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But what about the healing energy of a positive haircut? And house shoes. I mean, you can tell some people have just given up from the slippers they wear.

Only option left. The bastards have made it abundantly clear they don't want to get better.

And they'll need to do a whole load of housework, admin, and general life stuff that other patients might get support with, and possibly even return to work sooner. Not surprising then if they report more fatigue.

I don't know if it works for ME hyperhidrosis and/or guys, but I wouldn't have been able to carry on working if my GP hadn't talked to colleagues about relief for people who can't take HRT, and someone had suggested gabapentin. LITERALLY save my sanity! I think I took it for about three and a...

No, not yet – swimming and laundry day, so I've only just sat down! I'll come back on later when I've had some food. :)

I don't really have a theory, I've no medical training or understanding. I just know that when my brain was sending out signals that I was so hot my upper body needed to be drenched in sweat – my clothes and hair would literally look as if I'd just been out in a downpour – I could find no...

Well, I don't know anything about him, but it is nice to see a bit of good Yorkshire pronunciation still going strong in NYC. The full name's Douthwaite, but Douthat is how they used to say it in the East Riding. As with practically everyone else from that area, the name crops up numerous times...

Interesting! It's the normal adrenaline for me, which is a pleasant energy surge at the time. As you say it suppresses pain, and along with it all vestiges of weakness and fatigue.

Being in stimulating company makes me completely over-stimulated, and filled with adrenaline to the extent that my hands go shaky. I'm autistic, though, I don't know whether that has anything to do with it? Laughing at a funny book or TV programme when I'm on my own doesn't have the same effect.

In me, the ceiling disappears altogether. For a while. It's never seemed to me that our cells can't make energy; more that they're being told not to. With adrenaline that lid gets knocked off temporarily, because it's an emergency (even though it usually isn't a real emergency).

Me too. But the more adrenaline, it always seems the worse the PEM! So spending about half an hour swimming 1.5k, which doesn't involve much (if any) adrenaline, can leave me in less severe PEM than spending about half an hour sitting down talking to a friend whose conversation makes me laugh a...

If you can't remove the cause of the sticky blood, then I guess yes? But if it actually worked, it would provide a target for further research. And once a lot of the gunk has been filtered out, treatment with existing drugs might help delay its return.

They're saying 'a version of APS syndrome', which I suppose could mean something that is not APS but produces similar effects? It's not a very satisfactory way of expressing it, though, even assuming they know what they mean in the first place.

I've been thinking about this whilst trying to find the best way to record swim data, and it's clear that it's the app that makes most of the difference. For instance, standard health apps aren't interested in whether someone is resting in a sitting or lying position, but that would be...

You know those air fresheners in public buildings that are triggered by opening the door to the toilets? Every time the door of the staffroom is opened in one of the fatigue clinics, it should trigger a recording of Dr Khan's "It is a myth" statement.

That's a good thought. I'm pretty sure I know what induces my falls – PEM-induced clumsiness, "spaciness", muscle rigidity, and dizziness – but am also pretty sure that a lot of therapists aren't even aware of those symptoms. ETA: small clarification.

So reading what @Trish, @Jonathan Edwards, @Simbindi, and @Peter Trewhitt have written, should new-style clinics begin with the following? We can't put ME right, but we can: Learn how to diagnose it reliably and record a detailed picture of the onset pattern, symptom profile, and natural...

I think it needs a venous catheter? I remember a relative having one during his treatment. It's presumably fairly routine in hospitals when monitoring some conditions, but it's invasive, so I doubt it's something a local clinic would offer.

Yeah, right.

It wouldn't necessarily mean the text of the guideline, would it? It could mean accompanying commentary or framing, for instance. To me that seems more likely because text changes could trigger a demand for further consultation...but really, who knows!