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This lays out the problem pretty well. The suggestions for alternative designs make sense but are maybe bit pedestrian. There is a suggestion that maybe somehow expectation bias could be 'factored out'y measuring it. That seems to me unlikely to be realistic. The whole problem with expectation...

Ah, yes, that would be a different issue and a reason for people to whisper behind his back. But attacking the system and others' treasured dogmas is called standing up for what you believe in. Anyone with any backbone does that with pride and takes the backlash on the chin - I have been at it...

From my perspective as someone in a similar job to Garner I really don't recognise this. Colleagues might have judged him for being careless enough to get infected - which in his case was unlikely to be from seeing sick people in A/E. But the medics I know with LongCovid are given huge sympathy...

I would be happy to take this article a little tongue in cheek: So that's the nutty professor's N=Me This is my N=Me Nah-nah-na-nah-nah! Two can play at that game. And since you did it first you can't complain.

Aren't people confusing empathy with sympathy. Empathy is the ability to understand and share the feelings of another. Really don't understand Garner's feelings. If I had Covid and remained ill, as a physician well familiar with the concept of post viral fatigue I would feel relieved that I had...

Simple answer to the title: No. Apheresis has an effect for a week or so - what's the point?

Perhaps they had help from THE DOCTOR.

I think Garner is LSTM - Liverpool School of Tropical Medicine - without the hygiene!

The study you quote looks quite good. From what I have read nobody has been able to demonstrate Kwok's MSG effect either, despite trying. If reasonable studies show nothing then maybe it isn't there?

I think that depends on what sort of examples are considered. Shared risk taking is something doctors and patients have been doing in discussion for years in rheumatology, where most drugs are risky. Much of the time that is through explaining risks and the patient coming to a decision. For...

In general I have a rule not to advise individual people on their health problems but I try not to follow that just for the sake of it. A general comment that comes to my mind is that swelling following stimulus is not a feature of allodynia, but of some sort of tissue sensitivity. Allodynia...

I realise that this situation exists. Interestingly, I don't think I ever found myself in it except when NICE refused to let me use the drug I had proven to work! And that wasn't my decision. And for one or two patients I inherited who had become hooked on regular steroid injections that were...

(I am a professor of medicine.) I don't think electrophysiological tests are any use for the face. There are no electrophysiological abnormalities in ME/CFS or fibromyalgia that I am aware of. Electrical tests on limbs are chiefly of use to excuse other things - and their use is quite limited...

If you want to be openly derogatory about all doctors that's fine by me but as a doctor it doesn't ring true. Most doctors would like to do their best for people but they get fed up if people have unreasonable expectations associated with diagnoses that don't mean anything useful. Surely the...

Indeed. As far as I was concerned as a doctor all the decisions were made by the patient. I was just there to explain what was available. Why should patients have to share their decisions with health workers?

I am afraid this looks like window dressing to me. I have this awful vision of an ignorant health care worker offering a useless treatment explaining at length how they are going to be terribly nice and friendly and share the decision with me as long as I am terribly nice and friendly to them...

The irony is that 'fibromyalgia' really means, in medical language 'whingeing about pain when there is nothing really wrong, oops, I mean it's all biopsychosocial'. Unexplained pain is at least just unexplained pain. The more a doctor believe in fibromyalgia the more they don't believe it's...

'I was told that they don’t treat patients with fibromyalgia, like me, regardless of what they come in for.' I can guarantee that is not actually what was said. Does anyone actually believe those words were used?

I am of course very well aware of the problem of not being believed. But just as members read this article from the perspective of being the patient I read it from experience of being on the other end as well. (Yes, I too have been the unbelieved patient.) Everything I see in this article...

I see this from the point of view of the doctor. 'Fibromyalgia is a term used 100 times more frequently by some physicians than others. Prevalence rates vary from 8% down to 0.05%. Which basically means the term is meaningless. ME/CFS has a specific meaning and is clearly useful, even if there...