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A request to those involved in ME research to indicate their position on spinal surgery

Discussion in 'ME/CFS research news' started by Jonathan Edwards, Aug 25, 2020.

  1. Forbin

    Forbin Senior Member (Voting Rights)

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    Other objections aside, I think that, at a minimum, patients who have been ill less than five years should be strongly discouraged from undertaking any treatment with a high degree of risk for their future health.

    The reason is that it seems as though some patients experience a level of improvement within the first five years. Dr. Bell said some of his patients "recovered" during that period. I experienced significant improvement in the fourth year of being ill myself.

    Five years is a pretty vague guess, though. I wish someone would do some good studies to see how common improvement is in this period and to get a better idea of the timing of this "window."

    Someone who has experienced a level of improvement is apt to consider the risks of experimental treatment a lot less enthusiastically than someone who has not, so such treatments should probably not be considered early on.


    Also, shouldn't an evidence base be developed first, like proving that these "abnormalities" are more common in symptomatic patients than in healthy controls?
     
    Last edited: Aug 27, 2020
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  2. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    He started a thread and said he agreed.
     
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  3. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    It is even more basic than that. We need to see some evidence that there are any abnormalities. So far I have seen none on images put on the web. (Other than some pictures of fairly usual cervical spine disc disease of a sort that lots of older people have and which in any case would not affect the brain stem.)
     
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  4. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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    Robert Phair is also already a member (but not on the list).
    @RDP
     
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  5. Trish

    Trish Moderator Staff Member

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    I'm not entirely surprised at some researchers expressing an interest in the subject of spinal surgery and ME. It is interesting when we hear that a few people have found their health has improved in unexpected ways after medical interventions.

    It was interesting when Fluge and Mella found that some people's ME went into remission after they were treated for cancer with Rituximab.

    The thing that concerns me here and should concern all of us is the different trajectory of actions following those interesting observations.

    Fluge and Mella were so interested they set up a series of clinical trials culminating in a full scale double blind trial run properly and with long enough follow up to be meaningful. And in the meantime they warned patients and doctors not to experiment outside the trial.

    What scares me is that, with the help of social media, and presumably with the collusion of the surgeons involved, patients are being enticed, by people with no medical knowledge, into life changing and potentially dangerous treatment without any clinical trial first to see if that treatment is justified.

    So there may be a tiny subset of people with ME who also have spinal structural problems that when treated also trigger a remission from their ME symptoms, but by going about it this way, we will never know whether the association is causative, chance or placebo effect.

    What I would expect responsible scientists to do in this situation is yes, of course wish individuals well who have undergone any treatment, but also tell JenB very firmly that the way she is going about her campaign is unscientific, harmful and wrong.

    Sorry, rant over.

    I'm ranting because I have just gained access to some of the materials JenB's facebook groups provide their members. I haven't read them all yet, but they are far more than the guides to how to find a doctor she said in reply to me on Twitter.

    They include guides on how to read scans, offers to read each others' scans, and how to self diagnose with various spinal disorders, how to do traction, and a protocol of some sort. Yes, they add warnings that they are not doctors, and to get medical opinions, see experts before you try traction etc, but they seem to me highly irresponsible.
     
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  6. Barry

    Barry Senior Member (Voting Rights)

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    Only just digested this part of your post Trish. Good grief!!!

    Surely there must be precedents in law where disclaimers are way too inadequate for the provocative material they supposedly disclaim.
     
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  7. InfiniteRubix

    InfiniteRubix Senior Member (Voting Rights)

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    A cross border legal mess of practically unaddressable impossibilities for most people in terms of restitution/recourse, I would assume. I'm out of date, but would assume that the law in most jurisdictions has not caught up with social media realities, even where all people are in one jurisdiction - conversation between people/patients is not unlawful. Defining what goes too far beyond that idea is probably tricky, especially if no static or event marketing are involved that clearly contravene regulations.

    On another note:

    Are/should ME organisations being asked for positions also, from Solve, MEA to Physios for ME?

    (Edited)
     
    Last edited: Aug 27, 2020
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  8. InfiniteRubix

    InfiniteRubix Senior Member (Voting Rights)

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    Some org rep's have liked posts of surgery result images on Twitter, but many readers do not realise that Twitter likes do not equal endorsements and are often used merely to flag newsflow.

    At worst, it appears like an endorsement, at best, it confuses, at least before positions are explicitly taken.
     
    Last edited: Aug 27, 2020
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  9. Jaybee00

    Jaybee00 Senior Member (Voting Rights)

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    I've reached out via a Columbia U. liaison to Lipkin, Horning and Komaroff. Do I get a Cadbury Flake or the Fruit Pastilles?

    To reach Ron Davis and Ron Tompkins try contacting Chris Armstrong
    carmstrong@omf.ngo

    Somebody else do this. You get an old standby--Hershey bar with almonds.
     
  10. lunarainbows

    lunarainbows Senior Member (Voting Rights)

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    Jen Brea herself knows that the research isn’t there, but is still ok with it:

    https://twitter.com/user/status/1266557574578450433


    I think this is the worst thing.

    But in any case, it’s not a legitimate excuse. Covid happened in 2020. But surgeons haven’t even provided controlled studies into traction - and for using the measurements they use - for CCI itself, and outcomes. They’ve had decades to do this. Weird how she doesn’t mention that.
     
  11. Bjorn Bragee

    Bjorn Bragee Established Member

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    14
    Location:
    Stockholm, Sweden
    We researchers at our clinicfully agree on the core purpose and values of this organisation: to provide a platform to discuss all aspects of this disease, with a special focus on science, support, and advocacy. We value four things especially
    • high quality scientific research, which will be necessary to produce effective treatments;
    • open, critical discussion of claims and ideas;
    • mutual support and respect;
    • equality
    No one should claim mechanisms based on pseudoscience or no science at all. On the other hand one should be careful not to deny facts and figures and respect peer review articles and meet arguments in right arena. We do not advocate hypes or wrongful surgery, but one should not exclude a patient group within the cohort of ME/CFS adequate surgical procedures if there are indications. And we have found that there might be an overrepresentation of both craniocervical obstructions and joint hypermobility as well as possible trait of intracranial hypertension, published today in Frontiers of Neurology. It can be downloaded or read onsite. We DO NOT argue for surgery, there are many other options if our findings are confirmed, and really we are starting new studies based on that. And I absolutely agree on the need for warnings on wrongful or not indicated surgery, I am a pain specialist after all, and within a surgical speciality and have seen severe side effects or outcome of such surgery through the years.

    But it would be contraindicated to deny further peer-reviewed research on the topic, and even more important that those performing surgery publish their results. That is a demand that this forum can advocate for. Please publish results on surgery in ME patients. We are trying to identify and interview such patients in Sweden.
     
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  12. Trish

    Trish Moderator Staff Member

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  13. MSEsperanza

    MSEsperanza Senior Member (Voting Rights)

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    Just a recent example of what I said about journalists in Germany taking the 'stuctural spinal cause of ME' as facts:

    https://www.berliner-zeitung.de/ges...ein-kind-wenn-ich-nicht-mehr-da-bin-li.102327

    google translate of the article: https://translate.google.com/translate?sl=auto&tl=en&u=https://www.berliner-zeitung.de/gesundheit-oekologie/fatigue-cfsme-chronisches-erschoepfungssyndrom-berlin-spandau-wer-pflegt-mein-kind-wenn-ich-nicht-mehr-da-bin-li.102327

    the last paragraph:
    I think Prof Scheibenbogen, the LVS (a German ME charity) and the two outpatient clinics that are quoted/ linked in other parts of the article should distance themselves from this paragraph. @Joh

    Edited to add: The Berliner Zeitung is one of the major Belrin based daily newspapers.
     
    Last edited by a moderator: Sep 10, 2020
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