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 these major 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

Eriksen’s ME/CFS Hypothesis: An Update

In June 2017, I put out a series of blog posts about Dr. Willy Eriksen’s hypothesis regarding the causes and potential treatment of ME/CFS (myalgic encephalomyelitis, aka chronic fatigue syndrome): summary, interview, and reaction. Now, in September 2018, Dr. Eriksen has provided an update:

Has your hypothesis changed since you published it?

No, my hypothesis is the same. So far, I have not seen any study results that have convinced me that the hypothesis is wrong.

Have your ideas regarding potential treatments changed? Continue reading

Every storm (and sunny day) is due to global warming—really!

As I write this, the sky is pouring cats and dogs on D.C., as it has been for the past several days. In fact, it’s record-setting. Elsewhere in the world, there are people frying eggs on the sidewalk where before they might have prepared a delightful salad. But just a few weeks ago D.C. had unusually dry weather. And last winter we suffered through a bizarrely consistent stretch of cold. In short: we’re living through turbulent times.

Inevitably, news stories ask whether each of these unexpected weather events is “caused by global warming.” Continue reading

Vision Zero after zero progress?

Washington, D.C., like other cities around the world, is trying to eliminate traffic deaths through a program called Vision Zero. Inspired by Sweden, this has been a model project in many ways, but the lack of positive results is testing its proponents.

Effecting change per se is my topic here, rather than the specific alterations that D.C. et al. have wrought as part of Vision Zero. Continue reading

Notes on lobbying Congress for ME/CFS funding

Hart-Senate-LobbyOn March 6, I accompanied the irrepressible Emily Taylor of the Solve ME/CFS Initiative to lobby members of Congress. Specifically, we urged them to add ME/CFS (myalgic encephalomyelitis, or chronic fatigue syndrome) to a list of diseases eligible for research funding from the Department of Defense. This post contains some reflections on the experience. Continue reading