With the rapid increase of social media appropriation globally, there has been a surge in the number of chronically ill adults who leverage social media tools as part of their illness management practice. While numerous studies discuss the potential benefits of appropriation there seem to be limited studies that have explored appropriation of social media by investigating how and why these technologies have been appropriated by these patients. This paper applies an interpretive case study with mixed methods to examine appropriation of Facebook by these cohorts. Our results highlight the patterns of social media appropriation: lurking as passive learning; liking and reacting to show support and; borderless appropriation of multiple social media tools. Among a range of influences, crafting a positive illness identity, communal filtering of misinformation were found to be positive influences and barriers like emotional overload were found to influence appropriation for chronically ill adults on social media.