White House Chronicle

News Analysis With a Sense of Humor

Research Funding: Scientists Fear as the Sick Despair

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When you are sick, very sick, you wait for medicine to work its magic. But if the disease is Myalgic Encephalomyelitis (ME), you have to wait for the medicine to be invented.

The bad news is that so little funding is going into solving the ME problem, commonly known as Chronic Fatigue Syndrome, that those sick today may be sick for the rest of their lives. They are living a life that is a nearly intolerable to themselves and a massive burden to their loved ones, spouses, parents and caregivers.

What is known is that ME is a disease of the immune system. It is vicious and debilitating, leaving the patient confined to a marginal life, a parallel and unequal existence.

Most infections are of healthy people who are struck down often, but not always, after exercise. The first symptoms can be flu-like: The sufferers feel a few days in bed will do the trick. But having ME is a life sentence. There also have been group infections, known as “clusters,” where hundreds have been stricken.

If you have ME, the least exertion can force you to spend days in bed, exhausted, hurting in myriad ways from headaches to what one woman described as “feeling like your bones are exploding.”

In severe cases, the patient cannot tolerate light or sound. A young man, newly married, and felled unaccountably, had to live in a closet for an extended period before he could handle light and sound. Symptoms vary but most of the time a victim feels, as one told me, “like you are a car that has run out of gas and your tank cannot be filled up again.” A teenager told me that if she is to go out with friends, she has to weigh that against days of bed rest, in a complete state of collapse.

The National Institutes of Health (NIH)— the principal researcher into ME and dozens of other perplexing diseases — has historically given ME a pittance. In the last three years funding has been held to $5 million a year, although the Obama administration had promised more. To put this in perspective, the trade association of the pharmaceutical industry calculates that it costs $1.2 billion dollars to bring a new drug to market. Sadly that industry has not shown interest in ME, so the research is mostly funded by NIH and private groups and individuals.

The news that the Trump administration is thinking of cutting the total NIH budget by $5 billion has ​caused a palpable anxiety to grip the ME community. The disease is cruel enough, does it need to be compounded by the government?

That is why those who could manage it and members of their families were enthusiastic supporters of the March for Science. They were out there with a sense of being at the barricades as the barbarians massed on the other side.

The United States has led the world for years in scientific discovery and implementation. It is deeply disturbing to think that the country would draw back from it. But the administration’s ambivalence is clear. The Department of Energy with 17 national laboratories, every one the envy of the world, is headed by Rick Perry​.

W​hen he ran for president, ​he ​did so on a plank that included closing ​the department.​ The Environmental Protection Agency, with a history of struggling to get the regulatory science right, is headed by Scott Pruitt​. As​ attorney general of Oklahoma, ​he ​sought to hobble the agency with lawsuits.

So across science, from the National Aeronautics and Space Administration to the research service of the Department of Agriculture, there is fear among scientists; fear for their jobs, fear for science and fear for America.

In the sick rooms of the 1 million or so ME sufferers, despondency has reached new depths. You will not be cured if no one cares enough to look for a cure. Can you double down on despair?

 

ME/CFS Alert YouTube Channel: https://www.youtube.com/user/MECFSAlert

ME/CFS  Alert Facebook Group: https://www.facebook.com/mecfsalert/

 

Underwear Goes on the Outside for Charity

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By Llewellyn King

Ronald Davis is a respected professor of biochemistry and genetics at Stanford University, and director of its Genome Technology Center. So why is a picture of him wearing his underwear over his pants superhero-style circulating on social media?

Davis is not alone. Others are joining in making themselves look ridiculous every day.

Ron Davis, ME Undies Challenge

Looking silly for a serious cause

The answer is that Davis is a research scientist whose son is severely afflicted with Myalgic Encephalomyelitis (ME), better known as Chronic Fatigue Syndrome — a name that dismisses the severity of this little understood and understudied disease that has devastated the lives of perhaps 1 million Americans, and what are calculated to be 17 million people worldwide.

Taking a selfie with underwear worn over outerwear is a new campaign, “Undies on the Outside,” to raise money — desperately needed money — for research on ME. This money possibly should have come through the government years ago, but the principal medical research arm of the United States, the National Institutes of Health, has been parsimonious in funding ME down through the years. Only $5 million a year is devoted to the affliction.

Yet the sick are almost inevitably sentenced to a lifetime of unspeakable suffering — often being confined to bed for months at a time and sometimes years — in pain and hideous isolation. They tell their story on ME/CFSAlert, the YouTube channel that I co-founded.

ME is an equal-opportunity monster: It strikes all ages and both sexes. Dr. Jose Montoya of the Stanford University Medical Center describes it as ordering a “parallel life.”

One of my close friends, who has suffered from the disease for 25 years, is fairly typical in her adversity. She was an athletic woman with a passion for squash and cycling. She said that when she was afflicted she became “like a car that had run out of gas.” That was on good days.

My friend’s life went from one of accomplishment and fullness in all the ways that a life can go right to one of surviving on the margins. For two years, she was bedridden. Every type of exertion is followed by a kind of unreasonable punishment for just trying to be normal. Recently, we spent a few hours together and had lunch in a restaurant. The price she paid was being so sick for two days that she had to stay in bed.

Normal family life, work and simple enjoyments are prescribed by ME. I have been writing and broadcasting about it for five years, during which I have come to think of those who suffer day in and day out, essentially without hope, as the children of a lesser god, alive but denied the joys of being alive. Suicide rates are high, and my e-mail box is full of e-mails from people who say they wish they could die.

Symptoms vary from a patient who told me her limbs seemed to be exploding to many who suffer mental fog, known as dysphasia, and need hours to write a few simple sentences.

ME Undies Challenge Logo

The “Undies on the Outside” challenge was devised by an Australian woman. It came from a party game of residents at cheetah rescue center in South Africa, who relieved the tedium of an evening by dressing up with their underwear over their outerwear. Years later one of those revelers, Kate Booker, now living in London, suffering from ME for 18 years, and bitterly aware of the paucity of funding globally for the disease, was inspired to work up a challenge to raise money.

Everyone photographed wearing their undies over their clothes is sending $10 to the Open Medicine Foundation in the Los Angeles area, and challenging three other people to do likewise. Booker chose the foundation because it is raising money for pure research into ME and is concentrating initially on finding a biomarker, so that people can be diagnosed and not thrown into medical limbo.

The Open Medicine Foundation is run by Linda Tannenbaum, whose adult daughter has been afflicted since she was a teenager.

It is especially sad that this disease seems only to be known and understood by those who have a family member or close friend who has been, as it were, taken from them while still being there, shuttered away in plain sight. — For InsideSources

Holidays: The Pain in with the Glitter

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By Llewellyn King

We all know about the dark side of the holidays: the pain of the lovelorn; the stress for the recovering alcoholic; the torment of parents who cannot provide gifts, even homes, for their children. Then there are those who bear loss: loss of employment, loss of a parent, loss of a partner and, most sad, loss of a child. And there are those who are shut-in, alone, and possibly hungry; others are in pain, physical pain that defies amelioration.

In the holiday season, my thoughts are about those who suffer from Myalgic Encephalomyelitis (ME), also known as Chronic Fatigue Syndrome (CFS). Its sufferers are walled off in plain sight, jailed by a disease that has no known cure and promises only suffering — by the day, the month, the year, the decade.

The government estimates that as many as  1 million Americans and another 17 million people worldwide are imprisoned by ME. Little is known about it, and nothing about the causes. It is understood to be a disease of the immune system, but there are those who want to believe, and have convinced some governments, that it is a psychiatric affliction. It is easier for government institutions, like Britain’s National Health Service, to believe in psychiatric nostrums than to treat and research the terrible suffering of the sick, the physically sick.

ME patients can be bedridden for years, unable to tolerate light or sound, and must rely on families or friends for basic needs. Sometimes they may seem a little better, but they cannot do the things of normal life. They are vulnerable to collapse after exercise or just normal activity.

Patients tell me that they know too well what my friend, colleague and ME sufferer Deborah Waroff says is the excruciating loneliness that comes with the induced isolation. It is the kind of loneliness that moved the 17th-century English poet John Milton to say, “Loneliness is the first thing which God’s eye named, not good.”

How often can a caregiver ask, “How are you feeling?” when the answer is known; was known yesterday, last year, and the year before, going back decades.

One sufferer told me she thought, in the height of her suffering, that she was already dead and was in limbo. Many sufferers have written to me saying they pray that they will not wake in the morning.

Suicide rates are high. Surely, suicide must be preceded by a loneliness that cannot be imagined? ME victims – and I have interviewed or had correspondence with hundreds — feel that not only do they suffer from symptoms which vary from pain in the joints, a sense that their limbs are exploding, headaches and mental fog, but they also have debilitating fatigue. Deborah Waroff, who has suffered since 1989, says it is like being a car that has no gas: You press the accelerator and nothing happens.

She, like other victims, has to ration her social life: a dinner with friends will result in collapse, and two or more days in bed. Likewise, going to a movie or a family gathering. Sometimes just making a simple meal is too much, and results in a return to one’s lonely bed.

Doctors, once they have decided that a patient has the disease, and if they have any knowledge of it, prescribe a variety of drugs from antivirals to large doses of vitamins. Some help with some symptoms, some do not. Ryan Prior, a young man who has made a documentary movie about ME, “Forgotten Plague,” takes as many as 19 pills a day. He was a star athlete in high school before being stricken. Now he manages his activities with stringent care. He is one of the lucky ones.

My correspondents from around the globe write to me about many things, but the most constant is their loneliness, exacerbated by the holidays. Marriages fail, love affairs go by default, and one is terribly, awfully alone.

There is aching aloneness for them each day, while others laugh and love. Mother Teresa said, “Loneliness is the most terrible poverty.”

That poverty is part of this disease. — For InsideSources

 

May 12: A Disease Gets Its Day, but Who Cares?

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May 12 is not a day that is written into history. It is not a day when there will be, like clockwork, a presidential proclamation, or a moment of silence. Yet, for some, it is a day of recurring infamy.

Since 1992, it has been the day on which Myalgic Encephalomyelitis (ME) sufferers — and those who care for them– have marked the disease. It is, for these people, a day of sorrow, of remembrance and of yearning. They remember those who have died, or committed suicide.

They are angry — often too angry to be persuasive — that ME is not on the national radar. They are angry that after more than three decades, the federal government is still seeking to define the disease, which afflicts about 1 million people here and 17 million worldwide; that research funding, at $5 million, is so low that in the world of Washington expenditures, you practically need an electron microscope to find it; and that the suffering goes on unmitigated.

They are angry that the government, through the Centers for Disease Control, abandoned the old name, Myalgic Encephalomyelitis, in favor of the dismissive new name, Chronic Fatigue Syndrome. They believe this trivializes the disease, and favors those who want to define it as a psychological affliction rather than a real disease.

They are angry that distinguished researchers, like the virus hunter Dr. Ian Lipkin of the Columbia University Medical Center, has had to resort to crowdfunding to continue his work that might help ME patients.

Why does the ME community observe May 12? It is the birthday of Florence Nightingale, who may have suffered at the end of her life from a variant of ME.

So this May 12, Mary Dimmock, a mother of a suffering son, will endeavor to unfurl a banner made of pillowcases on the grass outside the U.S. Capitol. Her goal: Get recognition for the disease, so the long work of finding answers and a cure can be accelerated.

What is known is that ME is a disease of the immune system, and it starts with flu-like symptoms or with collapse after exercise. In extreme cases, as with Dimmock's 26-year-old son, Matt, the patient becomes almost totally incapacitated with mental fog, painful joints, terrible headaches, intestinal upset, and extreme sensitivity to sound and light. Matt Dimmock has to spend his days on a bed set up in a closet.

Patients go through periods of extreme debilitation for two or more years, sometimes recovering enough to function for several hours a day. What a healthy person would consider to be normal activity — like going to dinner or a movie with friends — can result in two days in bed for a ME patient.

Doctors, on the whole, know very little about the disease.

Mary Dimmock is an unlikely protester. She has presence: tall and distinguished. She is a scientist, who took early retirement from a large drug company to care for her son and has become an advocate for this disease, which has confiscated so many lives.

Although ME knows no age or gender, the National Institutes of Health (NIH) has lodged what little effort it makes under “women's health.” One patient said, “Maybe they think we are hysterical women, who are just making a fuss.”

Dimmock is the antithesis of an hysterical woman. She became an activist when she found, after her son fell ill four years ago, that where ME is concerned, the system is broken. She told me, “It has been profoundly disturbing to watch the world around my son, especially the medical community, ridicule and even brutalize him for believing that his disease is real and serious.”

Around the world, the ME story is the same: Doctors who do not know anything about the disease and governments that do not want to know anything about it, or want to believe, for economic reasons, that it is a psychosomatic affliction, when there is ample evidence that it is an immune system disease.

I have interviewed many patients, and some of the small coterie of doctors who are working on the disease. They all wish the Department of Health and Human Services would take a proactive role through its agencies, the NIH and the CDC. More and more dedicated researchers have been forced to turn to crowdfunding because the agencies of government, charged with the public health, have turned out to be selective in their sense of who is sick. — For the Hearst-New York Times Syndicate

Getting a Seat at the Table

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Think of this as a primer for all of those, like the sufferers of the awful disease Chronic Fatigue Syndrome, who need to be heard in Washington and aren't. Silence has a price.
 
There are two branches of lobbying in Washington. The first is big lobbying, with big money making big campaign contributions. The second is everyday lobbying, which is quietly effective, scarcely organized and part of the fabric of decision-making. Call it "informational lobbying."
 
Congress cannot expected to be knowledgeable about a myriad of issues, and this is where the lobbyists perform their often more innocent function. Simply, they know stuff. Their advice isn't always objective, but it's informed.
 
Certainly, Congress has the best research available through the Congressional Research Service of the Library of Congress and all the executive branch agencies. But it's a lot easier to call a friend, where a question can be asked and answered in the vernacular: “Joe, what's the story on the helium shortage?” It can be argued that, at this level, lobbying is not suspect but efficient.
 
Proximity is a force in Washington, familiarity a lever. There are no fingerprints; it's how the system works. A chance meeting in a restaurant can change the course of policy; influence a congressional opinion about something obscure but important, like the Endangered Species  Act, which is now receiving attention on its 40th anniversary.
 
The indictment of this informal lobbying regime is not that it exists and works, but that if you aren't at the table, you won't be heard. Woe betide those who don't have a lobbying operation, however modest, in Washington.
 
The lobby-less must suffer in obscurity: no lobby means no input. No conversation after church or at a kid's soccer game means no information is spreading about actions and decisions that will have impact down the line.
Make no mistake, proximity means a lot in the informing of government. A few casual words will often trump a great academic study.
 
For the past several years, I've taken a keen interest in Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis. It's a disease associated with the suppression, for reasons unknown, of the immune system. To get it is to contract a life sentence of daily suffering, often so severe that patients can be bedridden for years. They think of themselves as “the damned.”
 
This community has issues with the federal government; specifically with the Department of Health and Human Services, which has oversight of the National Institutes of the Health. Yet the advocates for CFS — many of them superbly articulate – aren't heard in Washington.
 
This is very clear, at the moment, when the department, acting through the NIH, has signed a contract with the Institute of Medicine to, according to NIH, to develop “clinical diagnostic criteria” for CFS.
 
This has so enraged the top tier of 35 doctors and researchers in the field that they — risking good relations and future research funding — have written to HHS Secretary Kathleen Sibelius, imploring her to halt this folly. The Institute of Medicine doesn't have expertise in this field, according to the CFS doctors.
 
Most CFS specialists agree that an effective definition of the disease, known as the Canadian Consensus Criteria, is working fine and should be retained. Confusion and expense from Washington aren't needed. A wrong definition can be destructive to research, treatment and patient well-being. It will have consequences.
 
But the protests may have come too late, as knowledge of what the NIH was up to came too late.
 
To me, this bureaucratic shuffle by HHS is an example of the dangers of not having a presence in Washington. Government responds to pressure. No presence, no pressure, no result — or worse, a bad result.
 
You don't need huge money to lobby. Effective lobbying is often a case of simply being there and being known to be there: walking the halls of Congress catches the attention not only of Congress, but also wayward federal departments and the media. — For the Hearst-New York Times Syndicate

Florence Nightingale Still Comforting the Sick

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It is time to add May 12th to our list of dates worth commemorating — especially for 1 million in the United States who suffer from Chronic Fatigue Syndrome, also known as Myalgic Encephalomyelitis.

This year marks 192 years since Florence Nightingale’s birth in Florence, Italy to wealthy English parents. As a young woman, she felt herself called to take up nursing. Later, her heroic work caring for wounded British soldiers during dark nights of the Crimean War earned her worldwide fame as "The Lady of the Lamp.”

Nightingale is given credit for inventing secular and modern nursing because she recognized that troops were dying, not just from their untreated wounds, but also from malnutrition and dehydration.

She followed up her war work by writing a landmark text for nurses and founding a training school in London. Her natural talent for numbers helped her keep detailed data on patients, and she ultimately won extra renown as a statistician.

But from 1857 Nightingale found herself often disabled by poor health, which some suggest may well have been Chronic Fatigue Syndrome(CFS). As a result, Nightingale now has been adopted as a kind of patron saint by for this under-studied disease. CFS sufferers here and abroad (17 million) commemorate her birthday as a kind of rallying point; their own lamp in the dark.

And the world of CFS is dark indeed — an abysmal place of unmediated pain, disability, hopelessness, financial ruin and sometimes suicide. One doctor told me that if she were to have to choose for herself between CFS and cancer, she would choose cancer. “At least for cancer, there are treatments; if they fail, you die. With CFS you are the living dead,” she said.

Everything about CFS is controversial. It has been on the medical agenda since 1934, when there was an outbreak centered on a Los Angeles hospital. Currently 63 outbreaks have been documented, but still what is not known dwarfs what is known.

What is known is that it is a disease of the immune system, related to and in some cases overlapping fibromyalgia, a disease of the muscles. It also involves the neurologic and endocrine systems. The disease has broken out in startling clusters – locations in Nevada, Florida, New York and California among others just in the 1980s.

Its deadliness is slow and subtle. Studies suggest that it takes 20-25 years off the average sufferer’s life, but there are no dramatic sudden deaths or gory symptoms to attract attention.

Expert virologists such as Columbia University’s Dr. Ian Lipkin agree that the disease may yet turn out to be viral. But the once-exciting report from the Whittemore Peterson Institute in Reno, Nev., targeting the XMRV retrovirus had to be retracted for faulty science.

Doctors are slow to diagnose CFS because if that is not the area of their practice, there is no easy diagnosis.

At present there are no bodily fluid tests, no imaging, no temperature transients. Nothing. Just very sick people; very, very sick people. Immune system studies, spinal fluid aberrations, and other biomarkers show promise and may be used to identify the disease some day.

Probably 75 percent of CFS victims start with some flu-like disease. Maybe 4 percent of people who come down with mononucleosis will get CFS.

Most sufferers' lives are turned upside down. Their first collapse comes without warning, usually following exercise.

Although memory and verbal-skills loss are often part of CFS, most victims remember exactly the day and time they were stricken. Laura Hillenbrand, who incredibly has written two best sellers, cannot leave her home and could not attend her own wedding.

Deborah Waroff, a New York writer has had CFS for 23 years. In September 2003 and all through 2004, she could do little more than lie on the living room couch. Waroff struggled back to the point of functioning a few hours a day. But two back surgeries in 2010 left her immune system at a record low level, and brought on another long-term collapse. She is back to two or three-hour spells of activity, but not on two consecutive days. “I've lost half of my adult life,” she says.

These stories are multiplied a million times. Being a victim can include abandonment by families, spouses and lovers, friends and colleagues, workplaces and insurance companies.

Florence Nightingale shone a light of hope from her lamp in the ghastly Crimean hospital wards. CFS sufferers hope that the spirit of Nightingale will shine a loving light into the darkness of their disease — lost as they are in plain sight of the world around them. – For the Hearst-New York Times Syndicate

CFS: One Disease and Its Costs

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What would happen to health care if a million new patients with just one of many now incurable and largely untreated diseases flooded the system, relying on medicine that could cost $70,000?

It might happen. Actually, it’s more than desirable that it should happen.

In one instance, a million or more patients who suffer from the devastating, life-robbing disease known as Chronic Fatigue Syndrome (CFS), or myalgic encephalomyelitis, struggle through days of almost total incapacitation, disorientation, pain and despair, clinging to hope that science will rescue them. All that’s known is that like AIDS, it’s a disease of the immune system.

The horror of this affliction is almost indescribable. I’ve been writing and broadcasting about these patients for several years and never have I seen such extended suffering, lives hollowed out, every tomorrow to be feared, the slightest departure from strict routines of inactivity to be met with punishing suffering.

The mother of an afflicted teenager told me that for New Year, her daughter went out for amid celebration. That exertion cost her two weeks in bed.

My friend and colleague (we host a YouTube channel, mecfsalert), Deborah Waroff, a New York-based writer, has been afflicted for 23 years and has seen her life confiscated. Like other patients she lives in a prison of her body with painful memories of when she was well. The body hurts, the memory tortures. Sleep does not refresh and long hours in bed do not heal.

Sufferers, held together in their pain by the Internet, trade sad notes. Going the rounds now is Winston Churchill’s statement in old age his life was finished but not ended. One sufferer e-mails me that she prays every night that she won’t wake up in the morning.

Patients groups say suicide rates are high. Determining the morbidity rate is a challenge because sufferers die from opportunistic infections rather than from CFS. In this, and other ways, it resembles AIDS and diabetes.

So far, the burden has been carried more by families and loved ones than by the health care industry. This is because there is no diagnosis per se for CFS, and no cure.

Dr. Andreas Kogelnik of the Open Medicine Institute in Mountain View, Calif., says there are no “markers” for the disease. There is nothing in the blood, marrow or soft tissue that identifies the disease.

Therefore, diagnosing the disease is by elimination – a time-consuming undertaking that the present medical regime is ill-equipped to provide. “You can’t do much in 10 minutes,” Kolgelnik says, referring to average amount of time allotted to patients by doctors.

So this is a disease that, even without a cure, the medical establishment has already indicated that it cannot afford.

The matter of affordability, for example, has affected diagnosis and treatment severely in the United Kingdom. There the National Health Service, always struggling with budgets, has encouraged doctors to teat CFS as a psychosomatic condition related to depression. The patients hate this and only recently has the British Medical Research Council softened its position.

That other medical nostrum, diet and exercise, is favored in the UK, too, but not by patients. They write to me constantly pointing out that exercise is corporal punishment for them; a recipe for relapse.

With only under-funded research scattered across the country at clinics and universities, the picture is bleak. But there are two pinpricks of light: a Norwegian cancer drug, Rituxan, which has helped patients in Norway and Germany, and a drug that is still in clinical trials in the United States, Ampligen, which rebalances the immune system.

Even those who administer the drugs, like Dr. Derek Enlander in New York and Kogelnik in California, don’t hail them as panaceas but as hopeful pacesetters. Neither is available except to a few patients in trials. And cost? Ampligen costs about $25,000 for a year of treatment, and Rituxan comes in at a whopping $70,000.

A slew of other diseases await expensive cures. In the future health-care costs, no matter what the Supreme Court and the politicians do, are going to go up and up. To the sick and their families, any price is a small one.

For the Hearst-New York Times Syndicate.

CFS: To Suffering, Add Anger

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I’ve been walking on the sad side. My mailbox is jammed with dozens of heartrending e-mails from sufferers of Chronic Fatigue Syndrome (CFS); a terrible disease that is little understood, little researched and hard to diagnose.

Chronic Fatigue Syndrome, which is known as Myalgic Encephalomyelitis in many parts of the world, mostly strikes people in their thirties and forties. The disease begins with flu-like symptoms which are often a precursor to a full collapse, often after exercise.

The disease largely disables the immune system; and leads to joint and muscle pain, cognitive dissonance, memory loss, dysphasia and problems with simple math. Sufferers are often confined to bed for months, functioning at a substantially reduced capacity, where the simplest tasks become monumental.

CFS-afflicted authors describe taking years to finish projects that should have taken months. These include Hillary Johnson, whose book “Osler’s Web” is about CFS; Laura Hillenbrand, who wrote the bestseller “Sea Biscuit” while struggling with the disease; and Deborah Waroff, who is writing a book about the Jewish hero Sholom Schwartzbard, but who has found the task dragging on for years, working as she can between severe periods of disability, confined to bed.

The human suffering of both the afflicted and those close to them is incalculable in its awful impact. One woman who e-mailed me wrote: “When I became totally disabled seven years ago, because I had not announced my illness previously, nearly everyone I knew figured the illness was in my head. They were aided and abetted with this sort of reasoning based on how the majority of the medical establishment and media had treated CFS. Like many with CFS, I lost all of my companions and my spouse.”

One of the most hopeful of recent discoveries is also generating a collateral fear. The retrovirus XMRV has been found to be present in CFS patients and has led them to worry about transmitting the disease to family members. One woman who e-mailed me from Britain wrote that her husband contracted the disease after years of nursing her. Who, she asked, will look after them now?

A sufferer in Maryland wrote to me that she worries about her family. She and her husband decided to have a child. They were blessed with triplets – and the return of the mother’s disease. Now she worries for her husband and the three babies.

A man—one-third of victims are male, although the National Institutes of Health treats CFS as a woman’s disease–sums up the anger in the community towards the political establishment, and particularly the Centers for Disease Control which changed the name from Myalgic Encephalomyelitis, in a controversial action.

He wrote: “Washington didn’t so much forget – they were never told. The CDC swept it under the carpet, despite the fact that their main raison d’être is to investigate and sort epidemics of new diseases before they take hold. Now, because of the CDC’s wrongdoings, there are more than 1 million people affected in the USA and possibly 17 million worldwide. Most of these people are too sick to stand up for themselves, to fight back.”

Breaking down the e-mails, I find these commonalities:

· Anger at the CDC and, to a lesser extent, the National Institutes of Health and government in general.

· Tremendous suffering and horrendous problems with affording treatment; frequent misdiagnosis, as doctors use a “dustbin” approach that discards all the possibilities until they get to CFS.

· Anger at the media and others for not taking CFS seriously enough.

· The knowledge, with a cure rate of between 4 and 8 percent, that they are awaiting the inevitable in huge discomfort. They are on medical death row.

· Sufferers describing themselves as “living corpses.” Alone with their suffering, many commit suicide.

I’m not a medical writer. Writing about medicine has never interested me. But in a career of writing for newspapers, spanning more than 50 years, I’ve never received so much mail that has so consumed the thought process and torn at the heart.

There is a ghastly disease out there that cries out to be taken seriously, to get proper attention in the medical world, and to be prioritized along with the other big diseases claiming research dollars.


The Awful Disease Washington Forgot

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In the end, as with so much else, the fight against disease leads to Washington. There are big diseases with big lobbies, like AIDS, Alzheimer’s, cancer, diabetes and heart. Their millions of sufferers have associations and lobbies to push for federal research money and to shape its expenditure. Most have their celebrity backers, like Elizabeth Taylor for AIDS, Jerry Lewis for muscular dystrophy, and Mary Tyler Moore for diabetes.

Big lobbies mean big federal dollars, the attention of the National Institutes of Health in Bethesda, Md., and the Centers for Disease Control in Atlanta. If the disease is the kind for which a single or series of silver bullets can produce a cure, Big Pharma comes in with big funding, in the hope that it can develop a lucrative line of medicines, patentable for long-term profits.

Yet there is a vast archipelago of diseases as cruel in their impact, horrible to bear and crying out for research that is not sporadic, underfunded or, through ignorance, misdirected.

One such is Chronic Fatigue Syndrome (CFS), a name so gentle that it belies the ghastliness of this affliction. Sufferers accuse the U.S. government, abetted by other governments, of choosing this name over the older and more commanding name, myalgic encephalomyelitis.

CFS is not about a name game. It is about debilitation lasting decades, essentially from inception to death. It is about years of lost living, terrible joint pain and total collapse, as the immune system more or less shuts down. It is like some great constricting snake that denies its victims the final convulsion.

Enter Sen. Harry Reid (D-Nev.). While he is not generally regarded as a man on a horse these days, to CFS sufferers he is a figure of hope. He has stood up for CFS research.

This is not because the Senate majority leader sought to know a lot about a hard-to-understand and terrible affliction, but because CFS was found in two clusters in his home state. The largest outbreak was at Incline Village, Nev. In New York state, there is a cluster too.

In the 1980s government scientists looked at these clusters, but refused to accord them the respect the suffering deserves. It was then that the name was changed; “fatigue” was less politically incendiary than myalgic encephalomyelitis.

Incline Village is significant because it shows that CFS is infectious, or that it has environmental causes. The thinking is that while clearly not having a strong transmission path, it does happen.

Recently a sufferer in England wrote to The Daily Mail, saying that her husband, who had cared for her for nearly 20 years, had become infected. This is particularly serious in England, where the medical establishment has insisted on treating the disease as a psychological disorder, despite recent research suggesting strongly that it is retrovirus XMRV.

Now, at last, two world-famous pathogen hunters, Anthony Fauci of NIH, previously seen as a debunker of CFS science, and Ian Lipkin, a celebrity pathogen hunter, are heading a major safari into the dark world of retroviruses.

For the first time, the loose global network of sufferers–nobody knows how many there are in the world, but in the United States there could be as many as 800,000—are beginning to apply political pressure.

Their plight is pitiable. The full horror of the disease is described in a paper by Deborah Waroff, a gifted New York writer who was stricken in July 1989. An energetic cyclist, skier, squash and tennis player, Waroff wrote in a paper for a Washington conference:

“My sickness began with a flu-like illness. After a week, thinking I was pretty much well, I went back to my ordinary activities, like tennis and my biking. A week later, I was sick again. This repeated several times that summer until I soon got to a point where I was never well again. I had classic symptoms. After a little activity I would just collapse, totally fold up. I also had symptoms like fevers, dizziness, upset tummy, swollen lymph glands and a new type of frequent headache. I had cognitive problems embarrassingly often, including dysphasia—putting the wrong words in sentences. I was often too weak to talk on the phone, or after five minutes of talking I would fold.”

In 2003, things got worse. But two years later, Waroff regained some of her life through the controversial treatment of ozone therapy. This treatment cannot be prescribed in most states. Allowed in New York, it is hard to come by and expensive. Some other countries, particularly Canada, have been more committed to fighting CFS and the use of ozone therapy.

Harry Reid, and others, there is more work to be done.