Posted on 08/20/2016 10:06:55 PM PDT by Seizethecarp
In response to requests by U.S. patient organizations and advocates, the U.S. Agency for Healthcare Research and Quality (AHRQ) has issued an Addendum to its 2014 ME/CFS evidence review. This Addendum downgrades the conclusions on the effectiveness of cognitive behavioral therapy (CBT) and graded exercise therapy (GET), and this has tremendous implications for medical education and treatment recommendations. GET is Ineffective for ME Patients. CBT Is Barely Effective.
(Excerpt) Read more at occupyme.net ...
I must admit though, that you certainly are a doctor.
Only someone so pompous as a doctor would write a novella on a chat site.
Ciao
The golf courses are opening. You’ll be late.
I know! And the vacations! The best vacation I ever had was the four years I got to spend in a foreign country courtesy of you taxpayers. My rich Uncle sort of insisted that I take it, though, after paying for my tuition and books for four years. Thankfully, I had learned to love learning and so I really took advantage of the opportunity to observe a very different culture and how it works, or fails to, as the case may be.
so why push PT?
My lowly education and 20+ yrs of helping people with similar issues as this article talks of tells me they need to loosen joints and stuck fascia and muscles, to put it simply they need to help their body relax and open up the restricted areas, reduce inflammation (thru nutrition, hydration, decreasing physical tension and mental stresser sorts of things) and then slowly address exercise (making the muscles work more than routine daily stuff) to strengthen or build more muscle, increase circulation and endorphins etc. promoting healing.
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I’ve heard docs refer to PT as “Whatever it is they do down there.”
PT is on the provider lists. It’s covered and part of the institutional ‘family’. Other modalities, (such as you describe) are not. Sometimes those modalities are included within the PT department, billed at hundreds of $/hour, limited # of times and under the direction of clinicians with little interest or acceptance of PT, itself, let alone its poor stepsisters.
Otherwise, those modalities are private, much, much more affordable, but out of pocket. Most PTs are fine with them, but they aren’t referrable.They will not be reimbursed. They are also most effective over a much longer time.
Like so much that’s frustrating, ineffective and plain wrong, it’s simply the culture and, usually, the culture wins.
Sorry, no golf. I can’t afford it. I never claimed to be a GOOD doctor. It seems, somehow, I failed to get rich.
Wow. You really are a jerk. Take another dose of vitriol and stew in your own unreasoning hate.
kiss :)
If you had a brain, you’d be concerned with brain injured soldiers not getting Disability because of suspicious and/or lazy doctors.
But if venting your rage at me helps you feel better, I am glad :) Let it out.
ping
Doc, I hear you. I have family that went through what you did, came out the other side and are also not rich. It is, as I said above, a culture and, also as you indicated, one quite similar to our military.
At least you tried to empathize. There just too many conditions for which institutionalized medicine has no answers.
The outsider modalities, the ones not recognized within the culture, try to explain their successes after the fact, by working backwards.It’s deduction and there are no tests, just a wealth of anecdotal experience, which, as we are constantly reminded, is not data.
I’m retired. I wonder if institutional medicine will ever become inclusive of the modalities that work despite not being quantifiable for painful and debilitating conditions which are also not quantifiable.
Like any profession, medicine has all sorts. Increasingly, for patients, it’s just a lottery as to which type you’ll get.
Enjoyed your well-written summary.
Perhaps it is just expectations. When your job is making life and death decisions it may be difficult for some people who would otherwise be fairly normal to consider yourself some kind of god. Especially if you don’t recognize the true God. This probably lends itself to the expectation that a patient may form that you have an answer for every question. While you may have an answer for many questions and a suggestion for treatment of many problems only He has all the answers.
Why do bad things happen to good people? Easy, actually, so He can make even better things happen.
Well, dammit! I just completed a lengthy message to you, Dr. wastoute and dammit, dammit, somehow it vanished. Not certain which damn key I mistakenly hit. Sheeeesh.
I want you to know that I thoroughly enjoyed reading your very interesting and very entertaining account of your journey into the medical profession. I must take issue with you when you state that you don’t think you’re a good doctor because you’re not rich. I have some experience in that aspect, given that I’m a very bereaved widow of a very prominent doctor who was not “doctor rich.” LOL. It would be a fallacy and an injustice to measure his goodness or his acumen, knowledge, high-profile patients or his successes by his material wealth or bank accounts. Those things mattered little to him. Yes, he loved his Porsche-Carrera (did I spell that correctly?) but that was about “it.” LOL.
Mine NEVER played gold either and he always started his day by going to Mass before going to his office. Of course hospital rounds were earlier.
Blessings!
P.S. Good thing *you* calmed down Staten Island!
You might think about attending a nice Mass today, yourself.
Sorry. Bad experience with one doctor doesn’t excuse attacking another.
Insomnia and pain put me in foul mood but I should stay off the board during those times if it affects my posts.
On tap for 1am mass at Holy Child. If i’m not thrown 20 feet away when I get near the door.
Sorry to hear of your separation from your better half. I know you are comforted in the assurance of reuniting. Dp is just having a bad day, as he says and I probably should have just left it alone but as I responded privately, self discipline is my short suit in recent years as I played those cards long ago.
Medicine is an art, not a science. When n=1 there is no science. In many cases people expect too much but we seem to encourage it. But think about it, doctors get sick and die, too, as you experienced.
Say “ hi” for me when you are in His Presence at Mass.
But it always helps to have some armchair quack second-guessing them and spewing his ignorance all over the internet. So please, continue to enlighten us.
I apologize. I’ve been out of line.
I just get SO FRUSTRATED that there’s no real help out there for this thing and the TBI soldiers
throw in insomnia and pain, and I had no right being on the board if I couldn’t control my temperament.
I apologize And I hope you accept.
Everyone gets frustrated. Not everyone uses that as justification to act like a complete jerk.
I sympathize with your pain and insomnia. AND your frustration. But if you're going to lash out, at least strike at the people responsible, not your allies. You can probably find a lot of support here if you watch where you're shooting.
It’s over bro. Let it go.
If you read all of my posts, I DID apologize to him.
Have a great Sunday
Ciao
No, I should not have launched into a Dickens length response dripping with sarcasm.
Here is the now dated WebMD article from Feb 2015 that broke the news to the medical profession that the US Gov’t finally considered ME/CFS to be a “legitimate” illness.
On the basis of this article alone my own PCP of 4 years at the time threw in the towel and stopped mocking my condition as psychological even though for two years I had been being treated by one of the foremost ME/CFS research clinics in the WORLD run under the direction of Dr. Nancy Klimas at NOVA U. in Ft. Lauderdale.
I have a typical ME/CFS profile of suppressed neuroimmune function with reactivated HHV-4, HHV-6, Coxsackie A, and Parvovirus B19. I take 1500 mg of Valtrex per day to keep the HHV-4. Anything less renders me pseudo-demented in no time flat!
The new name suggested in the article has since been dropped and for now the ME/CFS jumble name is continuing, it seems.
God bless you for doing it!!!
Mrs. AV
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