So site means cell it's it's comes from the Greek uh like kaitos or cytos, meaning a hollow receptacle basket. So site means cell. So a lymphocyte is just a a cell that is found in the lymph. So these lymphocytes, they're amazing things. They're they're really, they're really incredible. And there's there's lots of different kinds of lymphocyte. And we're going to look at a couple in particular. So one of them's called a B cell. And these B cells, they're awesome because they create antibodies. So what's an antibody? OK, an antibody. That's another. It's a. It's another kind of protein. It's usually it's Y shaped. So it's got these two fork ends and and one sort of like. One stem I guess you could call it so these two forked ends, they they. Have this ability to lock on to very specific proteins by they bind to them. So an anti so an antibody is just a, it's a. It's another kind of protein which will only bond to a very specific antigen on the surface of. A cell or a virus or pathogen. And nothing else. It won't bind to anything else, so it's very specifically just binds to something and the other end the sort of stem end it's. It's usually very much the same. Across all types of antibody and all, and we'll come back to that in, in, in a minute to to talk about why that is so. So these B cells, they, they're. Circulating around our bodies, they're sort of, you know, roaming around and they they create. Antibodies usually like generally a small amount to begin with, just just enough to be able to latch on to. A pathogen. If it finds one. And each each B cell creates. They're very specific. They only create one kind of antigen. So you can imagine we've got like loads and loads of different kinds of B cell which. Only produce one different kind of antigen each. And they float around these these antibodies, they then flow around as well inside our bodies. Until they find a pathogen, they bind to it. And once they bind to it, the other end of the antibody, this this sort of stem end, which is generally it's the same. It's the same because again, that has its own little. Sort of shape on it. That acts as a signal. To another kind of cell called a macrophage. Macrophages are like the big bouncers. They're Macross, means large in Greek, and Feige. Means to eat, so they're these big things that like to eat other things. So these macrophages, they, they come around and they they're looking for antibodies that have attached themselves to something. Because that's their signal that this thing is probably a pathogen or it's something that we want to get rid of and it it literally absorbs that thing and eats it. And that's how. That's how the macro macrophage actually, you know, protects us it it actually consumes these things and eats them. And they're patrolling all over our bodies. They're macrophages are like in every part of our body. They're they're constantly patrolling and looking for antibodies that attach themselves to something. And macrophage they also they also eat and bits of debris and bits of things that are floating around that don't need to be there anymore. They eat cancer cancerous cells, so they're really, really helpful. They're they're a really good part. Of the immune system. These antibodies once thing once an antibody attaches to something. Another cool thing that they do is that they signal to the bees cells that produce them to produce. A lot more. Of these antibodies, because they're at right, I found something. I found something that we needed to destroy. So there might be a lot more of these things flowing around. So let's produce a lot more antibodies. And they do this by creating another kind of cell called a plasma cell, and that's specialised to produce. Loads of antibodies really, really quickly. Get this they they can produce thousands of antibodies every second. Yeah, like every second thousands of these little antibody molecules, it's just it's that it's just amazing. And then there's also memory cells that are produced. And and memory cells just speed up the whole process so that and and they linger it, they can. They can stick around for literally years, decades even. So that if we get the same pathogen coming along. The whole process of that antibody flowing around and eventually finding the pathogen and locking onto it and then signalling to the B cell to produce more. That will happen hopefully lot quickly, a lot more quickly the next time because of these memory cells. It's just amazing, right? Just all the all this complicated stuff goes on. And and antibodies they they can actually just make viruses, they can deactivate viruses just by just by binding to them because by binding to these viruses to their. Antigens, they sort of fill up. These antigen slots, because it's actually the antigens that allow the viruses to latch onto. Body cells that they want to invade, and if they're all sort of stuffed up by these antibodies, you know, it's like, you know, they got clogged up basically, then they can't do anything. So that's B cells. We've also got another type which I'll I'll talk about called T cells. So there are loads of different kinds of T cell. I'm just going to talk about a couple, so one of them is called a cytotoxic T cell and they work by. So T cells don't bother with producing antibodies, they they just they bind directly. To the antigens on pathogens and. And like so, the cytotoxic T cells, they like puncture holes in the membrane of of pathogens. And so enzymes can get inside through the membrane and inside to eat them, and then you've got you've got helper T cells, so they work slightly differently. They they again, they latch directly onto the pathogens, but they sort of signal to other, they help. To stimulate the B cells and other cells to say hey. So we need help, we need. We need to do stuff here. There's there's a pathogen. So let's let's do. Something about it? And there's all sorts of different kinds, and doing doing all sorts of different things. So there's there's not one thing going on here. There's like loads of different things going on and they're all in this like chain reactions of one thing leads to another thing and then that leads to another thing. And then that makes another type of cell do another thing. It's just amazing. It's it's incredible that it. It all works. It also means that there are lots of different ways that it can go wrong. So auto immunity, auto immune disease, auto means self. So what we're talking about autoimmune disease is when the immune system turns against our cells us. The thing it's supposed to be protecting. And to be honest, we. Don't really. The headline is we don't really know. We know some bits and pieces. But we don't know the exact mechanisms, and there's probably lots of different mechanisms, but we don't really understand them all. We don't know. But here's a couple of things that can go wrong. One thing that can go wrong. Is there so these B cells and T cells they're produced in? In bone marrow, they're actually that's where they're actually created and when they're producing the bone marrow before they leave, they they get like they get like tested. Auto activity so they get tested to see if they'll react. To our own body cells. And if they, they do. They get sort of cold off they. Say right? Not. Let's not produce that because it's going to attack us. It's this amazing mechanism that that basically tests testing cells before they leave the factory if you like. So B cells and T cells, they they they're normally like they they they undergo these tests and also in the in the spleen so so B cells when they're produced in the bone marrow they then go to the spleen and in the spleen they're supposed to be these these cheques happen these more cheques happen. And teen cells, they they go to the thymus. I had to look up. What? What the hell is a thymus? It's this gland in in our chest. It's like right in the middle, sort of under the rib cage. So that so they. T cells sort of go go there and they they're supposed to have these sort of tests for autoimmune. Causing, but sometimes these tests don't work, they don't happen and so we end up being able to produce these B cells and T cells which. Don't. Also don't only just attack pathogens, but they start attacking us as well. And another thing that can go wrong and this is this is kind of a big one and it's. Kind of an umbrella problem that. Be like. Further divided into like a million other problems, the general problem is that is when. So we talked about these antigens and they're on the surface of pathogens, but they're also on the surface of all cells in our body, these proteins, these shapes. And there's a problem. The problem is that sometimes these shapes. Can sometimes be very similar. The ones on pathogens can sometimes be very similar to the ones on our own body cells. So remember when I talked about all the the the proteins that are made-up of all these building blocks, these amino acids, sometimes there can be little fragments of amino acid chains and little parts of these proteins which are very, very similar to the ones on our body. And so sometimes these similarities can can be mistaken. You know, the immune system basically makes it it mistakes. This bit of a protein on a pathogen. It it it it's. It recognises that OK, that little shape, that little part of a shape that. Is a pathogen. When I see that shape, it's a pathogen. It's it's gonna I I gotta attack it. Sometimes that same shape or something very, very similar to it just happens to be. On some cells in our body as well. And So what happens is that whole process that and we've just gone through about. The antibody. It's it gets produced from the beam cell and never latches on to the antigen and then other cells come along and to to attack it and destroy it. It can happen to our own body cells. And it's just a mistake. It's just a miss targeting. And it's not surprising really, that this can happen. Because they they're just, there's so many different cells. There's so many different protein shapes, and it's such a difficult job for the immune system to be only pick out these particular shapes. That somehow it you know, it knows that those shapes, that's a disease that shape, that's a body leave it alone and just a very, very occasionally. It will get it wrong. And it'll start attacking our own body cells. And just by, you know, basically random chance if it's starts attacking this kind of body cell, it's rheumatoid arthritis because it happens to be the cells inside our joints. Or if it's, you know if it's Ms, I think that attacks the the the lining on the nerve cells, isn't it? It's it's some something, something like. And if it's, you know if it's attacks, this kind of cell, it causes this autoimmune disease and if it attacks that kind of cell causes a completely different autoimmune disease. But basically. That's what's happening. But exactly the detail of. How that comes about? We don't really understand it all. Yeah. And that's why, you know, we don't have cures for autoimmune diseases yet. But we're starting to understand a lot more about the immune system. Technology is allowing us to understand a lot more. All the different kinds of cells that are in our body and we can now sort of isolate individual cells. We can pick out these these sort of rogue cells that are attacking our bodies out of all the 10s of thousands of other kinds of cells, we can now sort of begin to pick them out. And really, study these things and try to understand what? Why are you miss targeting what? What exactly? Why have you mistaken this? This, this protein shape or? What other thing? Because that's just one thing that can go wrong. This sort of missed targeting this. It's like potentially lots of different ways it. It can go wrong. So I find it just it helps to understand all this. Stuff a little bit. Because I feel like. I feel like. You know, like like before I. Learned all this stuff, I just. I just hated the fact that I was in pain. I just hated the fact that I was always tired. I just felt like I was being. I didn't really feel like I was being punished, but it just. It was just this. It just. I just hated this thing that was happening and it just didn't make any sense. It's like, why? Why is this happening? But now I just had. I feel like I have got a bit more respect. For my body and a little bit more sympathy for. For my immune system. It's like, OK, I kind of get it now. I kind of understand why you're going wrong, because like, it's kind of amazing that you can, that you work in the 1st place, so. You know, I understand. Understand why I'm in pain a bit more. Understand why what's happening is happening and and for me. I just find it helps me cope. It just helps me. Come to accept it or I find. And just I can live more at peace with knowing. A bit more of how it works, so I hope it does you too. I I hope this helps. Just share the knowledge and share some of this understanding and. We've just, we've. Just touched on the the real basics. There's there's loads of more really interesting stuff to learn and I hope to in future episodes maybe dive into few more of these topics and maybe be a bit more specific on like how does fibromyalgia work or how does actual spondyloarthritis. Work. What? What do we know specifically about these things? Ohh my my my hips, my hips are really aching. I've got my electric blanket on but it's it's just it's not. It's not really helping, I I really need to stand up. I really need to start moving because it's coming up to coming up. To an hour. And I'm really starting to feel it. So I'm I'm gonna. I'm gonna have a bit of a move. I'll probably have a bit of a bit of a lie down bit. Of a rest. Because this has really taken out of me. But I I I hope, I hope this helps. I hope to see you again next week and. I hope to hear from me. You know if if you if you wanna write in, feel free to to say hello, you can just e-mail me at james@chronicinsights.com. And remember to check out my symptom diary if you haven't already. Is something that I've made to help myself to begin with. Just to record my pain and fatigue and all the symptoms and all the ups and downs and and help me communicate. By drawing on to these 3D models like what it actually what my pain looks like. So if you find. If you think that'll help, give it a go. And and let me know what you think and let me know if you've got any features that you want to that. You want to see on there? You just search the App Store for chronic insights and it'll come up. All right, spooning. I'm going to love. You and leave. You I I. I really hope you you're doing OK, but if if you're not. It's OK. I, you know, we're in this together. I'm here with you. I'm always going to be here with you. So you're not alone. You're not alone. Spoonies. Alright, I'll see you next week. I love you. Bye bye.