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A fantastic job by @Nightsong. It is all becoming clear that the problem was very much as suspected - not a fault with guidelines but with people putting groundless theories before what was needed. I have had some suggestions about things to add to my Qeios piece, which I can do whenever I...

I am sure that is right. But I think it may be important to note that somewhere Maeve had said something like that she had been told to lie flat all the time for months as the only road to recovery. That concerns me. We need evidence.

So yes, reading through who said what, it seems clear that Warren was also working on beliefs at the time.

I am suggesting that he gets it now, or at least is saying what he would say if he did. I am not in the least implying that the problem was not about beliefs of doctors - in fact that is my point and his point hear - people should have been focusing on what the patient needed, not what they...

Well, for me the point hits the nail on the head. Which it would do of course because I wouldn't be surprised if it was making use of my Qeios piece.

Maurice Merleau-Penty is the godfather of pseudo-academic drivel.

We recently discussed a paper on a forum thread about gastroparesis that suggested that the diagnosis is quite unreliable and makes no difference to management, if I remember rightly. I haven't seen any clear data that people with ME/CFS have reliably documented gastroparesis. From what the...

What are you hoping for @SteveFifield ? There isn't much physicians can offer. All the reasonably sensible ones who had ME/CFS practices I know in London have fairly recently retired from them.

From the Telegraph, Dr Warren seems to get it: "When asked, he said he did not know whether ME was a physical or psychological condition, but said the “more important question is what does the person with ME need”." Dr Roy seems to miss the point. He doesn't know either but assumes that the...

To clarify, your experience would suggest that the argument about stomachs benefitting from being used is probably unfounded? @cassava7

I remember recently reading about a new fashion for 'gut-brain axis' medicine, which sounds like an empty slogan to me. I also remember reading a piece by some gastroenterologists who seemed to be actively pushing back against using nutritional support for 'functional' cases. I am getting the...

I have never heard of that in the context of people being fed IV on ITU for whatever reason. It sounds like hot air to me. Edit: Dr Roy seems to have made quite a bit of this idea of needing to keep the stomach used. As far as I know there is no evidence for that at all.

I don't know the details. The studies I am aware of were done probably in the 1950s or 1960s. I don't think we have any answers to these questions in relation to the lives of people with severe ME/CFS and we need answers to be able to advise people sensibly.

Health Rising has never been a very reliable source for science. I remember reading the Bell studies in the past and not being very convinced the conclusions could be applied to the ME/CFS population in a meaningful way. If there is diabetes insidious present then that would explain a low...

I don't think there is well established evidence. There are some old volume studies but a lot of these studies have methodological problems. One thing that I think is important to consider is that if people with ME/CFS do have low blood volume I think much the most plausible explanation for...

Managing Covid-19 is a very different issue, chiefly involving acute respiratory failure.

Maybe 'is there any training?' Specialist training is training after passing the general College exams for entry into specialities. There is no specialist training for ME/CFS for adults because ME/CFS does not belong to any specialism (unless the liaison psychiatrists have training!). For...

The problem that we have had to face is that NICE have complex requirements for any guideline process such that even a modification seems to require setting things up that would cost a lot of money. A committee has to be convened. Evidence has to be assessed... Interested parties have been told...

We do have conflicts to deal with but surely that example is entirely non sequitur? The doctor does not take the key from the sleeping guard and unlock the murderer's handcuffs for him.

To me that sums it up. It was ultimately inappropriate because it did not appear to show integrity. Dr Weir's credibility was being undermined in a way that might have been in the hospital's interest but not in the interest of a fact finding inquest. It looks very much as if some of the...