I just don't want to promote the idea that there is such a thing as a useable "syndrome of CFS" that we can logically put people into which don't fit x criterion for ME.
I reject the ME versus CFS dichotomy because I reject the notion that there is a valid clinical entity of CFS. There is no clinical entity which can validly be described by Fukuda, Holmes, Oxford, or Lloyd/Hickie 'definitions' or identified by the "Empirical approach". Simply doesn't exist in real life. In a CFS group there are 1) misdiagnosed people with a variety of other primary conditions which have been missed for whatever reason.
Then there is 2) ME, and there may be a whole spectrum of ME-like diseases (whether like or unlike eitiologically; I do not see that we have the evidence to know which, at present), perhaps in a similar way that there are various forms of MS and diabetes and lupus, in a similar way as we think the autoimmune disease categories we have presently are arbitrary and artificial and there is a lot of variety within what we currently label with the same disease name.
I do not think that ME is different from the RA example I linked to and I think it is unrealistic to think that ME should be expected to yield a more pure patient sample than SLE, RA, MS, etc.
I think our inappropriate struggles for legitimacy have foisted unrealistic expectations upon us, since we are held to a different standard (many other diseases do not have biomarkers which are present among all/substantially all persons diagnosed, many other diseases do not have an ultimate causation identified [comparatively few do]; yet these things are demanded from our disease).
I reject the ME versus CFS dichotomy because I reject the notion that there is a valid clinical entity of CFS. There is no clinical entity which can validly be described by Fukuda, Holmes, Oxford, or Lloyd/Hickie 'definitions' or identified by the "Empirical approach". Simply doesn't exist in real life. In a CFS group there are 1) misdiagnosed people with a variety of other primary conditions which have been missed for whatever reason.
Then there is 2) ME, and there may be a whole spectrum of ME-like diseases (whether like or unlike eitiologically; I do not see that we have the evidence to know which, at present), perhaps in a similar way that there are various forms of MS and diabetes and lupus, in a similar way as we think the autoimmune disease categories we have presently are arbitrary and artificial and there is a lot of variety within what we currently label with the same disease name.
I do not think that ME is different from the RA example I linked to and I think it is unrealistic to think that ME should be expected to yield a more pure patient sample than SLE, RA, MS, etc.
I think our inappropriate struggles for legitimacy have foisted unrealistic expectations upon us, since we are held to a different standard (many other diseases do not have biomarkers which are present among all/substantially all persons diagnosed, many other diseases do not have an ultimate causation identified [comparatively few do]; yet these things are demanded from our disease).