Paul Garner on Long Covid and ME/CFS - BMJ articles and other media.

When Gerada writes post PE, what is she referring to?

 

PE is usually shorthand for physical education, but in this context I think she means pulmonary embolism

 

Looks like Garner is on the Central Sensitisation bandwagon. I guess he must that it’s a bit of a sturdier bandwagon to be on than the deconditioning bandwagon, which has the wheels falling off.

PS The graphic is from Australia’s outdated 2002 clinical guidelines for CFS. No doubt Australia’s BPS brigade (who are furious that the government agreed that our guidelines need to be updated) are thrilled that someone like Garner is using their work.

https://twitter.com/user/status/1359605463042715649

 

I imagine there's supposed to be some sort of coherent idea here but I can't make sense of it, all I see is a bunch of labels and boxes with arrows thrown with no discernable sense.

 

It very much reminds me of when we were pinning up our degree project drawing submissions prior to crits ( where you present and people verbally pull.your design to bits )

One of my year had produced wonderful watercolour renderings . Impressive imagery , but technical content summed up in 2 mins by a year tutor - wonderful presentation, shame the scheme is shit. ...

 

Maybe if they start thinking instead of drawing arrows through all the organs and systems in the body they will find out it becomes harder and harder to actually make a coherent argument about a plausible disease mechanism that is not entirely superficial

 

As an aside, I hadn't seen this before. Someone on Twitter posted it in response to Gerada's latest nonsense:

As usual, it's not her fault. Those horrible patients are to blame yet again.

 

I suppose he had better include that Tweet in the next Cochrane review and analysis of evidence. In 2oo2 they would of course have known so much about Covid that no further comment is considered necessary'

He could be woofing up the wrong tree.

 

Central sensitisation hypothesis has always struck me as another form of denial of patient symptoms, i.e another incarnation of trying to pretend ME is hysteria.

This is what suits the financial interests because they can say it isnt what it is and dont need to pay for it and the megalo-psychs can continue patient blaming.

From my own experience I think the CNS is affected by ME but ME is not caused by CNS dysfunction.

I doubt that Garner ever had ME of the kind I experienced, he may just have convinced himself he had ME during Covid + Dengue recovery to play Trojan horses for GET which he was already well aware and probably had opinions about because of the reversal of Cochrane on GET, which significantly diminished Cochranes credibility i.e. sour grapes poser.

 

https://twitter.com/user/status/1359620616291160064

 

I guess...

That diagram is yet another from the annals of nonspecific and meaningless medical illustrations. If he thinks it explains anything useful, he doesn't know much about biology.

 

Its the dangerous combination of both thinking you know what you are talking about, speaking from a position of authority and professional realignment .
Toxic combination

 

Of course he didn't, he has recovered-post-infectious Covid, but for some reason he can't let go of the ME dx.

 

Of course even if the idea of central dysregulation of homeostatic pathways were correct it does not require one to believe either that psychological stress has caused it to persist nor that thinking oneself well will cure it. They have no evidence for that interpretation.

Yet putting this forward as 'the science bit' seems to allow them believe that their magical thinking concept can be quietly tagged on without notice. Where is their pretty diagram for how the dyregulation persists and how it's cured?

 

It's plucked from chronic pain and fibromyalgia research and passed across as if these things are assumed by some to be the same where they are not. (CS is not understood as being driven by dysfunction psychology in chronic pain).

 

As if proven when CSS is hypothetical. As if CSS can account for dislocating your jaw when you chew due to inflammation of the TMJ membrane. As if CSS can account for a day of IBS squits because you ate too much pepper. These CSS ideas do not stand up to even a modicum of common sense let alone scientific scrutiny.

And yet it would seem, if I may mix my metaphors, the BPS brigade are well into trying to hoover up all these syndromes (FM TMJ* IBS* etc) which are not well understood using Central Sensitisation Syndrome as a springboard to shoehorn in BPS.

e.g. "Psychosocial Factors and Central Sensitivity Syndromes" Adams & Turk
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4728142/#:~:text=Central sensitivity syndromes (CSSs) represent,being the most prominent feature.

As far as they are concerned, evidently, its the same blag by a different acronym and as far as I am concerned BPS and CSS are fiction, without a shred of hard evidence.

Another thing which strikes me about this Garner episode besides his own bias is that he has probably been targeted by BPS sycophants because of his role in Cochrane.