You may be unaware of a doctor called Danya Glaser, she works in children's psychology at Great Ormond Street Hospital. She is a major force behind the current epidemic of false allegation of FII against families with children who have complex needs. She and her team have devised the flowchart "Guidance on management of Children & Young People Presenting with Perplexing presentations to secondary healthcare Sept 2017" which is being used by children's services and hospitals nationally. Families may enter the flowchart because indeed Myalgic Encephalymylitis is a "medically unexplained symptoms" in the fact that there is no medically proven cause for ME. However that's because nobody has ever properly looked into what causes ME, rather than it being a fabricated illness.
Any family with a child with ME whose health and social care professionals have had hold of this horrible flow chart will have a hard time avoiding false allegations of FII and child protection proceedings, which can cause, physical and emotional abuse of children, forced admission, forced GET therapy, family breakdown, loss of income, career, housing, benefits, mental health problems and even suicidal ideation (see my previous articles 2tiredandatoddler.blogspot.com )
one or more of the following present
. A carer reporting symptoms and observed signs that are not explained by any known medical condition
Recently ME has been repackaged and relabelled to be "CFS" "chronic fatigue" to "unexplained Medical symptoms". This all encompassing term includes pretty much any other medical or behavioural condition that a professional wishes to stick under it. A training document was leaked from a major hospital last year advertising Medically Unexplained symptoms training that seemed to refer to these children as MUPPETS. They claimed that it actually referred to the medical professionals as MUPPETS, but most people in the chronic illness community did not buy into this explanation.
. Physical examination and results of investigations do not explain the symptoms or signs reported by the carer
There is no physical sign of ME, there is no blood test for ME, there is no brain scan that will show a change big enough to convince a general paediatrician of ME, there is no xray that will show ME, there is no breath test, biopsy, psychological evaluation, there is NOTHING that will show ME. This is because no one invests in ME research.
. The child/yp has an inexplicably poor response to prescribed medication or other treatment, or intolerance of treatment.
The current belief that Graded Exercise Therapy cures ME which is categorised by Post Exertional Malaise is completely ridiculous and based on a fraudulent study which has now been debunked but continues to rest in the NICE guidelines and be prescribed by practitioners. If GET works, it is quite unlikely the patient actually has ME and more likely they were caught under the umbrella terms CFS/MUS. It was discussed in Parliament that GET is harmful and suggested that further prescription of GET could result in litigation last year, however it continues to be prescribed. If indeed the presenting ME was "medically unexplained symptom" then how could it possibly have prescribed treatment, given it is unexplained?
. Acute symptoms and signs are exclusively observed by/in the presence of one carer.
Many children with ME have one carer, many children with ME "crash" (exacerbation of ME) at home and are seen to be very sick there. They are denied GP home visits and this is only seen by family members. Children with ME are only ever out of the house when they are feeling at their very best. Also, relating this to children with "high functioning autism" we see the "coke bottle affect" where children "mask" all day and then show behavioural symptoms at home. Children with ME may do a similar thing where they push themselves to do something and then "crash" at home.
. On resolution of the child/yp presenting problems the carer reports different symptoms or reports symptoms in children in sequence.
MEis often seen in families, they do not "resolve" as they are chronic illnesses.
. The Child/yp daily life is limited beyond what is expected due to any disorder from which the child/yp is known to suffer, for example partial or no school attendance and use of seemingly unnecessary special aids.
Many children with ME have had their condition dismissed by medical and other professionals (see my articles) . So considering many professionals claim to not believe in these conditions, its not surprising they don't believe these children can't attend school and need a wheelchair. The stigma towards ME of "just being tired" drives many ableist ideas that these children can just "push through" and aren't really disabled".
. The carer seeks multiple opinions inappropriately
"Inappropriately" is not defined here, but my experience of several other peoples cases tells me it means "getting a private opinion when dismissed by NHS professionals"
Actions to take/consider
This is where many families are badly let down, no one takes the time to actually look properly at the time line of events and instead rely on heresay. Communication is always massively lacking in every case i have personally heard. The last idea, to consider if it is an organic disease is ignored, especially by those professionals who choose to declare that ME/EDS etc doesn't exist. Also, there is no way of positively confirming ME. Many professionals go for the option of admitting the child/yp for close observation. The fact that this usually means all treatment of symptoms, aids, pain relief etc is removed is not openly stated, but that is what happens and this so called "observation" can quickly become physical and psychological abuse of a sick child.
New or rare syndrome
ME is not new or rare, yet also still has no test to show it is present, so will never be cleared and "treated appropriately" until there is proper investment and investigation into the causes of ME.
Still no agreed medical explanation child's presentation
There wont ever be, until professionals acknowledge the existence of ME and proper investment is made into ME research.
Lead consultant meet with family to explain:
. that they are unable to give diagnosis, (avoid naming disorders which are actually descriptions eg chronic pain syndrome)
Its rather convenient that ME is renamed "Chronic fatigue syndrome" only to be dismissed here, leaving the child with ME with no diagnosis.
. These symptoms are not life threatening and the child/yp will not come to harm result
ME is life threatening, failure to record deaths as related to ME makes it seem not many die from ME, as their complications are recorded as cause of death rather than the ME. Some headline names of children/yp with ME who have died of ME died of a direct cause of the neglect/abuse from health care staff in pushing GET and ignoring the condition.
.Investigations/opinions to date
Nothing will show up in investigations to indicate ME, opinions on ME from medical staff will not be positive or child centred or we wouldn't be on this pathway. If these symptoms are medically unexplained then there should be little valid opinion.
. Further investigation/specialists referrals are not warranted and likely to do more harm than good
Finding a professionals who treats people with ME with care and respect is invaluable and does not cause harm.
.Child/yp needs to be helped to function alongside symptoms
This completely dismisses the severity of symptoms
.Health team recommends and will support rehabilitation and coping with symptoms and that evidence shows this improves quality of life even though actual symptoms may take longer to improve.
What evidence? The shameful and fraudulent PACE trial? At this stage we are still treating something we declare to be medically unexplained, there can not be any research on a treatment for a set of symptoms that aren't medically explained and have no diagnosis.
2nd Green box
Parent and carer accept plan and engage in multi disciplinary agency plan
The plan is detailed at the bottom of the page and includes weaning off unnecessary treatments/aids, parents to "coach" children to get out of house, graded exercise, sleep.
Not many families will accept a plan where their very real symptoms are dismissed they are denied a diagnosis of ME or even CFS and are told to exercise and sleep well. The very diagnostic criteria for ME is that people with ME can not exercise or sleep well. Failure to comply with this plan (or failure to improve) or initially agreeing and then realising it is a ridiculous way to manage a biomedical disease, lead to Red Box 2
A shorter journey to red box 2 is to deny the professionals the opportunity to physically and psychologically abuse the child with an admission with forced GET and removal of pain relief and mobility aids.
At this stage it is advised that the professional seek safeguarding advice and refer for FII.
I would love to hear anyone explain to me how a family with a child with ME could possibly get through this flowchart unhurt.
In the recent (January 2019) discussion of ME in Parliament the health commissioner Steven Brine, declared that NICE state GET is a choice and no one is being forced. This flowchart shows that if you refuse GET for your "medically unexplained symptoms" that ME (and many other conditions) have been relabelled as, you WILL be referred to children's services for Fabricated and Induced Illness. The consequences of this could be a criminal record, loss of career (due to record), loss of benefits and housing, loss of children, damage to children (from medical neglect of ME), and forever encountering barriers to receiving medical and social care. (see my article)
Are we now declaring that the UK has discovered all their is to know about medicine? Because i can see no other reason that any condition that doesn't currently have a physical test to classify it could be funnelled into "medically unexplained symptoms" and child protection.