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Media nonsense about ME and exercise

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This article has been re-blogged from the Blog http://www.uttingwolffspouts.com which is written by Claudia Gillberg and Geoffrey Jones.  I had to reblog this as it concerns a very important subject that has often been misunderstood concerning the impact of exercise on people with ME or CFS.  The dreadful article on the front page of a major newspaper this week prompted a justifiable outcry from many sufferers of this illness. And it was no wonder – our lives are hard enough without having to contend with this rubbish. The Telegraph article is here http://www.telegraph.co.uk/news/health/11959193/Chronic-Fatigue-Syndrome-sufferers-can-overcome-symptoms-of-ME-with-positive-thinking-and-exercise.html  (if anyone wants to read it).

The blogpost speaks for itself – and I love the title :

” THE SCIENTIFICALLY CHALLENGED UK MEDIA STRIKES BACK “

” When I first heard The Telegraph had featured an article concerning a follow-up study of the notorious PACE trial I was inclined to ignore it1. I’ve long become used to the appalling coverage of ME by the British media2 and felt I didn’t need to read any more disinformation disseminated via the Science Media Centre. However, I cracked and had the misfortune to read an article written by Sarah Knapton that is the worst I have seen in the thirty years I have been ill with this disease, which considering the competition is an impressive achievement1.

The article clearly implies ME is a non-illness, the suggestion in the headline that a bit of positivity and exercise could cure sufferers merits no other interpretation. One wonders what spin was put on the latest study by the SMC, as the results of this research bear no similarity to its reporting in the press. Indeed, flawed as the PACE trial is, at no point do the researchers suggest GET or CBT cure ME, as claimed by Ms Knapton in her inaccurate and mendacious article1.

Most in the ME community are aware of the substantial problems with the PACE study, including the selection criteria, the self-reporting and lack of objective measures, a flawed methodology, which have been outlined in detail by various authors including Angela Kennedy, Professor Malcolm Hooper, Tom Kindlon, Jane Colby, the late Dr Elizabeth Dowsett and, most recently, David Tuller in the US. Unfortunately the UK media continues its obsession with treating ME as a non-illness affecting lazy people whose only problem is their inability to pull themselves together and push through their fatigue, which seems to be the only symptom the media acknowledge.

To start Knapton states:

‘Chronic Fatigue Syndrome is not actually a chronic illness and sufferers can overcome symptoms by increasing exercise and thinking positively, Oxford University has found’1.

Not a single word in that opening paragraph is accurate. The study included a large number of participants who probably did not have ME as the primary criteria for participating was fatigue. Despite this the PACE trial was only able to establish that some participants showed mild improvement while undergoing GET and CBT (though these were self-reported, subjective results). Participants remained ill and severely limited in their ability to perform normal daily activities.  To repeat, any positive results revealed by the trial were barely notable yet according to Knapton,

‘The new study found that graded exercise therapy (GET), in which sufferers gradually increase activity levels, as well as cognitive behavioural therapy (CBT), which encourages positive thinking and behaviour, had a dramatic impact’1.

A definition of dramatic: sudden and striking, impressive3

The PACE trial in no way justifies such an adjective, a more accurate description would be, ‘a negligible impact’ though this would not have supported the slant of Knapton’s piece.

Her next paragraph aggravates matters,

‘The finding is important because many CFS sufferers believe that exercise will make their condition worse.’1

Sufferers do not believe, ME is not a religion (the proponents of the psychosocial model and their media acolytes exhibit cult-like behaviour but that’s a separate issue). ME sufferers know exercise can make their condition worse through first hand experience of the damage it can cause, something supported by scientific studies illustrating physiological damage(4,5).

Two more paragraphs in the article were particularly disturbing:

‘But gradually increasing exercise and therapy to remove patients’ negative thoughts that they would never get better seemed to work. Prof Sharpe said the study was likely to prove controversial because a “minority” believe that CFS is either caused by a virus or is chronic and cannot be alleviated.’1

In what other chronic illness would sufferers be accused of contributing to their illness due to their ‘negative thoughts’? A more clear case of blaming the patient is hard to imagine and to make such a statement with zero evidence to support it, is unworthy of an academic. Suggesting that only a minority believe a virus triggers the disease and that it is chronic is not only untrue, there has never been any suggestion that ME is an acute condition, but a use of language designed to offend ME sufferers. The following paragraph continues in the same vein,

Prof Sharpe added: “It’s wrong to say people don’t want to get better, but they get locked into a pattern and their life constricts around what they can do. If you live within your limits that becomes a self-fulfilling prophesy.”1

There is no science to substantiate anything the professor states in this sentence and I can think of no other illness in which a researcher would speak of sufferers in such a fashion, it is immoral, breaches the Hippocratic Oath and constitutes abuse of a vulnerable group of patients.

Another point to make, highlighted by John Cohen in Science6, is that the basis of the original trial’s supposed success has been undermined by this latest study. The PACE trial claim that GET and CBT were the best treatments for ME is demolished by the finding in this latest study, which revealed that all therapy options produced the same results. To quote John Cohen,

After analyzing the responses, the researchers concluded that the benefits reported in the original study, which assessed participants at 1 year, were maintained for at least another 1.5 years. But the participants randomized to receive the two interventions that initially did nothing also improved, and there “was little evidence of differences in outcomes” when compared with the people in the other treatment groups’5.

Sharpe et al try to explain this by claiming that participants undergoing other therapies switched to GET and CBT in the intervening period but there is no evidence to support this conclusion. I’d also like to query what condition participants are in now, as the suggestion that any improvement was maintained for ‘at least another 1.5 years’ implies their health could have declined after this period of time.

Knapton’s article provides a list of ME symptoms, which exclude post-exertional malaise (PEM) arguably the defining symptom of the illness. It also includes a link to a video featuring Martine McCutcheon talking about the lightning process, telling you all you need to know about the malicious intent behind this article.

‘These are not magic cures’ says Sharpe. Apparently Sarah Knapton disagrees.

A final comment from Professor Sharpe:

‘It’s sometimes quite hard to understand what motivates the very vocal minority that gets upset by this apparently benign bit of moderately helpful treatment’1.

Perhaps some of the headlines in the British media this morning will enlighten the good professor as to why so many in the ME community are upset by his ‘treatment’.

1) http://www.telegraph.co.uk/news/health/11959193/Chronic-Fatigue-Syndrome-sufferers-can-overcome-symptoms-of-ME-with-positive-thinking-and-exercise.html?utm_campaign=Echobox&utm_medium=Social&utm_source=Twitter#link_time=1446019914 (Accessed 28/10/2015)

2) http://uttingwolffspouts.com/2015/02/14/chronically-fatigued-the-uk-media-and-the-recently-released-iom-report/

3) http://www.oxforddictionaries.com/definition/english/dramatic (Accessed 28/10/2015)

4) http://www.ncbi.nlm.nih.gov/pubmed/23813081 (Accessed 28/10/2015)

5) http://www.ncbi.nlm.nih.gov/pubmed/25990639 (Accessed 28/10/2015)

6) http://news.sciencemag.org/health/2015/10/criticism-mounts-long-controversial-chronic-fatigue-study (Accessed 28/10/2015)

Going Into Hospital

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Can hardly believe it’s already the 24th Jan 2014.
I haven’t managed to do many posts in the last while, I know.

Everything has been too difficult.
Same old story . . .

Incase anyone thinks I am being a drama queen – my husband was almost in
tears the other night. And was saying things like “this is a terrible life” . . ,
NB.  He won’t thank me for quoting this here – but I have to.
As very few people can have any idea of how much struggling with CFS/ME long term takes out of you, and your partner. (Where you’re lucky enough to still have one that is.)
When there has been so little help available.

This is just a very brief update :

On Monday 27th Jan I will be getting the benefit of a 5 day in-patient stay (treatment and rest) in the Homeopathic Dept of Gartnavel Hospital in Glasgow.
And while I could say :
At last – some much needed help after what feels like a 25 year struggle, etc etc etc . . .  I do realise I am very fortunate to be offered this at all.
There are many people with CFS/ME much worse than me.
And so many people are just left to rot. Which was what I felt had happened to me – until recently.

Looking forward to this has without doubt given me a big mental & emotional boost – because how could this week fail to help me ?
Even just a little bit will be a huge bonus.
They are a Centre Of Integrative Care after all – which sounds ideal for people with CFS/ME.

But the effort involved in sorting out various work things, putting some changes in place, etc – has had a bad  physical effect on my health this past 2 weeks.

I’m getting that heavy pressing weight in my chest again. Lots of other symptoms too – but the weight on the chest (and out of puff so easily) is a problem that isn’t easily ignored.

I haven’t even been able to give much thought to what I want (and need) to take into hospital with me yet. And right now I have so little energy left that I can see me arriving at the hospital with just my handbag and maybe a toothbrush in it.
And little else !

But this is meant to be a positive post – and I have no doubt this coming week will benefit me.  Even if I do arrive looking as if I’ve been pulled through a hedge backwards . . .
And I’m really grateful for this chance.

I don’t think there are many of these Integrated Care centres throughout the UK.
I am very lucky that this one exists right  here in Glasgow.

Roll on Monday . . .

Some Days Positive Thinking Just Doesn’t Work

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Negative Blogpost Alert !

You have heard the song It’s My Party And I’ll Cry If I Want To ?
Well this is My Blog and I’ll moan if I want to . . .
Feel free not to read on.

There are some days when all the positive thinking in the world just doesn’t work for me.
And I want to throw all my self-help books, gratitude lists, motivational, inspirational & philosophical quotes, etc etc etc onto the nearest bonfire.

And just scream :

  • I hate having CFS

  • I hate how I have lost so much of my life to it

  • I hate how it becomes more “normal” to have symptoms than not have them

  • I hate how I have been in bed for so much of this year

  • I hate how it is often 1 step forward, then 2 back

  • I hate the view out my bedroom window – the side of next door’s house, a brick wall.

  • I hate how the longer you have CFS the more symptoms you seem to develop

  • I hate how I have been treated by GPs

I hate that I have been taking anti-depressants for such a long time, maybe 8 years.
I actually wonder if they make the “brain fog” worse ? This is an incredibly disabling symptom (especially when trying to work).

  • I hate how I can’t manage GP visits well, always a disaster. I crumble every time.

  • I hate how my husband often plays it down to people. It makes me look as if I’m exagerating how bad it has been.

  • I hate that the house always needs cleaned.
    (I can’t manage it without half killing myself, hubby is overloaded with stuff to do, and we can’t afford a cleaner.)

  • I hate that our grass is always overgrown at front and back.
    (Same reasons as above but substitute gardner for cleaner.)

I hate that our central heating system doesn’t work properly (the boiler is approx 40 yrs old). The heating doesn’t heat the rooms upstairs well (bedrooms & my office).
Dreading winter.

  • I hate that many people seem to think CFS and ME are trivial

  • I hate that I have no help or guidance managing my CFS.
    On my last visit to my GP I virtually begged for practical help. She just doubled my dose of anti-depressants. This was 2.5 years ago.

  • I hate that I wasn’t strong enough (physically or mentally) to have coped better with the stresses of the last few years. Partly caused by a tenant from hell, a very poor letting agent and scum/bullying tradesmen.

  • I hate that I cannot get away from my work and have a long long break

  • I hate that I know how much Mickel Therapy helps CFS, but I haven’t been able to use the “tools” for the last few years.
    Everything in my life seems to be working against it.

  • I hate feeling that I just want to run away from everything at times

  • I hate how very pathetic this all sounds . . . !

  • Some days I am totally sick of everything.

I feel quite a lot better now for having this rant.

I am sure it is healthy and positive to let these bad emotions out once in a while. Coping with a long term (mainly negative) situation by just surpressing these emotions all the time – we are in danger of becoming like a pressure cooker. Ready to burst.

We can positive think all we want, but this will not change the practical reality of a physical condition.

To quote what David Mickel once said to me :

” The body is the boss”

ie. it will not be fooled into being told a situation is ok when it’s not.

Things People Say (positive thinking & housework)

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” She keeps her house immaculate – but then she has such a positive attitude “

This one also merits a post of its own.

A friend visiting me at home told me about a friend (of hers) who was sadly very ill with cancer.

My friend has know me for over 30 years – therefore has known me before CFS and all the time I have had it. And she knows that I regularly struggle with doing some physical things.
Like housework and cleaning for instance.
Which can often defeat me (and cause me to stress over it). Or I actually manage to do some – but often pay the price afterwards with a bad relapse or “crash” and may need a day or so in bed to recover. Or at best a long rest – and waste half a day while energy is restored.

When my energy is very limited I often have to choose between essentials. Therefore things like managing to have food in the house, and make meals just has to take a higher priority. Or laundry. Or even personal cleaning/hygiene.
I mean what is the point of a clean house if I am a mess myself, with no clean clothes to wear ? And hair an unwashed straggly mess.
And food – well it’s an essential for life. We cannot do without it.
Also my work – which can quickly spiral out of control when I fail to keep on top of it. And is a constant challenge for me.

But a dust-free room, clean kitchen floor, hoovered carpets etc – just cannot be as high up the priority list when you have to choose. Everybody would agree with that – surely ?

All these things my friend knows – as I have explained over and over throughout the years.
So although I tried not to – I couldn’t help but feel upset at her comment. As it kind of implied that if only I was to change my attitude in some way then I too could have a lovely clean house !

With regard to her friend who was managing to maintain a spotless house despite her awful health predicament – I had to admit I was curious.
I was imaging some sort of mind over matter positive thinking. You know the sort of thing you read about where a person somehow manages to summon up a huge amount of mental energy and can make themselves do amazing things.  Like walk over red-hot coals in bare feet.

Finally I just had to blurt out “but how does she do it ?”
The answer was not what I expected.
It was : She pays her sister to clean her house for her.

Now there is absolutely nothing at all wrong with this as it was obviously an arrangement that suited both of them.  And if I had the money to spare then I would have a cleaner too for sure. But the way that my friend was quoting it to me as an example of “positive thinking” . . .

I think maybe because of the look on my face my friend went on to explain further that the sister  “hadn’t done very well for herself in life” and that her ill friend was actually helping her out by letting her clean her house and paying her for it.

For once I was left speechless . . . .

Footnote :

I decided to add this incase I have caused any offence or distress to any cancer sufferers out there with this post ? As this was totally not my intention.  The employment of a cleaner is something to be recommended 100% if you have the spare funds to pay for it.  The point of my post was the comment made by my friend – and wasn’t meant to sound critical of the person with the cancer in any way at all.

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