Opinion on "ME/CFS Service", UK

I think this is a very important point, in that patients should be entitled to symptomatic treatment by the relevant specialists as a fundamental function of any health system:

And a very good argument in favor of getting rid of the bullshit CFS services, even the ones which aren't actively doing harm, but are still failing to provide meaningful help:

 

I can understand that if a service has nothing useful to offer it might be best to offer nothing.

What I do not understand is the way that patients suffering from clear, but unknown and poorly understood, illness should simply be pushed out of the door. Any serious attempt at health provision would at the very least have arranged regular follow up appointments, even if only annually, to follow the course of the illness and try to understand its likely outcome.

I regard the failure to do this as negligent.

 

The frustrating thing is that we have known what to do for years. Nigel Speight has said that many of his patients improved or recovered. The great medical secret - let people rest as much as they need.

So give them advice - even call it CBT!!! - to organise their life, give them tips on how to even out their energy usage, like the ones Mark Van Ness gives (even after all these years I learnt something when he suggested packing everything perishable into one bag then you just have to unpack that one when you get home from shopping)

Help them with benefits or time off work, school or whatever, work with a well informed social services department. They could emphasise to new patients that not pushing on at the beginning could save years of ill health.

Get wheelchairs, get OTs involved, give people permission to be sick, treat them symptomatically and for comorbidities. None of it is expensive compared to drugs for HIV or other things and could save the country a fortune in lost income and payouts of benefits.

And this has been available knowledge for at least forty years!!!

 

From the quote in Cheshire's post https://www.s4me.info/index.php?threads/opinion-on-me-cfs-service-uk.925/ :

I expected to be able to have access to things that some people in the ME community have found helpful such as B12 injections

People with Pernicious Anaemia (an inability to absorb vitamin B12 via the gut that can/will kill if the patient doesn't get regular injections), a condition for which testing is unreliable, are often told that they can't have more B12 injections than one every three months. Pleading for more injections is sometimes met with the comment from doctors that the only reason patients want more is because vitamin B12 is addictive (which is nonsense!), so therefore they can't have more for their own good. Patients attending a day early for their three monthly injection have been refused it by nurses and told to make another appointment because they can't have the injection early.

Doctors allegedly "believe in" pernicious anaemia and vitamin B12 deficiency, and yet they still treat the patients like shit. So, much as it pisses me off to say so, I'm not surprised that doctors don't "believe in" B12 injections for ME and CFS. Note that the ampoules are only about 55p each, so doctors can't even complain that the treatment is expensive.

In the UK injectable B12 is prescription only. In many countries in the world it is available over the counter. The clued up patient in the UK starts buying their own B12, needles, syringes and sharps boxes online so they can have whatever B12 they need. Patients may need to experiment to find out which form of B12 works best for them - cyanocobalamin, hydroxocobalamin or methylcobalamin. I'm not sure if adenosycobalamin is available in injectable form.

A scary video on the subject of B12 deficiency, but worth watching :

https://www.youtube.com/watch?v=BvEizypoyO0

Edit : Added "(which is nonsense)" after the word "addictive".

 

Whoever Flos is, they've written a stunningly good piece. The title should really be "ME/CFS Disservice".

 

Pretty much sums up the whole sorry state of things.

 

I do worry that MEA can be too instinctively pro spending money on specialist 'care', when a huge amount of that money is wasted on people who do not help patients. Also, spending money on 'specialists' creates people who have an incentive to exaggerate their own expertise and ability to help patients, and this can cause harm in a wide range of ways.