Ah, that clears it up. Dr Lapp is a wonderful man, imo. However, when I saw him quite a few years ago, he wasn't doing immune testing which limited his ability to treat me effectively. The exercise testing was beneficial because pacing did help slow my downhill slide. He also helped with sleep meds and treated my hypothyroid condition. Unfortunately, that was not enough to improve my health in a large way. I went to Dr Lapp hoping to get in the Ampligen program, not realizing then that living so far from Charlotte made Ampligen treatment impossible for me. While I like Dr Lapp, I don't consider him one of the top ME/CFS docs anymore. The top docs on my list are doing testing and treatment (where possible) for immune dysfunction, pathogens, dysautonomia, endocrine dysfunction, and other common dysfunctions in ME/CFS as well as participating in experimental studies of more cutting-edge therapies. I'm surprised, though, that Dr Lapp is not suggesting any conventional medical treatment for you beyond just waiting and hoping you'll recover. The way I remember him, he was very interested in improving quality of life for his patients.