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    Created in 2008, Phoenix Rising is the largest and oldest forum dedicated to furthering the understanding of, and finding treatments for, complex chronic illnesses such as chronic fatigue syndrome (ME/CFS), fibromyalgia, long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases.

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Live webcast IoM meeting Jan. 27th 1:pm starting

Bob

Senior Member
Messages
16,455
Location
England (south coast)
Though NID doesn't sound helpful if said as a word, but N.I.D. sounds more like a health agency, or a special kind of ID card, which is probably not all bad...
Yes, N.I.D. sound OK.

Or skip the "endocrine"; I think there is some of that but I think the cortisol stuff, which everyone thinks of first, is a consequence of being profoundly ill for a long time, and not an actual central pathology of this particular disease.
I used to think that endocrine dysfunction didn't play a big role in ME because, during my first few years of illness, I didn't have many of the annoying hard-to-pin-down weird symptoms.

I purely suffered from PEM, exhaustion, memory loss and cognitive dysfunction.

But when I experienced a major relapse, 10 years into my illness, I suddenly experienced what seemed to be a fluctuating endocrine system. (I felt over-stimulated, while also being exhausted.) (I'm just guessing but it seemed like an auto-immune flare up to me, involving my endocrine system.)

The NHS doesn't usually offer extensive blood tests, but my thyroid stimulating hormone was found to be abnormally high (while my thyroid levels were supposedly normal.)

The over-stimulation settled down some months later, as I improved after my relapse. I'd never experienced it before, and it's not flared up again since.

I get the feeling that many ME patients suffer from weird stuff like this going on. (i.e. subtle endocrine dysfunction, and dysautonomia etc.)

(My doctor dismissed my clinically abnormal TSH levels, saying that they were irrelevant, but that's a long story for another time!)
 
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Ember

Senior Member
Messages
2,115
Posted by Wildaisy: "Transcript by Patricia Carter You are welcome to post this transcript elsewhere on the internet if you say the transcript is from MECFSForums and give a link to this page."
EILEEN HOLDERMAN:

Good afternoon. My name is Eileen Holderman. I’m an advocate. I apologize for not having any formal presentation. I have some notes, so I’m going to “wing it.” But I’ve been living this IOM thing for quite some time since November 2012 when CFSAC made a recommendation. We’ll get to that in a moment. But I’m here today to state my opposition to the IOM HHS contract, and I’m calling for the cancelation of the contract.

The majority of stakeholders oppose the contract for many reasons, and it’s evidenced by the letter and call campaigns, twitter campaigns, the congressional calls an meetings, the two petitions, the demonstration, the media interviews, legal actions, Freedom of Information Acts, the advocates’ letters signed by 171 advocates, and the ME/CFS expert letter. Fifty ME/CFS experts, researchers and clinicians, got together—they wrote a letter and they sent it and mailed it to Secretary Sebelius , and in that letter they said:

“We, the experts have developed a definition, the Canadian Consensus Criteria, to describe ME/CFS. We’re using it, we’ve been using it, we’re committed to refining it. Now we want the government to use it.”

Simple as that. Why waste a million dollars on a contract, especially when this disease gets only five million, and as Dr. Klimas said eloquently, less than male pattern baldness. And that’s a fact. That money could go toward biomedical research. Why waste 18 months to do a study when we already have a good consensus criteria, and then years more to roll that out and “mis-educate” doctors and healthcare professionals with what may be a worse definition than Fukuda and worse name than “Chronic Fatigue Syndrome”? And it’s no reflection off the people on this panel because I do have tremendous respect for all of you as an individual, but when HHS sets up a poor study design, you guys can do only so good as what they dictate. And I know that CDC does this all the time by inviting experts to participate on their website, on the C and E courses, but then when they dictate the terms of it and say that you can only teach doctors by using the Fukuda definition, which is 20 years old, outdated, erroneous—doesn’t have the hallmark symptom of PEM—and is used for research only, then you’re really not educating doctors; you’re mis-educating them.

So what is so upsetting to the patient community is that in November 2012, CFSAC—and I’m a member of that committee—we made a recommendation, and I helped craft the language of it, that recommendation, and we wanted to convene a workshop with only ME/CFS experts, meaning researchers, clinicians and patients, to reach a consensus on a research and clinical case definition, starting with the Canadian Consensus Criteria. We basically wanted to just endorse that criteria. And what happened after that was outrageous because in our subcommittees, contention at the highest level.

I chair one of the subcommittees, and I don’t want to get into the ugly realities of what was going on behind the scenes; but it was so ugly that anyone who spoke out, and I was one of them, got calls from the government. And we were intimidated, and we were threatened with eviction off the committee, and there is an ongoing investigation about it. It directly relates to the case definition recommendation we made. We are the experts making the recommendation, and the government is not taking our

recommendation. They’re hijacking it, making it their own, and not using all experts like we asked, drawing it out. They’re going to do the same thing that VA-IOM did to Gulf War by redefining—by giving them a new name, “Chronic Multisymptom Illness,” by saying the best clinical practices for that disease is CBT, GET and antidepressants. And that study that came out in January was very alarming because it had a section on ME/CFS, and in that section it said the same clinical practices, GET, CBT and antidepressants, would be used for ME/CFS. So we don’t know how this new panel could possibly contradict the earlier findings of the IOM study. I simply don’t know how that would work.

It also troubles me that CDC and NIH will be participating in this, and there is a contradiction because on one hand, IOM says once the sponsor finishes, they’ll have no further contact. On the other hand, HHS says there will be continual meetings with NIH and CDC to give them information. And I’ve been very vocal about the flaws in both of those studies. I’m not going to get into them today, other than to say that for 30 years we waited for biomedical research for this brutal neuroimmune disease with an infectious component; and instead, we are getting now three initiatives at the same time. Talk about redundant and waste of money! To come up with case definitions. We’ve already got one It’s the Canadian Consensus Criteria. Our 50 ME/CFS experts have said “We’ve got it. Let’s use it. Let’s use the money instead for biomedical research, education and treatment for the over one million Americans and 17 million worldwide suffering from this serious neuroimmune disease, Myalgic Encephalomyelitis.

So, I’m part of the patient advocacy movement that is going to continue to push the envelope and ask for the cancelation of the contract, and let’s get on with the serious business of studying and treating this disease. Thanks.

ELLEN WRIGHT CLAYTON:

I do want to clarify one point: there will be no contact between the committee members and HHS at any point from now on until the end of the study. The contact between the staff is only to show that they’re doing work so that is…uh…you know…just to give progress reports, but it will in no way go to the substance of what the committee is talking about. There will be no contact between the committee and HHS till the end of the study. I just want to be very, very clear about that.

Thank you very much for your comments. And I…uh…and I’m…uh…very grateful to hear them.
 

Bob

Senior Member
Messages
16,455
Location
England (south coast)
In one of the IOM committee videos, there is a short discussion whereby members of the committee say that they are looking towards the patient community for thoughts and proposals about the name. Perhaps we could start a new thread to discuss ideas for names, and then run a forum poll on a shortlist of names, and then officially submit the results to the committee from Phoenix Rising. Anyone think that's a good idea?
 
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Sing

Senior Member
Messages
1,782
Location
New England
Yes. It could be a serious thread, minus our joking here (which I enjoyed). And if naming a disease after the name of a person is no longer done, we could skip "Ramsay's Disease", though I like it. Instead we could just try to come up with names and their acronyms which express something pertinent about our illness, that don't, in acronymic form, express something negative.
 

Denise

Senior Member
Messages
1,095
Yes, having all non-ME-experts, much less non-scientists and non-medically-trained people is totally insane.

The jury analogy fails in my mind. You are right about the OJ trial. Jurys in criminal trials with technical evidence have long been controversial. And you don't even have a right to a jury in civil cases. Judges will deny requests for juries if the evidence won't be understood by the jury (because it is technical, etc). There are even specialized courts like water rights courts and tax courts bc it's realized that even judges need specialized training to hear some kinds of technical cases.

Also, Maier conveniently didn't answer Lily Chu's question/point that the P2P process is only for non-controversial topics. I think that point is our best argument (though we have other very strong ones too), it's so cut and dried.


While I totally understand (and share) the very serious concerns about, and objections to the P2P, I think it might be helpful to note the wording on the P2P site --- (bolding added by me)
"P2P workshops are designed for topics that have incomplete or underdeveloped research, difficulty producing a report synthesizing published literature, and are generally not controversial." http://prevention.nih.gov/p2p/default.aspx
 

justinreilly

Senior Member
Messages
2,498
Location
NYC (& RI)
While I totally understand (and share) the very serious concerns about, and objections to the P2P, I think it might be helpful to note the wording on the P2P site --- (bolding added by me)
"P2P workshops are designed for topics that have incomplete or underdeveloped research, difficulty producing a report synthesizing published literature, and are generally not controversial." http://prevention.nih.gov/p2p/default.aspx

Hm, good point.

I think this can be read two ways, one is that the process is not designed to handle most controversial topics, but it could handle some. The question here is how is it not going to work for most but will for others, and what's the characteristic(s) of the ones it would work with?

The other meaning would be that the process will not work with any diseases which are generally controversial, i.e. are substantially controversial, or if there is some amount of controversy among most members of the profession about it. If there were only a minor amount of controversy over the topic, the process would be suitable. ME would fall into the excluded topics by this meaning, I am pretty sure.

I think the latter is probably the meaning they, uh, meant.
 

CBS

Senior Member
Messages
1,522
P2P = "Pathway to Prevention." "The P2P program is strategically located in the NIH Office of Disease Prevention (ODP).

Office of Disease Prevention? Are they serious?

The reason the P2P process is best suited for non-controversial subjects is likely because you have to have some degree of consensus regarding the nature (or even the existance) of something if you are trying to prevent it as opposed to simply trying to agree on a set of diagnostic criteria.