Is Labour abolishing illness?

By: Alison Ravetz, The Independent, Published 01 May 2008

The new rules on incapacity benefit stake everything on a major gamble: that a large proportion of claimants are, in fact, well enough to work

• Incapacity benefit has become one of this year’s favourite scare stories.
• Hardly a day passes without a new headline deploring its soaring costs and the rising numbers of claimants who get “something for nothing”, at the expense of decent, hardworking taxpayers.
• We are told that we are footing an outrageously escalating bill for 2.4 million people,
• a million of whom shouldn’t be on the benefit at all, and each successive work and pensions minister vows to be more ruthless than the last.

The true picture is somewhat different. The unreported version, which can be culled from Department for Work and Pensions (DWP) data, is that only …..

Saying No to CBT …

“Saying No Can Be Positive” empowers sufferers who wish to refuse psychological therapies.

SIMON WESSELY FOODIE BOY

Horseradish graters, meat hooks, outsize ladles … Why is …

This is the only reasonable response to someone who after 20 odd years still doesn’t want to acknowledge that Chronic Fatigue, Chronic Fatigue Syndrome and ME are three different entities.

Jane Colby’s letter in The Sun: CFS is a BARMY name !!!

Letters page, The Sun, May 12:

Dear Sir,

It was a bad day for children when ME got called by the barmy name ‘Chronic
fatigue syndrome’. Some of our children can’t speak or swallow and have to
be tube fed. That is so not ‘fatigue’. That is devastation.

Jane Colby
Executive Director
The Young ME Sufferers Trust

Denise Vella: Malta’s ME advocate

From silent sufferer to eloquent and beautiful advocate for ME – that’s the astonishing story of sixth-former Denise Vella, who lives in Malta……

DOCTORS are more at risk to commit suicide …

CHICAGO – There’s a grim, rarely talked-about twist to all that medical know-how doctors learn to save lives: It makes them especially good at ending their own. An estimated 300 to 400 U.S. doctors kill themselves each year — a suicide rate thought to be higher than in the general population, although exact figures are hard to come by.

Some doctors believe the stigma of mental illness is magnified in a profession that prides itself on stoicism and bravado. Many fear admitting psychiatric problems could be fatal to their careers, so they suffer in silence.

And when the pain is too much………

TWO year old boy with DEMENTIA …

Taylor with parents Dave Smith and Stephanie O’Hara

Taylor Smith, from Barrow-in-Furness in Cumbria, has been diagnosed with Niemann-Pick Type C, also known as Children’s Alzheimer’s.

The disease means that the toddler is likely to develop signs of dementia before he becomes a teenager, although the symptoms can appear at any time.

Stephanie O’Hara, 22, Taylor’s mother, described the disease as like “living with a timebomb”.
She said:………….

 

 

Dr Derek Enlander interviewed on UTV – May 6th 2008

Professor White and redefining ME as a psycho illness at the RSM …

Report of the presentation given by Professor Peter White by Dr Charles Shepherd Hon Medical (CS)Adviser, ME Association:

NAME:
Peter White,
Professor of Medicine at Bart’s and the London School of Medicine (psychiatrist)

PRESENTATION TITLE:
What is Chronic Fatigue Syndrome?
And What is ME?

What is CFS?

Peter White started off by summarising the five ways in which he believed chronic fatigue and chronic fatigue syndrome, the name preferred by most physicians, can be classified using ICD10:

F48: neurasthenia
F45.3 somatoform autonomic dysfunction
F45.9 somatoform disorder, unspecified
R53 malaise and fatigue
R54 senile asthenia
[Dr Shepherd's note: The only place that ME appears in ICD10 is in the neurology chapter under G93:3; CFS is also indexed to G93:3]

He then summarised the 7 different research criteria that have been published for CFS in adults and children:

CDC Holmes
Australian
Oxford
London
CDC 1994
CDC Revised 2003
However, as there is no evidence of a CDC defined CFS out there in the general population, this is not a useful criteria to use for clinical diagnosis.

Peter White also pointed out how research (eg the Witchita epidemiological study) indicates that for every patient with CDC diagnosed CFS there are far more people in the population with chronic disabling fatigue.

He then considered the three different clinical definitions that can be applied to CFS:

Canadian Criteria
NICE criteria (ie fatigue plus one symptom from the NICE list)
Royal College of Paediatricians and Child Health criteria
and what he felt were their relative value in clinical practice, especially in regard to their use of lists of symptoms in addition to fatigue.

Peter White pointed out that as more symptoms are used to define a core illness the more likely it is that people with a psychiatric illness will be brought into the definition.

[CS note: Most members of the public probably don't realise that as a rough rule of thumb many doctors work on roughly the same basis - the more ' non red flag' symptoms someone has above 5 in number, the more likely they are to have a psychiatric illness.]

Peter White considered that the Canadian Criteria had too many symptoms (8 in all) from long lists of grouped symptoms – some of which (eg ataxia) had an uncertain relationship to CFS.

As a result he could not recommend the use of the Canadian Criteria for the clinical diagnosis of CFS.

The new NICE criteria, which only require fatigue plus four symptoms, allows a diagnosis to be made around four months and are, he felt, useful.

The RCPCH criteria were his ‘Gold Star’ choice when it came to making a clinical diagnosis of CFS.

What is ME?

Peter White gave a brief summary of events at the Royal Free Hospital back in 1955, the editorial in the Lancet introducing the term ME/myalgic encephalomyelitis, and pointed out that some of the clinical features of ME (eg cranial nerve palsies) were not seen in individual cases today.

ME implied an incurable organic neurological illness that was originally defined on the basis of symptoms and signs found in outbreaks/epidemics. However, a conference at the RSM in 1978 had helped to legitimise a move from ME being an illness that occurred in epidemics to an endemic one.

To back this up, part of the presentation on ME was accompanied by a slide using the front cover of the January issue of ME Essential magazine with a photo of a severely affected lady in a wheelchair.

Peter White believed (on the basis of a piece of research) that having a label of ME carried a worse prognosis than having a label of CFS.

ME is, therefore, a name/diagnosis that is not helpful for doctors to use.

Lumpers and Splitters

The final part of this presentation looked at the issue of lumping or splitting – in other words do conditions such as CFS form part of a spectrum of overlapping disorders or are they more distinct clinical entities?

Peter White’s conclusion is that CFS is likely to be heterogeneous (ie composed of diverse elements) in nature when it comes to pathophysiology/causation whereas it is more useful to regard CFS as homogeneous (ie of the same kind) when considering treatments.

Conclusion (Peter White):

‘The reality is that mind and body cannot be divided and illnesses such as CFS/ME involve “both”, like most chronic diseases. The ME-CFS debate may be remembered in future more as one of the tipping point for the rejection of Cartesian dualism than for diseases that lie within’.

What conclusion would be a doctor with no prior interest in ME/CFS come away with?

Had I been a doctor attending this meeting with no prior or specialist interest in ME/CFS I would have come away with the conclusion that:

CFS is by far the best name for this illness
CFS affects both mind and body
Research criteria for CFS aren’t helpful for making a clinical diagnosis
The best diagnostic criteria to use for making a diagnosis of CFS are those produced by NICE and the RCPCH
Canadian Criteria are not helpful for making a diagnosis of CFS

There is a safe and effective treatment for people with CFS: graded exercise therapy (he is funny that man, I must give him that, CBT is safe for CBT psychiatrists only, might I suggest he reads professor Wessely’s article that declares CBT to be utter useless unless you suffer from anxiety or fears……see my previous post…and GET is only safe if you DO NOT HAVE ME, a minor detail professor….. )

The term ME is best avoided as it refers to an illness with neurological signs that occurred in outbreaks some time ago – such as the one at the Royal Free Hospital
Giving people a label of ME, implying a serious and possibly incurable neurological disease, is likely to lead to a less favourable prognosis.

Had I been at the conference I would have known that CBT stands for telling porkies as Dr Speedy would say and for recreating and redefining a debilatating neurological illness into a mental health problem of which professor White is not sure what it is actually as he uses FIVE different diagnostic codes.

And that is why the general public wasn’t allowed access to the RSM……….. We might have loudly objected if we didn’t suffer from ME and quite a few of us are bedridden and suffer from hypersensitivity to noise.

But how would professor White know such a thing as he refuses to see people with (severe) ME yet he still has a delightful opinion about something he would not recognise if his whole family would go down with it, just like all the other CBT fanatics……….

Now this time CBT doesn’t cure anything according to professor WESSELY …

CBT does not cure cancer, schizophrenia or arthritis, but it does improve mood, coping and quality of life. By professor Simon Wessely, Published 01 May 2008, New Statesman.

CBT is about identifying conscious thoughts – thoughts about dying when having a panic attack, for instance, or about being useless when in the presence of other people. And then it is about how we react to these thoughts and how these behaviours in turn impact back on our thoughts and feelings. Perhaps I was in a road accident some years ago.

Now I refuse to get into a car in case it happens again, and get tense and anxious even thinking about it.

What I need is to identify my fearful thoughts, understand how they relate to my experiences, and then start a cautious programme of overcoming these fears by gradually spending more and more time in cars, as I learn that it is not inevitable that history will repeat itself.

CBT is directive – it is not enough to be kind or supportive, although CBT therapists should be both – what is also needed is clarifying the thoughts which are determining our reactions and planning new behaviours as alternatives to these previously unsuccessful ways of coping or managing symptoms……

So here the man himself says it is utterly useles for ME or anything else for that matter, unless you have fears or anxieties……….