MEA Responds to BBC Radio Scotland Recommendation of GET for Long Covid & ME/CFS

On the 25 March, Jackie Brambles was standing in for Kay Adams on the BBC Radio Scotland Mornings show and held a phone-in with Dr Punam Krishnan around the issues of Long Covid.  

BBC Radio Scotland Mornings with Jackie Brambles | 25 March 2021

The show was in general very helpful. It reviewed, for example, the recent Long Covid study from the University of Leicester last week which concluded that seven in ten patients hospitalised with COVID-19 were not fully recovered five months after discharge and had symptoms similar to ME/CFS.  

Dr Krishnan also related her own experiences of Covid-19 and discussed the similarities between Long Covid and ME/CFS and how the focus has helpfully shifted towards these post-viral conditions in light of the pandemic. 

But, at 2.15.20 a text was read out that moved the conversation on to treatments for Long Covid-like illnesses and ME/CFS. Dr Krishnan talked about cognitive behavioural therapy and graded exercise therapy as well as other possible options.  

The ME Association 

We have worked with Kay Adams and BBC Radio Scotland several times in the past with Dr Shepherd appearing on the show, but on this occasion we were not consulted prior to broadcast. 

Last Friday, we wrote in to the programme advising that GET had been withdrawn from the new draft of the NICE clinical guideline after a thorough review of published research and that exercise should not be prescribed; something that is equally relevant to Long Covid.  

We also advised that CBT should not be prescribed as a treatment for ME/CFS or Long Covid, but that it can help people learn to cope, accept, and adapt to chronic medical conditions of this nature. 

Partial Transcript (2.15.20) 

Jackie Brambles:  

Sarah has texted in from Dunblane, she says: 

“During winter 2018, I had a flu-like illness that led to pleurisy in my lungs. The short-term flu symptoms got better in a few weeks, but I’ve been left with chronic fatigue, muscle weakness, and leg pain. I’ve been told by doctors and specialists that there’s no more to be done, [and] I’ve got to live with it. My whole life has changed over these three years and it’s hard to come to terms with. It sounds very similar to Long Covid, is there any advice you could give me?” 

Dr Punam Krishnan: 

Yes, it does sounds very similar to Long Covid and I really empathise with that because it does cause a lot of the issues we are hearing here. Now, some of the treatments – we don’t have a direct cure for chronic fatigue and M.E. – some of the things that can be helpful are talking therapies, so, cognitive behavioural therapy is very effective… 

Jackie Brambles: 

Now why is that? I’ve heard that before and that makes it sound like there’s a sort of mental illness going on when it’s the physical symptoms are do debilitating… 

Dr Punam Krishnan: 

It absolutely is but it’s about accepting if you’ve got a long-term condition and its coming to terms with that and understanding ways in order to distract yourself when symptoms are particularly flaring up. 

To perhaps understand and accept the diagnosis and also to be able to manage the symptoms – because sometimes that chronic pain can become really taxing mentally. 

Therapists and psychologists are very good at finding ways to give us psychological tricks and tips to convert that negative chat and to try and focus more positively on symptoms. It is really beneficial and a lot of patients get really good results from that.  

If pain is an issue there are lots of different types of pain relief. I know its not what everybody wants, but in the short-term if you are struggling with pain, its just to remember that its okay to take that to be able to function and to get through your day, and perhaps just speak with your GP about the different options available… 

Physiotherapy is again… Physiotherapists have a programme where they do Graded Exercise Therapy and can really help to strengthen particular areas or muscles that are perhaps experiencing weakness. And I would recommend that if it’s not already been tried then to try that. 

And lastly, the power of lifestyle. Now, its not going to completely take it away and I don’t want to ever patronise anyone when you’re feeling lethargic – you don’t want people to tell you to go out and exercise – but just any form of small movements throughout the day just to sort of sit less and move more is powerful.  

Looking at what you are putting into your body – so making sure that your nutrition is good and you’re taking your vitamin D – that you’re resting well and listening to your body. People tend to resist that. If your body is telling you you are knackered – take the rest and be kind to yourself. 

Jackie Brambles: 

It’s interesting isn’t it? It seems to crop up more and more and, as we said earlier, when we opened the lines initially in the previous hour about Long Covid being very, very similar to what’s diagnosed as chronic fatigue syndrome, they don’t really know why, we just know that some people are left after a virus or an illness like Flu with this fatigue. But we don’t really know what the biological reasons are… 

Dr Punam Krishnan: 

Exactly, and that’s why something like talking therapies, like the CBT I mentioned, is helpful because – I absolutely get it – it’s not fair and it’s not fair to have something that you don’t quite know the answers to and that can cause a lot of uncertainty for patients, a lot of anxiety for people suffering from it. 

And others around you might not get it and they might be like, “Just get up and get on with it”, and it’s not as simple as that. So, I definitely think that if it hasn’t been tried then you consider the power of therapy. 

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