Just because the Pied Piper is playing the only song in town, should
we follow him into the Weser river? Do we follow a piper, such as the
Centers for Disease Control's CFS program, just because it is the
only agency expending considerable dollars on ME/CFS? Many seem to
feel that is enough reason to support the piper. But, what if the
beliefs of such a piper about ME/CFS are potentially very flawed?
More importantly, what if those beliefs appear to be in significant
opposition to our scientific and medical best interest as patients
with ME/CFS?
Such is the logic of continued advocacy efforts to increase funding
for the CDC's research program on CFS. Some feel because the CDC has
been conducting the bulk of the government's medical research on the
illness that we should follow the pied piper and that we should
enthusiastically support the health department's ME/CFS research
funding with no restriction on how it would be used. However, this
approach makes an assumption. The assumption is that increased
spending is evidence that funds will be used in a helpful, rather
than a harmful, manner.
We've seen far more biologic research advancements in the
understanding of ME/CFS coming from independent (extramural) research
than from the health department. In fact, I suspect that much of the
biological findings pertaining to ME/CFS are not attributable to the
efforts of the health department. This was evident at the January
2007 IACFS Conference.
A significant portion of the health department's ME/CFS funds have
been expended on research that has had little or nothing to do with
finding a root biological cause (or causes) of pure ME/CFS. A great
deal of this research focuses on how fatigued patients perceive
symptoms and react to stress. Some of the health department's
research may well impede efforts to get closer to an end goal of
finding a cause and effective treatments. Their research could
deleteriously change perceptions about the illness.
Now we're seeing the CDC CFS research program gradually redefine what
ME/CFS is through the development of new, and allegedly "scientific",
tools. Their use of the Symptom Inventory, the Medical Outcomes
Survey Short Form-36 (SF-36) and the Multidimensional Fatigue
Inventory (MFI are too inclusive. The end result of this
"integrative" approach is that they appear to be mixing psychological
disorders into the pot they're calling CFS. Gradually, the CDC has
changed the CFS case definition from an true clinical identity to a
"fatigue" research soup.
Even worse, the CDC CFS research program intentionally restricted
their "landmark" genetic profiling study to only include results
pertaining to neuroendocrine (stress response) aspects. Why announce
research findings as "landmark" that do not comprise a complete
genetic picture? Could it be that such an announcement, based on a
restricted investigation of the genetic picture of CFS, was used to
validate their interest in post-traumatic stress? It's not hard to
utilize science to validate whatever results a person wants to
achieve, if they are so inclined. It happens all too often.
The CDC knows what they are doing. They would not use these protocols
if it were not their intent to obtain results that portray ME/CFS as
a stress response disorder.
There is a long history of Dr. Reeves' involvement with stress
response type research and his belief that it may play a role in CFS.
At a meeting for Gulf War Syndrome in 1998, Reeve's stated that CFS
was probably caused by "multiple major lifetime stresses in the year
before one becomes ill" (1). Dr. Reeve's now holds a position in the
Department of Psychiatry at Emory University, as does another author
of the CDC's latest prevalence article.
Don't just accept my word for it. Read Leonard Jason's in-depth
review of the CDC's latest prevalence data.
(http://iacfs.net/p/1,544.html) Leonard Jason is a leading expert in
the fields of medical statistical research and the various ME/CFS
diagnostic criteria. Jason is also a respected psychologist with
great insight into psychiatric conditions that have overlapping
symptomatology with ME/CFS.
Remember, just because a scientist declares an illness to be "real"
and to have a "biological basis", is not evidence that he has come to
believe that illness is not a psychiatric disorder. All psychiatric
conditions, and in fact all thoughts, are considered to be real and
biological, because they are all of electro-chemical origin in the
brain.
Kim McCleary, President and CEO of the CFIDS Association of America
states, "The [CDC's] study is also a call to action to increase
research funding to enable scientists to determine the cause or
causes of CFS and to identify more effective treatment options to
help patients manage this debilitating, and often disabling,
condition." The problem with such a statement is that it shows no
concern for how money is spent. In fact, wouldn't such a statement
endorse the health department's flawed beliefs about CFS? Most
likely, yes. Political advocacy can produce harmful results, if we
are not led by leaders who care how DHHS money is spent. We need
leaders who go beyond calling for more funding to articulate specific
research needs.
We in the United States need an independent non-profit body of expert
ME/CFS doctors to act as a research advisory source -- a conduit for
private ME/CFS research funding. This body would function along
similar lines of ME Research UK. Forming such a resource would not be
enough though. We the people, the patients, would need to fund the
research. And why shouldn't we? After all, we're the ones to benefit
from it. We need to take direct responsibility, through research
donations, if we're to find the cause of our illness and more
effective treatments. Isn't that a worthwhile investment?
Given the figure of one million Americans afflicted by ME/CFS, if we
each donated just $10 a year, those donations would amount to far
more than our health department is spending on ME/CFS research. That
$10 is equivalent to a few Starbucks cappuccinos, or Big Macs,
annually. And for the cost of one month's Internet service per
person, we could probably triple that research. The problem is that
over the years few patients or families of patients have donated to
private research. Many of those who have done so have stopped because
of displeasures with the current ME/CFS organizations. It is time to
ask all patients to become part of a solution toward progress, rather
than remaining inactive.
Let's determine our own futures. If doctors will establish such a
non-profit for funding research, I'll donate the first check.
_______________________________
1. Reeves, W., Chief, Division of Viral Exanthems and Herpes Virus
Branch, National Center for Infectious Diseases, Centers for Disease
Control and Prevention, testimony before the Presidential Advisory
Committee on Gulf War Veterans' Illnesses, November 1995.
Copyright © 2007 Co-Cure
The CDC is Redefining ME/CFS -- We Need to Redefine our Advocacy Approach
by John Herd
June 13, 2007
Last Revision: June 13, 2007
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