| · NHS
· POM-to-P switches
· NHS IT
· Statutory Committee (2)
· Onlooker (2)
Letters to the Editor
|
Onlooker
Chronic fatigue syndrome is not the same as ME
From Mrs A. Bridges, RegPharmTech
Onlooker’s article on chronic
fatigue syndrome (PJ, 10 June, p688)
does not make clear that chronic fatigue is not the same illness as myalgic
encephalomyelitis (ME).
Malcolm Hooper of the University of Sunderland says that the treatment
(or lack of it) of ME sufferers in the UK is a national scandal. In a
synopsis of the problem for the ongoing UK Parliamentary Inquiry into
the illness he says that it is time that the school of psychiatrists
who perpetuate the myth that ME is a “non-disease” are held
publicly accountable.
ME has been well-documented in medical literature for over 60 years.
It was extensively documented and named by Melvin Ramsay, honorary consultant
physician at the infectious diseases department of the Royal Free Hospital,
for many years. He was the clinician at that hospital when a mass outbreak
occurred there exactly 50 years ago. Before his death Dr Ramsay, echoing
the sentiments of Professor Hooper, wrote: “The too facile assumption
that such an entity — despite a long series of cases extending
over several decades — can be attributed to psychological stress
is simply untenable.”
ME has been recognised and classified as a serious neurological disorder
by the World Health Organization since 1969.
Professor Hooper points out that most experienced ME clinicians accept
that some degree of encephalitis has occurred in patients with ME leading
to damage of the brain stem. In ME there is evidence of disruption in
ion channels in the cell membranes; such changes in ion channel function
offer a rational basis to explain the fluctuating symptoms experienced
by ME sufferers. Such ion channel changes are known to be induced by
physical activities, stress and fasting and these ion channel abnormalities
in the myocardium may form the basis of cardiac dysfunction in ME.
It is also the case that some enteroviruses are recognised as being implicated
in ME and are known to damage the heart muscle, while Vance Spence, of
Dundee University, has proved that free radical damage in the endothelium
can adversely affect all major organs. These separate studies show how
multi-organ damage occurs in patients with ME.
Some 240,000 people in the UK are thought to suffer with ME, a quarter
of them severely. It is hard to know for certain though, because there
is no Department of Health agreed rigorous diagnostic criteria and the
DoH refuses to collate statistics.
Cognitive behavioural therapy and graded exercise may benefit those who
are suffering from simple chronic fatigue but these are nothing more
than glorified coping strategies. For those who have neurological ME
these strategies can be positively harmful.
Annette Bridges
Derby
Almost invariably!
From Mr A. D Asher, MRPharmS
Onlooker wrote (PJ, 17 June, p726) that “politicians
almost invariably try to drive home a point of view”. “Invariably” is an
absolute and as such cannot be “almost”. The term “almost
invariably” is a tautological inexactitude and is to be deprecated.
In view of Onlooker’s more recent musings about the importance
of the correct use of the language (PJ, 24 June, p764), it is, more than ever,
vital that he himself be careful with the use of our rich and valuable
native language. Indeed, in the body of his piece he points up the errors
of “fairly unique” and “almost identical”. He gets
it right almost invariably but not, it would appear, invariably.
Allan D. Asher
London |
The
Pharmaceutical Journal