Tuesday 10th August

6-8pm

To plan next steps for specialist CFS/ME services & BACME
The new NICE guidelines are going to be published on the 18th Aug. Presumably the final draft will already be known by the time of this event so it will be interesting to know what they are planning and how they will 'adapt' current treatment practices; will they stop using CBT/GET or just call it something else.
 
I'd like to be a fly on the wall in that discussion. I suspect it will be all about preserving their jobs and making as little change as possible to services.
@PhysiosforME and @Joan Crawford are you able to join BACME and attend the event?

It would be good for someone to join for this reason. This is open to all clinicians; it's not a closed event only open to BACME members.
 
Thanks for posting I should get a chance to pop along.

As an aside: I'm involved in my NHS trust's long Covid response. From my experience so far I can see that the respiratory physios and AMPs (senior physios who screen patients for rheumatology, surgery and chronic pain clinics etc) are getting well up to speed on ME and long Covid - the Physios for ME site and information is being read and understood. And the respiratory physios are well aware of the different subgroups of pwLong Covid (those with post ICU symptoms, those who were often more mildly affected by Covid but who have gone on to develop PEM etc and so on).

More helpfully it'd be good to know what biomed research is being done, by whom and where. And how will success be measured? And if that yields very little - what'll happen then? If a vacuum forms (as it did with ME, ditto GWI) then that'll be moment the BPS brigade could step in.
 
That BACME event is geared entirely around the well-being of certain health professionals careers. No doubt an excellent opportunity for them to help reinforce to each other how much they are needed and valued. I'd prefer a SACKME event.

Well, BLOWME.... from BACME

Source: British Association for CFS/ME (BACME) Date: August 2021

URL: https://www.bacme.info/sites/bacme.info/files/BACME An Introduction to Dysregulation in MECFS.pdf An introduction to dysregulation in ME/CFS

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a condition defined by a specific pattern of symptoms rather than known pathology.There are currently no clinical tests to support a diagnosis of ME/CFS making a detailed medical history essential for diagnosis. Research findings to date illustrate some of the physiological changes that cause the symptoms of ME/CFS.Improving our understanding of the physiological changes that occur in ME/CFS and symptom patterns that result from these changes, can improve delivery of care to people diagnosed with ME/CFS. It is recognised that significantly more work needs to be done to improve our understanding of ME/CFS. This document aims to summarise the spectrum of research undertaken in the field of ME/CFS. This research can help all to begin to understand how and why people develop symptoms of ME/CFS. This understanding can lead to the development of general strategies for managing ME/CFS as well as helping us to recognise the individual variations that can occur making an individualised approach to management essential. -------- (c) 2021 BACME

Source: British Association for CFS/ME (BACME)
Date: August 2021
URL: https://www.bacme.info/sites/bacme.info/files/BACME Post-Exertional Malaise.pdf


Post-Exertional Malaise
-----------------------
There are many different causes of fatigue, some of which are not picked up on laboratory tests or routine investigations. It is important to be able to recognise different patterns of fatigue to identify the likely underlying cause as this can help guide management strategies.

One of the hallmark symptoms of ME/CFS (Chronic Fatigue Syndrome) is a pattern of fatigue called Post-Exertional Malaise (PEM), sometimes referred to as Post-Exertional Symptom Exacerbation (PESE). This pattern can also occur in Post-Viral Fatigue and conditions which cause Dysautonomia (problems with the Autonomic Nervous System functioning). PEM is not usually present when fatigue is caused by other conditions or problems.

It is important to identify Post-Exertional Malaise as it requires different management strategies to other types of fatigue, particularly regarding the management of daily activities along with approaches to physical activity including exercise. The Covid pandemic has led to large numbers of people experiencing prolonged symptoms after Covid-19 infection including fatigue, a common feature of post-Covidproblems. Not everyone with ongoing symptoms after Covid infection will have Post-Exertional Malaise but it is important to identify people who do experience PEMin order to provide them with appropriate guidance on management.

The NHS England 'Your Covid Recovery' online resource now includes a section on Post-Exertional Malaise. The following document was written in collaboration with the 'Your Covid Recovery' team and members of the BACME Board
 
Last edited by a moderator:
https://www.bacme.info/sites/bacme.info/files/BACME An Introduction to Dysregulation in MECFS.pdf An introduction to dysregulation in ME/CFS
"
The following document is reproduced with kind permission from the team at
The Yorkshire Fatigue Clinic:
Dr Sue Pemberton, PhD, MSc, BHSc, Dip COT MRCOT, Therapy Director
Dr Vikki McKeever, MB BS MRCGP General Practitioner with Special Interest in ME/CFS
Joseph Bradley, BSc OT, MRes, MRCOT Clinical Specialist Occupational Therapist

Some additions have also been made by
Dr Pete Gladwell PhD MCSP Team Lead Bristol M.E. Service, North Bristol NHS Trust, BACME trustee
Anna Gregorowski RSCN, B Sc, MA, Consultant Nurse, TRACCS, UCLH, BACME Chair"

It would be interesting to see what additions BACME have made

the yorkclinic website:
http://www.yorkshirefatigueclinic.co.uk/services

pdf on information on the dysregulation model
http://www.yorkshirefatigueclinic.c.../05/18/theory-model-nov-2020_[9279]-12628.pdf
 
https://www.bacme.info/sites/bacme.info/files/BACME An Introduction to Dysregulation in MECFS.pdf An introduction to dysregulation in ME/CFS
"
The following document is reproduced with kind permission from the team at
The Yorkshire Fatigue Clinic:
Dr Sue Pemberton, PhD, MSc, BHSc, Dip COT MRCOT, Therapy Director
Dr Vikki McKeever, MB BS MRCGP General Practitioner with Special Interest in ME/CFS
Joseph Bradley, BSc OT, MRes, MRCOT Clinical Specialist Occupational Therapist

Some additions have also been made by
Dr Pete Gladwell PhD MCSP Team Lead Bristol M.E. Service, North Bristol NHS Trust, BACME trustee
Anna Gregorowski RSCN, B Sc, MA, Consultant Nurse, TRACCS, UCLH, BACME Chair"

It would be interesting to see what additions BACME have made

the yorkclinic website:
http://www.yorkshirefatigueclinic.co.uk/services

pdf on information on the dysregulation model
http://www.yorkshirefatigueclinic.c.../05/18/theory-model-nov-2020_[9279]-12628.pdf

Coincidentally, I have just posted a blog on this very topic. See thread here: https://s4me.info/threads/blog-bacm...anticipation-of-updated-nice-guideline.21784/
 
One of the hallmark symptoms of ME/CFS (Chronic Fatigue Syndrome) is a pattern of fatigue called Post-Exertional Malaise
It is important to identify Post-Exertional Malaise as it requires different management strategies to other types of fatigue
Even when they try to just copy the language they can't do it because they don't understand what the words mean. I guess there is some progress in that they use PEM, rather than their usual post-exercise fatigue. But they use it to mean the exact same thing, because they have no idea what they're doing and never listen or pay attention to a damn thing.

Eternal rebranding is the strategy. Just a fresh coat of invisible paint. Like one yellow dude said: get bent, quacks.
 
I note they are using ME/CFS now, not CFS/ME.

-----

The deconditioning model swapped out for a dysregulation model. Meh. Apart from any other reason, dysregulation covers an awful lot of ground, without offering much clarity or insight.

They need to stop postulating models until they have good evidence for a coherent compelling one. Especially for determining clinical and policy advice.
One of the hallmark symptoms of ME/CFS (Chronic Fatigue Syndrome) is a pattern of fatigue called Post-Exertional Malaise

It is important to identify Post-Exertional Malaise as it requires different management strategies to other types of fatigue
They are going to shoehorn 'fatigue' in there somehow.

And they claim it is patients who have obsessive behaviour and distorted perceptions.

:rolleyes:

-----

In fairness, I think this is a critical acknowledgement and step in the right direction.

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a condition defined by a specific pattern of symptoms rather than known pathology.There are currently no clinical tests to support a diagnosis of ME/CFS making a detailed medical history essential for diagnosis. Research findings to date illustrate some of the physiological changes that cause the symptoms of ME/CFS. Improving our understanding of the physiological changes that occur in ME/CFS and symptom patterns that result from these changes, can improve delivery of care to people diagnosed with ME/CFS. It is recognised that significantly more work needs to be done to improve our understanding of ME/CFS. This document aims to summarise the spectrum of research undertaken in the field of ME/CFS. This research can help all to begin to understand how and why people develop symptoms of ME/CFS. This understanding can lead to the development of general strategies for managing ME/CFS as well as helping us to recognise the individual variations that can occur making an individualised approach to management essential. -------- (c) 2021 BACME
 
The thing that really gets me is they way BACME & the rest of the BPS crew constantly get away with avoiding the main issue.

Here they go muddying the waters by discussing yet another hypothesis.

The original hypothesis was wrong & there is no evidence the "new" one is any more accurate. The hypothesis isn't the issue here though.

The issue is the treatment. The treatment doesn't work. In fact in a great many cases the treatment causes harm. This has now been demonstrated by multiple patient surveys including one commissioned at the request of NICE.

PACE the trial to end all trial etc. is no longer considered to provide anything beyond low quality evidence. What PACE did do was test the treatment on offer here. When analysed properly the one thing PACE proved was that this treatment does not work.

So swapping one hypothesis for another is a deliberate attempt at distraction. It's not the hypothesis that's the problem here, it's the treatment. NICE provide treatment guidelines that are (or should be) evidence driven. The underlying hypothesis is irrelevant if the treatment doesn't work & isn't safe.
 
The thing that really gets me is they way BACME & the rest of the BPS crew constantly get away with avoiding the main issue.

Here they go muddying the waters by discussing yet another hypothesis.

The original hypothesis was wrong & there is no evidence the "new" one is any more accurate. The hypothesis isn't the issue here though.

The issue is the treatment. The treatment doesn't work. In fact in a great many cases the treatment causes harm. This has now been demonstrated by multiple patient surveys including one commissioned at the request of NICE.

PACE the trial to end all trial etc. is no longer considered to provide anything beyond low quality evidence. What PACE did do was test the treatment on offer here. When analysed properly the one thing PACE proved was that this treatment does not work.

So swapping one hypothesis for another is a deliberate attempt at distraction. It's not the hypothesis that's the problem here, it's the treatment. NICE provide treatment guidelines that are (or should be) evidence driven. The underlying hypothesis is irrelevant if the treatment doesn't work & isn't safe.
I think we (patients) should be pushing the main UK ME charities to take this issue up with BACME once the final NICE guidelines are published.
 
https://www.bacme.info/sites/bacme.info/files/BACME An Introduction to Dysregulation in MECFS.pdf An introduction to dysregulation in ME/CFS
"
The following document is reproduced with kind permission from the team at
The Yorkshire Fatigue Clinic:
Dr Sue Pemberton, PhD, MSc, BHSc, Dip COT MRCOT, Therapy Director
Dr Vikki McKeever, MB BS MRCGP General Practitioner with Special Interest in ME/CFS
Joseph Bradley, BSc OT, MRes, MRCOT Clinical Specialist Occupational Therapist
Looks like pseudoscience, not helpful.

I think we (patients) should be pushing the main UK ME charities to take this issue up with BACME once the final NICE guidelines are published.
Agree
 
https://www.bacme.info/sites/bacme....modules/image/BACME Annual report Jan2021.pdf

Charity name
British Association for CFS/ME
Becoming a Charitable Incorporated Organisation on January the 8th 2021
will ensure we can work with services at a more strategic level in more and effective ways.
From constitution
The relief of sickness for the public benefit by
:
3.1
Championing clinically effective practice in treating
CFS/ME and other primary fatigue conditions
3.2
Disseminating of recent evidence and practice to clinical
practitioners
Now that BACME has achieved CIO status,it would seem an opportune time to consider BACME rebranding and marketing and it would be great to see this alongside a new website.
 
I was just checking out the BACME website.

Screen Shot 2021-08-21 at 9.10.04 PM.png

I've included the front page here just in thumbnail, because I don't want to inflict it on you if you aren't feeling up to it.

I can not think of a less appropriate front page for a professional website related to ME/CFS. I mean, on another page it has a directory of ME/CFS clinics and services for people with ME/CFS to look at, so they are expecting people with ME/CFS to use the site. Apart from the riot of colour, there are black silhouettes of people running and jumping and climbing along the bottom. At the top right are some greyed out headings in caps that are hard to read.

I'm not expecting BACME to have a drab front page with a picture of a person with ME/CFS curled in the foetal position in bed. But an explosion of colour and the very explicit suggestion that we will soon be leaping around now that we have come to the right place is very odd.

Anyway.
 
This is what I came here for:
The following statement from (or at least attributed to) BACME has been posted and discussed on the guideline delay thread:
The following was posted on the Sussex and Kent Society website, yesterday. (Apologies if this statement has already been posted in one of the several threads.)


https://measussex.org.uk/british-association-for-cfs-me-bacme-august/

BRITISH ASSOCIATION FOR CFS/ME (BACME) – AUGUST
By admin On 20th August 2021

BACME will continue to support members to work with NICE guidance once published, within the remit of their professional practice and specialist CFS services. BACME put together a substantial and comprehensive response to the draft NICE ME/CFS guideline. We will continue to work on addressing any concerns previously highlighted by our members to ensure the delivery of safe and effective treatment and care to children, young people and adults diagnosed with ME/CFS and their carers and families. BACME recognises the need for specific guidance for children and young people and has a plan in place to further develop this as well as guidance for those severely affected by ME/CFS. BACME will continue to offer education and support to members through teaching and networking events. Many of these will focus on topics linked with the future publication of the NICE guideline on the diagnosis and management of myalgic encephalomyelitis (or encephalopathy)/ chronic fatigue syndrome (ME/CFS). BACME remain firmly committed to raising awareness of the impact of ME/CFS and fatigue conditions, striving for excellence in the delivery of research based care, evidence based therapies and the search for a breakthrough into the underlying causes of this debilitating illness. We await further information from NICE. BACME Board.
 
Last edited:
This is what I came here for:
The following statement from (or at least attributed to) BACME has been posted and discussed on the guideline delay thread:

Apologies for crossposting.
It doesn't seem to be an authorized statement. Also doesn't have a date on it.

What if the Sussex and Kent Society wanted to spread confusion by quoting only a part of an actual statement or even part of private correspondence?

Again, please consider the agenda of the Sussex and Kent Society see post above
 
Last edited:
Given the discussion on the messenger of this statement -- see the thread on the Sussex and Kent Society, I think we should be very cautious with interpretations, unless it's posted on BACME posted aiwebsite or any other reliable source, too.

The Sussex and Kent Society seems to have played tricks before. We can't be sure that what they posted is what BACME actually wanted to get across.



The S and K Society is a member of BACME and BACME may have sent out this statement to members of BACME in the last couple of days. I cannot confirm that this is a verbatim BACME statement and that it will be posted on their website.

The content of the S and K Society post:

"BRITISH ASSOCIATION FOR CFS/ME (BACME) – AUGUST"

is signed "BACME Board" and displays the BACME logo.


https://measussex.org.uk/about-us/

"...The charity is a member organisation of a number of local and national committees and working groups including the NHS Kent & Medway CFS/ME Service and the NHS Sussex-wide CFS/ME Service along with the British Association for CFS/ME (BACME) and the UK CFS/ME Research Collaborative."
 
Last edited:
Back
Top Bottom