Yep I think when I’ve looked at the long covid services they generally seem to be an ‘anything but [the actual condition me/cfs] service’
I get there isn’t a cure yet but until clinics are made to think it’s not an ok ‘innovation’ to have a service that doesn’t do regular follow-ups medically but is only funded to diagnose, triage if it’s anything else, then slapdash stuff on self-management that they’ve no idea whether it works because that’s the last time you’ll see them
and that there might well be little other medical things that are drawing on the same energy that mightnt seem so bad if it’s a not ill person (allergies, skin condition, deficiency) but all add up to whether you can vs can’t fit significant things. And how much harder navigating the generic support systems is when you’ve an energy limiting condition vs many other conditions. So people drown.
it feels a bit like an old days of ActionFraud - where they spent all the money on a hotline that pretended to take everything seriously but did nothing with the info or cases logged.
particularly when you think about what could just be gained from having decent stats with a proper medic following up each year. We could then see how many get very severe or severe and if things like b12 work for any of how prevalent certain straightforward issues are like the feeding stuff and prepping for it.
sorry going on and you know all this
but I can see why you feel conned by being combined with the ‘anything but servuce’ or is it a ‘polo mint service’?
I do like a catchy name that makes it hard to deny when it calls out the dies what it says on the tin.
it’s not like all those peoples jobs are cheap so the excuses of funding at the same time as that (and it not improving anyone so no value for money at all as it can’t do anything improvement wise) pees me off
Oh and PS I think this is why calling it an 'illness of exclusion' rather than moving towards (certainly with better research) it being an illness focused on the concept of PEM and deterioration if consistently over threshold for exertion/stimuli etc is really important
It is one thing underlining the importance not just of differential diagnoses, but also comorbidities as these make a huge impact whether they 'cure' all the symptoms or are just reducing the added debility. But they also shouldn’t just be limited to a tiny triage list vs having a team of specialists checking open-mindedly on ALL possibilities that make sense for the patients symptoms not only taking respiratory or specific cardiac things as a pathway
given it has historically not been one that has meant people were investigated properly so I suspect has a lot of people with missed diagnoses of something that perhaps also might be more treatable at an earlier stage, and would certainly interact with ME to create an unnecessary lower threshold or downward trajectory.
But instead This cursory 'check it isn't something we do want to treat' to triage them out, rather than proper medicine of 'anything that could be noted and treated' ... well that isn't anything.
And I think the 'illness of exclusion' label is somehow allowing those commissioning and running clinics to decide 'what those exclusions are'.
And them thinking that is the only medical part of treating/managing/doing anything for the condition - because the 'concept' isn't about the condition, it's about what it isn't. Apparently (but you can still get anemia if you have ME/CFS so that list isn't accurate)
And given the end-point is a bit fat nothing then it is making everything back-to-front. A literal wastepaper basket diagnosis. Just picking out the bits/people that might be useful for recycling first.
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