What Would YOU Like to Name Our Illness?

What's in a name? A lot, as those of us saddled with the moniker Chronic Fatigue Syndrome have learned the hard way.

As you've probably heard, a new name has been proposed in the U.S. by an expert committee at IOM, established by HHS: Systemic Exertion Intolerance Disease (SEID). Not everyone is thrilled with the proposed new name, though.

Now, you have a chance for your voice to be heard. Two different organizations are conducting simple surveys on the name so you can vote on which name you prefer and why.

The ProHealth website has a very brief survey - just 3 questions - on the proposed name change.

Paradigm Change has a similar survey with a few more questions on the proposed name change.

Each survey only takes about 5 minutes (or less), so take both!

Both surveys have questions about what name you would choose. Not happy with the current options but not sure what to suggest? My top choice is Neuro Endocrine Immune Disease - it gets at the heart of our illness and lets doctors know exactly what is wrong with our systems (basically, just about everything). NEID was talked about over the past couple of years (I didn't come up with it!), so I was surprised when it wasn't mentioned during all these naming discussions.

Click the links and take a moment to let your voice be heard! You CAN make a difference!

Shopping Strategies for ME/CFS

I undertook a big shopping expedition today to Target and Trader Joe's. The two stores are about a 25 minute drive away from us, so I only get up there once every 6-8 weeks or so. This time, I hadn't been since before Christmas, so we were out of everything! This was a BIG stock-up day. I also usually manage the local grocery store once a week.

I know that not everyone with ME/CFS can manage any kind of shopping - ever - but for those who have good days and bad days, like me, here are some of my strategies for shopping, to minimize the payback the next day:

Treat Orthostatic Intolerance. Long before you leave for the store, focus on treating OI. If you can stabilize your blood pressure and heart rate, then you can minimize post-exertional crashes and dramatically improve your quality of life. Some approaches to try:

• Learn how heart rate affects post-exertional crashes and use a heart rate monitor to monitor your own heart rate.
• Ingest HUGE amounts of salt and fluids - way more than you think you need - in order to increase blood volume and help to stabilize BP and HR. Just adding extra salt to your food isn't enough. Take salt tablets, use sea salt on everything, drink sodium-enhanced drinks like Gatorade or V-8 juice (before buying any kind of "electroyte drink" or drink mix, check the label to make sure it contains a lot of sodium - many don't).
• Try medications to help stabilize BP and HR, like Florinef, midodrine, and beta blockers. I couldn't go grocery shopping without crashing until I started beta blockers - now I go almost every week with no problem. They reduce my heart rate to more normal levels, so I can be active without crashing.

When you go shopping:

We're Going To Pump You Up!

• Pump up your blood volume before you go. I usually drink a 12-ounce can of V-8 juice before I go to the store and also carry my ever-present water bottle (which can also be filled with high-sodium electrolyte drink mix). Remember Hans and Franz from Saturday Night Live? "We're Going to Pump You Up." That's your new motto. And yes, this means I have to stop and use the restroom in every store I go to!
• Wear your heart rate monitor. I don't always do this now because I know that with beta blockers, I can manage grocery shopping without crashing, but I wore it today because I haven't been doing well lately. Set the alarm for your AT (see this post to estimate it), and listen to it - when it beeps, stop and rest, crouching or sitting if you can or at least putting one foot up on the bottom of the cart and breathing slowly and deeply until your HR comes back down.
• Commit to Slow Shopping. This was my motto today! I'm hoping to start a new trend. This is probably the hardest thing of all for me because I am naturally a fast person. Today, I consciously moved slowly and deliberately - be the ultimate Zen shopper.
• Avoid lifting your arms too much. I know from using my heart rate monitor that raising my arms over my head raises my heart rate. I was fine most of the time in Target until I went into the dressing room to try on a pajama top - I pulled my shirt over my head and beep, beep, beep!
• Let someone else bag. Again, moving your arms, lifting things - it all raises your heart rate. Choose a checkout lane with a bagger or let a store employee know that you need one.
• Ask for help taking your purchases to the car. I was amazed to find that the grocery stores in Oklahoma (where we used to visit my in-laws) do this automatically! It's more self-serve here on the East Coast, but you can always ask for someone to help you - let them help put the bags in the car.
• Ask someone at home to help bring your purchases into the house. When I first started wearing a heart rate monitor, I was amazed to find that pushing a heavy grocery cart didn't raise my heart rate too much, but carrying even light bags into the house did. Carrying stuff really raises your heart rate dramatically, so get some help. I bring in the frozen/refrigerated stuff myself and leave the rest in the car for when my husband and son get home. If you live alone, ask a neighbor or friend. Sometimes, I shop with a friend - we get to spend time together and she can help me.

So, those are my shopping tips. Do you have any others? What works for you?

Remember - Slow Shopping!

Movie Monday 2/23

We had a busy weekend, with snow days (actually, school was closed for COLD, not snow) tacked on and a houseful of teen boys most of the time, but my husband and I did find time for one movie. I was pretty badly crashed on Friday (yet another yeast overgrowth flare-up), so my husband brought home 5 Guys take-out and a DVD from Redbox - perfect!

We watched Lucy starring Scarlett Johansson. She plays a partying college student away in Taiwan who unwittingly gets mixed up with some nasty characters. They try to use her and several other poor victims in a criminal scheme, but along the way, something unexpected happens - she gets exposed to a drug that allows her to use 100% of her brain, and she develops all kinds of superhuman powers. Morgan Freeman stars as a renowned neuroscientist who explains that humans normally use only about 15% of their brain's capacity. What follows is an international kick-ass revenge fantasy, as Lucy goes after the villains who did this to her while getting in touch with Freeman's character to tell him about what's happened to her. It's a lightweight confection of a movie, basically an action movie with a sci fi theme and lots of very bizarre special effects. We enjoyed it as a fun bit of escapism, but there wasn't much depth to it.

Have you seen any movies lately? What do you recommend?

Weekly Inspiration: Never, Ever Give Up

Sorry that it's been a few weeks since I've posted a Weekly Inspiration post - crashes, family stuff, big news in the ME/CFS world - you know how it goes. Best laid plans and all....

So, I took some time this morning to watch some TED talks, which never fail to inspire me, and this one in particular caught my eye and then captured my spirit.

It's called Never, Ever Give Up and the speaker is Diana Nyad, the famous swimmer who broke all kinds of records and swam from Cuba to Florida at age 60. Now, you may be thinking, "What could a world-class, record-breaking athlete have to do with me who can barely walk around my own house?" I thought that, too, but she gives a talk that is engaging, funny, and yes, inspiring that applies just as well to us battling chronic illness as it does to athletes trying to achieve their dreams.

It's a short talk but very powerful (and entertaining as well):



I found her talk applicable to us in two ways. First, I thought of my own never-ending quest to find treatments that will help me to improve. I'm not delusional - I know there is no cure right now, and I am way past the point of most spontaneous recoveries (less than 5 years is the usual rule of thumb). But I have spent the past 12 years trying one treatment after another, reading studies, talking to my doctors, and trying anything that seems promising. I haven't found any one treatment that helps a lot, but I have found many treatments that help a little, and those small improvements add up over time, as evidenced by my improvement over the past few years so that I can now do more and have a better quality of life. So, Diana's motto of Never, Ever Give Up resonated with me in that way. I will keep trying new treatments and keep following and supporting the research and keep helping other people to do the same. I never stop trying, and I never stop hoping for a better tomorrow.

The other way that her talk resonated with me is from an emotional perspective rather than a physical one. To Never, Ever Give Up also means to never give up on being happy and finding joy in your life, in spite of your physical limitations. Sure, we all have times when we are down or depressed, but Never, Ever Give Up means to me that while we are trying new treatments and waiting for new research, we can be fully present in our lives and find small moments of joy in every day.

I hope you found Diana's talk as inspiring and entertaining as I did.

What does Never, Ever Give Up mean to you?

Survey on Access & Quality of Healthcare for ME/CFS

Leonard Jason, renowned ME/CFS researcher at DePaul University is conducting an online survey of ME/CFS patients on their access to healthcare and the quality of that care, specific to knowledge of how to treat ME/CFS.

This is a very important survey, so I urge you to participate at this link. It only took me less than 10 minutes to complete the survey.

Our family has been fortunate in this area for 3 reasons:

• I happened to stumble upon a local family doctor one year into my "mystery illness" who immediately recognized that I had ME/CFS, after a full year of seeing all kinds of doctors and searching for a diagnosis. She not only diagnosed my illness but knew the basics of how to treat it and was open to trying new things whenever I brought the latest study results to her. I know now, from other ME/CFS patients, just how unusual this is.
• We have the means to seek out top ME/CFS doctors and travel to see them. My husband has a stable job, and we have been fortunate to see Dr. David Bell before he retired and now see Dr. Susan Levine in NYC. I spent a lot of time and energy finding these doctors and making arrangements for me and the kids to see them. Granted, most of our money goes toward medical expenses and there is not much left over, but I am grateful we have it to begin with.
• We have excellent health insurance through my husband's job, including out-of-network coverage.

I am well aware that we are lucky in these respects and that the situation is not nearly so positive for most patients with ME/CFS.

That is why it's so important for you to take a few minutes to fill out this survey and make it known just how scarce good quality healthcare for ME/CFS really is.

Opinions & Editorials on the New Name & Criteria

Unless you've been offline for the past week or perhaps living in a cave in the Himalayas, you have probably seen at least some of the flurry of editorials and opinions about the new name - Systemic Exertion Intolerance Disease - and diagnostic criteria for our illness. I wrote about it last week, when it was announced, and included in that post my own opinions, but I've been curious to see what the mainstream media and some of the more prominent figures in our little world think about it all. So, here is a compilation:

The Media
I was thrilled to see that the release of this report was well-distributed to mainstream media news outlets - in all, over 300 articles and stories appeared! Woohoo!! Not all got it right in their reporting (some appeared not to have actually read the report). NBC Nightly News was especially bad in their coverage, which was a huge disappointment. The patient they filmed appeared to be a busy and active mom, despite the voice-over and interview saying she was sick (I'm not doubting she had ME/CFS - but they chose someone whose invisible illness really was invisible).  They capped off the segment with an interview with a "doctor" (she was a rheumatologist who makes frequent TV appearances) who said the best treatments are CBT and exercise! Seriously. With "Exertion Intolerance" front and center in the name. My husband was yelling at the TV screen! I tried to mount a defense and let NBC know they got it wrong, but my efforts were drowned in the bigger news of Brian Williams' suspension.  The Solve ME/CFS Initiative had better luck than I did (their CEO Carol Head was also featured in the segment and was the only bit of accuracy in it!) - they urged NBC to issue a retraction about exercise being a good "treatment" - which they did on their website, though I doubt that many of the millions of viewers who watched the NBC Nightly News will ever see it!

However, some did a good job accurately covering the story and spreading the word:

NPR's article was excellent and accurate and even included a quote from my good friend and outstanding advocate, Jennie Spotila.

The New York Times also ran a good piece (though it was a blog post and not a print article) that was accurate and included some history and quotes from Dr. Rowe, Dr. Bateman, and Leonard Jason.


Science Magazine covered the announcement in their ScienceInsider column and again, did a good job getting the facts right and interviewing real experts.

As always, Cort Johnson of Health Rising did a fantastic job of summarizing the media coverage - this blog post of his includes more excerpts from media outlets like WebMD, MedScape, and Nature magazine.

Our Experts/Our People
It has been very interesting to see the wide variation in responses from our own community of both ME/CFS patients and clinicians, researchers, and other experts. Here's a small sampling:

Jennie Spotilla, advocate extraordinaire, whose blog, Occupy CFS is my favorite source for up-to-date information on advocacy, politics, and inner workings of our illness, wrote a post called Your Move, HHS on the topic that has been on MY mind - what comes next?

Leonard Jason, a well-known and highly respected ME/CFS researcher, wrote a critical editorial on the name change, based on input from patients and his experiences.

Tina Tidmore, an ME/CFS patient and advocate, wrote a very thoughtful blog post on both the criteria and the name that is well worth reading and quite thought-provoking.

And perhaps most importantly, comments on the name change from Dr. Lucinda Bateman, who is not only a well-respected ME/CFS clinician but also served on the IOM committee that recommended the new name.

My opinion? You can read my detailed assessment in my previous blog post, but after having a week to think about it and read all these other opinions and editorials, my opinion is pretty much the same:

• The criteria is good - a huge step forward since we have NEVER had diagnostic criteria in the US before (a point that many seem to be overlooking).
• But not great - I would prefer to see symptoms of immune dysfunction (recurring sore throat, swollen glands, feeling feverish, etc.) somewhere in there because those signs were key to finding my own diagnosis (which took a year).
• SEID is better than CFS (anything is!) but not ideal. I agree that ME isn't scientifically accurate for all patients, and Dr. Bateman makes some excellent points about it already being defined in the UK. I would have preferred something along the lines of Neuro-Endocrine Immune Disease and am confused as to why this hasn't been discussed anywhere. There is plenty of science behind the presence of dysfunction in these 3 systems. I do think there is still the potential for "exertion" in the name to be misunderstood and minimized, but I can live with SEID - for now.

Whew. There's been a lot going on in our world this past week, and hopefully, all of this talk will lead to some action - more research funding and more research!

What are your thoughts?

NYC Study Recruiting Patients

The Solve ME/CFS Initiative is helping to recruit study participants for the Pain & Fatigue Study Center at Mt Sinai Beth Israel in New York City. They are conducting a study about Chronic Fatigue Syndrome (CFS). Your participation could help advance knowledge about the cause and treatment of CFS. Despite the vagueness of the study info below, it is specifically focused on ME/CFS aka SEID, not on generalized fatigue. Sounds like a great way to help move research forward!

Contact Michelle Blate at Mblate@chpnet.org and 212.844.6665 with questions or to volunteer.

BIG NEWS: New Name, New Criteria!

Well, friends and fellow sufferers, the good news is that we no longer have ME/CFS. The bad news is that we now have SEID: Systemic Exertion Intolerance Disease.

The IOM just announced the results of their efforts to review all the data and research and comb through input from patients and ME/CFS specialists. They have developed a new set of diagnostic criteria and a new name for our illness. Overall, this is fantastic news for all of us patients because with this new criteria comes a campaign to disseminate and inform doctors all over the country. I'm not in 100% agreement with what they came up, but it sure beats what we had.

The Name
Systemic Exertion Intolerance Disease (SEID). It's a mouthful. We finally got rid of the dreaded "f-word," so that's good news. And we've graduated from a Syndrome to a Disease - also good news, in terms of recognition and awareness.

However, I'm not thrilled that this new name still focuses in on just one symptom of our illness. Granted, it IS the central differentiating symptom (Post-Exertional Malaise or PEM), as opposed to fatigue which many illnesses and medical conditions share. However, I'm disappointed that the name is still focused on effects or symptoms rather than on what causes them. I do understand that the exact cause(s) of our illness are not yet fully understood, but experts and patients have known for many years that the basis of this illness is dysfunction in the immune, endocrine, and nervous systems. All symptoms stem from those dysfunctional systems. So, I would prefer one of the Neuro-Endocrine Immune type names that have been considered before.

The Criteria
For the record, we have never actually had official Diagnostic Criteria before, so this is a huge step forward. The criteria the CDC came up with years ago was meant to be used as research criteria.

Without further ado, here is the new SEID Diagnostic Criteria:

It doesn't seem to appear here (which is worrying), but in the presentation, they said there is an addendum that says something to the effect that these additional symptoms may be present:

• Pain
• GI problems
• Sore throat and/or swollen glands
• Headaches
• Sensitivity to external stimuli
• Certain infections can act as triggers

I am disturbed that this list doesn't seem to appear in the official written criteria - I had to go back to the presentation slides to find it.

I think it's great that PEM is now highlighted and required, as it is the single most defining and unique characteristic of our illness. I was also glad to see OI highlighted right in the criteria, not so much for diagnosis but to spread awareness that OI is an integral part of our illness (especially because it is one aspect that is treatable).

I am very disappointed to see that immune symptoms (sore throat, swollen glands, feeling feverish) weren't included because the sore throat was a critical factor for me in finally getting an accurate diagnosis - there were lots of conditions with fatigue but none of them included a sore throat. It was the one thing that told me right from the start that whatever I had was related to my immune system.

One highlight of the panel's conclusions is that co-morbidities no longer preclude a diagnosis of ME/CFS/SEID. In the CDC's 1994 version, if the patient had any other conditions (fibro, IBS, depression, etc.), then they were excluded - again, this is because that criteria was meant for use in research, not for diagnosis. This new criteria mentions common co-morbidities as a diagnostic & treatment tool for clinicians.

Dr. Rowe spoke specifically on pediatrics and explained that the information review they conducted for pediatric cases showed that this same criteria works equally well for children as for adults.

Dissemination
The next step - and perhaps the one that will impact patients the most - is to disseminate this new name and criteria and begin educating doctors across the U.S. The panel emphasized that one of their critical goals was that the criteria would be simple, easy to understand, and available so that ANY doctor, anywhere could use it - primary care doctors, pediatricians, ER doctors, etc. That would be amazing, wouldn't it?

Already today, both the Journal of the American Medical Association and the Annals of Internal Medicine have published announcements about the new criteria - wow! We haven't had that kind of mainstream medical coverage in...well, never. The committee will send the new criteria to all the medical professional organizations, as well as medical publications, in an effort to spread the word.

More Information
This IOM page includes links to detailed information on the new name and criteria.  Here are the Powerpoint slides of the announcement presentation I just watched live. Here is a brief summary report with the main criteria. See the IOM page for more information, including a diagnostic algorithm and key facts.

Is this possible? That a few years from now, regular doctors might be aware of our illness and recognize its signs and know how to diagnose it? Seems like a fantasy, but it could well come true.

Overall, I don't agree with everything the committee concluded, but all of this is a HUGE step forward for ME/CFS...ooops, SEID patients (that's going to take a little getting used to).

Movie Monday 2/9

Our college son who'd been home sick for the past two months moved back to his apartment last week! Woohoo!! Besides being thrilled for him, my husband and I were also glad to be able to catch up on our favorite TV shows that our son doesn't watch. So, we spent our evenings last week catching up on Madam Secretary, Grey's Anatomy, The Blacklist, Sleepy Hollow, Resurrection, The Good Wife, and The Americans (yes, we have too many shows going at once but they are all so good!).

Friday night, we watched a movie...that was neither a thriller nor an action flick! Wow.

We finally had a chance to see Boyhood, which won Best Pictures awards in both the Golden Globes and the Oscars. You may have heard about this ground-breaking movie last year that was filmed over the course of twelve years to capture - in real time - the childhood of one boy, played by Ellar Coltrane. In the movie, he plays Mason, who is six years old when the film opens and eighteen when it ends. It is a unique and effective approach that makes the characters in the movie feel very real. Even though his parents are played by Ethan Hawke and Patricia Arquette, two famous actors, we still fell completely under the movie's spell, as if we were watching a documentary instead of a work of fiction. Mason lives with his sister and his mother. His dad was absent for much of the kids' early lives but moves to Texas to be closer to them at the start of the film. Throughout the twelve years of the movie, their mom remarries twice, the family moves a couple of times, and Mason goes through the typical joys and pains of childhood and adolescence, as well as some more serious struggles with his family. This movie is so completely engrossing and compelling that by the end, we felt like we knew this family in real life. And the next morning, we both said that the movie popped up in our thoughts and dreams all night long! It's really a stunning achievement and a must-see, but be warned - it is a very long movie (almost 3 hours), so start early.

Have you seen any good movies lately?

New ME/CFS Diagnostic Criteria Being Announced Tomorrow

Tomorrow, February 10, 2015, the IOM will release the Report on the Diagnostic
Criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome at 11am ET. The event will be available via live webcast at this link.

If you are unfamiliar with the IOM process, here is a summary of what they've been working on that I posted last year.

This should be interesting! So glad this one is in the morning and not during nap time - I should be able to tune in.

Opportunity to Share Your Story

If you became ill with ME/CFS as a child or teen and are now an adult, the Tymes Trust in the UK would like to hear your story.

They are compiling an anthology of stories from adults who got ME as a child, in order to provide support for sick young people and their parents and to help educate the medical community about the special plight of children with ME.

You can read the details and contact information here.

The more we share our stories with the world, the better the outside world will understand the severity and devastation of this illness, especially on young people...so let your voice be heard and tell your story!

Getting Back to "Normal"

Well, not real normal, but we are getting back to our own version of normal!

I explained last week that we now know our college son's 2-month long couch-bound relapse was "just" an ME/CFS-type crash, probably triggered by the flu in November. Well, in the last week, we saw him come back to life! Each day, he seemed more alert, was sitting up more, and seeming more like himself. He was finally able to get back to some schoolwork, and as the week went on, he began to smile and talk more and even laugh. We knew things were moving in the right direction when he began teasing his younger brother again! It was such a relief to see him return to his old self.

On Tuesday, he moved back to his college apartment, thrilled to be back with his friends. He's spent this week studying and making up tests and final exams that he missed at the end of fall semester. He will be ready to start the spring semester on Monday, with his peers. What a relief! There were plenty of times this past month when we wondered if he'd have to take a semester off.

As usual, he is signed up for just 3 classes, but he manages them pretty well and enjoys living on his own with his friends. I know he is thrilled to be back to his own version of normal, too.

Of course, I am still worried about him! I know he won't be able to stick to his diet on his own as well as he did while home, and any sugar or grains can have a fairly immediate negative impact. He's also jumping back into his social life, with plans to go to the movies with friends tonight and go snowboarding (!!) tomorrow. But he is 20, and I need to let him live his own life and maybe make his own mistakes. It's hard to let go when your child has been through so much suffering.

Here at home, I am free! I thoroughly enjoyed getting back to my own routines this week, embracing the quiet solitude in the house, resuming a more regular exercise routine, and having more time for writing. I have been catching up on my favorite TV shows at lunchtime, the ones the males in my house don't want to see, and my husband and I have been catching up on our own favorite shows in the evening (our high school son has his own busy social life).

So, life is returning to normal for us, and we are grateful.