Thursday, April 24, 2014

Why are doctors skeptical and unhelpful, Parts 1 and 2

[These two articles are written by a journalist with ME/CFS. Part 2
covers more political issues like the CDC, exercise advice, the IoM
process, etc. Tom (@TomKindlon)]   i.e.

Guest Post, pt. 1: Why Are Doctors Skeptical & Unhelpful about Chronic
Fatigue Syndrome?

By: Julie Rehmeyer | April 23, 2014

--------------------------------   i.e.

Guest Post, pt. 2: Why Are Doctors Skeptical & Unhelpful about Chronic
Fatigue Syndrome?

By: Julie Rehmeyer | April 24, 2014

This is Part Two of a post on myalgic encephalomyelitis/chronic
fatigue syndrome — or just ME/CFS — which is a disease that 1) knocks
people right out of the game and 2) doctors can help with (though not
as well as one would like). But most doctors haven't a clue, often
even viewing the illness as psychosomatic and untreatable.  Part One
was yesterday, and it left off puzzling about why doctors are so

Resolving Conflicts When a Partner is Chronically Ill

It's hard enough to sustain a good relationship when neither partner is facing a health challenge. Illness ranks high on the list of life's stressful events, so it's no surprise that it can have a negative impact on a close relationship.
... You want your partner to accompany you to a doctor's appointment, partly for support and partly so that he or she can learn more about your medical condition and the challenges you face. If your partner refuses to go, your first reaction might be to assume that he or she doesn't care enough about you to be bothered.
* * *
My then-husband HAD to go with me to the doctor because I couldn't walk that far without being propped up.  So he was in the room when the quack announced that "all blood tests are normal; you're perfectly healthy" and suggested that the real problem was that I didn't want to work. 
Having been raised that the doctor is always right, his attitude immediately changed.  Instead of confirming to the doctor that he had seen with his own eyes the fever/vomiting/diarrhea/collapsing that I was reporting, and demanding the doctor take me seriously, he concurred with the doctor that I had roped him into my imaginings, and that he never saw any objective symptoms because there weren't any to see, because the doctor said they weren't there.

Wednesday, April 23, 2014

Inability to reproduce VO2peak indicates functional impairment


Inability of myalgic encephalomyelitis/chronic fatigue syndrome
patients to reproduce VO2peak indicates functional impairment
Betsy A Keller, John Luke Pryor and Ludovic Giloteaux

Journal of Translational Medicine 2014, 12:104  doi:10.1186/1479-5876-12-104

Published: 23 April 2014

Abstract (provisional)

Background: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
(ME/CFS) is a multi-system illness characterized, in part, by
increased fatigue following minimal exertion, cognitive impairment,
poor recovery to physical and other stressors, in addition to other
symptoms. Unlike healthy subjects and other diseased populations who
reproduce objective physiological measures during repeat
cardiopulmonary exercise tests (CPETs), ME/CFS patients have been
reported to fail to reproduce results in a second CPET performed one
day after an initial CPET. If confirmed, a disparity between a first
and second CPET could serve to identify individuals with ME/CFS, would
be able to document their extent of disability, and could also provide
a physiological basis for prescribing physical activity as well as a
metric of functional impairment.

Methods: 22 subjects diagnosed with ME/CFS completed two repeat CPETs
separated by 24 h. Measures of oxygen consumption (VO2), heart rate
(HR), minute ventilation (Ve), workload (Work), and respiratory
exchange ratio (RER) were made at maximal (peak) and ventilatory
threshold (VT) intensities. Data were analyzed using ANOVA and
Wilcoxon's Signed-Rank Test (for RER).

Results: ME/CFS patients showed significant decreases from CPET1 to
CPET2 in VO2peak (13.8%), HRpeak (9 bpm), Ve peak (14.7%), and
Work@peak (12.5%). Decreases in VT measures included VO2@VT (15.8%),
Ve@VT (7.4%), and Work@VT (21.3%). Peak RER was high (>=1.1) and did
not differ between tests, indicating maximum effort by participants
during both CPETs. If data from only a single CPET test is used, a standard classification of functional impairment based on VO2peak or VO2@VT results in over-estimation of functional ability for 50% of ME/CFS participants in this study.

Conclusion: ME/CFS participants were unable to reproduce most physiological measures at both maximal and ventilatory threshold intensities during a CPET performed 24 hours after a prior maximal
exercise test.
Our work confirms that repeated CPETs warrant
consideration as a clinical indicator for diagnosing ME/CFS.
Furthermore, if based on only one CPET, functional impairment
classification will be mis-identified in many ME/CFS participants.

The Last Word On Nothing | Guest Post, pt. 1: Why Are Doctors Skeptical

Each time I was stuck in bed, I scoured my activities, my diet, my environment, seeking a reason. Ultimately I concluded my illness might have been controlled by the Greek gods, creatures more irrational and capricious than the human mind can comprehend.

Autism and the Agitator -


Over the last few years, measles outbreaks linked to parents' refusals to vaccinate children have been laid at McCarthy's feet. The British study that opponents like her long cited has been revealed as fraudulent. And she and her tribe have gone from seeming like pitifully misguided dissidents to indefatigably senseless quacks, a changed climate and mood suggested by what happened last month when she asked her Twitter followers to name "the most important personality trait" in a mate. She got a bevy of blistering responses along the lines of "someone who vaccinates" and "critical thinking skills."

Seth Mnookin, the author of the 2011 book "The Panic Virus," which explores and explodes the myth that vaccines cause autism, noted that McCarthy had a relatively new gig on ABC's "The View" that could be jeopardized by continued fearmongering. What once raised her profile, he said, could now cut her down.