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PEM shouldn't necessarily be a qualifier. It should be proof. You don't have to have it for an ME/CFS diagnosis, but getting it cements the call.

As an interim? Until we have a pathology-tool? Patients have to deal with more than mere diagnoses. They have to provide proof. They've employers, disability agencies, family and friends, etc, they have to demonstrate disease. Things that can help are things that can help.

I'm sorry if this is redundant. What if PEM is peculiar to ME/CFS as most of us have posited? What if all these new diseases that claim PEM have - at least some of them - PEM, and that they've evolved into a condition where the Decode ME genes are activated? A qualified questionnaire might be...

That made me chuckle. Judging by my experience with other diseases like Lyme or Babesia or ME/CFS there are usually less doctors who think those patients have a chronic disease than actually have it.

Rationing is brilliant. I am wary of any word that has fatigue in its root. Maybe try replacing with a word thats not even medical, but conveys similar feelings? Waning, ebbing, etc, something that connotes a dminishing. Sorry, just spitballing. But I fully am behind the rationing idea.

Cool. Who is?

Cognitive impairment can be sustained when it occurs in pwME ( it doesn't in all pwME). Brain fog is an inadequate qualifier, btw. I can awaken with brain fog, and shake it away before I get out of bed. I cannot shed my cognitive impairment regardless of how I try. It's worse with PEM, but...

Plenty of precedents over the last half century, many of which are contemporaries of ME/CFS. Politics. Political fingerprints once again, but somehow inadmissible.

You won't see it much, but there's a theory of immune tolerance that might.

We cannot query the mice about their motivation. Fortunately, that limitation does not apply to humans. So I'd discard the entire sickness behavior model when humans are involved. Too much erudite/academic speculation regardless. We don't do shit because we feel crappy; it's a much more...

I'm not sure it was a failure.

Sure. albeit I wouldn't subscribe to the sickness behaviour thing. It's a non-human model. But back to your initial observation, why wouldn't a chronic infection resemble what you position as an acute? Acute is merely less than 30 days, more or less. As a general rule of thumb. We could all...

I'm confused. OI is about sensations. POTS is definitional according to BP and HR - this omitting any nonsense from entities with a horse in the race. What falls beneath either banner is political. Is POTS real? Is an unmarried widower a bachelor? I don't need to parse down further. I've...

I hope we don't forget the clutch of clinicians/researchers that helped keep our heads above water these last 40 years. Many of these have turned their attention to Long Covid.

Without fever, at least for most pwME. How do you convey that? Hangover-like? It makes me wonder about immune tolerance, which we lightly touched upon when it was the subject of the Nobel prize earlier. That's an entirely distinct rabbit hole.

Yes. Maybe even more, though: Patients know most doctors are wrong. It's not even intuitive; it's basic experience speaking to the clinicians' ignorance.

I think it's a fair comparison for many pwME, period. I fear it only addresses the degree. Some pwME have cognitive disability 24/7. It takes on a darker and more grim hue in PEM. True, it's merely less common and more difficult.

I think most look at PEM as ME/CFS underscored. It's ME/CFS on steroids. The relation reduces to degrees. It may be more appropriate to come at it as an overarching reaction that, although it involves usual ME/CFS symptoms, transcends all the "normal" sequelae in terms of time-to-onset...

I am not sure this study tells us much of anything that isn't fairly obvious: ME/CFS patients with balance issues are at greater risk of falling than healthy controls. That some of those falls may result in concussions is no more relevant than some may not, or some may result in a bruise to...

Zen and the Art of ME/CFS Maintenance. Uhmmmmmmmmmmmmmm.