Is it clearly better that the Founders won?

Happy 4th of July! This is a good time (or possibly a very bad time) to ask: Was it really better overall that the colonies won the American Revolution? I’m not sure how to weigh the evidence.

The British colonial government ended slavery in its remaining American colonies in the 1830s; this was 30 years before the U.S. did – and only because the South brought the issue to a head by starting the Civil War. Also, the British colonial government was more likely than the United States to respect treaties with Indian groups. Indeed, the taxes to which the colonists famously objected were to pay the military costs of the colonists’ push west into Native American lands. Today Britain has universal health care and has elected women as prime minister. (But they do drive on the wrong side of the road.)

On the other hand, the British government didn’t fully extend its democratic principles to the colonists and other subjects, and it had an official religion and a hereditary monarch with more authority than the mere figurehead of today, among other problems. Also, Britain eventually became the world leader in imperialism, which continues to have deleterious effects on its former subjects. But the United States has a pretty strong record of dominating/controlling other countries for its own benefit, as can be seen throughout the world but especially in Latin America.

Of course, the principles expressed in the Declaration and embedded in the Constitution, among other foundational documents, have inspired change here and around the world – probably in Britain, too. And it’s not just the words: the U.S. has actually adhered to those principles more than occurs in most other places. But our system of government was not invented out of whole cloth, without precedents; instead, much (but not all) of it recapitulated or tweaked existing British practice. One of the major differences is that the British legislature has more power over the executive, which doesn’t seem like such a bad system in these days of presidential presumption.

I could go on, but, in sum: I’m glad I don’t have a vote in the matter, because to me the right choice isn’t obvious.

PEM has too many meanings in ME/CFS

PEM – or post-exertional malaise – means different things to different people, but it’s often treated as if it were a single phenomenon, and that undermines diagnoses, treatment, and research. A better, minimally systematic approach would:

  • distinguish different types of PEM by timing
  • clarify the number and kind of symptoms required for PEM
  • investigate triggers beyond muscular exertion.
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ME/CFS Research Chatbot

Introducing the ME/CFS Research Chatbot!  It’s meant to provide a reliable, accurate, and up-to-date summary of published research for the general public.

While general LLMs like ChatGPT and Claude might provide fine answers to queries about myalgic encephalomyelitis/chronic fatigue syndrome, the sources are often unreported or of unknown quality, and the chatbots are prone to hallucination and to change answers from one moment to the next.

The chatbot that I have designed is a bit different: It relies only on research abstracts from the NIH’s PubMed database that address this disease, it can provide a list of the abstracts consulted, and it’s designed to provide the same, ‘best’ answer each time a particular question is asked – including admitting ignorance, if information is lacking.

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Can tracker readings predict daily health for PWME?

How well can the tracker data that’s available to me upon waking foretell my health status, as a person with ME/CFS (PWME), for the rest of the day? Over the past few years, I have applied a plethora of machine learning techniques to answer this question. The goal was to create an app to automatically predict PWME’s daily health each morning.

The result is disappointing: the best method will accurately predict whether my daily health will be ‘bad’ or ‘not bad’ only 57 percent of the time. Flipping a coin would result in 50 percent accuracy, so this is an improvement of only 7 percent.

I still believe that resting heart rate (RHR) and heart rate variability (HRV) generally change along with my health status, so what went wrong? My observation is that many other factors also influence these measurements, masking the relationship that I’m trying to model. The good-ish news is that a person likely can do a better job of taking these contingencies into account, making this a case when human learning probably outperforms machine learning.

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Spoonie? Balloonie? Debit cardie!

Like anyone with ME/CFS, I have a harder limit on my daily activities than most people do. Not only do I have little capacity at each moment, but exceeding an unknown threshold will result in ‘post-exertional malaise‘ (PEM: a significant worsening of my condition) a couple of days later. To describe these limits on our energy, many people with chronic diseases like to call themselves spoonies. This term refers to energy depletion through the odd metaphor of a spoon supply being used up. I think we can find a better term.

One of the problems I have with the metaphor of spoons is that I’m simply not concerned about using up actual spoons on a daily basis. In fact, I reuse spoons all the time (generally, after washing them). And the real-world penalty for running out of spoons doesn’t seem so onerous.

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Ads do change behavior: mine

“Behavior change is hard” is a common lament among do-gooders. They’re referring to voluntary changes in people’s practices, like eating less beef or consistently wearing a condom during sex. Despite limited success, one popular approach to motivating behavioral change is through advertising – especially public-service announcements (PSAs). What many PSAs lack, though, is a comparable alternative to the naughty action: okay, I shouldn’t smoke, but what’s the satisfying substitute?

Maybe that’s part of why this ad from Sodastream worked so well on me: it suggested an equivalent product at an equivalent price (and less hassle):

But what also worked was that it made me feel stupid for buying soft-drink bottles when a fine alternative exists. Shame, indeed!

Undoubtedly this commercial doesn’t have the same effect on everyone. But, for me, watching it one time provoked a quick, profound, and lasting change. Could ads for the Impossible Whopper be tailored to have the same effect?

By the way, this experience fits within Step 4 of my algorithm for How to Change the World (Or Your Corner of it).

How to Change the World: My brief guide now available!

I’ve distilled years of training, research, and practice into a short-and-sweet book on setting and achieving serious goals. The title is How to Change the World (Or Your Corner of It): Planning and Working for Success. It’s available from many sources, including Amazon and other vendors.

Here’s the blurb:

Do you want to change the world—or yourself? To improve your work? To make the best decisions possible? Then this brief but comprehensive guide to planning, doing, and revising is for you.

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How I measure HR and HRV

Elsewhere I explain how I use my heart rate (HR) to manage my chronic disease. In this post, I will describe my equipment, which also allows me to monitor my heart-rate variability (HRV). In short, I pair a Garmin Vivoactive 3 smartwatch to a Wahoo Tickr Fit armband; the watch measures HRV well but does a poor job with HR during low-level activity—which is about all I do.

Here are the details, including reasons for not choosing competing products: Continue reading

Monitoring my heart rate to manage ME/CFS

One of the basic bits of advice for people with ME/CFS is, “Don’t overdo it.” But, given the delayed reaction of PEM (post-exertional malaise), how can we know whether we’re exerting ourselves too much? Some medical professionals urge patients to monitor their pulse, or heart rate (HR), to stay within their energy envelope. Like many others, I follow this advice. But I believe that the focus on HR, and especially on a specific rate of beats per minute (BPM), is simplistic and actually can lead to ‘overdoing it.’

The first reason to not depend solely on heart rate is that psychological stress can cause PEM, too. This stress can be due to positive or negative situations, and the heart rate doesn’t have to rise as high as it does during overexertion to cause PEM. For example, while teaching a college class for 80 minutes twice a week (my only real activity), I feel low-level excitement, and my HR stays well below the rate that I can sustain for that length. Yet this excitement causes PEM. So exertion isn’t everything. (It would be great if researchers addressed this.)

The rest of this post discusses my approach to managing my exertion using heart rate. I list the equipment I use in another post. Continue reading

ME/CFS, Valcyte, and me: Third time lucky

In this post, I describe my improvement—and problems—while on valganciclovir, aka Valcyte. Before deciding to take this powerful but dangerous medication, I read a lot of other patients’ accounts, and I hope that my experience will help others in the same way.

Do herpes viruses cause or contribute to ME/CFS? This question continues to roil researchers, medical specialists, and patients. My evolving belief is that they do contribute in some but not all casesand certainly in mine. One reason reason for this belief is my experience on antivirals, especially Valcyte.

The big picture

I’ve taken valganciclovir three times and had three different results, but each time at least one symptom-trigger disappeared. Under my current regimen, I’m able to teach a college course, which is a wonderful resurrection. Continue reading