Situation for ME patients in Wales is ‘disgraceful’ (English translation)

Situation for ME patients in Wales is ‘disgraceful’

a translation of: Sefyllfa i gleifion ME yng Nghymru yn ‘warthus’ on the BBC Cymru fyw website, 24 Oct 2018 (This translation is not definitive, it may need some tweaking!)

Emma-Jayne Lloyd from Cardiff shares her experience of living with the condition of ME.

The situation for people in Wales who suffer from the condition of ME, or chronic fatigue syndrome, is “disgraceful”, according to one specialist in the field.

Charities will be holding a protest at the Senedd in Cardiff Bay on Wednesday to show a movie about the disease.

Jan Russell, from WAMES (Support Society ME and CFS Cymru), has called the lack of diagnosis and lack of advice on symptoms “a health and social care crisis, even a humanitarian crisis”.

The Welsh Government said “health boards in Wales are responsible for the healthcare requirements of their populations”.

‘Lack of understanding’ of chronic fatigue

Speaking on the BBC’s Eye On Wales program, Charles Shepherd, a medical advisor to the ME Association, said:

“From my experience with patients in Wales, many GPs are still very uncertain about how to diagnose this illness.

“They’re just as insecure about how to manage the illness.

“There are five adult services in Wales but none of them are led by a multidisciplinary doctor, and that is what these services should be.

“Overall, the situation in Wales is scandalous.”

Mistaken ME for depression

Emma-Jayne Lloyd, aged 39 and from Cardiff, has suffered from ME symptoms since she was 18, but only last year she was given an official diagnosis.

“Imagine rising in the morning with a hangover, flu and the worst  jet-lag you’ve ever had, all mixed up together,” she said.

“Then imagine that you get up every day and feel like that. That’s what ME is.

“The pain is all through the body, you are so tired and you’re so weak that you cannot get up, or dress, or try to make food – everything is difficult.

“Everything you do, you must think about, because everything causes pain, or can cause you to go back to bed and sleep.”

Two years ago Emma-Jayne had to stop her job as a teacher, and she does not drive now

For years, doctors thought she was depressed, and Ms Lloyd says that health workers are only beginning to understand ME.

She says that ME clinics and consultants are available in England, but there is no such provision in Wales.

“There’s nothing in the blood, so they all think it’s something mental,” he said.

“There is no medication, no consultants, no clinic here.

“If you break your arm or have cancer, you know that you can go somewhere and someone with expertise can talk to you – but there is no one with expertise in ME in Wales . “

‘Change is slow’

In 2014, recommendations were made to the Welsh Government on how to improve diagnosis at primary care level, as well as treating and managing symptoms.

An action group was set up in 2015 to work with Local Health Boards across Wales to make these recommendations active.

Owen Hughes, who chairs the action group, said “progress has been slow”.

“There are some very good services in Wales and it’s a shame that everyone does not have those services on their doorstep,” he said.

“That is part of the role of the action group – to share good practice and ensure that everyone is able to access high quality information and services.”

What is ME?

Around 13,000 people in Wales suffer from ME (Myalgic Encephalomyelitis), or chronic fatigue syndrome (CFS).

70% of people with the disease are women – and it is more likely to hit people between their twenties through to their 50s.

The disease is usually triggered by a viral infection.

Symptoms include muscle tiredness caused by activity, often with pain, as well as neurological symptoms such as short-term memory loss and ‘brain fog’.

Patients can also have problems with balance, ability to find words and lack of temperature control.

There is no complete cure to the condition, but symptoms with early diagnosis and with the right advice can be improved.

#TimeForUnrestWales

 

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ME makes me grieve for my past life

BBC website, 24 Oct, 2018: ME makes me grieve for my past life

An ME sufferer says she “grieved for her past life” after she was diagnosed with the condition.

Millie Earp, 22, from Cardiff, was 17 when she was diagnosed with the chronic illness but says she has learned to accept the condition.

She now works in Techniquest two days per week, but spends the remainder of her time resting.

The situation for patients in Wales has been described as “scandalous” by the ME Association, with patients saying they have struggled to get the help they need.

Watch the video

#TimeForUnrestWales

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#TimeForUnrestWales in the Senedd

#TimeForUnrestWales in the Senedd – Wed 24 Oct 2018

Seven AMs accepted the invitation from Mark Isherwood AM to join people with ME and carers at an event in the Senedd, the home of the Welsh Government. More AMs expressed interest and sent their apologies.

The message:

  • ME wrecks lives and disrupts families
  • Too few GPs understand enough about neurological ME to diagnose accurately & in a timely manner
  • Lack of medical expertise in ME also leads to inappropriate treatment referrals and management advice, often leading to a deterioration in symptoms

MESIG, the Cardiff Support Group presented an excerpt from the award winning, and very moving documentary film Unrest. This was followed by the opportunity to hear ME stories from local people, and an update on the state of healthcare for ME and the campaign #TimeForUnrestWales.

People with ME are asking for:

  • Welsh Government commitment to urgently provide finance and direction to enlist medical expertise and create a national training and awareness programme on neurological ME for NHS Wales
  • A speedy response by the Cabinet Secretary to implementing changes following the 2018 Review of services
  • Health Boards to be held accountable and assisted to implement training and awareness improvements in order improve diagnosis, management and access to generic services

An S4C news team arrived before the event to film and interview a group of people with ME and their families, who were standing outside the Senedd with posters, giving a visible presence to the event.

Mark Isherwood AM & attendees

Assembly members:

Mark Isherwood AM – North Wales                   Julie Morgan AM – Cardiff North
Jane Hutt AM  – Vale of Glamorgan                   Jenny Rathborne AM – Cardiff Central
John Griffiths AM – Newport                               Hefin David  AM – Caerphilly
Vikki Howells AM  – Cynon Taff                          Adam Price AM – Carmarthen

Hefin David AM Caerphilly

Julie Morgan AM Cardiff North

Adam Price AM Carmarthen

 

John Griffiths M Newport East

Jenny Rathbone AM Cardiff Central

Vikki Howells AM Cynon Taf

 

 

 

 

 

 

 

Jane Hutt AM Vale of Glamorgan

Stephen Allen, CE of C&V CHC

Chris Roach, Public Health Wales

 

 

 

 

 

Also present:

  • Stephen Allen, Chief Executive of Cardiff & Vale of Glamorgan Community Health Council
  • Christine Roach, Public Health Wales, seconded to the Welsh Government

ME stories:

  • Deirdre Penny – parent carer of adult daughter with severe ME
  • Millie Earp – young adult with ME
  • Jon Vaughan – carer of fiancé with severe ME

ME Health & Social Care crisis in Wales – #TimeForUnrestWales

Jan Russell, Chair of WAMES & patient rep on the government’s All Wales Implementation Group, explained how the recommendations in the Welsh Government’s 2014 Task & Finish Group Report had been designed to give practical steps to help Health Boards improve healthcare for people with ME & Fibromyalgia. 4 years later, many have not been implemented by Health Boards and no HB has implemented the recommendation to train and raise awareness with GPs and healthcare staff.

Dr Nina Muirhead, is a surgeon, person with ME & lecturer at Cardiff Medical School. Nina outlined her hopes and plans for Cardiff to be the first university to include neurological ME in medical students’ education.

The speakers were followed by a lively discussion about why doctors and the NHS are reluctant to take ME seriously and what could be done about it. All contributions will be considered via the ME services survey, the All Wales Implementation Group (AWIG) and/or WAMES.

Photos by Tom Martin

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ME in Wales in the media, 24 Oct 2018

Catch up with the media coverage of the ME and the #TimeForUnrestWales campaign.

Wales today at 6.30pm – the item on ME starts at 15:30, and is little changed from the earlier news bulletin. In the broadcast Owen Hughes says the All Wales Implementation group is working with WAMES to develop services.

Jan comments:

I represent pwme on the All Wales Implementation group, but my primary message for years has been the need for doctors and other NHS staff to be trained to understand neurological ME. Listening to pwme and studying the latest research is critical. Only then can the NHS develop services that actually meet the needs of patients.

Owen says Wales has to follow the old NICE guidelines but is this the case? Not all English clinics use the Bio Psycho Social version of GET & CBT for ME (based on the PACE trial). Some teach pacing. Clinical judgement CAN be used, when an alternative approach is shown to be helpful or patients are unhappy with the proposed approach. WAMES does not accept Wales HAS to implement controversial and unwanted therapies.

ME and chronic fatigue: ‘Some doctors don’t believe you’re sick’ 

Charles Shepherd, medical adviser to the ME Association, said:

“My experience from contact with patients in Wales is that many GPs are still very unsure and uncertain about how to diagnose this illness. They are equally uncertain about how to manage this illness.

Jan Russell, of Welsh Association of ME & CFS Support (WAMES), added :

the lack of diagnosis and help for patients is “a health and social care crisis, even a humanitarian crisis”.

ME makes me grieve for my past life’

Eye on Wales – a half hour programme about ME in Wales

 

 

Sefyllfa i gleifion ME yng Nghymru yn ‘warthus’ [The Situation for ME patients in Wales is ‘disgraceful’ ]

Newyddion 9 – the 5 minute lead story was on ME.

 

ME: “Mae ei bywyd hi jest wedi stopio” – the story of how severe ME has affected the life of Natalie and her fiance Jonathan. Translation: ME: her life has just stopped
Unrest in the Senedd with MESiG on Business News Wales website, 26 October 2018

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Diagnosis and Management of ME & CFS – Dr David Kaufman’s training video for doctors

Diagnosis and Management of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome

Dr David Kaufman’s training video for doctors shows how straight forward it is to begin the education for doctors in the true nature of ME.

Unrest Film
Published on 16 Oct 2018

This video on the diagnosis and management of myalgic encephalomyelitis and chronic fatigue syndrome is part of the Unrest Continuing Education module, made available through the American Medical Women’s Association and Indiana University School of Medicine, and in partnership with #MEAction. US medical providers can visit: https://www.unrest.film/cme to register to watch Unrest online for free and receive Continuing Education credit.

Transcript of video

#MEAction fact sheetDiagnosis & management of myalgic encephalomyelitis

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ME healthcare in Wales is in the news – ‘scandalous’, ‘a health & social care crisis’!

ME healthcare in Wales is in the news!

As, people with ME prepare to meet AMs at the Senedd today, 24th October 2018, to watch an excerpt of the award winning film Unrest, the BBC is featuring ME on the TV, Radio and online:

ME and chronic fatigue: ‘All I could do was lie in bed’

A woman who was diagnosed with ME says she struggled to get out of bed for several years after her diagnosis of the chronic condition.

Anne Kavanagh, 68, from Bridgend, had to give up work and check in to a self help centre, but was told she was not eligible for benefits.

The situation for patients in Wales has been described as “scandalous” by the ME Association.

The Welsh Government said health boards were responsible for their patients.

What is ME?
Myalgic encephalomyelitis (ME) or Chronic Fatigue Syndrome (CFS) is usually triggered by a viral infection which leads to muscle fatigue, pain and neurological symptoms such as short term memory loss.

About 13,000 people in Wales are thought to suffer from ME, and 70% of those are women.

Calls to scrap common treatment for ME
Chronic fatigue syndrome: What not to say

Ms Kavanagh, a former head of special needs at a comprehensive school, started showing symptoms for the condition 10 years ago.

“I was an exceedingly energectic person,” she told BBC Eye on Wales. “My job was very exacting but I loved it.

“I was a dog trainer, travelled all over the country. My life was good.”

After contracting a virus which gave her no symptoms other than a temperature, Ms Kavanagh was repeatedly signed off work with post viral fatigue as she struggled to get out of bed and return to work.

She says she felt “hopeless” because of the condition and her weight dropped to less than six stone, but added she was “worried whether people would believe I was genuinely ill”.

Charles Shepherd, medical adviser to the ME Association, said: “My experience from contact with patients in Wales is that many GPs are still very unsure and uncertain about how to diagnose this illness. They are equally uncertain about how to manage this illness.

“There are five adult services in Wales but none of them are multidisciplinary physician led which is what these services should be. Overall the situation in Wales is scandalous.”

Chronic fatigue trial results ‘not robust’

Jan Russell, of Wales Action of ME & CFS support (WAMES), added the lack of diagnosis and help for patients is “a health and social care crisis, even a humanitarian crisis”.

But Owen Hughes, who chairs a group to improve ME services, said progress had been made, despite issues.

“Progress has been slow. There are some very good services in Wales and it’s a shame that not everyone has those services on their doorstep,” he said.

The Welsh Government said: “Health boards in Wales are responsible for the healthcare needs of their population.”

After being forced to officially resign from her job as a teacher two years after falling ill, Ms Kavanagh underwent an assessment for Employment Support Allowance (ESA), but said she was told she was not eligible, an experience she describes as “humiliating”.

“They didn’t ask the appropriate questions. There was no relation to what I was feeling,” she added.

“I’d have had better luck if I’d had a bad back.”

Eventually, Ms Kavanagh was diagnosed with Chronic Fatigue Syndrome on the NHS and was offered some support early in the morning, but she had no way of getting to the centre to undergo rehabilitation exercises.

She found a place to start her recovery at the Sandville self-help centre in Porthcawl, where she was able to visit three times a week to do simple exercises.

“They just said ‘come when you’re ready’,” she said.

“I wouldn’t be where I am now without Sandville. It took about five years for them to see the outgoing, happy person that I was.”

For details of organisations offering help and support with ME/CFS visit bbc.co.uk/actionline

Eye on Wales is on BBC Radio Wales at 18:30 BST on Wednesday.

#TimeForUnrestWales

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School functioning in adolescents with CFS [Australia]

School functioning in adolescents with Chronic Fatigue Syndrome, by Sarah Jenette Knight,  Jennifer Politis,  Christine Garnham,  Adam Scheinberg and  Michelle Anne Tollit in Front. Pediatr., 16 October 2018

Background: 

It is well known that adolescents with chronic fatigue syndrome (CFS) experience greater school absenteeism compared to healthy adolescents. Less is known about other important aspects of school functioning including school participation, school connectedness, and academic performance in students with CFS. The aim of this study was to compare school functioning as a multifaceted construct in adolescents with CFS to healthy adolescent peers. We also explored whether illness factors were associated with school functioning in adolescents with CFS.

Methods:

Thirty-nine participants with CFS and 28 healthy controls (aged 13–17 years) completed a range of subjective and objective measures of school functioning, as well as measures of fatigue and emotional symptoms.

Results: 

Adolescents with CFS demonstrated significantly higher rates of school absence, as well as poorer school-related quality of life, reduced school participation, poorer connectedness with school, and reduced academic performance. Fatigue severity and emotional symptoms were significantly associated with most aspects of school function.

Conclusions: 

Adolescents with CFS are at increased risk for poor school functioning across a range of indicators which extend beyond school absenteeism.

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Withdrawn – Traditional Chinese medicinal herbs for the treatment of idiopathic chronic fatigue and chronic fatigue syndrome

Traditional Chinese medicinal herbs for the treatment of idiopathic chronic fatigue and chronic fatigue syndrome – This review has been withdrawn from the Cochrane Database of Systematic Reviews

Cochrane Systematic Review – Intervention Version published: 15 October 2018

Reason for withdrawal from publication

Supporting better health for those receiving care is central to Cochrane’s mission to promote evidence‐informed health decision‐making by producing high quality, relevant, accessible systematic reviews and other synthesized research evidence.

The Cochrane Common Mental Disorders Group is currently undertaking a strategic portfolio assessment of all existing and planned reviews and protocols, including those relating to Chronic Fatigue Syndrome (CFS).

During the course of our portfolio assessment, we are aiming to ensure that the most up to date evidence is available in the Cochrane Library to inform decision‐making. This latest version of the review was published in 2009. The Cochrane Common Mental Disorders Group are therefore temporarily withdrawing this review, with the full support of the author team, to allow time to determine whether the evidence is up‐to‐date.

The editorial group responsible for this previously published document have withdrawn it from publication.

More about the publication

 

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Final ME/CFS NICE guideline scope published, Oct 2018

Communication RE: NICE guideline on Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management (Oct 2020)

The final scope and equality impact assessment for this NICE guideline have now been published [Oct 16th], along with all the stakeholder comments that were received during consultation and our responses to these comments: documents

We would like to thank you for your continued involvement and interest in this guideline. The comments received during the consultation period helped us to develop and refine the scope.

Your organisation [WAMES] has been identified as a key stakeholder for this topic; we will contact you again when the draft guideline is released for consultation and ask that you please prioritise sending us your comments.

Provisional Schedule

Draft guidance consultation    21 April 2020 – 02 June 2020
Expected publication                14 October 2020

Committee members [more appointments to come]

Chair

  • Peter Barry Consultant Paediatric Intensivist, University Hospitals of Leicester

Vice Chair

  • Ilora Finlay Consultant in Palliative Medicine, Clinical Lead for Palliative Care for Wales,Velindre NHS Trust, Cardiff

Core members / Members

  • Secondary care paediatrician: Theo Anbu (Alder Hey, Liverpool)
  • Physician with an interest in ME/CFS:   Mike Beadsworth (Consultant
    Infectious Diseases, Liverpool)
  • Physiotherapist:   Joanne Bond-Kendall, Bath (MAGENTA & FITNET researcher)
  • Social worker:   Tony Crouch (Social work advisor – works with 25% Group & TYMES Trust)
  • Psychologist:    Jo Daniels, Bath   (Interests: CBT, anxiety disorders)
  • GP:               Luis Nacul (leads the CureMEteam and the UK ME/CFS Biobank)
  • Occupational therapist: Susan Watson, (Leeds & West Yorkshire CFS/ME Service)
  • Community paediatrician:
  • Dietician:
  • Epidemiologist:
  • Nurse with specialist interest in ME/CFS:
  • Community children’s nurse:
  • Lay member:  Saran Bonser
  • Lay member:  Sally Burch (http://sallyjustme.blogspot.com)
  • Lay member:  Nicola Kidby
  • Lay member:  Adam Lowe  (#MEAction)
  • Lay member:  Dorinda Jack
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Chronic Fatigue Syndrome: from chronic fatigue to more specific syndromes

Chronic Fatigue Syndrome: from Chronic Fatigue to More Specific Syndromes, by S Blitshteyn, P Chopra in Eur Neurol 2018; 80:73–77

 

Research Article:

In the last decade, a group of chronic disorders associated with fatigue (CDAF) emerged as the leading cause of chronic fatigue, chronic pain, and functional impairment, all of which have been often labeled in clinical practice as chronic fatigue syndrome (CFS) or fibromyalgia.

While these chronic disorders arise from various pathophysiologic mechanisms, a shared autoimmune or immune-mediated etiology could shift the focus from symptomatic treatment of fatigue and pain to targeted immunomodulatory and biological therapy.

A clinical paradigm shift is necessary to reevaluate CFS and fibromyalgia diagnoses and its relationship to the CDAF entities, which would ultimately lead to a change in diagnostic and therapeutic algorithm for patients with chronic fatigue and chronic pain. Rather than uniformly apply the diagnoses of CFS or fibromyalgia to any patient presenting with unexplained chronic fatigue or chronic pain, it may be more beneficial and therapeutically effective to stratify these patients into more specific diagnoses in the CDAF group.

Read full article

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