Thread by @Dr_M_Guthridge

1. thread.

Nice @FrontPediatrics paper providing guidance for docs and #pwME in the diagnosis and management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome #MECFS

#MedEd #MedTwitter #chronicillness #chronicpain #SickNotTired
frontiersin.org/article/10.338…

2. #MECFS is commonly misdiagnosed as a #somatic disorder

#pwME "..have been humiliated or dismissed by other providers, so [doctors] will need to be.. nonjudgmental.. & acknowledge that #MECFS is not a #psychological condition but a real illness"

frontiersin.org/article/10.338…

3. #MECFS symptoms can be diverse, complex, fluctuate and overlap with many other conditions making the diagnosis difficult

This @FrontPediatrics paper lists 33 (!) co-morbidities commonly associated with #MECFS

#MedEd #MedTwitter #pwME #SickNotTired
frontiersin.org/article/10.338…

4. a list of exclusionary conditions, mimics and false diagnoses for #MECFS from @FrontPediatrics

#narcolepsy
#thyroiditis
#depression
#schizophrenia
#psychoses
#EatingDisorders
alcohol/drug abuse
sleep #apnea
#sarcoidosis

#MedEd #MedTwitter #pwME frontiersin.org/article/10.338…

5. management priorities for #MECFS outlined in @FrontPediatrics

"it is.. important to address exertion intolerance and #PEM first; then #sleep and #pain, followed by cognition and the co-morbidities.. [#pwME].. must avoid overexerting.. "

#MedEd #pwME
frontiersin.org/article/10.338…

6. sleep disruption is a common symptom of #MECFS which is made worse by #PEM

This @FrontPediatrics paper suggests #sleep aids such as #melatonin, #theanine, #valerian, #tryptophan, #antihistamines, low dose tricyclic #antidepressants

#MedEd #pwME
frontiersin.org/article/10.338…

7. #pain is another disabling symptom of #MECFS

possible drug therapies suggested in this @FrontPediatrics paper include #duloxetine, #milnacipran, #pregabalin and Low Dose #Naltrexone #LDN

#MedEd #pwME #MedTwitter #SickNotWeak #SickNotTired
frontiersin.org/article/10.338…

8. "#MECFS is an invisible illness in that the patient appears normal despite tremendous.. impairments..

..patients are frequently dismissed or mistaken as hypochondriacs.. and greatly appreciate a provider who is knowledgeable.. and.. empathetic.."

frontiersin.org/article/10.338…