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so we can’t parade — but we can lounge in style. :D

The parasympathetic system may be healthy and functioning normally, but has an excessive load being placed on it by a pathology elsewhere in the body, which is causing it to be overstimulated. In which case further stimulating that system is not only unlikely to produce a benefit, it might be...

Yep. That is its purpose, which is why any evidence against its actual efficacy and relevance is ignored.

That is my sense of it. PEM is the consequence of whatever is driving the problems underneath. In the same way as somebody who has been stabbed and is bleeding onto the kitchen floor is not afflicted by blood on the kitchen floor syndrome. They are afflicted by a stab wound causing external...

I would like to see the end of the idea that specific dedicated exercise is some separate thing from daily life. The artificial separation of exercise from normal life is one the problems with exercise advice, as it removes the meaning or value from the activity, and for many is an inefficient...

Indeed. Where is the real mental and moral pathology here? There is (was?) an American psychiatrist who eventually gave up on the profession, after coming to the view that most psych patients would get more therapeutic benefit from having a nice pet dog/cat.

Yes, not all publicity is good.

That is interesting.

ME/CFS: Under the Hood ME/CFS: Behind the Science (or Research)

So they prefer uncritical analysis? If (if) they really are interested in finding the weaknesses in their hypothesis and experimental methodology, and getting the right (or at least better) answers, then the best people to find it are their critics, who will also usually do it for free.

Not just the money, though that is a big one. Being one who 'recovered' can bring a kind of calling, of being special, a leader chosen to help the lesser mortals. Only a short step from there to the unshakeable certainty of fanaticism.

I think this is important. Exertion, of any form, certainly is a consistent trigger/exacerbator of PEM for me. But it can also happen without any exertion in the previous few days (beyond minimal self-care and life admin stuff). The so called 'baseline' for me, to the extent it exists, is...

In fairness, you only posted that a week ago, and it is a very complex and weighty problem to address, that is never going to be easy nor quick to deal with. You are free to lead from the front on this.

Especially when those patients are informed, cogent, and have no incentive to compromise for the sake of career prospects, etc.

NICE 2021, and everything else, may well have not happened for all the difference it is making in the NHS. They just don't care, and are clearly going to hand us straight back to the psychosomatic club. It could not be more obvious. :grumpy:

Despite there being not a shred of hard evidence for any of it. :grumpy:

Multidisciplinary interventions, such as graduated exercise therapy with the Modified CHOP POTS protocol,11 incorporating pacing after energy expenditures, cognitive behavioral therapy, and neuromodulation, alongside dietary and nutraceutical interventions, have all shown promise in managing...

They are still playing the underdog card, I see. And it started so promisingly too. This is obviously the latest tactic. Sound so sympathetic and understanding about the patient's dilemma and medical trauma, then hit them with the same old toxic shit they have always foisted upon us. Sorry...

As Susan Sontag said (in Illness as Metaphor): Theories that diseases are caused by mental states and can be cured by willpower are always an index of how much is not understood about the physical terrain of a disease. Maybe do a video styled after the one by Chalder and Gerrada, but telling...

Not successfully, if the likes of Sir Simon have any influence over the outcome.