What I mean by feeling better is all the time. 'PEM' is just not feeling better after exertion. That counts. So yes we have to find a way of...
As far as I can see the choices are available - if you prepared to pay. If treatments have no proven value then a public health service cannot be...
I am very unimpressed by that passage though. This is a syndrome if it is anything. I can see the point in using a name recognised by patients but...
Yes, but that applies to things like rheumatoid arthritis, which isn't one thing either. When we do controlled trials we build in to the design...
If there is actually atrial going on it would be useful to know. But if this is just open label treatments then there is the usual problem of...
I wan't actually asking about effort. I was interested in what you meant by exertion to try and understand what you see as a problem
What do you mean by exertion, @duncan? Most people do pretty much equate it to effortful action. If you mean usage of respiratory metabolic...
If the idea is that this is a disordered signalling loop then yes that certainly makes sense. You might nudge the loop back into an upward spiral....
The simple problem is that we have no reliable evidence of there being benefit. I don't discount the conceivability that there is some ongoing...
Sadly I do not think this is realistic. I am beginning to understand that looking after VS ME/CFS requires a very high level of skill even to do...
Yes, 'sickness behaviour' is a dreadful term, based on what animals do when you inject them with nasty stuff. Presumably they feel awful but you...
Perhaps another point is that this discussion arose in the context of very severe patients not being able to feed. I think it may be very...
We don't actually know that saline helps through volume expansion. The amounts given are unlikely to make much difference even short term. There...
The athlete example works for these but one key point is that the time course in ME/CFS makes no sense in these terms through any mechanism that...
There are lots of examples where disease symptoms are not signalling effects. If you are diabetic and your leg goes black with ischaemia going to...
I need to emphasise the point that there are several parallel components to the process, but one of them I think is exactly this. As I get old,...
Yes, and that would fit with a signalling error along the lines of something like 'sickness behaviour' without necessary needing inflammation as such.
But in a way this is the exact opposite of my position. I would like a scientific explanation in the long run but when considering treatment I am...
Greenhalgh seems to have lost the plot completely. If people have prolonged symptoms from organ damage that is just what we have seen with organ...
It might be, but then it might be something of the same sort but importantly different. When I had Covid I had 'sickness behaviour' as for flu. I...
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