There is ample evidence that M.E. is primarily a neurological illness. It is classified as such under the WHO international classification of diseases (ICD 10, 1992) although non-neurological complications affecting the liver, cardiac and skeletal, muscle, endocrine and lymphoid tissues are also recognized. Apart from secondary infection, the commonest causes of relapse in this illness are physical or mental over-exertion. – Dr. Elizabeth Dowsett
Dr. Dowsett recommends: "M.E. Research workers must be encouraged and appropriately funded to work in this field. However they should first be directed to papers published before 1988, the time at which all specialized experience about poliomyelitis and associated infections seem to have vanished mysteriously!"
Not "mysteriously" at all, but through the involvement in the 1988 renaming process of psychiatrists who saw a gold mine in having the symptoms of this epidemic illness classified as something they and their colleagues could spend a lifetime "treating". If the patient didn’t improve (and viruses don’t improve just from talking about them), they could blame the patient "not wanting to get better" and recommend another year of counseling, and another and another. (Extra benefit, by portraying it as a psychiatric illness, private disability insurance need only pay for two years, not for life, and SSDI can refuse benefits on grounds that the patient is not receiving psychiatric treatment, a major cost savings for both SSDI and insurance companies.) A little sleight-of-hand, and ME becomes CFS, which is subsumed into psychiatric fatigue syndrome, and, voila, there is no connection between CFS (née ME) and ME, because ME no longer exists in the US by executive fiat, and CFS has been re-defined away from the original disease it was coined for.
Speaking for myself, there is no question that my symptoms began with a severe virus ... except in the minds of those doctors who made unequivocal statements to me that women don’t want to work, they want to be housewives. The virus is not mentioned in their notes; they came up with bogus psychiatric explanations not supported by the facts. It was easier than changing their misogynistic minds to accept that those of us raised in feminist households grew up expecting to have a career and never had the slightest intention of being a housewife – as a kid, I played Office, I did not play House. Stereotypes die hard.
As Dr. Dowsett notes, the "commonest causes of relapse" are physical OR mental over-exertion. Although I often work lying down (more blood flow to the brain that way) (see explanation at http://www.dfwcfids.org/medical/cheney/heart04.htm), so there’s very little physical exertion in my job, I can just as easily push myself over the edge with the mental exertion of concentrating on my editing work for too many hours. I know my limits, and I know what happens if I exceed them. A few years ago, I was encouraged to stretch my known limit of working 6-10 hours a week "just a little" to 12-15 hours; it doesn’t sound like much, but it was enough to have me first making mistakes in my work and then have what one of my doctors called "flu-like symptoms" for a couple of weeks. These are objective symptoms that cannot be denied or written off to fantasy – you’re welcome to come over and watch, if you’re one of those who believes CFS is entirely subjective, or that it consists only of "fatigue". And while I now have those symptoms only rarely, because I stay within my limits, I had them every single day when I pushed myself to exceed my limits. (And especially when my daily limit was less exertion than required to deal with the barest minimum of chores – feeding myself and the cats.)
Yes, the difference between 10 hours a week and 12 hours a week does make that much difference in my health, just as the minuscule difference between spending a dollar less or a dollar more than your take-home pay will eventually make the difference between having a few bucks in the bank or filing bankruptcy.
N.B. The US government/CDC/NIH have refused to accept the 1992 ICD-10, which makes it clear that CFS a/k/a ME is neurological and not psychological. It is essentially impossible to get an ME diagnosis in the US.
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