CDC CME for medical providers

CDC and Medscape released a CME activity for physicians and other healthcare providers. This CME is a discussion moderated by Dr. Bateman, with Drs. Azar, Klimas, and Montoya as panel members
https://www.medscape.org/viewarticle/907632?src=acdmpart_cdc

I have not looked at this yet.

This is also posted in the thread on Dr. Unger's video but I thought it might be good to have its own thread. I didnt see another thread specifically for this.

 

If somebody could create a PDF with the various pages that would be handy.

 

@Dolphin - You mean of the slides? They can be downloaded from here:
(https://img.medscape.com/images/907/632/907632_slides.pptx)

Edited to add link to downloaded version of the slides in case people can access through medscape
https://www.dropbox.com/s/bpw5ycs4eezmld2/CDC Medscape CME slides February 2019.pdf?dl=0

 

Couldn't upload the file because it was too large - which is weird cause it's only 34 pages long.

But if you go the 'print page' and just annulate the printing process, you can make a PDF of it quite easily. https://www.medscape.org/viewarticle/907632_print

 

So are you going to give them your feedback?

 

Could it be a basis for a review of RCGP METRIC ?

 

This is a bit off topic, but I just filled in a questionnaire for the UK BioBank (Not the ME BioBank) on Pain and Sensation. It was interesting, not least because some of the questions had a copyright sign at the bottom for Psychosomatic Research (or something like that). It was quite long, took about 20-30 minutes maybe.

There were a lot of questions on fatigue, which I found really difficult. However at the end you could give feedback, so I noted that I didn't so much suffer from fatigue as fatiguability. This seems to be something that doesn't get looked at, it's completely different to "fatigue".

 

Yes, it is fatiguability I get, not fatigue as such. I can tell how bad I am by how quickly I have to stop rather than whether I can start if you see what I mean

I definitely have ME (diagnosed by a consultant before CFS was invented) but in the bad days when I had young children so had to carry on long after I should have stopped (I often crawled to feed them, things like that) a 5 minute nap helped me keep going. It felt like it removed toxins from my body.

 

Thanks for taking this and posting about it, Hutan. I emailed CDC staff on the typo and hopefully, they can fix it quickly.

Good points on challenge of conveying PEM and symptoms only being present if you overexert. Are there any other specifics you would like to see addressed in fine-tuning?

 

I passed, too! Shall we open a clinic @Hutan ?

Of course I'm not a doctor so have no idea how doctors usually study but for myself I didn't find the format very conducive to learning. If I hadn't already known the material I think I would have found it very difficult to take in.

First I watched the video for a bit but kept losing focus as I always do when there's just people artificially talking back and forth giving lists of information (I need a story line otherwise it's in one ear and out the other, leaving no trace in my memory). Also I can't read slides and listen at the same time so had to constantly stop the video.

Got sick of that and started reading the transcript instead. Quickly moved to skim-reading as very long (so obviously the video would have been long, too, had I watched to the end). I didn't find it helpful to have the relevant information padded out into a question and answer chat format. Too much distracting stuff around the salient bits. And just way too much to read.

Then tried downloading the slides. Of the three, that was the best way of presenting the info. Just the important bits.

But I would have thought presenting more, and more in-depth, case studies of patients being diagnosed as having - and not having - ME would have been a better way to cover the material.

Also, PEM needed to be better explained and contrasted much more clearly with the sort of post-exertional fatigue common in other illnesses.

The test afterwards wasn't exactly challenging.

Didn't do the evaluation bit either, for the same reason. I couldn't see anywhere I could give the feedback I wanted - but that might have been because by then the text was doing a sort of psychedelic dance across the screen, always a sure sign my brain needs a rest.

 

Probably because a gyn can be a primary care doctor (and I guess OB because it tends to run with gyn. If you go to a urogynecologist that's now considered a specialist and not eligible to be a PCP, or requires a referral if your insurance asks for those.)

 

This. I agree that the way this is currently interpreted is incorrect. I read a paper by Fukuda (not the actual diagnostic criteria, but a later paper) where he explains that the reason for talking about not improving with rest was to distinguish from things like overtraining syndrome (not sure he said that phrase exactly, but was definitely talking about excluding symptoms arising from overexertion).

If that was followed it would weed out all these people who went for a sail and got cured "from ME".

Some patients report not feeling better after a nap.

I don't feel better if I am crashing as opposed to having a rest, but if I can get to the point where I am actually resting instead of just shuddering in bed, then I do feel better. Not cured in any way, just somewhat less bad.

Napping is more a way to recover from not sleeping, or the most recent episode of PEM, or the most recent episode of sleeplessness from PEM, then to recover from ME.

But it's not no good. The danger of saying naps are no good, is that then doctors will say not to rest in bed (as it doesn't help anyway and they are very enthusiastic about the benefits of being up and about, and know nothing about the risks of ME), and most of us need to rest in bed in order to not get worse (whether we can sleep well enough to be helped by a nap or not).

 

@Hutan - Great comments. Thank you for sharing

BTW, This slide was fixed