Unraveling Complex Illness With Dr. Michael Scoma

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When medicine gets messy—overlapping symptoms, normal labs, no clear path—most systems fall back on short visits and narrow playbooks. We went the other way. With Dr. Michael Scoma, an infectious disease and immunology specialist, we explore how long COVID, post-vaccine syndromes, POTS, mast cell activation, ME/CFS, and chronic tick-borne infections often collide in the same patient, and why solving them demands patience, pattern recognition, and care that doesn’t end at the 15‑minute mark.

Dr. Scoma shares a practical framework for treating complex illness: start with a deep history, map trends over time, test thoughtfully, and iterate based on results—not rigid protocols. We dive into hypotheses around persistent spike or viral fragments in tissues, the limitations of current diagnostics compared with conditions like HIV, and why some of the sickest patients need two-hour intakes, one-hour follow-ups, and access between visits. He explains how telemedicine and concierge-style availability help stabilize bedbound or homebound patients and how “old-school” medicine—listening, observing, adapting—still outperforms a rush to more tests.

We also wade into the nuance around vaccines, schedules, and public trust. Dr. Scoma acknowledges life-saving benefits while highlighting unanswered questions about long-term effects for a subset of patients and the need for better biomarkers, larger trials, and honest risk-benefit conversations. Beyond labels like “integrative,” he argues for whole-person infectious disease care that bridges gut, immune, autonomic, and environmental factors—because complex illness rarely respects specialty lines.

If you’ve been told “your labs are normal” but your life isn’t, this conversation offers clarity, validation, and a working roadmap. Subscribe, share with someone who needs a thoughtful clinician’s perspective, and leave a review to help more listeners find the show.

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