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10:00am Tuesday 25th May 2010 in News By Michelle Archard
PATIENTS have praised a specialist clinic in south Essex which is helping hundreds of people cope with a crippling condition that can often go undiagnosed.
Southend Hospital’s chronic fatigue syndrome and ME clinic has a number of branches in Essex, including one in Benfleet, helping people get their lives back on track.
Patients like Margaret Wigglesworth have benefited from their expertise and she spoke out to mark ME Awareness Week.
Margaret said: “It was such a relief to find people who understand what I have been going through and can help me build up my energy. I just wish I had been referred to the clinic earlier. I have spent nightmare years trying to get recognition.”
Before being diagnosed, Margaret suffered a series of viral infections each leaving her more exhausted so that even the simplest of tasks was a major challenge.
Various doctors told her the blinding headaches, nausea and fainting spells were all in the mind until she reached the stage when she was no longer able to put one foot in front of the other.
Margaret, 53, from Basildon, said: “Energy was just oozing out of me like a tap. Then my vision went, my speech and memory went and I felt spaced out, like I was in a bubble.”
After a long struggle to get help, Margaret eventually found a sympathetic doctor who understood ME, also known as chronic fatigue syndrome, and she was referred to one of the hospital’s clinics.
When she first attended, she could only hobble along with two sticks.
As well as seeing consultant physician Dr Tony Collings at the clinic, Margaret has also received help from a physiotherapist and an occupational therapist and is now walking unaided and beginning to recover some energy. She is hoping she will eventually be able to do a few hours of work each week.
Dr Collings said the condition – which typically affects high achievers and people with obsessional personalities – is still stigmatised.
He said:“It is difficult for other people to accept because there is nothing to see. But it is very real and can be quite devastating in its effects. It affects all ages, but is most common in late middle age, and affects more women than men. Although some patients manage to hold down a job, others are totally bed-bound and need full-time care.”
Anyone wishing to access the service should contact their GP.
Comments(9)
Talking Cures
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11:09am Thu 27 May 10
jolico
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11:17pm Fri 28 May 10
Talking Cures
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7:08am Sat 29 May 10
drjohngreensmith
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9:59am Sat 29 May 10
Talking Cures
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1:10pm Sat 29 May 10
jolico
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6:28pm Sat 29 May 10
jacqui39
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2:45pm Sun 30 May 10
Talking Cures
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6:08am Thu 10 Jun 10
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drjohngreensmith says...
10:07pm Wed 26 May 10
Michelle Archard's article, about the treatments on offer for people who are said to have M.E. (Myalgic Encephalomyelitis), shares a few niggling fundamental questions with other newspaper reports, in different parts of the country, which are rarely addressed by those clinicians who treat and lay people who claim to represent, patients like Margaret Wrigglesworth (Clinic helps people like Margaret cope with ME, Basildon Echo, 25 May 2010).
I hope that the Echo, to be scrupulously fair, will give the same space and prominence to consideration of why M.E.sufferers might receive no benefit or even be harmed by taking these treatments as it did to the promotion of them, without putting some cautions that were omitted, whether deliberately despite contrary evidence or in ignorance of it, in order that patients and doctors may make a better informed choice.
The first clue to the problem for people suffering with M.E. (and I mean Myalgic Encephalomyelitis, not any other diagnosis which is, without scientific justification, taken to be the equivalent of M.E.) is that the name of the clinic, as well as the other 11 in the network of clinics in the UK and the majority of local support groups, contains the term "Chronic Fatigue Syndrome". Other names, such as Myalgic Encephalopathy, Chronic Fatigue Syndrome and other diagnoses are not the same - or why give them different names? - since they all have different diagnostic criteria. The NICE (National Institute for Health and Clinical Excellence) 2007 guidelines do, however, refer to Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (or Encephalopathy) without making it clear whether they are synonymous or one is a subset of the other.
By bundling together patients, having different conditions with a variety of physical and/or psychiatric causes, the sample size of each one is reduced to such a small number to be of any significant value for statistical analysis. I have serious concerns about any statistics quoted about M.E. sufferers because they all originate from the hybrid ME/CFS estimate by the Department of Health which is also based on another estimate by the Centers for Disease Control (CDC) of America and do not contain, so far as I am aware, any breakdown by sex, age, social class etc. of either the M.E. component or any of the chronic fatigue conditions. I think Dr Tony Collings needs to tell us, when he says, "it is most common in late middle age and affects more women than men" and "which typically affects high achievers and people with obsessional personalities", whether he means M.E., CFS, or does not discriminate and also the source from which he derives these conclusions, so that other researchers, doctors and intelligent lay people can decide for themselves the level of credibility they deserve.
Dr Collings does know that some M.E. patients are housebound and bedridden. I wonder to what extent the optimistic figures of CBT and GET are skewed because none of these would be in the sample because they couldn't get to the hospital for the treatment to be tested? They, presumably, won't be amongst the patients who praised the specialists clinics and their experiences won't be counted. The subjective assertion of being "helped" is not defined by any measurable objective improvement, such as a return to work, school, or resumption of previously normal lifestyle, even to some percentage recovery level; reports made to the therapist who gave them the treatment, or to the GP who referred them for it, are likely to be tainted by fears of challenging authority or even being dropped from their lists (the subjects say quite different things to them than they do in ME patient groups and forums on the Internet!)
There are also some worrying ethical considerations: One is of conducting trials such as PACE (Pacing, Activity and Cognitive Behavioural Therapy: a randomised evaluation) and FINE (Fatigue Intervention by Nurses Evaluation) after the clinics to give the treatments have already been established and are giving them; such a practice would not be permissible in drugs trials or experiments with animals. Another worrying ethical matter that the work, which forms the basis of advice given by the Government, or NICE for the treatment of people with M.E., has been conducted by a majority of doctors, researchers and their sponsors, such as insurance companies, who will consequently benefit financially and with employment from the conclusions.
M.E. sufferers and anyone who cares for them, should be aware that the latest review (Twisk & Maes 2009) shows that all research evidence to date - including that of the very same people who advocate and practise them - shows that CBT is ineffective for M.E. sufferers and GET makes a majority worse, some irrecoverably so. Yet, astonishingly, in spite of their own findings, a majority of national and local support groups are calling for funding for an expansion of this service and getting it at the expense of more promising biomedical research, aimed at a better understanding of the organic cause with a view to providing safe appropriate treatment, perhaps a cure one day.
Many of the same concerns apply to the complementary treatments and radical coaching programmes, for which people with M.E. are encouraged to pay thousands of pounds they can ill afford, when on disability benefits. They are unproven and unregulated. Again, we only hear from those who say it worked for them, many of whom go on to be practitioners themselves and benefit from free advertising. The number who are prepared to speak out and say it did not work is probably reduced by censorship and selective editing on websites that promote them and threats of legal action if they do not withdraw such claims (M.E. and the Lightning Process, Private Eye, Legal news, p.10, Issue 1248, 30 October - 12 November 2009). Most of the "trainees" probably did not have M.E. because M.E. sufferers would not have the stamina for the three-day process. The extravagant claims of success of both orthodox and alternative treatments (in one case, 100%!) do not add up when the number of people remaining ill with M.E. remains stubbornly the same.
It seems logical, therefore, to this Research Psychologist and veteran M.E sufferer or 22 years, that it would be better to have no treatment at all than one which does you no good, or may be harmful. This organisation calls on the clinics to voluntarily suspend treatments (with therapists on full pay) to avoid any hurt and for GPs to reconsider referrals pending independently conducted research by people with no possible conflicting interests. If anyone wishes to consider working as part of a research team, under my direction, investigating the efficacy of all treatments offered as a cure or significant recovery for M.E,, for no financial or any other reward apart from the outcome of the work itself, please e-mail or write to me with CV and proposals.
The same problems with interpretation of research and, contingent upon it, treatment for people with M.E. are going to continue until M.E. establishes its identity as a discrete illness. I call upon any organisation purporting to represent M.E. sufferers to make it clear exactly where they stand; if they say that CFS (Chronic Fatigue Syndrome) is the same thing as M.E. and that CFS is the "preferred" term, to drop the ME part from their names or, if they are determined to keep it, say exactly what they mean by it.
In the meantime, M.E. sufferers do best with a sympathetic GP, who believes in their condition as a genuine neurological illness, provides support and treatment for symptom relief, such as pain etc. and with organisations, such as ours, which do not tolerate any other diagnostic label equivalent, for the opportunity to meet people who really do have M.E. and share a desire to find a cure for it.
Yours sincerely
drjohngreensmith@mef
reeforall.org
Dr John H Greensmith
ME Free For All.org