Thanks for that. In a way the response not so much expects too much but misses the central point.
I guess I wrote it for everyone, including the very familiar, but yes it 'talks' to that audience.
The response paper includes this sentence:
The case histories of patients who have been harmed...
The open response document seems to focus on what is known about the pathophysiology of ME/CFS. Unfortunately, nothing clinically useful is known. Even if we were sure of the physiology data we still need studies showing that applying the inferences from such data to clinical care is beneficial...
Jo Cambridge used to bring bottles of Fairies dust essence back from Barbados yeas ago. Jack Iron I think it was called. Capable of combustion without the gunpowder. We often had happy thoughts with it on a Friday afternoon meeting but I don't recall anyone leaving the ground.
Re-edit; I had...
To be honest, I think it would be a disastrous mistake, at best a distraction and at worst, much worse. Remember that this is how the PACE people got their bandwagon going. It leads to the expectation 'you had the treatment, now get a job'.
The irony is that healthcare doesn't actually work...
I know that I come across as a bit hard hearted at times. And I have always suspected that my mum had my ears done and that my real dad was from Vulcan but when I wrote the Qeios piece I decided to publish it after all my doubts because I did think I had heard some things worth trying to...
Maybe more important than this is the mainpoint I was trying to make in my Qeios piece - that management should be based on evidence not theory. If one physician says the patient should be treated this way because they are in PEM another physician can say, 'but that's your theory, my theory is...
Or retrospectively, in a cohort not biased by looking for NLC, i.e. the ME Biobank at CureME. If it has not been used it would be a good sample - ME/CFS, normals and MS all documented and available blinded.
I don't really follow that @Yann04 because 'PEM' is just what we call the time pattern of symptoms. It isn't a 'thing' that causes things in the sense that we know what it is. Having too much sensory stimulation may well cause PEM but for these very severe patients the account we hear is that...
Moved posts
I don't think PEM is an explanation. It is just a useful specific term for the way doings things can lead to symptoms like pain in ME/CFS.
I am not sure this is actually PEM though. Being intolerant of stimuli in severe ME is an immediate thing as I understand it. It certainly is...
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